V7 Complete

Technical Publications
Vivid 7 Dimension/Vivid 7 PRO

Version 7.x.x
0470
User’s Manual
Volume 1
GEVU #: FD092052
GEVU Rev. 01
MHLW No: 21300BZY00416000
Operating Documentation
Copyright © 2007 By General Electric Co.
MANUAL STATUS © GE Medical Systems. All rights reserved. No part of this
FD092052-01 manual may be reproduced, stored in a retrieval system, or
transmitted, in any form or by any means, electronic,
01/08/2007
mechanical, photocopying, recording, or otherwise,
without the prior written permission of GE Medical
Systems.
COMPANY DATA GE VINGMED ULTRASOUND A/S

Strandpromenaden 45, N-3191 Horten, Norway
Tel.: (+47) 3302 1100 Fax: (+47) 3302 1350
Table of Contents
Table of Contents
Introduction
Attention .........................................................................................1
Safety ..............................................................................................1
Interference caution.......................................................................1
Indications for use ........................................................................2
Contraindications...........................................................................2
Manual contents.............................................................................3
Finding information................................................................3
Conventions used in this manual.................................................4
Contact information .......................................................................5
Software license acknowledgments.............................................6
Chapter 1
Getting started
Introduction ....................................................................................8
Preparing the unit for use .............................................................9
Site requirements ..................................................................9
Connecting the unit .............................................................10
Switching On/Off .................................................................16
Moving and transporting the unit ...............................................18
Wheels ................................................................................18
Moving the unit ....................................................................20
Transporting the unit ...........................................................21
Reinstalling at a new location..............................................21
Unit acclimation time ...........................................................22
System description ......................................................................23
System overview .................................................................23
Control panel .......................................................................26
The Scanning screen ..........................................................39
Footswitch operation ...........................................................42
Connecting and disconnecting probes ...............................43 1
Adjusting the monitor display ..............................................43
LCD monitor adjustment......................................................46
Starting an examination ..............................................................48
Creating a new Patient record or starting an examination from
an existing patient record ....................................................48
Selecting a Probe and an Application .................................52
Chapter 2
Basic scanning operations
Assignable keys and Soft Menu Rocker ....................................55
Using the Soft Menu Rocker ...............................................56
Trackball operation ......................................................................57
Cineloop operation ......................................................................58
Cineloop overview ...............................................................58
Cineloop controls.................................................................60
Using cineloop.....................................................................61
Storing images and cineloops ....................................................62
To store a single image .......................................................62
To store a cineloop..............................................................62
Using removable media...............................................................63
Recommendation concerning CD and DVD handling .........63
Formatting removable media...............................................63
Ejecting removable media ...................................................65
Recording images on VCR ..........................................................66
Zoom .............................................................................................67
To magnify an image (Display zoom)..................................68
To activate the HR zoom.....................................................68
Performing measurements..........................................................69
To perform measurements: .................................................69
Physiological traces ....................................................................70
Pinout on AUX connectors ..................................................71
Connecting the ECG/Respiration ........................................71
Connecting the Phono.........................................................73
Connecting the Pulse pressure transducer .........................73
Physio overview ..................................................................74
Physio controls ....................................................................75
Displaying the physiological traces .....................................77
2
Adjusting the display of physiological traces .......................77
Annotations ..................................................................................79
To insert an annotation........................................................79
To edit annotation................................................................82
To erase annotation ............................................................82
Configuration of the pre-defined annotation list...................83
Bodymarks ..........................................................................85
Chapter 3
Scanning Modes
Introduction ..................................................................................89
2D-Mode ........................................................................................90
2D-Mode overview ..............................................................90
2D-Mode controls ................................................................92
Using 2D..............................................................................95
Optimizing 2D......................................................................95
M-Mode..........................................................................................96
M-Mode overview ................................................................96
M-Mode controls..................................................................98
Using M-Mode ...................................................................100
Optimizing M-Mode ...........................................................101
Color Mode ................................................................................102
Color 2D Mode overview ...................................................102
Color M-Mode overview ....................................................103
Color Mode controls ..........................................................105
Using Color Mode..............................................................108
Optimizing Color Mode......................................................109
PW and CW Doppler ..................................................................110
PW and CW Doppler overview..........................................110
PW and CW Doppler controls ...........................................112
Using PW/CW Doppler modes ..........................................115
Optimizing PW/CW Doppler modes ..................................115
Tissue Velocity Imaging (TVI) ...................................................117
TVI overview......................................................................117
TVI controls .......................................................................119
Using TVI...........................................................................122
Optimizing TVI...................................................................122
3
Tissue Tracking..........................................................................123
Tissue Tracking overview..................................................123
Tissue Tracking controls ...................................................125
Using Tissue Tracking.......................................................128
Optimizing Tissue Tracking ...............................................128
Strain rate ...................................................................................130
Strain rate overview...........................................................130
Strain rate controls ............................................................132
Using Strain rate................................................................135
Optimizing Strain rate........................................................135
Strain ...........................................................................................136
Strain overview..................................................................136
Strain controls ...................................................................138
Using Strain.......................................................................141
Optimizing Strain ...............................................................141
Tissue Synchronization Imaging (TSI) .....................................142
TSI overview......................................................................142
TSI controls .......................................................................144
Using TSI...........................................................................146
Optimizing TSI...................................................................147
Additional scanning features....................................................148
LogiqView..........................................................................148
Compound.........................................................................148
B-Flow ...............................................................................149
Blood flow imaging ............................................................149
Chapter 4
Stress Echo
Introduction ................................................................................152
Selection of a stress test protocol template............................153
Image acquisition.......................................................................155
Starting acquisition ............................................................156
Continuous capture mode .................................................160
Analysis .............................................................................168
Quantitative TVI Stress echo analysis .....................................173
Accessing QTVI Stress analysis tools...............................175
Vpeak measurement .........................................................175
4
Tissue Tracking .................................................................179
Quantitative analysis .........................................................180
References ........................................................................180
Editing/creating a template .......................................................181
Entering the Template editor screen .................................181
Template editor screen overview ......................................182
Editing/Creating a template ...............................................185
Chapter 5
Contrast Imaging
Introduction ................................................................................189
Data acquisition.................................................................189
Quantification ....................................................................190
Data acquisition .........................................................................192
Left Ventricular Contrast Imaging......................................192
Myocardial Contrast Imaging.............................................197
Real-Time Coded Phase Inversion (RTCPI) .....................205
Vascular Contrast Imaging ................................................213
Abdominal Contrast Imaging .............................................217
Rodent Contrast Imaging ..................................................221
Chapter 6
Measurement and Analysis
Introduction ................................................................................224
About Measurement results display ..................................224
The Assign and Measure modality ...........................................226
Starting the Assign and Measure modality........................226
Entering a study and performing measurements ..............228
Measure and Assign modality ..................................................230
Starting the Measure and Assign modality........................230
Post-measurement assignment labels ..............................231
Cardiac Measurements..............................................................234
2D Measurements .............................................................234
M-Mode Measurements ....................................................238
Doppler Measurements .....................................................242
TSI Measurements ............................................................245
5
Automated Function Imaging ............................................251
Vascular measurements............................................................269
B-Mode measurements .....................................................269
M-Mode Measurements ....................................................273
Doppler measurements .....................................................274
OB measurements .....................................................................280
OB graphs .........................................................................280
Measurement package configuration.......................................285
Measurement package configuration - example ...............285
Normal values ...................................................................287
User-defined formulas ...............................................................290
User-defined formula - example ........................................290
About units ........................................................................296
Measurement result table..........................................................299
Minimizing the Measurement result table..........................299
Moving the Measurement result table ...............................299
Deleting measurements ....................................................299
Worksheet...................................................................................301
Overview ...........................................................................301
Using Worksheet ...............................................................301
Chapter 7
Quantitative Analysis
Introduction ................................................................................306
For TVI: .............................................................................306
For Tissue Tracking:..........................................................306
For Strain rate: ..................................................................306
For Strain:..........................................................................306
For Contrast: .....................................................................306
Accessing the Quantitative analysis package ........................307
In replay mode:..................................................................307
In live .................................................................................307
Quantitative Analysis window ..................................................308
Overview ...........................................................................308
Generation of a trace .................................................................315
About the sample area ......................................................315
To generate a trace ...........................................................315
6
Manual tracking of the sample area (dynamic anchored
sample area) .....................................................................316
Zooming in the Analysis window .......................................317
Deletion of a trace ......................................................................318
To delete all traces ............................................................318
To delete one specific trace ..............................................318
Saving/retrieving Quantitative analysis ...................................318
Frame disabling..........................................................................319
Disabling frames................................................................319
Re-enabling all frames ......................................................319
Optimizing sample area.............................................................321
Reshaping a sample area .................................................321
Labelling a sample area ....................................................322
Optimizing the trace display .....................................................323
Optimizing the Y-axis ........................................................323
Trace smoothing................................................................324
Switching modes or traces .......................................................326
To switch mode .................................................................326
To switch trace ..................................................................326
Cine compound ..........................................................................327
Curve fitting analysis.................................................................328
Wash-in curve fitting analysis............................................330
Wash-out curve fitting analysis..........................................335
Anatomical M-Mode ...................................................................337
Introduction........................................................................337
Using Anatomical M-Mode ................................................337
Optimizing Anatomical M-Mode ........................................339
Chapter 8
Archiving
Introduction ................................................................................342
Storing images and cineloops ..................................................343
Storing an image ...............................................................345
Storing a cineloop..............................................................345
Saving stored images and cineloops to a standard format346
MPEGVue/eVue ................................................................348
Retrieving and editing archived information...........................351 7
Locating a patient record...................................................351
Selecting a patient record and editing data in the archive.355
Deleting archived information............................................361
Moving examinations.........................................................363
Review images in archive..........................................................366
Review the images from a selected examination ..............366
Select images from the Image list screen .........................367
Connectivity................................................................................371
The dataflow concept ........................................................371
Stand-alone scanner scenario...........................................375
A stand-alone scanner and a stand-alone EchoPAC PC
environment.......................................................................376
A stand-alone scanner and a stand-alone DICOM
workstation ........................................................................378
A scanner and EchoPAC PC in a direct connect
environment.......................................................................379
A scanner and EchoPAC PC in a network environment ...383
A scanner and a DICOM server in a network....................385
Export/Import patient records/examinations...........................395
Exporting patient records/examinations ............................395
Importing patient records/examinations ............................404
Disk management ......................................................................408
Configuring the Disk management function ......................409
Running the Disk management function ...........................411
Data Backup and restore...........................................................416
Backup procedure .............................................................417
Restore procedure.............................................................421
DICOM spooler ...........................................................................423
Starting the DICOM spooler ..............................................423
Chapter 9
Report
Introduction ................................................................................427
Creating a report ........................................................................428
Working with the report function........................................428
To print a report.................................................................431
To store a report................................................................431
8
Retrieving an archived report ............................................432
Deleting an archived report ...............................................432
Structured Findings ...................................................................433
Prerequisite .......................................................................433
Starting Structured Findings..............................................434
Structured Findings structure ............................................434
Using Structured Findings .................................................436
Structured Findings configuration......................................439
Direct report................................................................................450
Creating comments ...........................................................450
Creating pre-defined text inputs ........................................452
Report designer..........................................................................453
Accessing the Report designer .........................................453
Report designer overview..................................................454
Designing a report template ..............................................457
Saving the report template ................................................467
To exit the Report designer ...............................................468
Report templates management.................................................469
Configuration of the Template selection menu..................469
Export/Import of Report templates ....................................471
Chapter 10
Probes
Probe overview...........................................................................474
Supported probes..............................................................474
Probe orientation ...............................................................479
Probe labelling...................................................................479
Maximum probe temperature ............................................481
Probe Integration .......................................................................483
Connecting the probe ........................................................483
Activating the probe...........................................................486
Disconnecting the probe....................................................487
Care and Maintenance ...............................................................488
Planned maintenance........................................................488
Inspecting the probe ......................................................489
Cleaning and disinfecting probes ......................................490
Probe safety................................................................................493
9
Electrical hazards ..............................................................493
Mechanical hazards ..........................................................493
Biological hazards .............................................................494
Biopsy .........................................................................................495
Precaution concerning the use of biopsy procedures .......495
Preparing the Biopsy guide attachment ............................496
Displaying the Guide zone ................................................500
Biopsy needle path verification..........................................501
Starting the biopsy procedure ...........................................501
Cleaning, disinfection and disposal ...................................501
Chapter 11
Peripherals
Introduction ................................................................................503
VCR/DVD operation....................................................................505
VCR/DVD Overview ..........................................................505
Using VCR/DVD ................................................................506
Printing........................................................................................510
To print an image ..............................................................510
Printer configuration ..........................................................511
Specifications for peripherals...................................................513
Chapter 12
Presets and System setup
Introduction ................................................................................516
Starting the Configuration package .........................................519
To open the Configuration package ..................................519
Overview .....................................................................................520
Imaging .......................................................................................521
The Global setup sheet .....................................................521
Application.........................................................................524
Application menu...............................................................528
Measure/Text ..............................................................................530
The Measurement menu sheet .........................................531
The Advanced sheet .........................................................536
The Modify calculations sheet ...........................................537 10
The OB table sheet ...........................................................538
Report..........................................................................................544
The diagnostic codes sheet...............................................545
The Comment texts sheet .................................................547
Connectivity................................................................................550
Dataflow ............................................................................551
Additional outputs..............................................................560
Tools..................................................................................562
Formats .............................................................................563
TCP/IP...............................................................................568
System ........................................................................................569
The system settings ..........................................................569
About...........................................................................................573
Administration............................................................................574
Users .................................................................................575
Unlock Patient ...................................................................578
Chapter 13
User maintenance
System Care and Maintenance .................................................580
Inspecting the system........................................................580
Cleaning the unit ...............................................................581
Air filter ..............................................................................581
Prevention of static electricity interference........................583
System self-test..........................................................................584
System malfunction ...........................................................584
Chapter 14
Safety
Introduction ................................................................................588
Owner responsibility..................................................................589
Important safety considerations...............................................590
Notice against user modification .......................................590
Regulatory information..............................................................591
Standards used .................................................................591
Device labels ..............................................................................592 11
Classifications ...................................................................596
Acoustic output..........................................................................597
Definition of the acoustic output parameters .....................597
Acoustic output and display on the Vivid 7........................598
ALARA...............................................................................599
Safety statement ...............................................................599
System controls affecting acoustic output .........................599
Patient safety..............................................................................601
Patient identification ..........................................................601
Diagnostic information.......................................................601
Mechanical hazards ..........................................................601
Transesophageal probe safety .........................................602
Electrical Hazard ..............................................................602
Personnel and equipment safety..............................................603
Explosion hazard...............................................................603
Implosion hazard ...............................................................603
Electrical hazard................................................................603
Moving hazard...................................................................604
Biological hazard ...............................................................604
Pacemaker hazard ............................................................605
Electrical safety..........................................................................606
Device classifications ........................................................606
Internally connected peripheral devices ............................606
External Connection of other peripheral devices...............606
Allergic reactions to latex-containing medical devices .........607
Electromagnetic Compatibility (EMC) ......................................608
Environmental protection..........................................................610
System disposal ................................................................610
Appendix
Product description ...................................................................612
System Architecture ..........................................................612
Ergonomics .......................................................................613
Display Annotations...........................................................613
Tissue Imaging ..................................................................614
Color Doppler ....................................................................617
Spectral Doppler................................................................619
Advanced Options ............................................................621
Physiological Traces .........................................................624 12
Analysis Program ..............................................................624
User Interface....................................................................625
EchoPAC PC.....................................................................625
Wideband probes ..............................................................626
Virus Protection .................................................................628
Peripherals (options) .........................................................628
Physical Dimensions .........................................................629
Cart....................................................................................629
Electrical Specifications.....................................................630
Safety ................................................................................630
Probe/Application overview ......................................................631
Index
13
Introduction
The Vivid 7 ultrasound unit is a high performance digital
ultrasound imaging system.
The system provides image generation in 2D (B) Mode, Color
Doppler, Power Doppler (Angio), M-Mode, Color M-Mode, PW
and CW Doppler spectra, Tissue Velocity imaging and Contrast
applications.
The fully digital architecture of the Vivid 7 unit allows optimal
usage of all scanning modes and probe types, throughout the
full spectrum of operating frequencies.
Attention
Read and understand all instructions in the User's Manual
before attempting to use the Vivid 7 ultrasound unit. Keep the
manual with the equipment at all time. Periodically review the
procedures for operation and safety precautions.
For USA only:
United States law restricts this device to sale or use by, or on the
CAUTION
order of a physician.
Safety
All information in Chapter 14, ’Safety’ on page 586, should
be read and understood before operating the Vivid 7
ultrasound unit.
Interference caution
Use of devices that transmit radio waves near the unit could
cause it to malfunction.
CAUTION
Devices not to be used near this equipment:

Devices which intrinsically transmit radio waves such as
cellular phones, radio transceivers, mobile radio transmitters,
1
radio-controlled toys, and so on, should not be operated near
the unit.
Medical staff in charge of the unit are required to instruct
technicians, patients, and other people who may be around the
unit, to fully comply with the above recommendations.
Indications for use

The Vivid 7 ultrasound unit is intended for the following
applications:
• Abdominal
• Fetal/Obstetrics
• Pediatric
• Small Organ
• Adult and Neonatal Cephalic
• Cardiac
• Peripheral Vascular
• Musculo-skeletal
• Transesophageal
• Transrectal
• Transvaginal
• Interoperative
Contraindications
The Vivid 7 ultrasound unit is not intended for ophthalmic use
or any use causing the acoustic beam to pass through the eye.
2
Manual contents
The Vivid 7 User's Manual is organized to provide the
information needed to start scanning immediately.
If not otherwise specified, the functions described in this
manual are common to both Vivid 7 Dimension and Vivid 7
PRO.
The safety instruction must be reviewed before operation of the
unit.
CAUTION
Finding information
Table of Contents, lists the main topics and their location.
Headers and Footers, give the chapter name and page
number.
Index, provides an alphabetical and contextual list of topics.
3
Conventions used in this manual
The term Vivid 7 used throughout the manual refers to both
Vivid 7 Dimension and Vivid 7 PRO if not otherwise specified.
2-column layout, the right column contains the main text. The
left column contains notes, hints and warnings texts.
Keys and button, on the control panel are indicated by over
and underlined text (ex. 2D refers to the 2D mode key)
Bold type, describes button names on the screen.
Italic type: describes program windows, screens and dialogue
boxes.
Icons, highlight safety issues as follow:
Indicates that a specific hazard exists that, given inappropriate
conditions or actions, will cause:
DANGER • Severe or fatal personal injury
• Substantial property damage

WARNING • Severe personal injury
Indicates that a potential hazard may exist that, given

inappropriate conditions or actions, can cause:
CAUTION • Minor injury
• Property damage
4
Contact information
If additional information or assistance is needed, please
contact the local distributor or the appropriate support resource
listed bellow:
Europe
GE Ultraschall KG Tel: 0130 81 6370
Deutschland GmbH & Co. Tel: (49)(0) 212-28-02-208
Beethovenstraße 239
Postfach 11 05 60
D-42655 Solingen
USA
GE Medical Systems Tel: (1) 800-437-1171
Ultrasound Service Engineering Fax: (1) 414-647-4090
4855 W. Electric Avenue
Milwaukee, WI 53219
On-line Applications Support Tel: (1) 800-682-5327
or (262) 524-5698
Canada
Ultrasound Service Engineering
Milwaukee, WI 53219
or (262) 524-5698
Asia
GE Ultrasound Asia Tel: (65) 291-8528
Service Department Ultrasound Fax: (65) 272-3997
298 Tiong Gahru Road # 15-01/06
Central Plaza
Singapore 168730
5
Latin and South America
Ultrasound Service Engineering
Milwaukee, WI 53219
or (262) 524-5698
Brazil
GE Ultrasound Tel: (55.11) 887-8099
Rua Tomas Carvalhal, 711 Fax: (55.11) 887-9948
Paraiso
Cep: 04006-002 - São Paulo, SP
Software license acknowledgments

• WindowBlinds ™ OCX © Stardock ®
6
Chapter 1
Getting started
• Preparing the unit for use ............................................................ ....... 9

• Site requirements ..........................................................................9
• Connecting the unit .....................................................................10
• Switching On/Off .........................................................................16
• Moving and transporting the unit ................................................ ..... 18
• Wheels ........................................................................................18
• Moving the unit ...........................................................................20
• Transporting the unit ...................................................................21
• Reinstalling at a new location .....................................................21
• Unit acclimation time ...................................................................22
• System description ...................................................................... ..... 23
• System overview .........................................................................23
• Control panel ..............................................................................26
• The Scanning screen ..................................................................39
• Footswitch operation ...................................................................42
• Connecting and disconnecting probes ........................................43
• Adjusting the monitor display ......................................................43
• LCD monitor adjustment .............................................................46
• Starting an examination ............................................................... ..... 48
• Creating a new Patient record or starting an examination from an
existing patient record .................................................................48
• Selecting a Probe and an Application .........................................52
7
Introduction
Only qualified physicians or ultrasound sonographers should
perform scans of patients for medical diagnostic reasons.
Request training, if needed. Ensure that unauthorized
personnel do not tamper with the unit.
Service representatives authorized by GE Ultrasound will
unpack and install the unit. Do not attempt to install the unit
alone.
All the warnings in Chapter 14, ’Safety’ on page 586, should be
read and understood before operating the unit.
WARNING
Never set liquids on the unit in order to avoid spillage into the
unit or the control panel. Maintain a clean environment. Turn off
the circuit breaker before cleaning the unit. Refer to ’System
Care and Maintenance’ on page 580 for cleaning instructions.
To carry out regular preventative maintenance refer to
Chapter 13, ’User maintenance’ on page 579.
8
Preparing the unit for use
The Vivid 7 ultrasound unit must operate within the proper
environment and in accordance with the requirements
described in this section. Before using the system, ensure that
the requirements are met.
Site requirements
Optimal operation of the unit can be obtained by implementing
the following requirements:
Power requirements
The Vivid 7 ultrasound unit uses a separate power outlet for
100–120 VAC or 230 VAC, 50–60 Hz.
Operating the unit with the wrong voltage range causes
damages, voiding the factory warranty.
WARNING
Operating Environment
Ensure that there is sufficient air flow around the Vivid 7
ultrasound unit when installed in a fixed location.
Environmental requirements
The Vivid 7 ultrasound unit requires constant maintenance of
its operational environment. Different temperature and humidity
requirements are specified for operation, storage and
transportation.
Requirement Temperature Humidity Air Pressure
Operational 10–35 ºC 30–85% 700–1060 hPa
Storage -20–60 ºC 30–95% 700–1060 hPa
Transport -20–60 ºC 30–95% 700–1060 hPa
9
Electromagnetic interferences
The Vivid 7 ultra- Ensure that the unit is protected from electromagnetic
sound unit is ap- interferences as follows:
proved for use in
hospitals, clinics • Operate the unit at least 4.5 meters (fifteen feet) away from
and other environ- equipment that emits strong electromagnetic radiation.
mentally qualified • Shield the unit when operating it in the vicinity of radio
facilities, in terms of
broadcasting equipment, if necessary.
the prevention of ra-
dio wave interfer-
ence. Operation of Connecting the unit
the unit in an inap-
propriate environ- A GE-qualified person should perform the initial system
ment can cause installation.
electronic interfer-
ence to radios and Connecting the Vivid 7 ultrasound unit involves preliminary
television sets situ- checks of the power cord, voltage level and compliance with
ated near the medi- electrical safety requirements.
cal equipment.
Use only power supply cords, cables and plugs provided by or
designated by GE Medical Systems.
Ensure that the power cord and plug are intact and that the
power plug is the proper hospital-grade type (where required).
The unit should be connected to a fixed power socket which
has the protective grounding connector. Never use an
extension cord or adapter plug.
Failure to provide an adequate earth circuit can cause electrical
shock, resulting in serious injury.
WARNING
Connection of additional protective earth conductors or

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

Check the label near the circuit breaker on the rear side of the
system (see Figure 1-1). 10
1. Rating label
2. Circuit breaker
3. Power cable socket
4. Potential Equalization
1 2 3
4
Figure 1-1: The rating label
Check the voltage range indicated on the label:

• 100–120 VAC, 50–60 Hz, 10 A
Or
• 230 VAC, 50–60 Hz, 5 A
If the mains supply is not within the specified range, do not

connect the unit to the power source. Contact the dealer to have
WARNING the unit adjusted to the specific mains supply.
11
Connecting to the electrical outlet
POWER OUTAGE MAY OCCUR. The Vivid 7 requires a dedicated
single branch circuit. To avoid circuit overload and possible loss
WARNING of critical care equipment, make sure you DO NOT have other
equipment operating on the same circuit.
The unit’s power must be supplied from a separate, properly
rated outlet to avoid risk of fire. Refer to ’Power requirements’ on
page 9 for rating information.
The power cord should not, under any circumstances, be altered
to a configuration rated less than that specified for the current.
Do not use an extension cord or adapter plug.
1. Ensure that the wall outlet is of appropriate type, and that

the power switch is turned off.
2. Uncoil the power cable, allowing sufficient slack so that the
unit can be moved slightly.
3. Secure the power plug in the wall outlet.
Refer to page 502 Peripheral/Accessory connection
for further informa-
tion on peripherals. The external I/O connector is situated on the rear side of the
unit See Figure 1-10.
Accessory equipment connected to the analogue and digital
interfaces must be certified according to the respective IEC
WARNING standards (e.g. IEC 60950 for data processing equipment and
IEC 60601-1 (1988) for medical equipment). Any person
connecting additional equipment to the signal input part or
output part is configuring the medical system, and is therefore
responsible that the system complies with the requirements of
the system standard IEC 60601-1-1 (2000). If in doubt, consult the
technical service department or your local representative.
Do not touch the conducting parts of the USB or Ethernet cables
when connecting equipment to the unit.
12
Figure 1-2: The External I/O Panel
Socket Signal type Device type Note
Audio Out Audio VCR Audio Line level 1Vp-p

amplifier R = Right
L = Left
Trig Out Digital For future use 0 to 3V digital trig pulse

synchronization corresponding to ECG
signal
Footswitch 3 pedals
footswitch
13
Serial port RS-232 For future use

RS-232
Remote Remote control For future use

of external
peripherals
Modem Analog phone Connection to GE

line OnLine Center or
regional hubs for
access to InSite
remote diagnostic
and iLinq
assistance tool
Composite Composite VCR or video Signal level 1Vp-p

Video Out NTSC/PAL monitor
video
Black & White Black and white B&W printer Signal level 1Vp-p
Video Out video
S Video Out NTSC/PAL VCR or video Signal level 1Vp-p

S-Video monitor
SVGA Out RGB high Computer monitor

resolution video
14
USB Universal serial Printer

bus
Ethernet 10/100 Base-TX Network device

Ethernet IEEE
8023
15
Switching On/Off
To switch on the unit:
1. Switch on the circuit breaker on the rear of the unit (see
Figure 1-4).
2. Press (on/off button) on the top left of the control panel
(see Figure 1-4).
After initialization the default scanning screen (2D mode) is
displayed, the active probe being the one connected to the
left most connector socket.
Switching off the unit

When the Vivid 7 is switched off, the system performs an
automatic shutdown sequence. It is recommended to perform a
full shutdown at least once a week.
Shutdown
After switching off 1. Press (on/off button) on the top left of the control panel.
the system, wait at The Exit dialogue window is displayed.
least ten seconds be-
fore turning it on
again.
Figure 1-3: The Exit dialogue window
In case of total lock- 2. Select Shutdown.

up of the system, The shutdown process takes a few seconds and is
hold the on/off but- completed when the control panel illumination is turned off.
ton down a few sec-
onds to turn the To switch off before moving the unit, follow the additional steps
system off. below:
1. Set the circuit breaker to OFF.
2. Remove the plug from the mains power socket.
3. Secure the unit power cable around the cable storage
hooks on the rear of the unit.
16
FF11
Figure 1-4: The Circuit breaker and On/Off button
17
Moving and transporting the unit
Wheels
The wheels of the unit are controlled by the pedals situated
between the front wheels of the unit (see Figure 1-5).
Examine the wheels frequently for defects to avoid breaking or
jamming.
Wheel Characteristics
Front Swivel, swivel lock and full lock
Rear Swivel, but do not lock
1 2
1. Swivel lock pedal (Free position)

2. Full lock pedal (Free position)
3. Front wheel
Figure 1-5: The Vivid 7 ultrasound unit pedals
18
Wheel operation
To engage the pedal in full lock
Pedal Action
Press on pedal no. 2
To release the brake
Pedal Action
Press on pedal no.1
1 2
To engage swivel lock
Pedal Action
Press on pedal no.1
1 2
To release swivel lock
Pedal Action
Press on pedal no. 2
19
Moving the unit
To prepare the unit to be moved
1. If not locked, push the keyboard console to its park position.
2. Turn the system off, including the circuit breaker (see
page 16), and remove the plug from the wall.
3. Disconnect all cables linking the unit to any off-board
peripheral devices and network.
Note the marks on 4. Secure the unit’s power cable.
each cable to recon-
5. Place all probes in the probe holder. Ensure that the probe
nect them later.
cables do not protrude from the unit or interfere with the
wheels.
The park port may 6. Ensure that no loose items are left on the unit
also be used for a
7. Unlock the brake (see page 19).
probe connection al-
though it is not ac-
tive.
To ensure safety while moving the unit
1. Ensure that the keyboard console is in locked position.
Do not move the unit if the keyboard console is in free position.
WARNING
Ensure that the hands of the patient are away from the console
arm when moving the keyboard console.
2. For systems with LCD monitor: ensure that the LCD monitor
is locked (see page 46). You may rotate the monitor 90
degrees to get a better sight.
3. Proceed cautiously when crossing door or elevator
thresholds. Grasp the front handle grips or the back handle
bar and push or pull. Do not attempt to move the unit using
cables or probe connectors. Take extra care while moving
the unit on inclines.
4. Ensure that the unit does not strike the walls or door
frames.
5. Ensure the pathway is clear.
6. Move the unit slowly and carefully.
20
Avoid ramps that are steeper than 10 degrees.
CAUTION
7. Use two or more persons to move the unit over long

distances or on inclines.
Transporting the unit

Take extra care when transporting the unit by vehicle. In
addition to the moving precautions listed on page 20, follow the
procedure described below.
1. If not locked, push the keyboard console to its park position.
Do not move/lift the unit if the keyboard console is in free
position.
WARNING
2. For systems with LCD monitor: ensure that the LCD monitor
is locked (see page 46). You may rotate the monitor 90
degrees to get a better sight.
3. Disconnect all probes and secure them in their boxes.
4. Ensure that the transporting vehicle is appropriate for the
unit’s weight. The recommended load capacity is a
minimum of 190 kg (419 lbs).
5. Park the vehicle on a level surface for loading and
unloading.
6. Secure the unit while it is on the lift, to prevent rolling. Do
not attempt to hold it in place by hand. Cushion the unit and
strap the lower part so that it does not break loose.
7. Ensure that the unit is secured inside the vehicle. Secure it
with straps to prevent movement while in transit.
8. Drive cautiously to prevent vibration damage.
Reinstalling at a new location

1. When the unit is in place at a new location, lock the wheel
brakes (see page 19).
2. Follow the installation procedure described on page 10.
21
Unit acclimation time
Following transport the unit may be very cold or hot. Allow the
unit to acclimate before being switched on. Acclimation will
take one hour for each 2.5 oC increment when the unit’s
temperature is below 10 oC or above 40 oC.
oC 0 2.5 5 7.5 10 35 40 42.5

oF 32 36.5 41 45.5 50 95 104 108.5
Hours 4 3 2 1 0 0 2 3
oC 45 47.5 50 52.5 55 57.5 60
oF 113 117.5 122 126.5 131 135.5 140
Hours 4 5 6 7 8 9 10
22
System description
System overview
2
13
3
12
4
11
10 5
6
9
8 7
Figure 1-6: the Vivid 7 ultrasound system
Legend
Display Monitor:
1
Swivels to the left and right, tilts up and down.
23
Legend
Speakers
2
Control panel:
3
Contains all the buttons and the alphanumeric
keyboard used to operate the system. See
page 26 for further details.
Probe and gel holders:

4
Situated on either side of the Control panel.
VCR
5
Probe ports:
6
Three active and one park phased array
probe ports, and two pencil probe ports.
Foot brakes:
7
Control swivel and brake of the wheels. See
page 19 for further details.
8
CD-RW is not Portable disks:
supported, only
9
• Magneto optical disk
CD-R • CD-ROM
(recordable).
Patient I/O
Black & white video printer

10
Console swivel operating handle:

11
Situated in the middle beneath the front
handles.
• Vivid 7 Dimension: swivel and in/out
displacement
• Vivid 7 PRO: limited swivel only
24
Legend
Console lifting operating handle:

12
Situated in the left front handle.
Color video printer

13
25
Control panel
The following pictures illustrate the layout of the Vivid 7 control
panel. The buttons and controls are grouped together for ease
of use. A detailed description of the buttons is provided on the
following pages.
1. TGC sliders
2. Loudspeaker volume control
3. On/Off button
4. Protocol in/out
5. Navigation keys: Archiving &
Reporting buttons Pre-examination
buttons Video playback
6. Function keys:
• On-line manual
Alt. Alt. Alt. Alt.
• System Configuration
• Annotations
• Body marks
• DICOM spooler
7. Alphanumeric keyboard
8. 4D mode (Vivid 7 Dimension only)
9. Multi-plane mode (Vivid 7 Dimension
only)
Figure 1-7: The control panel (left side).
26
10. Active mode gain
11. 2D gain
12. Scan mode selection keys
13. Assignable keys
14. Zoom control
15. Depth control
13 16. Display format keys
17. Measurement, Image store and
menu keys
18. Soft menu rocker
19. VCR controls and print keys
20. Freeze keys
21. Trackball operation
14 16
12
11
15
Width 17 18
20
19
21
Figure 1-8: The control panel (right side).
27
Key illumination
The keys on the control panel are illuminated according to their
availability:
• Illumination in green: the key function is currently active.
• Illumination in yellow: the key function is available (but
not active) in the current state of the scanner.
• No illumination: The key is not available in the current
state of the scanner.
Power On/Off key
Key Description
Turns the unit on and off.
Navigation keys
The following buttons on the top left of the control panel are
used for navigation between different screen or packages on
the scanner. They are related to either pre or post-examination
operations. Each of these operations are described in more
detail in the following chapters.
Key Description
Displays the Search/Create patient window.

Enables the creation of a new patient record.
Displays the Select Probe and Application dialog

box that enables the users to select the desired
probe and application preset for the current
examination. For information about selecting
probes, refer to page 52 and page 486.
Displays the Application dialog box that enables

the users to select the appropriate application
preset for the current examination.
Gives access to controls for physiological traces.

The controls appear on the assignable keys.
28
Key Description
Displays the examination report.
Brings the scanner into the Image review mode,

that enables the user to select images from the
clipboard for analysis, activate the image
browser or enter the Image Review screen
where bigger previews of the images are shown
for image selection. Refer to page 366 for details
on the review of images.
Displays the Search/Create patient window if no

patient record is currently selected. Enables the
user to search a patient record in a patient
archive (see page 351). If a patient record is
selected, displays the Patient information
screen.
Displays the Measurement worksheet where the

user may edit or delete measurements, change
averaging etc. Refer to page 301 for details on
how to operate the worksheet.
Brings scanner into video playback mode that

enables the user to look at video tape
recordings. For further information about video
playback control refer to page 505.
29
Scan Mode Selection keys
The following keys are used to select the required scan mode,
and to select additional tools that enhance the application’s
capabilities. Refer to page 87 for detailed information about
scanning.
Key Description
Displays the 2D live acquisition mode that is the

default scanning screen for the unit. For further
information on 2D scanning, refer to page 90.
M-Mode can be Displays the M-Mode examination screen and

added from a 2D enables M-Mode functions. Used for viewing
scan also in motion patterns. For further information, refer to
replay. page 96.
Displays the examination screen in Color Flow

Mapping mode. Used to display color-coded
blood flow information. For further information,
refer to page 102.
In replay mode Displays the examination screen in Pulsed Wave

with TVI the Doppler mode. Used for displaying the Doppler
velocity trace spectrum of blood flow at a selected part of the
mode will be anatomy. For further information, refer to
toggled on by the page 110.
PW key.
CW mode is not Displays the examination screen in Continuous

available on all Wave Doppler mode. Allows examination of
scanning probes. blood flow data all along the Doppler CW cursor.
For further information, refer to page 110.
Displays the tissue velocity overlay on 2D and

M-Mode scans. If TVI is on, the Doppler modes
(PW/CW) will also be optimized for tissue
velocity. For further information, refer to
page 117.
Depending on the options installed on the

scanner, this key will bring up the menu for
selection of additional scanning modes.
30
Basic Mode Parameter Adjustment Controls
The following controls are used to modify and adjust the unit’s
display to best suit the user’s requirements, such as color, gain,
zoom and image depth, according to the mode being operated
by the user.
Controls Description
2D Gain Controls the total gain of the gray scale images

in 2D Mode.
Active mode Controls the total gain of other activated modes,

Gain such as, M-Mode, Color, PW, or CW Doppler
mode.
TGC Sliding keys that compensate for depth-related

attenuation in an image. The upper slider
corresponds to the smallest depth.
Depth Controls the displayed depth of tissue scan. Has

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

mode.
Changes the Doppler ultrasound beam angle on

linear probes. The steering angles are fixed for
each linear probe. This key has no effect with
sector imaging probes.
Toggles the high resolution (HR) zoom on/off.

The key has no effect in replay. The HR zoom
concentrates the image processing to a user
selectable portion of the image, resulting in an
improved image quality and a higher frame rate
in the chosen ROI
31
Controls Description
Display Zoom Controls image magnification. Rotate clockwise

to activate zoom mode and increase zoom
factor. Rotate counterclockwise to decrease and
turn off zoom. Zoom is available in both live and
replay.
Freeze keys
The freeze keys are used to freeze images and cine loops in all
modes for on-line analysis and storage for future use.
Key Description
Stops or restarts all data acquisition. When scan

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

mode, pressing 2D FREEZE will activate or
deactivate the 2D image, leaving the other mode
display unchanged. In freeze mode, stops/starts
the cineloop.
Display format keys

The following keys provide different view formats to best suit
the user’s requirements.
Key Description
Toggles the display priority of 2D-Mode or

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

which two or four images can be viewed
simultaneously. When reducing the number of
images, the active window will always been kept.
In combined mode, switches between the mode

specific assignable controls of the currently used
modes.
32
Key Description
Toggles the active window in multiple imaging

mode. The active window is indicated by a
highlighted frame. All imaging controls are
normally applied only to the active window.
Measurement controls
The following keys are used to take measurements and
perform calculations.
Key Description
Activates the Measurement & Analysis (M&A)

calculation program. This program is context
sensitive and will display relevant measurements
to the current mode and application. See
page 222 for further details on M&A.
Activates measurement tools (unassigned

measurement). See page 222 for further details
on M&A.
33
Clear, Menu, and Image Store keys
Key Description
Used for navigation between menus and

screens. CLEAR brings the display back to the
previous state.
Activates menu with additional options and

controls not available from the assignable keys.
Stores the currently active imaging window to

disk. The stored information depends of the
configuration of the current application. Stored
images are shown on the clipboard.
VCR Control and Print key
Key Description
Rec/Pause Toggles the VCR to Record or Pause. For further

information about using VCR, Refer to page 502.
Prints the current imaging screen content to a

selected (configurable) printer. For more
information about printing. Refer to page 502.
The PRINT key can also be configured for
alternative storing of images (Refer to
page 560.).
Prints the current imaging screen content to a

printer assigned to a second port (configurable).
For more information about printing, Refer to
page 510. The ALT key can also be configured
for alternative storing of images (Refer to
page 560.).
Trackball operation
The Trackball area consists of the trackball and five
surrounding keys. Three of these have the very same function
34
(the select function) for ergonomic reasons.
Key Description
Trackball Used for navigation and together with the

surrounding keys, to move, select or activate
objects on the screen.
Trackball key Toggles between the trackball functional groups

(see page 57).
Select Depending on the situation (see page 57):

• Performs the selected control or highlighted
menu item.
• Toggles between the Trackball functions within
the active group.
The key is duplicated for ergonomic reasons.
Update Menu In live mode, toggles between 2D imaging and

live time-motion imaging (Doppler/M-Mode). In
freeze, displays the function-specific menu
(same function as MENU, on page 34).
Assignable keys and rotary knobs

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

rotary knobs according to the scan mode and position that is
currently active. The assigned functions are
indicated above the rotary on the LCD display.
The mode-specific functions for these rotary
knobs are described in Chapter 3, ’Scanning
Modes’ on page 87.
35
Key Description
Assignable Five buttons, whose functions vary according to

Buttons the scan mode and position that is currently
active. The assigned functions are indicated
above the button on the LCD display. The
mode-specific functions for these buttons are
described in Chapter 3, ’Scanning Modes’ on
page 87.
Gives access to additional controls from the

assignable buttons.
The soft menu rocker
Key Description
Soft Menu A 4-way rocker used to access mode-specific

Rocker menus, select a menu option and adjust
option-related values.
• The vertical arrows are used to select the menu
options.
• The horizontal arrows are used to adjust the
values.
The mode-specific menus are described in
Chapter 3, ’Scanning Modes’ on page 87.
The 4D and Multi-plane keys
Key Description
Starts the 4D application (probe dependent),

Vivid 7 Dimension only.
Starts the Multi-plane application (probe

dependent), Vivid 7 Dimension only.
36
The alphanumeric keyboard
Key Description
Displays the on-line version of the user manual.
Displays the configuration dialog box, allowing

user configuration of various settings on the
scanner. Some settings are configured for each
application, press APPL. to access to
application-specific settings.
Displays the DICOM spooler window. The

DICOM spooler is used for checking the current
job’s status when a job is saved or when the total
spooler status on the right of the Archive
windows displays an error.
Displays the available body marks for the current

application.
Erases all previously typed annotations (and

body marks.
Activates a cursor for selection of a single

annotation to be deleted from an image.
Displays an arrow that can be used to point at a

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

image in two layers.
37
Key Description
Inserts predefined annotation on the image.
38
The Scanning screen
1 2 3 4 5 6 7 8 9 10 11
12
22 23
24
28
25
26 13
14
27
15
21 20 19 18 17 16
1. Current patient data 16. Trackball assignment
2. Institution 17. Status bar
3. Date & time 18. Prompt/Status information
4. Operator ID 19. Clipboard
5. Probe 20. Service and iLinq (future use)
6. Application 21. Caps on/off
7. Mechanical & Thermal Index 22. Measurement result table (measurement mode)
8. VCR counter (replay) 23. Probe orientation marker
9. VCR status 24. Scanplane indicator (for TE probe)
10. Date & time 25. Greyscale/Color bar
11. Heart rate 26. Measurement
12. Parameter window 27. Physiological traces (ECG, Phono, Resp)
13. Frame counter and timer 28. Focal zone and depth scale
14. Soft menu window
15. Pull-down soft menu
Figure 1-9: The scanning screen

39
The scanning screen is divided in several areas as follows:
The title bar

From the left:
The patient infor- Patient Information
mation displayed on
the Title bar is con-
Displays the information that uniquely identifies the patient,
figurable (see such as patient name, identification number and birth date.
page 563). This information is entered in the New patient window, as
described on page 48.
Institution name
The institution name is entered from the configuration package.
See page 569 for more detailed information.
Operator ID
Identification code of the operator. See page 575 for creating
operator ID’s.
Date and time
Displays the current date and time or for a retrieved image, the
date and time at which it was stored.
Probe and Application
Displays the currently selected probe and application or for
retrieved image the probe and application that were used. See
page 52 and page 486 for further information on how to select
probe and application.
Live scanning related information
Displays, if available, the current values for
• Mechanical Index (MI), for the current active image
• Thermal Index (TI), for the current active image
• probe temperature (for TE probe)
• Heart rate (HR)
VCR counter and status
Displays the VCR counter as it changes in real time, and a
status icon, which indicates the current operating status of the
VCR.
40
Archive Information
Displays the currently selected patient and image archives.
Parameters window
Displays scan mode or application specific parameters. In
scanning mode the parameters for the active mode are
highlighted. This window also displays zoom information,
stress template and image groups in image browser.
Soft menu window

Displays the mode specific controls operated from the 4-way
rocker on the control panel. The mode-specific menus are
described in Chapter 3, ’Scanning Modes’ on page 87. For
operating procedure of the 4-way rocker see page 56.
Clipboard
Displays the thumbnail images representing the acquired data
during the current examination.
The status bar

Consists of three information fields as follows:
Caps on/off indicator
Located on the left side of the status bar, the word CAPS is
highlighted when the caps lock function is on. The caps
function is activated by pressing CAPS LOCK key on the
alphanumeric keyboard.
Prompt/status field
Displays system messages or prompts the user for actions.
Trackball assignments fields
Displays the available assignments of the trackball. The current
assignment is highlighted.
The acquisition window

Displays the ultrasound image with relevant indicators such as
depth, focus, probe orientation marker, physiological
traces...etc.
41
Footswitch operation
The footswitch is used to free the hands of common key
operations, such as select keys, video recording, etc. The three
switches have different function assignments depending on the
current application (see page 524).
The standard footswitch is not for use in the operation room.
WARNING
Connecting the footswitch

1. Connect the footswitch to the input marked on the
External I/O panel (see Figure 1-10).
Figure 1-10: The Footswitch connector on the External I/O Panel
42
Connecting and disconnecting probes
The connector panel situated in the front of the unit has three
imaging probe ports, one parking port (inactive) and one pencil
probe port.
To connect probes
Handle the probes gently while connecting and disconnecting.
CAUTION
1. Hold the probe connector vertically with the cable pointing

upward.
Do NOT touch the patient and any of the connectors on the
ultrasound unit simultaneously, including ultrasound probe
WARNING connectors.
Probes can be con- 2. Turn the connector locking handle to the horizontal
nected or changed position.
any time while the
unit is on. 3. Align the connector with the probe port and carefully push
into place.
4. Rotate the locking handle to the full vertical position to lock
in place.
To disconnect probes
1. Rotate the lock handle counter-clockwise to the horizontal
position to unlock the connector.
2. Remove the connector.
Adjusting the monitor display

CRT monitor
The display monitor’s contrast and brightness controls may
need periodic adjustment due to changes in ambient light. They
are adjusted from the three buttons on the front part of the
display monitor.
To adjust contrast
1. Press the Center button on the display monitor once (see
Figure 1-11).
2. Press the Right button to increase contrast. 43
Press the Left button to decrease contrast.
To adjust brightness
1. Press the Center button on the display monitor twice (see
Figure 1-11).
2. Press the Right button to increase brightness.
Press the Left button to decrease brightness.
1 2 3
1. Decrease 3. Increase
2. Contrast (press once), Brightness (press twice)
Figure 1-11: Contrast and brightness adjustment
LCD monitor
Only the brightness and the blue tint can be adjusted. To aid in
the adjustment, a test image can be displayed by pressing
ALT + Q on the keyboard.
To adjust brightness
1. Press on the LCD monitor to increase brightness.
2. Press on the LCD monitor to decrease brightness.
44
To adjust the blue tint
1. Press ALT + > on the keyboard to increase the blue tint.
2. Press ALT + < on the keyboard to decrease the blue tint.
45
LCD monitor adjustment
The LCD monitor can be swiveled and tilted. Before moving or
transporting the system make sure to lock the LCD monitor as
described below.
To avoid injury or damage, make sure nothing is within the range
of motion before moving the monitor and monitor arm. This
CAUTION includes both objects and people.
To swivel the LCD monitor

1. Grab the left and right sides of the LCD monitor frame and
swivel the monitor to the desired position. The LCD monitor
must be unlocked.
To tilt the LCD monitor

1. Grab the top and bottom sides of the LCD monitor frame
and tilt the monitor up and down to the desired position.
To lock/unlock the LCD monitor

The monitor arm can swivel around the main arm axis and
around the arm joint.
To lock the LCD monitor
1. Slide the locking knob at the base of the arm into the locked
position (see Figure 1-12). Move the arm until it locks into
place.
2. Slide the locking knob at the arm joint into the locked
position (see Figure 1-12). Move the arm until it locks into
place.
To unlock the LCD monitor
1. Slide the locking knob at the base of the arm into the free
position (see Figure 1-12).
2. Slide the locking knob at the arm joint into the free position
(see Figure 1-12).
46
Locking knob positions
Locked Free
Arm base
Arm joint
Figure 1-12: LCD arm locking mechanism
47
Starting an examination
Beginning an exam consists of three steps:
• Creating a new patient record or starting a new examination
from an existing patient record (see below)
• Selecting Probe and Application (see page 52)
• Start scanning (see page 52)
Creating a new Patient record or

starting an examination from an
existing patient record
Connectivity on the Vivid 7 ultrasound unit
Refer to page 550 The connectivity on the Vivid 7 Ultrasound unit is based on the
for further informa- Dataflow concept. A Dataflow is a set of pre-configured
tion on connectivity services (e.g. DICOM services like storage, worklist,
setup.
verify...etc. or other service types like video print, standard print
or messaging). When starting an examination, the user selects
a pre-configured Dataflow that will automatically customize the
ultrasound unit to work according to the services associated to
the Dataflow.
Starting an examination
1. Press NEW EXAM.
To create an opera- If the unit is password protected a Log In window will
tor ID, see appear asking for operator ID, and password.
page 575.
1. Data stored only for

the duration of the
current examination
2. Select the operator
Figure 1-13: The Operator login window
2. Press Log on when completed. 48

The Search/Create Patient window is displayed (see
Figure 1-14).
3. Type the patient Last Name, and/or ID.
Do NOT use '\' or '^' in patient information fields, as these
characters might cause problems with some DICOM devices.
CAUTION
The unit can be con- When default configured, the system automatically
figured to automati- searches to see if the patient is already in the database.
cally generate a The result of this search is displayed in the Patient List
patient ID (see
page 563).
field.
If the Patient name is on the patient record list:
To restrain the 1. Trackball to the actual patient and double-click the
search to special Trackball SELECT key (or press SELECT once and then
category of patient Select patient).
record, press More
and use the search-
The unit is ready for scanning or the Patient information
ing filters. window is displayed (Figure 1-15) depending on system
configuration (see page 563).
If the Patient name is not on the patient record list:
The automatic 1. press Create Patient.
search tool display- The unit is ready for scanning or the Patient information
ing matching pa- window is displayed (Figure 1-15) depending on system
tient information in
the Patient list can
be turned off (see If the unit is configured to display the Patient information
page 563).
window, follow the steps below:
1. Enter additional patient information if required.
Select between cardiac, obstetric, gynecology... etc. to
enter application specific patient info (Displayed when the
button More is depressed, see Figure 1-15.).
Press EXAM. LIST to 2. Press Begin exam or any active scanning key to start the
display the previous examination.
examinations and In the scanning screen, the patient information is displayed
diagnosis informa-
tion for the selected
on the left side of the Title bar (see Figure 1-16).
patient.Enter addi-
tional patient infor-
mation if required.
49
1. Press one of the headings to sort the list 4. Extended menu
accordingly. 5. The system can be configured to display the
2. Select the column heading border and drag to Advanced search tool as default (see
adjust column width. page 563).
3. Select new archive and other pre-defined 6. Expended Patient record displaying belonging
services. examinations
Figure 1-14: The Search/Create Patient window
50
1. The date format is configurable (see page 569). 3. The Address field is configurable (see
2. The window can be configured to display the page 563).
expanded patient info as default (see page 563). 4. Select patient information category.
Figure 1-15: The Patient Information window
1. The patient information on the scanning screen is configurable (see page 521).
Figure 1-16: The Patient information on the scanning screen

51
Selecting a Probe and an Application
The combination Probes and their related applications are selected from the
Probe-Application Probes and applications pop-up menus as described below.
may be user-de- Only probes currently connected are displayed in the pop-up
fined. See page 524
for information on
menu. Only applications appropriate for the type of probe
probe/application selected are shown.
configuration.
To select a probe and an application
1. Press PROBE on the control panel.
To change applica- A list of the connected probes is displayed.
tion without chang-
2. Trackball to the desired probe.
ing the current
probe, press APPL. 3. Press SELECT.
on the control pan- An Application menu for the selected probe is displayed.
el.
4. Trackball to the desired application.
To select a probe 5. Press SELECT to launch the application.
with the default ap-
plication, press
SELECT twice on the
actual probe.
Make sure that the probe and application names displayed on the
screen correspond to the actual probe and application selection.
CAUTION
Check that the correct TI category is displayed (see ’Thermal
Index’ on page 597). TIB must be displayed when a fetal
application is selected.
52
Chapter 2
Basic scanning operations
• Assignable keys and Soft Menu Rocker .................................... ..... 55

• Using the Soft Menu Rocker .......................................................56
• Trackball operation ...................................................................... ..... 57
• Cineloop operation ....................................................................... ..... 58
• Cineloop overview ......................................................................58
• Cineloop controls ........................................................................60
• Using cineloop ............................................................................61
• Storing images and cineloops .................................................... ..... 62
• To store a single image ..............................................................62
• To store a cineloop .....................................................................62
• Using removable media ............................................................... ..... 63
• Formatting removable media ......................................................63
• Ejecting removable media ..........................................................65
• Recording images on VCR .......................................................... ..... 66
• Zoom .............................................................................................. ..... 67
• To magnify an image (Display zoom) .........................................68
• To activate the HR zoom ............................................................68
• Performing measurements .......................................................... ..... 69
• Physiological traces ..................................................................... ..... 70
• Connecting the ECG/Respiration ................................................71
• Connecting the Phono ................................................................73
• Connecting the Pulse pressure transducer .................................73
• Physio overview ..........................................................................74
• Physio controls ...........................................................................75
• Displaying the physiological traces .............................................77
• Adjusting the display of physiological traces ..............................77
• Annotations ................................................................................... ..... 79 53
• To insert an annotation ...............................................................79
• To edit annotation .......................................................................82
• To erase annotation ....................................................................82
• Configuration of the pre-defined annotation list ..........................83
• Bodymarks ..................................................................................85
54
Assignable keys and Soft Menu Rocker
1. Active mode & status

2. Filling gauge
A
3. Selected control shows highlighted
frame
4. Access to additional controls 1
2
3
Figure 2-1: A: the 4-Way Rocker and Soft Menu. B: the assignable
keys and rotary knobs on the control panel.
To toggle between The function of the assignable keys and the controls assigned
modes in combined to the soft menu vary according to the mode in which the
mode, press ACT. system is running. A detailed description of each function is
MODE.
provided each scanning mode in the following imaging mode
sections. In combined modes (i.e. combined Color flow and PW
Doppler), one mode is active (live) while the other is frozen. In
this case, the assignable keys and rotary knobs control the
active mode. Switching the active mode will change the key
and rotary assignments accordingly.
55
Using the Soft Menu Rocker
The Soft menu Rocker on the control panel enables the
adjustment of controls mapped in the Soft menu Window (see
Figure 2-1).
The first row of the soft menu indicates the active mode and its
status (freeze/live). The following rows list the mode specific
controls. The last row (marked with a ) gives access to
additional mode specific controls.
The relative setting of each control is indicated by a gauge bar
filling the cell as the control value increases.
To select a control from the menu

1. Press the vertical arrows on the 4-way Rocker to navigate
up or down through the menu.
The frame of the selected row is highlighted.
To adjust values
1. Press one of the horizontal arrows on the 4-way Rocker to
adjust the setting of the selected control.
- Right arrow increases control setting.
- Left arrow decreases control setting.
56
Trackball operation
Different functions can be assigned to the trackball depending
on the current active mode. The trackball functions are
organized in functional groups. The trackball functional groups
are displayed in the lower right corner of the screen. Each
group can have one or more controls that can be selected
using the keys on the trackball area as described below:
The trackball area consists of:
• The trackball: used as a cursor control in acquisition mode,
scrolling control in freeze mode and as a selecting tool (like
a mouse cursor) in post-processing mode.
• Three SELECT keys (identical): depending on the situation,
the SELECT keys toggle between the trackball functions
within the active functional group or perform the selected
control or highlighted menu item.
• The TRACKBALL key: toggles between the trackball
functional groups.
• The UPDATE MENU key: enables quick access to image
related functions from a pop-up menu (see Figure 2-2).
1. Trackball key: toggles between trackball functional groups.

