M-Turbo TM

Ultrasound System

User Guide
M-Turbo TM

Ultrasound System

User Guide
SonoSite,ȱInc.
21919ȱ30thȱDriveȱSE
Bothell,ȱWAȱ98021
USA
T:ȱ1Ȭ888Ȭ482Ȭ9449ȱorȱ1Ȭ425Ȭ951Ȭ1200
F:ȱ1Ȭ425Ȭ951Ȭ1201
SonoSiteȱLtd
AlexanderȱHouse
40AȱWilburyȱWay
Hitchin
HertsȱSG4ȱ0AP
UK
T:ȱ+44Ȭ1462Ȭ444800
F:ȱ+44Ȭ1462Ȭ444801

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

M-Turbo, SiteLink, SonoCalc, SonoHD, SonoSite, and the SonoSite logo are registered trademarks or trademarks of SonoSite, Inc.

DICOM is the registered trademark of the National Electrical Manufacturers Association for its standards publications relating to digital
communications of medical information.

Non-SonoSite product names may be trademarks or registered trademarks of their respective owners.

The SonoSite product(s) referenced in this document may be covered by one or more of the following US patents: 5722412, 5817024,
5893363, 6135961, 6203498, 6364839, 6371918, 6383139, 6416475, 6447451, 6471651, 6569101, 6648826, 6575908, 6604630, 6817982,
6835177, 6962566, 7169108, D456509, D461895, D509900, D538432, D544962, D558351, D559390, and by the following counterpart
foreign patents: AU727381, AU730822, CA2373065, CN98106133.8, CN98108973.9, DE60021552.0, DE60029777.2, DE60034670.6,
DE69730563.5, DE6980539.6, DE69831698.3, FR0875203, FR0881492, FR0815793, FR1180970, FR1175713, GB0875203, GB0881492,
GB0815793, GB1180970, GB1180971, GB1175713, IT0881492, IT0815793, IT1175713, KR532359, KR528102, NZ542968,
RCD000897368-0001, SP0881492, SP0815793. Patents pending.

P07662Ȭ02 10/2008
Copyrightȱ2008ȱbyȱSonoSite,ȱInc.
Allȱrightsȱreserved

ii
Contents

Introduction

Conventions, symbols, and terms ......................................................................... vii

Customer comments .................................................................................................. vii

Chapter 1: Getting Started

About the system .......................................................................................................... 1

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

Chapter 2: System Setup

Displaying the setup pages .....................................................................................15

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

iii
 OB Calculations setup ................................................................................................ 20
OB Custom Measurements setup .......................................................................... 21
OB Custom Tables setup ........................................................................................... 22
Presets setup ................................................................................................................. 22
System Information setup ........................................................................................ 23
USB Devices setup ...................................................................................................... 23
Limitations of JPEG format ............................................................................. 23

Chapter 3: Imaging

Imaging modes ............................................................................................................ 25

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

Chapter 4: Measurements and Calculations

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

iv
 Small Parts calculations ....................................................................................64
Transcranial Doppler and Orbital calculations ........................................65
Vascular calculations .........................................................................................67
Patient report ................................................................................................................68
Vascular and cardiac patient reports ...........................................................69
TCD patient report .............................................................................................69
OB patient report ...............................................................................................69
EMED worksheets ...............................................................................................70

Chapter 5: Troubleshooting and Maintenance

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

Chapter 6: Safety

Ergonomic safety .........................................................................................................85

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

v
 In Situ, derated, and water value intensities ...........................................105
Tissue models and equipment survey ......................................................106
Acoustic output tables ............................................................................................107
Terms used in the acoustic output tables ...............................................132
Acoustic measurement precision and uncertainty ..............................133
Labeling symbols ......................................................................................................134

Chapter 7: References

Measurement accuracy ...........................................................................................139

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

Chapter 8: Specifications

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

Glossary

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

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

vi
Introduction

Introduction
ThisȱMȬTurboȱUltrasoundȱSystemȱUserȱGuideȱ
providesȱinformationȱonȱpreparingȱandȱusingȱtheȱ
Customer comments
MȬTurbo™™ȱultrasoundȱsystemȱandȱonȱcleaningȱ Questionsȱandȱcommentsȱareȱencouraged.ȱ
andȱdisinfectingȱtheȱsystemȱandȱtransducers.ȱItȱ SonoSiteȱisȱinterestedȱinȱyourȱfeedbackȱregardingȱ
alsoȱprovidesȱreferencesȱforȱcalculations,ȱsystemȱ theȱsystemȱandȱtheȱuserȱguide.ȱPleaseȱcallȱ
specifications,ȱandȱsafetyȱandȱacousticȱoutputȱ SonoSiteȱatȱ888Ȭ482Ȭ9449ȱinȱtheȱUS.ȱOutsideȱtheȱ
information.ȱ US,ȱcallȱtheȱnearestȱSonoSiteȱrepresentative.ȱYouȱ
canȱalsoȱeȬmailȱSonoSiteȱ
Theȱuserȱguideȱisȱforȱaȱreaderȱfamiliarȱwithȱ
at comments@sonosite.com.
ultrasoundȱtechniques.ȱItȱdoesȱnotȱprovideȱ
trainingȱinȱsonographyȱorȱclinicalȱpractices.ȱ Forȱtechnicalȱsupport,ȱpleaseȱcontactȱSonoSiteȱasȱ
Beforeȱusingȱtheȱsystem,ȱyouȱmustȱhaveȱ follows:
ultrasoundȱtraining.
SonoSite Technical Support
SeeȱtheȱapplicableȱSonoSiteȱaccessoryȱuserȱguideȱ
forȱinformationȱonȱusingȱaccessoriesȱandȱ Phone (US or 877-657-8118
peripherals.ȱSeeȱtheȱmanufacturer’’sȱinstructionsȱ Canada):
forȱspecificȱinformationȱaboutȱperipherals.
Phone (Outside 425-951-1330
US and Canada): Or call your local
Conventions, symbols, and representative.

terms Fax: 425-951-6700

Theȱuserȱguideȱfollowsȱtheseȱconventions: E-mail: service@sonosite.com

•• AȱWARNINGȱdescribesȱprecautionsȱnecessaryȱ Web site: www.sonosite.com
toȱpreventȱinjuryȱorȱlossȱofȱlife. Click Support & Service.
•• AȱCautionȱdescribesȱprecautionsȱnecessaryȱtoȱ Europe +44-(0)1462-444-800
protectȱtheȱproducts. Service uk.service@sonosite.com
•• Numberedȱstepsȱinȱproceduresȱmustȱbeȱ Center:
performedȱinȱorder.
•• Itemsȱinȱbulletedȱlistsȱdoȱnotȱrequireȱaȱ
sequence.
•• SingleȬstepȱproceduresȱbeginȱwithȱ™.
Symbolsȱandȱtermsȱusedȱonȱtheȱsystemȱandȱ
transducerȱareȱexplainedȱinȱChapter 1,ȱChapter 5,ȱ
Chapter 6,ȱandȱGlossary.

vii
viii Customer comments
Chapter 1: Getting Started

About the system

TheȱMȬTurboȱultrasoundȱsystemȱisȱaȱportable,ȱ
softwareȬcontrolledȱdeviceȱusingȱallȬdigitalȱ
architecture.ȱTheȱsystemȱhasȱmultipleȱ

Getting Started
configurationsȱandȱfeatureȱsetsȱusedȱtoȱacquireȱ
andȱdisplayȱhighȬresolution,ȱrealȬtimeȱ
ultrasoundȱimages.ȱFeaturesȱavailableȱonȱyourȱ
systemȱdependȱonȱsystemȱconfiguration,ȱ 1 2 3 4
transducer,ȱandȱexamȱtype.
Figure 2 System Back Connectors:
Aȱlicenseȱkeyȱisȱrequiredȱtoȱactivateȱtheȱsoftware.ȱ
(1) DC input connector, (2) I/O connector, (3) Battery,
Seeȱ““Softwareȱlicensing””ȱonȱpage 71.ȱOnȱ
and (4) ECG connector
occasion,ȱaȱsoftwareȱupgradeȱmayȱbeȱrequired.ȱ
SonoSiteȱprovidesȱaȱUSBȱdeviceȱcontainingȱtheȱ
software.ȱOneȱUSBȱdeviceȱcanȱbeȱusedȱtoȱupgradeȱ To use the ultrasound system
multipleȱsystems.ȱ 1 Attachȱaȱtransducer.
2 Turnȱtheȱsystemȱon.ȱ(Forȱpowerȱswitchȱ
location,ȱseeȱ““Systemȱcontrols””ȱonȱpage 5.)
3 PressȱtheȱPATIENTȱkey,ȱandȱcompleteȱtheȱ
patientȱinformationȱform.
3
4 Pressȱanȱimagingȱmodeȱkey:ȱ2D,ȱM MODE,ȱ
COLOR,ȱorȱDOPPLER

4
Preparing the system
1

Installing or removing the battery

2 WARNING: To avoid injury to the operator and

to prevent damage to the
ultrasound system, inspect the
battery for leaks prior to installing.
Figure 1 System Front Features:
To avoid data loss and to conduct a
(1) Control panel, (2) Handle, (3) Display, (4) USB
safe system shutdown, always keep
ports for storage, updates, importing, and exporting
a battery in the system.

Chapter 1: Getting Started 1

 To install the battery
1 Disconnectȱtheȱpowerȱsupplyȱfromȱtheȱ
ultrasoundȱsystem.
2 RemoveȱtheȱsystemȱfromȱtheȱminiȬdockȱ(ifȱ
present)ȱandȱturnȱitȱupsideȱdown.
3 Placeȱtheȱbatteryȱintoȱtheȱbatteryȱ
compartment,ȱatȱaȱslightȱangle.ȱSeeȱFigure 3.
4 Slideȱtheȱbatteryȱforwardȱuntilȱitȱlocksȱintoȱ
place.
5 Pushȱdownȱonȱtheȱtwoȱlockingȱleversȱtoȱsecureȱ
theȱbattery.
Locking levers
To remove the battery
1 Disconnectȱtheȱpowerȱsupplyȱfromȱtheȱ
ultrasoundȱsystem.
2 RemoveȱtheȱsystemȱfromȱtheȱminiȬdockȱ(ifȱ
present)ȱandȱturnȱitȱupsideȱdown.
3 Pullȱupȱtheȱtwoȱlockingȱlevers.
4 Slideȱtheȱbatteryȱback.
5 Liftȱtheȱbatteryȱfromȱtheȱcompartment.

Using AC power and charging the

battery
Theȱbatteryȱchargesȱwhenȱtheȱsystemȱisȱ
connectedȱtoȱtheȱACȱpowerȱsupply.ȱAȱfullyȱ
dischargedȱbatteryȱrechargesȱinȱlessȱthanȱfiveȱ
hours.
TheȱsystemȱcanȱrunȱonȱACȱpowerȱandȱchargeȱtheȱ
batteryȱifȱACȱpowerȱisȱconnectedȱtoȱtheȱsystemȱ
directly,ȱtoȱaȱminiȬdock,ȱorȱtoȱaȱdockingȱsystem.ȱ
Theȱsystemȱcanȱrunȱonȱbatteryȱpowerȱforȱupȱtoȱ
twoȱhours,ȱdependingȱonȱtheȱimagingȱmodeȱandȱ
theȱdisplayȱbrightness.ȱWhenȱrunningȱonȱbatteryȱ
power,ȱtheȱsystemȱmayȱnotȱrestartȱifȱtheȱbatteryȱisȱ
low.ȱToȱcontinue,ȱconnectȱtheȱsystemȱtoȱACȱ
Figure 3 Install the Battery power.

2 Preparing the system

 Connecting transducers
WARNING: The equipment shall be connected WARNING: To avoid injury to the patient, do
to a center-tapped single phase not place the connector on the
supply circuit when users in the patient. Operate the ultrasound
United States connect the system in a docking system or on a
equipment to a 240V supply flat hard surface to allow air flow
system. past the connector.
Caution: To avoid damaging the transducer

Getting Started
Caution: Verify that the hospital supply connector, do not allow foreign
voltage corresponds to the power material in the connector.
supply voltage range. See
“Electrical” on page 154.

To operate the system using AC power

1 ConnectȱtheȱDCȱpowerȱcableȱfromȱtheȱpowerȱ
supplyȱtoȱtheȱconnectorȱonȱtheȱsystem.ȱSeeȱ
Figure 2ȱonȱpage 1.
2 ConnectȱtheȱACȱpowerȱcordȱtoȱtheȱpowerȱ
supplyȱandȱtoȱaȱhospitalȬgradeȱelectricalȱ
outlet.

Turning the system on or off

Caution: Do not use the system if an error
message appears on the display.
Note the error code and turn off the
system. Call SonoSite or your local
representative.

To turn the system on or off

™ Pressȱtheȱpowerȱswitch.ȱ(Seeȱ““Systemȱ
controls””ȱonȱpage 5.)

To wake up the system

Toȱconserveȱbatteryȱlifeȱwhileȱtheȱsystemȱisȱon,ȱ
theȱsystemȱgoesȱintoȱsleepȱmodeȱifȱtheȱlidȱisȱclosedȱ
orȱifȱtheȱsystemȱisȱuntouchedȱforȱaȱpresetȱtime.ȱToȱ
adjustȱtheȱtimeȱforȱsleepȱdelay,ȱseeȱ““Audio,ȱ
Batteryȱsetup””ȱonȱpage 19.
™ Pressȱaȱkey,ȱtouchȱtheȱtouchpad,ȱorȱopenȱtheȱ
lid.ȱ
Figure 4 Connect the Transducer

Chapter 1: Getting Started 3

To connect a transducer
1 RemoveȱtheȱsystemȱfromȱtheȱminiȬdockȱ(ifȱ
present),ȱandȱturnȱitȱupsideȱdown. WARNING: To avoid damaging the USB storage
device and losing patient data from
2 Pullȱtheȱtransducerȱlatchȱup,ȱandȱrotateȱitȱ it, observe the following:
clockwise. • Do not remove the USB storage
3 Alignȱtheȱtransducerȱconnectorȱwithȱtheȱ device or turn off the ultrasound
connectorȱonȱtheȱbottomȱofȱtheȱsystem. system while the system is
exporting.
4 Insertȱtheȱtransducerȱconnectorȱintoȱtheȱ • Do not bump or otherwise apply
systemȱconnector. pressure to the USB storage
5 Turnȱtheȱlatchȱcounterclockwise. device while it is in a USB port on
the ultrasound system. The
6 Pressȱtheȱlatchȱdown,ȱsecuringȱtheȱtransducerȱ connector could break.
connectorȱtoȱtheȱsystem.

To remove a transducer Caution: If the USB icon does not appear in

1 Pullȱtheȱtransducerȱlatchȱup,ȱandȱrotateȱitȱ the system status area on-screen,
clockwise. the USB storage device may be
defective or password-protected.
2 Pullȱtheȱtransducerȱconnectorȱawayȱfromȱtheȱ Turn the system off and replace the
system. device.

Inserting and removing USB storage To insert a USB storage device

devices ™ InsertȱtheȱUSBȱstorageȱdeviceȱintoȱanyȱUSBȱ
Imagesȱandȱclipsȱareȱsavedȱtoȱinternalȱstorageȱandȱ portȱonȱtheȱsystemȱorȱminiȬdock.ȱSeeȱFigure 1ȱ
areȱorganizedȱinȱaȱsortableȱpatientȱlist.ȱYouȱcanȱ onȱpage 1.
archiveȱtheȱimagesȱandȱclipsȱfromȱtheȱultrasoundȱ TheȱUSBȱstorageȱdeviceȱisȱreadyȱwhenȱtheȱ
systemȱtoȱaȱPCȱusingȱaȱUSBȱstorageȱdeviceȱorȱ USBȱiconȱappears.ȱ
Ethernetȱconnection.ȱAlthoughȱtheȱimagesȱandȱ
clipsȱcannotȱbeȱviewedȱfromȱaȱUSBȱstorageȱdeviceȱ Toȱviewȱinformationȱaboutȱtheȱdevice,ȱseeȱ
onȱtheȱultrasoundȱsystem,ȱyouȱcanȱremoveȱtheȱ ““USBȱDevicesȱsetup””ȱonȱpage 23.
deviceȱandȱviewȱthemȱonȱyourȱPC.
To remove a USB storage device
ThereȱareȱtwoȱUSBȱportsȱonȱtheȱsystem,ȱandȱoneȱ
RemovingȱtheȱUSBȱstorageȱdeviceȱwhileȱtheȱ
onȱtheȱminiȬdock.ȱForȱadditionalȱUSBȱports,ȱyouȱ
systemȱisȱexportingȱtoȱitȱmayȱcauseȱtheȱexportedȱ
canȱconnectȱaȱUSBȱhubȱintoȱanyȱUSBȱport.
filesȱtoȱbeȱcorruptedȱorȱincomplete.
Note: TheȱsystemȱdoesȱnotȱsupportȱpasswordȬ
1 WaitȱfiveȱsecondsȱafterȱtheȱUSBȱanimationȱ
protectedȱUSBȱstorageȱdevices.ȱMakeȱsureȱthatȱtheȱ
stops.
USBȱstorageȱdeviceȱyouȱuseȱdoesȱnotȱhaveȱpasswordȱ
protectionȱenabled. 2 RemoveȱtheȱUSBȱstorageȱdeviceȱfromȱtheȱport.

4 Preparing the system

System controls

1 14

2
15

Getting Started
3
4 16
5
17
18
6 19

20

8 9 10 11 12 13

1 Power switch Turns system on and off.

2 Alphanumeric keys Use to enter text and numbers.

3 Annotation keys See “Alphanumeric keyboard” on page 9.

4 ZOOM Magnifies the image 100%.

5 DEPTH UP, Decreases and increases imaging depth.

DEPTH DOWN

6 AUTO GAIN Adjusts gain automatically.

7 Gain

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

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

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

Chapter 1: Getting Started 5

 8 AC power indicator A steady light indicates that AC power is connected. A flashing light
indicates that the system is asleep.

9 CALIPER Displays calipers on-screen for measuring.

CALCS Turns the calculations menu on and off.

10 Touchpad Selects, adjusts, and moves items on-screen.

11 FREEZE Stops live imaging and displays a frozen image.

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

the report. See “Presets setup” on page 22.

13 CLIP Saves a clip to internal storage.

14 Control keys Control on-screen options.

15 Forms

SETUP Displays the system settings.

REPORT Accesses the patient report and EMED worksheets.

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

PATIENT Accesses patient information.

16 EXAM Opens exam menu.

17 A & B shortcut keys Keys that you can program to perform common tasks.

18 SET Sets a trace measurement.

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

SAVE CALC Saves calculations and their measurements to the patient report.

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

20 Imaging Modes

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

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

COLOR Turns CPD/Color on and off.

2D Turns 2D on.

6 System controls
Screen layout
9
1
2
3

4 10

Getting Started
6

11

7
8

Figure 1 Screen Layout

1 Mode Data Area Current imaging mode information (for example, Gen, Res, THI, and PW).

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

3 Text Text entered using keyboard.

4 Pictograph Pictograph to indicate anatomy and transducer position. You can select
anatomy and screen location.

5 Calculations Menu Contains available measurements.

6 Image Ultrasound image.

7 Measurement and Current data on measurements and calculations.

Calculations Data Area

8 On-screen Options Options available in the current context.

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

10 System Status Information on system status (for example, exam type, transducer, AC
connected, battery charging, and USB).

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

Chapter 1: Getting Started 7

General interaction Cycle Movesȱthroughȱaȱlistȱofȱsettingsȱ
continuously.ȱTheȱupperȱcontrolȱkeyȱcyclesȱ
upward.ȱTheȱlowerȱcontrolȱkeyȱcyclesȱdownward.ȱ
Touchpad and cursor
Up-Down Movesȱthroughȱaȱlistȱofȱsettings,ȱ
Useȱtheȱtouchpadȱtoȱadjustȱandȱmoveȱobjectsȱ stoppingȱatȱtheȱtopȱorȱbottom.ȱTheȱupperȱcontrolȱ
onȬscreen.ȱTheȱtouchpadȱcontrolsȱcaliperȱ keyȱmovesȱupward.ȱTheȱlowerȱcontrolȱkeyȱmovesȱ
position,ȱCPDȱorȱColorȱboxȱpositionȱandȱsize,ȱtheȱ downward.ȱByȱdefault,ȱaȱbeepȱsoundsȱwhenȱyouȱ
cursor,ȱandȱmore.ȱTheȱarrowȱkeysȱcontrolȱmuchȱ reachȱeitherȱendȱofȱtheȱrange.ȱ(Seeȱ““Audio,ȱBatteryȱ
ofȱtheȱsameȱfunctionalityȱasȱtheȱtouchpad. setup””ȱonȱpage 19.)
Theȱcursorȱappearsȱinȱtheȱsetupȱpages,ȱtheȱpatientȱ On-Off Turnsȱaȱfeatureȱonȱorȱoff.ȱYouȱcanȱpressȱ
informationȱform,ȱandȱpatientȱreport.ȱYouȱcontrolȱ eitherȱcontrolȱkey.ȱInȱforms,ȱyouȱcanȱinsteadȱselectȱ
theȱcursorȱthroughȱtheȱtouchpad.ȱForȱexample,ȱinȱ theȱoptionȱbyȱusingȱtheȱtouchpadȱandȱtheȱ
theȱpatientȱinformationȱform,ȱplaceȱtheȱcursorȱ SELECTȱkey.
overȱtheȱlastȱnameȱfieldȱandȱpressȱtheȱSELECTȱ
keyȱtoȱactivateȱthatȱfield.ȱAdditionally,ȱyouȱcanȱ Action Performsȱanȱaction.ȱYouȱcanȱpressȱeitherȱ
useȱtheȱcursorȱtoȱselectȱcheckȱboxesȱandȱitemsȱinȱ controlȱkey.ȱOrȱyouȱcanȱinsteadȱselectȱtheȱoptionȱ
lists.ȱ byȱusingȱtheȱtouchpadȱandȱtheȱSELECTȱkey.ȱ

On-screen options
TheȱonȬscreenȱoptionsȱletȱyouȱmakeȱadjustmentsȱ Figure 5 On-screen options (2D imaging shown)
andȱselectȱsettings.ȱTheȱoptionsȱavailableȱdependȱ
onȱcontext.ȱ
Eachȱoptionȱisȱcontrolledȱbyȱtheȱpairȱofȱkeysȱ
belowȱit.ȱDependingȱonȱtheȱoption,ȱtheȱcontrolȱ
keysȱfunctionȱinȱoneȱofȱfourȱways:

8 General interaction
Annotation and text
Alphanumeric keyboard

10
1

Getting Started
2 11
3
4

5 6 7 8 9

1 TAB Moves cursor among fields 8 DELETE Removes all text from the
in the forms, and tabs screen during text entry
between text position in and when not measuring.
dual screens.
9 Arrow Keys Move highlighted selection
2 CAPS LOCK Sets the keyboard to in calculations menu, move
capital letters. cursor one space when
entering text, move caliper
3 SHIFT Allows entry of capitalized position, move cine buffer
characters and forward and backward, and
international characters. move among pages in
4 TEXT Turns the keyboard on and image review and reports.
off for text entry. 10 BACKSPACE Removes the character left
5 PICTO Turns pictographs on and of the cursor in text-entry
off. mode.

6 ARROW Displays an arrow graphic 11 ENTER Moves cursor among fields

that can be moved and in forms and saves
rotated within the image calculations to report.
area.

7 SPACEBAR Turns the keyboard on for

text entry. In text entry,
adds a space.

Chapter 1: Getting Started 9

Symbols Preparing transducers
Youȱcanȱenterȱsymbolsȱandȱspecialȱcharactersȱinȱ
selectȱfieldsȱandȱforms.ȱTheȱsymbolsȱandȱspecialȱ WARNING: Some transducer sheaths contain
charactersȱavailableȱdependȱonȱcontext. natural rubber latex and talc, which
can cause allergic reactions in some
Patient information form: Last,ȱFirst,ȱMiddle,ȱ
individuals. Refer to 21 CFR 801.437,
PatientȱID,ȱAccession,ȱIndications,ȱProcedureȱID,ȱ
User labeling for devices that
User,ȱReadingȱDr.,ȱReferringȱDr.,ȱandȱInstitutionȱ
contain natural rubber.
fields
Some gels and sterilants can cause
DICOM or SiteLink configuration page: Aliasȱandȱ
an allergic reaction on some
AEȱTitleȱfields
individuals.
A & B Key, Footswitch setup page: Textȱfield
Text mode (imaging): Annotationȱfield Caution: To avoid damage to the transducer,
use only gels recommended by
SonoSite. Using gels other than the
one recommended by SonoSite can
damage the transducer and void
the warranty. If you have questions
about gel compatibility, contact
SonoSite or your local
representative.
SonoSite recommends that you
Figure 6 Symbols Dialog Box clean transducers after each use.
See “Cleaning and disinfecting
To enter symbols or special characters transducers” on page 74.
1 Selectȱtheȱfield,ȱandȱthenȱselectȱSymbols.
2 Selectȱtheȱdesiredȱsymbolȱorȱcharacter.ȱ Acousticȱcouplingȱgelȱmustȱbeȱusedȱduringȱ
exams.ȱAlthoughȱmostȱgelsȱprovideȱsuitableȱ
Youȱcanȱalsoȱpressȱtheȱkeysȱonȱtheȱkeyboard. acousticȱcoupling,ȱsomeȱgelsȱareȱincompatibleȱ
3 SelectȱOK. withȱsomeȱtransducerȱmaterials.ȱSonoSiteȱ
recommendsȱAquasonic®ȱgelȱandȱprovidesȱaȱ
sampleȱwithȱtheȱsystem.
Forȱgeneralȱuse,ȱapplyȱaȱliberalȱamountȱofȱgelȱ
betweenȱtheȱtransducerȱandȱtheȱbody.ȱForȱ
invasiveȱorȱsurgicalȱuse,ȱapplyȱaȱtransducerȱ
sheath.

10 Preparing transducers
 4 SelectȱtheȱVideosȱtab.
WARNING: To prevent contamination, the use 5 Ifȱtheȱlistȱdoesȱnotȱappear,ȱselectȱtheȱcorrectȱ
of sterile transducer sheaths and USBȱdevice:
sterile coupling gel is
a SelectȱSelect USB.ȱ
recommended for clinical
applications of an invasive or b InȱtheȱSelect USB device for media
surgical nature. Do not apply the playback dialog box,ȱselectȱtheȱEducationȱ
transducer sheath and gel until you KeyȱUSBȱdeviceȱ(““Training””ȱappearsȱunderȱ
are ready to perform the procedure. Type),ȱandȱthenȱselectȱSelect.

Getting Started
Note: ImageȱGalleryȱisȱanȱunsupportedȱfeature.ȱ
To apply a transducer sheath
SonoSiteȱrecommendsȱtheȱuseȱofȱmarketȬcleared,ȱ To view a video
transducerȱsheathsȱforȱintracavitaryȱorȱsurgicalȱ 1 Displayȱtheȱlistȱofȱvideos.
applications.Toȱlessenȱtheȱriskȱofȱcontamination,ȱ
2 Selectȱtheȱvideo.
applyȱtheȱsheathȱonlyȱwhenȱyouȱareȱreadyȱtoȱ
performȱtheȱprocedure. 3 SelectȱViewȱonȬscreen.
1 Placeȱgelȱinsideȱtheȱsheath. Theȱvideoȱbeginsȱplaying.
2 Insertȱtheȱtransducerȱintoȱtheȱsheath. 4 Selectȱanyȱofȱtheȱfollowing,ȱasȱneeded:
3 Pullȱtheȱsheathȱoverȱtheȱtransducerȱandȱcableȱ
untilȱtheȱsheathȱisȱfullyȱextended. •• ȱAdjustsȱtheȱvolume.ȱTheȱhigherȱtheȱ
number,ȱtheȱlouderȱtheȱsound.ȱZeroȱisȱ
4 Secureȱtheȱsheathȱusingȱtheȱbandsȱsuppliedȱ mute.
withȱtheȱsheath.
•• BackȱRewindsȱtheȱvideoȱ10ȱseconds.
5 Checkȱforȱandȱeliminateȱbubblesȱbetweenȱtheȱ
faceȱofȱtheȱtransducerȱandȱtheȱsheath. •• Pause Pausesȱtheȱvideo.
Bubblesȱbetweenȱtheȱfaceȱofȱtheȱtransducerȱ •• PlayȱResumesȱplayingȱofȱaȱpausedȱvideo.
andȱtheȱsheathȱmayȱaffectȱtheȱultrasoundȱ •• ForwardȱAdvancesȱtheȱvideoȱ10ȱseconds.
image.
6 Inspectȱtheȱsheathȱtoȱensureȱthatȱthereȱareȱnoȱ To exit a video
holesȱorȱtears. ™ Selectȱoneȱofȱtheȱfollowing:
•• Listȱtoȱreturnȱtoȱtheȱvideoȱlist.

Training videos •• Doneȱtoȱreturnȱtoȱ2Dȱimaging.

TheȱSonoSite®ȱEducationȱKey™™ȱtrainingȱvideosȱ
areȱanȱoptionalȱfeature.ȱ Intended uses
To display the list of videos Thisȱsystemȱtransmitsȱultrasoundȱenergyȱintoȱ
variousȱpartsȱofȱtheȱpatient’’sȱbodyȱtoȱobtainȱ
1 InsertȱtheȱEducationȱKeyȱUSBȱdeviceȱintoȱaȱ
ultrasoundȱimages,ȱasȱfollows.ȱ
USBȱportȱonȱtheȱsystem.
Forȱtheȱintendedȱtransducerȱandȱimagingȱmodesȱ
2 PressȱtheȱREVIEWȱkey.
forȱeachȱexamȱtype,ȱseeȱ““Imagingȱmodesȱandȱ
3 Ifȱthereȱisȱanȱactiveȱexam,ȱselectȱListȱonȬscreen. examsȱavailableȱbyȱtransducer””ȱonȱpage 31.

Chapter 1: Getting Started 11

Abdominal Imaging Applications Youȱcanȱassessȱ multipleȱpregnancy,ȱfetalȱhydrops,ȱplacentalȱ
theȱliver,ȱkidneys,ȱpancreas,ȱspleen,ȱgallbladder,ȱ abnormalities,ȱasȱwellȱasȱmaternalȱhypertension,ȱ
bileȱducts,ȱtransplantedȱorgans,ȱabdominalȱ diabetes,ȱandȱlupus.
vessels,ȱandȱsurroundingȱanatomicalȱstructuresȱ
forȱtheȱpresenceȱorȱabsenceȱofȱpathologyȱ WARNING: To prevent injury or misdiagnosis,
transabdominally. do not use this system for
Percutaneous Umbilical Blood
Cardiac Imaging Applications Youȱcanȱassessȱtheȱ Sampling (PUBS) or in vitro
heart,ȱcardiacȱvalves,ȱgreatȱvessels,ȱsurroundingȱ Fertilization (IVF) The system has
anatomicalȱstructures,ȱoverallȱcardiacȱ not been validated to be proven
performance,ȱandȱheartȱsizeȱforȱtheȱpresenceȱorȱ effective for these two uses.
absenceȱofȱpathology.
CPD or Color images can be used as
Youȱcanȱobtainȱtheȱpatient’’sȱelectrocardiogramȱ an adjunctive method, not as a
(ECG).ȱTheȱECGȱisȱusedȱforȱtimingȱofȱcardiacȱ screening tool, for the detection of
events. structural anomalies of the fetal
heart and as an adjunctive method,
WARNING: The ECG is not used to diagnose
not as a screening tool for the
cardiac arrhythmias and is not
diagnosis of Intrauterine Growth
designed for long term cardiac
Retardation (IUGR).
rhythm monitoring.

Pediatric and Neonatal Imaging Applications

Gynecology and Infertility Imaging Applications
Youȱcanȱassessȱtheȱpediatricȱandȱneonatalȱ
Youȱcanȱassessȱtheȱuterus,ȱovaries,ȱadnexa,ȱandȱ
abdominal,ȱpelvicȱandȱcardiacȱanatomy,ȱpediatricȱ
surroundingȱanatomicalȱstructuresȱforȱtheȱ
hips,ȱneonatalȱhead,ȱandȱsurroundingȱanatomicalȱ
presenceȱorȱabsenceȱofȱpathologyȱ
structuresȱforȱtheȱpresenceȱorȱabsenceȱofȱ
transabdominallyȱorȱtransvaginally.
pathology.
Interventional Imaging Applications Youȱcanȱuseȱ
Superficial Imaging Applications Youȱcanȱassessȱ
theȱsystemȱforȱultrasoundȱguidanceȱinȱbiopsyȱandȱ
theȱbreast,ȱthyroid,ȱtesticle,ȱlymphȱnodes,ȱ
drainageȱprocedures,ȱvascularȱlineȱplacement,ȱ
hernias,ȱmusculoskeletalȱstructures,ȱsoftȱtissueȱ
peripheralȱnerveȱblocks,ȱspinalȱnerveȱblocksȱandȱ
structures,ȱophthalmicȱstructures,ȱandȱ
taps,ȱovaȱharvesting,ȱamniocentesisȱandȱotherȱ
surroundingȱanatomicalȱstructuresȱforȱtheȱ
obstetricalȱprocedures,ȱandȱprovideȱassistanceȱ
presenceȱorȱabsenceȱofȱpathology.ȱYouȱcanȱuseȱtheȱ
duringȱabdominal,ȱbreast,ȱandȱneurologicalȱ
systemȱforȱultrasoundȱguidanceȱinȱbiopsyȱandȱ
surgery.
drainageȱprocedures,ȱvascularȱlineȱplacement,ȱ
Obstetrical Imaging Applications Youȱcanȱassessȱ peripheralȱnerveȱblocks,ȱandȱspinalȱnerveȱblocksȱ
theȱfetalȱanatomy,ȱviability,ȱestimatedȱfetalȱ andȱtaps.
weight,ȱgestationalȱage,ȱamnioticȱfluid,ȱandȱ
surroundingȱanatomicalȱstructuresȱforȱtheȱ
presenceȱorȱabsenceȱofȱpathologyȱ
transabdominallyȱorȱtransvaginally.ȱCPDȱandȱ
ColorȱimagingȱareȱintendedȱforȱhighȬriskȱ
pregnantȱwomen.ȱHighȬriskȱpregnancyȱ
indicationsȱinclude,ȱbutȱareȱnotȱlimitedȱto,ȱ

12 Intended uses
WARNING: To avoid injury to the patient, use
only an Orbital (Orb) or
Ophthalmic (Oph) exam type when
performing imaging through the
eye. The FDA has established lower
acoustic energy limits for
ophthalmic use. The system will
not exceed these limits only if the

Getting Started
Orb or Oph exam type is selected.

Transcranial Imaging Applications Youȱcanȱ

assessȱtheȱanatomicalȱstructuresȱandȱvascularȱ
anatomyȱofȱtheȱbrainȱforȱpresenceȱorȱabsenceȱofȱ
pathology.ȱYouȱcanȱuseȱimagingȱtemporally,ȱ
transȬoccipitally,ȱorȱtransȬorbitally.

WARNING: To avoid injury to the patient, use

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

Vascular Imaging Applications Youȱcanȱassessȱtheȱ

carotidȱarteries,ȱdeepȱveins,ȱandȱarteriesȱinȱtheȱ
armsȱandȱlegs,ȱsuperficialȱveinsȱinȱtheȱarmsȱandȱ
legs,ȱgreatȱvesselsȱinȱtheȱabdomen,ȱandȱvariousȱ
smallȱvesselsȱfeedingȱorgansȱforȱtheȱpresenceȱorȱ
absenceȱofȱpathology.

Chapter 1: Getting Started 13

14 Intended uses
Chapter 2: System Setup

Theȱsystemȱsetupȱpagesȱletȱyouȱcustomizeȱtheȱ Footswitch (L),ȱFootswitch (R) Theȱfunctionȱofȱtheȱ

systemȱandȱsetȱpreferences. leftȱandȱrightȱfootswitches:ȱSave Clip,ȱRecord,ȱ
Freeze,ȱSave Image,ȱorȱPrint.ȱSeeȱalsoȱ““Toȱconnectȱ
theȱfootswitch.””
Displaying the setup pages
To connect the footswitch
To display a setup page TheȱSonoSiteȱfootswitchȱallowsȱhandsȬfreeȱ
1 PressȱtheȱSETUPȱkey. operationȱwithȱaȱcustomizableȱtwoȬpedalȱ
footswitch.ȱTheȱfootswitchȱisȱanȱoptionalȱfeature.
2 SelectȱtheȱsetupȱpageȱunderȱSetup Pages.
Toȱreturnȱtoȱimagingȱfromȱaȱsetupȱpage,ȱselectȱ WARNING: To avoid contamination, do not use
DoneȱonȬscreen. the footswitch in a sterile
environment. The footswitch is not
sterilized.
Restoring default settings

Setup
1 Connectȱtheȱcables:
To restore default settings for a setup page
•• YȱadapterȱcableȱtoȱtheȱECGȱconnectorȱonȱ
™ Onȱtheȱsetupȱpage,ȱselect ResetȱonȬscreen. theȱminiȬdockȱorȱdockingȱsystem
To restore all default settings •• FootswitchȱcableȱtoȱYȱadapterȱcable
1 Turnȱtheȱsystemȱoff. 2 OnȱtheȱAȱ&ȱBȱKey,ȱFootswitchȱsetupȱpage,ȱ
2 ConnectȱtheȱsystemȱtoȱACȱpower.ȱ(Seeȱ““Toȱ selectȱaȱfunctionȱforȱtheȱleftȱandȱrightȱ
operateȱtheȱsystemȱusingȱACȱpower””ȱonȱ footswitches.ȱ
page 3.)
3 Simultaneouslyȱpressȱ1ȱandȱtheȱpowerȱkey.ȱ Administration setup
Theȱsystemȱbeepsȱseveralȱtimes. OnȱtheȱAdministrationȱsetupȱpage,ȱyouȱcanȱ
configureȱtheȱsystemȱtoȱrequireȱusersȱtoȱlogȱinȱ
andȱenterȱpasswords.ȱRequiredȱloginȱhelpsȱ
A & B Key, Footswitch setup protectȱpatientȱdata.ȱYouȱcanȱalsoȱaddȱandȱdeleteȱ
OnȱtheȱAȱ&ȱBȱKey,ȱFootswitchȱsetupȱpage,ȱyouȱcanȱ users,ȱchangeȱpasswords,ȱimportȱandȱexportȱuserȱ
programȱtheȱshortcutȱkeysȱandȱfootswitchȱtoȱ accounts,ȱandȱviewȱtheȱeventȱlog.
performȱcommonȱtasks.ȱSelectȱfromȱtheȱfollowingȱ
lists:
A Key, B Key Theȱfunctionȱofȱtheȱshortcutȱkeys.ȱByȱ
default,ȱtheȱAȱshortcutȱkeyȱisȱsetȱtoȱPrintȱandȱtheȱ
BȱshortcutȱkeyȱisȱsetȱtoȱRecord.ȱTheȱshortcutȱkeysȱ
areȱbelowȱtheȱalphanumericȱkeypad.

Chapter 2: System Setup 15

Security settings 2 InȱtheȱUser Loginȱlist,ȱselectȱOn.
•• Onȱrequiresȱaȱuserȱnameȱandȱpasswordȱatȱ
WARNING: Health care providers who maintain
startup.
or transmit health information are
required by the Health Insurance •• Offȱallowsȱaccessȱtoȱtheȱsystemȱwithoutȱaȱ
Portability and Accountability Act userȱnameȱandȱpassword.
(HIPAA) of 1996 and the European
Union Data Protection Directive To change the administrator password or let
(95/46/EC) to implement users change passwords
appropriate procedures: to ensure 1 LogȱinȱasȱAdministrator.
the integrity and confidentiality of
information; to protect against any 2 UnderȱUser List,ȱselectȱAdministrator.
reasonably anticipated threats or 3 Doȱanyȱofȱtheȱfollowing:
hazards to the security or integrity
of the information or unauthorized •• Changeȱtheȱadministratorȱpassword:ȱ
uses or disclosures of the UnderȱUser Information,ȱtypeȱtheȱnewȱ
information. passwordȱinȱtheȱPasswordȱboxȱandȱ
Confirmȱbox.ȱ(Seeȱ““Choosingȱaȱsecureȱ
password””ȱonȱpage 18.)
Securityȱsettingsȱonȱtheȱsystemȱallowȱyouȱtoȱmeetȱ
theȱapplicableȱsecurityȱrequirementsȱlistedȱinȱtheȱ •• Letȱusersȱchangeȱtheirȱpasswords:ȱSelectȱ
HIPAAȱstandard.ȱUsersȱareȱultimatelyȱ theȱPassword changesȱcheckȱbox.
responsibleȱforȱensuringȱtheȱsecurityȱandȱ 4 SelectȱSave.
protectionȱofȱallȱelectronicȱprotectedȱhealthȱ
informationȱcollected,ȱstored,ȱreviewed,ȱandȱ
transmittedȱonȱtheȱsystem. User setup

To log in as Administrator To add a new user

1 OnȱtheȱAdministrationȱsetupȱpage,ȱtypeȱ 1 LogȱinȱasȱAdministrator.
AdministratorȱinȱtheȱNameȱbox. 2 SelectȱNew.
2 Typeȱtheȱadministratorȱpasswordȱinȱtheȱ 3 UnderȱUser Information,ȱfillȱinȱtheȱName,ȱ
Passwordȱbox. Password,ȱandȱConfirmȱboxes.ȱ(Seeȱ““Choosingȱ
Ifȱyouȱdon’’tȱhaveȱtheȱadministratorȱpassword,ȱ aȱsecureȱpassword””ȱonȱpage 18.)
contactȱSonoSite.ȱ(Seeȱ““SonoSiteȱTechnicalȱ 4 (Optional)ȱInȱtheȱUser box,ȱtypeȱtheȱuser’’sȱ
Support””ȱonȱpage vii.) initialsȱtoȱdisplayȱthemȱinȱtheȱpatientȱheaderȱ
3 SelectȱLogin. andȱtheȱUserȱfieldȱinȱtheȱpatientȱinformationȱ
form.
To log out as Administrator 5 (Optional)ȱSelectȱtheȱAdministration Accessȱ
™ Turnȱoffȱorȱrestartȱtheȱsystem. checkȱboxȱtoȱallowȱaccessȱtoȱallȱadministrationȱ
privileges.
To require user login
6 SelectȱSave.
YouȱcanȱsetȱtheȱsystemȱtoȱdisplayȱtheȱUserȱLoginȱ
screenȱatȱstartup. To modify user information
1 LogȱinȱasȱAdministrator. 1 LogȱinȱasȱAdministrator.

16 Administration setup
2 UnderȱUser List,ȱselectȱtheȱuser. 2 LogȱinȱasȱAdministrator.
3 UnderȱUser Information,ȱmakeȱchangesȱasȱ 3 SelectȱImportȱonȬscreen.
desired.
4 SelectȱtheȱUSBȱstorageȱdevice,ȱandȱselectȱ
4 SelectȱSave. Import.
Anyȱchangeȱtoȱtheȱuserȱnameȱreplacesȱtheȱ 5 Restartȱtheȱsystem.
previousȱname.
Allȱuserȱnamesȱandȱpasswordsȱonȱtheȱsystemȱ
To delete a user areȱreplacedȱwithȱtheȱimportedȱdata.
1 LogȱinȱasȱAdministrator.
Exporting and clearing the Event log
2 UnderȱUser List,ȱselectȱtheȱuser.
TheȱEventȱlogȱcollectsȱerrorsȱandȱeventsȱandȱcanȱ
3 SelectȱDelete. beȱexportedȱtoȱaȱUSBȱstorageȱdeviceȱandȱreadȱonȱ
aȱPC.
4 SelectȱYes.
To display the Event log
To change a user password
1 LogȱinȱasȱAdministrator.
1 LogȱinȱasȱAdministrator.

Setup
2 SelectȱLogȱonȬscreen.
2 InȱtheȱUser List,ȱselectȱtheȱuser.
TheȱEventȱlogȱappears.
3 TypeȱtheȱnewȱpasswordȱinȱtheȱPasswordȱboxȱ
andȱConfirmȱbox. Toȱreturnȱtoȱtheȱpreviousȱscreen,ȱselectȱBack.
4 SelectȱSave. To export the Event log
TheȱEventȱlogȱandȱtheȱDICOMȱnetworkȱlogȱhaveȱ
Exporting or importing user accounts theȱsameȱfileȱnameȱ(log.txt).ȱExportingȱeitherȱoneȱ
Theȱexportȱandȱimportȱcommandsȱletȱyouȱ toȱaȱUSBȱstorageȱdeviceȱoverwritesȱanyȱexistingȱ
configureȱmultipleȱsystemsȱandȱbackȱupȱuserȱ log.txtȱfile.
accountȱinformation.
1 InsertȱaȱUSBȱstorageȱdevice.
To export user accounts 2 SelectȱLogȱandȱthenȱselectȱExport onȬscreen.ȱ
1 InsertȱaȱUSBȱstorageȱdevice. AȱlistȱofȱUSBȱdevicesȱappears.
2 LogȱinȱasȱAdministrator. 3 SelectȱtheȱUSBȱstorageȱdevice,ȱandȱselectȱ
3 SelectȱExportȱonȬscreen.ȱAȱlistȱofȱUSBȱdevicesȱ Export.
appears.
TheȱEventȱlogȱisȱaȱtextȱfileȱthatȱyouȱcanȱopenȱinȱaȱ
4 SelectȱtheȱUSBȱstorageȱdevice,ȱandȱselectȱ textȬeditingȱapplicationȱ(forȱexample,ȱMicrosoftȱ
Export. WordȱorȱNotepad).
Allȱuserȱnamesȱandȱpasswordsȱareȱcopiedȱtoȱ To clear the Event log
theȱUSBȱstorageȱdevice.
1 DisplayȱtheȱEventȱlog.
To import user accounts 2 SelectȱClearȱonȬscreen.
1 InsertȱtheȱUSBȱstorageȱdeviceȱthatȱcontainsȱtheȱ 3 SelectȱYes.
accounts.

Chapter 2: System Setup 17

Logging in as user 1 InȱtheȱExamȱlistȱonȱtheȱAnnotationsȱsetupȱ
page,ȱselectȱtheȱexamȱtypeȱwhoseȱlabelsȱyouȱ
Ifȱuserȱloginȱisȱrequired,ȱtheȱUserȱLoginȱscreenȱ
wantȱtoȱspecify.
appearsȱwhenȱyouȱturnȱonȱtheȱsystem.ȱ(Seeȱ““Toȱ
requireȱuserȱlogin””ȱonȱpage 16.) 2 ForȱGroup,ȱselect A, B, or Cȱforȱtheȱlabelȱgroupȱ
youȱwantȱassociatedȱwithȱthatȱexam.ȱ
To log in as user
Theȱpresetȱlabelsȱappearȱforȱtheȱselectedȱgroup.
1 Turnȱonȱtheȱsystem.
3 Doȱanyȱofȱtheȱfollowing:
2 InȱtheȱUser Loginȱscreen,ȱtypeȱyourȱnameȱandȱ
password,ȱandȱselectȱOK. •• Addȱaȱcustomȱlabelȱtoȱtheȱgroup:ȱTypeȱtheȱ
labelȱinȱtheȱTextȱbox,ȱandȱselectȱAdd.
To log in as guest
•• Renameȱaȱlabel:ȱSelectȱtheȱlabel,ȱtypeȱtheȱ
Guestsȱcanȱscanȱbutȱcan’’tȱaccessȱsystemȱsetupȱandȱ newȱnameȱinȱtheȱTextȱbox,ȱandȱselectȱ
patientȱinformation.
Rename.
1 Turnȱonȱtheȱsystem.
•• Moveȱaȱlabelȱwithinȱtheȱgroup:ȱSelectȱtheȱ
2 InȱtheȱUser Loginȱscreen,ȱselectȱGuest. label,ȱandȱthenȱselectȱtheȱonȬscreenȱupȱorȱ
downȱarrow.
To change your password
•• Deleteȱaȱlabelȱfromȱaȱgroup:ȱSelectȱtheȱ
1 Turnȱonȱtheȱsystem.ȱ label,ȱandȱselectȱDelete.
2 InȱtheȱUser Loginȱscreen,ȱselectȱPassword. Youȱcanȱuseȱsymbolsȱinȱlabels.ȱSeeȱ““Symbols””ȱ
3 Typeȱyourȱoldȱandȱnewȱpasswords,ȱconfirmȱ onȱpage 10.
theȱnewȱpassword,ȱandȱthenȱselectȱOK.
To specify text retention when unfreezing
Choosing a secure password Youȱcanȱspecifyȱwhichȱtextȱtoȱkeepȱwhenȱyouȱ
unfreezeȱanȱimageȱorȱchangeȱtheȱimagingȱlayout.
Toȱensureȱsecurity,ȱchooseȱaȱpasswordȱthatȱ
containsȱuppercaseȱcharactersȱ(AȬZ),ȱlowercaseȱ ™ InȱtheȱUnfreezeȱlistȱonȱtheȱAnnotationsȱsetupȱ
charactersȱ(aȬz),ȱandȱnumbersȱ(0Ȭ9).ȱPasswordsȱ page,ȱselectȱKeep All Text,ȱKeep Home Text,ȱorȱ
areȱcaseȬsensitive. Clear All Text.
TheȱdefaultȱsettingȱisȱKeep All Text.ȱForȱ
informationȱonȱsettingȱtheȱhomeȱposition,ȱseeȱ
Annotations setup ““Toȱresetȱtheȱhomeȱposition””ȱonȱpage 33.ȱ
OnȱtheȱAnnotationsȱsetupȱpage,ȱyouȱcanȱ To export predefined label groups
customizeȱpredefinedȱlabelsȱandȱsetȱtheȱ
preferenceȱforȱmanagingȱtextȱwhenȱunfreezingȱ 1 InsertȱaȱUSBȱstorageȱdevice.
images. 2 OnȱtheȱAnnotationsȱsetupȱpage,ȱselectȱExport.
Forȱinstructionsȱtoȱannotateȱimages,ȱseeȱ AȱlistȱofȱUSBȱdevicesȱappears.
““Annotatingȱimages””ȱonȱpage 32.
3 SelectȱtheȱUSBȱstorageȱdevice,ȱandȱselectȱ
To predefine a label group Export.
Youȱcanȱspecifyȱwhichȱlabelsȱareȱavailableȱforȱanȱ Aȱcopyȱofȱallȱpredefinedȱlabelȱgroupsȱforȱallȱ
examȱtypeȱwhenȱannotatingȱanȱimage.ȱ(Seeȱ““Toȱ examsȱsavesȱtoȱtheȱUSBȱstorageȱdevice.
placeȱtextȱonȱanȱimage””ȱonȱpage 32.)

