EN Vision 26366 28189 04 2008

Ziehm Vision Family
Operating Instructions
Ziehm Vision
P_26366/CD_28189 - EN-04/2008
Intended use The medical equipment is intended for fluoroscopies in the field of surgery, e.g. in
traumatology, orthopedics, neurology, urology, cardiology. Third-party devices and
components used in combination with this system must comply with the safety
requirements according to IEC 60601-1 and/or IEC 60601-1-1 or furnish proof of an
equivalent degree of safety.
To ensure CE conformity, these components must have a CE approval in accordance with
Council Directive 93/42/EEC. In addition, a declaration in compliance with Article 12 of the
said directive must be provided.
For components without CE approval, a conformity assessment procedure is obligatory.
Proper and safe operation of the system requires adequate transportation, storage,
assembly and installation as well as appropriate use and maintenance.
The limit values indicated in the present document must not be exceeded; this applies also
when putting the system into service.
The system is suitable for interventional procedures according to IEC 60601-2-43.
The Ziehm Vision Endo monitor is not suitable for diagnostic purposes.
Contraindications to the The exposure of humans to ionizing radiation must always be medically justified. Especially
use of X-rays on pregnant women, children and adolescents this procedure should be used with caution
or be avoided altogether. However, the final decision lies with the attending physician or
attending surgeon.
Ziehm Vision product The Ziehm Vision product family comprises the following models: Ziehm Vision, Ziehm
family Vision FD Vario, Ziehm Vision R, Ziehm Vision Endo and Ziehm Vision R Endo. Unless
stated otherwise, all information given here for the Ziehm Vision also refers to the Ziehm
Vision FD Vario, the Ziehm Vision R, Ziehm Vision Endo and the Ziehm Vision R Endo.
Operation (USA) In the USA, Federal law restricts use of this device to trained personnel on the order of a
physician.
Authorized personnel Only authorized personnel are allowed to assemble and/or repair the medical equipment
described in the present Operating Instructions. Authorized personnel are persons who
have attended an appropriate training course provided by the manufacturer.
Exclusion of liability The manufacturer accepts responsibility for the safety, reliability and performance of the
system only if
− any installation, modification or repair work is carried out exclusively by persons
authorized by the manufacturer;
− the electrical installation of the site where the system is operated complies with the
requirements of VDE 0107 or the corresponding national regulations of the country of
installation;
− only original spare parts or components that comply with Ziehm Imaging’s
specifications are used;
− the system is used in accordance with the Operating Instructions.
The warranty becomes invalid in case that any repair, modification or installation work is
carried out by unauthorized personnel. No consequential damages will be accepted either.
The equipment conforms to Class IIb according to Council Directive 93/42/EEC.
This document has been written and reviewed originally in German and translated.
Copyright Quality Standards

Copyright © 2008 Ziehm Imaging GmbH This manual was produced using a certified QM system in
All rights reserved. compliance with DIN EN ISO 13485 and meets the requirements of
Transmission or reproduction of this manual, exploitation and EG RL 93/42/EWG, Appendix I and further applicable standards.
disclosure of its contents to third persons is not permitted without The information provided in this manual may be updated at regular
express written consent of the manufacturer. Infringements shall intervals and is subject to change without prior notice.
entitle to damage claims.
Manufactured by: Distribution in USA:
Registered Trademarks Ziehm Imaging GmbH Ziehm Imaging, Inc.
This manual may contain the names of registered trademarks or Donaustr. 31 4181 Latham Street
brands, the use of which by third persons for their purposes may D-90451 Nuremberg (Germany) Riverside, CA 92501
infringe the rights of their respective owners. e-mail: info@ziehm-eu.com e-mail: info@ziehm.com
http://www.ziehm.com
Rev. 04/2008
Ziehm Vision
P_26366/CD_28189 - EN-04/2008
Contents
Contents I
1 About This Manual 1-1

1.1 Typographical conventions............................................................................... 1-2
1.2 Safety instructions ............................................................................................ 1-3
2 System Overview 2-1

2.1 Fields of application.......................................................................................... 2-1
2.2 Features ........................................................................................................... 2-2
2.3 Options ............................................................................................................. 2-4
2.4 Options (USA) .................................................................................................. 2-5
2.5 Optional accessories ........................................................................................ 2-6
2.6 Optional accessories (USA) ............................................................................. 2-6
2.7 X-ray protective equipment .............................................................................. 2-6
2.8 System components......................................................................................... 2-7
2.8.1 C-arm stand ...................................................................................... 2-7
2.8.2 Monitor cart Ziehm Vision ................................................................. 2-9
2.8.3 Monitor cart Ziehm Vision Endo ........................................................ 2-11
2.8.4 Screen assignment ........................................................................... 2-13
2.8.5 Video inputs and outputs .................................................................. 2-14
3 Safety Instructions 3-1

3.1 General safety instructions............................................................................... 3-1
3.2 X-rays ............................................................................................................... 3-2
3.3 Electromagnetic compatibility........................................................................... 3-4
3.4 Protective grounding ........................................................................................ 3-4
3.5 Equipotential grounding.................................................................................... 3-5
3.6 Laser radiation.................................................................................................. 3-5
3.7 Temperature..................................................................................................... 3-7
3.8 Environmental compatibility.............................................................................. 3-8
3.9 Transport .......................................................................................................... 3-8
3.10 Lower vertical position...................................................................................... 3-8
4 Putting the System into Service 4-1

4.1 Unpacking the system ...................................................................................... 4-1
4.2 Accessories ...................................................................................................... 4-2
4.3 Cable connections............................................................................................ 4-5
4.4 First power-up of the system ............................................................................ 4-6
4.5 Setting up the system....................................................................................... 4-6
5 Mechanical Handling 5-1

5.1 Transport position............................................................................................. 5-1
5.1.1 C-arm stand transport position.......................................................... 5-1
5.1.2 Monitor cart transport position........................................................... 5-4
5.2 Braking and steering the monitor cart .............................................................. 5-5
5.3 Braking and steering the C-arm stand.............................................................. 5-6
5.4 C-arm movements............................................................................................ 5-7
5.4.1 Orbital rotation .................................................................................. 5-8
5.4.2 Angulation ......................................................................................... 5-9
Ziehm Vision I
P_26366/CD_28189 - EN-04/2008
Contents
5.4.3 Swiveling (panning) ........................................................................... 5-11

5.4.4 Horizontal movement ........................................................................ 5-13
5.4.5 Vertical movement............................................................................. 5-14
6 Controls 6-1
6.1 Control panel .................................................................................................... 6-1
6.1.1 Elements of the control panel............................................................ 6-1
6.1.2 Controls in the Fluoroscopy and Subtraction operating modes......... 6-2
6.2 Buttons and switches on the unit...................................................................... 6-12
6.3 Hand switch and foot switch ............................................................................. 6-13
7 Switching the System On and Off 7-1

7.1 Preparing the system........................................................................................ 7-1
7.2 Switching the system on and off....................................................................... 7-2
7.3 EMERGENCY STOP button............................................................................. 7-3
7.4 Key switch ........................................................................................................ 7-4
8 Standard Fluoroscopic Operations 8-1

8.1 Overview........................................................................................................... 8-1
8.2 Fluoroscopy modes .......................................................................................... 8-2
8.2.1 Pulsed fluoroscopy ............................................................................ 8-2
8.2.2 Digital radiography (snapshot) .......................................................... 8-5
8.3 Manual exposure rate setting ........................................................................... 8-6
8.4 Object-Detected Dose Control (ODDC) in the Bones anatomical program
(n/a for Ziehm Vision FD) ................................................................................. 8-7
8.5 Fluoroscopy programs...................................................................................... 8-8
8.5.1 Anatomical programs ........................................................................ 8-8
8.5.2 Metal Artifact Correction function ...................................................... 8-10
8.5.3 Motion function .................................................................................. 8-10
8.5.4 High Quality function ......................................................................... 8-11
8.5.5 Automatic Dose Reduction function (n/a for Ziehm Vision FD) ......... 8-11
8.5.6 Automatic Noise Filter Adjustment function (n/a for Ziehm Vision FD) 8-12
8.6 Screen display during radiation ........................................................................ 8-12
8.7 Dose area product ............................................................................................ 8-13
8.8 Air kerma .......................................................................................................... 8-13
8.9 Saving............................................................................................................... 8-13
8.10 Printing the live screen image .......................................................................... 8-15
8.11 Warning signals and malfunctions.................................................................... 8-17
8.11.1 Permanent warning during radiation ................................................. 8-17
8.11.2 Interval warning during radiation ....................................................... 8-17
8.11.3 Temperature monitoring .................................................................... 8-18
8.11.4 Error and alert messages .................................................................. 8-18
9 Adjusting Live Images 9-1

9.1 Overview........................................................................................................... 9-1
9.2 Contrast and brightness adjustment of individual images (windowing) ............ 9-2
9.3 Filters................................................................................................................ 9-5
9.3.1 Recursive filter................................................................................... 9-5
9.3.2 Edge filter .......................................................................................... 9-7
9.3.3 LIH filter ............................................................................................. 9-8
9.4 Electronic image magnification (n/a for Ziehm Vision FD)................................ 9-9
9.5 Digital zoom...................................................................................................... 9-10
9.6 Grayscale inversion .......................................................................................... 9-12
9.7 Collimation........................................................................................................ 9-12
II Ziehm Vision
P_26366/CD_28189 - EN-04/2008
Contents
9.7.1 Iris collimator ..................................................................................... 9-12

9.7.2 Slot collimator ................................................................................... 9-13
9.7.3 Virtual collimator................................................................................ 9-14
9.8 Image swapping ............................................................................................... 9-14
9.8.1 Ziehm Vision, Ziehm Vision FD and Ziehm Vision R ........................ 9-14
9.8.2 Ziehm Vision Endo ............................................................................ 9-15
9.9 Image reversal and image rotation................................................................... 9-15
9.9.1 Horizontal and vertical image reversal .............................................. 9-16
9.9.2 Image rotation ................................................................................... 9-16
10 Data Management 10-1

10.1 Organization of patient, image and ESWL data ............................................... 10-1
10.1.1 Patient folders ................................................................................... 10-1
10.1.2 System-generated patient folders ..................................................... 10-1
10.2 Managing patient data...................................................................................... 10-2
10.2.1 Creating a new patient folder on the Ziehm Vision ........................... 10-3
10.2.1.1 Entering patient data manually .......................................... 10-3
10.2.2 Editing patient data ........................................................................... 10-4
10.3 Managing image data....................................................................................... 10-7
10.3.1 Managing patient folders................................................................... 10-8
10.3.1.1 Marking patient folders ...................................................... 10-9
10.3.1.2 Deleting patient folders ...................................................... 10-9
10.3.1.3 Inverting the entire archive ................................................ 10-11
10.3.1.4 Saving patient folders ........................................................ 10-11
10.3.2 Finding and displaying a patient folder.............................................. 10-14
10.3.3 Activating a patient folder.................................................................. 10-16
10.3.4 Browsing through the active patient folder ........................................ 10-19
10.3.5 Processing and outputting images in a patient folder ....................... 10-19
10.3.5.1 Displaying an image at full size ......................................... 10-21
10.3.5.2 Marking images ................................................................. 10-22
10.3.5.3 Protecting images .............................................................. 10-22
10.3.5.4 Deleting images ................................................................. 10-23
10.3.5.5 Printing on video printer..................................................... 10-25
10.3.5.6 Saving images ................................................................... 10-26
10.3.6 Comparing saved images ................................................................. 10-28
10.3.7 Making backup copies of patient folders ........................................... 10-29
10.3.7.1 Backup to USB stick .......................................................... 10-30
10.3.7.2 Backup to CD or DVD........................................................ 10-33
10.4 ESWL Data Management................................................................................. 10-36
11 DICOM Functions 11-1

11.1 Prerequisites .................................................................................................... 11-1
11.2 Downloading patient data from a DICOM server.............................................. 11-1
11.2.1 Query ................................................................................................ 11-2
11.2.2 Downloading a Worklist..................................................................... 11-3
11.2.2.1 Downloading a Worklist for a specific time span .............. 11-3
11.2.2.2 Downloading a patient-specific Worklist ........................... 11-6
11.2.2.3 Downloading a Worklist for a procedure step ................... 11-8
11.3 Processing scheduled procedure steps of a Worklist (MPPS) ......................... 11-11
11.4 Saving all images from one or several patient folders...................................... 11-16
11.5 Saving and printing images and cine loops from a patient folder..................... 11-17
11.6 Saving or printing single cine loop images ....................................................... 11-19
11.7 Importing images and cine loops from a DICOM server .................................. 11-20
Ziehm Vision III

P_26366/CD_28189 - EN-04/2008
Contents
11.8 Storage Commitment........................................................................................ 11-24
12 Cine Loops 12-1

12.1 Overview........................................................................................................... 12-1
12.2 Generating a cine loop ..................................................................................... 12-1
12.3 Opening a saved cine loop ............................................................................... 12-4
12.4 Controlling and editing a cine loop during playback ......................................... 12-5
12.5 Processing and outputting saved cine loops .................................................... 12-9
12.5.1 Replaying a cine loop ........................................................................ 12-10
12.5.2 Marking cine loops ............................................................................ 12-11
12.5.3 Protecting cine loops ......................................................................... 12-11
12.5.4 Deleting cine loops ............................................................................ 12-12
12.5.5 Saving cine loops .............................................................................. 12-14
12.6 Processing and outputting single cine loop images.......................................... 12-17
12.6.1 Marking cine loop images.................................................................. 12-18
12.6.2 Protecting cine loop images .............................................................. 12-18
12.6.3 Deleting cine loop images ................................................................. 12-19
12.6.4 Printing cine loop images on the video printer .................................. 12-21
12.6.5 Saving cine loop images ................................................................... 12-22
13 Subtraction Modes 13-1

13.1 Overview........................................................................................................... 13-1
13.2 Acquiring a DSA cine loop................................................................................ 13-3
13.3 Acquiring an MSA image .................................................................................. 13-5
13.4 Acquiring an RSA image .................................................................................. 13-6
13.5 Generating an MSA image or RSA image automatically.................................. 13-8
13.6 Generating MSA and RSA images from a saved DSA cine loop ..................... 13-11
13.6.1 Opening and postprocessing a DSA cine loop in an active
patient folder ..................................................................................... 13-11
13.6.2 Opening and postprocessing a DSA cine loop from any
patient folder ..................................................................................... 13-12
13.7 Editing a DSA cine loop.................................................................................... 13-15
13.8 Pixel shift .......................................................................................................... 13-17
13.9 Landmarking..................................................................................................... 13-18
14 Post-Processing Images 14-1

14.1 Overview........................................................................................................... 14-1
14.2 Activating the post-processing functions .......................................................... 14-3
14.3 Contrast and brightness adjustment of individual images (windowing) ............ 14-4
14.4 Edge filter ......................................................................................................... 14-6
14.5 Digital zoom...................................................................................................... 14-6
14.6 Grayscale inversion .......................................................................................... 14-8
14.7 Image rotation................................................................................................... 14-9
14.8 Horizontal and vertical image reversal ............................................................. 14-9
14.9 Digital collimation (image crop) ........................................................................ 14-9
14.10 Marking and deleting images............................................................................ 14-10
14.11 Outputting post-processed images................................................................... 14-13
15 Measurements 15-1
15.1 Measuring functions ......................................................................................... 15-1
15.2 Calibrating ........................................................................................................ 15-2
15.3 Measuring a length or distance ........................................................................ 15-4
15.4 3-point measurement........................................................................................ 15-8
15.5 4-point measurement........................................................................................ 15-11
IV Ziehm Vision
P_26366/CD_28189 - EN-04/2008
Contents
15.6 4-point ratio measurement ............................................................................... 15-14
16 Displayed Texts and Text Functions 16-1

16.1 Overview .......................................................................................................... 16-1
16.2 Image information on the screen...................................................................... 16-1
16.2.1 Upper left corner of the screen.......................................................... 16-1
16.2.2 Upper right corner of the screen ....................................................... 16-1
16.2.3 Lower left corner of the screen.......................................................... 16-2
16.2.4 Lower right corner of the screen ....................................................... 16-3
16.3 Entering and editing text................................................................................... 16-4
17 Laser Positioning Device 17-1

17.1 Applications ...................................................................................................... 17-2
18 Direct Radiography 18-1

18.1 Overview .......................................................................................................... 18-1
18.2 Fitting the film cassette holder.......................................................................... 18-1
18.3 Making a direct radiographic exposure ............................................................ 18-2
19 System Configuration 19-1

19.1 Overview .......................................................................................................... 19-1
19.2 Operation settings ............................................................................................ 19-2
19.2.1 Autotransfer ...................................................................................... 19-2
19.2.2 Autostore........................................................................................... 19-3
19.2.3 Image Swap with Save ..................................................................... 19-4
19.2.4 Displaying a crosshair ....................................................................... 19-4
19.2.5 Defining the start screen ................................................................... 19-6
19.2.6 Discarding the operation settings...................................................... 19-6
19.3 Basic settings ................................................................................................... 19-7
19.3.1 Setting the system date and the system time ................................... 19-7
19.3.2 Selecting the live screen ................................................................... 19-8
19.3.3 Entering the hospital data ................................................................. 19-9
19.3.4 Discarding the basic settings ............................................................ 19-10
19.4 Cine/DSA/Dose ................................................................................................ 19-10
19.4.1 Cine loop settings ............................................................................. 19-11
19.4.2 Showing or hiding the native image .................................................. 19-12
19.4.3 MSA Autotransfer.............................................................................. 19-13
19.4.4 DSA CO2 ........................................................................................... 19-14
19.4.5 Discarding the cine loop and subtraction settings............................. 19-14
19.5 Storage media .................................................................................................. 19-15
19.5.1 Defining the USB stick storage format .............................................. 19-16
19.5.2 Defining the CD/DVD storage format ................................................ 19-17
19.5.3 Deleting data from storage media ..................................................... 19-18
19.5.4 Selecting a DICOM storage server ................................................... 19-18
19.6 Setting the flat-screen monitors........................................................................ 19-19
19.6.1 Built-in keypad .................................................................................. 19-19
19.6.2 Setting the brightness, contrast and backlight brightness................. 19-20
19.6.3 Setting the menu language ............................................................... 19-21
19.6.4 Restoring the factory settings............................................................ 19-22
Appendix A A-1
A.1 Regular checks................................................................................................. A-1
A.1.1 Routine checks to be performed by the user .................................... A-1
A.1.2 Consistency test according to national regulations ........................... A-2
Ziehm Vision V
P_26366/CD_28189 - EN-04/2008
Contents
A.1.3 Checking the exposure rate control................................................... A-2

A.1.4 Dose meter check ............................................................................. A-2
A.1.5 Checking the computed dose values ................................................ A-3
A.1.6 Checking the useful beam................................................................. A-4
A.1.7 Leakage in the cooling system .......................................................... A-5
A.1.8 Gettering the image intensifier tube (n/a for Ziehm Vision FD) ......... A-5
A.1.9 Gain adjustment and pixel correction (Ziehm Vision FD) .................. A-5
A.2 Cleaning, disinfection, sterilization ................................................................... A-6
A.2.1 Cleaning ............................................................................................ A-6
A.2.2 Disinfection........................................................................................ A-6
A.2.3 Sterilization........................................................................................ A-7
A.3 Malfunctions ..................................................................................................... A-7
A.3.1 Types of malfunctions ....................................................................... A-7
A.3.1.1 Alerts during power-up....................................................... A-7
A.3.1.2 Errors during power-up ...................................................... A-8
A.3.1.3 Alerts during operation....................................................... A-8
A.3.1.4 Errors during operation ...................................................... A-8
A.3.2 List of errors, alerts and status messages......................................... A-9
A.4 Labels on the Ziehm Vision .............................................................................. A-17
A.5 Labels on the Ziehm Vision (USA) ................................................................... A-35
A.6 Focal spot position............................................................................................ A-51
A.6.1 Ziehm Vision ..................................................................................... A-51
A.6.2 Ziehm Vision FD................................................................................ A-52
A.6.3 Ziehm Vision R .................................................................................. A-53
A.7 Heat capacity.................................................................................................... A-54
A.8 Scattered radiation in the significant zone of occupancy.................................. A-56
A.8.1 Ziehm Vision ..................................................................................... A-56
A.8.2 Ziehm Vision FD................................................................................ A-57
A.8.3 Ziehm Vision R .................................................................................. A-58
A.9 Dimensions....................................................................................................... A-59
A.10 Technical data .................................................................................................. A-64
A.10.1 Ziehm Vision, Ziehm Vision FD, Ziehm Vision R;
systems with a voltage rating of 100 V, 120 V, 200 V ....................... A-66
systems with a voltage rating of 220 V, 230 V, 240 V ....................... A-70
A.10.3 Laser positioning device.................................................................... A-74
A.10.4 Dose meter........................................................................................ A-74
A.10.5 Air kerma ........................................................................................... A-75
A.10.5.1 Ziehm Vision and Ziehm Vision Endo ................................ A-77
A.10.5.2 Ziehm Vision FD ................................................................ A-81
A.10.5.3 Ziehm Vision R................................................................... A-83
A.10.6 Isokerma maps.................................................................................. A-85
A.10.6.1 Ziehm Vision and Ziehm Vision Endo ................................ A-86
A.10.6.2 Ziehm Vision FD ................................................................ A-89
A.10.6.3 Ziehm Vision R................................................................... A-92
Appendix B B-1
B.1 Attaching sterile disposable covers to the C-arm ............................................. B-1
Index i
VI Ziehm Vision
P_26366/CD_28189 - EN-04/2008
1 About This Manual
This manual is designed to enable owners and operators of any member

of the Ziehm Vision product family to operate the systems described
herein safely and efficiently.
Ziehm Vision product family, software version 5.15 or higher. Scope of validity of
this manual
The Ziehm Vision product family comprises the following models: Ziehm Ziehm Vision
Vision, Ziehm Vision FD, Ziehm Vision R, Ziehm Vision Endo and Ziehm product family
Vision R Endo.
NOTE
Unless stated otherwise, all information given here for the
Ziehm Vision also refers to the Ziehm Vision FD, the
Ziehm Vision R, the Ziehm Vision Endo and the Ziehm
Vision R Endo.
All illustrations in this manual are exemplary only, and may differ from the
actual situation.
The present Operating Instructions describe a system with maximum
configuration. The system configuration chosen by you may not contain
all options and functions described here.
For several system options, separate operating instructions may be Separate operating
available. They are supplied with the system, provided that the system instructions
configuration includes the respective option. You will find a
corresponding reference to those operating instructions in the relevant
sections of this document.
Ziehm Vision 1-1

P_26366/CD_28189 - EN-04/2008
1 About This Manual
1.1 Typographical conventions
In this manual, the following notations and formats are used to highlight
certain elements of the Vision Center control panel or the documentation
itself:
Element Format Example

Vision Center Bold Post Processing
elements (buttons,
symbols and
boxes), operating
modes, functions
Cross-references Italic, preceded by → Ch. 19, p. 19-1
an arrow
Procedure steps Preceded by a • • Press the OK
button.
Table 1-1 Notations and formats used in this manual
1-2 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
1 About This Manual
1.2 Safety instructions
The present document does not constitute a complete catalog of all

safety measures necessary for the operation of the respective medical
equipment, since special operating conditions may require further
measures. However, it does contain instructions which must be observed
in order to ensure the personal safety of operating staff and patients as
well as to avoid damage to property. These instructions are highlighted
as follows:
DANGER
DANGER indicates a hazardous situation which, if not
avoided, will result in death or serious injury.
WARNING
WARNING indicates a hazardous situation which, if not
avoided, may result in death or serious injury.
CAUTION
CAUTION indicates a hazardous situation which, if not
avoided, may result in minor or moderate injury.
NOTICE
NOTICE indicates a property damage message.
NOTE
Notes are merely informative. Additional useful
information and hints are provided for the operator here.
Ziehm Vision 1-3

P_26366/CD_28189 - EN-04/2008
1 About This Manual
1-4 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
2 System Overview
2.1 Fields of application
The Ziehm Vision is a mobile C-arm X-ray image intensifier which is Ziehm Vision
suitable for all surgical applications in traumatology, orthopedics,
neurology, urology and cardiology, for use in gastroenterology and
endoscopy as well as for all vascular applications.
The fully-digital Ziehm Vision FD is suitable for more demanding vascular Ziehm Vision FD
interventions requiring a high level of precision, e.g. in the field of
neurology. As the system is distortion-free, it is especially suitable for
afterloading treatment planning and navigation.
The Ziehm Vision R has a rotating anode and is therefore especially Ziehm Vision R
suitable for applications where a high power output may be required
temporarily. This may be the case e.g. in vascular surgery for AAA
procedures (Abdominal Aortic Aneurysms) performed on adipose
patients in order to penetrate the object. This feature is also essential in
cardiologic procedures, where small vessels of fast-moving objects need
to be visualized. To reduce motion blur, the exposure time intervals are
minimized while the dose rate is increased.
Due to their color screens, the Ziehm Vision Endo and Ziehm Vision R Ziehm Vision Endo,
Endo offer perfect conditions for endoscopic applications. Ziehm Vision R
Endo
Ziehm Vision 2-1

P_26366/CD_28189 - EN-04/2008
2 System Overview
2.2 Features
Mobility With its compact design and combined steering & braking system, the
Ziehm Vision offers unrestricted mobility at the operating table, even if
space is scarce.
The easy adjustability of the C-arm and the perfect counterbalancing of
the system make it possible to access even the most difficult positions.
Anatomical Computer-controlled anatomical programs ensure optimum exposure

programs rate and image quality control as well as high operating comfort. A ‘Soft’
program for soft tissue visualization during foreign body localization and
a ‘Metal’ program for suppressing image flare resulting from the use of
metal implants and surgical instruments complete the automatic
functions.
Radiation dose The superior penetration capabilities of the digital high-frequency

reduction generator enable a significant reduction in the patient skin dose.
Radiation-free collimation is provided by the system’s ‘Virtual Collimator’.
Image quality 18" flat-screen monitors guarantee flicker-free images. The advanced
Full Frame Technology, which uses non-interlacing throughout the entire
image processing chain, generates noise-free images without motion
artifacts, even if the subject has moved.
Ziehm Vision FD The Ziehm Vision FD features a fully-digital image processing chain. The
digital flat-panel detector ensures distortion-free images.
Ziehm Vision R The Ziehm Vision R provides short pulses of high intensity.
Image adjustment Comprehensive real-time image processing functions (customizable

noise and area filtering, electronic contrast and brightness adjustment,
zooming, radiation-free horizontal and vertical image reversal, digital
image rotation) ensure perfect adaptation of the image quality and
orientation on the screen to the surgeon’s needs.
Further image processing functions are available for saved images
(post-processing).
Active Cooling The Active Cooling system allows for nearly unlimited fluoroscopy times,
being often indispensable e.g. in cardiac and vascular surgery or
endoscopic applications.
Image management A patient-based image management system providing a 16-image

mosaic view and menu-controlled user guidance guarantees efficient
image data handling.
2-2 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
2 System Overview
For documentation purposes, a video printer is available. Documentation and

output
For filmless archiving, the following devices are available:
− DVD writer
− USB port
Images can be stored in the following formats:
− PC-compatible TIF format
− PC-compatible JPEG format with reduced resolution and reduced
color depth
− DICOM format
− DICOM format with reduced resolution and reduced color depth
− Multimedia format: AVI (CD or DVD)
The system documents not only patient-related data, but also image-
related data (e.g. the fluoroscopy parameters).
In addition, all systems have a video output.
The optional DICOM 3.0 interface (Ziehm NetPort) enables integration Networkability
into any network supporting DICOM, e.g. PACS. Thanks to ‘Primary
Capture’ support, the original fluoroscopic images can be archived
without the changes which may have been applied to them later. The
following DICOM classes are supported: Print, Storage (including
multiframe capability), Storage Commitment, Media, Worklist, MPPS,
Query/Retrieve and Verification.
It is possible to connect and configure several DICOM servers for each
DICOM Class.
For more information on DICOM, please refer to our DICOM
Conformance Statement included in the corresponding Service Manual.
Ziehm Vision 2-3

P_26366/CD_28189 - EN-04/2008
2 System Overview
2.3 Options

The following options can be integrated into the system upon request:
− 31 cm image intensifier
− Integrated dose meter for measuring the dose area product
− Laser positioning device on the generator and/or image intensifier
Ziehm Vision FD: Laser positioning device on the generator
− Key switch (Power on/off) (EMERGENCY STOP button not available
with this option)
− EMERGENCY STOP button (key switch (Power on/off) not available
with this option)
− Connection for external separate radiation warning lamp (including
software)
− DVD writer
− Video printer Sony® UP-970 (for printout on paper) or UP-980 (for
printout on paper or transparent film)
− External 18" flat-screen monitor
− 2 video connections for external flat-screen monitors (right and left
monitor)
− Color-coded brake handles
− Measurement
− DSA
− Pixel shift and landmarking
− Cine loop with 8 / 12.5 / 25 frames per second
− Additional image storage capacity: 10,000 / 30,000 / 55,000 images
− DICOM 3.0 interface Ziehm NetPort (Primary Capture)
Depending on the chosen system configuration, the following DICOM
classes are supported:
− Print Class
− Storage Class including multiframe capability
− Storage Commitment Class
− Media Class
− Worklist Class
− MPPS Class
− Query/Retrieve Class
− Verification Class
− Ziehm DICOM Viewer
− Customer-specific foot switch assignment
− Wireless LAN
2-4 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
2 System Overview
2.4 Options (USA)

The following options can be integrated into the system upon request:
− Integrated dose meter for measuring the dose area product
− DVD writer
− Video printer Sony® UP-970 (for printout on paper) or UP-980 (for
printout on paper or transparent film)
− Laser positioning device on the generator and/or image intensifier
− Measurement
− DSA
− Cine loop with 5 / 10 / 15 / 30 frames per second (30 fps only with DSA
option)
− Additional image storage capacity: 5,000 / 10,000 / 20,000 / 50,000
images (50,000 images only with DSA option)
− DICOM 3.0 interface Ziehm NetPort (Primary Capture)
Depending on the chosen system configuration, the following DICOM
classes are supported:
− Print Class
− Storage Class including multiframe capability
− Storage Commitment Class
− Media Class
− Worklist Class
− MPPS Class
− Query/Retrieve Patient Class
− Query/Retrieve Study Class
− Query/Retrieve Series Class
− Query/Retrieve Image Class
− Verification Class
− ESWL (Extracorporeal Shock Wave Lithotripsy)
Package with ESWL button to run ESWL applications and printable
ESWL data screen
Ziehm Vision 2-5

P_26366/CD_28189 - EN-04/2008
2 System Overview
2.5 Optional accessories
The following accessories are optionally available for the Ziehm Vision,
Ziehm Vision FD and Ziehm Vision R:
− Sterile disposable covers
− Hand surgery table (n/a for Ziehm Vision FD)
− Universal film cassette holder (n/a for Ziehm Vision FD)
− Foot switch cover
2.6 Optional accessories (USA)
− Hand surgery table

− Universal film cassette holder
− C-arm power assist
2.7 X-ray protective equipment
We recommend that you use the following X-ray protective equipment:

− X-ray protective apron
− X-ray protective eyewear
− Thyroid collar
− X-ray protective gloves
2-6 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
2 System Overview
2.8 System components
2.8.1 C-arm stand
Ziehm Vision
C-arm Image intensifier with integrated
CCD camera
Vision Center
control panel
C-arm
handle
Horizontal
carriage
Lifting
column Cassette holder
Swivel arm
Steering &
braking lever
Handle X-ray generator
Hand switch
Coupling cable
connection
Cable
guards
Fig. 2-1 C-arm stand Ziehm Vision
Ziehm Vision 2-7

P_26366/CD_28189 - EN-04/2008
2 System Overview
Ziehm Vision FD
C-arm Digital flat-panel detector
Vision Center
control panel C-arm
handle
Horizontal
carriage
Lifting Swivel arm

column
Steering &
braking lever
X-ray generator
Handle
Hand
switch
Coupling cable
connection
Cable
guards
Fig. 2-2 Ziehm Vision FD C-arm stand
Ziehm Vision R
C-arm Image intensifier with integrated
CCD camera
Vision Center
control panel C-arm
handle
Horizontal
carriage
Lifting
column Swivel arm
Steering & X-ray generator
braking lever
Handle
Hand switch
Cable
guards
Fig. 2-3 Mobile C-arm stand of the Ziehm Vision R
2-8 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
2 System Overview
2.8.2 Monitor cart Ziehm Vision
Ziehm Vision
Radiation monitor cart, front
warning lamp
view
Flat-screen
monitors
Control
panel
USB ports
Video printer
DVD writer
Foot lever for

braking and
direction
locking
Fig. 2-4 Ziehm Vision monitor cart, front view
Ziehm Vision
monitor cart, rear
view
Connection panel
Coupling for monitor outputs
cable and DICOM
support (→ Fig. 2-6)
Power cable
support
Coupling cable
connection
VIDEO OUT
(option)
Power supply
connection
Equipotential 2. Equipotential
grounding grounding
Fig. 2-5 Ziehm Vision monitor cart, rear view
Ziehm Vision 2-9

P_26366/CD_28189 - EN-04/2008
2 System Overview
Interface panel on
Ziehm Vision
monitor cart DICOM port
(RJ45)
VIDEO OUT VIDEO OUT 2 VIDEO OUT 1

RM LM
Fig. 2-6 Interface panel on the Ziehm Vision monitor cart, detailed
view
NOTE
When preparing the monitor cart for a transport
(→ Ch. 5.1.2, p. 5-4), first wind the power cable onto the
lower cable support and then the coupling cable onto the
upper cable support.
Equipotential Your monitor cart is equipped with a plug connection for equipotential
grounding grounding, e.g. with a hospital bed.
In addition, a screw connection for equipotential grounding (spare
equipotential grounding connection) is available.
Integrated Wireless If your system is equipped with Wireless LAN, a transceiver is integrated
LAN on the monitor into the monitor cart. You can see the R-TNC antennas at the back of the
cart monitor cart. The other transceiver is supplied with your accessories and
must be connected to the hospital’s DICOM network.
2-10 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
2 System Overview
2.8.3 Monitor cart Ziehm Vision Endo
Ziehm Vision Endo

Radiation warning
lamp monitor cart, front
view
Flat-screen
monitors
Control
panel
USB port
Video printer
DVD writer
Foot lever for

braking and
direction
locking
Fig. 2-7 Ziehm Vision Endo monitor cart, front view
Ziehm Vision Endo

monitor cart, rear
view
Coupling Connection
cable panel for
support monitor
outputs and
DICOM
Power cable (→ Fig. 2-9)
support
Coupling cable
connection
VIDEO OUT
(option)
Power supply
connection
Equipotential 2. Equipotential
grounding grounding
Fig. 2-8 Ziehm Vision Endo monitor cart, rear view
Ziehm Vision 2-11

P_26366/CD_28189 - EN-04/2008
2 System Overview
Interface panel on
Ziehm Vision Endo
monitor cart DICOM port
(RJ45) VIDEO IN
S-VHS
VIDEO OUT VIDEO OUT 2 VIDEO OUT 1

RM LM
Fig. 2-9 Interface panel on the Ziehm Vision Endo monitor cart,
detailed view
NOTE
When preparing the monitor cart for a transport
(→ Ch. 5.1.2, p. 5-4), first wind the power cable onto the
lower cable support and then the coupling cable onto the
upper cable support.
Equipotential Your monitor cart is equipped with a plug connection for equipotential
grounding grounding, e.g. with a hospital bed.
In addition, a screw connection for equipotential grounding (spare
equipotential grounding connection) is available.
Integrated Wireless If your system is equipped with Wireless LAN, a receiver is integrated into
LAN on the monitor the monitor cart. You can see the R-TNC antennas at the back of the
cart monitor cart. The other receiver is supplied with your accessories and
must be connected to the DICOM network.
2-12 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
2 System Overview
2.8.4 Screen assignment
On the Ziehm Vision, the live screen function has been factory-assigned Live and reference
to the left screen, and the reference screen function to the right screen. screen
During operation, the following images will be displayed on the screens:
− Live screen: Live images and saved images, both at full size
While the radiation warning lamp is illuminated, you always see a live
image.
When you terminate radiation, a composite image made up of 1 to 16
individual images (LIH – Last Image Hold) is displayed on the live
screen. The amount of images that are used for computing the LIH
depends on the LIH filter setting (→ Ch. 9.3.3, p. 9-8). The default
values are preset in the anatomical programs. You can modify these
settings using the LIH filter controls.
The kV and mA values that are displayed on the user interface are the
values set by the system upon termination of radiation emission. The
number that appears under LIH on the screen indicates how many
individual images have been used for computing the LIH (→ p. 16-2).
− Reference screen: Thumbnail mosaic, reference images at full size
On the Ziehm Vision Endo, the live screen function has been factory- Ziehm Vision Endo
assigned to the left (monochrome) screen, and the reference screen
function to the right (color) screen.
During operation, the following information is displayed on the screens:
• Monochrome screen: Fluoroscopic image
• Color screen: Menus or reference images, endoscopic image.
NOTE
To avoid confusion, the neutral terms ‘live screen’ and
‘reference screen’ are used throughout this document,
regardless of your custom setting.
You can swap the screen assignment in the Configuration operating Changing the
mode under Basic Settings (→ Ch. 19.3.2, p. 19-8). screen settings
You can also set the contrast and brightness of the flat-screen monitors
according to your preferences (→ Ch. 19.6, p. 19-19).
Ziehm Vision 2-13

P_26366/CD_28189 - EN-04/2008
2 System Overview
2.8.5 Video inputs and outputs
BNC socket A BNC socket which is used for video connection (VIDEO OUT) is
located on the back of the monitor cart.
VIDEO OUT The VIDEO OUT socket supplies a CCIR video signal of the live screen
image. The fluoroscopic image (live or stored) is available there for
further processing by a video cassette recorder, an external monitor, a
video printer, etc.
NOTICE
Supplementary equipment used in combination with the
Ziehm Vision must comply with the safety requirements
according to IEC 60601-1 and/or IEC 60601-1-1 or furnish
proof of an equivalent degree of safety.
To ensure CE conformity, these components must have a
CE approval in accordance with Council Directive 93/42/
EEC. In addition, a declaration in compliance with Article
12 of the said directive must be provided.
For components without CE approval, a conformity
assessment procedure is obligatory.
If you combine the Ziehm Vision with equipment which
does not comply with these requirements, the safety of
the entire system is no longer given and the warranty will
become invalid.
Ziehm Vision Endo On the Ziehm Vision Endo three BNC sockets and a mini-DIN socket for
video connection are located on the rear of the monitor cart.
Socket type Ziehm Vision

Endo
Video output socket 1 BNC left screen
(VIDEO OUT 1)
Video output socket 2 BNC right screen
(VIDEO OUT 2)
Video output socket 3 BNC CCIR
(VIDEO OUT)
Video input socket (VIDEO IN) mini-DIN Endo in
S-VHS (S-Video)
Table 2-1 Video inputs and outputs
2-14 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
2 System Overview
The VIDEO OUT socket supplies a CCIR video signal of the live screen VIDEO OUT
image. The following image is available for further processing by a video
cassette recorder, an external monitor, a video printer, etc.:
• Fluoroscopic image (live or saved)
The VIDEO OUT 1 socket (Ziehm Vision Endo only) supplies a video VIDEO OUT 1
signal of the left screen image. A second Ziehm flat-screen monitor can
be connected to this image memory output.
The VIDEO OUT 2 socket (Ziehm Vision Endo only) supplies a video VIDEO OUT 2
signal of the right screen image. A second Ziehm flat-screen monitor can
be connected to this image memory output.
The video input socket VIDEO IN (Ziehm Vision Endo only) must be VIDEO IN
connected to the video output of the endoscope. Here, the video signal
of the endoscope is fed in.
Ziehm Vision 2-15

P_26366/CD_28189 - EN-04/2008
2 System Overview
2-16 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
3 Safety Instructions
3.1 General safety instructions
WARNING
You must be familiar with the contents of the present
Operating Instructions in order to be able to operate the
system as intended. Read and understand the present
Operating Instructions before operating the system.
It is important to observe all directions, safety instructions
and warnings!
The responsibility for any C-arm-assisted surgical
intervention lies with the physician in charge.
NOTICE
Supplementary equipment used in combination with the
Ziehm Vision must comply with the safety requirements
according to IEC 60601-1 and/or IEC 60601-1-1 or furnish
proof of an equivalent degree of safety.
To ensure CE conformity, these components must have a
CE approval in accordance with Council Directive 93/42/
EEC. In addition, a declaration in compliance with Article
12 of the said directive must be provided.
For components without CE approval, a conformity
assessment procedure is obligatory.
If you combine the Ziehm Vision with equipment which
does not comply with these requirements, the safety of
the entire system is no longer given and the warranty will
become invalid.
Only properly trained personnel are allowed to operate the system. Operation
The system may only be operated by properly trained personnel under Operation (USA)
the direction of a physician.
Only authorized personnel are allowed to assemble the system and to Assembly and
provide technical service. The necessary qualifications can only be service
obtained by attending a training course provided by the manufacturer.
Ziehm Vision 3-1

P_26366/CD_28189 - EN-04/2008
CAUTION
Always observe the relevant regulations of the country of
installation for putting the system into service, training of
personnel and maintenance.
WARNING
Never use the system if you suspect any electrical or
radiation-generating components to be defective or if the
system exhibits unexpected malfunctions!
WARNING
Never pull at the power cable or coupling cable of the
monitor cart in order to move the cart to another position.
Otherwise severe equipment damage may result, thus
leading to severe injuries.
NOTICE
When printing on the Sony® UP-980/990 video printer,
always use the CUT button on the printer for cutting off
the printer paper. Tearing off the printer paper may
damage the video printer.
As opposed to that, on the Sony® UP-960/970 video
printer you must tear off the printer paper!
3.2 X-rays
General The system produces X-rays. If you do not observe the safety measures
and precautions required by your local radiation protection regulatory
body, these X-rays can be hazardous both to operating staff and other
persons within the radiation zone of occupancy.
WARNING
The system is intended for procedures where the skin
dose may be so high that there is a risk of deterministic
effects, even if the system is used as intended.
3-2 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
WARNING
The system may only be operated by personnel who has
undergone radiological training.
WARNING (USA)
The system may only be operated by properly trained
personnel under the direction of a physician.
WARNING
The relevant radiation protection regulations of the
country of installation must be observed.
WARNING
In order to avoid unintentional radiation, the foot switch
must be hung up on the foot switch support when the
system is switched on, but not in use.
Staff members who stay within the radiation controlled area must wear X- Protection of staff
ray protective clothing.
The radiation controlled area depends upon the size of the image
intensifier installed and has the following radius:
− 23 cm image intensifier: 4 m
− 31 cm image intensifier: 4 m
(→ Fig. A-29, p. A-56)
− Digital flat-panel detector: 4 m
(→ Fig. A-30, p. A-57)
To minimize the radiation burden of the patient, you must keep the Protection of the
source/skin distance as large as possible. The generator design patient
guarantees a minimum source/skin distance of 20 cm.
WARNING
Additional material located in the beam path (e.g. an
operating table not suitable for X-raying) may result in a
dose increase when using a fluoroscopy mode with
automatic exposure rate control.
Ziehm Vision 3-3

P_26366/CD_28189 - EN-04/2008
WARNING
When you initiate radiation and no live image is displayed
although all necessary settings have definitely been
made, please contact your after-sales service center!
3.3 Electromagnetic compatibility
Medical electrical equipment requires special precautionary measures

with respect to EMC and must be installed and put into service in
accordance with the EMC guidelines contained in the accompanying
documents.
Portable and mobile RF communications equipment may interfere with
medical electrical equipment.
All operating modes of the system have been considered in the EMC
tests. There are no exceptions to the rules.
Only conductors, connecting cables and accessories that are specified
by the manufacturer may be used.
WARNING
Using components other than those specified may result
in increased electromagnetic emissions or reduced
electromagnetic immunity.
Please observe also the Manufacturer’s Declaration concerning

Electromagnetic Compatibility according to IEC 60601-1-2 in the
Technical Manual!
3.4 Protective grounding
The system must be connected only to power systems having a separate

ground connection.
3-4 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
3.5 Equipotential grounding
If you use the system in combination with other equipment for Heart and brain
examinations of the heart or brain or the surrounding anatomical regions, examinations
equipotential grounding is required for patient and operating staff safety
(IEC 60601-1-1).
3.6 Laser radiation
As an option, the system may be equipped with a laser positioning device Laser positioning
at the image intensifier and/or generator. device
The laser positioning device uses diode laser modules which emit laser
radiation. Do not under any circumstances look directly at the laser
beam or any scattered laser radiation – either with the naked eye or with
optical instruments.
The laser positioning device is a Class 2M laser product according to IEC
60825-1. Make sure to comply with all operating safety precautions when
using the laser positioning device.
The maximum power output of continuous laser radiation, measured at
the laser beam apertures, is <1 mW. The wavelength of the emitted
radiation is 635 nm.
WARNING
Laser radiation – Do not stare into beam or view directly
with optical instruments (Laser Class 2M according to IEC
60825-1:2001).
Please observe the provisions of IEC 60825-1:2001,
Section 3, “User’s Guide” for operation of the laser
positioning device.
Viewing the laser output with certain optical instruments
(e.g. eye loupes, magnifiers and microscopes) within a
distance of 100 mm may pose an eye hazard.
CAUTION (USA)
LASER RADIATION – DO NOT STARE INTO BEAM
CLASS II LASER PRODUCT (in accordance with FDA 21
CFR, Subchapter J, Section 1040.10-11)
The laser positioning device is maintenance-free. Any adjustment or Maintenance

repair work which might become necessary must be carried out by the
manufacturer or a person who has been authorized to do so by the
manufacturer.
Ziehm Vision 3-5

P_26366/CD_28189 - EN-04/2008
Laser beam apertures
Fig. 3-1 Laser beam apertures on the image intensifier (left) and on
the generator (right) (Ziehm Vision)
Laser beam aperture
Fig. 3-2 Laser beam apertures on the digital flat-panel detector (left)
and on the generator (right) (Ziehm Vision FD)
3-6 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Fig. 3-3 Laser beam apertures on the image intensifier (left) and on
the generator (right) (Ziehm Vision R)
3.7 Temperature
Systems with Active Cooling are shipped with a water/anti-freeze mixture Coolant
in the cooling tank acting as a coolant during later operation. The coolant
enables the equipment to withstand temperatures down to –5°C during
storage and transport. No particular hazards are known.
Admissible anti-freeze agents: Glythermin® P 44-00

Plurasafe® P44
Mixture ratio 55% water
45% anti-freeze agent
Generator housing
CAUTION Ziehm Vision R
On the Ziehm Vision R the generator housing can reach
a temperature of 48°C.
Prolonged contact with the generator housing may result
in burns.
Make sure that the patient does not get in contact with the
generator housing.
Ziehm Vision 3-7

P_26366/CD_28189 - EN-04/2008
WARNING
When working with any of the anti-freeze agents you must
wear protective gloves and safety goggles.
Heat-sensitive
printer paper NOTICE
Temperatures above 40°C and relative air humidity above
60% may cause stains on the printer’s heat-sensitive
paper.
3.8 Environmental compatibility
The system does not produce any waste during operation.