2. Select keys:
• Toggles between the functions within the active group. Groups with several functions are marked
with a + symbol.
• Performs the selected control or highlighted menu item
3. Update Menu key: display a pop-up System menu.
Figure 2-2: The Trackball area

57
Cineloop operation
When no ECG is When the scan mode is frozen, the unit automatically displays
connected, a cine cineloop boundary markers on either side of the last detected
gauge is displayed heart cycles. The cineloop boundaries can be adjusted using
indicating the cur-
rent frame. in the
the cineloop assignable controls to cover one or more heart
cineloop. cycles.
Cineloop overview
3 4 5
1 2
1. ECG 4. Right marker

2. Left marker 5. Cine speed (replay)
3. Current frame
Figure 2-3: The cineloop controls display
58
1. Assignable keys:
• Left marker
• Right marker
• Cycle select
• Number of cycles
1 • First Cycle
• Last Cycle
• Sync
• Cineloop
• Select all
2. Image Store
3. Freeze: Start/stop
cineloop
4. Trackball:
• Scroll (in freeze)
• Cine speed (in replay)
Figure 2-4: The cineloop controls on the front panel
59
Cineloop controls
cineloop assignable controls
Left / Right Marker
Move the left and right markers to expand or trim the cineloop
boundaries.
Cycle select
Selects the heart cycle to be played back.
Number of cycle
Controls the number of heart cycles to be included in the loop.
First cycle / Last cycle
Selects the first or last heart cycle to be played back.
Sync
Phase synchronizes multiple cineloops.
Cineloop
Starts cineloop acquisition.
Cineloop Freeze Control

2D Freeze
Toggles between replay and freeze modes.
Cineloop trackball controls

Scroll
When the scan mode is frozen, trackball to move the current
marker and review the images
Cine speed
In cine replay mode, trackball to adjust the speed of the
cineloop playback.
Select All
Select all heart cycles.
60
Using cineloop
Selection of a cineloop
1. Press FREEZE.
The left and right markers on the ECG trace are displayed
on either side of the last detected heart cycle.
2. Press the CINELOOP assignable.
The selected heart beat is played back.
3. Press the 2D FREEZE assignable to freeze the cineloop.
4. Use the Trackball to scroll through the acquisition and find
the sequence of interest.
To jump directly to 5. Rotate the assignable CYCLE SELECT to move from heart
the first or to the beat to heart beat to select the heart cycle of interest.
last heart beat press
the assignables 6. Rotate the assignable NUM CYCLES clockwise to increase
FIRST CYCLE or the number of heart beats to be played back.
LAST CYCLE. 7. Rotate LEFT MARKER and RIGHT MARKER assignables to trim
or expand the cineloop boundaries.
Adjustment of cineloop playback

1. If in freeze mode, press the assignable 2D FREEZE to start
cineloop replay.
2. Use the Trackball to increase or decrease the speed of the
cineloop playback.
The speed factor is displayed on the right side of the ECG
(see Figure 2-3).
To view a cineloop frame by frame

1. If not in freeze mode, press the assignable 2D FREEZE to
freeze the cineloop.
2. Use the Trackball to scroll through the cineloop frame by
frame.
Or
Press the alphanumeric ARROW keys.
Synchronized playback of multiple cineloops

1. If in freeze mode, press the assignable 2D FREEZE to start
cineloop replay of the displayed cineloops.
2. Press the assignable SYNC to phase synchronize the loops.
61
Storing images and cineloops
Images stored on Images and cine-loops can be stored at any time during the
the clipboard dur- scanning session. A thumbnail of the stored image is displayed
ing the scanning on the clipboard on the scanning screen. An icon will also be
session are for im-
mediate purposes.
displayed in the Image Browser and Image Selection screens.
At the end of the ex- Protocol based stored images will also be displayed in the
amination, the data protocol grid in the Parameters window.
should be archived
in the patient ar- The amount of data stored from 2D live is defined by the
chiving system (re- settings of the current application. The application setting
fer to page 340). controls the number of cycles included (or time span if ECG is
not active), time span before R-wave...etc (refer to page 521
and page 524 for further information).
The amount of data stored in images from 2D replay is
determined by the defined cineloop.
Images can be stored in either DICOM and GE Raw Data
formats or DICOM format only, depending in the dataflow
configuration (refer to page 551 for further information).
To store a single image

1. Press FREEZE.
2. Press IMG. STORE to store the image digitally.
The thumbnail of the image is displayed on the clipboard.
See also page 343 for further information.
To store a cineloop
Cineloops may be stored directly or after preview, depending
on how the system is configured. The procedure for cineloop
storage is described on page 343.
62
Using removable media
The following removable media can be used for data storage:
• DVD-R
• CD-R (CD-RW is not supported.)
• USB Flash card
• 5 1/4” R/W Magneto Optical disk (MOD) (from Sony only,
1.2, 1.3, 2.3, 2.6, 5.2, 8.6 and 9.1 Gb) (Option)
CD/DVD:
• Do not use CD-R/DVD-R for permanent storage of patient data.
CAUTION • Use only 24x or higher CD-R.
USB Flash card:
• Use only shielded USB Flash cards that are verified for EMC
performance according to EN55011 Class B. The use of other
USB Flash cards may cause interference on the system itself or
on other electronic devices.
Recommendation concerning CD and

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

MOD, CD-R and DVD-R have to be formatted before use as
described below.
The formatting process will erase any data present on the disk.
CAUTION
Note: Removable media used during Disk space management

or Backup do not need to be formatted, the formatting process
is part of these procedures.
63
To format a removable media:
1. Insert the media in the drive.
2. Press CONFIG (F2).
3. If required, log on to the system.
The Configuration package is opened.
4. Select the category Connectivity and select the sheet
Tools (Figure 2-5).
Figure 2-5: The Tools sheet
5. Select the removable media from the Media pop-up menu.

6. Enter a name for the removable media in the Label field.
Note: Only the following characters and signs can be used
when labelling a media: A - Z, a - z, 0 - 9, “_” and “-”. Do
not use more than 11 characters or signs. Do not use
space.
7. Select Format.
A confirmation window is displayed.
8. Select OK to continue.
9. Wait for the display of the Information window indicating
that the formatting process is completed.
10. Select OK. 64
11. Eject the media as described below.
Ejecting removable media

Alternative: Press 1. Press ALT+E to eject the disk.
F3. Do not eject the The Eject device menu is displayed (Figure 2-6).
CD using the but-
ton on the CD
drive.
Figure 2-6: The Eject device menu
2. Select the relevant media.

The selected media is ejected.
When ejecting a MOD, the disk is half way ejected from the MOD
station. To avoid unintentional automatic re-insertion, take out
CAUTION the MOD from the MOD station.
65
Recording images on VCR
VCR recording is started and stopped from the RECORD/PAUSE
key on the control panel. The status of the VCR is indicated by
a symbol on the Title bar (for detail about how to use VCR
recorder, refer to ’VCR/DVD operation’ on page 505).
66
Zoom
The unit supports two types of zoom: the display zoom and the
high resolution (HR) zoom.
• The Display zoom magnifies the image display in both
frozen and live 2D, M-Mode and combined modes.
• The HR zoom concentrates the image processing to a user
selectable portion of the image, resulting in an improved
image quality and a higher frame rate in the chosen ROI.
1 2
1. High Resolution Zoom

2. Magnification control
3. Position the zoom area
Figure 2-7: The zoom controls
67
To magnify an image (Display zoom)
The Display zoom is 1. Rotate the Zoom knob clockwise.
available in live and The resulting magnified image appears in the acquisition
replay. window while the un-magnified image is displayed in the
control window showing the outlined zoom region.
2. Use the Trackball to position the zoom area over the
desired portion of the image.
3. To turn off the Display zoom, rotate the Zoom knob counter
clockwise.
To activate the HR zoom

As a default setting, 1. Press ZOOM.
the zoom area is The resulting zoomed image appears in the acquisition
centered to the cur- window and a frozen reference image is displayed in the
sor/color area if
present.
control window showing the outlined zoom region.
2. Use the Trackball to position the zoom area over the
desired portion of the image.
3. Increase size as desired by turning the zoom knob
clockwise.
4. Press ZOOM one more time to turn off the HR zoom.
68
Performing measurements
To perform measurements:
1. Press MEASURE to enter the Measurement mode.
Refer to page 222 for further information.
69
Physiological traces
The physiological module consists of four channels:
ECG/Respiration, Phono, AUX1 and AUX2. The two channels
AUX1 and AUX2 are both capable of handling external ECG
signals from other diagnostic ECG devices. AUX2 is also
capable of handling a pulse/pressure signal. The scanned
image that is displayed is synchronized with the ECG,
respiration and phono traces. In M-Mode or Doppler, the traces
are synchronized to that particular mode's sweep.
The operator can control the gain, the position and the sweep
rate of the traces using the assignables on the control panel.
Use only GE Medical Systems accessories
Conductive parts of electrodes and associated connectors for
CAUTION
applied parts, including neutral electrodes should not contact
other conductive parts, including earth.
Simultaneous use of two or more applied parts will cause
summation of patient leakage currents.
1 2 3 4
1. Phono 3. AUX 1
2. ECG 4. AUX 2 (Pressure/Pulse)
70
Figure 2-8: The patient (I/O) connection panel
Pinout on AUX connectors

The pinout for the AUX connectors is described in the table
below:
AUX1
1. pin 1: input -
2. pin 2: input +
3. pin 3: gnd
AUX1
AUX2
1. pin 1: input -
2. pin 2: input +
3. pin 3: gnd
AUX2 4. pin 4: nasal sensor 1
(Pressure/Pulse)
5. pin 5: nasal sensor 2
AUX1 and AUX2 are default a 1 Vpp (Volt peak-peak) input

with a max frequency of 300 Hz. The inputs are differential. For
a single ended sensor signal, the pin 1 (input -) should be
connected to the gnd of the sensor.
AUX2 has a programmable high gain mode with a maximum
input signal of 300 mVpp (millivolt peak-peak).
Connecting the ECG/Respiration

Overview
The ECG cable is a modular cable consisting of two different
cables parts:
• The Trunk: a single cable connecting to the system at one
end, and providing a cable splitter device at the other end
(see Figure 2-9).
• The triple color-coded electrode cable: to be inserted in
the splitter device. Each electrode cable hooks up to the
appropriate stick-on electrode by a color-coded clip type
connector. 71
The color-coding of the electrodes follows one of two standards
that are common in different parts of the world. The cable
splitter device has a drawing defining the color codes, names
and body location for the two standard color codes (see
Figure 2-9).
AHA (USA) IEC (Europe, Asia, ROW)
1. RA: White 1. R: Red

2. LA: Black 2. L: Yellow
3. LL: Red 3. F: Green
Figure 2-9: The cable splitter device with electrode placement

conventions
To connect the internal ECG

1. Connect the ECG trunk cable into the rectangular-shaped
socket marked ECG on the patient trace (I/O) panel. The
patient trace (I/O) panel is located in the front left of the
ultrasound unit (see Figure 2-8).
2. Hook up the electrode cables to the electrodes, following
the appropriate convention (see Figure 2-9).
72
Connecting the Phono
Overview
The phono consists of a microphone with a cable and a
connector.
1. Microphone
2. Connector
2
1
Figure 2-10: The phono device
To connect the Phono

1. Plug the connector into the socket marked Phono on
Patient (I/O) panel (see Figure 2-8).
Connecting the Pulse pressure

transducer
Overview
The pulse pressure transducer consists of pulse transducer
with a cable and a connector.
1. Pulse transducer
2. Connector
1 2
Figure 2-11: The Pulse pressure transducer
To connect the pulse pressure transducer

1. Plug the pulse pressure cable into the socket marked
AUX2 Pressure/Pulse on Patient (I/O) panel (see
Figure 2-8).
73
Physio overview
1. Assignable keys:
• ECG
• Horizontal sweep
• Gain
• Position
1 • ECG Lead
• ECG
• ECG Trig
• Dual Trig
• Timer Trig
• Beep
• Phono
• Gain
• Position
• Phono
• Phono filter
• Respiration
• Gain
• Position
• Reap Lead
• Resp
2 • AUX 1and AUX 2
• Gain
• Position
• AUX1
• AUX2/Press
2. Soft menu
• ECG Trig 1
• Dual Trig delay
• ECG Trig interval
• Timer delay
Figure 2-12: The physios controls on the front panel
74
Physio controls
Physio assignable controls
Common controls
Horizontal sweep
Adjust the refresh rate of the physiological trace. This control is
active only in 2D and color modes. The sweep speed of the
physio traces in M-Mode and Doppler is identical to the
M-Mode or Doppler horizontal sweep adjusted by the user.
Gain
Enables the user to change the amplitude of the physiological
trace displayed on the screen.
Position
Enables the user to move the physiological trace on the screen.
ECG specific controls
ECG Lead
Enables the user to choose the lead from which the ECG is
recorded:
• Lead I: ECG recorded between right and left arm.
• Lead II: ECG recorded between right arm and left leg.
• Lead III: ECG recorded between left arm and left leg.
ECG
Turns the ECG trace on and off.
ECG Trig
Enables intermittent imaging based on the ECG.
Dual Trig
Enables intermittent imaging with two ECG triggered frames
(primary and secondary). In this mode the scanner also
activates a dual display, where the primary frames are
displayed on the left side, whereas all frames (both primary and
secondary) are displayed on the right side.
Timer Trig
Enables intermittent imaging based on a timer.
75
Beep
Turns beep sound on and off.
Press MORE to ac- Phono specific controls
cess to the Phono
and Respiration Phono
controls. Turns the phono trace on and off.
Phono filter
Select a phono filter to apply from a pop-up menu.
Respiration specific controls
Respiration
Turns the respiration trace on and off.
AUX specific controls
AUX1
Turns the AUX1 physiological trace on and off.
AUX2/Press
Turns the AUX2 physiological trace on and off.
Physio Soft menu controls

ECG Trig 1
Specifies the delay (ms) from R-wave to triggered frame.
Dual Trig Delay
Specifies the delay (ms) from the first triggered frame (ECG
Trig 1) to the second triggered frame. Only active when Dual
Trig is turned on.
ECG Trig Interval
Controls the number of cardiac cycles between triggered
images.
Timer Delay
Controls time between triggers when timer triggering is turned
on.
76
Displaying the physiological traces
Display of the ECG
To turn the ECG Cardiac applications
display off, press
PHYSIO and press
The ECG is turned on by default in all cardiac applications.
the assignable ECG.
Other applications
1. Press PHYSIO on the control panel to get access to the ECG
controls.
2. Press the assignable ECG to display the trace.
Display of the phono trace

1. Press PHYSIO on the control panel.
2. Press MORE to display the assignables for the phono trace.
3. Press the assignable PHONO to display the trace.
Display of the respiration trace

2. Press MORE twice to display the assignables for the
respiration trace.
3. Press the assignable RESP. to display the trace.
Display of the pulse pressure trace

2. Press MORE three times to display the assignables for the
auxiliary traces
3. Press the assignable AUX 2 to display the pulse pressure
trace.
Adjusting the display of physiological

traces
Adjusting the trace sweep speed (ECG, phono
and respiration)
2. Turn the assignable rotary Horizontal Sweep to change
the sweep speed.
77
Adjusting the trace amplitude (ECG, phono,
respiration and pulse pressure)
The ECG signal's 1. Press PHYSIO on the control panel.
amplitude may vary
2. Press MORE to select the actual assignable set.
between patients
due to different skin 3. Turn the assignable rotary Gain to adjust the amplitude of
moisture and other the trace.
physiological pa-
rameters. Adjusting the trace position (ECG, phono,
respiration and pulse pressure)
2. Press MORE to select the actual assignable set.
3. Turn the assignable rotary POSITION to move the trace
vertically.
ECG Trigging
1. Press PHYSIO on the control panel to access to the ECG
controls.
2. Press the assignable ECG TRIG.
3. Adjust Trig 1 to position the first trig on the ECG (delay in
ms from R-wave to triggered frame).
4. Adjust ECG Trig Interval (number of cardiac cycles
between triggered images).
5. Press DUAL TRIG if dual triggering is desired.
6. Adjust Dual Trig delay (delay in ms from the first triggered
frame to the second triggered frame).
78
Annotations
Text annotations may be inserted anywhere on the screen. The
annotation can be free text or a pre-selected text from a
mode-specific annotation menu or a user-defined library.
Annotations (text, arrow or bodymark) are created on separate
layers. When viewing annotated images on a different system or
CAUTION when zooming the image, the position of the annotations on the
image may be slightly changed.
To insert an annotation
Free text
While typing, use 1. Type the required text.
BACKSPACE to de- A suggested word corresponding to the entered characters
lete backward. is displayed while typing. Press TAB to enter the suggested
word.
2. Trackball the text entered to the insertion position.
3. Press SELECT to add the annotation.
Pre-defined annotation
Word selection from the Annotation menu
1. Press the alphanumeric key TEXT.
A list of application specific pre-defined texts is displayed
(see Figure 2-13).
To display a list from another application, select the
heading and choose another application.
2. Trackball to the required abbreviation.
3. Press SELECT.
4. Trackball to the position at which the annotation is to be
inserted.
5. Press SELECT to add the annotation.
To draw an arrow
1. Press Arrow in the Annotation menu.
2. Trackball to the start position of the arrow to draw.
3. Press SELECT to anchor the arrow.
4. Trackball to the end position of the arrow to draw.
5. Press SELECT to fix the arrow.
79
1. Select to display annotation for other
applications
2. Free text
3. Draw an arrow
4. Edit previous annotation
5. Pre-defined application specific
annotations
6. Exit annotation mode
Figure 2-13: The mode-specific annotation menu
Word selection from the Library

Pre-defined text can be organized in a user configurable,
application dependent library with three different sections.The
user can easily select a pre-defined text from the Library using
the ARROW keys.
Creating a Library
1. Press F2 (CONFIG).
2. In the Configuration package, select Measure.
3. In the Measure category select Customize.
The Customize sheet is displayed (see Figure 2-14).
4. Select a pre-defined text in the Application pane.
5. Select Add in the desired section.
6. Repeat step 4 and 5 to populate the library.
7. To remove a pre-defined text from the library, select the
pre-defined text to remove and press Del.
8. To order the pre-defined text in a section, select the
pre-defined text to move and select Up or Down buttons to
move the word accordingly.
9. To exchange sections order, enter the sections to swap
next to Swap columns button and press Swap columns.
80
10. Press Save to store the library.
1. The Application pane

2. Library section
3. Insert selected pre-defined text in the section.
4. Remove selected pre-defined text from the section.
5. Move pre-defined text within the section.
6. Re-order sections.
7. Save Library
Figure 2-14: The Customize sheet
Using the Library

1. Press any ARROW key.
The pre-defined texts from the last used group are
displayed in the Status bar at the bottom of the screen,
with the active word within square brackets.
2. To select a pre-defined text within a section, press ARROW
UP or ARROW DOWN until the desired word is selected.
3. To change section, Press LEFT ARROW until the desired
section is displayed in the Status bar.
4. To insert the selected pre-defined text, press RIGHT ARROW. 81
Text overlays
There are 2 layers of text in annotations, which can be selected
by toggling the F10 (TEXT1/TEXT2) key. This function enables the
user to show/hide different annotations on the same image.
When displaying both layers (i.e Text1/Text2), any editing will
be assigned to layer 1. In order to write or edit on layer 2, the
user must press F10 to make Text2 visible.
To edit annotation
1. Press the alphanumeric key TEXT.
2. Press Edit in the Annotation menu.
The pointer is changed to a cross marker.
3. Trackball to the annotation to edit.
4. Press SELECT.
Once selected, the annotation can be moved freely.
The text can be edited using the following alphanumeric
keys:
• RIGHT ARROW: moves the text cursor forward.
• LEFT ARROW: moves the text cursor backward.
• TAB: moves the text cursor by word forward.
• SHIFT + TAB: moves the text cursor by word backward.
• BACKSPACE: deletes backward.
• DELETE: deletes the selected word.
• INSERT: toggles the text entry state from overwrite to
insert mode.
5. Do the appropriate changes to the annotation.
6. Press SELECT to anchor the edited annotation.
To erase annotation
The user can erase all annotations on the screen in one
operation or erase annotations one by one.
To erase all annotations

1. Press the alphanumeric key PAGE ERASE (F7).
If using text overlays, page erase applies only to the
displayed layer(s).
82
To erase one annotation
1. Press the alphanumeric key LINE ERASE (F8).
The cursor is changed to a cross marker.
2. Trackball to the annotation to delete.
3. Press SELECT to erase the annotation.
Configuration of the pre-defined

annotation list
1. Press F2 (CONFIG).
2. In the Configuration package, select Measure.
3. In the Measure category select Annotation.
The Annotation sheet is displayed where the user can add,
delete or re-arrange the annotation text (see Figure 2-15).
To re-arrange the annotation list

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

1. Trackball to the text entry field (see Figure 2-15).
2. Press SELECT to activate the text cursor.
3. Type the new annotation text.
4. Press add.
The new annotation text is added at the end of the list.
5. Press save to store the new annotation list.
83
1. Rearrange list
2. Delete selected text
3. Reset to factory default
4. Add new text to the list
5. Enter new text
Figure 2-15: The Annotation sheet
84
Bodymarks
Bodymarks are small graphic images that represent the
anatomy being examined. Using bodymarks, the user can
indicate the position that the probe was in during the
examination.
Inserting a bodymark
1. Press the alphanumeric key BODYMARK (F6).
The Bodymark menu is displayed showing a selection of
bodymarks relative to the selected exam category.
1. Select and display bodymark list for

other applications
2. Edit probe marker position and
orientation
3. Erase bodymark
4. Bodymark list for the current
application
5. Insert an arrow
6. Insert user-defined text
Figure 2-16: The Bodymark menu
2. Trackball to the desired bodymark and press SELECT.

The bodymark with a probe marker is displayed on the
scanning screen.
1. Probe marker
Figure 2-17: The bodymark with probe marker
3. Using the trackball, adjust the position of the probe marker

and press SELECT.
85
4. Using the trackball, adjust the probe marker orientation and
press SELECT.
Editing a bodymark
The Bodymark menu is displayed
2. Press Edit.
3. Using the trackball, adjust the position of the probe marker
and press SELECT.
4. Using the trackball, adjust the probe marker orientation and
press SELECT.
Deleting a bodymark
The Bodymark menu is displayed
2. Press Delete.
86
Chapter 3
Scanning Modes
• 2D-Mode ........................................................................................ ..... 90

• 2D-Mode overview ......................................................................90
• 2D-Mode controls .......................................................................92
• Using 2D .....................................................................................95
• Optimizing 2D .............................................................................95
• M-Mode .......................................................................................... ..... 96
• M-Mode overview .......................................................................96
• M-Mode controls .........................................................................98
• Using M-Mode ..........................................................................100
• Optimizing M-Mode ...................................................................101
• Color Mode .................................................................................... ... 102
• Color 2D Mode overview ..........................................................102
• Color Mode controls ..................................................................105
• Using Color Mode .....................................................................108
• Optimizing Color Mode .............................................................109
• PW and CW Doppler ..................................................................... ... 110
• PW and CW Doppler overview .................................................110
• PW and CW Doppler controls ...................................................112
• Using PW/CW Doppler modes .................................................115
• Optimizing PW/CW Doppler modes ..........................................115
• Tissue Velocity Imaging (TVI) ...................................................... ... 117
• TVI overview .............................................................................117
• TVI controls ...............................................................................119
• Using TVI ..................................................................................122
• Optimizing TVI ..........................................................................122
• Tissue Tracking ............................................................................ ... 123
• Tissue Tracking overview .........................................................123 87
• Tissue Tracking controls ...........................................................125
• Using Tissue Tracking ..............................................................128
• Optimizing Tissue Tracking ......................................................128
• Strain rate ...................................................................................... ... 130
• Strain rate overview ..................................................................130
• Strain rate controls ....................................................................132
• Using Strain rate .......................................................................135
• Optimizing Strain rate ...............................................................135
• Strain ............................................................................................. ... 136
• Strain overview .........................................................................136
• Strain controls ...........................................................................138
• Using Strain ..............................................................................141
• Optimizing Strain ......................................................................141
• Tissue Synchronization Imaging (TSI) ....................................... ... 142
• TSI overview .............................................................................142
• TSI controls ...............................................................................144
• Using TSI ..................................................................................146
• Optimizing TSI ..........................................................................147
• Additional scanning features ...................................................... ... 148
• LogiqView .................................................................................148
• Compound ................................................................................148
• B-Flow .......................................................................................149
• Blood flow imaging ....................................................................149
88
Introduction
The Vivid 7 ultrasound scanner provides several basic
scanning modes and several options for combining the use of
these modes.
The following scanning modes are described in this chapter:
• 2D Mode Imaging
• M-Mode Imaging
• Anatomical M-Mode (straight and curved)
• Color Mode Imaging
• Angio
• Doppler Mode Imaging
• Tissue Velocity Imaging
See page 343 for When performing an examination using any of these modes,
further information images and image sequences (cineloops) can be stored. The
on image and examination or part of it can also be stored on video tape.
cineloop storage.
Refer to page 502
for more informa-
tion on VCR re-
cording.
89
2D-Mode
2D-Mode overview
1. Focus marker
2. Probe orientation marker
3. Status window
4. Soft menu
Figure 3-1: The 2D screen (cardiac)
90
1. Assignable keys:
• Width
• Frequency/Resolution
• Focus
1 • Frame rate
• Up/Down R
• Left/Right R
• Cineloop (in Freeze, only)
• Dual focus
• B color maps
• Select all
2. Zoom
3. Depth
7 2 4. Soft menu
• Tilt
• Compress R
3 • Reject R
6 • Dynamic Range
• DDP R
• Adaptive reject R
• UD Clarity
4 • Speckle reduce
• Contour
• Diff On/Off
• Power
5 5. Freeze
6. 2D
7. Gain
Controls marked with R are also available in freeze and cine replay
Figure 3-2: The 2D controls on the front panel
The 2D mode displays a two-dimensional gray scale image of

the tissue within the probe's field of view. 2D mode can be
combined with:
In combined mode, • M-Mode, see ’M-Mode’ on page 96
press ACT. MODE to
• Color Mode, see ’Color Mode’ on page 102
toggle between
modes and access to • CW or PW Doppler Mode, see ’PW and CW Doppler’ on
the mode specific page 110
controls.
• Color and Doppler Modes (triplex)
91
2D-Mode controls
2D assignable controls
Width
Controls the size or angular width of the 2D image sector. A
smaller angle generally produces an image with a higher frame
rate.
Focus
Changes the location of the focal point(s). A triangular focus
marker indicates the depth of the focal point.
Frame rate
Adjusts frame rate (FPS). Rotate the knob clockwise to
increase frame rate. The relative setting of the frame rate is
displayed in the status window. When adjusting frame rate,
there is a trade off between spatial and temporal resolution.
Frequency/Resolution
On some low fre- Enables the adjustment of the probe's operating frequency.
quencies, the sys- Rotate the knob clockwise to increase the frequency. The
tem switches selected frequency is displayed in the status window. For some
automatically to
second-harmonic
probes/applications the lowest frequency settings will be
mode. The word Octave imaging settings.
“Octave” appears
in the status win- Invert
dow. • Left/Right Invert: enables a mirror image of the 2D image
to be created. The left/right reference marker V moves to
the other side of the image.
• Up/Down Invert: enables the 2D image to be flipped
180 degrees.
Dual focus
Activates Dual focus mode. To adjust the Dual focus, rotate the
FOCUS assignable.
Color maps
Displays a color map menu to optimize the greyscale
presentation. The menu enables an option from a list of
non-linear gray-curves or different 2D-colorized curves to be
selected.
92
Cineloop (in Freeze only)
Gain
When rotated clockwise, increases the overall gain applied to
the received echo signals equally for all depth.
Time Gain Compensation (TGC)
compensates for depth-related attenuation in an image. The
sliders nearest the operator affect the far field. TGC amplifies
returning signals to correct for the attenuation caused by tissue
at increasing depths.
Automatic Tissue Optimization (ATO)
ATO provides an automatic optimization of the 2D image by
adjusting the gray scale curve. Press the 2D GAIN rotary to
toggle ATO on or off. When activated, ATO is displayed in the
information window.
Depth
Sets the maximum (far field) distance that will be imaged.
Decreasing the depth may allow higher frame rates.
2D Soft menu controls

Compress
Controls the amount of contrast in the 2D image. An index
number is displayed in the status window to indicate the
relative level of compression.
Reject
Adjust reject level. When this control is increased, low-level
echoes are rejected and appear darker in the 2D image. An
index number is displayed in the status window to indicate the
relative level of rejection.
Dynamic Range
Enables control of the dynamic range or contrast of the image.
When dynamic range is set high, the image is softer and more
low-level data is visible.
93
DDP (Data Dependent Processing)
Performs temporal processing which reduces random noise
without affecting the motion of significant tissue structures. An
index number is displayed in the status window (under Proc) to
indicate the relative DDP level.
Tilt
Enables the axis of the 2D image to be tilted to the left or right.
By using this control in combination with angle control the
image can be “aligned” to the direction of interest, and frame
rates be optimized. By default the axis of symmetry of a 2D
image is vertical.
UD Clarity
Enables the user to create a personalized appearance of the
tissue. Moving the paddle to the left creates a smoother image,
though keeping boundaries sharp. Moving the paddle to the
right creates a crisper image.
Adaptive reject
Reduces near field haze and blood pool artifact without diluting
tissue appearance of moving structures.
Contour
Controls image processing related to the extent of edge
enhancement applied to an image.
Diff On/Off
Affects the level of reverberations in the image. When turned
on, the frame rate (or the number of focal zones) will decrease,
while the reverberations will be attenuated.
Power
When power is re- Controls the amount of acoustic power applied in all modes.
duced, it reduces When power is set to maximum, it is equal to or less than the
the signal-to-noise maximum acoustic power permitted by the FDA. The Thermal
ratio, so that the im-
age may become
Index (TI) and the Mechanical Index (MI) are displayed on the
noisier. screen.
94
Using 2D
Refer to page 524 The 2D-Mode is the system's default mode.
about creating pre-
1. Press 2D on the control panel to access 2D mode.
sets.
Check the Display's 2. Optimize the image by adjusting the image controls
brightness and con- described in the previous section.
trast setting before If necessary use preset for optimum performance with
adjusting the unit
imaging controls
minimum adjustment.
Optimizing 2D
The following controls can be adjusted to optimize the 2D Mode
display:
• Use the Gain and TGC controls to optimize the overall
image.
• Use the Depth control to adjust the range to be imaged.
• Use the Focus control to center the focal point(s) around
the region of interest.
• Use the Frequency (move to higher frequencies) or the
Frame rate control (move to lower frame rate) to increase
resolution in image
• Use the Frequency (move to lower frequency) to increase
penetration.
• Use the Reject control to reduce noise in the image.
• Use the DDP control to optimize imaging in the blood flow
regions and make a cleaner, less noisy image.
Always use the minimum power required to obtain acceptable

images in accordance with applicable guidelines and policies.
WARNING
95
M-Mode
M-Mode overview
1. Time motion cursor conventional M-Mode

2. Time motion cursor curved anatomical M-Mode
3. Time motion cursor anatomical M-Mode
4. Depth scale
5. Focus marker
6. Time scale
7. Status window
8. Soft menu
Note: the sweep speed information displayed in the bottom right corner of the image
represents the user selected sweep speed and should be used only as a reference to
confirm that the image was acquired at the selected sweep speed. It is not to be used
for measurements or analysis. This is not an absolute value, but simply a reference
number. Users performing studies using standardized protocols may find this sweep
speed information useful for reading studies from other institutions.
Figure 3-3: The cardiac M-Mode screen (top/bottom)
96
1. Assignable keys:
• Horizontal sweep R
• Frequency/Resolution
• Focus
1 • Contour
• Up/Down
• Color maps
2. Zoom
3. Img Size
4. Soft menu
• Compress R
• Reject R
• Dynamic Range
2 • Power
8
5. Freeze
7 6. M-Mode
6 7. Access to AMM & CAMM
3 8. Gain R
Controls marked with R are also available in freeze and cine replay.
Figure 3-4: The M-Mode controls on the front panel
This unit has three types of M-Mode:

• Conventional M-Mode (MM): displays a distance/time plot
of a cursor line in the axial plane of the 2D-image.
• Anatomical M-Mode (AMM): displays a distance/time plot
from a cursor line, which is independent from the axial
plane. AMM is available in greyscale, color, TVI, Tissue
Tracking, Strain rate and Strain modes.
• Curved Anatomical M-Mode (CAMM): displays a
distance/time plot from a free-drawn cursor line. CAMM is
available in greyscale, color, TVI, Tissue Tracking, Strain
rate and Strain modes.
97
M-Mode and 2D Mode display areas can be side by side or
top/bottom. Conventional M-Mode can be combined with Color
(see ’Color M-Mode overview’ on page 103).
M-Mode controls
M-Mode assignable controls
Horizontal sweep
Adjusts the horizontal refresh rate of the M-Mode area of the
display. Horizontal sweep does not change the acquisition
resolution, so that user can change the horizontal sweep in
replay (with no loss of quality).
On some low fre- Frequency/Resolution
quencies, the sys-
tem switches
Enables the adjustment of the probe's operating frequency.
automatically to Rotate the knob clockwise to increase the frequency. The
second-harmonic selected frequency is displayed in the status window. For some
mode. The word probes/applications the lowest frequency settings will be
“Octave” appears Octave imaging settings.
in the status win-
dow. Focus
Changes the location of the focal point(s). A triangular focus
marker indicates the depth of the focal point.
Contour
Controls image processing related to the extent of edge
enhancement applied to an image.
Up/Down
Flips the M-Mode display 180 degrees.
Color maps
Displays a color map menu to optimize the greyscale
non-linear gray-curves or different colorized curves to be
selected.
M-Mode Soft menu controls

Compress
Controls the amount of contrast in the image. An index number
is displayed in the status window to indicate the relative level of
compression. 98
Reject
Adjust reject level. When this control is increased, low-level
echoes are rejected and appear darker in the image. An index
number is displayed in the status window to indicate the
relative level of rejection.
Power
age, spectrum or
color scan may be- screen.
come noisier.
Dynamic Range
Enables control of the dynamic range or contrast of the image.
When dynamic range is set to High, the image is softer and
more low-level data is visible.
99
Using M-Mode
Conventional M-Mode
1. To access M-Mode from any other scan mode, press MM on
the control panel.
2. Use the trackball to position the cursor over the required
area of the image.
Gain, Frequency, 3. Adjust horizontal sweep, Gain, Frequency, Focus, Dynamic
Focus, Dynamic Range, Compression and Contour to optimize the display if
Range and Com- necessary.
pression affect also
the 2D image. 4. Press FREEZE to stop imaging.
Anatomical M-Mode
Anatomical 1. From the 2D Live or M-Mode view, press ALT.
M-Mode can also be The alternative modes are displayed on the assignable.
used with previous-
ly acquired digitally 2. Press AMM
stored 2D images.
OR
1. From the 2D Live, press FREEZE.
2. Press MM to access the Anatomical M-Mode.
The Trackball as- 3. Use the trackball to position the cursor over the required
signable Pos (Posi- area of the image.
tion) is activated.
The Trackball as- 4. Press TRACKBALL to allow free rotation of the solid
signable Angle is full-length cursor line throughout the 2D image.
activated.
5. Rotate the solid cursor line to the desired direction.
The Trackball as- 6. Press TRACKBALL twice and reposition the intersection
signable Pos is acti- point to the desired position along the cursor line.
vated.
7. Repeat steps 4. and 5. to change the angle of the solid
cursor line if necessary.
The M-Mode area of 8. Press TRACKBALL to activate scrolling control on the
the display updates trackball.
as the M-Mode sig-
nal is constructed. 9. Use the trackball to scroll through the data acquired at that
location. The M-Mode display will vary accordingly.
Curved Anatomical M-Mode

Curved Anatomi- 1. From the 2D or M-Mode view press ALT.
cal M-Mode can al- The alternative modes appear on the assignable display.
so be used with
previously ac- 2. Press CURVED AMM.
quired digitally
stored 2D images. 100
3. Use the trackball to position the starting point of the time
motion curve.
The time motion 4. Press SELECT to anchor the starting point of the time motion
curve can be edited curve.
by following the
curve back to the de- 5. Use the trackball to position the second point of the time
sired point and re- motion curve.
drawn as desired. 6. Press SELECT to anchor the second point of the time motion
Following the curve
curve.
back to the starting
point will delete the 7. Repeat step 5. and 6. up to seven times to draw a complete
time motion curve. time motion curve.
Optimizing M-Mode
Refer to page 524 The use of preset gives optimum performance with minimum
about creating pre- adjustment. If necessary, the following controls can be adjusted
sets. to further optimize the M-Mode display:
• Adjust Horizontal sweep to optimize the display resolution.
• Adjust Gain and TGC controls to adjust the range to be
imaged.
Except for Con- • Use the Frequency (move to higher frequencies) or the
tour, all the con- Frame rate control (move to lower frame rate) to increase
trols listed in the resolution in image.
optimizing
M-Mode section • Use the Frequency (move to lower frequency) to
will also affect the increase penetration.
2D image.
• Adjust Focus to move the focal point(s) around the region
of interest in the M-Mode display.
• Adjust Dynamic range to optimize the useful range of
incoming echoes to the available greyscale.
• Adjust Compress and Contour to further optimize the
display.
• Adjust Reject to reduce noise while taking care not to
eliminate significant low-level diagnostic information.
101
Color Mode
Color 2D Mode overview
1. Probe orientation marker

2. Color bar
3. Color sector marker
4. Status window
5. Soft menu
Figure 3-5: The Color Mode screen
102
Color M-Mode overview
1. Time motion cursors

2. Color bar
3. Focus marker
4. Flow sector marker
5. Time scale
6. Status window
7. Soft menu
Figure 3-6: The Color M-Mode screen (top/bottom display)
103
1. Assignable keys:
• Horizontal sweep (Color
M-Mode only) R
• Scale
1 • Baseline
• Frame rate
• Invert R
• Variance R
• Simultaneous
• Dual focus
• Color maps
• Angio (Color 2D only)
• Cineloop (in Freeze, Color 2D
2 mode only)
8 MORE
• Up/Down R
3 • Left/Right R
2. Zoom
4 • Display zoom
7 • HR zoom
3. Depth
5 4. Img Size (Color M-Mode)
5. Soft menu
• Tissue Priority R
• Sample Volume
6
• DDP (Color 2D only) R
• Frequency
• Lateral avg.
• Radial avg.
• Power
C 6. Freeze
ontrols marked with R are also available in freeze and cine replay.
7. Color
8. Access to AMM & CAMM
9. Gain R
Figure 3-7: The Color Mode controls on the front panel
104
Color Mode controls
Color Mode assignable controls
Horizontal sweep (Color M-Mode only)
Adjusts the horizontal refresh rate of the M-Mode area of the
display.
Scale
Adjusts the repetition rate of the Doppler pulses transmitted to
acquire the data for color flow mapping. The Scale (Nyquist
limit) should be adjusted so that no aliasing occurs, while still
having good resolution of velocities. The Nyquist limit should
be somewhat above the maximum velocity found in the data.
Baseline
Adjusts the color map to emphasize flow either toward or away
from the probe. Baseline is available in both Live and Freeze.
Invert
Enables the color scheme assigned to positive and negative
velocities to be inverted. Invert is available in live and cine
replay.
Variance
Controls the amount of variance data added to a color display.
Variance enables computer-aided detection of turbulent flow
(e.g. jets or regurgitation). Variance is available in live and cine
replay.
Dual focus (Color 2D mode only)
Activates Dual focus mode. To adjust the Dual focus, press
ACT. MODE and rotate the FOCUS assignable.
Color maps
Displays a menu of color map options. Use the trackball to
point to a color map and press SELECT to activate the desired
color map. Each color map is assigning different color hues to
different velocities.
Cineloop (in Freeze, Color 2D mode only)
105
Color-Mode Soft menu controls
Tissue priority
Emphasize either the color of the color mode or the greyscale
tissue detail of the 2D image. Tissue priority is available in both
Live and Freeze.
Sample volume
Adjusts the size of the color flow Doppler sampling area. Lower
setting gives better flow resolution while a higher setting
increases sensitivity and helps to locate turbulent flows.
LVR (Low Velocity Rejection)
Color data produced LVR, also called Wall motion filter, enables the extent of low
by very low flow velocity removal to be adjusted.
may cause interfer-
ence. Frequency
Enables the adjustment of the transmission frequency to
control the sensitivity or the level of penetration. The selected
frequency is displayed in the status window. Adjusting
Frequency may affect Sample Volume and LVR settings.
Lateral Averaging (Color 2D only)
Smooths the image by averaging collected data along the
same horizontal line. An increase of the lateral averaging will
reduce noise, but this will also reduce the lateral resolution.
Radial Averaging
same radial line. An increase of the radial averaging will reduce
noise, but this will also reduce the radial resolution.
Power
age may become
noisier. screen.
106
Trackball controls
ROI (Region Of Interest) size
When the trackball command Size is selected (see also
’Trackball operation’ on page 57), the height and width of the
color area (or ROI) is adjusted from the trackball.
ROI (Region Of Interest) position
When the trackball command Pos (position) is selected (see
also ’Trackball operation’ on page 57), the position of the color
area (or ROI) is adjusted with the trackball.
107
Using Color Mode
Color 2D
1. From an optimized 2D image press COLOR.
2. Use the trackball to position the ROI frame over the area
to be examined.
The assignable con- 3. Press SELECT. The instruction Size should be highlighted in
trols of the trackball the trackball status bar. If not, press SELECT again to select
are displayed in the Size.
trackball status bar
in the bottom right
Note: If the trackball control Pointer is selected, press
corner of the screen. TRACKBALL to be able to select between Position and Size
controls.
4. Use the trackball to adjust the dimensions of the ROI.
To enlarge or narrow the ROI, move the trackball to the
left or right.
To lengthen or shorten the ROI, move the trackball up or
down.
5. Press IMG. STORE.
Color M-Mode
1. From M-Mode press COLOR.
2. Use the trackball to position the color area in the M-Mode
display.
3. Press SELECT. The instruction Size should be highlighted in
the trackball status bar. If not, press TRACKBALL again to
select Size.
TRACKBALL to be able to select between Position and Size
controls.
4. Use the trackball to adjust the dimension of the color area.
To enlarge the color area, move the trackball up
To narrow the color area, move the trackball down.
108
Optimizing Color Mode
sets. to further optimize the Color Mode display:
• Adjust the Active mode gain to set the gain in the color
flow area.
The scale value may • Adjust Scale to the highest setting that provides adequate
affect FPS, Low Ve- flow detection.
locity Reject, and
Sample Volume. • Adjust Low Velocity Reject to remove low velocity blood
flow and tissue movement that reduces image quality.
• Adjust Variance to detect flow disturbances.
• Adjust Sample volume (SV) to a low setting for better flow
resolution, or a higher setting to more easily locate
disturbed flows
Frequency setting • Adjust Frequency to optimize the color flow display. Higher
may affect FPS, SV settings improve resolution. Lower settings improve depth
and Low Velocity penetration and sensitivity. This does not affect the
Reject.
frequency used for 2D and M-Mode.
The Power setting • Adjust Power to obtain an acceptable image using the
affects all other op- lowest setting possible.
erating modes.
Adjust the following settings to further optimize display of the
image:
• Use Invert to reverse the color assignments in the color
flow area of the display.
• Use Tissue priority to emphasize either the color flow
overlay, or the underlying greyscale tissue detail.
• Use Baseline to emphasize flow either toward or away
from the probe.
• Use Radial and Lateral Averaging to reduce noise in the
color flow area. Radial and Lateral Averaging smooths the
image by averaging collected data along the same
horizontal line. An increase of the lateral averaging will
Use all noise reduction controls with care. Excessive

application may obscure low level diagnostic information.
CAUTION
109
PW and CW Doppler
PW and CW Doppler overview
1. Sample volume (PW only)

2. Angle correction marker
3. Velocity scale
4. Low velocity reject
5. Nyquist velocity
6. Doppler baseline
7. Frequency scale (optional, see page 522)
8. Status window
9. Soft menu
Note: the sweep speed information displayed in the bottom right corner of the image
represents the user selected sweep speed and should be used only as a reference to
confirm that the image was acquired at the selected sweep speed. It is not to be used
for measurements or analysis. This is not an absolute value, but simply a reference
number. Users performing studies using standardized protocols may find this sweep
speed information useful for reading studies from other institutions.
Figure 3-8: The PW/CW Doppler Mode screen
110
1. Assignable keys:
• Horizontal sweep R
• Scale
• Baseline R
1 • LVR
• Invert R
• LPRF (in PW mode)
• Color maps R
MORE
• Quick angle
• Angle correction
2. Zoom:
• Display zoom
8 2 • HR zoom
3. Img Size:
• Small/large 2D display
• Top/bottom display
7 6 • Side by side display
3 4. Soft menu:
• Sample Volume (PW)
• Compress R
4 • Reject R
• Frequency
• Frame rate
• Power
5
5. Freeze
6. CW
7. PW
8. Gain R
Figure 3-9: The PW/CW controls on the front panel
111
PW and CW Doppler controls
PW and CW Doppler assignable controls
Horizontal sweep
Adjusts the horizontal refresh rate of the Doppler area of the
display. Horizontal sweep is available in live and cine replay.
Scale
Adjusts the velocity scale to accommodate faster/slower blood
flow velocities. Velocity scale determines pulse repetition
frequency.
Baseline
Enables the Doppler baseline to be shifted up and down. The
default Doppler baseline is set at the center of the vertical
aspect of the Doppler display, dividing evenly the flow toward
and away from the probe. By adjusting the baseline a larger
portion of the analysis is assigned to the flow direction present.
Baseline is available in live and cine replay.
Maximum velocity Velocity range
depends on sample
volume size, sample
Enables the vertical scale of the Doppler spectrum and the
volume position maximal detectable velocity to be modified. Velocity range
and frequency set- directly controls the pulse repetition frequency, which is
tings. responsible for the setting of the Nyquist limit (the ability to
detect maximum velocity without aliasing).
Low velocity reject
Enables the low velocity portions of the spectrum to be filtered,
since the Doppler spectrum and audio may contain strong
wall-motion signals. The amount of Low Velocity Reject. is
indicated by the green vertical bar at the right end of the
baseline.
If the Doppler mode Invert
is combined with
Color mode, the col-
Enables the Doppler spectrum to be flipped 180 degrees, so
or map will be also that negative velocities are displayed above the baseline and
inverted. positive velocities below the baseline. Invert is available in live
and cine replay.
112
LPRF (PW mode)
Sets the pulse repetition frequency for the PW Doppler
acquisition of flow data. Enables toggling between high and low
Pulse Repetition Frequency (PRF). When the Doppler PRF is
raised beyond a certain limit, more than one Doppler gate is
displayed on the screen.
Color maps
Displays a drop down menu of different Doppler colorization
maps.Use the trackball to select the desired map and press
SELECT to activate the map.
Quick angle and Angle correction

In non-cardiac ap- Enables correction of the Doppler velocity scale by defining the
plications, Angle angle between the Doppler beam and the investigated blood
correction is con- vessel or blood flow. A thin cross bar on the Doppler cursor will
trolled from the
Trackball.
rotate as the control is adjusted. Angle correction is available in
both Live and Freeze.
Quick angle adjusts the angle by 60 degrees.
Angle correction adjusts the angle between zero and
90 degrees with one degree increment.
PW/CW Doppler Soft menu controls

Sample volume
In PW mode, set the longitudinal size of the region to be
sampled for measurement. Adjusting Sample volume may
affect the PRF (Nyquist limit) settings. SV does not apply to
CW mode, where the volume sampled is the full length of the
area indicated by the cursor line.
Compress
Enables control over the contrast of the Doppler spectrum.
When compression is raised, the spectrum image becomes
softer and some low level background noise may appear.
Compress is available in both Live and Freeze.
Reject
Enables undesirable background noise to be removed from the
Doppler spectrum resulting in a darker background. Reject is
available in both Live and Freeze.
113
Frequency
Adjusts the transmission frequency in Doppler to control
sensitivity or level of penetration. The selected frequency is
displayed in the status window. Adjusting Frequency may affect
Sample Volume (PW) and LVR settings.
Frame rate
Adjusts the frame rate. The relative setting of the frame rate is
displayed in the status window (under 2D).
Power
age may become
noisier. screen.
114
Using PW/CW Doppler modes
Controls and opera- There are two ways to start PW/CW Doppler:
tions for PW and
CW mode are the Alternative 1
same unless other-
wise noted. 1. Press PW or CW. A scanning screen is displayed with a
Doppler cursor on the 2D mode image and a Doppler
spectrum in the lower part of the screen.
2. Use the trackball to position the Doppler cursor line and in
PW the sample volume location over the area of interest.
Sample Volume ad- 3. In PW, with the Soft menu rocker key, adjust the sample
justment may affect Volume (SV):
the Scale, Frame To enlarge the SV, press the Right arrow of the rocker
rate and LV rej. set-
tings.
To narrow the SV, press the Left arrow of the rocker.
Alternative 2
1. Press CURSOR on the control panel. A cursor line is
displayed on the 2D image.
2. With the trackball adjust the position of the cursor line.
3. Press PW or CW.
Optimizing PW/CW Doppler modes

sets to further optimize the PW/CW modes display:
• Adjust the Active mode gain to set the gain in the spectral
Doppler area.
• Adjust Low velocity reject to reduce unwanted low
velocity blood flow and tissue movement.
• In PW mode, adjust Sample volume to low setting for
better resolution, or higher setting to more easily locate the
disturbed flows.
• Adjust the Compress setting to balance the effect of
stronger and weaker echoes and obtain the desired
intensity display.
Frequency and • Adjust Frequency to optimize flow display. Higher setting
Frame rate settings will improve resolution and the lower setting will increase
may affect the Low the depth penetration.
Velocity Reject.
• Adjust Frame rate to a higher setting to improve motion
detection, or to a lower setting to improve resolution. 115
The Doppler Power • Adjust Power to obtain an acceptable image using the
setting affects only lowest setting possible. This is particularly important in CW
Doppler operating mode, as the energy duty cycle is 100% (constant).
modes.
Use all noise reduction controls with care. Excessive
application may obscure low level diagnostic information.
CAUTION
Adjust the following settings to further optimize the display of

the image.
• Use the Horizontal sweep to optimize the sweep speed.
• To view signal detail, use the Velocity range to enlarge the
vertical spectral Doppler trace.
• Use Invert to reverse the vertical component of the spectral
Doppler area of the display.
• Use Angle correction to steer the ultrasound beam to the
blood flow to be measured (Not typically required during
cardiac studies).
116
Tissue Velocity Imaging (TVI)
TVI overview
1. TVI sector marker

2. Status window
3. Soft menu
Figure 3-10: The TVI Mode screen
117
1. Assignable keys:
• 2D Width
• Scale
• Baseline R
1 • Frame rate
• Invert R
• TSI
• Simultaneous R
• Dual focus
• TSI visible
• Cineloop (Freeze only)
• Q-Analysis (Freeze only)
MORE
2 • Color maps
7 ALT
6 • Curved AMM R
• AMM R
• Tissue Tracking R
5 • Strain rate R
• Strain R
2. Zoom
3 • Display zoom
• HR zoom
3. Soft menu
4 • Compress R
• Reject
• Threshold
• Transparency
• Frequency
• Lateral avg.
Controls marked with R are also available in freeze and cine replay. • Radial avg.
• Power
4. Freeze
5. TVI
6. 2D
7. Alternatives
Figure 3-11: The TVI Mode controls on the front panel
Tissue Velocity Imaging (TVI) calculates and color-codes the

velocities in tissue. The tissue velocity information is acquired
by sampling of tissue Doppler velocity values at discrete points.
The information is stored in a combined format with greyscale
imaging during one or several cardiac cycles with high
temporal resolution.
118
TVI controls
TVI assignable controls
2D width
Controls the angular width of the 2D image sector.
Lower scale value Scale
allows greater depth
and lower Nyquist
limit. acquire the data for color mapping.The Scale value influences
the Nyquist limit (the ability to detect maximal velocity without
color-aliasing).
Baseline
Adjusts the color map to emphasize tissue motion either toward
or away from the probe. Baseline is available in both Live and
Freeze.
Frame rate
Controls the line density. When adjusting frame rate, there is a
trade off between spatial and temporal resolution.
Invert
tissue velocities to be inverted. Invert is available in live and
cine replay.
TSI
Starts TSI mode (see page 142).
Simultaneous
Enables simultaneous display of 2D image and 2D image with
TVI color.
Dual focus
Activates Dual focus mode. To adjust the Dual focus, press
ACT. MODE and rotate the FOCUS assignable.
TVI visible
Turns TVI display on/off.
119
Color maps
point a color map and press SELECT to activate a desired color
map. Each color map is assigning different color hues to
different velocities.
Q-analysis (in Freeze only)
Starts the Quantitative analysis application (see Chapter 7,
’Quantitative Analysis’ on page 304).
Alternative assignable controls

Press ALT to access to the following modes:
• Curved Anatomical M-Mode (see page 96)
• Tissue Synchronization Imaging (see page 142)
• Tissue Tracking (see page 123)
• Strain rate (see page 130)
• Strain (see page 136)
TVI Soft menu controls

Compress
Controls the amount of color compression. The color bar is
adjusted accordingly.
Reject (low velocity rejection)
Adjust the cut-off level for the low velocity of TVI to be
discarded when generating the color image.
Threshold
Controls the level of greyscale intensity that is used as a
threshold for color.
Transparency
Controls the degree of transparency of the TVI color.
Frequency
control the sensitivity or the level of penetration.
120
Lateral Averaging
Use Averaging con- Smooths the image by averaging collected data along the
trols with caution same horizontal line. An increase of the lateral averaging will
so as not to obscure reduce noise, but this will also reduce the lateral resolution.
significant diagnos-
tic information Radial Averaging
When power is re- Power
duced, it reduces
the signal-to-noise
Controls the amount of acoustic power applied in all modes.
ratio, so that the im- When power is set to maximum, it is equal to or less than the
age may appear maximum acoustic power level permitted by regulatory
noisier. standards. The Thermal Index (TI) and the Mechanical Index
(MI) are displayed on the screen.
121
Using TVI
1. Select the desired probe.
2. While in 2D mode press TVI on the control panel.
to be examined.
in the bottom right
controls.
To enlarge or narrow the ROI, move the trackball to the
left or right.
To lengthen or shorten the ROI, move the trackball up or
down.
Optimizing TVI
sets. to further optimize the TVI display:
The Scale value also • To reduce quantification noise (variance), the Nyquist limit
affects the frame should be as low as possible, without creating aliasing. To
rate. There is a trade reduce the Nyquist limit: Reduce the Scale value from the
off between the
frame rate and
assignables on the control panel.
quantification
noise.
PW will be opti- • TVI provides velocity information only in the beam direction.
mized for Tissue The apical view typically provides the best window since the
Velocities when ac- beams are then approximately aligned to the longitudinal
tivated from inside
TVI.
direction of the myocardium (except near the apex). To
obtain radial or circumferential tissue velocities, a
parasternal view must be used. However, from this window
the beam cannot be aligned to the muscle for all the parts
of the ventricle.
122
Tissue Tracking
Tissue Tracking overview

2. Tissue Tracking color bar
3. Status window
4. Soft menu
5. Track start and track end markers
6. Tracking start and end from R-peak
Figure 3-12: The Tissue Tracking Mode screen
123
1. Assignable keys:
• Track start R
• Track end R
• Track scale R
1 • Frame rate
• Invert R
• TSI
• Simultaneous R
• Dual focus
• Color maps R
MORE
2 • 2D width
ALT
6 • Curved AMM R
• AMM R
5 • Strain rate R
• Strain R
2. Zoom
3 3. Soft menu:
• Threshold R
• Transparency R
4 • Frequency
• Lateral avg.
• Radial avg.
• Power
• Cine compound (Freeze only)
4. Freeze
5. TVI
6. 2D
Figure 3-13: The Tissue Tracking controls on the front panel
Tissue Tracking calculates and color-codes the displacement in

the tissue over a given time interval, typically the systole. The
displacement is defined as the distance the tissue move during
this time interval. The displacement is found as the time
integral (sum) of the tissue velocities during this interval.
Only displacements in the beam direction are found. Only
positive (systolic) displacements are mapped into colors,
negative displacements are mapped into greyscale.
124
Tissue Tracking controls
Tissue Tracking assignable controls
Tracking start
The time after ECG R-peak when the integration should start.
Tracking end
The time after tracking start when the integration should end.
Tracking scale
Controls the color cut-off value of max displacement displayed.
The chosen values is shown on the color bar when the
assignable is activated.
Frame rate
Invert
tissue velocities to be inverted. Invert is available in live and
cine replay.
TSI
Simultaneous
Tissue Tracking color.
Color maps
map.
125
2D width (More menu)

Tissue Tracking Soft menu controls

Threshold
Controls the level of greyscale intensity that is used as a
Transparency
Controls the degree of transparency of the Tissue Tracking
color.
Frequency
Use Averaging con- Lateral Averaging
trols with caution
so as not to obscure
significant diagnos- same horizontal line. An increase of the lateral averaging will
tic information reduce noise, but this will also reduce the lateral resolution.
Radial Averaging
Power
Controls the amount of acoustic power applied. When power is
reduced the signal to noise ratio is reduced, so that the image
may become noisier.
126
Cine Compound (Freeze only)
Calculates and displays cineloops generated from a temporal
averaging of multiple consecutive heart cycles. The number of
cycles averaged is controlled from the Soft menu rocker. The
number of averaged cycles i displayed on the top left corner.
127
Using Tissue Tracking
1. From TVI Mode, press ALT on the control panel and press
the TISSUE TRACKING assignable.
2. Adjust TRACKING START (assignable) close to the R-peak.
3. Adjust TRACKING END (assignable) near the T-wave.
to be examined.
in the bottom right
controls.
Optimizing Tissue Tracking

• To reduce quantification noise (variance), the Nyquist limit
should be as low as possible, without creating aliasing. To
reduce the Nyquist limit, reduce the scale while in TVI.
• To check for aliasing, freeze the loop and apply velocity
trace (Press FREEZE and Q-ANALYSIS), see also Chapter 7,
• The main use of Tissue Tracking is to map positive systolic
displacements. This means that TRACKING START and
TRACKING END assignables should be adjusted to pick out
the systolic phase of the cardiac cycle: Adjust Tracking
start close to the R-Peak. Adjust Tracking end near the
T-wave.
• Negative displacement can be mapped by pressing INVERT.
TRACKING START and TRACKING END must then be adjusted
to pick out the diastolic phase of the cardiac cycle.
• The maximum displacement that is color-coded can be
adjusted using the TRACKING SCALE assignable. If set too
low, most of the wall will show the color indicating maximum
displacement. If set too high, the maximum displacement
color is never reached.
• Tissue Tracking provides velocity information only in the
beam direction. The apical view typically provides the best
window since the beams are then approximately aligned to
the longitudinal direction of the myocardium (except near 128
the apex).
129
Strain rate
Strain rate overview

2. Status window
3. Soft menu
4. Strain sample size
Figure 3-14: The Strain rate mode screen
130
1. Assignable keys:
• 2D width
• SRI scale R
• Frame rate
1 • Invert R
• TSI
• Simultaneous R
• Dual focus
• Color maps R
ALT
• Curved AMM R
2 • AMM R
7 • Tissue Tracking R
• Strain rate R
6 • Strain R
2. Zoom
5 • Display zoom
• HR zoom
3. Soft menu:
3 • Strain Length
• SRI Reject R
• Compress R
• Threshold R
4 • Transparency R
• Frequency
• Lateral avg.
• Radial avg.
• Power
• Cine compound R (Freeze
Controls marked with R are also available in freeze and cine replay. only)
4. Freeze
5. TVI
6. 2D
Figure 3-15: The Strain rate mode controls on the front panel
Strain rate calculates and color-codes the deformation per unit

time i.e the speed at which the tissue deformation occurs.
Strain rate is defined as the spatial gradient of velocity data.
131
Strain rate controls
Strain rate assignable controls
2D width
SRI scale
Defines the scale for the color coding of the strain rate.
Frame rate
Invert
Enables the color scheme assigned to strain rate to be
inverted. Invert is available in live and cine replay.
TSI
Simultaneous
Strain rate color.
Color maps
map.