18 Annotations setup
To import predefined label groups Connectivity setup
1 InsertȱtheȱUSBȱstorageȱdeviceȱthatȱcontainsȱtheȱ
OnȱtheȱConnectivityȱsetupȱpage,ȱyouȱspecifyȱ
labelȱgroups.
optionsȱforȱusingȱnonȬUSBȱdevicesȱandȱforȱalertsȱ
2 OnȱtheȱAnnotationsȱsetupȱpage,ȱselectȱImportȱ whenȱinternalȱstorageȱisȱfull.ȱYouȱalsoȱimportȱ
onȬscreen. wirelessȱcertificatesȱandȱspecifyȱsettingsȱ
(includingȱTransferȱModeȱandȱLocation)ȱforȱ
3 SelectȱtheȱUSBȱstorageȱdevice,ȱandȱthenȱselectȱ
SiteLinkȱandȱDICOM,ȱwhichȱareȱoptionalȱ
Import.
features.ȱReferȱtoȱtheȱSiteLinkȱandȱDICOMȱ
4 SelectȱDoneȱinȱtheȱdialogȱboxȱthatȱappears. documentation.
Allȱpredefinedȱlabelȱgroupsȱforȱallȱexamsȱareȱ To configure the system for a printer
replacedȱwithȱthoseȱfromȱtheȱUSBȱstorageȱ
device. 1 Setȱupȱtheȱprinterȱhardware.ȱ(Seeȱinstructionsȱ
includedȱwithȱtheȱprinterȱorȱdockingȱsystem.)
2 InȱtheȱPrinterȱlistȱonȱtheȱConnectivityȱsetupȱ
Audio, Battery setup page,ȱselectȱtheȱprinter.
OnȱtheȱAudio,ȱBatteryȱsetupȱpage,ȱyouȱcanȱselectȱ
To configure the system for a DVD recorder,

Setup
optionsȱinȱtheȱfollowingȱlists:
PC, or serial bar code scanner
Key clickȱSelectȱOnȱorȱOffȱforȱkeysȱtoȱclickȱwhenȱ 1 OnȱtheȱConnectivityȱsetupȱpage,ȱdoȱtheȱ
pressed. following:
Beep alert SelectȱOnȱorȱOffȱforȱtheȱsystemȱtoȱbeepȱ •• (DVDȱrecorder)ȱInȱtheȱVideo Modeȱlist,ȱ
whenȱsaving,ȱwarning,ȱstarting,ȱorȱshuttingȱ selectȱtheȱvideoȱstandard:ȱNTSCȱorȱPAL.
down.
•• InȱtheȱSerial Portȱlist,ȱselectȱtheȱperipheral.
Sleep delayȱSelectȱOff,ȱorȱ5ȱorȱ10ȱminutesȱtoȱ
specifyȱtheȱperiodȱofȱinactivityȱbeforeȱtheȱsystemȱ Computer (PC) allowsȱpatientȱreportȱdataȱ
goesȱintoȱsleepȱmode.ȱ toȱbeȱsentȱasȱASCIIȱtextȱfromȱtheȱsystemȱtoȱ
aȱPC.ȱTheȱPCȱmustȱhaveȱthirdȬpartyȱ
Power delayȱSelectȱOff,ȱorȱ15ȱorȱ30ȱminutesȱtoȱ softwareȱtoȱacquire,ȱview,ȱorȱformatȱtheȱ
specifyȱtheȱperiodȱofȱinactivityȱbeforeȱtheȱsystemȱ dataȱintoȱaȱreport.ȱCheckȱtheȱcompatibilityȱ
automaticallyȱturnsȱoff. ofȱyourȱsoftwareȱwithȱSonoSiteȱTechnicalȱ
Support.ȱ(Seeȱalsoȱ““Toȱsendȱaȱpatientȱ
Cardiac Calculations setup reportȱtoȱaȱPC””ȱonȱpage 69.)
Note: Becauseȱtheseȱperipheralsȱuseȱtheȱsameȱ
OnȱtheȱCardiacȱCalculationsȱsetupȱpage,ȱyouȱcanȱ RSȬ232ȱconnectorȱonȱtheȱminiȬdock,ȱyouȱcanȱ
specifyȱmeasurementȱnamesȱthatȱappearȱinȱtheȱ connectȱonlyȱoneȱofȱthemȱatȱaȱtime.
TissueȱDopplerȱImagingȱ(TDI)ȱcalculationsȱmenuȱ
2 Restartȱtheȱsystem.
andȱonȱtheȱreportȱpage.
3 Attachȱaȱserialȱcableȱ(RSȬ232)ȱfromȱtheȱserialȱ
Seeȱalsoȱ““Cardiacȱcalculations””ȱonȱpage 50.
portȱonȱtheȱminiȬdockȱorȱdockingȱsystemȱtoȱ
To specify cardiac measurement names theȱperipheral.
™ UnderȱTDI WallsȱonȱtheȱCardiacȱCalculationsȱ
setupȱpage,ȱselectȱaȱnameȱforȱeachȱwall.ȱ

Chapter 2: System Setup 19

To receive storage alerts IMT Calculations setup
™ OnȱtheȱConnectivityȱsetupȱpage,ȱselectȱ
OnȱtheȱIMTȱCalculationsȱsetupȱpage,ȱyouȱcanȱ
Internal Storage Capacity Alert.
customizeȱtheȱIMTȱcalculationsȱmenu.ȱYouȱcanȱ
Theȱsystemȱdisplaysȱaȱmessageȱifȱinternalȱ specifyȱupȱtoȱeightȱmeasurementȱnamesȱforȱbothȱ
storageȱisȱnearȱcapacityȱwhenȱyouȱendȱanȱ rightȱsideȱandȱleftȱsideȱcalculations.ȱTheȱ
exam.ȱTheȱsystemȱthenȱdeletesȱarchivedȱ measurementȱnamesȱalsoȱappearȱinȱtheȱpatientȱ
patientȱexamsȱifȱspecifiedȱinȱDICOM.ȱ report.
Seeȱalsoȱ““IMTȱcalculations””ȱonȱpage 59.
Date and Time setup
To customize the IMT calculations menu
WARNING: To obtain accurate obstetrics ™ OnȱtheȱIMTȱCalculationsȱsetupȱpage,ȱdoȱtheȱ
calculations, an accurate date and following:
time are critical. Verify that the date •• UnderȱIMT Calculations,ȱselectȱ
and time are accurate before each measurementȱnamesȱfromȱtheȱlists,ȱorȱ
use of the system. The system does selectȱNone.
not automatically adjust for
daylight saving time changes. Theȱselectedȱnamesȱappearȱinȱtheȱ
calculationsȱmenuȱandȱinȱtheȱpatientȱ
report.
To set the date and time
•• Typeȱtheȱdesiredȱwidthȱinȱtheȱ
™ OnȱtheȱDateȱandȱTimeȱsetupȱpage,ȱdoȱtheȱ
Region width (mm)ȱbox.
following:
•• InȱtheȱDate box,ȱtypeȱtheȱcurrentȱdate.
•• InȱtheȱTime box,ȱtypeȱtheȱcurrentȱtimeȱinȱ Network Status setup
24 hourȱformatȱ(hoursȱandȱminutes). TheȱNetworkȱStatusȱsetupȱpageȱdisplaysȱ
informationȱonȱsystemȱIPȱaddress,ȱLocation,ȱ
EthernetȱMACȱaddress,ȱandȱtheȱwirelessȱ
Display Information setup connectionȱifȱany.
OnȱtheȱDisplayȱInformationȱsetupȱpage,ȱyouȱcanȱ
specifyȱwhichȱdetailsȱappearȱonȬscreenȱduringȱ
imaging.ȱYouȱcanȱselectȱsettingsȱinȱtheȱfollowingȱ OB Calculations setup
sections: OnȱtheȱOBȱCalculationsȱsetupȱpage,ȱyouȱselectȱ
Patient HeaderȱInformationȱthatȱappearsȱinȱtheȱ authorsȱforȱOBȱcalculationȱtables.ȱYouȱcanȱalsoȱ
patientȱheader. importȱorȱexportȱadditionalȱOBȱcalculationȱtables.

Mode DataȱImagingȱinformation. Seeȱalsoȱ““OBȱcalculations””ȱonȱpage 61.

System StatusȱSystemȱstatusȱinformation.

20 Date and Time setup

 To import OB calculationȱtables
Tablesȱthatȱyouȱimportȱareȱaddedȱtoȱthoseȱalreadyȱ
onȱtheȱsystem.
1 InsertȱtheȱUSBȱstorageȱdeviceȱthatȱcontainsȱtheȱ
tables.
2 OnȱtheȱOBȱCalculationsȱsetupȱpage,ȱselectȱ
ImportȱonȬscreen.
3 SelectȱtheȱUSBȱstorageȱdevice,ȱandȱthenȱselectȱ
Import.
4 SelectȱOKȱinȱtheȱdialogȱboxȱthatȱappears.
Theȱsystemȱrestarts.
Figure 1 OB Calculations Setup Page

To specify gestational age and growth OB Custom Measurements

analysis setup

Setup
1 OnȱtheȱOBȱCalculationsȱsetupȱpage,ȱselectȱtheȱ OnȱtheȱOBȱCustomȱMeasurementsȱsetupȱpage,ȱ
desiredȱOBȱauthorsȱ(orȱselectȱNone)ȱinȱtheȱ youȱcanȱdefineȱmeasurementsȱthatȱappearȱinȱtheȱ
measurementȱlistsȱunderȱGestational Ageȱandȱ OBȱcalculationsȱmenuȱandȱOBȱreport.ȱOBȱCustomȱ
Growth Analysis. Measurementsȱisȱanȱoptionalȱfeature.
Selectingȱanȱauthorȱplacesȱtheȱassociatedȱ Seeȱalsoȱ““OBȱcalculations””ȱonȱpage 61.
measurementȱonȱtheȱcalculationsȱmenu.
2 (Optional)ȱSelectȱMoreȱtoȱdisplayȱtheȱlistȱofȱ To set up OB custom measurements
userȬdefinedȱcustomȱmeasurementsȱandȱtoȱ Youȱcanȱsaveȱupȱtoȱfiveȱcustomȱmeasurementsȱ
associateȱaȱcustomȱtableȱforȱtheȱcustomȱ thatȱappearȱinȱtheȱOBȱcalculationsȱmenuȱandȱOBȱ
measurement.ȱ report.
Thisȱoptionȱisȱavailableȱonlyȱwhenȱaȱ 1 OnȱtheȱOBȱCustomȱMeasurementsȱsetupȱpage,ȱ
userȬdefinedȱcustomȱtableȱhasȱbeenȱcreatedȱ selectȱNew.
forȱtheȱcustomȱmeasurement.
2 InȱtheȱNameȱbox,ȱtypeȱaȱuniqueȱname.
To export OB calculation tables 3 InȱtheȱTypeȱlist,ȱselectȱtheȱdesiredȱ
1 InsertȱaȱUSBȱstorageȱdevice. measurementȱtype.
2 OnȱtheȱOBȱCalculationsȱsetupȱpage,ȱselectȱ 4 SelectȱSave.
Export.ȱAȱlistȱofȱUSBȱdevicesȱappears.
To delete an OB custom measurement
3 SelectȱtheȱUSBȱstorageȱdevice,ȱandȱselectȱ
IfȱyouȱdeleteȱanȱOBȱcustomȱmeasurementȱduringȱ
Export.
anȱexam,ȱtheȱexamȱends.
AllȱuserȬdefinedȱtablesȱandȱmeasurementsȱareȱ
1 OnȱtheȱOBȱCustomȱMeasurementsȱsetupȱpage,ȱ
copiedȱtoȱtheȱUSBȱstorageȱdevice.
highlightȱtheȱmeasurementȱinȱtheȱCustom
Measurementsȱlist.
2 SelectȱDelete Last.

Chapter 2: System Setup 21

3 SelectȱYes. 4 SelectȱNewȱonȬscreen.
Theȱexamȱends,ȱandȱanyȱtablesȱandȱreportȱ 5 InȱtheȱAuthorȱbox,ȱtypeȱaȱuniqueȱname.
dataȱassociatedȱwithȱtheȱmeasurementȱareȱ
6 Enterȱtheȱdata.
removedȱfromȱtheȱsystem.
7 SelectȱSaveȱonȬscreen.

OB Custom Tables setup Toȱdisplayȱtheȱmeasurementȱforȱtheȱcustomȱtableȱ

inȱtheȱcalculationsȱmenu,ȱseeȱ““Toȱspecifyȱ
OnȱtheȱOBȱCustomȱTablesȱsetupȱpages,ȱyouȱcanȱ gestationalȱageȱandȱgrowthȱanalysis””ȱonȱpage 21.
customizeȱgrowthȱtablesȱthatȱappearȱinȱtheȱ
calculationsȱmenuȱandȱpatientȱreport. To edit or delete an OB custom table
Gestational Age Table Measurements Theȱsystemȱ 1 OnȱtheȱOBȱCalculationsȱorȱOBȱCustomȱ
providesȱgestationalȱageȱmeasurementsȱbyȱ Measurementsȱsetupȱpage,ȱselectȱTablesȱ
selectedȱauthorsȱforȱCRL,ȱGS,ȱBPD,ȱOFD,ȱHC,ȱAC,ȱ onȬscreen.
FL,ȱAPTD,ȱTTD,ȱFTA,ȱandȱ5 additionalȱcustomȱ 2 SelectȱtheȱOBȱcustomȱtable.
measurementȱlabels.
3 SelectȱoneȱofȱtheȱfollowingȱonȬscreen:
Growth Analysis Table MeasurementsȱTheȱ
systemȱprovidesȱgrowthȱgraphsȱorȱcurvesȱforȱ •• EditȱEnterȱdata,ȱandȱthenȱselectȱSaveȱ
onȬscreen.
BPD,ȱHC,ȱAC,ȱFL,ȱEFW,ȱandȱHC/AC.
•• Deleteȱtoȱremoveȱtheȱcustomȱtable.ȱSelectȱ
WARNING: Prior to use, verify that custom table Yes.
data entries are correct. The system
does not confirm the accuracy of
the custom table data entered by Presets setup
the user.
TheȱPresetsȱsetupȱpageȱhasȱsettingsȱforȱgeneralȱ
preferences.ȱYouȱcanȱselectȱfromȱtheȱfollowingȱ
To view OB tables lists:
1 OnȱtheȱOBȱCalculationsȱorȱOBȱCustomȱ
Doppler ScaleȱSelectȱcm/sȱorȱkHz.
Measurementsȱsetupȱpage,ȱselectȱTablesȱ
onȬscreen. Duplex TheȱlayoutȱforȱdisplayingȱMȱModeȱtraceȱ
andȱDopplerȱspectralȱtrace:1/3 2D, 2/3 Trace;ȱ1/2
2 Selectȱtheȱdesiredȱtableȱandȱ
2D, 1/2 Trace;ȱorȱFull 2D, Full Trace.
measurement/author.
Live TraceȱSelectȱPeakȱorȱMean.
To create a new OB custom table
Thermal Index YouȱcanȱselectȱTIS,ȱTIB,ȱorȱTIC.ȱTheȱ
YouȱcanȱcreateȱtwoȱcustomȱtablesȱforȱeachȱOBȱ
defaultȱsettingȱisȱbasedȱonȱexamȱtype:ȱOBȱisȱTIB,ȱ
measurement.ȱ
TCDȱisȱTIC,ȱandȱallȱothersȱareȱTIS.ȱ
1 OnȱtheȱOBȱCalculationsȱorȱOBȱCustomȱ
Save KeyȱBehaviorȱofȱtheȱSAVEȱkey.ȱImage Onlyȱ
Measurementsȱsetupȱpage,ȱselectȱTablesȱ
savesȱtheȱimageȱtoȱinternalȱstorage.ȱImage/Calcsȱ
onȬscreen.
savesȱtheȱimageȱtoȱinternalȱstorageȱandȱsavesȱtheȱ
2 Selectȱtheȱdesiredȱtableȱ(GestationalȱAgeȱorȱ currentȱcalculationȱtoȱtheȱpatientȱreport.
Growth Analysis).
Dynamic RangeȱSettingsȱincludeȱ-3,ȱ-2,ȱ-1,ȱ0,ȱ+1,ȱ
3 InȱtheȱMeasurementȱlist,ȱselectȱtheȱ +2,ȱorȱ+3.ȱNegativeȱnumbersȱshowȱhigher
measurementȱforȱtheȱcustomȱtable.

22 OB Custom Tables setup

contrastȱimages,ȱandȱpositiveȱnumbersȱshowȱ compression.ȱ(Seeȱalsoȱ““LimitationsȱofȱJPEGȱ
lowerȱcontrastȱimages. format.””)
UnitsȱUnitsȱforȱpatientȱheightȱandȱweightȱinȱ Aȱhighȱcompressionȱhasȱaȱsmallerȱfileȱsizeȱbutȱ
cardiacȱexams:ȱin/ft/lbsȱorȱcm/m/kg. lessȱdetail.
LanguageȱTheȱsystemȱlanguage.ȱChangingȱtheȱ ForȱSiteLinkȱexportȱtype,ȱtheȱimageȱformatȱ
languageȱrequiresȱrestartingȱtheȱsystem. affectsȱonlyȱstillȱimages.ȱForȱDICOMȱexportȱ
type,ȱtheȱimageȱformatȱaffectsȱbothȱstillȱ
Color SchemeȱTheȱbackgroundȱcolorȱofȱtheȱ
imagesȱandȱclips.
display.
4 ForȱSiteLinkȱexportȱtype,ȱselectȱaȱsortȱorderȱ
Auto save Pat. FormȱAutomaticallyȱsavesȱtheȱ
underȱSort By.
patientȱinformationȱformȱasȱanȱimageȱinȱtheȱ
patient’’sȱfile. Toȱreturnȱtoȱtheȱpreviousȱscreen,ȱselectȱDevices.

Limitations of JPEG format

System Information setup
WhenȱtransferringȱorȱexportingȱimagesȱinȱJPEGȱ
TheȱSystemȱInformationȱsetupȱpageȱdisplaysȱ format,ȱtheȱsystemȱusesȱlossyȱcompression.ȱLossyȱ
systemȱhardwareȱandȱsoftwareȱversions,ȱandȱ compressionȱmayȱcreateȱimagesȱthatȱhaveȱlessȱ

Setup
licenseȱinformation.ȱ absoluteȱdetailȱthanȱBMPȱformatȱandȱthatȱdon’’tȱ
renderȱidenticallyȱtoȱtheȱoriginalȱimages.ȱ
Seeȱalsoȱ““Toȱenterȱaȱlicenseȱkey””ȱonȱpage 72.
Inȱsomeȱcircumstances,ȱlossyȬcompressedȱimagesȱ
mayȱbeȱinappropriateȱforȱclinicalȱuse.ȱForȱ
USB Devices setup example,ȱifȱyouȱuseȱimagesȱinȱSonoCalcȱIMTȱ
software,ȱyouȱshouldȱtransferȱorȱexportȱthemȱ
OnȱtheȱUSBȱDevicesȱsetupȱpage,ȱyouȱcanȱviewȱ
usingȱBMPȱformat.ȱSonoCalcȱIMTȱsoftwareȱusesȱaȱ
informationȱaboutȱconnectedȱUSBȱdevices,ȱ
sophisticatedȱalgorithmȱtoȱmeasureȱimages,ȱandȱ
includingȱspaceȱavailability.ȱYouȱcanȱalsoȱspecifyȱ
lossyȱcompressionȱmayȱcauseȱerrors.ȱ
aȱfileȱformatȱforȱimagesȱandȱclipsȱinȱpatientȱexamsȱ
thatȱyouȱexportȱtoȱaȱUSBȱstorageȱdevice.ȱ(Seeȱ““Toȱ ForȱmoreȱinformationȱonȱusingȱlossyȬcompressedȱ
exportȱpatientȱexamsȱtoȱaȱUSBȱstorageȱdevice””ȱonȱ images,ȱconsultȱtheȱindustryȱliterature,ȱincludingȱ
page 38.) theȱfollowingȱreferences:ȱ

To specify a file format for exported images ““PhysicsȱinȱMedicineȱandȱBiology,ȱQualityȱ

AssessmentȱofȱDSA,ȱUltrasoundȱandȱCTȱ
1 OnȱtheȱUSBȱDevicesȱsetupȱpage,ȱselectȱExport.
DigitalȱImagesȱCompressedȱwithȱtheȱJPEGȱ
2 UnderȱUSB Export,ȱselectȱanȱexportȱtype: Protocol,””ȱDȱOkkalidesȱetȱalȱ1994ȱPhysȱMedȱ
Biolȱ39ȱ1407Ȭ1421ȱdoi:ȱ
•• SiteLinkȱorganizesȱfilesȱinȱaȱSiteLinkȬstyleȱ
10.1088/0031Ȭ9155/39/9/008ȱ
folderȱstructure.ȱClipsȱexportȱinȱH.264ȱ
www.iop.org/EJ/abstract/0031Ȭ9155/39/9/008
videoȱsavedȱasȱMP4ȱfiles.ȱToȱviewȱthem,ȱ
SonoSiteȱrecommendsȱQuickTimeȱ7.0ȱorȱ ““CanadianȱAssociationȱofȱRadiologists,ȱCARȱ
later. StandardsȱforȱIrreversibleȱCompressionȱinȱ
DigitalȱDiagnosticȱImagingȱwithinȱ
•• DICOMȱcreatesȱfilesȱreadableȱbyȱaȱDICOMȱ
Radiology,””ȱApproved:ȱJuneȱ2008.ȱ
reader.ȱDICOMȱisȱanȱoptionalȱfeature.
www.car.ca/Files/%5CLossy_Compression.ȱ
3 Selectȱanȱimageȱformatȱforȱyourȱexportȱtype.ȱ pdf
ForȱJPEGȱimageȱformat,ȱalsoȱselectȱaȱJPEGȱ

Chapter 2: System Setup 23

24 USB Devices setup
Chapter 3: Imaging

Imaging modes 2D options

Inȱ2Dȱimaging,ȱyouȱcanȱselectȱtheȱfollowingȱ
TheȱsystemȱhasȱaȱhighȬperformanceȱdisplayȱandȱ
onȬscreenȱoptions.
advancedȱimageȬoptimizationȱtechnologyȱthatȱ
significantlyȱsimplifiesȱuserȱcontrols.ȱImagingȱ Optimize Settings are as follows:
modesȱavailableȱdependȱonȱtheȱtransducerȱandȱ • Res provides the best possible
examȱtype.ȱSeeȱ““Imagingȱmodesȱandȱexamsȱ resolution.
availableȱbyȱtransducer””ȱonȱpage 31.
• Gen provides a balance between
resolution and penetration.
2D imaging • Pen provides the best possible
2Dȱisȱtheȱsystemȇsȱdefaultȱimagingȱmode.ȱTheȱ penetration.
systemȱdisplaysȱechoesȱinȱtwoȱdimensionsȱbyȱ Some of the parameters optimized
assigningȱaȱbrightnessȱlevelȱbasedȱonȱtheȱechoȱ to provide the best image include
signalȱamplitude.ȱToȱachieveȱtheȱbestȱpossibleȱ focal zones, aperture size, frequency
imageȱquality,ȱproperlyȱadjustȱtheȱdisplayȱ (center and bandwidth), and
brightness,ȱgain,ȱdepthȱsettings,ȱviewingȱangle,ȱ waveform. They cannot be adjusted
andȱexamȱtype.ȱAlso,ȱselectȱanȱoptimizationȱ by the user.
settingȱthatȱbestȱmatchesȱyourȱneeds.
Dynamic Adjusts the grayscale range: -3, -2,
To display the 2D image Range -1, 0, +1, +2, +3.
1 Doȱanyȱofȱtheȱfollowing: The positive range increases the

Imaging
number of grays displayed, and the
•• Turnȱonȱtheȱsystem. negative range decreases the
•• Pressȱtheȱ2Dȱkey. number of grays displayed.

2 Setȱoptionsȱasȱdesired.ȱSeeȱ““2Dȱoptions.”” Dual Displays side-by-side 2D images.

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

Chapter 3: Imaging 25
LVO On, LVO On turns on Left Ventricular SonoMB MB On and MB Off turn SonoMB™
LVO Off Opacification. LVO Off turns off this (MB) multi-beam imaging technology on
option. and off. When SonoMB is on, MB
Use LVO for cardiac exams in 2D appears in the upper left-hand
imaging mode when using an screen.
imaging contrast agent. LVO lowers SonoMB depends on transducer and
the mechanical index (MI) of the exam type.
system to enhance visualization of
ECG Displays the ECG trace. See “ECG
the contrast agent and endocardial
Monitoring” on page 38.
border.
This feature is optional and requires
This option depends on transducer
a SonoSite ECG cable.
and exam type.
Clips Displays the clips options. See “To
Orientation Select from four image orientations:
capture and save a clip” on page 35.
U/R (Up/Right), U/L (Up/Left), D/L
(Down/Left), D/R (Down/Right). This feature is optional.
THI Turns Tissue Harmonic Imaging on
Brightness Adjusts the display brightness. and off.
Settings range from 1 to 10. When on, THI appears in the upper
The display brightness affects left-hand screen. This feature is
battery life. To conserve battery life, optional and depends on transducer
adjust brightness to a lower setting. and exam type.
Biopsy Turns biopsy guidelines on and off. Page x/x Indicates which page of options is
This feature depends on transducer displayed. Select to display the next
type. See the SonoSite Biopsy user page.
guide.
Biopsy is not available when the M Mode imaging
ECG cable is connected. Motionȱmodeȱ(M Mode)ȱisȱanȱextensionȱofȱ2D.ȱItȱ
Guide Turns the guideline on and off. providesȱaȱtraceȱofȱtheȱ2Dȱimageȱdisplayedȱoverȱ
This feature depends on transducer time.ȱAȱsingleȱbeamȱofȱultrasoundȱisȱtransmitted,ȱ
and exam type. See the user guide andȱreflectedȱsignalsȱareȱdisplayedȱasȱdotsȱofȱ
for L25x transducer and needle varyingȱintensities,ȱwhichȱcreateȱlinesȱacrossȱtheȱ
guide. screen.

Sector (Cardiac exam) Specifies the sector To display the M-line

width. 1 PressȱtheȱM MODEȱkey.
SonoMB On is available only for
Note: IfȱtheȱMȬlineȱdoesȱnotȱappear,ȱmakeȱsureȱthatȱ
Sector Full.
theȱimageȱisn’’tȱfrozen.
2 UseȱtheȱtouchpadȱtoȱpositionȱtheȱMȬlineȱwhereȱ
desired.

26 Imaging modes
3 Setȱoptionsȱasȱdesired. 2 SelectȱCPDȱorȱColor.
Manyȱoptimizationȱandȱdepthȱoptionsȱ Theȱcurrentȱselectionȱalsoȱappearsȱinȱtheȱ
availableȱinȱ2Dȱimagingȱareȱalsoȱavailableȱinȱ upperȱleftȬhandȱscreen.
M Modeȱimaging.ȱSeeȱ““2Dȱoptions””ȱonȱ
TheȱColorȱindicatorȱbarȱonȱtheȱupperȱleftȬhandȱ
page 25.
screenȱdisplaysȱvelocityȱinȱcm/sȱinȱColorȱ
To display the M Mode trace imagingȱmodeȱonly.
1 DisplayȱtheȱMȬline. 3 Usingȱtheȱtouchpad,ȱpositionȱorȱresizeȱtheȱROIȱ
boxȱasȱneeded.ȱPressȱtheȱSELECTȱkeyȱtoȱtoggleȱ
2 Adjustȱtheȱdepthȱifȱnecessary.ȱ(Seeȱ““Toȱadjustȱ
betweenȱpositionȱandȱsize.
depth””ȱonȱpage 30.)
WhileȱyouȱpositionȱorȱresizeȱtheȱROIȱbox,ȱaȱ
3 PressȱtheȱM MODEȱkey.
greenȱoutlineȱshowsȱtheȱchange.ȱTheȱROIȱboxȱ
Theȱtimeȱscaleȱaboveȱtheȱtraceȱhasȱsmallȱmarksȱ indicatorȱonȱtheȱleftȬhandȱscreenȱshowsȱwhichȱ
atȱ200msȱintervalsȱandȱlargeȱmarksȱatȱ touchpadȱfunctionȱisȱactive.
oneȬsecondȱintervals. 4 Setȱoptionsȱasȱdesired.ȱSeeȱ““CPDȱandȱColorȱ
4 Doȱanyȱofȱtheȱfollowingȱasȱneeded: options.””

•• Selectȱtheȱsweepȱspeedȱ ȱ(Slow, Med,ȱorȱ CPD and Color options

Fast). InȱCPDȱorȱColorȱimaging,ȱyouȱcanȱsetȱtheȱ
•• PressȱtheȱUPDATEȱkeyȱtoȱtoggleȱbetweenȱ followingȱonȬscreenȱoptions.
theȱMȬlineȱandȱMȬModeȱtrace.
Color, CPD Toggle between CPD and Color.
•• Ifȱusingȱaȱduplexȱlayout,ȱpressȱtheȱM MODEȱ The current selection appears in the
keyȱtoȱtoggleȱbetweenȱtheȱfullȬscreenȱ upper left-hand screen.

Imaging
MȬlineȱandȱtheȱduplexȱlayout.
Toȱsetȱaȱduplexȱlayout,ȱseeȱ““Presetsȱsetup””ȱ Color Shows or hides color information.
onȱpage 22. Suppress You can select Show or Hide while
in live or frozen imaging. The
setting shown on-screen is the
CPD and color Doppler imaging current selection.
ColorȱpowerȱDopplerȱ(CPD)ȱandȱcolorȱDopplerȱ
(Color)ȱareȱoptionalȱfeatures. Flow The current setting appears
Sensitivity on-screen.
CPDȱisȱusedȱtoȱvisualizeȱtheȱpresenceȱofȱ • Low optimizes the system for low
detectableȱbloodȱflow.ȱColorȱisȱusedȱtoȱvisualizeȱ flow states.
theȱpresence,ȱvelocity,ȱandȱdirectionȱofȱbloodȱflowȱ
• Med optimizes the system for
inȱaȱwideȱrangeȱofȱflowȱstates.
medium flow states.
To display the CPD or Color image • High optimizes the system for
high flow states.
1 PressȱtheȱCOLORȱkey.
AȱROIȱboxȱappearsȱinȱtheȱcenterȱofȱtheȱ2Dȱ
image.

Chapter 3: Imaging 27
 YouȱcanȱuseȱPW/CWȱDopplerȱandȱCPD/Colorȱ
PRF Scale Select the desired pulse repetition
simultaneously.ȱIfȱCPD/Colorȱimagingȱisȱon,ȱtheȱ
frequency (PRF) setting by pressing
colorȱROIȱboxȱisȱtiedȱtoȱtheȱDȬline.ȱTheȱSELECTȱkeyȱ
the control keys.
cyclesȱamongȱcolorȱROIȱboxȱposition,ȱcolorȱROIȱ
There is a wide range of PRF boxȱsize,ȱtheȱDȬline,ȱandȱ(inȱPWȱDoppler)ȱangleȱ
settings for each Flow Sensitivity correction.ȱTheȱactiveȱselectionȱisȱgreen.ȱAlso,ȱtheȱ
setting (Low, Med, and High). indicatorȱonȱtheȱleftȬhandȱscreenȱshowsȱwhichȱ
Available on select transducers. touchpadȱfunctionȱisȱactive.
Wall Filter Settings include Low, Med, and
To display the D-line
High.
Available on select transducers. TheȱdefaultȱDopplerȱimagingȱmodeȱisȱPWȱ
Doppler.ȱInȱcardiacȱexams,ȱyouȱcanȱselectȱtheȱCWȱ
Steering Select the steering angle setting of DopplerȱonȬscreenȱoption.
the color ROI box (-15, 0, or +15). If 1 PressȱtheȱDOPPLERȱkey.
adding PW Doppler, see “PW
Doppler options” on page 29. Note: IfȱtheȱDȬlineȱdoesȱnotȱappear,ȱmakeȱsureȱ
thatȱtheȱsystemȱisȱinȱliveȱimaging.
Available on select transducers.
2 Doȱanyȱofȱtheȱfollowingȱasȱneeded:
Variance Turns variance on and off.
Available only for cardiac exam. •• Setȱoptions.ȱSeeȱ““PWȱDopplerȱoptions””ȱonȱ
page 29.
•• Usingȱtheȱtouchpad,ȱpositionȱtheȱDȬlineȱ
Invert Switches the displayed direction of whereȱdesired.
flow.
Available in Color imaging. •• (PWȱDoppler)ȱToȱcorrectȱtheȱangleȱ
manually,ȱpressȱtheȱSELECTȱkeyȱandȱthenȱ
Sector (Cardiac exam) Specifies the sector useȱtheȱtouchpadȱtoȱadjustȱtheȱangleȱinȱ2°ȱ
width. incrementsȱfromȱȬ74°ȱtoȱ+74°.ȱPressȱtheȱ
SELECTȱkeyȱagainȱtoȱsetȱtheȱdesiredȱangle.

TheȱSELECTȱkeyȱtogglesȱbetweenȱtheȱDȬlineȱ
Page x/x Indicates which page of options is andȱangleȱcorrection.
displayed. Select to display the next
page. To display the spectral trace
1 DisplayȱtheȱDȬline.
PW and CW Doppler imaging
2 PressȱtheȱDOPPLERȱkey.
Pulsedȱwaveȱ(PW)ȱDopplerȱandȱcontinuousȱwaveȱ
(CW)ȱDopplerȱimagingȱmodesȱareȱoptionalȱ Theȱtimeȱscaleȱaboveȱtheȱtraceȱhasȱsmallȱmarksȱ
features.ȱ atȱ200ȱmsȱintervalsȱandȱlargeȱmarksȱatȱ
oneȬsecondȱintervals.
PWȱDopplerȱisȱaȱDopplerȱrecordingȱofȱbloodȱflowȱ
velocitiesȱinȱaȱrangeȱspecificȱareaȱalongȱtheȱlengthȱ 3 Doȱanyȱofȱtheȱfollowingȱasȱneeded:
ofȱtheȱbeam.ȱCWȱDopplerȱisȱaȱDopplerȱrecordingȱ •• Setȱoptions.ȱSeeȱ““Spectralȱtraceȱoptions””ȱ
ofȱbloodȱflowȱvelocitiesȱalongȱtheȱlengthȱofȱtheȱ onȱpage 29.
beam.
•• PressȱtheȱUPDATEȱkeyȱtoȱtoggleȱbetweenȱ
theȱDȬlineȱandȱspectralȱtrace.

28 Imaging modes
 •• Ifȱusingȱaȱduplexȱlayout,ȱpressȱtheȱ
• 0 has an angle correction of 0°.
DOPPLERȱkeyȱtoȱtoggleȱbetweenȱtheȱ
fullȬscreenȱDȬlineȱandȱtheȱduplexȱlayout. • +15 has an angle correction of
+60°.
Toȱsetȱaȱduplexȱlayout,ȱseeȱ““Presetsȱsetup””ȱ You can manually correct the angle
onȱpage 22. after selecting a steering angle
setting. (See “To display the D-line”
PW Doppler options on page 28.)
InȱPWȱDopplerȱimaging,ȱyouȱcanȱsetȱtheȱ Available on select transducers.
followingȱonȬscreenȱoptions.ȱȱ
Page x/x Indicates which page of options is
PW, CW (Cardiac exam only) Toggle displayed. Select to display the next
between PW Doppler and CW page.
Doppler.
The current selection appears in the
upper left-hand screen.
Spectral trace options
Inȱspectralȱtraceȱimaging,ȱyouȱcanȱsetȱtheȱ
Angle Corrects the angle to 0°, +60°, or
followingȱonȬscreenȱoptions.
Correction -60°.
Scale Select the desired scale (pulse
repetition frequency [PRF]) setting.
(To change the Doppler scale to
Gate Size Settings depend on transducer and cm/s or kHz, see “Presets setup” on
exam type. page 22.)
In TCD or Orb exams, use the
Line Sets the baseline position.
touchpad to specify the Doppler

Imaging
gate depth (the depth of the center (On a frozen trace, the baseline can
of the gate in the Doppler image). be adjusted if Live Trace is off.)
The Doppler gate depth indicator is
on the lower right-hand screen. Invert Vertically flips the spectral trace.
(On a frozen trace, Invert is
TDI On, Select TDI On to turn on tissue available if Live Trace is off.)
TDI Off Doppler imaging. When on, TDI
appears in the upper left-hand Volume Increases or decreases Doppler
screen. The default is TDI off. speaker volume (0-10).
Available only in cardiac exams.
Steering Select the desired steering angle
setting. The PW Doppler angle Wall Filter Settings include Low, Med, High.
correction automatically changes
to the optimum setting.
• -15 has an angle correction of
-60°. Sweep Speed Settings include Slow, Med, Fast.

Chapter 3: Imaging 29
 box.ȱInȱPWȱandȱCWȱDopplerȱimaging,ȱtheȱ
Live Trace Displays a live trace of the peak or
theȱGAINȱknobȱaffectsȱDopplerȱgain.
mean. (See “Presets setup” on
page 22 to specify peak or mean.) Nearȱandȱfarȱcorrespondȱtoȱtheȱtimeȱgainȱ
compensationȱ(TGC)ȱcontrolsȱonȱotherȱ
Page x/x Indicates which page of options is ultrasoundȱsystems.
displayed. Select to display the next
page.
Freezing, viewing frames, and
Adjusting depth and gain zooming
To freeze or unfreeze an image
To adjust depth
™ PressȱtheȱFREEZEȱkey.
Youȱcanȱadjustȱtheȱdepthȱinȱallȱimagingȱmodesȱ
butȱtheȱtraceȱmodes.ȱTheȱverticalȱdepthȱscaleȱisȱ Onȱaȱfrozenȱimage,ȱtheȱcineȱiconȱandȱframeȱ
markedȱinȱ0.5 cm,ȱ1 cm,ȱandȱ5 cmȱincrements,ȱ numberȱappearȱinȱtheȱsystemȱstatusȱarea.
dependingȱonȱtheȱdepth.
To move forward or backward in the cine
™ Pressȱtheȱfollowingȱkeys: buffer
•• UPȱDEPTHȱkeyȱtoȱdecreaseȱtheȱdisplayedȱ ™ Freezeȱtheȱimage,ȱandȱdoȱoneȱofȱtheȱfollowing:
depth.
•• Turnȱtheȱ ȱknob.
•• DOWNȱDEPTHȱkeyȱtoȱincreaseȱtheȱdisplayedȱ
depth. •• Useȱtheȱtouchpad.ȱRightȱmovesȱforward,ȱ
andȱleftȱmovesȱbackward.
Asȱyouȱadjustȱtheȱdepth,ȱtheȱmaximumȱdepthȱ
numberȱchangesȱinȱtheȱlowerȱrightȱscreen. •• PressȱtheȱLEFTȱARROWȱandȱRIGHTȱARROWȱ
keys.
To adjust gain automatically Theȱframeȱnumberȱchangesȱasȱyouȱmoveȱ
™ PressȱtheȱAUTO GAINȱkey.ȱTheȱgainȱadjustsȱ forwardȱorȱbackward.ȱTheȱtotalȱnumberȱofȱ
eachȱtimeȱyouȱpressȱthisȱkey. framesȱinȱtheȱbufferȱappearsȱonȬscreenȱinȱtheȱ
systemȱstatusȱarea.
To adjust gain manually
™ Turnȱaȱgainȱknob: To zoom in on an image
Youȱcanȱzoomȱinȱ2DȱandȱColorȱimaging.ȱYouȱcanȱ
•• NEAR ȱadjustsȱtheȱgainȱappliedȱtoȱtheȱ
freezeȱorȱunfreezeȱtheȱimageȱorȱchangeȱtheȱ
nearȱfieldȱofȱtheȱ2Dȱimage.
imagingȱmodeȱatȱanyȱtimeȱwhileȱzooming.ȱ
•• FAR ȱadjustsȱtheȱgainȱappliedȱtoȱtheȱfarȱ 1 PressȱtheȱZOOMȱkey.ȱAȱROIȱboxȱappears.ȱ
fieldȱofȱtheȱ2Dȱimage.
2 Usingȱtheȱtouchpad,ȱpositionȱtheȱROIȱboxȱasȱ
•• GAIN ȱadjustsȱtheȱoverallȱgainȱappliedȱ desired.
toȱtheȱentireȱimage.ȱInȱCPDȱorȱColorȱ 3 PressȱtheȱZOOMȱkeyȱagain.
imaging,ȱtheȱGAINȱknobȱaffectsȱtheȱcolorȱ
gainȱappliedȱtoȱtheȱregionȱofȱinterestȱ(ROI)ȱ TheȱimageȱinȱtheȱROIȱboxȱisȱmagnifiedȱbyȱ
100%.
4 (Optional)ȱIfȱtheȱimageȱisȱfrozen,ȱuseȱtheȱ
touchpadȱorȱarrowȱkeysȱtoȱpanȱtheȱimageȱup,ȱ

30 Adjusting depth and gain

 down,ȱleft,ȱandȱright.ȱ(Youȱcannotȱpanȱinȱ Imaging modes and exams available by
Dual.) transducer
Toȱexitȱzoom,ȱpressȱtheȱZOOMȱkeyȱagain.ȱ
Imaging Mode

Imaging modes and exams

PW Doppler4

CW Doppler
Exam Type1
Transducer

M Mode

Color3
CPD3
available by transducer

2D2
WARNING: To prevent misdiagnosis or harm to
the patient, understand your
system’s capabilities prior to use. C11x Abd X X X X —

The diagnostic capability differs for Neo X X X X —

each transducer, exam type, and
imaging mode. In addition, Nrv X X X X —
transducers have been developed
to specific criteria depending on Vas X X X X —

their physical application. These C60x OB X X X X —

criteria include biocompatibility
requirements. Gyn X X X X —

To avoid injury to the patient, use Abd X X X X —

only an Orbital (Orb) or Ophthalmic
(Oph) when performing imaging Nrv X X X X —

through the eye. The FDA has

D2x Crd — — — — X
established lower acoustic energy

Imaging
limits for ophthalmic use. The HFL38x Bre X X X X —
system will not exceed these limits
only if the Orb or Oph exam type is SmP X X X X —

selected.
Vas X X X X —

Theȱtransducerȱyouȱuseȱdeterminesȱwhichȱexamȱ Msk X X X X —

typesȱareȱavailable.ȱInȱaddition,ȱtheȱexamȱtypeȱ IMT X X X X —
youȱselectȱdeterminesȱwhichȱimagingȱmodesȱareȱ
available. Nrv X X X X —

To change the exam type Ven X X X X —

™ Doȱoneȱofȱtheȱfollowing: ICTx Gyn X X X X —

•• PressȱtheȱEXAMȱkey,ȱandȱselectȱfromȱtheȱ
menu.ȱ OB X X X X —

•• Onȱtheȱpatientȱinformationȱform,ȱselectȱ
fromȱtheȱTypeȱlistȱunderȱExam.ȱ(Seeȱ
““Patientȱinformationȱform””ȱonȱpage 33.)

Chapter 3: Imaging 31
 Imaging Mode Imaging Mode

PW Doppler4

PW Doppler4
CW Doppler

CW Doppler
Exam Type1

Exam Type1
Transducer

Transducer
M Mode

M Mode
Color3

Color3
CPD3

CPD3
2D2

2D2
L25x Msk X X X X — Vas X X X X —

Vas X X X X — Ven X X X X —

Nrv X X X X — TEEx Crd X — X X X

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

Bre = Breast, Crd = Cardiac, Gyn = Gynecology, IMT =
Sup X X X X — Intima Media Thickness, Msk = Muscle, Neo = Neonatal,
Nrv = Nerve, OB = Obstetrical, Oph = Ophthalmic, Orb =
Ven X X X X — Orbital, SmP = Small Parts, Sup = Superficial, TCD =
Transcranial Doppler, Vas = Vascular, Ven = Venous.
L38x Bre X X X X — 2. The optimization settings for 2D are Res, Gen, and Pen.
3. The optimization settings for CPD and Color are low,
SmP X X X X — medium, and high (flow sensitivity) with a range of PRF
settings for Color depending on the setting selected.
Vas X X X X — 4. For the cardiac exam type, PW TDI is also available. See
“PW Doppler options” on page 29.
IMT X X X X —

Nrv X X X X —
Annotating images
Ven X X X X —
Youȱcanȱannotateȱliveȱimagesȱasȱwellȱasȱfrozenȱ
P10x Abd X X X X — images.ȱ(Youȱcannotȱannotateȱaȱsavedȱimage.)ȱ
Youȱcanȱplaceȱtextȱ(includingȱpredefinedȱlabels),ȱ
Crd X — X X X
anȱarrow,ȱorȱaȱpictograph.ȱToȱsetȱpreferencesȱforȱ
annotations,ȱseeȱ““Annotationsȱsetup””ȱonȱpage 18.
Neo X X X X —

P21x Abd X X X X — To place text on an image

Youȱcanȱplaceȱtextȱinȱtheȱfollowingȱimagingȱ
OB X X X X —
layouts:ȱfullȬscreenȱ2D,ȱfullȬscreenȱtrace,ȱdual,ȱorȱ
Crd X — X X X duplex.ȱYouȱcanȱplaceȱtextȱmanuallyȱorȱaddȱaȱ
predefinedȱlabel.
TCD X X X X —
1 PressȱtheȱTEXTȱkey.ȱAȱgreenȱcursorȱappears.
Orb X X X X —
2 Moveȱtheȱcursorȱwhereȱdesired:
SLAx Msk X X X X — •• Useȱtheȱtouchpadȱorȱarrowȱkeys.
Nrv X X X X — •• SelectȱHomeȱtoȱmoveȱtheȱcursorȱtoȱtheȱ
homeȱposition.
Sup X X X X —

32 Annotating images
 Theȱdefaultȱhomeȱpositionȱdependsȱonȱtheȱ 4 PressȱtheȱARROWȱkeyȱtoȱsetȱtheȱarrow.
imagingȱscreenȱlayout.ȱYouȱcanȱresetȱtheȱ
Theȱarrowȱchangesȱfromȱgreenȱtoȱwhite.
homeȱposition.ȱSeeȱ““Toȱresetȱtheȱhomeȱ
position””ȱonȱpage 33. Toȱremoveȱtheȱarrow,ȱpressȱtheȱARROWȱkeyȱandȱ
thenȱselectȱHide.
3 Usingȱtheȱkeyboard,ȱtypeȱtext.
•• Theȱarrowȱkeysȱmoveȱtheȱcursorȱleft,ȱright,ȱ To place a pictograph on an image
up,ȱandȱdown. Theȱpictographȱsetȱavailableȱdependsȱonȱ
•• TheȱDELETEȱkeyȱdeletesȱallȱtext. transducerȱandȱexamȱtype.
1 PressȱtheȱPICTOȱkey.
•• Theȱ Wordȱoptionȱremovesȱaȱword.
2 Selectȱ x/xȱtoȱdisplayȱtheȱdesiredȱ
•• SelectȱSymbolsȱtoȱenterȱspecialȱcharacters.ȱ
pictograph,ȱandȱthenȱpressȱtheȱSELECTȱkey.
Seeȱ““Symbols””ȱonȱpage 10.
Theȱfirstȱnumberȱshowsȱwhichȱpictographȱinȱ
4 (Optional)ȱToȱaddȱaȱpredefinedȱlabel,ȱselectȱ
theȱsetȱisȱselected.ȱTheȱsecondȱnumberȱisȱtheȱ
Label,ȱandȱthenȱselectȱtheȱdesiredȱlabelȱgroup:ȱ
numberȱofȱpictographsȱavailable.
, , or .ȱSelectȱtheȱgroupȱagainȱforȱ
3 Usingȱtheȱtouchpad,ȱpositionȱtheȱpictographȱ
theȱdesiredȱlabel.
marker.
Theȱfirstȱnumberȱshowsȱwhichȱlabelȱinȱtheȱ
4 (Optional)ȱToȱrotateȱtheȱpictographȱmarker,ȱ
groupȱisȱselected.ȱTheȱsecondȱnumberȱisȱtheȱ
pressȱtheȱSELECTȱkeyȱandȱthenȱuseȱtheȱ
numberȱofȱlabelsȱavailable.
touchpad.
Seeȱ““Annotationsȱsetup””ȱonȱpage 18.ȱ
5 Selectȱaȱscreenȱlocationȱforȱtheȱpictograph:ȱU/Lȱ
Toȱturnȱoffȱtextȱentry,ȱpressȱtheȱTEXTȱkey. (Up/Left),ȱD/Lȱ(Down/Left),ȱD/Rȱ

Imaging
(Down/Right),ȱU/Rȱ(Up/Right).
To reset the home position
Inȱaȱduplexȱlayout,ȱtheȱpictographȱisȱrestrictedȱ
1 PressȱtheȱTEXTȱkey. toȱupperȱleft.ȱInȱDual,ȱallȱfourȱpositionsȱareȱ
2 Usingȱtheȱtouchpadȱorȱarrowȱkeys,ȱpositionȱ available.
theȱcursorȱwhereȱdesired. Toȱremoveȱtheȱpictograph,ȱselectȱHide.
3 SelectȱHome/Set.

To place an arrow on an image Patient information form

Youȱcanȱaddȱanȱarrowȱgraphicȱtoȱpointȱoutȱaȱ Theȱpatientȱinformationȱformȱletsȱyouȱenterȱ
specificȱpartȱofȱtheȱimage. patientȱidentification,ȱexam,ȱandȱclinicalȱ
informationȱforȱtheȱpatientȱexam.ȱThisȱ
1 PressȱtheȱARROWȱkeyȱ .
informationȱautomaticallyȱappearsȱinȱtheȱpatientȱ
2 Ifȱyouȱneedȱtoȱadjustȱtheȱarrowȇsȱorientation,ȱ report.
pressȱtheȱSELECTȱkeyȱandȱthenȱuseȱtheȱ
Whenȱyouȱcreateȱaȱnewȱpatientȱinformationȱform,ȱ
touchpad.ȱWhenȱtheȱorientationȱisȱcorrect,ȱ
allȱimages,ȱclips,ȱandȱotherȱdataȱyouȱsaveȱduringȱ
pressȱtheȱSELECTȱkeyȱagain.
theȱexamȱareȱlinkedȱtoȱthatȱpatient.ȱ(Seeȱ““Patientȱ
3 Usingȱtheȱtouchpad,ȱpositionȱtheȱarrowȱwhereȱ report””ȱonȱpage 68.)
desired.

Chapter 3: Imaging 33
To create a new patient information form •• IDȱPatientȱidentificationȱnumber
1 PressȱtheȱPATIENTȱkey. •• Accession Enterȱnumber,ȱifȱapplicable.

2 Selectȱ ȱNew/End. •• Date of birth

3 Fillȱinȱtheȱformȱfields.ȱSeeȱ““Patientȱ •• Genderȱ
informationȱformȱfields””ȱonȱpage 34. •• Indications Enterȱdesiredȱtext
4 SelectȱDone. •• UserȱUserȱinitials
Seeȱalsoȱ““Toȱappendȱimagesȱandȱclipsȱtoȱaȱpatientȱ •• Procedure (button)ȱAvailableȱifȱtheȱDICOMȱ
exam””ȱonȱpage 37. Worklistȱfeatureȱisȱlicensedȱandȱconfigured.ȱ
SeeȱtheȱDICOMȱuserȱguide.
To edit a patient information form
Youȱcanȱeditȱpatientȱinformationȱifȱtheȱexamȱhasȱ SelectȱBackȱtoȱsaveȱentriesȱandȱreturnȱtoȱtheȱ
notȱbeenȱarchivedȱorȱexportedȱandȱifȱtheȱ previousȱscreen.
informationȱisȱnotȱfromȱaȱworklist. Exam
Seeȱalsoȱ““Toȱeditȱpatientȱinformationȱfromȱtheȱ •• Type Examȱtypesȱavailableȱdependȱonȱ
patientȱlist””ȱonȱpage 36. transducer.ȱSeeȱ““Imagingȱmodesȱandȱexamsȱ
availableȱbyȱtransducer””ȱonȱpage 31.ȱ
1 PressȱtheȱPATIENTȱkey.
•• LMP Estab. DDȱ(OBȱorȱGynȱexam)ȱInȱanȱOBȱ
2 Makeȱchangesȱasȱdesired. exam,ȱselectȱLMPȱorȱEstab. DDȱandȱthenȱenterȱ
3 Selectȱoneȱofȱtheȱfollowing: eitherȱtheȱdateȱofȱtheȱlastȱmenstrualȱperiodȱorȱ
theȱestablishedȱdueȱdate.ȱInȱaȱGynȱexam,ȱenterȱ
•• Cancelȱtoȱundoȱchangesȱandȱreturnȱtoȱ theȱdateȱofȱtheȱlastȱmenstrualȱperiod.ȱTheȱLMPȱ
imaging. dateȱmustȱprecedeȱtheȱcurrentȱsystemȱdate.
•• Doneȱtoȱsaveȱchangesȱandȱreturnȱtoȱ •• Twins (OBȱexam)ȱSelectȱtheȱTwinsȱcheckȱboxȱtoȱ
imaging. displayȱTwin AȱandȱTwin Bȱmeasurementsȱonȱ
theȱcalculationsȱmenuȱandȱforȱaccessȱtoȱTwinȱ
To end the exam AȱandȱTwinȱBȱscreensȱforȱpreviousȱexamȱdata.
1 Makeȱsureȱthatȱyouȱhaveȱsavedȱimagesȱandȱ
otherȱdataȱyouȱwantȱtoȱkeep.ȱ(Seeȱ““Savingȱ •• Previous Exams (button)ȱ(OBȱexam)ȱDisplaysȱ
imagesȱandȱclips””ȱonȱpage 35.) fieldsȱforȱfiveȱpreviousȱexams.ȱTheȱdateȱforȱaȱ
previousȱexamȱmustȱprecedeȱtheȱcurrentȱ
2 PressȱtheȱPATIENTȱkey. systemȱdate.ȱForȱtwins,ȱselectȱTwin A/Bȱtoȱ
toggleȱbetweenȱTwinȱAȱandȱTwinȱBȱscreens.ȱ(Ifȱ
3 Selectȱ New/End. theȱTwin A/Bȱoptionȱdoesȱnotȱappear,ȱselectȱ
Aȱnewȱpatientȱinformationȱformȱappears. Back,ȱandȱmakeȱsureȱthatȱtheȱTwinsȱcheckȱboxȱ
isȱselected.)
Patient information form fields SelectȱBackȱtoȱsaveȱchangesȱandȱreturnȱtoȱtheȱ
Theȱpatientȱinformationȱformȱfieldsȱavailableȱ previousȱscreen.
dependȱonȱexamȱtype.ȱInȱsomeȱfieldsȱyouȱcanȱ
•• BPȱ(Cardiac,ȱIMT,ȱOrbital,ȱTranscranial,ȱorȱ
selectȱSymbolsȱtoȱenterȱsymbolsȱandȱspecialȱ
Vascularȱexam)ȱBloodȱPressure
characters.ȱSeeȱ““Symbols””ȱonȱpage 10.
•• HR (Cardiac,ȱOrbital,ȱTranscranial,ȱorȱVascularȱ
Patient
exam)ȱHeartȱRate.ȱEnterȱtheȱbeatsȱperȱminute.ȱ
•• Last, First, Middle Patientȱname

34 Patient information form

 Savingȱtheȱheartȱrateȱusingȱaȱmeasurementȱ Byȱdefault,ȱtheȱSAVEȱkeyȱsavesȱonlyȱtheȱimage.ȱAsȱ
overwritesȱthisȱentry. aȱshortcutȱduringȱcalculations,ȱtheȱSAVEȱkeyȱcanȱ
saveȱbothȱtheȱimageȱtoȱinternalȱstorageȱandȱtheȱ
•• Height (Cardiacȱexam)ȱTheȱpatientȱheightȱinȱ
calculationȱtoȱtheȱpatientȱreport.ȱSeeȱ““Presetsȱ
feetȱandȱinchesȱorȱmetersȱandȱcentimeters.ȱ(Toȱ
setup””ȱonȱpage 22.
changeȱtheȱunits,ȱseeȱ““Presetsȱsetup””ȱonȱ
page 22.) To capture and save a clip
•• Weight (Cardiacȱexam)ȱTheȱpatientȱweightȱinȱ Clips,ȱanȱoptionalȱfeature,ȱletsȱyouȱcapture,ȱ
poundsȱorȱkilos.ȱ(Toȱchangeȱtheȱunits,ȱseeȱ preview,ȱandȱsaveȱclips.
““Presetsȱsetup””ȱonȱpage 22.)
1 SetȱClipsȱoptions.ȱ(Seeȱ““ToȱsetȱClipsȱoptions””ȱ
•• BSAȱ(Cardiacȱexam)ȱBodyȱSurfaceȱArea.ȱ onȱpage 35.)
Automaticallyȱcalculatedȱafterȱyouȱenterȱ
2 PressȱtheȱCLIPȱkey.
heightȱandȱweight.
•• Ethnicity (IMTȱexam)ȱEthnicȱorigin Oneȱofȱtheȱfollowingȱoccurs:

• Reading Dr. •• IfȱPrev/Offȱisȱselected,ȱtheȱclipȱsavesȱ

directlyȱtoȱinternalȱstorage.ȱ
• Referring Dr.
•• IfȱPrev/Onȱisȱselected,ȱtheȱclipȱplaysȱbackȱ
•• Institution inȱpreviewȱmode.ȱYouȱcanȱselectȱanyȱofȱtheȱ
followingȱonȬscreen:

Images and clips •• Aȱplaybackȱspeedȱ ȱ(1x, 1/2x, 1/4x)

•• Pauseȱtoȱinterruptȱplayback
Saving images and clips
•• Left: xȱorȱRight: xȱtoȱremoveȱframesȱ

Imaging
Whenȱyouȱsaveȱanȱimageȱorȱclip,ȱitȱsavesȱtoȱ fromȱtheȱleftȱorȱrightȱsidesȱofȱtheȱclipȱ
internalȱstorage.ȱTheȱsystemȱbeepsȱafterwardȱifȱ (whereȱxȱisȱtheȱbeginningȱorȱendingȱ
BeepȱAlertȱisȱon,ȱandȱtheȱpercentageȱiconȱflashes.ȱ frameȱnumber)
(Seeȱ““Audio,ȱBatteryȱsetup””ȱonȱpage 19.)ȱToȱaccessȱ
savedȱimagesȱandȱclips,ȱopenȱtheȱpatientȱlist.ȱ(Seeȱ •• Saveȱtoȱsaveȱtheȱclipȱtoȱinternalȱstorage
““Reviewingȱpatientȱexams””ȱonȱpage 36.)ȱ •• Deleteȱtoȱdeleteȱtheȱclip
Theȱpercentageȱiconȱinȱtheȱsystemȱstatusȱareaȱ
showsȱtheȱpercentageȱofȱspaceȱusedȱinȱinternalȱ
To set Clips options
storage.ȱToȱreceiveȱalertsȱwhenȱstorageȱisȱnearȱ SettingȱClipsȱoptionsȱensuresȱthatȱclipsȱareȱ
capacity,ȱseeȱ““Toȱreceiveȱstorageȱalerts””ȱonȱ capturedȱtoȱyourȱspecifications.ȱ
page 20. 1 Inȱ2Dȱimagingȱmode,ȱselectȱClipsȱonȬscreen.
Toȱaccessȱsavedȱimagesȱandȱclips,ȱopenȱtheȱ 2 Setȱoptionsȱasȱdesired.
patientȱlist.ȱSeeȱ““Reviewingȱpatientȱexams””ȱonȱ
page 36.