When the system has reached the end of its useful service life, the
relevant waste disposal regulations of the country of installation must be
observed.
3.9 Transport
Ziehm Vision R with When preparing the C-arm stand for a transport (→ Ch. 5.1, p. 5-1),
31 cm i.i. make sure that the C-arm is not in the lowermost vertical travel range. If
this is the case (both MOVE DOWN arrow buttons are flashing), use the
MOVE UP arrow buttons to lift the C-arm to a standard vertical position.
3.10 Lower vertical position
Ziehm Vision R with On the Ziehm Vision R with 31 cm i.i., you must lower the C-arm in two
31 cm i.i. steps in order to prevent the generator from colliding with the C-arm
stand foot.
WARNING
Make sure that the generator does not collide with the C-
arm stand foot. There is an increased risk of bruising
yourself, and the system may be damaged.
3-8 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
4 Putting the System into Service
4.1 Unpacking the system
You can find detailed information on how to unpack and assemble the Detailed
system in the Technical Manual that ships with the system. information
WARNING
Only authorized personnel (→ p. 1-2) are allowed to
unpack and assemble the system.
During assembly, the system may be handled only by
trained personnel who have studied the contents of Ch.
Putting the System into Service and Ch. Mechanical
Handling.
In case of major differences in temperature, all parts of the system must Room temperature
have reached room temperature before the system is put into service in
order to avoid damage to the system as a result of condensation.
NOTICE
Do not operate the system until the equipment has
reached a safe operating temperature of +13°C to +35°C
with no condensation present.
Otherwise severe equipment damage may result.
Ziehm Vision 4-1

P_26366/CD_28189 - EN-04/2008
4.2 Accessories
Depending on the integrated options, the following accessories are
included in the scope of delivery:
Accessories Qty.
Operating Instructions 1
CD (Operating Instructions) 1
CD (Technical Manual) 1
CD (Service Manual: Sweden, Iceland and 1
Ukraine)
Specifications and Certificates 1
All systems
Quick Guide 3
Coupling cable (7.5 m) 1
Equipotential grounding cable (6 m) 1
(Art. No. 24054)
Touch-up paint RAL 9001 (Art. No. 89655) 1
Touch-up paint light green (Art. No. 89615) 1
Active Cooling
Hose (1.5 m) (not for Ziehm Vision R) 2
Mounting material
(for systems on pallet: Art. No. 88711)
Foot switch
Four-pedal foot switch (Art. No. 88659)
Cassette holder
Cassette holder for a 23 cm image intensifier,
format 18x24 (Art. No. 88113)
Video printer
Operating instructions for video printer 1
Options
Printer paper 1 roll

Printer transparent film (depending on printer 1 roll
model)
DVD writer
DVD (4.7 GB) 1
DICOM
RJ45 interface with Cat.5 patch cable (10 m) 1
(Art. No. 24452)
Wireless LAN: Transceiver 1
Table 4-1 Accessories
4-2 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Accessories USA: Qty.

Operating Instructions 1
CD (Operating Instructions) 1
Technical Manual 1
CD (Technical Manual) 1
CD (Service Manual) 1
CDRH Maintenance Report 1
Specifications and Certificates 1
Quick Guide 3
Coupling cable with UL marking (7.5 m) 1
(Art. No. 29070)
Equipotential grounding cable (6 m) 1
(Art. No. 24054)
Mounting material (Art. No. 88711)
Skin cone with safety label (Art. No. 89694)
All systems
Touch-up paint RAL 9001 (Art. No. 89655) 1

Touch-up paint light green (Art. No. 89615) 1
Protocols
Copy of image intensifier test and test certificate of 1
the manufacturer.
Measuring protocols of X-ray generator
Data sheet with focal spot sizes
Inspection report for leakage radiation
measurement
Copy of module number lists: Monitor cart, C-arm
stand
Printout of predefined images, made on the
thermal printer
Active Cooling
Hose (1.5 m) (not for Ziehm Vision R) 2
Adapter hose (not for Ziehm Vision R) 1
Water pump (not for Ziehm Vision R) 1
Table 4-2 Accessories USA
Ziehm Vision 4-3

P_26366/CD_28189 - EN-04/2008
Accessories USA: Qty.

Foot switch
Four-pedal foot switch (Art. No. 88659)
Cassette holder
Cassette holder for a 23 cm image intensifier,
format 18x24 (Art. No. 88113)
Video printer
Operating instructions for video printer 1
Options
Printer paper 1 roll

Printer transparent film 1 roll
(depending on printer model)
DVD writer
DVD (4.7 GB) 1
DICOM
RJ45 interface with Cat.5 patch cable (10 m) 1
(Art. No. 24452)
Table 4-2 Accessories USA (cont.)
4-4 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
4.3 Cable connections
Before switching on the system for the first time, or after each transport, General
you must establish different cable connections.
To connect the system components, do the following:
• Unwind the coupling cable from the upper cable support on the back
of the monitor cart. Unwind the power cable from the lower cable
support (→ Fig. 2-5, p. 2-9 or → Fig. 2-8, p. 2-11).
• Plug the coupling cable connector into the socket located at the side
of the C-arm stand and lock the connector (→ Fig. 2-1, p. 2-7).
• Make sure that a suitable supply voltage is available and that the
socket-outlet is properly grounded and fused.
• Check the power plug on the monitor cart power cable (→ Fig. 2-5,
p. 2-9 or → Fig. 2-8, p. 2-11) and the socket-outlet for compatibility.
• Connect the system to the power supply.

The OFF switch on the monitor cart is illuminated in white.
NOTICE
Never connect the monitor cart and C-arm stand when the
monitor cart is already connected to the power supply or
switched on.
Damage to the electronics of the system cannot be
excluded if this warning is ignored!
Ziehm Vision 4-5

P_26366/CD_28189 - EN-04/2008
4.4 First power-up of the system
Preparation • Make sure that the inclination of the system does not exceed 5° from
the level in operating position.
• Ensure that all electrical connections are properly established

(→ Ch. 4.3, p. 4-5).
• Put on suitable protective clothing.

• Switch on the system.
The power switches for switching the system on and off are located
on the top side of the monitor cart behind the control panel on the left,
and on the top left side of the C-arm stand next to the handle. Each of
the two power switches simultaneously switches on or off both system
components.
The default settings after power-up vary from system to system,
according to the customer-specific setup.
NOTICE
Do not plug any USB stick into the USB port until the
system has fully completed its power-up sequence.
NOTE
Due to background radiation, the Air Kerma or Air Kerma
Rate display may indicate some small value after power-
up of the system.
4.5 Setting up the system
Configuration You have the possibility to adjust various basic and operation settings so
as to meet your special working requirements. If these settings have not
already been made at the factory, you can make them yourself in the
Configuration operating mode (→ Ch. 19, p. 19-1).
Entering the In order to avoid having to enter the invariable hospital data (i.e., name
hospital data of the hospital, department and doctor) again and again for each new
patient, you can record this data once in the Configuration operating
mode under Basic Settings (→ Ch. 19.3.3, p. 19-9). Each time you
create a new patient folder (→ Ch. 10.2.1, p. 10-3), the hospital data
which has been entered there will appear automatically in the
corresponding boxes.
4-6 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
5 Mechanical Handling
5.1 Transport position
For safety reasons, you must return both the C-arm stand and the General
monitor cart to their respective transport position before transporting
them.
NOTICE
Do not move the system over floors with an inclination of
more than 10° from level during transport. This applies to
both the C-arm stand and the monitor cart.
Exercise extreme caution when moving the C-arm stand
and the monitor cart over rough surfaces such as tile
flooring, pavement, asphalt or carpet. Take care that the
cable guards do not drag and the wheels do not catch or
tilt causing damage to the equipment.
5.1.1 C-arm stand transport position
To prepare the C-arm stand for a transport, do the following: How to proceed
• Wind the foot switch cable onto the foot switch support and hang up
the foot switch there.
• Rotate the C-arm orbitally until the image intensifier is positioned

directly above the generator and secure it with the relevant (blue)
brake (→ Fig. 5-1, p. 5-2 and → Fig. 5-7, p. 5-8).
• Lower the lifting column completely (→ Fig. 5-1, p. 5-2 and → Fig. 5-
19, p. 5-15) using the MOVE UP/DOWN arrow buttons.
On a Ziehm Vision R with 31 cm image intensifier, the MOVE DOWN
arrow buttons are flashing when the C-arm is in the lowermost vertical
travel range.
If this is the case, move up the lifting column a little bit using the
MOVE UP arrow button.
• Put the swivel arm of the C-arm into an upright position and secure it
with the relevant (red) brake (→ Fig. 5-1, p. 5-2 and → Fig. 5-10,
p. 5-10).
Ziehm Vision 5-1

P_26366/CD_28189 - EN-04/2008
• Swivel the horizontal carriage into a central position and secure it with
the relevant (green) brake (→ Fig. 5-1, p. 5-2 and → Fig. 5-10,
p. 5-10).
• Retract the horizontal carriage completely and secure it with the

relevant (yellow) brake (→ Fig. 5-1, p. 5-2 and → Fig. 5-16, p. 5-13).
• Switch off the system and disconnect the power cable from the power
supply.
• Unlock the coupling cable connector on the C-arm stand and unplug
the connector.
• Release the parking brake by lifting the (green) steering & braking
lever (→ Fig. 5-1, p. 5-2).
C-arm + brake
(brake handle optionally blue)
Swivel arm + brake

(brake handle optionally red)
Horizontal carriage + brake
(brake handle optionally
yellow)
Swivel brake
(brake handle optionally green)
Steering & braking lever
(green)
Lifting
column
Cable guards
Fig. 5-1 C-arm stand transport position (Ziehm Vision)
C-arm + brake
Swivel arm + brake

yellow)
Swivel brake

(green)
Lifting column
Cable guards
Fig. 5-2 C-arm stand transport position (Ziehm Vision FD)
5-2 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
C-arm + brake
Swivel arm + brake


yellow)
Swivel brake
(green)
Lifting
column
Cable guards
Fig. 5-3 C-arm stand transport position (Ziehm Vision R)
Ziehm Vision 5-3

P_26366/CD_28189 - EN-04/2008
5.1.2 Monitor cart transport position
To prepare the monitor cart for a transport, do the following:
• Wind the power cable onto the cable support on the back of the
monitor cart.
• Wind the coupling cable onto the cable support on the back of the
monitor cart.
• If applicable, disconnect the equipotential grounding cable from the

system ground.
• If applicable, disconnect the system from the DICOM network.
• Unlock the parking brake by pushing the foot levers on the front
wheels with your foot into the middle position.
Coupling cable
support
Power cable
support
Fig. 5-4 Monitor cart transport position of the Ziehm Vision (left) and
the Ziehm Vision Endo (right)
5-4 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
5.2 Braking and steering the monitor cart
On both front wheels of the monitor cart there is a foot lever which serves Brake
for locking and releasing the brakes.
Foot lever for

wheel locking
Fig. 5-5 Monitor cart front wheel
You can push the foot levers with your foot into three different positions:
− Levers in middle position:
the wheels can move freely, the brake is released
− Levers in lower position:
the wheels are locked, the brake is locked as well
− Levers in upper position:
You can move the monitor cart to the left and right side.
To steer the monitor cart, use the two lateral handles. Steering
Ziehm Vision 5-5

P_26366/CD_28189 - EN-04/2008
5.3 Braking and steering the C-arm stand
Steering & braking The C-arm stand has a combined steering & braking lever. It is located
lever at the rear end of the C-arm stand (→ Fig. 2-1, p. 2-7).
Parking brake The C-arm stand parking brake operates as follows:

− Steering & braking lever lowered:
Rear wheels are locked
− Steering & braking lever raised:
Rear wheels can move freely
Steering To steer the C-arm stand, do the following:
• Lift the steering & braking lever and turn it until reaching the desired
position. The lever can be turned freely; however, detents are placed
at 90° increments. The rear wheels will always stay parallel to one
another aligned exactly in parallel with the steering & braking lever.
− To maneuver the C-arm stand freely, ensure that the steering &
braking lever has engaged in its central position, pointing directly
backward from the unit (→ Fig. 5-6, p. 5-7, left).
− To move the C-arm stand in an exactly-defined direction, rotate the
steering & braking lever until it points toward the desired direction
(→ Fig. 5-6, p. 5-7, right).
• Push the C-arm stand in the desired or predefined direction using the
lateral handles, or use the hand rail around the image intensifier to
pull the C-arm stand.
CAUTION
Release the parking brake only to move or position the C-
arm stand.
5-6 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Fig. 5-6 C-arm stand steering (schematic representation, view from

above)
5.4 C-arm movements
The C-arm can be moved in virtually any plane. For each movement, a Mechanical brakes
separate brake is available, allowing you to secure the C-arm in any
position.
To release the corresponding brake, turn it counter-clockwise.
The limit stop of the brake handles can be adjusted individually. To do so,
lift the spring-loaded brake handle, turn it until reaching the desired limit
stop position and release it to re-engage it at the new position.
CAUTION
Before moving the C-arm, make sure that there is nobody
within its range of movement.
Ziehm Vision 5-7

P_26366/CD_28189 - EN-04/2008
WARNING
Release the mechanical brakes only for positioning.
Take care to always seize the C-arm at its handle during
any adjustment in order to prevent the C-arm from hitting
the respective limit stop at full speed!
Take care not to place your hand in the C-arm guide rails
when adjusting the C-arm.
Make sure that all mechanical brakes are locked when
transporting the C-arm stand!
5.4.1 Orbital rotation
CAUTION
Before rotating the C-arm, make sure that it does not
collide with any persons or objects.
You can rotate the C-arm orbitally by 135° (optionally 115°): –90° from
vertical to horizontal position and +45° (optionally +25°) forward. A scale
with 5° divisions on the outside of the C-arm as well as a mechanical
detent at the ‘zero’ position are provided to facilitate precise positioning.
Angulation brake
(brake handle
optionally red)
Orbital rotation brake

(brake handle
optionally blue)
Fig. 5-7 Orbital rotation of the C-arm (Ziehm Vision)
5-8 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Angulation brake
(brake handle
optionally red)
Orbital rotation
brake (brake handle
optionally blue)
Fig. 5-8 Orbital rotation of the C-arm (Ziehm Vision FD)
Angulation
brake (brake
handle
optionally red)
Orbital rotation
brake (brake
handle
optionally blue)
Fig. 5-9 Orbital rotation of the C-arm (Ziehm Vision R)
5.4.2 Angulation
You can rotate the C-arm by ± 225° in the vertical plane around the
horizontal axis (i.e., the horizontal carriage). A scale with 10° divisions is
provided at the pivot joint of the horizontal carriage (except on 31 cm i.i.
systems) to facilitate precise positioning.
Ziehm Vision 5-9

P_26366/CD_28189 - EN-04/2008
CAUTION
Ziehm Vision R: When you angulate the C-arm by ± 180°,
the image intensifier may collide with the C-arm stand
foot.
Fig. 5-10 Angulation of the C-arm (Ziehm Vision)
Fig. 5-11 Angulation of the C-arm (Ziehm Vision FD)
5-10 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Fig. 5-12 Angulation of the C-arm (Ziehm Vision R)
The angulation brake is located on the horizontal carriage (→ Fig. 5-7,

p. 5-8).
5.4.3 Swiveling (panning)
You can swivel the C-arm 10° to the left or to the right around the vertical
axis of the lifting column.
Swivel brake
Fig. 5-13 Swiveling (panning) of the C-arm (Ziehm Vision, view from
above)
Ziehm Vision 5-11

P_26366/CD_28189 - EN-04/2008
Swivel brake
Fig. 5-14 Swiveling (panning) of the C-arm (Ziehm Vision FD, view
from above)
Swivel brake
Fig. 5-15 Swiveling (panning) of the C-arm (Ziehm Vision R, view

from above)
5-12 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
5.4.4 Horizontal movement
CAUTION
Before moving the C-arm back and forth, make sure that
it does not collide with any persons or objects.
You can move the C-arm forward and backward by 22 cm in the

horizontal plane by means of the horizontal carriage. A scale with 1 cm
divisions is provided to facilitate precise positioning.
Horizontal movement brake

(carriage brake)
(brake handle optionally yellow)
Fig. 5-16 Horizontal movement of the C-arm (Ziehm Vision)

(carriage brake)
(brake handle optionally yellow)
Fig. 5-17 Horizontal movement of the C-arm (Ziehm Vision FD)
Ziehm Vision 5-13

P_26366/CD_28189 - EN-04/2008

(carriage brake) (brake handle
optionally yellow)
Fig. 5-18 Horizontal movement of the C-arm (Ziehm Vision R)
5.4.5 Vertical movement
You can move the C-arm up and down by 43 cm. This movement is
motorized. A scale with 1 cm divisions is provided on the lifting column to
facilitate precise positioning.
The MOVE UP/DOWN arrow buttons are on the C-arm stand next to the
lateral handles. To move the C-arm up or down, you must press and hold
down the corresponding MOVE UP/DOWN arrow button.
CAUTION
Before moving the C-arm up or down, make sure that it
does not collide with any persons or objects.
When you move down the C-arm, the clearance between
the C-arm stand base and the horizontal carriage may get
so tight that there is a risk of bruising your hands and
fingers.
5-14 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
MOVE
UP/DOWN
buttons
Fig. 5-19 Vertical movement of the C-arm (Ziehm Vision)
MOVE
UP/DOWN
buttons
Fig. 5-20 Vertical movement of the C-arm (Ziehm Vision FD)
Ziehm Vision 5-15

P_26366/CD_28189 - EN-04/2008
Lowering a Ziehm On the Ziehm Vision R with 31 cm i.i., you must lower the C-arm in two
Vision R with 31 cm steps in order to prevent the generator from colliding with the C-arm
i.i. completely stand foot.
WARNING
Make sure that the generator does not collide with the C-
arm stand foot. There is an increased risk of bruising
yourself, and the system may be damaged.
To move the C-arm of a Ziehm Vision R with 31 cm image intensifier

to the lowermost vertical position, do the following:
• Press and hold down one of the MOVE DOWN arrow buttons until the
downward movement stops automatically.
• Press and hold down both MOVE DOWN arrow buttons until the C-
arm reaches the desired vertical position or until the downward
movement stops automatically.
Both MOVE DOWN arrow buttons are flashing.
MOVE
UP/DOWN
buttons
Fig. 5-21 Vertical movement of the C-arm (Ziehm Vision R)
5-16 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
6 Controls
6.1 Control panel
Both the C-arm stand and the monitor cart have a control panel. The two
control panels always show the same screen, enabling you to use any of
them for system operation. Depending on the selected function, different
controls (tabs, buttons, input boxes, displays, etc.) will appear on the
control panel screen.
The Vision Center control panel is designed as a touchscreen. For
system operation, just press the desired button or option directly on the
touchscreen.
6.1.1 Elements of the control panel
Warning
symbols
Selected Title bar
operating
mode
Displays
Ziehm
SmartEye
Dynamic
control area Buttons
Buttons
Tabs for
operating
mode
selection
Fig. 6-1 Elements of the control panel
Ziehm Vision 6-1

P_26366/CD_28189 - EN-04/2008
6 Controls
There are three types of buttons:

− Buttons with a gray background: When you press one of these
buttons, an action is executed immediately on the screen, or a mode
is activated. If a certain mode is active, the corresponding button is
highlighted in yellow.
− Buttons with a gray background and a purple bar at the top:
When you press one of these buttons, new controls appear in the
dynamic control area, allowing you to make further settings.
− Buttons with a gray background and a green bar at the top: When
you press one of these buttons, another mode or sub-mode is
activated.
6.1.2 Controls in the Fluoroscopy and Subtraction operating modes
Fluoroscopy In the Fluoroscopy operating mode, you can make different settings for
operating mode fluoroscopies:
Fig. 6-2 Control panel in the Fluoroscopy operating mode with Air
Kerma display
6-2 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
6 Controls
Fig. 6-3 Control panel in the Fluoroscopy operating mode with Air
Kerma Rate display
Ziehm Vision 6-3

P_26366/CD_28189 - EN-04/2008
6 Controls
Symbol(s) Meaning
Pulsed fluoroscopy
Activates the pulsed fluoroscopy mode and
displays the pulse rate setting controls in the
dynamic control area.
High Quality
Activates the High Quality supplementary
function.
(USA only; exception: the cine loop mode is
activated)
Caution: Reduce exposure time!
Snapshot (digital radiography)
Activates the Snapshot mode.
Manual exposure rate setting

Enables manual setting of tube voltage and tube
current.
Caution: Use only in exceptional cases!
Large patient
Activates the Large Patient supplementary
function.
Cine
Activates or deactivates the Cine Loop mode.
Image swapping
Swaps the images between the live and reference
screens.
Rotate Image CW
Rotates the image in clockwise direction.
Ziehm Vision FD: As soon as the image is rotated,
it assumes a circular shape.
Rotate Image CCW
Rotates the image in counter-clockwise direction.
Ziehm Vision FD: As soon as the image is rotated,
it assumes a circular shape.
Rotate Image to 0°
Resets the angle of rotation of the image in one
step to 0°.
Reverse Up/Down
Mirrors the image vertically around the horizontal
axis.
Table 6-1 Controls in the Fluoro operating mode
6-4 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
6 Controls
Symbol(s) Meaning
Reverse Left/Right
Mirrors the image horizontally around the vertical
axis.
Close Iris Collimator

Closes the iris collimator.
Open Iris Collimator Fully

Fully opens the iris collimator in one step.
Close Vertical Slot Collimator

Closes the slot collimator.
When you press the Close Vertical Slot
Collimator button, the buttons for opening and
rotating the collimator appear on the control panel:
Open Vertical Slot Collimator
Opens the slot collimator.
Rotate Vertical Slot Collimator CW

Rotates the slot collimator in clockwise direction.
Rotate Vertical Slot Collimator CCW

Rotates the slot collimator in counter-clockwise
direction.
Open Vertical Slot Collimator Fully

Fully opens the vertical slot collimator in one step.
Rotate Vertical Slot Collimator to 0°

Resets the vertical slot collimator in one step to 0°.
Bones
Activates the anatomical program for visualizing
any part of the skeleton.
Heart
the heart and thorax region.
Abdomen
the abdominal region.
Table 6-1 Controls in the Fluoro operating mode (cont.)
Ziehm Vision 6-5

P_26366/CD_28189 - EN-04/2008
6 Controls
Symbol(s) Meaning
Uro (not illustrated in Fig. 6-1)
soft tissues and surgical instruments during
interventional urologic procedures.
Endo
Activates the anatomical program for endoscopic
applications.
ESWL
Activates the anatomical program for ESWL
applications (Extracorporeal Shock Wave
Lithotripsy).
Metal
Activates the Metal Artifact Correction
supplementary function.
Motion
Activates the Motion supplementary function.
Soft (not illustrated in Fig. 6-1)

soft tissues.
Up Arrow
Displays the image with the next higher number in
the active patient folder at full size.
Down Arrow
Displays the image with the next lower number in
the active patient folder at full size.
Save
Saves the active image to the hard disk.
Laser
Activates or deactivates the laser positioning
device(s).
Filters
Shows or hides the controls for raw image
processing (recursive filter, edge filter, LIH filter) in
the dynamic control area.
Magnify (n/a for Ziehm Vision FD)
Shows or hides the controls for setting the image
intensifier’s electronic magnification in the
dynamic control area. The buttons always show
the current image magnification level.
6-6 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
6 Controls
Symbol(s) Meaning
Zoom
Shows or hides the zoom controls in the dynamic
control area.
Contrast/brightness
Shows or hides the screen setting and contrast
and brightness (windowing) controls in the
dynamic control area.
Printing the live screen image
Prints the image displayed on the live screen on
the video printer.
Text
Activates the Text mode.
ESWL Data
Activates the ESWL Data mode (→ p. 6-11).
Grayscale inversion
Displays the active (positive) image with a
negative grayscale or vice versa.
Fluoro
Activates the Fluoroscopy operating mode, which
is used for performing standard fluoroscopies.
Subtraction
Activates the Subtraction operating mode, which
is used for generating DSA, MSA and RSA
images.
Radiogr.(n/a for Ziehm Vision FD)
Activates the Radiography operating mode,
which is used for making direct radiographies.
Patient
Activates the Patient operating mode, which is
used for managing patient data.
Post Proc.
Activates the Post Processing operating mode,
which is used for post-processing saved images.
Measurement
Activates the Measurement operating mode,
which is used for measuring distances and angles
in saved images.
Archive
Activates the Archive operating mode, which is
used for managing saved images.
Ziehm Vision 6-7

P_26366/CD_28189 - EN-04/2008
6 Controls
Symbol(s) Meaning
Config
Activates the Configuration operating mode,
which is used for adjusting the operation settings
and the basic settings and for deleting data from
storage media.
Voltage display
Shows the automatically determined or manually
set tube voltage in kV.
After fluoroscopy, the last kV value remains
stored.
Current display
Shows the automatically determined tube current
in mA.
After fluoroscopy, the last mA value remains
stored.
Pulse width % display
Shows the current pulse width.
Pulses/s display
Shows the current pulse rate.
Air Kerma display

Shows the air kerma for the active patient folder in
mGy.
or or
Air Kerma Rate display
Shows the current air kerma rate in µGy/s during
the exposure.
or or
Dose Area Product display
Shows the dose area product for the active patient
folder in cGy cm2.
Radiation Time display

Shows the accumulated radiation time for
fluoroscopies and direct radiographies for the
active patient folder in minutes and seconds.
6-8 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
6 Controls
Symbol(s) Meaning
Temperature symbol
Shows the thermal conditions in the generator.
X-ray symbol
Lights up yellow during X-ray exposure
(fluoroscopy and direct radiography).
Ziehm Vision 6-9

P_26366/CD_28189 - EN-04/2008
6 Controls
Subtraction The Subtraction operating mode screen is to a large extent identical to

operating mode the Fluoroscopy operating mode screen. Instead of the Soft and Metal
buttons, it shows the DSA button:
Fig. 6-4 Control panel in the Subtraction operating mode with Air
Kerma display
Fig. 6-5 Control panel in the Subtraction operating mode with Air
Kerma Rate display
6-10 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
6 Controls
Symbol(s) Meaning
DSA
Displays the controls for the DSA subtraction
mode settings in the dynamic control area.
Table 6-2 Additional controls in the Subtraction operating mode
Controls which are not required in a certain operating situation (e.g. Unavailable
playback of a saved cine loop) are automatically locked, i.e. they are not controls
available.
Use the ESWL Data button to acquire patient data associated with an ESWL Data button
ESWL treatment (Extracorporeal Shock Wave Lithotripsy).
Pressing the ESWL Data button activates the ESWL Data operating
mode and opens the screen for patient and/or treament related data
acquisition (→ Fig. 10-22, p. 10-36).
In the Patient, Text, Archive Search, Archive Backup and Alphanumeric

Configuration operating modes, an alphanumeric keypad is displayed, keypad
allowing you to enter texts.
Fig. 6-6 Alphanumeric keypad displayed on the Vision Center

control panel
NOTE
It is not possible to press two keys on the keypad
simultaneously. To combine a key with the Shift key, first
press and release the Shift key and then the desired key.
To generate uppercase letters and special characters, first press and Uppercase letters
release the Shift key and then the corresponding key. and special
characters
The Shift key acts on one subsequent letter or special character.
Ziehm Vision 6-11

P_26366/CD_28189 - EN-04/2008
6 Controls
To type several consecutive uppercase letters or special characters,

press the Caps Lock key before entering the letters or characters. To
deactivate the Caps Lock mode, press the Caps Lock key once again.
To generate a blank space, press the Space key.
6.2 Buttons and switches on the unit
Both the C-arm stand and the monitor cart have main switches for
switching the entire system on or off (→ Fig. 7-1, p. 7-2). The ON
switches are green, while the OFF switches are white.
NOTE
The OFF switch on the monitor cart illuminates as soon as
you connect the system to the power supply.
The OFF switch on the monitor cart flashes in the
following cases:
− Short circuit in the coupling cable
− EMERGENCY STOP button on the C-arm stand has
been actuated.
When you press the EMERGENCY STOP button on the
monitor cart, the OFF switch does not illuminate, even if
the system is connected to the power supply. As soon as
you unlock the EMERGENCY STOP button, the OFF
switch on the monitor cart re-illuminates, provided that the
system is connected to the power supply.
Once you have switched off the unit, you cannot switch it back on until
after a delay of 5 s.
On the C-arm stand, there are two MOVE UP/DOWN arrow buttons,
which are used for lifting and lowering the C-arm on its mobile stand.
6-12 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
6 Controls
6.3 Hand switch and foot switch
The Ziehm Vision is equipped with a hand switch and a two-pedal foot General
switch.
Hand switch
Fig. 6-7 Hand switch
Two-pedal foot
.
switch
Fig. 6-8 Two-pedal foot switch
Radiation is initiated either with the hand switch or the fluoroscopy pedal
of the foot switch.
The default pedal assignment of the two-pedal foot switch is as follows:
− Left pedal: Fluoroscopy
− Right pedal: Save image (→ Ch. 8.9, p. 8-13)
Ziehm Vision 6-13

P_26366/CD_28189 - EN-04/2008
6 Controls
Four-pedal foot The Ziehm Vision Endo is equipped with a four-pedal foot switch. The
switch default pedal assignment is listed in → Table 6-1, p. 6-14.
Fig. 6-9 Four-pedal foot switch
Pedal Four-pedal foot switch Four-pedal foot switch

Ziehm Vision, Ziehm Ziehm Vision Endo
Vision FD and Ziehm
Vision R
1 Fluoroscopy Fluoroscopy
2 Save image Save image

( → Ch. 8.9, p. 8-13) (→ Ch. 8.9, p. 8-13)
3 Start/stop cine loop ( Start/stop cine loop

→ Ch. 12.2, p. 12-1)
4 Image swapping Start/stop endoscopy

( → Ch. 9.8, p. 9-14)
Table 6-1 Default foot switch assignment
NOTE
The foot switch pedals are able to be assigned with
customer-specific functions. If this is the case, the
respective functions are indicated on labels on the foot
switch itself and on the C-arm stand.
6-14 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
6 Controls
The following table lists the labels which may appear on the foot switch:
Symbol Meaning
Initiate Radiation
Initiates radiation.
Cine
Generates a cine loop.
DSA
Activates the DSA mode.
DSA/MSA/RSA
Switches from DSA to MSA and then to RSA.
Image swapping
Swaps the images between the live and reference
screens.
Press Briefly
Means that stepping briefly on the foot switch
pedal activates another function than holding it
down for a while.
Press and Hold Down
Means that holding the foot switch pedal down for
a while activates another function than stepping
briefly on it.
Magnify
Activates the electronic image magnification of the
image intensifier.
OFF
Deactivates the respective function.
ON/OFF
Activates or deactivates the respective function.
Snapshot
Acquires a snapshot.
Table 6-1 Optional labels on the foot switch (→ Ch. A.4, p. A-17)
Ziehm Vision 6-15

P_26366/CD_28189 - EN-04/2008
6 Controls
Symbol Meaning
Save
Saves the active image to the hard disk.
Freeze
The endoscopic image freezes on the live screen.
Table 6-1 Optional labels on the foot switch (→ Ch. A.4, p. A-17) (cont.)
6-16 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
7 Switching the System On and
Off
7.1 Preparing the system
Before switching on the system, e.g. after a transport, you must connect General
the two system components to each other and also connect the entire
system to the power supply.
NOTICE
Never connect the monitor cart and C-arm stand when the
monitor cart is already connected to the power supply or
switched on.
Damage to the electronics of the system cannot be
excluded if this warning is ignored!
To prepare the system for operation, do the following:
• Unwind the power cable from the lower cable support on the back of
the monitor cart. Unwind the coupling cable from the upper cable
support (→ Fig. 2-5, p. 2-9 or → Fig. 2-8, p. 2-11).
• Plug the coupling cable connector into the socket located at the side
of the C-arm stand and lock the connector (→ Fig. 2-1, p. 2-7).
• Make sure that a suitable supply voltage is available and that the
socket-outlet is properly grounded and fused.
• Check the power plug on the monitor cart power cable (→ Fig. 2-5,
p. 2-9 or → Fig. 2-8, p. 2-11) and the socket-outlet for compatibility.
• Connect the system to the power supply.

The OFF switch on the monitor cart is illuminated in white.
• Make sure that the inclination of the system does not exceed 5° from
the level in operating position.
• Put on suitable protective clothing.
Ziehm Vision 7-1

P_26366/CD_28189 - EN-04/2008
7 Switching the System On and Off
7.2 Switching the system on and off
Both the C-arm stand and the monitor cart have power switches for
switching the system on or off (→ Fig. 7-1, p. 7-2). Each of the two power
switches simultaneously switches on or off both system components.
Fig. 7-1 ON/OFF switches on the C-arm stand (left) and on the
monitor cart (right)
NOTICE
Do not plug any USB stick into the USB port until the
system has fully completed its power-up sequence.
NOTE
Due to background radiation, the Air Kerma or Air Kerma
Rate display may indicate some small value after power-
up of the system.
To switch on the system, do the following:

• Press the ON switch.
The system is switched on. The ON switch illuminates.
Customer-specific The default settings after power-up vary from system to system,
default settings according to the customer-specific setup. You may e.g. choose your
preferred start screen yourself (→ Ch. 19.2.5, p. 19-6).
Furthermore, you may choose to have a certain anatomical program and
various live image settings (→ Ch. 9, p. 9-1) preset as default after
power-up. You cannot make these presettings yourself.
• Please contact your in-house service engineer if you wish to make or

modify the default settings.
To switch off the system, do the following:

• Press the OFF switch.
The system switches off. Any unsaved patient data and/or images are
lost.
7-2 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
7.3 EMERGENCY STOP button
There is an EMERGENCY STOP button on both the C-arm stand and the
monitor cart of the Ziehm Vision, enabling you to switch off all electrical
functions of the unit in case of emergencies.
When you press the EMERGENCY STOP button on the C-arm stand, the
OFF switch on the monitor cart flashes.
When you press the EMERGENCY STOP button on the monitor cart, the
OFF switch on the monitor cart does not illuminate, even if the system is
connected to the power supply. As soon as you unlock the EMERGENCY
STOP button, the OFF switch on the monitor cart re-illuminates, provided
that the system is connected to the power supply.
To switch off the system in an emergency situation, do the

following:
• Fully press down the EMERGENCY STOP button.

The EMERGENCY STOP button is locked in this position. The system
switches off immediately. All electrical functions of the system are
disabled.
Any unsaved patient data and/or images are lost.
• To unlock the EMERGENCY STOP button, press the red knob with a
slight twist in clockwise direction.
The unit remains switched off. You can switch the unit back on with
the ON switch.
NOTE
If the system cannot be switched on, the EMERGENCY
STOP button may have been actuated inadvertently, e.g.
during a transport. Check whether the EMERGENCY
STOP button is locked and unlock it, if applicable.
Ziehm Vision 7-3

P_26366/CD_28189 - EN-04/2008
7.4 Key switch
The Ziehm Vision monitor cart is equipped with one or two key switches.
The X-Ray key switch is present on all systems. With this key switch you
can lock the radiation function of the system. If the unit is additionally
equipped with the Power on key switch, you can lock the complete unit.
CAUTION
Make sure to always use the key switch(es) in order to
prevent unauthorized persons from switching on the unit
and/or initiating radiation.
Fig. 7-2 Key switch for locking the entire system (left) or the
radiation function (right), Lock or Off position
Power on With the Power on key switch you can completely switch off the unit
(equivalent to OFF switch) and lock it. When you remove the key while it
is in the Lock position, the Ziehm Vision can no longer be switched on
with the ON switch.
To be able to switch on and operate the Ziehm Vision, you must first
insert the key and turn it to the Unlock position. While in the Unlock
position, the key cannot be removed.
X-Ray on/off With the X-Ray key switch, you can lock the radiation function of the
unit. When you remove the key while it is in the Off position, it is possible
to switch on the Ziehm Vision and to use functions such as patient data
management or image postprocessing. However, it is not possible to
initiate radiation with the hand or foot switch.
To be able to initiate radiation, you must first insert the key and turn it to
the On position. While in the On position, the key cannot be removed.
7-4 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
8 Standard Fluoroscopic
Operations
8.1 Overview
To perform a standard fluoroscopy, you must always make the following Steps and settings
steps and settings:
• Create a new patient folder in the Patient operating mode, or activate

the desired patient folder in the Patient or Archive operating mode.
• Select the desired fluoroscopy mode in the Fluoroscopy or

Subtraction operating mode. If you have not activated a patient
folder before, the system automatically creates and activates a patient
folder.
• Select standard control mode or low-level control mode using the

pulse rate setting function.
• Select the fluoroscopy program.
• Generate the fluoroscopic image.
• Save the fluoroscopic image.
• Print the fluoroscopic image, if desired.
Ziehm Vision 8-1

P_26366/CD_28189 - EN-04/2008
8 Standard Fluoroscopic Operations
8.2 Fluoroscopy modes
Fluoroscopy During fluoroscopy, radiation is interrupted at certain intervals (pulsed).

modes The length (pulse width) and frequency (pulse rate) of the radiation
interval are preset for each anatomical program and are displayed on the
control panel.
The Ziehm Vision provides two different fluoroscopy modes:
− Pulsed fluoroscopy (→ Ch. 8.2.1, p. 8-2)
− Digital radiography (snapshot) (→ Ch. 8.2.2, p. 8-5)
Anatomical Both fluoroscopy modes work with automatic exposure rate control
programs (AERC), unless you explicitly activate the Manual Exposure Rate
Setting mode (→ Ch. 8.3, p. 8-6).
The tube voltage and the tube current are adjusted automatically, taking
into account the selected fluoroscopy program (→ Ch. 8.5, p. 8-8) as well
as the thickness and structure of the object.
Automatic exposure rate control (AERC) reduces the radiation burden of
both patient and operating staff to a minimum and prevents
overexposure of the screened body region.
WARNING
Using the Manual Exposure Rate Setting mode
influences the radiation quality, image quality, air kerma
and air kerma rate.
Automatic Dose The Bones and Abdomen anatomical programs (with the exception of
Reduction (n/a for the Abdomen program on 31 cm i.i. systems) include a motion
Ziehm Vision FD) detection function, which automatically reduces the pulse rate when the
screened object does not move.
8.2.1 Pulsed fluoroscopy
In pulsed fluoroscopy mode, the system emits radiation pulses as long

as you press the radiation switch.
Pulse rate You may adjust the pulse rate. The lower the pulse rate setting, the lower
the radiation dose.
Using the pulse rate setting function you can choose whether you want
to work in standard control mode or low-level control mode. For standard
control mode select 25 pulses/s or 30 pulses/s, for low-level control mode
≤ 8 pulses/s or ≤ 10 pulses/s.
8-2 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
An Automatic Dose Reduction function is active in the Bones and Automatic Dose
Abdomen anatomical programs (→ Ch. 8.5.1, p. 8-8, except in the Reduction (n/a for
Abdomen program on 31 cm i.i. systems). Depending on whether the Ziehm Vision FD)
screened object is moving or not, the pulse rate is constantly and
automatically readjusted. When the object moves, the pulse rate is
increased; when the object is immobile, the pulse rate is decreased.
The pulse width is indicated in percent and cannot be modified. A pulse Pulse width
width of 100% corresponds to 40 ms (USA: 30 ms).
The pulse width and pulse rate for each anatomical program are preset Pulse settings for
in the Configuration operating mode under Service Settings. You anatomical
cannot make these presettings yourself. programs
• Please contact your in-house service engineer if you wish to preset or

modify the pulse width and/or pulse rate values for any anatomical
program.
To generate an image in pulsed fluoroscopy mode, do the following:

• Press the Pulsed Fluoroscopy button.
The preset pulse width and pulse rate for the selected anatomical
program are indicated on the Pulse width % and Pulses/s displays
on the control panel.
The pulse rate controls appear in the dynamic control area.
Fig. 8-1 Pulse rate setting (on systems with 25 fps)
• Press the button for the desired pulse rate, e.g. 2 pulses/s (standard
control mode = 25 or 30 pulses/s; low-level control mode = ≤ 8 or ≤
10 pulses/s).
Ziehm Vision 8-3

P_26366/CD_28189 - EN-04/2008
• Initiate radiation.
Acquiring images An Automatic Dose Reduction function is active in the Bones and
with Automatic Abdomen anatomical programs (→ Ch. 8.5.1, p. 8-8, except in the
Dose Reduction Abdomen program on 31 cm i.i. systems). Depending on whether the
(n/a for Ziehm screened object is moving or not, the pulse rate is constantly and
Vision FD) automatically readjusted. This means that you need not select a pulse
rate manually.
To generate an image in pulsed fluoroscopy mode with Automatic

Dose Reduction, do the following:
The preset pulse width and pulse rate for the selected anatomical
program are indicated on the Pulse width % and Pulses/s displays
The pulse rate controls including the AUTO button appear in the
dynamic control area. The AUTO button is active. You need not make
any further settings.
Fig. 8-2 Pulse rate setting with Automatic Dose Reduction (on
systems with 25 fps)
Depending on whether the screened object is moving or not, the pulse
rate is constantly and automatically readjusted. When the object
moves, the pulse rate is increased; when the object is immobile, the
pulse rate is decreased.
8-4 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
For each individual anatomical program, certain filter factors can be Filter factors
preset for pulsed fluoroscopy mode. This is done in the Configuration
operating mode under Service Settings. You cannot make these
presettings yourself.

modify the filter factors for any anatomical program.
8.2.2 Digital radiography (snapshot)
NOTE
This function has not been tested for interventional
procedures in accordance with IEC 60601-2-43.
In Snapshot mode, the radiation time does not depend on how long you
press the radiation switch. For each anatomical program, a specific
AERC characteristic is stored on the system for the digital radiography
mode. The fluoroscopy parameters are adjusted using the respective
AERC characteristic, and radiation is terminated automatically
afterwards.
The pulse rate controls appear in the dynamic control area. You cannot
make any further settings with these buttons, though.
The snapshot mode is suitable for examinations involving no patient Fields of

movement. The aim of snapshot mode is to generate high-quality static application
images, e.g. for printing / documentation purposes.
To generate an image in snapshot mode, do the following:

• Press the Snapshot button.
• To deactivate the snapshot mode, press the Pulsed Fluoroscopy

button.
NOTE
When you activate the snapshot mode, the Cine button
disappears from the control panel.
For each individual anatomical program, certain filter factors can be Filter factors
preset for the snapshot mode. This is done in the Configuration
operating mode under Service Settings. You cannot make these
presettings yourself.
Ziehm Vision 8-5

P_26366/CD_28189 - EN-04/2008

modify the filter factors for any anatomical program.
8.3 Manual exposure rate setting
The tube voltage and the tube current are usually adjusted automatically
by the system’s automatic exposure rate control. You may, however, set
the exposure rate also manually, if necessary.
WARNING
To protect patients and staff against high radiation doses,
the Manual Exposure Rate Setting mode remains
blocked until you have initiated radiation in one of the
fluoroscopy modes with automatic exposure rate control
at least once.
Only use the Manual Exposure Rate Setting mode in
exceptional circumstances. The automatic exposure rate
control provides optimum image quality while minimizing
the dose rate.
Using the Manual Exposure Rate Setting mode
influences the radiation quality, image quality, air kerma
and air kerma rate.
To generate an image in Manual Exposure Rate Setting mode, do

the following:
• Select the desired anatomical program (→ Ch. 8.5.1, p. 8-8).
• Select one of the fluoroscopy modes with automatic exposure rate

control:
− Pulsed fluoroscopy
or or
− Snapshot
(→ Ch. 8.2, p. 8-2).
• Initiate radiation for a brief moment.
8-6 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
• Press the Manual Exposure Rate Setting button.

The kV value which has been automatically determined is saved for
subsequent fluoroscopies, and the system switches to the manual
mode.
The manual exposure rate setting controls appear in the dynamic
control area.
Fig. 8-3 Settings in the Manual Exposure Rate Setting mode
• Select the desired kV and mA values using the Up Arrow and Arrow
and Down Arrow buttons. Each time you press an arrow button, the
value is increased/decreased by 1 kV or 0.1 mA.
To deactivate the Manual Exposure Rate Setting Mode, do the

following:
• Press the Manual Exposure Rate Setting button.
or or
• Press the Off button in the dynamic control area.
The Manual Exposure Rate Setting mode is deactivated.
8.4 Object-Detected Dose Control (ODDC) in the Bones

anatomical program (n/a for Ziehm Vision FD)
The Bones and Abdomen anatomical programs (except the Abdomen Function
program on 31 cm i.i. systems) include a grid control which automatically
detects objects in the entire field of view and accordingly sets optimum
exposure parameters for the ROI. This is achieved through a grid of 256
measuring cells covering the entire field of view. This means that even
objects that are located off-center are optimally visualized.
Ziehm Vision 8-7

P_26366/CD_28189 - EN-04/2008
Automatic Metal The Automatic Metal Correction function that is implemented in the
Correction Bones and Abdomen anatomical programs (not yet available for the
Abdomen program on 31 cm i.i. systems) corrects a possible flaring of
the fluoroscopic image resulting from metal objects in the beam path and
increases contrast at tube voltages above 50 kV.
8.5 Fluoroscopy programs
Using the pulse rate setting function you can choose whether you want
to work in standard control mode or low-level control mode. For standard
control mode select 25 pulses/s or 30 pulses/s, for low-level control mode
≤ 8 pulses/s or ≤ 10 pulses/s.
Fig. 8-4 Controls for selecting the number of pulses/s
8.5.1 Anatomical programs
The following anatomical programs are optionally available:

Bones
The Bones anatomical program is optimized for visualizing any part of
the human skeleton. It is used mainly in orthopedics.
An Automatic Dose Reduction function (→ Ch. 8.5.5, p. 8-11) and an
Automatic Noise Filter Adjustment function (→ Ch. 8.5.6, p. 8-12) are
implemented in the Bones anatomical program (n/a for Ziehm Vision
FD).
Heart
The Heart anatomical program is optimized for visualizing the heart and
the thorax. It is used e.g. in heart surgery or also for dilatations in the
heart region.
Abdomen
The Abdomen anatomical program is optimized for visualizing any
anatomical structure in the abdominal region. It is used e.g. for
cholangiographies and for preparing dilatations and stent implantations.
An Automatic Dose Reduction function (→ Ch. 8.5.5, p. 8-11) and an
Automatic Noise Filter Adjustment function (→ Ch. 8.5.6, p. 8-12) are
implemented in the Abdomen anatomical program (n/a for 31 cm i.i.
systems and Ziehm Vision FD).
8-8 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Uro
The Uro anatomical program is optimized for visualizing soft tissues and
surgical instruments during interventional urologic procedures.
Endo
The Endo anatomical program is optimized for endoscopic applications.
Soft
The Soft anatomical program is optimized for visualizing soft tissues. It is
used e.g. for foreign body localization and for visualization of syringe
needles and skin contours.
ESWL
The ESWL anatomical program is optimized for Extracorporeal Shock
Wave Lithotripsy.
To activate an anatomical program, do the following:
• Press the button for the desired anatomical program.