132
Strain rate Soft menu controls

Strain length
Determines the strain sample volume size.
SRI Reject
Adjust the cut-off level of the low tissue velocity to be discarded
when generating the color image. Rejected values are
displayed in green.
Compress
Controls the amount of color compression. The color bar is
adjusted accordingly.
Transparency
Control the degree of transparency of the strain rate color.
Threshold
Controls the level of greyscale intensity that is used as
Frequency
Lateral Averaging
Use Averaging con- Radial Averaging
trols with caution
significant diagnos- same radial line. An increase of the radial averaging will reduce
tic information. noise, but this will also reduce the radial resolution.
Power
may become noisier.
133
134
Using Strain rate
STRAIN RATE.
to be examined.
in the bottom right
controls.
Optimizing Strain rate

• To reduce quantification noise (variance), the Nyquist limit
should be as low as possible, without creating aliasing. To
reduce the Nyquist limit, reduce the scale while in TVI.
• To check for aliasing, freeze the loop and apply velocity
trace (Press FREEZE and Q-ANALYSIS), see also Chapter 7,
• Strain rate provides velocity information only in the beam
direction. The apical view typically provides the best
the longitudinal direction of the myocardium (except near
the apex).
• There is a trade-off between noise and spatial resolution
controlled by the Strain length. To minimize noise the
Strain length should be maximized.
• The maximum Strain rate that is color-coded can be
adjusted using the SRI SCALE assignable. If set too low,
most of the wall will show the color indicating maximum
Strain rate. If set too high, the maximum Strain rate color is
never reached.
135
Strain
Strain overview

2. Strain color bar
3. Status window
4. Soft menu
5. Strain start and end markers
6. Strain start and end from R-peak and Strain sample size
Figure 3-16: The Strain mode screen
136
1. Assignable keys:
• Strain start R
• Strain end R
• Strain scale R
1 • Frame rate
• Invert R
• TSI
• Simultaneous R
• Dual focus
• Color maps R
MORE
2 • 2D width
7 ALT
6 • Curved AMM R
• AMM R
5 • Strain rate R
• Strain R
2. Zoom
3 • Display zoom
• HR zoom
3. Soft menu:
4 • Strain Length R
• Strain Reject R
• Threshold R
• Transparency R
• Frequency
• Lateral avg.
Controls marked with R are also available in freeze and cine replay. • Radial avg.
• Power
• Cine compound R (Freeze
only)
4. Freeze
5. TVI
6. 2D
Figure 3-17: The Strain Mode controls on the front panel
Strain calculates and color-codes the extent of tissue

deformation (lengthening or shortening) relative to the original
size over a given time interval, typically the systole.
137
Strain controls
Strain assignable controls
Strain start
The time after ECG R-peak when the strain calculation should
start. The strain start time is displayed on the screen and is
represented on the ECG by a red marker.
Strain end
The time after strain start when the strain calculation should
end. The strain end time is displayed on the screen and is
represented on the ECG by a red marker.
Strain scale
Defines the scale for the color coding of the tissue deformation.
Frame rate
Invert
Enables the color scheme assigned to shortening and
elongation tissue deformation to be inverted. Invert is available
in live and cine replay.
TSI
Simultaneous
Strain color.
Color maps
map.
138
2D width (More menu)

Strain Soft menu controls

Strain length
Determines the strain sample volume size.
Strain Reject
Adjust the cut-off level of the low tissue velocity to be discarded
when generating the color image. Rejected values are
uncolored.
Threshold
Transparency
Control the degree of transparency of the strain color.
Frequency
Lateral Averaging
139
Use Averaging con- Radial Averaging
trols with caution
significant diagnos- same radial line. An increase of the radial averaging will reduce
tic information. noise, but this will also reduce the radial resolution.
Power
may become noisier.
140
Using Strain
STRAIN.
2. Adjust STRAIN START close to the R-peak.
3. Adjust STRAIN END near the T-wave.
to be examined.
in the bottom right
controls.
Optimizing Strain
• From an optimized Strain rate display adjust strain tracking
to pick out the systolic phase.
• The main use of Strain is to map negative systolic
deformation. This means that STRAIN START and STRAIN
END should be adjusted to pick out the systolic phase of the
cardiac cycle: Adjust STRAIN START close to the R-Peak.
Adjust STRAIN END near the T-wave.
• Positive deformation can be mapped by pressing INVERT.
STRAIN START and STRAIN END must then be adjusted to pick
out the diastolic phase of the cardiac cycle.
• The maximum deformation that is color-coded can be
adjusted using the STRAIN SCALE assignable. If set too low,
most of the wall will show the color indicating maximum
deformation. If set too high, the maximum deformation color
is never reached.
• Strain provides velocity information only in the beam
direction. The apical view typically provides the best
the longitudinal direction of the myocardium (except near
the apex).
141
Tissue Synchronization Imaging (TSI)
TSI overview
1. TSI start/end and TSI Cut-off

2. TSI start and end markers
3. QRS marker
4. TSI color bar
5. Status window
6. Soft menu
Figure 3-18: The TSI mode screen
142
1. Assignable keys:
• Frame rate
• TSI R
• Simultaneous R
1 • Color maps R
MORE
• 2D width
ALT
• Strain rate R
• Strain R
2
PHYSIO + MORE twice
• QRS visible
6 2. Zoom
3. Soft menu:
5 • TSI Cut-off R
• Threshold R
• Transparency R
3 • Frequency
• Power
• Cine compound (Freeze only)
4. Freeze
4 5. TVI
6. 2D
Figure 3-19: The TSI mode controls on the front panel
TSI calculates and color-codes the time from onset of QRS to a

detected event, typically the time to peak systolic velocity.
143
TSI controls
TSI assignable controls
Invert
Invert is available for TEE acquisitions. When applied, the time
to peak negative velocity is calculated (instead of the time to
peak positive velocity). Invert makes it possible to use TSI on
TEE acquisitions where the image sector is inverted.
Frame rate
TSI
Starts/stops TSI.
Simultaneous
TSI color.
Color maps
map.

144
Physio assignable control
Press PHYSIO and MORE twice to access to the following
control.
QRS visible
Shows/hides the QRS marker on the ECG.
TSI Soft menu controls

TSI Cut-off
Controls the cut-off time: using this control it is possible to color
all parts of the TSI image that has a time to peak less than a
certain cutoff time.
Threshold
Transparency
Control the degree of transparency of the TSI color.
Frequency
Power
may become noisier.
145
Using TSI
1. From TVI, Tissue Tracking, Strain or Strain rate mode,
select TSI.
2. Optionally adjust THRESHOLD.
to be examined.
in the bottom right
controls.
TSI markers adjustments

The default TSI markers settings are:
• TSI start: 60 ms from onset of QRS (estimated aortic valve
opening)
• TSI end: estimated End Systole + 200 ms.
The system can be configured to automatically adjust the TSI
start marker to Aortic Valve Opening, providing that this event
is measured. If not measured, the default setting is used
(60 ms).
The system can be configured to automatically adjust the TSI
end marker relatively to the to Aortic Valve Closure (AVC) or
Mitral Valve Opening (MVO) event, providing that these events
are measured. If not measured, the TSI end marker is adjusted
relatively to the estimated End Systole.
The configuration alternatives are:
• TSI start: 60 ms, 80, 100, 120, AVO or Manual control
• TSI end: AVC - 200 ms, AVC - 150 ms, AVC - 100 ms,
AVC - 50 ms, AVC, AVC + 50 ms, AVC + 100 ms,
AVC + 150 ms, AVC + 200 ms, MVO, MVO + 100 ms,
MVO + 160 ms, MVO + 200 ms, MVO + 260 ms or Manual
control.
Note: Manual adjustment of TSI start and TSI end markers
is available in Q Analysis. (Press MORE and adjust
TSI START and TSI END.). To store the modified marker
146
settings, press IMG STORE and choose the configuration
setting Manual control to avoid automatic adjustment of
the markers.
To configure TSI markers:
1. Press CONFIG (F2) and select the category Measure.
2. In the Measure category, select the sheet Advanced.
3. In the Application specific parameters section adjust TSI
start and TSI end parameters by selecting a new value from
the combo menu displayed upon selection.
Optimizing TSI
• Use apical view when imaging.
• Activate TSI from an optimized TVI or Strain rate display.
147
Additional scanning features
LogiqView
LogiqView provides the ability to construct and view a static 2D
image which is wider than the field of view of a given
transducer. This feature allows viewing and measurements of
anatomy that is larger than what would fit in a single image.
LogiqView constructs the extended image from individual
image frames as the operator slides the transducer along the
surface of the skin in the direction of the scan plane. The
quality of the resulting image is somewhat user-dependent and
requires some additional skill and practice to develop proper
technique.
LogiqView is available with linear probes in 2D mode only.
Using LogiqView
1. Perform a detailed examination of the anatomy/pathology.
Optimize parameters for tissue texture and visible window
prior to activating LogiqView.
2. Press the assigned key LOGIQVIEW.
3. To start acquiring the image, press 2D FREEZE key.
Scan slowly and in a uniform motion lengthwise.
• Continuous contact is required throughout the length of
the extended image.
• Always keep the transducer perpendicular to the skin
surface.
• Keep the motion within the same scan plane.
• Do not make abrupt changes in speed of motion.
4. If required, press 2D FREEZE again to restart the acquisition.
5. To complete the scan, press FREEZE.
6. Adjust the assigned rotary LOGIQVIEW ROTATE to rotate the
acquisition.
7. Press IMG STORE.
Compound
Compound is a process of combining two, three (default) or five
frames from different steering angles into a single frame. The
148
combined single image has the benefits of reduced speckle
noise, reduced clutter, and continuity of specular reflectors.
Therefore, this technique can improve contrast resolution.
Compound is available with linear probes in 2D and Color Flow
live modes. Compound is on by default.
Using Compound
1. To toggle Compound on/off, press COMPOUND.
2. To change the number of compounded frames, adjust
Compound frames to two, three or five frames.
B-Flow
B-Flow provides an intuitive representation of non quantitative
hemodynamics in vascular structures. B-Flow enables
visualization of complex hemodynamics and highlights moving
blood and tissue. There are no artifacts such as bleeding,
blooming, or aliasing.
B-Flow is available Color flow mode with linear probes only.
Using B Flow
1. While in Color flow, press the assigned key B-FLOW.
2. Adjust the soft menu control TEXTURE GAIN. Increased gain
enhances hemodynamic.
The greater the speed, the better the image scatter density and
size. If the scan direction is the same as the flow direction, then
the image scatter is elongated; if the scan direction is the
opposite as the flow direction, then the image scatter is tighter.
Therefore, have the scan direction opposite to that of flow
direction. Switch the way you hold the probe, with the probe
orientation marker inferior to maintain correct orientation on the
monitor. Flow starts from where the focal zone is located.
Blood flow imaging

Blood flow imaging (BFI) is a Color flow mode with added
speckle information. The speckle information visualizes the
blood flow direction.
Note: when scanning in BFI triplex mode it is normal to have a
time delay between the Doppler display/Doppler audio and the
BFI color display. 149
Using Blood flow imaging
1. While in Color flow, press the assigned key BFI.
2. Adjust the soft menu control BFI GAIN. Increased gain
enhances hemodynamic.
See page 102 for Color flow image optimization.
150
Chapter 4
Stress Echo
• Introduction ................................................................................... ... 152

• Selection of a stress test protocol template .............................. ... 153
• Image acquisition ......................................................................... ... 155
• Starting acquisition ...................................................................156
• Continuous capture mode .........................................................160
• Analysis ....................................................................................168
• Quantitative TVI Stress echo analysis ........................................ ... 173
• Accessing QTVI Stress analysis tools ......................................175
• Vpeak measurement .................................................................175
• Tissue Tracking ........................................................................179
• Quantitative analysis .................................................................180
• References ...............................................................................180
• Editing/creating a template .......................................................... ... 181
• Entering the Template editor screen .........................................181
• Template editor screen overview ..............................................182
• Editing/Creating a template ......................................................185
151
Introduction
The Vivid 7 ultrasound unit provides an integrated stress echo
package, with the ability to perform image acquisition, review,
image optimization, and wall segment scoring and reporting for
a complete, efficient stress echo examination.
The stress package provides protocol templates for exercise,
as well as, pharmacological stress examinations. In addition to
preset factory protocol templates, templates can be created or
modified to suit users' needs. Users can define various quad
screen review groups, in any order and combination, that will
suit their normal review protocol. When reviewing stress
examination images, the images are viewed at their original
image quality, and different post-processing and zoom factors
may be applied to the images under review for effective image
optimization. The protocol template may be configured for
Continuous capture. In addition to standard wall motion scoring
analysis, the user can perform quantitative stress analysis
based on tissue velocity information (TVI).
A stress echo examination consists of three steps:
• Selection of a stress test protocol template (page 153)
• Image acquisition (page 155)
• Stress analysis (page 168)
• Quantitative Stress analysis (page 173)
152
Selection of a stress test protocol template
1. Press PROTOCOL to enter the stress echo mode.
The Protocol screen is displayed (see Figure 4-1) showing
the default stress protocol for the current probe.
To create or edit a 2. To use the current template:
template see Turn freeze off to initiate scanning.
page 181. To use another template:
Press the assignable TEMPLATE.
The template list is displayed.
3. Trackball to the desired template.
4. Press SELECT.
5. Turn freeze off to initiate scanning using the new template.
153
1. Projection selection
2. Level
3. Current acquisition
4. Projection
5. Group of views
Figure 4-1: The Protocol screen
154
Image acquisition
Images are acquired in a pre-defined order, according to the
selected template. The highlighted cell (green) of the matrix,
displayed in the Clipboard window indicates which view is
currently being acquired (see Figure 4-2). The names of both
the view and the level for the current cell is displayed on the top
corner of the image area and under the template matrix.
1. Current view label

2. Template matrix
3. Current view (Green cell)
4. Timers
Figure 4-2: The stress mode acquisition screen
155
Starting acquisition
To use the Timer, 1. Turn freeze off to initiate scanning.
see page 159.
2. Perform a scan that conforms with the view that is
highlighted in the template matrix on the Clipboard window.
Smart Stress is If the selected template has the option Smart Stress
turned on by de- turned on (see page 184), a subset of the image
fault in factory tem- acquisition settings for each view in the baseline level will
plates.
be stored and automatically reused in the corresponding
views in the next levels.
3. Press STORE.
For further infor- • If the actual stress level is configured to preview
mation on stress cineloop before storing, use the cineloop controls to
test configuration, select the most appropriate heart cycle and, if desired
see page 181.
adjust the loop markers (see ’Cineloop operation’ on
page 58 for further information). Press STORE to save
the selected cineloop.
• If the actual stress level is not configured to preview
cineloop before storing, the system will automatically
store the last cardiac cycle.
When storage of the cineloop is completed, the actual
highlighted cell in the template matrix displays a 2D icon
indicating that the view has been acquired. After storing
the loop, the system automatically highlights the next view
in the matrix to be acquired.
For further infor- Stress levels can be configured for side by side
mation on stress display/comparison of the reference loop from baseline or
test configuration, previous level and the loop to acquire (see Figure 4-3).
see page 181.
4. Repeat previous steps until all required views are
completed.
If using DICOM Server dataflow for stress-echo acquisition,
images should not be saved to permanent archive before the
CAUTION complete protocol exam is acquired.
The template used can be configured so that analysis is

automatically started, displaying the first protocol group. The
wall segment scoring diagrams for each view is displayed in the
Parameters window on the right side of the screen (see
Figure 4-9, page 170).
156
1. Current acquisition loop
2. Corresponding reference loop
Figure 4-3: Display of the Reference loop during acquisition
Protocol Pause function

During the stress acquisition it is possible to temporarily exit the
protocol acquisition mode to acquire images in any mode
outside the stress protocol.
1. To temporarily exit the protocol mode, press:
• MORE and PROTO. PAUSE
OR
• PROT. IN/OUT key on the control panel.
2. Acquire the desired images outside the protocol.
3. Press MORE and PROTO. PAUSE, or PROT. IN/OUT to restart
the protocol acquisition mode and resume the stress
acquisition.
Selecting a view during acquisition

A fixed protocol is provided for scanning, based on the selected
template. The system automatically highlights the next view to 157
be acquired in the template matrix, as images are stored.
However, the order of scanning may be changed manually as
follow:
Manual selection of a view during acquisition
1. Use the arrow keys on the alphanumeric keyboard to
highlight the cell that represents the view that is to be
acquired.
The selected cell in the template matrix is highlighted in
red, indicating non-default position and is blinking if it
contains a previously stored acquisition.
2. Turn freeze off to initiate scanning.
3. Scan and save the selected loop as explained in the
previous section.
After storage the system automatically highlights the next
available view to be acquired.
Replacing an acquired image

1. Use the arrow keys on the alphanumeric keyboard to
highlight the cell that represents the view that is to be
replaced.
The selected cell in the template matrix is highlighted in
red, indicating non-default position.
2. Turn freeze off to initiate scanning.
3. Scan and save the selected loop as explained in the
previous section.
After storage the system automatically highlights the next
available view to be acquired.
Moving an acquired image

An Image can be moved from one cell to another during
acquisition. There are two ways to move images:
Procedure 1
1. When in the Protocol screen, press MORE (assignable
menu).
2. Press the assignable MOVE IMAGES.
3. Trackball to the image to move (source cell).
4. Press SELECT.
5. Trackball to the destination cell.
158
6. Press SELECT.
The image is moved from the source cell to the destination
cell.
Procedure 2
1. In the Protocol screen, trackball to the cell containing the
image to move (source cell).
2. Press and hold down SELECT.
3. With the SELECT key still depressed, trackball to the
destination cell.
4. Release the SELECT key.
The image is moved from the source cell to the destination
cell.
Stored images can- If the destination cell contains an image, the images from the
not be moved. source and destination cells will be exchanged when moving
an acquired image.
Timers
Two timers can be displayed in the Stress mode acquisition
screen, beside the template matrix (see Figure 4-4).
1. Timers display
Figure 4-4: The timers in the acquisition screen
• T1 displays the elapsed time from the start of the stress

examination.
• T2 starts when entering live scanning on the second stress
level
159
Both T1 and T2 timers can be manually stopped and restarted
during the acquisition from the System Menu (Press MENU on
the control panel).
The display of T1 and T2 is user-configurable (see page 181).
Continuous capture mode

Continuous capture mode enables the user to perform
acquisition continuously for all views at any level depending on
the selected template configuration. Continuous capture
consists of temporary saving images acquired in a storage
buffer. To enable best possible use of the limited storage buffer
capacity, a Pause/Capture mode is provided, as opposed to the
normal Freeze/Scan mode. The Pause mode enables scanning
and live display on the screen, without any capture, thereby
leaving the buffer available.
To run Continuous capture, the user has to select a template
where this feature is activated (see page 181 about template
configuration).
The buffer bar

When entering a level with Continuous capture enabled, a
Buffer bar is displayed in the Info window (see Figure 4-5). The
Buffer bar displays the following information:
• The unit's scanning state:
• PAUSE (live scanning without storing)
• CAPTURE (live scanning with storing to buffer)
• The percentage of the buffer that is filled
• The buffer filling progression showed by a green filling
gauge
• The capturing sessions, reflected by the red lines along the
Buffer bar
160
2
3 4 5
1. Scanner's state
2. Capture session
3. Pause session
4. Buffer gauge
5. Percentage of filled buffer
Figure 4-5: The buffer bar in Continuous capture
Controlling the capture process

When entering a stress level with Continuous capture enabled,
the unit is automatically set in Pause mode.
1. Press IMAGE STORE or 2D FREEZE to start image capture.
“Capture” is displayed in the buffer bar, the gauge starts
filling and the percentage of filled memory buffer increases
(see Figure 4-5, page 161).
2. Press IMAGE STORE or 2D FREEZE again to stop capture.
“Pause” is displayed in the buffer bar.
When 90% of the memory buffer is filled up, the text display in
the buffer bar turns red.
161
The unit enters Freeze mode automatically once the buffer is
full and the captured loops are displayed in the Continuous
capture selection screen (see below).
Running Continuous capture

1. Do all your pre-stress acquisitions in the Cardiac
application.
The application Ex- 2. Press PROTOCOL to enter the stress echo mode.
ercise should be The Protocol screen is displayed (see Figure 4-1,
used in order to get page 154).
maximum continu-
ous capture buffer. 3. Press Template.
The template list is displayed.
4. Select the template Exercise 2x4.
The Exercise proto- 5. Press Begin/Cont.
col template is auto-
6. Acquire the resting loops in all four views.
matically selected
when the applica- 7. Once the fourth loop is acquired the system enter into a
tion Exercise is ac- waiting mode where Continuous Capture is in pause state
tive. awaiting the patient to exercise.
8. When the patient is back on the bed, press IMAGE STORE or
2D FREEZE. The Continuous capture acquisition is started.
9. Acquire all your views.
The memory buffer gauge increases (Figure 4-5). When
memory filling exceeds 90%, the percent number turns
red.
10. Press FREEZE to finish.
11. Press the SELECT CYCLE assignable.
The Continuous capture selection screen is displayed (see
If the buffer is filled up the system will automatically display
the Continuous capture selection screen.
Refer to the next section if additional image acquisition is
necessary after the buffer is filled up.
12. Assign the cineloops to the four views (see page 165).
A dialogue window is displayed asking whether the entire
Continuous capture acquisition should be saved or not.
162
Using Store all to 13. Press Delete to discard the loop
save the entire loop OR
may take up to 15 Press Select later if you want to reselect any loops (open
seconds on Loca-
lArch-IntHD and
the capture again from the Protocol screen).
several minutes on OR
LocalArch-MOD. Press Store all to keep the entire loop.
14. Perform Analysis and scoring (see page 168).
Continuous capture with additional image acquisition
If the buffer is filled up before all the image acquisitions are
done, additional loops can be stored in the clipboard before
doing image assignment to the views:
1. Perform Continuous capture as described above (steps 1
to 10).
2. If the buffer is not filled up: press MORE and PROTOCOL
PAUSE, or the PROT. IN/OUT key on the control panel. Live
scanning is activated.
If the buffer is filled up: press Select later in the
Continuous capture selection screen. Live scanning is
activated.
3. Perform the additional acquisition (e.g. CFM, Doppler).
Images will be stored outside the protocol.
4. In order to resume the stress echo exam and assign loops
for the views from the Continuous capture buffer, press
PROTOCOL.
5. Press on the Continuous capture icon on the lower left
corner of the Protocol screen.
The Continuous capture selection screen is displayed.
6. Assign the cineloops to the views (see page 165).
7. Press Delete to discard the loop
OR
Press Store all to keep the entire loop.
The normal procedure is to discard the loop. The loop is
very big and will take a lot of disk space.
163
Postponed image assignment
The assignment of the cineloops to the views can be done on a
later stage on a stored Continuous capture acquisition.
1. Perform Continuous capture as described in ’Running
Continuous capture’ on page 162 (steps 1 to 11).
The continuous 2. Press Store all.
capture loop is very The entire Continuous capture acquisition is stored. The
big, and ending the examination can be ended and the image assignment,
exam may take sev-
eral minutes if stor-
analysis and scoring can be done on a later stage.
ing through a slow 3. Re-open the examination if necessary.
network or storing
4. Press PROTOCOL.
to MOD.
The Protocol screen is displayed.
5. Press on the Continuous capture icon on the lower left
corner of the Protocol screen.
The Continuous capture selection screen is displayed.
6. Assign the cineloops to the views (see page 165).
7. Press Done when finished.
9. When exiting this patient a dialogue window is displayed
asking whether the remaining continuous capture images
should be deleted.
• Press Yes to delete the remaining continuous capture
images
OR
• Press No to keep the entire continuous capture
acquisition.
The normal procedure is to delete the remaining images as
they take a lot of disk space.
Restart capture from the Continuous capture selection
screen
1. Press RESTART CAPTURE.
The recording in memory is deleted and the Continuous
capture is started again.
Resume Continuous capture
1. Press CONTINUE CAPTURE.
Resumes Continuous capture recording (only if the
Continuous capture buffer is not full).
164
Assigning and storing the loops
The cineloops captured in the buffer are assigned to the stress
protocol views and stored from the Continuous capture
selection screen (see Figure 4-6).
1. Rotate CHANGE PAGE assignable to display 4. Red bar: pause session

other pages. 5. Grey gauge: position of the highlighted loop
2. Cycle number and total number of cycles within the buffer area
3. Highlighted loop
Figure 4-6: The Continuous capture selection screen
Assigning a cineloop to a view

1. Trackball to the desired loop in order to assign it to a
particular view of the stress template.
The frame of the loop is highlighted.
2. Press SELECT.
165
A pop-up menu is displayed with the view names of the
template (see Figure 4-7).
The views that are 3. Trackball to the required view name.
already assigned are
4. Press SELECT.
tick marked (see
Figure 4-7). The name of the view is displayed above the timers in the
loop window.
5. Repeat steps Figure 1 through Figure 4 to assign loops to
the other views of the level.
6. Press the assignable DONE when completed.
7. Press Delete to discard the loop
Saving the entire OR
loop takes 5 to 10 Press Store all to keep the entire loop.
seconds on Loca- The normal procedure is to discard the loop. The loop is
lArch-IntHD and
several minutes on
very big and will take a lot of disk space.
LocalArch-MOD.
166
1. Assigned loop
2. Highlighted loop
3. Views pop-up menu
4. Highlighted views
5. Already assigned view
Figure 4-7: Loop assignment in Continuous capture
167
Analysis
Analysis consists of viewing previously saved loops and
assigning scores to each cardiac segment, in order to quantify
the function of the muscle, or wall motion.
Depending on the protocol configuration, the analysis stage
can be started automatically after completion of the stress test
or it can be started manually. In this case, the usual procedure
consists of sequentially opening all image groups (if defined)
and perform scoring from image to image.
The quad screen is the standard display for comparing heart
cycles (Figure 4-9). The heart cycle loops in the display are
synchronized to enable comparison. Each loop in the quad
screen can be magnified, using the zoom control (see
page 67).
Image selection for analysis

Images can be selected manually or from a pre-defined group
in the Protocol screen.
Selection of images from a group
If groups of images have been defined in the protocol template
(see page 187), the user can select a group of images for
analysis and sequentially analyze all images from all groups
from within the analysis screen (see Figure 4-9, page 170).
1. In a stress examination, press PROTOCOL.
A preview of the acquisitions is displayed.
2. Trackball to a group in the Group list.
The frame of the images belonging to the group are
highlighted.
3. Press SELECT to open images in the Analyze screen (see
page 170).
168
1. Select a Projection
2. Select an image
3. Select and open an Image group
Figure 4-8: Image selection from the Protocol screen
Manual selection of images in the Analysis screen

1. When currently in protocol analysis in the Stress analysis
quad screen (Figure 4-9), hold down SHIFT while performing
steps 2 to 4.
2. Trackball to the first image to select in the Template matrix.
3. Press SELECT.
The selected loop is displayed in the Stress analyze
screen and the next window in the quad screen is
automatically selected.
4. Repeat steps 2 and 3 to select other images.
5. Depress SHIFT.
Manual selection of images in the Protocol screen
1. In a stress examination, press PROTOCOL.
A preview of the acquisitions is displayed.
2. Trackball to the first image to select.
3. Press SELECT.
The frame of the selected loop is highlighted.
4. Repeat steps 2 and 3 to select other images. 169
Alternative: Double 5. Press ANALYZE to open images in the Analyze screen (see
click on the last se- page 170).
lected image to open
images. Scoring acquired loops
1. After image selection (see page 168), press ANALYZE.
The Stress Echo Analysis screen is displayed (see
Figure 4-9).
1. Selected loop (highlighted frame) 4. Change page or enter next image group
2. Highlighted segment name 5. Exit Wall motion scoring
3. Wall segment diagrams 6. displayed loops (highlighted frames)
Figure 4-9: The stress echo analysis screen (Quad screen)
To edit a score, se- 2. Trackball to a segment in one of the scoring diagrams and
lect it and choose a press SELECT.
new score. The Score pop-up list is displayed (see Figure 4-10).
3. Trackball to a score.
170
Alternative: Press 4. Press SELECT.
the arrow heads at The score is displayed in the relevant segment area in the
the bottom of the diagram (see Figure 4-10).
scoring diagram
(see Figure 4-9) 5. Repeat steps 1 through 3 to score relevant segments.
6. Rotate the assignable CHANGE PAGE to display next group
of images.
7. Repeat steps 1 through 3 to score relevant segments on the
new loops.
171
1. Selected segment
2. Selected score
1. Scored segment
Figure 4-10: Segment scoring
172
Quantitative TVI Stress echo analysis
QTVI Stress analysis is meant as a guide to wall motion scoring.
WARNING
Diagnosis must not be based on results achieved by QTVI Stress
analysis only.
The Vivid 7 Ultrasound unit provides a Quantitative TVI (QTVI)

Stress analysis package based on Tissue velocity information
(TVI). The TVI data is stored in a combined format with grey
scale imaging during stress examination.
When selecting a template supporting TVI data acquisition, the
ultrasound unit will automatically store TVI information,
generally for the apical views of the stress examination.
The QTVI Stress analysis option currently applies only to
Dobutamine stress-echo.
Wall Motion Scoring remains the basis for the diagnosis of CAD
in stress echocardiography. QTVI Stress may be used as a
guidance tool to check this interpretation.
The current version of QTVI Stress is based on the assessment
of peak velocity at peak Dobutamine stress (see reference 1 on
page 180). The normal ranges have been validated in the
“average” patient presenting for stress testing. The velocity
cutoff values for the Vpeak measurement will not work in the
following cases:
• Submaximal stress (<85% predicted max HR)
• Patients at extremes of age (<40 or >70)
• Previous myocardial infarction / revascularization
• Previous heart-failure / cardiomyopathy / hypertrophy /
arrhythmia / aortic regurgitation
173
Velocity measure- The velocity cutoff values are based on placing the sample
ments in mid and volume at center of each cardiac segment at start of systole,
basal segments of the left ventricle myocardial segments are defined by the
the myocard will
contain contribu-
American Society of Echocardiography 16 segments model.
tions from the api- However, the velocity cutoff model does not cover the apical
cal region of the segments (due to low velocities and segment orientation), (see
myocard. E.g. if side note).
measured value in a
mid segment is be- Tissue Doppler does not have perfect site-specificity because
low the cutoff value of tethering by adjacent segments. Thus, although an ischemic
for this segment segment has little thickening (and therefore could be expected
then this might re-
to show low velocity), measured velocity may be influenced by
late to a reduced
function in the mid local tethering, reflecting contraction in surrounding segments.
or apical region. Conversely, a normal segment may have its velocity reduced
by an adjacent segment with reduced velocity. This tethering
effect may decrease the sensitivity for single vessel disease,
but nonetheless the sensitivity and specificity of the cut-offs are
approximately 80% (see reference 1 on page 180).
Three different analysis tools based on TVI data are available:
• ’Vpeak measurement’ on page 175, enables the display
of a tissue velocity trace for a selected region of a
previously scored segment through the entire heart cycle.
In addition Vpeak is color-coded on the 2D image. From the
velocity trace, the user can estimate the peak systolic
velocity (see reference 1 on page 180).
This tool is available in views from peak levels only and
only when a segment has been scored in one of these
views.
• ’Tissue Tracking’ on page 179, enables visualization of
the systolic contraction of the heart by color-coding the
myocardial displacement through the systole.
• ’Quantitative analysis’ on page 180, enables further
quantitative analysis based on multiple tissue velocity
traces.
The quantitative analysis is described in Chapter 7,
’Quantitative Analysis’ on page 304.
174
Accessing QTVI Stress analysis tools
The three QTVI Stress analysis tools are entered by pressing a
dedicated button on the scoring diagram (see Figure 4-11) of
the selected view. Only views with TVI data acquired will
display QTVI Stress tools buttons on the respective diagrams.
1. Vpeak measurement (V-peak measurement is 2. Tissue Tracking

displayed in views from peak levels and only 3. Quantitative analysis
after scoring.)
Figure 4-11: QTVI Stress tools buttons
Vpeak measurement
This tool enables the user to generate a tissue velocity profile
for a given wall segment through the entire heart cycle and
display color-coded Vpeak in tissue.
From the velocity trace, the user can determine whether the
systolic Vpeak is over or under a clinically determined velocity
threshold (see reference 1 on page 180) to confirm the wall
motion scoring.
QTVI Stress can be used only in conjunction with wall motion
scoring analysis, as a guiding tool.
CAUTION
When activating QTVI Stress, the measurement applies only to
the currently highlighted segment for the current level and
projection view. 175
To display a Vpeak measurement
1. Perform segment scoring as described on page 170.
When performing scoring i a view from a peak level, the
Vpeak measurement button (V) is displayed in the
corresponding diagram.
2. In the Scoring diagram, press V.
The trackball cursor is changed to sampling area and the
scored peak views are updated showing:
• A diagram with the current segment highlighted (scoring
bullet with a ring) and the segment's velocity cutoff (see
Figure 4-12).
See page 178 for • Color-coded velocity in tissue. The color-coding
further information convention is as follow:
on Vpeak measure-
ment interpreta- - Green: Velocities above threshold value + 5%
tion. - Yellow: Velocities near threshold (+/- 5% interval)
- White: Velocities below threshold value - 5%
• A result window to display tissue velocity profile, shown
when moving the sampling area in the view.
3. In the 2D sector, trackball the sampling point over the wall
area corresponding to the current segment (shown as the
highlighted segment in the diagram).
A tissue velocity profile for the actual segment is generated
in the Result window (see Figure 4-12).
4. Use SEGMENT SELECT assignable to analyze the other
segments in the peak view,
Or
Select another scoring bullet in the diagram in one of the
peak views.
Turn-off the Vpeak measurement tool

1. Trackball to one of the V button in the peak view scoring
diagrams.
2. press SELECT in the trackball area.
176
1. Threshold for current segment (green) 5. Color-coded tissue velocity:
2. Sampling point 6. Result window with tissue velocity profile
3. Current segment
4. Vpeak threshold for current segment
Color-coding (velocity thresholds and tissue):

• Green: velocities above threshold value
• Yellow: velocities near threshold (0 to -10% interval)
• White: velocities below threshold value - 10%
Figure 4-12: Vpeak QTVI Stress display
177
V-peak measurement interpretation
The systolic Vpeak in the tissue velocity profile is automatically
detected and highlighted by a vertical bar (see Figure 4-12).
The automatically detected Vpeak should be visually verified by
the user. In addition Vpeak thresholds are displayed as
color-coded horizontal lines (see Figure 4-12). These
thresholds represent statistical guideline values for peak
velocity at peak stress level (Dobutamine stress procedure) for
the three apical views. Only threshold values for basal and
mid-segments for each apical view are defined (see reference
1 on page 180). The result is highlighted by a color-coding of
the thresholds lines, the color-coding in the 2D image and the
scoring bullet (see Figure 4-12).
178
Tissue Tracking
Tissue Tracking calculates and color-codes the displacement in
tissue over a given time interval. The displacement is found as
the time integral (sum) of the tissue velocities during the given
time interval. The color-coded displacements calculated in the
myocardium are displayed as color overlay in the respective
acquisition window.
By studying the color patterns generated in the different
segments, the user can confirm the standard segmental wall
motion scoring at peak levels.
To display Tissue Tracking

1. Trackball to a loop with TVI data (usually an apical view at
peak level).
2. Press SELECT on the control panel.
3. Trackball to the corresponding Wall segment diagram.
4. Press T on the Wall segment diagram field (see
The Tissue Tracking color overlay is displayed in the
Acquisition window.
Figure 4-13: Tissue Tracking display
179
Quantitative analysis
Quantitative analysis enables further analysis based on
multiple tissue velocity traces. Quantitative analysis is
performed using the Quantitative analysis package described
in Chapter 7, ’Quantitative Analysis’ on page 304.
To start quantitative analysis

1. Trackball to a loop with TVI data (usually an apical view at
peak level).
3. Trackball to the corresponding Wall segment diagram.
4. Press Q on the Wall segment diagram field to launch the
Quantitative analysis package (see page 304).
References
1. Application of Tissue Doppler to Interpretation of
Dubotamine Echocardiography and Comparison With
Quantitative Coronary Angiography. Cain P, Baglin T,
Case C, Spicer D, Short L. and Marwick T H. Am. J. Cardiol.
2001; 87: 525-531
180
Editing/creating a template
The stress package provides protocol templates for exercise as
well as pharmacological stress examinations. The user can
create new templates or modify existing templates to suit the
individual needs. Up to ten projections and fourteen stress
levels can be created in a template.
Templates created may be temporary, used only during the
current examination, or saved as new templates, for future use
and reference. The editions that may be performed include:
• Adding/deleting levels and projections, page 185
• Assigning new labels to levels and projections, page 186
• Defining level options, page 186
• Defining new groups, page 187
Templates are edited/created from the Template editor screen.
Entering the Template editor screen

1. Press PROTOCOL to enter the stress echo mode.
2. Press the assignable TEMPLATE.
The Template pop-up menu is displayed.
3. Trackball to Template Editor.
4. Press SELECT.
The Template editor screen is displayed (see Figure 4-14).
181
Template editor screen overview
Figure 4-14: The Template editor screen
Template
Parameter Description
Template:
• select a pre-defined template from the
pop-up menu. The Protocol template
preview (see below) is updated
accordingly.
182
Protocol template preview
Protocol template preview:

• displays an updated preview of the
template accordingly to the settings
applied.
• To change Projection and Stress level
labels, select a pre-defined label from the
pop-up menu or press SELECT in the actual
label field and type a new name.
Q Stress acquisition: enables TVI data
acquisition for QTVI Stress analysis.
Template settings
Template settings:
• Cycles: select the number of cineloop
heart cycles to store for each level from the
drop-down menu.
• Continuous capture:
: enables continuous image acquisition
throughout the level. The images acquired
are temporarily stored in the unit's storage
buffer.
• Preview of store:
: enables review and adjustment of
cineloops before storage (see page 345 for
further information).
• Show reference:
: displays a dual screen with the
reference level (first or previous level) on
the left and the live image on the right.
183
Other options
Grid size:
• Enter the number of levels and projections
for the selected template.
Timers:
• : starts T1 and T2 timers automatically

Auto-start analysis:
• : displays the Stress Echo Analysis

screen when the last acquisition is
performed.
Smart Stress:
• : stores a subset of the image

acquisition settings (geometry incl. zoom,
gain, compress, reject, power...etc) for
each view in the protocol. Smart Stress
enables to set image acquisition settings
for each view at baseline level and
automatically get the same image settings
in the corresponding views in the next
levels.
In Continuous capture acquisition at peak
stress, the active cell must be moved
manually through the views using the arrow
buttons (or foot pedal).
Reference image:
• When Show Reference is selected (see
page 183), selects either corresponding
baseline loop or corresponding loop from
the previous level to be displayed as
reference image during acquisition.
184
Pre-defined groups
Pre-defined groups:
• Shows the image groups created.
• New group: creates a new image group.
Select the desired images on the template
preview (see page 187).
• Update group: edits a selected group after
new loop selection on the template preview
(see page 187).
• Delete group: deletes selected group (see
page 187).
Editing/Creating a template
Selecting a base template to edit
1. Trackball to the Template pop-up menu on the upper left
corner of the Template editor screen.
2. Press SELECT on the arrow.
Determine the re- 3. Trackball to the base template to edit.
quired number of
4. Press SELECT.
projections and lev-
els you need and se- The selected template is displayed in the Protocol
lect the most template preview field, showing the levels and projections
appropriate founda- and their labels.
tion template.
Adding/deleting levels and projections
1. Enter the number of levels and projections in the Grid size
field (see Figure 4-14).
The new grid size is displayed in the Protocol template
preview field.
2. Press New Template to create a new template. 185
Or
Press Save Template to update the base template.
The timers can also Display timer(s)
be started or
stopped at any time
1. Check the box(es) to display timer(s) as specified (see
during stress exam- Figure 4-14).
ination using the
assignables T1 and Start analysis automatically
T2 on the control 1. Check Auto start analysis to display the Stress Echo
panel.
Analysis screen when the last acquisition is performed.
Assigning new labels to levels and projections

1. In the Protocol template preview field, Trackball to the Label
field that is to be changed.
2. Select the Label pop-up menu and press SELECT on the
desired pre-defined label.
Or
• If the Label field is empty:
Press SELECT and enter the label or projection name.
• If the Label field has a name to be changed:
Press SELECT twice (double-click) to highlight the text to
be replaced and enter the new label or projection name.
Configuring levels
The following options can be set up for each level:
Number of cycles to be stored in the cineloop:
1. Enter the desired number in the Cycles field.
Up to four cycles/cineloop can be stored.
Continuous capture
1. Check Continuous capture if continuous image
acquisition throughout the level is desired.
When Continuous capture is selected, preview of cineloop
and reference display (see below) during acquisition are
not possible.
Preview of store
1. Check Preview of store if review and adjustment of
cineloops before storage is desired.
Show reference
1. Check Show reference if the display of the corresponding 186
reference loop is desired during acquisition (dual screen
mode).
Adding a group
1. In the Protocol template preview field select the cells to be
part of the group.
2. In the Pre-defined group field, press New group.
A dialogue box is displayed asking the user to enter a
name for the new group.
3. Enter the group name.
4. Press OK.
The new group is displayed in the Pre-defined group field.
Updating an existing group

A selected group is 1. In the Pre-defined group field, select the group to edit.
highlighted by a The selected cell are highlighted in the Protocol template
yellow frame. preview field.
2. Either select (a) new cell(s) to add to the group or deselect
(an) existing cell(s) to remove from the group.
3. Press Update group in the Pre-defined group field.
The display in the Protocol template preview field is
updated accordingly.
Deleting a group
A selected group is 1. In the Pre-defined group field, select the group to delete.
highlighted by a
2. Press Delete group.
yellow frame.
The group is removed from the list in the Pre-defined
group field.
187
Chapter 5
Contrast Imaging
• Introduction ................................................................................... ... 189

• Data acquisition ........................................................................189
• Quantification ............................................................................190
• Data acquisition ............................................................................ ... 192
• Left Ventricular Contrast Imaging .............................................192
• Myocardial Contrast Imaging ....................................................197
• Real-Time Coded Phase Inversion (RTCPI) .............................205
• Vascular Contrast Imaging .......................................................213
• Abdominal Contrast Imaging ....................................................217
• Rodent Contrast Imaging ..........................................................221
188
Introduction
The two basic steps of contrast imaging are data acquisition
and quantification. Data acquisition is described in this chapter.
Quantification is described in Chapter 7, ’Quantitative Analysis’
on page 304.
Data acquisition
Appropriate training
WARNING
Only physicians or echo technicians who have received
appropriate training can use the Contrast applications.
Always read and follow carefully the manufacturer instructions

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

commercially available contrast agents. Because the
availability of these agents is subject to government regulation
and approval, product features intended for use with these
agents may not be commercially marketed nor made available
before the contrast agent is approved for use. Advanced
contrast features are only enabled on systems for delivery in
countries or regions where the agents are approved for use or
for investigational or research use.
Cardiac imaging
Three main contrast acquisition applications are available for
cardiac imaging:
• Left Ventricular Contrast imaging: The LV Contrast and
LVO Stress applications are optimized for endocardial
border detection and assessment of wall motion and wall
thickening. LVO Stress is optimized for higher heart rate.
Both applications require the LVO Contrast option enabled.
• Myocardial Contrast imaging: optimized for assessment
of myocardial perfusion. The MC Contrast application is
pre-configured to give access to high power settings of the
Coded Harmonic Angio technique, which combines the
strength of harmonic imaging and power Doppler. MC
Contrast application shall be used in intermittent mode. The
189
application is intended for clinical research and requires the
Advanced Contrast option enabled.
• Real-time Coded Phase Inversion (RTCPI): is intended
for visualization of myocardial perfusion by the use of
ultrasound contrast agents. As opposed to MC Contrast,
RTCPI will perform myocardial contrast imaging in a
non-triggered mode. The application is intended for clinical
research and requires the Advanced Contrast option
enabled.
MC Contrast and RTCPI applications are for research purposes

only. Diagnosis must not be based on results achieved by
WARNING contrast analysis alone.
Non-cardiac imaging
The following non-cardiac contrast acquisition applications are
available.
• Abdominal Contrast imaging: optimized to visualize
contrast in non-beating organs, e.g. liver and kidneys.
Requires the Vascular/Abdominal Contrast option enabled.
• Vascular Contrast imaging: optimized to visualize
contrast in larger vessels, e.g. carotid artery. Requires the
Vascular/Abdominal Contrast option enabled.
• Rodent Contrast imaging: optimized to visualize contrast
in rodents, e.g. rat heart or rat liver. This application is
intended for pre-clinical research only. Requires the
Advanced Contrast option enabled.
Abdominal and Vascular Contrast applications are for research

purposes only. Diagnosis must not be based on results achieved
WARNING by contrast analysis alone.
Quantification
Refer to Chapter 7, Quantification enables the user to perform the following
’Quantitative analysis:
Analysis’ on
page 304. • Time-Intensity analysis: allows instant time-intensity
calculation from up to eight regions of interest (Angio power
or tissue intensity display).
• Curve fitting analysis: for research studies of myocardial
190
perfusion rates using contrast agents.
• Arbitrary Anatomical M-Mode (Curved and Straight):
M-Mode applied to intensity data calculates and
color-codes tissue and Angio intensity along a path drawn
by the operator vs. time.
Misdiagnosis based on image artifacts
WARNING
Misdiagnosis in ultrasound contrast images may be caused by
several artifacts, most importantly:
Motion artifacts: gives rise to signals independently of contrast
presence. This may be caused by patient movement; including
respiration, or by probe movement influenced by the operator.
Regional drop outs: caused by unintentional destruction of the
contrast agent, too low concentration of contrast agent, poor
acoustic penetration due to rib/lung shadows or system failing to
detect the contrast agent due to erroneous settings induced by
the operator.
Tissue harmonics: gives contrast-like signals independently of
the presence of contrast agent.
The field of myocardial perfusion using contrast agents is still a
research field. The myocardial applications RTCPI and MC
Contrast are research tools for the development of this field.
Default machine settings are set to minimize the amount these
artifacts, but the operator has to take these artifacts into account
while analyzing the data and confirm the results using other
techniques.
191
Data acquisition
Left Ventricular Contrast Imaging
The Left Ventricular (LV) Contrast application has an optimized
system preset for optimal resolution of endocardial borders and
for optimal assessment of wall motion and wall thickening.
The LV Contrast application may help to identify LV thrombus
and evaluate wall motion.
LV Contrast overview
1. Status window
2. Soft menu
Figure 5-1: The LV Contrast acquisition screen
192
4
1
3
2
1. Application 5. Soft menu

2. Probe • Power
• Compress R
3. Gain R
• Reject R
4. Assignable keys: • DDP R
• Width
• Dynamic Range
• Frequency
• Tilt
• Focus • Edge Enhance
• Frame rate
• Diff On/Off
• Up/Down R
• Left/Right R
• T1
• B color maps R
MORE menu
• T2
Figure 5-2: The LV Contrast controls on the front panel
193
LV Contrast controls
LV Contrast assignable controls
Width
Controls the size and angular width of the image sector. A
smaller angle generally produces a scan with a higher frame
rate.
Frequency
Enables the adjustment of the probe's operating frequency. A
higher frequency gives better resolution. Frequency is also
used to switch between Octave (single-pulse) and CPI
(multi-pulse).
Focus
Changes the location of the focal point. A triangular marker on
the depth scale along the image sector indicates the position of
the focal point.
Two triangular markers pointing towards each other (><)
indicate that Coded Phase Inversion (CPI) is being used. CPI is
a multi-pulse technique with focus at the indicated depth.
Frame rate
Lower frame rate Controls the line density.
gives better resolu-
tion. Up/Down
Enables the 2D image to be flipped 180 degrees.
Left/Right
Enables the display of a mirrored image. When applied, the
reference marker V moves to the other side of the image.
T1/T2 (Timers)
Contrast timer: press T1 once to start the timer, press again to
stop the timer. A second timer (T2) is available from the More
menu.
B Color maps
Displays a 2D maps menu to optimize the grey scale
non-linear grey-curves or different 2D-colorized curves to be
selected.
194
LV Contrast Soft menu controls
Power
Too high Power lev- Controls the amount of acoustic power applied to the
el will destroy the transmitted pulse.
contrast agent.
Compress
Controls the degree of image contrast.
Reject
Controls the Echo rejection level. When increased, low level
echoes are rejected and appear darker in the 2D image.
DDP (Data Dependant Processing)
Performs temporal processing, which reduces random noise
without affecting the motion of significant tissue structures.
Dynamic Range
Controls the image contrast. A high dynamic range setting
gives a softer image.
Tilt
Enables the axis of the 2D image to be tilted to the left or to the
right. By default the axis of the 2D image is vertical.
Edge Enhance
Controls the image processing related to the extent of edge
enhancement applied.
The Diff control de- Diff on/off
creases the frame
rate and the number
Affects the level of reverberation in the image. The
of focal zones when reverberation in the image is reduced when Diff control is
turned on. turned on.
195
Running LV Contrast
The LV Contrast application works with the M3S, 3S, M4S, 5S,
3V and 6T probes.
To select LV Con- 1. Press PROBE on the control panel.
trast application A list of the connected probes is displayed.
without changing
the current probe, 2. Trackball to the desired probe supporting the LV Contrast
press APPL. on the application.
control panel. The Application menu for the selected probe is listed.
3. Trackball to LV Contrast application.
4. Press SELECT to launch the application.
5. Perform the acquisition.
Always read and follow carefully the manufacturer instructions
on the contrast agent label.
WARNING
Optimizing LV Contrast
The default setting for the LV contrast application is optimized
for contrast detection and not tissue imaging. Therefore, with
some patients it may be difficult to orient the probe before the
contrast agent arrives. In this case we recommend to stay in
the Cardiac application until the contrast agent is observed in
the right ventricle and quickly switch to the LV Contrast or LVO
Stress application.
If a swirling pattern is observed and persists after the LV cavity
has been filled with contrast, the power should be reduced until
homogenous opacification is obtained.
Too high Power setting will destroy the contrast agent in the LV
cavity.
CAUTION
196
Myocardial Contrast Imaging
The main goal of the Myocardial (MC) Contrast application is in
the assessment of myocardial perfusion.
This application is intended for clinical research only. Diagnosis
must not be based on results achieved by contrast analysis
WARNING alone.
This application may not be available on your system. Contrast

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

Contrast option enabled.
The MC Contrast application is pre-configured to give access
to high power settings of the Coded Harmonic Angio technique,
which combines the strength of harmonic imaging and power
Doppler. MC Contrast application shall be used in intermittent
mode.
197
MC imaging overview
1. Status window
2. Soft menu
Figure 5-3: The MC Contrast acquisition screen
198
4
1
3
2
1. Application 5. Soft menu 2D Live:

2. Probe • Tilt
3. Gain R • Power
• Sample volume
4. Assignable keys:
• Frame rate
• 2D Width
• Color threshold R
• ECG Trig 1 • PRF
• Dual Trig Delay
• Low velocity reject
• ECG Trig interval
• Radial average
• Simultaneous R • Lateral average
• ECG Trig
6. Trackball
• Dual Trig
• ROI position
• T1 • ROI size
• Color maps R
• Cineloop (in Freeze)
MORE menu
• Frequency
• Focus
• T2
Figure 5-4: The MC Contrast controls on the front panel

199
MC Contrast controls
MC Contrast assignable controls
2D Width
Changes the width of the tissue sector while in Angio. This
control may be used to control the frame rate. A narrow sector
sector produces a scan with higher frame rate. The color sector
width is adjusted with the trackball (see description below).
ECG Trig 1
Specifies the delay (ms) from R-wave to the triggered frame.
Dual Trig Delay
Specifies the delay (ms) from the first triggered frame (ECG
Trig 1) to the second triggered frame. Only active when Dual
Trig is turned on.
ECG Trig Interval
Controls the number of cardiac cycles between triggered
images.
Simultaneous
Enables simultaneous display of 2D B-mode and 2D Angio
Color mode.
ECG Trig
Dual Trig
Enables intermittent imaging with two ECG triggered frames
(primary and secondary). In this mode the scanner also
activates a dual display, where the primary frames are
displayed on the left side, whereas all frames (both primary and
secondary) are displayed on the right side.
T1/T2 (Timers)
menu.
Color Maps
Displays a Color map menu to optimized the color
presentation. 200
Horizontal sweep
Adjusts the refresh on the ECG.
Frequency
higher frequency gives better resolution.
Focus
the focal point.
MC Contrast Soft menu controls (2D Angio mode)
Tilt
Power
Controls the amount of acoustic power applied to the
transmitted pulse.
Color threshold
Too high a Power Controls the level of greyscale intensity that is used as a
level will destroy threshold for color overlay.
the contrast agent.
PRF (Pulse Repetition Frequency)
acquire the data for color mapping.
Lower frame rates Frame rate
give better resolu-
tion.
Controls the line density.
Low Velocity Reject
Controls the extend of low velocity removal.
Sample volume
Controls the size of the color angio area. Adjustment of the
Sample volume may affect the PRF setting.
Radial Averaging
Smooths the image by averaging the data collected along the
same radial line.
201
Lateral Averaging
Smooths the image by averaging data collected along the
same lateral line. An increase of the lateral averaging will
reduce noise, but will also reduce the lateral resolution.
Trackball controls
ROI (Region Of Interest) size
When the trackball command Size is selected (see also
’Trackball operation’ on page 57), the height and width of the
color area is adjusted by rolling the trackball (up/down,
right/left).
ROI (Region Of Interest) position
When the trackball command Pos (position) is selected (see
also ’Trackball operation’ on page 57), the position of the color
area is adjusted by rolling the trackball.
202
Running MC Contrast
The MC Contrast application works with the M3S, 3S, M4S and
5S probes.
To select MC Con- 1. Press PROBE on the control panel.
trast application A list of the connected probes is displayed.
without changing
the current probe, 2. Trackball to the desired probe supporting the MC Contrast
press APPL. on the application.
control panel. The Application menu for the selected probe is listed.
3. Trackball to MC Contrast application.
5. Press COLOR to start color angio.
6. Press the assignable ECG TRIG.
7. Adjust the assignable TRIG 1.
The delay (ms) is displayed in the Status window (see
Premature ventricular contractions (PVC's) have been reported
in patients with the combination of end-systolic high MI triggered
WARNING ultrasound and a contrast agent. Precautionary actions are built
into the system, not allowing MI above 1.0 for contrast imaging.
However, caution should be taken in this situation.
Literature: Van der Wouw P.A., Brauns A.C., Bailey S.E., Powers
J.E., Wilde A.A.A. “Premature ventricular contractions during
triggered imaging with ultrasound contrast” J. Am. Soc.
Echocardiography, 13 (4), pp. 288-294, 2000
8. Adjust the assignable ECG TRIG INTERVAL.

The number of heart cycles between the frame acquisition
is displayed in the MC Contrast Status window under
Trigger (Every (HB)).
9. Adjust ACTIVE GAIN from the Control Panel.
10. If desired, press the SIMULTANEOUS assignable to prompt a
dual screen for side by side display of 2D B-mode and 2D
Angio mode.
11. Press DUAL TRIG if dual triggering is desired, and adjust
DUAL TRIG DELAY.
12. Acquire the baseline images.
13. Press IMAGE STORE to save the baseline acquisition.
203
The contrast solu- 14. Prepare the Contrast agent as described by the
tion should be pre- manufacturer.
pared just before
injection. 15. Administrate the Contrast agent.
16. Acquire the contrast images.
17. Press FREEZE.
18. Press CINELOOP.
See also page 58 19. Adjust LEFT MARKER and RIGHT MARKER to define the
about cineloop oper- cineloop to transfer.
ation.
20. Press IMAGE STORE to save the contrast acquisition.
Optimizing MC Contrast
• A good baseline image is the key for successful myocardial
contrast imaging. Using Coded Harmonic Angio, no colors
should be found in the myocardium at baseline.
• The ECG triggering position should be adjusted to avoid
wall motion artifacts.
• At rest a triggering interval from 1:3 to 1:5 should be used
to allow for adequate contrast filling in normal regions. At
peak stress a triggering interval of 1:1 is recommended.
• If there is poor contrast in a particular region adjust the
focus to this depth.
• If there is too much filling or blooming, decrease the
contrast dose or concentration (if attenuation appears) or
decrease the sample volume size.
• In dual triggering, minimum distance between the primary
and the secondary frame is given by 1/(frame rate). To get
the secondary frame closer to the primary frame, increase
frame rate by reducing the 2D width.
204
Real-Time Coded Phase Inversion
(RTCPI)
RTCPI is intended for visualization of myocardial perfusion by
use of ultrasound contrast agents. As opposed to MC Contrast,
RTCPI performs myocardial contrast imaging in a non-triggered
mode.
WARNING alone.

Note: the RTCPI application requires the Advanced Contrast

option enabled.
205
RTCPI overview
1. Status window
2. Soft menu
Figure 5-5: The RTCPI Contrast acquisition screen
206
4
1
3
2
1. Application 5. Soft menu:

2. Probe • Power
3. Gain R • Frame rate
• Compress R
4. Assignable keys:
• Reject R
• Width
• DDP R
• Frequency • Dynamic Range
• Focus
• Tilt
• Flash frames
6. Trackball
• Flash
• ECG Trig
• T1
• B color maps R
MORE menu
• Flash gain
• Flash power
• Up/Down R
• Left/Right R
• T2
Figure 5-6: The RTCPI controls on the front panel
207
RTCPI controls
RTCPI assignable controls
Width
Controls the size and angular width of the image sector. A
smaller angle generally produces a scan with a higher frame
rate.
Frequency
higher frequency gives better resolution. A lower frequency
gives better penetration and contrast detection. Frequency is
also used to switch between Octave (single-pulse) and CPI
(multi-pulse).
Focus
the focal point.
Two triangular markers pointing towards each other (><)
indicate that Coded Phase Inversion (CPI) is being used. CPI is
a multi-pulse technique with focus at the indicated depth.
Flash
Enables the transmission of a pulse with the maximum allowed
power over a given time. The purpose of the Flash function is to
destroy all contrast agent in the scan plane to create an
“artificial” baseline image. The actual MI during Flash is
displayed in the Status bar at the bottom of the screen.
Flash frames
Controls the length of the Flash specified in number of frames.
The duration of the Flash depends on the actual frame rate.
ECG Trig
T1/T2 (Timers)
menu.
208
B Color maps
Displays a 2D maps menu to optimize the grey scale
non-linear grey-curves or different 2D-colorized curves to be
selected.
Up/Down
Enables the 2D image to be flipped 180 degrees.
Left/Right
Enables the display of a mirrored image. When applied, the
reference marker V moves to the other side of the image.
Flash gain
Controls the (receive) gain of the Flash separately.
Flash power
Controls the power (amplitude) of the Flash. The maximum
allowed power is default.
RTCPI Soft menu controls
Power
Too high a Power Controls the amount of acoustic power applied to the
level will destroy transmitted pulse.
the contrast agent.
Frame rate
Lower frame rates Controls the line density.
give better resolu-
tion. Compress
Controls the degree of image contrast.
Reject
Controls the Echo rejection level. When increased, low level
echoes are rejected and appear darker in the 2D image.
DDP (Data Dependant Processing)
Performs temporal processing, which reduces random noise
Dynamic Range
Controls the image contrast. A high dynamic range setting
gives a softer image.
209
Tilt
210
Running RTCPI
The RTCPI application works with the M3S and M4S probes.
To select RTCPI ap- 1. Press PROBE on the control panel.
plication without A list of the connected probes is displayed.
changing the cur-
rent probe, press 2. Trackball to the desired probe supporting the RTCPI
APPL. on the control application.
panel. The Application menu for the selected probe is listed.
3. Trackball to Real Time CPI application.
5. Adjust the ACTIVE GAIN from the Control Panel.
6. Acquire the baseline images.
7. Press STORE to save the baseline acquisition.
The contrast solu- 8. Prepare and administer the contrast agent as described by
tion should be pre- the manufacturer.
pared just before
injection. 9. Press FLASH when the contrast agent has reached a stable
level (infusion) or just after peak (bolus injection).
The contrast agent is destroyed in the myocardium.
10. Wait approximately ten heartbeats observing contrast
wash-in.
11. Press FREEZE.
12. Press CINELOOP.
Note: the application can be preset to automatically save
N cardiac cycles in Config (F2)/Imaging/application.
See also page 58 13. Adjust CYCLE SELECT and NUMBER OF CYCLES to define the
about cineloop oper- cineloop to transfer.
ation.
Storage of real time 14. Press STORE to save the contrast acquisition.
data takes consider-
able space digitally.
Be aware of this
when selecting
more than one
cineloop for storage.
211
Optimizing RTCPI
RTCPI is by default scanning in low power mode to avoid
destruction of slow moving contrast in the myocardium. This
setting is required for real time contrast imaging, but is
sub-optimal for tissue imaging.
• To obtain good baseline images, the power may be
increased prior to contrast injection, but must be reset to its
default value before contrast injection or infusion to avoid
destruction of the contrast agent.
• If the patient is difficult to image, the power may be slightly
increased to get sufficient signal from the contrast agent.
212
Vascular Contrast Imaging
Vascular Contrast is intended for visualization of ultrasound
contrast agents in large vessels (e.g. carotid artery and femoral
artery).
The Vascular Contrast application works with the 7L, 10L and
M12L probes. Probes with lower frequency gives better
contrast detection.
The application uses Coded Phase Inversion (CPI) (greyscale)
to maximize the contrast detection and visualization.
WARNING alone.