To save an image
™ PressȱtheȱSAVEȱkey.
Theȱimageȱsavesȱtoȱinternalȱstorage.

Chapter 3: Imaging 35
Clips options
Time, ECG Time and ECG share the same
location on-screen.
• With Time, capturing is based
on number of seconds. Select
the time duration.
• With ECG, capturing is based
on the number of heart beats.
Select the number of beats.
Preview On, PrevOn and PrevOff turn the
Preview Off preview feature on and off.
• With Prev/On, the captured
clip automatically plays Figure 1 Patient List
on-screen. The clip can be
trimmed, saved, or deleted. To display the patient list
• With Prev/Off, the clip saves 1 PressȱtheȱREVIEWȱkey.ȱ
to internal storage, and the
trim and delete options are 2 Ifȱthereȱisȱanȱactiveȱexam,ȱselectȱListȱonȬscreen.
not available.
To sort the patient list
Prospective, Pro and Retro determine how
Afterȱtheȱsystemȱstarts,ȱtheȱpatientȱlistȱisȱarrangedȱ
Retrospective clips are captured:
byȱdateȱandȱtime,ȱwithȱtheȱmostȱrecentȱpatientȱfileȱ
• With Pro, a clip is captured first.ȱYouȱcanȱreȬsortȱtheȱpatientȱlistȱasȱneeded.
prospectively, after you press
the CLIP key. ™ Selectȱtheȱcolumnȱheadingȱthatȱyouȱwantȱtoȱ
• With Retro, a clip is captured sortȱby.ȱSelectȱitȱagainȱifȱsortingȱinȱreverseȱ
retrospectively, from order.
pre-saved data before you Note: Theȱ ȱcolumnȱheadingȱisȱselectable.
press the CLIP key.
To select patients in the patient list
Reviewing patient exams ™ Usingȱtheȱtouchpad,ȱselectȱtheȱcheckȱboxȱforȱ
oneȱorȱmoreȱpatients.
Caution: If the internal storage icon does not Select Allȱselectsȱallȱpatients.
appear in the system status area,
internal storage may be defective. Toȱdeselectȱpatients,ȱselectȱcheckedȱboxesȱorȱClear
Contact SonoSite Technical All.
Support. (See “SonoSite Technical To edit patient information from the patient
Support” on page vii.)
list
YouȱcanȱeditȱtheȱpatientȱnameȱandȱIDȱfromȱtheȱ
Theȱpatientȱlistȱorganizesȱsavedȱimagesȱandȱclipsȱ
patientȱlistȱinsteadȱofȱfromȱtheȱpatientȱ
inȱpatientȱexams.ȱYouȱcanȱdelete,ȱview,ȱprint,ȱorȱ
informationȱformȱifȱtheȱexamȱhasȱnotȱbeenȱ
archiveȱexams.ȱYouȱcanȱalsoȱcopyȱthemȱtoȱaȱUSBȱ
exportedȱorȱarchived.
storageȱdevice.
1 Inȱtheȱpatientȱlist,ȱselectȱtheȱpatient.

36 Images and clips

2 SelectȱEdit. Printing, exporting, and deleting images
3 Fillȱinȱtheȱformȱfields,ȱandȱselectȱOK. and clips

To append images and clips to a patient WARNING: To avoid damaging the USB
exam storage device and losing patient
data from it, observe the following:
Althoughȱyouȱcannotȱaddȱimagesȱandȱclipsȱtoȱaȱ
• Do not remove the USB storage
patientȱexamȱthatȱisȱended,ȱexported,ȱorȱarchived,ȱ
device or turn off the ultrasound
youȱcanȱautomaticallyȱstartȱaȱnewȱpatientȱexamȱ
system while the system is
thatȱhasȱtheȱsameȱpatientȱinformation.ȱ
exporting.
Dependingȱonȱyourȱarchiver,ȱtheȱtwoȱexamsȱ
appearȱasȱoneȱstudyȱwhenȱexportedȱorȱarchived. • Do not bump or otherwise apply
pressure to the USB storage
1 Selectȱtheȱexamȱinȱtheȱpatientȱlist. device while it is in a USB port on
2 SelectȱAppendȱonȬscreen. the ultrasound system. The
connector could break.
Aȱnewȱpatientȱinformationȱformȱappears.ȱTheȱ
formȱhasȱtheȱsameȱinformationȱasȱtheȱexamȱ
youȱselected.
To print an image
1 Verifyȱthatȱaȱprinterȱisȱselected.ȱSeeȱ““Toȱ
To review images and clips configureȱtheȱsystemȱforȱaȱprinter””ȱonȱ
Youȱcanȱreviewȱimagesȱandȱclipsȱinȱonlyȱoneȱ page 19.
patientȱexamȱatȱaȱtime. 2 Doȱoneȱofȱtheȱfollowing:
1 Inȱtheȱpatientȱlist,ȱhighlightȱtheȱpatientȱexamȱ •• Inȱtheȱpatientȱlist,ȱreviewȱtheȱpatient’’sȱ
whoseȱimagesȱandȱclipsȱyouȱwantȱtoȱreview. images.ȱSelectȱPrintȱwhenȱtheȱimageȱ

Imaging
2 SelectȱReviewȱonȬscreen. appears.
•• Withȱtheȱimageȱdisplayed,ȱpressȱtheȱAȱ
3 Selectȱ x/xȱtoȱcycleȱtoȱtheȱimageȱorȱclipȱyouȱ shortcutȱkey.
wantȱtoȱreview.
Byȱdefault,ȱtheȱAȱshortcutȱkeyȱprints.ȱToȱ
4 (ClipȱOnly)ȱSelectȱPlay.ȱ reprogramȱtheȱAȱandȱBȱshortcutȱkeys,ȱseeȱ
Theȱclipȱplaysȱautomaticallyȱafterȱloading.ȱ ““Presetsȱsetup””ȱonȱpage 22.
Theȱloadȱtimeȱdependsȱonȱclipȱlength.
To print multiple images
YouȱcanȱselectȱPauseȱtoȱfreezeȱtheȱclipȱandȱcanȱ 1 Verifyȱthatȱaȱprinterȱisȱselected.ȱSeeȱ““Toȱ
selectȱaȱplaybackȱspeedȱ 1x, 1/2x, 1/4x. configureȱtheȱsystemȱforȱaȱprinter””ȱonȱ
page 19.
5 Selectȱ ȱx/xȱtoȱcycleȱtoȱtheȱnextȱimageȱorȱclipȱ
2 Doȱoneȱofȱtheȱfollowing:
youȱwantȱtoȱview.
•• Printȱallȱimagesȱforȱmultipleȱpatients:ȱ
Toȱreturnȱtoȱtheȱpatientȱlist,ȱselectȱList.ȱToȱreturnȱ
Selectȱoneȱorȱmoreȱpatientsȱinȱtheȱpatientȱ
toȱimaging,ȱselectȱDone.
list.ȱThenȱselect Print.ȱ
•• Printȱallȱimagesȱforȱoneȱpatient:ȱHighlightȱ
theȱpatientȱinȱtheȱpatientȱlist,ȱandȱthenȱ
selectȱPrint.

Chapter 3: Imaging 37
 EachȱimageȱappearsȱbrieflyȱonȬscreenȱ To display information about a patient exam
whileȱprinting. 1 Onȱtheȱpatientȱlist,ȱselectȱtheȱexam.
To export patient exams to a USB storage 2 Select Info.
device
AȱUSBȱstorageȱdeviceȱisȱforȱtemporaryȱstorageȱofȱ
imagesȱandȱclips.ȱPatientȱexamsȱshouldȱbeȱ ECG Monitoring
archivedȱregularly.ȱToȱspecifyȱfileȱformat,ȱseeȱ ECGȱMonitoringȱisȱanȱoptionalȱfeatureȱandȱ
““USBȱDevicesȱsetup””ȱonȱpage 23. requiresȱaȱSonoSiteȱECGȱcable.
1 InsertȱtheȱUSBȱstorageȱdevice.
WARNING: To prevent misdiagnosis, do not use
2 Inȱtheȱpatientȱlist,ȱselectȱtheȱpatientȱexamsȱyouȱ the ECG trace to diagnose cardiac
wantȱtoȱexport. rhythms. The SonoSite ECG option
is a non-diagnostic feature.
3 SelectȱExp. USB onȬscreen.ȱAȱlistȱofȱUSBȱ
devicesȱappears. To avoid electrical interference with
aircraft systems, do not use the ECG
4 SelectȱtheȱUSBȱstorageȱdevice.ȱIfȱyouȱwantȱtoȱ
cable on aircraft. Such interference
hideȱpatientȱinformation,ȱdeselectȱInclude
may have safety consequences.
patient information on images and clips.
OnlyȱavailableȱUSBȱdevicesȱareȱselectable.
Caution: Use only accessories recommended
5 SelectȱExport. by SonoSite with the system. Your
system can be damaged by
Theȱfilesȱareȱfinishedȱexportingȱ
connecting an accessory not
approximatelyȱfiveȱsecondsȱafterȱtheȱUSBȱ
recommended by SonoSite.
animationȱstops.ȱRemovingȱtheȱUSBȱstorageȱ
deviceȱorȱturningȱoffȱtheȱsystemȱwhileȱ
exportingȱmayȱcauseȱexportedȱfilesȱtoȱbeȱ To monitor ECG
corruptedȱorȱincomplete.ȱToȱstopȱinȬprogressȱ 1 ConnectȱtheȱECGȱcableȱtoȱtheȱECGȱconnectorȱ
exporting,ȱselectȱCancel Export.ȱ onȱtheȱultrasoundȱsystem,ȱminiȬdock,ȱorȱ
dockingȱsystem.ȱ
To delete images and clips
ECGȱMonitoringȱturnsȱonȱautomatically.
1 Selectȱoneȱorȱmoreȱpatientsȱinȱtheȱpatientȱlist.
Note: AnȱexternalȱECGȱmonitorȱmayȱcauseȱaȱlagȱ
2 SelectȱDeleteȱtoȱdeleteȱtheȱselectedȱpatients.ȱAȱ
inȱtheȱtimingȱofȱtheȱECGȱtrace,ȱcorrespondingȱwithȱ
confirmationȱscreenȱappears.
theȱ2Dȱimage.ȱBiopsyȱguidelinesȱareȱnotȱavailableȱ
To manually archive images and clips whenȱECGȱisȱconnected.
YouȱcanȱsendȱpatientȱexamsȱtoȱaȱDICOMȱprinterȱ 2 SelectȱECGȱonȬscreen.ȱ(ECGȱmayȱbeȱonȱanotherȱ
orȱarchiver,ȱorȱtoȱaȱPCȱusingȱSiteLink.ȱDICOMȱ page.ȱItȱappearsȱonlyȱifȱtheȱECGȱcableȱisȱ
andȱSiteLinkȱareȱoptionalȱfeatures.ȱForȱmoreȱ connected.)
informationȱaboutȱarchiving,ȱseeȱtheȱSiteLinkȱandȱ
3 Selectȱoptionsȱasȱdesired.
DICOMȱdocumentation.
1 Selectȱoneȱorȱmoreȱpatientsȱinȱtheȱpatientȱlist.
2 SelectȱArchive.

38 ECG Monitoring
ECG Monitoring options

Show/Hide Turns on and off ECG trace.

Gain Increases or decreases ECG gain.

Settings are 0-20.

Position Sets the position of the ECG trace.

Sweep Speed Settings are Slow, Med, and Fast.

Delay Displays Line and Save for clip

acquisition delay. (For instructions
to capture clips, see “To capture and
save a clip” on page 35.)
Line The position of the delay line on the
ECG trace. The delay line indicates
where the clip acquisition is
triggered.
Save Saves the current position of the

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

Chapter 3: Imaging 39
40 ECG Monitoring
Chapter 4: Measurements and Calculations

Youȱcanȱmeasureȱforȱquickȱreference,ȱorȱyouȱcanȱ Working with calipers

measureȱwithinȱaȱcalculation.ȱYouȱcanȱperformȱ
Whenȱmeasuring,ȱyouȱworkȱwithȱcalipers,ȱoftenȱ
generalȱcalculationsȱasȱwellȱasȱcalculationsȱ
inȱpairs.ȱResultsȱbasedȱonȱtheȱcalipers’’ȱpositionȱ
specificȱtoȱanȱexamȱtype.
appearȱatȱtheȱbottomȱofȱtheȱscreen.ȱTheȱresultsȱ
Measurementsȱareȱperformedȱonȱfrozenȱimages.ȱ updateȱasȱyouȱrepositionȱtheȱcalipersȱbyȱusingȱtheȱ
Forȱreferencesȱused,ȱseeȱChapter 7,ȱ““References.”” touchpad.ȱInȱtraceȱmeasurements,ȱtheȱresultsȱ
appearȱafterȱyouȱcompleteȱtheȱtrace.

Measurements Outsideȱaȱcalculation,ȱyouȱcanȱaddȱcalipersȱbyȱ
pressingȱtheȱCALIPERȱkey.ȱYouȱcanȱhaveȱmultipleȱ
Youȱcanȱperformȱbasicȱmeasurementsȱinȱanyȱ setsȱofȱcalipersȱandȱcanȱswitchȱfromȱoneȱsetȱtoȱ
imagingȱmodeȱandȱcanȱsaveȱtheȱimageȱwithȱtheȱ another,ȱrepositioningȱthemȱasȱneeded.ȱEachȱsetȱ
measurementsȱdisplayed.ȱ(Seeȱ““Toȱsaveȱanȱ showsȱtheȱmeasurementȱresult.ȱTheȱactiveȱ
image””ȱonȱpage 35.)ȱExceptȱforȱtheȱMȱModeȱHRȱ calipersȱandȱmeasurementȱresultȱareȱhighlightedȱ
measurement,ȱtheȱresultsȱdoȱnotȱautomaticallyȱ green.ȱAȱmeasurementȱisȱcompleteȱwhenȱyouȱ
saveȱtoȱaȱcalculationȱandȱtheȱpatientȱreport.ȱIfȱyouȱ finishȱmovingȱitsȱcalipers.
prefer,ȱyouȱcanȱfirstȱbeginȱaȱcalculationȱandȱthenȱ Withinȱaȱcalculation,ȱcalipersȱappearȱwhenȱyouȱ
measure.ȱSeeȱ““Performingȱandȱsavingȱ
selectȱfromȱtheȱcalculationsȱmenu.ȱ(Seeȱ““Toȱselectȱ
measurementsȱinȱcalculations””ȱonȱpage 45.
fromȱtheȱcalculationsȱmenu””ȱonȱpage 45.)
Someȱoptionsȱmayȱnotȱapplyȱtoȱyourȱsystem.ȱ
Forȱanȱaccurateȱmeasurement,ȱaccurateȱ
Optionsȱavailableȱdependȱonȱyourȱconfiguration,ȱ
placementȱofȱcalipersȱisȱessential.
transducer,ȱandȱexamȱtype.
To switch the active calipers
To save a measurement to a calculation and
™ Doȱoneȱofȱtheȱfollowing:
patient report
•• Toȱswitchȱtheȱactiveȱcaliperȱwithinȱaȱset,ȱ
1 Withȱtheȱmeasurementȱactiveȱ(green),ȱpressȱ
pressȱtheȱSELECTȱkey.
theȱCALCSȱkey.ȱ
•• Toȱswitchȱtheȱactiveȱsetȱwhenȱmeasuringȱ
2 Fromȱtheȱcalculationsȱmenu,ȱselectȱaȱ
outsideȱaȱcalculation,ȱselectȱSwitchȱ
measurementȱname.
onȬscreen.

Measurements
Onlyȱmeasurementȱnamesȱavailableȱforȱtheȱ
imagingȱmodeȱandȱexamȱtypeȱareȱselectable. To delete or edit a measurement
3 Saveȱtheȱcalculation.ȱ(Seeȱ““Toȱsaveȱaȱ ™ Withȱtheȱmeasurementȱactiveȱ(highlighted),ȱ
calculation””ȱonȱpage 45.) doȱoneȱofȱtheȱfollowing:
•• Toȱdelete,ȱselectȱDeleteȱonȬscreen.
Toȱstartȱaȱcalculationȱbeforeȱmeasuring,ȱseeȱ
““Performingȱandȱsavingȱmeasurementsȱinȱ •• Toȱedit,ȱuseȱtheȱtouchpadȱtoȱmoveȱtheȱ
calculations””ȱonȱpage 45. calipers.
Note: Traceȱmeasurementsȱcannotȱbeȱeditedȱonceȱset.ȱ

Chapter 4: Measurements and Calculations 41

To improve precision of caliper placement Youȱcanȱperformȱaȱcombinationȱofȱdistance,ȱarea,ȱ
™ Doȱanyȱofȱtheȱfollowing: circumference,ȱandȱmanualȱtraceȱmeasurementsȱ
atȱoneȱtime.ȱTheȱtotalȱnumberȱpossibleȱdependsȱ
•• Adjustȱtheȱdisplayȱforȱmaximumȱ onȱtheirȱorderȱandȱtype.
sharpness.
•• Useȱleadingȱedgesȱ(closestȱtoȱtheȱ To measure distance (2D)
transducer)ȱorȱbordersȱforȱstartingȱandȱ Youȱcanȱperformȱupȱtoȱeightȱdistanceȱ
stoppingȱpoints. measurementsȱonȱaȱ2Dȱimage.ȱ
•• Maintainȱaȱconsistentȱtransducerȱ 1 Onȱaȱfrozenȱ2Dȱimage,ȱpressȱtheȱCALIPERȱkey.
orientationȱforȱeachȱtypeȱofȱmeasurement.
Aȱpairȱofȱcalipersȱappears,ȱconnectedȱbyȱaȱ
•• Makeȱsureȱthatȱtheȱareaȱofȱinterestȱfillsȱasȱ dottedȱline.ȱ
muchȱofȱtheȱscreenȱasȱpossible.
2 Usingȱtheȱtouchpad,ȱpositionȱtheȱfirstȱcaliper,ȱ
•• (2D)ȱMinimizeȱtheȱdepth,ȱorȱzoom. andȱthenȱpressȱtheȱSELECTȱkey.
Theȱotherȱcaliperȱbecomesȱactive.
2D measurements
3 Usingȱtheȱtouchpad,ȱpositionȱtheȱotherȱcaliper.
Theȱbasicȱmeasurementsȱthatȱyouȱcanȱperformȱinȱ
2Dȱimagingȱareȱasȱfollows: Ifȱyouȱmoveȱtheȱcalipersȱcloseȱtogether,ȱtheyȱ
shrinkȱandȱtheȱdottedȱlineȱdisappears.ȱ
•• Distanceȱinȱcm
Seeȱ““Toȱsaveȱaȱmeasurementȱtoȱaȱcalculationȱandȱ
•• Areaȱinȱcm2 patientȱreport””ȱonȱpage 41.
•• Circumferenceȱinȱcm
To measure area or circumference (2D)
Youȱcanȱalsoȱmeasureȱareaȱorȱcircumferenceȱbyȱ
1 Onȱaȱfrozenȱ2Dȱimage,ȱpressȱtheȱCALIPERȱkey.
tracingȱmanually.
2 SelectȱEllipseȱonȬscreen.
Note: Ifȱyouȱexceedȱtheȱallowedȱnumberȱofȱ
measurements,ȱEllipseȱisȱnotȱavailable.
3 Useȱtheȱtouchpadȱtoȱadjustȱtheȱsizeȱandȱ
positionȱofȱtheȱellipse.ȱTheȱSELECTȱkeyȱtogglesȱ
betweenȱpositionȱandȱsize.
Seeȱ““Toȱsaveȱaȱmeasurementȱtoȱaȱcalculationȱandȱ
patientȱreport””ȱonȱpage 41.

To trace manually (2D)

1 Onȱaȱfrozenȱ2Dȱimage,ȱpressȱtheȱCALIPERȱkey.
2 SelectȱManualȱonȬscreen.
Note: Ifȱyouȱexceedȱtheȱallowedȱnumberȱofȱ
Figure 1 2D image with two distance and one
measurements,ȱManualȱisȱnotȱavailable.
circumference measurement
3 Usingȱtheȱtouchpad,ȱpositionȱtheȱcaliperȱ
whereȱyouȱwantȱtoȱbegin.

42 Measurements
4 PressȱtheȱSELECTȱkey. 4 PressȱtheȱSELECTȱkey.
5 Usingȱtheȱtouchpad,ȱcompleteȱtheȱtrace,ȱandȱ Aȱsecondȱverticalȱcaliperȱappears.ȱ
pressȱtheȱSETȱkey.
5 Usingȱtheȱtouchpad,ȱpositionȱtheȱsecondȱ
Seeȱ““Toȱsaveȱaȱmeasurementȱtoȱaȱcalculationȱandȱ verticalȱcaliperȱatȱtheȱpeakȱofȱtheȱnextȱ
patientȱreport””ȱonȱpage 41. heartbeat.
Seeȱ““Toȱsaveȱaȱmeasurementȱtoȱaȱcalculationȱandȱ
M Mode measurements patientȱreport””ȱonȱpage 41.ȱSavingȱtheȱheartȱrateȱ
Theȱbasicȱmeasurementsȱthatȱyouȱcanȱperformȱinȱ measurementȱtoȱtheȱpatientȱreportȱoverwritesȱ
M Modeȱimagingȱareȱasȱfollows: anyȱheartȱrateȱenteredȱonȱtheȱpatientȱinformationȱ
form.
•• Distanceȱinȱcm/Timeȱinȱseconds
Seeȱalsoȱ““Toȱmeasureȱfetalȱheartȱrateȱ(MȱMode)””ȱ
•• HeartȱRateȱ(HR)ȱinȱbeatsȱperȱminuteȱ(bpm)
onȱpage 63.
Theȱtimeȱscaleȱaboveȱtheȱtraceȱhasȱsmallȱmarksȱatȱ
200 msȱintervalsȱandȱlargeȱmarksȱatȱoneȬsecondȱ Doppler measurements
intervals.
Theȱbasicȱmeasurementsȱthatȱyouȱcanȱperformȱinȱ
To measure distance (M Mode) DopplerȱimagingȱareȱVelocityȱ(cm/s),ȱPressureȱ
Gradient,ȱElapsedȱTime,ȱ+/xȱRatio,ȱResistiveȱ
Youȱcanȱperformȱupȱtoȱfourȱdistanceȱ
Index (RI),ȱandȱAcceleration.ȱYouȱcanȱalsoȱtraceȱ
measurementsȱonȱanȱimage.
manuallyȱorȱautomatically.ȱ
1 OnȱaȱfrozenȱM Modeȱtrace,ȱpressȱtheȱCALIPERȱ
ForȱDopplerȱmeasurements,ȱtheȱDopplerȱscaleȱ
key.
mustȱbeȱsetȱtoȱcm/s.ȱSeeȱ““Presetsȱsetup””ȱonȱ
Aȱsingleȱcaliperȱappears. page 22.
2 Usingȱtheȱtouchpad,ȱpositionȱtheȱcaliper. To measure Velocity (cm/s) and Pressure
3 PressȱtheȱSELECTȱkeyȱtoȱdisplayȱtheȱsecondȱ Gradient (Doppler)
caliper. 1 OnȱaȱfrozenȱDopplerȱspectralȱtrace,ȱpressȱtheȱ
CALIPERȱkey.
4 Usingȱtheȱtouchpad,ȱpositionȱtheȱsecondȱ
caliper. Aȱsingleȱcaliperȱappears.
Seeȱ““Toȱsaveȱaȱmeasurementȱtoȱaȱcalculationȱandȱ 2 Usingȱtheȱtouchpad,ȱpositionȱtheȱcaliperȱtoȱaȱ
patientȱreport””ȱonȱpage 41. peakȱvelocityȱwaveform.

Measurements
To measure heart rate (M Mode) Thisȱmeasurementȱinvolvesȱaȱsingleȱcaliperȱfromȱ
theȱbaseline.
1 OnȱaȱfrozenȱM Modeȱtrace,ȱpressȱtheȱCALIPERȱ
key. Seeȱ““Toȱsaveȱaȱmeasurementȱtoȱaȱcalculationȱandȱ
patientȱreport””ȱonȱpage 41.
2 SelectȱHRȱonȬscreen.
Aȱverticalȱcaliperȱappears.
3 Usingȱtheȱtouchpad,ȱpositionȱtheȱverticalȱ
caliperȱatȱtheȱpeakȱofȱtheȱheartbeat.ȱ

Chapter 4: Measurements and Calculations 43

To measure Velocities, Elapsed Time, +/x 4 Usingȱtheȱtouchpad,ȱtraceȱtheȱwaveform.ȱ
Ratio, Resistive Index (RI), and Acceleration Toȱmakeȱaȱcorrection,ȱselectȱUndoȱonȬscreen,ȱ
(Doppler) backtrackȱwithȱtheȱtouchpad,ȱorȱpressȱtheȱ
1 OnȱaȱfrozenȱDopplerȱspectralȱtrace,ȱpressȱtheȱ BACKSPACEȱkey.
CALIPERȱkey.
5 PressȱtheȱSETȱkey.
Aȱsingleȱcaliperȱappears.
Theȱmeasurementȱresultsȱappear.
2 Usingȱtheȱtouchpad,ȱpositionȱtheȱcaliperȱtoȱaȱ
Seeȱ““Toȱsaveȱaȱmeasurementȱtoȱaȱcalculationȱandȱ
peakȱsystolicȱwaveform.
patientȱreport””ȱonȱpage 41.
3 PressȱtheȱSELECTȱkey.
To trace automatically (Doppler)
Aȱsecondȱcaliperȱappears.
Afterȱtracingȱautomatically,ȱconfirmȱthatȱtheȱ
4 Usingȱtheȱtouchpad,ȱpositionȱtheȱsecondȱ systemȬgeneratedȱboundaryȱisȱcorrect.ȱIfȱyouȱareȱ
caliperȱatȱtheȱendȱdiastoleȱonȱtheȱwaveform. notȱsatisfiedȱwithȱtheȱtrace,ȱobtainȱaȱhighȬqualityȱ
Seeȱ““Toȱsaveȱaȱmeasurementȱtoȱaȱcalculationȱandȱ Dopplerȱspectralȱtraceȱimage,ȱorȱtraceȱmanually.ȱ
patientȱreport””ȱonȱpage 41. (Seeȱ““Toȱtraceȱmanuallyȱ(Doppler)””ȱonȱpage 44.)
1 OnȱaȱfrozenȱDopplerȱspectralȱtrace,ȱpressȱtheȱ
To measure time duration (Doppler) CALIPERȱkey.ȱ
1 OnȱaȱDopplerȱspectralȱtrace,ȱpressȱtheȱCALIPERȱ
2 SelectȱAutoȱonȬscreen.ȱ
key.
Aȱverticalȱcaliperȱappears.
2 PressȱTimeȱonȬscreen.
3 Usingȱtheȱtouchpad,ȱpositionȱtheȱcaliperȱatȱtheȱ
3 Aȱverticalȱcaliperȱappears.
beginningȱofȱtheȱwaveform.
4 Usingȱtheȱtouchpad,ȱpositionȱtheȱcaliperȱ
Ifȱcalipersȱareȱnotȱpositionedȱcorrectly,ȱtheȱ
whereȱdesired,ȱandȱpressȱtheȱSELECTȱkey.ȱ
calculationȱresultȱisȱinaccurate.
5 Aȱsecondȱcaliperȱappears.
4 PressȱtheȱSELECTȱkey.
6 Usingȱtheȱtouchpad,ȱpositionȱtheȱsecondȱ
Aȱsecondȱverticalȱcaliperȱappears.
caliperȱwhereȱdesired,ȱandȱpressȱtheȱSELECTȱ
key.ȱ 5 Usingȱtheȱtouchpad,ȱpositionȱtheȱsecondȱ
caliperȱatȱtheȱendȱofȱtheȱwaveform.
To trace manually (Doppler)
6 PressȱtheȱSETȱkey.ȱ
1 OnȱaȱfrozenȱDopplerȱspectralȱtrace,ȱpressȱtheȱ
CALIPERȱkey.ȱ Theȱmeasurementȱresultsȱappear.
2 SelectȱManualȱonȬscreen. Seeȱ““Toȱsaveȱaȱmeasurementȱtoȱaȱcalculationȱandȱ
patientȱreport””ȱonȱpage 41.
Aȱsingleȱcaliperȱappears.
3 Usingȱtheȱtouchpad,ȱpositionȱtheȱcaliperȱatȱtheȱ Automatic trace results
beginningȱofȱtheȱdesiredȱwaveform,ȱandȱpressȱ Dependingȱonȱtheȱexamȱtype,ȱtheȱresultsȱfromȱ
theȱSELECTȱkey. automaticȱtracingȱincludeȱtheȱfollowing:
Ifȱcalipersȱareȱnotȱpositionedȱcorrectly,ȱtheȱ •• VelocityȱTimeȱIntegralȱ(VTI)
resultȱisȱinaccurate.
•• PeakȱVelocityȱ(Vmax)

44 Measurements
•• MeanȱPressureȱGradientȱ(PGmean) Menuȱitemsȱfollowedȱbyȱellipsesȱ(.ȱ.ȱ.)ȱhaveȱ
subentries.ȱ
•• MeanȱVelocityȱonȱPeakȱTraceȱ(Vmean)
•• PressureȱGradientȱ(PGmax) To select from the calculations menu
•• CardiacȱOutputȱ(CO) 1 Onȱaȱfrozenȱimage,ȱpressȱtheȱCALCSȱkey.

•• PeakȱSystolicȱVelocityȱ(PSV) Theȱcalculationsȱmenuȱappears.

•• TimeȱAverageȱMeanȱ(TAM)* 2 Usingȱtheȱtouchpadȱorȱarrowȱkeys,ȱhighlightȱ
theȱdesiredȱmeasurementȱname.
•• +/×ȱorȱSystolic/Diastolicȱ(S/D)
Toȱdisplayȱadditionalȱmeasurementȱnames,ȱ
•• PulsatilityȱIndexȱ(PI) highlightȱNext,ȱPrev,ȱorȱaȱmeasurementȱnameȱ
•• EndȱDiastolicȱVelocityȱ(EDV) thatȱhasȱellipsesȱ(.ȱ.ȱ.).ȱThenȱpressȱtheȱSELECTȱ
key.ȱ
•• AccelerationȱTimeȱ(AT)
Onlyȱmeasurementȱnamesȱavailableȱforȱtheȱ
•• ResistiveȱIndexȱ(RI) imagingȱmodeȱareȱselectable.
•• TimeȱAverageȱPeakȱ(TAP) 3 PressȱtheȱSELECTȱkey.
•• GateȱDepth Toȱcloseȱtheȱcalculationsȱmenu,ȱpressȱtheȱCALCSȱ
keyȱonceȱ(ifȱtheȱmenuȱisȱactive)ȱorȱtwiceȱ(ifȱtheȱ
menuȱisȱinactive).
General calculations
Withinȱcalculations,ȱyouȱcanȱsaveȱmeasurementȱ Performing and saving measurements
resultsȱtoȱtheȱpatientȱreport.ȱYouȱcanȱdisplay,ȱ in calculations
repeat,ȱandȱdeleteȱmeasurementsȱfromȱaȱ Inȱperformingȱaȱmeasurementȱwithinȱaȱ
calculation.ȱSomeȱmeasurementsȱcanȱbeȱdeletedȱ calculation,ȱyouȱselectȱfromȱtheȱcalculationsȱ
directlyȱfromȱtheȱpatientȱreportȱpages.ȱSeeȱ menu,ȱpositionȱtheȱcalipersȱthatȱappear,ȱandȱthenȱ
““Patientȱreport””ȱonȱpage 68. saveȱtheȱcalculation.ȱUnlikeȱmeasurementsȱ
Calculationȱpackagesȱdependȱonȱexamȱtypeȱandȱ performedȱoutsideȱaȱcalculation,ȱtheȱcalipersȱ
transducer. appearȱbyȱselectingȱfromȱtheȱcalculationsȱmenu,ȱ
notȱbyȱpressingȱtheȱCALIPERȱkey.ȱTheȱtypeȱofȱ
calipersȱthatȱappearȱdependsȱonȱtheȱ
Calculations menu
measurement.ȱ
Theȱcalculationsȱmenuȱcontainsȱmeasurementsȱ

Measurements
availableȱforȱtheȱimagingȱmodeȱandȱexamȱtype.ȱ To save a calculation
Afterȱyouȱperformȱandȱsaveȱaȱmeasurement,ȱtheȱ ™ Doȱoneȱofȱtheȱfollowing:
resultȱsavesȱtoȱtheȱpatientȱreport.ȱ(Seeȱ““Patientȱ
report””ȱonȱpage 68.)ȱAlso,ȱaȱcheckȱmarkȱappearsȱ •• Saveȱtheȱcalculationȱonly:ȱPressȱtheȱ
SAVE CALCȱkey,ȱorȱselectȱSaveȱonȬscreen.ȱ
nextȱtoȱtheȱmeasurementȱnameȱinȱtheȱcalculationsȱ
menu.ȱIfȱyouȱhighlightȱtheȱcheckedȱmeasurementȱ Theȱcalculationȱsavesȱtoȱtheȱpatientȱreport.ȱ
name,ȱtheȱresultsȱappearȱbelowȱtheȱmenu.ȱIfȱyouȱ Toȱsaveȱtheȱimageȱwithȱtheȱmeasurementsȱ
repeatȱtheȱmeasurement,ȱtheȱresultsȱbelowȱtheȱ displayed,ȱseeȱ““Toȱsaveȱanȱimage””ȱonȱ
menuȱreflectȱeitherȱtheȱlastȱmeasurementȱorȱtheȱ page 35.
average,ȱdependingȱonȱtheȱmeasurement.ȱ
•• Saveȱbothȱtheȱimageȱandȱcalculation:ȱPressȱ
theȱSAVE keyȱifȱtheȱSAVEȱkeyȱfunctionalityȱ

Chapter 4: Measurements and Calculations 45

 isȱsetȱtoȱImage/Calcs.ȱ(Seeȱ““Presetsȱsetup””ȱ Someȱmeasurementsȱcanȱbeȱdeletedȱdirectlyȱfromȱ
onȱpage 22.) theȱpatientȱreportȱpages.ȱSeeȱ““Patientȱreport””ȱonȱ
page 68.
Theȱcalculationȱsavesȱtoȱtheȱpatientȱreport,ȱ
andȱtheȱimageȱsavesȱtoȱinternalȱstorageȱ
withȱtheȱmeasurementsȱdisplayed. EMED calculations
TheȱresultsȱfromȱEMEDȱcalculationsȱ
Displaying, repeating, and deleting automaticallyȱappearȱinȱtheȱEMEDȱworksheets.ȱ
saved measurements in calculations AllȱEMEDȱcalculationsȱareȱavailableȱforȱeachȱ
examȱtype.
To display a saved measurement
To perform an EMED calculation:
™ Doȱoneȱofȱtheȱfollowing:
1 PressȱtheȱCALCSȱkey.
•• Highlightȱtheȱmeasurementȱnameȱinȱtheȱ
calculationsȱmenu.ȱTheȱresultȱappearsȱ 2 SelectȱEMEDȱonȬscreen.
belowȱtheȱmenu. TheȱcalculationsȱmenuȱbecomesȱtheȱEMEDȱ
Openȱtheȱpatientȱreport.ȱSeeȱ““Patientȱreport””ȱonȱ calculationsȱmenu.
page 68. 3 Selectȱtheȱcalculationȱname.
To repeat a saved measurement 4 Performȱaȱdistanceȱmeasurement.
1 Highlightȱtheȱmeasurementȱnameȱinȱtheȱ 5 Saveȱtheȱmeasurement.
calculationsȱmenu.
Toȱreturnȱtoȱtheȱcalculationsȱmenu,ȱselectȱCalcsȱ
2 PressȱtheȱSELECTȱkeyȱorȱtheȱCALIPERȱkey. onȬscreen.
3 Performȱtheȱmeasurementȱagain.
TheȱnewȱresultsȱappearȱonȬscreenȱinȱtheȱ
Percent reduction calculations
measurementȱandȱcalculationsȱdataȱarea.ȱ(Seeȱ WARNING: To avoid incorrect calculations,
““Screenȱlayout””ȱonȱpage 7.)ȱYouȱcanȱcompareȱ
verify that the patient information,
themȱtoȱtheȱsavedȱresultsȱbelowȱtheȱmenu.
date, and time settings are accurate.
4 Toȱsaveȱtheȱnewȱmeasurement,ȱpressȱtheȱ
To avoid misdiagnosis or harming
SAVE CALCȱkey.
the patient outcome, start a new
Theȱnewȱmeasurementȱsavesȱtoȱtheȱpatientȱ patient information form before
reportȱandȱoverwritesȱtheȱpreviouslyȱsavedȱ starting a new patient exam and
measurement. performing calculations. Starting a
new patient information form clears
To delete a saved measurement the previous patient’s data. The
1 Selectȱtheȱmeasurementȱnameȱfromȱtheȱ previous patient’s data will be
calculationsȱmenu. combined with the current patient
if the form is not first cleared. See
2 SelectȱDeleteȱonȬscreen. “To create a new patient
Theȱmeasurementȱlastȱsavedȱisȱdeletedȱfromȱ information form” on page 34.
theȱpatientȱreport.ȱIfȱitȱisȱtheȱonlyȱ
measurement,ȱtheȱcheckȱmarkȱisȱdeletedȱfromȱ
theȱcalculationsȱmenu.

46 General calculations
 b Usingȱtheȱtouchpad,ȱmoveȱtheȱcaliperȱtoȱ
theȱtraceȱstartingȱpoint,ȱandȱpressȱtheȱ
Transducer Exam Types SELECTȱkey.

C11x Abdomen c Usingȱtheȱtouchpad,ȱtraceȱtheȱdesiredȱarea.ȱ

C60x Abdomen Toȱmakeȱaȱcorrection,ȱselectȱUndoȱ

onȬscreenȱorȱpressȱtheȱBACKSPACEȱkey.
HFL38x IMT, Small Parts, Vascular
d Completeȱtheȱtrace,ȱandȱpressȱtheȱSETȱkey.
L25x Vascular, Muscle e Saveȱtheȱcalculation.ȱSeeȱ““Toȱsaveȱaȱ
L38x IMT, Small Parts, Vascular calculation””ȱonȱpage 45.
Theȱpercentȱareaȱreductionȱresultȱappearsȱ
P10x Abdomen
onȬscreenȱinȱtheȱmeasurementȱandȱcalculationȱ
P21x Abdomen dataȱareaȱandȱinȱtheȱpatientȱreport.

SLAx Muscle, Vascular To calculate percent diameter reduction

1 Onȱaȱfrozenȱ2Dȱimage,ȱpressȱtheȱCALCSȱkey.
2 DoȱtheȱfollowingȱforȱD1ȱandȱthenȱforȱD2:ȱ
a Fromȱtheȱcalculationsȱmenu,ȱselectȱtheȱ
measurementȱnameȱunderȱDia Red.
b Positionȱtheȱcalipers.ȱ(Seeȱ““Workingȱwithȱ
calipers””ȱonȱpage 41.)
c Saveȱtheȱcalculation.ȱSeeȱ““Toȱsaveȱaȱ
calculation””ȱonȱpage 45.
Theȱpercentȱdiameterȱreductionȱresultȱappearsȱinȱ
theȱmeasurementȱandȱcalculationȱdataȱareaȱandȱ
inȱtheȱpatientȱreport.

Figure 2 Percent area reduction calculation of right

carotid bulb

Measurements
To calculate percent area reduction
Theȱpercentȱareaȱreductionȱcalculationȱinvolvesȱ
twoȱmanualȱtraceȱmeasurements.ȱ
1 Onȱaȱfrozenȱ2Dȱimage,ȱpressȱtheȱCALCSȱkey.
2 DoȱtheȱfollowingȱforȱA1ȱandȱthenȱforȱA2:
a Fromȱtheȱcalculationsȱmenu,ȱselectȱtheȱ
measurementȱnameȱunderȱArea Red.

Chapter 4: Measurements and Calculations 47

Volume calculations To calculate volume
Theȱvolumeȱcalculationȱinvolvesȱthreeȱ2Dȱ
WARNING: To avoid incorrect calculations, distanceȱmeasurements:ȱD1,ȱD2,ȱandȱD3.ȱAfterȱallȱ
verify that the patient information, measurementsȱareȱsaved,ȱtheȱresultȱappearsȱ
date, and time settings are onȬscreenȱandȱinȱtheȱpatientȱreport.
accurate.
™ Doȱtheȱfollowingȱforȱeachȱimageȱyouȱneedȱtoȱ
To avoid misdiagnosis or harming measure:
the patient outcome, start a new
patient information form before a Onȱtheȱfrozenȱ2Dȱimage,ȱpressȱtheȱCALCSȱ
starting a new patient exam and key.
performing calculations. Starting a b Doȱtheȱfollowingȱforȱeachȱmeasurementȱ
new patient information form youȱneedȱtoȱtake:
clears the previous patient’s data.
The previous patient’s data will be i Fromȱtheȱcalculationsȱmenu,ȱselectȱtheȱ
combined with the current patient measurementȱnameȱunderȱVolume.ȱ(Ifȱ
if the form is not first cleared. See VolumeȱisȱnotȱavailableȱinȱaȱGynȱexam,ȱ
“To create a new patient selectȱGynȱandȱthenȱselectȱVolume.)
information form” on page 34. ii Positionȱtheȱcalipers.ȱ(Seeȱ““Workingȱ
withȱcalipers””ȱonȱpage 41.)
iii Saveȱtheȱmeasurement.ȱSeeȱ““Toȱsaveȱaȱ
calculation””ȱonȱpage 45.
Transducer Exam Types

C11x Abdomen, Nerve Volume flow calculations

C60x Abdomen, Gyn, Nerve WARNING: To avoid incorrect calculations,
verify that the patient information,
HFL38x Breast, Nerve, Small Parts,
date, and time settings are accurate.
Vascular
To avoid misdiagnosis or harming
ICTx Gyn the patient outcome, start a new
L25x Muscle, Nerve, Vascular, patient information form before
Superficial, starting a new patient exam and
performing calculations. Starting a
L38x Breast, Nerve, Small Parts, new patient information form clears
Vascular the previous patient’s data. The
previous patient’s data will be
P10x Abdomen, Neonatal combined with the current patient
P21x Abdomen if the form is not first cleared. See
“To create a new patient
SLAx Muscle, Nerve, Superficial, information form” on page 34.
Vascular

48 General calculations
 •• Difficultyȱensuringȱuniformȱinsonationȱofȱ
theȱvessel.ȱ
Transducer Exam Types Theȱsystemȱisȱlimitedȱtoȱtheȱfollowingȱ
sampleȱvolumeȱsizes:
C11x Abdomen
•• C11xȱtransducer:ȱ1,ȱ2,ȱ3ȱGateȱSizeȱ(mm)
C60x Abdomen
•• C60xȱandȱP10xȱtransducers:ȱ2,ȱ3,ȱ5,ȱ7,ȱ
HFL38x Vascular 10,ȱ12ȱGateȱSizeȱ(mm)

L25x Vascular •• HFL38x,ȱL25x,ȱL38x,ȱandȱSLAxȱ

transducers:ȱ1,ȱ3,ȱ5,ȱ7,ȱ10,ȱ12ȱGateȱSizeȱ
L38x Vascular (mm)
P10x Abdomen •• P21xȱtransducer:ȱ2,ȱ3,ȱ5,ȱ7,ȱ11.5,ȱ14ȱGateȱ
Sizeȱ(mm)
P21x Abdomen
•• Precisionȱinȱplacingȱtheȱcaliper
SLAx Vascular
•• Accuracyȱinȱangleȱcorrection
Theȱfollowingȱtableȱshowsȱtheȱmeasurementsȱ Theȱconsiderationsȱandȱdegreeȱofȱaccuracyȱforȱ
requiredȱtoȱcompleteȱtheȱvolumeȱflowȱ volumeȱflowȱmeasurementsȱandȱcalculationsȱareȱ
calculation.ȱForȱdefinitionsȱofȱacronyms,ȱseeȱ discussedȱinȱtheȱfollowingȱreference:
““Glossary””ȱonȱpage 157.
Allan,ȱPaulȱL.ȱetȱal.ȱClinicalȱDopplerȱUltrasound,ȱ
Volume Flow Calculations 4thȱEd.,ȱHarcourtȱPublishersȱLimited,ȱ(2000)ȱ
36Ȭ38.
Measurement
Menu Calculation
Heading
(Imaging
Result
To calculate volume flow
Mode) 1 Performȱtheȱ2Dȱmeasurement:
Vol Flow D (2D) VF (Volume a OnȱaȱfrozenȱfullȬscreenȱ2Dȱimageȱorȱduplexȱ
TAM (Doppler) Flow l/min) image,ȱpressȱtheȱCALCSȱkey.
b Fromȱtheȱcalculationsȱmenu,ȱselectȱDȱ
Bothȱaȱ2DȱandȱaȱDopplerȱmeasurementȱareȱ (distance)ȱunderȱVol Flow.
requiredȱforȱtheȱvolumeȱflowȱcalculation.ȱTheȱ
Dopplerȱsampleȱvolumeȱshouldȱcompletelyȱ c Positionȱtheȱcalipers.ȱ(Seeȱ““Workingȱwithȱ
insonateȱtheȱvessel.ȱ calipers””ȱonȱpage 41.)

Measurements
Considerȱtheȱfollowingȱfactorsȱwhenȱperformingȱ d Saveȱtheȱcalculation.ȱSeeȱ““Toȱsaveȱaȱ
volumeȱflowȱmeasurements: calculation””ȱonȱpage 45.