The button is highlighted in yellow.
The anatomical program remains active until you choose another
program.
For each of these anatomical programs, certain filter factors can be Filter factors
preset. This done in the Configuration operating mode under Service
Settings. You cannot make these presettings yourself.

modify the filter factors.
If required, a number of supplementary functions can be combined with Supplementary

any anatomical program: functions
− Metal artifact correction (→ Ch. 8.5.2, p. 8-10)
− Motion (→ Ch. 8.5.3, p. 8-10)
− High Quality (→ Ch. 8.5.4, p. 8-11)
− Large Patient (→ Ch. , p. 8-11)
In the Bones and Abdomen anatomical programs (with the exception of
the Abdomen program on 31 cm i.i. systems), the following functions are
enabled by default:
− Automatic Dose Reduction (→ Ch. 8.5.5, p. 8-11)
− Automatic Noise Filter Adjustment (→ Ch. 8.5.6, p. 8-12)
• If you wish to disable the Automatic Dose Reduction and Auto-

matic Noise Filter Adjustment functions in the Bones or Abdomen
anatomical program, please contact your in-house service engineer.
Ziehm Vision 8-9

P_26366/CD_28189 - EN-04/2008
8.5.2 Metal Artifact Correction function
The Metal Artifact Correction function corrects a possible flaring of the

fluoroscopic image resulting from metal objects in the beam path and
increases contrast at tube voltages above 50 kV.
The Metal Artifact Correction function can be combined with any
anatomical program. In the Bones and Abdomen anatomical programs
(except in the Abdomen program on 31 cm i.i. systems and on the Ziehm
Vision FD), the Metal Artifact Correction function is not available, as
Automatic Metal Correction (→ p. 8-8) is enabled in these programs.
To activate the Metal Artifact Correction function, do the following:
• Press the Metal button.

To deactivate the Metal Artifact Correction function, do the
following:
• Press the Metal button again.

The button returns to its gray color, and the Metal Artifact Correction
function is deactivated.
8.5.3 Motion function
The Motion function uses special filter settings to reduce motion blurring
in the fluoroscopic images.
The Motion function can be combined with any anatomical program.
When the Automatic Noise Filter Adjustment function is enabled in the
Bones or Abdomen anatomical program (n/a for the Abdomen program
on 31 cm i.i. systems and for the Ziehm Vision FD), the Motion function
is not available.
To activate the Motion function, do the following:
• Press the Motion button.

To deactivate the Motion function, do the following:
• Press the Motion button again.

The button returns to its gray color, and the Motion function is
deactivated.
8-10 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
8.5.4 High Quality function
The High Quality function further enhances the image quality.

The High Quality function can be combined with any anatomical
program. In the DSA and Cine Loop mode, the High Quality function is
automatically active. If you activate the High Quality function in another
mode and initiate radiation, an audible alarm sounds.
Keep the exposure time as short as possible, since the High Quality
function uses a higher radiation dose.
To activate the High Quality function (USA or in combination with the
Cine Loop mode only):
• Press the High Quality button.

The button is highlighted in yellow. When you initiate radiation, an
audible alarm sounds.
To deactivate the High Quality function, do the following:

The button returns to its gray color, and the High Quality function is
deactivated.
The Large Patient function enables screening of patients of heavy build. Large Patient
The Large Patient function can be combined with any anatomical function
program.
To activate the Large Patient function, do the following:

• Press the Large Patient button.
To deactivate the Large Patient function, do the following:

The button returns to its gray color, and the Large Patient function is
deactivated.
8.5.5 Automatic Dose Reduction function (n/a for Ziehm Vision FD)
The Automatic Dose Reduction function constantly and automatically

readjusts the pulse rate during fluoroscopy, depending on whether the
screened object is moving or not. When the object moves, the pulse rate
is increased; when the object is immobile, the pulse rate is decreased.
The Automatic Dose Reduction function is enabled by default in the
Bones and Abdomen anatomical programs (except in the Abdomen
program on 31 cm i.i. systems).
Ziehm Vision 8-11

P_26366/CD_28189 - EN-04/2008
• If you wish to disable the Automatic Dose Reduction function in the

Bones or Abdomen anatomical program, please contact your in-
house service engineer.
8.5.6 Automatic Noise Filter Adjustment function (n/a for Ziehm Vision
FD)
The Automatic Noise Filter Adjustment function constantly and

automatically readjusts the recursive and LIH filter levels during
fluoroscopy, depending on whether the screened object is moving or not.
When the object moves, the filter levels are decreased; when the object
is immobile, the filter levels are increased.
The Automatic Noise Filter Adjustment function is enabled by default
in the Bones and Abdomen anatomical programs (except in the
Abdomen program on 31 cm i.i. systems).
• If you wish to disable the Automatic Noise Filter Adjustment

function in the Bones or Abdomen anatomical program, please
contact your in-house service engineer.
8.6 Screen display during radiation
Fluoroscopic While radiation is active, the current fluoroscopic image is displayed on

image the live screen and as a thumbnail (‘Ziehm SmartEye’) on the control
panel.
When you terminate radiation (by releasing the hand or foot switch), the
last fluoroscopic image is displayed on the live screen and as a thumbnail
(‘Ziehm SmartEye’) on the control panel (Last Image Hold).
This image remains displayed until it is replaced by a new fluoroscopic
image.
Fluoroscopy During the exposure, the tube voltage and the tube current are
parameters automatically set by the system, and the values are shown on the
Voltage (kV) and Current (mA) displays of the control panel.
Visual alarms During the exposure (fluoroscopy or direct radiography), the yellow
radiation warning lamp on the monitor cart and the X-ray symbol on the
control panel are illuminated. (→ Ch. 6.1.1, p. 6-1).
8-12 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
8.7 Dose area product
The dose area product is saved for each patient folder and updated with
each new exposure. The total dose received by a patient so far is
displayed on the live screen. This also includes the dose area product for
images which have not been saved.
When you activate a patient folder and switch to the Fluoroscopy or Display on the
Subtraction operating mode, the total dose received by the patient so far control panel
is shown in the Dose Area Product display on the control panel. If your
system is equipped with the air kerma and air kerma rate computation
option (→ Ch. 8.8, p. 8-13), the dose area product is only displayed on
the live screen, but not on the control panel.
When you generate a new fluoroscopic image or open a saved image, Image information
the accumulated dose area product for the active patient folder is on the screen
displayed on the live screen (→ Ch. 16.2.4, p. 16-3).
8.8 Air kerma
The air kerma is saved for each patient folder and updated with each new Air kerma display
exposure. The total dose in mGy received by a patient so far is shown on on the control panel
the Air Kerma display on the control panel. This also includes the air
kerma for images which have not been saved.
During the exposure, the Air Kerma Rate display showing the current air Air kerma rate
kerma rate in µGy/s appears on the control panel. display on the
control panel
8.9 Saving
NOTE
When the hard disk is full, the oldest patient folder is
overwritten without warning.
Before saving an image, make sure that there is enough
free hard disk space, and regularly back up the patient
folders which are still needed to external storage media or
to the network.
Ziehm Vision 8-13

P_26366/CD_28189 - EN-04/2008
Image number Each saved image automatically receives an image number. These
image numbers are assigned and incremented consecutively for each
separate patient folder.
Unsaved images (those without a number) will be replaced by a new
fluoroscopic image during the next fluoroscopy.
Default foot switch On the two-pedal foot switch, the save image function is usually
assignment assigned to the right pedal. Depending on the customer-specific
configuration, the foot switch pedals may be programmed with other
functions and are labeled accordingly in this case.
To save the last image displayed on the live screen to the active
patient folder, do the following:
• Press the Save button.
or or
• If the right foot switch pedal is programmed with the save image
function:
2 Press the right pedal of the two-pedal foot switch.
or or
• Ziehm Vision Endo: Press pedal 2 of the four-pedal foot switch
(→ Ch. 6-9, p. 6-14)
2
During the save operation, the save symbol is displayed on the live
screen.
When the save operation has been completed, the image number is
displayed on the screen (→ Ch. 16.2.2, p. 16-1).
Autostore function You can configure the Ziehm Vision so that during each fluoroscopy a
new image will be saved automatically as soon as you terminate radiation
(Autostore function).
To activate the Autostore function, do the following:

• Press the Save button for approx. 2 s.
The Autostore function is activated. The Save button is highlighted
in yellow. During each subsequent fluoroscopy, a new image is
automatically saved as soon as you terminate radiation.
To deactivate the Autostore function, do the following:

• Press the Save button briefly.
The button returns to its gray color, and the Autostore function is
deactivated.
8-14 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Alternatively, you can activate and deactivate the Autostore function in

the Configuration operating mode under Operation Settings
(→ Ch. 19.2.2, p. 19-3).
When you attempt to save an image and there is not enough hard disk Auto-delete
space left, the patient folders and/or images on the hard disk will be function
overwritten automatically and without confirmation prompt in the
following order:
• First, the oldest patient folder is overwritten. If there is still not enough
disk space for the save operation, then the second oldest, third oldest,
etc., patient folder are deleted. However, the active patient folder is
never deleted.
• If a patient folder contains one or more protected images, only the

unprotected images are deleted, but not the protected images or the
folder itself.
• If it is not possible to free up enough space on the hard disk for the
save operation due to the large number of protected images, an
audible alarm sounds and the following alert message appears on the
control panel:
Not enough space on hard disk.
Required: xyz. Available: xyz.
The save operation is aborted.
When you attempt to generate a cine loop, the system will check whether Cine loop
the remaining hard disk space is sufficient for the selected number of
images (→ Ch. 12.2, p. 12-1). If disk space is insufficient, the
unprotected patient folders and/or images are deleted in the above order.
If this does not free up sufficient disk space either, no cine loop is
acquired.
8.10 Printing the live screen image
The Print Live Screen Image function is available in the following

operating modes: Fluoroscopy, Subtraction, Post Processing,
Measurement and Archive. This function is only enabled if the monitor
cart is equipped with a video printer. The function always prints out the
image which is displayed at full size on the live screen.
The text information that is displayed on the screen together with the
image (name of the patient, angle of rotation of the image, etc.) will
appear as a text block on a gray background at the left margin of the
printout.
If you have performed measurements in an image and saved them
subsequently, the measured values are printed on a second page.
Ziehm Vision 8-15

P_26366/CD_28189 - EN-04/2008
To print the live screen image on the video printer, do the following:
• Press the Print Live Screen Image button.
The image displayed on the live screen is printed.
NOTICE
8-16 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
8.11 Warning signals and malfunctions
8.11.1 Permanent warning during radiation
Active radiation (both during fluoroscopy and direct radiography) is

indicated by two different visual alarms:
− The yellow radiation warning lamp on the monitor cart is illuminated.
− The X-ray symbol on the control panel is illuminated.
8.11.2 Interval warning during radiation
In order to prevent radiation from being accidentally generated over a Warning function
long time, the system has a warning function. After each 5 minutes of
elapsed total radiation time per patient, the system issues the following
interval warning:
− After 4 min 55 s, the following message appears on the control panel:
The radiation time is 5 minutes. Switch off alarm?
− 5 seconds later, an audible alarm sounds (if preset by your in-house
service engineer).
CAUTION
If you do not switch off the alarm after 30 s max., radiation
will be terminated automatically.
You can see the total radiation time for the active patient folder on the
Radiation Time display.
To switch off the alarm, do the following:

• In the message window
The radiation time is 5 minutes. Switch off alarm?
press the Yes button.
The audible alarm is not started or stops (if it is already sounding). The
total radiation time remains displayed.
Ziehm Vision 8-17

P_26366/CD_28189 - EN-04/2008
8.11.3 Temperature monitoring
The thermal conditions in the generator are indicated by the

Temperature symbol.
Active Cooling If required, the cooling pump switches on automatically, ensuring

sufficient cooling of the generator at any moment.
8.11.4 Error and alert messages
In the event of malfunctions, the corresponding error and alert messages

are displayed as text in a message window on the control panel. Error
and alert messages always start with the letter E.
At the same time, an audible alarm sounds.
For a detailed explanation of the messages, please refer to
→ Appendix A.3.2, p. A-9.
• In case of malfunctions, please communicate the malfunction code

number and the serial number of the system to your after-sales
service center.
• To close a message window which displays an error or alert message,
press the Yes button.
8-18 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
9 Adjusting Live Images
9.1 Overview
The Ziehm Vision offers the following functions for adjusting the Individual
appearance of the live image to your individual needs: adjustment
• Contrast/Brightness:
To adjust contrast and brightness of individual images (windowing)
• Filter:
Recursive filter, LIH filter and edge filter
• Magnify:
Electronic image magnification
• Zoom:
To enlarge a selected image area
• Grayscale Inversion:
To display an image with negative grayscale
• Iris collimator
• Vertical slot collimator
• Image Swapping:
To move an image to the other screen
Ziehm Vision 9-1

P_26366/CD_28189 - EN-04/2008
• Reverse Up/Down:
“Vertical image reversal
• Reverse Left/Right:
“Horizontal image reversal
• Image Rotation
• Text:
Text functions (→ Ch. 16, p. 16-1)
Any adjustments (except texts) that are applied to a live screen image
remain valid for all subsequent live images until you choose other
settings. When you save an image, it will be saved with all rotations,
reversals, filter settings, texts and markers, etc. All these modifications
(except texts) are visible when the image is displayed as a thumbnail in
the mosaic.
9.2 Contrast and brightness adjustment of individual

images (windowing)
Function The Windowing function allows you to adjust the contrast and brightness
of the image on the live screen. These settings affect any newly-acquired
live image which is displayed on the live screen and remain in force until
you make new windowing settings. When you save the live image, the
corresponding windowing values are saved together with the image.
After activating the Windowing function, you can select a number of gray
levels, which are then stretched over the entire range of 1024 gray levels
of the original image on the live screen. To achieve this effect, you set the
width and the level of the so-called contrast window.
The number of gray levels defines the width of the contrast window. The
width of the contrast window affects the image contrast. 1024 gray levels
correspond to the value W 100 on the Ziehm Vision.
The position of the selected gray levels on the original image grayscale
(ranging from 0 to 1024 gray levels) defines the level of the contrast
window. The level of the contrast window affects the image brightness.
Example:
You select all gray levels between 325 and 875. These gray levels are
then mapped (stretched) to the range of 0 to 1024 gray levels in the
processed image. This enhances the contrast.
9-2 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Gray levels 0 to 324 of the original image are displayed as black, and
gray levels 876 to 1024 of the original image are displayed as white. This
means that the processed image is darker than the original image.
There are two different windowing modes available:
− Standard windowing:
The standard windowing mode allows you to freely choose the level
and width of the contrast window.
− Step windowing:
With step windowing, you choose between several predefined
windowing steps. These steps are preset and cannot be modified.
The chosen windowing values are shown on the screen as W X for the
width and L X for the level.
NOTE
When you change the windowing values of a single cine
loop image, the change will apply to all images of the
respective cine loop.
To set the brightness and contrast in standard windowing mode, do

the following:
• Press the Windowing button.
The windowing setting controls appear.
Fig. 9-1 Standard windowing controls
• Under Width, set the number of gray levels using the arrow buttons.
The chosen width is indicated by the length of the blue bar in the
dynamic control area. The changes become immediately visible in the
live screen image.
• Under Level, set the brightness range using the arrow buttons.
The chosen level is indicated by the position of the slider in the
live screen image.
• To restore the factory settings (level 50, width 100), press the Home
button.
Ziehm Vision 9-3

P_26366/CD_28189 - EN-04/2008
To set the brightness and contrast in step windowing mode, do the

following:
• Press the Contrast/Brightness button.
The screen setting controls appear in the dynamic control area.
Fig. 9-2 Screen setting and step windowing controls
• Select the desired windowing step using the arrow buttons.

The settings become immediately visible in the live screen image.
• To restore the factory settings for step windowing, press the Home
button.
Step windowing is reset to step 0. Simultaneously, brightness and
contrast are reset to their default values.
The screen setting controls disappear from the dynamic control area.
9-4 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
9.3 Filters
You may apply different filters to the live image. The following filters are
available:
− Recursive filter
− Edge filter
− LIH filter
Fig. 9-3 Filter settings in the live image
9.3.1 Recursive filter
The recursive filter adds the specified number of images during

fluoroscopy. Each newly-acquired image is superimposed by the result
of the previous addition with a certain weighting factor.
The higher the number of images you select, the greater the noise Noise suppression
suppression, but also the greater motion blurring.
There are three recursive filter levels, each corresponding to a preset
number of images between 1 and 16.
The Automatic Noise Filter Adjustment function in the Bones and Automatic Noise
Abdomen anatomical programs (not implemented in the Abdomen Filter Adjustment
program on 31 cm i.i. systems) constantly and automatically readjusts (n/a for Ziehm
the recursive and LIH filter levels during fluoroscopy, depending on Vision FD)
whether the screened object is moving or not. When the object moves,
the filter levels are decreased; when the object is immobile, the filter
Ziehm Vision 9-5

P_26366/CD_28189 - EN-04/2008
levels are increased. This means that you need not select a recursive
filter level manually.
To set the recursive filter for the live image, do the following:
• Press the Filter button.
The filter controls appear in the dynamic control area.
Fig. 9-4 Filter settings for recursive, edge and LIH filter
• Under Recursive, select the desired recursive filter level by pressing

the corresponding button.
The filter setting becomes immediately visible in the live screen
image. The chosen recursive filter level is shown on the screen as NR
X.
The filter controls disappear from the dynamic control area.
Configuration The individual presettings for the recursive filter levels are made in the
Configuration operating mode under Service Settings. You cannot
make these presettings yourself.

modify the individual recursive filter levels.
9-6 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
9.3.2 Edge filter
The edge filter allows you to select a greater or lesser degree of edge Edge enhancement
enhancement within the image. There are 4 levels available:
Level Meaning
Off No edge enhancement (original fluoroscopic image)
1 Slight edge enhancement
2 Medium edge enhancement
3 Strong edge enhancement
-1 Unsharp mask to reduce noise
Table 9-1 Edge filter levels
To set the edge filter for the live image, do the following:
Fig. 9-5 Filter settings
• Under Edge, select the desired edge filter level by pressing the
corresponding button.
image. The chosen edge filter level is shown on the screen as RTE Y.
Ziehm Vision 9-7

P_26366/CD_28189 - EN-04/2008
9.3.3 LIH filter
The LIH filter generates and adds a specified number of images after
radiation has been terminated.
Noise suppression The higher the number of images you select, the greater the noise
suppression, but also the greater motion blurring if the patient moves
during image generation. You can choose between the following number
of images: 1 image (Off), 2, 4, 8, 16 images.
Automatic Noise The Automatic Noise Filter Adjustment function in the Bones and
Filter Adjustment Abdomen anatomical programs (not implemented in the Abdomen
(n/a for Ziehm program on 31 cm i.i. systems) constantly and automatically readjusts
Vision FD) the recursive and LIH filter levels during fluoroscopy, depending on
whether the screened object is moving or not. When the object moves,
the filter levels are decreased; when the object is immobile, the filter
levels are increased. This means that you need not select an LIH filter
level manually.
To set the LIH filter for the live image, do the following:
Fig. 9-6 Filter settings
• Under LIH, select the desired LIH filter level by pressing the
corresponding button.
image. The chosen LIH filter level is shown on the screen as LIH Z.
9-8 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
9.4 Electronic image magnification (n/a for Ziehm Vision FD)
The image intensifier’s format selection function (‘magnification’) Function

magnifies the fluoroscopic image electronically, whereby the image
resolution increases proportionally to the magnification factor.
For 23 cm i.i. systems, the following magnification levels are available: 23
cm, 15 cm and 10 cm. For 31 cm i.i. systems, the magnification levels 31
cm, 23 cm and 15 cm are available.
The current image magnification level is automatically indicated on the
Magnify button.
To select the image magnification level, do the following:

• Press the Magnify button.
The current level is indicated on the button.
The magnification level controls appear in the dynamic control area.
Fig. 9-7 Image magnification levels of C-arm

on systems with 23 cm i.i.
Fig. 9-8 Image magnification levels of C-arm

on systems with 31 cm i.i.
• Select the desired image magnification level.

The settings become immediately visible in the live screen image. The
chosen image magnification level is shown on the screen as MAG X.
• Press the Magnify button.
The magnification level controls disappear from the dynamic control
area.
Ziehm Vision 9-9

P_26366/CD_28189 - EN-04/2008
9.5 Digital zoom
Function The Zoom function allows you to enlarge a certain image area. There are
three zoom levels available. You can select the desired image area either
with the arrow buttons or with the integrated touchpad.
Touchpad
Fig. 9-9 Zoom function for the live image
To enlarge an image area, do the following:

• Press the Zoom button.
The active image also appears on the reference screen.
The zoom controls appear in the dynamic control area.
Fig. 9-10 Zoom controls
• Select the desired zoom factor by pressing the corresponding button,

e.g. 4 X.
A marking circle appears in the center of the image on the reference
screen. The image area which is enclosed by the marking circle is
displayed on the live screen with the chosen zoom level.
• Move the marking circle to the desired image area using the arrow
buttons.
The chosen image area is displayed on the reference screen with the
chosen zoom level.
9-10 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
• To move the marking circle back to the center of the live image, press
the Home button.

The zoom controls disappear from the dynamic control area.
To enlarge an image area with the help of the touchpad, do the

following:

e.g. 4 X.
• Move the marking circle to the desired position by gliding your finger
slightly across the touchpad.
chosen zoom level.
the Home button.

Ziehm Vision 9-11

P_26366/CD_28189 - EN-04/2008
9.6 Grayscale inversion
Function The Grayscale Inversion function allows you to view the live image with
a negative grayscale.
To display an image with a negative (or positive) grayscale, do the

following:
• Press the Grayscale Inversion button.
The live image is displayed with a negative grayscale on the live
screen, and the button is highlighted in yellow.
• Press the Grayscale Inversion button again.

The live image is displayed with a positive grayscale again, and the
button returns to its gray color.
9.7 Collimation
Function The system is equipped with an iris and a slot collimator. These
collimators allow you to limit the area of exposure of the patient just to the
region of interest.
This offers the following advantages:
− Reduction of the radiation burden
− Less chance of flaring
− Better detail rendition and higher contrast
9.7.1 Iris collimator
The iris collimator can be adjusted steplessly. Normally, the iris collimator
is completely open, and only the Close Iris Collimator button is visible
on the control panel. As soon as you start closing the iris collimator, the
Open Iris Collimator button appears on the control panel.
To adjust the iris collimator, do the following:

• Press the Close Iris Collimator button until the collimator aperture on
the live screen is as desired.
The Open Iris Collimator button appears on the control panel.
• Press the Close Iris Collimator button until the collimator aperture on
In addition, you can fully open the iris collimator in one step:
9-12 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
• Press the Open Iris Collimator Fully button.
9.7.2 Slot collimator
The slot collimator can be adjusted steplessly. Normally, the slot

collimator is completely open, and only the Close Vertical Slot
Collimator button is visible on the control panel. As soon as you start
closing the slot collimator, the Open Vertical Slot Collimator, Rotate
Vertical Slot Collimator CW and Rotate Vertical Slot Collimator CCW
buttons appear on the control panel.
To adjust the slot collimator, do the following:

• Press the Close Vertical Slot Collimator button until the collimator
aperture on the live screen is as desired.
The Open Vertical Slot Collimator, Rotate Vertical Slot Collimator
CW and Rotate Vertical Slot Collimator CCW buttons appear on the
control panel.
• Press the Open Vertical Slot Collimator button until the collimator
• Press the Rotate Vertical Slot Collimator CW button until the

collimator orientation on the live screen is as desired.
• Press the Rotate Vertical Slot Collimator CCW button until the
collimator orientation on the live screen is as desired.
In addition, you can fully open the slot collimator or reset it to the 0°
position, each in one step:
• Press the Open Vertical Slot Collimator Fully button.
The slot collimator opens completely.
• Press the Rotate Vertical Slot Collimator to 0° button.

The slot collimator is reset to the 0° position.
Ziehm Vision 9-13

P_26366/CD_28189 - EN-04/2008
9.7.3 Virtual collimator
Function The Ziehm Vision is equipped with a virtual collimator, allowing you to
adjust the collimators without radiation. Using this feature, you can
significantly reduce patient exposure.
To perform a virtual collimation, do the following:

• Press the Open Iris Collimator Fully button.
The iris collimator opens completely.
• Press the Open Vertical Slot Collimator Fully button.

The vertical slot collimator opens completely.
• Select the desired anatomical program (→ Ch. 8.5.1, p. 8-8).

• Initiate radiation for a brief moment.
The generated image is displayed on the live screen.
• Adjust the iris and the slot collimator as desired without radiation.
The areas of the image that will not be visible later are shown beneath
a gray overlay. The collimator boundaries are represented by white
edges.
9.8 Image swapping
9.8.1 Ziehm Vision, Ziehm Vision FD and Ziehm Vision R
Function With the Image Swapping function, you can move an image from one
screen to the other. This allows you to generate two images and to
compare them directly to one another.
To compare an image with a live image, do the following:

• Generate a live image.
The image is displayed on the live screen.
9-14 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
• Press the Image Swapping button.

The first image is moved to the reference screen. If the Image Swap
With Save option has been activated in the Configuration operating
mode under Operation Settings (→ Ch. 19.2.3, p. 19-4), the image
will be saved automatically before being moved to the reference
screen.
• Generate a second live image.
The image is displayed on the live screen. Now you can compare the
images on the two screens to one another.
9.8.2 Ziehm Vision Endo
On a Ziehm Vision Endo, the image swapping function is used for moving Function
the fluoroscopic image from the monochrome screen to the color screen.
To represent a fluoroscopic image on the color screen, do the

following
• If you press pedal 4 of the four-pedal foot switch (→ Ch. 6-9, p. 6-14)
long, the endoscopic image on the color screen is replaced with the
fluoroscopic image of the monochrome screen. 4
To redisplay the endoscopic image on the color screen, do the

following
• If you press pedal 4 of the four-pedal foot switch (→ Ch. 6-9, p. 6-14)
long, the endoscopic image is redisplayed on the color screen.
4
9.9 Image reversal and image rotation
The Image Reversal and Image Rotation functions are used for Function
individual adjustment of the image orientation on the live screen.
You can use these functions to align the image orientation with the
patient’s orientation. To make orientation easier for the operator, a label
is attached to both the image intensifier and the generator housing,
showing a patient in supine position. If the patient is positioned as
illustrated by the label, then the image orientation on the live screen
corresponds to the patient’s orientation.
Both image reversal and image rotation are produced digitally and
without the need to initiate any further radiation.
Ziehm Vision 9-15

P_26366/CD_28189 - EN-04/2008
9.9.1 Horizontal and vertical image reversal
• Press the Reverse Up/Down button.

The button is highlighted in yellow. On the live screen, the image
appears with top and bottom reversed, and a symbol for up/down
reversal is displayed.
• Press the Reverse Left/Right button.
The button is highlighted in yellow. On the live screen, the image
appears with left and right side reversed, and a symbol for left/right
reversal is displayed.
Image reversal is symbolized on the screen by an R which is either
mirrored left-right or upside-down.
9.9.2 Image rotation
• Press the Rotate Image CW button until the image orientation on the
live screen is as desired.
The image is rotated steplessly in clockwise direction.
• Press the Rotate Image CCW button until the image orientation on
The image is rotated steplessly in counter-clockwise direction.
The chosen angle of rotation is shown on the screen as R X.
Ziehm Vision FD As soon as an image is rotated, it assumes a circular shape. The image
has a square shape only when in the following angle positions: 0°/360°,
90°, 180°, 270°.
To reset the angle of rotation to 0°, do the following:

• Press the Rotate Image to 0° button.
The image is reset to the 0° position.
9-16 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
10 Data Management
10.1 Organization of patient, image and ESWL data
Patient and image data is managed in the Patient (→ Ch. 10.2, p. 10-2)
and Archive operating modes (→ Ch. 10.3, p. 10-7). All data of a patient
is stored in a patient folder on the hard disk. All image data is assigned
to the corresponding patient folder.
When you switch to the Fluoroscopy or Subtraction operating mode
and no patient folder is active, the system will automatically create a new
patient folder (→ Ch. 10.1.2, p. 10-1).
For systems that are equipped with the ESWL (Extracorporeal Shock
Wave Lithotripsy) option you can activate the ESWL Data operating
mode (→ p. 6-11). An additional ESWL Data screen is available allowing
you to enter ESWL related data (→ Fig. 10-22, p. 10-36).
10.1.1 Patient folders
In order to be able to relate the fluoroscopic images to a certain patient, Function

you must always create or activate a patient folder before acquiring an
image or a cine loop.
You can create as many patient folders as desired on the hard disk. In Storage capacity
each patient folder, you can store as many images as you wish. The total
number of images is limited only by the hard disk size (‘image memory’).
The size of the image memory depends on the chosen system
configuration.
When you save an image for which there would be no more space on the Auto-delete
hard disk otherwise, the oldest patient folder on the hard disk is function
automatically overwritten (→ Ch. 8.9, p. 8-13). If the oldest patient folder
contains one or more protected images (→ p. 10-23), only the
unprotected images are deleted, though. The folder itself as well as the
protected images are preserved.
10.1.2 System-generated patient folders
When you switch on the system, a new patient folder is automatically

generated and activated. If you do not activate another patient folder
before switching to the Fluoroscopy or Subtraction operating mode, all
images are saved to this automatically generated patient folder.
Ziehm Vision 10-1

P_26366/CD_28189 - EN-04/2008
10 Data Management
Generated data The patient name which is generated is composed of the time of day and
date, e.g. P_12_34_01_04_03 for a patient folder which was created on
April 1, 2003 at 12:34 o’clock. In addition, a patient ID called PAT xyz is
created. If you have predefined default data for the Hospital, Department
and Doctor input boxes, this data is also written to the generated patient
folder.
All new images and/or cine loops will be saved to the generated patient
folder until you activate another patient folder. You may edit or complete
all patient data later (→ Ch. 10.2.2, p. 10-4).
If the system has generated such a patient folder, but no images or cine
loops have been saved to it, the generated patient folder will be deleted
during the next power-up of the Ziehm Vision.
10.2 Managing patient data
Patient data is managed in the Patient operating mode. When you create
a new patient folder, you may retrieve the patient’s data from a DICOM
server under certain conditions (→ Ch. 11.2, p. 11-1).
Length of the The length of the patient ID is limited by the system to 64 digits.
patient ID
Display of the If the patient number cannot be displayed completely in the fluoroscopic
patient ID image, it is represented in the form 1234567....
In the read-only boxes in the Archive operating mode, only the first 18 or
24 digits of the patient ID are displayed. In the Patient ID input box in the
Patient operating mode, you can scroll through the whole patient ID
using the arrow keys of the keypad.
Access. No You can manually enter a hospital-specific internal administrative

number (Access. No), or import it with the patient data.
Subject You can enter a subject for each patient folder, which is saved together
with the patient data.
Editing data You can edit all data in an existing patient folder or add new data at any
time.
Importing images When you have created a new patient folder or activated an existing
from a DICOM patient folder, you can import one or more images or a series of images
server from a DICOM server into this patient folder (→ Ch. 11.7, p. 11-20).
10-2 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
10 Data Management
NOTE
The date formats may vary, depending on the customer-
specific settings. In the present document, all date
formats appear in the format DD.MM.YYYY.
To activate the Patient operating mode, do the following:

• Press the Patient tab.
The input boxes of the Patient operating mode as well as the
alphanumeric keypad are now available on the control panel.
Buttons for Input

the input boxes
boxes
Alpha-
numeric
keypad
Fig. 10-1 Patient operating mode
When you have activated a patient folder, the corresponding data is

displayed in the input boxes. The title bar shows you – in addition to the
selected operating mode – the number of images that you can still save
to the hard disk.
10.2.1 Creating a new patient folder on the Ziehm Vision
When creating a new patient folder, you may choose between the
following ways of entering the patient data:
− Entering the patient data manually using the alphanumeric keypad.
− You retrieve the patient data from the DICOM server (Query or
Worklist, → Ch. 11.2, p. 11-1).
10.2.1.1 Entering patient data manually

The Patient operating mode is activated.
Ziehm Vision 10-3

P_26366/CD_28189 - EN-04/2008
10 Data Management
NOTE
You may predefine default data for the Hospital,
Department and Doctor input boxes. The respective
data is entered in the Configuration operating mode
under Basic Settings.
• Press the New button.

The input boxes are cleared (if any data has been displayed before in
them), with the exception of those with default data (→ Ch. 19.3.3,
p. 19-9).
You may now enter the patient data.
• Press the button of the desired input box, e.g. the Last Name button.
The button is highlighted in yellow. The cursor jumps to the
corresponding input box.
NOTE
To type an uppercase letter, press and release the Shift
key before entering the respective letter. The Shift key
acts on one subsequent letter. To type several
consecutive uppercase letters, press the Caps Lock key
before entering the letters.
• Enter the patient data using the alphanumeric keypad. To move to the
next input box, always press the Enter key.
You must fill in at least the Last Name input box. The length of the
patient ID must not exceed 64 digits. If you do not enter any patient
ID, the system automatically assigns a number (e.g. PAT123) in the
Patient ID box.
• Save the new patient folder and the data entered by pressing the
Save button.
The new patient folder is automatically activated. A blank fluoroscopy
mask with the newly-entered patient data appears on the live screen. You
may now proceed to generating fluoroscopic images, which will be
automatically assigned to the newly-created patient folder:
• Switch to the Fluoroscopy or Subtraction operating mode and
generate the desired fluoroscopic images (→ Ch. 8, p. 8-1).
or
10.2.2 Editing patient data
You may edit the patient data in any existing patient folder at any time.
You can use the name of the patient, the patient ID or a subject to search
for the patient folder whose data you want to edit.
10-4 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
10 Data Management
Any patient data changes affect all existing and future images as well as Effects
the active image.
NOTE
If you use the patient ID to search for a patient folder,
please verify the search result by checking the patient
name. It may happen occasionally that a patient ID is
assigned more than once on a DICOM network.
To modify the data in an existing patient folder, do the following:

The input boxes may contain data you want to delete.

All input boxes are cleared.
• Press the Search button.
A thumbnail mosaic with all patient folders is displayed on the
reference screen. Each patient folder is symbolized by the most
recent image contained in it.
In the dynamic control area, the input boxes for searching as well as
an alphabetically sorted list of all patient folders are displayed.
Ziehm Vision 10-5

P_26366/CD_28189 - EN-04/2008
10 Data Management
Fig. 10-3 Input boxes for searching and hit list
Now you can browse through the patient folder mosaic with the help of
the arrow buttons or enter the desired search string:
• Enter the search string using the alphanumeric keypad.
NOTE
The search function is not case-sensitive.
With each letter you enter, the alphabetical hit list is more and more
confined to match the search string.
The All button appears, allowing you to redisplay the entire list.
• Select the desired item on the list using the arrow buttons and press
the OK button.
The data of the selected patient appears in the input boxes. You may
overwrite this data now.
• Press the button of the input box whose data you want to edit.
• Overwrite the data you want to edit.

A message window with a confirmation prompt is displayed:
• Press the Overwrite button.
The existing data in the patient folder is overwritten by the newly-
entered ones.
or or

A new patient folder with the modified data is created.
10-6 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
10 Data Management
10.3 Managing image data
Image data is managed in the Archive operating mode.
To activate the Archive operating mode, do the following:

• Press the Archive tab.
The read-only boxes and controls for managing the patient folders
appear on the control panel.
Hard Disk
display
List
Read-
only Arrow
boxes buttons
Fig. 10-4 Archive operating mode
All patient folders on the hard disk are displayed as a thumbnail mosaic Mosaic
(up to 16 images at a time) on the reference screen, each folder being
symbolized by its most recent image. In addition, the following
information appears for each patient folder of the mosaic: name of the
patient and number of images contained in the folder. You can browse
through the thumbnail mosaic using the arrow buttons.
The list shows the names of all patient folders in the order in which they List of patient
were created. The most recent folder appears at the bottom of the list, the folders
oldest one at the top.
The name of the folder which is marked by the cursor on the reference
screen is highlighted by a yellow bar in the list, and the related data is
displayed in the read-only boxes. You cannot enter or edit any data in
these read-only boxes.
Using the arrow buttons you can move the cursor around the list and Arrow buttons
simultaneously from one patient folder or image to another on the
reference screen.
The Hard Disk display indicates the percentage of used hard disk space. Hard Disk display
Ziehm Vision 10-7

P_26366/CD_28189 - EN-04/2008
10 Data Management
10.3.1 Managing patient folders
The following functions for navigating and managing patient folders are
available in the Archive operating mode:
− Search:
To search for a patient folder (→ Ch. 10.3.2, p. 10-14)
− Pos 1:
To place the cursor on the first patient folder in the mosaic
− End:
To place the cursor on the last patient folder in the mosaic
− Mark:
To mark one or more patient folders
− Delete:
To delete patient folders
− Invert entire archive:

To invert the grayscale of all images on the hard disk
− CD/DVD:
To write marked patient folders to CD or DVD.
The title bar shows you – in addition to the selected operating mode
– the remaining storage capacity of the CD or DVD to which you want
to write the marked patient folders.
− USB:
To save marked patient folders to a USB stick.
– the remaining storage capacity of the USB stick to which you want
to save the marked patient folders.
− DICOM Store:
To save marked patient folders to a DICOM server (→ Ch. 11.4,
p. 11-16)
10-8 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
10 Data Management
− DICOM Storage Commitment:

To search for previously stored images on a DICOM server
− Backup:
To select patient folders and back them up to a USB stick or a CD/
DVD (→ Ch. 10.3.7, p. 10-29)
− Restore from CD/DVD:

To retrieve backed-up patient folders from a CD or DVD (→ p. 10-35)
− Restore from USB Stick:

To retrieve backed-up patient folders from a USB stick (→ p. 10-32)
10.3.1.1 Marking patient folders
To mark one or more patient folders, do the following:
• Select the desired patient folder in the thumbnail mosaic on the

reference screen using the arrow buttons.
• Press the Mark button.
The patient folder is now marked and flagged with an M.
• To mark additional patient folders, repeat the procedure.
To unmark a patient folder, do the following:
• Select the desired marked patient folder on the reference screen

using the arrow buttons.
The patient folder becomes unmarked.
10.3.1.2 Deleting patient folders
You can delete either all marked patient folders, or all unmarked patient
folders, or only the patient folder where the cursor is.
You can delete a patient folder only if does not contain any protected
images (→ Ch. 10.3.5.3, p. 10-22). When you try to delete a folder which
contains protected images, the folder itself as well as the protected
images remain on the hard disk. Only the unprotected images are
deleted. To delete protected images, you must unprotect them first
(→ p. 10-23).
Ziehm Vision 10-9

P_26366/CD_28189 - EN-04/2008
10 Data Management
To delete one or more patient folders, do the following:
NOTE
Deleted patient folders are irretrievably lost.
Back up the patient folders you want to keep before
deleting them, or make sure that they are really no longer
needed.
• Mark the patient folders you want to delete and press the Delete
Marked Items button.
The following confirmation prompt is displayed:
Fig. 10-5 Delete patient folder confirmation prompt
or or
• Mark the patient folders you want to keep and press the Delete
Unmarked Items button.
or or
• Use the arrow buttons to select an individual patient folder you want
to delete and press the Delete button.
10-10 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
10 Data Management
• Confirm by pressing the Yes button.

The patient folders are deleted from the hard disk. If one of the
selected patient folders contains any protected images, only the
unprotected images will be deleted, and the following message
appears on the control panel:
Patient folder with protected images cannot be deleted!
10.3.1.3 Inverting the entire archive
If you are used to viewing negative images (e.g. because you are a
radiologist), you can invert the grayscale of all images on the hard disk in
one step. This function is not available for cine loops, DSA cine loops,
MSA and RSA images. Images that have already been saved with a
negative grayscale remain the way they are.
To invert the grayscale of all images or to undo the grayscale

inversion, do the following:
• Press the Invert All button.
The grayscale of all images on the hard disk is inverted. In the mosaic
view, the images are always displayed with a positive grayscale. The
negative grayscale will not become visible until you display an image
at full size.
• Terminate the Archive operating mode, or press the Invert All button
again.
The grayscale inversion of all images is undone.
10.3.1.4 Saving patient folders
Depending on your chosen system configuration, you can save images Graphics formats
from one or more patient folders in various graphics formats to different
storage media. Some formats with reduced resolution and color depth
are also available.
Ziehm Vision 10-11

P_26366/CD_28189 - EN-04/2008
10 Data Management
Storage File Resolution Color File size Storage medium

format extensi depth
CD/DVD USB stick
on
16 bit TIF *.tif 1024 × 1024 16 bit 2 MB • •
DICOM — 1024 × 1024 16 bit 2 MB • •
Cine loop *.avi 512 × 512 8 bit depends on • —
cine loop
Single *.jpg 512 × 512 8 bit 256 KB • •
images
DICOM — 512 × 512 8 bit 256 KB • •
512 × 512
JPEG *.jpg 512 × 512 8 bit 256 KB • •
512 × 512
Table 10-1 Available graphics formats
NOTE
Saving image data with a resolution of 512 × 512 pixels
may lead to information loss.
The desired storage format is defined in the Configuration operating

mode under Storage Media (→ Ch. 19.5, p. 19-15).
Ziehm DICOM Whenever you save images in standard DICOM format or ‘reduced’
Viewer DICOM format (with a resolution of 512×512 pixels and 8 bit color depth)
to an external storage medium, the Ziehm DICOM Viewer program is
automatically saved to the storage medium as well. This program
enables you to view the DICOM images on any PC with Microsoft®
Windows® operating system (version Microsoft® Windows® 98 or
higher). When residing on a CD or DVD, the Ziehm DICOM Viewer starts
automatically. When residing on a USB stick, the program must be
launched manually.
Saving to USB stick To save one or more patient folders to a USB stick, do the following:
• Mark the desired patient folder(s).
• Plug the USB stick into the USB port on the monitor cart.
• Press the USB button.

The marked patient folders are saved to the USB stick. A progress
indicator in a message window on the control panel informs you about
the status of the save operation. The Cancel button appears,
enabling you to interrupt the save operation.
Once they have been saved, the patient folders become unmarked.
10-12 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
10 Data Management
With the DVD writer, data can be written to both CDs and DVDs. The Writing to CD or
selected patient folders are copied to a compilation file on the hard disk DVD
first. You can decide whether you want to write the patient folders from
the compilation file to CD or DVD immediately or later. This enables you
to gather entire patient folders and single images from different patient
folders in the compilation file and to write them to CD or DVD later in one
go.
If you switch off the Ziehm Vision before having actually written the
patient folders and images from the compilation file to CD or DVD, the
system will preserve the compilation file information.
To write one or more patient folders to CD or DVD, do the following:

• Mark the desired patient folder(s).
• Insert an empty CD or DVD into the DVD writer mounted in the

monitor cart.
• Press the CD/DVD button.
The following messages appear one after the other:
Checking CD/DVD ...
Copying image xyz to CD/DVD mirror ...
Once they have been included in the compilation file, the patient folders
become unmarked.
The following message appears:
Write images to CD/DVD?
• To leave the marked patient folders in the compilation file on the hard
disk for the time being, press the No button in the message window.
or or
To write the marked patient folders to CD or DVD right away, confirm
by pressing the Yes button. The write process is started, and the
following message appears:
Writing CD/DVD. Estimated time x minutes.
A progress indicator informs you about the status of the write
operation.
Once the write operation has been completed successfully, the
following message is displayed:
Writing of CD/DVD completed successfully
• Press the OK button.
Ziehm Vision 10-13

P_26366/CD_28189 - EN-04/2008
10 Data Management
10.3.2 Finding and displaying a patient folder
Search criteria The following criteria can be used to search for a patient folder:
− Name of the patient (Last Name box)
− Patient number (Patient ID box)
− Keyword (Subject box)
You can combine these search criteria using an AND operation. Thus,
you could look e.g. for all patients called Miller with the subject Knee.
NOTE
To find a patient folder, do the following:

The Archive operating mode is activated.
The input boxes for searching appear in the dynamic control area. A
list of all patient names is displayed.
Now you can enter the desired search string(s).

NOTE
10-14 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
10 Data Management
• Press the Back button.
You are returned to the Archive screen. The data of all patients who
match the search string(s) is displayed in the list.
• Select the desired patient folder using the arrow buttons.

All images contained in this patient folder are displayed as thumbnails
on the reference screen. The most recent image is highlighted by a
white frame. Cine loop sequences are symbolized by their last image
and flagged with C.
Other buttons and read-only boxes for processing individual images
(→ Ch. 10.3.5, p. 10-19) or cine loops (→ Ch. 12.5, p. 12-9) appear
The thumbnails in the mosaic reflect all the modifications applied to them Thumbnail display
after fluoroscopy (e.g. contrast adjustment, rotation, zoom).
The information pertaining to the image which is marked by the cursor on Image information
the reference screen is displayed on the control panel:
Fig. 10-9 Archive operating mode: Read-only boxes displaying

image information
Ziehm Vision 10-15

P_26366/CD_28189 - EN-04/2008
10 Data Management
10.3.3 Activating a patient folder
To be able to save new images to an existing patient folder, you must

activate this patient folder before switching to the Fluoroscopy or
Subtraction operating mode. You can activate an existing patient folder
either in the Patient or Archive operating mode.
To activate a patient folder in the Patient operating mode, do the

following:
The input boxes may contain data you want to delete.

All input boxes are cleared.
A thumbnail mosaic with all patient folders is displayed on the
reference screen. Each patient folder is symbolized by the most
recent image contained in it.
In the dynamic control area, the input boxes for searching as well as
an alphabetically sorted list of all patient folders are displayed.
10-16 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
10 Data Management
Now you can browse through the patient folder mosaic with the help of
the arrow buttons or enter the desired search string:
NOTE
• Select the desired item on the list using the arrow buttons.

The data of the selected patient appears in the input boxes, and the
patient folder is activated. Now you can switch to the Fluoroscopy or
Subtraction operating mode.
To activate a patient folder in the Archive operating mode, do the

following:
Ziehm Vision 10-17

P_26366/CD_28189 - EN-04/2008
10 Data Management

NOTE

The patient data as well as the image and cine loop processing
controls appear in the dynamic control area.