Note: The Vascular Contrast application requires the

213
Vascular Contrast overview
1. Status window
2. Soft menu
Figure 5-7: The Vascular Contrast acquisition screen
214
4
1
3
2

2. Probe • Power
3. Gain R • Dynamic Range R
• Reject R
4. Assignable keys:
• Persistence R
• Width
• Speckle reduction R
• Frequency • Edge Enhance
• Focus
6. Trackball
• Flash frames
• Logiq View
• Flash
• PRF
• T1
• B color maps R
MORE menu
• Flash gain
• Flash power
• Up/Down R
• Left/Right R
• T2
Figure 5-8: The Vascular Contrast controls on the front panel

215
Vascular Contrast controls
Vascular Contrast assignable controls
The Vascular contrast assignable controls are similar to the
RTCPI controls. See ’RTCPI assignable controls’ on page 208
for more information on each controls.
Vascular Contrast Soft menu controls
Power, Dynamic Range and Reject
See ’RTCPI Soft menu controls’ on page 209 for more
information about these controls.
Persistence
Enables the adjustment of color images, so that the current
frame retains some color information from previous frames, in
order to minimize noise.
Speckle Reduction
See ’UD Clarity’ on page 94 for more information.
Edge Enhance
See ’Edge Enhance’ on page 195 for more information.
216
Abdominal Contrast Imaging
Abdominal Contrast is intended for visualization of ultrasound
contrast agents in abdominal organs (e.g. liver or kidney).
The Abdominal Contrast application works with the 3.5C and
4C probes.
WARNING alone.

Note: The Abdominal Contrast application requires the

217
Abdominal Contrast overview
1. Status window
2. Soft menu
Figure 5-9: The Abdominal Contrast acquisition screen
218
4
1
3
2

2. Probe • Power
3. Gain R • Dynamic Range R
• Reject R
4. Assignable keys:
• Persistence R
• Width
• Speckle reduction R
• Frequency • Edge Enhance
• Focus
6. Trackball
• Flash frames
• Flash
• ECG Trig
• T1
• B color maps R
MORE menu
• Flash gain
• Flash power
• Up/Down R
• Left/Right R
• T2
Figure 5-10: The Abdominal Contrast controls on the front panel
219
Abdominal Contrast controls
Abdominal Contrast assignable controls
The Abdominal contrast assignable controls are similar to the
RTCPI controls. See ’RTCPI assignable controls’ on page 208
for more information on each control.
Abdominal Contrast Soft menu controls
The Abdominal contrast assignable controls are similar to the
RTMC controls. See ’RTCPI Soft menu controls’ on page 209
for more information on each control.
220
Rodent Contrast Imaging
Rodent Contrast Imaging is intended for visualization of
ultrasound contrast agents in rodents (e.g. rat heart or rat liver).
The Rodent Contrast application works with the i13L probe.
This application is intended for pre-clinical research only.
WARNING
Note: the Rodent Contrast application requires the Advanced

Contrast option enabled.
221
Chapter 6
Measurement and Analysis
• Introduction ................................................................................... ... 224

• About Measurement results display ..........................................224
• The Assign and Measure modality ............................................. ... 226
• Starting the Assign and Measure modality ...............................226
• Entering a study and performing measurements ......................228
• Measure and Assign modality ..................................................... ... 230
• Starting the Measure and Assign modality ...............................230
• Post-measurement assignment labels ......................................231
• Cardiac Measurements ................................................................ ... 234
• 2D Measurements ....................................................................234
• M-Mode Measurements ............................................................238
• Doppler Measurements ............................................................242
• TSI Measurements ...................................................................245
• Automated Function Imaging ....................................................251
• Vascular measurements .............................................................. ... 269
• B-Mode measurements ............................................................269
• M-Mode Measurements ............................................................273
• Doppler measurements ............................................................274
• OB measurements ........................................................................ ... 280
• OB graphs .................................................................................280
• Measurement package configuration ......................................... ... 285
• Measurement package configuration - example .......................285
• Normal values ...........................................................................287
• User-defined formulas ................................................................. ... 290
• User-defined formula - example ...............................................290
• About units ................................................................................296
• Measurement result table ............................................................ ... 299 222
• Minimizing the Measurement result table .................................299
• Moving the Measurement result table .......................................299
• Deleting measurements ............................................................299
• Worksheet ..................................................................................... ... 301
• Overview ...................................................................................301
• Using Worksheet ......................................................................301
223
Introduction
The Vivid 7 Ultrasound unit provides functionality for two
measurement conventions:
A study is a set of • Assign and Measure (Measure Protocols): the user
related measure- selects a study consisting in a set of pre-labeled
ments, or measure- measurements related to the active scanning mode and
ments that are
logically grouped
clinical application. The user is prompted through the
together. The mea- measurements in the order of the measurement labels.
surements in a This convention is started from the MEASURE button on the
study are some- control panel. A set of tools is implemented to make the
times used in a for- measurement process as fast and easy as possible for the
mula to calculate
user:
new parameters
(e.g. biplane volume • The user is guided through the study: an auto-sequence
with EF, SV and functionality automatically selects the next
CO). measurement in a study.
• The selected measurement is highlighted in the
Measurement menu.
• The performed measurement is indicated in the
Measurement menu.
• The MENU key on the control panel enables quick access
to the Measurement menu.
The studies and their parameters are user-configurable. The
user can create its own studies containing the relevant
measurements only (see page 530).
• Measure and Assign (Free style): the user performs a
measurement and assigns a label. This convention is
started either from MEASURE or CALIPER button on the
Control panel.
Only assigned measurements are saved when ending the

examination.
CAUTION
About Measurement results display

Be aware of the following:
• Measurement results display
By default the system always displays absolute values for
parameters measured in Doppler. This means that values
224
from above and below baseline will all be displayed as
positive results.
For Cardiac this behavior cannot be changed. For
non-Cardiac the Absolute Value setting can be turned off in
Config -> Meas/Text -> Advanced, by setting the attribute
Absolute Value to Off.
• Calculated parameters
For calculated parameters the system uses signed values
in calculation formulas, and displays the absolute value of
the result.
225
The Assign and Measure modality
In this measurement modality, the user selects a study
consisting in a set of related pre-labelled measurements.
Starting the Assign and Measure

modality
1. Press MEASURE on the control panel.
The Measurement Menu is displayed in the Parameters
window (see example Figure 6-3).
The trackball cursor is in the scanning window, ready for
starting measurement.
In Freeze mode, the 2. For fast access to the Measurement menu, press MENU.
UPDATE MENU key The cursor is moved to the Measurement menu. After
on the trackball area selection of a measurement the cursor is automatically
has the same func-
tion as the MENU
moved back to the scanning window, ready for
key. measurement.
1. Menu: fast access to the

Measurement menu (when in measure
mode)
2. Measure: assign and measure
3. Caliper: measure and assign (see
page 230)
Figure 6-1: Launching the Measurement conventions
226
1. Active application
2. Study
3. Selected study
4. Opened study
5. Measurements related to the
area study for the cardiac
application
Figure 6-2: Example of a measurement study

227
Entering a study and performing
measurements
1. Press MEASURE on the front panel to enter the Assign and
Measure modality.
The Measurement menu with a list of studies is displayed
in the Parameters window (see example Figure 6-3).
When entering the Measurement mode for the first time,
the Caliper tool is selected by default. When re-entering
the Measurement mode, the first measurement in the
actual study that has not been performed is selected by
default.
To perform a measurement from another study

Alternative: Press 1. Trackball to the required study.
MENU to access to
2. Press SELECT on the trackball area.
the Measurement
menu and track- The study folder is opened displaying the measurements
ball to the actual related to this study. Other related studies may also be
study available from within the study.
3. Trackball to the measurement to perform.
4. Press SELECT on the trackball area to activate the
measurement tool.
The cursor is moved back to the scanning window.
5. Perform the measurement.
Completed measurements are marked with a check mark
(Figure 6-3).
When the measurement operation is completed the next
measurement on the list is automatically selected.
To skip a measurement in a study

Alternative: Press 1. Trackball to the desired measurement
MENU to access to
2. Press SELECT to activate the measurement tool.
the Measurement
menu and track-
ball to the actual
study
228
1. Performed measurement
2. Next measurement is
automatically selected
Figure 6-3: Display of a performed measurement (example)
229
Measure and Assign modality
In this measurement modality, the user performs a
measurement and assign a label.
Only assigned measurements will be saved.
CAUTION
Starting the Measure and Assign

modality
Alternative: Press 1. Press MEASURE on the control panel.
CALIPER on the con- The Measurement Menu is displayed in the Parameters
trol panel and select window (see example Figure 6-4).
the measurement
tool from the as- 2. If not selected, trackball to the actual measurement tool.
signables. 3. Press SELECT on the trackball area to activate the
measurement tool.
The cursor is moved back to the scanning window, ready
for measurement.
1. Measurement tools
Figure 6-4: The 2D Mode Measurement tools (Cardiac application)
230
Post-measurement assignment labels
Each type of measurement, within each mode, can be
associated with a set of pre-defined parameter labels.
Parameter labels can be assigned to the highlighted
measurement by the user.
To assign a parameter label to a

measurement:
1. Trackball to the actual measurement in the Measurement
result table (see Figure 6-5).
The selection of a 2. Press SELECT.
measurement with- A Parameter label menu is displayed.
out pre-defined la-
bels will not display 3. Trackball through the Parameter label menu to highlight the
the Parameter la- required label.
bel menu. 4. Press SELECT to assign the highlighted parameter label to
the measurement.
The assigned measurements may be reviewed in the
Worksheet (see page 301). Up to five assigned measurements
with the same label can be stored in the patient archive.
Only assigned measurements will be saved. Measurements
without assignment will be lost when scanning is resumed.
CAUTION
231
1. Parameter Label menu
2. Selected label
Assignment
3. Assigned measurement
Figure 6-5: Measurement assignment
To assign a user-defined parameter label

1. Trackball to the actual measurement in the Measurement
result table (see Figure 6-5).
2. Press SELECT.
A Parameter label menu is displayed.
3. Trackball to User and press SELECT.
The Enter new parameter window is displayed.
232
Figure 6-6: The Enter new parameter window
4. Type a name for the parameter label.

5. Press OK.
The user defined parameter label is assigned to the
selected measurement.
233
Cardiac Measurements
2D Measurements
2D Length measurements
1. Generate the 2D image.
2. Press FREEZE to stop the cineloop.
Alternative: Press 3. Press MEASURE on the Control Panel.
CALIPER on the con-
4. Select Caliper in the Measurement Menu (see Figure 6-2).
trol panel and press
CALIPER assignable. 5. Trackball the cursor to the start point of the measurement.
6. Press SELECT to anchor the start point of the measurement.
See the Status bar 7. Trackball the cursor to the measurement end point.
to get the next step The current distance value is displayed in the
to perform. Measurement result table and is instantaneously updated
when moving the cursor.
The measurement 8. Press SELECT to anchor the end point of the measurement.
display color on the The measurement result is displayed in the Measurement
2D image changes result table.
from green to red af-
ter completion of 9. To assign a label to the measurement, see page 231.
the measurement. 10. Repeat steps 5 through 8 to make additional length
measurements.
The measurements 2D length measurement ratio
displayed on the 2D
image and the cor-
responding results 2. Press FREEZE to stop the cineloop.
are numbered.
3. Press MEASURE on the Control Panel.
Alternative: Press 4. Select Dist. ratio in the Measurement Menu (see
CALIPER and DIST Figure 6-2).
RATIO assignable.
5. Perform two length measurements as described in steps 5
through 8 in the above section.
The measurement results including the ratio (%) of the two
measured lengths are displayed in the Measurement result
table.
Editing 2D Length measurements

1. Trackball the cursor to one of the anchor points of the
measurement to modify.
2. Double-click the SELECT key to select the anchor point.
The selected marker turns green and is unanchored.
234
3. With the Trackball, reposition the marker.
4. Press SELECT to anchor.
2D Area measurements
CALIPER and AREA
4. Select Area (trace) in the Measurement Menu (see
assignable.
Figure 6-2).
5. Trackball the cursor to the start point of the measurement.
See the Status bar 6. Press SELECT to anchor the start point of the measurement.
to get the next step
7. Trace the area (planetary) with the Trackball.
to perform.
The measurement The current area and circumference values are displayed
display color on the in the Measurement result table and are instantaneously
2D image changes updated when moving the cursor.
ter completion of 8. Press SELECT to complete the measurement.
the measurement. The measurement result is displayed in the Measurement
result table.
9. To assign a label to the measurement, see page 231.
The measurements 10. Repeat steps 5 through 8 to make additional area
displayed on the 2D measurements.
image and the cor-
responding results 2D area measurement ratio
are numbered.
2. Press FREEZEto stop the cineloop.
CALIPER, MORE as-
4. Select Area ratio in the Measurement Menu (see
signable and AREA
RATIO.
Figure 6-2).
5. Perform two area measurements as described in steps 5
through 8 in the above section.
See the Status bar The measurement results including the ratio (%) of the two
to get the next step measured areas are displayed in the Measurement result
to perform. table.
Editing 2D Area measurements

1. Trackball the cursor to the anchor point of the area
measurement to modify.
2. Press SELECT twice (Double-click) to select the anchor
point. 235
The selected marker turns green and is unanchored.
3. With the Trackball, reposition the marker.
4. Press the SELECT to anchor.
2D Volume measurements
The measurements described in this section enable volume
measurement in a defined zone. The measurements tool
generates results by two methods:
For measurement • Method of Disk (displayed as Vmod in the Measurement
formulae, refer to result table), known as Simpson's method.
the Reference
Manual. • Area/Length method (displayed as Va-l in the
Measurement result table).
To perform a volume measurement:
CALIPER and
4. Select Volume in the Measurement Menu (see Figure 6-2).
VOLUME assignable.
5. Trackball the cursor to the start point where a volume is to
be measured.
See the Status bar 6. Press SELECT to anchor the start point of the measurement.
to get the next step
7. Trackball the cursor to draw the length.
to perform.
8. Press SELECT to anchor the second point.
9. Drag the cursor with the Trackball to outline the area of
interest.
The measurement The current area, circumference and Area/Length Volume
display color on the (Va-l) values are displayed in the Measurement result table
2D image changes (see Figure 6-2) and are instantaneously updated when
ter completion of
moving the cursor.
the measurement. 10. Press SELECT to complete the measurement.
The measurement results including Vmod (Simpson) are
displayed in the Measurement result table (see
Figure 6-2).
The measurements 11. To assign a label to the measurement, see page 231.
displayed on the 2D
12. Repeat steps 5 through 10 to make additional volume
image and the cor-
responding results measurements.
are numbered.
236
2D Depth measurements
The measurements described in this section enable depth
measurement from the probe to a selected point.
To perform a depth measurement:
See the Status bar 4. Press the assignable POINT to select the depth
to get the next step measurement function.
to perform.
5. Trackball the cursor to the position to measure.
The current distance from the probe is displayed in the
Measurement result table and is instantaneously updated
The measurements 6. Press SELECT to anchor the point.
displayed on the 2D The depth value (cm) is displayed in the Measurement
image and the cor- result table.
responding results
are numbered.
237
M-Mode Measurements
In M-Mode, the user can perform distance and time
measurements. This measurement package has also the
following pre-defined measurement studies:
• LA/Ao
• LV
• RV
M-Mode Length measurements

1. Generate the M-Mode image.
CALIPER on the con-
4. Select caliper in the Measurement Menu.
CALIPER assignable. 5. Trackball the cursor to the start point of the measurement.
See the Status bar 7. Trackball the cursor to the measurement end point.
to get the next step The current distance value is displayed in the
to perform. Measurement result table and is instantaneously updated
8. Press SELECT to anchor the end point of the measurement.
The measurement The measurement result is displayed in the Measurement
display color on the result table.
M-Mode changes
from green to red af- 9. To assign a label to the measurement, see page 231.
ter completion of 10. Repeat steps 5 through 8 to make additional length
the measurement. measurements.
The measurements Editing M-Mode Length measurements
displayed on the
M-Mode image and
1. Trackball the cursor to one of the anchor points of the
the corresponding measurement to modify.
results are num- 2. Press SELECT twice (double-click).
bered. The selected marker turns green and is unanchored.
3. With the Trackball, reposition the marker to a new position.
4. Press SELECT.
Ao/LA study
238
CALIPER on the con-
4. Select Ao/LA in the Measurement Menu.
the AO/LA assign- 5. Trackball the cursor along the time axis to the required point
able. to start measurement of Aorta root diameter.
See the Status bar 6. Press SELECT.
to get the next step The starting point for the measurement is anchored.
to perform.
7. Trackball to the end point of the measurement.
The current value is 8. Press SELECT.
updated while mov- The measurement end point is anchored and the value is
ing the cursor. displayed in the Measurement result table.
A new free-moving cursor is displayed on the image, ready
for the next measurement.
9. Repeat steps 5, through 8 to measure Left Atrium.
The LA value is displayed in the Measurement result table.
The Ao/LA ratio is displayed in the Measurement result
table.
LV study
The LV study consists of measurements in fixed-time mode in
both systole and diastole of:
• Interventricular septum thickness (IVS)
• Left ventricular internal dimension (LVID)
• Left ventricular posterior wall thickness (LVPW)
The following parameters are also calculated:
• EDV (End diastole volume)
• ESV (End systole volume)
• SV (Stroke volume)
• EF (Ejection Fraction)
To perform LV study
CALIPER on the con-
4. Select LV study in the Measurement Menu.
the LV STUDY as- 5. Trackball the cursor along the time axis to the required point
signable. to start measurement of IVSd.
6. Press SELECT.
The starting point for the measurement is anchored.
239
7. Trackball to the end point of the measurement.
8. Press SELECT.
The IVSd measurement end point is anchored and the
value is displayed in the Measurement result table.
The end point of the IVSd is also the start point for the LVIDd.
1. Trackball to the end point of the LVIDd measurement.
2. Press SELECT.
The LVIDd measurement end point is anchored and the
The end point of the LVIDd is also the start point for the
LVPWd.
1. Trackball to the end point of the LVPWd measurement.
2. Press SELECT.
The LVPWd measurement end point is anchored and the
3. Repeat steps 5, through 2 to measure IVS, LVID and LVPW
in systole.
RV study
The RV study consists of measurement in fixed-time mode of
Right ventricular internal dimension (RVID) in both diastole and
systole.
To perform RV study
CALIPER on the con-
4. Select RV study in the Measurement Menu.
the RV STUDY as- 5. Trackball the cursor along the time axis to the required point
signable. to start measurement of RVIDd.
6. Press SELECT.
The starting point for the measurement is anchored.
The current value is 7. Trackball to the end point of the measurement.
updated while mov-
8. Press SELECT.
ing the cursor.
The measurement end point is anchored and the RVIDs
measurement value is displayed in the Measurement
result table.
A new free-moving cursor is displayed on the image, ready
for the next measurement. 240
9. Repeat steps 5, through 8 to measure RVIDs.
The RVIDs value is displayed in the Measurement result
table.
241
Doppler Measurements
The following measurements may be calculated on Doppler
mode spectra:
For measurement • Maximum (peak) and mean velocity
formulae, refer to
• Maximum and mean pressure gradient
the Reference
Manual. • Pressure half-time (PHT)
• Velocity time integral (VTI)
• Mitral valve area (MVA), derived from PHT
Velocity and Pressure point measurements

1. Generate the spectrum to be measured.
CALIPER on the con-
4. Select Point Caliper in the Measurement Menu.
the POINT CALIPER 5. Trackball the cursor to the position to measure.
assignable. The current velocity is displayed in the Measurement result
table and is instantaneously updated when moving the
cursor.
The measurement 6. Press SELECT to anchor the point.
display on the spec- The velocity (m/s) and pressure (mm Hg) values are
trum and the corre- displayed in the Measurement result table.
sponding results
are numbered.
Velocity and Pressure caliper measurements
CALIPER on the con-
4. Select Caliper in the Measurement Menu.
the CALIPER assign- 5. Trackball the cursor to the start point of the measurement.
able. 6. Press SELECT to anchor the start point of the measurement.
7. Trackball the cursor to the measurement end point.
The current velocity and pressure values are displayed in
the Measurement result table and are instantaneously
updated when moving the cursor.
The measurement 8. Press SELECT to anchor the end point of the measurement.
display color on the The following measurement results are displayed in the
spectrum changes Measurement result table:
ter completion of • Velocity and pressure at anchor point positions
the measurement. • Velocity (V3) and pressure (p3) differences between 242
anchor point position
• Time difference (dT) between anchored points position
The measurement 9. To assign a label to the measurement, see page 231.
display on the spec-
10. Repeat steps 5 through 8 to make additional
trum and the corre-
sponding result are measurements.
numbered.
Manual Doppler trace measurements
Adjust Compress 1. Generate the spectrum to be measured.
and reject controls
to optimize the
Doppler signal. 3. Press MEASURE on the Control Panel.
Alternative: Press 4. Select Manual trace in the Measurement Menu.
CALIPER on the con- A vertical green cursor is displayed on the spectrum.
the MANUAL TRACE 5. Trackball the cursor to the start point on the left side of the
assignable trace.
7. With the trackball, trace the Doppler envelope.
The trace can be adjusted, while tracing, by moving the
cursor backward to erase portion of the trace (or the entire
trace) and then create the trace again.
The measurement 8. Press SELECT to complete the trace.
display color on The following measurement results are displayed in the
spectrum changes Measurement result table:
ter completion of • Maximum and mean Velocities
the measurement. • Maximum and mean pressures
• Env. Ti
9. Trackball the cursor to the start point of the next heart beat.
10. Press the SELECT to anchor the next heart beat starting
point.
The heart rate (BPM) is displayed in the Measurement
result table.
Automatic Doppler trace measurements

and reject controls
to optimize the
243
Alternative: Press 4. Select Auto Trace in the Measurement Menu.
CALIPER on the con- A vertical green cursor is displayed on the spectrum.
the AUTO TRACE as- 5. Trackball the cursor to the starting point.
signable. 6. Press SELECT to anchor the start point of the measurement.
7. Trackball to the end trace position.
8. Press SELECT to anchor the end point of the trace.
The trace is automatically generated and the following
measurements are displayed in the Measurement result
table:
• Maximum and mean Velocities
• Maximum and mean pressures
• Env. Ti
9. Trackball the cursor to the next heart beat.
10. Press SELECT to anchor the next heart beat starting point.
The heart rate (BPM) is displayed in the Measurement
result table.
MV E/A ratio
and reject controls
to optimize the
Alternative: Press 4. Select MV E/A ratio in the Measurement Menu.
CALIPER on the con-
5. Trackball the cursor to the peak of the E wave.
the MV E/A RATIO as- 6. Press SELECT to anchor the point.
signable. 7. Drag cursor to baseline to mark dT.
8. Press SELECT on the trackball area to anchor the second
point.
9. Trackball the cursor to the peak of A wave.
10. Press SELECT to anchor the point.
the velocity at peak for E and A waves and the calculated
E/A ratio are displayed in the Measurement result table.
Event timing measurements

Event timing enables the time measurement for opening and
closure of the Aortic and Mitral valves, as referred to the
automatically detected QRS marker, which normally is on the
rising slope of the R-wave.
244
Event timing can be performed on a Doppler spectrum or an
M-Mode acquisition showing the corresponding valves. The
procedure is similar on both modes. In addition event timing
can be done on curved anatomical M-Mode traces in
Q Analysis. The measurements are shown as dashed lines in
the Analysis window and Anatomical M-Mode window in
Q Analysis.
4. Select Event Timing in the Measurement menu.
The following event timing measurements are available
(with the first measurement on the list selected):
• AVO: Aortic Valve Opening
• AVC: Aortic Valve Closure
• MVO: Mitral Valve Opening
• MVC: Mitral Valve Closure
5. Trackball the cursor to the corresponding point on the
spectrum for the selected measurement.
6. Press SELECT to anchor the point.
The event timing measurement (ms) is displayed in the
Measurement result table.
TSI Measurements
Each sample in the TSI image represents the time to the
maximum velocity within the chosen TSI search interval from
TSI Start to TSI End. (See page 146 on how to set the TSI
search interval.)
There are two automatic TSI time to peak measurement tools:
• Generic TSI Time to peak measurement: displays the TSI
value at the location point set by the user.
• Segment TSI Time to peak measurement: measures the
time to peak velocity in specific wall segments and gets
automatically calculated TSI indexes based on these
measurements. The measurements may be presented in a
color coded Bull's eye diagram.
245
Alternatively, TSI time to peak measurement can be done in
Q Analysis by manually measuring the time between the QRS
marker and the peak velocity on the velocity trace.
Generic Time to peak measurement

1. Acquire a TSI apical loop.
2. Press MEASURE.
3. In the Measurement menu, select Generic and Time to
peak (see Figure 6-7).
The TSI loop freezes at the TSI end frame.
4. Place a point in the middle of a basal or mid-level
myocardial segment in the TSI image.
5. The Time to peak value for the segment is displayed in the
Measurement result window.
Note: to judge the quality of your data at the measuring
point in the 2D image see the Caution text on page 251.
Figure 6-7: TSI Generic Time to peak measurement screen
246
Segment Time to peak measurements
1. Acquire TSI loops from all three apical views.
2. Press MEASURE and select TSI time study.
The TSI loop freezes at the TSI end frame.
The first measurement in the study is automatically
selected (see Figure 6-8).
3. Place a point in the middle of the corresponding segment in
the TSI image.
The Time to peak and the Peak velocity for the segment
are displayed in the Measurement result window.
4. Perform a measurement for all basal and mid-level
segments in all three apical views.
In addition to the Time to peak and the Peak velocity for
each segment, the following TSI indexes are calculated:
• Septal lateral delay: difference in Time to peak velocity
in the basal lateral wall and basal septum.
• Septal posterior delay: difference in Time to peak
velocity in the basal posterior wall and the basal
antero-septum.
• Basal max delay: difference between the maximum and
minimum time to peak measurements in the six basal
segments. Requires at least four of the six basal
segment measurements.
• Basal standard deviation: the standard deviation of the
time to peak measurements in the six basal segments.
Requires at least four of the six basal segment
measurements.
• All segments max delay: difference between the
maximum and minimum time to peak measurements in
all the measured basal and mid level segments.
Requires at least eight of the twelve segmental
measurements.
• All segments standard deviation: the standard deviation
of the time to peak measurements in all measured basal
and mid level segments. Requires at least eight of the
twelve segmental measurements.
The TSI indexes indicate degrees of asynchrony in time to
peak velocity
5. Select TSI Bull’s eye report in the Measurement menu.
247
The measurements are displayed in a color coded bull’s
eye diagram together with a list of the calculated TSI
indexes.
Figure 6-8: Segment Time to peak measurements screen
TSI trace
The TSI Time to peak measurement can be verified and
eventually manually changed from the TSI trace.
1. Double click on the measurement point.
The ROI and the corresponding TSI curve are displayed
(see Figure 6-9).
2. Press SELECT to anchor the ROI and trace.
3. If required, select a new peak location in the trace.
4. Click in the acquisition window to exit the TSI trace.
248
1. TSI ROI
2. TSI trace
3. TSI Time to peak marker
Figure 6-9: TSI trace
Time to peak measurement in Q Analysis

1. From a TSI apical loop, press Q ANALYSIS.
2. Place a sample area in a myocardial segment.
A velocity trace is displayed in the Analysis window (see
Figure 6-10).
3. Press MEASURE.
4. In the Measurement menu, select Generic and Time.
Note: if Time is not available in the Generic folder, Press
ACTIVE MODE on the Control panel.
5. In the Analysis window, measure the time from the yellow
QRS marker to the peak velocity of the velocity trace.
249
1. Time measurement tool
2. Sample area
3. QRS marker
4. Time to peak measurement
Figure 6-10: Manual TSI Time to peak measurement in Q Analysis
Note: it is possible to do a Generic or a Segment Time to peak

measurement from within Q Analysis and compare the result
with a manual Time to peak measurement. To access to the
corresponding measurement tool in Q Analysis you may have
to press ACTIVE MODE to display the relevant Measurement
menu.
250
The Time to peak measurement in Q Analysis may differ from the
Generic and Segment Time to peak measurements due to the
CAUTION following considerations:
• The Generic and Segment Time to peak measurements find the
maximum velocity only within the TSI search interval. If the
desired peak on the velocity trace is outside the TSI search
interval, the Generic and Segment Time to peak measurements
will return a different result than the manual Time to peak
measurement.
• If the maximum velocity is at one of the ends of the TSI search
interval, the Generic and Segment time to peak measurements
return the time of the end of the TSI search interval. In some
cases the falling flank of an iso-volumic contraction peak at the
time of TSI Start or the rising flank of a post-systolic
contraction peak at the time of TSI End may be detected. In a
manual measurement the time to a peak within the TSI search
interval with a lower velocity than the velocity at the end of the
interval may be measured instead.
• If there are two or more peaks of comparable velocity within the
TSI search interval, or a poor signal quality, the Generic and
Segment Time to peak measurements may return the time to a
different peak than what a manual method would do. Typically
in these situations, the TSI image will show a wide range of
colors over a small spatial region.
Automated Function Imaging

Automated Function Imaging (AFI) is a decision support tool for
regional assessment of the LV systolic function. AFI is a tool
derived from 2D Stain, which calculates the myocardial tissue
deformation based on feature tracking on 2D grey scale loops.
AFI is performed on apical views in the following order: apical
long-axis, 4-chamber and 2-chamber view, following an on
screen guided workflow (see also Figure 6-11).
The result is presented as a Bull’s eye display showing color
coded and numerical values for peak systolic longitudinal
strain. All values are stored to the worksheet. In addition, global
strain for each view and average global strain for the whole LV
are stored to the worksheet.
251
APLAX 4-Ch 2-Ch Step
Acquired views
Defining a ROI
Tracking validation
AVC timing adjustment
Parametric image result
Trace and Bull’s eye result
Figure 6-11: AFI workflow
252
Acquisition
1. Create an exam, connect the ECG device and make sure
to obtain a stable ECG trace.
2. Acquire 2D grey scale cineloops of an Apical long axis
(APLAX) view, an Apical 4 chamber view and an Apical
2 chamber view.
Note: it is recommended to acquire all three apical views
sequentially in order to get similar heart rate in all views.
• The frame rate should be between 37 and 80 frames per
second. A higher frame rate is recommended for high
heart rate.
• The scanner should be configured to store 100 ms
before and after each heart cycle.
• If the acquisition has more than one heart cycle, the
analysis will be done on the second last heart cycle.
• The entire myocardium should be visible.
• A depth range that includes the entire left ventricle
should be used.
Starting AFI
1. Open an APLAX view and press MEASURE.
2. In the Measurement menu, select AFI.
The View selection menu is displayed (see Figure 6-12).
Figure 6-12: Measurement and View selection menus

253
3. Select APLAX.
The AFI application is started. A ROI can be defined.
When performing AFI on all three apical views, the user is asked
to start with the APLAX view. This allows manual adjustment of
CAUTION the Aortic Valve Closure (AVC) event timing that is used in the
calculation of the longitudinal systolic strain in all apical views.
AFI on the APLAX view

Defining a ROI
When selecting the view to analyze the system automatically
displays a frame where the endocardial border is usually
clearly visible. To use another frame, adjust SELECT FRAME. The
ROI is defined by placing two annular points and one at the
apex following the order shown on screen.
To define a ROI, place three points at the endocardial border;
two annular points and one at the apex (see Figure 6-13).
Follow the indications displayed on the screen when placing
the three points.
Note: the Yo-yo function is turned on to help finding correct
location for the points.
254
Figure 6-13: Defining a ROI
After placing the apex point the ROI is displayed.

Note: Correct ROI definition is important for an accurate strain
measurement. The system has an adaptive ROI function: using
the endocardial three points as a guide, the system will analyze
the image and automatically adapt the ROI to an optimal
position.
You may adjust the shape of the ROI by moving the cursor over
the inner ROI border, select an anchor point and move it to a
new location (Figure 6-14). The shape of the ROI is updated
accordingly.
Figure 6-14: Selected anchor point on the inner ROI border

255
Note: Data processing is started automatically if the cursor is
not moved for a few seconds. If the ROI needs to be adjusted
make sure to make the changes immediately after the ROI is
displayed.
Note: The auto processing function is configurable (from

Config/Meas-Text/Advanced/AFI auto processing).
Figure 6-15: AFI auto processing configuration
Quick tips
Correct ROI definition is crucial to get good tracking. Refer to
the example displayed in the Tip window for correct point
placements. To display additional guidelines, select the Tip
button on the Tip window. Make sure to follow the
recommendations when placing the three points (see below).
256
Base Correct Wrong
1. Correct position of
the base points.
2. The ROI extends
into the aortic tract.
Apex Correct Wrong
the Apex point.
2. The apex point is
placed too high.
The ROI is
extending beyond
the epicardium.
257
Apex Correct Wrong
the Apex point.
2. The upper right
border of the ROI is
way too much into
the chamber cavity.
Bulges Correct Wrong
1. Correct ROI.
2. ROI should not be
bulging or follow
the papillary
muscle. To edit the
ROI, see ’ROI
adjustment’ on
page 261.
258
General Correct Wrong
The left ventricle must be

visible through the entire
cycle.
1. End systole frame:
the entire left
ventricle is
displayed.
2. End diastole frame:
the annulus is not
displayed.
The data is processed and the Tracking validation screen is

displayed.
259
1. Display Quick Tips on tracking quality assessment
2. The ROI divided in segments
3. The Scoring table
• : acceptable tracking
• : not acceptable tracking
4. Bull’s eye icon:
• Segments with yellow border: segments being analyzed.
• Green segments: segments already analyzed.
• Black segments: segments not analyzed.
Figure 6-16: Tracking validation screen
The ROI is divided into segments. The tracking quality for each
segment is automatically evaluated and summarized in the
Scoring table (see Figure 6-16).
Tracking validation
The tracking for each segment must be visually controlled and
validated. Poor tracking quality could result from a variety of
causes. Select Quick tips (see Figure 6-16) to get tips on the
most common causes for bad tracking. The common causes
for bad tracking are:
• Erroneous placement of the basal points when defining the
ROI. If the basal points are placed too far from the annular
region, the ROI segments at the annular base will not move
together with the underlying 2D image throughout the entire
heart beat (see example cineloops in the Quick tips). 260
• Erroneous placement of the apex point when defining the
ROI. The point should be placed so that the resulting ROI
covers mainly the endocardium. If the apex point is placed
too high, the ROI will mainly cover the epicardium resulting
in poor tracking (see example cineloops in the Quick tips).
• Too small ROI width. Narrowing the ROI too much will
result in poor tracking due to lack of tissue data in the ROI
(see example cineloops in the Quick tips).
• Too much clutter. Images with too much static clutter will
result in poor tracking (see example cineloops in the Quick
tips).
1. Inspect each segment and make sure that the center line is
moving together with the underlying 2D image.
Note: To get a better visualization you may press
Show/Hide ROI to show or hide the ROI borders.
The tracking quality is automatically evaluated for each
segment and displayed in the Scoring table.
The tracking in each segment is scored as either
Acceptable ( ) or Not acceptable ( ).
If the tracking needs to be improved for some segments,
the user can modify the ROI as described in ’ROI
adjustment’ on page 261.
The user may override the tracking quality evaluation done
by the system by clicking on the evaluation result in the
Scoring table.
2. Once the tracking quality has been validated for all
segments, press Approve in the Scoring table.
The user is asked to confirm or adjust the AVC timing
setting (see ’Timing validation’ on page 262).
ROI adjustment
1. Press RECALC.
2. The following adjustments can be done:
• Adjust ROI WIDTH.
• Press DRAW CURVE to re-define the ROI.
• Adjust the shape of the existing ROI: move the cursor
over the inner ROI border, select an anchor point and
move it to a new location. The shape of the ROI is
updated accordingly.
Data processing is started automatically if the cursor is not
moved for a few seconds. 261
The Tracking validation screen is displayed for tracking
validation.
Timing validation
Timing information may be crucial to accurate diagnosis. The
most important event timing is the aortic valve closure (AVC),
since it is part of the definition of the peak systolic strain
parameter.
Determination of the AVC timing by the system is as follow,
depending on the situation:
• If AVC timing has been measured by the operator (through
an event timing measurement, see page 244) prior to
running AFI, the system is using this data.
• If event timing is not available, an automatic AVC estimate
is used, determined by the temporal contraction of all LV
segments (Strain curves).
• From the APLAX view, the user can adjust the estimated
AVC timing. The adjusted AVC timing will then be used in
the other apical views when running AFI on these views.
This option is only available from the APLAX view.
AVC timing adjustment
This procedure is available in the APLAX view only.
1. After validation of the tracking quality, the frame for the
current AVC setting (automatic or event timing
measurement) is displayed and highlighted on the ECG.
2. To keep the current AVC setting, press SELECT. To change
the AVC setting, use the trackball to display another frame
and press SELECT.
If the AVC setting was changed, a Confirmation window is
displayed. Select one of the following options:
• Manual to accept the manual AVC setting.
• Event timing to discard the manual AVC setting (if for
example the AVC setting was not possible to assess
from the APLAX view). The AVC event timing
measurement will then be used.
Note: This choice is only visible if AVC event timing
measurement has been done.
• Auto to discard the manual AVC setting and use the
automatic AVC timing.
262
The Parametric systolic strain APLAX view is displayed
(see Figure 6-17).
Figure 6-17: Parametric systolic strain APLAX view
Note: The image will not be saved unless IMG. STORE is

pressed.
Peak detection
The peak systolic strain detection for each segment can be
verified and eventually manually changed.
To adjust the peak detection:
1. Press QUAD SCREEN.
A quad screen is displayed (see Figure 6-18) showing:
• 2D image with the ROI
• 2D image with Peak systolic strain parametric data
• Segmental curves with peak marker
• M-Mode image with strain parametric data
Note: the Quad screen will not be saved unless IMG. STORE
is pressed.
263
Figure 6-18: Quad screen for the APLAX view
2. To change the peak marker position on a curve:

• Press SELECT on the peak marker (white square point)
on one of the curves, hold down the SELECT key and
move the peak marker to a new position. Release the
SELECT key.
OR
• Place the cursor on a segment in one of the 2D images.
The corresponding curve is highlighted.
Click on the segment to select the corresponding peak
marker and move it to a new position.
AFI on A4-Ch and A2-Ch views

The procedure for AFI on Apical 4-chamber and 2-chamber
views is similar to the one used in the APLAX view:
• Open the apical view from the clipboard.
• Select the corresponding view in the View selection menu
• Define a ROI (see page 254).
264
• Validate tracking (see page 260).
Note: the AVC timing setting defined in the APLAX view is used
by the system when running AFI on the other apical views.
Results
For the APLAX and apical 4-chamber views the following
results are available:
• Single screen (see Figure 6-17) displaying a 2D image with
strain parametric data.
• Quad screen (see Figure 6-18) displaying:
• 2D image with the ROI
• 2D image with Peak systolic strain parametric data
• M-Mode image with strain data
• Segmental curves
If auto-AVC is used as AVC timing calculation method when

running AFI (see page 262), the strain values displayed in the
CAUTION Quad screen for the APLAX and 4 Chamber views may differ from
the strain values obtained after the system has performed the
final calculation from all three views. The reason for this is that
the Auto-AVC calculation derived from all three views is most
accurate and may be different from the intermediate AVC
calculations used for each view. The strain values displayed in
the Quad screen on APLAX and 4 Chamber views are therefor
preliminary values. Only final strain values should be reported.
Note: If you enter Quad screen again after all three loops have
been processed, the strain values will be correct.
When performing AFI on all three apical views the following

results are also available:
• Quad curve screen (Figure 6-19) displaying:
• Segmental curves for each three Apical views
• Bull’s eye presentation with segmental Peak systolic
strain color coding and segmental Peak systolic strain
values
• Single Bull’s eye screen (see Figure 6-20) displaying:
• Bull’s eye presentation with segmental Peak systolic
strain color coding and segmental Peak systolic strain
values
265
Note: The Bull’s eye can be configured to display either
18 or 17 segments (from
Config/Meas-Text/Advanced/AFI Segment model).
Note: The system can be configured so that the user
can also choose to display Post systolic index (PSI)
color coding and segmental PSI values in the Bull’s eye
(from Config/Meas-Text/Advanced/AFI).
• Global Peak strain values for all three apical views.
• Averaged global Peak strain value from all three apical
view data.
• AVC measurement (either automatic, event timing
measurement or manual, see page 262)
Getting the results
When approving the tracking in the Apical 2-chamber the Quad
curve screen with segmental curves and Bull’s eye is displayed
(Figure 6-19). Select Bull’s eye only to display the Single
Bull’s eye screen (Figure 6-20).
Figure 6-19: Quad screen
266
Figure 6-20: Single Bull’s eye screen
To save the results, press Img. store. Once the results are
saved, the measurements are available in the Worksheet and
can be used in the report.
If the tracking quality of a segment was scored as Not
acceptable ( ), the colorimetric display on the Bull’s eye
is greyed. (see Figure 6-21).
267
1. Segment with tracking quality scored as Not acceptable ( ).
Figure 6-21: Colorimetric display
About the results

• Clinical assessments should be made based on both color
and segmental Peak systolic strain values.
• The Save As function is intended for research purposes
and should not be used to archive diagnostic data.
• To populate the worksheet and the report the Single Bull’s
eye screen must be saved.
• All results shown (curves, colors and values) are based on
drift compensated values. Any strain drifting is linearly
compensated throughout the cycle. If the drift
compensation in a given segment is too high, the tracking
quality is automatically set to Not acceptable (X).
• If the tracking quality was scored as Not acceptable (X) in
more than one segment, the Global peak strain value is not
calculated.
Reprocessing data
The data from one or several views from a saved AFI analysis
may be reprocessed. When reprocessing an AFI analysis new
result screens are created.
1. Double-click on the Bull’s eye thumbnail.
A quad screen is displayed showing the three apical views
and the Bull’s eye diagram.
2. Select the view to reprocess and perform the analysis as
described on page 254. 268
Vascular measurements
B-Mode measurements
The following instructions assume that you first scan the patient
and press FREEZE.
% Stenosis
% Stenosis by diameter
2. Open % Stenosis in the Measurement menu.
3. Select % Sten (Diam).
4. Make a distance measurement of the inner area of the
blood vessel.
5. Make a distance measurement of the outer area of the
blood vessel.
The distance measurements and the % Stenosis are
displayed in the Measurement result table.
% Stenosis by area
2. Open % Stenosis in the Measurement menu.
3. Select % Sten (Area).
4. Make a trace measurement of the inner area of the blood
vessel.
5. Make a trace measurement of the outer area of the blood
vessel.
The area measurements and the% Stenosis are displayed
in the Measurement result table.
Volume
The volume calculation can be made from one, two or three
distance measurements.
2. Select Volume in the Measurement menu.
3. When doing volume calculation from three distance
measurements (i. e. biplane volume), the measurements
should be done in dual mode displaying a sagittal and an
axial view. One measurement is usually made in the sagittal
plane and two measurements in the axial plane. 269
When doing volume calculation from one or two distance
measurements, make one or two distance measurements
and press MENU or CLEAR.
The distance measurement(s) and the volume calculation
are displayed in the Measurement result table.
A/B Ratio
In B-Mode, A/B Ratio can be measured by diameter or area.
A/B Ratio by diameter
2. Open A/B Ratio in the Measurement menu.
3. Select between:
• Ratio (Diam)
• Ratio (Area)
4. Make the corresponding two measurements.
The measurements and the corresponding A/B Ratio are
Intima-Media Thickness
The Intima-Media Thickness (IMT) is calculated based on
automatic contour detection of the Intima and Media layers on
a user-defined search region along the vessel wall. Multiple
IMT measurements are made between pairs of intima and
adventitia points along the wall (Figure 6-22). IMT can be
measured both on the posterior and the anterior walls of the
vessel.
The IMT measurement is available with linear probes only.
Note: due to the physical properties of ultrasound imaging, the
posterior IMT measurement is generally more accurate than
the anterior IMT measurement.
The following parameters are calculated:
• Average IMT
• Maximum IMT
• Minimum IMT
• Standard deviation of IMT measurements
• Number of successful IMT measurements
270
1. Vessel lumen 3. Lumen-Intima boundary
2. Vessel wall 4. Media-Adventitia boundary
5. Multiple IMT measurements
Figure 6-22: IMT measurement (Posterior wall)
IMT Measurement procedure

The following procedure describes the posterior IMT
measurement.
1. Acquire a longitudinal scan of the carotid artery and
optimize the image.
2. Press FREEZE.
3. Scroll to an end-diastolic frame where the intima layer is
clearly visible.
4. Press MEASURE.
5. Select the appropriate IMT measurement. If measuring the
IMT of the posterior wall of the right common carotid select
Rt and CCA IMT Post (Figure 6-23).
271
Figure 6-23: IMT Measurement menu (Right Common Carotid
Posterior IMT measurement tool)
6. Place the cursor in the artery closer to the posterior wall and
press SELECT to anchor the start of the search region
(Figure 6-24, left).
7. Move the cursor parallel to the artery to define the end point
of the search region. Make sure the Intima and Media
layers are within the search region (indicated by the lower
dotted line in Figure 6-24, left).
Press SELECT to anchor the point. For the posterior wall
the contour detector searches for the leading of the edges
of the intima and adventitia layers. The detected contours
are drawn in the image (Figure 6-24, right).
The measurement calculations are displayed in the
Measurement result Table.
Note: if the Intima and Media layers are not within the
search region, the contour is not drawn. Select (double
click) and move the anchored points closer to the Intima
layer.
272
1. Measurement segment 2. IMT trace
Figure 6-24: IMT Measurement segment and traces
8. If the contour is not optimal, the following assigned control

may be adjusted to improve border detection:
• TRACE FIT: the traces are modified according to different
threshold values.
If the contour is still not optimal, try to perform the IMT
measurement on another frame, preferably close to the
end diastole.
IMT trace approval
Since the IMT measurements are done semi-automatically, the
operator has to approve the detection by visual inspection
before storing the results in worksheet and report.
1. If the traces fit both layers of the posterior wall, approve the
measurement by selecting Transfer in the Measurement
menu.
Once transferred, the calculations can be viewed in the
worksheet and report.
Note: measurements that are not approved will not be
saved.
Note: any image adjustments (e.g Gain or zoom) on
approved (transferred) measurements will unassign the
measurements. Press Transfer to approve the
measurements again.
M-Mode Measurements
and press FREEZE.
273
% Stenosis
2. Select % Stenosis in the Measurement menu.
3. Make a distance measurement of the inner area of the
blood vessel.
4. Make a distance measurement of the outer area of the
blood vessel.
The distance measurements and the % Stenosis are
A/B Ratio
In M-Mode, A/B Ratio can be measured by diameter, time or
velocity.
2. Open A/B Ratio in the Measurement menu.
3. Select between:
• Ratio (Diam
• Ratio (Time)
• Ratio (Velocity)
4. Make the corresponding two measurements.
The measurements and the corresponding A/B Ratio are
Doppler measurements
The system can detect the trace automatically or the user can
draw the trace manually.
Auto vascular calculation

The system performs calculation automatically on the spectrum
trace.
The auto vascular calculation can operate in live, freeze or be
turned off (Live, Frozen and Off commands in the
Measurements menu).
From the Modify Calcs menu, the user can:
• select the calculations to be displayed in the Measurement
result table.
• set the calculations that should be default when an exam is 274
started (Save as default command).
• turn on the automatically detected trace to display max
and/or mean trace (Max and Mean commands).
• display forward flow, reverse flow or both flows (Above,
Below and Both commands).
Setting up auto vascular calculation
1. Press MEASURE.
The Vascular measurement menu is displayed
(Figure 6-25).
2. Press Auto and select between:
• Live: calculation displayed on the real-time image.
• Freeze: calculation displayed on the frozen image.
• Off: auto vascular calculation is turned off.
3. Press Modify Calcs.
The Modify Calcs menu is displayed (Figure 6-25).
4. Select:
• Above, Below or Both to select the spectrum to perform
the calculations on, i. e. above or below the baseline or
both.
• Max and/or Mean to display max and/or mean velocities.
5. In the Modify Calcs menu, select the measurements and
calculations to be displayed in the Measurement result
table.
6. Press Save as default to set the selected calculations to be
default when a new study or exam is started.
275
1. Selected vessel 5. Trace parameters
2. Vessel location parameters 6. Selected measurements and calculation to
3. Manual/auto calculation controls appear in the Measurement result table.
4. Other vessels 7. Assign measurement and calculation
Figure 6-25: Vascular measurement menu (example)
Using Auto vascular calculation

1. Perform the scan and press FREEZE.
The system performs the calculation automatically and the
pre-defined measurements and calculation are displayed
2. The following controls may be adjusted from the control
panel:
• CYCLE SELECT: change the selected cycle. 276
• TRACE SENSITIVITY: optimize the trace contour.
• CURSOR SELECT: select Peak systolic or End diastolic
marker. The selected marker can be moved to a new
location. Press SELECT to anchor the marker to its new
location.
Assigning auto calculations
1. In the Vascular Measurement menu (Figure 6-25), select:
• The actual vessel name
• Prox, Mid or Dist: the location of the vessel (Proximal,
Middle or Distal).
• Rt or Lt: right or left side of the patient.
2. Press Transfer to assign the measurements and
calculations.
To undo the assign- The Measurement result table is updated accordingly and
ment, press Cancel the measurements and calculations are added to the
transfer. worksheet and report.
Manual vascular calculation

When doing manual measurements, the system can detect the
trace automatically or it can be drawn by the user. This is
controlled by the Auto and Manual commands is the
Measurement menu.
and press FREEZE.
1. Adjust the vessel location parameters in the Vascular
measurement menu (Figure 6-25).
2. Select the measurement to be performed from the
Measurement menu or from the Show All menu for
additional measurements.
3. Perform the measurement as described below.
Acceleration, Acceleration time (AT)
1. Select Accel or AT.
2. Position the caliper at the start point and press SELECT to
anchor the caliper.
3. Position the second caliper at the end point and press
SELECT to anchor the caliper and complete the
measurement.
277
The acceleration and/or the acceleration time is displayed
Heart rate
Heart rate is calculated by selecting two identical points over
four heart cycles.
1. Select HR.
2. Position the caliper at a recognizable point in the first cycle
and press SELECT to anchor the caliper.
3. Position the second caliper at the identical point in the
fourth cycle and press SELECT to anchor the caliper and
complete the measurement.
The Heart rate is displayed in the Measurement result
table.
Peak systole (PS), End diastole (ED) and Mid diastole (MD)
1. Select PS, ED or MD.
2. Position the caliper at the corresponding measurement
point and press SELECT to complete the measurement.
The selected measurement is displayed in the
Pulsatility index (PI)
With Auto trace on
1. Select PI.
2. Position the caliper at the beginning of the wave form and
press SELECT to anchor the caliper.
3. Position the second caliper at end diastole and press
SELECT.
A trace is displayed between the two calipers and PS, MD,
ED, TAMAX and PI are displayed in the Measurement
result table.
With Manual trace on
1. Select PI.
2. Position the caliper at the beginning of the wave form and
3. Using the trackball, draw the trace to the end diastole and
press SELECT.
The trace is displayed and PS, MD, ED, TAMAX and PI are
278
Peak systole/End diastole (PS/ED) and End diastole/Peak
systole (ED/PS) ratio
1. Select PS/ED or ED/PS.
2. Position the caliper at Peak systole or End systole and
3. Position the second caliper at End diastole or Peak systole
and press SELECT to anchor the caliper and complete the
measurement.
The Peak systole, End diastole and PS/ED or ED/PS ratio
are displayed in the Measurement result table.
Resistive index (RI)
1. Select RI.
2. Position the caliper at Peak systole and press SELECT to
anchor the caliper.
3. Position the second caliper at end diastole and press
SELECT.
The Peak systole, End diastole and RI are displayed in the
TAMAX/TAMEAN/Volume Flow
With Auto trace on
1. Select TAMAX, TAMEAN or Volume Flow.
anchor the caliper.
3. Position the second caliper at the end point and press
SELECT to anchor the caliper and complete the
measurement.
A trace is displayed between the two calipers and
corresponding measurements are displayed in the
With Manual trace on
1. Select TAMAX, TAMEAN or Volume Flow.
anchor the caliper.
3. Using the trackball, draw the trace to the end point and
press SELECT.
The trace is displayed and the corresponding
measurements are displayed in the Measurement result
table.
279
OB measurements
1. From an obstetric exam on a scan in Freeze, press
MEASURE.
2. Select the desired study.
3. Perform the required measurements from the selected
study.
Follow the on-screen indications when performing
measurements.
OB graphs
OB Graphs allow you to assess fetal growth compared to a
normal growth curve. When a patient has completed two or
more ultrasound exams, you can also use the graphs to look at
fetal trending. For multi-gestational patients you can show
curves for all fetuses and compare the growth on the graphs.
The Vivid 7 provides the following two basic types of graphs:
• Fetal Growth Curve graphs – show one measurement per
graph. These graphs show the normal growth curve,
positive and negative standard deviations or applicable
percentiles, and ultrasound age of the fetus using the
current measurement. For multi-gestational pregnancies,
you can show curves for all fetuses. If previous exam data
is available, the graph can show fetal trending.
• Fetal Growth Bar graph – shows the ultrasound age and
the gestational age based on patient data. Plots all
measurements on one graph.
To view OB graphs
1. Press WORKSHEET.
2. Press Graph.
The Fetal growth curve graph is displayed (Figure 6-26).
The horizontal axis shows the fetal age in weeks. The
system determines this age from the data entered in the
Patient information window. Depending on the
measurement selected the vertical axis displays
measurements (mm or cm), ratios (%) or fetal weight (g).
The Fetal growth curve graph shows the following
information for the selected measurement:
• The normal growth curve
• The standard deviations or relevant percentiles 280
• The gestational age of the fetus, using patient data
(vertical dotted line)
• Using the current ultrasound measurement data, where
the fetus is on the growth curve
From the OB graphs screen, the user can enter relevant
information in the Fetus position and Placenta fields.
Figure 6-26: Fetal growth curve graph
To select the measurement

1. Select the measurement in the Measurement type field.
A list of available measurements is displayed.
2. Select the measurement to display.
To scroll through all Fetal growth curve graphs, adjust
GRAPH CHANGE.
To select the age to use

1. Adjust SELECT GA.
The plot displays either gestational age (GA) from the
LMP, or the composite ultrasound age (CUA).
281
When selected, the gestational age may be changed by the
user.
1. Select the GA (LMP) value.
An editing window is displayed.
2. Enter a new value and select OK.
The GA (LMP) label is changed to GA(GA) showing the
new value entered. This information is also updated in the
Patient information window. In addition the EDD (LMP) is
updated to EDD (GA) with new calculated value.
To view single or quad screen
1. Press QUAD to display four graphs simultaneously.
2. To select the measurements to display in the quad screen,
select the drop-down button on the left of each graph and
select the desired measurement.
3. Press SINGLE to display single graph screen again.
Figure 6-27: Fetal growth curve graph: quad screen
282
Fetal trending
When you have ultrasound data for more than one exam for a
patient, you can use the data to look at fetal trending on the
Fetal growth curve graphs. Fetal trending requires that a LMP
value is entered in the Patient information screen.
1. Press WORKSHEET.
2. Press GRAPHS and select the desired measurement to
display.
3. Press MORE and PLOT BOTH.
The system automatically finds the data from previous
ultrasound exams, and displays it on the graph with the
present data.
Figure 6-28: Fetal trending graph
Fetal growth bar graph

The fetal growth bar graph shows current exam measurements
and the normal growth range based on the gestational age. It
shows all measurements on one graph.
1. Press WORKSHEET.
2. Press GRAPH.
3. Press BAR.
The fetal growth bar graph is displayed.
283
Figure 6-29: Fetal growth bar graph
• The horizontal axis shows the gestational weeks.