•• Usersȱshouldȱfollowȱcurrentȱmedicalȱpracticeȱ 2 PerformȱtheȱDopplerȱmeasurement:
forȱvolumeȱflowȱcalculationȱapplications. a OnȱaȱfrozenȱDopplerȱspectralȱtrace,ȱpressȱ
•• Theȱaccuracyȱofȱtheȱvolumeȱflowȱcalculationȱ theȱCALCSȱkey.
largelyȱdependsȱonȱtheȱuser. b Fromȱtheȱcalculationsȱmenu,ȱselectȱTAM
•• Theȱfactorsȱidentifiedȱinȱtheȱliteratureȱthatȱ underȱVol Flow.
affectȱtheȱaccuracyȱareȱasȱfollows: Aȱverticalȱcaliperȱappears.
•• Usingȱtheȱdiameterȱmethodȱforȱ2Dȱarea

Chapter 4: Measurements and Calculations 49

 c Usingȱtheȱtouchpad,ȱpositionȱtheȱverticalȱ
caliperȱatȱtheȱbeginningȱofȱtheȱwaveform.
Transducer Exam Type
Ifȱcalipersȱareȱnotȱpositionedȱcorrectly,ȱtheȱ
calculationȱresultȱisȱinaccurate. D2x Cardiac
d PressȱtheȱSELECTȱkeyȱtoȱdisplayȱaȱsecondȱ P10x Cardiac
verticalȱcaliper.
P21x Cardiac
e Usingȱtheȱtouchpad,ȱpositionȱtheȱsecondȱ
verticalȱcaliperȱatȱtheȱendȱofȱtheȱwaveform. TEEx Cardiac
f PressȱtheȱSETȱkeyȱtoȱcompleteȱtheȱtraceȱandȱ
toȱdisplayȱtheȱresults. Theȱfollowingȱtableȱshowsȱtheȱmeasurementsȱ
requiredȱtoȱcompleteȱdifferentȱcardiacȱ
g Saveȱtheȱcalculation.ȱSeeȱ““Toȱsaveȱaȱ calculations.ȱForȱdefinitionsȱofȱacronyms,ȱseeȱ
calculation””ȱonȱpage 45. ““Glossary””ȱonȱpage 157.
Toȱdisplayȱtheȱvolumeȱflowȱcalculation,ȱseeȱ Cardiac Calculations
““Patientȱreport””ȱonȱpage 68.
Cardiac
Menu Calculation
Measurements
Exam-based calculations Heading
(Imaging Mode)
Results

Inȱadditionȱtoȱtheȱgeneralȱcalculations,ȱthereȱareȱ
calculationsȱspecificȱtoȱtheȱCardiac,ȱGynecologyȱ LV…LVd RVW (2D) CO
(Gyn),ȱIMT,ȱOB,ȱOrbital,ȱSmallȱParts,ȱTranscranialȱ RVD (2D) EF
Dopplerȱ(TCD),ȱandȱVascularȱexamȱtypes. IVS (2D) SV
LVD (2D) LVESV
Cardiac calculations LVPW (2D) LVEDV
IVSFT
WARNING: To avoid incorrect calculations, …LVs RVW (2D)
LVPWFT
verify that the patient information, RVD (2D)
LVDFS
date, and time settings are accurate. IVS (2D)
CI
To avoid misdiagnosis or harming LVD (2D)
SI
the patient outcome, start a new LVPW (2D)
patient information form before HRa needed for
starting a new patient exam and CO & CI
performing calculations. Starting a
new patient information form clears Ao/LA Ao (2D or Ao
the previous patient’s data. The M Mode) LA/Ao
previous patient’s data will be
combined with the current patient AAo (2D) AAo
if the form is not first cleared. See LA (2D or LA
“To create a new patient M Mode) LA/Ao
information form” on page 34.
LVOT D (2D) LVOT D
LVOT area

50 Exam-based calculations
 Cardiac Cardiac
Menu Calculation Menu Calculation
Measurements Measurements
Heading Results Heading Results
(Imaging Mode) (Imaging Mode)

ACS (M Mode) ACS PISA Ann D (2D) PISA Area

Radius (Color) ERO
LVET (M Mode) LVET
MR/VTI (Doppler) MV Rate
MV EF:Slope EF SLOPE MV/VTI (Doppler) Regurgitant
(M Mode) Volume
EPSS (M Mode) EPSS Regurgitant
Fraction
LV…LVd RVW (M Mode) CO
Qp/Qs LVOT D (2D) D
RVD (M Mode) EF
RVOT D (2D) VTI
IVS (M Mode) SV
LVOT VTI VMax
LVD (M Mode) LVESV
(Doppler) PGmax
LVPW (M Mode) LVEDV
RVOT VTI Vmean
IVSFT (Doppler)
…LVs RVW (M Mode) PGmean
LVPWFT
RVD (M Mode) SV
LVDFS
IVS (M Mode) Qp/Qs
CI
LVD (M Mode)
SI TDI (Wall) e’ and a’ E(MV)/e’ ratio
LVPW (M Mode)
LV Mass (Doppler)
HR HRa (Wall) e’ and a’
(Doppler)
Area AV (2D) AV Area
(Wall) e’ and a’
MV (2D) MV Area (Doppler)
(Wall) e’ and a’
LV Vol A4Cd (2D) LV Vol (Doppler)
(EF) A4Cs (2D) LV Area (Wall) ‘e and a’
A2Cd (2D) EF (Doppler)
A2Cs (2D) CO

Measurements
SV
CI
SI
Biplane

LV mass Epi (2D) LV Mass

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

Chapter 4: Measurements and Calculations 51

 Cardiac Cardiac
Menu Calculation Menu Calculation
Measurements Measurements
Heading Results Heading Results
(Imaging Mode) (Imaging Mode)

P. Vein A (Doppler) VMax AV Vmax (Doppler) Vmax

PGmax
Adur (Doppler) time
VTI (Doppler) VTI
S (Doppler) VMax
Vmax
S/D ratio
D (Doppler) PGmax
MV E (Doppler) E Vmean
A (Doppler) E PG PGmean
A VTI or Vmax from AVA
A PG LVOT (Doppler)
E:A VTI or Vmax from
AV (Doppler)
Adur (Doppler) time
Ao/LA LVOT D (2D)
PHT (Doppler) PHT
MVA AV VTI (Doppler) SV
Decel time Ao/LA LVOT D (2D)
VTI (Doppler) VTI AV VTI (Doppler) CO
Vmax
PGmax Ao/LA LVOT D (2D)
Vmean HR HRa
PGmean
LVOT Vmax (Doppler) Vmax
IVRT (Doppler) time PGmax
MV…MR dP:dTb (CW dP:dT VTI (Doppler) VTI
Doppler) Vmax
PGmax
Vmean
PGmean

AV…AI PHT (slope) AI PHT

(Doppler) AI slope

52 Exam-based calculations
 To measure LVd and LVs
Cardiac
Menu Calculation 1 Onȱaȱfrozenȱ2DȱimageȱorȱM Modeȱtrace,ȱpressȱ
Measurements
Heading Results theȱCALCSȱkey.ȱ
(Imaging Mode)
2 Fromȱtheȱcalculationsȱmenu,ȱselectȱtheȱ
TV TRmax (Doppler) Vmax measurementȱname.
PGmax
3 Positionȱtheȱactiveȱ(green)ȱcaliperȱatȱtheȱ
E (Doppler) E startingȱpoint.ȱ(Seeȱ““Workingȱwithȱcalipers””ȱ
A (Doppler) E PG onȱpage 41.)
A 4 PressȱtheȱSELECTȱkey,ȱandȱpositionȱtheȱsecondȱ
A PG caliper.
E:A 5 PressȱtheȱSELECTȱkey.
PHT (Doppler) PHT Anotherȱcaliperȱappears,ȱandȱtheȱcalculationsȱ
MVA menuȱhighlightsȱtheȱnextȱmeasurementȱname.
Decel time 6 Positionȱtheȱcaliper,ȱandȱpressȱtheȱSELECTȱkey.ȱ
VTI (Doppler) VTI Repeatȱforȱeachȱmeasurementȱnameȱinȱtheȱ
calculationȱgroup.
Vmax
PGmax EachȱtimeȱyouȱpressȱtheȱSELECTȱkey,ȱanotherȱ
Vmean caliperȱappears,ȱandȱtheȱcalculationsȱmenuȱ
highlightsȱtheȱnextȱmeasurementȱname.
PGmean
7 Saveȱtheȱcalculation.ȱ(Seeȱ““Toȱsaveȱaȱ
RA pressurec RVSP calculation””ȱonȱpage 45.)
PV Vmax (Doppler) Vmax
To measure Ao, LA, AAo, or LVOT D
PGmax
1 Onȱaȱfrozenȱ2DȱimageȱorȱM Modeȱtrace,ȱpressȱ
VTI (Doppler) VTI theȱCALCSȱkey.ȱ
AT (Doppler) Vmax 2 Fromȱtheȱcalculationsȱmenu,ȱselectȱtheȱ
PGmax measurementȱname.ȱ
Vmean 3 Positionȱtheȱcalipers.ȱ(Seeȱ““Workingȱwithȱ
PGmean calipers””ȱonȱpage 41.)
AT

Measurements
4 Saveȱtheȱcalculation.ȱ(Seeȱ““Toȱsaveȱaȱ
a. You can enter the HR measurement three ways: Patient calculation””ȱonȱpage 45.)
information form, Doppler measurement (See “To
calculate Heart Rate (HR)” on page 57), or M Mode To calculate LV Volume (Simpson’s Rule)
measurement (See “To measure heart rate (M Mode)” on
page 43). 1 Onȱaȱfrozenȱ2Dȱimage,ȱpressȱtheȱCALCSȱkey.
b. Performed at 100 cm/s and 300 cm/s. 2 Doȱtheȱfollowingȱforȱeachȱmeasurement:
c. Specified on the cardiac patient report. See “To delete a
vascular or cardiac measurement” on page 69. a Fromȱtheȱcalculationsȱmenu,ȱselectȱtheȱ
desiredȱviewȱandȱphase.
b Positionȱtheȱcaliperȱatȱtheȱmitralȱannulus,ȱ
andȱpressȱtheȱSELECTȱkeyȱtoȱstartȱtheȱtrace.

Chapter 4: Measurements and Calculations 53

 c Usingȱtheȱtouchpad,ȱtraceȱtheȱleftȱ 5 Positioningȱtheȱcalipers,ȱmeasureȱtheȱ
ventricularȱ(LV)ȱcavity. ventricularȱlength.ȱ(Seeȱ““Workingȱwithȱ
calipers””ȱonȱpage 41.)
Toȱmakeȱaȱcorrection,ȱselectȱUndoȱonȬscreenȱ
orȱpressȱtheȱBACKSPACEȱkey. 6 Saveȱtheȱcalculation.
d Completeȱtheȱtrace,ȱandȱpressȱtheȱSETȱkey.ȱ To measure peak velocity
e Saveȱtheȱcalculation.ȱ(Seeȱ““Toȱsaveȱaȱ Forȱeachȱcardiacȱmeasurement,ȱtheȱsystemȱsavesȱ
calculation””ȱonȱpage 45.) upȱtoȱfiveȱindividualȱmeasurementsȱandȱ
calculatesȱtheirȱaverage.ȱIfȱyouȱtakeȱmoreȱthanȱ
To calculate MV or AV area fiveȱmeasurements,ȱtheȱmostȱrecentȱmeasurementȱ
1 Onȱaȱfrozenȱ2Dȱimage,ȱpressȱtheȱCALCSȱkey. replacesȱtheȱfifthȱone.ȱIfȱyouȱdeleteȱaȱsavedȱ
measurementȱfromȱtheȱpatientȱreport,ȱtheȱnextȱ
2 Inȱtheȱcalculationsȱmenu,ȱlocateȱArea,ȱandȱ
measurementȱtakenȱreplacesȱtheȱdeletedȱoneȱinȱ
thenȱselectȱMVȱorȱAV.
theȱpatientȱreport.ȱTheȱmostȱrecentlyȱsavedȱ
3 Positionȱtheȱcaliperȱwhereȱyouȱwantȱtoȱbeginȱ measurementȱappearsȱatȱtheȱbottomȱofȱtheȱ
theȱtrace,ȱandȱpressȱtheȱSELECTȱkey. calculationsȱmenu.ȱ
4 Usingȱtheȱtouchpad,ȱtraceȱtheȱdesiredȱarea.ȱ 1 OnȱaȱfrozenȱDopplerȱspectralȱtrace,ȱpressȱtheȱ
CALCSȱkey.ȱ
Toȱmakeȱaȱcorrection,ȱselectȱUndoȱonȬscreenȱorȱ
pressȱtheȱBACKSPACEȱkey. 2 Fromȱtheȱcalculationsȱmenu,ȱselectȱMV,ȱTV,ȱorȱ
TDI,ȱorȱP. Vein.
5 Completeȱtheȱtrace,ȱandȱpressȱtheȱSETȱkey.
3 Doȱtheȱfollowingȱforȱeachȱmeasurementȱyouȱ
6 Saveȱtheȱcalculation.ȱ(Seeȱ““Toȱsaveȱaȱ
wantȱtoȱtake:
calculation””ȱonȱpage 45.)
a Selectȱtheȱmeasurementȱnameȱfromȱtheȱ
To calculate LV Mass calculationsȱmenu.ȱ
1 Onȱaȱfrozenȱ2Dȱimage,ȱpressȱtheȱCALCSȱkey.ȱ
b Positionȱtheȱcalipers.ȱ(Seeȱ““Workingȱwithȱ
2 Inȱtheȱcalculationsȱmenu,ȱlocateȱLV Mass. calipers””ȱonȱpage 41.)
3 DoȱtheȱfollowingȱforȱEPIȱandȱthenȱforȱEndo: c Saveȱtheȱcalculation.ȱ(Seeȱ““Toȱsaveȱaȱ
calculation””ȱonȱpage 45.)
a Selectȱtheȱmeasurementȱnameȱfromȱtheȱ
calculationsȱmenu. To calculate Velocity Time Integral (VTI)
b Positionȱtheȱcaliperȱwhereȱyouȱwantȱtoȱ Note: Thisȱcalculationȱcomputesȱotherȱresultsȱinȱ
beginȱtheȱtrace,ȱandȱpressȱtheȱSELECTȱkey. additionȱtoȱVTI.ȱSeeȱtheȱtableȱ““CardiacȱCalculations””ȱ
onȱpage 50.
c Usingȱtheȱtouchpad,ȱtraceȱtheȱdesiredȱarea.
1 OnȱaȱfrozenȱDopplerȱspectralȱtrace,ȱpressȱtheȱ
Toȱmakeȱaȱcorrection,ȱselectȱUndoȱ CALCSȱkey.
onȬscreenȱorȱpressȱtheȱBACKSPACEȱkey.
2 Fromȱtheȱcalculationsȱmenu,ȱselectȱVTI underȱ
d Completeȱtheȱtrace,ȱandȱpressȱtheȱSETȱkey. MV,ȱAV,ȱTV,ȱPV,ȱorȱLVOT.
e Saveȱtheȱcalculation.ȱ(Seeȱ““Toȱsaveȱaȱ 3 Positionȱtheȱcaliperȱatȱtheȱstartȱofȱtheȱ
calculation””ȱonȱpage 45.). waveform,ȱandȱpressȱtheȱSELECTȱkeyȱtoȱstartȱ
4 SelectȱApical fromȱtheȱcalculationsȱmenu. theȱtrace.

54 Exam-based calculations
4 Usingȱtheȱtouchpad,ȱtraceȱtheȱwaveform. •• InȱAV,ȱpositionȱtheȱcaliperȱatȱtheȱendȱ
diastole.
Toȱmakeȱaȱcorrection,ȱselectȱUndoȱonȬscreen,ȱ
backtrackȱwithȱtheȱtouchpad,ȱorȱpressȱtheȱ 5 Saveȱtheȱcalculation.ȱ(Seeȱ““Toȱsaveȱaȱ
BACKSPACEȱkey. calculation””ȱonȱpage 45.)
5 PressȱtheȱSETȱkeyȱtoȱcompleteȱtheȱtrace. To calculate Proximal Isovelocity Surface
6 Saveȱtheȱcalculation.ȱ(Seeȱ““Toȱsaveȱaȱ Area (PISA)
calculation””ȱonȱpage 45.) TheȱPISAȱcalculationȱrequiresȱaȱmeasurementȱinȱ
Forȱinformationȱonȱtheȱautomaticȱtraceȱtool,ȱseeȱ 2D,ȱaȱmeasurementȱinȱColor,ȱandȱtwoȱ
““Toȱtraceȱautomaticallyȱ(Doppler)””ȱonȱpage 44. measurementsȱinȱDopplerȱspectralȱtrace.ȱAfterȱallȱ
measurementsȱareȱsaved,ȱtheȱresultȱappearsȱinȱ
To calculate Right Ventricular Systolic theȱpatientȱreport.
Pressure (RVSP) 1 MeasureȱfromȱAnnȱDȱ(2D):
1 OnȱaȱfrozenȱDopplerȱspectralȱtrace,ȱpressȱtheȱ
a Onȱaȱfrozenȱ2Dȱimage,ȱpressȱtheȱCALCSȱkey.ȱ
CALCSȱkey.
b Fromȱtheȱcalculationsȱmenu,ȱlocateȱPISA,ȱ
2 Fromȱtheȱcalculationsȱmenu,ȱselectȱTVȱandȱ
andȱthenȱselectȱAnn D.
thenȱselectȱTRmax.
c Positionȱtheȱcalipers.ȱ(Seeȱ““Workingȱwithȱ
3 Positionȱtheȱcaliper.ȱ(Seeȱ““Workingȱwithȱ
calipers””ȱonȱpage 41.)
calipers””ȱonȱpage 41.)
d Saveȱtheȱcalculation.ȱ(Seeȱ““Toȱsaveȱaȱ
4 Saveȱtheȱcalculation.ȱ(Seeȱ““Toȱsaveȱaȱ
calculation””ȱonȱpage 45.)
calculation””ȱonȱpage 45.)
2 MeasureȱfromȱRadiusȱ(Color):
5 ToȱadjustȱtheȱRAȱpressure,ȱseeȱ““Toȱdeleteȱaȱ
vascularȱorȱcardiacȱmeasurement””ȱonȱpage 69. a OnȱaȱfrozenȱColorȱimage,ȱpressȱtheȱCALCSȱ
key.ȱ
ChangingȱtheȱRAȱpressureȱfromȱtheȱdefaultȱ5ȱ
affectsȱtheȱRVSPȱcalculationȱinȱtheȱpatientȱ b Fromȱtheȱcalculationsȱmenu,ȱselectȱRadius.
report.
c Positionȱtheȱcalipers.
To calculate Pressure Half Time (PHT) in MV, d Saveȱtheȱcalculation.ȱ
AI, or TV
3 OnȱaȱfrozenȱDopplerȱspectralȱtrace,ȱpressȱtheȱ
1 OnȱaȱfrozenȱDopplerȱspectralȱtrace,ȱpressȱtheȱ CALCSȱkey.
CALCSȱkey.

Measurements
4 DoȱtheȱfollowingȱtoȱmeasureȱfromȱMRȱVTIȱ
2 Fromȱtheȱcalculationsȱmenu,ȱselectȱMV, AV,ȱorȱ andȱagainȱtoȱmeasureȱfromȱMVȱVTIȱ(Doppler):
TV,ȱandȱthenȱselectȱPHT.
a Fromȱtheȱcalculationsȱmenu,ȱselectȱPISAȱ
3 Positionȱtheȱfirstȱcaliperȱatȱtheȱpeak,ȱandȱpressȱ andȱthenȱselectȱMR VTI orȱMV VTI.
theȱSELECTȱkey.
b Positionȱtheȱcaliperȱatȱtheȱstartȱofȱtheȱ
Aȱsecondȱcaliperȱappears. waveform,ȱandȱpressȱtheȱSELECTȱkeyȱtoȱ
4 Positionȱtheȱsecondȱcaliper: startȱtheȱtrace.

•• InȱMV,ȱpositionȱtheȱcaliperȱalongȱtheȱEFȱ c Usingȱtheȱtouchpad,ȱtraceȱtheȱwaveform.
slope.

Chapter 4: Measurements and Calculations 55

 Toȱmakeȱaȱcorrection,ȱselectȱUndoȱ 4 PressȱtheȱSELECTȱkey.
onȬscreen,ȱbacktrackȱwithȱtheȱtouchpad,ȱorȱ
Aȱsecondȱhorizontalȱdottedȱlineȱwithȱanȱactiveȱ
pressȱtheȱBACKSPACEȱkey.
caliperȱappearsȱatȱ300ȱcm/s.
d PressȱtheȱSETȱkeyȱtoȱcompleteȱtheȱtrace.
5 Positionȱtheȱsecondȱcaliperȱalongȱtheȱ
e Saveȱtheȱcalculation. waveformȱatȱ300ȱcm/s.
Forȱinformationȱonȱtheȱautomaticȱtraceȱtool,ȱseeȱ 6 Saveȱtheȱcalculation.ȱ(Seeȱ““Toȱsaveȱaȱ
““Toȱtraceȱautomaticallyȱ(Doppler)””ȱonȱpage 44.ȱ calculation””ȱonȱpage 45.)

To calculate Isovolumic Relaxation Time To calculate Aortic Valve Area (AVA)

(IVRT) TheȱAVAȱcalculationȱrequiresȱaȱmeasurementȱinȱ
1 OnȱaȱfrozenȱDopplerȱspectralȱtrace,ȱpressȱtheȱ 2DȱandȱtwoȱmeasurementsȱinȱDoppler.ȱAfterȱtheȱ
CALCSȱkey. measurementsȱareȱsaved,ȱtheȱresultȱappearsȱinȱ
theȱpatientȱreport.
2 Fromȱtheȱcalculationsȱmenu,ȱselectȱMVȱandȱ
thenȱselectȱIVRT. 1 MeasureȱfromȱLVOTȱ(2D):
Aȱverticalȱcaliperȱappears. a Onȱaȱfrozenȱ2Dȱimage,ȱpressȱtheȱCALCSȱkey.ȱ
3 Usingȱtheȱtouchpad,ȱpositionȱtheȱcaliperȱatȱtheȱ b Fromȱtheȱcalculationsȱmenu,ȱselectȱLVOT D.
aorticȱvalveȱclosure.
c Positionȱtheȱcalipers.ȱ(Seeȱ““Workingȱwithȱ
4 PressȱtheȱSELECTȱkey. calipers””ȱonȱpage 41.)
Aȱsecondȱverticalȱcaliperȱappears. d Saveȱtheȱcalculation.ȱ(Seeȱ““Toȱsaveȱaȱ
calculation””ȱonȱpage 45.)
5 Usingȱtheȱtouchpad,ȱpositionȱtheȱsecondȱ
caliperȱatȱonsetȱofȱmitralȱinflow. 2 MeasureȱfromȱLVOT,ȱandȱthenȱmeasureȱfromȱ
AVȱ(Doppler):
6 Saveȱtheȱcalculation.ȱ(Seeȱ““Toȱsaveȱaȱ
calculation””ȱonȱpage 45.) •• ForȱVmax,ȱseeȱ““Toȱmeasureȱpeakȱvelocity””ȱ
onȱpage 54.ȱFromȱtheȱcalculationsȱmenu,ȱ
To calculate Delta Pressure: Delta Time selectȱAV,ȱselectȱsampleȱsite,ȱandȱthenȱ
(dP:dT) selectȱVmax.
ToȱperformȱtheȱdP:dTȱmeasurements,ȱtheȱCWȱ •• ForȱVTI,ȱseeȱ““ToȱcalculateȱVelocityȱTimeȱ
Dopplerȱscaleȱmustȱincludeȱvelocitiesȱofȱ300 cm/sȱ Integralȱ(VTI)””ȱonȱpage 54.ȱFromȱtheȱ
orȱgreaterȱonȱtheȱnegativeȱsideȱofȱtheȱbaseline.ȱ calculationsȱmenu,ȱselectȱAV,ȱselectȱsampleȱ
(Seeȱ““Spectralȱtraceȱoptions””ȱonȱpage 29.) site,ȱandȱthenȱselectȱVTI.
1 OnȱaȱfrozenȱCWȱDopplerȱspectralȱtrace,ȱpressȱ
theȱCALCSȱkey.ȱ
To calculate Qp/Qs
TheȱQp/Qsȱcalculationȱrequiresȱtwoȱ
2 Fromȱtheȱcalculationsȱmenu,ȱselectȱMV,ȱandȱ measurementsȱinȱ2Dȱandȱtwoȱmeasurementsȱinȱ
thenȱselectȱdP:dT. Doppler.ȱAfterȱtheȱmeasurementsȱareȱsaved,ȱtheȱ
Aȱhorizontalȱdottedȱlineȱwithȱanȱactiveȱcaliperȱ resultȱappearsȱinȱtheȱpatientȱreport.
appearsȱatȱ100ȱcm/s. 1 Onȱaȱfrozenȱ2Dȱimage,ȱpressȱtheȱCALCSȱkey.
3 Positionȱtheȱfirstȱcaliperȱalongȱtheȱwaveformȱ 2 DoȱtheȱfollowingȱtoȱmeasureȱfromȱLVOTȱDȱ
atȱ100ȱcm/s. andȱagainȱtoȱmeasureȱfromȱRVOT D:

56 Exam-based calculations
 a Fromȱtheȱcalculationsȱmenu,ȱlocateȱQp/Qsȱ c Positionȱtheȱcalipers.ȱ(Seeȱ““Workingȱwithȱ
andȱthenȱselectȱLVOT D or RVOT D. calipers””ȱonȱpage 41.)
b Positionȱtheȱcalipers.ȱ(Seeȱ““Workingȱwithȱ d Saveȱtheȱcalculation.ȱ(Seeȱ““Toȱsaveȱaȱ
calipers””ȱonȱpage 41.) calculation””ȱonȱpage 45.)
c Saveȱtheȱcalculation.ȱ(Seeȱ““Toȱsaveȱaȱ 3 Measureȱfromȱaortaȱ(Doppler).ȱSeeȱ““Toȱ
calculation””ȱonȱpage 45.) calculateȱVelocityȱTimeȱIntegralȱ(VTI)””ȱonȱ
page 54.ȱFromȱtheȱcalculationsȱmenu,ȱselectȱ
3 OnȱaȱfrozenȱDopplerȱspectralȱtrace,ȱpressȱtheȱ
AVȱandȱthenȱselectȱVTI.
CALCSȱkey.
Forȱinformationȱonȱtheȱautomaticȱtraceȱtool,ȱseeȱ
4 DoȱtheȱfollowingȱtoȱmeasureȱfromȱLVOTȱVTIȱ
““Toȱtraceȱautomaticallyȱ(Doppler)””ȱonȱpage 44.ȱ
andȱagainȱtoȱmeasureȱfromȱRVOTȱVTI:
a Fromȱtheȱcalculationsȱmenu,ȱselectȱQp/Qsȱ To calculate Heart Rate (HR)
andȱthenȱselectȱLVOT VTI or RVOT VTI. HeartȱRateȱisȱavailableȱinȱallȱcardiacȱpackages.ȱ
b PressȱtheȱSELECTȱkeyȱtoȱstartȱtheȱtrace. TheȱHeartȱRateȱisȱnotȱcalculatedȱusingȱtheȱECGȱ
trace.
c Usingȱtheȱtouchpad,ȱtraceȱtheȱwaveform.
Savingȱtheȱheartȱrateȱtoȱtheȱpatientȱreportȱ
Toȱmakeȱaȱcorrection,ȱselectȱUndoȱ overwritesȱanyȱheartȱrateȱenteredȱonȱtheȱpatientȱ
onȬscreen,ȱbacktrackȱwithȱtheȱtouchpad,ȱorȱ informationȱform.
pressȱtheȱBACKSPACEȱkey.
1 OnȱaȱfrozenȱDopplerȱspectralȱtrace,ȱpressȱtheȱ
d PressȱtheȱSETȱkeyȱtoȱcompleteȱtheȱtrace. CALCSȱkey.

e Saveȱtheȱcalculation.ȱ(Seeȱ““Toȱsaveȱaȱ 2 Fromȱtheȱcalculationsȱmenu,ȱselectȱHR.
calculation””ȱonȱpage 45.)
Aȱverticalȱcaliperȱappears.
Forȱinformationȱonȱtheȱautomaticȱtraceȱtool,ȱseeȱ
““Toȱtraceȱautomaticallyȱ(Doppler)””ȱonȱpage 44. 3 Usingȱtheȱtouchpad,ȱpositionȱtheȱfirstȱverticalȱ
caliperȱatȱtheȱpeakȱofȱtheȱheartbeat.ȱ
To calculate Stroke Volume (SV) or Stroke 4 PressȱtheȱSELECTȱkey.
Index (SI)
Aȱsecondȱverticalȱcaliperȱappears.ȱTheȱactiveȱ
TheȱSVȱandȱSIȱcalculationsȱrequireȱaȱ
caliperȱisȱhighlightedȱgreen.
measurementȱinȱ2Dȱandȱaȱmeasurementȱinȱ
Doppler.ȱSIȱalsoȱrequiresȱBodyȱSurfaceȱAreaȱ 5 Usingȱtheȱtouchpad,ȱpositionȱtheȱsecondȱ
(BSA).ȱAfterȱtheȱmeasurementsȱareȱsaved,ȱtheȱ verticalȱcaliperȱatȱtheȱpeakȱofȱtheȱnextȱ

Measurements
resultȱappearsȱinȱtheȱpatientȱreport. heartbeat.
1 (SIȱOnly)ȱFillȱinȱtheȱHeightȱandȱWeightȱfieldsȱ 6 Saveȱtheȱcalculation.ȱ(Seeȱ““Toȱsaveȱaȱ
onȱtheȱpatientȱinformationȱform.ȱTheȱBSAȱisȱ calculation””ȱonȱpage 45.)
calculatedȱautomatically.ȱ(Seeȱ““Toȱcreateȱaȱ
newȱpatientȱinformationȱform””ȱonȱpage 34.) To calculate Cardiac Output (CO) or Cardiac
Index (CI)
2 MeasureȱfromȱLVOTȱ(2D):
TheȱCOȱandȱCIȱcalculationsȱrequireȱStrokeȱ
a Onȱaȱfrozenȱ2Dȱimage,ȱpressȱtheȱCALCSȱkey.ȱ VolumeȱandȱHeartȱRateȱcalculations.ȱCIȱalsoȱ
requiresȱBodyȱSurfaceȱAreaȱ(BSA).ȱAfterȱtheȱ
b Fromȱtheȱcalculationsȱmenu,ȱselectȱLVOT D.
measurementsȱareȱsaved,ȱtheȱresultȱappearsȱinȱ
theȱpatientȱreport.

Chapter 4: Measurements and Calculations 57

1 (CIȱOnly)ȱFillȱinȱtheȱHeightȱandȱWeightȱfieldsȱ
onȱtheȱpatientȱinformationȱform.ȱTheȱBSAȱisȱ
WARNING: To avoid incorrect calculations,
calculatedȱautomatically.ȱ(Seeȱ““Toȱcreateȱaȱ
verify that the patient information,
newȱpatientȱinformationȱform””ȱonȱpage 34.)
date, and time settings are
2 CalculateȱSV.ȱSeeȱ““ToȱcalculateȱStrokeȱVolumeȱ accurate.
(SV)ȱorȱStrokeȱIndexȱ(SI)””ȱonȱpage 57.
To avoid misdiagnosis or harming
3 CalculateȱHR.ȱSeeȱ““ToȱcalculateȱHeartȱRateȱ the patient outcome, start a new
(HR)””ȱonȱpage 57. patient information form before
starting a new patient exam and
To measure a Tissue Doppler Imaging (TDI) performing calculations. Starting a
waveform new patient information form
1 EnsureȱthatȱTDIȱisȱon.ȱ(Seeȱ““PWȱDopplerȱ clears the previous patient’s data.
options””ȱonȱpage 29.) The previous patient’s data will be
combined with the current patient
2 OnȱaȱfrozenȱDopplerȱspectralȱtrace,ȱpressȱtheȱ if the form is not first cleared. See
CALCSȱkey.
“To create a new patient
3 Fromȱtheȱcalculationsȱmenu,ȱselectȱTDI,ȱandȱ information form” on page 34.
thenȱdoȱtheȱfollowingȱforȱeachȱmeasurementȱ
youȱwantȱtoȱtake:
a Fromȱtheȱcalculationsȱmenu,ȱselectȱtheȱ
Transducer Exam Type
measurementȱname.
b Positionȱtheȱcalipers.ȱ(Seeȱ““Workingȱwithȱ C60x Gyn
calipers””ȱonȱpage 41.)
ICTx Gyn
c Saveȱtheȱcalculation.ȱ(Seeȱ““Toȱsaveȱaȱ
calculation””ȱonȱpage 45.) To measure uterus or ovary
1 Onȱaȱfrozenȱ2Dȱimage,ȱpressȱtheȱCALCSȱkey.ȱ
Gynecology (Gyn) calculations 2 Fromȱtheȱcalculationsȱmenu,ȱselectȱGyn.ȱ
Gynecologyȱ(Gyn)ȱcalculationsȱincludeȱUterus,ȱ
Ovary,ȱFollicle,ȱandȱVolume.ȱForȱinstructionsȱtoȱ 3 Doȱtheȱfollowingȱforȱeachȱmeasurementȱyouȱ
calculateȱvolume,ȱseeȱ““Volumeȱcalculations””ȱonȱ wantȱtoȱtake:
page 48. a Selectȱtheȱmeasurementȱnameȱfromȱtheȱ
calculationsȱmenu.
b Positionȱtheȱcalipers.ȱ(Seeȱ““Workingȱwithȱ
calipers””ȱonȱpage 41.)
c Saveȱtheȱcalculation.ȱ(Seeȱ““Toȱsaveȱaȱ
calculation””ȱonȱpage 45.)

58 Exam-based calculations
To measure follicles To avoid incorrect calculations,
Youȱcanȱsaveȱupȱtoȱsixȱfollicularȱmeasurements,ȱ verify that the patient information,
oneȱdistanceȱmeasurementȱforȱeachȱofȱupȱtoȱsixȱ date, and time settings are
follicles. accurate.
1 Onȱaȱfrozenȱ2Dȱimage,ȱpressȱtheȱCALCSȱkey. To avoid misdiagnosis or harming
the patient outcome, start a new
2 Fromȱtheȱcalculationsȱmenu,ȱselectȱFollicle.
patient information form before
3 Doȱtheȱfollowingȱforȱeachȱfollicleȱyouȱwantȱtoȱ starting a new patient exam and
measure: performing calculations. Starting a
new patient information form
a Fromȱtheȱcalculationsȱmenu,ȱselectȱtheȱ
clears the previous patient’s data.
measurementȱnameȱunderȱRight FolȱorȱLeft
The previous patient’s data will be
Fol.
combined with the current patient
b Positionȱtheȱcalipers.ȱ(Seeȱ““Workingȱwithȱ if the form is not first cleared. See
calipers””ȱonȱpage 41.) “To create a new patient
information form” on page 34.
c Saveȱtheȱcalculation.ȱ(Seeȱ““Toȱsaveȱaȱ
calculation””ȱonȱpage 45.)

IMT calculations Transducer Exam Type

WARNING: To ensure high quality images, all L38x IMT
patient images must be obtained
by qualified and trained individuals. HFL38x IMT

To avoid patient injury, IMT results Theȱfollowingȱtableȱshowsȱavailableȱ

should not be used as a sole measurementsȱforȱIMTȱcalculations.ȱTheȱIMTȱ
diagnostic tool. All IMT results measurementȱnamesȱareȱspecifiedȱonȱtheȱIMTȱ
should be interpreted in setupȱpage.ȱSeeȱ““IMTȱCalculationsȱsetup””ȱonȱ
conjunction with other clinical page 20.
information or risk factors.
To avoid measurement errors, all
measurements must be of the
common carotid artery (CCA). This

Measurements
tool is not intended for measuring
the bulb or the internal carotid
artery (ICA).

Chapter 4: Measurements and Calculations 59

 IMT tool options
IMT Calculations (2D) WhenȱusingȱtheȱIMTȱtool,ȱyouȱcanȱselectȱtheȱ
followingȱoptionsȱonȬscreen.
Menu Heading Available Measurements

Right-IMT Ant N (Anterior Near Wall) Option Description

Left-IMT Ant F (Anterior Far Wall) Hide Use to check results. Hides the
Lat N (Lateral Near Wall) measurement results and trace
Lat F (Lateral Far Wall) line. Select Show to redisplay
Post N (Posterior Near Wall) them.
Post F (Posterior Far Wall) Move Repositions the tool horizontally
IMT 1 by several pixels. The upper key
IMT 2 moves the tool right, and the
IMT 3 lower key moves the tool left.
IMT 4 Width Adjusts the tool width by 1 mm.
IMT 5 The upper key increases the
IMT 6 width, and the lower key
IMT 7 decreases the width.
IMT 8 Edit Displays Smooth, Adven, and
Lumen.
Plaque Plaq 1
Plaq 2 Smooth Adjusts the IMT line smoothing.
Select Edit to display this option.
To calculate IMT automatically
Adven Adjusts the adventitia-media
1 Onȱaȱfrozenȱ2Dȱimage,ȱpressȱtheȱCALCSȱkey.
line. The upper key moves the
2 Fromȱtheȱcalculationsȱmenu,ȱselectȱtheȱ line upward. The lower key
measurement. moves the line downward.
3 Usingȱtheȱtouchpadȱorȱarrowȱkeys,ȱpositionȱ Select Edit to display this option.
theȱIMTȱtoolȱoverȱtheȱareaȱofȱinterestȱuntilȱtheȱ Lumen Adjusts the lumen-intima line.
measurementȱresultsȱappear. The upper key moves the line
4 Adjustȱtheȱtool,ȱandȱeditȱasȱneeded.ȱSeeȱ““IMTȱ upward. The lower key moves the
toolȱoptions””ȱonȱpage 60. line downward.
Each of the two IMT lines can be
5 Saveȱtheȱcalculation.ȱ(Seeȱ““Toȱsaveȱaȱ
adjusted independently.
calculation””ȱonȱpage 45.)
Select Edit to display this option.

60 Exam-based calculations
To trace IMT manually a Positionȱtheȱcaliperȱatȱtheȱbeginningȱofȱtheȱ
InȱmanuallyȱtracingȱIMT,ȱtheȱuserȱdefinesȱtheȱ boundaryȱandȱpressȱtheȱSELECTȱkey.
location. b Usingȱtheȱtouchpad,ȱmarkȱpointsȱbyȱ
1 Onȱaȱfrozenȱ2Dȱimage,ȱpressȱtheȱCALCSȱkey movingȱtheȱcaliperȱtoȱtheȱnextȱdesiredȱ
pointȱandȱpressingȱtheȱSELECTȱkey.
2 Fromȱtheȱcalculationsȱmenu,ȱselectȱaȱ
measurementȱname. Toȱmakeȱaȱcorrection,ȱselectȱUndoȱ
onȬscreenȱorȱpressȱtheȱBACKSPACEȱkeyȱtoȱ
3 SelectȱEditȱonȬscreen,ȱandȱthenȱselectȱManual,ȱ deleteȱtheȱlastȱsegment.
andȱthenȱselectȱSketch.
c PressȱtheȱSETȱkeyȱtoȱcompleteȱtheȱtraceȱline.
Aȱsingleȱcaliperȱappears,ȱandȱTraceȱappearsȱ
nextȱtoȱtheȱmeasurement. d Ifȱnecessary,ȱadjustȱorȱeditȱtheȱ
measurement.ȱSeeȱ““IMTȱtoolȱoptions””ȱonȱ
4 Doȱtheȱfollowingȱforȱtheȱdesiredȱ page 60.
adventitiaȬmediaȱboundaryȱandȱthenȱforȱtheȱ
lumenȬintimaȱboundary: e Saveȱtheȱcalculation.ȱ(Seeȱ““Toȱsaveȱaȱ
calculation””ȱonȱpage 45.)
a Positionȱtheȱcaliperȱatȱtheȱbeginningȱofȱtheȱ
boundary,ȱandȱpressȱtheȱSELECTȱkey.
OB calculations
b Usingȱtheȱtouchpad,ȱmarkȱpointsȱbyȱ EFWȱisȱcalculatedȱonlyȱafterȱappropriateȱ
movingȱtheȱcaliperȱtoȱtheȱnextȱdesiredȱ measurementsȱareȱcompleted.ȱIfȱanyȱoneȱofȱtheseȱ
pointȱandȱpressingȱtheȱSELECTȱkey. parametersȱresultsȱinȱanȱEDDȱgreaterȱthanȱwhatȱ
Toȱmakeȱaȱcorrection,ȱselectȱUndoȱ theȱOBȱcalculationȱtablesȱprovide,ȱtheȱEFWȱisȱnotȱ
onȬscreenȱorȱpressȱtheȱBACKSPACEȱkeyȱtoȱ displayed.
deleteȱtheȱlastȱsegment.
WARNING: Make sure that you have selected
c PressȱtheȱSETȱkeyȱtoȱcompleteȱtheȱtraceȱline. the OB exam type and the OB
author for the OB calculation table
5 Saveȱtheȱcalculation.ȱ(Seeȱ““Toȱsaveȱaȱ
you intend to use. See “Results from
calculation””ȱonȱpage 45.)
System-Defined OB Measurements
To sketch IMT and Table Authors” on page 62.
TheȱIMTȱsketchȱmeasurementȱinvolvesȱtwoȱ To avoid incorrect obstetrics
userȬdefinedȱsketchȱlinesȱthatȱyouȱcanȱadjustȱ calculations, verify with a local
manually. clock and calendar that the system’s
date and time settings are correct

Measurements
1 Onȱaȱfrozenȱ2Dȱimage,ȱpressȱtheȱCALCSȱkey
before each use of the system. The
2 Fromȱtheȱcalculationsȱmenu,ȱselectȱaȱ system does not automatically
measurementȱname. adjust for daylight savings time
changes.
3 SelectȱEditȱonȬscreen,ȱandȱthenȱselectȱManual.
AȱsingleȱcaliperȱappearsȱonȬscreen,ȱandȱSketchȱ
appearsȱnextȱtoȱtheȱmeasurement.
4 Doȱtheȱfollowingȱforȱtheȱdesiredȱ
adventitiaȬmediaȱboundaryȱandȱthenȱforȱtheȱ
lumenȬintimaȱboundary:

Chapter 4: Measurements and Calculations 61

 To avoid misdiagnosis or harming Results from System-Defined OB Measurements
the patient outcome, start a new and Table Authors
patient information form before
starting a new patient exam and Calculation Gestational OB Table
performing calculations. Starting a Result Measurements Authors
new patient information form
Gestational YS —
clears the previous patient’s data. Agea
The previous patient’s data will be GS Hansmann,
combined with the current patient Nyberg,
if the form is not first cleared. See Tokyo U.
“To create a new patient CRL Hadlock,
information form” on page 34. Hansmann,
Osaka,
Prior to use, verify that OB custom Tokyo U.
table data entries are correct. The
system does not confirm the BPD Chitty,
Hadlock,
accuracy of the custom table data Hansmann,
entered by the user. Osaka,
Tokyo U.

Transducer Exam Type OFD Hansmann

HC Chitty,
C60x OB Hadlock,
Hansmann
ICTx OB
TTD Hansmann,
P21x OB Tokyo U.b

Ifȱyouȱchangeȱtheȱcalculationȱauthorȱduringȱtheȱ APTD Tokyo U.b

exam,ȱtheȱcommonȱmeasurementsȱareȱretained. AC Hadlock,
Hansmann,
TheȱfollowingȱtableȱshowsȱtheȱsystemȬdefinedȱ
Tokyo U.
measurementsȱavailableȱforȱOBȱcalculationsȱbyȱ
author.ȱForȱdefinitionȱofȱtheȱacronyms,ȱseeȱ FTA Osaka
““Glossary””ȱonȱpage 157.ȱToȱselectȱauthors,ȱseeȱ
FL Chitty,
““OBȱCalculationsȱsetup””ȱonȱpage 20. Hadlock,
Hansmann,
Seeȱalsoȱ““OBȱCustomȱMeasurementsȱsetup””ȱonȱ
Osaka,
page 21ȱandȱ““OBȱCustomȱTablesȱsetup””ȱonȱ Tokyo U.
page 22.
CX L —

62 Exam-based calculations
 page, determines the measurements you must perform to
Calculation Gestational OB Table obtain an EFW calculation. (See “OB Calculations setup” on
Result Measurements Authors page 20.)
Individual selections for Hadlock’s EFW equations 1, 2, and 3
Estimated Fetal HC, AC, FL Hadlock 1 are not determined by the user. The selected equation is
Weight (EFW)c determined by the measurements that have been saved to
BPD, AC, FL Hadlock 2 the patient report with priority given to the order listed
above.
AC, FL Hadlock 3 d. The Growth Analysis tables are used by the Report Graphs
feature. Three growth curves are drawn using the table data
BPD, TTD Hansmann
for the selected growth parameter and published author.
BPD, FTA, FL Osaka U. Growth tables are only available with a user-entered LMP or
Estab. DD.
BPD, AC Shepard
To measure gestational growth (2D)
BPD, TTD, APTD, FL Tokyo U.
Forȱeachȱ2DȱOBȱmeasurementȱ(exceptȱAFI),ȱtheȱ
Ratios HC/AC Campbell systemȱsavesȱupȱtoȱthreeȱindividualȱ
FL/AC Hadlock
measurementsȱandȱtheirȱaverage.ȱIfȱyouȱtakeȱ
moreȱthanȱthreeȱmeasurements,ȱtheȱearliestȱ
FL/BPD Hohler measurementȱisȱdeleted.
FL/HC Hadlock 1 Inȱtheȱpatientȱinformationȱform,ȱselectȱOBȱ
Amniotic Fluid Q ,Q ,Q ,Q
1 2 3 4 Jeng
examȱtype,ȱandȱselectȱLMPȱorȱEstab.DD.ȱSelectȱ
Index Twinsȱifȱappropriate.

Growth Analysis BPD Chitty, 2 Onȱaȱfrozenȱ2Dȱimage,ȱpressȱtheȱCALCSȱkey.

Tablesd Hadlock,
Jeanty
3 Doȱtheȱfollowingȱforȱeachȱmeasurementȱyouȱ
wantȱtoȱtake:
HC Chitty,
Hadlock, a Fromȱtheȱcalculationsȱmenu,ȱselectȱtheȱ
Jeanty measurementȱname.ȱForȱtwins,ȱselectȱ
Twin AȱorȱTwin B,ȱandȱthenȱselectȱtheȱ
AC Chitty,
Hadlock,
measurementȱname.
Jeanty Theȱcaliperȱtoolȱmayȱchangeȱdependingȱonȱ
FL Chitty, theȱmeasurementȱselected,ȱbutȱtheȱpositionȱ
Hadlock, remainsȱconstant.
Jeanty
b Positionȱtheȱcalipers.ȱ(Seeȱ““Workingȱwithȱ

Measurements
EFW Hadlock, calipers””ȱonȱpage 41.)
Jeanty
c Saveȱtheȱcalculation.ȱ(Seeȱ““Toȱsaveȱaȱ
HC/AC Campbell calculation””ȱonȱpage 45.)
a. The Gestational Age is automatically calculated and displayed
next to the OB measurement you selected. The average of the
To measure fetal heart rate (M Mode)
results is the AUA. 1 OnȱaȱfrozenȱM Modeȱtrace,ȱpressȱtheȱCALCSȱ
b. For Tokyo U., APTD and TTD are used only to calculate EFW. No key.
age or growth tables are associated with these
measurements. 2 SelectȱFHRȱfromȱtheȱcalculationsȱmenu.
c. The Estimated Fetal Weight calculation uses an equation that
consists of one or more fetal biometry measurements. The Aȱverticalȱcaliperȱappears.
author for the OB tables, which you choose on a system setup

Chapter 4: Measurements and Calculations 63

3 Usingȱtheȱtouchpad,ȱpositionȱtheȱverticalȱ CerebralȱArtery)ȱorȱUmbAȱ(Umbilicalȱ
caliperȱatȱtheȱpeakȱofȱtheȱheartbeat.ȱ Artery).
4 PressȱtheȱSELECTȱkey. b Positionȱtheȱcalipers:
Aȱsecondȱverticalȱcaliperȱappears.ȱ •• ForȱS/D, RI,ȱpositionȱtheȱfirstȱcaliperȱatȱ
theȱpeakȱsystolicȱwaveform.ȱPressȱtheȱ
5 Usingȱtheȱtouchpad,ȱpositionȱtheȱsecondȱ
SELECTȱkey,ȱandȱpositionȱtheȱsecondȱ
verticalȱcaliperȱatȱtheȱpeakȱofȱtheȱnextȱ
caliperȱatȱtheȱendȱdiastoleȱonȱtheȱ
heartbeat.
waveform.
6 Saveȱtheȱcalculation.ȱ(Seeȱ““Toȱsaveȱaȱ
•• ForȱS/D, RI, PI,ȱpositionȱtheȱcaliperȱatȱ
calculation””ȱonȱpage 45.)
theȱbeginningȱofȱtheȱdesiredȱwaveform,ȱ
OB Doppler Calculations andȱpressȱtheȱSELECTȱkey.ȱUseȱtheȱ
touchpadȱtoȱmanuallyȱtraceȱtheȱdesiredȱ
Menu OB area.ȱPressȱtheȱSETȱkey.
Results
Heading Calculation Ifȱcalipersȱareȱnotȱpositionedȱcorrectly,ȱ
theȱcalculationȱresultȱisȱinaccurate.
MCA (Middle S/D, RI SD
Cerebral RI c Saveȱtheȱcalculation.ȱ(Seeȱ““Toȱsaveȱaȱ
Artery) calculation””ȱonȱpage 45.)ȱ
Onlyȱoneȱcalculationȱ(S/D, RIȱorȱS/D, RI, PI)ȱ
S/D, RI, PI* SD
canȱbeȱsaved.
RI
PI
Small Parts calculations
Umb A S/D, RI SD
SmallȱPartsȱcalculationsȱincludeȱvolume,ȱhipȱ
(Umbilical RI
angle,ȱandȱd:Dȱratio.ȱForȱinstructionsȱtoȱcalculateȱ
Artery)
volume,ȱseeȱ““Volumeȱcalculations””ȱonȱpage 48.ȱ
S/D, RI, PI* SD
RI Transducer Exam Type
PI
HFL38x Small Parts
*Calculation requires a trace measurement.
L38x Small Parts
To calculate MCA or Umba (Doppler)
Note: TheȱsystemȱdoesȱnotȱprovideȱanȱMCA/UmbAȱ To calculate hip angle
ratioȱfromȱtheȱPIȱ(PulsatilityȱIndex).ȱ 1 Onȱaȱfrozenȱ2Dȱimage,ȱpressȱtheȱCALCSȱkey.
1 Select OBȱexamȱtype,ȱandȱselectȱLMPȱorȱ 2 Fromȱtheȱcalculationsȱmenu,ȱselectȱRightȱorȱ
Estab.DDȱinȱtheȱpatientȱinformationȱform. Left.
2 OnȱaȱfrozenȱDopplerȱspectralȱtrace,ȱpressȱtheȱ 3 SelectȱBaselineȱunderȱHip Angle.
CALCSȱkey.
AȱbaselineȱappearsȱonȬscreen.
3 Doȱtheȱfollowingȱforȱeachȱmeasurementȱyouȱ
needȱtoȱtake: 4 Positionȱtheȱbaseline,ȱandȱpressȱtheȱSETȱkey.ȱ
(Seeȱ““Workingȱwithȱcalipers””ȱonȱpage 41.)
a Fromȱtheȱcalculationsȱmenu,ȱselectȱtheȱ
measurementȱnameȱunderȱMCAȱ(Middleȱ LineȱAȱ(alphaȱline)ȱappearsȱonȬscreen,ȱandȱ
Line Aȱisȱselectedȱinȱtheȱcalculationsȱmenu.

64 Exam-based calculations
5 PositionȱLineȱA,ȱandȱsaveȱtheȱmeasurement.ȱ Transcranial Doppler and Orbital
(Seeȱ““Toȱsaveȱaȱcalculation””ȱonȱpage 45.) calculations
LineȱBȱ(betaȱline)ȱappearsȱonȬscreen,ȱandȱLine
Bȱisȱselectedȱinȱtheȱcalculationsȱmenu. WARNING: To avoid injury to the patient, use
only an Orbital (Orb) exam type
6 PositionȱLineȱB,ȱandȱsaveȱtheȱmeasurement. when performing imaging through
the eye.
To calculate d:D ratio
Verify that the patient information,
1 Onȱaȱfrozenȱ2Dȱimage,ȱpressȱtheȱCALCSȱkey.
date, and time settings are
2 Fromȱtheȱcalculationsȱmenu,ȱselectȱRightȱorȱ accurate.
Left.
To avoid carrying over
3 Underȱd:D Ratio,ȱselectȱFem Hdȱ(femoralȱ measurements from the previous
head). patient, start a new patient
information form for each new
4 Usingȱtheȱtouchpad,ȱpositionȱandȱresizeȱtheȱ
patient before you perform
circle.ȱTheȱSELECTȱkeyȱtogglesȱbetweenȱ
calculations on the new patient.
positionȱandȱsize.
See “To create a new patient
5 PressȱtheȱSETȱkey.ȱ information form” on page 34.
Theȱbaselineȱautomaticallyȱappearsȱwithȱtheȱ
leftȱcaliperȱactive.
6 Positionȱtheȱcaliper.ȱ(Seeȱ““Workingȱwithȱ
Transducer Exam Types
calipers””ȱonȱpage 41.)
7 Saveȱtheȱmeasurement.ȱ(Seeȱ““Toȱsaveȱaȱ P21x Transcranial (TCD), Orbital
calculation””ȱonȱpage 45.) (Orb)

Theȱfollowingȱtableȱshowsȱtheȱmeasurementsȱ
requiredȱtoȱcompleteȱTranscranialȱDopplerȱ(TCD)ȱ
andȱOrbitalȱ(Orb)ȱcalculations.ȱForȱdefinitionsȱofȱ
acronyms,ȱseeȱ““Glossary””ȱonȱpage 157.

Measurements

Chapter 4: Measurements and Calculations 65

 Transcranial and Orbital Calculations
Transcranial and Orbital Calculations
TCD and Orb
Menu Heading Results
TCD and Orb Measurements
Menu Heading Results
Measurements
FM VA TAP
TT TAP PSV
FM
MCA Dist PSV EDV
BA Prox
Mid EDV PI
Mid
Prox PI RI
Dist
RI S/D
Bifur* S/D Gate Size
ACA Gate Size
AL ECVA TAP
ACoA*
PSV
TICA
EDV
PI
TT PCAp1
RI
PCAp2
S/D
PCoA
Gate Size
TO OA TAP *Available but not required
Siphon PSV
EDV
PI WARNING: To avoid injury to the patient, use
RI only an Orbital (Orb) or
S/D Ophthalmic (Oph) when
Gate Size performing imaging through the
eye. The FDA has established
SM ECICA TAP lower acoustic energy limits for
PSV opthalmic use. The system will not
EDV exceed these limits only if the
Orbital or Ophthalmic exam type
PI
is selected.
RI
S/D
To perform a Transcranial Doppler or Orbital
Gate Size calculation
1 Selectȱtheȱcorrectȱexamȱtype:
•• Orbital (Orb)ȱtoȱmeasureȱOpthalmicȱArteryȱ
andȱSiphon
•• Transcranial (TCD)ȱforȱotherȱmeasurements
Seeȱ““Toȱchangeȱtheȱexamȱtype””ȱonȱpage 31.