The patient folder is now active. Now you can switch to the
Fluoroscopy or Subtraction operating mode.
10-18 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
10 Data Management
10.3.4 Browsing through the active patient folder
In the Fluoroscopy, Subtraction and Post Processing operating

modes, you can display all images of the active patient folder at full size
without having to switch to the Archive operating mode.
• Activate the desired patient folder (→ Ch. 10.3.3, p. 10-16).
• Switch to the desired operating mode (Fluoroscopy, Subtraction or

Post Processing).
• Use the arrow buttons to browse through the active patient folder.
The Down Arrow button moves you to the image with the next lower
image number.
The Up Arrow button moves you to the image with the next higher
image number.
10.3.5 Processing and outputting images in a patient folder
Once you have displayed (→ Ch. 10.3.2, p. 10-14) or activated

(→ Ch. 10.3.3, p. 10-16) a patient folder, you can process and output the
images and the cine loops that are stored there. Different read-only
boxes and controls are displayed on the control panel for that purpose.
Read-
only
boxes
Buttons for Arrow

marking buttons
and for screen
deleting navigation
Buttons
for
printing
Buttons
for saving
Fig. 10-13 Archive operating mode with displayed patient folder
The read-only boxes show patient data and image information. The Read-only boxes
Images (Total) box shows how many images or cine loops are stored in
the patient folder. If the cursor is on a cine loop within the patient folder,
Ziehm Vision 10-19

P_26366/CD_28189 - EN-04/2008
10 Data Management
the Images box shows the number of images that make up the cine loop.
If the cursor is on an individual image, the number 1 appears there.
Image processing In the following sections, we will describe how to process and output
and output individual images. For information on how to process and output cine
loops in a patient folder, please refer to → Ch. 12.5, p. 12-9.
The following functions are available in a displayed or active patient
folder for navigating within the folder and for displaying and processing
individual images:
− OK (with displayed patient folder only):
To display an image at full size on the live screen and to activate the
displayed patient folder
− Full-Screen Image:
To display an image at full size on the reference screen
Mosaic:
To restore the mosaic view on the live screen
The Mosaic button appears as soon as you have chosen the full-size
image view on the live screen.
− Pos 1:
To place the cursor on the first image of the patient folder
− End:
To place the cursor on the last image of the patient folder
− Mark:
To mark one or more images
− Protect:
To protect the image marked by the cursor against being deleted
− Delete:
To delete images
− DICOM Retrieve:
To import images from a DICOM server into the displayed or active
patient folder (→ Ch. 11.7, p. 11-20)
10-20 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
10 Data Management
− Print:
To print marked images on the video printer
− DICOM Print:
To print marked images on a DICOM network printer (→ Ch. 10.3.5,
p. 10-19)
− CD/DVD:
To write marked images to CD or DVD
− USB:
To save marked images to a USB stick
− DICOM Store:
To save marked images to a DICOM server (→ Ch. 10.3.5, p. 10-19)
− DICOM Storage Commitment:

To search for previously stored images on a DICOM server.
10.3.5.1 Displaying an image at full size
To display an image at full size on the live screen, do the following:

• Select the desired image in the thumbnail mosaic on the reference
screen using the arrow buttons.

The selected image is displayed at full size on the live screen.
Simultaneously, the displayed patient folder is activated.
Ziehm Vision 10-21

P_26366/CD_28189 - EN-04/2008
10 Data Management
To display an image at full size on the reference screen, do the

following:
• Press the Full-Screen Image button.

The selected image is displayed at full size on the reference screen.
The Mosaic button appears, enabling you to restore the mosaic view
on the reference screen.
10.3.5.2 Marking images
Before being able to print images or to save them to an external storage

medium, you must mark the desired image(s).
Once you have printed the marked images or saved them to an external
storage medium, they will automatically become unmarked.
To mark one or more images, do the following:

• Select the desired image on the reference screen using the arrow
buttons.

The image is now marked and flagged with an M.
• To mark additional images, repeat the procedure.
To unmark an image, do the following:

• Select the desired marked image on the reference screen using the
arrow buttons.

The image becomes unmarked.
10.3.5.3 Protecting images
You can protect images against being deleted. When you try to delete a
folder which contains protected images, the folder itself as well as the
protected images remain on the hard disk.
10-22 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
10 Data Management
To protect one or more images, do the following:

buttons.
• Press the Protect button.

The image is now delete-protected and flagged with a P.
• To protect additional images, repeat the procedure.
To unprotect an image, do the following:

• Select the desired protected image using the arrow buttons.

The image becomes unprotected.
NOTE
Patient folders containing protected images cannot be
deleted automatically. If many folders on the hard disk
contain protected images, the Auto-Delete function will
not delete them, and you will be unable to save new
images.
To avoid this situation, regularly back up the patient
to a DICOM server. You can then manually delete those
patient folders or unprotect them and allow the Auto-
Delete function to free up space on your hard disk.
10.3.5.4 Deleting images
You can delete either all marked images, or all unmarked images, or only
the image where the cursor is.
To delete one or more images from a patient folder, do the

following:
NOTE
Deleted images are irretrievably lost.
Back up the images you want to keep before deleting
them, or make sure that they are really no longer needed.
Ziehm Vision 10-23

P_26366/CD_28189 - EN-04/2008
10 Data Management
• Mark the images you want to delete and press the Delete Marked
Items button.
Fig. 10-14 Delete images confirmation prompt
or or
• Mark the images you want to keep and press the Delete Unmarked
Items button.
or or
• Use the arrow buttons to select an individual image you want to delete
and press the Delete button.
Fig. 10-16 Delete image confirmation prompt

The images are deleted from the patient folder.
10-24 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
10 Data Management
If you happen to select protected images, only the unprotected ones

will be deleted, and the following message appears on the control
panel:
Protected images were not deleted!
10.3.5.5 Printing on video printer
You can mark one or more images in a patient folder and print them all in
one go. Besides, you can print the image displayed on the live screen.
NOTICE
To print images on the video printer, do the following:

• Position the cursor on the desired image, or mark the images you
want to print.
• Press the Print button.

The marked images are printed on the video printer mounted in the
monitor cart. A progress indicator in a message window on the control
panel informs you about the status of the print operation. The Cancel
button appears, enabling you to interrupt the print operation.
Once they have been printed, the images become unmarked.
The text information that is displayed on the live screen together with the
printout.
NOTE
When you launch the print job directly from the video
printer, the resulting hard copy will be an exact
reproduction of the live screen.
Ziehm Vision 10-25

P_26366/CD_28189 - EN-04/2008
10 Data Management
Further information For further information, please refer to the video printer’s separate
operating instructions provided with this system.
10.3.5.6 Saving images
Graphics formats Depending on your chosen system configuration, you can save one or
more images in various graphics formats to different storage media.
Some formats with reduced resolution and color depth are also available.

CD/DVD USB stick
on
16 bit TIF *.tif 1024 × 1024 16 bit 2 MB • •
DICOM — 1024 × 1024 16 bit 2 MB • •
Multimedia:
Cine loop *.avi 512 × 512 8 bit depending on • —
cine loop
Single *.jpg 512 × 512 8 bit 256 KB • •
images
DICOM — 512 × 512 8 bit 256 KB • •
JPEG *.jpg 512 × 512 8 bit 256 KB • •
NOTE
launched manually.
Saving to USB stick To save images to a USB stick, do the following:

want to save.
10-26 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
10 Data Management

The marked images are saved to the USB stick. A progress indicator
in a message window on the control panel informs you about the
status of the save operation. The Cancel button appears, enabling
you to interrupt the save operation.
Once they have been saved, the images become unmarked.
selected images are copied to a compilation file on the hard disk first. You DVD
can decide whether you want to write the images from the compilation file
to CD or DVD immediately or later. This enables you to gather images
from different patient folders as well as entire patient folders in the
compilation file and to write them to CD or DVD later in one go.
images and patient folders from the compilation file to CD or DVD, the
system will preserve the compilation file information.
To write one or more images to CD or DVD, do the following:

• Mark the desired image(s).

monitor cart.
Checking CD/DVD ...
Once they have been included in the compilation file, the images become
unmarked.
• To leave the marked images in the compilation file on the hard disk for
the time being, press the No button in the message window.
or or
To write the marked images to CD or DVD right away, confirm by
pressing the Yes button. The write process is started, and the
operation.
Ziehm Vision 10-27

P_26366/CD_28189 - EN-04/2008
10 Data Management
10.3.6 Comparing saved images
You may display saved images either from one patient folder or from
several different patient folders at full size on the live and reference
screen and compare them to each other.
To compare two images from the same patient folder, do the

following:
• Activate the Archive operating mode.
• Display the desired patient folder (→ Ch. 10.3.2, p. 10-14).

buttons.

The image is displayed at full size on the live screen.
• Using the arrow buttons, select the second desired image and press
the Full-Screen Image button.
The second image is displayed at full size on the reference screen.
The Mosaic button appears, enabling you to restore the mosaic view.
You may compare the two images now.
To compare two images from different patient folders, do the

following:
• Activate the Archive operating mode.

buttons.

The image is displayed at full size on the live screen.
• Display the desired second patient folder (→ Ch. 10.3.2, p. 10-14).
10-28 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
10 Data Management
• Using the arrow buttons, select the second desired image and press
the Full-Screen Image button.
The second image is displayed at full size on the reference screen.
The Mosaic button appears, enabling you to restore the mosaic view.
You may compare the two images now.
10.3.7 Making backup copies of patient folders
You can back up the patient folders stored on the hard disk to a USB stick
or a CD/DVD. To select the patient folders you want to back up, you can
use different search criteria (Last Name, Patient ID, Subject) and/or the
image creation date. You can combine all these search criteria and also
the image creation date (if desired) using an AND operation. Thus, you
could e.g. search for and back up all patients called Miller with the subject
Knee.
Fig. 10-17 Archive Backup operating mode
You can back up only entire patient folders with all images contained in Selecting patient
them. To determine which folders are to be backed up, you use the image folders
creation date and certain search criteria:
− Selection using the image creation date
When you enter e.g. a period between 01.01.YYYY and 31.01.YYYY,
all patient folders containing images that were created between
January 1, YYYY and January 31, YYYY will be backed up. These
folders are backed up in their entirety, including the images that were
not created within the specified period of time.
Ziehm Vision 10-29

P_26366/CD_28189 - EN-04/2008
10 Data Management
− Selection using search criteria

You can specify the patient folders you want to back up by entering
the patient name (Last Name), patient number (Patient ID) and/or the
Subject as search criteria.
All search criteria as well as the time period are automatically combined
by an AND operation.
In addition, you can back up all patient folders to the chosen storage
medium.
10.3.7.1 Backup to USB stick
Storage capacity To be able to back up images on a USB stick, the latter must be empty.
During backup, the system will check automatically whether the
remaining disk space is sufficient for the next folder to be backed up. If
the folder is too large to fit on the connected USB stick, you will be
prompted to plug another USB stick into the USB port.
Restoring backed- You can restore the data which has been backed up to a USB stick to the
up data system’s hard disk at any time (→ p. 10-32). If the backup copy has been
distributed to several USB sticks, you must plug in the USB sticks in the
same order as during the backup procedure for restoring the data.
To back up selected patient folders to a USB stick, do the following:

• Press the Backup button.
The backup setting controls appear in the dynamic control area. The
Start Date input box contains by default the date 01.01.1970. The
End Date input box contains by default the current date.
Fig. 10-18 Backup setting controls
• Plug a USB stick into the USB port.

10-30 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
10 Data Management
• Press the Last Name button and enter a search string in the related
input box.
NOTE
• If desired, press the Patient ID button and enter a patient number in
the related input box.
• If desired, press the Subject button and enter a search string in the
related input box.
• To confine the image creation period, press the Start Date button and
enter another date in the related input box.
• To further confine the image creation period, press the End Date
button and enter another date in the related input box.
Press the Show Selected button.

All patient folders shown on the list are backed up to the USB stick. A
progress indicator in a message window informs you about the status
of the backup operation.
If there is not enough disk space left on the connected USB stick, the
Please insert new USB stick.
• Plug another USB stick into the USB port. Make sure to label the USB
sticks so that you can later identify the order in which they were used.
To back up all patient folders to a USB stick, do the following:

The backup setting controls appear in the dynamic control area.
The Start Date input box contains by default the date 01.01.1970.
The End Date input box contains by default the current date. This
period covers all possible image creation dates.
Ziehm Vision 10-31

P_26366/CD_28189 - EN-04/2008
10 Data Management
• Plug a USB stick into the USB port.

All patient folders are backed up to the USB stick. A progress indicator
in a message window informs you about the status of the backup
operation.
If there is not enough disk space left on the connected USB stick, the
Please insert new USB stick.
• Plug another USB stick into the USB port. Make sure to label the USB
sticks so that you can later identify the order in which they were used.
To restore backed-up data from a USB stick to the hard disk, do the
following:
• Plug the USB stick that contains the first part of the backup copy into
the USB port.
• Press the Restore from USB Stick button.
All patient folders and images that have been backed up to the USB
stick before are restored and saved to the system’s hard disk. All
restored patient folders are recreated on the hard disk, in addition to
the already existing ones.
• Plug all further USB sticks used for the backup into the USB port (if
applicable). Make sure to keep to the same order as during the
backup procedure.
10-32 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
10 Data Management
10.3.7.2 Backup to CD or DVD
With the DVD writer, data can be written to or retrieved from both CDs CD writer or DVD
and DVDs. writer
The contents of a patient folder cannot be distributed to several CDs or Storage capacity
DVDs.
During backup, the system will check automatically whether the
remaining disk space is sufficient for the next folder to be backed up. If
the folder is too large to fit on the CD or DVD in the drive, you will be
prompted by a message to insert another CD or DVD into the drive.
You can restore the data which has been backed up to CD or DVD to the Restoring backed-
system’s hard disk at any time (→ p. 10-35). If the backup copy has been up data
distributed to several CDs or DVDs, you must insert the CDs or DVDs in
the same order as during the backup procedure for restoring the data.
To back up selected patient folders to CD or DVD, do the following:

End Date input box contains by default the current date.
• Insert an empty CD or DVD into the DVD writer.

• Press the Last Name button and enter a search string in the related
input box.
NOTE
Ziehm Vision 10-33

P_26366/CD_28189 - EN-04/2008
10 Data Management
• If desired, press the Patient ID button and enter a patient number in
the related input box.
• If desired, press the Subject button and enter a search string in the
related input box.
• To confine the image creation period, press the Start Date button and
enter another date in the related input box.
• To further confine the image creation period, press the End Date
button and enter another date in the related input box.
• Press the Show Selected button.

Checking CD/DVD ...
All patient folders shown on the list are backed up to the CD or DVD.
A progress indicator in a message window informs you about the
status of the backup operation.
If there is not enough disk space left on the inserted CD or DVD, the
Please insert new CD/DVD.
• Insert another CD or DVD. Make sure to label the CDs or DVDs so

that you can later identify the order in which they were used.
Once the write operation has been completed successfully, the following
message is displayed:
To back up all patient folders to CD or DVD, do the following:

End Date input box contains by default the current date. This period
covers all possible image creation dates.
10-34 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
10 Data Management
• Insert an empty CD or DVD into the DVD writer.

Checking CD/DVD ...
All patient folders are backed up to the CD or DVD. A progress
indicator in a message window informs you about the status of the
backup operation.
If there is not enough disk space left on the inserted CD or DVD, you
will be prompted to insert another disk into the drive:
Please insert new CD/DVD.
• Insert another CD or DVD. Make sure to label the CDs or DVDs so

that you can later identify the order in which they were used.
Once the write operation has been completed successfully, the following
message is displayed:
To restore backed-up data from a CD or DVD to the hard disk, do the

following:
• Insert the CD or DVD that contains the first part of the backup copy
into the DVD drive.
• Press the Restore from CD/DVD button.
All patient folders and images which have been backed up to the CD
or DVD before are restored and saved to the system’s hard disk. All
restored patient folders are recreated on the hard disk, in addition to
the already existing ones.
Ziehm Vision 10-35

P_26366/CD_28189 - EN-04/2008
10 Data Management
• Insert all further CDs or DVDs used for the backup into the
corresponding drive (if applicable). Make sure to keep to the same
order as during the backup procedure.
10.4 ESWL Data Management
On systems equipped with ESWL (Extracorporeal Shock Wave Lithot-

ripsy) and activated ESWL Data operating mode (page 6-11) an addi-
tional ESWL Data screen is available allowing you to enter ESWL related
data (→ Fig. 10-22).
Upon completion of the treatment you can enter the relevant data into the
corresponding input boxes, such as Start Time, Shocks etc.
You can finish by pressing the Print ESWL Data button to print out the
data to the printer mounted in the monitor cart. While pressing this button
the data are automatically saved to the hard disk.
In order to be able to relate the ESWL data to a certain patient, you must
always create or activate a patient folder before acquiring data
(→ Ch. 10.3.3, p. 10-16.
Fig. 10-22 ESWL Data operating mode
10-36 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
10 Data Management
ESWL data The following buttons are available in the ESWL Data operating mode
acquisition screen (→ Fig. 10-22, p. 10-36):
To enter the start time, do the following:

• Press the Start Time button.
The button is highlighted in yellow and the input box next to the button
gets the focus allowing you to enter data.
• Enter numerical values in 24-hour format (hh:mm:ss).

This entry indicates the time the treatment has begun.
To enter the stop time, do the following:

• Press the Stop Time button.
• Enter numerical values in 24-hour format (hh:mm:ss).

This entry indicates the time the treatment was completed.
To enter the number of shocks, do the following:

• Press the Shocks button.
• Enter numerical values with a maximum length of 4 digits.

This entry indicates the number of total shock waves triggered during
treatment.
To enter the SMLI index, do the following:

• Press the SMLI button.

This entry indicates the number of the lithotripsy index.
To enter the energy level, do the following:

• Press the Energy Level button.

This entry indicates the energy level used to conduct the ESWL
treatment.
Ziehm Vision 10-37

P_26366/CD_28189 - EN-04/2008
10 Data Management
To enter the focus setting, do the following:

• Press the Focus button.
• Press either of the buttons p, e or d on the touchscreen keyboard. The

input box will auto-populate accordingly with either of the character
strings precise (for character p), extended (for character e) and dual
(for character d).
This entry indicates the focus setting.
To enter additional notes, do the following:

• Press the Notes button.
• Enter characters, numbers and symbols using the touchscreen

keyboard with a maximum length of 50 characters.
This entry allows you to enter additional patient and/or treatment
related information.
To save the screen data entered, do the following:

The data on the screen will be saved to the hard disk.
To print ESWL data, do the following:

• Press the Print ESWL Data button.
The ESWL data contents (→ Fig. 10-22, p. 10-36) will be printed to
the video printer mounted in the monitor cart. While pressing this
button the data are automatically saved to the hard disk.
The patient related data will appear as a text block on a gray back-
ground at the left margin of the printout while the screen’s button
labels and related information will appear as a text block on a black
background at the right margin.
To return to the previous screen, do the following:

The current screen is closed and you are returned to the previously
active operating mode.
10-38 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
11 DICOM Functions
11.1 Prerequisites
Depending on the DICOM classes integrated in the system (→ Ch. 2.3,

p. 2-4), you can use certain DICOM functions. Your Ziehm Vision must
be connected to a DICOM network via cable or Wireless LAN for that
purpose.
Depending on the system configuration, you can use the following Functions
DICOM functions:
− Downloading patient data from a DICOM server: Query
(→ Ch. 11.2.1, p. 11-2) or Worklist (→ Ch. 11.2.2, p. 11-3)
− Saving all images from one or several patient folders
(→ Ch. 11.4, p. 11-16)
− Saving and printing images and cine loops from a patient folder
(→ Ch. 11.5, p. 11-17)
− Saving or printing single cine loop images (→ Ch. 11.6, p. 11-19)
− Importing images and cine loops from a DICOM server
(→ Ch. 11.7, p. 11-20)
11.2 Downloading patient data from a DICOM server
When creating a new patient folder (→ Ch. 10.2.1, p. 10-3), you can
download the patient data from the DICOM server (using Query or
Worklist).
The following prerequisites must be given: Prerequisites

− The Ziehm Vision must be connected to a DICOM server.
− The respective patient data must be stored on the DICOM server
already.
− You must know the patient ID of the respective patient.
Ziehm Vision 11-1

P_26366/CD_28189 - EN-04/2008
11 DICOM Functions
11.2.1 Query
The Query DICOM function enables you to download a patient’s data

(e.g. first name, last name) from the DICOM server.
NOTE
To download patient data from a DICOM server, do the following:

NOTE
You may predefine default data for the Hospital,
Department and Doctor input boxes. The respective
data is entered in the Configuration operating mode
under Basic Settings.

The input boxes are cleared (if any data has been displayed before in
them), with the exception of those with default data (→ Ch. 19.3.3,
p. 19-9).
• Press the Patient ID button and enter the patient ID of the patient you
are looking for.
The patient ID is displayed in the Patient ID box.
• Press the Query button.
The patient data record is downloaded from the DICOM server and
appears automatically in the input boxes.
• If necessary, complete any missing data.

• Save the new patient folder and the downloaded data by pressing the
Save button.
The new patient folder is automatically activated. A blank fluoroscopy
mask with the downloaded patient data appears on the live screen.
11-2 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
11 DICOM Functions
11.2.2 Downloading a Worklist
You can download a specific Worklist from the DICOM server. The Contents of the
Worklist contains the patient data as well as the examinations which are Worklist
scheduled for the patient.
You can use a filter to determine the time span that is covered by the Time span of the
Worklist. The following filter criteria are available for that purpose: Worklist
− Default setting: Today (0:00 – 24:00 o’clock)
− Yesterday (0:00 – 24:00 o’clock)
− Yesterday and today (0:00 – 24:00 o’clock)
− Now +/– 8 hours
Besides you can limit the contents of the Worklist to be downloaded using Filters for Worklist
the following criteria: download
− Patient name (Last Name)
− Patient ID (Patient ID)
− Hospital-specific internal administrative number (Access. No)
− Specific procedure step (Req. Proc. ID)
Once you have downloaded a Worklist on a certain day, you can open it Opening the
as often as you like, even if the Ziehm Vision is no longer connected to Worklist offline
the DICOM server. In this case, the word OFFLINE appears in the
Worklist on the screen.
When you try to open a Worklist in offline mode although no Worklist has
been downloaded on that day from the DICOM server yet, the message
No connection to server appears, and no Worklist is displayed.
11.2.2.1 Downloading a Worklist for a specific time span
To download a Worklist that covers a specific time span from a

DICOM server, do the following:
• Press the Worklist button.
The filter criteria for limiting the contents of the Worklist to be
downloaded are displayed. If you already specified a patient name
(Last Name), patient ID (Patient ID) or a hospital-specific internal
administrative number (Access. No) in the Patient operating mode,
this data appears automatically in the corresponding boxes.
Ziehm Vision 11-3

P_26366/CD_28189 - EN-04/2008
11 DICOM Functions
Fig. 11-1 Filter criteria for limiting the Worklist contents
• Select the time span to be covered by the Worklist.

• If there is any data displayed in the Last Name, Patient ID and/or
Access. No boxes, press the Delete button.
The Last Name, Patient ID and/or Access. No boxes are cleared.
The data of all patients who are scheduled for the specified time span
is downloaded from the DICOM server. A list of all downloaded data
appears on the control panel.
11-4 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
11 DICOM Functions
Fig. 11-2 DICOM Worklist
To sort the items, do the following: Sorting by columns

You can sort the items in the Last Name, First Name, Patient ID, Date
and Time columns in ascending or descending order. You can use the
column headers (which are designed as buttons) for sorting the items.
• Press e.g. the Last Name button.
The arrow on the button points downwards. The name items are
sorted alphabetically in ascending order.
• Press e.g. the Last Name button once again.
The arrow on the button points upwards. The name items are sorted
alphabetically in descending order.
To select an item from the Worklist, do the following: Worklist item


The downloaded patient data appears in the input boxes of the
Patient operating mode. The new patient folder is automatically
activated. A blank fluoroscopy mask with the downloaded patient data
appears on the live screen.
To overwrite an active patient folder with data from a Worklist item, Overwrite function
do the following:
You can overwrite the data in an active patient folder with data from the
Worklist (e.g. in emergency cases, in order to correct or complete the
emergency patient’s data at a later moment).
Ziehm Vision 11-5

P_26366/CD_28189 - EN-04/2008
11 DICOM Functions
CAUTION
When you overwrite a patient folder with data from the
Worklist, the original folder data is irretrievably lost.
Make sure to overwrite only patient data that is really no
longer needed!
• Use the arrow buttons to select the list item with which you want to
overwrite the active patient folder.
The active patient folder is updated.
11.2.2.2 Downloading a patient-specific Worklist
NOTE
To download a patient-specific Worklist from a DICOM server, do

the following:
• Press the Last Name button and enter the last name of the desired
patient.
• Press the Patient ID button and enter the patient ID of the desired
patient.
• Press the Access. No button and enter the hospital-specific internal
administrative number of the desired patient.
11-6 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
11 DICOM Functions
• To limit the time span covered by the Worklist to be downloaded,

select the desired time span.
The data of the selected patient is downloaded from the DICOM
server. A list with all patient-specific data downloaded appears on the
control panel. If you have specified a name or the first letter(s) of a
name as filter criterion, all matching items are listed.
Fig. 11-4 Patient-specific Worklist
Ziehm Vision 11-7

P_26366/CD_28189 - EN-04/2008
11 DICOM Functions
Sorting by columns To sort the items, do the following:

Worklist item To select an item from the Worklist, do the following:


Overwrite function To overwrite an active patient folder with data from a Worklist item,
do the following:
CAUTION
longer needed!
11.2.2.3 Downloading a Worklist for a procedure step
To download a Worklist that refers to a specific procedure step from

a DICOM server, do the following:
11-8 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
11 DICOM Functions

• Press the Req. Proc. ID button and enter the ID of the desired
procedure step.
The data of the specified procedure step is downloaded from the
DICOM server. The cursor is automatically positioned on the list item.
Ziehm Vision 11-9

P_26366/CD_28189 - EN-04/2008
11 DICOM Functions
Fig. 11-6 Worklist for a procedure step
Worklist item To select the Worklist item, do the following:
• Select the item.

Overwrite function To overwrite an active patient folder with data from a Worklist item,
do the following:
CAUTION
longer needed!
11-10 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
11 DICOM Functions
11.3 Processing scheduled procedure steps of a Worklist

(MPPS)
The DICOM function MPPS (Modality Performed Procedure Step) allows Function
you to open a procedure step (job) scheduled in a Worklist
(→ Ch. 11.2.2, p. 11-3), process it and then report it as being completed
to the MPPS server. The corresponding function must be enabled in the
DICOM settings for that purpose.
• Please contact your in-house service engineer if you wish to enable

the MPPS function.
Note:
You can use the MPPS function also when you create a
patient folder manually (→ Ch. 10.2.1, p. 10-3). In this
case, a procedure step is automatically generated and
started when you save the patient data, provided that the
MPPS function is enabled.
To process a procedure step scheduled in a Worklist, do the

following:
• Make sure that the MPPS function is enabled.

Ziehm Vision 11-11

P_26366/CD_28189 - EN-04/2008
11 DICOM Functions
• Select the time span to be covered by the Worklist.

The data of all patients who are scheduled for the specified time span
is downloaded from the DICOM server. A list of all downloaded data
appears on the control panel.
11-12 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
11 DICOM Functions
Fig. 11-8 DICOM Worklist
To sort the items, do the following: Sorting by columns

To select an item from the Worklist, do the following: Worklist item


To overwrite an active patient folder with data from a Worklist item, Overwrite function
do the following:
Ziehm Vision 11-13

P_26366/CD_28189 - EN-04/2008
11 DICOM Functions
CAUTION
longer needed!
Fig. 11-9 Procedure step has been started: MPPS in progress
The MPPS server is notified that the selected procedure step has
been started. The message IN PROGRESS appears in the MPPS
box.
If an error message is displayed, please contact your in-house service
engineer.
• Perform the required examination, generating and saving as many

fluoroscopic images as you like.
• Mark the images you want to save.
NOTE
The message and the image list can be sent only once to
the MPPS server. Therefore make sure that you have
marked all relevant images.
11-14 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
11 DICOM Functions
• Press the DICOM Store button.

The marked images or cine loops are transferred to the DICOM server
and saved there.
The marked images are transferred to the DICOM server.
The procedure step is reported as being completed to the MPPS
server:
Fig. 11-10 Procedure step has been completed: MPPS COMPLETED
A list of the images that have been transferred to the DICOM server
is sent to the MPPS server.
To cancel the procedure step, do the following:
• Press the MPPS Discontinue button.
The procedure step is canceled:
Fig. 11-11 Procedure step has been canceled: MPPS

DISCONTINUED
Ziehm Vision 11-15

P_26366/CD_28189 - EN-04/2008
11 DICOM Functions
11.4 Saving all images from one or several patient folders
DICOM Store If the system is connected to a DICOM network, you can save images
from one or more patient folders to a DICOM server.
Saving options You can use the following options to save images to the DICOM server:
− Save images without text information and attributes (such as
rotation, reversal, etc.).
− Save images with their attributes.
− Save images with their text information and their attributes.
Storage formats You can save the images in three different formats:
Resolution Color depth

1024 × 1024 16/8 bit
512 × 512 8 bit
Table 11-1 Storage formats
One of these three formats is always preset as default. Please contact

your in-house service engineer if you need one of the other two formats.
Transferring If you send only images to the DICOM server which are not stored there
images already, all images are actually transferred and saved. Images that are
already stored on the DICOM server are not saved there again. Images
that have been downloaded from the DICOM server with the Retrieve
function will not be retransferred to the DICOM server.
To save all images from one or several patient folders to a DICOM

server, do the following:
• Position the cursor on the desired patient folder, or mark the desired
patient folders.

The images of the marked patient folder(s) are transferred to the
DICOM server and saved there.
A progress indicator in a message window on the control panel
informs you about the status of the save operation. The Cancel button
appears, enabling you to interrupt the save operation.
Images that have been successfully transferred are flagged with a D.
Once all images have been transferred, the patient folders become
unmarked.
11-16 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
11 DICOM Functions
You can edit the patient data of images (→ Ch. 10.2, p. 10-2) that have Editing patient data
already been stored on the DICOM server at any moment. Once you
have edited the patient data, the D flag is removed from the images. You
may retransfer them to the DICOM server with the new patient data
afterwards.
You can modify the attributes of images (→ Ch. 14, p. 14-1) that have Modifying archived
already been stored on the DICOM server at any moment. Once you images
have modified the attributes, the D flag is removed from the images. You
may retransfer them to the DICOM server with the new attributes
afterwards.
11.5 Saving and printing images and cine loops from a

patient folder
Once you have displayed or activated a patient folder, you can save the
images and cine loops which are stored there to a connected DICOM
server and/or print them on a connected DICOM network printer.
To print images or cine loops from a patient folder on a DICOM

network printer, do the following:

or

• Position the cursor on the desired image or cine loop.
or or
• Mark the images or cine loops you want to print.
• Press the DICOM Print button.

The marked images or cine loops are printed on the DICOM network
printer.
informs you about the status of the print operation. The Cancel button
appears, enabling you to interrupt the print operation.
Ziehm Vision 11-17

P_26366/CD_28189 - EN-04/2008
11 DICOM Functions
Once they have been printed, the images or cine loops become
unmarked.
Transferring If you send only images to the DICOM server which are not stored there
images already, all images are actually transferred and saved. Images that are
already stored on the DICOM server are not saved there again. Images
that have been downloaded from the DICOM server with the Retrieve
function will not be retransferred to the DICOM server.
NOTE
Never modify any patient data in a patient folder after
having transferred images from this patient folder to the
DICOM server!
To save images or cine loops to a DICOM server, do the following:


or

• Position the cursor on the desired image or cine loop.
or or
• Mark the images or cine loops you want to save.

The marked images or cine loops are transferred to the DICOM server
and saved there.
Once they have been saved, the images or cine loops become
unmarked.
11-18 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
11 DICOM Functions
11.6 Saving or printing single cine loop images
If the system is connected to a DICOM network, you can save one or

several single images from an open cine loop to the DICOM server and/
or print them on a DICOM network printer.
To print images from a cine loop on a DICOM network printer, do the

following:
• Open the desired cine loop (→ Ch. 12.3, p. 12-4).

The individual images of the cine loop are displayed as a thumbnail
image mosaic on the reference screen.
• Position the cursor on the desired image.
or or
• Mark the images you want to print.
• Press the DICOM Print button.

The marked images are printed on the DICOM network printer.
informs you about the status of the print operation. The Cancel button
appears, enabling you to interrupt the print operation.
To save cine loop images to a DICOM server, do the following:

• Open the desired cine loop (→ Ch. 12.3, p. 12-4).

image mosaic on the reference screen.
• Position the cursor on the desired image.
or or
Ziehm Vision 11-19

P_26366/CD_28189 - EN-04/2008
11 DICOM Functions
• Mark the images you want to save.

The marked images are transferred to the DICOM server and saved
there.
Once they have been transferred, the images become unmarked.
11.7 Importing images and cine loops from a DICOM server
After displaying or activating a patient folder in the Archive or Patient

operating mode, you can download images and cine loops (image level
query/retrieve) or entire series of images and cine loops (series level
query/retrieve) from the connected DICOM server and save them to the
displayed or active patient folder.
You can download images and cine loops with a size of up to 27 MB from
the DICOM server. The maximum number of images in each patient
folder is not limited as long as the overall storage capacity of the system
is not exceeded.
To import one or more images from the DICOM server into a patient
folder, do the following:
or or

or
• Press the Retrieve button or DICOM Retrieve button.

The Studies, Series and Images lists with the related controls
appear on the control panel. The Studies list contains all studies
which are available on the server.
11-20 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
11 DICOM Functions
Fig. 11-12 Studies, Series and Images retrieval lists, with items on
the Studies list
• Select the desired study from the Studies list using the arrow buttons.
• Press the Refresh button next to the Studies list.

All series of the selected study appear in the Series list.
the Studies and Series lists
Ziehm Vision 11-21

P_26366/CD_28189 - EN-04/2008
11 DICOM Functions
• Using the arrow buttons, position the cursor on the desired series in
the Series list.
• Press the Refresh button next to the Series list.
All images of the selected series are displayed in the Images list.
Fig. 11-14 Studies, Series and Images retrieval lists, with items on all
lists
• Using the arrow buttons, position the cursor on the image of the
Images list you want to import.
or or
• Mark the images you want to import in the Images list.
Fig. 11-15 Images list with marked item
• Press the Retrieve button next to the Images list.

The marked images are downloaded from the DICOM server to the
patient folder. A progress indicator in a message window on the
control panel informs you about the status of the transfer operation.
Images that have been successfully downloaded are flagged with an
R.
11-22 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
11 DICOM Functions
NOTE
Do not switch off the system during image data transfer!
The transfer time depends on the network interface card
and the network load.
To import a series of images from the DICOM server into a patient

folder, do the following:
or or

or

• Press the Retrieve button DICOM Retrieve button.
The Studies, Series and Images lists with the related controls
appear on the control panel. The Studies list contains all studies
which are available on the server.
the Studies list
• Select the desired study from the Studies list using the arrow buttons.
Ziehm Vision 11-23

P_26366/CD_28189 - EN-04/2008
11 DICOM Functions
• Press the Refresh button next to the Studies list.

All series of the selected study appear in the Series list.
the Studies and Series lists
• Using the arrow buttons, position the cursor in the Series list on the
series whose images you want to import.
• Press the Retrieve button.
All images of the series are downloaded from the DICOM server to the
patient folder. A progress indicator in a message window on the
control panel informs you about the status of the transfer operation.
Images that have been successfully downloaded are flagged with
an R.
NOTE
Do not switch off the system during image data transfer!
The transfer time depends on the network interface card
and the network load.
11.8 Storage Commitment
Storage You can check whether the images that are flagged with a D
Commitment (→ Ch. 11.5, p. 11-17 or → Ch. 11.6, p. 11-19) have actually been
function stored on the DICOM server, e.g. before you proceed deleting them from
the hard disk of the Ziehm Vision. The Storage Commitment function
must be enabled in the DICOM settings for that purpose.
11-24 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
11 DICOM Functions

the Storage Commitment function.
To check whether the images are stored on the DICOM server, do

the following:
• Make sure that the Storage Commitment function is enabled.

• Press the DICOM Storage Commitment button.
The system searches the hard disk for images which have already
been saved to the DICOM Storage server, i.e., the ones flagged with
a D. Then the system verifies for each one of these images whether it
is actually stored on the DICOM server. A progress indicator informs
you about the status of the verification process.
Fig. 11-18 Commitment progress indicator
All images which are present on the DICOM server are flagged with a
C in the thumbnail mosaic.
If the Automatic Storage Commitment function is enabled in the Automatic Storage

DICOM settings, the system automatically performs a Storage Commitment
Commitment operation after each successful saving procedure. function

the Automatic Storage Commitment function.
Ziehm Vision 11-25

P_26366/CD_28189 - EN-04/2008
11 DICOM Functions
11-26 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
12 Cine Loops
12.1 Overview
A cine loop consists of several fluoroscopic images that are acquired in General
sequence. It can be replayed like a movie later and also post-edited.
Cine loops are useful whenever dynamic movement needs to be Applications

visualized. Typical fields of application are:
− Orthopedics:
You can generate a cine loop for visualizing movements of the
skeletal system.
− Vascular surgery:
You can combine a cine loop with DSA (→ Ch. 13.2, p. 13-3) to
visualize a contrast medium flow.
− Endoscopy:
You can generate a cine loop sequence e.g. for visualizing the
contrast medium flow in the bile duct.
12.2 Generating a cine loop
You can define the frame rate (speed) and the number of frames (length) Settings
for each cine loop you acquire. With a maximum system configuration of
the Ziehm Vision, the following values are available:
− Frame rate:
1, 2, 4, 8, 12.5 or 25 frames per second (fps)
(on systems with 25 fps)
1, 2, 5, 10, 15 or 30 frames per second (fps)
(on systems with 30 fps and on the Ziehm Vision FD)
− Length:
100, 200, 300, 400 images per cine loop
If you activate the Auto option, all images that are generated during
the time of exposure are automatically saved. With this option, you do
not need to set the recording length prior to fluoroscopy.
You can preset the frame rate (speed) and the number of frames (length)
of the cine loop in the Configuration operating mode under Operation
Ziehm Vision 12-1

P_26366/CD_28189 - EN-04/2008
12 Cine Loops
Settings (→ Ch. 19.4.1, p. 19-11). You can, however, modify these

settings during operation for each individual cine loop you acquire.
Fig. 12-1 Cine loop settings (on systems with 25 fps)
Saving a cine loop The cine loop images are automatically saved during radiation. The first
image of the cine loop is saved as the start image, the last one as the stop
image.
The number of images that are actually saved depends on the cine loop
length you have chosen:
− If you terminate radiation before reaching the selected cine loop
length, only the images generated during the time of exposure will be
saved.
− If radiation is continued beyond the selected cine loop length, only the
most recent images will be saved; the first images are lost.
− If you have activated the Auto option, all images that are generated
during the time of exposure are automatically saved.
Storage capacity Before you initiate fluoroscopy, the system checks automatically whether
there is enough hard disk space available for the preset cine loop. If,
despite the Auto-Delete function (→ p. 8-15), it is not possible to free up
enough disk space, an audible alarm sounds and the following alert
message appears on the control panel:
Not enough space on hard disk. Required: xyz. Available: xyz.
To free up disk space for a cine loop, do the following:
• Unprotect all protected images of a stored patient folder (→ p. 10-22)

and then delete the patient folder from the hard disk.
12-2 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
12 Cine Loops
or
• Decrease the length of the cine loop you want to acquire.
• Make a backup to a USB stick or a CD/DVD as soon as possible and

then delete the patient folders you have backed up before from the
hard disk.
NOTE
As long as the snapshot fluoroscopy mode is active, the
Cine button is hidden on the control panel.
To acquire a cine loop, do the following:

• Press the Cine button.
The cine loop setting controls appear in the dynamic control area.
or
• Ziehm Vision Endo: Press pedal 3 of the four-pedal foot switch

(→ Ch. 6-9, p. 6-14).
3
The cine loop setting controls appear in the dynamic control area.
Fig. 12-2 Cine loop setting controls on systems with 25 fps (left) and
30 fps (right)
• Select the desired cine loop length or the Auto function under
Length.
• Select the desired frame rate under Frames/s.

The cine loop is acquired and saved.
• Terminate radiation.
The new cine loop is now automatically replayed at the preset frame
rate in an endless loop on the live screen. You can control and edit
the cine loop (→ Ch. 12.4, p. 12-5).
Ziehm Vision 12-3

P_26366/CD_28189 - EN-04/2008
12 Cine Loops
12.3 Opening a saved cine loop
You can reopen and replay a cine loop saved on the hard disk at any
time.
To open a cine loop saved on the hard disk, do the following:

NOTE

All images contained in this patient folder are displayed as thumbnails
on the reference screen. The most recent image is highlighted by a
white frame. Cine loop sequences are symbolized by their last image
and flagged with C.
• Select the desired cine loop in the patient folder using the arrow
buttons.
12-4 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
12 Cine Loops

The first image of the cine loop is displayed at full size on the live
screen. The cine loop number in the patient folder is shown in the
image as CINE XY.
mosaic on the reference screen.
The controls for playback and editing of the cine loop as well as those for
processing and outputting individual cine loop images appear on the
control panel:
Cine loop
playback and
editing controls
Cine loop image

processing and
output controls
Fig. 12-3 Archive operating mode during cine loop playback (on
systems with 30 fps)
• Press the Play button.

The cine loop is replayed in an endless loop on the live screen. During
playback, a moving indicator shows the position of the currently
displayed image within the cine loop.
The buttons in the dynamic control area are used to control and edit the
cine loop which is replayed on the live screen (→ Ch. 12.4, p. 12-5).
When you open a DSA cine loop, additional controls are displayed in the
dynamic control area. The buttons in the lower half of the control panel
are used to process and output the individual images of the cine loop
(→ Ch. 12.6, p. 12-17).
12.4 Controlling and editing a cine loop during playback
As soon as a newly-acquired or saved cine loop is replayed on the live

screen, the cine loop playback and editing controls appear in the dynamic
control area.
When you replay a DSA cine loop, additional controls for the following
functions appear in the dynamic control area:
Ziehm Vision 12-5

P_26366/CD_28189 - EN-04/2008
12 Cine Loops
− Mask image control (→ Ch. 13.7, p. 13-15)

− Pixel shift (→ Ch. 13.8, p. 13-17)
− Landmarking (→ Ch. 13.9, p. 13-18)
Fig. 12-4 Cine loop (without DSA) playback and editing controls on
systems with 25 fps (above) and 30 fps (below)
All the settings that you make in the dynamic control area always affect
the cine loop which is marked by a white frame on the screen.
You can control cine loop playback in the following ways:
Changing the • To change the playback speed of the cine loop, choose another value
playback speed under Frms/s.
• To stop cine loop playback, press the Stop button.
The Play button appears.
• To scroll through the cine loop, press the Forward or Backward

arrow button.
The longer you press the button, the faster the cine loop images are
opened one after the other.
• To continue cine loop playback, press the Play button.
The Stop button appears.
Editing options The following options are available for editing a cine loop during
playback:
− Trimming the cine loop
− Cleaning up the cine loop
12-6 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
12 Cine Loops
You can trim the cine loop for playback, e.g. if the contrast medium has Trimming the cine
been injected too late, thus making the first images of the cine loop loop
useless. This is done by defining a new start image and a new stop image
for cine loop playback.
To trim the cine loop, do the following:

• Press the Stop button.
Now you can scroll through the individual images of the cine loop with
the help of the arrow buttons.
• Select the desired start image using the arrow buttons.
• Press the Start Img button.
• Select the desired stop image using the arrow buttons.
• Press the Stop Img button.

The cine loop sequence is trimmed.

The trimmed cine loop sequence is replayed in an endless loop.
• To replay the entire original cine loop, press the Complete button.
You can delete all images outside the trimmed cine loop, i.e. those before Cleaning up the
the start image and those after the stop image. cine loop
NOTE
Once you have cleaned up the cine loop, you can no
longer restore the original cine loop with the Complete
button.
To clean up a cine loop, do the following:

Ziehm Vision 12-7

P_26366/CD_28189 - EN-04/2008
12 Cine Loops
• Press the Clean up button.

All images which are not enclosed between the start image and the
stop image are deleted without confirmation prompt.
12-8 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
12 Cine Loops
12.5 Processing and outputting saved cine loops
Once you have displayed (→ Ch. 10.3.2, p. 10-14) or activated

(→ Ch. 10.3.3, p. 10-16) a patient folder, you can process the images
and the cine loops that are stored there. Different read-only boxes and
controls are displayed on the control panel for that purpose. In the
thumbnail mosaic on the reference screen, cine loop sequences are
symbolized by their last image and flagged with Cine.
Read-
only
boxes
Buttons for Arrow

marking buttons
and for screen
deleting navigation
Buttons
for
printing
Buttons
for saving
Fig. 12-5 Archive operating mode with displayed patient folder
In the following sections, we will describe how to process and output cine
loops. For information on how to process and output individual images in
a patient folder, please refer to → Ch. 10.3.5, p. 10-19.
The following cine loop processing functions are available in a displayed
or active patient folder:
− Mark:
To mark one or more cine loops
− Protect:
To protect marked cine loops against being deleted
− Delete:
To delete cine loops
− DICOM Retrieve:
To import cine loops from a DICOM server (→ Ch. 11.7, p. 11-20)
Ziehm Vision 12-9

P_26366/CD_28189 - EN-04/2008
12 Cine Loops
− Print:
To print marked cine loops on the video printer
− DICOM Print:
To print marked cine loops on a DICOM network printer (→ Ch. 11.5,
p. 11-17)
− CD/DVD:
To write marked cine loops to CD or DVD
− USB:
To save marked cine loops to a USB stick
− DICOM Store:
To save marked cine loops to a DICOM server (→ Ch. 11.5, p. 11-17)
12.5.1 Replaying a cine loop
To replay a cine loop, do the following:

• Select the desired cine loop in the thumbnail mosaic on the reference

The start image of the cine loop is displayed on the live screen.
mosaic on the reference screen.
The controls for playback and editing of the cine loop (→ Ch. 12.4,
p. 12-5) as well as those for processing and outputting single cine
loop images (→ Ch. 12.6, p. 12-17) appear on the control panel.
The cine loop is replayed on the live screen.
12-10 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
12 Cine Loops
12.5.2 Marking cine loops
To mark one or more cine loops, do the following:

• Select the desired cine loop on the reference screen using the arrow
buttons.

The cine loop is now marked and flagged with an M.
• To mark additional cine loops, repeat the procedure.
To unmark a cine loop, do the following:

• Select the desired marked cine loop on the reference screen using the
arrow buttons.

The cine loop becomes unmarked.
12.5.3 Protecting cine loops
You can protect cine loops against being deleted. When you try to delete
a folder which contains protected cine loops, the folder itself as well as
the protected cine loops remain on the hard disk.
To protect one or more cine loops, do the following:
• Select the desired cine loop on the reference screen using the arrow
buttons.
The cine loop is now protected and flagged with a P.
• To protect additional cine loops, repeat the procedure.
To unprotect a cine loop, do the following:
• Select the desired protected cine loop using the arrow buttons.
The cine loop becomes unprotected.
Ziehm Vision 12-11

P_26366/CD_28189 - EN-04/2008
12 Cine Loops
NOTE
Patient folders containing protected cine loops or images
cannot be deleted automatically. If many folders on the
hard disk contain protected cine loops or images, the
Auto-Delete function will not delete them, and you will be
unable to save new images.
12.5.4 Deleting cine loops
You can delete either all marked cine loops, or all unmarked cine loops,
or only the cine loop where the cursor is.
To delete one or more cine loops from a patient folder, do the

following:
NOTE
Deleted cine loops are irretrievably lost.
Back up the cine loops you want to keep before deleting
• Mark the cine loops you want to delete and press the Delete Marked
Items button.
or or
• Mark the cine loops you want to keep and press the Delete
Unmarked Items button.
12-12 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
12 Cine Loops
or or
• Using the arrow buttons, position the cursor on the cine loop you want
to delete, and then press the Delete button.