• The red vertical line shows the gestational age using the
patient data.
• The blue dotted vertical line shows the ultrasound age
using the current measurements.
• The yellow x shows the ultrasound age for each
measurement.
• The green rectangle shows the normal age range for the
measurement.
284
Measurement package configuration
A list of all cardiac calculations with needed measurements and
location in the Measurement package can be found in the
Reference manual.
There are many more measurements and parameters in the
measurement package than shown in the default Measurement
menu. Use the configuration system to set up the
measurements that should be available in the Measurement
menu and which parameters should be calculated.
The following example based on calculation of AV CO (Cardiac
Output by Aortic Flow) describes how to configure the
measurement package so that necessary measurements and
the resulting calculations are displayed on screen.
Measurement package configuration -

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

If the AV diameter measurement is not present in the folder
Dimension in the Measurement menu, follow the following
procedure:
The Measurement menu sheet is displayed (see
Figure 6-30).
2. AV Diam is a 2D measurement, make sure that 2D is
checked in the Measurement sheet.
3. Select folder Dimension in the Measurement menu.
285
A list of all available measurements for the selected folder
is displayed in the Measurement menu sheet.
4. Check the box in front of AV Diam.
The AV Diam measurement is displayed in the folder
Dimension in the Measurement menu.
5. For the AV VTI measurement, check Doppler in the
Measurement menu sheet and select the folder Aortic in
the Measurement menu.
6. Check the box in front of AV Trace.
The AV Trace measurement is displayed in the folder
Aortic in the Measurement menu.
1. Select the scanning mode for the measurement to add to the Measurement menu.
2. Select the folder for the measurement to add.
3. Select the measurement to add.
Figure 6-30: Configuration of the Measurement menu
286
Configuration of the Measurement result table
If AV CO calculation is not displayed in the Measurement result
table, follow the following procedure:
1. Press CONFIG (F2) and select the Config category
Measure/Text.
The Measurement menu sheet is displayed.
2. The AV CO calculation is based on Doppler AV Trace
measurement in the folder Aortic, check Doppler in the
Measurement menu sheet and select the folder Aortic.
A list of all available measurements and calculations for
the selected folder is displayed in the Measurement menu
sheet.
Note: Entries in green are calculated measurements.
3. In the Measurement menu sheet, double-click on the AV
Trace measurement.
A list of all available measurements and calculations for
the AV Trace measurement is displayed in the
Measurement menu sheet.
4. Check the box in front of AV CO.
The AV CO calculation will be displayed in the
Normal values
Normal values can be defined by the user for all parameters. A
normal value can be either a range or a threshold. Normal
values entered are grouped by measurement category (e.g.
Cardiac, Pediatrics...etc).
Normal values can be displayed in the report.
287
To define a Normal value
1. Measurement category
2. Selected measurement
3. Parameters
4. Press to define Normal value
Figure 6-31: Adding Normal value
1. Press CONFIG (F2) and select the Config category

Measure/Text.
The Measurement menu sheet is displayed (Figure 6-31).
2. In the Measurement menu, browse to the measurement of
interest.
The parameters for the selected measurements are
displayed in the Measurement menu sheet.
Note: to change Measurement category, press the
Heading in the Measurement menu and select another
Measurement category.
3. Select in the Normal value column.
The Normal value window is displayed.
288
Figure 6-32: The Normal value window
4. In the Normal value window:

• Select the Normal value type (Range, Above or Below).
• Type in the Normal value.
• Optionally enter a reference for the Normal value.
5. Select OK.
The Normal value is displayed in the Measurement menu
sheet.
To display normal values and references in the Report, the
Report template must be configured to show Normal values
(see page 461). Measurements outside the Normal value are
highlighted with an “!” in the report.
289
User-defined formulas
User-defined formulas can be created using existing
measurements or by defining new measurements. The
following example describes the creation of a formula based on
existing measurements.
GE Ultrasound does not take any responsibility for the
correctness of the user-defined functions.
CAUTION
User-defined formula - example

The workflow for user-defined formula is:
• If the user-defined formula is based on several
measurements of different types, create a user-defined
folder in the Measurement menu so that all measurements
and the formula are grouped together. If the formula is
based on a single measurement you may select an existing
appropriate folder.
• Add the measurement(s) needed for the formula to the
user-defined (or existing) folder.
• Create the formula based on the added measurements.
The following procedure describes the creation of user-defined
LIMP formula as follow: My LIMP = (MCO-AV ET)/AV ET.
290
Creation of a user-defined folder
1. Select the appropriate scanning mode.

2. Create a folder in the Measurement menu.
Figure 6-33: The Measurement menu sheet

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

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

291
Measurement menu.
2. Press Add Measurement in the Measurement menu
sheet.
The Add measure window is displayed.
Figure 6-35: The Add measure window
3. MCO and AV ET are measurements that already exist on

the system, check Use copy of and select MCO from the
drop down menu.
4. Select OK to add the MCO measurement.
5. Repeat steps 2 to 4 to add the AV ET measurement.
292
Creation of the formula
1. Select the last measurement.

2. Double click and enter the formula name.
3. Select “=” to create the formula.
The formula for this example is as follow:

My LIMP = (MCO-AV ET)/AV ET
1. In the user-defined folder (e.g.”My folder”), select the last
measurement created (e.g. AV ET).
2. Double-click (Name) in the last line in the Parameter list in
the Measurement menu sheet.
3. Enter the name for the formula (e.g. My LIMP).
4. Select .
The Edit formula window is displayed.
293
Figure 6-37: The Edit formula window
5. Select “(“from the Operators drop-down menu.

6. In the Doppler drop-down list, select
MCO [My Folder, MCO].
Make sure to select the measurement located in the user
defined folder (e.g. “My Folder”).
7. Select “-“from the Operators drop-down menu.
AV ET [My Folder, AVET].
9. Select “)“from the Operators drop-down menu.
10. Select “/“from the Operators drop-down menu.
AV ET [My Folder, AVET].
The Formula line should display: ({MCO}-{AVET})/{AVET}.
No units are necessary since the formula is a ratio (see
also ’About units’ on page 296).
12. Press Check to make sure that the syntax for the formula
is correct.
User-defined measurements
Some user-defined formula may require measurements that do
not exist on the system. The following example based on a
generic distance measurement illustrates how to create
user-defined measurements. 294
1. Select the appropriate scanning mode.
2. Select the appropriate folder.
3. Press Add measurement.

2. In the Measurement menu sheet, select the appropriate
scanning mode for the measurement to be created (e.g.
2D).
3. Select the appropriate folder in the Measurement menu
(e.g. Dimension).
4. Press Add Measurement in the Measurement menu
sheet.
The Add measure window is displayed.
Figure 6-39: The Add measure window
5. Check Blank and press OK.

The Measurement menu sheet is updated. 295
1. Enter a name for the measurement.
2. Select the appropriate measurement tool.
3. Double click and enter the formula name.
6. In the Measurement menu sheet, enter the name for the

measurement (e.g. My Distance).
7. Select the appropriate measurement tool in the drop-down
menu, next to Tool (e.g. 2D Caliper).
8. Double-click (Name) in the appropriate parameter (e.g
Distance) and enter a name for the parameter (e.g. My
Length).
If desired change the unit and the number of decimals for
the measurement by double clicking the values under Unit
and Precision (see also ’About units’ on page 296).
About units
• All formulas are calculated in SI units (see table below).
• If no unit is specified in the Edit formula window when
defining a formula, the displayed value will be in SI unit.
296
To define a different unit
1. When creating a formula, enter the unit to use when
displaying the formula output. E.g. if Y in the formula Y=f(x)
is to be displayed in cm, enter cm in the Unit field.
The Unit field is case sensitive, make sure to enter the
exact unit as shown in the table below (Alternative unit
column).
2. The output of a formula must always be in an SI unit (see
table below). Conversion to the specified display unit is then
done automatically.
Example: an user wants to add a regression formula for
estimating a length B from a measured length A, both in
cm.
The formula is: B = 2.4 + 1.1*A.
• As A is a measurement value the system will enter the
formula in the SI unit for length (m). The formula expects
A in cm, and to get that, A must be multiplied by 100:
B = 2.4 + 1.1*A*100
• The formula now gives B in cm. Converting the output
from cm to the SI unit (m), is done by dividing by 100:
B = (2.4 + 1.1*A*100)/100
The output is now in m, and by entering this formula into
the system the user gets the expected result. Measuring
an A of 2 cm gives:
B = (2.4 + 1.1*0.02*100)/100 = 0.046 m.
Before display of the value it is converted according to the
specified display unit (cm), and the system displays
4.6 cm. If the selected display unit was set to mm the
formula would give the exact same output, 0.046 m, but
the automatic unit conversion would now instead give a
displayed value of 46 mm.
Calculation SI Alternative unit
Time s
Ratio %
Frequency bpm
Angle rad
297
Calculation SI Alternative unit
Distance m
Velocity m/s
Acceleration m/s2
Area m2
Volume m3
Volume flow m3/s
Pressure mm Hg*
Pressure/time mm Hg/s
Mass kg
Other
* The correct SI unit for pressure is Pa, but here mm Hg was used as base unit as it is a
standard pressure unit to use in medicine.
298
Measurement result table
The display of the Measurement result table can be minimized
and moved to prevent the table obscuring parts of the
ultrasound image.
Minimizing the Measurement result

table
1. Trackball to the symbol on the heading of the
Measurement result table (see Figure 6-41).
2. Press SELECT.
Repeat step 1 to en- The Measurement result table is minimized to the heading
large the Measure- bar.
ment result table.
Moving the Measurement result table
Alternative: Rotate 1. Trackball to the symbol on the heading of the
the assignable
Measurement result table (see Figure 6-41).
RESULT WINDOW to
move the Measure- 2. Press SELECT to grab the table.
ment result table 3. Trackball the Measurement result table to a new position.
from corner to cor-
ner on the Acquisi- 4. Press SELECT to anchor the table.
tion window.
1. Minimize/maximize table
2. Move table
Figure 6-41: Measurement result table display tools
Deleting measurements
1. Trackball to the measurement to delete in the
299
Measurement result table and press SELECT.
A menu is displayed.
2. Select Delete Measurement.
300
Worksheet
The worksheet function enables the user to review, edit, delete
or print data independently of a report. All measurements and
calculations taken during the examination can be viewed at any
time using the worksheet.
Overview
1. Measurement type 4. Measured / calculated values

2. Measurement parameter 5. Value type
3. Value: Averaging, Max, Min or Last 6. Measurement type selection
Figure 6-42: The Worksheet screen (Cardiac)
Using Worksheet
1. Press WORKSHEET on the control panel and select the
301
measurement type (see Figure 6-42).
To scroll through pages

1. Select PAGE DOWN or PAGE UP.
To select the type of value

1. Trackball to the relevant cell in the Method column.
2. Press SELECT.
A pop-up menu is displayed showing the different options
available (Figure 6-43).
1. Average of the measurements taken

2. Maximum measurement
3. Minimum measurement.
4. Last measurement that was taken
Figure 6-43: The Calculation method options list.
3. Trackball to the required option.

4. Press SELECT.
The value is updated accordingly.
Excluding or including measurements

One or more measurement values from a set of measurements
for a parameter can be excluded when doing average
calculation.
To exclude a measurement
1. Trackball to the measurement value to exclude.
2. Press UPDATE MENU.
The Worksheet menu is displayed.
When excluded the 3. Trackball to Exclude Value.
measurement dis-
4. Press SELECT.
play turns grey.
To include a measurement
1. Trackball to the measurement value to include.
3. Trackball to Include Value.
302
4. Press SELECT.
Manually changing a value

Individual measured values can be manually changed using
the alphanumeric keyboard.
To manually change a value
1. Trackball to the value that is to be changed.
2. Press SELECT.
An asterisk indi- 3. Use the alphanumeric keyboard to enter the required value.
cates that the value
has been manually To restore automatic calculation
altered. The calcula- 1. Trackball to the relevant cell in the Method column.
tion type is changed
to Edit.
2. Press SELECT.
A pop-up menu is displayed showing the different
calculation options available (Figure 6-43).
3. Press SELECT.
The value is re-calculated according the method selected.
Deleting measurement parameter

1. Trackball to the measurement parameter to delete.
3. Trackball to Delete Value.
4. Press SELECT.
303
Chapter 7
Quantitative Analysis
• Introduction ................................................................................... ... 306

• Accessing the Quantitative analysis package ........................... ... 307
• Quantitative Analysis window ..................................................... ... 308
• Overview ...................................................................................308
• Generation of a trace .................................................................... ... 315
• About the sample area ..............................................................315
• To generate a trace ..................................................................315
• Manual tracking of the sample area (dynamic anchored sample
area) ..........................................................................................316
• Zooming in the Analysis window ...............................................317
• Deletion of a trace ........................................................................ ... 318
• To delete all traces ...................................................................318
• To delete one specific trace ......................................................318
• Saving/retrieving Quantitative analysis ..................................... ... 318
• Frame disabling ............................................................................ ... 319
• Disabling frames .......................................................................319
• Re-enabling all frames ..............................................................319
• Optimizing sample area ............................................................... ... 321
• Reshaping a sample area .........................................................321
• Labelling a sample area ............................................................322
• Optimizing the trace display ........................................................ ... 323
• Optimizing the Y-axis ................................................................323
• Trace smoothing .......................................................................324
• Switching modes or traces .......................................................... ... 326
• To switch mode .........................................................................326
• To switch trace ..........................................................................326
• Cine compound ............................................................................ ... 327 304
• Curve fitting analysis ................................................................... ... 328
• Anatomical M-Mode ...................................................................... ... 337
• Introduction ...............................................................................337
• Using Anatomical M-Mode ........................................................337
305
Introduction
The quantitative analysis software package is designed for
analysis of TVI, Tissue Tracking, Strain, Strain rate and
Contrast related raw data.
The main features of these options are:
For TVI:
• Multiple Time -motion trace display from selected points in
the myocardium.
• Arbitrary Curved anatomical M-Mode
For Tissue Tracking:

• Multiple tissue displacement trace display from selected
segments in the myocardium.
For Strain rate:

• Multiple Strain rate (Rate of deformation (s-1)) trace display
from selected segments in the myocardium.
For Strain:
• Multiple Strain (extend of tissue deformation (%)) trace
display from selected segments in the myocardium.
For Contrast:
• Time-Intensity analysis from multiple region of interest
• Curve fitting
If not otherwise specified, the topics described in this chapter
are applicable for both TVI and contrast data.
306
Accessing the Quantitative analysis package
In replay mode:
1. Open an examination and recall a TVI or contrast loop.
2. Press the assignable Q ANALYSIS.
The Quantitative Analysis screen is displayed (see
Figure 7-1).
In live
1. Press FREEZE.
Note: if in 2D mode outside a contrast application, press
ALT and MORE assignable.
2. Press the assignable Q ANALYSIS.
The Quantitative Analysis screen is displayed (see
Figure 7-1).
307
Quantitative Analysis window
Overview
1. Color cineloop window 5. Time at cursor position and velocity at cursor

2. Tissue cineloop window position
3. Analysis window 6. Trackball Assignments
4. Sample Area 7. Sample area tools
Figure 7-1: The Quantitative analysis window (here with TVI data)
The color cineloop window
308
Displays TVI, Tissue Tracking, Strain, Strain
rate or Angio color-coded data.
Sample area (1):
Indicates sampling position of the velocity
1 (TVI), displacement (Tissue Tracking), percent
deformation (Strain), deformation rate (Strain
rate) or intensity (Contrast) trace. The sample
area is color-coded: the first sample area is
yellow, the second green...etc.
The cineloop windows system menu

This menu is entered by pressing UPDATE
MENU when the QA trackball cursor is within
one of the Cineloop windows.
• Delete all Sample areas: removes all traces
at once.
• Disable frameb: the current frame is
excluded from the cineloop display.
• Set Sample area Shapea: enables resizing
of a selected sample area by setting height,
width and tilt angle. The trackball marker
must be pointed at an anchored sample area.
• Label Sample area...a: set a descriptive
name to the sample area. The label is useful
for identification of the sample area when
exporting data.
a)Shown only when a sample area is • Delete anchorc: remove anchoring from a
selected (pointed at). dynamic sample area (see also page 315
b) With Contrast data only. and page 316).
c)Shown only when pointing at an
anchored sample area.
• Delete Sample areaa: removes selected

sample area from the Cineloop window and
belonging trace in the Analysis window. The
trackball marker must be pointed at an
anchored sample area.
• Cancel: exits the System menu.
309
The Tissue cineloop window
Displays 2D data
Sample area (1):
Indicates sampling position of the velocity
(TVI), displacement (Tissue Tracking), percent
1 deformation (Strain), deformation rate (Strain
rate) or intensity (Contrast) trace. The sample
area is color-coded: the first sample area is
yellow, the second green...etc.
Sample area tools:

• : creates a sample area based on
freehand drawing.
• : creates a sample area with a
pre-defined circular/elliptic shape
(configurable, see page 321)
310
The analysis window
TVI:
6
Displays velocity trace
-2.3
1. Y axis: velocity scale (cm/s)
2. X axis: Time (s)
1 3. ECG
5 4
4. Time at cursor position
5. Velocity at cursor position
6. Velocity at frame marker position
(color coded)
Tissue Tracking:
Displays tissue displacement trace
2 1. Y axis: displacement scale (mm)
2. X axis: time (s)
3 3. ECG with Tracking start and Tracking
end markers
5. Displacement at cursor position
6. Displacement at frame marker
position (color coded)
Strain rate:
Displays Strain rate trace (rate of deformation
(s-1))
1. Y axis: s-1
2. X axis: time (s)
3. ECG
5. Strain rate at cursor position
6. Strain rate at frame marker position
311
Strain:
6
Displays Strain trace (extent of tissue
deformation (%))
-2.3
1. Y axis: percent displacement

1 2. X axis: time (s)
5 4
3. ECG with Strain start and Strain end
markers
5. % deformation at cursor position
6. % deformation at frame marker
2 Contrast:
Displays time-intensity curve
3 1. Y axis: Intensity scale (logarithmic)
(dB) or linear acoustic units (AU).
2. X axis: Time (s) or dT (s), elapsed
time from previous frame.
3. ECG: displays ECG trace, the current
frame marker and the start and stop
markers for the cineloop.
5. Intensity (dB or AU) at cursor position
6. Intensity (dB or AU) at frame marker
312
The analysis window system menu:
This menu is entered by pressing UPDATE
MENU when the QA cursor is within one of the
analysis window.
• Delete all Sample areas: removes all traces
at once.
• Analysis signal: toggles trace display
between velocity, displacement, strain rate,
stain or greyscale intensity curves.
• Drift compensation: compensates drifting
of strain or Tissue Tracking curves by either
resetting the curve to zero at the tracking
start point (cycle resetting) or by linear
compensation throughout the cycle (linear
compensation)
• Horizontal scale: set horizontal unit as time
(s) or time interval (dt) between frames.
• Vertical auto-scaling: selects between full
unit range or a range according to the
maximum and minimum values of the
displayed trace(s).
• Vertical unita: toggles between logarithmic
(dB) and linear acoustical units (AU).
• Line style: selects between solid line only or
solid line with square markers at each data
a)
point.
With contrast data only.
• Smoothing: smooths the trace displayed by
b) Shown only in zoom mode. applying a filter over a defined time window.
Both the filter type and time window are
user-selectable. The type of filter available is
depending on the analysis signal displayed.
• Export traces: saves trace data in ASCII

format, readable in spreadsheet programs. If
present, trace data for physiological traces
are also exported.
• Curve fittinga: toggles between Wash-in,
Wash-out and off.
• Unzoomb: restores full analysis window
display when in zoom mode.
• Cancel: exits the System menu.
313
The Trackball assignments
QA:
Pointing tool in Quantitative analysis mode.
Scroll/Speed:
• When the cineloop is stopped, enables
scrolling through the cineloop.
• When the cineloop is running, enables
control of the cine replay speed.
314
Generation of a trace
Up to eight traces can be generated.
About the sample area

The sample area can be in three different states:
• Free sample area: freely moving sample area (QA cursor)
before anchoring.
The free sample area • Static sample area: the free sample area is anchored by
disappears when the pressing SELECT on the Trackball area.
QA cursor is moved
over a static an- • Dynamic anchored sample area: the sample area is
chored frame. anchored in two or more frames (see Manual tracking
below). In these particular frames, the sample area is
displayed with an anchor. The sample area moves
smoothly between the anchored positions when
playing/scrolling the cineloop.
To generate a trace
Trace from a pre-defined sample area
The shape of the pre-defined sample area is configurable (see
page 321).
1. If the Trackball assignment is not on QA, press TRACKBALL
until QA is highlighted.
The trace and sam- 2. If necessary, select the sample area Shape button .
ple area are col-
3. Trackball to one of the Cineloop windows.
or-coded. First
generated trace is The trackball cursor is changed to a sample area (white
yellow, second circle).
green...etc. A preview of the trace is displayed in the Analysis window.
4. Press SELECT to anchor the sample area.
In this frame the sample are is marked with an anchor.
If the cineloop has more than one heart cycle a sample
area will also be anchored in the corresponding frame in
the next heart cycles.
The trace is updated accordingly in the Analysis window.
The Strain cursor
In Strain and Strain rate modes, the sample area displays a
Strain cursor showing the segment along the beam direction
that is used for Strain and Strain rate calculations. Make sure 315
that the Strain cursor is within the myocardium when anchoring
the sample area.
Trace from a freehand sample area

1. Select the Pencil button .
2. Trackball to one of the Cineloop windows.
The trackball cursor is changed to a cross.
3. Press and hold down the SELECT button while drawing a
sample area with the trackball.
4. Release the SELECT button.
The sample area is automatically closed.
The trace is updated accordingly in the Analysis window.
Manual tracking of the sample area

(dynamic anchored sample area)
The sample area can be moved within the loop to ensure that
data in the trace are generated from the same anatomical
location during the cyclic motion of the heart.
1. Place a sample area over a region of interest.
Note the anatomical location of the sample area.
2. Using the trackball, scroll to a new frame.
3. Press TRACKBALL until the QA trackball assignment is
selected.
4. Trackball to the sample area.
5. Press SELECT.
The sample area is unanchored.
6. Drag the sample area to the corresponding anatomical
location in the new frame.
In the original When the sample area is anchored in more than one
frame and this par- frame, linear interpolation is performed, so that the sample
ticular frame the area is smoothly moved between the anchored positions in
sample area is
marked with an an-
the selected frames when running the cineloop.
chor. 7. Press TRACKBALL until the Scroll trackball assignment is
selected.
8. Using the Trackball, scroll through the cineloop and control
that the sample area follows the moving anatomical
structure.
9. Add anchored sample areas in several frames to obtain a
more accurate displacement of the sample area. 316
To move a dynamic anchored sample area
1. Press TRACKBALL until the Scroll trackball assignment is
selected.
In these frames the 2. Using the trackball, browse through the cineloop to display
sample area is one of the frames where the sample area was anchored.
marked with an an-
chor. 3. Press TRACKBALL until the QA trackball assignment is
selected.
4. Trackball to the sample area to move, in one of the
Cineloop windows.
5. Press SELECT.
The sample area is unanchored.
6. Drag the sample area to a new location.
7. Press SELECT to anchor the sample area to the new
location.
Zooming in the Analysis window

1. In the Analysis window, press and hold down the SELECT
key while dragging the trackball cursor to define the
zooming area.
2. Release the SELECT key.
The selected area is displayed in the Analysis window.
To unzoom
1. Press UPDATE MENU in the trackball area on the control
panel.
The System menu is displayed.
2. Trackball to Unzoom.
3. Press SELECT.
317
Deletion of a trace
The user can delete all traces at once or one at a time.
To delete all traces

1. If necessary, press TRACKBALL until the QA trackball
assignment is selected.
panel.
3. Trackball to Delete all traces.
4. Press SELECT.
To delete one specific trace

2. Trackball to the sample area to delete.
panel.
4. Trackball to Delete trace.
5. Press SELECT to perform deletion.
Saving/retrieving Quantitative analysis

1. Press IMAGE STORE to save the quantitative analysis
session.
2. To recall the Quantitative analysis session, select the icon
on the clipboard, and press the assigned key Q ANALYSIS.
318
Frame disabling
Frame disabling excludes the actual frame from the cineloop
display. Frame disabling is available only with contrast data.
Disabling frames
To re-enable a 1. Trackball to the frame marker of the frame to disable
frame: Press beneath the Analysis window (see Figure 7-2).
SELECT on the cor-
responding frame 2. Press SELECT to disable the frame.
marker. The frame marker turns red.
disabling successive frames at a time

To re-enable succes- 1. Press and hold down SELECT while dragging the cursor
sive frames: press over the frame markers of the frames to disable.
and hold down The frame markers turn red.
the SELECT key
while dragging the
ECG triggered frame disabling
cursor over the
frame markers. In a multi-cycle acquisition, the user may deselect all frames in
all heart cycles but a selected one. This function can be used
for example to select a particular systolic frame for each heart
cycle.
1. Scroll through the cineloop to identify the cardiac phase to
analyze or identify the cardiac phase on the ECG trace.
2. Trackball to the frame marker of the frame of interest in one
of the heart cycles (see Figure 7-2).
4. Trackball to ECG triggering.
5. Press SELECT.
All frames in all heart cycles are disabled except for the
selected and corresponding frames in the other heart
cycles.
Re-enabling all frames

1. Trackball the cursor to the Frame marker axis.
panel.
3. Trackball to Enable all frames.
4. Press SELECT. 319
All previously disabled frames are re-enabled.
1. Analysis window
2. Frame marker axis
3. Enabled frame (green marker)
4. Disabled frame (red marker)
5. ECG
6. Current frame
Figure 7-2: Frame disabling
320
Optimizing sample area
The sample area can be reshaped and labelled.
Reshaping a sample area

There are two ways of modifying a sample area: either from the
Update menu or by selecting the SAMPLE SHAPE assignable.
Reshaping a sample area from the Update

menu
2. Trackball to the sample area to reshape.
panel.
4. Trackball to Set Sample area shape.
5. Press SELECT.
A Dialogue window is displayed where the user can adjust
the height, the width and the angle of the sample area (see
Figure 7-3).
Figure 7-3: The sample area reshaping window
6. Drag the sliders to adjust the shape of the sample area as

desired.
7. Press OK to return to the Quantitative analysis window and
use the settings for the current analysis only.
OR
Press Set as default to return to the Quantitative analysis
screen and keep the settings as default.
321
Reshaping a sample area from the assignables
This procedure allows to reshape either a free sample area or a
specific anchored sample area providing that the QA cursor is
pointing at the actual sample area.
1. Press the SAMPLE SHAPE assignable.
The Sample shape assignable controls are displayed.
2. Adjust the size and angle of the sample area using the
assignable rotaries.
3. If desired press the assignable SET DEFAULT to keep the
settings as default.
Labelling a sample area

The sample area label is used to identify data associated to the
sample area when exporting to a spreadsheet program.
2. Trackball to the sample area to label.
panel.
4. Trackball to Label Sample area....
5. Press SELECT.
A Dialogue window with a free text field is displayed (see
Figure 7-4).
6. Type a name for the sample area.
7. Press OK to return to the Quantitative analysis screen.
1. Free text
Figure 7-4: The sample area labelling window
322
Optimizing the trace display
Optimizing the Y-axis
Auto-scaling
The system can be configured to display the full unit range or a
range according to the maximum and minimum values of the
displayed trace(s) (auto-scaling function). In addition, the
auto-scaling function can be set to be live update (updates
while the sample area is moved) or delayed (updated when the
sample area is anchored).
Setting the auto-scaling function
2. Trackball to the Analysis window.
panel.
4. Trackball to Vertical auto-scaling.
5. Press SELECT.
The Vertical autoscaling menu is displayed.
Figure 7-5: The Vertical Auto-scaling menu
6. Trackball to the desired option:

• Delayed: autoscaling takes place after anchoring the
sample area.
• On: autoscaling while moving the sample area.
• Off: displays full scale.
7. Press SELECT.
323
Vertical units
Applicable with When analyzing contrast data, the Y-axis can be set to display
contrast data only. either logarithmic scale (dB) or linear, acoustical units (AU) for
both tissue intensity (2D) or Angio intensity data.
Selecting the Y-axis unit
panel.
4. Trackball to Vertical unit.
5. Press SELECT.
The Vertical unit menu is displayed.
Figure 7-6: The Vertical unit menu
6. Trackball to the desired option.

7. Press SELECT.
Trace smoothing
The system can smooth the traces displayed by applying a filter
over a defined time window. The type of filter available is
depending on the analysis signal displayed.
Smoothing trace(s)
panel.
The System menu is displayed. 324
4. Select Smoothing.
The Smoothing menu is displayed.
5. Select a smoothing filter.
The trace display is updated.
325
Switching modes or traces
The user can toggle between TVI, Tissue Tracking, Strain rate
or Strain modes to access to the mode specific controls (soft
menu and assignable) or display alternative traces from within
a selected mode.
To switch mode
1. Press MORE.
2. Select the desired mode (TVI, Tissue Tracking, Strain rate
or Strain.
The Soft menu and assignables are updated accordingly.
To switch trace
panel.
4. Trackball to Analysis signal.
5. Press SELECT.
The Analysis signal menu is displayed.
Figure 7-7: The Analysis signal menu
6. Trackball to the desired trace.

7. Press SELECT.
The Analysis window is updated with the selected trace.
326
Cine compound
Cine compound calculates and displays cineloops generated
from a temporal averaging of multiple consecutive heart cycles.
The number of averaged cycles is displayed on the top left
corner.
To apply cine compound:
1. Using the Soft menu rocker, adjust the number of heart
cycles to average.
The traces are updated showing averaged data. The
number of heart cycles averaged is displayed on the top
left corner.
2. Press the assigned key CC Zoom to display the last
recorded heart cycle.
3. Press CC Zoom again to unzoom.
327
Curve fitting analysis
Curve fitting analysis is used to estimate local myocardial
perfusion rate using ultrasound contrast agents.
The analysis is based on two algorithms:
• Wash-in curve fitting: find and estimate local perfusion
rate using contrast agent.
Exponential wash-in is described by the function:
y(t)=A[1-e-kt]+B, where:
• A (dB or AU) is the intensity from the contrast agent.
Note that A+B = • B (dB or AU) is the intensity at time t = 0 (defined as the
contrast + tissue = time of left marker). This corresponds to the tissue
plateau level. (baseline) signal if no contrast is present at the selected
starting point.
• k (1/s) is a time constant.
• Wash-out curve fitting: find and estimate the wash-out
rate of contrast agent locally (e.g. LV or myocardium).
Exponential wash-out is described by the function:
y(t)=Ae-kt+B, where:
• A (dB or AU) is the intensity from the contrast agent.
Note that A+B is • B (dB or AU) is the intensity from the tissue = baseline
the initial intensity signal.
level.
• k (1/s) is a time constant.
328
1200 1200
k=0.15
900 900 k=0.7
600 600
k=0.15
300 300
k=0.3
k=0.7
A B
0 1 2 3 4 5 6 7 8 9 10 0 1 2 3 4 5 6 7 8 9 10
1. Intensity (AU)
2. Time (s)
Figure 7-8: Curve fitting examples, A) wash-in, B) wash-out

A=900 AU, B=300 AU for all curves
329
Wash-in curve fitting analysis
Overview
The purpose of wash-in curve fitting analysis is to find and
estimate local perfusion rate using contrast agent. There are
two methods to obtain this information:
• Use the Real-time CPI application (see page 205) with low
transmit power (MI 0.1). Applying Flash will destroy most or
all contrast within the imaging plane. The period of low
power imaging immediately following the flash will contain
the information on how fast contrast agent washes into
different segments of the myocardium. By storing data 5 to
10 seconds after Flash and performing curve fitting to this
data set, the user can explore myocardial perfusion.
• Use the myocardial Contrast application in triggered mode
(page 197). This imaging mode is destructive for the
contrast agent, and the interval between each frame
determines the image intensity. Vary the triggering interval
to obtain information regarding how fast the contrast agent
washes into the myocardium after destruction.
Performing wash-in curve fit

From a contrast examination in Quantitative analysis:
1. Disable frames that are significantly different (i.e. because
of respiration or probe movements), see page 319.
Up to eight different 2. Trackball the sample area over the myocardium in one of
sample areas may be the Cineloop windows.
generated in the
myocardium. 3. Press SELECT to anchor a sample area in the myocardium.
4. If desired, reshape the sample area as described on
page 321.
Refer to ’Manual 5. Because of heart motion, the sample area in each frame
tracking of the sam- has to be adjusted manually to be located inside the
ple area (dynamic myocardium (Manual tracking of the sample area).
anchored sample ar-
ea)’ on page 316 for
The signals originating from the heart cavities are typically
further details 10 to 20 times stronger than the signals from the
myocardium, and will have a major effect on the averaging
of signals in the sample area.
6. Browse through the cineloop to ensure that the sample
area is in the same anatomical position in all frames.
330
7. Rotate the HORIZONTAL SWEEP assignable and scroll
through the cineloop to visualize a specific part of the data,
typically the region immediately after Flash.
8. Rotate the LEFT MARKER and RIGHT MARKER assignables to
apply curve fitting to a specific region.
panel.
11. Trackball to Curve fitting.
12. Press SELECT.
The Curve fitting menu is displayed.
Figure 7-9: The Curve fitting menu
13. Trackball to Wash-in.

14. Press SELECT.
The Wash-in curve is displayed in the Analysis window
(see Figure 7-10).
331
1. Parameter window
Figure 7-10: Wash-in curve fit of Real Time CPI data
Wash-in curve fitting using varying triggering

intervals
If the data set contains frames with uneven time intervals, e.g.
triggered images with increasing triggering intervals, it is
possible to plot the data using the time interval (dt) on the
X-axis.
1. Disable unwanted frames. Curve fitting will be performed
using all enabled frames.
The frame disabling 2. Trackball the sample area over the myocardium in one of
procedure is ex- the Cineloop windows.
plained on
page 319.
332
Up to eight different 3. Press SELECT to anchor a sample area in the myocardium.
sample areas may be
4. Repeat steps 2 and 3 if other sample areas are desired.
generated in the
myocardium. 5. If desired, reshape the sample area as described on
page 321.
See page 316 for 6. Perform manual tracking of the sample areas on all
more information frames to ensure that the sample area is inside the
on sample area myocardium.
manual tracking.
panel.
9. Trackball to Horizontal scale.
10. Press SELECT.
The Horizontal scale menu is displayed.
11. Trackball to dT scaling.
12. Press SELECT.
The X-axis in the Analysis window is updated accordingly.
13. Press UPDATE MENU again.
15. Press SELECT.
16. Trackball to Wash-in.

17. Press SELECT.
The Wash-in curve is displayed in the Analysis window.
333
Angio (dB)
(s)
1 2
1
1. Parameter window
Figure 7-12: Wash-in curve fitting after varying triggering interval
334
Wash-out curve fitting analysis
Overview
The purpose of wash-out curve fitting analysis is to find and
estimate a local wash-out rate. The analysis may be used for
wash-out of contrast from LV or myocardium.
Performing wash-out curve fitting

From a contrast examination in Quantitative analysis:
1. Disable frames that are significantly different (i.e. because
of respiration or probe movements), see page 319.
2. Trackball the sample area over the myocardium in one of
the Cineloop windows.
Up to eight different 3. Press SELECT to anchor a sample area in the myocardium.
sample areas may be
4. If desired, reshape the sample area as described on
generated in the
myocardium. page 321.
Refer to ’Manual 5. Because of heart motion, the sample area in each frame
tracking of the sam- has to be adjusted manually to be located inside the
ple area (dynamic myocardium (Manual tracking of the sample area).
anchored sample ar-
ea)’ on page 316 for
The signals originating from the heart cavities are typically
further details. 10 to 20 times stronger than the signals from the
myocardium, and will have a major effect on the averaging
of signals in the sample area.
6. Browse through the cineloop to ensure that the sample
area is in the same anatomical position in all frames.
7. Rotate the HORIZONTAL SWEEP assignable and scroll
through the cineloop to visualize a specific part of the data.
8. Rotate the LEFT MARKER and RIGHT MARKER assignables to
apply curve fitting to a specific region.
panel.
12. Press SELECT.
335
13. Trackball to Wash-out.

14. Press SELECT.
The Wash-out curve is displayed in the Analysis window
(see Figure 7-14).
Angio (dB)
(s)
Figure 7-14: Wash-out curve fit of two sample regions in an in-vitro

experiment
336
Anatomical M-Mode
Introduction
M-Mode applied to TVI, Tissue Tracking, Strain rate, Strain or
intensity data (Contrast) calculates and color/codes data
accordingly along a path drawn by the operator.
Using Anatomical M-Mode

1. Press the CAMM assignable.
2. In one of the Cineloop windows, trackball to the region from
where to start the sampling path.
3. Press SELECT to anchor the first point of the path.
4. Trackball to the location for the next anchoring point of the
path.
To edit a path under 5. Press SELECT to anchor the point.
construction, A path with two anchor points will give a straight
trackball back- anatomical M-Mode profile. By creating more than two
ward and retrace
the path.
anchor points, the user can bend the path and obtain a
curved anatomical M-Mode profile.
6. To end the trace press SELECT twice (double clicking).
Rotate HORIZ. The color-coded display of the corresponding data
SWEEP and scroll calculated along the path is shown in the Analysis window
through the (see Figure 7-15).
cineloop to optimize
the display to the
portion of interest.
337
1
1. Cineloop window 3. Path anchor point

2. Analysis window 4. Time scale
Figure 7-15: The anatomical M-Mode display (here TVI data)
338
Optimizing Anatomical M-Mode
Edition of the curve
The drawn Anatomical M-Mode path can be edited by moving
the anchor points.
To move an anchor point

1. Trackball to anchor point to move.
2. Press SELECT.
3. Trackball the anchor point to a new position.
4. Press SELECT to anchor the point to its new location.
339
Chapter 8
Archiving
• Introduction ................................................................................... ... 342

• Storing images and cineloops .................................................... ... 343
• Storing an image .......................................................................345
• Storing a cineloop .....................................................................345
• Saving stored images and cineloops to a standard format .......346
• MPEGVue/eVue .......................................................................348
• Retrieving and editing archived information ............................. ... 351
• Locating a patient record ..........................................................351
• Selecting a patient record and editing data in the archive ........355
• Deleting archived information ...................................................361
• Moving examinations ................................................................363
• Review images in archive ............................................................ ... 366
• Review the images from a selected examination .....................366
• Select images from the Image list screen .................................367
• Connectivity .................................................................................. ... 371
• The dataflow concept ................................................................371
• Stand-alone scanner scenario ..................................................375
• A stand-alone scanner and a stand-alone EchoPAC PC
environment ..............................................................................376
• A stand-alone scanner and a stand-alone DICOM workstation 378
• A scanner and EchoPAC PC in a direct connect environment .379
• A scanner and EchoPAC PC in a network environment ...........383
• A scanner and a DICOM server in a network ...........................385
• Export/Import patient records/examinations ............................. ... 395
• Exporting patient records/examinations ....................................395
• Importing patient records/examinations ....................................404
• Disk management ......................................................................... ... 408 340
• Configuring the Disk management function ..............................409
• Running the Disk management function ...................................411
• Data Backup and restore ............................................................. ... 416
• Backup procedure .....................................................................417
• Restore procedure ....................................................................421
• DICOM spooler .............................................................................. ... 423
• Starting the DICOM spooler ......................................................423
341
Introduction
During an examination, the operator stores data, images and
cineloops for immediate purposes. The Vivid 7 ultrasound unit
includes an integrated patient archiving system for data and
image storage.
Do not use the internal harddrive for long-term image storage.
CAUTION
The Vivid 7 ultrasound unit enables also storing of data and

images to external databases (EchoServer, Magneto Optical
(MO) disk or CD-R). The patient and image archives are set by
the selected dataflow (see page 551 about available dataflows
and default dataflow selection).
342
Storing images and cineloops
DICOM images are Images and cineloops that are stored during a current
stored to formatted examination are displayed as thumbnails on the clipboard (see
Magneto Optical Figure 8-1). When an image is stored, all the additional
disks separately
from patient data.
information that is displayed is saved with it (e.i. probe and
application selected, image setting, annotations or
measurements...).
The image archive is set by the dataflow selected (see
page 551 about available dataflows and default dataflow
selection).
Do not use the internal harddrive for long-term image storage.
A formatted (see page 562) Magneto Optical Disk is
CAUTION
recommended for image archive.
If working off-line with a dataflow pointing to a DICOM server, the

images stored during the examination will have to be manually
CAUTION resent in the DICOM spooler (page 423) when reconnecting the
unit. Resend all jobs that are failed or on hold (See page 423 for
more information on DICOM spooler.).
In addition, stored images and cineloops can be saved to a

removable media in the standard formats JPEG, MPEG, AVI
and DICOM (see page 346).
343
1. Single image stored
2. Cineloop stored Scrolling tool
3. Scrolling tool
Figure 8-1: The Clipboard on the scanning screen
344
Storing an image
Images are displayed chronologically on the clipboard.
1. While scanning in any mode, press FREEZE.
2. Trackball to scroll through the cineloop and select the
required image.
3. Press STORE.
The image is stored and a thumbnail is displayed on the
clipboard. The number “1” on the thumbnail image
indicates that the image stored is a single frame (see
Storing a cineloop
A cineloop is a sequence of images recorded over a certain
time frame. The time frame can be adjusted to cover one or
more heart cycles. The stored cineloops are displayed
chronologically on the clipboard. Cineloops can be stored at
any time during the scanning session. The user can choose to
preview the cineloop before storage or save the cineloop
directly as described below.
Preview and storage of a cineloop

1. While scanning in any mode, press FREEZE.
2. Press the Assignable CINELOOP.
3. Determine the best cineloop to store using the assignables
(see page 58 for further information on cineloop operation).
4. Press STORE.
The cineloop is stored and a thumbnail is displayed on the
clipboard (Figure 8-1, page 344).
Direct storage of a cineloop

Depending on whether the system has been configured to
enable or disable the Preview Loop before store function
(see page 521), the following procedures enable the cineloop
to be stored directly.
345
Storing cineloop without preview
The function Preview Loop before store is disabled (see
page 521).
1. While scanning, press STORE.
The last valid cineloop is stored in the archive and a
thumbnail is displayed on the clipboard (Figure 8-1,
page 344).
Scanning resumes immediately.
Storing cineloop with preview
The function Preview Loop before store is enabled (see
page 521).
1. While scanning, press STORE.
The last valid cineloop is previewed on the screen (but not
stored).
2. If desired, press CINELOOP and adjust the cineloop to be
stored using the assignables (see page 58).
3. Press STORE to save the cineloop.
A thumbnail is displayed on the clipboard (Figure 8-1,
page 344).
Saving stored images and cineloops to

a standard format
Stored images and cineloops can be saved to a removable
media in the following standard formats:
• Still images: JPEG, MPEG, DICOM and RawDICOM (Raw
data + DICOM)
• Cineloops: AVI, MPEG, DICOM and RawDICOM (Raw
data + DICOM)
Images can also be stored as MPEG format on a CD-R using
the Export function as described on page 348.
Procedure:
1. Trackball to the required image or loop icon on the
clipboard.
2. Press SELECT.
The selected image is displayed.
3. Press MENU on the control panel.
The System menu is displayed. 346
Figure 8-2: The System menu
4. Trackball to Save as.

5. Press SELECT.
The Save as menu is displayed.
Figure 8-3: The Save as menu
6. Select the desired removable media from the Save in

archive pull-down menu.
7. Enter a file name in the File name field.
347
If the image or cineloop is saved as DICOM or RawDICOM
the file name is automatically generated to follow the
DICOM standard.
8. Select between:
• Store image only: saves the image or cineloop only.
• Store secondary capture: creates a still image of the
image area and the Title bar.
The secondary capture is not available when saving
images as DICOM or RawDICOM.
9. Select the image compression type (JPEG or RIe) or no
compression.
10. Enter in the desired Image quality (between 10 and 100).
A high quality setting will give a lower compression.
11. In the Save as type field select one of the following formats:
• RawDICOM: saves the still image or cineloop in both GE
raw format and DICOM format.
• DICOM: saves the still image or cineloop in pure DICOM
format.
• JPEG: saves a still image in JPEG format.
• MPEG: saves the still image or cineloop in MPEG
format.
• AVI: saves the cineloop in AVI format.
12. Press Save.
A file is saved in the selected archive.
MPEGVue/eVue
MPEGVue/eVue enables the user to export or save an exam
(images, measurements and reports) into MPEG format
readable from a regular Windows computer together with a
special MPEG viewer. The measurements performed during
the exams are stored as an Excel file, the saved report as
Compiled HTML format.
MPEG exams can be created using the Export function
(MPEGVue) or by using the dataflow Local Archive - Int.
HD/eVue (eVue).
The MPEGVue option is used to create MPEG exams on
finished exams. The eVue option is used to create MPEG
exams when performing the exam, upon saving the images. 348
Creating a MPEG exam using the Export
function (MPEGVue)
Refer to ’Exporting patient records/examinations’ on page 395.
Creating a MPEGVue exam using the dataflow

Local Archive - Int. HD/eVue (eVue)
The dataflow must be configured before first time use as follow:
1. Press CONFIG (F2) and log on as administrator.
2. Select the Connectivity category and Dataflow subgroup.
The Dataflow sheet is displayed.
3. Select the dataflow Local Archive - Int. HD/eVue in the
Name pull-down menu.
Figure 8-4: The Dataflow sheet
4. Select the eVue device in the Selected devices pane and

press Properties.
The eVue properties window is displayed.
349
Figure 8-5: The eVue properties window
5. Select a removable media or a network volume remote path

as the destination in the Destination Pull-down menu.
Note: Remote paths of network volumes must be entered
once in the Remote path field before they can be selected
from the Destination Pull-down menu.
6. Check the options as required.
7. Select OK and press CONFIG (F2).
To create an MPEG exam using the dataflow Local Archive
- Int. HD/eVue
1. Press ARCHIVE.
The Search/Create patient window is displayed.
2. Select the dataflow Local Archive - Int. HD/eVue.
3. Perform an exam.
When saving an image, it is stored as raw data to the local
archive, a MPEG copy is created and stored to the
destination set during the configuration of the dataflow.
Reading a MPEG exam

A MPEG exam can be read from any computer with
Windows 98/2000/XP, provided that DirectX 8.1 or later and
Windows Media Player 7.1 or later are installed.
Refer to the MPEGvue User Manual for details on readings
MPEG exams on a computer.
350
Retrieving and editing archived information
Locating a patient record
To create an opera- 1. Press ARCHIVE on control panel.
tor ID, see If the unit is password protected a Log In window
page 575. (Figure 8-6) will appear asking for user ID, and password.
The unit can be con- 2. Press Log on when completed.

figured to automati- The Search/Create patient window is displayed
cally generate a (Figure 8-7).
patient ID (see
page 563) 3. Type the patient Last Name, and/or ID.
CAUTION
The automatic When default configured, the system automatically

searching tool dis- searches to see if the patient is already in the database.
playing matching The result of this search is displayed in the Patient list field.
patient information
in the Patient list 4. Trackball to the actual patient and press the Trackball
can be turned off SELECT key.
(see page 563) The patient record is highlighted.
5. Press SELECT PATIENT
Or
Press [+] in front of the actual patient record and select the
desired examination.
The Examination List window for the actual patient is
displayed (refer to Figure 8-9).
351
1. Press one of the headings to sort the list 4. Select the column heading border and drag to
accordingly. adjust column width
services examinations
3. Extended menu
The Search/Create patient window may be slightly different depending on the Dataflow selected
Figure 8-7: The Search/Create Patient window
352
Advanced search
The list of searching To restrain the search to a specific patient group, one or more
filters may vary de- filters may be applied to the search. The table below shows the
pending on the filters applicable to a patient search:
Dataflow selected
Searching filter
Echolab
Diag. code
Date of birth (time span)
Examination date (time span)
Current date
Images
Stress examinations
Report
Searching with filter:

The unit can be con- 1. Trackball to the More button in the Search/Create Patient
figured to display window.
the Advanced
search tool as de- 2. Press SELECT on the control panel.
fault (see page 563) The Search/Create Patient window is extended displaying
the searching filters (see Figure 8-8).
3. Type the information in the required searching filter field.
The matching data is displayed in the Patient list when the
automatic search function is turned on.
Sorting data
The search result can be sorted according to the fields
displayed in the patient list, in ascending or descending order.
To sort data:
1. In the Patient list field, Trackball to the field header by which
the sort is to be performed (Figure 8-8, page 354).
The patient list is sorted in ascending order according to
the field selected.
353
3. Press SELECT once more.
The patient list is sorted in descending order according to
the field selected.
1. Press one of the headings to sort the list 4. Select the column heading border and drag to
accordingly. adjust column width
services examinations
3. The system can be configured to display the
Advanced search tool as default (see page 563)
The Search/Create patient window may be slightly different depending on the Dataflow selected.
Figure 8-8: The extended Search/Create Patient window
Printing patient list

1. In the Search/Create patient window, select More to display
the additional menu.
2. Select Print Patients.
The displayed patient list is printed.
354
Selecting a patient record and editing
data in the archive
After locating the patient in the database (see page 351
page 354), the user must select the patient record, to be able to
review and edit archived data.
Selecting a patient record from the patient list

1. In the Search/Create patient window, trackball to the actual
patient and press the Trackball SELECT key.
The patient record is highlighted.
2. Press SELECT PATIENT.
The Examination List window is displayed showing
previous examinations and diagnosis information related
to the selected patient (see Figure 8-9).
355
1. The information displayed in the Patient list is 3. Insert pre-defined text in the Comment field
configurable (see page 563). 4. Select the column heading border and drag to
2. Go to Search/Create Patient window (see adjust column width
page 352)
Figure 8-9: The Examination list window
356
Editing Referral Reasons, Comments and
Diagnosis
The user can edit the actual text in the Examination List
window using the alphanumeric keyboard and by inserting
pre-defined text input.
The user is responsible for patient demographic data, diagnostic
information or any other patient related information entered in
CAUTION the database.
Text edition
1. In the Examination list window (Figure 8-9), trackball to the
required field.
2. Press SELECT.
Use the Arrow keys 3. Using the alphanumeric keyboard, edit the information.
to move text mark-
4. Press ARCHIVE on the control panel to quit the archive.
er.
Inserting pre-defined text input
1. In the Examination list window, trackball to Insert Text over
the actual field.
2. Press SELECT.
The Insert text window is displayed (see Figure 8-10).
The pre-defined text list is organized in a three level
hierarchy. Selecting one item in the first column displays
pre-defined text entries related to the selected text in the
second and third column.
3. Navigate through the pre-defined text list by selecting items
in the columns and double-click on the desired pre-defined
text to be inserted. If an entry in the third column is inserted,
the selected text in the second column is also inserted.
Press More>> to display the full text for the selected entry.
357
Figure 8-10: The Insert text window
Creating, editing and deleting text input

These features are described in ’The Comment texts sheet’ on
page 547.
Diagnosis code
Entering a Diagnosis code
1. In the Examination list window, select Code (see
Figure 8-9).
The Entered Code window is displayed.
2. Select Add.
The Code list window is displayed.
3. Double-click the code to enter.
The Code selected is displayed in the Examination list
window.
1. The Entered code window

2. The Code list window
Figure 8-11: Entering Diagnosis codes
Deleting an entered Diagnosis code

Figure 8-9).
The Entered code window is displayed.
2. In the Entered code window, select the code to delete and
press Delete.
358
Creating a Diagnosis code
Figure 8-9).
The Entered code window is displayed.
2. Select Add.
The Code list window is displayed.
3. Select New.
4. Enter the new code.
5. Select Done to exit.
See also ’The diagnostic codes sheet’ on page 545.
359
Editing Demographic details
If you modify the Patient ID, Last name, First name or Date of
birth on a patient in the archive, be aware that the contents of the
WARNING archived images for that patient is not updated. If the images are
still in the buffer and not yet archived, the image files are updated
if you modify any patient information, but not if the images are
archived. So if any of these images are later on exported to
DICOM media or DICOM server, they will still contain the original
patient information, as it was before you did the modification in
the archive. The system does not alter the contents of the image
files at all when doing DICOM export.**
1. Press PATIENT INFO.

The Patient information window is displayed.
2. Trackball to the field to edit.
4. Using the alphanumeric keyboard, edit the information.
CAUTION
Alternative: Press 5. Press the EXAM LIST assignable to go back to the

any active scanning Examination list window. OR
mode key. Press ARCHIVE on the control panel to quit the archive.
360
Deleting archived information
Only user logged in To delete a patient record
with full operator
rights can delete pa-
1. Press ARCHIVE on the Front panel.
tient records (see The Search/Create Patient window is displayed
page 575 for further (Figure 8-7, page 352).
information). 2. Type the patient Last Name, and/or ID.
3. Trackball to the actual patient record.
4. Press SELECT to highlight the patient record to delete.
5. Press Delete in the Search/Create Patient window.
A dialogue box is displayed asking for confirmation of the
deletion (Figure 8-12).
6. Trackball to OK and press SELECT on the control panel.
Figure 8-12: Delete patient record confirmation prompt
To delete an examination
The Search/Create Patient window is displayed
(Figure 8-7, page 352).
2. Type the patient Last Name, and/or ID depending on
system configuration.
3. Trackball to the actual patient record and double-click the
Trackball SELECT key (or press SELECT once and SELECT
PATIENT) to select the patient.
The Examination list window is displayed.
4. Trackball to the examination to delete. 361
5. Press the trackball SELECT key.
6. Press More in the Examination list window (see Figure 8-9,
page 356).
7. Press Del Exam to delete the examination.
A warning message is displayed asking the user to confirm
the action to perform (see Figure 8-13).
8. Trackball to OK and press SELECT to delete the selected
examination.
Trackball to Cancel and press SELECT to abort deletion.
Figure 8-13: Delete Examination prompt
To delete an image
The Search/Create Patient window is displayed.
3. Trackball to the required patient to highlight the record.
4. Press the SELECT assignable.
The Examination list window is displayed.
5. Trackball to the actual examination in the Examination list
window.
6. Press the SELECT assignable.
7. Press REVIEW.
The images for the selected examination are displayed on
the Review screen (Figure 8-16, page 367).
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Repeat steps 8 and 9 8. Trackball to the image to delete.
to delete several im-
ages.
10. Press Delete.
A pop-up dialog box is displayed asking for confirmation of
the deletion.
The image is deleted.
To delete an image from the clipboard

1. If in live, press FREEZE.
2. Press TRACKBALL until the Pointer tool is selected.
3. Move the pointer over the image to delete in the clipboard.
4. Press Update menu.
5. Select Delete clipboard cell from the Update menu.
A pop-up dialog box is displayed asking for confirmation of
the deletion.
The image is deleted.
Moving examinations
An examination can be moved from one patient record to
another. This feature should only be used if an examination
was performed and stored to a wrong patient record.
When moving an examination, verify that the target patient
record is correct.
CAUTION
1. In the Search/Create Patient window press [+] in front of

the patient record containing the examination(s) to move
2. Select the examination to move.
3. Press More in the lower, right-hand corner of the
Search/Create Patient window.
4. Press Move Exam.
The Move exam window is displayed.
363
Figure 8-14: The Move exam window
5. Search and select the target patient record.

6. Press Move Exam.
A warning message is displayed asking the user to confirm
the action to perform (see Figure 8-15).
Make sure that the patient record selected is correct.
CAUTION
364
Figure 8-15: Moving examination prompt
7. Trackball to OK and press SELECT.

An information window is displayed to confirm the
operation.
8. Press OK.
365
Review images in archive
There are two ways to access to archived images:
• Review the images from a selected examination.
• Select images from the Image list screen displaying all the
images sorted by examination sessions for the actual
patient.
Review the images from a selected

examination
1. In the Examination list window (see Figure 8-9, page 356),
trackball to the actual examination.
2. Press SELECT on the control panel to highlight the
examination.
3. Press REVIEW on the control panel.
The stored images for the selected examination are
displayed in the Review screen (see Figure 8-16).
To analyze images:
1. Press SELECT on the images to analyze.
2. Press ANALYZE.
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1. Page number 3. Selection tools
2. Selected image (bold frame)
Figure 8-16: The Review screen
Select images from the Image list

screen
The procedure described below enables the analysis of images
belonging to different examinations for a selected patient
record. If images are stored on multiple removable media, they
have to be restored to the local hard drive prior to review as
described below.
1. In the Examination list window (see Figure 8-9, page 356),
press Image list.
The Image list screen is displayed (see Figure 8-19)
showing thumbnails of stored images for the actual patient
sorted by examination.
367
If the images are stored on a removable media that is not
mounted, the image thumbnail is replaced by a symbol.
2. Press SELECT on the images to review or press ANALYSE to
review all images.
• If all images are available the images are displayed for
review.
• If some of the images are not available locally the
Restore images window is displayed.
Figure 8-17: The Restore images window
3. Select between:
• Restore only the selected images: only selected
images that are not available locally are restored.
• Restore all images of the selected exam: all images
that are not available locally in the exams where an
image was selected are restored.
• Restore current patient: restores all images in all
examinations.
4. Press OK.
The Insert media window is displayed.
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Figure 8-18: The Insert media window
5. Insert the required media.