66 Exam-based calculations
2 OnȱaȱfrozenȱDopplerȱspectralȱtrace,ȱpressȱtheȱ Vascular calculations
CALCSȱkey.
WARNING: To avoid misdiagnosis or harming
3 Fromȱtheȱcalculationsȱmenu,ȱselectȱLeftȱorȱ
the patient outcome, start a new
Right.
patient information form before
4 Doȱtheȱfollowingȱforȱeachȱmeasurementȱyouȱ starting a new patient exam and
wantȱtoȱtake: performing calculations. Starting a
new patient information form
a Fromȱtheȱcalculationsȱmenu,ȱselectȱtheȱ
clears the previous patient’s data.
measurement.ȱ(Youȱmayȱneedȱtoȱselectȱ
The previous patient’s data will be
NextȱorȱPrevȱtoȱlocateȱtheȱmeasurement.)
combined with the current patient
b Doȱoneȱofȱtheȱfollowing: if the form is not first cleared. See
“To create a new patient
•• Forȱaȱmanualȱtraceȱmeasurement,ȱuseȱtheȱ
information form” on page 34.
touchpadȱtoȱpositionȱtheȱcaliper.ȱPressȱtheȱ
SELECTȱkey.ȱUseȱtheȱtouchpadȱtoȱtraceȱtheȱ To avoid incorrect calculations,
waveform. verify that the patient information,
date, and time settings are
Ifȱyouȱneedȱtoȱmakeȱaȱcorrection,ȱselectȱ
accurate.
UndoȱonȬscreenȱorȱpressȱtheȱBACKSPACEȱ
key.
•• Forȱanȱautoȱtraceȱmeasurement,ȱselectȱ
AutoȱonȬscreen,ȱandȱuseȱtheȱtouchpadȱtoȱ Transducer Exam Type
positionȱtheȱfirstȱcaliperȱatȱtheȱbeginningȱ
ofȱtheȱwaveform.ȱPressȱtheȱSELECTȱkey,ȱandȱ C11x Vascular
positionȱtheȱsecondȱcaliperȱatȱtheȱendȱofȱ
theȱwaveform. HFL38x Vascular

ConfirmȱthatȱtheȱsystemȬgeneratedȱ L25x Vascular

boundaryȱisȱcorrect.ȱIfȱyouȱareȱnotȱsatisfiedȱ
L38x Vascular
withȱtheȱtrace,ȱobtainȱaȱhigherȱqualityȱ
Dopplerȱspectralȱtraceȱimage,ȱorȱtraceȱ SLAx Vascular
manually.
c PressȱtheȱSETȱkey. Theȱvascularȱmeasurementsȱthatȱyouȱcanȱsaveȱtoȱ
theȱpatientȱreportȱareȱlistedȱinȱtheȱfollowingȱtable.ȱ
d Saveȱtheȱcalculation.ȱ(Seeȱ““Toȱsaveȱaȱ Forȱdefinitionsȱofȱacronyms,ȱseeȱ““Glossary””ȱonȱ

Measurements
calculation””ȱonȱpage 45.) page 157

Chapter 4: Measurements and Calculations 67

. 3 Doȱtheȱfollowingȱforȱeachȱmeasurementȱyouȱ
Vascular Calculations wantȱtoȱtake:
a Fromȱtheȱcalculationsȱmenu,ȱselectȱtheȱ
Menu Vascular Calculation measurementȱname.
Heading Measurement Results
b Usingȱtheȱtouchpad,ȱpositionȱtheȱcaliperȱatȱ
CCA Prox s (systolic), theȱpeakȱsystolicȱwaveform.
d (diastolic)
c PressȱtheȱSELECTȱkey.
Mid s (systolic), Aȱsecondȱcaliperȱappears.
d (diastolic)
d Usingȱtheȱtouchpad,ȱpositionȱtheȱsecondȱ
Dist s (systolic), caliperȱatȱtheȱendȱdiastoleȱonȱtheȱ
d (diastolic) waveform.
Bulb s (systolic), e Saveȱtheȱcalculation.ȱ(Seeȱ““Toȱsaveȱaȱ
d (diastolic) calculation””ȱonȱpage 45.)

ICA Prox s (systolic),

d (diastolic) Patient report
Mid s (systolic), Theȱpatientȱreportȱcontainsȱcalculationȱresultsȱ
d (diastolic) andȱpatientȱinformation.ȱForȱCardiac,ȱOB,ȱ
Transcranial,ȱandȱVascularȱexams,ȱtheȱpatientȱ
Dist s (systolic),
reportȱhasȱadditionalȱdetailsȱandȱfeatures.
d (diastolic)
Youȱcanȱdisplayȱtheȱpatientȱreportȱatȱanyȱtimeȱ
ECA Prox s (systolic), duringȱtheȱexam.ȱ
d (diastolic)
Theȱvalueȱforȱaȱcalculationȱappearsȱonlyȱifȱtheȱ
Mid s (systolic), calculationȱisȱperformed.ȱTheȱpoundȱsymbolȱ(###)ȱ
d (diastolic) indicatesȱaȱvalueȱthatȱisȱoutȱofȱrangeȱ(forȱexample,ȱ
tooȱlargeȱorȱsmall).ȱCalculationȱvaluesȱthatȱareȱoutȱ
Dist s (systolic),
ofȱrangeȱareȱnotȱincludedȱinȱderivedȱcalculationsȱ
d (diastolic)
(forȱexample,ȱmean).ȱ
VArty s (systolic),
d (diastolic) To display a patient report
1 PressȱtheȱREPORTȱkey.
To perform a Vascular calculation 2 Doȱanyȱofȱtheȱfollowing:
Afterȱyouȱperformȱvascularȱmeasurements,ȱ
valuesȱinȱtheȱICA/CCAȱratiosȱareȱselectableȱonȱtheȱ •• Toȱdisplayȱadditionalȱpages,ȱselectȱ ȱ1/xȱ
vascularȱpageȱofȱtheȱpatientȱreport. onȬscreen.
1 OnȱaȱfrozenȱDopplerȱspectralȱtrace,ȱpressȱtheȱ •• (Cardiac,ȱVascular,ȱorȱTCD)ȱSelectȱDetailsȱ
CALCSȱkey.ȱ orȱSummaryȱonȬscreen.ȱTheȱmeanȱofȱtheȱ
detailȱentriesȱisȱusedȱinȱtheȱsummary.
2 Fromȱtheȱcalculationsȱmenu,ȱselectȱLeftȱorȱ
Right. 3 (Optional)ȱPressȱtheȱSAVEȱkeyȱtoȱsaveȱtheȱ
currentȱpageȱofȱtheȱpatientȱreport.

68 Patient report
Toȱexitȱtheȱpatientȱreportȱandȱreturnȱtoȱimaging,ȱ To delete a row of TCD measurements
selectȱDone. 1 OnȱtheȱDetailsȱpageȱofȱtheȱTCDȱpatientȱreport,ȱ
selectȱtheȱrow’’sȱTAPȱmeasurementȱusingȱtheȱ
To send a patient report to a PC
touchpad.ȱ(Theȱselectedȱmeasurementȱisȱ
YouȱcanȱsendȱaȱpatientȱreportȱtoȱaȱPCȱasȱaȱtextȱfile. green.)ȱ
1 Ensureȱcorrectȱconfiguration.ȱSeeȱ““Toȱ 2 SelectȱDeleteȱonȬscreen.
configureȱtheȱsystemȱforȱaȱDVDȱrecorder,ȱPC,ȱ
orȱserialȱbarȱcodeȱscanner””ȱonȱpage 19. Deletedȱmeasurementsȱareȱnotȱincludedȱinȱtheȱ
summaryȱinformation.
Makeȱsureȱtoȱuseȱtheȱconnectionȱcableȱ
suppliedȱbyȱSonoSite.ȱOtherȱconnectionȱcablesȱ
mayȱcauseȱaudioȱinterference,ȱincludingȱanȱ
OB patient report
inaudibleȱDopplerȱsignal. TheȱOBȱpatientȱreportȱpagesȱhaveȱaȱspaceȱforȱ
signingȱprintedȱreports.
2 SelectȱSend Rep.ȱonȬscreen.
To display the OB Twins patient report
Vascular and cardiac patient reports ™ OnȱtheȱOBȱpatientȱreport,ȱselectȱoneȱofȱtheȱ
followingȱonȬscreen:
To delete a vascular or cardiac measurement
•• Twin A/Bȱforȱindividualȱtwinȱpatientȱ
1 OnȱtheȱDetailsȱpageȱofȱtheȱpatientȱreport,ȱ reports
selectȱtheȱmeasurementȱbyȱusingȱtheȱ
touchpad.ȱ(Theȱselectedȱmeasurementȱisȱ •• Compareȱforȱbothȱtwinsȱinȱoneȱpatientȱ
green.)ȱ report

2 SelectȱDeleteȱonȬscreen. To delete an OB measurement

Deletingȱsomeȱmeasurementsȱalsoȱdeletesȱ 1 OnȱtheȱOBȱpatientȱreport,ȱselectȱtheȱOBȱ
relatedȱmeasurements.ȱDeletedȱ measurementȱbyȱusingȱtheȱtouchpad.
measurementsȱareȱnotȱincludedȱinȱtheȱ Theȱselectedȱmeasurementȱisȱgreen.
summaryȱinformation.
2 SelectȱDeleteȱonȬscreen.
(Vascular) To modify the ICA/CCA ratio
Toȱdeleteȱallȱmeasurements,ȱselectȱtheȱ
™ InȱtheȱRatioȱlistȱinȱtheȱvascularȱpatientȱreport,ȱ measurementȱlabelȱandȱpressȱtheȱSELECTȱkeyȱ
selectȱmeasurementsȱforȱtheȱICA/CCAȱratioȱ andȱthenȱselectȱDeleteȱonȬscreen.
forȱbothȱtheȱrightȱandȱleftȱsides.

Measurements
(Cardiac) To adjust the RA pressure
™ OnȱtheȱSummaryȱpageȱofȱtheȱcardiacȱpatientȱ
report,ȱselectȱfromȱtheȱRAȱlist.
ChangingȱtheȱRAȱpressureȱfromȱtheȱdefaultȱ5ȱ
affectsȱtheȱRVSPȱcalculationȱresult.

TCD patient report

TheȱmaximumȱvaluesȱforȱtheȱTAPȱcalculationȱ
appearȱonȱtheȱsummaryȱpage.

Chapter 4: Measurements and Calculations 69

 measurement/authorȱorȱselectȱ 1/xȱ
onȬscreen.
Forȱtwins,ȱbothȱmeasurementȱsetsȱareȱplottedȱ
onȱtheȱsameȱgraph.
3 (Optional)ȱPressȱtheȱSAVEȱkeyȱtoȱsaveȱtheȱ
currentȱgraphȱpage.
4 SelectȱoneȱofȱtheȱfollowingȱonȬscreen:
•• Reportȱtoȱreturnȱtoȱtheȱpreviousȱpatientȱ
reportȱpage
•• Doneȱtoȱreturnȱtoȱliveȱimaging.

Figure 3 OB Anatomy Checklist Page EMED worksheets

EMEDȱworksheetsȱcontainȱresultsȱfromȱEMEDȱ
To fill out the OB anatomy checklist calculationsȱandȱchecklistsȱthatȱyouȱcanȱcomplete.
Youȱcanȱdocumentȱreviewedȱanatomy.
To display an EMED worksheet
™ OnȱtheȱAnatomy ChecklistȱpageȱinȱtheȱOBȱ
Thisȱfeatureȱisȱoptional.
patientȱreport,ȱselectȱtheȱcheckȱboxes.
PressȱtheȱTABȱkeyȱtoȱmoveȱbetweenȱfieldsȱandȱ 1 Afterȱorȱduringȱtheȱexam,ȱpressȱtheȱREPORTȱ
theȱSPACEBARȱtoȱselectȱandȱdeselectȱitemsȱinȱ key.
theȱchecklist. 2 SelectȱEMEDȱonȬscreen.
To complete the OB biophysical profile 3 SelectȱtheȱworksheetȱfromȱtheȱWorksheetȱlistȱ
™ Onȱpageȱ2ȱofȱtheȱOBȱpatientȱreport,ȱselectȱ orȱbyȱselectingȱ ȱx/xȱonȬscreen.
valuesȱunderȱBPP.ȱ
Theȱtotalȱisȱcalculatedȱwhenȱvaluesȱareȱ
selected.ȱNSTȱ(nonȬstressȱtest)ȱisȱoptional.

To display OB graphs
YouȱcanȱdisplayȱOBȱgraphsȱifȱtheȱLMPȱorȱEstab.
DDȱfieldsȱareȱcompleteȱinȱtheȱpatientȱinformationȱ
form.
1 OnȱtheȱOBȱpatientȱreport,ȱselectȱGraphsȱ
onȬscreen.
2 InȱtheȱGraphsȱlist,ȱselectȱtheȱdesiredȱ
measurement/author.
Theȱgraphȱforȱtheȱselectedȱmeasurementȱ
appears.ȱYouȱcanȱselectȱanotherȱ

70 Patient report
Chapter 5: Troubleshooting and Maintenance

Thisȱchapterȱcontainsȱinformationȱtoȱhelpȱcorrectȱ EnsureȱthatȱtheȱDVDȱrecorderȱisȱturnedȱonȱandȱ
problemsȱwithȱsystemȱoperation,ȱtoȱenterȱaȱ setȱupȱproperly.ȱSeeȱtheȱapplicableȱSonoSiteȱ
softwareȱlicense,ȱandȱtoȱtakeȱproperȱcareȱofȱtheȱ accessoryȱuserȱguideȱandȱtheȱmanufacturers’’ȱ
system,ȱtransducer,ȱandȱaccessories. instructions.
Externalȱmonitorȱdoesȱnotȱwork.
Troubleshooting Checkȱtheȱmonitorȱconnections.
Ifȱyouȱencounterȱdifficultyȱwithȱtheȱsystem,ȱuseȱ Checkȱtheȱmonitorȱtoȱensureȱthatȱitȱisȱturnedȱonȱ
theȱfollowingȱlistȱtoȱhelpȱtroubleshootȱtheȱ andȱsetȱupȱproperly.ȱSeeȱtheȱmonitorȱ
problem.ȱIfȱtheȱproblemȱpersists,ȱcontactȱSonoSiteȱ manufacturers’’ȱinstructions,ȱifȱnecessary.
TechnicalȱSupport.ȱ(Seeȱ““SonoSiteȱTechnicalȱ
System does not recognize the transducer.ȱ
Support””ȱonȱpage vii.)
Disconnectȱandȱreconnectȱtheȱtransducer.
System does not turn on.Checkȱallȱpowerȱ
connections. A maintenance icon appears on the system
screen.ȱSystemȱmaintenanceȱmayȱbeȱrequired.ȱ
RemoveȱtheȱDCȱinputȱconnectorȱandȱbattery,ȱwaitȱ
RecordȱtheȱnumberȱinȱparenthesesȱonȱtheȱC:ȱlineȱ
10ȱseconds,ȱandȱthenȱreinstallȱthem.
andȱcontactȱSonoSiteȱorȱyourȱSonoSiteȱ
Ensureȱthatȱtheȱbatteryȱisȱcharged. representative.
System image quality is poor.ȱAdjustȱtheȱdisplayȱ
toȱimproveȱviewingȱangle.
Software licensing
Adjustȱtheȱbrightness.
SonoSiteȱsoftwareȱisȱcontrolledȱbyȱaȱlicenseȱkey.ȱ
Adjustȱtheȱgain. Afterȱyouȱinstallȱnewȱsoftware,ȱtheȱsystemȱ
promptsȱyouȱforȱaȱlicenseȱkey.ȱYouȱmustȱobtainȱ
No CPD image.ȱAdjustȱtheȱgain.
oneȱkeyȱforȱeachȱsystemȱorȱtransducerȱthatȱusesȱ
No Color image.ȱAdjustȱtheȱgainȱorȱtheȱPRFȱscale. theȱsoftware.
NoȱOBȱmeasurementȱselections. Theȱsoftwareȱwillȱoperateȱforȱaȱshortȱtimeȱ(theȱ
graceȱperiod)ȱwithoutȱaȱlicenseȱkey.ȱDuringȱtheȱ
SelectȱtheȱOBȱexamȱtype.
graceȱperiod,ȱallȱsystemȱfunctionsȱareȱavailable.ȱ
Print does not work.ȱSelectȱtheȱprinterȱonȱtheȱ Afterȱtheȱgraceȱperiod,ȱtheȱsystemȱisȱnotȱusableȱ
Connectivityȱsetupȱpage.ȱSeeȱ““Toȱconfigureȱtheȱ untilȱyouȱenterȱaȱvalidȱlicenseȱkey.ȱGraceȱperiodȱ
systemȱforȱaȱprinter””ȱonȱpage 19. timeȱisȱnotȱusedȱwhileȱtheȱsystemȱisȱoffȱorȱasleep.ȱ
Graceȱperiodȱtimeȱremainingȱappearsȱonȱtheȱ
Checkȱtheȱprinterȱconnections.
licenseȱupdateȱscreen.ȱ
Troubleshooting

Ensureȱthatȱtheȱprinterȱisȱturnedȱonȱandȱsetȱupȱ
properly.ȱSeeȱtheȱprinterȱmanufacturer’’sȱ Caution: After the grace period expires, all
instructions,ȱifȱnecessary. system functions except licensing
are unavailable until a valid license
DVD recorder does not record.ȱCheckȱtheȱDVDȱ key is entered.
recorderȱconnections.

Chapter 5: Troubleshooting and Maintenance 71

Toȱobtainȱaȱlicenseȱkeyȱforȱyourȱsoftware,ȱcontactȱ recommendationsȱinȱtheȱperipheralȱ
SonoSiteȱTechnicalȱSupport.ȱ(Seeȱ““SonoSiteȱ manufacturer’’sȱinstructionsȱwhenȱcleaningȱorȱ
TechnicalȱSupport””ȱonȱpage vii.)ȱYouȱneedȱtoȱ disinfectingȱyourȱperipherals.
provideȱtheȱfollowingȱinformation.ȱ(Seeȱ““Systemȱ
Noȱperiodicȱorȱpreventiveȱmaintenanceȱisȱ
Informationȱsetup””ȱonȱpage 23.)
requiredȱforȱtheȱsystem,ȱtransducer,ȱorȱ
accessoriesȱotherȱthanȱcleaningȱandȱdisinfectingȱ
System Software Transducer Software theȱtransducerȱafterȱeveryȱuse.ȱ(Seeȱ““Cleaningȱ
andȱdisinfectingȱtransducers””ȱonȱpage 74.)ȱThereȱ
Name of person Name of person installing
areȱnoȱinternalȱcomponentsȱthatȱrequireȱperiodicȱ
installing the the upgrade
testingȱorȱcalibration.ȱAllȱmaintenanceȱ
upgrade
requirementsȱareȱdescribedȱinȱthisȱchapterȱandȱinȱ
Serial number (on Transducer serial number theȱultrasoundȱsystemȱserviceȱmanual.ȱ
bottom of system) Performingȱmaintenanceȱproceduresȱnotȱ
describedȱinȱtheȱuserȱguideȱorȱserviceȱmanualȱ
ARM version Transducer part number mayȱvoidȱtheȱproductȱwarranty.
(REF)
or model number (for ContactȱSonoSiteȱTechnicalȱSupportȱforȱanyȱ
example, C60x) maintenanceȱquestions.ȱ(Seeȱ““SonoSiteȱTechnicalȱ
Support””ȱonȱpage vii.)
PCBA serial Transducer bundle version
number WARNING: Disinfectants and cleaning methods
listed are recommended by
Afterȱyouȱobtainȱaȱlicenseȱkey,ȱyouȱmustȱenterȱitȱ SonoSite for compatibility with
intoȱtheȱsystem. product materials, not for biological
effectiveness. Refer to the
To enter a license key disinfectant label instructions for
1 Turnȱonȱtheȱsystem. guidance on disinfection efficacy
and appropriate clinical uses.
Theȱlicenseȱupdateȱscreenȱappears.
The level of disinfection required for
2 EnterȱtheȱlicenseȱkeyȱinȱtheȱEnter license a device is dictated by the type of
numberȱfield. tissue it contacts during use. To
3 SelectȱDoneȱonȬscreen. avoid infection, ensure that the
disinfectant type and the solution
Ifȱyouȱenteredȱaȱvalidȱlicenseȱkeyȱbutȱtheȱ strength and duration are
licenseȱupdateȱscreenȱappears,ȱverifyȱthatȱyouȱ appropriate for the equipment. For
enteredȱtheȱlicenseȱkeyȱcorrectly.ȱIfȱtheȱlicenseȱ information, see the disinfectant
updateȱscreenȱstillȱappears,ȱcontactȱSonoSiteȱ label instructions and the
TechnicalȱSupport.ȱ(Seeȱ““SonoSiteȱTechnicalȱ recommendations of the
Support””ȱonȱpage vii.) Association for Professionals in
Infection Control and Epidemiology
(APIC) and the FDA.
Maintenance
Useȱtheȱrecommendationsȱinȱthisȱsectionȱwhenȱ
cleaningȱorȱdisinfectingȱyourȱultrasoundȱsystem,ȱ
transducer,ȱandȱaccessories.ȱUseȱtheȱcleaningȱ

72 Maintenance
WARNING: To prevent contamination, the use Caution: Do not spray cleaners or
of sterile transducer sheaths and disinfectant directly on the system
sterile coupling gel is surfaces. Doing so may cause
recommended for clinical solution to leak into the system,
applications of an invasive or damaging the system and voiding
surgical nature. Do not apply the the warranty.
transducer sheath and gel until you
Do not use strong solvents such as
are ready to perform the procedure.
thinner or benzene, or abrasive
cleansers, since these will damage
the exterior surfaces.
Caution: Some transducer sheaths contain Use only recommended cleaners or
natural rubber latex and talc, which disinfectants on system surfaces.
can cause allergic reactions in some Immersion-type disinfectants are
individuals. Refer to 21 CFR 801.437, not approved for use on system
User labeling for devices that surfaces.
contain natural rubber.
When you clean the system, ensure
that the solution does not get
Cleaning and disinfecting the inside the system controls or the
ultrasound system battery compartment.
Theȱexteriorȱsurfaceȱofȱtheȱultrasoundȱsystemȱandȱ Do not scratch the LCD screen.
theȱaccessoriesȱcanȱbeȱcleanedȱandȱdisinfectedȱ
usingȱaȱrecommendedȱcleanerȱorȱdisinfectant.ȱSeeȱ
““Recommendedȱdisinfectants””ȱonȱpage 77.
To clean the LCD screen
™ Dampenȱaȱclean,ȱnonȬabrasive,ȱcottonȱclothȱ
withȱanȱethanolicȬbasedȱcleaner,ȱandȱwipeȱtheȱ
screenȱclean.ȱ
WARNING: To avoid electrical shock, before
cleaning, disconnect the system Applyȱtheȱcleanerȱtoȱtheȱclothȱratherȱthanȱtheȱ
from the power supply or remove surfaceȱofȱtheȱscreen.
from the mini-dock or docking
system.
To clean and disinfect system surfaces
1 Turnȱoffȱtheȱsystem.
To avoid infection always use
protective eyewear and gloves 2 Disconnectȱtheȱsystemȱfromȱtheȱpowerȱsupply,ȱ
when performing cleaning and orȱremoveȱitȱfromȱtheȱminiȬdockȱorȱdockingȱ
disinfecting procedures. system.

To avoid infection, ensure that the 3 Cleanȱtheȱexteriorȱsurfacesȱusingȱaȱsoftȱclothȱ

solution expiration date has not lightlyȱdampenedȱinȱaȱmildȱsoapȱorȱdetergentȱ
passed. cleaningȱsolutionȱtoȱremoveȱanyȱparticulateȱ
Troubleshooting

matterȱorȱbodyȱfluids.
Applyȱtheȱsolutionȱtoȱtheȱclothȱratherȱthanȱtheȱ
surface.
4 Mixȱtheȱdisinfectantȱsolutionȱcompatibleȱwithȱ
theȱsystem,ȱfollowingȱdisinfectantȱlabelȱ

Chapter 5: Troubleshooting and Maintenance 73

 instructionsȱforȱsolutionȱstrengthsȱandȱ Using a non-recommended
disinfectantȱcontactȱduration. cleaning or disinfection solution,
5 Wipeȱsurfacesȱwithȱtheȱdisinfectantȱsolution. incorrect solution strength, or
immersing a transducer deeper or
6 Airȱdryȱorȱtowelȱdryȱwithȱaȱcleanȱcloth. for a longer period of time than
recommended can damage or
Cleaning and disinfecting transducers discolor the transducer and void the
Toȱdisinfectȱtheȱtransducerȱandȱitsȱcable,ȱuseȱtheȱ transducer warranty.
immersionȱmethodȱorȱtheȱwipeȱmethod.ȱ Do not allow cleaning solution or
Immersibleȱtransducersȱcanȱbeȱdisinfectedȱonlyȱifȱ disinfectant into the transducer
theȱproductȱlabelingȱindicatesȱtheyȱcanȱbeȱusedȱ connector.
withȱanȱimmersionȱmethod.
Do not allow disinfectant to contact
SeeȱTable 1,ȱ““DisinfectantȱCompatibilityȱwithȱ metal surfaces. Use a soft cloth
SystemȱandȱTransducers””ȱonȱpage 77.ȱ lightly dampened in a mild soap or
compatible cleaning solution to
WARNING: To avoid electrical shock, before
remove any disinfectant that
cleaning, disconnect the transducer
remains on metal surfaces.
from the system.
Attempting to disinfect a
To avoid injury, always use
transducer or transducer cable
protective eyewear and gloves
using a method other than the one
when performing cleaning and
included here can damage the
disinfecting procedures.
transducer and void the warranty.
To avoid infection, ensure that the
solution expiration date has not To clean and disinfect a transducer (wipe
passed. method)
1 Disconnectȱtheȱtransducerȱfromȱtheȱsystem.
Caution: Transducers must be cleaned after
2 Removeȱanyȱtransducerȱsheath.
every use. Cleaning transducers is
necessary prior to effective 3 Cleanȱtheȱsurfaceȱusingȱaȱsoftȱclothȱlightlyȱ
disinfection. Ensure that you follow dampenedȱinȱaȱmildȱsoapȱorȱdetergentȱ
the manufacturer's instructions cleaningȱsolutionȱtoȱremoveȱanyȱparticulateȱ
when using disinfectants. matterȱorȱbodyȱfluids.
Do not use a surgeon's brush when Applyȱtheȱsolutionȱtoȱtheȱclothȱratherȱthanȱtheȱ
cleaning transducers. Even the use surface.
of soft brushes can damage a
4 Rinseȱwithȱwaterȱorȱwipeȱwithȱ
transducer. Use a soft cloth.
waterȬdampenedȱcloth;ȱthenȱwipeȱwithȱaȱdryȱ
cloth.
5 Mixȱtheȱdisinfectantȱsolutionȱcompatibleȱwithȱ
theȱtransducer,ȱfollowingȱdisinfectantȱlabelȱ
instructionsȱforȱsolutionȱstrengthsȱandȱ
disinfectantȱcontactȱduration.
6 Wipeȱsurfacesȱwithȱtheȱdisinfectantȱsolution.

74 Maintenance
7 Airȱdry. Cleaning and disinfecting the battery
8 Examineȱtheȱtransducerȱandȱcableȱforȱdamageȱ
Caution: To avoid damaging the battery, do
suchȱasȱcracks,ȱsplitting,ȱorȱfluidȱleaks.ȱ
not allow cleaning solution or
Ifȱdamageȱisȱevident,ȱdiscontinueȱuseȱofȱtheȱ disinfectant to come in contact
transducer,ȱandȱcontactȱSonoSiteȱorȱyourȱlocalȱ with the battery terminals.
representative.

To clean and disinfect a transducer To clean and disinfect a battery (wipe

(immersion method) method)
1 Removeȱtheȱbatteryȱfromȱtheȱsystem.
1 Disconnectȱtheȱtransducerȱfromȱtheȱsystem.
2 Cleanȱtheȱsurfaceȱusingȱaȱsoftȱclothȱlightlyȱ
2 Removeȱanyȱtransducerȱsheath.
dampenedȱinȱaȱmildȱsoapȱorȱdetergentȱ
3 Cleanȱtheȱsurfaceȱusingȱaȱsoftȱclothȱlightlyȱ cleaningȱsolution.
dampenedȱinȱaȱmildȱsoapȱorȱcompatibleȱ
Applyȱtheȱsolutionȱtoȱtheȱclothȱratherȱthanȱtheȱ
cleaningȱsolutionȱtoȱremoveȱanyȱparticulateȱ
surface.
matterȱorȱbodyȱfluids.
Applyȱtheȱsolutionȱtoȱtheȱclothȱratherȱthanȱtheȱ 3 Wipeȱtheȱsurfacesȱwithȱtheȱdisinfectionȱ
solution.ȱSaniȬClothȱHB,ȱSaniȬClothȱWipes,ȱorȱ
surface.
70%ȱisopropylȱalcoholȱisȱrecommended.
4 Rinseȱwithȱwaterȱorȱwipeȱwithȱ
4 Airȱdr.
waterȬdampenedȱcloth,ȱandȱthenȱwipeȱwithȱaȱ
dryȱcloth.
Cleaning the footswitch
5 Mixȱtheȱdisinfectantȱsolutionȱcompatibleȱwithȱ
theȱtransducer,ȱfollowingȱdisinfectantȱlabelȱ Caution: To avoid damaging the footswitch,
instructionsȱforȱsolutionȱstrengthsȱandȱ do not sterilize. It is not intended for
disinfectantȱcontactȱduration. use in a sterile environment.
6 Immerseȱtheȱtransducerȱintoȱtheȱdisinfectionȱ
solutionȱnotȱmoreȱthanȱ12Ȭ18 inchesȱ To clean the footswitch
(31Ȭ46 cm)ȱfromȱtheȱpointȱwhereȱtheȱcableȱ
1 DampenȱaȱnonȬabrasiveȱclothȱwithȱoneȱofȱtheȱ
entersȱtheȱconnector.
followingȱproducts:
Followȱtheȱinstructionsȱonȱtheȱdisinfectantȱ
•• Isopropylȱalcohol
labelȱforȱtheȱdurationȱofȱtheȱtransducerȱ
immersion. •• Soapȱandȱwater
7 Usingȱtheȱinstructionsȱonȱtheȱdisinfectantȱ •• Cidex
label,ȱrinseȱtoȱtheȱpointȱofȱtheȱpreviousȱ
•• SodiumȱHypochloriteȱ5.25%ȱ(Bleach)ȱ
immersion,ȱandȱthenȱairȱdryȱorȱtowelȱdryȱwithȱ
dilutedȱ10:1
aȱcleanȱcloth.
2 Wringȱoutȱclothȱuntilȱslightlyȱwetȱandȱthenȱ
Troubleshooting

8 Examineȱtheȱtransducerȱandȱcableȱforȱdamageȱ
gentlyȱrubȱsoiledȱareaȱuntilȱclean.
suchȱasȱcracks,ȱsplitting,ȱorȱfluidȱleaks.
Ifȱdamageȱisȱevident,ȱdiscontinueȱuseȱofȱtheȱ
transducer,ȱandȱcontactȱSonoSiteȱorȱyourȱlocalȱ
representative.

Chapter 5: Troubleshooting and Maintenance 75

Cleaning and disinfecting ECG cables
Caution: To avoid damaging the ECG cable,
do not sterilize.

To clean and disinfect the ECG cable (wipe

method)
1 Removeȱtheȱcableȱfromȱtheȱsystem.
2 Cleanȱtheȱsurfaceȱusingȱaȱsoftȱclothȱlightlyȱ
dampenedȱinȱaȱmildȱsoapȱorȱdetergentȱ
cleaningȱsolution.
Applyȱtheȱsolutionȱtoȱtheȱclothȱratherȱthanȱtheȱ
surface.
3 Wipeȱtheȱsurfacesȱwithȱanyȱofȱtheȱfollowingȱ
products:
•• Bleachȱ(sodiumȱhypochlorite)
•• Cidexȱdisinfectants
•• Greenȱsoap
4 Airȱdryȱorȱtowelȱdryȱwithȱaȱcleanȱcloth.

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

Seeȱwww.sonosite.comȱforȱupdatedȱcleaningȱandȱdisinfectantȱinformation.ȱ

Table 1: Disinfectant Compatibility with System and Transducers

C60x
ICTx
Disinfection and Country L38x C11x/ System
Type Active Ingredient D2x HFL38x
Cleaning Solutions of Origin P10x L25x Surfaces
P21x
Chapter 5: Troubleshooting and Maintenance

SLAx

AbcoCide 14 USA Liquid Gluteraldehyde A A A U

Accel Plus CAN Wipe Hydrogen Peroxide N N N U

Accel TB CAN Wipe Hydrogen Peroxide N N N U

Accel Wipes CAN Wipe Hydrogen Peroxide A A A U

Aidal Plus AUS Liquid Gluteraldehyde A A A U

Alkacide FRA Liquid Gluteraldehyde A A A U

Alkazyme FRA Liquid Quat. Ammonia A A A U

Anioxyde 1000 FRA Liquid Peracetic Acid N N N U

Aquatabs (1000) IRL Tablet Sodium A N A U

Dichloroisocyanurate
77

Troubleshooting
 Table 1: Disinfectant Compatibility with System and Transducers (continued)
78

C60x
ICTx
Disinfection and Country L38x C11x/ System
Type Active Ingredient D2x HFL38x
Cleaning Solutions of Origin P10x L25x Surfaces
P21x
SLAx

Aquatabs (2000) IRL Tablet Sodium A U N A U

Dichloroisocyanurate

Aquatabs (5000) IRL Tablet Sodium N U N N U

Dichloroisocyanurate

Ascend USA Liquid Quat Ammonia A U A A U

Asepti-HB USA Liquid Quat Ammonia A U A A U

Asepti-Steryl USA Spray Ethanol A U A A U

Asepti-Wipes USA Wipe Propanol (Isopropyl A U A A A

Alcohol

Bacillocid rasant DEU Liquid Glut./Quat. Ammonia A U A A U

Bacoban DEU Liquid Ethanol Isopropanol A A U U U

Bacoban WB DEU Liquid Benzalkoniumchloride A A U U U

Diethylenglycol

Banicide USA Liquid Gluteraldehyde A U U A U

Betadine USA Liquid Providone-Iodine N U N A U

Bleach USA Liquid NaCl Hypochlorite A U A A U

Cavicide USA Liquid Isopropyl A U A A U

Caviwipes USA Wipes Isopropanol A U A N A

Chlor-Clean GBR Liquid Sodium A U N A U

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

C60x
ICTx
Disinfection and Country L38x C11x/ System
Type Active Ingredient D2x HFL38x
Cleaning Solutions of Origin P10x L25x Surfaces
P21x
SLAx

Cidalkan FRA Liquid Alkylamine, isopropanol U N U U U

Cidalkan Lingettes FRA Wipes Ethyl Alcohol U N U U U

Cidex USA Liquid Gluteraldehyde A U A A A

Cidex OPA USA Liquid Ortho-phthaldehyde A A A A U

Cidex Plus USA Liquid Gluteraldehyde A U A A A

Cleanisept DEU Wipes Quat. Ammonia A A A A A

Clorox Wipes USA Wipes Isopropanol A U A A U

Control III USA Liquid Quat. Ammonia A U A N U

Chapter 5: Troubleshooting and Maintenance

Coverage Spray USA Spray Quat. Ammonia A U A N N

Denatured Alcohol USA Liquid Ethanol N U N N U

DentaSept FRA Liquid Quat. Ammonia N U N N U

DisCide Ultra USA Wipes Isopropyl Alcohol U U U U N

Disinfecting
Towelettes

DisCide Wipes USA Wipes Isopropyl Alcohol A U A A N

DisOPA JPN Liquid Ortho-phthaldehyde A A A A A

Dispatch USA Spray NaCl Hypochlorite A A A A U

Dynacide PA FRA Liquid Peracetic Acid U A U U U

79

Troubleshooting
 Table 1: Disinfectant Compatibility with System and Transducers (continued)
80

C60x
ICTx
Disinfection and Country L38x C11x/ System
Type Active Ingredient D2x HFL38x
Cleaning Solutions of Origin P10x L25x Surfaces
P21x
SLAx

End-Bac II USA Liquid Quat. Ammonia A U A A A

Endozime AW Plus FRA Liquid Propanol A U A A U

Envirocide USA Liquid Isopropyl A U U N U

Enzol USA Cleaner Ethylene Glycol A U A A U

Expose USA Liquid Isopropyl A U A A U

Gigasept AF DEU Liquid Quat. Ammonia A U A A U

Gigasept FF DEU Liquid Bersteinsaure N U N N U

Gluteraldehyde SDS USA Liquid Gluteraldehyde A U U A U

Hexanios FRA Liquid Polyhexanide/Quat. A U A A U

Ammonia

Hi Tor Plus USA Liquid Chloride A U A N U

Hibiclens USA Cleaner Chlorhexidine A U A A U

Hydrogen Peroxide USA Liquid Hydrogen Peroxide A A A A A

Isopropanol Alcohol ALL Liquid Alcohol N U N N U

Kodan Tücher DEU Liquid Propanol A U A A N

Kohrsolin ff DEU Liquid Gluteraldehyde A U U A U

Korsolex basic DEU Liquid Gluteraldehyde N U N N U

Lem-O-Quat USA Liquid Alkyl/Chloride U A U U U

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

C60x
ICTx
Disinfection and Country L38x C11x/ System
Type Active Ingredient D2x HFL38x
Cleaning Solutions of Origin P10x L25x Surfaces
P21x
SLAx

LpHse USA Liquid O-phenylphenol A U A A U

Lysol USA Spray Ethanol N U N N U

Lysol IC USA Liquid O-phenylphenol A U N A U

Madacide 1 USA Liquid Isopropanol A N A N N

Matar USA Liquid O-phenylphenol A U U A U

MetriCide 14 USA Liquid Gluteraldehyde A U A A U

MetriCide 28 USA Liquid Gluteraldehyde A U A A U

MetriZyme USA Cleaner Propylene Glycol A U A A U

Chapter 5: Troubleshooting and Maintenance

Mikrobak forte DEU Liquid Ammonium Chloride A U A A U

Mikrozid Wipes DEU Wipe Ethanol/Propanol A U A A N

Nuclean FRA Spray Alcohol/Biguanide A U A A U

Precise USA Spray O-phenylphenol N U N N U

Ruthless USA Spray Quat. Ammonia A U A N U

Sagrosept Wipe DEU Wipe Propanol A U A A U

Salvanios pH 7 FRA Liquid Quat. Ammonia A U A A U

Sani-Cloth HB USA Wipe Quat. Ammonia A U A N A

Sani-Cloth Plus USA Wipe Quat. Ammonia A U A A A

Sekusept DEU Liquid Gluteraldehyde U A U U U

81

Troubleshooting
 Table 1: Disinfectant Compatibility with System and Transducers (continued)
82

C60x
ICTx
Disinfection and Country L38x C11x/ System
Type Active Ingredient D2x HFL38x
Cleaning Solutions of Origin P10x L25x Surfaces
P21x
SLAx

Sklar USA Liquid Isopropanol A U A N U

Sporicidin USA Liquid Phenol A N A A U

Sporicidin Wipes USA Wipe Phenol A U A A N

Staphene USA Spray Ethanol A U N A N

Steranios FRA Liquid Gluteraldehyde A U A A U

Super Sani-Cloth USA Wipe Isopropyl Alcohol N U N N N

T-Spray USA Spray Quat. Ammonia A U A N N

T-Spray II USA Spray Alkyl/Chloride A U A A U

TASK 105 USA Spray Quat. Ammonia A U A A U

TBQ USA Liquid Alkyl A U A A U

Theracide Plus USA Wipe Quat. Ammonia A U A A A

Wipes

Tor USA Liquid Quat. Ammonia A U A N U

Transeptic USA Cleaner Alcohol N U N N U

Tristel GBR Liquid Chlorine Dioxide A A A A U

Tristel Duo GBR U U U U U

Tristel Solo GBR Foam Hexamethylenebiguanide U A U U U

Tristel Wipes GBR Wipe Chlorine Dioxide N A N N A

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

C60x
ICTx
Disinfection and Country L38x C11x/ System
Type Active Ingredient D2x HFL38x
Cleaning Solutions of Origin P10x L25x Surfaces
P21x
SLAx

Vesphene II USA Liquid Sodium/ A U A A U

o-Phenylphenate

Virex II 256 USA Liquid Ammonium Chloride A U A A U

Virex TB USA Liquid Quat. Ammonia A U A N N

Virox 5 CAN Wipe Hydrogen Peroxide A A A A A

Virufen FRA Liquid Alkyl Ammonium Chloride U A U U U

Wavicide -01 USA Liquid Gluteraldehyde N U N N U

Wavicide -06 USA Liquid Gluteraldehyde A U A A U

Chapter 5: Troubleshooting and Maintenance

Wet Wipe DNK Wipe Guanidinium-chloride U A U U U

Disinfection

Wex-Cide USA Liquid O-phenylphenol A U A A U

A = Acceptable
N = No (Do not use)
U = Untested (Do not use)
83

Troubleshooting
84
Chapter 6: Safety

Safety
Thisȱchapterȱcontainsȱinformationȱrequiredȱbyȱregulatoryȱagencies,ȱincludingȱinformationȱ
aboutȱtheȱALARAȱ(asȱlowȱasȱreasonablyȱachievable)ȱprinciple,ȱtheȱoutputȱdisplayȱstandard,ȱ
acousticȱpowerȱandȱintensityȱtables,ȱandȱotherȱsafetyȱinformation.ȱTheȱinformationȱappliesȱtoȱ
theȱultrasoundȱsystem,ȱtransducer,ȱaccessories,ȱandȱperipherals.ȱ

Ergonomic safety
Theseȱhealthyȱscanningȱguidelinesȱareȱintendedȱtoȱassistȱyouȱinȱtheȱcomfortȱandȱeffectiveȱuseȱ
ofȱyourȱultrasoundȱsystem.

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

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

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

Chapter 6: Safety 85
 e.Habes, D.J. and S. Baron. “Health Hazard Report 99-0093-2749.” University of Medicine and Dentistry of New
Jersey. (1999).
f.Vanderpool, H.E., E.A. Friis, B.S. Smith, and K.L. Harms. “Prevalence of Carpal Tunnel Syndrome and Other
Work-related Musculoskeletal Problems in Cardiac Sonographers.” Journal of Medicine. 35:6 (1993), 605-610.

Position the system

Promote comfortable shoulder, arm, and hand postures
•• Useȱaȱstandȱtoȱsupportȱtheȱweightȱofȱtheȱultrasoundȱsystem.

Minimize eye and neck strain

•• Ifȱpossible,ȱpositionȱtheȱsystemȱwithinȱreach.
•• Adjustȱtheȱangleȱofȱtheȱsystemȱandȱdisplayȱtoȱminimizeȱglare.
•• Ifȱusingȱaȱstand,ȱadjustȱitsȱheightȱsoȱthatȱtheȱdisplayȱisȱatȱorȱslightlyȱbelowȱeyeȱlevel.

Position yourself
Support your back during an exam
•• Useȱaȱchairȱthatȱsupportsȱyourȱlowerȱback,ȱthatȱadjustsȱtoȱyourȱworkȱsurfaceȱheight,ȱthatȱ
promotesȱaȱnaturalȱbodyȱposture,ȱandȱthatȱallowsȱquickȱheightȱadjustments.
•• Alwaysȱsitȱorȱstandȱupright.ȱAvoidȱbendingȱorȱstooping.

Minimize reaching and twisting

•• Useȱaȱbedȱthatȱisȱheightȱadjustable.
•• Positionȱtheȱpatientȱasȱcloseȱtoȱyouȱasȱpossible.
•• Faceȱforward.ȱAvoidȱtwistingȱyourȱheadȱorȱbody.
•• Moveȱyourȱentireȱbodyȱfrontȱtoȱback,ȱandȱpositionȱyourȱscanningȱarmȱnextȱtoȱorȱslightlyȱinȱ
frontȱofȱyou.
•• Standȱforȱdifficultȱexamsȱtoȱminimizeȱreaching.
•• Positionȱtheȱultrasoundȱsystemȱorȱdisplayȱdirectlyȱinȱfrontȱofȱyou.
•• Provideȱanȱauxiliaryȱmonitorȱforȱpatientȱviewing.

Promote comfortable shoulder and arm postures

•• Keepȱyourȱelbowȱcloseȱtoȱyourȱside.
•• Relaxȱyourȱshouldersȱinȱaȱlevelȱposition.
•• Supportȱyourȱarmȱusingȱaȱsupportȱcushionȱorȱpillow,ȱorȱrestȱitȱonȱtheȱbed.

86
 Promote comfortable hand, wrist, and finger postures
•• Holdȱtheȱtransducerȱlightlyȱinȱyourȱfingers.

Safety
•• Minimizeȱtheȱpressureȱappliedȱonȱtheȱpatient.
•• Keepȱyourȱwristȱinȱaȱstraightȱposition.

Take breaks, exercise, and vary activities

•• Minimizingȱscanningȱtimeȱandȱtakingȱbreaksȱcanȱeffectivelyȱallowȱyourȱbodyȱtoȱrecoverȱfromȱ
physicalȱactivityȱandȱhelpȱyouȱavoidȱMSDs.ȱSomeȱultrasoundȱtasksȱmayȱrequireȱlongerȱorȱ
moreȱfrequentȱbreaks.ȱHowever,ȱsimplyȱchangingȱtasksȱcanȱhelpȱsomeȱmuscleȱgroupsȱrelaxȱ
whileȱothersȱremainȱorȱbecomeȱactive.
•• Workȱefficientlyȱbyȱusingȱtheȱsoftwareȱandȱhardwareȱfeaturesȱcorrectly.
•• Keepȱmoving.ȱAvoidȱsustainingȱtheȱsameȱpostureȱbyȱvaryingȱyourȱhead,ȱneck,ȱbody,ȱarm,ȱ
andȱlegȱpositions.
•• Doȱtargetedȱexercises.ȱTargetedȱexercisesȱcanȱstrengthenȱmuscleȱgroups,ȱwhichȱmayȱhelpȱyouȱ
avoidȱMSDs.ȱContactȱaȱqualifiedȱhealthȱprofessionalȱtoȱdetermineȱstretchesȱandȱexercisesȱ
thatȱareȱrightȱforȱyou.

Electrical safety classification

Class I equipment Ultrasound system powered from power supply or part
of the Mobile Docking System

Internally powered equipment Ultrasound system not connected to the power supply
(battery only)

Type BF applied parts Ultrasound transducers

Type CF applied parts ECG module/ECG leads

IPX-7 (watertight equipment) Ultrasound transducers

IPX-8 (watertight equipment) Footswitch

Non AP/APG Ultrasound system power supply, docking system, and

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

Chapter 6: Safety 87
Electrical safety
ThisȱsystemȱmeetsȱEN60601Ȭ1,ȱClassȱI/internallyȬpoweredȱequipmentȱrequirementsȱandȱTypeȱ
BFȱisolatedȱpatientȬappliedȱpartsȱsafetyȱrequirements.
Thisȱsystemȱcompliesȱwithȱtheȱapplicableȱmedicalȱequipmentȱrequirementsȱpublishedȱinȱtheȱ
CanadianȱStandardsȱAssociationȱ(CSA),ȱEuropeanȱNormȱHarmonizedȱStandards,ȱandȱ
UnderwritersȱLaboratoriesȱ(UL)ȱsafetyȱstandards.ȱSeeȱChapter 8,ȱ““Specifications.””
Forȱmaximumȱsafetyȱobserveȱtheȱfollowingȱwarningsȱandȱcautions.

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

88
WARNING: To avoid the risk of electrical shock, do not use any transducer that has been
immersed beyond the specified cleaning or disinfection level. See Chapter 5,
“Troubleshooting and Maintenance.”

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

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

Chapter 6: Safety 89
Equipment safety
Toȱprotectȱyourȱultrasoundȱsystem,ȱtransducer,ȱandȱaccessories,ȱfollowȱtheseȱprecautions.

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

Battery safety
Toȱpreventȱtheȱbatteryȱfromȱbursting,ȱigniting,ȱorȱemittingȱfumesȱandȱcausingȱpersonalȱinjuryȱ
orȱequipmentȱdamage,ȱobserveȱtheȱfollowingȱprecautions.

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

90
 Do not connect the battery to an electrical power outlet.
WARNING: Do not continue recharging the battery if it does not recharge after two successive
six hour charging cycles.

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

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

Chapter 6: Safety 91
Clinical safety
WARNING: Non-medical (commercial) grade peripheral monitors have not been verified or
validated by SonoSite as being suitable for diagnosis.
To avoid the risk of a burn hazard, do not use the transducer with high frequency
surgical equipment. Such a hazard may occur in the event of a defect in the high
frequency surgical neutral electrode connection.
Do not use the system if it exhibits erratic or inconsistent behavior. Discontinuities in
the scanning sequence are indicative of a hardware failure that must be corrected
before use.
Some transducer sheaths contain natural rubber latex and talc, which can cause
allergic reactions in some individuals. Refer to 21 CFR 801.437, User labeling for
devices that contain natural rubber.
Perform ultrasound procedures prudently. Use the ALARA (as low as reasonably
achievable) principle and follow the prudent use information concerning MI and TI.
SonoSite does not currently recommend a specific brand of acoustic standoff. If an
acoustic standoff is used, it must have a minimum attentuation of .3dB/cm/MHz.
Some SonoSite transducers are approved for intraoperative applications if a
market-cleared sheath is used.
To avoid injury or reduce the risk of infection to the patient, observe the following:
• • Follow Universal Precautions when inserting and maintaining a medical device
for interventional and intraoperative procedures.
• Appropriate training in interventional and intraoperative procedures as dictated
by current relevant medical practices as well as in proper operation of the
ultrasound system and transducer is required. During vascular access, the
potential exists for serious complications including without limitation the
following: pneumothorax, arterial puncture, guidewire misplacement, and risks
normally associated with local or general anesthesia, surgery, and post-operative
recovery.
To avoid device damage or patient injury, do not use the P10x, P17x, or P21x needle
guide bracket on patients with pacemakers or medical electronic implants. The
needle guide bracket for the P10x, P17x, and P21x transducers contains a magnet
that is used to ensure the bracket is correctly oriented on the transducer. The
magnetic field in direct proximity to the pacemaker or medical electronic implant
may have an adverse effect.

92
Hazardous materials
WARNING: The liquid crystal display (LCD) contains mercury. Dispose of the LCD properly in

Safety
accordance with local regulations.

Electromagnetic compatibility
Theȱultrasoundȱsystemȱhasȱbeenȱtestedȱandȱfoundȱtoȱcomplyȱwithȱtheȱelectromagneticȱ
compatibilityȱ(EMC)ȱlimitsȱforȱmedicalȱdevicesȱtoȱIECȱ60601Ȭ1Ȭ2:2001.ȱTheseȱlimitsȱareȱdesignedȱ
toȱprovideȱreasonableȱprotectionȱagainstȱharmfulȱinterferenceȱinȱaȱtypicalȱmedicalȱinstallation.

Caution: Medical electrical equipment requires special precautions regarding EMC and must
be installed and operated according to these instructions. It is possible that high
levels of radiated or conducted radio-frequency electromagnetic interference (EMI)
from portable and mobile RF communications equipment or other strong or nearby
radio-frequency sources, could result in performance disruption of the ultrasound
system. Evidence of disruption may include image degradation or distortion, erratic
readings, equipment ceasing to operate, or other incorrect functioning. If this occurs,
survey the site to determine the source of disruption, and take the following actions
to eliminate the source(s).
• Turn equipment in the vicinity off and on to isolate disruptive equipment.
• Relocate or re-orient interfering equipment.
• Increase distance between interfering equipment and your ultrasound system.
• Manage use of frequencies close to ultrasound system frequencies.
• Remove devices that are highly susceptible to EMI.
• Lower power from internal sources within facility control (such as paging
systems).
• Label devices susceptible to EMI.
• Educate clinical staff to recognize potential EMI-related problems.
• Eliminate or reduce EMI with technical solutions (such as shielding).
• Restrict use of personal communicators (cell phones, computers) in areas with
devices susceptible to EMI.
• Share relevant EMI information with others, particularly when evaluating new
equipment purchases which may generate EMI.
• Purchase medical devices that comply with IEC 60601-1-2 EMC Standards.

Chapter 6: Safety 93
 Caution: To avoid the risk of increased electromagnetic emissions or decreased immunity, use
only accessories and peripherals recommended by SonoSite. Connection of
accessories and peripherals not recommended by SonoSite could result in
malfunctioning of your ultrasound system or other medical electrical devices in the
area. Contact SonoSite or your local representative for a list of accessories and
peripherals available from or recommended by SonoSite. See the SonoSite
accessories user guide.
Electrostatic discharge (ESD), or static shock, is a naturally occurring phenomenon.
ESD is common in conditions of low humidity, which can be caused by heating or air
conditioning. Static shock is a discharge of the electrical energy from a charged
body to a lesser or non-charged body. The degree of discharge can be significant
enough to cause damage to a transducer or an ultrasound system. The following
precautions can help reduce ESD: anti-static spray on carpets, anti-static spray on
linoleum, and anti-static mats.

Manufacturer’s declaration
Table 1ȱandȱTable 2ȱdocumentȱtheȱintendedȱuseȱenvironmentȱandȱEMCȱcomplianceȱlevelsȱofȱtheȱ
system.ȱForȱmaximumȱperformance,ȱensureȱthatȱtheȱsystemȱisȱusedȱinȱtheȱenvironmentsȱ
describedȱinȱthisȱtable.
Theȱsystemȱisȱintendedȱforȱuseȱinȱtheȱelectromagneticȱenvironmentȱspecifiedȱbelow.
Table 1: Manufacturer’s Declaration - Electromagnetic Emissions

Emissions Test Compliance Electromagnetic Environment

RF emissions Group 1 The SonoSite ultrasound system uses RF energy only

ClSPR 11 for its internal function. Therefore, its RF emissions
are very low and are not likely to cause any
interference in nearby electronic equipment.

RF emissions Class A The SonoSite ultrasound system is suitable for use in

ClSPR 11 all establishments other than domestic and those
directly connected to the public low-voltage power
supply network which supplies buildings used for
domestic purposes.

Harmonic emissions Class A

IEC 61000-3-2

Voltage fluctuations/ Complies

flicker emissions
IEC 61000-3-3

94
Theȱsystemȱisȱintendedȱforȱuseȱinȱtheȱelectromagneticȱenvironmentȱspecifiedȱbelow.
Table 2: Manufacturer’s Declaration - Electromagnetic Immunity

Safety
Electromagnetic
Immunity Test IEC 60601 Test Level Compliance Level
Environment

Electrostatic 2.0KV, 4.0KV, 6.0KV 2.0KV, 4.0KV, 6.0KV Floors should be wood,
Discharge (ESD) contact contact concrete or ceramic tile. If
IEC 61000-4-2 2.0KV, 4.0KV, 8.0KV air 2.0KV, 4.0KV, 8.0KV floors are covered with
air synthetic material, the relative
humidity should be at least
30%.