The cine loops are deleted from the patient folder.
You can mark one or more cine loops and print all images contained in Printing on video
them in one go. printer
To print a cine loop on the video printer, do the following:

• Position the cursor on the desired cine loop or mark the cine loops you
want to print.

The marked cine loops are printed on the video printer mounted in the
Once they have been printed, the cine loops become unmarked.
Ziehm Vision 12-13

P_26366/CD_28189 - EN-04/2008
12 Cine Loops
NOTICE
12.5.5 Saving cine loops
Graphics formats Depending on your chosen system configuration, you can save the
images of one or more cine loops in various graphics formats to different
storage media. Some formats with reduced resolution and color depth
are also available.

CD/DVD USB stick
on
16 bit TIF *.tif 1024 × 1024 16 bit 2 MB • •
DICOM — 1024 × 1024 16 bit 2 MB • •
Multimedia:
cine loop
Single *.jpg 512 × 512 8 bit 256 KB • •
images
DICOM — 512 × 512 8 bit 256 KB • •
JPEG *.jpg 512 × 512 8 bit 256 KB • •
NOTE

launched manually.
12-14 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
12 Cine Loops
To save cine loops to a USB stick, do the following: Saving to USB stick
• Position the cursor on the desired cine loop or mark the cine loops you
want to save.
The marked cine loops are saved to the USB stick. A progress
indicator in a message window on the control panel informs you about
the status of the save operation. The Cancel button appears,
enabling you to interrupt the save operation.
Once they have been saved, the cine loops become unmarked.
selected cine loops are copied to a compilation file on the hard disk first. DVD
You can decide whether you want to write the cine loops from the
compilation file to CD or DVD immediately or later. This enables you to
gather entire cine loops or patient folders as well as single images from
different patient folders and cine loops in the compilation file and to write
them to CD or DVD later in one go.
If you switch off the Ziehm Vision before having actually written the cine
loops, patient folders and images from the compilation file to CD or DVD,
the system will preserve the compilation file information.
To write one or more cine loops to CD or DVD, do the following:

• Mark the desired cine loop(s).

monitor cart.
Checking CD/DVD ...
Once they have been included in the compilation file, the cine loops
become unmarked.
• To leave the marked cine loops in the compilation file on the hard disk
for the time being, press the No button in the message window.
or or
To write the marked patient folders to CD or DVD right away, confirm
by pressing the Yes button. The write process is started, and the
Ziehm Vision 12-15

P_26366/CD_28189 - EN-04/2008
12 Cine Loops

operation.
12-16 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
12 Cine Loops
12.6 Processing and outputting single cine loop images
As soon as you open a saved cine loop in the Archive operating mode
(→ Ch. 12.3, p. 12-4), the individual images of the cine loop are
displayed as a thumbnail mosaic on the reference screen.
When you place the cursor on an individual image of the thumbnail
mosaic, this image is automatically displayed at full size on the live
screen.
The following functions are available for processing single cine loop
images:
− Mark:
To mark one or more images
− Protect:
To protect the image marked by the cursor against being deleted
− Delete:
To delete images
− Print:
To print marked images on the video printer
− DICOM Print:
To print marked images on a DICOM network printer
(→ Ch. 11.6, p. 11-19)
− CD/DVD:
To write marked images to CD or DVD
− USB:
To save marked images to a USB stick
− DICOM Store:
To save marked images to a DICOM server (→ Ch. 11.6, p. 11-19)
Ziehm Vision 12-17

P_26366/CD_28189 - EN-04/2008
12 Cine Loops
12.6.1 Marking cine loop images
To mark one or more images of a cine loop, do the following:

• Select the desired image in the thumbnail mosaic on the live screen
using the arrow buttons.


• Select the desired marked image using the arrow buttons.
12.6.2 Protecting cine loop images
You can protect cine loop images against being deleted. When you try to
delete a folder which contains cine loops with protected images, the
folder itself as well as the respective cine loops remain on the hard disk.
To protect one or more images of a cine loop, do the following:


The image is now delete-protected and flagged with a P.

• Select the desired protected image with the arrow buttons and press
the Protect button.
12-18 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
12 Cine Loops
NOTE
images.
12.6.3 Deleting cine loop images
You can delete either all marked images, or all unmarked images, or only
the image where the cursor is.
To delete one or more images of a cine loop, do the following:
NOTE
• Mark the images you want to delete.
• Press the Delete Marked Items button.

or or
• Mark the images you want keep.
Ziehm Vision 12-19

P_26366/CD_28189 - EN-04/2008
12 Cine Loops
• Press the Delete Unmarked Items button.

or or
• Select the individual image you want to delete using the arrow
buttons.
• Press the Delete button.


12-20 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
12 Cine Loops
12.6.4 Printing cine loop images on the video printer
You can mark one or more images of the cine loop and print them all in
one go. Besides, you can print the image displayed on the live screen.
NOTICE
To print images from a cine loop on the video printer, do the

following:
want to print.

Once they have been printed, the cine loop images become
unmarked.
The text information that is displayed on the live screen together with the
printout.
NOTE
When you launch the print job directly from the video
printer, the resulting hard copy will be an exact
reproduction of the live screen.
For further information, please refer to the video printer’s separate Further information
operating instructions provided with this system.
Ziehm Vision 12-21

P_26366/CD_28189 - EN-04/2008
12 Cine Loops
12.6.5 Saving cine loop images
Depending on your chosen system configuration, you can save cine loop
images in various graphics formats to different storage media. Some
formats with reduced resolution and color depth are also available.

CD/DVD USB stick
on
16 bit TIF *.tif 1024 × 1024 16 bit 2 MB • •
DICOM — 1024 × 1024 16 bit 2 MB • •
Multimedia:
cine loop
Single *.jpg 512 × 512 8 bit 256 KB • •
images
DICOM — 512 × 512 8 bit 256 KB • •
JPEG *.jpg 512 × 512 8 bit 256 KB • •
NOTE

launched manually.
Saving to USB stick To save cine loop images to a USB stick, do the following:
want to save.
The marked images are saved to the USB stick. A progress indicator
in a message window on the control panel informs you about the
status of the save operation. The Cancel button appears, enabling
you to interrupt the save operation.
12-22 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
12 Cine Loops
Once they have been saved, the cine loop images become unmarked.
selected images are copied to a compilation file on the hard disk first. You DVD
can decide whether you want to write the images from the compilation file
to CD or DVD immediately or later. This enables you to gather images
from different cine loops and patient folders as well as entire cine loops
or patient folders in the compilation file and to write them to CD or DVD
later in one go.
images, cine loops and patient folders from the compilation file to CD or
DVD, the system will preserve the compilation file information.
To write cine loop images to CD or DVD, do the following:

• Mark the desired image(s).

monitor cart.
Checking CD/DVD ...
Once they have been included in the compilation file, the images become
unmarked.
• To leave the marked images in the compilation file on the hard disk for
the time being, press the No button in the message window.
or or
To write the marked images to CD or DVD right away, confirm by
pressing the Yes button. The write process is started, and the
operation.
Ziehm Vision 12-23

P_26366/CD_28189 - EN-04/2008
12 Cine Loops
12-24 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
13 Subtraction Modes
13.1 Overview
The Ziehm Vision provides three subtraction modes (DSA, MSA and Applications
RSA), which are used mainly in vascular surgery. As the generation of
MSA and/or RSA images requires a DSA cine loop, MSA and RSA can
be performed exclusively in conjunction with DSA.
DSA (Digital Subtraction Angiography) mode generates a conventional DSA

subtracted image. This means that one image is subtracted from the
other, so that only the differences between the images become visible.
On the Ziehm Vision, DSA is always combined with a cine loop
(→ Ch. 12, p. 12-1).
MSA (Maximum Opacification Subtraction Angiography) mode MSA

generates a subtracted image showing the entire path of the contrast
medium flow during the acquisition run with maximum contrast
opacification. The MSA image is generated from the DSA cine loop
without any additional radiation.
An RSA image (Roadmapping Subtraction Angiography) is generated in RSA

three steps:
− The MSA image is inverted.
− A new DSA image is generated.
− The new DSA image is superimposed over the inverted MSA image.
Thus, during an interventional procedure, surgeons can clearly see
where they are moving (e.g. with a catheter) within the contrast medium
path generated.
You can generate as many RSA images as desired during one session.
Before acquiring a DSA cine loop, you must create or activate a patient Saving
folder. The DSA cine loop, the MSA image and the RSA images are
saved to the active patient folder in the order in which they have been
generated and may be reopened or post-processed later.
Ziehm Vision 13-1

P_26366/CD_28189 - EN-04/2008
Image types In subtraction mode, three types of images are generated:

− Mask image
The mask image is the fluoroscopic image which is subsequently
subtracted from the native image(s). The mask image is always
acquired first.
− Native image
Generally speaking, a native image is an original fluoroscopic image
without any modification. In the subtraction modes, the native image
is the image from which the mask image is subtracted to obtain the
subtracted image.
− Subtracted image
A subtracted image is the result of the subtraction process: native
image minus mask image.
Showing or hiding You can preset whether you want the native image to appear on the
the native image reference screen during the acquisition of a DSA cine loop, MSA image
or RSA image. This is done in the Configuration operating mode under
Operation Settings (→ Ch. 19.4.2, p. 19-12). If you deactivate the
option DSA Native on, you may display a reference image on the
reference screen during the entire subtraction procedure. If you activate
the option DSA Native on, any image which is displayed on the
reference screen will disappear as soon as you switch to the Subtraction
operating mode.
Cine loop Each DSA is automatically combined with a cine loop. The first image of
the cine loop is saved as the mask image, and all subsequent native
images are subtracted from the mask image.
Scrolling You cannot scroll through the individual cine loops on the reference
screen.
13-2 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
13.2 Acquiring a DSA cine loop
Fig. 13-1 DSA cine loop settings (on systems with 25 fps)
To be able to acquire a DSA cine loop, you must first create a new patient Prerequisite
folder (→ Ch. 10.2.1, p. 10-3) or activate an existing patient folder
(→ Ch. 10.3.3, p. 10-16).
With a DSA cine loop, the system automatically saves all images that are Length of the DSA
generated during the time of exposure. In the DSA cine loop settings, the cine loop
Auto option is preset under Length. You cannot select a defined length
for a DSA cine loop (→ p. 12-2).
If your system is equipped with the CO2 option, you can use carbon Working with CO2
dioxide negative contrast medium. In this case, the DSA CO2 option is negative contrast
available in the Configuration operating mode under Cine/DSA/Dose medium
(→ Ch. 19.4, p. 19-10).
The CO2 button is displayed if the DSA CO2 option has been activated in
the Configuration operating mode. In that case, the CO2 mode as well
as a corresponding AERC characteristic are automatically preset. The
contrast medium path is corrected so as to appear black.
To deactivate the preset CO2 mode, do the following:
• Press the CO2 button.
The CO2 button turns white. The CO2 mode is deactivated.
Ziehm Vision 13-3

P_26366/CD_28189 - EN-04/2008
To acquire a DSA cine loop, do the following:

• Press the Subtraction tab.
The Subtraction operating mode is activated.
• Press the DSA button.
The cine loop setting controls appear in the dynamic control area. The
Auto option is preset under Length and cannot be changed. The
buttons for setting a specific cine length are unavailable for this
reason.
• Set the desired frame rate for the DSA cine loop under Frms/s
(→ Ch. 12.2, p. 12-1).
• Press the hand switch or the fluoroscopy pedal of the two-pedal foot
switch.
The status message Mask image acquisition... appears together
with a progress indicator on the control panel.
A countdown of 5 s is performed on the live screen. After 2 s, radiation
is released automatically.
After the mask image has been acquired, the request ...Injection
appears on the title bar of the control panel.
• Inject the contrast medium.

Cine loop acquisition continues. The subtracted images are displayed
on the live screen. If you have activated the DSA Native on option,
the native images are displayed on the reference screen.
The cine loop is automatically saved to the active patient folder. It is
replayed in an endless loop on the live screen.
The cine loop playback and editing controls (→ Ch. 12.4, p. 12-5) as
well as the MSA (→ Ch. 13.3, p. 13-5), LM (landmarking, → Ch. 13.9,
p. 13-18) and P-Sh (pixel shift → Ch. 13.8, p. 13-17) buttons appear
in the dynamic control area.
Fig. 13-2 DSA cine loop playback and editing controls on systems
with 25 fps (left) and 30 fps (right)
The Subtraction operating mode remains active. When you initiate

radiation again, a new DSA cine loop is acquired with the defined
settings.
Filter factors Various filter factors can be preset for the DSA mode in the
13-4 Ziehm Vision

P_26366/CD_28189 - EN-04/2008

modify the filters for the DSA mode.
The default windowing values (width and level of the contrast window) for Windowing values
the DSA mode can be preset in the Configuration operating mode under
Service Settings. You cannot make these presettings yourself.

modify the windowing values for the DSA mode.
13.3 Acquiring an MSA image
To acquire an MSA image, do the following:
• Generate a DSA cine loop (→ Ch. 13.2, p. 13-3).

The cine loop is replayed in an endless loop on the live screen. The
cine loop playback and editing controls as well as the MSA button
appear in the dynamic control area.
• Press the MSA button.

The message MSA in Process... appears on the control panel.
An MSA image is generated without any further release of radiation.
The MSA image is automatically saved to the active patient folder.
The cine loop playback and editing controls disappear from the
dynamic control area. The RSA button appears.
Fig. 13-4 Dynamic control area after the generation of an MSA

image
Various filter factors can be preset for the MSA mode in the Filter factors
Ziehm Vision 13-5

P_26366/CD_28189 - EN-04/2008

modify the filters for the MSA mode.
Windowing values The default windowing values (width and level of the contrast window) for
the MSA mode can be preset in the Configuration operating mode
under Service Settings. You cannot make these presettings yourself.

modify the windowing values for the MSA mode.
13.4 Acquiring an RSA image
To acquire an RSA image, do the following:
• Generate a DSA cine loop (→ Ch. 13.2, p. 13-3).
• Generate an MSA image (→ Ch. 13.3, p. 13-5).

The RSA button appears in the dynamic control area.

image
• Press the RSA button.

The RSA button disappears from the dynamic control area, and the
buttons for landmarking (→ Ch. 13.9, p. 13-18) and pixel shift
(→ Ch. 13.8, p. 13-17) appear instead.
Fig. 13-6 Dynamic control area in RSA mode
A DSA image is generated. The MSA image is inverted, so that the
contrast medium path appears white instead of black. The DSA image
(not inverted) is superimposed over the MSA image.
13-6 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
The combined last subtracted image remains displayed on the live
screen and is saved automatically to the patient folder.
• To generate another RSA image, initiate radiation again.

You can generate and save as many RSA images as you wish.
Various filter factors can be preset for the RSA mode in the Filter factors

modify the filters for the RSA mode.
The default windowing values (width and level of the contrast window) for Windowing values
the RSA mode can be preset in the Configuration operating mode under
Service Settings. You cannot make these presettings yourself.

modify the windowing values for the RSA mode.
Ziehm Vision 13-7

P_26366/CD_28189 - EN-04/2008
13.5 Generating an MSA image or RSA image automatically
Prerequisite You must activate MSA Autotransfer in the Configuration operating

mode under Cine/DSA/Dose.
To be able to acquire a DSA cine loop, you must first create a new patient
folder (→ Ch. 10.2.1, p. 10-3) or activate an existing patient folder
(→ Ch. 10.3.3, p. 10-16).
Length of the DSA With a DSA cine loop, the system automatically saves all images that are
cine loop generated during the time of exposure. In the DSA cine loop settings, the
Auto option is preset under Length. You cannot select a defined length
for a DSA cine loop (→ p. 12-2).
Filter factors Various filter factors can be preset for the DSA, MSA and RSA
subtraction modes in the Configuration operating mode under Service
Settings. You cannot make these presettings yourself.

modify the filters for the DSA, MSA and RSA subtraction modes.
Windowing values The default windowing values (width and level of the contrast window) for
the DSA, MSA and RSA subtraction modes can be preset in the

modify the windowing values for the DSA, MSA and RSA subtraction
modes.
Fig. 13-7 Settings for the automatic generation of an MSA or RSA

image
13-8 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
To automatically generate an MSA image or RSA image, do the

following:
• Press the Subtraction tab.
The Subtraction operating mode is activated.
• Press the MSA or RSA button.
The cine loop setting controls appear in the dynamic control area. The
Auto option is preset under Length and cannot be changed. The
buttons for setting a specific cine length are unavailable for this
reason. or
• Set the desired frame rate for the DSA cine loop under Frms/s
(→ Ch. 12.2, p. 12-1).
• Press the hand switch or the fluoroscopy pedal of the two-pedal foot
switch.
The status message Mask image acquisition... appears together
with a progress indicator on the control panel.
A countdown of 5 s is performed on the live screen. After 2 s, radiation
is released automatically.
After the mask image has been acquired, the request ...Injection
appears on the title bar of the control panel.
• Inject the contrast medium.

Cine loop acquisition continues. The subtracted images are displayed
on the live screen. If you have activated the DSA Native on option,
the native images are displayed on the reference screen.
The cine loop is automatically saved to the active patient folder. It is
replayed in an endless loop on the live screen.
The Subtraction operating mode remains active.
Depending on whether you have pressed the MSA or RSA button before,
the system automatically performs the entire subtraction procedure up to
the generation of an MSA or RSA image.
An MSA image is generated without any further release of radiation. The
MSA image is automatically saved to the active patient folder.
Ziehm Vision 13-9

P_26366/CD_28189 - EN-04/2008

13-10 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
13.6 Generating MSA and RSA images from a saved DSA

cine loop
You can open a saved DSA cine loop and generate an MSA image or
RSA images at a later moment without having to reinject any contrast
medium. You can do this either in the active patient folder (→ Ch. 13.6.1,
p. 13-11) or in any patient folder on your system (→ Ch. 13.6.2,
p. 13-12).
13.6.1 Opening and postprocessing a DSA cine loop in an active patient

folder
To generate MSA or RSA images from a saved DSA cine loop when
the respective patient folder is already active, do the following:
• Activate the Subtraction operating mode.
• Use the arrow buttons to browse through the active patient folder.
The images and cine loops that are stored in the patient folder are
displayed at full size on the reference screen.
• Once you have opened the desired DSA cine loop, press the Image
Swapping button.
The first image of the DSA cine loop is displayed at full size on the live
screen. The cine loop playback and editing controls as well as the
MSA button appear in the dynamic control area.

Ziehm Vision 13-11

P_26366/CD_28189 - EN-04/2008

image


13.6.2 Opening and postprocessing a DSA cine loop from any patient
folder
To generate MSA or RSA images from any saved DSA cine loop, do
the following:
13-12 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
• Select the desired DSA cine loop in the patient folder using the arrow
buttons.

The cine loop playback and editing controls appear on the control
panel. The Subtraction button appears in the dynamic control area.
Fig. 13-11 DSA cine loop playback and editing controls, including
Subtraction button, on systems with 25 fps (above) and 30
fps (below)
• Press the Subtraction button in the dynamic control area.

The cine loop playback and editing controls as well as the MSA button
appear in the dynamic control area.

Ziehm Vision 13-13

P_26366/CD_28189 - EN-04/2008

image


13-14 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
13.7 Editing a DSA cine loop
As soon as a newly-acquired (→ Ch. 13.2, p. 13-3) or saved

(→ Ch. 12.3, p. 12-4) DSA cine loop is replayed on the live screen,
the cine loop playback and editing controls appear in the dynamic
control area.
All the settings that you make in the dynamic control area always affect
the cine loop which is marked by a white frame on the screen.
You can control cine loop playback in the following ways:
• To change the playback speed of the cine loop, choose another value Changing the
under Frms/s. playback speed
• To stop cine loop playback, press the Stop button.
The Play button appears.
• To continue cine loop playback, press the Play button.

The Stop button appears.
The following options are available for editing a cine loop during Editing options
playback:
− Trimming the cine loop
− Cleaning up the cine loop
− Defining another mask image
You can trim the cine loop for playback, e.g. if the contrast medium has Trimming the cine
been injected too late, thus making the first images of the cine loop loop
useless. This is done by defining a new start image and a new stop image
for cine loop playback.
To trim the cine loop, do the following:

Ziehm Vision 13-15

P_26366/CD_28189 - EN-04/2008
• Select the desired start image with the arrow buttons and press the
Start Img button.
• Select the desired stop image with the arrow buttons and press the
Stop Img button.
The cine loop sequence is trimmed.

The trimmed cine loop sequence is replayed in an endless loop.
• To replay the entire original cine loop, press the Complete button.
Cleaning up the You can delete all images outside the trimmed cine loop, i.e. those before
cine loop the start image and those after the stop image.
NOTE
Once you have cleaned up the cine loop, you can no
longer restore the original cine loop with the Complete
button.
To clean up a cine loop, do the following:

• Press the Clean up button.

All images which are not enclosed between the start image and the
stop image are deleted without confirmation prompt.
Defining a mask You can define a mask image other than the original one for a DSA cine
image loop (→ p. 13-2).
To define an image of the cine loop as mask image, do the

following:
• Select the image you want to define as mask image with the arrow
buttons and press the Mask button.
13-16 Ziehm Vision

P_26366/CD_28189 - EN-04/2008

The cine loop is replayed. During cine playback, all images of the cine
loop are subtracted from the defined mask image.
To deactivate the mask image, do the following:

• Press the Mask off button.
The cine loop is replayed without subtraction. The former mask image
remains stored in the cine loop, only its mask function is deactivated.
13.8 Pixel shift
Possible patient or C-arm movements between the acquisition of the Function

mask image and the acquisition of the native image may lead to artifacts
in the subtracted image. Using the Pixel Shift function, you can move the
mask image and thus realign the two images once again.
You can use the Pixel Shift function in the following situations:
− After the acquisition of a DSA cine loop in the Subtraction operating
mode
− During playback of a saved DSA cine loop in the Archive operating
mode
− After the acquisition of an RSA image in the Subtraction operating
mode
As long as you have not saved the modified image yet, you can undo the
mask image shift with the Home button.
To correct artifacts in a subtracted image, do the following:

• Press the P-Sh button.
• Using the four arrow buttons, move the mask image pixel by pixel until
it has reached the desired position. You can move the image by up to
8 pixels into each direction.
The corrected image is saved.
Ziehm Vision 13-17

P_26366/CD_28189 - EN-04/2008
13.9 Landmarking
Function With the landmarking function, you can superimpose a certain proportion
of the mask image (70% max.) onto the subtracted image, thus providing
anatomical landmarks for better orientation.
You can use the Landmarking function in the following situations:
− After the acquisition of a DSA cine loop in the Subtraction operating
mode
− During playback of a saved DSA cine loop in the Archive operating
mode
− After the acquisition of an RSA image in the Subtraction operating
mode
As long as you have not saved the modified image yet, you can undo the
mask image overlay with the Home button.
To overlay a certain proportion of the mask image onto the

subtracted image (landmarking), do the following:
• Press the LM button.
• To increase the visible mask image amount in the subtracted image,

press the Up Arrow button until reaching the desired level.
• To decrease the visible mask image amount in the subtracted image,

press the Down Arrow button until reaching the desired level.

The image with the mask image overlay is saved.
13-18 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
14 Post-Processing Images
14.1 Overview
Saved images can be post-processed at any time in the Post General

Processing operating mode. Any adjustments that you make in the Post
Processing operating mode affect only the selected image (exception:
screen settings).
The following post-processing functions are available: Post-processing

functions
− Contrast/Brightness:
To adjust contrast and brightness of individual images (windowing)
− Filter:
Edge filter
− Zoom:
To enlarge a selected image area
− Grayscale Inversion:
To display an image with negative grayscale
− Vertical Slot Collimator:

Digital collimation (image crop)
− Horizontal Slot Collimator:

Digital collimation (image crop)
− Reverse Up/Down:
Vertical image reversal
Ziehm Vision 14-1

P_26366/CD_28189 - EN-04/2008
− Reverse Left/Right:
Horizontal image reversal
− Image rotation
− Text:
Text functions (→ Ch. 16, p. 16-1)
Saving the changes Any modification becomes immediately visible in the live screen image.
When you save an image, any modifications are saved as well and will
be visible both when you reopen the image and in mosaic view. However,
you can post-process an image as often as desired, thus undoing any
changes you have made before.
14-2 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
14.2 Activating the post-processing functions
To activate an image for subsequent post-processing, do the

following:
• Locate the desired patient folder in the Archive operating mode and
display it (→ Ch. 10.3.2, p. 10-14).
• Open the image you want to post-process.
The selected image is displayed at full size on the live screen.
• Press the Post Proc. tab.

The Post Processing operating mode is activated.
Fig. 14-1 Post Processing operating mode
Now you can post-process the selected image. You can browse through
the active patient folder on the live screen using the arrow buttons. In
addition, you can mark and delete individual images.
Ziehm Vision 14-3

P_26366/CD_28189 - EN-04/2008
14.3 Contrast and brightness adjustment of individual

images (windowing)
Function The windowing function allows you to adjust the contrast and brightness
of the image on the live screen. These settings affect only the selected
image. When you save an image, the modified windowing values are
saved as well, even if you have retrieved the image from the archive.
After activating the Windowing function, you can select a number of gray
levels, which are then stretched over the entire range of 1024 gray levels
of the original image on the live screen. To achieve this effect, you set the
width and the level of the so-called contrast window.
The number of gray levels defines the width of the contrast window. The
width of the contrast window affects the image contrast. 1024 gray levels
correspond to the value W 100 on the Ziehm Vision.
The position of the selected gray levels on the original image grayscale
(ranging from 0 to 1024 gray levels) defines the level of the contrast
window. The level of the contrast window affects the image brightness.
Example:
You select all gray levels between 325 and 875. These gray levels are
then mapped (stretched) to the range of 0 to 1024 gray levels in the
processed image. This enhances the contrast.
Gray levels 0 to 324 of the original image are displayed as black, and
gray levels 876 to 1024 of the original image are displayed as white. This
means that the processed image is darker than the original image.
There are two different windowing modes available:
− Standard windowing:
The standard windowing mode allows you to freely choose the level
and width of the contrast window.
− Step windowing:
With step windowing, you choose between several predefined
windowing steps. These windowing steps are preset and cannot be
modified.
The chosen windowing values are shown on the screen as W X and L Y.
To set the brightness and contrast in standard windowing mode, do

the following:
The windowing setting controls appear.
14-4 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Fig. 14-2 Standard windowing controls
• Under Width, set the number of gray levels using the arrow buttons.
The chosen width is indicated by the length of the blue bar in the
live screen image.
• Under Level, set the brightness range using the arrow buttons.
The chosen level is indicated by the position of the slider in the
live screen image.
• To restore the factory settings (level 50, width 100), press the Home
button.
To set the brightness and contrast in step windowing mode, do the

following:
The screen setting controls appear in the dynamic control area.
Fig. 14-3 Screen setting and step windowing controls
• Select the desired windowing step using the arrow buttons.

The settings become immediately visible in the live screen image.
• To restore the factory settings for step windowing, press the Home
button.
Step windowing is reset to step 0. Simultaneously, brightness and
contrast are reset to their default values.
The screen setting controls disappear from the dynamic control area.
Ziehm Vision 14-5

P_26366/CD_28189 - EN-04/2008
14.4 Edge filter
The edge filter allows you to select a greater or lesser degree of edge
enhancement within the image. There are 4 levels available:
Level Meaning
OFF No edge enhancement (original fluoroscopic image)
1 Slight edge enhancement
2 Medium edge enhancement
3 Strong edge enhancement
-1 Unsharp mask to reduce noise
Table 14-1 Edge filter levels
To set the edge filter for the image, do the following:

The edge filter setting controls appear in the dynamic control area.
Fig. 14-4 Edge filter settings
• Select the desired edge filter level by pressing the corresponding

button.
image. The chosen edge filter level is shown on the screen as RTE X.
The edge filter setting controls disappear from the dynamic control
area.
14.5 Digital zoom
The Zoom function allows you to enlarge a certain image area. There are
three zoom levels available. You can select the desired image area either
with the arrow buttons or with the integrated touchpad.
14-6 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Touchpad
Fig. 14-5 Zoom function in the Post Processing operating mode
To enlarge an image area, do the following:


e.g. 4 X.
• Move the marking circle to the desired image area using the arrow
buttons.
chosen zoom level.
the Home button.

Ziehm Vision 14-7

P_26366/CD_28189 - EN-04/2008
To enlarge an image area with the help of the touchpad, do the

following:
the Home button.

14.6 Grayscale inversion
Function The Grayscale Inversion function allows you to view the active image
with a negative grayscale.
To display an image with a negative (or positive) grayscale, do the

following:
• Press the Grayscale Inversion button.
The image is displayed with negative grayscale on the live screen.
• Press the Grayscale Inversion button again.

The image is again displayed with a positive grayscale.
14-8 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
14.7 Image rotation
• Press the Rotate Image CW button until the image orientation on the
live screen is as desired.
The image is rotated steplessly in clockwise direction.
• Press the Rotate Image CCW button until the image orientation on
The image is rotated steplessly in counter-clockwise direction.
The chosen angle of rotation is shown on the screen as R X.
As soon as an image is rotated, it assumes a circular shape. The image Ziehm Vision FD
90°, 180°, 270°.
14.8 Horizontal and vertical image reversal
• Press the Reverse Up/Down button.

On the live screen, the image appears with top and bottom reversed,
and a symbol for up/down reversal is displayed.
• Press the Reverse Left/Right button.

On the live screen, the image appears with left and right side
reversed, and a symbol for left/right reversal is displayed.
Image reversal is symbolized on the screen by an R which is either
mirrored left-right or upside-down.
14.9 Digital collimation (image crop)
• Press the Close Vertical Slot Collimator button until the collimator
The vertical slot collimator closes steplessly.
• Press the Open Vertical Slot Collimator button until the collimator
The vertical slot collimator opens steplessly.
Ziehm Vision 14-9

P_26366/CD_28189 - EN-04/2008
• Press the Close Horizontal Slot Collimator button until the

collimator aperture on the live screen is as desired.
The horizontal slot collimator closes steplessly.
• Press the Open Horizontal Slot Collimator button until the

collimator aperture on the live screen is as desired.
The horizontal slot collimator opens steplessly.
14.10 Marking and deleting images
Browsing through You can browse through an active patient folder in the Post Processing
the patient folder operating mode without having to switch to the Archive operating mode.
The live screen always shows the selected image at full size.
Marking To mark one or more images, do the following:

• Select the desired image on the live screen using the arrow buttons.


• Select the desired marked image on the live screen using the arrow
buttons.

The image becomes unmarked.
Protecting To protect one or more images, do the following:

• Select the desired image on the live screen using the arrow buttons.

The image is now protected and flagged with a P.
14-10 Ziehm Vision

P_26366/CD_28189 - EN-04/2008

• Select the desired protected image using the arrow buttons.

The image becomes unprotected.
NOTE
images.
To delete one or more images from a patient folder, do the

following:
NOTE
• Mark the images you want to delete and press the Delete Marked
Items button.
Fig. 14-8 Delete marked images confirmation prompt
or or
• Mark the images you want to keep and press the Delete Unmarked
Items button.
Ziehm Vision 14-11

P_26366/CD_28189 - EN-04/2008
Fig. 14-9 Delete unmarked images confirmation prompt
or or
• Select the individual image you want to delete using the arrow
buttons.


14-12 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
14.11 Outputting post-processed images
You can save individual images to hard disk (→ Ch. 8.9, p. 8-13) or print Output options
them on the video printer in the Post Processing operating mode as
well. These actions are always applied to the selected image or to the
marked images.
When you save an image, all changes applied to it are saved as well and
will be visible the next time you open the image. However, you can post-
process an image as often as desired, thus undoing any changes you
have made before.
To print images on the video printer, do the following:

• Select the image you want to print.
or or
• Mark the images you want to print.

panel informs you about the status of the print operation.
Ziehm Vision 14-13

P_26366/CD_28189 - EN-04/2008
14-14 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
15 Measurements
15.1 Measuring functions
The Ziehm Vision lets you measure various distances and angles in a General
saved fluoroscopic image. You can use the same measuring method
several times in an image.
Fig. 15-1 Measurement operating mode
The following functions are available for that purpose:

− Calibration:
To have an absolute scale for measurements, you must acquire the
length of a reference object prior to each measurement.
− Length or distance (2-Point):
To measure the length of a line.
− 3-point measurement (3-Point):

To measure the lengths of two contiguous lines and the interior angle
between them. In addition, the angle difference to a full circle is
calculated.
− 4-point measurement (4-Point):
To measure the lengths of two noncontiguous lines and the angle
Ziehm Vision 15-1

P_26366/CD_28189 - EN-04/2008
15 Measurements
between them. In addition, the angle difference to 180° is calculated.

− 4-point ratio measurement (4-Point Ratio)
To compute the length ratio between two lines.
All measurements you perform in a fluoroscopic image are shown
simultaneously in the image. The measuring points are identified by
capital letters which are assigned in alphabetic order. This means that
the designation of the measuring points may vary, depending on the
order in which you perform the different measurements.
Measuring The larger the distance between the object of measurement and the
inaccuracy image intensifier, the more inaccurate the measurement will be.
Therefore position the object of measurement as closely as possible to
the image intensifier or use the electronic magnification function,
especially if the object of measurement is very small.
The measuring resolution on the screen is 512 pixels. With a 31 cm i.i.,
this results in a pixel pitch of 310/512 = 0.6 mm in relation to the object
of measurement.
Zoom function If you change the zoom factor (→ Ch. 14.5, p. 14-6) after making a
measurement, the measured values will no longer be correct. In this
case, the following message will be displayed on the control panel:
Measurement invalid due to zoom factor change.
Thumbnail mosaic The measurements that you have performed on an image are not visible
in the thumbnail mosaic view.
Cine loop When you perform a measurement on a cine loop image and save it, this
measurement is saved for the entire cine loop and will be visible in all cine
loop images.
15.2 Calibrating
To have an absolute scale for a measurement, you must first acquire a

reference length. For that purpose, you must screen a reference object
of a known length or distance (e.g. a ruler or a balloon catheter with
radiopaque markers). Then you mark the known distance or length in the
fluoroscopic image and enter the corresponding value manually.
15-2 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
15 Measurements
Point A Point B
Fig. 15-2 Calibrating
Measurements on a fluoroscopic image will only provide accurate results Validity of the
if, during the acquisition of the relevant calibration image, the reference calibration
object has been placed in exactly the same plane as the object to be
measured later.
If the position of the patient or the C-arm is changed after the calibration,
you must repeat the calibration before performing a new measurement.
To perform a calibration, do the following:
The measuring points may have different designations, depending on the Designation of the
order in which the measurements are performed (→ p. 15-2). In the measuring points
following procedure, the measuring points are designated as A and B by
way of example.
• Screen the reference object in the Fluoroscopy operating mode.
The reference object must be in the same plane as the object you
want to measure later.
The image is displayed on the live screen.
• Press the Measure tab.
The Measurement operating mode is activated.
• Press the Calibration button.
The buttons and boxes for the Calibration function are displayed in
the dynamic control area.
Fig. 15-3 Calibration function
Ziehm Vision 15-3

P_26366/CD_28189 - EN-04/2008
15 Measurements
Two white marker squares appear in the fluoroscopic image on the

live screen; they mark the exact measuring points. The measuring
points are called A and B, and the marker square next to point A is
highlighted by a double frame.
The two marker squares are connected by a line. This line symbolizes
the reference length which is to be determined.
• Move marker square A with the four arrow buttons to the desired first
measuring point on the reference object, e.g. the first radiopaque
marker on a balloon catheter.
• Press the Next Measuring Point button.

Marker square B is now highlighted by a double frame.
• Move the second marker square with the four arrow buttons to the
desired second measuring point on the reference object, e.g. the
second radiopaque marker on a balloon catheter.
• Enter the length of the reference object in the Reference Length

input box.
• Press the Enter button.
• To edit the length you have entered, press the Delete button and
enter another value.
The acquired and saved calibration value remains in force until you
switch off the system.
15.3 Measuring a length or distance
This function measures the distance between two freely-definable points.
15-4 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
15 Measurements
Point A Point B
Fig. 15-4 Length or distance measurement
To be able to measure a length or distance, you must perform a Prerequisite

calibration first (→ Ch. 15.2, p. 15-2). The calibration value remains in
force until you switch off the system.
To measure a length or distance, do the following:
following procedure, the measuring points are designated as A and B by
way of example.
• Open the desired image in the Archive operating mode (→ Ch. 10.3,
p. 10-7).
The Measurement operating mode is activated. The selected image
is displayed at full size on the live screen.
• Press the 2-Point button.
NOTE
If the 2-Point button is unavailable, you must perform a
calibration first.
The length or distance controls appear in the dynamic control area.
Fig. 15-5 Length or Distance function
Ziehm Vision 15-5

P_26366/CD_28189 - EN-04/2008
15 Measurements
Two white marker squares appear in the fluoroscopic image on the

points are called A and B, and the marker square next to point A is
The two marker squares are connected by a line. This line symbolizes
the length or distance which is to be determined.
• Move marker square A to the starting point of the desired line using
the four arrow buttons.
The Reference Length read-only box shows the reference length
which was entered during calibration.
The Length 1 read-only box shows the current length of the distance.
• Once the marker square is on the desired starting point, press the
Next Measuring Point button.
• Move the second marker square to the final point of the desired length
or distance using the four arrow buttons.
The current length of the distance is shown in the Length 1 read-only
box on the control panel. The value is instantly readjusted as soon as
you change the position of any of the measuring points.
• To correct the position of a measuring point, press the Next
Measuring Point button until the corresponding marker square starts
flashing, and then move it to the desired new position.
The length of the modified distance is shown in the Length 1 read-
only box on the control panel.

The image is saved together with the measurement.
Editing a distance You can edit any distance or length measurement as long as the patient
or length folder containing the image with the respective measurement is active.
measurement
NOTE
You cannot edit any distance/length measurements in
images that have been retrieved from the archive. The
arrow buttons are unavailable. However, you can delete
any existing length or distance measurements and make
new ones.
15-6 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
15 Measurements
To edit a distance or length measurement, do the following:

• Press the Edit button.
The marker square is on one of the measuring points.
• Press the Next Measuring Point button until the marker square is on
the measuring point whose position you want to change.
• Move the marker square to the desired new position using the arrow
buttons.

You can repeat this procedure as often as you want as long as the patient
folder is active.
To delete a length or distance measurement, do the following:
The measured length or distance is deleted.
To jump from one measurement to the next one, do the following:

The marker square is on one of the measuring points of the first
measurement.

The marker square jumps to one of the measuring points of the next
measurement.
• Repeat these two steps until the marker square is on one of the
measuring points of the desired measurement.
Ziehm Vision 15-7

P_26366/CD_28189 - EN-04/2008
15 Measurements
15.4 3-point measurement
A 3-point measurement determines the lengths of two contiguous lines,

the angle between them and the angle difference to a full circle.
360° - Angle
Point B
Angle
Point A Point C
Fig. 15-6 3-point measurement
Prerequisite To be able to measure a length or distance, you must perform a

To perform a 3-point measurement, do the following:
Designation of the The measuring points may have different designations, depending on the
measuring points order in which the measurements are performed (→ p. 15-2). In the
following procedure, the measuring points are designated as A, B and C
by way of example.
p. 10-7).
NOTE
calibration first.
The 3-point measurement controls appear in the dynamic control

area.
15-8 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
15 Measurements
Fig. 15-7 3-Point Measurement function
Three white marker squares appear in the fluoroscopic image on the

points are called A, B and C, and the marker square next to point A is
• Move the marker square to the desired point A using the four arrow
buttons.

The current length and angle values are displayed together with their
designations in the Length 1 (distance 1), Length 2 (distance 2),
Angle (interior angle) and 360° – Angle (angle difference to a full
circle) read-only boxes. The values are instantly readjusted as soon
as you change the position of any of the measuring points.
• Move the second marker square to the desired point B using the four
arrow buttons.

Marker square C is now highlighted by a double frame.
• Move the third marker square to the desired point C using the four
arrow buttons.

The new values of the modified distances are shown in the respective
boxes on the control panel.
Ziehm Vision 15-9

P_26366/CD_28189 - EN-04/2008
15 Measurements

Editing a 3-point You can edit any 3-point measurement as long as the patient folder
measurement containing the image with the respective measurement is active.
NOTE
You cannot edit any 3-point measurements in images that
have been retrieved from the archive. The arrow buttons
are unavailable. However, you can delete any existing 3-
point measurements and make new ones.
To edit a 3-point measurement, do the following:

buttons.

folder is active.
To delete a 3-point measurement, do the following:

The 3-point measurement is deleted.
15-10 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
15 Measurements

measurement.

measurement.
15.5 4-point measurement
A 4-point measurement determines the lengths of two noncontiguous

lines, the angle between them and the angle difference to 180°.
180° - Angle
Point B
Point C
Angle
Point A
Point D
Fig. 15-8 4-point measurement
To be able to measure a length or distance, you must perform a Prerequisite

To perform a 4-point measurement, do the following:
following procedure, the measuring points are designated as A, B,C and
D by way of example.
p. 10-7).
Ziehm Vision 15-11

P_26366/CD_28189 - EN-04/2008
15 Measurements

NOTE
calibration first.
The 4-point measurement controls appear in the dynamic control

area.
Fig. 15-9 4-Point Measurement function
Four white marker squares appear in the fluoroscopic image on the

points are called A, B, C and D, and the marker square next to point
A is highlighted by a double frame.
buttons.

The current length and angle values are displayed together with their
designations in the Length 1 (distance 1), Length 2 (distance 2),
Angle (interior angle) and 180° – Angle read-only boxes. The values
are instantly readjusted as soon as you change the position of any of
the measuring points.
arrow buttons.

15-12 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
15 Measurements
arrow buttons.

Marker square D is now highlighted by a double frame.
• Move the marker square to the desired point D using the four arrow
buttons.


You can edit any 4-point measurement as long as the patient folder Editing a 4-point
containing the image with the respective measurement is active. measurement
NOTE
You cannot edit any 4-point measurements in images that
have been retrieved from the archive. The arrow buttons
are unavailable. However, you can delete any existing 4-
point measurements and make new ones.
To edit a 4-point measurement, do the following:

buttons.
Ziehm Vision 15-13

P_26366/CD_28189 - EN-04/2008
15 Measurements

folder is active.
To delete a 4-point measurement, do the following:

The 4-point measurement is deleted.

measurement.

measurement.
15.6 4-point ratio measurement
A 4-point ratio measurement determines the lengths of two

noncontiguous lines and their length ratio.
Point B
Point C
Point A
Point D
Fig. 15-10 4-point ratio measurement
Prerequisite To be able to measure a length or distance, you must perform a

15-14 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
15 Measurements
To perform a 4-point ratio measurement, do the following:
following procedure, the measuring points are designated as A, B,C and
D by way of example.
p. 10-7).
• Press the 4-Point Ratio button.
NOTE
If the 4-Point Ratio button is unavailable, you must
perform a calibration first.
The 4-point ratio measurement controls appear in the dynamic control

area.
Fig. 15-11 4-Point Ratio Measurement function
Four white marker squares appear in the fluoroscopic image on the

points are called A, B, C and D, and the marker square next to point
A is highlighted by a double frame.
buttons.

The current length and length ratio values are displayed in the Length
1 (distance 1), Length 2 (distance 2) and Length 1 / Length 2 (length
ratio) read-only boxes. The values are instantly readjusted as soon as
you change the position of any of the measuring points.
Ziehm Vision 15-15

P_26366/CD_28189 - EN-04/2008
15 Measurements
arrow buttons.

arrow buttons.

Marker square D is now highlighted by a double frame.
• Move the marker square to the desired point D using the four arrow
buttons.