6. Select between:
• OK: the images on the mounted media are restored on
the local hard drive. If not all the required images are on
the inserted media, the user is prompted to insert
another media until all required images are restored on
the hard drive.
• Skip media: the images stored on the media required
are not restored. If not all the required images are on the
inserted media, the user is prompted to insert another
media until all required images are restored on the hard
drive.
• Cancel: no images are restored.
The selected images are displayed for review.
369
1. Examination
2. Examination date and archive location
3. Selected image
4. Preview of selected image
5. Missing images
Figure 8-19: The Image list screen
370
Connectivity
This section describes the communication and connection
options for the Vivid 7 ultrasound unit with other devices in the
hospital information system. This section covers the
procedures for configuration and optimal data management
from a Vivid 7 in the following scenarios:
• A stand-alone Vivid 7 (page 375).
• A Vivid 7 and one or several EchoPAC PC workstations in
a sneaker net environment (page 376).
• A Vivid 7 and an EchoPAC PC workstations in a direct
connect environment (page 379).
• A Vivid 7 and a DICOM server in a network (page 385).
The dataflow concept

Communication between the Vivid 7 ultrasound unit and other
information providers on the network takes the form of
dataflows. Selecting a dataflow will automatically customize the
ultrasound unit to work according to the services associated
with this dataflow. Each dataflow defines the location and
format of patient information. Patient information can include
demographic data and images, as well as reports,
measurement and analysis data. By utilizing dataflows, the
user can configure the Vivid 7 ultrasound unit to optimally meet
the connectivity needs of the facility, while keeping the user
interface unchanged. The dataflow concept allows the flexibility
of data to be obtained from various sources and allows data to
flow to various output sources.
371
Dataflow examples
Refer to Chapter 12, ’Presets and System setup’ on page 514
for a complete list and description of supported dataflows.
Stand-alone scanner
The figure below illustrates two different dataflows for a
stand-alone scanner.
A: LocalArchive-Int.HD dataflow:
Vivid 7
The local database is used for A
patient archiving. Images are
stored to internal harddrive.
B: LocalArchive-MOD dataflow:
Vivid 7
The local database is used for B
patient archiving. Images are
stored to a MOD
Figure 8-20: Stand-alone scanner dataflows
372
Scanner in a network
The figure below illustrates two different dataflows for a
scanner connected to a network.
C: RemoteArch-Remote HD
dataflow: EchoPAC PC
A remote database (here
C
EchoPAC PC) is used for patient
archiving. Images are stored to a
remote archive (here
EchoPAC PC).
D: Worklist/LocalArchive-DICOM
Server/Int.HD dataflow: DICOM Server
Search in the DICOM Modality
D
Worklist, the patient found is copied
into the local database. Images are
stored to a DICOM server and to
the internal harddrive.
Figure 8-21: Scanner in a network dataflows (example)
Dataflow selection
Select a dataflow from the Search/Create Patient window (see
’Creating a new Patient record or starting an examination from
an existing patient record’ on page 48) or configure the system
with a default dataflow from the Configuration management
package as described below.
Default dataflow selection
1. Press CONFIG (F2) and log on as administrator if required.
The Dataflow sheet is displayed (see Figure 8-22).
3. Select the desired dataflow in the Name pull-down menu
and check the option Default.
4. Press CONFIG (F2) to exit the Configuration management
package.
373
1. Select Connectivity category
2. Select Dataflow subgroup
3. Select a dataflow
4. Default option for the selected dataflow
Figure 8-22: Default dataflow setting
374
Stand-alone scanner scenario
In this scenario images will most likely be reviewed from VCR
tape. If digital images are stored, they should be stored on the
scanner’s internal harddrive.
Vivid 7
Figure 8-23: Stand-alone scanner with LocalArchive-Int.HD dataflow
Data management
Data acquisition
1. Select the LocalArchive-Int.HD dataflow as default
dataflow.
In this configuration the local database is used for patient
archiving. Images are stored to internal harddrive.
Image review
The same dataflow is used for review on the system.
375
A stand-alone scanner and a
stand-alone EchoPAC PC environment
In this scenario the EchoPAC PC (one or several) is used for
review of studies acquired on one or more Vivid 7 without being
connected via a private or a local area network.
Images can be stored on the scanner’s internal harddrive
(recommended) or on a dedicated MOD.
Images stored on the internal harddrive
Vivid 7
EchoPAC PC
MOD
EXP
E XP IMP
Vivid 7: dataflow LocalArchive-IntHD

EXP: export from LocalArchive-Int.HD to Removable MOD Archive
IMP: import from Removable MOD Archive to LocalArchive-Int.HD
EchoPAC PC: dataflow LocalArchive-Int.HD
Figure 8-24: A stand alone scanner and a stand alone EchoPAC PC

environment with images stored on the scanner’s harddrive
In this configuration images are first stored on the scanner’s

harddrive and then exported from the scanner’s harddrive to a
MOD and finally imported from the MOD to the EchoPAC PC’s
internal harddrive.
Data management
Scanner’s dataflow configuration
dataflow.
The local database is used for patient archiving. Images
are stored to internal harddrive.
Export from Vivid 7
1. Export the data (images, demographics, measurements
and report) for the patient(s) to be reviewed on a blank
dedicated formatted MOD as described in ’Export/Import 376
patient records/examinations’ on page 395.
Export from LocalArchive-Int.HD to Removable MOD
Archive.
Make sure that the option Copy images is checked.
Import on EchoPAC PC
1. Select the LocalArchive-Int.HD dataflow on the
EchoPAC PC (can be configured as default dataflow).
The MOD dedicat- 2. Import the data from the Export/import MOD to
ed to Export/Import EchoPAC PC internal harddrive using the Import function
can be reformatted as described in the workstation user manual.
and reused.
Import from Removable MOD Archive to
LocalArchive-Int.HD
Make sure that the option Copy images is checked.
3. Press Archive and select the patient to be reviewed.
377
A stand-alone scanner and a
stand-alone DICOM workstation
In this scenario a DICOM workstation is used for review of
studies acquired on one a Vivid 7 without being connected via
a private or a local area network.
Vivid 7
DICOM Workstation
DICOM-MOD
EXP
E XP IMP
Vivid 7: dataflow: LocalArchive-Int.HD

EXP: export from LocalArchive-Int.HD to DICOM MOD
IMP: import from the MOD to the DICOM workstation
Figure 8-25: A stand-alone scanner stand-alone DICOM workstation
Data management
dataflow.
2. Export the data to the DICOM MOD using the following
settings: export from LocalArchive-Int.HD to Pure DICOM
MOD (see ’Export/Import patient records/examinations’ on
page 395).
378
A scanner and EchoPAC PC in a direct
connect environment
In this scenario the data is transferred from the Vivid 7 to a
dedicated EchoPAC PC workstation over the Ethernet (either in
a peer-to-peer connection with a crossover cable, or in a
network). The database from the EchoPAC PC is used as the
master and images are stored directly to the EchoPAC PC
internal harddrive. In this configuration the scanner is just an
intermediate acquisition unit which after completion of a study,
will not contain any patient information, measurements or
images.
Up to three scanners can be connected to one EchoPAC PC if
the workstation has the EchoPAC Share option enabled.
EchoPAC PC
Vivid 7: dataflow RemoteArch-RemoteHD

EchoPAC PC: dataflow LocalArchive-Int.HD
Figure 8-26: A scanner and EchoPAC PC in a direct connect

environment (peer to peer or network)
The acquisition can be done online or offline. Both situations

are described below.
Scanner’s connectivity configuration

If working in a peer-to-peer connection with a crossover cable
between a Vivid 7 and an EchoPac PC, the default delivery
TCP/IP settings should be used.
If working in a network, follow the procedure described below to
configure the scanner.
379
Scanner’s TCP/IP settings
To be able to use the network functions when connected to a
hospital network, the scanner must have a proper network
address. Typically source for this information in the network
administrator.
2. Select the Connectivity category and TCP/IP subgroup.
The TCPIP subgroup is displayed.
1. Computer name: device’s name of type 3. Remote archive setup: remote archive IP
VIVID7-00nnnn or ECHOPAC7-00nnnn, where address and name (EchoPAC PC or
“nnnn” is the system’s serial number. Do not EchoServer)
change the computer name. 4. Save TCP/IP settings. The changes will be
2. IP settings: system IP settings effective after the system is rebooted.
Figure 8-27: TCP/IP setting
3. In the IP settings area enter:

• The IP address for the scanner
• The subnet mask for the scanner
• The IP address for the Default Gateway
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4. In the Remote archive setup area enter:
• The IP address for the remote archive
• The name of the remote archive
5. Press Save settings and reboot the system.
Direct connect with online acquisition

Data management
1. Select the RemoteArch-RemoteHD dataflow as default
dataflow.
When saving the study on the scanner, the images are
transferred from the scanner’s image buffer to the
harddrive of the EchoPAC PC. Patient demographics,
measurements and reports are transferred on the fly when
entering the information on the Vivid 7.
Review on the EchoPAC PC workstation
1. Select the LocalArchive-Int.HD dataflow on the
Do NOT open a study on the EchoPAC PC workstation before the
study is closed on the scanner.
CAUTION
Direct connect with offline acquisition

Data management
Scanner’s dataflow configuration for offline
acquisition
1. When offline, select the LocalArchive-IntHD dataflow.
Export examinations done offline from the scanner to
EchoPAC PC
1. When reconnected, export the data (images,
demographics, measurements and report) for the
examination(s) done offline to EchoPAC PC as describes in
381
’Export/Import patient records/examinations’ on page 395.
Press Today to dis- Export from LocalArchive-Int.HD to
play today’s exams RemoteArch-RemoteHD.
to ease the search. Make sure that the option Copy images is checked.
The examination done offline can now be reviewed on the
workstation.
382
A scanner and EchoPAC PC in a
network environment
In this scenario the Vivid 7 is configured to work with an
ImageVault 3 or an EchoServer 7 patient demographics and
image server in a network environment. Images are first saved
on the local image buffer on the scanner and transferred to the
server when saving the examination.
The acquisition can be done online or offline. Both situations
are described below.
Network environment with online acquisition

Data management
1. Select the RemoteArch-RemoteHD dataflow as default
dataflow in the sublevel Dataflow in the subgroup
Connectivity of the Configuration management package
(see page 551 and following pages).
When saving the study on the scanner, the images are
transferred from the scanner’s image buffer to the server.
Patient demographics, measurements and reports are
transferred on the fly when entering the information on the
Vivid 7.
Review on the EchoPAC PC workstation
1. Select the RemoteArch-RemoteHD dataflow on the
Do NOT open a study on the EchoPAC PC workstation before the
study is closed on the scanner.
CAUTION
Network environment with offline acquisition

Data management
Scanner’s dataflow configuration for offline
acquisition
1. When offline, select the LocalArchive-IntHD dataflow.
383
Export examinations done offline from the scanner to
the server
1. When reconnected, export the data (images,
demographics, measurements and report) for the
examination(s) done offline to the server as described in
’Export/Import patient records/examinations’ on page 395.
Press Today to dis- Export from LocalArchive-Int.HD to
play today’s exams RemoteArch-RemoteHD.
to ease the search. Make sure that the option Copy images is checked.
To free space in the internal harddrive on the scanner,
check the command Delete selected patient(s) after
copy in the Export patient window (see Figure 8-38,
page 399).
The examination done offline can now be reviewed on the
workstation.
384
A scanner and a DICOM server in a
network
In this scenario the Vivid 7 is configured to work with a DICOM
server in a network environment. Images are first saved on the
local image buffer on the scanner. At the end of the
examination the images are sent to the DICOM server via a
DICOM spooler.
The DICOM server dataflows supported are:
• DICOM server: images are stored to a DICOM server.
• Local Archive - Int HD/DICOM Server: the local archive is
used for patient archiving. Images are stored to the internal
harddrive and to a DICOM server.
• Remote Archive - Remote HD/DICOM Server: a remote
database is used for patient archiving. Images are stored to
a network image volume and to a DICOM server.
• Worklist/Local Archive - DICOM Server/Int HD: search in
a DICOM Modality Worklist, the patient found is copied into
local database. The patient information and the
examination results are stored to the local database.
Images are stored to a DICOM server and to an image
volume on the local harddrive.
• Worklist/Remote Archive - DICOM Server/Remote HD:
search in a DICOM Modality Worklist, the patient found is
copied into a remote database. The patient information and
the examination results are stored to a remote database.
Images are stored to a DICOM server and to an image
network volume as pure DICOM in both locations.
• Query/Retrieve: retrieve images from a DICOM server
based on query parameters.
This scenario requires that the scanner is configured to be
connected to the DICOM server as described below.
Scanner’s connectivity configuration

The scanner’s TCP/IP settings must be configured as
described in ’Scanner’s TCP/IP settings’ on page 380.
In addition, to work against the DICOM server the following
information has to be entered in the scanner:
• The DICOM server IP address 385
• The DICOM server port number
• The DICOM server AE title (the server’s name)
Typically source for this information in the network
administrator.
Setup of the DICOM server in the scanner’s configuration
management package
DICOM dataflow selection
3. Select the DICOM dataflow to configure in the Name
pull-down menu (see Figure 8-28).
DICOM devices configuration

Depending on the DICOM dataflow selected, one or several
DICOM devices may have to be configured.
1. Select a DICOM device in the Selected devices pane and 386
press Properties (see Figure 8-29).
1. Select the DICOM device. 2. Press Properties.
Figure 8-29: Display of the DICOM device Properties window
The Properties window for the selected DICOM device is

displayed (Figure 8-30).
387
Figure 8-30: DICOM worklist properties window
2. Select the DICOM server from the IP-address pull-down

menu.
Follow the steps below if the IP address settings for the
DICOM server need to be modified or created:
• Select <Modify> from the IP-address pull-down menu.
The IPs window is displayed.
• Select the DICOM server and press Modify in the IPs
window (or press Add if creating a new IP address).
The Enter name and IP window is displayed.
• Enter the name and/or IP address of the server and
press OK to return to the Properties window.
388
Figure 8-31: Modifying/Creating the IP address
3. In the Properties window, enter:

• The DICOM server AE title. This entry is case sensitive
and must match exactly.
• The DICOM server port
For some DICOM servers, the default Timeout setting
may be too low.
When configuring the DICOM storage device, the following
image settings should be entered in the Properties
window:
• Check DICOM SR if required (see below).
• Keep Reopen per image unchecked.
• Keep Allow raw data unchecked.
• Set Max Frame rate to 30.
• Keep Only Black and White unchecked.
• Set Compression to JPEG.
• Set Quality to 95.
• Check Allow multiframe.
DICOM SR
DICOM Structured Reporting (SR) is a standardized format for
medical results. Vivid 7 and EchoPAC PC support the
specialized form for Adult Echo Ultrasound (“Supplement 72")
for M&A results.
With the DICOM SR support, M&A for an exam can be sent at
the end of the exam or when exported from local archive. The
destination can be either a server on the network (Storage
389
SCP) or a removable media (DICOM Media) depending on the
DICOM dataflow selected.
“Supplement 72" does not support all M&A results from Vivid 7
and EchoPAC PC. “Supplement 72" limits the information that
is possible to send to the following:
• Publicly coded parameters, no pediatric or fetal cardiac or
unassigned measurement.
Refer to the Vivid 7 Reference manual for a complete list of
supported parameters.
• Basic modes: 2D, M-mode, Color Flow, PW and CW
Doppler.
• Publicly coded methods, not Modified Simpson or Bullet.
Refer to the Vivid 7 Reference manual for a complete list of
supported methods.
• Basic derivations (Average, Last), no references between
the derived measurements and the ones they were made
from.
• Wall Motion Scoring: individual segment scores only
according to 16-segment model, no graded Hypokinesis
(only Hypokinesis is used).
Activating DICOM SR
DICOM SR must be activated for each DICOM device.
3. Select the DICOM dataflow to configure in the Name
pull-down menu (see Figure 8-28).
4. Select a DICOM storage device in the Selected devices
pane and press Properties.
The Properties window for the selected DICOM storage
device is displayed.
390
Figure 8-32: DICOM storage properties window
5. Check the option DICOM SR.

6. Select OK.
Adjusting the Search criteria
When selecting a DICOM Worklist dataflow or Query/Retrieve,
search criteria can be set for the system to use when searching
the database.
The Dataflow sheet is displayed (see Figure 8-33).
3. Select a DICOM Worklist dataflow or the Query/Retrieve
dataflow.
4. Select the Worklist or Query/Retrieve device in the
Selected devices pane and press Properties.
The Properties window for the selected DICOM device is
displayed.
5. Press Search criteria.
The Search criteria window is displayed.
6. Select a Search criteria from the Select tag pull-down
menu.
391
7. Enter a value if required or leave blank if not to be used.
This entry is case sensitive and must match exactly.
8. Press Add to list.
9. Press OK to close the Search criteria window.
1. The dataflow sheet

2. The Properties window for the Worklist device.
3. The Search criteria window
Figure 8-33: Adjusting the Search criteria
392
Checking the connection to the DICOM server
1. In the Dataflow sheet, select the DICOM device to verify the
connection to.
2. Press Check.
The verification process may takes several seconds.
• A green check mark is displayed in front of the DICOM
device if the verification is successful.
• A red cross is displayed in front of the DICOM device if
the verification failed.
Data management (DICOM dataflows)

Performing a study
Online scanner
1. In the Search/Create patient window, select a DICOM
dataflow.
2. If a DICOM worklist dataflow is selected, enter a search
criteria and press Query.
The patient list is updated.
3. Select or create a new patient and perform the examination
in a usual manner.
During the examination images are temporarily stored in
the local buffer on the system.
4. At the end of the study press END EXAM on the Control
panel.
The save images dialogue window is displayed.
5. Press All to save all images on the DICOM server or press
Select to display the Image review screen where to select
specific images to be saved.
The images are transferred to the server via the DICOM
spooler.
6. Press F4 or ALT+S to display the DICOM spooler (see
’DICOM spooler’ on page 423 for further details).
Offline scanner
When working offline the images are stored in the DICOM
spooler. Images are sent to the DICOM server when
re-connecting the system to the network.
1. If a DICOM worklist dataflow is selected, the patient list
393
must be queried before the system is disconnected.
2. After offline acquisition, the images stored on the DICOM
spooler are automatically sent to the DICOM server when
connecting the system.
Press F4 or ALT+S to display the DICOM spooler (see
’DICOM spooler’ on page 423 for further details).
394
Export/Import patient records/examinations
Patient records/examinations from the local archive on one
system (Vivid 7 or EchoPAC PC) can be exported to the local
archive on another system via a removable media. Patient
records/examinations from the local archive can also be
exported directly to a remote archive (Echo server, DICOM
server or EchoPAC PC depending on the environment). In
addition patient records/examinations from a remote archive
(Echo server or EchoPAC PC depending on the environment)
can be exported to a removable media or to a DICOM server.
Database information (patient and report archives) can be
exported with or without images. No data is deleted from the
source archive when exporting data unless the command
Delete selected patient(s) after copy is checked in the Export
patient window (see Figure 8-38, page 399).
Similarly, patient records/examinations from the local archive
on one system can be imported to the local archive on another
system via a removable media. Database information can be
imported with or without images. No data is deleted from the
source archive when importing data. In addition patient records
from a removable archive can be imported to a remote archive
(Echo server).
If an examination is opened, it must be closed before performing
Export/Import of patient records/examinations to guarantee that
CAUTION all data is included in the transfer.
Exporting patient records/examinations

1. Insert a removable media in the drive.
3. Select the source archive in the Dataflow field:
• LocalArchive-Int.HD: exports data from the local
archive.
• RemoteArch-RemoteHD: exports data from an Echo
server.
4. Press Export in the Search/Create Patient window.
The Export dialogue window is displayed.
395
Figure 8-34: The Export Dialogue window
5. Select one of the following available destinations from the

Destination drop-down menu:
• MOD Archive: exports raw and DICOM (if present) data
to a removable MOD.
• DICOM MOD 5.25: export DICOM data only to a
removable MOD.
• CD/DVD Archive: exports raw and DICOM (if present)
data to a CD/DVD.
• DICOM CD/DVD: export DICOM data only to a
CD/DVD-R/W.
• Remote Import/Export Archive: exports raw and
DICOM (if present) data to an Echo server (network) or
EchoPAC PC (direct connect or network).
• DICOM Server: exports DICOM data only to a DICOM
server.
• Excel file: exports data to a spreadsheet. The export
destination must be configured (see page 401).
• DICOM Print: prints images to a DICOM printer via
DICOM spooler.
• MPEGVue: exports examinations to MPEGVue format
readable from a regular computer. Ultrasound images
are stored as MPEG, measurements as an Excel file and
saved reports as CHM-files.
The export destination must be configured (see
page 401).
6. Press OK.
396
The following situations may occur:
• The system is checking that the removable media is
inserted. If not, a dialogue window is displayed
prompting the user to insert a media.
Figure 8-35: Insert media window
Insert the media and select Retry.

• The system is checking if the destination media is empty
and needs to be formatted. If yes an Information window
is displayed asking the user whether or not to format the
media.
Figure 8-36: Media formatting window
If desired enter a new label and select OK.

Note: only the following characters and signs can be
used when labelling a media: A - Z, a - z, 0 - 9, “_” and
397
“-”. Do not use more than 11 characters or signs. Do not
use space.
• If the media is not empty, the Add files window is
displayed.
Figure 8-37: Add files windows
Select Yes.
The system is preparing the media to allow addition of
new files.
The Export patient window is displayed (see Figure 8-38).
398
Figure 8-38: The Export patient window
7. Search and select the patient records/examinations to

export in the Patient list.
The following selection methods can be used:
• Press and hold down SHIFT while selecting patient
records/examinations to select several consecutive
items at a time.
• Press and hold down CTRL while selecting patient
records/examinations to select several discrete items.
• Press Select all in the Export patient window to export
all patient records.
Press More to dis- • Press Today to display today's examinations and select
play the extended the actual examinations.
Export patient
window if neces- • Fill in the Exam between field to display the patient
sary. records done during a specific time period and select the
actual records.
• Fill in the Born between field to display the patient
399
records of patients born during a specific time period and
select the actual records.
8. Adjust the following settings (if available) as desired:
• Delete selected patient(s) after copy
• Copy images
9. Press Copy.
If one or more patient examination is already present in the
destination archive the Export/Import conflict window is
displayed (see Figure 8-39). For each conflicting item,
select:
Keep: to keep the existing examination in the destination
archive.
Replace: to replace the existing examination with the
corresponding item in the source archive.
Figure 8-39: The Export/Import conflict window
Press OK to resume export.
400
A progress indicator is displayed. When done a status
window is displayed showing the number of patient records
that have been successfully exported.
10. Press OK.
A check mark is displayed in the Copied field in the Export
patient window for each item exported.
A status message is displayed for each item exported.
Make sure that the operation was successful for each item
exported.
11. Press Done in the Export patient window to complete the
process.
Do not eject the CD 12. Press ALT+E to eject the media.
using the button on The Eject device menu is displayed.
the CD drive
Figure 8-40: The Eject device menu
13. Select the relevant media.

The selected removable media is ejected.
Export configuration
The destination for Export of patient records to Excel and
MPEG must be configured prior to use. This is done from the
Dataflow sheet in the Configuration package.
To display the Dataflow sheet:
The Dataflow sheet is displayed (Figure 8-41).
3. Select the dataflow Misc. Export in the Name pull-down
menu.
401
Export to Excel configuration

1. Select the Excel storage device in the Selected devices
pane and press Properties.
The Excel properties window is displayed.
Figure 8-42: The Excel properties window

402
Export to MPEGVue configuration
1. Select the eVue device in the Selected devices pane and
press Properties.
The eVue properties window is displayed.
Figure 8-43: The MPEGVue properties window

3. Check the options as required.
403
Importing patient records/examinations
1. Insert the removable media of the source archive in the
corresponding drive (MO drive or CD-ROM).
3. Select destination archive in the Dataflow field:
• LocalArchive-Int.HD: imports data to the local archive.
• RemoteArch-RemoteHD: imports data to an Echo
server (network) or an EchoPAC PC (direct connect).
4. Press Import in the Search/Create Patient window.
The Import dialogue window is displayed (see
Figure 8-44).
Figure 8-44: The Import Dialogue window
5. Select one of the following available source archive from

the Source drop-down menu:
• MOD Archive: imports raw and DICOM data (if present)
from a MOD.
• DICOM MOD 5.25: imports DICOM data only from a
MOD.
• CD/DVD Archive: imports raw and DICOM data (if
present) from a CD/VDV-R.
• DICOM CD/DVD: imports DICOM data only from a
CD/DVD-R.
• Remote Import/Export Archive: imports raw and
DICOM (if present) data from an Echo server (network)
or EchoPAC PC (direct connect or network). 404
• Query retrieve: imports data from a DICOM server.
6. Press OK.
The Import patient window is displayed (see Figure 8-45).
Figure 8-45: The Import patient window
7. Search and select the patient records to import in the

Patient list.
The following selection methods can be used:
• Press and hold down SHIFT while selecting patient
records/examinations to select several consecutive
items at a time.
• Press and hold down CTRL while selecting patient
records/examinations to select several discrete items.
• Press Select all in the Import patient window to export
all patient records.
405
Press More to dis- • Press Today to display today's examinations and select
play the extended the actual examinations.
Import patient
window if neces- • Fill out the Exam between field to display the patient
sary. records done during a specific time period and select the
actual records.
• Fill out the Born between field to display the patient
records of patients born during a specific time period and
select the actual records.
8. Adjust the following settings (if available) as desired:
• Copy images
9. Press Copy.
If one or more patient examination is already present in the
destination archive the Export/Import conflict window is
displayed (see Figure 8-39). For each conflicting item,
select:
Keep: to keep the existing examination in the destination
archive.
Replace: to replace the existing examination with the
corresponding item in the source archive.
406
Figure 8-46: The Export/Import conflict window
Press OK to resume import.

A progress indicator is displayed. When done a status
window is displayed showing the number of patient records
that have been successfully imported.
10. Press OK.
A check mark is displayed in the Copied field in the Import
patient window for each item imported.
A status message is displayed for each item imported.
Make sure that the operation was successful for each item
imported.
11. Press Done in the Import patient window to complete the
process.
407
Disk management
The Disk management function allows the user to manage hard
disk space while maintaining the patient database on the
system. The Disk management function can be used to move,
copy or delete images and reports from the oldest patient
records (configurable). The Disk management function has
also an auto-purge feature that will automatically delete images
and reports that have already been copied if the local hard disk
is getting full.
Three different disk management scenarios are possible
depending on the system configuration:
When moving or • Disk management is set to move files: the user runs the
copying files a copy Disk management function on a regular basis to move
of the patient ar- images and reports from older patient records to removable
chive is also created
on the media.
media or to a network volume. Using this setting, moved
images and reports are deleted from the local hard drive
and copied to the specified destination. This scenario
prevents the local disk to fill up and keeps images and
reports from the most recent patient records on the local
disk. Using this scenario, the user can control what should
remain on the system while keeping the disk free space at
an operational level.
• Disk management is set to copy files: the user runs the
Disk management function on a regular basis to copy
images and reports from older patient records to removable
media or to a network volume. To prevent the local disk to
fill up, the auto-purge function automatically deletes files
that were previously copied when the disk free space has
reached the minimum allowed limit. This scenario lets the
system automatically manage the disk space on the
system.
Note: when using this setting, the images location
displayed in the Examination list screen will be the
selected destination for the copy operation, even if the
images are still present on the local hard drive. When
reviewing the exam, the original images will be retrieved
from the local hard drive as long as they are available
there. When the images are deleted from the local hard
drive by the auto-purge function, the copied images will be
retrieved.
408
• Disk management is set to delete files: the user runs the
Disk management function on a regular basis to delete
images and reports from older patient records.
Ensure that you have established a data management protocol
for your office/institution. The user MUST manage the
removable media used when running Disk management by
keeping a log and by creating a media filing system.
A person should be in charge of performing the process. The
Disk management system can be set up so that a reminder is
displayed at a regular time span.
Configuring the Disk management

function
Configuration of the Disk management system can only be
done by user with administration rights.
If required log on as administrator.
2. Select the category Admin.
3. In the Admin category, select the sheet Disk management.
409
1. Sets the reminder time interval for running Disk management.
2. Sets the files to be managed based on the examination dates.
3. Sets the Disk management to copy, move or delete images.
4. Sets the destination device.
Figure 8-47: The Disk management sheet
Disk management schedule setting

1. Next to Reminder interval, specify the number of
days/weeks you want the system to prompt you to perform
disk management.
This setting should be set based on the activity of your
office/institution. If None is selected, no reminder will be
displayed.
Data management settings

1. Select a number of days, weeks or months or a specific
date next to Manage files older than. Only files older than
the specified setting will be copied or moved.
If none is selected, all files will be copied or moved.
410
2. Next to Operation check:
• Copy: the images and reports from the examinations
older than the specified setting defined in step 1 are
copied to the specified destination. Using this setting,
the files will exist in two locations, the local hard drive
and the media used to copy to.
• Move: the images and reports from the examinations
copied to the specified destination, verified and then
deleted from the local hard drive. Using this setting, the
files will exist in one location, the media used to move
the files to. They are removed from the local hard drive.
• Delete: the images and reports from the examinations
deleted from the hard drive.
Destination device setting

1. Next to Destination device, select a removable media or a
network shared folder.
Note: to be able to select a network shared folder in the
Destination device field, its path must have been entered
once in the field next to Remote path.
If using removable media, it is recommended to use dedicated
media to the Disk management process. Removable media used
CAUTION for data backup must not be used when performing Disk
management.
Do not use the same removable media on several systems.
Running the Disk management function

The Disk management function can be run at any time. In
addition, the user may be prompted to run Disk management if
the time since the last Disk management operation performed
has reached the setting for the Reminder interval (see
page 410), or if the local hard drive is about to be full.
Manual start of Disk management

1. Press ARCHIVE on the control panel.
2. Press More in the Search/Create patient window to display
additional menu options and select Disk management. 411
The Disk management welcome screen is displayed
(Figure 8-48).
Figure 8-48: The Disk management welcome screen
The Disk management operation will either copy, remove

or delete files from the local archives depending on the
Disk management configuration (see page 409). Make
sure that the correct configuration is set.
3. Press Next.
The Storage size information window is displayed
(Figure 8-49).
Verify the information displayed. If using removable media,
the operation may require several media as specified on
the screen. Make sure to gather the necessary number of
disks.
412
Figure 8-49: The Storage size information window
4. Insert a removable media in the specified drive.

The disk does not need to be formatted.
5. Press Next.
The Copying files window is displayed (Figure 8-50).
413
Figure 8-50: The Copying files window
The system automatically formats and labels new disks. If

the media contains backup or export data, a Warning
window is displayed.
Select between:
• Cancel: the Disk management process is stopped.
• Eject: the media is ejected, a new media must be
inserted to resume the Disk management process.
• OK: (Export disk only) the export data on the disk is
deleted and the Disk management process is resumed.
This choice is not available if the disk contains backup
data.
The information displayed on the Copying files window is
updated while the files are being copied.
6. If more than one media is necessary the filled media is
ejected and a dialogue window is displayed asking the user
to label the ejected disk and insert a new media.
Press OK after the new media is inserted.
The operation is resumed.
When all the files are copied, the media is automatically
ejected.
7. Press Next to continue. 414
The Summary window is displayed (Figure 8-51), showing
a list of the disks used.
• Select Print summary to print the list for archiving
purpose.
• Select Detailed summary to display the list of the
patient records copied.
Figure 8-51: The Summary window
8. Make sure that all media are physically labelled according

to the list displayed in the Summary window. The media
label should also have an identification of the system the
Disk management was run from.
9. Press Done to complete the Disk management operation
and file the media.
415
Data Backup and restore
The Backup/Restore function enables the user to:
• Copy/Restore the patient archive.
• Copy/Restore the system configuration. The Copy/Restore
system configuration feature enables the user to configure
several units with identical presets, providing that the units
have the same software version.
To minimize accidental loss of data, perform backup of the
patient archive stored on the local harddrive at least once a
week.
GE Medical Systems is not responsible for lost data if the
suggested backup procedures are not followed and will not aid
WARNING in the recovery of lost data.
There is no backup function for the images or reports (no

creation of a safety copy). For long-term storage, images and
reports should be moved to removable MOD or to a network
shared folder using the Disk management procedure (see
page 408).
DO NOT use the local harddrive for long-term image storage.
CAUTION
The backup of the patient archive on the harddrive and the

system configuration is done from the configuration
management package as described on page 417.
Data from Backup/Restore disks may be restored to the local
harddrive using the Restore procedure as described on
page 421.
Only users with administration rights have access to the
backup/Restore function.
416
Backup procedure
1. Press ARCHIVE.
The Operator login window is displayed.
2. Select the operator with administration rights, enter the
password and press Log on.
3. In the Search/Create patient window, select the dataflow
Local Archive - Int. HD.
Figure 8-52: Dataflow selection for backup

6. Select the Backup sheet.
Figure 8-53: The Backup sheet
7. In the Backup sheet select as needed:

417
• Patient archive to backup the patient records.
• System configuration to copy system settings and
user presets.
8. Select a removable media or a shared network folder as
destination.
Note: to be able to select a shared network folder, the path
(of type: \\server-name\share-name) must be entered once
in the Remote path field.
9. If the backup is done to a removable media, insert a
dedicated media in the drive.
10. Select Start backup.
The following situations may occur:
• The system is checking that the removable media is
inserted. If not, a dialogue window is displayed
prompting the user to insert a media.
Figure 8-54: The Insert media window
Insert the media and select OK.

• The system is checking if the media needs to be
formatted. If yes, the media is automatically formatted.
An Information window is displayed showing the media
label.
418
Figure 8-55: The Information window
Write down the label and select OK.

• The system is checking if there is already a backup or a
Disk management copy on the media. If the following
error message is displayed, the disk is ejected and the
user is asked to use a new media that does not contain
any backup or Disk management data.
Figure 8-56: The Replace current media window
Insert a new media and select OK.

Note: to reuse a Backup media when performing a new
archive backup, the media has to be re-formatted first.
11. During backup, Progress windows are displayed showing
the current operation being performed.
Figure 8-57: The Backup progress windows 419

12. At the end of the process, the media is ejected and the
Backup completed window is displayed.
Figure 8-58: The Backup completed window
Select OK.
The Backup result is displayed on the Backup sheet.
Figure 8-59: The Backup result
13. Make sure to physically label the media. An identification of

the system should also be noted on the media and a
backup log should be kept.
File the media in a safe place.
420
Restore procedure
3. Select the Restore sheet.
Figure 8-60: The Restore sheet
4. In the Restore sheet select as needed:

• Patient archive to restore the patient archive.
• System configuration to restore all system settings
and user presets.
OR
• One or several system configuration items to restore
parts of the system settings and user presets (see
Figure 8-60).
5. Make sure that Restore from Source Device is selected.
6. Select the appropriate Source device.
The Restore procedure will OVERWRITE the existing data on the
local harddrive. Make sure to select the correct source device.
CAUTION
421
7. If restore is done from a backup on a removable media,
insert the media in the drive.
The Restore procedure will OVERWRITE the existing data on the
local harddrive. Make sure to insert the correct media.
CAUTION
8. Select Restore now.

Depending on the selection, one or two Restore
confirmation windows are displayed:
Figure 8-61: The Restore confirmation window
9. Ensure that the correct source is selected an select OK.

The selected items are copied to the systems. If items from
the system configuration are restored the system needs to
be rebooted. The Reboot system window is displayed.
Figure 8-62: The Reboot system window
10. Select OK to reboot the system.
422
DICOM spooler
DICOM spooler displays the current DICOM output jobs. The
jobs may be Storage, Print, Modality Performed Procedure
Step or Storage Commitment. The DICOM spooler is used for
checking the current job's status when a job is saved or when
the total spooler status on the right of the Archive windows
displays an error.
From the DICOM spooler the user can also:
• Delete non-active jobs
• Resend a job that has failed or is in hold
• Send a job that has failed or is in hold, to a new destination.
• Hold a job that is not active.
The job's status displayed in the DICOM spooler window can
be:
• Pending: the job is complete, waiting to be active.
• Hold: the job is complete, but suspended, waiting for an
user action.
• Append: the job is incomplete, waiting for more images
(Direct store function).
• Active: the job is complete and connected to the
destination device.
• Failed: the job is complete but one or more images failed to
transmit to the destination device.
• Done: the job is saved to the destination device. The jobs
that are done are removed from the spooler after a while.
Starting the DICOM spooler

Alternative: Press 1. On the alphanumeric keyboard, press and hold down the
F4. ALT key and press S.
The DICOM spooler window is displayed (see
Figure 8-63).
The DICOM spooler window is automatically updated. Press
Refresh to update the information displayed at any time.
423
Figure 8-63: The DICOM job spooler window
Deleting a job
Only non-active 1. Trackball to the job to delete in the DICOM job spooler
jobs can be deleted. window.
Note: several jobs can be selected.
2. Press SELECT.
3. Trackball to Delete.
4. Press SELECT.
Resending a job
Only jobs that 1. Trackball to the job to re-send in the DICOM job spooler
failed or are in hold window.
can be resent. Note: several jobs can be selected.
2. Press SELECT.
3. Trackball to Resend.
4. Press SELECT.
Sending a job to a new destination

Only jobs that 1. Trackball to the job to send in the DICOM job spooler
failed or are in hold window.
can be sent to a new
destination. 2. Press SELECT.
3. Trackball to Send to....
424
4. Press SELECT.
A dialogue window is displayed.
5. Select the new destination from the Destination popup
menu.
6. Trackball to Send.
7. Press SELECT.
Holding a job
1. Trackball to the job to hold in the DICOM job spooler
window.
Note: several jobs can be selected. Only inactive jobs can
be set on hold.
2. Press SELECT.
3. Trackball to Hold.
4. Press SELECT.
To undo hold, press Resend.
425
Chapter 9
Report
• Introduction ................................................................................... ... 427

• Creating a report ........................................................................... ... 428
• Working with the report function ...............................................428
• To print a report ........................................................................431
• To store a report .......................................................................431
• Retrieving an archived report ....................................................432
• Deleting an archived report .......................................................432
• Structured Findings ..................................................................... ... 433
• Prerequisite ...............................................................................433
• Starting Structured Findings .....................................................434
• Structured Findings structure ....................................................434
• Using Structured Findings ........................................................436
• Structured Findings configuration .............................................439
• Direct report .................................................................................. ... 450
• Creating comments ...................................................................450
• Creating pre-defined text inputs ................................................452
• Report designer ............................................................................ ... 453
• Accessing the Report designer .................................................453
• Report designer overview .........................................................454
• Designing a report template ......................................................457
• Saving the report template ........................................................467
• To exit the Report designer ......................................................468
• Report templates management ................................................... ... 469
• Configuration of the Template selection menu .........................469
• Export/Import of Report templates ............................................471
426
Introduction
The Vivid 7 system enables the creation of patient and
examination reports containing measurements, images and
analysis that were made during the examination. The layout of
the reports is defined by generic templates delivered with the
system. Custom templates can also be made.
Saved reports are read-only. Therefore it is recommended that
the data is carefully reviewed before the report is saved. Use
the worksheet (see page 301) to facilitate the review and
adjustment of data before generating a report. The final report
can be printed on a regular laser printer.
427
Creating a report
Reports summarize data obtained in the examination. They can
contain data and images.
Once generated, the report can be viewed, images can be
added, wall segment diagrams can be assigned and text can
be entered in the free text fields. All other information must be
changed from the Patient information window and the
Worksheet screen.
Working with the report function

1. Press REPORT.
The default template for the current examination is
displayed (see Figure 9-1). The information entered during
the examination is automatically filled in (e.g.
demographic, Diagnosis, Comments...etc.).
428
1. Assigned keys
• Print
• Store
• Retrieve
• Template
• Insert text
MORE menu
• Save as
• Delete
• Designer
• Findings
Figure 9-1: The Report screen and assigned keys
429
To choose another report template
1. Press the assignable TEMPLATE.
The Template selection menu is displayed showing the
available report templates organized by application.
Note: The Template selection menu can be configured to
display only the templates of interest (see page 469).
2. Do one of the following:
• Select a template from the current application template
list.
• Select another application and select the desired
template from the sub-menu displayed.
Note: From a sub-menu, select Back to return to the
current application template list.
The selected template is displayed on the screen.
To change patient information

1. Trackball to heading of the information to change.
The trackball marker is changed to a hand with pointing
finger .
2. Press SELECT on the Trackball area.
The original location of the data is displayed.
3. Change the information entered if required.
4. Press REPORT when completed.
To add an image to the report

Images are inserted in the report by dragging a selected image
from the clipboard into an Image container in the report.
1. Trackball to the Image of interest in the Image clipboard.
2. Press and hold down the SELECT key and using the
trackball, drag the selected image in the Image container in
the report.
3. To move images between image containers, press and
hold down the SELECT key and using the trackball, drag the
selected image to the new location.
4. To remove an image from the report, press and hold down
the SELECT key and using the trackball, drag the selected
image back to the clipboard.
430
To print a report
Only members of the user group “Cardiologist” are allowed to
print a report (see page 575).
1. Press PRINT.
The report is printed on the default printer. A status window
is displayed showing the printing process.
For printer configuration, see page 511.
To store a report
store a report (see page 575).
1. Press STORE.
The report is stored in the Report archive.
A confirmation window is displayed when completed.
2. Press OK.
Alternative storage
Reports can also be saved in a user-defined locations in the
following formats:
• Compiled HTML (.CHM) files: readable from any web
browser.
• Portable Document Format (.PDF) files: readable with
Adobe Acrobat reader.
1. Press MORE.
The additional controls are displayed (Figure 9-1).
2. Press SAVE AS.
The Save as dialogue window is displayed.
3. Select the destination folder from the Save in pull down
menu. The default location is the Export folder.
The Report archive folder is selected by default.
The default name for the report is of type:
<exam DICOM UID>.
4. Select PDF or CHM format from the Save as type pull down
menu.
5. Press SAVE.
431
Retrieving an archived report
1. Press RETRIEVE.
A list of the available reports for the actual examination is
displayed.
The default name for a report is of type:
<template type>_<store date>_<store time>.
To display the current report, select Show active exam.
2. Trackball to the report to retrieve.
3. Press SELECT.
Deleting an archived report

delete a report (see page 575).
1. Press MORE.
The additional controls are displayed (Figure 9-1).
2. Press DELETE.
A list of the available reports for the actual examination is
displayed.
The default name for a report is of type:
<template type>_<store date>_<store time>.
3. Trackball to the report to delete.
4. Press SELECT.
432
Structured Findings
Structured Findings is a feature that enables the user to insert
pre-configured structured diagnostic statements and codes
(e.g Billing, Accreditation) in the patient report and create a
conclusion based on the inserted statements.
Prerequisite
To be able to insert structured diagnostic statements and create
a conclusion in a patient record, the report template used must
have assigned fields for the structured findings, the codes and
the conclusion.
To create the assigned fields in a report template:
1. Press REPORT.
2. Press TEMPLATE and select the desired report template.
3. Press MORE and DESIGNER.
The Report designer screen is displayed.
4. Select the location in the report template where to insert the
Structured findings fields.
5. Select Insert and Archive Information.
The Archive information box is displayed (Figure 9-2).
6. Double-click on Select All under all three parameter fields
in the Archive information box to deselect all parameters.
7. Select Structured findings, Findings conclusion
Indication codes and Billing codes in the Exam
Information field (Figure 9-2).
8. Select OK.
9. Save the Report template and exit the Report designer.
433
Figure 9-2: The Archive information box
Starting Structured Findings

1. Press REPORT.
Make sure the current template has a Structured Findings
field and a Conclusion field defined or select another
template if necessary.
2. Press MORE and FINDINGS.
The Structured Findings window is displayed (Figure 9-5).
Structured Findings structure

The diagnostic statements are organized in tab folders (see
Figure 9-3). Each tab folder may contain:
• Underlying tab folders that contain Tab sheets.
• Tab sheets that contain diagnostic statements.
434
1. Tab folder with underlying tab sheets
2. Tab sheet
Figure 9-3: Structured findings structure
There are three types of diagnostic statements (see

Figure 9-4):
• Check box statement: when selected the statement is
included in the report.
• Combo box statement: create a statement by selecting one
alternative text among several choices.
• Statement group: create several statements by selecting
multiple check box statements.
435
1. Check box statement
2. Combo box statement
3. Statement group
Figure 9-4: Diagnostic statement types
Using Structured Findings

1. Start Structured Findings (see page 434).
2. Browse to the tab sheet containing the statements of
interest.
3. To insert a statement in the report (Findings field):
• Check box statement: select the statement.
• Combo box statement: select an alternative text in the
combo box next to the statement.
• Statement group: select the statements of interest within
the group.
A preview of the selected statement(s) is displayed in the
Findings preview field (see Figure 9-5). The statement text
in the preview field can be edited. This will apply only for
the current report.
Once a statement is selected an asterisk is displayed on
the tab of the current sheet and folder.
Note: select Normal to select only normal statements from
the current tab sheet (see page 443 for more information
on how to define normal statements). 436
Note: select Clear to deselect all statements from the
current tab sheet.
To insert a conclusion statement in the report:

• Press the Conclusion button in front of the statement of
interest.
A preview of the selected conclusion statement is
displayed in the Conclusion preview field (see Figure 9-5).
Conclusion statements are displayed in a numbered list.
The list can be reordered: triple-click on the conclusion
statement to move in the Conclusion preview field and use
the ARROW UP or ARROW DOWN key to move the statement
up or down.
The conclusion text in the preview field can be edited. This
will apply only for the current report.
To display the changes in the report, select Refresh
report.
Note: pressing the Conclusion button in front of a
statement that was not previously selected results in
simultaneously inserting the finding statement and create
the conclusion.
4. Press OK.
The report for the current patient is displayed with the
selected findings, conclusion statement(s) and associated
codes (if any).
Note: Some diagnostic statements have measurements
values in the body text referred by a tag (e.g the {EF} tag
refers to EF measurement). These statements require that
the actual measurement is done to display correctly in the
report.
437
1. Statement inserted in the Conclusion and Findings field.
2. Statement inserted in the Findings field only.
3. Findings preview field
4. Conclusion preview field
5. Remove all selections.
6. Insert normal findings for the current tab sheet.
Figure 9-5: Structured Findings window
Global selection of normal statements

It is possible to select all normal statements from all tab sheets.
1. Place the cursor in the Statement field, press UPDATE MENU
438
on the control panel and select All normal.
All statements defined as normal are selected from all the
tab sheets. An asterisk is displayed on the tab of all the tab
sheets that contain normal statements.
Note: this operation will remove any other “non-normal”
previously selected statements.
2. To remove all statements at once, place the cursor in the
Statement field, press UPDATE MENU and select Clear all.
Structured Findings configuration

Structured Findings configuration is used to:
• Create, edit or delete finding statements, conclusion
statements and codes.
• Organize the diagnostic statements in the Structured
Findings screen.
• Define the normal diagnostic statements.
Accessing the Structured Findings

configuration screen
1. Press CONFIG (F2) and select the Report category.
2. Select the Structured Findings tab.
The Structured Findings configuration screen is displayed
(Figure 9-6).
Or from within Structured Findings:
1. Press UPDATE MENU on the control panel and select Config.
439
1. Structured Findings structure tree:
• tab folder
• tab sheet
• Check box statement
• Combo box statement
• Statement group
2. Tab or statement label
3. Findings text
4. Conclusion text
5. Codes for the selected statement
6. Create, move, copy or delete statement
7. Create folder, Combo box or statement groups
8. Enter a variable in statement or conclusion text
9. Hide selected tab or statement from the Structured Finding window
10. Set the selected statement as normal
11. Rest factory default findings
12. Export/import findings.
Figure 9-6: Structured Findings configuration screen
440
Creation of a tab folder
The following procedure describes how to create a new top
level tab folder.
1. Configuration window
2. Structured findings window
Figure 9-7: New tab folder
1. In the Structured Findings configuration window

(Figure 9-6), select the Structured Findings tab folder.
2. Select Add.
A new entry is created in the Structured Findings tab
folder. The new entry is by default a tab sheet ( ).
3. Select Enable one more tab level to change the new entry
to a tab folder ( ).
A warning message is displayed. Select OK.
4. With the new entry selected, follow the following steps:
• Enter a name in the Label field (tab name).
• Enter a description in the Findings text field. The
description will be displayed in the report as a heading
when selecting a statement from the underlying tab
sheets. The system is always using the Findings text
from the highest item in the structure as a heading for
the selected underlying statements.
• Enter the appropriate codes.
441
Note: to enter several codes separate each code by a
space.
5. Press Up or Down to move the tab in the structure tree (or
do drag and drop).
Creation of a tab sheet

The following procedure described how to create a tab sheet in
a tab folder.
Figure 9-8: New tab sheet
1. Make sure that the tab folder is selected and press Add.
A new entry is created in the tab folder. The new entry is by
default a tab sheet ( ).
• Enter a name in the Label field (tab name).
• Enter a description in the Findings text field.
If required:
space.
442
Adding statements in the tab sheet
Check box statement
The following procedure describes how to create a check box
statement.
Figure 9-9: New check box statement
1. Make sure that the tab sheet is selected and press Add.
A new entry is created in the tab sheet. The new entry is by
default a check box statement ( ).
• Enter a name in the Label field (statement name).
• Enter the full statement in the Findings text field.
• Enter a conclusion in the Conclusion text field (optional).
Note: if the Conclusion text field is left empty, the
statement text will be used as conclusion when
selected.
443
If required:
space.
• Check Include findings in normal report to define the
statement as normal.
All statements within the selected tab sheet that have
this option checked will be included in the report when
Normal is selected in the Structured Findings window
(see ’Using Structured Findings’ on page 436).
Combo box statement
The following procedure describes how to create a combo box
statement.
444
Figure 9-10: New combo box statement
1. Create a new statement as described above. A check box

statement is created by default.
2. With the new statement selected, press Add.
A new underlying entry is created and the parent
statement is changed to a Combo box statement ( ).
3. With the new underlying entry selected, follow the following
steps:
• Enter a name in the Label field.
• Enter a text in the Findings text field. 445
• Enter a conclusion in the Conclusion text field (optional).
4. Repeat the procedure from step 2 to create as many
underlying statements as necessary. Each underlying
statement will be a selectable entry in the combo box.
Statement group
Statement groups are created by changing a combo statement
to a statement group.
1. Create a combo box statement as described above.
2. Make sure the combo box statement is selected and
deselect the option Enable pull-downs.
The combo box statement is changed to a statement group
( ). Each underlaying entries are changed to check box
statements.
Editing a statement
Tab label, statements and statement alternative texts can be
edited.
(Figure 9-6), select the item to edit.
2. Make the required changes.
Inserting variable parameters in a statement

Variable parameters such as patient name, institution name,
measurement values...etc can be inserted in a statement as
tagged information.
To insert variable parameters in a statement:
1. Place the cursor at the required position in the Findings text
field (or Conclusion text field).
2. Press Insert parameter.
The Insert parameter window is displayed (see
Figure 9-11).
3. Browse and select the actual parameter to insert.
Note: for measurement values, select first the scanning
mode.
4. Press OK.
The selected parameter is inserted in the statement as a
tag (e.g the {EF} tag refers to EF measurement)
446
Note: to display correctly in the report, the actual
parameter value must exist, e.g. if a measurement value is
included in a statement as a variable parameter, a
measurement value must exist for the current patient,
otherwise the parameter name is displayed.
Figure 9-11: Insert parameter window
Copy of a statement
Tab folders, tab sheets and statements can be copied from one
location to another. The word “Copied” is added to the copied
item name.
(Figure 9-6), select the item to copy.
2. Select Copy.
3. Select the item to contain the copy.
4. Select Paste. 447
Note: if the item to copy cannot be copied in the selected
location, the operation is ignored.
Note: copy can be done by drag-and-drop, while holding
CTRL depressed.
Deletion of a statement
Tab folders, tab sheets and statements can be deleted.
Deletion cannot be undone.
CAUTION

(Figure 9-6), select the item to delete.
2. Select Delete.
The selected item is deleted.
Factory reset
All statements can be reset back to the factory default.
Factory reset cannot be undone.
CAUTION
1. Select Reset.
The Reset statements window is displayed.
2. Select:
• Yes to reset all statement to the factory default (No
undo).
• No to cancel the operation.
Exporting/Importing statements
Diagnostic statements can be exported from one system and
imported on another system.
Exporting statements
(Figure 9-6), select Export.
A browsing window is displayed.
2. Browse to a destination and select Save.
448
Importing statements
Importing statements will replace the current statements. If
necessary, backup the current statements by exporting them
CAUTION before performing import.

(Figure 9-6), select Import.
A browsing window is displayed.
2. Browse to a destination and select Open.
449
Direct report
Direct report enables the user to insert comments at any time
during the examination that will be part of the final report.
Direct report provides also an overview over the measurements
completed.
Creating comments
2. Select Direct report (see Figure 9-12).
3. In the Direct report screen, select the comment type.
4. Type your comments in the Text field.
5. To add a measurement in the comment, double-click a
measurement in the Measurement overview field.
450
1. Open Direct report
2. Select the type of information
3. Create/insert pre-defined text
4. Text field
5. List of measurements completed
6. Exits the Direct report
Figure 9-12: The Direct report
451
Inserting pre-defined text input
1. Select the insertion point in the Text field.
2. Select Insert text.
The Insert text window is displayed (see Figure 9-13).
Figure 9-13: The Insert text window
The pre-defined text list is organized in a three level

hierarchy. Selecting one item in the first column displays
pre-defined text entries related to the selected text in the
second and third column.
3. Navigate through the pre-defined text list by selecting items
in the columns and double-click on the desired pre-defined
text to be inserted. If an entry in the third column is inserted,
the selected text in the second column is also inserted.
Press More>> to display the full text for the selected entry.
Creating pre-defined text inputs

This feature is described in ’The Comment texts sheet’ on
page 547.
452
Report designer
The Report designer software package enables the user to
create report templates that best suit its needs.
Designing a report template consists of choosing the
information to display in the report (e.g. header, footer, logo,
patient information, images, measurements...etc.) and arrange
it in the report viewer.
The Report designer function is based on the information
container concept: each type of information is included within a
container with parameters that can be configured (size, color,
font properties, information to display...etc.).
Accessing the Report designer

1. Press REPORT on the Control panel.
The Report screen is displayed.
2. Press DESIGNER.
The Report designer screen is displayed with the selected
template in the Report template design area (see
Figure 9-14).
453
Report designer overview
The Report designer screen
1. Menu bar
2. Report template design area
Figure 9-14: The Report designer screen
454
The menu bar
Menu Description
File • New: start working on an new template.

• Save: save the template using the same name. Factory
report templates cannot be overwritten.
• Save as: save the template using a new name.
• Page setup: define printing orientation and
header/footer for the printed report.
• Print Preview: display a print preview of the report
template.
• Exit: exit the Report designer and returns to the report
function. The user can choose whether to save the
updates or restore the original template.
Menu Description
Edit • Delete: remove the selected object from the report

template.
• Undo: restore the previous state of the report template.
455
Menu Description
Insert • Page Break: insert a new page in the report template.

• Table: configure and insert a table in the report
template.
• Logo: select and insert a logo to the report template.
• Archive info: select and insert data from the following
categories:
Patient information
Exam information
Site information
• Anatomical graphics: select and insert an anatomical
graphic (cardiac, vascular or TEE).
• Image: create a container for the display of ultrasound
images.
• Wall motion analysis: insert a container for the display
of Stress Echo analysis results (cut planes Bull’s eye
and scoring table).
• OB/GYN: insert OB graph.
• Measurements: insert a container for the display of
measurements and calculations. When creating a
measurement container, the user is prompted through a
configuration procedure enabling the selection of mode
specific measurements and/or calculations.
• Text field: insert a container where the user can write in
the report.
• Fixed text: insert a container with static text. The text
typed during the creation of the container will be
displayed in the report.
Menu Description
Preferences • Page Color: sets the default background color for the
template page.
456
Designing a report template
Starting template designing
1. Start the Report designer (see page 453).
2. Press File and select New to display a blank page or use
the current report template as basis template.
Setting the layout preferences

Adjusting the report page color background
1. Press Customize and select Page Color.
The Color selection window is displayed.
2. Select the desired color.
3. Press OK.
Header and footer in the printed report
This function is described on page 466.
Inserting an information container in the

report template body
The different type of information to be included in a report are
grouped in information containers. Designing a report template
consists in inserting and configuring the different information
containers in the template page in an ordered manner.
Information containers can be inserted either:
• Directly into the report template body: this procedure does
not allow side-by-side insertion, the information container
will normally cover the width of the report template page.
• Within a table: this procedure allows side-by-side insertion
of several information containers.
Inserting a table
1. Press the Left mouse button at the desired insertion point
in the Report template design area.
2. Press Insert and select Table.
The Container properties window is displayed (see
Figure 9-15).
3. Adjust the parameters as desired.
4. Press OK.
The table is displayed in the template. 457
Note: To modify an inserted table, double-click in an empty
area in the table. A selection menu is displayed where the
user can add, delete a row or a column or open the Table
properties window.
Figure 9-15: The Table properties window
Inserting a logo
1. Provide the hospital logo in JPEG or Bitmap format onto a
CD or MO disk.
2. Select the location where to insert the logo (a table cell or
directly in the report template).
3. Select Insert and Logo.
The Logo box is displayed.
Figure 9-16: The logo box 458

4. Select a logo, or if not available, select Import logo.
Browse and select the logo and select OK.
5. Specify the appearance.
6. Select OK.
Inserting fixed text

Fixed text is an entry that cannot be changed in the report (e.g.
hospital information).
1. Select the location where to insert the fixed text (a table cell
or directly in the report template).
2. Select Insert and Fixed text.
The Fixed text box is displayed.
Figure 9-17: The Fixed text box
3. Enter the text and specify the appearance.

4. Select OK.
Inserting archive information

Archive information contains all the objects of the different
information menus (Patient, Exam, Study and Site Information).
You may display the archive information over two columns
using a table container as described below.
1. Insert a table for the archive information to the desired
location (a table cell or directly in the report template).
2. Select the first table cell. 459
3. Select Insert and Archive information.
The Archive information box is displayed.
Figure 9-18: The Archive information box
4. If desired, enter a heading and select a heading link from

the pull-down menu.
5. Select the Information parameters to be displayed in the
first cell.
Select Box properties to change the font, alignment,
appearance, etc.
6. Select OK.
7. Select the next table cell and repeat steps 3 to 6 to enter the
remaining archive information.
Inserting an Image container

• Select the location where to insert the fixed text (a table cell
or directly in the report template).
• Select Insert and Image.
The Ultrasound image box is displayed.
460
Figure 9-19: The Ultrasound image box
• If desired, enter a heading, set the container size and

specify the text appearance.
• Select OK.
Inserting measurement containers

You may display the measurements over several columns
using a table container as described below.
1. Insert a table for the measurements to the desired location.
2. Select the first table cell.
3. Select Insert and Measurements.
The Measurements box is displayed.
461
Figure 9-20: The Measurements box
4. Enter a heading (e.g. 2D).

5. Using the Filter criteria, define the type of measurements to
be displayed (e.g. Cardiac, 2D, measured and calculated).
Select Show normal value to display user-defined Normal
value next to the measurements in the Report (see
’Normal values’ on page 287 for more information).
Note: References for the normal values can be displayed
in the report by checking Normal value references from
Insert -> Archive Info (see page 459).
The Measurement list on the left side is updated.
6. From the measurement list, select the measurement to
insert and press Add. Both single measurements or a folder
may be added.
7. The list of the inserted measurements is displayed in the
Selected measurement list on the right side.
8. Press OK.
9. Select the next table cell and repeat steps 3 to 8 to insert
several measurements.
Inserting Text fields

Text fields are: 462
• Containers for Referral reasons, Comments and Diagnosis
information.
• Containers for free text, where the user can type
information in the report.
1. Select the location where to insert the text field container (a
table cell or directly in the report template).
2. Select Insert and Text field.
The Text field box is displayed.
Figure 9-21: The Text field box
3. Enter a heading.
4. From the Display field, select between:
• Referral reasons: displays the information entered in
the Direct report (see page 450) or in the Examination
list window.
• Comments: displays the information entered in the
Direct report (see page 450) or in the Examination list
window.
• Diagnosis: displays the information entered in the 463
Direct report (see page 450) or in the Examination list
window.
• Free text 1-8: creates an empty free text container.
5. If desired, adjust the font settings for the header and data.
Inserting Wall motion scoring analysis

containers
Two different containers must be inserted for the Wall motion
scoring analysis:
• A Wall motion scoring diagrams container (Cut planes or
Bull’s eyes)
• A Wall motion scoring table
Inserting Wall motion scoring diagrams container
1. Select the location where to insert the free text container (a
table cell or directly in the report template).
2. Select Insert, Wall motion analysis and select between
Cut planes and Bull’s eye.
The corresponding Wall motion scoring box is displayed.
Figure 9-22: The Wall motion scoring box (Cut planes)
3. Adjust the parameters and select OK:

The scoring diagrams are inserted in the report template
Inserting Wall motion scoring table container
1. Place the cursor right below the Wall motion scoring
464
diagrams container.
2. Select Insert, Wall motion analysis and select Score
table box.
The Score table box is displayed.
Figure 9-23: The Score table box
3. Adjust the layout parameters in the Score table box and

select OK.
The Score table is inserted in the report template.
Editing the information container

Resizing the information container
1. Move the Mouse cursor over the border of the container to
resize.
The mouse cursor is changed to a cross .
2. Press Left mouse button once.
The container is displayed with anchor squares on the
sides and at the corners.
3. Resize the container by dragging from the anchor points.
Editing the information container properties
Modifying the container’s specific properties
1. Move the Mouse cursor over the border of the container to
edit.
The mouse cursor is changed to a cross .
2. Double-click on the Left mouse button.
The Container box is displayed.
3. Adjust the parameters specific to the selected container.
465
Note: Some information containers have additional
parameters that may be adjusted by selecting Box
properties.
Inserting a new page

1. In the template, position the Mouse cursor at the insertion
point.
2. Press the Left mouse button.
3. Press Insert and select Page Break.
Inserting header and footer

Header and footer may be defined to be displayed in the
printed report. The header and footer are not visible in the on
screen report.
To insert header and footer in the printed report:
1. Select File and Page setup.
The Page setup box is displayed.
Figure 9-24: The Page setup box
2. Adjust the printing orientation.