Electrical fast 2KV on the mains 2KV on the mains Mains power quality should
Transient burst 1KV on signal lines 1KV on signal lines be that of a typical
commercial or hospital
IEC 61000-4-4
environment.

Surge 0.5KV, 1.0KV, 2.0KV on 0.5KV, 1.0KV, 2.0KV Mains power quality should
IEC 61000-4-5 AC power lines to on AC power lines be that of a typical
ground to ground commercial or hospital
0.5KV, 1.0KV on AC 0.5KV, 1.0KV on AC environment.
power lines to lines power lines to
lines

Voltage dips, >5% UT >5% UT Mains power quality should

short (>95% dip in UT ) for (>95% dip in UT ) be that of a typical
interruptions commercial or hospital
0.5 cycle for 0.5 cycle
and voltage environment. If the user of the
variations on 40% UT 40% UT SonoSite ultrasound system
power supply (60% dip in UT ) for 5 (60% dip in UT ) for requires continued operation
input lines cycles 5 cycles during power mains
IEC 61000-4-11 interruptions, it is
70% UT 70% UT recommended that the
(30% dip in UT ) for 25 (30% dip in UT ) for SonoSite ultrasound system
cycles 25 cycles be powered from an
uninterruptible power supply
>5% UT >5% UT
or a battery.
(>95% dip in UT ) for 5s (>95% dip in UT )
for 5s

Chapter 6: Safety 95
 Table 2: Manufacturer’s Declaration - Electromagnetic Immunity (Continued)

Electromagnetic
Immunity Test IEC 60601 Test Level Compliance Level
Environment

Power 3 A/m 3 A/m If image distortion occurs, it

Frequency may be necessary to position
Magnetic Field the SonoSite ultrasound
IEC 61000-4-8 system further from sources of
power frequency magnetic
fields or to install magnetic
shielding. The power
frequency magnetic field
should be measured in the
Intended installation location
to assure that it is sufficiently
low.

Conducted RF 3 Vrms 3 Vrms Portable and mobile RF

IEC 61000-4-6 150 kHz to 80 MHz communications equipment
should be used no closer to
any part of the SonoSite
ultrasound system including
cables, than the
recommended separation
distance calculated from the
equation applicable to the
frequency of the transmitter.

Recommended Separation
Distance
d = 1.2 P

Radiated RF 3 Vim 3 V/m d = 1.2 P

IEC 61000-4-3 80 MHz to 2.5 GHz 80 MHz to 800 MHz
d = 2.3 P
800 MHz to 2,5 GHz
Where P is the maximum
output power rating of the
transmitter in watts (W)
according to the transmitter
manufacturer and d is the
recommended separation
distance in meters (m).

96
 Table 2: Manufacturer’s Declaration - Electromagnetic Immunity (Continued)

Electromagnetic
Immunity Test IEC 60601 Test Level Compliance Level

Safety
Environment

Radiated RF Field strengths from fixed RF

IEC 61000-4-3 transmitters, as determined by
an electromagnetic Site
(continued)
surveya, should be less than
the compliance level in each
frequency rangeb.
Interference may occur in the
vicinity of equipment marked
with the following symbol:

(IEC 60417 No. 417-IEC-5140:

“Source of non-ionizing
radiation”)
Note: UT is the AC mains voltage prior to application of the test level.
At 80 MHz and 800 MHz, the higher frequency range applies.
These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and
reflection from structures, objects and people.

a.Field strengths from fixed transmitters such as base stations for radio (cellular/cordless) telephones and
land mobile radios, amateur radio, AM and FM radio broadcast and TV broadcast cannot be predicted
theoretically with accuracy. To assess the electromagnetic environment due to fixed RF transmitters, an
electromagnetic site survey should be considered. If the measured field strength in the location in which
the SonoSite ultrasound system is used exceeds the applicable RF compliance level above, the SonoSite
ultrasound system should be observed to verify normal operation. If abnormal performance is observed,
additional measures may be necessary, such as re-orienting or relocating the SonoSite ultrasound system.
b.Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 3 V/m.

ALARA principle
ALARAȱisȱtheȱguidingȱprincipleȱforȱtheȱuseȱofȱdiagnosticȱultrasound.ȱSonographersȱandȱotherȱ
qualifiedȱultrasoundȱusers,ȱusingȱgoodȱjudgmentȱandȱinsight,ȱdetermineȱtheȱexposureȱthatȱisȱ
““asȱlowȱasȱreasonablyȱachievable.””ȱThereȱareȱnoȱsetȱrulesȱtoȱdetermineȱtheȱcorrectȱexposureȱforȱ
everyȱsituation.ȱTheȱqualifiedȱultrasoundȱuserȱdeterminesȱtheȱmostȱappropriateȱwayȱtoȱkeepȱ
exposureȱlowȱandȱbioeffectsȱtoȱaȱminimum,ȱwhileȱobtainingȱaȱdiagnosticȱexamination.
Aȱthoroughȱknowledgeȱofȱtheȱimagingȱmodes,ȱtransducerȱcapability,ȱsystemȱsetupȱandȱ
scanningȱtechniqueȱisȱnecessary.ȱTheȱimagingȱmodeȱdeterminesȱtheȱnatureȱofȱtheȱultrasoundȱ
beam.ȱAȱstationaryȱbeamȱresultsȱinȱaȱmoreȱconcentratedȱexposureȱthanȱaȱscannedȱbeam,ȱwhichȱ
spreadsȱthatȱexposureȱoverȱthatȱarea.ȱTheȱtransducerȱcapabilityȱdependsȱuponȱtheȱfrequency,ȱ

Chapter 6: Safety 97
 penetration,ȱresolution,ȱandȱfieldȱofȱview.ȱTheȱdefaultȱsystemȱpresetsȱareȱresetȱatȱtheȱstartȱofȱ
eachȱnewȱpatient.ȱItȱisȱtheȱscanningȱtechniqueȱofȱtheȱqualifiedȱultrasoundȱuserȱalongȱwithȱ
patientȱvariabilityȱthatȱdeterminesȱtheȱsystemȱsettingsȱthroughoutȱtheȱexam.
TheȱvariablesȱwhichȱaffectȱtheȱwayȱtheȱqualifiedȱultrasoundȱuserȱimplementsȱtheȱALARAȱ
principleȱinclude:ȱpatientȱbodyȱsize,ȱlocationȱofȱtheȱboneȱrelativeȱtoȱtheȱfocalȱpoint,ȱattenuationȱ
inȱtheȱbody,ȱandȱultrasoundȱexposureȱtime.ȱExposureȱtimeȱisȱanȱespeciallyȱusefulȱvariable,ȱ
becauseȱtheȱqualifiedȱultrasoundȱuserȱcanȱcontrolȱit.ȱTheȱabilityȱtoȱlimitȱtheȱexposureȱoverȱtimeȱ
supportsȱtheȱALARAȱprinciple.

Applying ALARA
Theȱsystemȱimagingȱmodeȱselectedȱbyȱtheȱqualifiedȱultrasoundȱuserȱisȱdeterminedȱbyȱtheȱ
diagnosticȱinformationȱrequired.ȱ2Dȱimagingȱprovidesȱanatomicalȱinformation;ȱCPDȱimagingȱ
providesȱinformationȱaboutȱtheȱenergyȱorȱamplitudeȱstrengthȱofȱtheȱDopplerȱsignalȱoverȱtimeȱ
atȱaȱgivenȱanatomicalȱlocationȱandȱisȱusedȱforȱdetectingȱtheȱpresenceȱofȱbloodȱflow;ȱColorȱ
imagingȱprovidesȱinformationȱaboutȱtheȱenergyȱorȱamplitudeȱstrengthȱofȱtheȱDopplerȱsignalȱ
overȱtimeȱatȱaȱgivenȱanatomicalȱlocationȱandȱisȱusedȱforȱdetectingȱtheȱpresence,ȱvelocity,ȱandȱ
directionȱofȱbloodȱflow;ȱTissueȱHarmonicȱImagingȱusesȱhigherȱreceivedȱfrequenciesȱtoȱreduceȱ
clutter,ȱartifact,ȱandȱimproveȱresolutionȱonȱtheȱ2Dȱimage.ȱUnderstandingȱtheȱnatureȱofȱtheȱ
imagingȱmodeȱusedȱallowsȱtheȱqualifiedȱultrasoundȱuserȱtoȱapplyȱtheȱALARAȱprinciple.
Prudentȱuseȱofȱultrasoundȱrequiresȱthatȱpatientȱexposureȱtoȱultrasoundȱbeȱlimitedȱtoȱtheȱlowestȱ
ultrasoundȱoutputȱforȱtheȱshortestȱtimeȱnecessaryȱtoȱachieveȱacceptableȱdiagnosticȱresults.ȱ
Decisionsȱthatȱsupportȱprudentȱuseȱareȱbasedȱonȱtheȱtypeȱofȱpatient,ȱexamȱtype,ȱpatientȱhistory,ȱ
easeȱorȱdifficultyȱofȱobtainingȱdiagnosticallyȱusefulȱinformation,ȱandȱpotentialȱlocalizedȱ
heatingȱofȱtheȱpatientȱdueȱtoȱtransducerȱsurfaceȱtemperature.
Theȱsystemȱhasȱbeenȱdesignedȱtoȱensureȱthatȱtemperatureȱatȱtheȱfaceȱofȱtheȱtransducerȱwillȱnotȱ
exceedȱtheȱlimitsȱestablishedȱinȱSectionȱ42ȱofȱENȱ60601Ȭ2Ȭ37:ȱParticularȱrequirementȱforȱtheȱ
safetyȱofȱultrasoundȱmedicalȱdiagnosticȱandȱmonitoringȱequipment.ȱSeeȱ““Transducerȱsurfaceȱ
temperatureȱrise””ȱonȱpage 104.ȱInȱtheȱeventȱofȱaȱdeviceȱmalfunction,ȱthereȱareȱredundantȱ
controlsȱthatȱlimitȱtransducerȱpower.ȱThisȱisȱaccomplishedȱbyȱanȱelectricalȱdesignȱthatȱlimitsȱ
bothȱpowerȱsupplyȱcurrentȱandȱvoltageȱtoȱtheȱtransducer.
Theȱsonographerȱusesȱtheȱsystemȱcontrolsȱtoȱadjustȱimageȱqualityȱandȱlimitȱultrasoundȱoutput.ȱ
Theȱsystemȱcontrolsȱareȱdividedȱintoȱthreeȱcategoriesȱrelativeȱtoȱoutput:ȱcontrolsȱthatȱdirectlyȱ
affectȱoutput,ȱcontrolsȱthatȱindirectlyȱaffectȱoutput,ȱandȱreceiverȱcontrols.

Direct controls
Theȱsystemȱdoesȱnotȱexceedȱaȱspatialȱpeakȱtemporalȱaverageȱintensityȱ(ISPTA)ȱofȱ720 mW/cm2ȱ
forȱallȱimagingȱmodes.ȱ(ForȱeitherȱtheȱOphthalmicȱorȱOrbitalȱexam,ȱtheȱacousticȱoutputȱisȱ
limitedȱtoȱtheȱfollowingȱvalues:ȱISPTAȱdoesȱnotȱexceedȱ50 mW/cm2;ȱTIȱdoesȱnotȱexceedȱ1.0,ȱandȱ
MIȱdoesȱnotȱexceedȱ0.23.)ȱTheȱmechanicalȱindexȱ(MI)ȱandȱthermalȱindexȱ(TI)ȱmayȱexceedȱvaluesȱ
greaterȱthanȱ1.0ȱonȱsomeȱtransducersȱinȱsomeȱimagingȱmodes.ȱOneȱmayȱmonitorȱtheȱMIȱandȱTIȱ
valuesȱandȱadjustȱtheȱcontrolsȱtoȱreduceȱtheseȱvalues.ȱSeeȱ““GuidelinesȱforȱreducingȱMIȱandȱTI””ȱ

98
 onȱpage 99.ȱAdditionally,ȱoneȱmeansȱforȱmeetingȱtheȱALARAȱprincipleȱisȱtoȱsetȱtheȱMIȱorȱTIȱ
valuesȱtoȱaȱlowȱindexȱvalueȱandȱthenȱmodifyingȱthisȱlevelȱuntilȱaȱsatisfactoryȱimageȱorȱDopplerȱ
modeȱisȱobtained.ȱForȱmoreȱinformationȱonȱMIȱandȱTI,ȱseeȱBSȱENȱ60601Ȭ2Ȭ37:2001:ȱAnnexȱHH.

Safety
Indirect controls
Theȱcontrolsȱthatȱindirectlyȱaffectȱoutputȱareȱcontrolsȱaffectingȱimagingȱmode,ȱfreeze,ȱandȱ
depth.ȱTheȱimagingȱmodeȱdeterminesȱtheȱnatureȱofȱtheȱultrasoundȱbeam.ȱTissueȱattenuationȱisȱ
directlyȱrelatedȱtoȱtransducerȱfrequency.ȱTheȱhigherȱtheȱPRFȱ(pulseȱrepetitionȱfrequency),ȱtheȱ
moreȱoutputȱpulsesȱoccurȱoverȱaȱperiodȱofȱtime.

Receiver controls
Theȱreceiverȱcontrolsȱareȱtheȱgainȱcontrols.ȱReceiverȱcontrolsȱdoȱnotȱaffectȱoutput.ȱTheyȱshouldȱ
beȱused,ȱifȱpossible,ȱtoȱimproveȱimageȱqualityȱbeforeȱusingȱcontrolsȱthatȱdirectlyȱorȱindirectlyȱ
affectȱoutput.

Acoustic artifacts
Anȱacousticȱartifactȱisȱinformation,ȱpresentȱorȱabsentȱinȱanȱimage,ȱthatȱdoesȱnotȱproperlyȱ
indicateȱtheȱstructureȱorȱflowȱbeingȱimaged.ȱThereȱareȱhelpfulȱartifactsȱthatȱaidȱinȱdiagnosisȱandȱ
thoseȱthatȱhinderȱproperȱinterpretation.ȱExamplesȱofȱartifactsȱinclude:
•• Shadowing
•• Throughȱtransmission
•• Aliasing
•• Reverberations
•• Cometȱtails
Forȱmoreȱinformationȱonȱdetectingȱandȱinterpretingȱacousticȱartifacts,ȱseeȱtheȱfollowingȱ
reference:
Kremkau,ȱFrederickȱW.ȱDiagnosticȱUltrasound:ȱPrinciplesȱandȱInstruments.ȱ7thȱed.,ȱW.B.ȱ
SaundersȱCompany,ȱ(Oct.ȱ17,ȱ2005).

Guidelines for reducing MI and TI

TheȱfollowingȱareȱgeneralȱguidelinesȱforȱreducingȱMIȱorȱTI.ȱIfȱmultipleȱparametersȱareȱgiven,ȱ
theȱbestȱresultsȱmayȱbeȱachievedȱbyȱminimizingȱtheseȱparametersȱsimultaneously.ȱInȱsomeȱ
modesȱchangingȱtheseȱparametersȱdoesȱnotȱaffectȱMIȱorȱTI.ȱChangesȱtoȱotherȱparametersȱmayȱ
alsoȱresultȱinȱMIȱandȱTIȱreductions.ȱPleaseȱnoteȱtheȱMIȱandȱTIȱvaluesȱonȱtheȱrightȱsideȱofȱtheȱ
screen.

Chapter 6: Safety 99
 Table 3: MI

Transducer Depth

C11x n

C60x n

HFL38x n

ICTx n

L25x n

L38x n

P10x n

P21x n

SLAx n

TEEx n
pDecrease or lower setting of parameter to reduce MI.
nIncrease or raise setting of parameter to reduce MI.

Table 4: TI (TIS, TIC, TIB)

Color Power Doppler Settings

Transducer PW Settings
Box Box Box
PRF Depth Optimize
Width Height Depth

C11x n p n p (Depth)

C60x p n p n p(PRF)

HFL38x n n n p(Depth)

ICTx n n p Exam Gyn p (PRF)

L25x p n p (PRF)

L38x p p (Depth)

P10x — — n p — — p (PRF)

P21x p p n p (PRF)

100
Table 4: TI (TIS, TIC, TIB)

Color Power Doppler Settings

Safety
Transducer PW Settings
Box Box Box
PRF Depth Optimize
Width Height Depth

SLAx — — n p n — p (PRF)

TEEx — — — p p — p (PRF)
pDecrease or lower setting of parameter to reduce MI.
nIncrease or raise setting of parameter to reduce MI.

Chapter 6: Safety 101

Output display
TheȱsystemȱmeetsȱtheȱAIUMȱoutputȱdisplayȱstandardȱforȱMIȱandȱTIȱ(seeȱlastȱreferenceȱinȱ
““Relatedȱguidanceȱdocuments””ȱbelow).ȱTable 5ȱindicatesȱforȱeachȱtransducerȱandȱoperatingȱ
modeȱwhenȱeitherȱtheȱTIȱorȱMIȱisȱgreaterȱthanȱorȱequalȱtoȱaȱvalueȱofȱ1.0,ȱthusȱrequiringȱdisplay.
Note: TheȱD2xȱtransducerȱhasȱaȱstaticȱcontinuousȱwaveȱ(CW)ȱoutput.ȱThisȱoutputȱisȱfixed.ȱTherefore,ȱ
TIȱandȱMIȱvaluesȱcannotȱbeȱchangedȱbyȱanyȱsystemȱcontrolsȱavailableȱtoȱtheȱuser.
Table 5: TI or MI t 1.0

2D/ CPD/ PW CW
Transducer Model Index
M Mode Color Doppler Doppler

C11x/8-5 MI No No No —

TIC,TIB, or TIS No Yes Yes —

C60x/5-2 MI Yes No No —

TIC, TIB, or TIS No No Yes —

D2x/2 MI — — — No

TIC,TIB, or TIS — — — Yes

HFL38x/13-6 MI No Yes Yes —

TIC, TIB, or TIS No Yes Yes —

ICTx/8-5 MI No No No —

TIC, TIB, or TIS No No Yes —

L25x/13-6 MI No Yes No —

TIC,TIB, or TIS No No Yes —

L38x/10-5 MI No Yes Yes —

TIC, TIB, or TIS No Yes Yes —

P10x/8-4 MI No Yes Yes No

TIC, TIB, or TIS Yes Yes Yes Yes

P21x/5-1 MI Yes Yes Yes No

TIC, TIB, or TIS Yes Yes Yes Yes

SLAx/13-6 MI No No No —

TIC, TIB, or TIS No No Yes —

102
 Table 5: TI or MI t 1.0 (Continued)

2D/ CPD/ PW CW
Transducer Model Index

Safety
M Mode Color Doppler Doppler

TEEx/8-3 MI No No No No

TIC, TIB, or TIS No No Yes Yes

EvenȱwhenȱMIȱisȱlessȱthanȱ1.0,ȱtheȱsystemȱprovidesȱaȱcontinuousȱrealȬtimeȱdisplayȱofȱMIȱinȱallȱ
imagingȱmodes,ȱinȱincrementsȱofȱ0.1.
TheȱsystemȱmeetsȱtheȱoutputȱdisplayȱstandardȱforȱTIȱandȱprovidesȱaȱcontinuousȱrealȬtimeȱ
displayȱofȱTIȱinȱallȱimagingȱmodes,ȱinȱincrementsȱofȱ0.1.
TheȱTIȱconsistsȱofȱthreeȱuserȬselectableȱindices,ȱandȱonlyȱoneȱofȱtheseȱisȱdisplayedȱatȱanyȱoneȱ
time.ȱInȱorderȱtoȱdisplayȱTIȱproperlyȱandȱmeetȱtheȱALARAȱprinciple,ȱtheȱuserȱselectsȱanȱ
appropriateȱTIȱbasedȱonȱtheȱspecificȱexamȱbeingȱperformed.ȱSonoSiteȱprovidesȱaȱcopyȱofȱAIUMȱ
MedicalȱUltrasoundȱSafety,ȱwhichȱcontainsȱguidanceȱonȱdeterminingȱwhichȱTIȱisȱappropriateȱ(Seeȱ
““Relatedȱguidanceȱdocuments””ȱonȱpage 104).

MI and TI output display accuracy

TheȱaccuracyȱresultȱforȱtheȱMIȱisȱstatedȱstatistically.ȱWithȱ95%ȱconfidence,ȱ95%ȱofȱtheȱmeasuredȱ
MIȱvaluesȱwillȱbeȱwithinȱ+18%ȱtoȱȬ25%ȱofȱtheȱdisplayedȱMIȱvalue,ȱorȱ+0.2ȱofȱtheȱdisplayedȱvalue,ȱ
whicheverȱvalueȱisȱlarger.
TheȱaccuracyȱresultȱforȱtheȱTIȱisȱstatedȱstatistically.ȱWithȱ95%ȱconfidence,ȱ95%ȱofȱtheȱmeasuredȱ
TIȱvaluesȱwillȱbeȱwithinȱ+21%ȱtoȱȬ40%ȱofȱtheȱdisplayedȱTIȱvalue,ȱorȱ+0.2ȱofȱtheȱdisplayedȱvalue,ȱ
whicheverȱvalueȱisȱlarger.ȱTheȱvaluesȱequateȱtoȱ+1dBȱtoȱȬ3dB.
Aȱdisplayedȱvalueȱofȱ0.0ȱforȱMIȱorȱTIȱmeansȱthatȱtheȱcalculatedȱestimateȱforȱtheȱindexȱisȱlessȱthanȱ
0.05.

Factors that contribute to display uncertainty

Theȱnetȱuncertaintyȱofȱtheȱdisplayedȱindicesȱisȱderivedȱbyȱcombiningȱtheȱquantifiedȱuncertaintyȱ
fromȱthreeȱsources:ȱmeasurementȱuncertainty,ȱsystemȱandȱtransducerȱvariability,ȱandȱ
engineeringȱassumptionsȱandȱapproximationsȱmadeȱwhenȱcalculatingȱtheȱdisplayȱvalues.
Measurementȱerrorsȱofȱtheȱacousticȱparametersȱwhenȱtakingȱtheȱreferenceȱdataȱareȱtheȱmajorȱ
sourceȱofȱerrorȱthatȱcontributesȱtoȱtheȱdisplayȱuncertainty.ȱTheȱmeasurementȱerrorȱisȱdescribedȱ
inȱ““Acousticȱmeasurementȱprecisionȱandȱuncertainty””ȱonȱpage 133.
TheȱdisplayedȱMIȱandȱTIȱvaluesȱareȱbasedȱonȱcalculationsȱthatȱuseȱaȱsetȱofȱacousticȱoutputȱ
measurementsȱthatȱwereȱmadeȱusingȱaȱsingleȱreferenceȱultrasoundȱsystemȱwithȱaȱsingleȱ
referenceȱtransducerȱthatȱisȱrepresentativeȱofȱtheȱpopulationȱofȱtransducersȱofȱthatȱtype.ȱTheȱ
referenceȱsystemȱandȱtransducerȱareȱchosenȱfromȱaȱsampleȱpopulationȱofȱsystemsȱandȱ
transducersȱtakenȱfromȱearlyȱproductionȱunits,ȱandȱtheyȱareȱselectedȱbasedȱonȱhavingȱanȱ
acousticȱoutputȱthatȱisȱrepresentativeȱofȱtheȱnominalȱexpectedȱacousticȱoutputȱforȱallȱ
transducer/systemȱcombinationsȱthatȱmightȱoccur.ȱOfȱcourseȱeveryȱtransducer/systemȱ

Chapter 6: Safety 103

 combinationȱhasȱitsȱownȱuniqueȱcharacteristicȱacousticȱoutput,ȱandȱwillȱnotȱmatchȱtheȱnominalȱ
outputȱonȱwhichȱtheȱdisplayȱestimatesȱareȱbased.ȱThisȱvariabilityȱbetweenȱsystemsȱandȱ
transducersȱintroducesȱanȱerrorȱintoȱdisplayedȱvalue.ȱByȱdoingȱacousticȱoutputȱsamplingȱ
testingȱduringȱproduction,ȱtheȱamountȱofȱerrorȱintroducedȱbyȱtheȱvariabilityȱisȱbounded.ȱTheȱ
samplingȱtestingȱensuresȱthatȱtheȱacousticȱoutputȱofȱtransducersȱandȱsystemsȱbeingȱ
manufacturedȱstaysȱwithinȱaȱspecifiedȱrangeȱofȱtheȱnominalȱacousticȱoutput.
Anotherȱsourceȱofȱerrorȱarisesȱfromȱtheȱassumptionsȱandȱapproximationsȱthatȱareȱmadeȱwhenȱ
derivingȱtheȱestimatesȱforȱtheȱdisplayȱindices.ȱChiefȱamongȱtheseȱassumptionsȱisȱthatȱtheȱ
acousticȱoutput,ȱandȱthusȱtheȱderivedȱdisplayȱindices,ȱareȱlinearlyȱcorrelatedȱwithȱtheȱtransmitȱ
driveȱvoltageȱofȱtheȱtransducer.ȱGenerally,ȱthisȱassumptionȱisȱveryȱgood,ȱbutȱitȱisȱnotȱexact,ȱandȱ
thusȱsomeȱerrorȱinȱtheȱdisplayȱcanȱbeȱattributedȱtoȱtheȱassumptionȱofȱvoltageȱlinearity.

Related guidance documents

InformationȱforȱManufacturersȱSeekingȱMarketingȱClearanceȱofȱDiagnosticȱUltrasoundȱ
SystemsȱandȱTransducers,ȱFDA,ȱ1997.
MedicalȱUltrasoundȱSafety,ȱAmericanȱInstituteȱofȱUltrasoundȱinȱMedicineȱ(AIUM),ȱ1994.ȱ(Aȱ
copyȱisȱincludedȱwithȱeachȱsystem.)
AcousticȱOutputȱMeasurementȱStandardȱforȱDiagnosticȱUltrasoundȱEquipment,ȱNEMAȱ
UD2Ȭ2004.
AcousticȱOutputȱMeasurementȱandȱLabelingȱStandardȱforȱDiagnosticȱUltrasoundȱEquipment,ȱ
AmericanȱInstituteȱofȱUltrasoundȱinȱMedicine,ȱ1993.
StandardȱforȱRealȬTimeȱDisplayȱofȱThermalȱandȱMechanicalȱAcousticȱOutputȱIndicesȱonȱ
DiagnosticȱUltrasoundȱEquipment,ȱNEMAȱUD3Ȭ2004.
GuidanceȱonȱtheȱinterpretationȱofȱTIȱandȱMIȱtoȱbeȱusedȱtoȱinformȱtheȱoperator,ȱAnnexȱHH,ȱBSȱ
ENȱ60601Ȭ2Ȭ37ȱreprintedȱatȱP05699.

Transducer surface temperature rise

Table 6ȱandȱTable 7ȱlistȱtheȱmeasuredȱsurfaceȱtemperatureȱriseȱfromȱambientȱ(23°Cȱ±ȱ3°C)ȱofȱ
transducersȱusedȱonȱtheȱultrasoundȱsystem.ȱTheȱtemperaturesȱwereȱmeasuredȱinȱaccordanceȱ
withȱENȱ60601Ȭ2Ȭ37ȱsectionȱ42ȱwithȱcontrolsȱandȱsettingsȱpositionedȱtoȱgiveȱmaximumȱ
temperatures
Table 6: Transducer Surface Temperature Rise, External Use (°C)

Test C11x C60x D2 HFL38x L25x L38x P10x P21x

Still air 17.6 16.2 8.3 15.5 16.1 16.3 15.6 16.8

Simulated
9.1 8.8 1.9 7.9 8.5 9.6 9.8 9.0
Use

104
 Table 7: Transducer Surface Temperature Rise, Internal Use (°C )

Safety
Test ICTx SLAx TEEx

Still air 9.2 9.5 9.3

Simulated
5.2 4.8 5.8
Use

Acoustic output measurement

Sinceȱtheȱinitialȱuseȱofȱdiagnosticȱultrasound,ȱtheȱpossibleȱhumanȱbiologicalȱeffectsȱ(bioeffects)ȱ
fromȱultrasoundȱexposureȱhaveȱbeenȱstudiedȱbyȱvariousȱscientificȱandȱmedicalȱinstitutions.ȱInȱ
Octoberȱ1987,ȱtheȱAmericanȱInstituteȱofȱUltrasoundȱinȱMedicineȱ(AIUM)ȱratifiedȱaȱreportȱfromȱ
itsȱBioeffectsȱCommitteeȱ(BioeffectsȱConsiderationsȱforȱtheȱSafetyȱofȱDiagnosticȱUltrasound,ȱJȱ
UltrasoundȱMed.,ȱSept.ȱ1988:ȱVol.ȱ7,ȱNo.ȱ9ȱSupplement).ȱTheȱreport,ȱsometimesȱreferredȱtoȱasȱ
theȱStoweȱReport,ȱreviewedȱavailableȱdataȱonȱpossibleȱeffectsȱofȱultrasoundȱexposure.ȱAnotherȱ
report,ȱ““BioeffectsȱandȱSafetyȱofȱDiagnosticȱUltrasound,””ȱdatedȱJanuaryȱ28,ȱ1993,ȱprovidesȱ
moreȱcurrentȱinformation.
Theȱacousticȱoutputȱforȱthisȱultrasoundȱsystemȱhasȱbeenȱmeasuredȱandȱcalculatedȱinȱ
accordanceȱwithȱ““AcousticȱOutputȱMeasurementȱStandardȱforȱDiagnosticȱUltrasoundȱ
Equipment””ȱ(NEMAȱUD2Ȭ2004),ȱandȱ““StandardȱforȱRealȬTimeȱDisplayȱofȱThermalȱandȱ
MechanicalȱAcousticȱOutputȱIndicesȱonȱDiagnosticȱUltrasoundȱEquipment””ȱ(NEMAȱ
UDe3Ȭ2004).

In Situ, derated, and water value intensities

Allȱintensityȱparametersȱareȱmeasuredȱinȱwater.ȱSinceȱwaterȱdoesȱnotȱabsorbȱacousticȱenergy,ȱ
theseȱwaterȱmeasurementsȱrepresentȱaȱworstȱcaseȱvalue.ȱBiologicalȱtissueȱdoesȱabsorbȱacousticȱ
energy.ȱTheȱtrueȱvalueȱofȱtheȱintensityȱatȱanyȱpointȱdependsȱonȱtheȱamount,ȱtypeȱofȱtissue,ȱandȱ
theȱfrequencyȱofȱtheȱultrasoundȱpassingȱthroughȱtheȱtissue.ȱTheȱintensityȱvalueȱinȱtheȱtissue,ȱ
In Situ,ȱhasȱbeenȱestimatedȱbyȱusingȱtheȱfollowingȱformula:
In Situ=ȱWaterȱ[eȬ(0.23alf)]
where:ȱ
In Situȱ=ȱIn Situȱintensityȱvalue
Waterȱ=ȱWaterȱintensityȱvalueȱ
eȱ=ȱ2.7183
aȱ=ȱattenuationȱfactorȱ(dB/cm MHz)

Chapter 6: Safety 105

 Attenuationȱfactorȱ(a)ȱforȱvariousȱtissueȱtypesȱareȱgivenȱbelow:
brainȱ=ȱ0.53
heartȱ=ȱ0.66
kidneyȱ=ȱ0.79
liverȱ=ȱ0.43
muscleȱ=ȱ0.55
lȱ=ȱskinlineȱtoȱmeasurementȱdepthȱinȱcm
fȱ=ȱcenterȱfrequencyȱofȱtheȱtransducer/system/modeȱcombinationȱinȱMHz
Sinceȱtheȱultrasonicȱpathȱduringȱtheȱexamȱisȱlikelyȱtoȱpassȱthroughȱvaryingȱlengthsȱandȱtypesȱ
ofȱtissue,ȱitȱisȱdifficultȱtoȱestimateȱtheȱtrueȱIn Situȱintensity.ȱAnȱattenuationȱfactorȱofȱ0.3ȱisȱusedȱ
forȱgeneralȱreportingȱpurposes;ȱtherefore,ȱtheȱIn Situȱvalueȱcommonlyȱreportedȱusesȱtheȱ
formula:ȱ
In Situȱ(derated)ȱ=ȱWaterȱ[eȱȬ(0.069lf)]
SinceȱthisȱvalueȱisȱnotȱtheȱtrueȱIn Situȱintensity,ȱtheȱtermȱ““derated””ȱisȱusedȱtoȱqualify it.
Theȱmaximumȱderatedȱandȱtheȱmaximumȱwaterȱvaluesȱdoȱnotȱalwaysȱoccurȱatȱtheȱsameȱ
operatingȱconditions;ȱtherefore,ȱtheȱreportedȱmaximumȱwaterȱandȱderatedȱvaluesȱmayȱnotȱbeȱ
relatedȱbyȱtheȱIn Situȱ(derated)ȱformula.ȱForȱexample:ȱaȱmultiȬzoneȱarrayȱtransducerȱthatȱhasȱ
maximumȱwaterȱvalueȱintensitiesȱinȱitsȱdeepestȱzone,ȱbutȱalsoȱhasȱtheȱsmallestȱderatingȱfactorȱ
inȱthatȱzone.ȱTheȱsameȱtransducerȱmayȱhaveȱitsȱlargestȱderatedȱintensityȱinȱoneȱofȱitsȱshallowestȱ
focalȱzones.

Tissue models and equipment survey

TissueȱmodelsȱareȱnecessaryȱtoȱestimateȱattenuationȱandȱacousticȱexposureȱlevelsȱIn Situȱfromȱ
measurementsȱofȱacousticȱoutputȱmadeȱinȱwater.ȱCurrently,ȱavailableȱmodelsȱmayȱbeȱlimitedȱinȱ
theirȱaccuracyȱbecauseȱofȱvaryingȱtissueȱpathsȱduringȱdiagnosticȱultrasoundȱexposuresȱandȱ
uncertaintiesȱinȱtheȱacousticȱpropertiesȱofȱsoftȱtissues.ȱNoȱsingleȱtissueȱmodelȱisȱadequateȱforȱ
predictingȱexposuresȱinȱallȱsituationsȱfromȱmeasurementsȱmadeȱinȱwater,ȱandȱcontinuedȱ
improvementȱandȱverificationȱofȱtheseȱmodelsȱisȱnecessaryȱforȱmakingȱexposureȱassessmentsȱ
forȱspecificȱexamȱtypes.
Aȱhomogeneousȱtissueȱmodelȱwithȱattenuationȱcoefficientȱofȱ0.3 dB/cm MHzȱthroughoutȱtheȱ
beamȱpathȱisȱcommonlyȱusedȱwhenȱestimatingȱexposureȱlevels.ȱTheȱmodelȱisȱconservativeȱinȱ
thatȱitȱoverestimatesȱtheȱIn Situȱacousticȱexposureȱwhenȱtheȱpathȱbetweenȱtheȱtransducerȱandȱ
siteȱofȱinterestȱisȱcomposedȱentirelyȱofȱsoftȱtissue.ȱWhenȱtheȱpathȱcontainsȱsignificantȱamountsȱ
ofȱfluid,ȱasȱinȱmanyȱfirstȱandȱsecondȬtrimesterȱpregnanciesȱscannedȱtransabdominally,ȱthisȱ
modelȱmayȱunderestimateȱtheȱIn Situȱacousticȱexposure.ȱTheȱamountȱofȱunderestimationȱ
dependsȱuponȱeachȱspecificȱsituation.

106
 FixedȬpathȱtissueȱmodels,ȱinȱwhichȱsoftȱtissueȱthicknessȱisȱheldȱconstant,ȱsometimesȱareȱusedȱtoȱ
estimateȱIn Situȱacousticȱexposuresȱwhenȱtheȱbeamȱpathȱisȱlongerȱthanȱ3 cmȱandȱconsistsȱlargelyȱ
ofȱfluid.ȱWhenȱthisȱmodelȱisȱusedȱtoȱestimateȱmaximumȱexposureȱtoȱtheȱfetusȱduringȱ

Safety
transabdominalȱscans,ȱaȱvalueȱofȱ1 dB/cm MHzȱmayȱbeȱusedȱduringȱallȱtrimesters.
Existingȱtissueȱmodelsȱthatȱareȱbasedȱonȱlinearȱpropagationȱmayȱunderestimateȱacousticȱ
exposuresȱwhenȱsignificantȱsaturationȱdueȱtoȱnonȬlinearȱdistortionȱofȱbeamsȱinȱwaterȱisȱpresentȱ
duringȱtheȱoutputȱmeasurement.
Theȱmaximumȱacousticȱoutputȱlevelsȱofȱdiagnosticȱultrasoundȱdevicesȱextendȱoverȱaȱbroadȱ
rangeȱofȱvalues:
•• Aȱsurveyȱofȱ1990ȬequipmentȱmodelsȱyieldedȱMIȱvaluesȱbetweenȱ0.1 andȱ1.0ȱatȱtheirȱhighestȱ
outputȱsettings.ȱMaximumȱMIȱvaluesȱofȱapproximatelyȱ2.0ȱareȱknownȱtoȱoccurȱforȱcurrentlyȱ
availableȱequipment.ȱMaximumȱMIȱvaluesȱareȱsimilarȱforȱrealȬtimeȱ2DȱandȱM Modeȱimaging.
•• Computedȱestimatesȱofȱupperȱlimitsȱtoȱtemperatureȱelevationsȱduringȱtransabdominalȱscansȱ
wereȱobtainedȱinȱaȱsurveyȱofȱ1988ȱandȱ1990ȱpulsedȱDopplerȱequipment.ȱTheȱvastȱmajorityȱofȱ
modelsȱyieldedȱupperȱlimitsȱlessȱthanȱ1°ȱandȱ4°Cȱ(1.8°ȱandȱ7.2°F)ȱforȱexposuresȱofȱ
firstȬtrimesterȱfetalȱtissueȱandȱsecondȬtrimesterȱfetalȱbone,ȱrespectively.ȱTheȱlargestȱvaluesȱ
obtainedȱwereȱapproximatelyȱ1.5°Cȱ(2.7°F)ȱforȱfirstȬtrimesterȱfetalȱtissueȱandȱ7°Cȱ(12.6°F)ȱforȱ
secondȬtrimesterȱfetalȱbone.ȱEstimatedȱmaximumȱtemperatureȱelevationsȱgivenȱhereȱareȱforȱ
aȱ““fixedȱpath””ȱtissueȱmodelȱandȱareȱforȱdevicesȱhavingȱISPTAȱvaluesȱgreaterȱthanȱ500 mW/
cm2.ȱTheȱtemperatureȱelevationsȱforȱfetalȱboneȱandȱtissueȱwereȱcomputedȱbasedȱonȱ
calculationȱproceduresȱgivenȱinȱSectionsȱ4.3.2.1Ȭ4.3.2.6ȱinȱ““BioeffectsȱandȱSafetyȱofȱDiagnosticȱ
Ultrasound””ȱ(AIUM,ȱ1993).

Acoustic output tables

Table 8ȱthroughȱTable 31ȱindicateȱtheȱacousticȱoutputȱforȱtheȱsystemȱandȱtransducerȱ
combinationsȱwithȱaȱTIȱorȱMIȱequalȱtoȱorȱgreaterȱthanȱone.ȱTheseȱtablesȱareȱorganizedȱbyȱ
transducerȱmodelȱandȱimagingȱmode.ȱForȱaȱdefinitionȱofȱtermsȱusedȱinȱtheȱtables,ȱseeȱ““Termsȱ
usedȱinȱtheȱacousticȱoutputȱtables””ȱonȱpage 132.

Chapter 6: Safety 107

Table 8: Transducer Model: C11x/8-5 Operating Mode: CPD/Color

TIS TIB
Index Label M.I. Non-scan TIC
Scan Non-scan
Aaprtd1 Aaprt>1
Global Maximum Index Value (a) (a) — — — 1.2
pr.3 (MPa) #
W0 (mW) # — — 40.50
min of [W.3(z1),ITA.3(z1)] (mW) —
Associated Acoustic

z1 (cm) —
Parameter

zbp (cm) —
zsp (cm) # —
deq(zsp) (cm) —
fc (MHz) # # — — — 4.38
Dim of Aaprt X (cm) # — — — 0.36
Y (cm) # — — — 0.5
PD (µsec) #
PRF (Hz) #
Other Information

pr@PIImax (MPa) #
deq@Pllmax (cm) —
Focal Length FLx (cm) # — — 1.56
FLy (cm) # — — 2.5
IPA.3@MImax (W/cm2) #
Control 1: Mode CPD
Conditions
Operating
Control

Control 2: Exam Type Vas

Control 3: PRF 2841
Control 4: Optimization/Depth Med/2.0
Control 5: Color Box Top/
Position/ Size Short

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

108
Table 9: Transducer Model: C11x/8-5 Operating Mode: PW Doppler

TIS TIB

Safety
Index Label M.I. Non-scan TIC
Scan Non-scan
Aaprtd1 Aaprt>1
Global Maximum Index Value (a) — (a) — 1.8 1.7
pr.3 (MPa) #
W0 (mW) — # 26.29 24.65
min of [W.3(z1),ITA.3(z1)] (mW) —
Associated Acoustic

z1 (cm) —
Parameter

zbp (cm) —
zsp (cm) # 1.1
deq(zsp) (cm) 0.236
fc (MHz) # — # — 4.36 4.36
Dim of Aaprt X (cm) — # — 0.28 0.2
Y (cm) — # — 0.5 0.5
PD (µsec) #
PRF (Hz) #
Other Information

pr@PIImax (MPa) #
deq@Pllmax (cm) 0.226
Focal Length FLx (cm) — # — 0.77
FLy (cm) — # — 2.5
IPA.3@MImax (W/cm2) #
Control 1: Exam Type Any Any
Conditions
Operating
Control

Control 2: Sample Volume 2 mm 3 mm

Control 3: PRF 3906 t3906
Control 4: Sample Volume Position Zone 1 Zone 0

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

Chapter 6: Safety 109

Table 10: Transducer Model: C60x/5-2 Operating Mode: 2D

TIS TIB
Index Label M.I. Non-scan TIC
Scan Non-scan
Aaprtd1 Aaprt>1
Global Maximum Index Value 1.0 (a) — — — (b)
pr.3 (MPa) 1.69
W0 (mW) # — — #
min of [W.3(z1),ITA.3(z1)] (mW) —
Associated Acoustic

z1 (cm) —
Parameter

zbp (cm) —
zsp (cm) 4.7 —
deq(zsp) (cm) —
fc (MHz) 2.84 # — — — #
Dim of Aaprt X (cm) # — — — #
Y (cm) # — — — #
PD (µsec) 0.579
PRF (Hz) 5440
Other Information

pr@PIImax (MPa) 2.679

deq@Pllmax (cm) —
Focal Length FLx (cm) # — — #
FLy (cm) # — — #
IPA.3@MImax (W/cm2) 197.7
Control 1: Exam Type Abd/
OB
Conditions
Operating

Control 2: Optimization Any

Control

Control 3: Depth 11/

13 cm
Control 4: THI On
Control 5: MB (Multi Beam) On

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

110
Table 11: Transducer Model: C60x/5-2 Operating Mode: M Mode

TIS TIB

Safety
Index Label M.I. Non-scan TIC
Scan Non-scan
Aaprtd1 Aaprt>1
Global Maximum Index Value 1.0 — (a) — (a) (b)
pr.3 (MPa) 1.62
W0 (mW) — # # #
min of [W.3(z1),ITA.3(z1)] (mW) —
Associated Acoustic

z1 (cm) —
Parameter

zbp (cm) —
zsp (cm) 4.7 #
deq(zsp) (cm) #
fc (MHz) 2.85 — # — # #
Dim of Aaprt X (cm) — # — # #
Y (cm) — # — # #
PD (µsec) 0.577
PRF (Hz) 800
Other Information

pr@PIImax (MPa) 2.576

deq@Pllmax (cm) #
Focal Length FLx (cm) — # — #
FLy (cm) — # — #
IPA.3@MImax (W/cm2) 184.3
Control 1: Exam Type Any
Conditions
Operating
Control

Control 2: Optimization Pen

Control 3: Depth 7.8 cm
Control 4: MB (Multi Beam) Off or
On

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

Chapter 6: Safety 111

Table 12: Transducer Model: C60x/5-2 Operating Mode: PW Doppler

TIS TIB
Index Label M.I. Non-scan TIC
Scan Non-scan
Aaprtd1 Aaprt>1
Global Maximum Index Value (a) — (a) — 3.1 (b)
pr.3 (MPa) #
W0 (mW) — # 85.64 #
min of [W.3(z1),ITA.3(z1)] (mW) —
Associated Acoustic

z1 (cm) —
Parameter

zbp (cm) —
zsp (cm) # 1.255
deq(zsp) (cm) 0.51
fc (MHz) # — # — 2.233 #
Dim of Aaprt X (cm) — # — 0.6552 #
Y (cm) — # — 1.3 #
PD (µsec) #
PRF (Hz) #
Other Information

pr@PIImax (MPa) #
deq@Pllmax (cm) 0.415
Focal Length FLx (cm) — # — #
FLy (cm) — # — #
IPA.3@MImax (W/cm ) 2
#
Control 1: Exam Type Abd
Conditions
Operating
Control

Control 2: PRF Any

Control 3: Sample Volume 12 mm
Control 4: Sample Volume Position Zone 1

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

112
Table 13: Transducer Model: D2x/2 Operating Mode: CW Doppler

TIS TIB

Safety
Index Label M.I. Non-scan TIC
Scan Non-scan
Aaprtd1 Aaprt>1
Global Maximum Index Value (a) — (a) — 2.6 (b)
pr.3 (MPa) #
W0 (mW) — # 90.52 #
min of [W.3(z1),ITA.3(z1)] (mW) —
Associated Acoustic

z1 (cm) —
Parameter

zbp (cm) —
zsp (cm) # 1.1
deq(zsp) (cm) 0.66
fc (MHz) # — # — 2.00 #
Dim of Aaprt X (cm) — # — 0.8 #
Y (cm) — # — 0.4 #
PD (µsec) #
PRF (Hz) #
Other Information

pr@PIImax (MPa) #
deq@Pllmax (cm) 0.54
Focal Length FLx (cm) — # — #
FLy (cm) — # — #
IPA.3@MImax (W/cm2) #
Control 1: Exam Type Crd
Conditions
Operating
Control

Control 2: Depth Fixed

Control 3: Zone Fixed

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

Chapter 6: Safety 113

Table 14: Transducer Model: HFL38x/13-6 Operating Mode: CPD/Color

TIS TIB
Index Label M.I. Non-scan Non- TIC
Scan
Aaprtd1 Aaprt>1 scan

Global Maximum Index Value 1.1 1.0 — — — (b)

pr.3 (MPa) 2.556
W0 (mW) 53.49 — — #
min of [W.3(z1),ITA.3(z1)] (mW) —
Associated Acoustic

z1 (cm) —
Parameter

zbp (cm) —
zsp (cm) 1.2 —
deq(zsp) (cm) —
fc (MHz) 5.328 5.324 — — — #
Dim of Aaprt X (cm) 0.44 — — — #
Y (cm) 0.4 — — — #
PD (µsec) 0.525
PRF (Hz) 2597
Other Information

pr@PIImax (MPa) 3.187

deq@Pllmax (cm) —
Focal Length FLx (cm) 1.32 — — #
FLy (cm) 2.5 — — #
IPA.3@MImax (W/cm2) 325.5
Control 1: Mode Color Color
Control 2: Exam Type Any Any
Conditions
Operating

Control 3: Optimization/Depth/PRF Med/

Control

Low/3.3 cm/
2.7 cm/
393
1938
Control 4: Color Box Position/Size Top/
Any
Short

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

114
Table 15: Transducer Model: HFL38x/13-6 Operating Mode: PW Doppler

TIS TIB

Safety
Index Label M.I. Non-scan TIC
Scan Non-scan
Aaprtd1 Aaprt>1
Global Maximum Index Value 1.0 — 1.2 — 2.2 (b)
pr.3 (MPa) 2.37
W0 (mW) — 46.55 46.55 #
min of [W.3(z1),ITA.3(z1)] (mW) —
Associated Acoustic

z1 (cm) —
Parameter

zbp (cm) —
zsp (cm) 0.9 1.1
deq(zsp) (cm) 0.33
fc (MHz) 5.32 — 5.33 — 5.33 #
Dim of Aaprt X (cm) — 1.04 — 1.04 #
Y (cm) — 0.4 — 0.4 #
PD (µsec) 1.29
PRF (Hz) 1008
Other Information

pr@PIImax (MPa) 2.404

deq@Pllmax (cm) 0.46
Focal Length FLx (cm) — 3.72 — #
FLy (cm) — 2.5 — #
IPA.3@MImax (W/cm2) 323.35
Control 1: Exam Type Bre/Vas Vas/Ven/ Vas/Ven/
Conditions

SmP/IMT IMT IMT

Operating
Control

Control 2: Sample Volume 1 mm 12 mm 12 mm

Control 3: PRF 1008 10417 10417
Control 4: Sample Volume Position Zone 2 Zone 7 Zone 7

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

Chapter 6: Safety 115

Table 16: Transducer Model: ICTx/8-5 Operating Mode: PW Doppler

TIS TIB
Index Label M.I. Non-scan TIC
Scan Non-scan
Aaprtd1 Aaprt>1
Global Maximum Index Value (a) — (a) — 1.2 (a)
pr.3 (MPa) #
W0 (mW) — # 16.348 #
min of [W.3(z1),ITA.3(z1)] (mW) —
Associated Acoustic

z1 (cm) —
Parameter

zbp (cm) —
zsp (cm) # 1.6
deq(zsp) (cm) 0.192
fc (MHz) # — # — 4.36 #
Dim of Aaprt X (cm) — # — 0.6 #
Y (cm) — # — 0.5 #
PD (µsec) #
PRF (Hz) #
Other Information

pr@PIImax (MPa) #
deq@Pllmax (cm) 0.187
Focal Length FLx (cm) — # — #
FLy (cm) — # — #
IPA.3@MImax (W/cm2) #
Control 1: Exam Type Any
Conditions
Operating
Control

Control 2: Sample Volume 3 mm

Control 3: PRF Any
Control 4: Sample Volume Position Zone 1

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

116
Table 17: Transducer Model L25x/13-6 Operating Mode: PW Doppler

TIS TIB

Safety
Index Label M.I. Non-scan TIC
Scan Non-scan
Aaprtd1 Aaprt>1
Global Maximum Index Value (a) — (a) — 1.6 (b)
pr.3 (MPa) #
W0 (mW) — # 14.02 #
min of [W.3(z1),ITA.3(z1)] (mW) —
Associated Acoustic

z1 (cm) —
Parameter

zbp (cm) —
zsp (cm) # 0.6
deq(zsp) (cm) 0.155
fc (MHz) # — # — 6.00 #
Dim of Aaprt X (cm) — # — 0.16 #
Y (cm) — # — 0.3 #
PD (µsec) #
PRF (Hz) #
Other Information

pr@PIImax (MPa) #
deq@Pllmax (cm) 0.1549
Focal Length FLx (cm) — # — #
FLy (cm) — # — #
IPA.3@MImax (W/cm2) #
Control 1: Exam Type Vas/Nrv/
Conditions

Ven
Operating
Control

Control 2: Sample Volume 12 mm

Control 3: PRF 20833
Control 4: Sample Volume Position Zone 0

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

Chapter 6: Safety 117

Table 18: Transducer Model: L38x/10-5 Operating Mode: CPD/Color

TIS TIB
Index Label M.I. Non-scan TIC
Scan Non-scan
Aaprtd1 Aaprt>1
Global Maximum Index Value 1.3 1.0 — — — (b)
pr.3 (MPa) 2.89
W0 (mW) 64.88 — — #
min of [W.3(z1),ITA.3(z1)] (mW) —
Associated Acoustic

z1 (cm) —
Parameter

zbp (cm) —
zsp (cm) 1.1 —
deq(zsp) (cm) —
fc (MHz) 4.91 4.91 — — — #
Dim of Aaprt X (cm) 0.54 — — — #
Y (cm) 0.4 — — — #
PD (µsec) 0.529
PRF (Hz) 9547
Other Information

pr@PIImax (MPa) 3.48

deq@Pllmax (cm) —
Focal Length FLx (cm) 1.5 — — #
FLy (cm) 2.5 — — #
IPA.3@MImax (W/cm2) 439.3
Control 1: Mode Color CPD
Control 2: Exam Type Any Bre
Conditions
Operating
Control

Control 3: PRF 331 2137

Control 4: Optimization/Depth Any/3.1 Med/3.1
Control 5: Color Box Position/Size Def/
Any
Def/Def

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

118
Table 19: Transducer Model: L38x/10-5 Operating Mode: PW Doppler

TIS TIB

Safety
Index Label M.I. Non-scan TIC
Scan Non-scan
Aaprtd1 Aaprt>1
Global Maximum Index Value 1.04 — 2.0 — 2.6 (b)
pr.3 (MPa) 2.345
W0 (mW) — 84.94 84.94 #
min of [W.3(z1),ITA.3(z1)] (mW) —
Associated Acoustic

z1 (cm) —
Parameter

zbp (cm) —
zsp (cm) 0.8 1.3
deq(zsp) (cm) 0.4685
fc (MHz) 5.01 — 5.05 — 5.05 #
Dim of Aaprt X (cm) — 1.80 — 1.80 #
Y (cm) — 0.4 — 0.4 #
PD (µsec) 1.29
PRF (Hz) 1008
Other Information

pr@PIImax (MPa) 2.693

deq@Pllmax (cm) 0.2533
Focal Length FLx (cm) — 5.54 — #
FLy (cm) — 2.5 — #
IPA.3@MImax (W/cm2) 284.5
Control 1: Exam Type Any Vas Vas
Conditions
Operating