Editing a 4-point You can edit any 4-point ratio measurement as long as the patient folder
ratio measurement containing the image with the respective measurement is active.
NOTE
You cannot edit any 4-point ratio measurements in
images that have been retrieved from the archive. The
arrow buttons are unavailable. However, you can delete
any existing 4-point ratio measurements and make new
ones.
To edit a 4-point ratio measurement, do the following:
15-16 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
15 Measurements

buttons.

folder is active.
To delete a 4-point ratio measurement, do the following:
The 4-point ratio measurement is deleted.

measurement.

measurement.
Ziehm Vision 15-17

P_26366/CD_28189 - EN-04/2008
15 Measurements
15-18 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
16 Displayed Texts and Text
Functions
16.1 Overview
On a Ziehm Vision, the image always has a circular shape. On a Ziehm Shape of displayed
Vision FD, the image normally has a square shape. As soon as an image image
is rotated on a Ziehm Vision FD, it assumes a circular shape. The image
90°, 180°, 270°.
Some image information is always displayed automatically as text on the Image information
screen. Detailed patient and image data can be found on the control
panel (→ Ch. 10.3, p. 10-7).
In addition, you may enter your own text or markers directly onto the
fluoroscopic image in a text annotation area on the screen and save a
note together with the image.
16.2 Image information on the screen
16.2.1 Upper left corner of the screen
In this area, the last name, first name, patient ID and date of birth of the Patient data
patient are displayed. Patient data is entered or corrected in the Patient
operating mode (→ Ch. 10.2, p. 10-2).
16.2.2 Upper right corner of the screen
In this area, the name of the hospital, attending physician and hospital Hospital data
department are displayed.
The default hospital data can be entered in the Configuration operating
mode under Basic Settings (→ Ch. 19.3.3, p. 19-9) and may be
corrected later in the Patient operating mode, if necessary
(→ Ch. 10.2.1, p. 10-3).
Ziehm Vision 16-1

P_26366/CD_28189 - EN-04/2008
16 Displayed Texts and Text Functions
Image number and As soon as you have saved an image, its image number is displayed
flag (→ Ch. 8.9, p. 8-13). For marked or protected images, the flag M or P is
displayed directly behind the image number.
DICOM status If the image has already been transferred to a DICOM server
(→ Ch. 11.5, p. 11-17) or imported from a DICOM server into the Ziehm
Vision (→ Ch. 11.7, p. 11-20), it is flagged with DICOM X:
− DICOM D: The image has been transferred successfully to the
DICOM server
− DICOM C: The image has been transferred successfully to the
DICOM server and stored safely (Storage Commitment)
− DICOM R: The image has been imported from the DICOM server into
the Ziehm Vision
Image type If a cine loop, DSA, MSA or RSA image is displayed, it is flagged
correspondingly (CINE, DSA, MSA, RSA).
16.2.3 Lower left corner of the screen
Image reversal Image reversal is symbolized on the screen by an R which is either

mirrored upside-down or left-right. This symbol appears in the following
cases:
− The live image is reversed (→ Ch. 9.9.1, p. 9-16).
− An image which has been saved with reversal is displayed
(→ Ch. 14.8, p. 14-9).
Recursive filter The chosen recursive filter level (→ Ch. 9.3.1, p. 9-5) is shown as NR X.
Edge filter The chosen edge filter level (→ Ch. 9.3.2, p. 9-7 or → Ch. 14.4, p. 14-6)
is shown as RTE X.
LIH filter The chosen LIH filter level (→ Ch. 9.3.3, p. 9-8) is shown as LIH X.
Angle of rotation The angle of rotation which has been chosen for the image (→ Ch. 9.9.2,
p. 9-16 or → Ch. 14.7, p. 14-9) is shown as R X.
Windowing values The chosen windowing values (→ Ch. 9.2, p. 9-2 or → Ch. 14.3, p. 14-4)
are shown as W X and L Y.
Time and date of The time and date of saving are automatically assigned by the system
saving and cannot be edited.
16-2 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
16.2.4 Lower right corner of the screen
The following fluoroscopy parameters are displayed here: Fluoroscopy

parameters
− Tube voltage in kV
− Tube current in mA
− Dose area product in cGy cm2
− Total radiation time accumulated so far for the active patient folder in
seconds (→ Ch. 8.7, p. 8-13)
The values are automatically assigned by the system and cannot be
edited.
Furthermore, the image magnification level chosen for the image is Image
shown as MAG X. magnification level
Below the fluoroscopy parameters, an abbreviation indicates which Anatomical

anatomical program was used for generating the image: program
Abbreviation Anatomical program

BONE Bones
HRT Heart
ABD Abdomen
URO Uro
ENDO Endo
SOFT Soft
DSA DSA
MSA MSA
RSA RSA
Table 16-1 Abbreviations for anatomical programs
Ziehm Vision 16-3

P_26366/CD_28189 - EN-04/2008
16.3 Entering and editing text
Activating the Text You can activate the Text operating mode from any of the following
operating mode operating modes:
− Fluoroscopy
− Subtraction
− Post Processing
− Measurement
• Simply press the Text button in the corresponding operating mode.
The Text operating mode is activated.
Fig. 16-1 Text operating mode
You may add the following elements to a fluoroscopic image on the live
screen:
− Any desired text
− An arrow in various sizes pointing to different directions
− The markers L or R in various sizes

Both arrows and marking letters are available in three sizes (large,
medium, small). The chosen size is indicated in the center of the arrow
block. The default size is always large. The size can be modified with the
Size button.
16-4 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Fig. 16-2 Arrow block and size indication
The texts, markers or arrows you have added to the image are not visible Thumbnail mosaic
in the thumbnail mosaic view.
In the Text operating mode, you may furthermore enter a note on the Note
current image. This note is displayed in the Archive operating mode
together with the image information (→ Fig. 10-4, p. 10-7).
To add a text to the fluoroscopic image, do the following:

• Press the Text button.
The cursor on the control panel jumps to the text input box.
• Enter the desired text using the alphanumeric keypad which is

displayed on the control panel.
NOTE
The text appears both in the input box on the control panel and in the
fluoroscopic image on the screen. The text in the fluoroscopic image
is surrounded by a marker frame.
• Move the text to the desired position using the arrow buttons.
• To undo your input, press the Cancel button.
The text and its position are deleted.
or or
• To confirm your input, press the OK button.
The marker frame disappears. The text input box on the control panel
is cleared.
Ziehm Vision 16-5

P_26366/CD_28189 - EN-04/2008

The previously active operating mode is reactivated.
To add a marker to the fluoroscopic image, do the following:
• Select the arrow or the marking letter you want to insert by pressing
the corresponding button.
The arrow or the marking letter appear in the fluoroscopic image on
the screen.
• Move the arrow or marking letter to the desired position using the
arrow buttons.
• Press the Size button until the marker size is as desired.
The chosen size (large, medium, small) is indicated in the center of
the arrow block.
• To undo your input, press the Cancel button.
The arrow or marking letter and its position are deleted.
or or
• To confirm your input, press the OK button.

The previously active operating mode is reactivated.
To edit a text annotation, do the following:

• Press the Edit button until the cursor on the screen is on the
annotation you want to edit.
• Enter the new text using the alphanumeric keypad.
To delete a text annotation, do the following:

• Press the Edit button until the cursor on the screen is on the
annotation you want to delete.
To edit a marker, do the following:

• Press the Edit button until the cursor on the screen is on the marker
you want to edit.
• Make the desired changes.
16-6 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
To delete a marker, do the following:

• Press the Edit button until the cursor on the screen is on the marker
you want to delete.
To enter a note on an image, do the following:

• Press the Note button.
The cursor on the control panel jumps to the note input box.
• Enter the desired note using the alphanumeric keypad which is

displayed on the control panel.
NOTE
Ziehm Vision 16-7

P_26366/CD_28189 - EN-04/2008
16-8 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
17 Laser Positioning Device
As an option, the system may be equipped with a laser positioning device

at the image intensifier and/or generator.
The system comes with a laser positioning device built into the digital flat- Ziehm Vision FD
panel detector. As an option, the system may be equipped with a second
laser positioning device at the generator.
The laser positioning device uses diode laser modules which emit laser Safety instructions
radiation. Do not under any circumstances look directly at the laser
beam or any scattered laser radiation – either with the naked eye or with
optical instruments.
Make sure to comply with all operating safety precautions when using the
laser positioning device. The maximum power output of continuous laser
radiation, measured at the laser beam apertures, is <1 mW. The
wavelength of the emitted radiation is 635 nm.
The laser positioning device generates a laser-beam crosshair, the
central point of which marks the position of the central X-ray beam on the
patient.
For safety, the laser positioning device is switched off automatically after
1 minute.
WARNING
Laser radiation – Do not stare into beam or view directly
with optical instruments (Laser Class 2M according to IEC
60825-1:2001).
Please observe the provisions of IEC 60825-1:2001,
Section 3, “User’s Guide” for operation of the laser
positioning device.
Viewing the laser output with certain optical instruments
(e.g. eye loupes, magnifiers and microscopes) within a
distance of 100 mm may pose an eye hazard.
CAUTION (USA)
LASER RADIATION – DO NOT STARE INTO BEAM
CLASS II LASER PRODUCT (in accordance with FDA 21
CFR, Subchapter J, Section 1040.10-11)
Ziehm Vision 17-1

P_26366/CD_28189 - EN-04/2008
17 Laser Positioning Device
17.1 Applications
You can use the laser positioning device for the following tasks:
− As alignment aid for positioning the C-arm
− For foreign body localization
− As a navigational aid for nail fixations.
CAUTION
Use of controls or adjustments or performance of
procedures other than those specified herein may result
in hazardous radiation exposure.
Positioning aid The laser positioning device allows you to position the C-arm exactly
above the patient without having to initiate radiation:
• Press the Laser button.
A laser-beam crosshair is generated, the central point of which
corresponds to the position of the central X-ray beam.
• Position the C-arm in such a way above the patient that the central
point of the laser-beam crosshair is exactly in the center of the region
of interest.
Foreign body You can use the laser positioning device also for foreign body
localization localization: For that purpose, you must activate the on-screen crosshair
first (→ Ch. 19.2.4, p. 19-4).
To localize a foreign body with the help of the laser positioning

device, do the following:
The foreign body becomes visible in the image on the live screen.
• Position the C-arm in such a way above the patient that the center of
the crosshair on the screen lies exactly over the foreign body in the
fluoroscopic image.
• Press the Laser button.
The laser positioning device’s laser-beam crosshair now marks the
patient’s skin exactly above the point where the foreign body lies, thus
allowing a precise determination of the point of surgical incision.
17-2 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
18 Direct Radiography
NOTE
This function has not been tested for interventional
procedures in accordance with IEC 60601-2-43.
18.1 Overview
The Ziehm Vision and the Ziehm Vision R can also be used for making
direct radiographic film exposures. This option is not available for the
Ziehm Vision FD.
Direct radiographies are only possible if your system is equipped with a
film cassette holder (optional accessory).
18.2 Fitting the film cassette holder
To fit the film cassette holder for direct radiographic exposures

onto the image intensifier, do the following:
• Pull the spring-loaded securing lever on the film cassette holder

outwards.
• Slide the film cassette holder over the supporting ridge on the image
intensifier.
• Release the spring-loaded securing lever.
• The securing lever engages above the supporting ridge.
• Insert a loaded film cassette fully into the film cassette holder from the
side.
Image intensifier
Securing lever Film cassette holder
Film cassette
Fig. 18-1 Fitting the film cassette holder and inserting the film
cassette
Ziehm Vision 18-1

P_26366/CD_28189 - EN-04/2008
18.3 Making a direct radiographic exposure
For direct radiography, you can set the following maximum collimator
apertures for the film or cassette size used:
31 cm image intensifier (not available in the USA):
− 24 cm
− 30 cm; the visible image has a diameter of max. 27 cm
23 cm image intensifier:
− 24 cm; the visible image has a diameter of 23 cm
WARNING
Make sure that the selected collimator aperture does not
exceed the cassette size used.
Manual settings For tube voltage, use the value that the system has automatically
selected during the previous fluoroscopy. You may correct this value
manually if necessary.
The mAs value (tube current in mA × time in s) is always set manually.
On a Ziehm Vision, the tube current ranges from 15 mA to 20 mA; on a
Ziehm Vision R, it ranges from 2 mA to 72 mA. The system automatically
adjusts this value to reach the manually set value. The exposure time is
also computed automatically from the manually set value and appears
rounded to the first digit after the decimal point on the display.
To make a direct radiographic exposure, do the following:
WARNING
Make sure that the film cassette holder is properly
attached to the image intensifier, so that the cassette
cannot fall down onto the patient!
NOTE
Make sure that the source/skin distance is at least 45 cm.
• Press the Radiogr. tab.

The Radiography operating mode is activated. The direct
radiography controls appear in the dynamic control area.
18-2 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Fig. 18-2 Radiography operating mode
• Set the desired tube voltage value using the arrow buttons.
The selected value appears on the Voltage display.
• Set the desired tube current × time (mAs) value using the arrow
buttons.
The selected value appears on the mAs display.
• Initiate radiation using the hand switch. In the Radiography operating

mode, you cannot initiate radiation with the foot switch.
An audible alarm will sound throughout the exposure time. Radiation
is terminated automatically after the computed exposure time. You
can interrupt the exposure before the computed exposure time has
elapsed by releasing the hand switch.
• Withdraw the film cassette.
• Remove the film cassette holder from the image intensifier.
Ziehm Vision 18-3

P_26366/CD_28189 - EN-04/2008
18-4 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
19 System Configuration
19.1 Overview
A large number of parameters can be preset for the Ziehm Vision. General
The following controls are provided for this purpose:
− Configuration operating mode – Operation Settings
(→ Ch. 19.2, p. 19-2)
− Configuration operating mode – Basic Settings
(→ Ch. 19.3, p. 19-7)
− Configuration operating mode – Cine/DSA/Dose
(→ Ch. 19.4, p. 19-10)
− Managing storage media (Configuration operating mode – Storage
Media, → Ch. 19.5, p. 19-15)
− Setting the flat-screen monitors (→ Ch. 19.6, p. 19-19)
The Vision Center control panel on the C-arm stand also provides access Service settings
to the Service Settings. This access is password-protected.
Consequently, the following settings and/or actions can and must be
made by trained service engineers only:
− Settings for anatomical programs
− DICOM settings
− Collimator adjustments
Ziehm Vision 19-1

P_26366/CD_28189 - EN-04/2008
19.2 Operation settings
Function Under Operation Settings you define the settings which determine the
operational conditions during fluoroscopy.
• Press the Config tab.
The Configuration operating mode is activated. The Operation
Settings controls appear.
Fig. 19-1 Configuration operating mode
19.2.1 Autotransfer
Moving the Under Autotransfer you activate or deactivate the Autotransfer

fluoroscopic image (automatic image swapping) function.
Fig. 19-2 Autotransfer
− Autotransfer activated:
When you initiate radiation, the fluoroscopic image on the live screen
is moved automatically to the reference screen.
− Autotransfer deactivated:
When you initiate radiation, the present fluoroscopic image on the live
screen is automatically deleted.
When you switch on the system, the Autotransfer function is deactivated
by default.
19-2 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
To activate the Autotransfer function, do the following:

• Press the Autotransfer option.
The check box receives a check mark.
• Press the Apply button.
The Autotransfer function is activated.
19.2.2 Autostore
Under Autostore you activate or deactivate the Autostore (automatic

saving) function.
Fig. 19-3 Autostore
− Autostore activated:
During each fluoroscopy, a new image will be saved automatically as
soon as you terminate radiation.
− Autostore deactivated:
The system does not save the images automatically. You must save
the desired fluoroscopic images manually (→ p. 8-13).
Alternatively, you can activate the Autostore function by means of the
Save button (→ p. 8-14).
When you switch on the system, the Autostore function is deactivated
by default.
To activate the Autostore function, do the following:

• Press the Autostore option.
The Autostore function is activated.
Ziehm Vision 19-3

P_26366/CD_28189 - EN-04/2008
19.2.3 Image Swap with Save
Under Image Swap with Save you activate and deactivate the Image
Swap with Save function.
Fig. 19-4 Image Swap with Save
− Image Swap with Save activated:

As soon as you move a live image to the reference screen, this image
is saved automatically.
− Image Swap with Save deactivated:
The system does not automatically save the image that is moved to
the reference screen. You must save the image manually (→ Ch. 8.9,
p. 8-13) before moving it to the reference screen with the Image
Swapping button.
When you switch on the system, the Image Swap with Save function is
deactivated by default. If you activate the Image Swap with Save
function during operation, it will be deactivated automatically when you
switch off the system.
To activate the Image Swap with Save function, do the following:

• Press the Image Swap with Save option.
The Image Swap with Save function remains active until you switch
off the system.
19.2.4 Displaying a crosshair
Positioning aid Under Crosshair you determine whether a crosshair is displayed as

positioning aid (e.g. for foreign body localization, → Ch. 17.1, p. 17-2) in
the image on the live screen during fluoroscopy. The central point of the
crosshair corresponds to the position of the central X-ray beam. In
addition you can set whether you want the crosshair to be activated
together with the laser positioning device when pressing the Laser
button (→ Ch. 17.1, p. 17-2).
19-4 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Fig. 19-5 Crosshair
− Crosshair activated:
The crosshair is always displayed in the image on the live screen.
− Crosshair deactivated:
No crosshair is displayed on the live screen.
When you switch on the system, the crosshair is deactivated by default.
If you display the crosshair during operation, this setting will be valid only
for the current session.
− with Laser on activated:
When you press the Laser button, the crosshair is activated together
with the laser positioning device.
− with Laser on deactivated:
When you press the Laser button, only the laser positioning device is
activated.
To display the crosshair, do the following:

• Press the Crosshair option.
The crosshair remains displayed until you switch off the system.
To have the crosshair activated with the Laser button, do the

following:
• Press the Crosshair – with Laser on option.

When you press the Laser button, the crosshair is activated together
with the laser positioning device.
Ziehm Vision 19-5

P_26366/CD_28189 - EN-04/2008
19.2.5 Defining the start screen
Under Start Screen you determine which operating mode is activated by

default after power-up of the Ziehm Vision.
Fig. 19-6 Start screen
The following options are available:

− Fluoro:
After power-up of the system, the Fluoroscopy operating mode is
activated.
− Subtraction:
After power-up of the system, the Subtraction operating mode is
activated.
− Patient:
After power-up of the system, the Patient operating mode is
activated.
The default start screen is configured according to the customer’s
wishes.
To define the start screen, do the following:

• Press the option for the desired operating mode.

As from the next power-up of the system, the selected operating
mode will be activated automatically.
19.2.6 Discarding the operation settings
After having defined or modified the operation settings, these settings

must be applied explicitly in order to become valid in the system. As long
as the settings or changes have not been applied yet, you can discard
them, so that the previous settings remain valid.
19-6 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
To discard the operation settings which have not been applied yet,
do the following:
• Press the Cancel button.
or
• Quit the Configuration operating mode without applying the settings.
19.3 Basic settings
Under Basic Settings you make different settings which directly affect Function
the user interface, e.g. default data for the date or hospital department.
Usually, the basic settings are made by a service engineer when putting
the system into service. However, you can modify the basic settings if
you wish to.
• Press the Basic Settings button.
The Basic Settings controls are displayed in the dynamic control area.
Fig. 19-7 Basic settings
19.3.1 Setting the system date and the system time
The system date and the system time must be entered once in order to
enable the system to store and display the date and time of saving
together with the image data.
Ziehm Vision 19-7

P_26366/CD_28189 - EN-04/2008
Date format The displayed date format may vary depending on the customer-specific
settings (order of day, month and year; dot or slash as date separator).
The set date format is also used for displaying patient data in the Patient
(→ Ch. 10.2, p. 10-2) and Archive (→ Ch. 10.3, p. 10-7) operating
modes. Throughout this document, the DD.MM.YYYY date format is
used.
• If you want to change the date format, please contact your in-house
service engineer.
To set the system date and system time, do the following:

The Configuration operating mode is activated.
The Basic Settings controls are displayed in the dynamic control
area.
• Press the Time button.
The button is highlighted in yellow, and the cursor jumps to the Time
input box.
• Enter the system time in the Time input box using the format
hh:mm:ss.
• Press the Date button.
The button is highlighted in yellow, and the cursor jumps to the Date
input box.
• Enter the system date in the Date input box.

19.3.2 Selecting the live screen
Under Live Image you determine which screen will act as the live screen.
The live screen is the screen where the live fluoroscopic image is
displayed. The other screen serves as reference screen, where the
saved fluoroscopic images from the image memory are opened and
displayed.
Fig. 19-8 Determining the live screen
The following options are available:

− Live Image left:
The left screen is the live screen, and the right screen is the reference
screen
19-8 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
− Live Image right:

The right screen is the live screen, and the left screen is the reference
screen
To determine the live screen, do the following:

area.
• Press the Live Image left or Live Image right option.

19.3.3 Entering the hospital data
In order to avoid having to type the same hospital data for each new
patient folder you create, you can preset default data for the Hospital,
Department and Doctor input boxes (→ Ch. 10.2.1, p. 10-3). This data
appears automatically in the Patient operating mode.
To define default data for the Hospital, Department and Doctor input
boxes, do the following:
area.
• Press the Hospital button.
The button is highlighted in yellow, and the cursor jumps to the
Hospital input box.
• Enter the desired name in the Hospital input box.

• Press the Department button and enter the desired name in the
Department input box.
• Press the Doctor button and enter the desired name in the Doctor
input box.
Ziehm Vision 19-9

P_26366/CD_28189 - EN-04/2008
19.3.4 Discarding the basic settings
After having defined or modified the basic settings, these settings must
be applied explicitly in order to become valid in the system. As long as
the settings or changes have not been applied yet, you can discard them,
so that the previous settings remain valid.
To discard the basic settings which have not been applied yet, do
the following:
or
19.4 Cine/DSA/Dose
Function Under Cine/DSA/Dose you make various settings for the cine loop and
the subtraction operating modes.
• Press the Cine/DSA/Dose button.
The controls for the cine loop and subtraction operating modes are
displayed in the dynamic control area.
Fig. 19-9 Cine/DSA/Dose
19-10 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
19.4.1 Cine loop settings
Under Cine you preset the frame rate (speed) and the number of frames
(length) that are used for generating cine loops. You can change these
preset values during operation for each cine loop you acquire.
Fig. 19-10 Cine loop settings
To preset the frame rate for cine loops, do the following:

• Select the desired frame rate (number of frames per second) under
Rate with the help of the arrow buttons.
When you acquire a cine loop, the selected value is preset under
Frames/s (→ p. 12-3).
To preset the length of cine loops, do the following:

• Select the desired number of frames under Length with the help of
the arrow buttons.
When you acquire a cine loop, the selected value is preset under
Length (→ p. 12-3).
Under Autoplay you activate or deactivate the Autoplay (automatic cine
loop playback) function.
Fig. 19-11 Autoplay
− Autoplay activated:
After you have acquired a cine loop, it is replayed automatically.
− Autoplay deactivated:
You must start cine loop playback manually.
Ziehm Vision 19-11

P_26366/CD_28189 - EN-04/2008
When you switch on the system, the Autoplay function is deactivated by

default. If you activate the Autoplay function during operation, it will be
deactivated automatically when you switch off the system.
To activate the Autoplay function, do the following:

• Press the Autoplay option.
The Autoplay function remains active until you switch off the system.
19.4.2 Showing or hiding the native image
Under DSA you determine whether the native image is displayed on the
reference screen during generation of a DSA/MSA/RSA (→ Ch. 13.2,
p. 13-3, → Ch. 13.3, p. 13-5, → Ch. 13.4, p. 13-6).
Fig. 19-12 Showing or hiding the native image
− Native on activated:
When you generate a DSA cine loop or MSA/RSA images, the native
image is displayed on the reference screen.
− Native on deactivated:
When you generate a DSA cine loop or MSA/RSA images, no native
image is displayed. Before switching to the Subtraction operating
mode, you may open a reference image on the reference screen,
which remains displayed there during the entire subtraction process.
To display the native image in the Subtraction operating mode, do

the following:
• Press the DSA Native on option.

When you generate a DSA cine loop or MSA/RSA images, the native
image is displayed on the reference screen.
19-12 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
19.4.3 MSA Autotransfer
Under MSA Autotransfer you activate or deactivate the MSA

Autotransfer (automatic MSA or RSA image generation) function.
Fig. 19-13 MSA Autotransfer
− MSA Autotransfer activated:

Following the acquisition of a DSA cine loop, the MSA or RSA image
is generated automatically.
− MSA Autotransfer deactivated:
You must generate the MSA or RSA image step by step.
When you switch on the system, the MSA Autotransfer function is
deactivated by default. If you activate the MSA Autotransfer function
during operation, it will be deactivated automatically when you switch off
the system.
To activate the MSA Autotransfer function, do the following:

• Press the MSA Autotransfer option.
The MSA Autotransfer function remains active until you switch off
the system.
Ziehm Vision 19-13

P_26366/CD_28189 - EN-04/2008
19.4.4 DSA CO2
Under DSA CO2 you activate or deactivate the DSA CO2 function.
Fig. 19-14 DSA CO2
In that case, the CO2 mode as well as a corresponding AERC

characteristic are automatically preset. The contrast medium path is
corrected so as to appear black.
− DSA CO2 activated:
The CO2 mode as well as a corresponding AERC characteristic are
automatically preset. DSA cine loops are automatically generated in
CO2 mode.
− DSA CO2 deactivated:
DSA cine loops are generated in standard mode.
19.4.5 Discarding the cine loop and subtraction settings
After having defined or modified the settings on this tab, these settings
must be applied explicitly in order to become valid in the system. As long
as the settings or changes have not been applied yet, you can discard
them, so that the previous settings remain valid.
To discard the settings which have not been applied yet, do the
following:
or
19-14 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
19.5 Storage media
Under Storage Media you can define the graphics formats used for Function
saving images to different storage media. Furthermore, you can delete
data from different external storage media.
Fig. 19-15 Storage media
Depending on your chosen system configuration, you can save one or Graphics formats
more images in various graphics formats to different storage media.
Some formats with reduced resolution and color depth are also available.

CD/DVD USB stick
on
16 bit TIF *.tif 1024 × 1024 16 bit 2 MB • •
DICOM — 1024 × 1024 16 bit 2 MB • •
Multimedia:
cine loop
Single *.jpg 512 × 512 8 bit 256 KB • •
images
DICOM — 512 × 512 8 bit 256 KB • •
JPEG *.jpg 512 × 512 8 bit 256 KB • •
Ziehm Vision 19-15

P_26366/CD_28189 - EN-04/2008
NOTE
19.5.1 Defining the USB stick storage format
Graphics formats For saving selected images to a USB stick in the Archive operating
mode (→ p. 10-26), the following graphics formats are available:
− TIF with a color depth of 16 bit (for further use on a PC)
− JPEG with a resolution of 512×512 pixels and a color depth of 8 bit
(for further use on a PC)
− DICOM (for further use on a DICOM network or viewing with a
DICOM viewer in 1024×1024 pixels/16 bit original format)
− DICOM with a resolution of 512×512 pixels and a color depth of 8
bit (for further use on a DICOM network or viewing with a DICOM
viewer)
Under USB Format you determine which of these graphics formats is
used for saving images to a USB stick. There is no possibility to set the
desired graphics format on the spot in the Archive operating mode when
saving images.
Fig. 19-16 USB format
To define the USB stick storage format, do the following:

• Press the Storage Media button.
• Press the desired storage format option under USB Format.

19-16 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
19.5.2 Defining the CD/DVD storage format
With the DVD writer, data can be written to both CDs and DVDs. DVD writer
For writing selected images to CD or DVD in the Archive operating mode Graphics formats
(→ p. 10-27), the following graphics formats are available:
− TIF with a color depth of 16 bit (for further use on a PC)
− JPEG with a resolution of 512×512 pixels and a color depth of 8 bit
(for further use on a PC)
− DICOM (for further use on a DICOM network or viewing with a
DICOM viewer in 1024×1024 pixels/16 bit original format)
− DICOM with a resolution of 512×512 pixels and a color depth of 8
bit (for further use on a DICOM network or viewing with a DICOM
viewer)
− Multimedia (JPG and AVI files for viewing or replaying on the PC)
Under CD/DVD Format you determine which of these graphics formats
is used for writing images to CD or DVD. There is no possibility to set the
desired graphics format on the spot in the Archive operating mode when
saving images.
Fig. 19-17 CD/DVD format
To define the CD/DVD storage format, do the following:

• Press the desired storage format option under CD/DVD Format.

Ziehm Vision 19-17

P_26366/CD_28189 - EN-04/2008
19.5.3 Deleting data from storage media
To delete all images from a USB stick, do the following:

• Press the Erase USB Media button.

The following confirmation prompt is displayed: Erase USB Media

All images are deleted from the USB stick.
19.5.4 Selecting a DICOM storage server
You can select the desired DICOM storage server from the drop-down list
box below the storage formats (→ Fig. 19-18, p. 19-18). You can access
only the servers that have been enabled by your in-house service
engineer.
• Please contact your in-house service engineer if you want to access

further servers.
To select a DICOM storage server, do the following:

• Press the Down Arrow button.
All available servers are displayed in the drop-down list:
Fig. 19-18 Selecting a storage server
19-18 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
• Select the desired sever.

The desired DICOM storage server is selected.
19.6 Setting the flat-screen monitors
You can change the following screen settings yourself: Screen settings
− Brightness
− Contrast
− Backlight brightness
− Menu language for screen settings
In addition, you can restore the factory settings.
The factory-set menu language is English.
If you want to change any of the following screen settings, please contact
your in-house service engineer:
− Video source (Inputs)
− Gamma
− Display settings (Picture), e.g. horizontal and vertical position,
sharpness, scaling
− Menu setup (Setup), e.g. menu lock (exception: language setting)
19.6.1 Built-in keypad
Each flat-screen monitor has a built-in keypad with six keys, which are
used for accessing the screen setting menus.
Fig. 19-19 Built-in keypad of the flat-screen monitor
Ziehm Vision 19-19

P_26366/CD_28189 - EN-04/2008
19.6.2 Setting the brightness, contrast and backlight brightness
Brightness To set the screen brightness, do the following:

• Press the Brightness/Contrast key.
The Brightness control appears on the screen.
• Press the + or – arrow key to increase or decrease the screen

brightness.
The settings become immediately active on the screen. After a few
seconds, the Brightness control disappears automatically.
Contrast To set the screen contrast, do the following:

• Press the Brightness/Contrast key twice.
The Contrast control appears on the screen.
• Press the + or – arrow key to increase or decrease the contrast.

seconds, the Contrast control disappears automatically.
Backlight To set the screen backlight brightness, do the following:

brightness
• Press the Brightness/Contrast key three times.
The Backlight Brightness control appears on the screen.
• Press the + or – arrow key to increase or decrease the backlight

brightness.
seconds, the Brightness control disappears automatically.
19-20 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
NOTE
Lowering the backlight level will increase the backlight
lifetime.
19.6.3 Setting the menu language
The factory-set menu language is English. You can choose one of the
following languages as menu language:
− German
− French
− Italian
− Spanish
− Dutch
− Swedish
To define the menu language, do the following:

• Press the MENU key.
The on-screen menu appears.
• Select the Setup tab with the help of the + or – arrow keys.
• Move to the Language item with the help of the Scroll key.
• Press the + arrow key until the desired language is displayed.

All on-screen menu elements and controls are displayed immediately
in the chosen language.
Ziehm Vision 19-21

P_26366/CD_28189 - EN-04/2008

The on-screen menu disappears.
19.6.4 Restoring the factory settings
After having changed the screen settings, you may restore the factory-
set values at any time.
To restore the factory settings, do the following:

The on-screen menu appears.
• Select the Defaults tab with the help of the + or – arrow keys.
• Press the Scroll key.

The Factory Defaults item is selected.
• Press the + arrow key.

The on-screen menu disappears. All settings are reset to the factory
values.
19-22 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
A.1 Regular checks
A.1.1 Routine checks to be performed by the user
The following safety checks must be performed at regular intervals:
Check Interval Remarks

X-ray generator Monthly Inspect for physical damage.
Radiation switches Monthly Must initiate radiation only if
pressed permanently. Releasing
them must terminate radiation
after 1 s max. (depending on the
LIH filter settings).
Radiation signals Monthly During the exposure, the yellow
radiation warning lamp on top of
the monitor housing and the X-ray
symbol on the control panel must
be illuminated.
Audible alarm Monthly Must sound in direct radiography
mode during the whole exposure
time, and in fluoroscopy mode at
5 min. intervals.
Information labels Monthly All warning and information labels
must be properly attached and
easily legible.
Power cable Monthly Must not show any signs of
physical damage.
C-arm stand Wheneve Clean when dirty.
wheels r
necessar
y
Table A-1 Regular checks
NOTE
For a detailed maintenance schedule, please refer to the
corresponding Technical Manual. Technical information
necessary to repair or upgrade the Ziehm Vision system
will be made available by Ziehm Imaging to authorized
and qualified personnel upon request.
Ziehm Vision A-1

P_26366/CD_28189 - EN-04/2008
Appendix A
A.1.2 Consistency test according to national regulations
At regular intervals, at least once a month, you must check whether the
system shows any deviations from the reference values by performing a
consistency test.
NOTE
The relevant radiation protection regulations of the
country of installation must be observed.
Check the displayed dose values during the regular consistency test by
comparing them to the values of a reference measurement.
A.1.3 Checking the exposure rate control
Quantitative method:
The system is in its initial state after switching it on.
The following value must be achieved:
70±3kV
Measured with a 25 mm Al + 1.5 mm Cu patient equivalent filter inserted
in the X-ray beam.
A.1.4 Dose meter check
Test interval You should check the dose meter each time you switch on the system.
You must perform and document a dose meter check once a month when
you perform the consistency test.
To check the dose meter, do the following:

• Press the Cine/DSA/Dose button.
The Dose Meter Check button is displayed in the dynamic control
area.
A-2 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
Fig. A-1 Sensor / dose meter check functions
• Press the Dose Meter Check button.

The test starts. It takes 30 s. A message window with a progress
indicator and the message DAP test running is displayed. A Cancel
button appears in addition, enabling you to interrupt the check.
Once the test is complete, and if the measured values are within the
tolerance limits, the message DAP ok; actual value: xyz is
displayed.
If the measured values are beyond the tolerance limits, the following
message appears:
DAP fault; nominal value: x, actual value: y
• If the values are beyond the tolerance limits, repeat the dose meter
check.
• If the values measured are still beyond the tolerance limits, please
contact your in-house service engineer.
A.1.5 Checking the computed dose values
Check the displayed dose values during the regular consistency test by
comparing them to the values of a reference measurement.
Ziehm Vision A-3

P_26366/CD_28189 - EN-04/2008
Appendix A
A.1.6 Checking the useful beam
Inspection interval Together with the consistency test, it is necessary to check the size and
centering of the useful X-ray beam.
Centering To determine the correct alignment of the ray beam to the center of the
image intensifier and any possible deviation, do the following:
• Angulate the C-arm by 180°, so that the X-ray generator is above and
the image intensifier or digital flat-panel detector is below.
• Place a reference or test object (e.g. measuring board, graduated

collimator test tool) exactly in the center of the image intensifier.
• Close the iris collimator as far as possible and initiate radiation by

pressing the hand or foot switch. The object must appear exactly in
the center of the fluoroscopic image.
Collimator diameter The size of the collimator diameter in the image plane must not differ from
accuracy the nominal image diameter by more than 2% of the source/image
receptor distance (SID). The SID and the nominal image diameter
depend on the image intensifier or flat-panel detector size.
Size SID Nominal image

diameter
31 cm 97 cm 27.0 cm
23 cm 97 cm 20.1 cm
19.8 × 19.8 cm2 111 cm —
Table A-2 Nominal image diameter
Maximum radiation When the iris collimator is completely open, the edges of the collimator
field size must be just visible on the screen.
Ziehm Vision FD When the image is rotated by 1° and the iris collimator is completely
open, the edges of the collimator must be just visible on the screen.
WARNING
Contact your after-sales service center in case of any
non-conformities!
A-4 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
A.1.7 Leakage in the cooling system
If you observe any moisture on the outside of the C-arm stand during Moisture
operation, leakage of the cooling system might be the reason. Cooling penetration
may be diminished or fail completely in such cases.
If there is leakage in the generator area, the cooling pump switches off, Leakage in the
and a message window with an alert appears on the control panel. generator
WARNING
Contact your after-sales service center in case of any
moisture penetration or generator leakage!
A.1.8 Gettering the image intensifier tube (n/a for Ziehm Vision FD)
To increase the useful life of the image intensifier, we recommend Increasing the
gettering the image intensifier tube after a period of 6 months of useful life
continuous non-use or storage.
To getter the image intensifier tube, do the following:
• Switch on the system.
• Leave it switched on for at least 1 hour.
• Do not initiate radiation during this time!
We recommend keeping an operator’s log, where all operating times, Operator’s log
gettering times and maintenance events are recorded.
A.1.9 Gain adjustment and pixel correction (Ziehm Vision FD)
On a Ziehm Vision FD, it is necessary to perform a gain adjustment and

a pixel correction procedure every 6 months. Please contact your after-
sales service center for that purpose.
WARNING
If the live image shows streaks although the gain
adjustment and pixel correction procedures have been
performed at regular intervals, please contact your after-
sales service center!
Ziehm Vision A-5

P_26366/CD_28189 - EN-04/2008
Appendix A
A.2 Cleaning, disinfection, sterilization
Preparation Always switch off the system and disconnect it from the power supply
before cleaning or disinfecting it.
A.2.1 Cleaning
Recommended For cleaning the system, use only water with mild detergents applied with
detergents a damp cloth. Never use abrasive cleansing agents, organic solvents or
detergents which contain solvents (e.g. alcohol, petroleum ether, liquid
stain remover).
NOTE
If the unit presents dirt stains that cannot be removed with
the method described above, please contact your in-
house service engineer.
WARNING
Take care that no liquids penetrate into the unit through
sockets, plugs, ventilation holes or gaps (integrated
external devices!).
Never apply spray cleaners directly onto the unit!
Cleaning the For cleaning the display screens, use only pure alcohol or a mixture
monitor screens consisting of 1/3 alcohol and 2/3 distilled water. Wipe the screens and
surrounding painted surfaces dry with a soft cotton cloth immediately
after cleaning.
A.2.2 Disinfection
You must use one of the following disinfectants:

− Terralin®
− Dax YT
− Antifect® AF
• Dilute the disinfectant according to the manufacturer’s instructions.
• Dampen a cloth with the solution.
• Thoroughly wipe the entire outside of the unit with this cloth.
A-6 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
WARNING
Never use pure alcohol or Sagrotan for disinfection, as
these substances may corrode the surfaces.
Never use disinfecting sprays, since the liquid droplets
may penetrate inside the unit, endangering safe system
operation. Electronic components may be damaged, and
explosive air/solvent vapor mixtures may develop.
A.2.3 Sterilization
The detachable film cassette holder is sterilizable.
CAUTION
The detachable film cassette holder is non-sterile upon
delivery.
Make sure to sterilize it prior to first use. Make sure to
clean and sterilize it after each subsequent use!
The disposable covers (optional accessories) are sterile upon delivery.
CAUTION
The disposable covers are not resterilizable.
Be sure to discard the disposable covers properly after
use!
For attaching the sterile disposable covers to the C-arm → Appendix B.1,
p. B-1.
A.3 Malfunctions
A.3.1 Types of malfunctions
The following types of malfunctions are detected and indicated:
A.3.1.1 Alerts during power-up
Alert messages are displayed in a message window on the control panel.

An audible alarm sounds. If you get an alert message during system
power-up, you can close the message window and continue to work with
the system. However, the system will not be fully operational.
Ziehm Vision A-7

P_26366/CD_28189 - EN-04/2008
Appendix A
• Press the Yes button in the message window.

The message window is closed.
A.3.1.2 Errors during power-up
Error messages are displayed in a message window on the control panel.

An audible alarm sounds. Although you can close the message window,
you cannot continue to work with the system.
The message window is closed. In some cases, a new message
window with another error message is displayed.
WARNING
If an error message is displayed, the system is not ready
for operation!
The error must be corrected by your after-sales service
center!
Please communicate the error code number (E...) and the
serial number of the system to your after-sales service
center.
A.3.1.3 Alerts during operation
Alert messages are displayed in a message window on the control panel.

An audible alarm sounds. If you get an alert message during system
operation, radiation is not interrupted, and you can continue to initiate
radiation. However, the system will not be fully operational.
The message window is closed.
A.3.1.4 Errors during operation
Error messages are displayed in a message window on the control panel.

An audible alarm sounds. Radiation is interrupted and you can no longer
initiate any radiation.
The message window is closed. In some cases, a new message
window with another error message is displayed.
A-8 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
WARNING
If an error message is displayed, the system is not ready
for operation!
The error must be corrected by your after-sales service
center!
Please communicate the error code number (E...) and the
serial number of the system to your after-sales service
center.
WARNING
Please contact your after-sales service center also if a
certain error occurs frequently!
A.3.2 List of errors, alerts and status messages
If an alert or status message is displayed, do the following:

The message window is closed. You may continue to work. The
system is not fully operational.
If an error occurs, do the following:
• Contact your after-sales service center.
Code Type Description

E1000 Error Thin filament defective
E1001 Error Thick filament defective
E1002 Error No V-Sync
E1003 Error Operating temperature not yet reached, please wait
E1004 Alert Cooling phase in process, please wait
E1005 Error Temperature 2 too low
E1006 Alert Temperature 2 too high
E1007 Error Machine data corrupt
E1008 Error Interrupt 1 flipflop defective
E1009 Error Interrupt 2 flipflop defective
E1010 Error HW signal XRay active during power-up
E1011 Error CAN XRay Enable active during power-up
Table A-3 List of errors and alerts
Ziehm Vision A-9

P_26366/CD_28189 - EN-04/2008
Appendix A

E1012 Error D/A converter reference voltage defective
E1013 Error D/A converter kV defective
E1014 Error Oil overtemperature switch active
E1015 Error Wrong machine data version
E1016 Error Moisture sensor alarm
E1017 Error Test of ‘FAULT’ signal failed
E1018 Error Debug switch is on
E1019 Error Monitoring anode rotation does not work
E1050 Alert High-voltage fault
E1051 Alert High-voltage fault (anode)
E1052 Alert High-voltage fault (cathode)
E1053 Alert mA peak value fault
E1054 Alert kV nominal/actual value fault
E1055 Alert mA nominal/actual value fault
E1056 Alert XRay Enable fault
E1057 Alert Life monitoring missing
E1058 Alert Hardware monitoring missing
E1059 Alert External radiation interrupt (XRayBreak)
E1060 Alert Signal / XRay missing
E1061 Alert High-voltage arc
E1062 Alert Nominal kV value greater max. kV value
E1063 Alert Nominal mA value greater max. mA value
E1064 Alert Nominal mA value greater max. mA value
E1065 Alert Nominal power value greater max. power value
E1066 Alert CAN fault line active
E1067 Error Basic heating faults
E1068 Error V-Sync faults
E1069 Alert Temperature sensor 1
E1070 Alert Temperature sensor 2
E1071 Error Signal / XRay without radiation
E1072 Error Oil overtemperature switch active
E1073 Error Moisture sensor alarm
E1074 Error kV value too high (no radiation)
Table A-3 List of errors and alerts (cont.)
A-10 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A

E1075 Error Test of rotating anode failed
E1082 Alert Nominal kV value less min. kV value
E1083 Error Rotating anode could not be started
E1084 Error Rotating anode failed
E1085 Alert Average Power in Burst Mode > 600 Watt
E1086 Alert mA-Value too high for thin filament
E1095 Alert Generator overheated, recovery time %d seconds a
E1098 Error Generator power-up fault
E1099 Error Generator fault
E1100 Alert Hand switch 1 pressed during power-up
E1101 Alert Hand switch 2 pressed during power-up
E1102 Alert Foot switch 1 pressed during power-up
E1108 Error Short circuit in hand switch 1
E1110 Error Short circuit in foot switch 1
E1116 Error XRay Enable present during power-up
E1117 Error External I/O fault
E1118 Error Wrong EEPROM checksum
E1132 Alert Short circuit in hand switch 1
E1133 Alert Short circuit in hand switch 2
E1134 Alert Short circuit in foot switch 1
Ziehm Vision A-11

P_26366/CD_28189 - EN-04/2008
Appendix A

E1140 Alert XRay Enable not active
E1141 Alert CAN fault line active
E1142 Alert External I/O fault
E1143 Error Error Lifemonitoring Imaging System
E1148 Alert Timeout post-fluoro time (LIH)
E1172 Error XRay Enable without switch
E1173 Error CAN fault line active
E1174 Error External I/O fault
E1175 Error Error Lifemonitoring Imaging System
E1176 Error Fan blocked
E1197 Error Main interface XRay break fault
E1198 Error Main interface power-up fault
E1199 Error Main interface fault
E1200 Error Timeout main interface (1)
E1201 Error Timeout main interface (2)
E1202 Error Timeout while reading power-up errors
E1203 Error Timeout generator machine data (1)
E1206 Error Timeout generator pulse width
E1207 Error Timeout filament selection
E1208 Error Timeout measuring range selection
A-12 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A

E1209 Error Timeout kVmA setpoint value
E1210 Error Timeout while reading collimator limit value (1)
E1211 Error Timeout while reading collimator limit value (2)
E1212 Error Timeout ack system running
E1213 Alert Timeout while reading XRay break errors
E1214 Alert Timeout XRay break: interface busy
E1215 Error Internal error %d a
E1216 Alert Internal alert %d a
E1217 Error Error while clearing hard disk %d a
E1218 Error Timeout CAN module %d CAN Bus switched off by host a
E1219 Error Unexpected ACK from CAN module %d a
E1220 Alert Function assigned to XRay switch (%d), ignored! a
E1221 Alert XRAY command assigned to function switch (%d), ignored! a
E1222 Alert Temperature limit alert: Reduce radiation power!
E1223 Error CAN bus cannot be addressed during power-up!
E1224 Error CAN Module missing:
E1225 Alert Radiation allowed after technique values are displayed!
E1226 Error CAN Modules missing:
E1227 Error CAN module faulty: %d a
E1228 Error CAN Module 6 U544 faulty
E1229 Error CAN Bus faulty BUS OFF
E1230 Error Only CAN Module 6 U544 present
E1231 Error CAN Module(s) not connected correct ( stand alone ? )
E1232 Error Timeout: no answer from a CAN Module
E1233 Error Memory full. Image can not be stored!
E1234 Error dis8000.ini missing!
E1235 Error No acknowledge to %d from %d a
E1236 Error vision.md does not match U544 firmware
E1237 Error vision.md does not match dongle
E1238 Error Machine data missing
E1239 Message Service task performed by:
E1240 Message Database OK
E1241 Error Database damaged. Please clear hard disk !
Ziehm Vision A-13

P_26366/CD_28189 - EN-04/2008
Appendix A

E1242 Error Mobile stand not detected, but Main Interface present!
E1243 Error Iris calibration error !
E1244 Error vision.md: Section missing!
E1245 Error Radiation blocked by key switch
E1299 Error Image system fault
E1300 Error SPI interface MAX 504
E1301 Alert Overtemperature
E1302 Error Reference voltage MAX 504
E1303 Error Output voltage MAX 504
E1350 Error SPI interface MAX 504
E1351 Alert Overtemperature
E1352 Alert Actual value too high
E1353 Alert Actual value too low
E1354 Error Output voltage MAX 504
E1355 Error CAN fault line active
E1358 Alert Output voltage beyond tolerance
E1398 Error PPS power-up fault
E1399 Error PPS fault
E1400 Error Servo %d position fault a
E1401 Error Servo %d not connected a
E1402 Error Servo %d not ready a
E1449 Error Vision Track fault
E1450 Error Servo position fault
E1451 Error Servo not connected
E1452 Error Servo not ready
E1499 Error II power supply fault
E1500 Alert Radiation alert lamp defective
E1501 Alert CRT high voltage
E1502 Alert Video voltage
E1503 Alert Video signal
E1504 Alert CRT filament
E1505 Alert Horizontal deflection
A-14 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A

E1506 Alert 150V supply
E1507 Alert Vertical deflection
E1509 Alert V-Blank signal missing
E1516 Alert Radiation alert lamp defective
E1517 Alert CRT high voltage
E1518 Alert Video voltage
E1519 Alert Video signal
E1520 Alert CRT filament
E1521 Alert Horizontal deflection
E1522 Alert 150V supply
E1523 Alert Vertical deflection
E1599 Error Monitor fault
E1600 Alert Busy printer 1 active
E1601 Alert Busy printer 2 active
E1620 Alert Printer 1 busy error
E1649 Error U525 fault
E1700 Alert kVmA table: kV not ascending
E1701 Alert kVmA table: Power not ascending
E1702 Alert kVmA Table not finished
E1703 Alert kV maximal value too high
E1704 Alert mA maximal value too high
E1705 Error No external video signal
E1708 Error Generator pulse error
E1709 Error No VSync
E1710 Error No Interrupt
E1711 Error No Communication PPC-generator
Ziehm Vision A-15

P_26366/CD_28189 - EN-04/2008
Appendix A

E1712 Error mA from generator invalid
E1713 Error XRAY not allowed
E1714 Error Max mA value cannot be read.
E1716 Error SDRAM PPC defective
E1717 Error GammaLUT PPC defective
E1718 Error Offset adjustment not possible
E1719 Error Gain adjustment not possible
E1720 Error Hardware Version, Release
E1721 Error IRQ3 Error
E1722 Error VSync korrupt 30/25 Hz
E1723 Error Video standard unknown
E1724 Error Bootprogram unknown
E1725 Error M-Data unknown
E1726 Alert Collimator does not support DAP values
E1727 Error Flatpanel not supported in this version
E1732 Error Reference voltage defective
E1733 Error AD14 Offset adjustment defective
E1734 Error AD14 Gain adjustment defective
E1735 Error AD14 Gain*4 adjustment defective
E1736 Error AD8 Offset adjustment defective
E1737 Error AD8 Gain adjustment defective
E1738 Error No external video signal
E1740 Error Hardware doesn't support grid regulation
E1741 Error Hardware doesn't support motion detection
E1742 Error Hardware doesn't support DAP calculation
E1743 Error Hardware doesn't support automatic dose reduction
E1799 Error Error PPC
a. %d is a placeholder for a number
A-16 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
A.4 Labels on the Ziehm Vision
I
1*
D
F E
2#
B 2)
G
2!
C
I
Fig. A-2 Labels on the C-arm stand (Ziehm Vision)
1*
I
D
H
F E
B 2)
G
2!
C
I
Fig. A-3 Labels on the C-arm stand (Ziehm Vision FD)
Ziehm Vision A-17

P_26366/CD_28189 - EN-04/2008
Appendix A
1*
D
2@
H (Ziehm
Vision R
with 31 cm
i.i. only)
F
E
2) B
G
2!
C
I
Fig. A-4 Labels on the C-arm stand (Ziehm Vision R)
E J 1)
1)
Fig. A-5 Labels on systems with laser positioning device on the

image intensifier (left) and on the generator (right)
A-18 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
E J 1)
1) J

digital flat-panel detector (left) and on the generator (right)
(Ziehm Vision FD)
J
1)
1)

image intensifier (left) and on the generator (right) (Ziehm
Vision R)
Ziehm Vision A-19

P_26366/CD_28189 - EN-04/2008
Appendix A
1(
Interface panel for

monitor outputs
and DICOM
(→ Fig. A-10)
2!
1$
1@ 1!
1# G
Fig. A-8 Labels on the monitor cart of a Ziehm Vision
1(
Interface panel for

monitor outputs
and DICOM
(→ Fig. A-11)
2!
1$
1@ 1!
1# G
Fig. A-9 Labels on the monitor cart of a Ziehm Vision Endo
A-20 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
1^ 1%
Fig. A-10 Interface panel on the monitor cart, detailed view Ziehm
Vision
2$
Fig. A-11 Interface panel on the monitor cart, detailed view Ziehm
Vision Endo
Ziehm Vision A-21

P_26366/CD_28189 - EN-04/2008
Appendix A
The labels shown in the following table are merely reproductions. Their
sizes and colors may differ from reality and serve illustrative purposes
only.
No. Label Comments

B Ziehm Vision
Ziehm Vision FD
Ziehm Vision R
Table A-4 Labels on the Ziehm Vision (n/a for USA)
A-22 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
No. Label Comments

C Ziehm Vision
Ziehm Vision FD
Ziehm Vision R
TT = tube type
Possible tube types:
− RAD15
− RTM 70
Table A-4 Labels on the Ziehm Vision (n/a for USA) (cont.)
Ziehm Vision A-23

P_26366/CD_28189 - EN-04/2008
Appendix A
No. Label Comments

D Ziehm Vision (the illustrated image intensifier
type is an example)
Ziehm Vision FD
Ziehm Vision R (the illustrated image intensifier

type is an example)
A-24 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
No. Label Comments

E —
F —
G Please observe accompanying documents!
H —
I —
J Systems with laser positioning device only
1) Systems with laser positioning device only
Ziehm Vision A-25

P_26366/CD_28189 - EN-04/2008
Appendix A
No. Label Comments

1! Ziehm Vision
Ziehm Vision, 200V systems for Japan only
Ziehm Vision, 100V systems for Japan only
A-26 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
No. Label Comments

1! Ziehm Vision FD
Ziehm Vision R
The variables mean the following:
Y = Voltage rating
Z = Typical current consumption
U = Power supply fuse rating
The following combinations are possible:
− Y = 100 V, Z = 25 A continuous /
34 A momentary, U = C 20 A / C 30 A
28 A momentary, U = C 20 A
23 A momentary, U = C 20 A / C 30 A
1@ Equipotential grounding
1# Spare GND connection
1$ Protection Class I, Type B
Ziehm Vision A-27

P_26366/CD_28189 - EN-04/2008
Appendix A
No. Label Comments

1% —
Japan only
1^ Systems with DICOM option and RJ45

connection only; connection optionally either in
the upper or lower half of the monitor cart
1* Ziehm Vision
Ziehm Vision FD
Ziehm Vision R
A-28 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
No. Label Comments

1( Ziehm Vision
Ziehm Vision FD
Ziehm Vision R
2) China only
SERIAL NO.:
XXXX
1275
: 220V~ ± 10% 50/60 Hz± 1 Hz
< = 0,6 Ω
8A Contineous / 15A Momentary
L 16A
Class I Type B
Ziehm Imaging GmbH Germany

D-90451 Nürnberg - Donaustrasse 31
Manufactured Month:XXXXXX Year:XXXX
Made in Germany
Ziehm Vision A-29

P_26366/CD_28189 - EN-04/2008
Appendix A
No. Label Comments

2! EU countries only
2@ Please observe accompanying documents!