3. Define the header and footer for the printed report, by
typing text and entering the required variables listed in the
table below.
Check Different on first page and create a specific
header/footer for the first page.
4. Select OK. 466
To check the display of the header and footer, select File
and Print preview.
Variable Description
{pid} Patient ID
{pnm} Patient name
{pdb} Patient date of birth
{exd} Examination date
{prd} Current date (printing date)
{prt} Current time (printing time)
{cp} Current page
{tp} Page count
{c} Subsequent entries are centered
{r} Subsequent entries are right aligned
Saving the report template

Replace an existing template
Factory templates cannot be overwritten.
1. Press File and select Save.
A dialogue window is displayed asking for confirmation.
2. Select:
• Yes to save the report template
• No to discard the report template
• Cancel to go back to the Report designer without saving
the report template.
Save existing template with a new name

1. Press File and select Save as.
The Save as template window is displayed.
467
Figure 9-25: The Save as template window
2. Enter a name for the template.

3. Press OK.
The template is saved.
To exit the Report designer

1. Select File and Exit.
The Exit window is displayed.
2. In the Exit window, select:
• Yes: to save the report template and exit the application.
• No: to exit the application without saving the changes
made in the report template.
• Cancel: to return to the application.
468
Report templates management
This section describes:
• Configuration of the Template selection menu.
• Deletion of user-defined report templates.
• Export/import of user-defined report templates.
The report templates management is done from the Report
templates sheet in the system configuration package.
To access to the Report templates sheet:
1. Press CONFIG (F2) and select the Report category.
The Report category sheet is displayed.
Figure 9-26: The Report template sheet
Configuration of the Template selection

menu
The Template selection menu displays the application specific
report templates that can be selected when creating a report.
The Template selection menu can be configured to display only
the templates of interest.
469
Inserting a template in the Templates
selection menu
1. Press CONFIG (F2) and select Report.
The Report template sheet is displayed (Figure 9-26)
2. In the Available templates field (left field), select the
template to insert in the Template selection menu.
3. Next to Section, select the appropriate application.
4. Press the Right arrow button .
The selected template is inserted in the Template selection
menu.
Note: Double-clicking on a template in the Available
template field will also insert the template in the Template
menu.
Removing a template from the Template

selection menu
1. In the Report template menu field (right field), select the
template to remove.
2. Press the Left arrow button .
The selected template is removed from the Template
selection menu.
Note: Double-clicking on a template in the Report template
menu field will also remove the template from the Template
menu.
Sorting the templates in the Template

selection menu
1. In the Report template menu field, select the template to
move.
2. Press the Up or Down arrow buttons .
The selected template is moved accordingly in the
Template selection menu.
Deleting a report template from the system

Only user-defined report templates can be deleted from the
system.
1. In the Available templates field (left field), select the report
to delete (Figure 9-26).
2. Press Delete.
470
A Confirmation window is displayed.
3. Select Yes to delete the report template.
Export/Import of Report templates

User-defined report templates can be exported to a removable
media and imported from the removable media into another
system (Vivid 7/EchoPAC PC).
Export of Report templates

1. Insert a removable media in the in the drive.
The Report template sheet is displayed (Figure 9-26,
page 469).
3. Select Export Templates.
The available user-defined templates are displayed in the
Export templates window.
Figure 9-27: The Export templates window
4. Select the templates(s) to export. Multiple selection can be

done using SHIFT or CTR key.
5. Select the desired removable media under Select target
device.
6. Press OK.
A Confirmation window is displayed. 471
7. Press OK.
The selected template(s) are exported to the removable
media.
8. Press ALT + E and select the media to eject.
Import of Report templates

1. Insert the removable media with the report template(s) to
import.
The Report template sheet is displayed (Figure 9-26,
page 469).
3. Select Import Templates.
The Import template window is displayed.
Figure 9-28: The Import template window
4. Select the source device from the pull-down menu.

5. Press OK.
6. Press OK.
The templates are imported into the system.
7. Press ALT + E and select the media to eject.
472
Chapter 10
Probes
• Probe overview ............................................................................. ... 474

• Supported probes .....................................................................474
• Probe orientation ......................................................................479
• Probe labelling ..........................................................................479
• Maximum probe temperature ....................................................481
• Probe Integration .......................................................................... ... 483
• Connecting the probe ...............................................................483
• Activating the probe ..................................................................486
• Disconnecting the probe ...........................................................487
• Care and Maintenance ................................................................. ... 488
• Planned maintenance ...............................................................488
• Inspecting the probe .................................................................489
• Cleaning and disinfecting probes ..............................................490
• Probe safety .................................................................................. ... 493
• Electrical hazards .....................................................................493
• Mechanical hazards ..................................................................493
• Biological hazards .....................................................................494
• Biopsy ............................................................................................ ... 495
• Precaution concerning the use of biopsy procedures ...............495
• Preparing the Biopsy guide attachment ....................................496
• Displaying the Guide zone ........................................................500
• Biopsy needle path verification .................................................501
• Starting the biopsy procedure ...................................................501
• Cleaning, disinfection and disposal ..........................................501
473
Probe overview
The Vivid 7/Vivid 7 PRO ultrasound unit supports four types of
probes:
• Phased Array Sector
• Linear Array
• Curved Array (Convex)
• Continuous Wave Doppler
Supported probes
Phased Array Sector probes
Probe Mode Intended use Technical data
3S 2D mode Cardiology Frequency: 1.5–3.8 MHz

M-Mode Coronary Foot print: 18 x 24 mm
Color Flow Transcranial
CW Doppler Abdomen
PW Doppler Pediatric
M3S 2D mode Cardiology Frequency: 1.5–4.3 MHz

CW Doppler Abdomen
M4S 2D mode Cardiology Frequency: 1.5–4.3 MHz

CW Doppler Abdomen

Color Flow Pediatric
CW Doppler
PW Doppler
474

CW Doppler
PW Doppler

CW Doppler
PW Doppler

CW Doppler
PW Doppler
3Va 2D mode Cardiology Frequency: 1.5–4.0 MHz

M-Mode 4D and Multi-plane Foot print: 21 x 26 mm
Color Flow imaging
CW Doppler
PW Doppler
a) Vivid 7 Dimension only
Linear Array probes
7L 2D mode Peripheral vascular Frequency: 2.2–8.0 MHz

M-Mode Small parts Foot print: 17 x 58 mm
Color Flow
PW Doppler
9L 2D Peripheral vascular Frequency: 3.0–10.0 MHz

M-Mode Small parts Foot print: 14 x 52 mm
Color Flow
PW Doppler
475
10L 2D mode Small parts Frequency: 4.0–10.0 MHz

M-Mode peripheral vascular Foot print: 17 x 49 mm
Color Flow
PW Doppler
12L 2D mode Small parts Frequency: 4.9–13.0 MHz

M-Mode peripheral vascular Foot print: 17 x 49 mm
Color Flow
PW Doppler
M12L 2D mode Carotid Frequency: 4.9–14.0 MHz

M-Mode Superficial Foot print: 10 x 45 mm
Color Flow
PW Doppler
i8L 2D mode Cardiac intraoperative Frequency: 3.9–10.0 MHz

M-Mode Foot print: 16 x 44 mm
Color Flow
PW Doppler
i13L 2D mode Cardiac intraoperative Frequency: 5.3–14.0 MHz

M-Mode Foot print: 10 x 28 mm
Color Flow
PW Doppler
Curved Array (Convex) probes
3.5C 2D mode Abdomen Frequency: 2.0–5.0 MHz

M-Mode Fetal Heart Foot print: 18 x 64 mm
Color Flow Obstetrics FOV: 70 degrees
PW Doppler Pelvic
Renal
4C 2D mode Abdomen Frequency: 1.6–5.0 MHz

PW Doppler Pelvic
Renal 476

PW Doppler Pelvic
Renal
M7C 2D mode Abdomen Frequency: 2.9–7.0 MHz

PW Doppler Pelvic
Renal

M-Mode Carotid Foot print: 23 x 10 mm
Color Flow Neo Head FOV: 128 degrees
PW Doppler
E8C 2D mode Fetal Heart Frequency: 3.7–8.0MHz

Color Flow Obstetrics Foot print: 23 x 10 mm
PW Doppler Pelvic FOV: 128 degrees
Doppler probe
2D (P2D) CW Doppler Cardiology Frequency: 2.0 MHz

PW Doppler
6D (P6D) CW Doppler Carotid Frequency: 5.0 MHz

PW Doppler 5.8 MHz
Multiplane Transesophageal Phased Array

probe
477
6T/6T-RS 2D mode Transesophageal Frequency: 2.7–7.0 MHz

M-Mode Cardiology
Color Flow
CW Doppler
PW Doppler
6Tc 2D mode Transesophageal Frequency: 2.7–7.0 MHz

M-Mode Cardiology
Color Flow
CW Doppler
PW Doppler
9T/9T-RS 2D mode Transesophageal Frequency: 3.1–10.0 MHz

M-Mode pediatric Cardiology
Color Flow
CW Doppler
PW Doppler
5T 2D mode Transesophageal Frequency: 2.7–7.0 MHz

PAMPTE M-Mode Cardiology
Color Flow
CW Doppler
PW Doppler
478
Probe orientation
Some probes are provided with a green light (LED) orientation
marking near their head (see Figure 10-1). Probes which do
not have a LED have an indentation (notch) for orientation on
the probe housing. This LED, or notch, corresponds with the V
mark on the scanning screen. The V mark indicates the
orientation of the probe to the scan.
1. LED 3. V-mark on screen: indicates the orientation of

2. Notch the probe to the scan.
Figure 10-1: Orientation marking on probe and on screen
Probe labelling
Each probe is labelled with the following information:
• Name of distributor and manufacturer
• Operating frequency
• Model number
• Probe serial number
• Year of manufacture
479
The probe name displayed on both the probe housing and the
connector can be read when the probe is connected.
1. CE mark
2. Probe name
M12L
MODEL 2250695
SERIAL
Figure 10-2: Probe labelling (examples)
480
Maximum probe temperature
Probe Max Temp Probe Max Temp
3S 41.1 i8L 37.6
M3S 40.7 i13L 36.2
3V 42.6 3.5C 40.4
M4S 42.2 4C 41.1
5S 39.8 5C 40.9
6S 40.8 M7C 41.0
7S 38.2 8C 40.5
10S 40.1 E8C 37.1
7L 38.7 6T/5T/PAMPTE 40.7
9L 40.6 6Tc 41.9
10L 39.9 9T 37.6
12L 38.2 P2D 37.1
M12L 40.8 P6D 38.9
Notes: Lens temperature measured under following conditions

per IEC 60601-2-37 Amd.1:
1. Thermocouple was placed at the geometric center of the
lens.
Thermal phantom 2. a: Thermal phantom at 37 °C for non-external probes.
made with tis- b: Thermal phantom at 33 °C (or 23 °C) for external
sue-mimicking ma- probes. (Temperature rise is measured and added to 33 °C
terial as referenced
in IEC60601-2-37
if the phantom is at 23 °C).
Amd 1: Annex II.2 c: P2D and P6D with probe transmitting in air, no
phantom.
3. Probe placed upright in contact with above thermal
phantom.
4. Auto-freeze capability is disabled.
5. Lens temperature is monitored for 30 minutes.
6. 6T/6Tc/5T/PAMPTE, 9T, M4S and 3V probes are equipped
with internal temperature sensor and mechanism to monitor
and limit temperature. 481
7. a: Measurement uncertainty for probes with temperature
sensor: 0.3 °C
b: Measurement uncertainty and probe variation for other
probes: 2 °C
482
Probe Integration
This section covers:
• Connecting the probe
• Activating the probe
• Disconnecting the probe
Connecting the probe

Probes can be connected at any time, whether the unit is on or
off.
Systems with the 4D Imaging option installed have one probe
port of a new type (Figure 10-3).
A B
A: system without 4D Imaging option B: system with 4D Imaging option

1. Standard probe ports 1. Standard probe ports
2. Park probe port 2. Probe port for 4D Imaging option
Figure 10-3: Probe ports
Do not allow the probe head to hang freely. Impact to the probe
head may result in irreparable damage.
CAUTION
Do NOT touch the patient and any of the connectors on the

ultrasound unit simultaneously, including ultrasound probe
WARNING connectors.
To connect a probe
1. Hold the probe connector vertically with the cable pointing
483
upward.
2. Turn the connector locking handle counterclockwise.
3. Align the connector with the probe port and carefully push
into place.
4. Turn the locking handle clockwise to the full vertical position
to lock in place.
5. Position the probe cable so that it is not resting on the floor.
Take the following precautions with the probe cables:
• Keep free from the wheels.
CAUTION • Do not bend.
• Do not cross cables between probes.
Connecting the PAMPTE or the 6Tv probe

Transesophageal probes require a special handling. Refer to the
user documentation enclosed with these probes.
CAUTION
The PAMPTE and the 6Tv probes are equipped with a Vivid
Five connector. To connect the these probes on the
Vivid 7/Vivid 7 PRO, an adaptor must be used (see
Figure 10-4).
To connect the PAMPTE or 6Tv probe:
1. Turn the probe connector locking handle to the horizontal
position.
2. Align the connector with the adaptor port and carefully push
into place.
3. Rotate the probe connector locking handle to the full
vertical position to lock the probe connector and the
adaptor together.
4. Ensure that the locking handle on the adaptor is in up
position (see Figure 10-4).
5. Align the adaptor with the probe port and carefully push into
place.
6. Move the locking handle to the down position to lock in
place (see Figure 10-4).
7. Position the probe cable so that it is not resting on the floor.
484
1. PAMPTE or 6Tv probe connector in
2. To the system probe port
3. Unlocked position
4. Locked position
Figure 10-4: The PAMPTE probe adaptor
Connecting the 6T-RS or the 9T-RS probe

CAUTION
The 6T-RS and the 9T-RS probes are equipped with a Vivid i
connector. To connect these probes on the Vivid 7, an adaptor
must be used (see Figure 10-5).
485
1. Insert the RS adaptor in the system probe port.
2. Lock the adaptor.
3. Insert the RS type probe connector in the adaptor.
4. Lock the probe connector
Figure 10-5: The RS probe adaptor
Activating the probe

When a probe is connected to the unit it is automatically
detected.
To select a probe and an application:

To change applica- 1. Press PROBE on the control panel. A list of the connected
tion without chang- probes will pop up.
ing the current
probe, press APPL. 2. Trackball to the desired probe.
on the control pan- An application menu for the desired probe is then listed.
el. 3. Trackball to the desired application
Make sure that the probe and application names displayed on the
screen correspond to the actual probe and application selection.
CAUTION
Check that the correct TI category is displayed (see ’Thermal
Index’ on page 597). TIB must be displayed when a fetal
application is selected.
486
Disconnecting the probe
To disconnect probes:
1. Rotate the lock handle counter-clockwise to the horizontal
position to unlock the connector.
The probes that are 2. Remove the connector from the port.
not connected to the
3. Ensure that the probe head is clean before placing the
unit should be
stored in their stor- probe in its storage case.
age case.
487
Care and Maintenance
This section covers:
• Planned maintenance
• Probe inspection
• Probe cleaning
• Probe disinfection
Planned maintenance
Improper handling can lead to early probe failure and electric
shock hazards.
CAUTION
DO follow the specific cleaning and disinfection procedures
provided in this chapter and the germicide manufacturers
instructions.
Failure to do so will void probe warranty.
Transesophageal and intraoperative probes require a special

handling. Refer to the user documentation enclosed with these
CAUTION probes.
It is recommended to keep a maintenance log and note all

probe malfunctions. Follow the maintenance schedule below to
ensure optimum operation and safety:
After each use:

• Inspect the probe
• Clean the probe
• If required disinfect the probe
Before each use:

• Inspect the probe
488
Inspecting the probe
If any damage is found, DO NOT use the probe until it has been
inspected and released for further use by a GE service
CAUTION representative.
After each use:

1. Inspect the lens, the probe housing and the cable
(Figure 10-6.
2. Look for damage that might allow liquid into the probe.
Before each use:

1. Inspect the lens, the probe housing and the cable
(Figure 10-6).
2. Look for damage that might allow liquid into the probe.
3. Test the functionality of the probe.
1. Housing
2. Strain relief
3. Seal
4. Lens
Figure 10-6: Probe parts
489
Cleaning and disinfecting probes
Transesophageal and intraoperative probes require a special
handling. Refer to the user documentation enclosed with these
CAUTION probes.
Cleaning probes
Cleaning procedure
1. Disconnect the probe from the unit.
2. Remove the coupling gel by wiping the probe lens with a
soft cloth.
3. Wipe the probe and cable with a soft cloth moisten in a
warm soap and water solution (<80 oF/27 oC).
4. Wipe the probe and cable with a soft cloth moisten in clean
water (<80 oF/27 oC) until all soap is removed.
5. Wipe dry with a soft towel.
Disinfecting probes
In order to provide users with options in choosing a germicide,
GE Medical Systems routinely reviews new medical germicides
for compatibility with the materials used in the transducer
housing, cable and lens. Although a necessary step in
protecting patients and employees from disease transmission,
liquid chemical germicides must also be selected to minimize
potential damage to the transducer.
Refer to the Probe Care Card enclosed in the probe case or to
http://www.gehealthcare.com/usen/ultrasound/products/pr
obe_care.html for the latest list of compatible cleaning
solutions and disinfectants.
Low-level disinfection
1. After cleaning, the probe and cable may be wiped with a
tissue sprayed with a recommended disinfectant.
Use additional precautions (e.g. gloves and gown) when
decontaminating an infected probe.
High-level disinfection
High-level Disinfection destroys vegetative bacteria; lipid &
non-lipid viruses, fungi and, depending highly on time of
contact, is effective on bacterial spores. This is required for 490
endocavity (TV,TR,TE) probes after contact with mucosal
membrane.
High-level disinfection procedure
Follow the manu- 1. Prepare the germicide solution according to the
facturer's instruc- manufacturer's instructions.
tions for storage,
use and disposal of
the disinfection so-
lution.
Use only germicides that are listed in the Probe Care Card
enclosed with the probe. In addition, refer to the local / national
WARNING regulations.
Do not steam autoclave or subject the probe to Ethylene Oxide
(ETO).
2. Place the cleaned dried probe in contact with the germicide

for the time duration specified by the manufacturer.
Do not immerse the probe in liquid beyond the level specified for
that probe (see Figure 10-7).
WARNING
Never immerse the probe connector or probe adapters in liquid.
The probe should not be exposed to the germicide longer than
specified to achieve the desired effect.
DO NOT soak or saturate probes with solutions containing
alcohol, bleach, ammonium chloride compounds. In addition TE
probes must not be immersed in solutions containing hydrogen
peroxide.
3. Rinse the part of the probe which was in contact with the
germicide according to the germicide manufacturer's
instructions.
4. Wipe dry with a soft towel or air dry the probe.
CREUTZFELD-JACOB DISEASE
WARNING
Neurological use on patients with this disease must be avoided.
If a probe becomes contaminated, there is no adequate
disinfecting means.
491
1. Fluid level 3S / M3S 2D (P2D) 6D (P6D)
2. Contact face with patient M4S / 5S
environment 6S / 7S / 3V
E8C
7L / 9L
3.5C / 4C 10L / 12L
5C / M7C 8C M12L
Figure 10-7: Probe immersion levels
492
Probe safety
This section includes information on hazards to both the user
and the equipment, as follow:
• Electrical hazards
• Mechanical hazards
• Biological hazards
Electrical hazards
Probes are driven by electricity, which can injure the patient or
user when exposed to contact with conductive solution.
Do not immerse the probe into any liquid beyond the level shown
in Figure 10-7. Never immerse the probe connector or adaptors
WARNING into any liquid.
Do not subject the probe to mechanical shock or impact, which
may result in cracks or chips in the housing and degrade
performance.
Inspect the probe before and after each use, as described on
page 489, for damage or degradation to the housing, strain relief,
lens and seal.
DO NOT apply excessive force to the probe cable, to prevent
insulation failure.
Electrical leakage checks should be performed regularly by a GE
service representative or qualified hospital personnel, according
to the procedures described in EN 60601-1/IEC 60601-1 §19.
Mechanical hazards
Take precaution to avoid mechanical hazards.
Observe immersion levels as displayed in Figure 10-7, page 492.
WARNING
Inspect probes for sharp edges or rough surfaces that could
injure sensitive tissue.
DO NOT bend or pull the cable forcefully, to avoid mechanical
shock or impact to the probe.
493
Biological hazards
CAUTION
To minimize disease transmission, legally marketed and sterile

pyrogen-free sheaths should be used for each probe
recommended for intra-cavity procedures.
Adequate cleaning and disinfection are essential to prevent
disease transmission. It is the responsibility of the user to verify
and maintain the effectiveness of the infection control
procedures in use.
494
Biopsy
The Vivid 7 supports biopsy capability for the 3.5C, 4C, M7C,
7L, 9L, 10L, 12L, M12L, 3S, M4S, M3S and E8C probes. The
biopsy option is intended for use by a duly licensed physician
who has received the appropriate training in biopsy techniques
as dictated by current relevant practices, as well as in proper
operation of the Vivid 7 ultrasound unit.
Precaution concerning the use of

biopsy procedures
Do not freeze the image during a biopsy procedure. The image
must be live to avoid a positioning error.
WARNING
The use of biopsy devices and accessories that have not been
evaluated for use with the equipment may not be compatible and
CAUTION could result in injury.
The invasive nature of biopsy procedures requires proper

preparation and technique to control infection and disease
CAUTION transmission. Equipment must be cleaned as appropriate for the
procedure prior to use.
• Follow the probe cleaning and disinfection procedures and
precautions to properly prepare the probe.
• Follow the manufacturer’s instructions for the cleaning of biopsy
devices and accessories.
• After use, follow proper procedures for decontamination, cleaning,
and waste disposal.
Improper cleaning methods and the use of certain cleaning and
disinfecting agents can cause damage to the plastic components
that will degrade imaging performance or increase the risk of
electric shock.
495
Preparing the Biopsy guide attachment
The 3.5C, 4C, M7C, 7L, 9L, 10L, 12L, M12L, 3S, M4S, M3S
and E8C probes have an optional biopsy kit specific for each
probe. The biopsy kit consists of:
• One reusable non-sterile bracket
• Five disposable sterile Ultra-Pro IITM Needle guide kits
(Civco Medical Instruments Co, Inc.) consisting of:
• Two sets with needle inserts covering gauge
size 14 through 23 (2.1 mm to 0.6 mm)
• One sterile sheath
• Two rubber bands
• gel
• One reusable needle guide
• Instructions
In addition sterile Ultra-Pro IITM Needle guide kits can be
ordered as replacement kit.
Read the following instructions and the user’s guide for the
Ultra-Pro IITM Needle Guide kit before using the biopsy
WARNING equipment.
496
Bracket attachment procedure
1. Identify the appropriate biopsy guide bracket as shown in
Figure 10-8 and Figure 10-9.
Probe Biopsy
3.5C
4C
M7C
7L
9L
10L
Figure 10-8: The biopsy brackets
497
Probe Biopsy
12L/M12L
M3S/M4S/3S
E8C
Figure 10-9: The biopsy brackets
2. Orient the bracket so that the needle clip attachment is on

the same side as the probe orientation mark (notch or LED),
see Figure 10-10.
3. Attach the biopsy bracket to the probe by sliding the bracket
over the end of the probe until it clicks or lock into place.
Make sure the bracket is firmly attached to the probe.
498
1. Needle clip attachment on the bracket
2. Bracket label
3. Probe label
4. Probe orientation mark (notch or LED)
5. Lever lock
Figure 10-10: Probe/bracket alignment
4. M3S, M4S and 3S probes: tighten the biopsy bracket to the

probe by locking the lever lock.
Placing the probe and bracket into the sterile

sheath
Refer to the Ultra-Pro IITM Needle Guide user manual.
Attaching the needle guide to the bracket

Refer to the Ultra-Pro IITM Needle Guide user manual.
499
Displaying the Guide zone
1. Select the desired probe with biopsy support.
2. Press F5 (Biopsy) on the alphanumeric keyboard.
3. If the needle multi-angle is supported, select the correct
angle from the Biopsy menu.
Figure 10-11: The Biopsy menu
The biopsy guide zone is displayed on the screen.
1. Biopsy guide zone The first red mark is at 5 cm from the top of the needle
• 5 cm between the red marks guide.
• 1 cm between the large yellow marks
• 0.5 cm between two consecutive marks
Figure 10-12: Biopsy guide zone
500
Biopsy needle path verification
Perform the Needle path verification once a year or whenever
there is a suspicion of malfunction.
To verify that the path of the needle is accurately indicated
within the guide zone on the system monitor, perform the
following:
1. Properly install the bracket and biopsy guide (see
page 497).
2. Scan in a container filled with a glycerol solution (6% in
water).
3. Display the biopsy guide zone on the monitor (see
page 500).
4. Ensure that the needle echo falls within the guide zone
markers.
Starting the biopsy procedure

1. Press F5.
Enabling color flow 2. Place sterile coupling gel on the scanning surface of the
would allow for vi- probe/sheath.
sualization of the
vascular structure 3. Perform the biopsy.
around the area to
be biopsied. Cleaning, disinfection and disposal
1. Refer to the Ultra-Pro IITM Needle Guide user manual for
cleaning and disinfection of the bracket.
2. Perform cleaning and disinfection of the probe as described
in page 490.
3. Dispose the sheath, bands and needle guide after use,
according to medical regulations for biohazardious waste.
501
Chapter 11
Peripherals
• Introduction ................................................................................... ... 503

• VCR/DVD operation ...................................................................... ... 505
• VCR/DVD Overview ..................................................................505
• Using VCR/DVD .......................................................................506
• Printing .......................................................................................... ... 510
• To print an image ......................................................................510
• Printer configuration ..................................................................511
• Specifications for peripherals ..................................................... ... 513
502
Introduction
This chapter provides information on peripherals that can
operate with the Vivid 7 ultrasound unit, as follows:
• VCR
• DVD recorder (DVD-R and DVD-RW only)
• Color Thermal Video Printer
• Black & White Thermal Video Printer
Use only GE Medical Systems approved internal equipment

when replacing an internal peripheral.
CAUTION
External peripheral equipment must be CE marked and in
compliance with related standards (EN 60601-1 or EN 60950).
Conformance to EN 60601-1-1 (2000) must be verified.
All devices meeting IEC60950 must be kept outside of the patient
environment, as defined in IEC60601-1-1 (2000), unless it,
according to IEC60601-1-1 (2000), is equipped with additional
protective earth or extra isolating transformer. Commercial
devices such as laser cameras, printers, VCRs and external
monitors, usually exceed allowable leakage current limits and,
when plugged into separate AC outlets, are in violation of patient
safety standards. Suitable electrical isolation of such external
AC outlets, or providing the device with extra protective earth,
will be required in order to meet UL2601-1 and IEC60601-1
standards for electrical leakage.
503
1. Color Video Printer (side)
2. B&W Video Printer
3. VCR or DVD
Figure 11-1: Peripheral locations on the Vivid 7.
When using peripheral device, observe all warnings and

cautions given in peripheral operator manuals.
WARNING
504
VCR/DVD operation
VCR/DVD Overview
The VCR/DVD is operated from the ultrasound unit control
panel. The VCR/DVD status displayed on the screen indicates
the current VCR/DVD function (see Figure 11-2).
1 2 3 4 5 6 7 8 9 10
11
12
1. Recording (red) 7. Eject

2. Stop 8. Search
3. Play 9. Shuttle Forward
4. Pause (red while recording) 10. Shuttle Rewind
5. Fast Forward 11. Date and time
6. Rewind 12. Video counter
Figure 11-2: The Video status area on the Title bar
505
1. Video: enter video playback mode. Displays the video assignable controls.
2. Assignable keys
3. Record/Pause
4. Shuttle speed
Figure 11-3: The Video controls on the Control panel
Using VCR/DVD
Adjustment of the Video Counter (VCR only)
To start the video counter at a different point:
1. Press VIDEO on the Control Panel.
2. Press UPDATE MENU in the Trackball area.
3. Trackball to Video Counter/Search.
4. Press SELECT.
The Video Counter/Search window is displayed
(Figure 11-4).
506
5. Use the alphanumeric keyboard to enter the counter
number in the counter field.
OR
Press Search Blank to set the counter number to a blank
(unrecorded) section on the tape (works in a the forward
direction only).
Selecting Cancel 6. Press Set Counter to save the change.
will undo the cur-
7. Press VIDEO on the Control Panel to return to the scanning
rent changes to the
counter. mode.
The Video Set Counter/Search

Window is also displayed when
inserting the tape in the VHS.
Figure 11-4: The Video set counter / Search window
Start Recording
1. VCR: Ensure that the VCR counter is set correctly.
2. Press REC/PAUSE on the Control panel.
A red dot is displayed in the VCR/DVD status area on the
Title bar to indicate that recording has begun (see
Figure 11-2).
Note: DVD: a record start to a record stop is treated as one
title. Up to 49 titles can be recorded.
Pause recording
1. Press REC/PAUSE on the Control panel.
The video status icon is changed to (Pause) .
Note: DVD: each time Pause is used a new chapter is
created.
507
Play back an examination
2. Use the Assignable keys on the Control panel to perform
actions on the recorded session, such as stop, pause,
rewind or fast forward (see Figure 11-3).
The video status icon is updated accordingly (see
Figure 11-2).
DVD: press MORE to access to the controls: Previous/Next
Chapter and Previous/Next Title.
Searching in the video tape/DVD

2. Press UPDATE MENU and select Video Counter/Search or
press MORE and GO TO/SEARCH.
The Video Counter/Search window is displayed
(Figure 11-4).
3. DVD: select a title from the Recording title drop-down menu
and enter a counter value if desired.
VCR: Enter a counter value.
4. Select Search.
Additional playback features

When playing back an examination, part of it can be stored on
the computer’s memory as a cineloop. The cineloop enables
the user to perform further operations on the stored section
(see page 58 for further information on cineloop operation).
To store a recorded sequence as a cineloop
1. Press FREEZE while playing back a recorded session.
The last few seconds are stored as a cineloop.
Refer to ’Cineloop operation’ on page 58 for further details on
working with cineloops.
Ejecting DVD
1. Press STOP/EJECT.
The Finalize window is displayed.
2. Select:
• Yes: the DVD is finalized and ejected. Finalized DVD
cannot be reused for recording.
• No: the DVD is ejected without being finalized. The DVD 508
can be reused for recording additional titles, but it will not
be playable on other DVD players without being
finalized.
509
Printing
The Vivid 7 ultrasound unit can support a color and a black &
white thermal video printer. The printer devices are controlled
from the PRINT keys on the control panel (see Figure 11-5).
The PRINT keys can also be configured to perform alternative
storage (i.e. storage to DICOM media or secondary capture).
See page 560 for configuration of the PRINT keys.
1. Alt. Print
2. Print
Figure 11-5: The printer controls on the Control panel
To print an image
For details on the 1. Press PRINT or ALT. on the Control panel (see Figure 11-5).
Thermal video The image displayed on the screen is printed on B&W or
printers operation, Color printer, depending on the key assignment
consult the manu-
facturer operator
manual provided
with the printer.
510
Printer configuration
The following procedure describes how to configure and select
a printer as the default printer.
2. Select Connectivity and Additional output.
The Additional output screen is displayed (see
Figure 11-6).
3. In the Additional output screen select Advanced in the
Printer setup field.
The Standard printer properties window is displayed.
4. Press Configure.
The Print setup window is displayed.
5. In the Print setup window, select the printer and adjust the
parameters for the printer. Additional settings may be
adjusted by selecting Properties.
6. Select OK to close the Print setup window.
The Standard printer properties window is displayed.
To choose the configured printer as the default printer:
1. Select Open in the Standard printer properties window.
The Printer status window for the opened printer is
displayed.
2. Select Printer and Set as default printer.
3. Close the Printer status window and select OK in the
Standard printer properties window.
511
Figure 11-6: Printer configuration
512
Specifications for peripherals
Please refer to the documentation accompanying the
peripherals.
513
Chapter 12
Presets and System setup
• Introduction ................................................................................... ... 516

• Starting the Configuration package ............................................ ... 519
• To open the Configuration package ..........................................519
• Overview ........................................................................................ ... 520
• Imaging .......................................................................................... ... 521
• The Global setup sheet .............................................................521
• Application ................................................................................524
• Application menu ......................................................................528
• Measure/Text ................................................................................. ... 530
• The Measurement menu sheet .................................................531
• The Advanced sheet .................................................................536
• The Modify calculations sheet ..................................................537
• The OB table sheet ...................................................................538
• Report ............................................................................................ ... 544
• The diagnostic codes sheet ......................................................545
• The Comment texts sheet .........................................................547
• Connectivity .................................................................................. ... 550
• Dataflow ....................................................................................551
• Additional outputs .....................................................................560
• Tools .........................................................................................562
• Formats .....................................................................................563
• TCP/IP ......................................................................................568
• System ........................................................................................... ... 569
• The system settings ..................................................................569
• About ............................................................................................. ... 573
• Administration .............................................................................. ... 574
• Users ........................................................................................575 514
• Unlock Patient ...........................................................................578
515
Introduction
This chapter describes the configuration management package
of the Vivid 7 ultrasound unit. The Vivid 7 configuration
package enables users to customize the global configuration
for the unit and the application-specific settings.
In addition, users with administration rights have access to the
local archive backup function, local archive restore function and
creation of users.
Note: the default factory password for the “ADM” user is
ulsadm (case sensitive).
The configuration management package consists of a Setup
dialogue window divided in different setup categories with
sublevels.
The table below summarizes the contents and access rights of
the different categories and sublevels of the Vivid 7
configuration package:
Category and sublevel Description access Refer to
Imaging page 521
• Global Sets the cineloop controls and All

display.
Sets the patient information
display.
Sets the scan information
displayed on the video record.
• Application Configures the probe and All

application specific settings.
• Application menu Configures the Application All

menu.
Measure/Text page 530
516
• Measurement menu Configures the Measurement All

• Advanced menu by selecting and defining
• Modify calculations the sequence of the
measurements and calculation
to perform.
Creates user-defined
measurements
Configures vascular Doppler
calculations to be performed.
• OB table Create user-defined OB tables. All
• Annotation Configures the Annotation menu All

• Customize and create pre-defined
annotation.
Report page 544
• Templates • Configures the Report All

templates menu by selecting
and ordering the templates to
show in the menu.
• Diagnostic codes Create or delete pre-defined text All

input for the referral reasons and
diagnosis.
• Comment texts Create or delete pre-defined text All

input for the comments.
Connectivity page 550
• Dataflow Create new dataflows or Admin

configure existing dataflows.
• Additional outputs Configure the PRINT and ALT All

keys.
• Tools Formats removable media. All
• Formats Configures the Examination list All

window display and other
options related to the patient
management.
• TCPIP Sets the Transmission Admin

Protocol/Internet Protocol.
517
System page 569
• Settings Sets the date and time format, Admin

language and units.
• Test Enables testing of the different Admin

parts of the unit.
About Displays information about the All page 573

software, hardware and probes.
Administration page 574
• Backup Local archive and system Admin

configuration backup.
• Restore Restore local archive and Admin

system configuration from a
backup.
• Users Operator and referring staff Admin

registration, operator's rights
settings.
• Unlock patient Unlock patient records that were Admin

not properly finished.
Service This sheet is for service staff Admin

only. Deals with video selection,
LCD light setting, printer
definition and keyboard
configuration.
518
Starting the Configuration package
To access the Configuration package the user has to log on as
a specific user (see page 575). This ensures user-specific and
user-defined settings and presets to be used.
The access to the entire configuration package is user
configuration dependent (see page 575).
To open the Configuration package

1. Press CONFIG on the alphanumeric keyboard.
The Log In window is displayed asking for operator ID and
password (see Figure 12-1).
2. Select Log on when completed.
The Setup dialogue window is displayed (see Figure 12-2).

2. Type password
519
Overview
The configuration management package consists of a Setup
dialogue window divided in different setup categories with
sublevels (sheets labelled with tab).
The functionality of each configuration category and associated
sublevels are described on the following pages.
1. Sublevel tabs for the selected Setup

category.
2. Setup categories
3. Selected Setup category
Figure 12-2: The Setup dialogue window structure
520
Imaging
• Global: enables the user to configure display-related
settings.
• Application: enables configuration of the probe and
application specific settings.
• Application menu: enables configuration of the
Measurement menu.
The Global setup sheet
Figure 12-3: The Global setup sheet
521
Cineloop store
Cineloop store:
• Time before/after heart cycle: sets the total
storage time span of the cineloop in ECG
mode.
• Time span (no ECG): sets the total storage
time span of the cineloop with no ECG.
• Preview loop before store: when selected
enable review of cineloops before storage.
Crop images
Crop images:
: In the Analysis screen, removes top and
bottom of the image when more than two
images have been selected.
Doppler
Doppler:
• Show KHz scale: when selected, displays
the KHz scale on the left side of the Doppler
spectrum (see page 110).
522
Patient Info
Patient Info:
• Title bar Line 1 & 2: selects from the
pop-up menu the patient information
to display on the scanning screen's
Title bar (see page 51).
• Anonymous patient: when checked,
no patient information is displayed on
the scanning screen's Title bar.
Scan Info
Scan Info:
• : displays scan information on the
video record.
523
Application
The Application category enables the configuration of
probe/application specific settings (presets). The
application-specific settings can be stored and used as default
presets with this probe.
Figure 12-4: The Application setup sheet (example)
524
The Probe/application configuration
parameters
Image Store settings:

• Single frame (live store):
: Store cineloop.
: Store single frame image only.
• Number of heart cycles:
Select the number of heart cycles to
store (Single frame must be
unchecked).
Auto freeze:
• Freeze 2D image in Doppler: the last
2D or color flow image is displayed
when entering in Doppler mode.
• Auto freeze after: sets the time after
which the system enters in freeze when
not in use.
Footswitch functionality:
Configures the footswitch pedal for the
selected application.
Select the operation to perform for each
pedal from the associated Pedal pop-up
menu.
Templates and Packages:

Defines the default stress protocol
associated to the application.
Select the default Protocol to be
associated to the selected application
from the pop-up menu.
Auto invert on steer:

In Color flow, the color bar is inverted
when steering the color flow sector angle.
525
Create new application:

Press New to create a new Application. A
dialogue window is displayed where the
operator is asked to give a name to the
new application.
Remove current application:
Press Delete to remove the current
application. Factory Application settings
cannot be deleted.
Save image/appl. settings
Press Save to store the changes applied
to the current setting. Not applicable on
factory application settings.
Create a new Application

The application created is probe dependant. Select the desired
probe before configuring a new application.
1. Press APPLICATION on the Control panel.
2. Trackball to Preset... in the Application pop-up menu.
The Application setup sheet (see Figure 12-4) is displayed.
3. Adjust the parameters as desired (see page 525).
4. Press New.
A Dialogue window is displayed.
5. Enter a name for the new application.
6. Press OK
To edit an application
1. Press APPLICATION and select the application to edit.
2. Press APPLICATION again.
4. Change the parameters as desired (see page 525).
5. Press Save to store the changes.
Applicable only on user-defined applications.
526
Deletion of an Application
1. Press APPLICATION and select the application to delete.
2. Press APPLICATION again.
4. Press Delete to remove the selected application.
527
Application menu
The Application menu category enables rearrangement of the
the Application menu to best suit the user's requirements.
The Application menu is a two-levels pop-up menu. The first
level called Application, displays the most frequently used
applications in any desired order. The second level called
More... displays the less frequently used applications.
1. First menu level 3. Moving tools

2. Second menu level
Figure 12-5: The Application menu setup sheet (example)
528
Configuration of the Application menu
The Application menu can be configured by moving the
applications up and down inside the pop-up menu and from
one level to the other.
To move an application inside one level
1. Trackball to the application to move.
2. Press SELECT.
3. Press .
The application is moved one step up.
Press Default to 4. Press .
get factory setting. The application is moved one step down.
To move an application from one level to the other
1. Trackball to the application to move.
2. Press SELECT.
3. Press as many times as necessary:
• if the application to move is in the More menu
• if the application to move is in the Applications
menu
till the application has moved to the other menu.
529
Measure/Text
The Measure/Text category deals with:
• Configuration of the Measurement menu (see page 531)
• Creation of user-defined measurements (see page 290)
• Configuration of Measurement tools (see page 536)
• Configuration of the vascular Doppler calculation (see
page 537)
• Creation of user-defined OB tables (see page 538)
• Configuration of the Annotation function (see page 83)
530
The Measurement menu sheet
The Measurement sheet enables the organization of the
Factory default Measurement menu and the creation of
user-defined Measurements.
1. Configuration window (see next pages for 2. The measurement menu (displays updated
details) configuration)
Figure 12-6: The Measurement menu setup sheet
531
Add measurement:
Create or select from the pop-up list a
measurement to be added to a folder (see
page 290).
Add folder:
Enables the user to create its own folder
with the desired measurements. The
folder is displayed the Measurement
menu.
M&A Categories:
Enables selection of the measurement
categories to display in the Measurement
menu. Only checked items will be
displayed.
• Create Copy: Enables copy of a
selected measurement category
(selection is done by selecting the
category name).
• Delete: enables deletion of user-defined
measurement categories.
• Factory Default: restores factory
display.
2D, MM and Dop. radio buttons:

Enables the display of mode related
Measurement menu in the configuration
window.
Configuration tools:
Deletes selected entry (folder or
measurement) in the Measurement
menu. The factory entries cannot be
deleted.
Moves selected measurement
or folder up or down inside the
Measurement menu.
532
Folder:
Displayed when a folder is selected in the
Measurement Menu.
Shows the entire contents of a selected
folder.
• : The items is displayed in the
Measurement menu.
• : The item is hidden from the
Measurement menu.
Measurement:
Displayed when a measurement is
selected in the Measurement Menu.
Shows all the parameters related to the
selected measurement.
• : The items is displayed in the
Measurement menu.
• : The item is hidden from the
Measurement menu.
Only checked parameters will be
displayed in the Measurement result
window, the worksheet and the report.
Auto sequence:
: Prompts the next measurement in the
folder.
533
Configuration of the Measurement menu
There are many more measurements and parameters in the
measurement package than shown in the default Measurement
menu. Use the configuration system to set up the
measurements that should be available in the Measurement
menu and which parameters should be calculated (see also
’Measurement package configuration’ on page 285).
Display of the Measurement categories
1. Press M&A categories in the Configuration window.
The M&A categories are displayed in a pop-up window
(see page 532).
2. Check the categories to be displayed.
Uncheck the categories to hide.
To copy a Measurement category
1. Press M&A categories in the Configuration window.
The M&A categories are displayed in a pop-up window
(see page 532).
2. Move the trackball marker over the M&A category name.
3. Press SELECT to highlight the category.
4. Press Create copy.
A copy of the selected measurement category is displayed
in the Measurement menu.
Factory Measure- To rename the Measurement category:
ment categories 1. Select the Measurement category in the Measurement
cannot be renamed. menu.
2. Enter a new name in the Measurement field.
Selection of a Measurement category
1. Trackball to the Measurement menu heading.
2. Press SELECT.
The measurement categories are displayed in a
sub-menu.
3. Trackball to the measurement category of interest.
4. Press SELECT.
The measurement category is displayed.
Moving an item in the Measurement menu
1. Trackball to the entry to move into the Measurement menu.
2. Press SELECT.
534
3. Press or to move the selection up or down inside
the Measurement menu.
Deleting an item in the Measurement menu
Only user created 1. Trackball to the entry to delete in the Measurement menu.
items can be delet-
2. Press SELECT.
ed.
3. Press to delete the item.
Display/hide a folder or a measurement in the

Measurement menu
The Measurement menu (Folders and Measurements) can be
configured to display only the entries (folders and
measurements) of interest.
To hide a folder or a measurement:
1. Uncheck the actual folder or measurement in the Folder or
Measurement field in the Configuration window.
To display a hidden folder or measurement:
1. Check the actual folder or measurement in the Folder or
Measurement field in the Configuration window.
Creating a user-defined folder
1. If the folder is to be inside another folder, select the actual
folder in the Measurement menu.
2. Press Add folder.
The Measurement menu is updated.
3. Select the new folder and Enter the folder name in the
Name text field.
Adding a measurement to a folder
The user can either add a pre-defined measurement or create
a new measurement with user-defined parameters to a folder
(see page 290 for more information).
535
The Advanced sheet
The Advanced sheet enables further configuration of the
Measurement function. The settings are divided into application
specific parameters and global parameters.
Figure 12-7: The Advanced sheet
Parameter configuration:
1. If configuring application specific parameters, select an
application from the M&A category pull-down menu.
When pointing at a 2. Select the configuration value next to the parameter to
parameter an expla- configure.
nation label is dis- A pull-down menu is displayed (see Figure 12-7).
played.
3. Select a new value from the pull-down menu.
536
The Modify calculations sheet
The Modify calculation sheet is used to configure the
calculations to be performed when doing a Doppler vascular
measurements.
Figure 12-8: The Modify calculations sheet
The following example describes how to configure the Carotid

Doppler calculations.
1. In the Modify calculations sheet, select Vascular next to
M&A Categories.
The Vascular measurement category is displayed.
2. Select Carotid.
The available calculations are displayed.
3. Check the desired calculations to be performed.
4. Select Save.
537
The OB table sheet
The OB table sheet enables the creation and edition of
user-defined OB tables.
Figure 12-9: The OB table sheet
The following example describes how to create a fetal age

OB-2/3 table based on Bi Parietal Diameter measurements.
1. In the Measure/Text category, select the Measurement
menu sheet.
2. In the Measurement menu sheet, select 2D mode.
3. Select the OB table sheet.
4. In the Measurement menu, select the category Obstetrics
(Measurement menu heading) and the OB-2/3
measurement study.
5. In the OB table sheet, check New table.
6. Enter or select the following:
• OB Table Template: when creating a new OB table,
select Template (1 - 7) which you want to use as the
basis of the user programmable OB Table (see
page 540).
538
When editing an existing user OB table, select the
desired OB table to edit.
• Tool type: Select the type of measurement (e.g.
Distance)
• Measure Name: type the name of measurement that will
display in the Measurement menu (e.g. My BPD
Measure).
• Author Name: Type the author’s name (e.g. My Name).
• Table Type: If necessary, select the table type (e.g.
Fetal Age).
• Measure type: select the desired measurement (e.g.
BPD).
7. Select Edit table.
The OB Table spreadsheet is displayed, showing the table
template selected.
Figure 12-10: The Edit table spreadsheet
8. Enter the Min, Max and Interval values in the Parameters

field.
The system automatically fills in the MEAS column.
9. Enter the input values for the MEAN and SD columns.
10. Select Exit to save.
539
The OB table templates
Template 1 (based on Hadlock)
Fetal age format: MEAS MEAN SD
Unit: mm week week
Table range: 1 SD
Graph range: 1 SD
Measurement Value: [cm]

result
GA: [#w#d]
Min: [#w#d]
Max: [#w#d]
Fetal growth Format: AGE MEAN SD
Unit: week mm week
Others are same as above
Template 2 (based on Tokyo)
Fetal age Format: MEAS MEAN SD
Unit: mm day day
Table range: 1 SD
Graph range: 1 SD

result
GA: [#w#d]
SD: [day (+/-)]
Unit: day mm day
540
Template 3 (based on Osaka)
Unit: mm day mm
Table range: 1 SD
Graph range: 1 SD

result
GA: [#w#d]
SD: [(mv-pv)/sd]
Unit: day mm day
Template 4 (based on several European tables)
Unit: mm weekday mm
Table range: 5%–95%
Graph range: 5%–95%

result
GA: [#w#d]
GP: [%] Calculated by Fetal growth table. If Fetal

growth table is not edited, GP is not calculated.
Unit: weekday mm day
541
Unit: mm weekday mm
Table range: 1 SD

result
GA: [#w#d]

Unit: weekday mm day
Fetal age Format: MEAS MIN MEAN SD
Unit: mm weekday weekday weekday
Table 10%–90%
range:
Graph 10%–90%
range:

result
GA: [#w#d]
GP: [%] Calculated by Fetal growth table. If Fetal growth

table is not edited, GP is not calculated.
Fetal growth Format: AGE MIN MEAN SD
Unit: weekday mm mm mm
542
Unit: mm weekday mm
Table range: 1 SD

result
GA: [#w#d]

Unit: weekday mm mm
543
Report
The Report configuration category is divided in three sheets:
• Templates: enables the configuration of the Template
selection menu and the export/import of user-defined
templates. See ’Report templates management’ on
page 469 for more information.
• Diagnostic codes: enables the creation of pre-defined text
inputs to be used in the Diagnosis information field in the
Examination list window (see Figure 8-10, page 358).
• Comment texts: enables the creation of pre-defined text
inputs to be used in the Comment information field in the
• Structured findings: enables the insertion of
pre-configured structured diagnosis statements and
Billing/Accreditation codes in the patient report (see
’Structured Findings’ on page 433).
544
The diagnostic codes sheet
This sheet enables the creation (and deletion) of text inputs
that can be used when entering diagnostic codes in the
1. List of text inputs 3. Text input display area (free text area)
2. Text input name 4. Create a text input
Figure 12-11: The Diagnostic codes sheet
Creating a diagnostic codes

1. Select New text to create a new diagnostic code (see
Figure 12-11).
2. In the Code field enter a name for the diagnostic code.
3. Trackball to the Text input display area.
545
4. Press SELECT.
5. Enter the text.
To add a diagnostic code to an examination refer to ’Diagnosis
code’ on page 358
Deleting a diagnostic code

1. In the Code list field, trackball to the diagnostic code to
delete (see Figure 12-11).
2. Press SELECT.
3. Trackball to Delete.
4. Press SELECT.
546
The Comment texts sheet
This sheet enables the creation (and deletion) of text inputs
that can be used when entering comments in the Examination
list window (see Figure 8-10, page 358) or in the Direct report.
Figure 12-12: The Comment texts sheet
The pre-defined text list is organized in a three level hierarchy.

Selecting one item in the first column displays pre-defined text
entries related to the selected text in the second and third
column.
547
Creating pre-defined text input
First level
1. Select the first level.
2. Press New.
The Enter new text window is displayed.
Figure 12-13: The Enter new text window
3. Enter a title in the Text field.

Enter the pre-defined text in the Full text field.
4. Press OK.
Second and third level
1. Select an item in the first column.
The pre-defined text input to be created in the second and
third column will be related to this selection only.
2. Select the second or third column.
3. Press New.
The Enter new text window is displayed (Figure 12-13).
4. Enter a title in the Text field.
Enter the pre-defined text in the Full text field.
5. Press OK.
Editing a pre-defined text input

1. Select the term to edit in one of the columns.
2. Press Edit. 548
3. The Edit text window is displayed.
Figure 12-14: The Edit text window
4. Edit the text in both the Text and Full text fields.
5. Press OK.
Deleting a pre-defined text input

1. Select the item to delete in one of the columns.
2. Press Delete.
3. A Confirmation window is displayed.
4. Press Yes.
The selected text input is deleted including the belonging
text inputs.
549
Connectivity
This configuration setup category deals with:
• Dataflow: connection and communication setup of the
ultrasound unit with other devices.
• Additional output: configuration of the PRINT and ALT keys
on the control panel.
• Tools: formatting of removable media
• Formats: configuration of the Examination list window and
other tools related to patient management.
• TCPIP: internet protocol configuration
550
Dataflow
Communication between the Vivid 7 ultrasound unit and other
information providers on the network takes the form of
dataflows. Each dataflow defines the transfer of patient
information and images from an input source to the unit, and
from the unit to one or several output sources.
A dataflow is a set of pre-configured settings. Selecting a
dataflow will automatically customize the unit to work according
to the settings associated with this dataflow.
Dataflows are configured in the Dataflow sublevel sheet in the
Connectivity setup category as described below. The Dataflow
sublevel sheet is only available to users with administration
rights.
551
1. Select a dataflow to configure 6. Add/Remove a user-defined dataflow (available
2. Use selected dataflow as default with Service Dongle only)
3. Store data directly to archive 7. Available input/output devices that can be
4. Hide selected dataflow from the list of available assigned to the current dataflow
dataflow 8. Input/output devices assigned to the current
5. Option for the search function. In the dataflow
Search/Create patient window select between 9. Add/remove selected device to/from the current
None, All patients and Today’s patient dataflow (user-defined dataflows only)
10. Adjust the settings for the selected assigned
device
Figure 12-15: The sublevel Dataflow (example)
Dataflows available
A set of pre-defined dataflows is available on the unit as listed
in the table below. Input/output devices cannot be
552
added/removed to/from the pre-defined dataflows. However the
settings for the devices can be adjusted (see page 558).
Dataflow Description
No Archive Enables to perform an examination

without storing the data to the
archive.
LocalArchive-Int.HD Local archive internal harddrive

The local database is used for
patient archiving. Images are stored
to internal harddrive.
LocalArchive-MOD Local archive Magneto Optical

Disk (MOD)
to a MOD. The stored image files will
consist of raw data only, together
with a single-frame DICOM preview
image (no DICOM multi-frame is
stored).
LocalArchive-Int.HD/MOD Local archive internal harddrive

and Magneto Optical Disk
to the internal harddrive and to a
MOD as DICOM Media. The stored
image files, both to internal harddrive
and to the MOD, will consist of both
DICOM (multi-frame if cineloop) and
raw data.
Local Archive - Int The local archive is used for patient

HD/DICOM Server archiving. Images are stored to the
internal hard drive and to a DICOM
server.
Some of the measurements are
stored if DICOM SR is turned on
(see page 389).
553
RemoteArch-RemoteHD Remote archive remote harddrive

A remote database (either on
EchoPAC workstation or on
EchoServer) is used for patient
network image volume (either
internal HD on EchoPAC workstation
or EchoServer volume).
Remote Archive - Remote A remote database is used for

HD/DICOM Server patient archiving. Images are stored
to a network image volume and to a
DICOM server.
(see page 389).
This dataflow RemoteArchive-MOD Remote archive Magneto Optical

cannot be used Disk
with an A remote database (either on
ImageVault 3.0 EchoPAC workstation or on
server. EchoServer) is used for patient
MOD.
WL-LA-DServ: Worklist/LocalArchive-DI Modality Worklist local archive

the local COMServer/Int.HD DICOM server and local harddrive
database is not Search in the DICOM Modality
searched, only Worklist, the patient found is copied
the DICOM into local database. The patient
Modality Worklist. information and the examination
results are stored to the local the
database. Images are stored to a
DICOM Server and to an image
volume on the local harddrive.
(see page 389).
554
Worklist/RemoteArchive- Modality Worklist remote archive

DICOMServer/RemoteHD DICOM server and remote
harddrive
Search in the DICOM Modality
Worklist, the patient found is copied
into a remote database. The patient
information and examination results
are stored to a remote database.
Images are stored to a DICOM
Server and to an image network
volume as pure DICOM in both
locations.
(see page 389).
Worklist/Remote Archive This dataflow is used in a network

- Remote Storage environment that includes Vivid HL7
Gateway. The patient list in the
Search/Create Patient window is
coming from Vivid HL7 Gateway
through DICOM Modality Worklist.
All patient data and images are
stored to EchoServer.
Raw DICOM MOD Raw image format to/from a DICOM

Magneto Optical Disk
Read/Write images in raw format
from/to a DICOM formatted 5.25''
MO-disk.
(see page 389).
DICOM MOD Pure DICOM image format to/from a

DICOM Magneto Optical Disk
Read/Write images in “pure” DICOM
format from/to a DICOM formatted
5.25'' MO-disk.
(see page 389).
555
DICOM CD/DVD read DICOM CD/DVD read

Read DICOM Media from the
CD/DVD-drive.
Read only dataflow, no data can be
stored.
EP MAC MOD: EchoPAC Mac MOD read EchoPAC Macintosh Magneto

the MOD must be Optical Disk read
PC-formatted. Read MOD from EchoPAC
Only images can (Macintosh).
be read. Read only dataflow, no data can be
stored.
DICOM Server DICOM server

Store pure DICOM images to a
DICOM device.
(see page 389).
Query Retrieve Retrieve images from a DICOM

server
LocalArchive-Int.HD/eVue The local database is used for

to internal harddrive and a MPEG
exam is created to the configured
destination.
RemoteArch-RemoteHD/ A remote database (either on

eVue EchoPAC workstation or on
EchoServer) is used for patient
network image volume (either
internal HD on EchoPAC workstation
or EchoServer volume) and a MPEG
exam is created to the configured
destination.
556
To select the default dataflow
1. Select the dataflow in the Name drop-down menu. (see
Figure 12-15).
2. Check the Default box.
The dataflow will be selected by default when restarting
the unit.
3. Check the Direct Store box to have data stored
automatically to the archive (no buffer storage).
To create a new dataflow

1. Press Add.
The Add dataflow window is displayed.
Figure 12-16: The Add dataflow window
2. Enter a name for the new dataflow.

3. Press OK.
4. Select an Input device in the Available inputs/outputs field
and press the Right arrow button to assign the service to
the dataflow.
5. Repeat step 4 to assign input/output devices as desired.
Most dataflows consist of one input device and one or
several output devices. However in two cases it is possible
to have two input devices, when defining a dataflow with
DICOM Worklist or DICOM Query/Retrieve in combination
with a database.
6. Adjust the device’s parameters as described below.
7. To remove a device from the dataflow, select the device in
the Selected devices field and press the Left arrow button.
557
Adjusting the assigned devices
1. Select the device in the Selected devices field.
2. Press Properties.
The Properties window is displayed.
3. Adjust the device specific parameters as desired (see table
below). Not all the settings listed below apply to all devices.
General settings Definition
Name Free text: give a descriptive name for the device.
IP address Select from drop-down menu
Database Name Automatically selected according to the IP address
File destination Automatically selected according to the IP address
Removable Check the entry is the media is removable.
MPPS Modality Perform Procedure Step: send information

(typically to a HIS) that a scheduled exam has been
started, performed or interrupted.
Image settings Definition
Allow raw data : Save data in both raw and DICOM format.
: Save data in DICOM format only.
Raw Compression Enables compression of raw data images upon storage

and export. Raw compression is active only if the setting
Allow raw data is checked.
Max Frame rate Select 25, 30 or Full (original acquisition) from the pop-up
menu.
Compression Select compression type or no compression.
Quality Set picture quality from 1 to 100%. A low picture quality

level allows high data compression, while a high picture
quality restrains the compression.
Allow Multiframe : Allow cineloop storage.
Connection settings Definition
Retry Set maximum number of connection tentative, time

interval between tentative and time-out.
558
DICOM settings Definition
AE Title The Application Entity Title is set during DICOM

configuration. Refer to the network specifications.
Port The Port no. is allocated during DICOM configuration.