Control 2: Sample Volume 1 mm 12 mm 12 mm

Control

Control 3: PRF 1008 Any Any

Control 4: Sample Volume Position Zone 0
Zone 7 Zone 7
(top)

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

Chapter 6: Safety 119

Table 20: Transducer Model: P10x/8-4 Operating Mode: 2D Mode

TIS TIB
Index Label M.I. Non-scan TIC
Scan Non-scan
Aaprtd1 Aaprt>1
Global Maximum Index Value (a) (a) — — — 1.0
pr.3 (MPa) #
W0 (mW) # — — 35.24
min of [W.3(z1),ITA.3(z1)] (mW) —
Associated Acoustic

z1 (cm) —
Parameter

zbp (cm) —
zsp (cm) # —
deq(zsp) (cm) —
fc (MHz) # # — — — 4.84
Dim of Aaprt X (cm) # — — — 0.416
Y (cm) # — — — 0.7
PD (µsec) #
PRF (Hz) #
Other Information

pr@PIImax (MPa) #
deq@Pllmax (cm) —
Focal Length FLx (cm) # — — 1.67
FLy (cm) # — — 5.0
IPA.3@MImax (W/cm2) #
Control 1: Exam Type Neo
Conditions
Operating
Control

Control 2: Optimization Gen

Control 3: Depth 2.0
Control 4: MB/SonoHD Off/Off

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

120
Table 21: Transducer Model: P10x/8-4 Operating Mode: Color

TIS TIB

Safety
Index Label M.I. Non-scan TIC
Scan Non-scan
Aaprtd1 Aaprt>1
Global Maximum Index Value 1.0 (a) — — — 1.3
pr.3 (MPa) 2.02
W0 (mW) # — — 41.38
min of [W.3(z1),ITA.3(z1)] (mW) —
Associated Acoustic

z1 (cm) —
Parameter

zbp (cm) —
zsp (cm) 2.4 —
deq(zsp) (cm) —
fc (MHz) 3.90 # — — — 3.91
Dim of Aaprt X (cm) # — — — 0.608
Y (cm) # — — — 0.7
PD (µsec) 0.70
PRF (Hz) 2772
Other Information

pr@PIImax (MPa) 2.80

deq@Pllmax (cm) —
Focal Length FLx (cm) # — — 2.48
FLy (cm) # — — 5.0
IPA.3@MImax (W/cm2) 252
Control 1: Mode Color Color
Control 2: Exam Type Neo Abd
Conditions
Operating

Control 3: Optimization/Depth/PRF Low/ Med/

Control

3.7/ 2.0/
772 2315
Control 4: Color Box Pos/Size Any/ Short/
Tall Narrow

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

Chapter 6: Safety 121

Table 22: Transducer Model: P10x/8-4 Operating Mode: PW Doppler

TIS TIB
Index Label M.I. Non-scan TIC
Scan Non-scan
Aaprtd1 Aaprt>1
Global Maximum Index Value 1.0 — 1.2 — 2.0 1.8
pr.3 (MPa) 2.03
W0 (mW) — 36.25 34.4 31.5
min of [W.3(z1),ITA.3(z1)] (mW) —
Associated Acoustic

z1 (cm) —
Parameter

zbp (cm) —
zsp (cm) 2.1 0.8
deq(zsp) (cm) 0.32
fc (MHz) 3.87 — 6.86 — 3.84 3.86
Dim of Aaprt X (cm) — 0.992 — 0.416 .224
Y (cm) — 0.7 — 0.7 0.7
PD (µsec) 1.28
PRF (Hz) 1563
Other Information

pr@PIImax (MPa) 2.70

deq@Pllmax (cm) 0.25
Focal Length FLx (cm) — 6.74 — 0.92
FLy (cm) — 5.0 — 5.0
IPA.3@MImax (W/cm2) 233
Control 1: Exam Type Crd Crd Neo Crd
Conditions
Operating

Control 2: Sample Volume 1 mm 7 mm 12 mm 1 mm

Control

Control 3: PRF/TDI 1563/ Any/ 15625/ 5208/

Off On Off Off
Control 4: Sample Volume Position Zone 3 Zone 6 Zone 2 Zone 1

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

122
Table 23: Transducer Model: P10x/8-4 Operating Mode: CW Doppler

TIS TIB

Safety
Index Label M.I. Non-scan TIC
Scan Non-scan
Aaprtd1 Aaprt>1
Global Maximum Index Value (a) — (a) — 2.1 2.0
pr.3 (MPa) #
W0 (mW) — # 40.72 30.00
min of [W.3(z1),ITA.3(z1)] (mW) —
Associated Acoustic

z1 (cm) —
Parameter

zbp (cm) —
zsp (cm) # 0.7
deq(zsp) (cm) 0.36
fc (MHz) # — # — 4.00 4.00
Dim of Aaprt X (cm) — # — 0.320 0.16
Y (cm) — # — 0.7 0.7
PD (µsec) #
PRF (Hz) #
Other Information

pr@PIImax (MPa) #
deq@Pllmax (cm) 0.27
Focal Length FLx (cm) — # — 0.92
FLy (cm) — # — 5.0
IPA.3@MImax (W/cm2) #
Control 1: Exam Type Card Card
Conditions
Operating
Control

Control 2: Depth Any Any

Control 3: Zone Zone 3 Zone 0

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

Chapter 6: Safety 123

Table 24: Transducer Model: P21x/5-1 Operating Mode: 2D

TIS TIB
Index Label M.I. Non-scan TIC
Scan Non-scan
Aaprtd1 Aaprt>1
Global Maximum Index Value 1.4 (a) — — — 2.3
pr.3 (MPa) 1.92
W0 (mW) # — — 171.53
min of [W.3(z1),ITA.3(z1)] (mW) —
Associated Acoustic

z1 (cm) —
Parameter

zbp (cm) —
zsp (cm) 5.1 —
deq(zsp) (cm) —
fc (MHz) 1.93 # — — — 1.94
Dim of Aaprt X (cm) # — — — 1.9
Y (cm) # — — — 1.3
PD (µsec) 0.842
PRF (Hz) 4000
Other Information

pr@PIImax (MPa) 2.53

deq@Pllmax (cm) —
Focal Length FLx (cm) # — — 18.46
FLy (cm) # — — 5.5
IPA.3@MImax (W/cm2) 355.1
Control 1: Exam Type Card Card
Control 2: Optimization Res Pen
Conditions
Operating
Control

Control 3: Depth 4.7/7.5

27 cm
cm
Control 4: THI On Off
Control 5: Sector Width Narrow Narrow

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

124
Table 25: Transducer Model: P21x/5-1 Operating Mode: M Mode

TIS TIB

Safety
Index Label M.I. Non-scan TIC
Scan Non-scan
Aaprtd1 Aaprt>1
Global Maximum Index Value 1.5 — (a) — 1.4 1.1
pr.3 (MPa) 2.10
W0 (mW) — # 40.08 29.71
min of [W.3(z1),ITA.3(z1)] (mW) —
Associated Acoustic

z1 (cm) —
Parameter

zbp (cm) —
zsp (cm) 3.645 4.9
deq(zsp) (cm) 0.343
fc (MHz) 1.93 — # — 1.93 1.94
Dim of Aaprt X (cm) — # — 1.835 1.9
Y (cm) — # — 1.3 1.3
PD (µsec) 0.904
PRF (Hz) 800
Other Information

pr@PIImax (MPa) 2.679

deq@Pllmax (cm) 0.341
Focal Length FLx (cm) — # — 18.46
FLy (cm) — # — 5.5
IPA.3@MImax (W/cm2) 237.4
Control 1: Exam Type Abd/ Abd/OB
Abd/OB
OB /Card
Conditions
Operating

Control 2: Optimization Any Gen/Res Pen

Control

Control 3: Depth 7.5 cm 10/13 cm 27 cm

Control 4: THI On On Off
Control 5: MB On or
On On or Off
(Multibeam) Off

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

Chapter 6: Safety 125

Table 26: Transducer Model: P21x/5-1 Operating Mode: CPD/Color

TIS TIB
Index Label M.I. Non-scan TIC
Scan Non-scan
Aaprtd1 Aaprt>1
Global Maximum Index Value 1.5 1.3 — — — 2.4
pr.3 (MPa) 2.19
W0 (mW) 136.91 — — 137.5
min of [W.3(z1),ITA.3(z1)] (mW) —
Associated Acoustic

z1 (cm) —
Parameter

zbp (cm) —
zsp (cm) 4.5 —
deq(zsp) (cm) —
fc (MHz) 2.15 2.16 — — — 2.16
Dim of Aaprt X (cm) 0.918 — — — 0.918
Y (cm) 1.3 — — — 1.3
PD (µsec) 1.20
PRF (Hz) 1063
Other Information

pr@PIImax (MPa) 2.574

deq@Pllmax (cm) —
Focal Length FLx (cm) 3.68 — — 3.68
FLy (cm) 5.5 — — 5.5
IPA.3@MImax (W/cm2) 330.4
Control 1: Mode Color CPD Color
Control 2: Exam Type Abd/
OB Abd
OB
Conditions
Operating
Control

Control 3: PRF/Depth 300/10 850/7.5 751/7.5

Control 4: Color Optimization Any Med Med
Control 5: THI On Off Off
Control 6: Color Box Size Short and Short and
Any
Narrow Narrow

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

126
Table 27: Transducer Model: P21x/5-1 Operating Mode: PW Doppler

TIS TIB

Safety
Index Label M.I. Non-scan TIC
Scan Non-scan
Aaprtd1 Aaprt>1
Global Maximum Index Value 1.2 — — 1.3 4.0 2.7
pr.3 (MPa) 1.844
W0 (mW) — — 95.55 95.55
min of [W.3(z1),ITA.3(z1)] (mW) 120.13
Associated Acoustic

z1 (cm) 3.1
Parameter

zbp (cm) 2.66

zsp (cm) 3.718 0.6
deq(zsp) (cm) 0.49
fc (MHz) 2.16 — — 2.22 2.23 2.23
Dim of Aaprt X (cm) — — 1.9 0.459 0.459
Y (cm) — — 1.3 1.3 1.3
PD (µsec) 1.21
PRF (Hz) 1562.5
Other Information

pr@PIImax (MPa) 2.432

deq@Pllmax (cm) 0.49
Focal Length FLx (cm) — — 13.84 1.55
FLy (cm) — — 5.5 5.5
IPA.3@MImax (W/cm2) 187.5
Control 1: Exam Type Card Card TCD TCD
Conditions
Operating
Control

Control 2: Sample Volume 1mm 3mm 14mm 14mm

Control 3: PRF 1563 3906 12500 12500
Control 4: Sample Volume Position Zone 1 Zone 4 Zone 0 Zone 0

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

Chapter 6: Safety 127

Table 28: Transducer Model: P21x/5-1 Operating Mode: CW Doppler

TIS TIB
Index Label M.I. Non-scan TIC
Scan Non-scan
Aaprtd1 Aaprt>1
Global Maximum Index Value (a) — — 1.0 3.4 2.9
pr.3 (MPa) #
W0 (mW) — — 88.30 101.73
min of [W.3(z1),ITA.3(z1)] (mW) 102.54
Associated Acoustic

z1 (cm) 1.386
Parameter

zbp (cm) 1.71

zsp (cm) # 1.255
deq(zsp) (cm) 0.49
fc (MHz) # — — 2.00 2.00 2.00
Dim of Aaprt X (cm) — — 0.786 0.655 0.459
Y (cm) — — 1.3 1.3 1.3
PD (µsec) #
PRF (Hz) #
Other Information

pr@PIImax (MPa) #
deq@Pllmax (cm) 0.45
Focal Length FLx (cm) — — 13.84 1.55
FLy (cm) — — 5.5 5.5
IPA.3@MImax (W/cm2) #
Control 1: Exam Type Card Card Card
Conditions
Operating
Control

Control 2: Zone
Zone 4 Zone 1 Zone 0

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

128
Table 29: Transducer Model: SLAx/13-6 Operating Mode: PW Doppler

Safety
TIS TIB
Index Label M.I. Non-scan TIC
Scan Non-scan
Aaprtd1 Aaprt>1
Global Maximum Index Value (a) — (a) — 1.2 (b)
pr.3 (MPa) #
W0 (mW) — # 8.75 #
min of [W.3(z1),ITA.3(z1)] (mW) —
Associated Acoustic

z1 (cm) —
Parameter

zbp (cm) —
zsp (cm) # 0.65
deq(zsp) (cm) 0.13
fc (MHz) # — # — 6.00 #
Dim of Aaprt X (cm) — # — 0.24 #
Y (cm) — # — 0.3 #
PD (µsec) #
PRF (Hz) #
Other Information

pr@PIImax (MPa) #
deq@Pllmax (cm) 0.13
Focal Length FLx (cm) — # — #
FLy (cm) — # — #
IPA.3@MImax (W/cm ) 2
#
Control 1: Exam Type Vas, Nrv,
Conditions

Ven
Operating
Control

Control 2: Sample Volume 5 mm

Control 3: PRF 20833
Control 4: Sample Vol. Position Zone 2

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

Chapter 6: Safety 129

Table 30: Transducer Model: TEEx/8-3 Operating Mode: PW Doppler

TIS TIB
Index Label M.I. Non-scan TIC
Scan Non-scan
Aaprtd1 Aaprt>1
Global Maximum Index Value (a) — (a) — 1.7 (b)
pr.3 (MPa) #
W0 (mW) — # 29.29 #
min of [W.3(z1),ITA.3(z1)] (mW) —
Associated Acoustic

z1 (cm) —
Parameter

zbp (cm) —
zsp (cm) # 0.6
deq(zsp) (cm) 0.34
fc (MHz) # — # — 3.84 #
Dim of Aaprt X (cm) — # — 0.261 #
Y (cm) — # — 0.9 #
PD (µsec) #
PRF (Hz) #
Other Information

pr@PIImax (MPa) #
deq@Pllmax (cm) 0.34
Focal Length FLx (cm) — # — #
FLy (cm) — # — #
IPA.3@MImax (W/cm2) #
Control 1: Exam Type Crd
Conditions
Operating
Control

Control 2: Sample Volume 1 mm

Control 3: PRF t 2604
Control 4: Sample Volume Position Zone 1

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

130
Table 31: Transducer Model: TEEx/8-3 Operating Mode: CW Doppler

TIS TIB

Safety
Index Label M.I. Non-scan TIC
Scan Non-scan
Aaprtd1 Aaprt>1
Global Maximum Index Value (a) — (a) — 1.2 (b)
pr.3 (MPa) #
W0 (mW) — # 27.23 #
min of [W.3(z1),ITA.3(z1)] (mW) —
Associated Acoustic

z1 (cm) —
Parameter

zbp (cm) —
zsp (cm) # 1.1
deq(zsp) (cm) 0.39
fc (MHz) # — # — 4.00 #
Dim of Aaprt X (cm) — # — 0.435 #
Y (cm) — # — 0.9 #
PD (µsec) #
PRF (Hz) #
Other Information

pr@PIImax (MPa) #
deq@Pllmax (cm) 0.34
Focal Length FLx (cm) — # — #
FLy (cm) — # — #
IPA.3@MImax (W/cm2) #
Control 1: Exam Type Crd
Conditions
Operating
Control

Control 2: Depth Any

Control 3: Zone Zone 3

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

Chapter 6: Safety 131

Terms used in the acoustic output tables
Table 32: Acoustic Output Terms and Definitions

Term Definition

ISPTA.3 Derated spatial peak, temporal average intensity in units of milliwatts/cm2.

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

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

MI Mechanical index.

Ipa.3@MImax Derated pulse average intensity at the maximum MI in units of W/cm2.

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

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

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

Aaprt Area of the active aperture measured in cm2.

Pr.3 Derated peak rarefactional pressure associated with the transmit pattern
giving rise to the value reported under MI (Megapascals).

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

W.3(z1) Derated ultrasonic power at axial distance z1 in units of milliwatts.

ISPTA.3(z1) Derated spatial-peak temporal-average intensity at axial distance z1

(milliwatts per square centimeter).

z1 Axial distance corresponding to the location of maximum [min(W.3(z), ITA.3(z)

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

zbp 1.69  A a p r t  in centimeters.

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

132
 Table 32: Acoustic Output Terms and Definitions (Continued)

Term Definition

Safety
deq(z) Equivalent beam diameter as a function of axial distance z, and is equal to
 4 e  S     Wo  e  I TA  z    , where ITA(z) is the temporal-average intensity as a
function of z in centimeters.

fc Center frequency in MHz.

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

PD Pulse duration (microseconds) associated with the transmit pattern giving

rise to the reported value of MI.

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

pr@PIImax Peak rarefactional pressure at the point where the free-field, spatial-peak
pulse intensity integral is a maximum in Megapascals.

deq@PIImax Equivalent beam diameter at the point where the free-field, spatial-peak
pulse intensity integral is a maximum in centimeters.

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

measured in centimeters.

Acoustic measurement precision and uncertainty

Allȱtableȱentriesȱhaveȱbeenȱobtainedȱatȱtheȱsameȱoperatingȱconditionsȱthatȱgiveȱriseȱtoȱtheȱ
maximumȱindexȱvalueȱinȱtheȱfirstȱcolumnȱofȱtheȱtable.ȱMeasurementȱprecisionȱandȱuncertaintyȱ
forȱpower,ȱpressure,ȱintensity,ȱandȱotherȱquantitiesȱthatȱareȱusedȱtoȱderiveȱtheȱvaluesȱinȱtheȱ
acousticȱoutputȱtableȱareȱshownȱinȱtheȱtableȱbelow.ȱInȱaccordanceȱwithȱSection 6.4ȱofȱtheȱOutputȱ
DisplayȱStandard,ȱtheȱfollowingȱmeasurementȱprecisionȱandȱuncertaintyȱvaluesȱareȱ
determinedȱbyȱmakingȱrepeatȱmeasurementsȱandȱstatingȱtheȱstandardȱdeviationȱasȱaȱ
percentage.

Chapter 6: Safety 133

 Table 33: Acoustic Measurement Precision and Uncertainty

Precision Uncertainty
Quantity
(% of standard deviation) (95% confidence)

Pr 1.9% +11.2%

Pr.3 1.9% +12.2%

Wo 3.4% +10%

fc 0.1% +4.7%

PII 3.2% +12.5 to -16.8%

PII.3 3.2% +13.47 to -17.5%

Labeling symbols
Theȱfollowingȱsymbolsȱareȱusedȱonȱtheȱproducts,ȱpackaging,ȱandȱcontainers.
Table 34: Labeling Symbols

Symbol Definition
Alternating Current (AC)

Class 1 device indicating manufacturer’s declaration of conformance with

Annex VII of 93/42/EEC

Class 1 device requiring verification by the Notified Body of sterilization or

measurement features, or to a Class IIa, IIb, or III device requiring verification or
auditing by the Notified Body to applicable Annex(es) of 93/42/EEC

Attention, see the user guide

Device complies with relevant Australian regulations for electronic devices.

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

LOT
Biological risk

134
Table 34: Labeling Symbols (Continued)

Symbol Definition

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

Canadian Standards Association. The “C” and “US” indicators next to this mark
signify that the product has been evaluated to the applicable CSA and ANSI/UL
Standards, for use in Canada and the US, respectively.

REF Catalog number

Collect separately from other household waste (see European Commission

Directive 93/86/EEC). Refer to local regulations for disposal.

STERILE EO Contents sterilized using ethylene oxide process.

Corrugated recycle

Dangerous voltage

Date of manufacture

Direct Current (DC)

Do not get wet.

Do not stack over 2 high.

Do not stack over 5 high.

Chapter 6: Safety 135

 Table 34: Labeling Symbols (Continued)

Symbol Definition
Do not stack over 10 high.

Electrostatic sensitive devices

Device complies with relevant FCC regulations for electronic devices.

Fragile

GEL STERILE R Gel sterilized by radiation.

Hot

Indoor use only

Device emits a static (DC) magnetic field.

Non-ionizing radiation

Paper recycle

SN Serial number type of control number

Storage temperature conditions

Submersible. Protected against the effects of temporary immersion.

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

136
Table 34: Labeling Symbols (Continued)

Symbol Definition

Safety
Handle transducer with care.

Follow manufacturer’s instructions for disinfecting time.

Disinfect transducer.

Type BF patient applied part

(B = body, F = floating applied part)

Defibrillator proof type CF patient applied part

Underwriter’s Laboratories labeling

Pollution Control Logo. (Applies to all parts/products listed in the China RoHS
disclosure table. May not appear on the exterior of some parts/products
because of space limitations.)

China Compulsory Certificate mark (“CCC Mark”). A compulsory safety mark for
compliance to Chinese national standards for many products sold in the
People’s Republic of China.
Contains mercury. (Applies to the LCD and may apply to other components in
the ultrasound system.)
WARNING: WARNING: Connect Only
Connect Only
Accessories and Accessories and Peripherals
Peripherals
Recommended by Recommended by SonoSite
SonoSite

Chapter 6: Safety 137

138
Chapter 7: References

Measurement accuracy Table 1: 2D Measurement Accuracy and Range

Test Methodb
2D Measure

Range (cm)
Theȱmeasurementsȱprovidedȱbyȱtheȱsystemȱdoȱ

and Range

Tolerancea
Accuracy

Accuracy
System
notȱdefineȱaȱspecificȱphysiologicalȱorȱanatomicalȱ

By
parameter.ȱRather,ȱtheȱmeasurementsȱareȱofȱaȱ
physicalȱpropertyȱsuchȱasȱdistanceȱforȱevaluationȱ

References
byȱtheȱclinician.ȱTheȱaccuracyȱvaluesȱrequireȱthatȱ
youȱcanȱplaceȱtheȱcalipersȱoverȱoneȱpixel.ȱTheȱ Axial < ±2% plus Acquisition Phantom 0-26 cm
valuesȱdoȱnotȱincludeȱacousticȱanomaliesȱofȱtheȱ Distance 1% of full
body. scale

Theȱ2Dȱlinearȱdistanceȱmeasurementȱresultsȱareȱ Lateral < ±2% plus Acquisition Phantom 0-35 cm

Distance 1% of full
displayedȱinȱcentimetersȱwithȱoneȱplaceȱpastȱtheȱ scale
decimalȱpoint,ȱifȱtheȱmeasurementȱisȱtenȱorȱ
greater;ȱtwoȱplacesȱpastȱtheȱdecimalȱpoint,ȱifȱtheȱ Diagonal < ±2% plus Acquisition Phantom 0-44 cm
measurementȱisȱlessȱthanȱten. Distance 1% of full
scale
Theȱlinearȱdistanceȱmeasurementȱcomponentsȱ
Areac < ±4% plus Acquisition Phantom 0.01-720
haveȱtheȱaccuracyȱandȱrangeȱshownȱinȱtheȱ (2% of full cm2
followingȱtables. scale/smallest
dimension) *
100 plus 0.5%

Circumfer- < ±3% plus Acquisition Phantom 0.01-96

enced (1.4% of full cm
scale/
smallest
dimension) *
100 plus 0.5%

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

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

Chapter 7: References 139

Table 2: M Mode Measurement and Table 3: PW Doppler Mode Measurement and
Calculation Accuracy and Range Calculation Accuracy and Range

Accuracy and Range

M Mode Measurement
Accuracy and Range

System Tolerance

Doppler Mode
Measurement

Accuracy By
Test Method

Tolerance
Accuracy By

Methoda
System

Range
Test
Range
Velocity < +/- 2% Acquisition Phantom 0.01
Distance < +/- Acquisition Phantomb 0-26 cm cursor plus 1% of cm/sec-
2% full scaleb 550 cm/s
plus ec
1% of
Frequency < +/- 2% Acquisition Phantom 0.01kHz-
full
cursor plus 1% of 20.8 kHz
scalea
full scaleb
Time < +/- Acquisition Phantomd 0.01-10
Time < +/- 2% Acquisition Phantom 0.01-10
2% sec
plus plus 1% of sec
1% of full scalec
full
scalec a. SonoSite special test equipment was used.
b. Full scale for frequency or velocity implies the total frequency
Heart Rate < +/- Acquisition Phantomd 5-923 or velocity magnitude, displayed on the scrolling graphic
2% bpm image.
plus c. Full scale for time implies the total time displayed on the
(Full scrolling graphic image.
Scalec *
Heart
Rate/1
00) % Sources of measurement
a. Full scale for distance implies the maximum depth of the
errors
image. Inȱgeneral,ȱtwoȱtypesȱofȱerrorsȱcanȱbeȱintroducedȱ
b. An RMI 413a model phantom with 0.7 dB/cm MHz
intoȱtheȱmeasurement:
attenuation was used.
c. Full scale for time implies the total time displayed on the Acquisition Error Includesȱerrorsȱintroducedȱbyȱ
scrolling graphic image. theȱultrasoundȱsystemȱelectronicsȱrelatingȱtoȱ
d. SonoSite special test equipment was used.
signalȱacquisition,ȱsignalȱconversion,ȱandȱsignalȱ
processingȱforȱdisplay.ȱAdditionally,ȱ
computationalȱandȱdisplayȱerrorsȱareȱintroducedȱ
byȱtheȱgenerationȱofȱtheȱpixelȱscaleȱfactor,ȱ
applicationȱofȱthatȱfactorȱtoȱtheȱcaliperȱpositionsȱ
onȱtheȱscreen,ȱandȱtheȱmeasurementȱdisplay.
Algorithmic Error Theȱerrorȱintroducedȱbyȱ
measurements,ȱwhichȱareȱinputȱtoȱhigherȱorderȱ
calculations.ȱThisȱerrorȱisȱassociatedȱwithȱ

140 Sources of measurement errors

floatingȬpointȱversusȱintegerȬtypeȱmath,ȱwhichȱisȱ Body Surface Area (BSA) in m2
subjectȱtoȱerrorsȱintroducedȱbyȱroundingȱversusȱ
Grossman,ȱW.ȱCardiacȱCatheterizationȱandȱ
truncatingȱresultsȱforȱdisplayȱofȱaȱgivenȱlevelȱofȱ
Angiography.ȱPhiladelphia:ȱLeaȱandȱFebiger,ȱ
significantȱdigitȱinȱtheȱcalculation.
(1980),ȱ90.
BSAȱ=ȱ0.007184ȱ*ȱWeight0.425ȱ*ȱHeight0.725
Measurement publications Weightȱ=ȱkilograms
and terminology Heightȱ=ȱcentimeters
Theȱfollowingȱsectionsȱlistȱtheȱpublicationsȱandȱ

References
terminologyȱusedȱforȱeachȱcalculationȱresult. Cardiac Index (CI) in l/min/m2
Terminologyȱandȱmeasurementsȱcomplyȱwithȱ Oh,ȱJ.K.,ȱJ.B.ȱSeward,ȱA.J.ȱTajik.ȱTheȱEchoȱManual.ȱ
AIUMȱpublishedȱstandards. 2ndȱEdition,ȱBoston:ȱLittle,ȱBrownȱandȱCompany,ȱ
(1999),ȱ59.
Cardiac references CIȱ=ȱCO/BSA
where: COȱ=ȱCardiacȱOutput
Acceleration (ACC) in cm/s2
BSAȱ=ȱBodyȱSurfaceȱArea
Zwiebel,ȱW.J.ȱIntroductionȱtoȱVascularȱ
Ultrasonography.ȱ4thȱed.,ȱW.B.ȱSaundersȱ Cardiac Output (CO) in l/min
Company,ȱ(2000),ȱ52.
Oh,ȱJ.K.,ȱJ.B.ȱSeward,ȱA.J.ȱTajikȱTheȱEchoȱManual.ȱ
ACCȱ=ȱabsȱ(deltaȱvelocity/deltaȱtime) 2ndȱed.,ȱLippincott,ȱWilliams,ȱandȱWilkins,ȱ
(1999),ȱ59.
Acceleration Time (AT) in msec
COȱ=ȱ(SVȱ*ȱHR)/1000
Oh,ȱJ.K.,ȱJ.B.ȱSeward,ȱA.J.ȱTajik.ȱTheȱEchoȱManual.ȱ
2ndȱed.,ȱLippincott,ȱWilliams,ȱandȱWilkins,ȱ where: COȱ=ȱCardiacȱOutput
(1999),ȱ219. SVȱ=ȱStrokeȱVolume
HRȱ=ȱHeartȱRate
Aortic Valve Area (AVA) by Continuity
Equation in cm2 Cross Sectional Area (CSA) in cm2
Reynolds,ȱTerry.ȱTheȱEchocardiographer’’sȱPocketȱ Reynolds,ȱTerry.ȱTheȱEchocardiographer’’sȱPocketȱ
Reference.ȱ2ndȱed.,ȱSchoolȱofȱCardiacȱUltrasound,ȱ Reference.ȱ2ndȱed.,ȱSchoolȱofȱCardiacȱUltrasound,ȱ
ArizonaȱHeartȱInstitute,ȱ(2000),ȱ393,ȱ442. ArizonaȱHeartȱInstitute,ȱ(2000),ȱ383.
A2ȱ=ȱA1ȱ*ȱV1/V2 CSAȱ=ȱ0.785ȱ*ȱD2
where: A2ȱ=ȱAoȱvalveȱarea where: Dȱ=ȱdiameterȱofȱtheȱanatomyȱofȱ
interest
A1ȱ=ȱLVOTȱarea;ȱV1ȱ=ȱLVOTȱvelocity;ȱ
V2ȱ=ȱAoȱvalveȱvelocity Deceleration Time in msec
LVOTȱ=ȱLeftȱVentricularȱOutflowȱ Reynolds,ȱTerry.ȱTheȱEchocardiographer’’sȱPocketȱ
Tract Reference.ȱ2ndȱed.,ȱSchoolȱofȱCardiacȱUltrasound,ȱ
AVAȱ(PVLVOT/PVAO)ȱ*ȱCSALVOT ArizonaȱHeartȱInstitute,ȱ(2000),ȱ453.
AVAȱ(VTILVOT/VTIAO)ȱ*ȱCSALVOT |timeȱaȱȬȱtimeȱb|

Chapter 7: References 141

Delta Pressure: Delta Time (dP:dT) in Elapsed Time (ET) in msec
mmHg/s ETȱ=ȱtimeȱbetweenȱvelocityȱcursorsȱinȱ
Otto,ȱC.M.ȱTextbookȱofȱClinicalȱEchocardiography.ȱ milliseconds
2ndȱed.,ȱW.B.ȱSaundersȱCompany,ȱ(2000),ȱ117,ȱ
118. Heart Rate (HR) in bpm
32 mmHg/timeȱintervalȱinȱseconds HRȱ=ȱ3ȱdigitȱvalueȱinputȱbyȱuserȱorȱmeasuredȱonȱ
M ModeȱandȱDopplerȱimageȱinȱoneȱheartȱcycle
E:A Ratio in cm/sec
Interventricular Septum (IVS) Fractional
E:Aȱ=ȱvelocityȱE/velocityȱA Thickening, percent
E/Ea Ratio Laurenceau,ȱJ.ȱL.,ȱM.C.ȱMalergue.ȱTheȱEssentialsȱofȱ
Echocardiography.ȱLeȱHague:ȱMartinusȱNijhoff,ȱ
Reynolds,ȱTerry.ȱTheȱEchocardiographer’’sȱPocketȱ
(1981),ȱ71.
Reference.ȱ2ndȱed.,ȱSchoolȱofȱCardiacȱUltrasound,ȱ
ArizonaȱHeartȱInstitute,ȱ(2000),ȱ225. IVSFTȱ=ȱ((IVSSȱ––ȱIVSD)/IVSD)ȱ*ȱ100%
EȱVelocity/Eaȱvelocity where:ȱ IVSSȱ=ȱInterventricularȱSeptalȱ
ThicknessȱatȱSystole
where: Eȱvelocityȱ=ȱMitralȱValveȱEȱvelocity
IVSDȱ=ȱInterventricularȱSeptalȱ
Eaȱ=ȱannularȱEȱvelocity,ȱalsoȱknownȱ
ThicknessȱatȱDiastole
as:ȱEȱprime
Isovolumic Relaxation Time (IVRT) in msec
Effective Regurgitant Orifice (ERO) in mm2
Reynolds,ȱTerry.ȱTheȱEchocardiographer’’sȱPocketȱ
Reynolds,ȱTerry.ȱTheȱEchocardiographer’’sȱPocketȱ
Reference.ȱSchoolȱofȱCardiacȱUltrasound,ȱArizonaȱ
Reference.ȱ2ndȱed.,ȱSchoolȱofȱCardiacȱUltrasound,ȱ
HeartȱInstitute,ȱ(1993),ȱ146.
ArizonaȱHeartȱInstitute,ȱ(2000),ȱ455.
|timeȱaȱȬȱtimeȱb|
EROȱ=ȱ6.28ȱ(r2)ȱ*ȱVa/MRȱVel
where: rȱ=ȱradius Left Atrium/Aorta (LA/Ao)
Vaȱ=ȱaliasingȱvelocity Feigenbaum,ȱH.ȱEchocardiography.ȱPhiladelphia:ȱ
LeaȱandȱFebiger,ȱ(1994),ȱ206,ȱFigureȱ4Ȭ49.
Ejection Fraction (EF), percent
Oh,ȱJ.K.,ȱJ.B.ȱSeward,ȱA.J.ȱTajik.ȱTheȱEchoȱManual.ȱ Left Ventricular End Volumes (Teichholz) in
2ndȱed.,ȱLippincott,ȱWilliams,ȱandȱWilkins,ȱ ml
(1999),ȱ40. Teichholz,ȱL.E.,ȱT.ȱKreulen,ȱM.V.ȱHerman,ȱet.ȱal.ȱ
EFȱ=ȱ((LVEDVȱ––ȱLVESV)/LVEDV)ȱ*ȱ100% ““Problemsȱinȱechocardiographicȱvolumeȱ
determinations:ȱechocardiographicȬangiographicȱ
where: EFȱ=ȱEjectionȱFraction correlationsȱinȱtheȱpresenceȱorȱabsenceȱofȱ
LVEDVȱ=ȱLeftȱVentricularȱEndȱ asynergy.””ȱAmericanȱJournalȱofȱCardiology,ȱ(1976),ȱ
DiastolicȱVolume 37:7.
LVESVȱ=ȱLeftȱVentricularȱEndȱ LVESVȱ=ȱ(7.0ȱ*ȱLVDS3)/(2.4ȱ+ȱLVDS)
SystolicȱVolume
where: LVESVȱ=ȱLeftȱVentricularȱEndȱ
SystolicȱVolume

142 Measurement publications and terminology

 LVDSȱ=ȱLeftȱVentricularȱDimensionȱ Left Ventricular Volume: Single Plane
atȱSystole Method in ml
LVEDVȱ=ȱ(7.0ȱ*ȱLVDD3)/(2.4ȱ+ȱLVDD) Schiller,ȱN.B.,ȱP.M.ȱShah,ȱM.ȱCrawford,ȱet.al.ȱ
where: LVEDVȱ=ȱLeftȱVentricularȱEndȱ ““RecommendationsȱforȱQuantitationȱofȱtheȱLeftȱ
DiastolicȱVolume VentricleȱbyȱTwoȬDimensionalȱ
LVDDȱ=ȱLeftȱVentricularȱDimensionȱ Echocardiography.””ȱJournalȱofȱAmericanȱSocietyȱofȱ
atȱDiastole Echocardiography.ȱSeptemberȬOctoberȱ1989,ȱ2:362.
n
Left Ventricular Mass in gm S 2 § L·
V = §© ---·¹ ¦ ai ---
© n¹

References
4
Oh,ȱJ.K.,ȱJ.B.ȱSeward,ȱA.J.ȱTajik.ȱTheȱEchoȱManual.ȱ i=1
2ndȱEdition,ȱBoston:ȱLittle,ȱBrownȱandȱCompany,ȱ
(1999),ȱ39. where: Vȱ=ȱVolume
aȱ=ȱDiameter
LVȱMassȱ=ȱ1.04ȱ[(LVIDȱ+ȱPWTȱ+ȱIVST)3ȱ––ȱLVID3]ȱ*ȱ
nȱ=ȱNumberȱofȱsegmentsȱ(n=20)
0.8ȱ+ȱ0.6
Lȱ=ȱLength
where: LVIDȱ=ȱInternalȱDimension iȱ=ȱSegment
PWTȱ=ȱPosteriorȱWallȱThickness
IVSTȱ=ȱInterventricularȱSeptalȱ Left Ventricular Dimension (LVD) Fractional
Thickness Shortening, percent
1.04ȱ=ȱSpecificȱgravityȱofȱtheȱ Oh,ȱJ.K.,ȱJ.B.ȱSeward,ȱA.J.ȱTajik.ȱTheȱEchoȱManual.ȱ
myocardium Boston:ȱLittle,ȱBrownȱandȱCompany,ȱ(1994),ȱ
0.8ȱ=ȱCorrectionȱfactor 43Ȭ44.
LVDFSȱ=ȱ((LVDDȱ––ȱLVDS)/LVDD)ȱ*ȱ100%
Left Ventricular Volume: Biplane Method in
ml where: LVDDȱ=ȱLeftȱVentricleȱDimensionȱatȱ
Schiller,ȱN.B.,ȱP.M.ȱShah,ȱM.ȱCrawford,ȱet.al.ȱ Diastole
““RecommendationsȱforȱQuantitationȱofȱtheȱLeftȱ LVDSȱ=ȱLeftȱVentricleȱDimensionȱatȱ
VentricleȱbyȱTwoȬDimensionalȱ Systole
Echocardiography.””ȱJournalȱofȱAmericanȱSocietyȱofȱ
Echocardiography.ȱSeptemberȬOctoberȱ1989,ȱ2:362. Left Ventricular Posterior Wall Fractional
Thickening (LVPWFT), percent
n
S L Laurenceau,ȱJ.ȱL.,ȱM.C.ȱMalergue.ȱTheȱEssentialsȱofȱ
V = §© ---·¹ ¦ ai bi §© --n-·¹
4 Echocardiography.ȱLeȱHague:ȱMartinusȱNijhoff,ȱ
i=1
(1981),ȱ71.
where: Vȱ=ȱVolumeȱinȱml LVPWFTȱ=ȱ((LVPWSȱ––ȱLVPWD)/LVPWD)ȱ*ȱ100%
aȱ=ȱDiameter
where: LVPWSȱ=ȱLeftȱVentricularȱPosteriorȱ
bȱ=ȱDiameter
WallȱThicknessȱatȱSystole
nȱ=ȱNumberȱofȱsegmentsȱ(n=20)
LVPWDȱ=ȱLeftȱVentricularȱPosteriorȱ
Lȱ=ȱLength WallȱThicknessȱatȱDiastole
iȱ=ȱSegment
Mean Velocity (Vmean) in cm/s
Vmeanȱ=ȱmeanȱvelocity

Chapter 7: References 143

Mitral Valve Area (MVA) in cm2 Pressure Half Time (PHT) in msec
Reynolds,ȱTerry.ȱTheȱEchocardiographer’’sȱPocketȱ Reynolds,ȱTerry.ȱTheȱEchocardiographer’’sȱPocketȱ
Reference.ȱ2ndȱed.,ȱSchoolȱofȱCardiacȱUltrasound,ȱ Reference.ȱ2ndȱed.,ȱSchoolȱofȱCardiacȱUltrasound,ȱ
ArizonaȱHeartȱInstitute,ȱ(2000),ȱ391,ȱ452. ArizonaȱHeartȱInstitute,ȱ(2000),ȱ391.
MVAȱ=ȱ220/PHT PHTȱ=ȱDTȱ*ȱ0.29
where: PHTȱ=ȱpressureȱhalfȱtime where: DTȱ=ȱdecelerationȱtime
Note: 220ȱisȱanȱempiricalȱderivedȱconstantȱandȱmayȱ
notȱaccuratelyȱpredictȱmitralȱvalveȱareaȱinȱmitralȱ Proximal Isovelocity Surface Area (PISA) in
prostheticȱheartȱvalves.ȱTheȱmitralȱvalveȱareaȱ cm2
continuityȱequationȱmayȱbeȱutilizedȱinȱmitralȱ Oh,ȱJ.K.,ȱJ.B.ȱSeward,ȱA.J.ȱTajik.ȱTheȱEchoȱManual.ȱ
prostheticȱheartȱvalvesȱtoȱpredictȱeffectiveȱorificeȱarea. 2ndȱed.,ȱBoston:ȱLittle,ȱBrownȱandȱCompany,ȱ
(1999),ȱ125.
MV Flow Rate in cc/sec
PISAȱ=ȱ2 S r2
Reynolds,ȱTerry.ȱTheȱEchocardiographer’’sȱPocketȱ
Reference.ȱ2ndȱed.,ȱSchoolȱofȱCardiacȱUltrasound,ȱ where: 2 S ȱ=ȱ6.28
ArizonaȱHeartȱInstitute,ȱ(2000),ȱ396.
rȱ=ȱaliasingȱradius
Flowȱ=ȱ6.28ȱ(r2)ȱ*ȱVa
Qp/Qs
where: rȱ=ȱradius
Reynolds,ȱTerry.ȱTheȱEchocardiographer’’sȱPocketȱ
Vaȱ=ȱaliasingȱVelocity
Reference.ȱ2ndȱed.,ȱSchoolȱofȱCardiacȱUltrasound,ȱ
ArizonaȱHeartȱInstitute,ȱ(2000),ȱ400.
Pressure Gradient (PGr) in mmHG
Oh,ȱJ.K.,ȱJ.B.ȱSeward,ȱA.J.ȱTajik.ȱTheȱEchoȱManual.ȱ Qp/Qsȱ=ȱSVȱQpȱsite/SVȱQsȱsite
2ndȱed.,ȱLippincott,ȱWilliams,ȱandȱWilkins,ȱ SVȱsitesȱwillȱvaryȱdependingȱuponȱtheȱlocationȱofȱ
(1999),ȱ64. theȱshunt.
PGrȱ=ȱ4ȱ*ȱ(Velocity)2
Regurgitant Fraction (RF) in percent
PeakȱEȱPressureȱGradientȱ(E PG)
Oh,ȱJ.K.,ȱJ.B.ȱSeward,ȱA.J.ȱTajik.ȱTheȱEchoȱManual.ȱ
E PGȱ=ȱ4ȱ*ȱPE2 Boston:ȱLittle,ȱBrownȱandȱCompany,ȱ(1999),ȱ125.
PeakȱAȱPressureȱGradientȱ(A PG) RFȱ=ȱRV/ȱMVȱSV
A PGȱ=ȱ4ȱ*ȱPA2 where: RVȱ=ȱRegurgitantȱVolume
MVȱSVȱ=ȱMitralȱStrokeȱVolume
PeakȱPressureȱGradientȱ(PGmax)
PGmaxȱ=ȱ4ȱ*ȱPV2 Regurgitant Volume (RV) in cc
MeanȱPressureȱGradientȱ(PGmean) Reynolds,ȱTerry.ȱTheȱEchocardiographer’’sȱPocketȱ
Reference.ȱSchoolȱofȱCardiacȱUltrasound,ȱArizonaȱ
PGmeanȱ=ȱAverageȱofȱpressureȱ HeartȱInstitute,ȱ(2000),ȱ396,ȱ455.
gradients/Durationȱofȱflow
RVȱ=ȱEROȱ*ȱMRȱVTI

144 Measurement publications and terminology

Right Ventricular Systolic Pressure (RVSP) in Stroke Volume (SV) 2D and M Mode in ml
mmHg Oh,ȱJ.K.,ȱJ.B.ȱSeward,ȱA.J.ȱTajik.ȱTheȱEchoȱManual.ȱ
Reynolds,ȱTerry.ȱTheȱEchocardiographer’’sȱPocketȱ 2ndȱed.,ȱBoston:ȱLittle,ȱBrownȱandȱCompany,ȱ
Reference.ȱSchoolȱofȱCardiacȱUltrasound,ȱArizonaȱ (1994),ȱ44.
HeartȱInstitute,ȱ(1993),ȱ152. SVȱ=ȱ(LVEDVȱ––ȱLVESV)
RVSPȱ=ȱ4ȱ*ȱ(VmaxȱTR)2ȱ+ȱRAP where: SVȱ=ȱStrokeȱVolume
where: RAPȱ=ȱRightȱAtrialȱPressure LVEDVȱ=ȱEndȱDiastolicȱVolume
LVEDSVȱ=ȱEndȱSystolicȱVolume
S/D

References
Reynolds,ȱTerry.ȱTheȱEchocardiographer’’sȱPocketȱ Velocity Time Integral (VTI) in cm
Reference.ȱ2ndȱed.,ȱSchoolȱofȱCardiacȱUltrasound,ȱ Reynolds,ȱTerry.ȱTheȱEchocardiographer’’sȱPocketȱ
ArizonaȱHeartȱInstitute,ȱ(2000),ȱ217. Reference.ȱ2ndȱed.,ȱSchoolȱofȱCardiacȱUltrasound,ȱ
Sȱvelocity/ȱDȱvelocity ArizonaȱHeartȱInstitute,ȱ(2000),ȱ383.

where: Sȱvelocityȱ=ȱPulmonaryȱveinȱSȱwaveȱ VTIȱ=ȱsumȱofȱabsȱ(velocitiesȱ[n])

Dȱvelocity=ȱPulmonaryȱveinȱDȱwaveȱ where:ȱ AutoȱTraceȱ––ȱdistanceȱ(cm)ȱbloodȱ
travelsȱwithȱeachȱejectionȱperiod.ȱ
Stroke Index (SI) in cc/m2 Velocitiesȱareȱabsoluteȱvalues.
Mosby’’sȱMedical,ȱNursing,ȱ&ȱAlliedȱHealthȱ
Dictionary,ȱ4thȱed.,ȱ(1994),ȱ1492. Obstetrical references
SIȱ=ȱSV/BSA
Amniotic Fluid Index (AFI)
where: SVȱ=ȱStrokeȱVolume Jeng,ȱC.ȱJ.,ȱetȱal.ȱ““AmnioticȱFluidȱIndexȱ
BSAȱ=ȱBodyȱSurfaceȱArea MeasurementȱwithȱtheȱFourȱQuadrantȱTechniqueȱ
DuringȱPregnancy.””ȱTheȱJournalȱofȱReproductiveȱ
Stroke Volume (SV) Doppler in ml Medicine,ȱ35:7ȱ(Julyȱ1990),ȱ674Ȭ677.
Oh,ȱJ.K.,ȱJ.B.ȱSeward,ȱA.J.ȱTajik.ȱTheȱEchoȱManual.ȱ
2ndȱed.,ȱLippincott,ȱWilliams,ȱandȱWilkins,ȱ Average Ultrasound Age (AUA)
(1999),ȱ40,ȱ59,ȱ62. TheȱsystemȱprovidesȱanȱAUAȱderivedȱfromȱtheȱ
SVȱ=ȱ(CSAȱ*ȱVTI) componentȱmeasurementsȱfromȱtheȱ
measurementȱtables.
where CSAȱ=ȱCrossȱSectionalȱAreaȱofȱtheȱ
orificeȱ(LVOTȱarea) Estimated Date of Delivery (EDD) by Average
VTIȱ=ȱVelocityȱTimeȱIntegralȱofȱtheȱ Ultrasound Age (AUA)
aorticȱvalve Resultsȱareȱdisplayedȱasȱmonth/day/year.
Tricuspid Valve Area (TVA) EDDȱ=ȱsystemȱdateȱ+ȱ(280ȱdaysȱ––ȱAUAȱinȱdays)
Reynolds,ȱTerry.ȱTheȱEchocardiographer’’sȱPocketȱ
Estimated Date of Delivery (EDD) by Last
Reference.ȱ2ndȱed.,ȱSchoolȱofȱCardiacȱUltrasound,ȱ
ArizonaȱHeartȱInstitute,ȱ(2000),ȱ55,ȱ391,ȱ452.
Menstrual Period (LMP)
Theȱdateȱenteredȱintoȱtheȱpatientȱinformationȱforȱ
TVAȱ=ȱ220ȱ/ȱPHT
LMPȱmustȱprecedeȱtheȱcurrentȱdate.
Resultsȱareȱdisplayedȱasȱmonth/day/year.

Chapter 7: References 145

EDDȱ=ȱLMPȱdateȱ+ȱ280ȱdays Last Menstrual Period Derived (LMPd) by
Established Due Date (Estab. DD)
Estimated Fetal Weight (EFW)
Resultsȱareȱdisplayedȱasȱmonth/day/year.
Hadlock,ȱF.,ȱetȱal.ȱ““EstimationȱofȱFetalȱWeightȱ
withȱtheȱUseȱofȱHead,ȱBody,ȱandȱFemurȱ LMPd(Estab. DD)ȱ=ȱEstab. DDȱ––ȱ280ȱdays
Measurements,ȱAȱProspectiveȱStudy.””ȱAmericanȱ
JournalȱofȱObstetricsȱandȱGynecology,ȱ151:3ȱ Gestational age tables
(Februaryȱ1,ȱ1985),ȱ333Ȭ337.
Abdominal Circumference (AC)
Hansmann,ȱM.,ȱetȱal.ȱUltrasoundȱDiagnosisȱinȱ
ObstetricsȱandȱGynecology.ȱNewȱYork:ȱ Hadlock,ȱF.,ȱetȱal.ȱ““EstimatingȱFetalȱAge:ȱ
SpringerȬVerlag,ȱ(1986),ȱ154. ComputerȬAssistedȱAnalysisȱofȱMultipleȱFetalȱ
GrowthȱParameters.””ȱRadiology,ȱ152:ȱ(1984),ȱ
OsakaȱUniversity.ȱUltrasoundȱinȱObstetricsȱandȱ 497Ȭ501.
Gynecology.ȱ(July 20,ȱ1990),ȱ103Ȭ105.
Hansmann,ȱM.,ȱetȱal.ȱUltrasoundȱDiagnosisȱinȱ
ShepardȱM.J.,ȱV.ȱA.ȱRichards,ȱR.ȱL.ȱBerkowitz,ȱetȱ ObstetricsȱandȱGynecology.ȱNewȱYork:ȱ
al.ȱ““AnȱEvaluationȱofȱTwoȱEquationsȱforȱ SpringerȬVerlag,ȱ(1986),ȱ431.
PredictingȱFetalȱWeightȱbyȱUltrasound.””ȱ
AmericanȱJournalȱofȱObstetricsȱandȱGynecology,ȱ142:1ȱ UniversityȱofȱTokyo,ȱShinozuka,ȱN.ȱFJSUM,ȱetȱal.ȱ
(Januaryȱ1,ȱ1982),ȱ47Ȭ54. ““StandardȱValuesȱofȱUltrasonographicȱFetalȱ
Biometry.””ȱJapaneseȱJournalȱofȱMedicalȱUltrasonics,ȱ
UniversityȱofȱTokyo,ȱShinozuka,ȱN.ȱFJSUM,ȱetȱal.ȱ 23:12ȱ(1996),ȱ885.
““StandardȱValuesȱofȱUltrasonographicȱFetalȱ
Biometry.””ȱJapaneseȱJournalȱofȱMedicalȱUltrasonics,ȱ WARNING: The gestational age calculated by
23:12ȱ(1996),ȱ880,ȱEquationȱ1. your SonoSite system does not
match the age in the
Gestational Age (GA) by Last Menstrual aforementioned reference at the
Period (LMP) 20.0 cm and 30.0 cm abdominal
TheȱgestationalȱageȱderivedȱfromȱtheȱLMPȱdateȱ circumference (AC) measurements.
enteredȱonȱtheȱpatientȱinformationȱform. The implemented algorithm
extrapolates the gestational age
Resultsȱareȱdisplayedȱinȱweeksȱandȱdays,ȱandȱisȱ from the slope of the curve of all
calculatedȱasȱfollows: table measurements, rather than
GA(LMP)ȱ=ȱSystemȱdateȱ––ȱLMPȱdate decreasing the gestational age for a
larger AC measurement indicated in
Gestational Age (GA) by Last Menstrual the referenced table. This results in
Period (LMPd) Derived from Established Due the gestational age always
Date (Estab. DD) increasing with an increase in AC.
SameȱasȱGAȱbyȱEstab. DD.
Anteroposterior Trunk Diameter (APTD)
Theȱgestationalȱageȱderivedȱfromȱtheȱsystemȱ
derivedȱLMPȱusingȱtheȱEstablishedȱDueȱDateȱ UniversityȱofȱTokyo,ȱShinozuka,ȱN.ȱFJSUM,ȱetȱal.ȱ
enteredȱonȱtheȱpatientȱinformationȱform. ““StandardȱValuesȱofȱUltrasonographicȱFetalȱ
Biometry.””ȱJapaneseȱJournalȱofȱMedicalȱUltrasonics,ȱ
Resultsȱareȱdisplayedȱinȱweeksȱandȱdays,ȱandȱisȱ 23:12ȱ(1996),ȱ885.
calculatedȱasȱfollows:
GA(LMPd)ȱ=ȱSystemȱDateȱ––ȱLMPd

146 Measurement publications and terminology

Biparietal Diameter (BPD) Hadlock,ȱF.,ȱetȱal.ȱ““EstimatingȱFetalȱAge:ȱ
ComputerȬAssistedȱAnalysisȱofȱMultipleȱFetalȱ
Chitty,ȱL.ȱS.ȱandȱD.G.ȱAltman.ȱ““Newȱchartsȱforȱ
GrowthȱParameters.””ȱRadiology,ȱ152:ȱ(1984),ȱ
ultrasoundȱdatingȱofȱpregnancy.””ȱUltrasoundȱinȱ
497Ȭ501.
ObstetricsȱandȱGynecologyȱ10:ȱ(1997),ȱ174Ȭ179,ȱ
Tableȱ3. Hansmann,ȱM.,ȱetȱal.ȱUltrasoundȱDiagnosisȱinȱ
Hadlock,ȱF.,ȱetȱal.ȱ““EstimatingȱFetalȱAge:ȱ ObstetricsȱandȱGynecology.ȱNewȱYork:ȱ
ComputerȬAssistedȱAnalysisȱofȱMultipleȱFetalȱ SpringerȬVerlag,ȱ(1986),ȱ431.
GrowthȱParameters.””ȱRadiology,ȱ152:ȱ(1984),ȱ OsakaȱUniversity.ȱUltrasoundȱinȱObstetricsȱandȱ
497Ȭ501. Gynecology.ȱ(July 20,ȱ1990),ȱ101Ȭ102.