(Ziehm Vision R with 31 cm i.i. only)
2# Ziehm Vision, China only
2$ Ziehm Vision Endo only
4! a Optional foot switch pedal assignment

Function: Initiate radiation – Save
Background color: white
Art. No.: 58371
4! b Optional foot switch pedal assignment

Function: Initiate radiation – Save
Background color: transparent
Art. No.: 58372
4@ a Optional foot switch pedal assignment

Function: Initiate radiation – Cine
Art. No.: 58415
4@ b Optional foot switch pedal assignment

Function: Initiate radiation – Cine
Art. No.: 58416
A-30 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
No. Label Comments

4# a Optional foot switch pedal assignment
Function: Initiate radiation – Magnify
Art. No.: 58413
4# b Optional foot switch pedal assignment

Function: Initiate radiation – Magnify
Art. No.: 58414
4$ a Optional foot switch pedal assignment

Function: Initiate radiation – Snapshot
Art. No.: 58417
4$ b Optional foot switch pedal assignment

Function: Initiate radiation – Snapshot
Art. No.: 58418
4% a Optional foot switch pedal assignment

Function: DSA – Cine
Art. No.: 58419
4% b Optional foot switch pedal assignment

Art. No.: 58420
Ziehm Vision A-31

P_26366/CD_28189 - EN-04/2008
Appendix A
No. Label Comments

4^ a Optional foot switch pedal assignment
Function: Cine – Save
Art. No.: 58421
4^ b Optional foot switch pedal assignment

Function: Cine – Save
Art. No.: 58422
4& a Optional foot switch pedal assignment

ENDO Function: Cine – Endo On/Off-Freeze
Art. No.: 58423
4& b Optional foot switch pedal assignment

ENDO Function: Cine – Endo On/Off-Freeze
Art. No.: 58424
4* a Optional foot switch pedal assignment

Function: Cine – Endo On/Off
Art. No.: 58425
4* b Optional foot switch pedal assignment

Art. No.: 58426
A-32 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
No. Label Comments

4( a Optional foot switch pedal assignment
Function: Initiate radiation – Image swapping
Art. No.: 58427
4( b Optional foot switch pedal assignment

Function: Initiate radiation – Image swapping
Art. No.: 58428
5) a Optional foot switch pedal assignment

Function: DSA/MSA/RSA – Off
Art. No.: 58429
5) b Optional foot switch pedal assignment

Art. No.: 58430
5! a Optional foot switch pedal assignment

Function: Long stroke – DSA/MSA/RSA & Cine;
short stroke – Off
Art. No.: 58433
5! b Optional foot switch pedal assignment

Function: Long stroke – DSA/MSA/RSA & Cine;
short stroke – Off
Art. No.: 58434
Ziehm Vision A-33

P_26366/CD_28189 - EN-04/2008
Appendix A
No. Label Comments

5@ a Optional foot switch pedal assignment
Function: Cine – Image swapping
Art. No.: 58431
5@ b Optional foot switch pedal assignment

Function: Cine – Image swapping
Art. No.: 58432
5# a Optional foot switch pedal assignment

Function: Long stroke – DSA/MSA/RSA; short
stroke – Off & magnification
Art. No.: 58435
5# b Optional foot switch pedal assignment

Function: Long stroke – DSA/MSA/RSA; short
stroke – Off & magnification
Art. No.: 58436
A-34 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
A.5 Labels on the Ziehm Vision (USA)
2(b
3(
3&+3*
3#+3$
G
b 1#
Fig. A-12 Labels on the Ziehm Vision C-arm stand (USA)
2(b
3(
3#+3$
G
1# b
Fig. A-13 Labels on the Ziehm Vision FD C-arm stand (USA)
Ziehm Vision A-35

P_26366/CD_28189 - EN-04/2008
Appendix A
2(b
3(
3&+3*
3#+3$
G
1# b
Fig. A-14 Labels on the Ziehm Vision R C-arm stand (USA)
J
B
4) 1!
4!b-5$b 1@
C D
E F
Fig. A-15 Labels on the C-arm stand (USA)
A-36 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
3^ 1& a i
3% 1$
3! b 1%
(23 cm
image
intensifier)
1*a
3)
(31 cm front
image
intensifier)
3! b 1^
Fig. A-16 Labels on the generator (USA)
1# a
3@
1%
1^
1* b
1&b 1$
front rear
Fig. A-17 Labels on the 23 cm image intensifier for the Ziehm Vision
and Ziehm Vision R (USA)
1# a
3@
H
1%
1^
1*b
1&b 1$
front rear
Fig. A-18 Labels on the 31 cm image intensifier for the Ziehm Vision
and Ziehm Vision R (USA)
Ziehm Vision A-37

P_26366/CD_28189 - EN-04/2008
Appendix A
side
front front
1^
1$ 1&b 1# a
side
front rear
1% 1*b H
Fig. A-19 Labels on the digital flat-panel detector for Ziehm Vision FD
(USA).
2(c
2^
2% c 2% b
2% a
2)
2!
1(
2$ 4)
2@ 1)
2#
Fig. A-20 Labels on the monitor cart of a Ziehm Vision (USA)
4!a-5$a
Fig. A-21 Label on the two-pedal foot switch (USA)
A-38 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
The labels shown in the following table are merely reproductions. Their
sizes and colors may differ from reality and serve illustrative purposes
only.
No. Label Comments

B Model values: 1
Ziehm Vision
Ziehm Vision FD
Ziehm Vision R
ZIR/ZIN Part No.: 58444
C ZIR Part No.: 10-2936 1

ZIN Part No.: 58450
D Canada only 1
ZIR Part No.: 10-2937
ZIN Part No.: 58451
E ZIR Part No.: 10-2938 1

ZIN Part No.: 58452
F Canada only 1
ZIN Part No.: 58453
Table A-5 Labels on the Ziehm Vision (USA)
Ziehm Vision A-39

P_26366/CD_28189 - EN-04/2008
Appendix A
No. Label Comments

G Model values: 1
Ziehm Vision
Ziehm Vision FD
Ziehm Vision R
Max KVP values:
Ziehm Vision = 110 kV
Ziehm Vision FD = 110 kV
Ziehm Vision R = 120 kV
Filtration values:
Ziehm Vision, Ziehm Vision FD
= ≥ 3.9 mm AL / 110 kV
Ziehm Vision R
= ≥ 4,3 mm AL / 120 kV
Focal Spot values:
= 0.6 mm
Ziehm Vision R = 0.3 / 0.6 mm
Tube Housing values:
= VISION PULSE 3-110
Ziehm Vision R = VISION R 75
Tube Insert Type values:
= D-064R
Ziehm Vision R = RAD 15 or RTM 70
ZIR/ZIN Part No.: 10-2943
Table A-5 Labels on the Ziehm Vision (USA) (cont.)
A-40 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
No. Label Comments

H Model values: 1
Ziehm Vision
Ziehm Vision R
Model value: 1
Ziehm Vision FD
I ZIR Part No.: 10-2946 1

ZIN Part No.: 58302
J ZIR Part No.: 10-2947 1

ZIN Part No.: 58440
1) Please observe accompanying 1

documents!
ZIN Part No.: 58361
1! ZIR Part No.: 10-2949 1
ZIN Part No.: 58441
1@ Canada only 1
ZIN Part No.: 58448
1# a ZIR Part No.: 10-2951 1
ZIN Part No.: 58442
The label shall be positioned with the
pictured person facing up.
Ziehm Vision A-41

P_26366/CD_28189 - EN-04/2008
Appendix A
No. Label Comments

1# b ZIR Part No.: 10-2952 1
ZIN Part No.: 58443
The label shall be positioned with the
pictured person facing down.
1$ Systems with laser positioning device 2
only
ZIN Part No.: 58391
1% Systems with laser positioning device 2
only
ZIN Part No.: 58444
1^ Systems with laser positioning device 2

only
ZIN Part No.: 58445
1( a Systems with laser positioning device 1

only
ZIN Part No.: 58446
1& b Systems with laser positioning device 2
only
ZIN Part No.: 58447
1* a Systems with laser positioning device 1
only
Model values:
Ziehm Vision
Ziehm Vision FD
Ziehm Vision R
A-42 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
No. Label Comments

1* b Systems with laser positioning device 1
only
Model values:
Ziehm Vision
Ziehm Vision FD
Ziehm Vision R
1( a 120 VAC systems (for USA only) 1

Model values:
Ziehm Vision
Ziehm Vision FD
Ziehm Vision R
Current Input values:
= 10A continuous / 22A momentary
Ziehm Vision R
Main Fuse value:
20A, 250V
1( b 230 VAC systems (for USA only) 1
Model values:
Ziehm Vision
Ziehm Vision FD
Ziehm Vision R
Current Input values:
Ziehm Vision R
Main Fuse value:
15A, 250V
2) ZIR Part No.: 10-2962 1
ZIN Part No.: 58454
Ziehm Vision A-43

P_26366/CD_28189 - EN-04/2008
Appendix A
No. Label Comments

2! Canada only 1
ZIN Part No.: 58455
2@ Equipotential grounding 1
ZIN Part No.: 58331
2# Spare GND connection 1
ZIN Part No.: 58338
2$ Protection Class I, Type B 1
ZIN Part No.: 58330
2% a 60 Hz video output 1
ZIN Part No.: 58456
2% b 60 Hz video output 1
ZIN Part No.: 58457
2% c 60 Hz video output 1
ZIN Part No.: 58458
2^ Systems with DICOM option and RJ45 1
connection only; connection optionally
either in the upper or lower half of the
monitor cart
ZIN Part No.: 58459
2( b Model values: 1
Ziehm Vision
Ziehm Vision FD
Ziehm Vision R
A-44 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
No. Label Comments

3) Model values: 1
Ziehm Vision
Ziehm Vision FD
Ziehm Vision R
3! b Model values: 1
Ziehm Vision
Ziehm Vision FD
Ziehm Vision R
3@ n/a for Ziehm Vision FD 1

Model values:
Ziehm Vision
Ziehm Vision R
ZIN Part No.: 58463
3% ZIR Part No.: 10-2977 1

ZIN Part No.: 58460
3^ Canada only 1
ZIN Part No.: 58461
3& Systems with cassette holder only 1

n/a for Ziehm Vision FD
ZIN Part No.: 58462
Ziehm Vision A-45

P_26366/CD_28189 - EN-04/2008
Appendix A
No. Label Comments

3* Systems with cassette holder only 1
Canada only
n/a for Ziehm Vision FD
ZIN Part No.: 58463
3( ZIR Part No.: 10-2983 1
ZIN Part No.: 58407
4) ZIR Part No.: 10-2984 1

ZIN Part No.: 58464
4! a Foot pedal option

Function: Initiating radiation – Store
ZIN Part No.: 58371
4! b Foot pedal option

Function: Initiating radiation – Store
Background color: clear
ZIN Part No.: 58372
4@ a Foot pedal option

Function: Initiating radiation – Cine
ZIN Part No.: 58415
4@ b Foot pedal option

Function: Initiating radiation – Cine
ZIN Part No.: 58416
A-46 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
No. Label Comments

4# a Foot pedal option
Function: Initiating radiation –
Magnification
ZIN Part No.: 58413
4# b Foot pedal option
Magnification
ZIN Part No.: 58414
4$ a Foot pedal option
Snapshot
ZIN Part No.: 58417
4$ b Foot pedal option
Snapshot
ZIN Part No.: 58418
4% a Foot pedal option 1
ZIN Part No.: 58419
4% b Foot pedal option 1

ZIN Part No.: 58420
Ziehm Vision A-47

P_26366/CD_28189 - EN-04/2008
Appendix A
No. Label Comments

4^ a Foot pedal option 1
Function: Cine – Store
ZIN Part No.: 58421
4^ b Foot pedal option 1

Function: Cine – Store
ZIN Part No.: 58422
4& a Foot pedal option 1

Function: Cine – Endo On/Off-freeze
ZIN Part No.: 58423
4& b Foot pedal option 1

Function: Cine – Endo On/Off-freeze
ZIN Part No.: 58424
4* a Foot pedal option 1

ZIN Part No.: 58425
4* b Foot pedal option 1

ZIN Part No.: 58426
A-48 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
No. Label Comments

4( a Foot pedal option
Function: Initiating radiation – Image
swap
ZIN Part No.: 58427
4( b Foot pedal option
Function: Initiating radiation – Image
swap
ZIN Part No.: 58428
5) a Foot pedal option 1
ZIN Part No.: 58429
5) b Foot pedal option 1

ZIN Part No.: 58430
5! a Foot pedal option 1

Function: Long stroke – DSA/MSA/
RSA & Cine; short stroke – Off
ZIN Part No.: 58433
5! b Foot pedal option 1
RSA & Cine; short stroke – Off
ZIN Part No.: 58434
Ziehm Vision A-49

P_26366/CD_28189 - EN-04/2008
Appendix A
No. Label Comments

5@ a Foot pedal option 1
Function: Cine – Image swap
ZIN Part No.: 58431
5@ b Foot pedal option 1

Function: Cine – Image swap
ZIN Part No.: 58432
5# a Foot pedal option 1

RSA; short stroke – Off & magnification
ZIN Part No.: 58435
5# b Foot pedal option 1
RSA; short stroke – Off & magnification
ZIN Part No.: 58436
5$ a Foot pedal option 1
Function: Magnification – Image swap
ZIN Part No.: 58437
5$ b Foot pedal option 1

Function: Magnification – Image swap
ZIN Part No.: 58438
A-50 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
A.6 Focal spot position
A.6.1 Ziehm Vision
307.3
9°
Reference axis
970
Horizontal
deviation of X-ray
1°
tube
Focal spot
(red dot)
8°
Anode angle
Fig. A-22 Focal spot position on systems with 23 cm i.i. (Ziehm

Vision)
Ziehm Vision A-51

P_26366/CD_28189 - EN-04/2008
Appendix A
A.6.2 Ziehm Vision FD
280
7.2° 7.2°
Reference axis
1110
Focal spot
(red dot)
8°
Anode angle

Vision FD)
A-52 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
A.6.3 Ziehm Vision R
240
Primary beam
7° limitation
970
Reference axis
Focal spot
(red dot)
10° Anode angle

Vision R)
Ziehm Vision A-53

P_26366/CD_28189 - EN-04/2008
Appendix A
A.7 Heat capacity
Heating Heating characteristic at 110 kV / 3.2 mA

characteristic of (800,000 J heat capacity, 50 W continuous heat dissipation)
Ziehm Vision and
Ziehm Vision FD
Temp. (°C)
Time (min.)
Fig. A-25 Heating characteristic (Model D-064R)
Cooling Cooling characteristic

characteristic of
Ziehm Vision and
Ziehm Vision FD
Temp. (°C)
Time (min.)
Fig. A-26 Cooling characteristic (Model D-064R)
A-54 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
Heating characteristic at 600 W output power Heating

(60 kV, 20 mA, 20 ms pulse width, 25 pulses/s) characteristic
Ziehm Vision R
Temp. (°C)
Time (min.)
Fig. A-27 Heating characteristic of Ziehm Vision R
Cooling characteristic Cooling

characteristic
Ziehm Vision R
Temp. (°C)
Time (min.)
Fig. A-28 Cooling characteristic of Ziehm Vision R
Ziehm Vision A-55

P_26366/CD_28189 - EN-04/2008
Appendix A
A.8 Scattered radiation in the significant zone of occupancy
A.8.1 Ziehm Vision
Distribution of scattered radiation in the significant zone of occupancy of the C-

arm stand
Measurement conditions in accordance with EN 60601-1-3:1994

Exposure conditions: Automatic control, 76 kV / 5.9 mA / 448 W
Rectangular water phantom 25 cm × 25 cm × 15 cm + 1.5 mm Cu
Measuring instrument: Radcal 9015
Height above floor in cm
Copper
Water
phantom
45 cm X-ray source/floor : 25 cm phantom/image intensifier anti-scatter grid distance
Distance to central ray beam in cm
Patient
positioning Significant zone of
occupancy
80 × 60 × 200 cm
Fig. A-29 Scattered radiation Ziehm Vision
A-56 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
A.8.2 Ziehm Vision FD

arm stand

Exposure conditions: Automatic control, 89 kV / 15.8 mA / 16 ms pulse width / 30
pulses/s / 700 W
Copper
Water
phantom
Significant zone
of occupancy
80×60×200cm
Fig. A-30 Scattered radiation Ziehm Vision FD
Ziehm Vision A-57

P_26366/CD_28189 - EN-04/2008
Appendix A
A.8.3 Ziehm Vision R

arm stand

Exposure conditions: Automatic control, 82 kV / 9.0 mA / 738 W
Copper
Water
phantom
Significant zone
of occupancy
80×60×200cm
Fig. A-31 Scattered radiation of the Ziehm Vision R
A-58 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
A.9 Dimensions
Ziehm Vision C-arm

stand with 31 cm i.i.
Fig. A-32 Dimensions of a Ziehm Vision C-arm stand with 31 cm i.i.
Ziehm Vision A-59

P_26366/CD_28189 - EN-04/2008
Appendix A
Ziehm Vision C-arm

stand with 23 cm i.i.
45° 90°
220
430
680
760
970
910
345
155
445 - 665
1665 - 1885
2125 - 2345
Fig. A-33 Dimensions of a Ziehm Vision C-arm stand with 23 cm i.i.
A-60 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
Ziehm Vision FD C-
arm stand
Fig. A-34 Dimensions of a Ziehm Vision FD C-arm stand
Ziehm Vision A-61

P_26366/CD_28189 - EN-04/2008
Appendix A
Ziehm Vision R C-
arm stand with
23 cm i.i.
Fig. A-35 Dimensions of a Ziehm Vision R C-arm stand with 23 cm i.i.
A-62 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
Monitor cart Ziehm

Vision
Fig. A-36 Dimensions of a Ziehm Vision monitor cart
Ziehm Vision Endo

monitor cart
Fig. A-37 Dimensions of a Ziehm Vision Endo monitor cart
Ziehm Vision A-63

P_26366/CD_28189 - EN-04/2008
Appendix A
A.10 Technical data
Tube
Image intensifier
Scintillator Cesium iodide

Nominal sizes 31 / 23 / (15) cm or 23 / 15 / (10) cm
Anti-scatter grid Pb 8/40
Detector
flat-panel detector
Scintillator Cesium iodide

Digital
Size 19.8 × 19.8 cm

Resolution in pixels 1024 × 1024
Anti-scatter grid Pb 8/70
18.1" flat-screen monitors

Monitors
Screen size 460 mm (18.1")

Resolution in pixels 1280 × 1024 / 50 Hz or 60 Hz
CCIR, 50 Hz refresh rate, like PAL, no color
Video standard
EIA 343, 60 Hz refresh rate, like NTSC, no color

output
During storage/transport
Environmental
Temperature –5°C to +55°C

conditions
Relative air humidity 20 – 70 %

During operation
Temperature +13°C to +35°C
Relative air humidity 20 – 70 %
Table A-6 General technical data of the Ziehm Vision, Ziehm Vision FD, Ziehm Vision R
A-64 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
C-arm
Source/image receptor distance
Ziehm Vision / Ziehm Vision R 970 mm
Ziehm Vision FD 1110 mm
Vertical free space (generator/i.i.)
Ziehm Vision / Ziehm Vision R 760 mm
Dimensions
Vertical free space (generator/digital flat-panel detector)

Ziehm Vision FD 895 mm
C-arm depth 680 mm
Orbital rotation 23 cm i.i.: 135°, optionally 115°
31 cm i.i. 115°
Angulation ±225°
Swiveling (panning) ±10°
Horizontal movement 220 mm
Vertical movement 430 mm
C-arm stand
Ziehm Vision 23 cm i.i.: approx. 260 kg
31 cm i.i.: approx. 280 kg
Weight
Ziehm Vision FD approx. 280 kg

Ziehm Vision R 23 cm i.i.: approx. 380 kg
31 cm i.i.: approx. 398 kg
Monitor cart
With flat-screen monitors 152 kg min., 158 kg max.
Table A-6 General technical data of the Ziehm Vision, Ziehm Vision FD, Ziehm Vision R (cont.)
Ziehm Vision A-65

P_26366/CD_28189 - EN-04/2008
Appendix A

systems with a voltage rating of 100 V, 120 V, 200 V
Systems with a voltage / 100 VAC, 50/60 Hz 120 VAC, 50/60 Hz 200 VAC, 50/60 Hz
frequency rating of:
Power supply fuse C 20 A or C 32 A C 20 A C 20 A or C 32 A
rating
(tripping characteristic C acc. to VDE 0641, Part 11; DIN EN
60898 + IEC 898)
Required residual IN ≥ 20 A, IN ≥ 20 A, IN ≥ 16 A,
current circuit
breaker (RCD) IAN = 30 mA IAN = 30 mA IAN = 30 mA
Typical current consumption

Ziehm Vision 10 A continuous 10 A continuous 8 A continuous
22 A momentary 22 A momentary 16 A momentary
Ziehm Vision FD 10 A continuous 10 A continuous 8 A continuous
Ziehm Vision R 25 A continuous 20 A continuous 14 A continuous
(fluoroscopy, depending on fluoroscopy mode)
(Radiography operating mode)
Power supply in standby mode
System
Ziehm Vision/ 450 VA (4.5 A) 450 VA (3.75 A) 450 VA (2.25 A)

Ziehm Vision FD
Ziehm Vision R approx. 480 VA approx. 480 VA approx. 460 VA
(approx. 4 A) (approx. 4 A) (approx. 2 A)
The values depend on the integrated documentation systems.
Power input fuse
Ziehm Vision/ 20 A, slow (2 pcs.) 20 A, slow (2 pcs.) 15 A, slow (2 pcs.)
Ziehm Vision FD
Ziehm Vision R 20 A, slow (2 pcs.)
Maximum line ≤ 0.3 Ω ≤ 0.3 Ω ≤ 0.6 Ω
impedance
Equipment Protection Class I, Type B ( ), ordinary equipment, continuous
protection operation
classification
Radiation controlled area
(with generator in lowermost position and C-arm vertical)
23/31 cm i.i. and digital flat-panel detector: 4 m
Table A-7 Technical data of Ziehm Vision, Ziehm Vision FD, Ziehm Vision R; systems with a voltage
rating of 100 V, 120 V, 200 V
A-66 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
Power
Direct radiography (n/a for Ziehm Vision FD)
Ziehm Vision 40–110 kV 40–110 kV 40–110 kV
12 mA min./ 15 mA min./ 15 mA min./
20 mA max., 20 mA max., 20 mA max.,
1.5 mAs min./ 1.5 mAs min./ 1.5 mAs min./
100 mAs max. 100 mAs max. 100 mAs max.
Ziehm Vision R 40–120 kV
2 mA min./
72 mA max.,
0.2 mAs min./
250 mAs max.
Fluoroscopy
Ziehm Vision/ 40–110 kV 40–110 kV 40–110 kV
Ziehm Vision FD 1.5–12 mA 1.5–15 mA 1.5–20 mA
1.5–75 mA
Generator
Pulsed fluoroscopy
Ziehm Vision Pulse width 10–30 ms;
1, 2, 4, 8, 12.5, 25 pulses/s (on systems with 25 pulses/s)
1, 2, 5, 10, 15, 30 pulses/s (on systems with 30 pulses/s)
Ziehm Vision FD Pulse width 16 ms (invariable);
1, 2, 5, 10, 15, 30 pulses/s
Ziehm Vision R Pulse width 4–30 ms;
Digital radiography (snapshot)
Ziehm Vision/ 40–110 kV
Ziehm Vision FD 0.1 mA min./
20 mA max.
1.5 mA min./
75 mA max.
Operating 40 kHz
frequency
rating of 100 V, 120 V, 200 V (cont.)
Ziehm Vision A-67

P_26366/CD_28189 - EN-04/2008
Appendix A
Max. operating data
Fluoroscopy
Ziehm Vision/ 110 kV / 12 mA 110 kV / 15 mA 110 kV / 18 mA
Ziehm Vision FD 65 kV / 20 mA 80 kV / 20 mA 80 kV / 20 mA
Ziehm Vision R 120 kV / 62.5 mA 120 kV / 62.5 mA 120 kV / 62.5 mA
100 kV / 75 mA 100 kV / 75 mA 100 kV / 75 mA
Ziehm Vision 110 kV / 12 mA 110 kV / 15 mA 110 kV / 15 mA
65 kV / 20 mA 80 kV / 20 mA 80 kV / 20 mA
Ziehm Vision R 100 kV / 60 mA 100 kV / 60 mA 100 kV / 60 mA
Digital radiography
Ziehm Vision/ 110 kV / 12 mA 110 kV / 18 mA 110 kV / 18 mA
Ziehm Vision FD 65 kV / 20 mA 80 kV / 20 mA 80 kV / 20 mA
Ziehm Vision R 100 kV / 75 mA
Max. power output
Generator
Fluoroscopy
Ziehm Vision/ 1320 W 1650 W 1980 W
Ziehm Vision FD (110 kV / 12 mA) (110 kV / 15 mA) (110 kV / 18 mA)
Ziehm Vision R 7500 W (100 kV / 75 mA)
Ziehm Vision 1320 W 1650 W 1650 W
(110 kV / 12 mA) (110 kV / 15 mA) (110 kV / 15 mA)
Ziehm Vision R 6000 W 6000 W 6000 W
(100 kV / 60 mA) (100 kV / 60 mA) (100 kV / 60 mA)
Digital radiography
Ziehm Vision/ 1320 W 1650 W 1980 W
Ziehm Vision FD (110 kV / 12 mA) (110 kV / 15 mA) (110 kV / 18 mA)
Nominal electric power
Ziehm Vision/ 1320 W at 100 kV / 2000 W at 100 kV / 2000 W at 100 kV /
Ziehm Vision FD 13.2 mA / 0.1 s 20 mA / 0.1 s 20 mA / 0.1 s
Ziehm Vision R 7500 W at 100 kV / 75 mA / 0.1 s
A-68 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
X-ray tube
Ziehm Vision/ Single-focus stationary-anode tube
Ziehm Vision FD
Ziehm Vision R Dual-focus rotating-anode tube
Focal spot nominal size, in relation to reference axis (→ Appendix A.6, p. A-51)
Ziehm Vision/ 0.6 acc. to IEC 336
Ziehm Vision FD
Ziehm Vision R 0.6 acc. to IEC 336 large focus
0.3 acc. to IEC 336 small focus
Focal spot horizontal tolerance, in relation to reference axis
(→ Appendix A.6, p. A-51)
± 0.5 mm (controlled)
Anode angle, in relation to reference axis (→ Appendix A.6, p. A-51)
Generator
Ziehm Vision/ 8°
Ziehm Vision FD
Ziehm Vision R 10°
Anode material
Ziehm Vision/ Tungsten
Ziehm Vision FD
Ziehm Vision R Tungsten rhenium molybdenum
Total filtration
Ziehm Vision ≥ 3.9 mm Al, including 0.06 mm Cu
Ziehm Vision FD ≥ 3.9 mm Al
Ziehm Vision R ≥ 4.3 mm Al, including 0.06 mm Cu
Maximum X-ray tube loading factors for
Ziehm Vision/ 1h; 3 mA at 110 kV 10800 mAs/h
Ziehm Vision FD
Ziehm Vision R 1h; 4.58 mA at 120 kV 21600 mAs/h
Ziehm Vision A-69

P_26366/CD_28189 - EN-04/2008
Appendix A

systems with a voltage rating of 220 V, 230 V, 240 V
Power supply fuse C 16 A (tripping characteristic C acc. to VDE 0641, Part 11; DIN
rating EN 60898 + IEC 898)
Required residual IN ≥ 16 A, IAN = 30 mA
current circuit
breaker (RCD)
Typical current consumption
Ziehm Vision 8 A continuous,
16 A momentary
Ziehm Vision FD 8 A continuous,
16 A momentary
Ziehm Vision R 14 A continuous 14 A continuous 14 A continuous
(fluoroscopy, depending on fluoroscopy mode)
System
(Radiography operating mode)

Power supply in standby mode
Ziehm Vision/ approx. 450 VA (approx. 1.95 A)
Ziehm Vision FD
Ziehm Vision R approx. 460 VA (approx. 2 A)
The values depend on the integrated documentation systems.
Power input fuse 15 A, slow (2 pcs.)
Maximum line ≤ 0.6 Ω
impedance
Equipment Protection Class I, Type B ( ), ordinary equipment, continuous
protection operation
classification
Radiation controlled area
(with generator in lowermost position and C-arm vertical)
23/31 cm i.i. and digital flat-panel detector: 4 m
rating of 220 V, 230 V, 240 V
A-70 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
Power
Ziehm Vision 40–110 kV
15 mA min./
20 mA max.,
1.5 mAs min./
80 mAs max.
2 mA min./
72 mA max.,
0.2 mAs min./
250 mAs max.
Fluoroscopy
Ziehm Vision FD 1.5–20 mA
1.5–75 mA
Generator
Pulsed fluoroscopy
Ziehm Vision Pulse width 10–30 ms;
Ziehm Vision FD Pulse width 16 ms (invariable);
1, 2, 5, 10, 15, 30 pulses/s
Ziehm Vision R Pulse width 4–30 ms;
Digital radiography (snapshot)
Ziehm Vision FD 0.1 mA min./
20 mA max.
1.5 mA min./
75 mA max.
Operating 40 kHz
frequency
Ziehm Vision A-71

P_26366/CD_28189 - EN-04/2008
Appendix A
Max. operating data
Fluoroscopy
Ziehm Vision/ 110 kV / 18 mA
Ziehm Vision FD 80 kV / 20 mA
Ziehm Vision R 120 kV / 62.5 mA
100 kV / 75 mA
Ziehm Vision 110 kV / 15 mA
80 kV / 20 mA
Digital radiography
Ziehm Vision/ 110 kV / 18 mA
Ziehm Vision FD 80 kV / 20 mA
Max. power output
Fluoroscopy
Generator
Ziehm Vision/ 1980 W (110 kV / 18 mA)

Ziehm Vision FD
Ziehm Vision 1650 W (110 kV / 15 mA)
Digital radiography
Ziehm Vision/ 1980 W (110 kV / 18 mA)
Ziehm Vision FD
Nominal electric power
Ziehm Vision/ 2000 W at 100 kV / 20 mA / 0.1 s
Ziehm Vision FD
Ziehm Vision R 7500 W at 100 kV / 75 mA / 0.1 s
X-ray tube
Ziehm Vision/ Single-focus stationary-anode tube
Ziehm Vision FD
Ziehm Vision R Dual-focus rotating-anode tube
A-72 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
Focal spot nominal size, in relation to reference axis (→ Appendix A.6, p. A-51)
Ziehm Vision/ 0.6 acc. to IEC 336
Ziehm Vision FD
Ziehm Vision R 0.6 acc. to IEC 336 large focus
0.3 acc. to IEC 336 small focus
Focal spot horizontal tolerance, in relation to reference axis
(→ Appendix A.6, p. A-51)
± 0.5 mm (controlled)
Anode angle, in relation to reference axis (→ Appendix A.6, p. A-51)
Ziehm Vision/ 8°
Ziehm Vision FD
Generator
Ziehm Vision R 10°

Anode material
Ziehm Vision/ Tungsten
Ziehm Vision FD
Ziehm Vision R Tungsten rhenium molybdenum
Total filtration
Ziehm Vision ≥ 3.9 mm Al, including 0.06 mm Cu
Ziehm Vision FD ≥ 3.9 mm Al
Ziehm Vision R ≥ 4.3 mm Al, including 0.06 mm Cu
Maximum X-ray tube loading factors for
Ziehm Vision/ 1h; 3 mA at 110 kV 10800 mAs/h
Ziehm Vision FD
Ziehm Vision R 1h; 4.58 mA at 120 kV 21600 mAs/h
NOTICE
Temperatures above 40°C and relative air humidity above
60% may cause stains on the printer’s heat-sensitive
paper.
Ziehm Vision A-73

P_26366/CD_28189 - EN-04/2008
Appendix A
A.10.3 Laser positioning device
Laser Class Class 2M acc. to IEC 60825-

1:2001
Max. power output of < 1 mW
continuous laser radiation,
measured at the laser beam
apertures
Wavelength of the radiation 635 nm
Table A-9 Technical data of laser positioning device
A.10.4 Dose meter
Additional absorption 3 mm Al
Sensitivity ≥ 700 pC / mGy•cm2

(75 kV; 2.7 mm Al HVL)
Measuring range of DAP power 0,1 – 104 mGy • cm2/s
Voltage range 40 – 150 kV
Voltage correction → Fig. A-38, p. A-74
Aluminum equivalent < 0.4 mm

Table A-10 Technical data of VacuDAP C dose meter
Voltage correction
Additional absorption: 3 mm Al filtration
Correction factor
Fig. A-38 Voltage correction of VacuDAP C dose meter
A-74 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
A.10.5 Air kerma
In compliance with the requirements of international standards (e.g. 21

CFR 1020.32-d (1), IEC 60601-2-43), Ziehm fluoroscopy systems with
automatic exposure rate control are not operable at any combination of
tube voltage and tube current which will result in an exposure rate in
excess of 88 mGy/min in standard control mode and 176 mGy/min in
high-level control mode on the Ziehm Vision R at the point where the
center of the useful beam enters the patient, measured at the reference
point.
Ziehm Vision
Image intensifier
input plane
Lead
300 blocker
Dose probe
Interventional
reference point
970
Focal spot
Fig. A-39 Interventional reference point

(Ziehm Vision and Ziehm Vision Endo)
Ziehm Vision A-75

P_26366/CD_28189 - EN-04/2008
Appendix A
Ziehm Vision FD
Lead
Interventional blocker
300
reference point
Dose probe
1110
Focal spot
Fig. A-40 Interventional reference point (Ziehm Vision FD)
Ziehm Vision R
Image intensifier
input plane
Lead
blocker
Dose probe
Interventional
reference point
Focal spot
Fig. A-41 Interventional reference point (Ziehm Vision R)
The air kerma that is displayed on the system’s user interface refers to
the interventional reference point according to IEC 60601-2-43 and 21
CFR 1020.32-d. The manufacturer has chosen this location for said
reference point, as experience has shown that, in most applications, this
is a typical point for the patient surface.
Test phantom A test phantom is required to carry out the reference measurements for
the air kerma rate. The test phantom consists of a
polymethylmethacrylate (PMMA) cube. In the test setup this cube is
placed directly in front of the image intensifier.
A-76 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
Setting 25 pulses/s at 50 Hz or 30 pulses/s at 60 Hz corresponds to Normal mode

standard control mode on the Ziehm Vision and Ziehm Vision R.
Setting 30 pulses/s at 50 Hz or 60 Hz corresponds to standard control
mode on the Ziehm Vision FD.
Setting 8 or less pulses/s at 50 Hz or 10 or less pulses/s at 60 Hz Low-level control

corresponds to low-level control mode on the Ziehm Vision and Ziehm mode
Vision R.
Setting 10 or less pulses/s at 50 Hz or 60 Hz corresponds to low-level
control mode on the Ziehm Vision FD.
A.10.5.1 Ziehm Vision and Ziehm Vision Endo
Test geometry
Test
phantom
Dose
meter
Fig. A-42 Test geometry for measuring the air kerma rate
The comparison of the air kerma rate in standard control mode and low- Comparison
level control mode was made for a selected example (DSA HQ) only. between standard
control mode and
Autom. Program Voltage Current Pulses/s Pulse Air kerma low-level control
mode at in kV in mA width rate mode
50 Hz in ms in mGy/s
X DSA HQ 88 16,5 25 30 2,78
X DSA HQ 88 15,5 8 30 1,01
Table A-11 Comparison of the air kerma rate between normal mode and low
mode on the example of DSA HQ at 50 Hz
Ziehm Vision A-77

P_26366/CD_28189 - EN-04/2008
Appendix A
Autom. Program Voltage Current Pulses/s Pulse Air kerma

mode at in kV in mA width rate
60 Hz in ms in mGy/s
X DSA HQ 87 16,2 30 30 2,92
X DSA HQ 88 16,4 10 30 1,01
mode on the example of DSA HQ at 60 Hz
Change of air Autom. Program Voltage Current Pulses/s Pulse Air kerma
kerma rate at 50 Hz mode in kV in mA width rate
in ms in mGy/s
X Heart 89 3,4 25 30 0,57
X Heart 88 3,3 25 30 0,55
magnification
1
X Heart 101 3,8 25 30 0,84
magnification
2
X Heart HQ 78 18,4 25 30 2,19
X Heart HQ 78 18,4 25 30 2,19
magnification
1
X Heart HQ 79 18,4 25 30 2,26
magnification
2
X Heart LPK 67 8,0 25 30 0,64
X Heart LPK 70 9,0 25 30 0,83
magnification
1
X Heart LPK 80 9,2 25 30 1,18
magnification
2
X DSA HQ 88 16,5 25 30 2,68
X DSA HQ 89 16,6 25 30 2,75
magnification
1
X DSA HQ 90 17,0 25 30 2,86
magnification
2
X DSA LPK 82 14,6 25 30 1,98
X DSA LPK 84 15,1 25 30 2,15
magnification
1
X DSA LPK 85 15,4 25 30 2,25
magnification
2
Table A-13 Change of air kerma rate based on input field size at 50 Hz
A-78 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
You can use the factors for the different pulse rates in all anatomical Pulse rate at 50 Hz
programs. After measuring the air kerma rate at 25 pulses/s, you can use
these factors to compute the other air kerma rates.
Autom. Pro- Voltage Current Pulses/ Pulse Air kerma Fac-

mode gram in kV in mA s width rate tor
in ms in mGy/s
X Heart 89 3,4 25 30 0,57 1
X Heart 92 3,5 12,5 30 0,31 0,54
X Heart 92 3,5 8 30 0,21 0,37
X Heart 93 3,5 4 30 0,11 0,19
X Heart 94 3,6 2 30 not —
measurable
X Heart 93 3,5 1 30 not —
measurable
Table A-14 Factors for the different pulse rates at 50 Hz
Autom. Program Voltage Current Pulses/s Pulse Air kerma Change of air
mode in kV in mA width rate kerma rate at 60 Hz
in ms in mGy/s
X Heart 87 3,3 30 30 0,6
X Heart 87 3,3 30 30 0,6
magnification
1
X Heart 102 3,9 30 30 1,0
magnification
2
X Heart HQ 78 18,4 30 30 2,52
X Heart HQ 78 18,4 30 30 2,68
magnification
1
X Heart HQ 80 18,5 30 30 2,61
magnification
2
X Heart LPK 66 7,6 30 30 0,68
X Heart LPK 70 9,0 30 30 0,91
magnification
1
X Heart LPK 80 9,2 30 30 1,33
magnification
2
X DSA HQ 87 16,2 30 30 2,92
X DSA HQ 87 16,2 30 30 2,89
magnification
1
Ziehm Vision A-79

P_26366/CD_28189 - EN-04/2008
Appendix A
Autom. Program Voltage Current Pulses/s Pulse Air kerma

mode in kV in mA width rate
in ms in mGy/s
X DSA HQ 90 17,0 30 30 2,91
magnification
2
X DSA LPK 82 14,5 30 30 2,23
X DSA LPK 83 14,5 30 30 2,36
magnification
1
X DSA LPK 85 15,4 30 30 2,26
magnification
2
Pulse rate at 60 Hz You can use the factors for the different pulse rates in all anatomical
Autom. Progra Voltag Curren Pulses/ Pulse Air kerma Facto

mode m e in kV t in mA s width rate r
in ms in mGy/s
x Heart 88 3.3 30 30 0.62 1
x Heart 90 3.4 15 30 0.34 0.55
x Heart 91 3.5 10 30 0.23 0.37
x Heart 91 3.5 5 30 0.12 0.19
x Heart 92 3.5 2 30 not —
measurable
x Heart 92 3.5 1 30 not —
measurable
Table A-16 Factors for the different pulse rates at 60 Hz
Maximum air kerma Manual Program Voltage Current Pulses/s Pulse Air kerma
rate in fluoro mode mode in kV in mA width rate
at 50 Hz in ms in mGy/s
X DSA HQ 110 14,9 25 30 4,11
Table A-17 Maximum air kerma rate in fluoro mode at 50 Hz
at 60 Hz in ms in mGy/s
X DSA HQ 110 14,9 30 20 4,44
Table A-18 Maximum air kerma rate in fluoro mode at 60 Hz
A-80 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
Manual Program Voltage Current Product of Air Maximum air kerma

mode in kV in mA current and kerma rate in radiography
time in mAs in mGy mode at 50 Hz
X Radiography 110 14,9 100 32,58
Table A-19 Maximum air kerma rate in radiography mode at 50 Hz

time in mAs in mGy mode at 60 Hz
X Radiography 110 14,9 100 35,44
Table A-20 Maximum air kerma rate in radiography mode
A.10.5.2 Ziehm Vision FD
Test geometry
Test
phantom
Dose
meter
control mode and
mode in kV in mA width rate mode
in ms in mGy/s
X DSA HQ 94 18,4 30 16 2,68
X DSA HQ 94 18,3 10 16 0,83
mode on the example of DSA HQ
Ziehm Vision A-81

P_26366/CD_28189 - EN-04/2008
Appendix A
Change of air Autom. Program Voltage Current Pulses/s Pulse Air kerma
kerma rate mode in kV in mA width rate
in ms in mGy/s
X Heart 95 3,4 30 30 0,57
X Heart HQ 86 74,8 30 10 3,53
X Heart LPK 73 8,0 30 30 0,69
X DSA HQ 94 75,0 30 20 4,74
X DSA LPK 87 66,4 30 20 4,39
Table A-22 Change of air kerma rate based on input field size
Pulse rate You can use the factors for the different pulse rates in all anatomical
Autom. Pro- Voltage Current Pulses/ Pulse Air kerma Fac-

mode gram in kV in mA s width rate tor
in ms in mGy/s
X Heart 95 7,0 30 16 0,96 1
X Heart 94 6,9 15 16 0,48 0,5
X Heart 92 6,8 10 16 0,29 0,3
X Heart 92 6,8 5 16 0,14 0,146
X Heart 92 6,8 2 16 not —
measurable
X Heart 92 6,8 1 16 not —
measurable
Table A-23 Factors for the different pulse rates
in ms in mGy/s
X DSA HQ 110 14,9 30 16 2,95
Table A-24 Maximum air kerma rate in fluoro mode
A-82 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
A.10.5.3 Ziehm Vision R
Test geometry
Test
phantom
Dose
meter
control mode and
mode in kV in mA width rate mode
in ms in mGy/s
X DSA HQ 79 74,5 25 20 4,66
X DSA HQ 79 73,9 8 20 1,59
mode on the example of DSA HQ
Autom. Program Voltage Current Pulses/ Pulse Air kerma Change of air
mode in kV in mA s width rate kerma rate
in ms in mGy/s
X Heart 93 3,4 25 30 0,57
X Heart 94 3,5 25 30 0,57
magnification
1
X Heart 111 3,9 25 30 0,87
magnification
2
X Heart HQ 90 74,8 25 10 3,53
Table A-26 Change of air kerma rate based on input field size
Ziehm Vision A-83

P_26366/CD_28189 - EN-04/2008
Appendix A
Autom. Program Voltage Current Pulses/ Pulse Air kerma

mode in kV in mA s width rate
in ms in mGy/s
X Heart HQ 92 74,7 25 10 3,54
magnification
1
X Heart HQ 93 74,6 25 10 3,52
magnification
2
X Heart LPK 67 8,0 25 30 0,69
X Heart LPK 72 9,0 25 30 0,89
magnification
1
X Heart LPK 82 9,5 25 30 1,22
magnification
2
X DSA HQ 80 75,0 25 20 4,74
X DSA HQ 84 75,0 25 20 4,85
magnification
1
X DSA HQ 80 75,0 25 20 4,79
magnification
2
X DSA LPK 73 66,4 25 20 4,39
X DSA LPK 73 66,4 25 20 4,24
magnification
1
X DSA LPK 74 67,7 25 20 4,31
magnification
2
Table A-26 Change of air kerma rate based on input field size (cont.)
Pulse rate You can use the factors for the different pulse rates in all anatomical
Autom. Progra Voltag Curren Pulses/ Pulse Air kerma Facto

mode m e in kV t in mA s width rate r
in ms in mGy/s
x Heart 91 3.4 25 30 0.53 1
x Heart 94 3.4 12.5 30 0.27 0.51
x Heart 95 3.5 8 30 0.18 0.34
x Heart 96 3.5 4 30 0.09 0.17
x Heart 98 3.6 2 30 not —
measurable
x Heart 97 3.5 1 30 not —
measurable
Table A-27 Factors for the different pulse rates
A-84 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
Manual Program Voltage Current Pulses/s Pulse Air kerma Maximum air kerma
mode in kV in mA width rate rate in fluoro mode
in ms in mGy/s
X DSA HQ 120 62,5 25 20 12,68
Table A-28 Maximum air kerma rate in fluoro mode

time in mAs in mGy mode
X Radiography 120 30,8 250 117,5
Table A-29 Maximum air kerma rate in radiography mode
A.10.6 Isokerma maps
Isokerma maps are distribution maps for scattered radiation. They show Definition
the amount of radiation at various distances from the system, referred to
the interventional reference point.
The isokerma maps provide information on the distribution of scattered Application

radiation. This information serves to protect the operating staff from
radiation. The maps can also be used to design structural radiation
protection or to place mobile shields.
Ziehm Vision A-85

P_26366/CD_28189 - EN-04/2008
Appendix A
A.10.6.1 Ziehm Vision and Ziehm Vision Endo
Setting The test phantom consists of a polymethylmethacrylate (PMMA) cube

(side length 250 mm). In the test setup this cube is placed with its lower
edge at a distance of 300 mm from the image intensifier.
Available parameters Settings

Exposure rate control Manual
Anatomical program Heart HQ
X-ray tube voltage 110 kV
X-ray tube current 14.9 mA
Pulse width 30 ms
Colllimator setting Iris collimator at 18.9 cm
(100 cm2 on test phantom)
Table A-30 Parameter settings
Test geometry
Test
phantom
Fig. A-45 Test geometry for measuring the isokerma maps
A-86 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
Measuring results
for horizontal beam
direction
Fig. A-46 Isokerma maps in µGy/(µGy × m2) for horizontal beam

direction in 1 m height

direction in 1.5 m height
Ziehm Vision A-87

P_26366/CD_28189 - EN-04/2008
Appendix A
Measuring results
for vertical beam
direction
Fig. A-48 Isokerma maps in µGy/(µGy × m2) for vertical beam


A-88 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
A.10.6.2 Ziehm Vision FD
The test phantom consists of a polymethylmethacrylate (PMMA) cube Setting

edge at a distance of 300 mm from the digital flat-panel detector.

Pulse width 30 ms
Test geometry
Test
phantom
Ziehm Vision A-89

P_26366/CD_28189 - EN-04/2008
Appendix A
Measuring results
for horizontal beam
direction


A-90 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
Measuring results
for vertical beam
direction


Ziehm Vision A-91

P_26366/CD_28189 - EN-04/2008
Appendix A
A.10.6.3 Ziehm Vision R
Setting The test phantom consists of a polymethylmethacrylate (PMMA) cube

edge at a distance of 300 mm from the image intensifier.

Pulse width 10 ms at 25 pulses/s
Test geometry
Test
phantom
A-92 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix A
Measuring results
for horizontal beam
direction


Ziehm Vision A-93

P_26366/CD_28189 - EN-04/2008
Appendix A
Measuring results
for vertical beam
direction


A-94 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Appendix B
B.1 Attaching sterile disposable covers to the C-arm
®
UNIVERSAL C-ARM SET
C-ARM SET for quick C-arm covering

1275
B Collapsible-folded hose
facilitates placement over the
spring clasp.
C The sterile person opens the

hose by means of the fold-over
sleeve at Label 1.
The circulating person inserts
the non-sterile spring clasp into
the open hose.
The sterile person opens the
hose and pulls it little by little
over the spring clasp.
Simply fold over excess hose
end.
D Hook the spring clasp into the

C-arm.
E Put the hoods or bags

contained in the SET over the
X-ray tube assembly and
image intensifier by sliding your
hands under the elastic rim.
UNIVERSAL
Ziehm C-SET Hose cover B for image intensifier: R for X-ray tube assembly:
REF: 341 B/R # 34100 3 # 30077 2 # 30054
7 # 30094
0 without – please order
separately
Rev.: 11-09-2005 / P0142-01
STERINORM UNIVERSAL Ziehm C-Arm Set Rev03.doc
Udo Heisig GmbH - The Disposables Company - Hermann-Oberth-Straße 17 - D-85640 Putzbrunn

CEO: Udo Heisig y AG München HRB 82813 y +49-(0)89-4623920 y Fax +49-(0)89-46239228
Internet: www.heisig.de - e-mail: info@heisig.de
Ziehm Vision B-1

P_26366/CD_28189 - EN-04/2008
Appendix B
B-2 Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Index
Archive (operating mode) 10-7, 11-20

Numbers Archive (tab) 6-7, 10-7, 10-14, 10-17,
10-30, 10-31, 10-32, 10-33, 10-34,
180° - Angle (read-only box) 15-12 10-35, 11-16, 11-17, 11-18, 11-19,
2-Point (button) 15-5 11-20, 11-23, 12-4, 13-12
360° - Angle (read-only box) 15-9 Arrow
3-Point (button) 15-8 Adding to an image 16-6
4-Point (button) 15-12 Auto-delete function 8-15
4-Point Ratio (button) 15-15 Automatic exposure rate control 8-2
Automatic metal correction 8-8
Autostore 19-3
Activating 8-14, 19-3
A Autotransfer 19-2
Activating 19-3
Abdomen (anatomical program) 8-8
Abdomen (button) 6-5
Access. No (button) 11-6
Accessories included in the scope of delivery B
4-2
Accessories, optional 2-6 Backup
Acquiring Patient folders 10-29
Cine loop 12-3 Restoring from CD/DVD 10-35
Active Cooling 8-18 Restoring from USB stick 10-32
Air Kerma (display) 6-8 Selecting patient folders 10-29
Air Kerma Rate (display) 6-8 Selection using search criteria 10-30
Alarm (radiation time) 8-17 Selection using the image creation date
Switching off 8-17 10-29
Alert messages 8-18 To CD/DVD 10-33
Alerts To USB stick 10-30
During operation A-8 Backup (button) 10-30, 10-31, 10-33,
During power-up A-7 10-34
List of errors and alerts A-9 Backup copy
Alphanumeric keypad 6-11 Restoring from CD/DVD 10-35
Anatomical programs 8-8 Restoring from USB stick 10-32
Abdomen 8-8 Selecting patient folders 10-29
Activating 8-9 Selection using search criteria 10-30
Bones 8-8 Selection using the image creation date
Deactivating 8-9 10-29
ESWL 8-9 To CD/DVD 10-33
Heart 8-8 To USB stick 10-30
Soft 8-9 Basic settings 19-7
Angle (read-only box) 15-9, 15-12 Discarding 19-10
Angle of rotation Entering the hospital data 19-9
Information on the screen 16-2 Selecting the live screen 19-8
Angulation System date 19-7
C-arm 5-9 System time 19-7
Archive Basic Settings (button) 19-7, 19-8, 19-9
Inverting the entire archive 10-11 Bones (anatomical program) 8-8
Ziehm Vision i
P_26366/CD_28189 - EN-04/2008
Index
Bones (button) 6-5 Button ‘Heart’ 6-5

Brake Button ‘High Quality’ 6-4, 8-11
C-arm stand 5-6 Button ‘Hospital’ 19-9
Monitor cart 5-5 Button ‘Image Swapping’ 6-4, 9-15
Brightness Button ‘Invert All’ 10-11
Setting 19-19 Button ‘Large Patient’ 6-4, 8-11
Button ‘2-Point’ 15-5 Button ‘Laser’ 6-6, 17-2
Button ‘3-Point’ 15-8 Button ‘Last Name’ 11-6
Button ‘4-Point Ratio’ 15-15 Button ‘LM’ 13-18
Button ‘4-Point’ 15-12 Button ‘Magnify’ 6-6, 6-15, 9-9
Button ‘Abdomen’ 6-5 Button ‘Manual Exposure Rate Setting’ 6-4,
Button ‘Access. No’ 11-6 8-7
Button ‘Backup’ 10-30, 10-31, 10-33, 10-34 Button ‘Mark’ 10-9, 10-22, 11-22, 12-11,
Button ‘Basic Settings’ 19-7, 19-8, 19-9 14-10
Button ‘Bones’ 6-5 Button ‘Mask off’ 13-17
Button ‘Calibration’ 15-3 Button ‘Mask’ 13-16
Button ‘CD/DVD’ 10-13, 10-27, 12-15, Button ‘Metal’ 6-6, 8-10
12-23 Button ‘Monitor / Dose’ A-2
Button ‘CD/DVD’ (Backup) 10-34, 10-35 Button ‘Mosaic’ 10-20
Button ‘Cine/DSA/Dose’ 19-10 Button ‘Motion’ 6-6, 8-10
Button ‘Cine’ 6-4, 12-3 Button ‘MSA’ 13-5, 13-11, 13-13
Button ‘Clean up’ 12-8, 13-16 Button ‘New’ 10-4, 10-5, 10-16, 11-2
Button ‘Close Horizontal Slot Collimator’ Button ‘Next Measuring Point’ 15-4, 15-6,
14-10 15-9, 15-12, 15-13, 15-15, 15-16
Button ‘Close Iris Collimator’ 6-5, 9-12 Button ‘Open Horizontal Slot Collimator’
Button ‘Close Vertical Slot Collimator’ 6-5, 14-10
9-13, 14-9 Button ‘Open Iris Collimator Fully’ 6-5, 9-13,
Button ‘CO2’ 13-3 9-14
Button ‘Complete’ 12-7, 13-16 Button ‘Open Iris Collimator’ 9-12
Button ‘Contrast/Brightness’ 6-7, 9-4, 14-5 Button ‘Open Vertical Slot Collimator Fully’
Button ‘Date’ 19-8 6-5, 9-13, 9-14
Button ‘Delete Marked Items’ 10-10, 10-24, Button ‘Open Vertical Slot Collimator’ 6-5,
12-12, 14-11 9-13, 14-9
Button ‘Delete Unmarked Items’ 10-10, Button ‘Patient ID’ 11-2, 11-6
10-24, 12-12, 14-11 Button ‘Play’ 12-6, 13-15, 13-17
Button ‘Delete’ 10-10, 10-24, 12-13, 14-12 Button ‘Print Live Screen Image’ 6-7, 8-16,
Button ‘Delete’ (Measurement) 15-4 10-25, 10-38, 12-21
Button ‘Department’ 19-9 Button ‘Print’ 12-13, 14-13
Button ‘DICOM Print’ 11-17, 11-19 Button ‘Protect’ 10-23, 12-11, 14-10, 14-11
Button ‘DICOM Retrieve’ 11-20, 11-23 Button ‘P-Sh’ 13-17
Button ‘DICOM Store’ 11-15, 11-16, 11-18, Button ‘Pulsed Fluoroscopy’ 6-4, 8-3, 8-4,
11-20 8-6
Button ‘Doctor’ 19-9 Button ‘Query’ 11-2
Button ‘Dose Meter Check’ A-2 Button ‘Refresh’ 11-21, 11-24
Button ‘Down Arrow’ 6-6 Button ‘Restore from CD/DVD’ 10-35
Button ‘DSA’ 6-11, 6-15, 13-4, 13-9 Button ‘Restore from USB Stick’ 10-32
Button ‘Endo’ 6-6 Button ‘Retrieve’ 11-20, 11-23, 11-24
Button ‘Erase Media’ 19-18 Button ‘Reverse Left/Right’ 6-5, 9-16, 14-9
Button ‘ESWL Data’ 6-7, 6-11 Button ‘Reverse Up/Down’ 6-4, 9-16, 14-9
Button ‘ESWL’ 6-6 Button ‘Rotate Image CCW’ 6-4, 9-16, 14-9
Button ‘Filter’ 6-6, 9-6, 9-7, 9-8 Button ‘Rotate Image CW’ 6-4, 9-16, 14-9
Button ‘Full-Screen Image’ 10-20 Button ‘Rotate Image to 0°’ 6-4, 9-16
Button ‘Grayscale Inversion’ 6-7, 9-12, 14-8 Button ‘Rotate Vertical Slot Collimator CCW’
ii Ziehm Vision
P_26366/CD_28189 - EN-04/2008
Index
9-13 Illustration (Ziehm Vision FD) 2-8

Button ‘Rotate Vertical Slot Collimator CW’ Illustration (Ziehm Vision R) 2-8
6-5, 9-13 Illustration (Ziehm Vision) 2-7
Button ‘Rotate Vertical Slot Collimator to 0°’ Steering 5-6
6-5, 9-13 Transport position 5-1
Button ‘Rotate Vertical Slot Collimator’ 6-5 CD
Button ‘RSA’ 13-6, 13-12, 13-14 Backup copy 10-33
Button ‘Save’ 6-6, 8-14, 16-5, 16-6 Restoring backed-up data 10-35
Button ‘Search’ (Archive operating mode) Saving a cine loop 12-15
10-14, 10-17, 12-4 Saving images 10-27
Button ‘Search’ (Patient operating mode) Saving patient folders 10-13
10-5, 10-16 Saving single cine loop images 12-23
Button ‘Size’ 16-6 Storage format 19-17
Button ‘Snapshot’ 6-4, 8-5, 8-6 CD/DVD (button in Backup) 10-34, 10-35
Button ‘Soft’ 6-6 CD/DVD (button) 10-13, 10-27, 12-15,
Button ‘Start Img’ 12-7, 13-16 12-23
Button ‘Stop Img’ 12-7, 13-16 Checks
Button ‘Stop’ 12-6, 12-7, 13-15, 13-16 Checking the useful beam A-4
Button ‘Storage Media’ 19-16, 19-17, 19-18 Consistency test A-2
Button ‘Text’ 6-7, 16-4, 16-5 Regular checks A-1
Button ‘Time’ 19-8 Routine checks by the user A-1
Button ‘Up Arrow’ 6-6 Cine (button) 6-4, 12-3
Button ‘Uro’ 6-6 Cine loop 12-1
Button ‘USB’ 10-12, 10-27, 12-15 Acquiring 12-3
Button ‘USB’ (Backup) 10-31, 10-32 Applications 12-1
Button ‘Windowing’ 9-3, 14-4 Auto setting 12-1
Button ‘Worklist’ 11-3, 11-6, 11-7, 11-9, Changing the playback speed 12-6,
11-11 13-15
Button ‘Zoom’ 6-7, 9-10, 9-11, 14-7, 14-8 Cleaning up 12-7, 13-16
Buttons Controlling 12-5, 13-15
MOVE UP/DOWN 6-12 Defining a mask image 13-16
ON/OFF 6-12 Deleting 12-12
Buttons on the control panel 6-1, 6-2 Deleting single images 12-19
Frame rate 12-1
Length 12-1
Marking 12-11
C Marking single images 12-18
Mosaic view 12-17
Cable connections 4-5 Opening 12-4
Cables Presetting the frame rate 19-11
Power cable 7-1 Presetting the length 19-11
Calibrating 15-2 Printing on video printer 12-13
Calibration (button) 15-3 Printing single images 12-21
C-arm Processing 12-5, 12-9, 13-15
Angulation 5-9 Processing single images 12-17
Horizontal movement 5-13 Protecting 12-11
Movements 5-7 Protecting single images 12-18
Orbital rotation 5-8 Replaying 12-4, 12-5, 12-10, 13-15
Swiveling (panning) 5-11 Saving single images to USB stick 12-22
Vertical movement 5-14 Saving to hard disk 12-2
C-arm stand 2-7 Start image 12-7, 13-15
Brake 5-6 Stop image 12-7, 13-15
Dimensions A-59 Trimming 12-7, 13-15
Ziehm Vision iii

P_26366/CD_28189 - EN-04/2008
Index
Unmarking 12-11
Unprotecting 12-11 D
Writing single images to CD/DVD 12-23
Writing to CD/DVD 12-15 Date (button) 19-8
Cine/DSA/Dose (button) 19-10 Date format 19-8
Clean up (button) 12-8, 13-16 Date of saving
Cleaning A-6 Information on the screen 16-2
Recommended detergents A-6 Delete (button in Measurement mode) 15-4
Screen A-6 Delete (button) 10-10, 10-24, 12-13, 14-12
Close Horizontal Slot Collimator (button) Delete Marked Items (button) 10-10, 10-24,
14-10 12-12, 14-11
Close Iris Collimator (button) 6-5, 9-12 Delete protection 10-23
Close Vertical Slot Collimator (button) 6-5, Removing from a cine loop 12-11
9-13, 14-9 Removing from an image 10-23
CO2 (button) 13-3 Delete Unmarked Items (button) 10-10,
CO2 negative contrast medium 13-3 10-24, 12-12, 14-11
Collimators Deleting
Iris collimator 9-12 All images from a USB stick 19-18
Slot collimator 9-13 Cine loop 12-12
Virtual collimator 9-14 Image 10-23, 14-11
Complete (button) 12-7, 13-16 Patient folders 10-9
Config (tab) 6-8, 19-2, 19-3, 19-4, 19-5, Single cine loop images 12-19
19-6, 19-8, 19-9, 19-11, 19-12, Department (button) 19-9
19-13, 19-16, 19-17, 19-18, A-2 Department (input box) 19-9
Configuration 4-6 DICOM
Autostore 19-3 Downloading a Worklist 11-3
Autotransfer 19-2 Downloading patient data 11-2
Basic settings 19-7 Images (list) 11-20
CD/DVD storage format 19-17 MPPS 11-11
Crosshair 19-4 Networkability 2-3
Deleting all images from a USB stick Saving options 11-16
19-18 Selecting a storage server 19-18
Discarding the operation settings 19-6 Series (list) 11-20
Entering the hospital data 19-9 Storage Commitment 11-24
Image Swap with Save 19-4 Studies (list) 11-20
Operation settings 19-2 DICOM network printer
Selecting the live screen 19-8 Printing images 11-17
Service settings 19-1 DICOM Print (button) 11-17, 11-19
Storage media 19-15 DICOM Retrieve (button) 11-20, 11-23
System date 19-7 DICOM server
System time 19-7 Downloading a Worklist 11-3
USB stick storage format 19-16 Downloading patient data 11-2
Consistency test A-2 Importing images 11-20
Contrast Saving patient folders 11-16
Setting 19-19 DICOM Store 11-16
Contrast/Brightness (button) 6-7, 9-4, 14-5 DICOM Store (button) 11-15, 11-16, 11-18,
Control panel 6-1 11-20
Elements 6-1 Digital collimation 14-9
Cooling characteristic A-54, A-55 Digital radiography 8-5
Cooling, Active 8-18 Digital zoom 9-10
Crosshair 19-4 Zoom factor 9-10, 9-11, 14-7
Showing 19-5 Digital zoom (post-processing) 14-6
Current (display) 6-8, 8-12 Dimensions
iv Ziehm Vision
P_26366/CD_28189 - EN-04/2008
Index
C-arm stand A-59 Enhancement 9-7

Monitor cart, closed version A-63 Electronic image magnification 9-9
Monitor cart, open version A-63 Emergencies
Direct radiography 18-1 Switching off 7-3
Collimator apertures 18-2 EMERGENCY STOP button 2-4, 7-3
Film cassette holder 18-1 Endo (button) 6-6
Generating 18-2 Endo model
Tube current 18-2 Four-pedal foot switch 6-14
Disinfection A-6 Enhancement
Display Edges 9-7
Hard disk 10-7 Entire archive
Displays Grayscale inversion 10-11
Air Kerma 6-8 Erase USB Media (button) 19-18
Air Kerma Rate 6-8 Error
Current 6-8, 8-12 During operation A-8
Dose area product 6-8 During power-up A-8
mAs 18-3 List of errors and alerts A-9
Pulse width % 6-8 Error messages 8-18
Pulses/s 6-8 ESWL 6-11, 10-1, 10-36
Radiation time 6-8, 8-17 ESWL (anatomical program) 8-9
Tube current × time 18-3 ESWL (button) 6-6
Voltage 6-8, 8-12, 18-3 ESWL Data (button) 6-7, 6-11
Displays on the control panel 6-1 Exposure rate control, automatic 8-2
Doctor (button) 19-9 Exposure rate setting, manual 8-6
Doctor (input box) 19-9 Extracorporeal Shock Wave Lithotripsy
Dose Area Product (display) 6-8 6-11, 10-1, 10-36
Dose meter
Technical data A-74
Dose Meter Check (button) A-2
Down Arrow (button) 6-6
DSA 13-1
F
DSA (button) 6-11, 6-15, 13-4, 13-9 Film cassette holder 18-1
DSA cine loop 13-1 Fitting 18-1
Acquiring 13-3 Filter (button) 6-6, 9-6, 9-7, 9-8
DSA CO2 19-14 Filters
DVD Edge filter 9-7
Backup copy 10-33 Edge filter (post-processing) 14-6
Restoring backed-up data 10-35 In the live image 9-5
Saving a cine loop 12-15 LIH filter 9-8
Saving images 10-27 Noise suppression 9-5, 9-8
Saving patient folders 10-13 Recursive filter 9-5
Saving single cine loop images 12-23 First power-up of the system 4-6
Storage format 19-17 Flat-screen monitors
Screen settings 19-19
Fluoro (tab) 6-7
Fluoroscopy (operating mode) 6-2, 8-1
E Defining as start screen 19-6
Fluoroscopy modes 8-2
Edge filter 9-7 Digital radiography (snapshot) 8-5
Information on the screen 16-2 Pulsed fluoroscopy 8-2
Levels 9-7, 14-6 Fluoroscopy parameters
Edge filter (post-processing) 14-6 Information on the screen 16-3
Edges Fluoroscopy programs 8-8
Ziehm Vision v
P_26366/CD_28189 - EN-04/2008
Index
Focal spot position A-51 Horizontal image reversal (post-processing)

Foot switch 6-13 14-9
Four-pedal foot switch 6-14 Horizontal movement
Foreign body localization 17-2 C-arm 5-13
Four-Point (button) 15-12 Hospital (button) 19-9
Four-Point Ratio (button) 15-15 Hospital (input box) 19-9
Frame rate Hospital data
Cine loop 12-1 Entering 19-9
Full-Screen Image (button) 10-20 Information on the screen 16-1
Full-size image 10-21
Displaying an image at full size 10-21,
10-22
Functions
High Quality 8-11
I
Large patient 8-11 Illustrations
Metal artifact correction 8-10 C-arm stand (Ziehm Vision FD) 2-8
Motion 8-10 C-arm stand (Ziehm Vision R) 2-8
Functions, optional 2-4 C-arm stand (Ziehm Vision) 2-7
C-arm stand transport position (Ziehm Vi-
sion FD) 5-2
G sion R) 5-3
Gettering the image intensifier tube A-5 sion) 5-2
Graphics format Dimensions of C-arm stand (Ziehm Vision
CD/DVD 19-17 FD) A-61
USB stick 19-16 Dimensions of C-arm stand (Ziehm Vision
Grayscale inversion R) A-62
All images 10-11 Dimensions of C-arm stand (Ziehm Visi-
Entire archive 10-11 on) A-59, A-60
Image 9-12 Dimensions of monitor cart, closed versi-
Undoing the grayscale inversion 10-11 on A-63
Grayscale Inversion (button) 6-7, 9-12, Monitor cart, closed version 2-9, 2-11
14-8 Monitor cart, semi-open version 2-9,
Grayscale inversion (post-processing) 2-11
Image 14-8 Transport position of the monitor cart 5-4
Image
Adding a marker 16-6
Adding an arrow 16-6
H Adding text 16-5
Comparing 9-14
Hand switch 6-13 Deleting 10-23, 14-11
Hard disk Displaying at full size 10-21, 10-22
Saving a cine loop 12-2 Edge enhancement 9-7
Saving images 8-13 Grayscale inversion 9-12
Hard disk space 10-7 Grayscale inversion (post-processing)
Heart (anatomical program) 8-8 14-8
Heart (button) 6-5 Importing from DICOM server 11-20
Heat capacity A-54 Inverting all images 10-11
Heating characteristic A-54, A-55 Marking 10-22, 14-10
High Quality (button) 6-4, 8-11 Mirroring (reversal) 9-16
High Quality (function) 8-11 Mirroring (reversal) (post-processing)
Horizontal image reversal 9-16 14-9
vi Ziehm Vision
P_26366/CD_28189 - EN-04/2008
Index
Note 16-5
Printing live screen images on video prin- K
ter 8-15
Printing on DICOM network printer 11-17 Key switch 2-4, 7-4
Printing on video printer 10-25, 14-13 Power on 7-4
Processing 10-19 X-Ray 7-4
Protecting 10-23, 12-11, 14-10 Keypad, alphanumeric 6-11
Reverse left/right 9-16
Reverse up/down 9-16
Rotating 9-16
Rotating (post-processing) 14-9
Rotating to 0° 9-16
L
Saving to hard disk 8-13 Labels ??– A-50
Saving to USB stick 10-26, 12-15 23 cm image intensifier for USA (Ziehm
Undoing the grayscale inversion 9-12 Vision, Ziehm Vision R) A-37
Undoing the grayscale inversion of all 31 cm image intensifier for USA (Ziehm
images 10-11 Vision, Ziehm Vision R) A-37
Unmarking 10-22, 14-10 C-arm stand (USA) A-36
Unprotecting 10-23, 14-11 C-arm stand (Ziehm Vision FD) A-17
Writing to CD/DVD 10-27 C-arm stand (Ziehm Vision R) A-18
Image area C-arm stand (Ziehm Vision) A-17
Enlarging 9-10 C-arm stand for USA (Ziehm Vision FD)
Image crop 14-9 A-35
Image data C-arm stand for USA (Ziehm Vision R)
Managing 10-7 A-36
Image information 16-1 C-arm stand for USA (Ziehm Vision) A-35
Image magnification level 6-6, 6-15 Digital flat-panel detector for USA (Ziehm
Image number 8-14 Vision) A-38
Information on the screen 16-2 Generator (USA) A-37
Image reversal Laser positioning device (Ziehm Vision
Horizontal image reversal 9-16 FD) A-19
Vertical image reversal 9-16 Laser positioning device (Ziehm Vision R)
Image rotation 9-16 A-19
Image rotation (post-processing) 14-9 Laser positioning device (Ziehm Vision)
Image Swap with Save 19-4 A-18
Image swapping 9-14 Monitor cart (Ziehm Vision Endo) A-20
Image Swapping (button) 6-4, 9-15 Monitor cart (Ziehm Vision) A-20
Images (DICOM list) 11-20 Monitor cart for USA: A-38
Importing Two-pedal foot switch for USA A-38
Images from DICOM server 11-20 Landmarking 13-18
Input box ‘Department’ 19-9 Large Patient (button) 6-4, 8-11
Input box ‘Doctor’ 19-9 Large Patient (function) 8-11
Input box ‘Hospital’ 19-9 Laser
Input box ‘Reference Length’ 15-4 Laser Class 3-5, 17-1
Input box ‘Time’ 19-8 Laser positioning device 3-5
Invert All (button) 10-11 Maintenance 3-5
Iris collimator 9-12 Laser (button) 6-6, 17-2
Closing 9-12 Laser positioning device 17-1
Opening 9-12 Applications 17-2
Opening fully 9-13, 9-14 Localizing foreign bodies 17-2
Technical data A-74
Last Image Hold 8-12
Last Name (button) 11-6
Ziehm Vision vii

P_26366/CD_28189 - EN-04/2008
Index
Leakage in the cooling system A-5 4-point measurement 15-11

Length 4-point ratio measurement 15-14
Cine loop 12-1 Button ‘Delete’ 15-4
Length 1 (read-only box) 15-6, 15-9, 15-12, Calibrating 15-2
15-15 Length or distance 15-4
Length 1 / Length 2 (read-only box) 15-15 Length ratio 15-15
Length 2 (read-only box) 15-9, 15-12, 15-15 Reference length 15-6, 15-9, 15-15
Length or distance Reference object 15-2
Measuring 15-4 Measurement (operating mode) 15-1
LIH filter 9-8 Measuring functions 15-1
Information on the screen 16-2 Metal (button) 6-6, 8-10
Noise suppression 9-8 Metal artifact correction 8-10
Number of images 9-8 Activating 8-10
Live Image left (option button) 19-9 Automatic metal correction 8-8
Live Image right (option button) 19-9 Deactivating 8-10
Live screen 2-13 Metal Artifact Correction (function) 8-10
Defining 19-8 Monitor / Dose (button) A-2
LM (button) 13-18 Monitor cart 2-9, 2-11
Locking Brake 5-5
Entire system 7-4 Dimensions A-63
X-rays 7-4 Illustration of closed version 2-9, 2-11
Lower vertical position 3-8, 5-1 Illustration of semi-open version 2-9,
2-11
Steering 5-5
Transport position 5-4
M Mosaic (button) 10-20
Mosaic view 10-7
Magnification, electronic 9-9 Motion (button) 6-6, 8-10
Magnify (button) 6-6, 6-15, 9-9 Motion (function) 8-10
Manual exposure rate setting 8-6 MOVE UP/DOWN buttons 6-12
Activating 8-7 Movement
Deactivating 8-7 C-arm 5-7
Manual Exposure Rate Setting (button) 6-4, MPPS 11-11
8-7 MSA 13-1
Mark (button) 10-9, 10-22, 11-22, 12-11, MSA (button) 13-5, 13-11, 13-13
14-10 MSA image
Marker Acquiring 13-5
Adding to an image 16-6
Deleting 16-7
Editing 16-6
Marking N
Cine loop 12-11
Image 10-22, 14-10 Native image 13-2
Patient folders 10-9 Hiding 19-12
Single cine loop images 12-18 Showing 19-12
mAs (display) 18-3 Negative contrast medium CO2 13-3
Mask (button) 13-16 Networkability 2-3
Mask image 13-2 New (button) 10-4, 10-5, 10-16, 11-2
Mask off (button) 13-17 Next Measuring Point (button) 15-4, 15-6,
Measure (tab) 6-7, 15-3, 15-5, 15-11 15-9, 15-12, 15-13, 15-15, 15-16
Measurement Noise suppression
2-point measurement 15-4 LIH filter 9-8
3-point measurement 15-8 Recursive filter 9-5
viii Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Index
Note on the image 16-5 Editing 10-4

Entering manually 10-3
Information on the screen 16-1
Managing 10-2
O Patient folders 10-1
Activating 10-16
OFF switches 6-12, 7-2 Backup 10-29
ON/OFF switches 6-12, 7-2 Backup to CD/DVD 10-33
Open Horizontal Slot Collimator (button) Backup to USB stick 10-30
14-10 Creating a new patient folder 10-3
Open Iris Collimator (button) 9-12 Deleting 10-9
Open Iris Collimator Fully (button) 6-5, 9-13, Displaying image information 10-15
9-14 Editing data 10-4
Open Vertical Slot Collimator (button) 6-5, Marking 10-9
9-13, 14-9 Processing 10-8
Open Vertical Slot Collimator Fully (button) Saving to USB stick 10-12
6-5, 9-13, 9-14 Search criteria 10-14
Operating modes Searching 10-4, 10-14
Archive 10-7, 11-20 Storage capacity 10-1
Fluoroscopy 8-1 Subject 10-2
Measurement 15-1 Unmarking 10-9
Patient 10-2, 11-20 Writing to CD/DVD 10-13
Post-processing 14-1, 14-10, 14-13 Patient ID
Radiography 18-2, 18-3 Display 10-2
Subtraction 8-1 Length 10-2
Text 16-4 Patient ID (button) 11-2, 11-6
Operation settings 19-2 Pixel shift 13-17
Autostore 19-3 Play (button) 12-6, 13-15, 13-17
Autotransfer 19-2 Post Proc. (tab) 6-7, 14-3
CD/DVD storage format 19-17 Post Processing (operating mode) 14-10,
Crosshair 19-4 14-13
Defining the start screen 19-6 Post-processing 14-1
Discarding 19-6 Activating an image 14-3
Image Swap with Save 19-4 Digital zoom 14-6
USB stick storage format 19-16 Edge filter 14-6
Option button ‘Live Image left’ 19-9 Image reversal 14-9
Option button ‘Live Image right’ 19-9 Image rotation 14-9
Optional accessories 2-6 Inverting the image grayscale 14-8
Optional functions 2-4 Printing images on video printer 14-13
Orbital rotation Protecting images 14-10
C-arm 5-8 Power cable 7-1
Print (button) 12-13, 14-13
Print Live Screen Image (button) 6-7, 8-16,
10-25, 10-38, 12-21
Printing
P Cine loops on video printer 12-13
Patient (operating mode) 10-2, 11-20 Images on DICOM network printer 11-17
Activating 10-3 Images on video printer 10-25, 14-13
Defining as start screen 19-6 Live screen images on video printer 8-15
Patient (tab) 6-7, 10-3, 10-5, 10-16, 11-2, Measured values 8-15
11-3, 11-6, 11-8, 11-11 Single cine loop images on video printer
Patient data 12-21
Downloading from DICOM server 11-2 Text information 8-15
Ziehm Vision ix
P_26366/CD_28189 - EN-04/2008
Index
Protect (button) 10-23, 12-11, 14-10, 14-11 Reverse left/right 9-2, 9-16
Protecting Information on the screen 16-2
Cine loop 12-11 Reverse Left/Right (button) 6-5, 9-16, 14-9
Image 10-23, 12-11, 14-10 Reverse up/down 9-2, 9-16
Image (post-processing) 14-10 Information on the screen 16-2
Protective grounding 3-4 Reverse Up/Down (button) 6-4, 9-16, 14-9
P-Sh (button) 13-17 Rotate Image CCW (button) 6-4, 9-16, 14-9
Pulse width % (display) 6-8 Rotate Image CW (button) 6-4, 9-16, 14-9
Pulsed fluoroscopy 8-2 Rotate Image to 0° (button) 6-4, 9-16
Pulsed Fluoroscopy (button) 6-4, 8-3, 8-4, Rotate Vertical Slot Collimator (button) 6-5
8-6 Rotate Vertical Slot Collimator CCW (button)
Pulses/s (display) 6-8 9-13
Rotate Vertical Slot Collimator CW (button)
6-5, 9-13
Rotate Vertical Slot Collimator to 0° (button)
Q 6-5, 9-13
RSA 13-1
Query (button) 11-2 RSA (button) 13-6, 13-12, 13-14
RSA image
Acquiring 13-6
R
Radiation controlled area 3-3 S
Radiation time
Alarm 8-17 Safety instructions
Warning function 8-17 Electromagnetic compatibility 3-4
Radiation Time (display) 6-8, 8-17 Environmental compatibility 3-8
Radiogr. (tab) 6-7, 18-2 Equipotential grounding 3-5
Radiography (operating mode) 18-2, 18-3 General safety instructions 3-1
Radiography (tab) 6-7, 18-2 Laser radiation 3-5
Read-only box ‘180° - Angle’ 15-12 Protective grounding 3-4
Read-only box ‘360° - Angle’ 15-9 X-rays 3-2
Read-only box ‘Angle’ 15-9, 15-12 Save (button) 6-6, 8-14, 16-5, 16-6
Read-only box ‘Length 1 / Length 2’ 15-15 Saving 6-14
Read-only box ‘Length 1’ 15-6, 15-9, 15-12, Cine loops to CD/DVD 12-15
15-15 Cine loops to hard disk 12-2
Read-only box ‘Length 2’ 15-9, 15-12, Images to CD/DVD 10-27
15-15 Images to hard disk 8-13
Read-only box ‘Reference Length’ 15-6, Images to USB stick 10-26, 12-15
15-9, 15-12, 15-15 Patient folders to CD/DVD 10-13
Recursive filter 9-5 Patient folders to DICOM server 11-16
Information on the screen 16-2 Patient folders to USB stick 10-12
Levels 9-5 Single cine loop images to CD/DVD
Noise suppression 9-5 12-23
Reference Length (input box) 15-4 Single cine loop images to USB stick
Reference Length (read-only box) 15-6, 12-22
15-9, 15-12, 15-15 Scattered radiation A-56
Reference screen 2-13 Screen assignment 2-13
Refresh (button) 11-21, 11-24 Screen settings 19-19
Restore from CD/DVD (button) 10-35 Search (button in Archive operating mode)
Restore from USB Stick (button) 10-32 10-14, 10-17, 12-4
Retrieve (button) 11-20, 11-23, 11-24 Search (button in Patient operating mode)
x Ziehm Vision
P_26366/CD_28189 - EN-04/2008
Index
10-5, 10-16 Native image 13-2

Search criteria for patient folders 10-14 Pixel shift 13-17
Security key switch 7-4 RSA 13-1
Series (DICOM list) 11-20 Subtracted image 13-2
Service settings 19-1 Switches
Size (button) 16-6 Hand switch 6-13
Slot collimator 9-13 Two-pedal foot switch 6-13
Closing 9-13 Switching off in emergency situations 7-3
Opening 9-13 Switching on
Opening fully 9-13 First power-up of the system 4-6
Rotating 9-13 Swiveling (panning)
Rotating to 0° 9-13 C-arm 5-11
Snapshot 8-5 System
Snapshot (button) 6-4, 8-5, 8-6 ON/OFF switches 7-2
Soft (anatomical program) 8-9 Preparing 7-1
Soft (button) 6-6 Switching on 7-2
Standard fluoroscopy 8-1 System date 19-7
Standard windowing 9-3 System time 19-7
Standard windowing (post-processing) 14-4
Start image of a cine loop 12-7, 13-15
Start Img (button) 12-7, 13-16
Start screen
Defining 19-6
T
Steering Tab ‘Archive’ 6-7, 10-7, 10-14, 10-17,
C-arm stand 5-6 10-30, 10-31, 10-32, 10-33, 10-34,
Monitor cart 5-5 10-35, 11-16, 11-17, 11-18, 11-19,
Step windowing 9-3 11-20, 11-23, 12-4, 13-12
Step windowing (post-processing) 14-4 Tab ‘Config’ 6-8, 19-2, 19-3, 19-4, 19-5,
Sterilization A-7 19-6, 19-8, 19-9, 19-11, 19-12,
Stop (button) 12-6, 12-7, 13-15, 13-16 19-13, 19-16, 19-17, 19-18, A-2
Stop image of a cine loop 12-7, 13-15 Tab ‘Fluoro’ 6-7
Stop Img (button) 12-7, 13-16 Tab ‘Measure’ 6-7, 15-3, 15-5, 15-11
Storage Commitment 11-24 Tab ‘Patient’ 6-7, 10-3, 10-5, 10-16, 11-2,
Automatic 11-25 11-3, 11-6, 11-8, 11-11
Storage format Tab ‘Post Proc.’ 6-7, 14-3
CD/DVD 19-17 Tab ‘Radiogr.’ 6-7, 18-2
USB stick 19-16 Tab ‘Radiography’ 6-7, 18-2
Storage media 19-15 Tab ‘Subtraction’ 6-7, 13-4, 13-9
Storage Media (button) 19-16, 19-17, 19-18 Technical data A-64
Studies (DICOM list) 11-20 Temperature in the generator 8-18
Subject 10-2 Temperature monitoring 8-18
Subtracted image 13-2 Temperature symbol 6-9, 8-18
Subtraction (operating mode) 6-10, 8-1 Text
Defining as start screen 19-6 Adding to an image 16-5
Subtraction (tab) 6-7, 13-4, 13-9 Deleting 16-6
Subtraction modes Editing 16-6
Acquiring a DSA cine loop 13-3 Text (button) 6-7, 16-4, 16-5
Acquiring an MSA image 13-5 Text (operating mode) 16-4
Acquiring an RSA image 13-6 Three-point (button) 15-8
DSA 13-1 Time (button) 19-8
Landmarking 13-18 Time (input box) 19-8
Mask image 13-2 Time of saving
MSA 13-1 Information on the screen 16-2
Ziehm Vision xi
P_26366/CD_28189 - EN-04/2008
Index
Touchpad (digital zoom) 9-11 Vertical slot collimator

Transport 3-8 Opening fully 9-13, 9-14
Transport position Rotating to 0° 9-13
C-arm stand 5-1 Video
Monitor cart 5-4 BNC socket 2-14
Two-pedal foot switch 6-13 Output 2-15
Assignment 6-13 Signal 2-15
Two-Point (button) 15-5 Socket 2-15
VIDEO OUT 2-14
Video output 2-14
Video signal 2-14
U Video printer
Printing a cine loop 12-13
Unpacking the system 4-1 Printing images 10-25, 14-13
Up Arrow (button) 6-6 Printing the live screen image 8-15
Uro (button) 6-6 Virtual collimator 9-14
USA Voltage (display) 6-8, 8-12, 18-3
Labels on the 23 cm image intensifier
(Ziehm Vision, Ziehm Vision R) A-37
Labels on the 31 cm image intensifier
(Ziehm Vision, Ziehm Vision R) A-37 W
Labels on the C-arm stand A-36
Labels on the C-arm stand (Ziehm Vision Warning function (radiation time) 8-17
FD) A-35 Warning symbols
Labels on the C-arm stand (Ziehm Vision Temperature 6-9, 8-18
R) A-36 X-rays 6-9, 8-12, 8-17
Labels on the C-arm stand (Ziehm Vision) Windowing 9-2, 14-4
A-35 Restoring the factory settings 9-3, 9-4,
Labels on the digital flat-panel detector 14-5
(Ziehm Vision) A-38 Standard windowing 9-3
Labels on the generator A-37 Step windowing 9-3
Labels on the monitor cart A-38 Windowing (button) 9-3, 14-4
Labels on the two-pedal foot switch A-38 Windowing values
USB (button in Backup) 10-31, 10-32 Information on the screen 16-2
USB (button) 10-12, 10-27, 12-15 Worklist
USB stick Downloading from DICOM server 11-3
Backup copy 10-30 Processing procedure steps 11-11
Deleting all images 19-18 Worklist (button) 11-3, 11-6, 11-7, 11-9,
Restoring backed-up data 10-32 11-11
Saving images 10-26, 12-15 Writing
Saving patient folders 10-12 Backup to CD/DVD 10-33
Saving single cine loop images 12-22 Cine loops to CD/DVD 12-15
Storage format 19-16 Images to CD/DVD 10-27
Patient folders to CD/DVD 10-13
Single cine loop images to CD/DVD
12-23
V
Vertical image reversal 9-16
Vertical image reversal (post-processing) X
14-9
Vertical movement X-ray symbol 6-9, 8-12, 8-17
C-arm 5-14
xii Ziehm Vision

P_26366/CD_28189 - EN-04/2008
Index
Z
Zoom 9-10
Zoom factor 9-10, 9-11, 14-7
Zoom (button) 6-7, 9-10, 9-11, 14-7, 14-8
Zoom (post-processing) 14-6
Zoom factor
Digital zoom 9-10, 9-11, 14-7
Ziehm Vision xiii

P_26366/CD_28189 - EN-04/2008
Index
xiv Ziehm Vision

P_26366/CD_28189 - EN-04/2008

EN Vision 26366 28189 04 2008

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

EN Vision 26366 28189 04 2008

Uploaded by

Copyright:

Available Formats

Ziehm Vision Family

Copyright Quality Standards

1 About This Manual 1-1

2 System Overview 2-1

3 Safety Instructions 3-1

4 Putting the System into Service 4-1

5 Mechanical Handling 5-1

5.4.3 Swiveling (panning) ........................................................................... 5-11

7 Switching the System On and Off 7-1

8 Standard Fluoroscopic Operations 8-1

9 Adjusting Live Images 9-1

9.7.1 Iris collimator ..................................................................................... 9-12

10 Data Management 10-1

11 DICOM Functions 11-1

Ziehm Vision III

11.8 Storage Commitment........................................................................................ 11-24

12 Cine Loops 12-1

13 Subtraction Modes 13-1

14 Post-Processing Images 14-1

15.6 4-point ratio measurement ............................................................................... 15-14

16 Displayed Texts and Text Functions 16-1

17 Laser Positioning Device 17-1

18 Direct Radiography 18-1

19 System Configuration 19-1

A.1.3 Checking the exposure rate control................................................... A-2

This manual is designed to enable owners and operators of any member

Ziehm Vision 1-1

1.1 Typographical conventions

Element Format Example

1-2 Ziehm Vision

1.2 Safety instructions

The present document does not constitute a complete catalog of all

Ziehm Vision 1-3

1-4 Ziehm Vision

2.1 Fields of application

Ziehm Vision 2-1

Anatomical Computer-controlled anatomical programs ensure optimum exposure

Radiation dose The superior penetration capabilities of the digital high-frequency

Image adjustment Comprehensive real-time image processing functions (customizable

Image management A patient-based image management system providing a 16-image

2-2 Ziehm Vision

For documentation purposes, a video printer is available. Documentation and

Ziehm Vision 2-3

The present Operating Instructions describe a system with maximum

2-4 Ziehm Vision

2.4 Options (USA)

The present Operating Instructions describe a system with maximum

Ziehm Vision 2-5

2.5 Optional accessories

2.6 Optional accessories (USA)

− Hand surgery table

2.7 X-ray protective equipment

We recommend that you use the following X-ray protective equipment:

2-6 Ziehm Vision

2.8 System components

2.8.1 C-arm stand

Handle X-ray generator

Fig. 2-1 C-arm stand Ziehm Vision

Ziehm Vision 2-7

Lifting Swivel arm

Fig. 2-2 Ziehm Vision FD C-arm stand

Fig. 2-3 Mobile C-arm stand of the Ziehm Vision R

2-8 Ziehm Vision