References
Hansmann,ȱM.,ȱetȱal.ȱUltrasoundȱDiagnosisȱinȱ UniversityȱofȱTokyo,ȱShinozuka,ȱN.ȱFJSUM,ȱetȱal.ȱ
ObstetricsȱandȱGynecology.ȱNewȱYork:ȱ ““StandardȱValuesȱofȱUltrasonographicȱFetalȱ
SpringerȬVerlag,ȱ(1986),ȱ440. Biometry.””ȱJapaneseȱJournalȱofȱMedicalȱUltrasonics,ȱ
23:12ȱ(1996),ȱ886.
OsakaȱUniversity.ȱUltrasoundȱinȱObstetricsȱandȱ
Gynecology.ȱ(July 20,ȱ1990),ȱ98.
Fetal Trunk Cross-Sectional Area (FTA)
UniversityȱofȱTokyo,ȱShinozuka,ȱN.ȱFJSUM,ȱetȱal.ȱ OsakaȱUniversity.ȱUltrasoundȱinȱObstetricsȱandȱ
““StandardȱValuesȱofȱUltrasonographicȱFetalȱ Gynecology.ȱ(July 20,ȱ1990),ȱ99Ȭ100.
Biometry.””ȱJapaneseȱJournalȱofȱMedicalȱUltrasonics,ȱ
23:12ȱ(1996),ȱ885. Gestational Sac (GS)
Crown Rump Length (CRL) Hansmann,ȱM.,ȱetȱal.ȱUltrasoundȱDiagnosisȱinȱ
ObstetricsȱandȱGynecology.ȱNewȱYork:ȱ
Hadlock,ȱF.,ȱetȱal.ȱ““FetalȱCrownȬRumpȱLength:ȱ SpringerȬVerlag,ȱ(1986).
ReȬevaluationȱofȱRelationȱtoȱMenstrualȱAgeȱ(5Ȭ18ȱ
weeks)ȱwithȱHighȬResolution,ȱRealȬTimeȱ Nyberg,ȱD.A.,ȱetȱal.ȱ““TransvaginalȱUltrasound.””ȱ
Ultrasound.””ȱRadiology,ȱ182:ȱ(Februaryȱ1992),ȱ MosbyȱYearbook,ȱ(1992),ȱ76.
501Ȭ505. Gestationalȱsacȱmeasurementsȱprovideȱaȱfetalȱ
Hansmann,ȱM.,ȱetȱal.ȱUltrasoundȱDiagnosisȱinȱ ageȱbasedȱonȱtheȱmeanȱofȱone,ȱtwo,ȱorȱthreeȱ
ObstetricsȱandȱGynecology.ȱNewȱYork:ȱ distanceȱmeasurements;ȱhowever,ȱNyberg’’sȱ
SpringerȬVerlag,ȱ(1986),ȱ439. gestationalȱageȱequationȱrequiresȱallȱthreeȱ
distanceȱmeasurementsȱforȱanȱaccurateȱ
OsakaȱUniversity.ȱUltrasoundȱinȱObstetricsȱandȱ estimate.
Gynecology.ȱ(Julyȱ20,ȱ1990),ȱ20ȱandȱ96.
TokyoȱUniversity.ȱ““GestationalȱWeeksȱandȱ
TokyoȱUniversity.ȱ““GestationalȱWeeksȱandȱ ComputationȱMethods.””ȱUltrasoundȱImagingȱ
ComputationȱMethods.””ȱUltrasoundȱImagingȱ Diagnostics,ȱ12:1ȱ(1982Ȭ1).
Diagnostics,ȱ12:1ȱ(1982Ȭ1),ȱ24Ȭ25,ȱTableȱ3.
Head Circumference (HC)
Femur Length (FL)
Chitty,ȱL.ȱS.ȱandȱD.G.ȱAltman.ȱ““Newȱchartsȱforȱ
Chitty,ȱL.ȱS.ȱandȱD.G.ȱAltman.ȱ““Newȱchartsȱforȱ ultrasoundȱdatingȱofȱpregnancy.””ȱUltrasoundȱinȱ
ultrasoundȱdatingȱofȱpregnancy.””ȱUltrasoundȱinȱ ObstetricsȱandȱGynecologyȱ10:ȱ(1997),ȱ174Ȭ191,ȱ
ObstetricsȱandȱGynecologyȱ10:ȱ(1997),ȱ174Ȭ179,ȱ Tableȱ5,ȱ182.
Tableȱ8,ȱ186.

Chapter 7: References 147

Hadlock,ȱF.,ȱetȱal.ȱ““EstimatingȱFetalȱAge:ȱ Biparietal Diameter (BPD)
ComputerȬAssistedȱAnalysisȱofȱMultipleȱFetalȱ
Chitty,ȱLynȱS.ȱetȱal.ȱ““ChartsȱofȱFetalȱSize:ȱ2.ȱHeadȱ
GrowthȱParameters.””ȱRadiology,ȱ152:ȱ(1984),ȱ
Measurements.””ȱBritishȱJournalȱofȱObstetricsȱandȱ
497Ȭ501.
Gynaecologyȱ101:ȱ(Januaryȱ1994),ȱ43,ȱAppendix:ȱ
Hansmann,ȱM.,ȱetȱal.ȱUltrasoundȱDiagnosisȱinȱ BPDȬOuterȬInner.
ObstetricsȱandȱGynecology.ȱNewȱYork:ȱ
Hadlock,ȱF.,ȱetȱal.ȱ““EstimatingȱFetalȱAge:ȱ
SpringerȬVerlag,ȱ(1986),ȱ431.
ComputerȬAssistedȱAnalysisȱofȱMultipleȱFetalȱ
GrowthȱParameters.””ȱRadiology,ȱ152:ȱ(1984),ȱ
Occipito-Frontal Diameter (OFD)
497Ȭ501.
Hansmann,ȱM.,ȱetȱal.ȱUltrasoundȱDiagnosisȱinȱ
ObstetricsȱandȱGynecology.ȱNewȱYork:ȱ JeantyȱP.,ȱE.ȱCousaert,ȱandȱF.ȱCantraine.ȱ““Aȱ
SpringerȬVerlag,ȱ(1986),ȱ431. LongitudinalȱStudyȱofȱFetalȱLimbȱGrowth.””ȱ
AmericanȱJournalȱofȱPerinatology,ȱ1:ȱ(Januaryȱ1984),ȱ
Transverse Trunk Diameter (TTD) 136Ȭ144,ȱTableȱ5.
Hansmann,ȱM.,ȱetȱal.ȱUltrasoundȱDiagnosisȱinȱ (AlsoȱpublishedȱinȱHansmann,ȱHackeloer,ȱ
ObstetricsȱandȱGynecology.ȱNewȱYork:ȱ Staudach,ȱWittman.ȱUltrasoundȱDiagnosisȱinȱ
SpringerȬVerlag,ȱ(1986),ȱ431. ObstetricsȱandȱGynecology.ȱSpringerȬVerlag,ȱ
NewȱYork,ȱ(1986),ȱ176,ȱTableȱ7.8.)
UniversityȱofȱTokyo,ȱShinozuka,ȱN.ȱFJSUM,ȱetȱal.ȱ
““StandardȱValuesȱofȱUltrasonographicȱFetalȱ Estimated Fetal Weight (EFW)
Biometry.””ȱJapaneseȱJournalȱofȱMedicalȱUltrasonics,ȱ
23:12ȱ(1996),ȱ885. HadlockȱF.,ȱetȱal.ȱ““InȱUteroȱAnalysisȱofȱFetalȱ
Growth:ȱAȱSonographicȱWeightȱStandard.””ȱ
Radiology,ȱ181:ȱ(1991),ȱ129Ȭ133.
Growth analysis tables
Jeanty,ȱPhilippe,ȱF.ȱCantraine,ȱR.ȱRomero,ȱE.ȱ
Abdominal Circumference (AC) Cousaert,ȱandȱJ.ȱHobbins.ȱ““AȱLongitudinalȱStudyȱ
ofȱFetalȱWeightȱGrowth.””ȱJournalȱofȱUltrasoundȱinȱ
Chitty,ȱLynȱS.ȱetȱal.ȱ““ChartsȱofȱFetalȱSize:ȱ3.ȱ
Medicine,ȱ3:ȱ(Julyȱ1984),ȱ321Ȭ328,ȱTableȱ1.
AbdominalȱMeasurements.””ȱBritishȱJournalȱofȱ
ObstetricsȱandȱGynaecologyȱ101:ȱ(Februaryȱ1994),ȱ (AlsoȱpublishedȱinȱHansmann,ȱHackeloer,ȱ
131,ȱAppendix:ȱACȬDerived. Staudach,ȱandȱWittman.ȱUltrasoundȱDiagnosisȱ
inȱObstetricsȱandȱGynecology.ȱSpringerȬVerlag,ȱ
Hadlock,ȱF.,ȱetȱal.ȱ““EstimatingȱFetalȱAge:ȱ
ComputerȬAssistedȱAnalysisȱofȱMultipleȱFetalȱ NewȱYork,ȱ(1986),ȱ186,ȱTableȱ7.20.)
GrowthȱParameters.””ȱRadiology,ȱ152:ȱ(1984),ȱ
Femur Length (FL)
497Ȭ501.
Chitty,ȱLynȱS.ȱetȱal.ȱ““ChartsȱofȱFetalȱSize:ȱ4.ȱFemurȱ
JeantyȱP.,ȱE.ȱCousaert,ȱandȱF.ȱCantraine.ȱ““Normalȱ Length.””ȱBritishȱJournalȱofȱObstetricsȱandȱ
GrowthȱofȱtheȱAbdominalȱPerimeter.””ȱAmericanȱ Gynaecologyȱ101:ȱ(Februaryȱ1994),ȱ135.
JournalȱofȱPerinatology,ȱ1:ȱ(Januaryȱ1984),ȱ129Ȭ135.
Hadlock,ȱF.,ȱetȱal.ȱ““EstimatingȱFetalȱAge:ȱ
(AlsoȱpublishedȱinȱHansmann,ȱHackeloer,ȱ ComputerȬAssistedȱAnalysisȱofȱMultipleȱFetalȱ
Staudach,ȱWittman.ȱUltrasoundȱDiagnosisȱinȱ GrowthȱParameters.””ȱRadiology,ȱ152:ȱ(1984),ȱ
ObstetricsȱandȱGynecology.ȱSpringerȬVerlag,ȱ 497Ȭ501.
NewȱYork,ȱ(1986),ȱ179,ȱTableȱ7.13.)

148 Measurement publications and terminology

JeantyȱP,ȱE.ȱCousaert,ȱandȱF.ȱCantraine.ȱ““Aȱ Length/AbdominalȱCircumferenceȱRatio,””ȱ
LongitudinalȱStudyȱofȱFetalȱLimbȱGrowth.””ȱ AmericanȱJournalȱofȱRoentgenology,ȱ141:ȱ(Novemberȱ
AmericanȱJournalȱofȱPerinatology,ȱ1:ȱ(Januaryȱ1984),ȱ 1983),ȱ979Ȭ984.
136Ȭ144,ȱTableȱ5.
FL/BPD Ratio
(AlsoȱpublishedȱinȱHansmann,ȱHackeloer,ȱ
Staudach,ȱWittman.ȱUltrasoundȱDiagnosisȱinȱ Hohler,ȱC.W.,ȱandȱT.A.ȱQuetel.ȱ““Comparisonȱofȱ
ObstetricsȱandȱGynecology.ȱSpringerȬVerlag,ȱ UltrasoundȱFemurȱLengthȱandȱBiparietalȱ
NewȱYork,ȱ(1986),ȱ182,ȱTableȱ7.17.) DiameterȱinȱLateȱPregnancy,””ȱAmericanȱJournalȱofȱ
ObstetricsȱandȱGynecology,ȱ141:7ȱ(Dec.ȱ1ȱ1981),ȱ
Head Circumference (HC) 759Ȭ762.

References
Chitty,ȱLynȱS.,ȱetȱal.ȱ““ChartsȱofȱFetalȱSize:ȱ2.ȱHeadȱ FL/HC Ratio
Measurements.””ȱBritishȱJournalȱofȱObstetricsȱandȱ
Gynaecologyȱ101:ȱ(Januaryȱ1994),ȱ43,ȱAppendix:ȱ HadlockȱF.P.,ȱR.ȱB.ȱHarrist,ȱY.ȱShah,ȱandȱS.ȱK.ȱPark.ȱ
HCȬDerived. ““TheȱFemurȱLength/HeadȱCircumferenceȱ
RelationȱinȱObstetricȱSonography.””ȱJournalȱofȱ
Hadlock,ȱF.,ȱetȱal.ȱ““EstimatingȱFetalȱAge:ȱ UltrasoundȱinȱMedicine,ȱ3:ȱ(Octoberȱ1984),ȱ439Ȭ442.
ComputerȬAssistedȱAnalysisȱofȱMultipleȱFetalȱ
GrowthȱParameters.””ȱRadiology,ȱ152:ȱ(1984),ȱ HC/AC Ratio
497Ȭ501.
CampbellȱS.,ȱThomsȱAlison.ȱ““Ultrasoundȱ
JeantyȱP,ȱE.ȱCousaert,ȱandȱF.ȱCantraine.ȱ““Aȱ MeasurementsȱofȱtheȱFetalȱHeadȱtoȱAbdomenȱ
longitudinalȱstudyȱofȱFetalȱHeadȱBiometry.””ȱ CircumferenceȱRatioȱinȱtheȱAssessmentȱofȱ
AmericanȱJȱofȱPerinatology,ȱ1:ȱ(Januaryȱ1984),ȱ GrowthȱRetardation,””ȱBritishȱJournalȱofȱObstetricsȱ
118Ȭ128,ȱTableȱ3. andȱGynaecology,ȱ84:ȱ(Marchȱ1977),ȱ165Ȭ174.
(AlsoȱpublishedȱinȱHansmann,ȱHackeloer,ȱ
Staudach,ȱWittman.ȱUltrasoundȱDiagnosisȱinȱ General references
ObstetricsȱandȱGynecology.ȱSpringerȬVerlag,ȱ
NewȱYork,ȱ(1986),ȱ176,ȱTableȱ7.8.) +/x or S/D Ratio
+/xȱ=ȱabsȱ(VelocityȱA/VelocityȱB)
Head Circumference (HC)/Abdominal
Circumference (AC) where Aȱ=ȱvelocityȱcursorȱ+
Bȱ=ȱvelocityȱcursorȱx
CampbellȱS.,ȱThomsȱAlison.ȱ““Ultrasoundȱ
MeasurementsȱofȱtheȱFetalȱHeadȱtoȱAbdomenȱ Acceleration Index (ACC)
CircumferenceȱRatioȱinȱtheȱAssessmentȱofȱ
GrowthȱRetardation,””ȱBritishȱJournalȱofȱObstetricsȱ Zwiebel,ȱW.J.ȱIntroductionȱtoȱVascularȱ
andȱGynaecology,ȱ84:ȱ(Marchȱ1977),ȱ165Ȭ174. Ultrasonography,ȱ4thȱed.,ȱW.B.ȱSaundersȱ
Company,ȱ(2000),ȱ52.
Ratio calculations ACCȱ=ȱabsȱ(deltaȱvelocity/deltaȱtime)

FL/AC Ratio Elapsed Time (ET)

HadlockȱF.P.,ȱR.ȱL.ȱDeter,ȱR.ȱB.ȱHarrist,ȱE.ȱRoecker,ȱ ETȱ=ȱtimeȱbetweenȱvelocityȱcursorsȱinȱ
andȱS.K.ȱPark.ȱ““AȱDateȱIndependentȱPredictorȱofȱ milliseconds
IntrauterineȱGrowthȱRetardation:ȱFemurȱ

Chapter 7: References 149

Hip Angle/d:D Ratio Percent Diameter Reduction
Graf,ȱR.ȱ““FundamentalsȱofȱSonographicȱ Handa,ȱNobuoȱetȱal.,ȱ““EchoȬDopplerȱVelocimeterȱ
DiagnosisȱofȱInfantȱHipȱDysplasia.””ȱJournalȱofȱ inȱtheȱDiagnosisȱofȱHypertensiveȱPatients:ȱTheȱ
PediatricȱOrthopedics,ȱVol.ȱ4,ȱNo.ȱ6:ȱ735Ȭ740,ȱ1984. RenalȱArteryȱDopplerȱTechnique,””ȱUltrasoundȱinȱ
MedicineȱandȱBiology,ȱ12:12ȱ(1986),ȱ945Ȭ952.
Morin,ȱC.,ȱHarcke,ȱH.,ȱMacEwen,ȱG.ȱ““TheȱInfantȱ
Hip:ȱRealȬTimeȱUSȱAssessmentȱofȱAcetabularȱ %ȱDiameterȱReductionȱ=ȱ(1ȱȬȱD2(cm)/D1(cm))ȱ*ȱ
Development.””ȱRadiologyȱ177:ȱ673Ȭ677,ȱDecemberȱ 100
1985.
where: D1ȱ=ȱoriginalȱdiameterȱofȱtheȱvesselȱ
Intima Media Thickness (IMT) inȱcm
D2ȱ=ȱreducedȱdiameterȱofȱtheȱvesselȱ
HowardȱG,ȱSharrettȱAR,ȱHeissȱG,ȱEvansȱGW,ȱ
inȱcm
ChamblessȱLE,ȱRileyȱWA,ȱetȱal.ȱ““CarotidȱArteryȱ
IntimaȬMedialȱThicknessȱDistributionȱinȱGeneralȱ Pressure Gradient (PGr) in mmHG
PopulationsȱAsȱEvaluatedȱbyȱBȬModeȱ
Ultrasound.””ȱARICȱInvestigators.ȱ Oh,ȱJ.K.,ȱJ.B.ȱSeward,ȱA.J.ȱTajik.ȱTheȱEchoȱManual.ȱ
AtherosclerosisȱRiskȱinȱCommunities.ȱStroke.ȱ 2ndȱed.,ȱLippincott,ȱWilliams,ȱandȱWilkins,ȱ
(1993),ȱ24:1297Ȭ1304. (1999),ȱ64.

O’’Leary,ȱDanielȱH.,ȱMDȱandȱPolak,ȱJoseph,ȱF.,ȱ 4ȱ*ȱ(Velocity)2
MD,ȱetȱal.ȱ““UseȱofȱSonographyȱtoȱEvaluateȱ PeakȱEȱPressureȱGradientȱ(E PG)
CarotidȱAtherosclerosisȱinȱtheȱElderly.ȱTheȱ
CardiovascularȱHealthȱStudy.””ȱStroke.ȱ(Septemberȱ E PGȱ=ȱ4ȱ*ȱPE2
1991),ȱ22,1155Ȭ1163. PeakȱAȱPressureȱGradientȱ(A PG)
Redberg,ȱRitaȱF.,ȱMDȱandȱVogel,ȱRobertȱA.,ȱMD,ȱ A PGȱ=ȱ4ȱ*ȱPA2
etȱal.ȱ““Taskȱforceȱ#3——WhatȱisȱtheȱSpectrumȱofȱ
CurrentȱandȱEmergingȱTechniquesȱforȱtheȱ PeakȱPressureȱGradientȱ(PGmax)
NoninvasiveȱMeasurementȱofȱAtherosclerosis?””ȱ PGmaxȱ=ȱ4ȱ*ȱPV2
JournalȱofȱtheȱAmericanȱCollegeȱofȱCardiology.ȱ(Juneȱ
4,ȱ2003),ȱ41:11,ȱ1886Ȭ1898. MeanȱPressureȱGradientȱ(PGmean)
PGmeanȱ=ȱ4ȱ*ȱVmax2
Percent Area Reduction
TaylorȱK.J.W.,ȱP.N.ȱBurns,ȱP.ȱBreslau.ȱClinicalȱ Pulsatility Index (PI)
ApplicationsȱofȱDopplerȱUltrasound,ȱRavenȱPress,ȱ Kurtz,ȱA.B.,ȱW.D.ȱMiddleton.ȱUltrasoundȬtheȱ
N.Y.,ȱ(1988),ȱ130Ȭ136. Requisites.ȱMosbyȱYearȱBook,ȱInc.,ȱ(1996),ȱ469.
ZwiebelȱW.J.,ȱJ.A.ȱZagzebski,ȱA.B.ȱCrummy,ȱetȱal.ȱ PIȱ=ȱ(PSVȱ––ȱEDV)/V
““CorrelationȱofȱpeakȱDopplerȱfrequencyȱwithȱ
lumenȱnarrowingȱinȱcarotidȱstenosis.””ȱStroke,ȱ3:ȱ where ȱPSVȱ=ȱpeakȱsystolicȱvelocity
(1982),ȱ386Ȭ391. EDVȱ=ȱendȱdiastolicȱvelocity
Vȱ=ȱmeanȱflowȱvelocityȱthroughoutȱ
%ȱAreaȱReductionȱ=ȱ(1ȱȬȱA2(cm2)/A1(cm2))ȱ*ȱ100
theȱentireȱcardiacȱcycle
where: A1ȱ=ȱoriginalȱareaȱofȱtheȱvesselȱinȱ
squareȱcm Resistive Index (RI)
A2ȱ=ȱreducedȱareaȱofȱtheȱvesselȱinȱ Kurtz,ȱA.B.,ȱW.D.ȱMiddleton.ȱUltrasoundȬtheȱ
squareȱcm Requisites.ȱMosbyȱYearȱBook,ȱInc.,ȱ(1996),ȱ467.

150 Measurement publications and terminology

RIȱ=ȱabsȱ((VelocityȱAȱ––ȱVelocityȱB)/VelocityȱA)ȱinȱ
measurements
where Aȱ=ȱvelocityȱcursorȱ+
Bȱ=ȱvelocityȱcursorȱx

Time Averaged Mean (TAM) in cm/s

TAMȱ=ȱmeanȱ(meanȱTrace)

Volume (Vol)

References
Beyer,ȱW.H.ȱStandardȱMathematicalȱTables,ȱ28thȱed.,ȱ
CRCȱPress,ȱBocaȱRaton,ȱFL,ȱ(1987),ȱ131.

Volume Flow (VF) in l/m

Allan,ȱPaulȱL.ȱetȱal.ȱClinicalȱDopplerȱUltrasound,ȱ
4thȱed.,ȱHarcourtȱPublishersȱLimited.ȱ(2000),ȱ
36Ȭ38.
VFȱ=ȱCSAȱ*ȱTAMȱ* .06

Chapter 7: References 151

152 Measurement publications and terminology
Chapter 8: Specifications

Thisȱchapterȱcontainsȱsystemȱandȱaccessoryȱ
specificationsȱandȱstandards.ȱTheȱspecificationsȱ
Imaging modes
forȱrecommendedȱperipheralsȱareȱinȱtheȱ •• 2Dȱ(256ȱgrayȱshades)
manufacturers’’ȱinstructions.
•• ColorȱpowerȱDopplerȱ(CPD)ȱ(256ȱcolors)
•• ColorȱDopplerȱ(Color)ȱ(256ȱcolors)
Dimensions •• M Mode
•• Pulsedȱwaveȱ(PW)ȱDoppler
System
Length:ȱ11.8ȱin.ȱ(29.97ȱcm) •• Continuousȱwaveȱ(CW)ȱDoppler

Width:ȱ10.8ȱin.ȱ(27.43ȱcm) •• TissueȱDopplerȱImagingȱ(TDI)

Specifications
Height:ȱ3.1ȱin.ȱ(7.87ȱcm) •• TissueȱHarmonicȱImagingȱ(THI)

Weight:ȱ8.5ȱlbs.ȱ(3.9ȱkg)ȱwithȱtheȱC60xȱtransducerȱ
andȱbatteryȱinstalled Image and clip storage
Internalȱstorage:ȱTheȱnumberȱofȱimagesȱandȱclipsȱ
Display youȱcanȱsaveȱdependsȱonȱimagingȱmodeȱandȱfileȱ
Length:ȱ8.4ȱin.ȱ(21.34ȱcm) format.
Height:ȱ6.3ȱin.ȱ(16ȱcm)
Diagonal:ȱ10.4ȱin.ȱ(26.4ȱcm) Accessories
Theȱfollowingȱitemsȱareȱeitherȱincludedȱwithȱorȱ
Supported transducers availableȱforȱuseȱonȱtheȱultrasoundȱsystem:
•• Battery
•• C11x/8Ȭ5ȱMHzȱ(6ȱft/1.8ȱm)
•• C60x/5Ȭ2ȱMHzȱ(5.5ȱft/1.7ȱm) •• BiopsyȱGuide

•• D2x/2ȱMHzȱ(5.5ȱft/1.7ȱm) •• Carryȱcase

•• HFL38x/13Ȭ6ȱMHzȱ(5.6ȱft/1.7ȱm) •• ECGȱcableȱ(6ȱft/1.8ȱm)

•• ICTx/8Ȭ5ȱMHzȱ(5.5ȱft/1.7ȱm) •• Educationȱkeys

•• L25x/13Ȭ6ȱMHzȱ(7.5ȱft/2.3ȱm)ȱ •• Externalȱdisplay

•• L38x/10Ȭ5ȱMHzȱ(5.5ȱft/1.7ȱm) •• Footswitch

•• P10x/8Ȭ4ȱMHzȱ(6ȱft/1.8ȱm) •• MiniȬDock

•• P21x/5Ȭ1ȱMHz(6ȱft/1.8ȱm) •• MobileȱDockingȱSystemȱMȱSeriesȱ(MDSm)ȱ

•• SLAx/13Ȭ6ȱMHzȱ(7.5ȱft/2.3ȱm) •• MobileȱDockingȱSystemȱLiteȱIIȱ(MDSȱLiteȱII)
•• NeedleȱGuide
•• TEEx/8Ȭ3ȱMHzȱ(7.2ȱft./2.2ȱm)

Chapter 8: Specifications 153

•• Powerȱsupply Shipping and storage
•• SiteLinkȱImageȱManagerȱ
System and transducer
•• SonoCalcȱIMT
Ȭ35––65°Cȱ(Ȭ31––149°F),ȱ15––95%ȱR.H.
•• SystemȱACȱpowerȱcordȱ(10ȱft/3.1ȱm)
500ȱtoȱ1060hPaȱ(0.5ȱtoȱ1.05ȱATM)
•• TripleȱTransducerȱConnect
Battery
Peripherals Ȭ20––60°Cȱ(Ȭ4––140°F),ȱ15––95%ȱR.H.ȱ(Forȱstorageȱ
longerȱthanȱ30ȱdays,ȱstoreȱatȱorȱbelowȱroomȱ
Seeȱtheȱmanufacturer’’sȱspecificationsȱforȱtheȱ
temperature.)
followingȱperipherals.
500ȱtoȱ1060hPaȱ(0.5ȱtoȱ1.05ȱATM)
Medical grade
•• Barȱcodeȱscanner,ȱserial
Electrical
•• Barȱcodeȱscanner,ȱUSB
PowerȱSupplyȱInput:ȱ100Ȭ240ȱVAC,ȱ50/60ȱHz,ȱ2.0ȱ
•• BlackȬandȬwhiteȱprinter AȱMaxȱ@ȱ100ȱVAC
Recommendedȱsourcesȱforȱprinterȱpaper:ȱ PowerȱSupplyȱOutputȱ#1:ȱ15ȱVDC,ȱ5.0ȱAȱMax
ContactȱSonyȱatȱ800Ȭ686Ȭ7669ȱorȱ
www.sony.com/professionalȱtoȱorderȱsuppliesȱ PowerȱSupplyȱOutputȱ#2:ȱ12ȱVDC,ȱ2.3ȱAȱMax
orȱtoȱfindȱtheȱlocalȱdistributor.
•• Colorȱprinter Battery
•• DVDȱrecorder TheȱbatteryȱcomprisesȱsixȱlithiumȬionȱcellsȱplusȱ
electronics,ȱaȱtemperatureȱsensor,ȱandȱbatteryȱ
Non-medical grade contacts.
•• Kensingtonȱsecurityȱcable Runȱtimeȱisȱupȱtoȱtwo hours,ȱdependingȱonȱ
•• USBȱstorageȱdevice imagingȱmodeȱandȱdisplayȱbrightness.

Temperature and humidity Electromechanical safety

limits standards
Note: Theȱtemperature,ȱpressure,ȱandȱhumidityȱlimitsȱ ENȱ60601Ȭ1:1997,ȱEuropeanȱNorm,ȱMedicalȱ
applyȱonlyȱtoȱtheȱultrasoundȱsystem,ȱtransducers,ȱandȱ ElectricalȱEquipment––Part 1.ȱGeneralȱ
battery. RequirementsȱforȱSafety.
ENȱ60601Ȭ1Ȭ1:2001,ȱEuropeanȱNorm,ȱMedicalȱ
Operating ElectricalȱEquipment––Partȱ1.ȱGeneralȱ
RequirementsȱforȱSafety––Sectionȱ1Ȭ1.ȱCollateralȱ
System, battery, and transducer Standard.ȱSafetyȱRequirementsȱforȱMedicalȱ
10––40°Cȱ(50––104°F),ȱ15––95%ȱR.H. ElectricalȱSystems.

700ȱtoȱ1060hPaȱ(0.7ȱtoȱ1.05ȱATM)

154 Temperature and humidity limits

ENȱ60601Ȭ2Ȭ37:2001ȱ+ȱAmendmentȱA1:2005,ȱ
EuropeanȱNorm,ȱParticularȱrequirementsȱforȱtheȱ
Airborne equipment
safetyȱofȱultrasonicȱmedicalȱdiagnosticȱandȱ standards
monitoringȱequipment.
RTCA/DOȬ160E:2004,ȱRadioȱTechnicalȱ
CAN/CSAȱC22.2,ȱNo.ȱ601.1ȬM90,ȱCanadianȱ CommissionȱforȱAeronautics,ȱEnvironmentalȱ
StandardsȱAssociation,ȱMedicalȱElectricalȱ ConditionsȱandȱTestȱProceduresȱforȱAirborneȱ
Equipment––Partȱ1.ȱGeneralȱRequirementsȱforȱ Equipment,ȱSection 21.0ȱEmissionȱofȱRadioȱ
Safetyȱ(includingȱCSAȱ601.1ȱSupplementȱ1:1994ȱ FrequencyȱEnergy,ȱCategory B.
andȱCSAȱ601.1ȱAmendmentȱ2:1998).
CEI/IECȱ61157:1992,ȱInternationalȱ
ElectrotechnicalȱCommission,ȱRequirementsȱforȱ
DICOM standard
theȱDeclarationȱofȱtheȱAcousticȱOutputȱofȱ NEMAȱPS 3.15:ȱ2000,ȱDigitalȱImagingȱandȱ
MedicalȱDiagnosticȱUltrasonicȱEquipment. CommunicationsȱinȱMedicineȱ(DICOM)ȬPartȱ15:ȱ
SecurityȱProfiles.
ULȱ60601Ȭ1ȱ(1stȱEdition),ȱUnderwritersȱ
Laboratories,ȱMedicalȱElectricalȱ
HIPAA standard

Specifications
EquipmentȬPart 1:ȱGeneralȱRequirementsȱforȱ
Safety.
TheȱHealthȱInsuranceȱandȱPortabilityȱandȱ
AccountabilityȱAct,ȱPub.L.ȱNo.ȱ104Ȭ191ȱ(1996).
EMC standards classification 45ȱCFRȱ160,ȱGeneralȱAdministrativeȱ
ENȱ60601Ȭ1Ȭ2:2007,ȱEuropeanȱNorm,ȱMedicalȱ Requirements.
ElectricalȱEquipment.ȱGeneralȱRequirementsȱforȱ
45ȱCFRȱ164,ȱSecurityȱandȱPrivacy.
SafetyȬCollateralȱStandard.ȱElectromagneticȱ
Compatibility.ȱRequirementsȱandȱTests.
CISPR11:2004,ȱInternationalȱElectrotechnicalȱ
Commission,ȱInternationalȱSpecialȱCommitteeȱonȱ
RadioȱInterference.ȱIndustrial,ȱScientific,ȱandȱ
Medicalȱ(ISM)ȱRadioȬFrequencyȱEquipmentȱ
ElectromagneticȱDisturbanceȱ
CharacteristicsȬLimitsȱandȱMethodsȱofȱ
Measurement.
TheȱClassificationȱforȱtheȱultrasoundȱsystem,ȱ
dockingȱsystem,ȱaccessories,ȱandȱperipheralsȱ
whenȱconfiguredȱtogetherȱis:ȱGroupȱ1,ȱClassȱA.

Chapter 8: Specifications 155

156 HIPAA standard
Glossary

Terms
Forȱultrasoundȱtermsȱnotȱincludedȱinȱthisȱglossary,ȱreferȱtoȱRecommendedȱUltrasoundȱ
Terminology,ȱSecondȱEdition,ȱpublishedȱinȱ1997ȱbyȱtheȱAmericanȱInstituteȱofȱUltrasoundȱinȱ
Medicineȱ(AIUM).

as low as reasonably The guiding principle of ultrasound use, which states that you should
achievable (ALARA) keep patient exposure to ultrasound energy as low as reasonably
achievable for diagnostic results.

curved array Identified by the letter C (curved or curvilinear) and a number (60). The
transducer number corresponds to the radius of curvature of the array expressed
in millimeters. The transducer elements are electrically configured to
control the characteristics and direction of the acoustic beam. For
example, C15, C60e.

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

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

in situ In the natural or original position.

LCD liquid crystal display

Glossary
linear array Identified by the letter L (linear) and a number (38). The number
transducer corresponds to the radius of width of the array expressed in
millimeters. The transducer elements are electrically configured to
control the characteristics and direction of the acoustic beam. For
example, L38.

mechanical index An indication of the likelihood of mechanical bioeffects occurring: the

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

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

NTSC National Television Standards Committee. A video format setting. See

also PAL.

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

phased array A transducer designed primarily for cardiac scanning. Forms a sector
image by electronically steering the beam direction and focus.

Glossary 157
 skinline A depth on the display that corresponds to the skin/transducer
interface.

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

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

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

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

Tissue Doppler A pulsed wave Doppler technique used to detect myocardial motion.
Imaging (TDI)

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

TIB (bone thermal A thermal index for applications in which the ultrasound beam passes
index) through soft tissue and a focal region is in the immediate vicinity of
bone.

TIC (cranial bone A thermal index for applications in which the ultrasound beam passes
thermal index) through bone near the beam entrance into the body.

TIS (soft tissue A thermal index related to soft tissues.

thermal index)

Tissue Harmonic Transmits at one frequency and receives at a higher harmonic

Imaging frequency to reduce noise and clutter and improve resolution.

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

variance Displays a variation in Color Doppler flow imaging within a given

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

158
Abbreviations
Abbreviations in User Interface

Abbreviation Definition

+/× “+” Caliper/”×” Caliper Ratio

A “A” Wave Peak Velocity

A PG “A” Wave Peak Pressure Gradient

A2Cd Apical 2 Chamber diastolic

A2Cs Apical 2 Chamber systolic

A4Cd Apical 4 Chamber diastolic

A4Cs Apical 4 Chamber systolic

AAA Abdominal Aortic Aneurysm

AAo Ascending Aorta

Abd Abdomen

abs Absolute value

AC Abdominal Circumference

Glossary
ACA Anterior Cerebral Artery

ACC Acceleration Index

ACoA Anterior Communicating Artery

ACS Aortic Valve Cusp Separation

Adur “A” wave duration

AFI Amniotic Fluid Index

AI Aortic Insufficiency

AI PHT Aortic Insufficiency Pressure Half Time

AL Atlas Loop

Ann D Annulus Diameter

ANT F Anterior Far

ANT N Anterior Near

Glossary 159
 Abbreviations in User Interface (Continued)

Abbreviation Definition

Ao Aorta

AoD Aortic Root Diameter

Apical Apical View

APTD Anteroposterior Trunk Diameter

AT Acceleration (Deceleration) Time

AUA Average Ultrasound Age

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

AV Aortic Valve

AV Area Aortic Valve Area

AVA Aortic Valve Area

BA Basilar Artery

Bifur Bifurcation

BP Blood Pressure

BPD Biparietal Diameter

BPM Beats per Minute

Bre Breast

BSA Body Surface Area

CCA Common Carotid Artery

CI Cardiac Index

CO Cardiac Output

CPD Color Power Doppler

Crd Cardiac

CRL Crown Rump Length

CW Continuous Wave Doppler

160
Abbreviations in User Interface (Continued)

Abbreviation Definition

Cx L Cervix Length

D Diameter

D Apical Distance Apical

DCCA Distal Common Carotid Artery

DECA Distal External Carotid Artery

DICA Distal Internal Carotid Artery

Dist Distal

dP:dT Delta Pressure: Delta Time

E “E” Wave Peak Velocity

E PG “E” Wave Peak Pressure Gradient

E:A E:A Ratio

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

ECA External Carotid Artery

Glossary
ECG Electrocardiogram

ECICA Extracranial Internal Carotid Artery

ECVA Extracranial Vertebral Artery

EDD Estimated Date of Delivery

EDD by AUA Estimated Date of Delivery by Average Ultrasound Age

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

EDD by LMP Estimated Date of Delivery by Last Menstrual Period

The due date calculated from the user-entered LMP.

EDV End Diastolic Velocity

EF Ejection Fraction

EF:SLOPE E-F Slope

Glossary 161
 Abbreviations in User Interface (Continued)

Abbreviation Definition

EFW Estimated Fetal Weight

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

Endo Endocardial

Epi Epicardial

EPSS “E” Point Septal Separation

Estab. DD Established Due Date

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

ET Elapsed Time

FH Femoral Head

FHR Fetal Heart Rate

FL Femur Length

FM (Right and Left) Foramen Magnum (same as SO)

FTA Fetal Trunk Area

GA Gestational Age

GA by LMP Gestational Age by Last Menstrual Period

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

GA by LMPd Gestational Age by derived Last Menstrual Period

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

Gate Depth of Doppler Gate

GS Gestational Sac

Gyn Gynecology

HC Head Circumference

HR Heart Rate

162
Abbreviations in User Interface (Continued)

Abbreviation Definition

ICA Internal Carotid Artery

IMT Intima Media Thickness

IVRT Iso Volumic Relaxation Time

IVS Interventricular Septum

IVSd Interventricular Septum Diastolic

IVSFT Interventricular Septum Fractional Thickening

IVSs Interventricular Septum Systolic

LA Left Atrium

LA/Ao Left Atrium/Aorta Ratio

LAT F Lateral Far

LAT N Lateral Near

LMP Last Menstrual Period

LMP Last Menstrual Period

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

Glossary
age and EDD.

LMPd derived Last Menstrual Period

Calculated from the user-entered Estab. DD.

LV Left Ventricular

LV Area Left Ventricular Area

LV mass Left Ventricular mass

LV Volume Left Ventricular Volume

LVd Left Ventricular diastolic

LVD Left Ventricular Dimension

LVDd Left Ventricular Dimension Diastolic

LVDFS Left Ventricular Dimension Fractional Shortening

LVDs Left Ventricular Dimension Systolic

Glossary 163
 Abbreviations in User Interface (Continued)

Abbreviation Definition

LVEDV Left Ventricular End Diastolic Volume

LVESV Left Ventricular End Systolic Volume

LVET Left Ventricular Ejection Time

LVO Left Ventricular Opacification

LVOT Left Ventricular Outflow Tract

LVOT Area Left Ventricular Outflow Tract Area

LVOT D Left Ventricular Outflow Tract Diameter

LVOT VTI Left Ventricular Outflow Tract Velocity Time Integral

LVPW Left Ventricular Posterior Wall

LVPWd Left Ventricular Posterior Wall Diastolic

LVPWFT Left Ventricular Posterior Wall Fractional Thickening

LVPWs Left Ventricular Posterior Wall Systolic

LVs Left Ventricular systolic

MB SonoMB

MCA Middle Cerebral Artery

MCCA Mid Common Carotid Artery

MECA Mid External Carotid Artery

MI Mechanical Index

MICA Mid Internal Carotid Artery

Mid Middle

MM M Mode

MR PISA Mitral Regurgitation Proximal Iso Velocity Surface Area

MR/VTI Mitral Regurgitation/Velocity Time Integral

Msk Muscle

MV Mitral Valve

164
Abbreviations in User Interface (Continued)

Abbreviation Definition

MV Area Mitral Valve Area

MV Regurgitant Mitral Valve Regurgitant Fraction

Fraction

MV Regurgitant Volume Mitral Valve Regurgitant Volume

MV/VTI Mitral Valve/Velocity Time Integral

MVA Mitral Valve Area

MV ERO Mitral Valve Effective Regurgitant Orifice

MV PISA Area Mitral Valve Proximal Iso Velocity Surface Area

MV Rate Mitral Valve Rate

Neo Neonatal

Nrv Nerve

NST Non-stress test

NTSC National Television Standards Committee

OA Ophthalmic Artery

Glossary
OB Obstetrical

OFD Occipital Frontal Diameter

Oph Ophthalmic

Orb Orbital

PAL Phase Alternating Line

PCAp Posterior Cerebral Artery Peak

PCCA Proximal Common Carotid Artery

PCoA Posterior Communicating Artery

PECA Proximal External Carotid Artery

PGmax Maximum Pressure Gradient

PGmean Mean Pressure Gradient

PGr Pressure Gradient

Glossary 165
 Abbreviations in User Interface (Continued)

Abbreviation Definition

PHT Pressure Half Time

PI Pulsatility Index

PICA Proximal Internal Carotid Artery

PISA Proximal Isovelocity Surface Area

Plaq Plaque

POST F Posterior Far

POST N Posterior Near

PRF Pulse Repetition Frequency

Prox Proximal

PSV Peak Systolic Velocity

PV Pulmonic Valve

P. Vein Pulmonary Vein

PW Pulsed Wave Doppler

Qp/Qs Pulmonary blood flow divided by systemic blood flow

RA Right Atrial (pressure)

RI Resistive Index

RVD Right Ventricular Dimension

RVDd Right Ventricular Dimension Diastolic

RVDs Right Ventricular Dimension Systolic

RVOT D Right Ventricular Outflow Tract Diameter

RVOT VTI Right Ventricular Outflow Tract Velocity Time Integral

RVSP Right Ventricular Systolic Pressure

RVW Right Ventricular Free Wall

RVWd Right Ventricular Free Wall Diastolic

RVWs Right Ventricular Free Wall Systolic

166
Abbreviations in User Interface (Continued)

Abbreviation Definition

S SonoHD

S/D Systolic/Diastolic Ratio

SI Stroke Index

Siphon Siphon (internal carotid artery)

SM Submandibular

SmP Small Parts

SO Suboccipital

Sup Superficial

SV Stroke Volume

TAM Time Average Mean

TAP Time Average Peak

TCD Transcranial Doppler

TDI Tissue Doppler Imaging

Glossary
THI Tissue Harmonic Imaging

TI Thermal Index

TICA Terminal Internal Carotid Artery

TO Transorbital

TRmax Tricuspid Regurgitation (peak velocity)

TT Transtemporal

TTD Transverse Trunk Diameter

TV Tricuspid Valve

TVA Tricuspid Valve Area

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

Umb A Umbilical Artery

Glossary 167
 Abbreviations in User Interface (Continued)

Abbreviation Definition

VA Vertebral Artery

VArty Vertebral Artery

Vas Vascular

Ven Venous

VF Volume Flow

Vmax Peak Velocity

Vmean Mean Velocity

Vol Volume

VTI Velocity Time Integral

YS Yolk Sac

168
Index

Symbols setup 19
specifications 154
+/x measurement 44
beeps 19
biological safety 92
Numerics biopsy 26
bodymarker. See pictographs
2D imaging 25 brightness 26
2D options 25

C
A cables
A & B shortcut keys 15 clean and disinfect ECG 76
abbreviations 159 connect power 3
abdominal, intended uses 12 calculations
AC power indicator 6 cardiac. See cardiac calculations
acceleration (ACC) index 44 delete measurement 46
accessories list 153 general 45
acoustic measurement precision 133 gynecology (Gyn) 58
acoustic output IMT 59
measurement 105 menu 7, 45
tables 107, 132 OB 61
acquisition error 140 percent area 47
add new user 16 percent diameter 47
Administrator 16 percent reduction 46
age, gestational 62 perform measurement 45
airborne equipment standards 155 performing 45
ALARA principle 97, 98, 157 repeat measurement 46
alphanumeric keys 5 save 45
angle correction 28, 29 small parts 64
annotations specialized 50
keys 5 vascular 67
place 32 view measurement 46
predefine label groups 18

Index
volume 48
setup 18 volume flow 48, 49
aorta (Ao) 53 calipers 41
aortic valve area (AVA) 56 cardiac calculations
arrow graphic 33 AAo 53
ascending aorta (AAo) 53 Ao 53
audio 19 AVA 56
CI 57
CO 57
B dP:dT 56
bar code scanner 19 HR 57
baseline 29 IVRT 52
battery LA 53
clean 75 LV volume (Simpson’s Rule) 53
safety 90

Index 169
 LVd 53 depth
LVOT D 53 adjust 30
LVs 53 definition 157
MV/AV area 54 keys 5
overview 50 marker 7
PHT 55 DICOM standard 155
PISA 51 disinfect
RVSP 55 battery 75
setup 19 ECG cable 76
SV 57 system 73
TDI 58 transducers 74
VTI 54 disinfectants, compatibility 77
cardiac index (CI) 57 display setup 20
cardiac output (CO) 57 distance measurements
cardiac references 141 2D 42
cardiac, intended uses 12 M mode 43
cautions, definition vii D-line 28
cine buffer 5, 30 Doppler
clean Doppler gate depth 29
battery 75 measurements 43
ECG cable 76 scale setup 22
footswitch 75 dual images 25
LCD screen 73 duplex 22
system 73 DVD recorder 19, 71
transducers 74 Dynamic Range 22
clip acquisition delay 39
clips
See also images and clips E
options 26, 35 ECG
color Doppler (Color) imaging 27 Monitoring 26, 38
color power Doppler (CPD) imaging 27 elapsed time (ET) measurement 44
color scheme, background 23 electrical
color suppress 27 safety 88
Color. See color Doppler (Color) imaging specifications 154
connectivity setup, wireless certificates 19 electromagnetic compatibility 93
continuous wave (CW) Doppler imaging 28, 29 electromechanical safety standards 154
controls EMC classification standards 155
direct 98 EMED worksheets 70
indirect 99 equipment safety 90
receiver 99 error message 89
CPD. See color power Doppler (CPD) imaging errors
customer assistance vii acquisition 140
CW Doppler. See continuous wave (CW) Doppler algorithmic 140
imaging measurement 140
estimated date of delivery (EDD) 145
estimated fetal weight (EFW) 146
D Event log 17
date 20 exam
default settings 15 change type 31
delta pressure:delta time (dP:dT) 56 end 34

170 Index
 type and transducer 31 export to USB 38
export and import review 37
OB calculation tables 21 imaging modes
predefined label groups 18 list of 153
user accounts 17 transducer 31
import. See export and import
IMT. See Intima Media Thickness (IMT)
F in situ, definition 157
far 5 infertility, intended uses 12
fetal heart rate (FHR) 63 intended uses 11–13
flow sensitivity 27 intensity
focal zones, optimize 25 derated 105
footswitch setup 15 in situ 105
forms 6 water-value 105
freeze 30 interventional, intended uses 12
Intima Media Thickness (IMT)
calculations 20, 59
G sketch 61
gain trace 61
adjust 30 intraoperative, intended uses 12
ECG 39 invert
knob 5 Color 28
gate size 29 spectral trace 29
gestational age iso volumic relaxation time (IVRT) 52
setup 21
tables, references 146
gestational growth, measure 63 K
grace period 71 keys 5
grayscale 25 knobs 5
growth analysis
setup 21
tables, references 148 L
guidance documents, related 104 labeling symbols 134
guideline 26 language 23
gynecology, intended uses 12 layout 22
LCD screen

Index
clean 73
H output 103
heart rate 34 left atrium (LA) 53
heart rate (HR) 43, 57, 63 left ventricular diastolic (LVd) 53
HIPAA standard 155 left ventricular outflow tract diameter (LVOT D) 53
home position 33 left ventricular systolic (LVs) 53
humidity limits 154 left ventricular volume (LV volume) 53
license key 71
live trace 22, 30
I login
image quality, poor 71 Administrator 16
images and clips user 16
archive 38 LVO (Left Ventricular Opacification) 26
delete 38

Index 171
 M custom tables setup 22
graphs 70
M Mode imaging 26
intended uses 12
maintenance 72
references 145
measurements
tables setup 22
+/x Ratio, Doppler 44
on-screen controls 6
See also calculations
optimize 25
2D 42
orientation
about 41
marker 7
Acceleration, Doppler 44
option 26
accuracy 41, 139
output display 103
area, 2D 42
automatic trace, Doppler 44
circumference, 2D 42 P
delete 41
PAL
distance, 2D 42
definition 157
distance, M Mode 43
option 19
Doppler 43
password 16, 17, 18
edit 41
patient header 7, 20
Elapsed Time, Doppler 44
patient information form 33, 36, 37
errors 140
patient list 36
fetal heart rate 63
patient report
heart rate 43, 63
about 68
M Mode 43
cardiac 69
manual trace 42, 44
general 68
Pressure Gradient, Doppler 43
OB 69
publications 141
save measurement to 41
Resistive Index, Doppler 44
vascular 69
save to calculation and report 41
PC 19
terminology 141
pediatric, intended uses 12
vascular 67
percent reduction calculation 46
Velocities, Doppler 44
peripherals 154
mechanical index (MI) 103, 157
pictographs
mitral valve/aortic valve (MV/AV) 54
PICTO key 7
M-line 26
placing 33
mode data 7, 20
power delay 19
modes, keys 6
power key 5
precision, acoustic measurement 133
N preferences 22
presets 22
near 5
pressure half time (PHT) 55
network 20
pressure limits 154
NTSC
PRF 28, 29
definition 157
print 37
option 19
printer
problem 71
O setup 19
probe. See transducer
OB proximal isovelocity surface area (PISA) 51
calculations 20, 61 pulsed wave (PW) Doppler imaging 28
custom measurements setup 21

172 Index
PW Doppler. See pulsed wave (PW) Doppler imaging EMC classification 155
HIPAA 155
steering
R CPD 28
recording problem 71 Doppler 29
references storage specifications
cardiac 141 equipment 154
general 149 images 153
gestational age tables 146 stroke volume (SV) 57
growth analysis tables 148 superficial, intended uses 12
obstetrical 145 sweep speed
ratio calculations 149 Doppler 29
report, patient 68 ECG 39
resistive index (RI) measurement 44 M Mode 27
right ventricular systolic pressure (RVSP) 55 symbols, labeling 134
system
clean and disinfect 73
S controls 5
safety software 1
battery 90 status 7, 20
biological 92 wake up 3
electrical 88
electromagnetic compatibility 93
equipment 90 T
save Technical Support vii
calculations 45 temperature limits 154
image 6 text 32
measurements 41 text description 7
SAVE key 22 thermal index (TI) 22, 103, 158
scale 29 THI 26
scanhead. See transducer time setup 20
screen layout 7 tissue Doppler imaging (TDI) 29, 58
security 15, 16 tissue models 106
serial port 19 touchpad 6, 8
setup pages 15 transcranial, intended uses 13
shipping specifications 154 transducer

Index
shortcut keys 15 clean and disinfect 74
Simpson’s Rule 53 curved array 157
skin line, definition 158 definition 158
sleep delay 19 disinfect 74
small parts calculations 64 exam type 31
software license 71 general use 10
SonoHD 158 imaging modes 31
SonoMB 26, 158 invasive or surgical use 10
specifications 153 linear array 157
spectral trace 28 preparation 10
standards problems 71
airborne equipment 155 specifications 153
DICOM 155 troubleshoot 71
electromechanical 154

Index 173
 U
ultrasound terminology 157
unfreeze text 18
USB storage device, export to 38
user account 17
user guide, conventions used vii
user setup 16
uses, intended 11–13

V
variance 28
vascular
calculations 67
intended uses 13
velocity measurement 44
velocity time integral (VTI) 54
volume
calculation 48
Doppler, adjust 29
volume flow 48

W
wall filter 28, 29
warnings, definition vii
worksheets, EMED 70

Z
zoom 30

174 Index
 P07662-02
*P07662-02*