Refer to your network specifications.
Verification Verify the connection to another DICOM application
Storage commitment Send a request to a PACS, asking it to permanently

archive image(s)
MPPS Modality Perform Procedure Step: send information

(typically to a HIS) that a scheduled exam has been
started, performed or interrupted.
559
Additional outputs
The Additional outputs sheet deals with configuration of the
PRINT and ALT keys on the control panel. Several outputs (e.g.
Video Print, Laser print, DICOM storage...etc.) can be
associated to the keys (i.e. hitting PRINT can result in printing a
Color video print and storage to a DICOM media).
1. Select between PRINT and ALT keys. 5. Adjust the device settings for the selected
2. Available output devices that can be assigned assigned device
to the current button. 6. Select the type of images to produce and adjust
3. Output devices assigned to the current button. image settings.
4. Add or remove selected device to/from the 7. Printer configuration (see page 511)
current button.
Figure 12-17: The sublevel Additional outputs (example)
Print / Alt. Print key configuration

1. In Button field select Print or Alt. Print.
2. Select an output device in the available outputs field and
press the Right arrow button to assign the service to the
dataflow.
560
The Properties window for the selected device is
displayed.
3. Adjust the device specific parameters and select OK.
4. Adjust the image specific parameters (see table below).
Configuration parameter
Format Select between:

• Raw DICOM
• DICOM
Image compression Select compression mode from the pop-up menu.
Quality When JPEG compression is selected, adjust the picture

quality between 1 and 100%. A low picture quality level
allows high data compression, while a high picture quality
restrains the compression.
Image frames Select between:

• Single: stores single frame only
• Multiple: stores cineloop
• Secondary Capture: screen shot
Capture Area Select between:
• Video Area (1)

• Whole Screen (2)
To remove a device, select the device in the Selected devices

field and press the Left arrow button.
561
Tools
The Tools sublevel sheet deals with:
• formatting of removable media (MO disk, CD-R, DVD-R or
ZIP disk), see page 63.
• Creation or re-creation of a DICOM directory on a
removable media containing DICOM images.
• Enter a remote path of a network shared folder
(\\server-name\share-name) for:
• Export traces function in Q-Analysis
• Export of system error log file
• Save as function for images
Figure 12-18: The sublevel Tools
Creation of a DICOM directory

1. Insert the media in the drive.
2. Select Repair DICOM DIR.
Wait for the display of the Information window indicating
that the process is completed.
562
Formats
The Formats sublevel enables configuration of the Examination
list window (see page 356) and other tools related to patient
management, as described below.
Figure 12-19: The sublevel Formats
Configuration of the Examination list window

The user can configure the examination list displayed in the
Examination list window (see page 356) by deleting, adding
columns and change the information type displayed in each
column.
Column configuration
1. Trackball to the column to edit.
To adjust column 2. Press the SELECT key in the trackball area.
width, select and A sub-menu is displayed (see Figure 12-20).
drag column head-
ing border. 3. Select the action to perform:
• Insert: creates a new column
• Delete: removes selected column
• select the desired information to be displayed in the 563
selected column.
1. Insert new column to the left of the selected

column
2. Delete selected column
3. Select column heading
Figure 12-20: Configuration of the Examination list window
564
Other configuration settings
Use free text addresses:

In the Patient information window (see
page 51),
: The address information (e.g. street,
city...etc.) is entered in type-specific fields.
: The address information is entered in a
single field (free text).
Use Date of birth:

page 51), enter either the patient age or the
birth date:
: Enter age (Date of birth field not
available)
: Enter Date of birth, the age is calculated.
Use extended patient dialog:

page 51),
: The entire patient information data is
displayed.
: Patient information data displayed is
restricted to a minimum (e.g. name and
Patient ID). When unchecked, press More to
display the entire patient information data.
Use extended search dialog:

In the Search/Create Patient window (see
page 50, page 352 and page 354),
: All the searching filters are displayed as
default.
: The searching criteria are restricted to a
minimum. When unchecked, press More to
display all the searching filters.
565
Auto search for patient:

In the Search/Create Patient window (see
page 50, page 352 and page 354),
: The system searches automatically
through the patient archive selected while
entering patient information.
: The system searches through the patient
archive after pressing SELECT.
Pre-defined text directly:

In the Examination list window (see
page 356),
: The Insert text key launches pre-defined
text input.
: The Insert text key open the extended
text field.
Examination list on Archive button

When a patient is selected, pressing
ARCHIVE will:
: Open the Examination list window for the
selected patient.
: Open the Patient Information window for
the selected patient.
Automatic generation of patient ID:

In the Search/Create Patient window
(page 50),
: Patient ID is not required when entering a
new patient in the archive. The system
generates automatically an ID number.
: Patient ID is required when entering a
new patient in the archive.
Request acknowledge of End Exam

action:
: The user is asked to confirm action when
ending an examination.
566
Go directly to scanning from search:

: The unit goes directly to the Scanning
screen after selecting/creating patient
record.
: The unit displays the Patient information
window after selecting/creating patient
record for further information entry. The user
must press Begin Exam to enter the
Scanning screen.
Save all images on end exam:

: All images on the clipboard are
automatically saved when ending an
examination.
: A dialogue window is displayed when
ending an exam where the user can select
between:
• Store all images
• Select images to store
• Store no images
Exam screen/Report headings:

Enter user-defined headings for Comments,
Diagnosis and Referral reasons fields.
DICOM images:
Select between:
• No extra info
• Add visible patient info in the DICOM
images: displays patient information
(name, date of birth and ID) on DICOM
images.
• Add titlebar: adds the Titlebar to the
DICOM images.
567
TCP/IP
This configuration category enables the user with
administration rights to set the Transmission Protocol/Internet
Protocol for the system and connected remote archive.
1. Computer name: device’s name of type VIVID7-00nnnn or

ECHOPAC7-00nnnn, where “nnnn” is the system’s serial number. Do not
change the computer name.
2. IP settings: system IP settings
3. Remote archive setup: remote archive IP address and name (EchoPAC PC
or EchoServer)
4. Save TCP/IP settings. The changes will be effective after the system is
rebooted.
5. Advanced DICOM log: creates a detailed DICOM related report log. Should
be used only if DICOM issues are registered (see page 584 about report log
generation).
Figure 12-21: The sublevel TCP/IP
568
System
This configuration category is divided in two sheets:
• System Settings: enables the user to set the date and
time, choose the measurement unit and language for the
system and enter basic information about the organization,
such as the institution name and department.
• Test: enables testing of the different parts of the unit.
This sheet is accessible to users with administration rights only.
The system settings
Figure 12-22: The System settings setup sheet
569
Location
Location:
• Hospital: Enter the hospital name (up to 64
characters). This information is displayed
on the scanning screen's Title bar (up to 24
characters) and on the image properties of
all saved images.
• Department: Enter the department name
(up to 64 characters). This information is
displayed on the image properties of all
saved images.
570
Date and Time
Date and Time:

• Date: sets the date. Select the correct
date from the pop-up window.
• Time: sets the time. Press the arrow head
buttons to set the time (hour minute and
second).
• Time Format: select the desired format
(24 or 12 AM/PM) from the pop-up menu.
• Date Format: select the desired format
(EU or US) from the pop-up menu.
• Default Century: select the desired
Changes done on the date or time format format (1900, 2000 or None) from the
will be effective only after rebooting the pop-up menu.
system. 1900: the number 19 is automatically
displayed when entering the year in the
patient date of birth (to edit century, press
BACKSPACE twice).
2000: the number 20 is automatically
displayed when entering the year in the
patient date of birth (to edit century, press
BACKSPACE twice).
None: the four digits have to be typed
when entering the year in the patient date
of birth.
Languages
Language:
Select the desired language for the system
from the pop-up menu.
Manual language:
Select the desired language for the Online
Changes apply after rebooting the manual. If not available the English manual
system. will be displayed as default.
Units
571
Units:
Select the desired units (Metric or US) from
the pop-up menu.
572
About
The About sheet gives informations about the ultrasound unit
concerning:
• software
• hardware
• Probes
573
Administration
Only users with ad- The Admin. category deals with:
ministration rights
• Disk management: enables the management of the hard
have access to this
setup category (see disk space while maintaining the patient database on the
page 575). system (see page 408).
• Backup: enables the backup procedures for local patient,
and report archives as well as system and user-defined
• Restore: enables data retrieving of patient and report
archives as well as system and user-defined configuration
(presets) from a backup (see page 416).
• Users: deals with operators registration, operator's rights
setting and registration of staff related to an examination
(e.g. referral doctors, sonographers...etc.).
• System Administration: keeps track of all the options
implemented in the unit.
• Unlock patient: enables to unlock patient records that
were not properly terminated.
574
Users
The Users sheet deals with operators registration, operator's
rights setting and registration of referring members related to
examinations (e.g. referring and diagnosing physicians).
Figure 12-23: The Users setup sheet
Users are divided in groups with different rights. There are two
types of groups:
• User groups: members of these groups (see table below)
are allowed to login on the system when selected together
with the group Operator. They have group specific rights.
• Referring groups: members of these groups (Diagnosing
physician and Referring doctor) are not allowed to login on
the system. They are registered as references that can be
associated to a patient record.
575
Table 12-1: The User groups
Right (see definition below)
Store report
Print report
Service
Create
Admin
Group
Cardiologist + + + Activated
with a
Physician + + Dongle
Sonographer + +
Fellow + +
Sys Admin + + +
Hosp admin +
GE admin + + +
The rights associated to the user groups are:
Right Definition
Create and delete • Create, update and delete a patient record

• Create, update and delete an examination
• Create, update and delete an user or a referring member
• Import/Export patient records, examinations
• Move examinations
Print report • Print a report
Store report • Store a report
Admin • System administration
Service • Access to the service platform
Creating a user or a referring member

1. Press New
2. Enter the user’s information.
576
3. Select the type of user/referring member in Member of
Group(s).
To be able to login on the system, the group Operator MUST be
selected.
CAUTION
Editing an user configuration

1. Select the actual user in the User list.
2. Make the desired changes.
3. Press CONFIG or any active scanning key to exit the
Configuration management package.
Deleting a user
1. Select the actual user in the User list.
2. Press Delete.
The user is removed from the User list.
Auto logon and Auto screenlock

Auto logon
1. Select the desired logon setup from the pull down menu:
• Disabled: no default user is selected when logging on.
• Last user: the last user is selected automatically when
logging on.
• A specific user: select one of the users to be the default
user when logging on.
Auto screenlock
1. Set the time span (from 10 min) for the system to
automatically get locked when not in use. When the system
is locked, the current user may either log on again or the
system may be restarted by a different user.
577
Unlock Patient
If for any reason an examination is not properly finished, the
patient record is locked and cannot be opened again unless it
is unlocked.
Figure 12-24: The Unlock patient sheet
To unlock patient records:

3. In the Admin category, select the sheet Unlock Patient.
4. In the Unlock Patient sheet, select the patient record(s) to
unlock.
You can search for a specific patient record or a group of
patient record using the searching filters.
5. Select Unlock to unlock the selected patient record(s) or
select Unlock all to unlock all patient records.
6. Select OK.
578
Chapter 13
User maintenance
• System Care and Maintenance .................................................... ... 580

• Inspecting the system ...............................................................580
• Cleaning the unit .......................................................................581
• Air filter ......................................................................................581
• Prevention of static electricity interference ...............................583
• System self-test ............................................................................ ... 584
• System malfunction ..................................................................584
579
System Care and Maintenance
The user must ensure that safety inspections are performed at
least every 12 months according to the requirements of the
CAUTION patient safety standard IEC 60601-1 (1988).
Only trained persons are allowed to perform the safety
inspections mentioned above.
Technical descriptions are available on request.
To ensure that the Vivid 7 unit constantly operates at maximum

efficiency we recommend that the following procedures be
observed as part of the customer’s internal routine
maintenance program.
Inspecting the system

If any defects are observed or malfunctions occur, DO NOT
operate the equipment, and inform a qualified service person.
CAUTION
Monthly
Examine the following on a monthly basis (or whenever there is
a reason to assume that any issue may have occurred):
• Connectors on cables, for any mechanical defects
• Entire length of electrical and power cables, for cuts or
abrasions
• Equipment, for loose or missing hardware
• Control panel for defects
• Brakes
To avoid electrical shock hazard, do not remove panels or covers

from the unit.
WARNING
580
Cleaning the unit
Weekly
The Vivid 7 ultrasound unit requires weekly care and
maintenance to function safely and properly. The following
components should be cleaned:
System cabinet
1. Moisten a soft, non-abrasive folded cloth with a mild,
general purpose, non-abrasive soap and water solution or
a general purpose disinfectant.
2. Wipe down the top, front, back and both sides of the
cabinet. Do not spray any liquid directly into the unit.
Monitor
1. Apply a glass cleaner to a soft non-abrasive folded cloth.
2. Gently wipe the monitor face.
Diligent cleaning of Control panel
the Vivid 7 console 1. Turn off the power to the system.
reduces the risk of
spreading infection 2. Moisten a soft, non-abrasive folded cloth with water or a
from person to per- mild, non-abrasive soap and water solution.
son, and also helps 3. Gently wipe the surface of the console.
to maintain a clean
working environ- For difficult spots or general cleaning, an all-purpose cleaner
ment. may also be used.
Air filter
Every three months
Clean the unit’s air filter to ensure that a clogged filter does not
cause the unit to overheat and reduce system performance and
reliability.
The air filter is situated in the back of the system.
581
1. Filter cover
2. Air intake locations
3. Handle
Figure 13-1: The air filter location
To remove the filter

1. Grab the filter cover by the handle and pull away the cover
from the unit (see Figure 13-1).
2. Pull away the four clips holding the filter.
3. Remove the filter from the air duct.
DO NOT operate the unit without filter.
WARNING
To clean the filter

1. Shake the filter in an area away from the unit.
2. Wash the filter with a mild soapy solution.
3. Rinse and dry the filter.
582
Allow the filter to dry thoroughly before re-installing it in the unit.
WARNING
Prevention of static electricity

interference
Interference from static electricity can damage electronic
components in the system. The following measures help to
reduce the likelihood of electrostatic discharge:
• Wipe the alphanumeric keyboard and monitor with lint-free
tissue or a soft cloth dampened with anti-static spray on a
monthly basis.
• Spray carpets with anti-static spray because constant
walking on carpets in or near the scanning room may be a
source of static electricity.
583
System self-test
The Vivid 7 ultrasound unit is designed for reliable operation
and consistent, high-quality performance. Automatic
self-testing facilities are provided to monitor system operation
and to detect malfunction as soon as possible, thereby
eliminating unnecessary downtime. The detection of any
serious malfunction may result in immediate interruption of
scanner operation.
System malfunction
In the event of error or system malfunction the user may
generate and export a log file to a removable media as
described below and contact authorized service personnel.
Generating a logfile
1. Press ALT - D on the alphanumeric keyboard.
The Problem description dialogue window is displayed
(see Figure 13-2).
2. Type in a description of the problem. Notes should be made
regarding the selected probe, the imaging mode and the
application that was being used at the time of malfunction.
If applicable, try to describe the button or key pushing
sequence that immediately preceded the problem.
Check the mention System lockup if applicable.
3. Press Save to create a logfile.
584
Figure 13-2: The Problem description dialogue window
Exporting the logfile

1. Press ALT - D on the alphanumeric keyboard to display the
Problem description dialogue window again.
2. Select the destination where to export the logfile (MOD or
CD-R).
3. Press Export.
A Zip file (named “logfile_<date>_<time>.zip”) is copied on
to the selected removable media.
585
Chapter 14
Safety
• Introduction ................................................................................... ... 588

• Owner responsibility .................................................................... ... 589
• Important safety considerations ................................................. ... 590
• Notice against user modification ...............................................590
• Regulatory information ................................................................ ... 591
• Standards used .........................................................................591
• Device labels ................................................................................. ... 592
• Classifications ...........................................................................596
• Acoustic output ............................................................................ ... 597
• Definition of the acoustic output parameters ............................597
• Acoustic output and display on the Vivid 7 ...............................598
• ALARA ......................................................................................599
• Safety statement .......................................................................599
• System controls affecting acoustic output ................................599
• Patient safety ................................................................................ ... 601
• Patient identification ..................................................................601
• Diagnostic information ..............................................................601
• Mechanical hazards ..................................................................601
• Transesophageal probe safety .................................................602
• Electrical Hazard .......................................................................602
• Personnel and equipment safety ................................................ ... 603
• Explosion hazard ......................................................................603
• Implosion hazard ......................................................................603
• Electrical hazard .......................................................................603
• Moving hazard ..........................................................................604
• Biological hazard ......................................................................604
• Pacemaker hazard ....................................................................605 586
• Electrical safety ............................................................................ ... 606
• Device classifications ................................................................606
• Internally connected peripheral devices ...................................606
• External Connection of other peripheral devices ......................606
• Allergic reactions to latex-containing medical devices ............ ... 607
• Electromagnetic Compatibility (EMC) ......................................... ... 608
• Environmental protection ............................................................ ... 610
• System disposal ........................................................................610
587
Introduction
This section describes the important safety measures which
should be taken before operating the Vivid 7 ultrasound unit.
Procedures for simple care and maintenance of the unit are
also described.
Various levels of safety precautions may be found on the
equipment, and different levels of severity are identified by one
of the following icons that precede precautionary statements in
the text.
The following icons are used to indicate precautions:

WARNING • Severe or fatal personal injury

• Property damage
Other precautions or prudent-use recommendations are

indicated in the note sections in the left column. These are:
• Use of the Vivid 7 ultrasound unit as a prescription device,
under the order of a physician.
• Maintaining an optimum unit environment.
• Reference to the User's Manual.
588
Owner responsibility
For USA only:
Federal law restricts this device to use by, or on the orders of, a
CAUTION
physician.
It is the responsibility of the owner to ensure that anyone

operating the system reads and understands this section of the
manual. However, there is no representation that the act of
reading this manual renders the reader qualified to operate,
inspect, test, align, calibrate, troubleshoot, repair or modify the
system. The owner should make certain that only properly
trained, fully-qualified service personnel undertake the
installation, maintenance, troubleshooting, calibration and
repair of the equipment.
The owner of the Vivid 7 ultrasound unit should ensure that
only properly trained, fully qualified personnel are authorized to
operate the system. Before authorizing anyone to operate the
system, it should be verified that the person has read, and fully
understands, the operating instructions contained in this
manual. It is advisable to maintain a list of authorized
operators.
Should the system fail to operate correctly, or if the unit does
not respond to the commands described in this manual, the
operator should contact the nearest field GE Ultrasound
Service Office.
For information about specific requirements and regulations
applicable to the use of electronic medical equipment, consult
the local, state and federal agencies.
589
Important safety considerations
Notice against user modification
Never modify this product, including system components,
software, cables, and so on. User modification may cause
safety hazards and degradation in system performance. All
modification must be done by a GE qualified person.
This section includes considerations for the

following:
• Patient safety
• Personnel and equipment safety
The information contained in this section is intended to
familiarize the user with the hazards associated with the use of
the unit, and to alert them to the extent to which injury and
damage may occur if the precautions are not observed.
Users are obligated to familiarize themselves with these safety
considerations and to avoid conditions that could result in injury
or damage.
590
Regulatory information
The GE Vingmed Ultrasound product families are tested to
meet all applicable requirements in relevant EU Directives and
European/International standards. (See “Standards used”
below.) Any changes to accessories, peripheral units or any
other part of the system must be approved by the
manufacturer: GE Vingmed Ultrasound. Ignoring this advice
may compromise the regulatory approvals obtained for the
product.
Please consult your local GE Vingmed Ultrasound
representative for further details.
Standards used
The Vivid 7 ultrasound unit is a Class I device, type CF,
according to Clause 14 of IEC 60601-1 (1988). To fulfill the
requirements of relevant EC directives and/or European
Harmonized/International standards, the following
documents/standards have been used:
Standard/Directive Scope
93/42/EEC Medical Devices Directive (MDD)
EN55011: 1998+A1 :1999+A2: 2002 Emitted noise according to Class B

requirements + Electromagnetic
Susceptibility
IEC60601-1: 1988+A1: 1991+A2: 1995 Medical Electrical Equipment, Part 1;

EN60601-1: 1990+A1: 1993+A2: 1995 General Requirements for Safety
UL60601-1: 2003
CAN/CSA-C22.2 No 601.1-M90
IEC60601-2-37: 2001+A1: 2004 Medical electrical equipment - Part 2-37.

Particular requirements for the safety of
ultrasonic medical diagnostic and
monitoring equipment
IEC1157/ EN61157/ (1994)
Requirements for the declaration of the
acoustic output of medical diagnostic
ultrasonic equipment.
591
EN60601-1-2: 2001 Medical Electrical Equipment - part 1-2.
Collateral standard: Electromagnetic
compatibility - Requirements and tests.
EN60601-1-4: 1996+A1: 1999 Medical Electrical Equipment - part 1-4.

Collateral standard: Programmable
electrical medical systems
IEC60601-1-6: 2004 General requirements for safety - Usability

NEMA/AIUM Acoustic Output Display
Standard (NEMA UD-3, 2004)
0470
Device labels
The following table describes the purpose and location of
safety labels and other important information provided on the
equipment.
Label Purpose Location
Identification Plate Manufacturer's name and address Rear

Model
Device Listing/Certification Labels
Equipment Type BF, in which Probe connectors.

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

equipment having a floating applied
part having a degree of protection
suitable for direct cardiac contact.
592
Defibrillator-proof Type CF ECG connector

equipment.
Rear of unit.
0470
Alternating current Various
Protective earth (ground) Internal
Earth (ground) Internal
Equipotentiality: indicates terminal to Rear of unit

be used for connecting equipotential
conductors when interconnecting
(grounding) with other equipment as
described in IEC60601-1.
Attention - Consult accompanying Various

documents: alerts the user to refer to
the user documentation when
complete information cannot be
provided on the label.
CAUTION - Dangerous voltage: used Various

to indicate electric shock hazards.
ATTENTION - Observe precaution Rear of unit (External

for handling electrostatic sensitive I/O)
device.
The system is not designed for use Rear of unit

AP with flammable anesthetic gases. (Identification plate)
593
The disassembly and parts Rear of unit

disposition procedure is located on (Identification plate)
the card cage front cover.
To access to the procedure, remove
the right side panel by unscrewing the
two screws on the lower part.
This symbol indicates that the waste Rear of unit

of electrical and electronic equipment (Identification plate)
must not be disposed as unsorted
municipal waste and must be
collected separately. Please contact
the manufacturer or other authorized
disposal company to decommission
your equipment.
This product consists of devices that Rear of the LCD

may contain mercury, which must be monitor
recycled or disposed of in (USA only)
accordance with local, state, or
country laws. (Within this system, the
backlight lamps in the monitor display
contain mercury.)
This precaution is intended to prevent Rear of unit

injury that may result if one person (Identification plate)
attempts to move the unit over
considerable distances or on an
190 kg
incline due to the weight of the unit.
CAUTION - Do not move the unit if Keyboard console

the keyboard console is in the free
position
594
Apply a short push on the ON/OFF Keyboard console

button to shut down the system.
595
Classifications
Type of protection against electric shock
• Class I Equipment
Degree of protection against electric shock
• Type BF Applied part (for Probes marked with BF symbol)
• Type CF Applied part (for PCG, ECG and probes marked
with CF symbol)
Continuous Operation
System is Ordinary Equipment (IPX0)
Footswitch is IPX8
Class I Equipment
EQUIPMENT in which protection against electric shock not rely
on BASIC INSULATION only, but includes an earth ground.
This additional safety precaution prevents exposed metal parts
from becoming LIVE in the event of an insulation failure.
Type BF Applied part

TYPE BF APPLIED PART providing a specified degree of
protection against electric shock, with particular regard to
allowable LEAKAGE CURRENT.
Normal mode Single fault condition
Patient leakage current < 100 microA < 500 microA
Type CF Applied part

TYPE CF APPLIED PART providing a degree of protection
higher than that for Type BF Applied Part against electric shock
particularly regarding allowable LEAKAGE CURRENT.
Normal mode Single fault condition
Patient leakage current < 10 microA < 50 microA
596
Acoustic output
Definition of the acoustic output
parameters
Thermal Index
TI is an estimate of the temperature increase of soft tissue or
bone. There are three thermal index categories:
• TIS: Soft tissue thermal index. The main TI category. Used
for applications that do not image bone.
• TIB: Bone thermal index (bone located in a focal region).
Used for fetal application.
• TIC: Cranial bone thermal index (bone located close to the
surface). Used for transcranial application.
Mechanical Index
MI is the estimated likelihood of tissue damage due to
cavitation. The absolute maximum limits of the MI is 1.9 as set
by the FDA 510(k) guidance of 1997.
Ispta
The Ispta is the Spatial Peak Temporal Average Intensity. The
absolute maximum limit of Ispta is 720 MW/cm2 as set by the
FDA 510(k) guidance of 1997.
597
Acoustic output and display on the
Vivid 7
In the title bar, two fields are allocated for the display of power
values as shown in Figure 14-1.
1. Title bar
2. MI
3. TI
Figure 14-1: The display of MI and TI on the screen
The Vivid 7 chooses the correct category based on mode of

operation and chosen application, and presents only one TI to
the operator. It is therefore important that the operator chooses
the right application.
The Vivid 7 has an internal limit of 3.0 on TI. IEC87 has
suggested some time dependent thresholds that are partly
implemented on the Vivid 7 as color-coding of the thermal
index. The color-coding scheme together with the thermal
exposure times in the table below are not meant as limits on TI
or exposure time, but as an aid for the operator. Note that the
Vivid 7 does not monitor the thermal exposure time. The
displayed TI is coded as follow:
TI Color Recommended thermal exposure time
0.0–0.4 Dimmed -
0.4–1.5 White -
1.5–2.0 White < 12 h
2.0–3.0 White <1h
3.0–4.0 Red < 15 min.
The maximum possible MI and Ispta on the Vivid 7 is within the

limits set in Track 3 in the FDA 510(k) guide of 1997, MI < 1.9
and Ispta < 720 mW/cm2. 598
ALARA
Ultrasound procedures should be performed using output
levels and exposure times As Low As Reasonably Achievable
(ALARA) while acquiring clinical information.
Training
During each ultrasound examination the user is expected to
weigh the medical benefit of the diagnostic information that
would be obtained against the risk of potential harmful effects.
Once an optimal image is achieved, the need for increasing
acoustic output or prolonging the exposure cannot be justified.
It is recommended that all users receive proper training in
applications before performing them in a clinical setting.
Contact the GE Ultrasound sales representative for training
assistance.
Safety statement
GE Vingmed Ultrasound safety statement
Although no harmful biological effects have been demonstrated
for ultrasound frequencies, intensities and exposure times used
in examination with the GE Vingmed Vivid 7 system, GE
Vingmed Ultrasound recommends using the lowest acoustic
output settings which will produce diagnostically acceptable
information.
System controls affecting acoustic

output
The operator controls that directly affect the acoustic output are
discussed in the Acoustic Output Data Tables in the Reference
Manual. These tables show the highest possible acoustic
intensity for a given mode, obtainable only when the maximum
combination of control settings is selected. Most settings result
in a much lower output. It is important to note the following:
• The duration of an ultrasound examination is as important
as the acoustic output, since patient exposure to output is
directly related to the exposure time.
• Better image quality yields faster clinical results, making it
possible to complete the relevant ultrasound examination
599
more rapidly. Therefore, any control that improves the
quality of the examination can help to reduce patient
exposure, even though it may not directly affect acoustic
output.
Probe selection
As long as the appropriate application is available, any probe
can be used with the knowledge that the intensities fall at, or
below, those stated in the Acoustic Output Data Tables. The
duration of patient exposure is most likely minimized with the
use of a probe that is optimized to provide resolution and focal
depth, appropriate to the examination.
Application selection
Selecting the probe and application preset appropriate to a
particular ultrasound examination automatically provides
acoustic output limits within FDA guidelines for that application.
Other parameters which optimize performance for the selected
application are also set automatically, and should assist in
reducing the patient exposure time. See page 52, for
information on selecting probes and application presets.
Changing imaging modes

Acoustic output depends on the imaging mode selected. The
choice of mode (2D, M-Mode, Doppler or Color Flow)
determines whether the ultrasound beam is stationary or in
motion. This greatly affects the energy absorbed by the tissue.
See Chapter 3, ’Scanning Modes’ on page 87, for complete
information on changing imaging modes.
When operating in a combined mode, such as 2D and M-Mode,
the total acoustic output comprises contributions from each
individual mode. Depending on the modes in use, either or both
output indices may be affected.
The user can override the default settings, but care should be
taken to observe the displayed MI and TI values.
Power
It is possible to change the power in all operating modes so that
the operator can use the ALARA principle.
600
Patient safety
Patient identification
The concerns listed in this section can seriously affect the safety
of the patient undergoing a diagnostic ultrasound examination.
WARNING
Always include proper identification with all patient data and

verify the accuracy of the patient's name and/or identity number
when entering such data. Ensure that the correct patient ID is
provided on all recorded data and hard copy prints.
Identification errors could result in an incorrect diagnosis.
Diagnostic information
The images and calculations provided by the system are
intended for use by competent users, as a diagnostic tool. They
are explicitly not to be regarded as the sole, irrefutable basis for
clinical diagnosis. Users are encouraged to study the literature
and reach their own professional conclusions regarding the
clinical utility of the system.
The user should be aware of the product specifications and of
the system accuracy and stability limitations. These limitations
must be considered before making any decision based on
quantitative values. If in doubt, the nearest GE Ultrasound
Service Office should be consulted.
Equipment malfunction or incorrect settings can result in
measurement errors or failure to detect details in the image.
The user must become thoroughly familiar with the operation of
the unit in order to optimize its performance and to recognize
possible malfunctions. Application training is available through
the sales representative.
Be certain to ensure privacy data of patient information.
CAUTION
Mechanical hazards
Damaged probes or improper use and manipulation of the
transesophageal probe may result in injury or increased risk of 601
infection. Inspect probes frequently for sharp, pointed or rough
surface damage that could cause injury or tear protective
barriers (gloves and sheaths).
Transesophageal probe safety

Never use excessive force when manipulating the
transesophageal probe. The detailed operator manual
enclosed with the transesophageal probe must be read
carefully.
Electrical Hazard
A damaged probe may increase the risk of electric shock if
conductive solutions come in contact with internal live pads.
Inspect probes often for cracks or openings in the housing and
holes in and around the acoustic lens, or other damage that
could allow moisture to enter. Become familiar with the use and
care precautions described in Chapter 10, ’Probes’ on
page 473.
Vivid 7 and Electrosurgical units

This equipment provides no special means of protection from
high frequency (HF) burns that may result from using an
WARNING electrosurgical unit (ESU). To reduce the risk of HF burns, avoid
contact between the patient and ultrasound transducer or ECG
electrodes while operating the ESU. Where contact cannot be
avoided, as in the case of TEE monitoring during surgery, make
sure the transducer or ECG electrodes are not located between
the ESU active and dispersive electrodes and keep the ESU
cables away from the transducer or ECG cables
602
Personnel and equipment safety
The hazards listed below can seriously affect the safety of
personnel and equipment during a diagnostic ultrasound
DANGER examination.
Explosion hazard
Never operate the equipment in the presence of flammable or
explosive liquids, vapors or gases. Malfunctions in the unit, or
sparks generated by fan motors, can electrically ignite these
substances. Operators should be aware of the following points
to prevent such explosion hazards.
• If flammable substances are detected in the environment,
do not plug in or turn on the system.
• If flammable substances are detected after the system has
been turned on, do not attempt to turn off the unit, or to
unplug it.
• If flammable substances are detected, evacuate and
ventilate the area before turning off the unit.
Implosion hazard
Do not subject the unit to serious mechanical shocks because
the cathode ray tube (CRT) may implode if struck or jarred.
This may cause pieces of glass and/or phosphor coating to fly
into the air and result in serious injury.
Electrical hazard
The internal circuits of the unit use high voltages, capable of
causing serious injury or death by electrical shock.
WARNING
Note: Any rest energy within our scanners or their components

will be below 60 V DC or 2 mJ.
To avoid injury
• Do not remove the unit's protective covers. No
user-serviceable parts are inside. If servicing is required,
contact qualified technical personnel.
• Connect the attachment plug to a hospital-grade grounding 603
outlet to ensure adequate grounding.
• Do not place liquids on or above the unit. Conductive fluids
seeping into the active circuit components may cause short
circuiting, which could result in an electrical fire.
• An electrical hazard may exist if any light, monitor or visual
indicator remains on after the unit is turned off.
Fuses blown within 36 hours of being replaced may indicate a
malfunctioning electrical circuit within the system. In this event,
the unit must be checked by GE Ultrasound service personnel.
No attempt should be made to replace the fuses with others of
a higher rating.
Moving hazard
The Vivid 7 unit weighs approximately 190 Kg (419 lb.).
CAUTION
Special care must be used to avoid injury when moving or

transporting the unit.
• Always be sure the pathway is clear.
• Limit the speed of movement to a careful walk.
• Use at least two people when moving the unit on inclines.
Ensure that the unit is well prepared before transporting. Refer
to ’Moving and transporting the unit’ on page 18 for more
information.
Biological hazard
For patient and personnel safety, beware of biological hazards
while performing transesophageal procedures. To avoid the
risk of disease transmission:
• Use protective barriers (gloves and probe sheaths)
whenever necessary. Follow sterile procedures as
required.
• Thoroughly clean probes and reusable accessories after
each patient examination and disinfect or sterilize as
needed. Refer to Chapter 10, ’Probes’ on page 473, for
probe use and care instructions.
• Follow all in-house infection control policies as they apply
604
to personnel and equipment.
Pacemaker hazard
The possibility of the system interfering with pacemakers is
minimal. However, as this system generates high frequency
electrical signals, the operator should be aware of the potential
hazard this could cause.
605
Electrical safety
Device classifications
The Vivid 7 ultrasound unit is a Class I device, type CF,
according to Sub-clause 14 of IEC 60601-1 (1988).
Internally connected peripheral devices

The system, together with peripheral devices, such as video
tape recorders and printers, meets UL2601-1 and IEC 60601-1
(1988) standards for electrical isolation and safety. These
standards are applicable only when the specified peripheral
devices are plugged into the AC outlets provided in the unit.
External Connection of other peripheral

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

and external monitors, usually exceed allowable leakage limits
and, when plugged into separate AC outlets that are then
connected to the unit, are in violation of patient safety
standards. Suitable electrical isolation of such external AC
outlets may be required in order to meet UL2601-1 and
IEC 60601-1 (1988) standards for electrical leakage.
606
Allergic reactions to latex-containing
medical devices
Due to reports of severe allergic reactions to medical devices
containing latex (natural rubber), the FDA advises health-care
professionals to identify latex-sensitive patients, and be
prepared to treat allergic reactions promptly. Latex is a
component of many medical devices, including surgical and
examination gloves, catheters, incubation tubes, anesthesia
masks and dental dams. Patient reaction to latex has ranged
from contact urticaria, to systemic anaphylaxis.
For more details regarding allergic reaction to latex, refer to
FDA Medical Alert MDA91-1, March 29.
607
Electromagnetic Compatibility (EMC)
This unit carries the AII types of electronic equipment may characteristically cause
CE mark. It com- electromagnetic interference with other equipment, transmitted
plies with regulato- either through air or connecting cables. The term
ry requirements of
the European Di-
Electromagnetic Compatibility (EMC), indicates the capability
rective 93/42/EEC of the equipment to curb electromagnetic influence from other
concerning medical equipment, while at the same time not affecting other
devices. It also com- equipment with similar electromagnetic radiation.
plies with emission
limits for a Group 1, Radiated or conducted EMC can cause distortion, degradation,
Class B Medical or artifacts in the ultrasound image which could potentially
Device as stated in obscure diagnostic information.
EN 60601-1-2
(2001) There is no guarantee that interference will not occur in a
(IEC 60601-1-2 particular installation. If this equipment is found to cause or
(2001)).
respond to interference, which may be determined by turning
equipment on and off, qualified service personnel should
attempt to correct the problem by one or more of the following
measures:
• Re-orient or re-locate the affected device.
• Increase the separation between the unit and the affected
device.
• Power the equipment from a source other than that of the
affected device.
• Consult the service representative for further suggestions.
The manufacturer is not responsible for any interference or
responses caused by the use of interconnecting cables other
than those recommended, or by unauthorized changes or
modifications to this unit. Unauthorized changes or
modifications could void the user's authority to operate the
equipment.
To comply with the regulations on electromagnetic interference,
all interconnecting cables to peripheral devices must be
shielded and properly grounded. Use of cables not properly
shielded and grounded may result in the equipment causing or
responding to radio frequency interference, in violation of the
European Union Medical Device Directive and FCC
regulations.
Do not use devices which intentionally transmit RF signals, for
example, cellular phones, transceivers, or radio controlled
608
products, in the vicinity of this equipment as it may cause
performance outside the published specifications. Keep the
power to these types of devices turned off when near this
equipment.
609
Environmental protection
System disposal
Please follow the disassembly procedure and part disposition
attached inside the unit. To access to the procedure, remove
the right side panel by unscrewing the two screws on the lower
part.
610
Appendix
• Product description ...................................................................... ... 612

• Probe/Application overview ........................................................ ... 631
611
Product description
System Architecture
• TruScan architecture unleashes powerful imaging
capabilities for the Vivid 7.
• 3D Beamforming technology significantly improves
image quality with breakthrough performance in 2D,
color and Doppler imaging
• QScan imaging helps to extract more definitive
diagnostic information from cardiovascular images by
bringing quantitative assessment tools out of the
research lab and into your routine clinical exam.
• Total data management with true, raw data DICOM
networking capabilities to communicate findings and to
unlock data for future quantitative analysis.
• Unprecedented level of ergonomic design and comfort
with productivity software that allows operators to
personalize their workspace.
Data Acquisition
• Cardiac, cardiovascular, abdominal, OB/GYN, peripheral
vascular and OR optimized application presets
• High precision data acquisition
• Programmable open-ended system architecture
• Application-specific channel architecture
• 12 bit A/D converters per physical channel
• Digital data acquisition
• In addition to standard Phased Array, Doppler Probes, Flat
and Curved Linear transducers, it supports Active Matrix
Array Sector (M3S, M4S), Flat (M12L) and Curved Linear
(M7C) probes as well as the new 3V for 4D and
multi-dimensional imaging
• Parallel data processing on four channels
• Receive focusing, aperture, apodization, and frequency
response are all continuously variable as a function of
depth
Data Processing
• TruScan architecture provides raw data management 612
integrated into scan conversion processing
• PipeLink Technology: high speed parallel data bus for pre-
and post-processing
• Echo data processing of phase, amplitude and frequency
information
• Upgradable for future needs
• Raw data digital replay for retro and looping - allows for
adjustment of all major display parameters and M & A
• Selectable data compression (including compression of
raw data)
Display
• High resolution (up to 1024 x 768 pixels), flicker-free
17-inch computer graphics monitor, tilt and swivel
• 16.7 Million simultaneous colors available
• Scanner software supports 800 x 600 display resolution
• VCR input is played back through digital replay, allowing
VCR images to be looped during review and M&A capability
• Instant review screen displays 12 simultaneous
loops/images for quick study review
• Scanplane position indicator and probe temperature are
displayed with all multiplane TEE probes
• Image orientation marker
• Selectable display configuration of duplex and triplex
modes: side-by-side or top-bottom, during live, digital
replay and clipboard image recall
• Single, dual and quad-screen view
• Split screen view
Ergonomics
• Floating keyboard with lifting swivel and in/out keyboard
displacement
• Monitor with independent swivel and tilt movement
• Backlit keyboard
Display Annotations
• On-screen display of Mechanical Index (MI)
• On-screen display of Thermal Index 613
• Patient name/ID
• Hospital name
• Time/date
• Trackball driven annotation arrows
• Scanning parameters
• Active mode display
• Stress protocol parameters
• Parameter annotation follow ASE standard
Tissue Imaging
General
• Variable transmit frequencies for resolution/penetration
optimization
• Display zoom with zoom area control
• High Resolution (HR) Zoom: concentrates all image
acquisition power into selected Region of Interest (ROI)
• Variable Contour Filtering for edge enhancement
• Depth range up to 30 cm - probe specific
• Selectable greyscale parameters: Gain, Reject, DDP and
Compress - can be adjusted in live, digital replay and image
clipboard recall.
• Automatically calculated TGC curves require minimal
operator interaction
Multi-dimensional and Volume Imaging

(option)
Vivid 7 Dimension only
• 4D imaging allows real time acquisition and display of
volume data in gray scale
• Multi-dimensional imaging is used to acquire parasternal
bi-plane and apical tri-plane views and supports 2D, color,
as well as, Tissue Doppler modes (including Tissue
Synchronization Imaging which is part of the Advanced
QScan option)
• Full volume gray scale data acquired from 4 or 6 sequential
heart cycles in real time
• Slice mode allows an anyplane gray scale display based on 614
volume data
• 9 Slice view: efficient access to 9 simultaneous slices, in
particular useful for 9 short axis views at different levels of
LV
• Easy and fast optimization of rendered 4D image display
• Enhanced 4D render representation quality
• Comprehensive control set for optimizing rendered 4D
image display
• Full M&A package can be applied to multi-dimensional and
slice mode images
• The 3V probe which supports 4D and multi-dimensional
imaging allows also PW and CW Doppler examinations
• Contrast specific presets for 4D and multi-dimensional
imaging
• Colorized 4D data enhances representation of rendered
images
• All data can be stored in raw data DICOM format and can
be recalled for post-processing
• Data management is completely integrated in
EchoPAC PC archiving system
• Multi-plane imaging improves workflow as well as the
quality of Tissue Synchronization Imaging and stress echo
studies (separate options)
2D-Mode
• Sector tilt and width control
• Frame Rate in excess of 600 fps, depending on probe,
settings and applications
• Coded Octave Imaging with Coded Phase Inversion - 3rd
generation harmonic tissue imaging providing improved
lateral and contrast resolution over conventional imaging.
Features reduce noise, improve wall definition, and axial
resolution, making it the tissue modality of choice for all
patient groups.
• Confocal Imaging - allows for multiple transmit focal zones
over range of view and a high vector density - probes
dependent.
• Automatic Tissue Optimization - single key stroke optimizes
immediately and automatically different gray scale settings
615
adjusted for the real time image
• Speckle Reduce Imaging - an advanced image processing
technique to remove speckle in real time examining the
relative difference between neighboring pixel values and
determining whether the gray scale variations have a sharp
difference, follow a trend, or are random in nature
• Variable image width: a reduction either increases frame
rate or increases the number of focal zones while
maintaining the frame rate - application dependent
• Multiple Angle Compound Imaging - Multiple co-planar
images from different angles combined into a single image
in real time improving border definition, contrast resolution,
and reducing angular dependence of border or edge
• LOGIQView - provides the ability to construct and view a
static 2D image with wider field of view of a given
transducer. This allows viewing and measurements of
anatomy that is larger than what would fit in a single image
• Dual Focus: a powerful tool giving additional focal zone for
excellent spatial and contrast resolution from heart base to
apical areas
• L/R and Up/Down invert, in live, digital replay or image
clipboard recall
• Digital replay for retrospective review or automatic looping
of images, allowing for adjustment of parameters such as
gain, reject, Anatomical M-Mode, persistence and replay
speed.
• Data Dependent Processing performs temporal processing
which reduces random noise but leaves motion of
significant tissue structures largely unaffected. Can be
adjusted even in digital replay
• 256 shades of gray
• Colorized 2D-Mode, user selectable in real-time, digital
replay
M-Mode
• Trackball Steerable M-Mode line available with all imaging
probes, max steering angle is probe dependent.
• Simultaneous Real Time 2D- and M-Mode.
• M-Mode PRF 1 kHz, all image data acquired are combined
to give high quality recording regardless of display scroll 616
speed.
• Digital replay for retrospective review of spectral data
• Several top-bottom formats, side-by-side format and
time-motion only format - can be adjusted in live and digital
replay
• Selectable horizontal scroll speed: 1, 2, 3, 4, 6, 8, 12, 16
seconds across display.
• Horizontal scroll can be adjusted in live or digital replay.
Anatomical M-Mode
• M-Mode cursor can be adjusted at any plane
• Curved Anatomical M-Mode: free (curved) drawing of
M-Mode generated from the cursor independent from the
axial plane
• Can be activated from live, digital replay or image clipboard
recall
• Anatomical Color and Tissue Velocity M-Mode
• M & A Capability
B-Flow
• B-Flow is a new digital imaging technique that provides
real-time visualization of vascular hemodynamics by
directly visualizing blood reflectors and presenting this
information in a gray scale display
• Use of GE-patented techniques to boost blood echoes, and
to preferentially suppress non-moving tissue signals
• B-Flow is available for most vascular and shared service
applications
Blood Flow Imaging

• Combines color Doppler with gray scale speckle imaging
• Allows better delineation of blood flow without bleeding into
tissue or vessel wall
Color Doppler
General
• Steerable Color Doppler available with all imaging probes -
max steering angle is probe dependent
• Trackball-controlled ROI 617
• Removal of color map from the tissue during digital replay
• Digital replay for retrospective review of Color M-Mode data
allowing for adjustment of parameters such as Encoding
Principle, Color Priority and Color Gain even on stored data
• PRF settings - user selectable
• Advanced Regression Wall Filter gives efficient
suppression of wall clutter
• For each encoding principle, multiple-color maps can be
selected in live and digital replay - variance maps available
• More than 65,000 simultaneous colors processed,
providing a smooth display two-dimensional color maps
containing a multitude of color hues
• Simultaneous display of greyscale 2D and 2D with Color
Flow
• Color Invert, user selectable in live and digital replay
• Variable Color Baseline, user selectable in live and digital
replay
• Multivariate Color Priority function gives reliable delineation
of disturbed flows even across bright areas of the 2D-Mode
image
• Color Doppler frequency can be changed independently
from 2D for optimal flow
Color Doppler Imaging

• TruSpeed Imaging allows either ultra-high frame rate or
increased lateral resolution
• Very high digital signal processing power, maintaining high
frame rates with large ROIs even for very low PRF settings
• Frame rate in excess of 100 fps, depending on probe and
settings
• Variable ROI size in width and depth
• User-selectable Radial and Lateral Averaging for reduction
of statistical uncertainty in the color velocity and variance
estimates
• Data Dependent Processing (DDP) performs temporal
processing and display smoothing with reduced possibility
for loss of transient events of hemodynamic significance
• Digital replay for retrospective review or automatic looping
of color images, allowing for adjustment of parameters such 618
as DDP, encoding principle, baseline shift, color maps,
color priority and color gain even on frozen/recalled data
• Application dependent Multivariate Motion Discriminator
reduces flash artifacts
• Dedicated coronary flow application
Color Angio (Color Intensity Imaging)

• Angle independent mode for visualization of small vessels
with increased sensitivity compared to standard color flow
Color M-Mode
• Variable ROI length and position - user selectable
• User-selectable Radial Averaging for reduction of statistical
uncertainty in the color velocity and variance estimates
• Selectable horizontal scroll speed
• 1, 2, 3, 4, 6, 8, 12, 16 seconds across display - can be
adjusted during live, digital replay or image clipboard recall
• Real-time 2D image while in color M-Mode
• Same controls and functions available as in standard 2D
color Doppler
Anatomical Color M-Mode™

• Vingmed-patented any plane Color M-Mode display
derived from Color Doppler cineloop.
• Also applicable to Tissue Velocity Imaging
• M&A capability
Spectral Doppler
General
• Operates in PW, HPRF, and CW modes
• Trackball Steerable Doppler available with all imaging
probes - max steering angle is probe dependent
• Selectable Doppler frequency for better optimization
• High-Quality Real-time duplex or triplex operation in all
Doppler Modes, CW and PW and for all velocity settings
• Frame Rate Control for optimized use of acquisition power
between spectrum, 2D, and Color Doppler Modes in duplex
or triplex modes
619
• Very fast and flexible spectrum analysis with an equivalent
DFT rate of 0.2 ms
• Dynamic Gain Compensation for display of flows with
varying signal strengths over the cardiac cycle and
improved ease of use
• Dynamic Reject gives consistent suppression of
background - user selectable, in real-time, digital replay or
image clipboard recall
• digital replay for retrospective review of spectral Doppler
data
• Several top-bottom formats, side-by-side format and
time-motion only format - can be adjusted in live or digital
replay.
• Selectable horizontal scroll speed: 1, 2, 3, 4, 6, 8, 12, 16
seconds across display - can be adjusted in live or digital
replay
• Adjustable spectral Doppler display parameters: Gain,
Reject, Compress, Color Maps - can be adjusted in live or
digital replay
• User-adjustable baseline shift - in live, digital replay and
image clipboard recall
• Adjustable velocity scale
• Wall filters with range 10 - 2000 Hz (velocity scale
dependent)
• Angle correction with automatic adjustment of velocity
scale - in live, digital replay and image clipboard recall
• Stereo speakers mounted in the front panel
• Display annotations of frequency, mode, scales, Nyquist
limit, wall filter setting, angle correction, acoustic power
indices
PW / HPRF Doppler
• Automatic HPRF Doppler maintains its sensitivity even for
shallow depths and with the highest PRFs
• Digital Velocity Tracking Doppler employs processing in
range and time for high-quality spectral displays
• Adjustable sample volume size of 1-20 mm (probe
dependent)
• Maximum sample volume depth 30 cm
620
CW Doppler
• Highly sensitive steerable CW available with all phased
array probes
Advanced Options
Tissue Velocity Imaging
• Myocardial Doppler Imaging with color overlay on tissue
image
• Tissue Doppler data can be acquired in background during
regular 2D imaging
• Digital Velocity profile analysis allowing velocity and time
quantification at any point and at any time during the heart
cycle from digital replay or image clipboard recall
• Quantitative Segmental Wall Motion Analysis can be
obtained with use of Anatomical M-Mode, from digital
replay or image clipboard recall
• The velocity of all myocardial segments after entire heart
cycle can be displayed in one single image
• Tissue color overlay can be removed to show just the 2D
image, still retaining the tissue velocity information
• Quantitative profiles for TVI, Tissue Tracking, Strain and
Strain Rate can be derived
• Time markers for valve events derived from any TM mode
simplify understanding of signals in velocity traces or
curved Anatomical M-mode
Tissue Tracking
• Real time display of the time integral of TVI for quantitative
display of myocardial systolic displacement
• Myocardial displacement is calculated and displayed as a
color-coded overlay on the 2D image - different colors
represent different displacement ranges
Tissue Synchronization Imaging (option)

• Parametric imaging which gives information about
synchronicity of myocardial motion
• Delayed myocardial segments produce red overlay
whereas segments moving in normal rhythm are green
• Available in live scanning as well as an offline calculation 621
derived from tissue Doppler data
• Additional features in combination with multi-dimensional
imaging option:
• Simultaneous acquisition of tri-plane TSI images
covering all standard segments in apical views with
more than 100 fps
• Efficient segment specific TSI time measurements
• Immediate Bull’s eye report
• Automatic calculated TSI synchrony indexes
• TSI surface mapping
• LV synchronization report template
Strain rate/Strain imaging (option)

Research
• Tissue deformation and rate of tissue deformation are
calculated and displayed as real time color-coded overlay
on the 2D image
• Tissue deformation (Strain) is calculated and displayed as
real time color-coded overlay on the 2D image
• Cine compound calculates and displays cineloops
generated from a temporal averaging of multiple
consecutive heart cycles
• Anatomical M-Mode and Curved Anatomical M-Mode
displays (SI and SRI)
• Optimized strain presets for further 2D strain analysis on
EchoPAC PC Dimension workstation (separate research
option)
Intima Media Thickness (IMT) Measurement

(option)
• Automated measurement of IMT rather than the
conventional way of measuring the IMT manually
• Results representative of a region rather than a single point
of a vessel wall
• Reduction of examination time by providing a quick and
easy procedure in measuring the IMT
622
Contrast Imaging
(All use of contrast agents should be used as described on the
label by the contrast agent manufacturers.)
LVO Contrast (option)1

Enables contrast applications intended for clinical use:
• LV Contrast (3V, M3S, 3S, M4S, 5S and 6T) enhances
delineation of the LV border in combination with ultrasound
contrast agents. The new implementation of GE’s Coded
Phase Inversion (CPI) provides high resolution detection of
contrast in the LV cavity and excellent suppression of
myocardial tissue signals. Furthermore, tri-plane imaging
with 3V using LV Contrast enables acquisition of three
simultaneous apical views within one cardiac cycle
• LVO Stress (M3S), same as LV Contrast but with slightly
higher frame rate to account for the higher heart rates
during stress
1)Harmonic Imaging for supporting contrast agent imaging was
developed by Schering.
Vascular/Abdominal Contrast (option)2

Enables contrast applications intended for vascular and
abdominal contrast imaging:
• Vascular Contrast (7L, 10L and M12L) Coded Phase
Inversion enables excellent detection and resolution of
vascular contrast imaging
• Abdominal Contrast (3.5C and 4C) – Coded Phase
Inversion optimized for abdominal contrast imaging
Advanced Contrast (option)2

Enables contrast applications intended for research only.
Diagnosis shall not be based on these applications alone.
• Real Time CPI (M3S and M4S) – with improved resolution,
tissue suppression and higher contrast sensitivity is
obtained by utilizing new Coded Phase Inversion mode
(B-mode) intended for low power real time myocardial
contrast imaging. Destruction: wash-in studies are possible
online or offline using “flash” and Q-analysis features.
Offline ECG triggering (acquire the full cineloop is yet
another useful tool of the RTCPI application
623
• MC Contrast (M3S, 3S, M4S and 5S) – Harmonic Angio for
high power triggered myocardial contrast imaging
• Rodent Contrast (i13L) – With the unique combination of
high frequency of i13L and our newly developed CPI we
provide superior tools for small animal ultrasound research
2)GE Healthcare’s Vivid 7 Dimension designed for
compatibility with commercially available contrast agents.
Because the availability of these agents is subject to
government regulation and approval, product features intended
for use with these agents may not be commercially marketed
nor made available before the contrast agent is approved for
use. Advanced contrast features are only enabled on systems
for delivery in countries or regions where the agents are
approved for use or for investigational or research use.
Physiological Traces
• Up to five traces display simultaneously
• ECG trigger
• ECG lead selection
• High-resolution display of the following traces: ECG,
Respiration, Phono, AUX1 and Pressure/AUX2
Analysis Program
• Personalized measurement protocols allow individual set
and order of M&A items
• Measurement can be labelled seamlessly by using
protocols or post assignments
• Bodymark icons for location and position of probe
• Cardiac calculation package including extensive
measurements and display of multiple repeated
measurements
• Vascular measurements package
• Measurements assignable to protocol capability
• Parameter annotation follow ASE standard
• Measurements assignable to report generator
• Doppler auto trace function with automatic calculations in
both live and digital replay
• Possibility of performing Measure and Analysis on video
624
playback
• Seamless data storage and report creation
• Measurements are summarized in worksheets - individual
results can be edited or deleted
• User-assignable parameters
User Interface
• Easy-to-learn user interface with intelligent keyboard
• Front panel with application-specific rotaries and push
buttons for primary controls
• Application-specific secondary controls available through
slidebars operated by a four-way rocker
• Slide pot TGC curve with eight pots
• Overall gain for 2D-Mode, Active mode, Depth and Zoom
Span on dedicated rotaries
• Digital harvesting of images and loops into image clipboard
• Patient Browser Screen for registration of demographic
data and quick review of Image Clipboard contents
• Fully programmable user presets for probe/application
default settings
EchoPAC PC
• EchoPAC PC adds connectivity and image analysis
capability to Vivid 7
• Instant access to ultrasound raw data provided by the
system
• Advanced Post-Processing Analysis
• MO drive (option)
• DVD writer (supports CD-R and DVD-R)
• Three user levels help organizing data security
requirements
Image and Data Management

• Ultimate workflow with instant access data management
• Next generation of DICOM image format: raw image
DICOM incorporates raw image data information with all its
data management flexibility into the image communication
standard DICOM 625
• 2D, CFM or TVI data at maximum frame rate may be
reviewed by scrolling or by running cine loops (can contain
more than 1000 images for all imaging modes)
• Image Clipboard for stamp-size storage and review of
stored images and loops
• Built-in patient archive with image/loops, patient
information, measurements and reports
• Structured findings report tools support efficient text entries
• User can enter normal values which are then compared to
actual measurements
• Configurable HTML-based report function
• Report Templates can be customized on board
• ASE-based default text modules (English), user
customizable
• Internal archive data can be exported to Removable Image
Storage through Magneto-Optical Disk and DICOM Media
• Internal Hard Disk: for storing programs, application
defaults, ultrasound images and patient archive
• All data storage is based on ultrasound raw data, allowing
to change gain, baseline, color maps, sweep speeds etc.,
for recalled images and loops
• DICOM media: read/write images on DICOM format
• Alphanumeric patient data can be exported in MS Excel
compatible format
• JPEG export for still frames
• AVI and MPEG export for cineloops MPEGvue
• Using MPEGvue, exams may be stored onto removable
media or on remote networked system together with
integrated MPEGvue player for viewing on standard PC
• Smart e-mail feature allows transparent transmission of
images via e-mail using resident Outlook e-mail client
eVue (option)
• Allows interactive viewing of images, loops or full exams
from remote location
Wideband probes
• Electronic selection between three solid state and one
stand-alone Doppler connectors 626
• Biopsy support for 3.5C, 4C, M7C, E8C, 9L, 10L, 7L, 12L,
M12L, 3S, M3S and M4S probes
Probe Freq. Range Cat. #
Phased Array Sector
M3S 1.5–4.3 MHz H45011SZ
M4S 1.5–4.3MHz H4000PA
3S 1.5–3.8 MHz H4550SZ

H4701SZ
5S 2.2–5.0 MHz H4901RA

H40422LA
6S 2.7–8.0 MHz H45021RS
7S 2.9–8.0 MHz H4000P

H40422LB
10S 3.7–11.5 MHz H4901PC
3Va 1.5–4.0 MHz H4900PC
Linear Array
7L 2.2–8.0 MHz H40412LF
9L 3.0–10.0 MHz H44112LT
10L 4.0–10.0 MHz H40212LG
12L 4.9–13.0 MHz H40412LH
M12L 4.9–14.0 MHz H40412LD
i8L 3.9–10.0 MHz H45511NW
i13L 5.3–14.0 MHz H45511NT
Curved Array (Convex)
3.5C 2.0–5.0 MHz H4901PE
4C 1.6–5.0 MHz H4904PC
5C 3.0–6.7 MHz H40412LA
M7C 2.9–7.0 MHz H40412LC

627
Probe Freq. Range Cat. #
8C 3.7–8.0 MHz H40412LJ
E8C 3.7–8.0 MHz H40412LE
Doppler
2D (P2D) 2.0 MHz H4830JE
6D (P6D) 5.0 MHz H4830JG

5.8 MHz
Multiplane Transesophageal Phased Arrayb
6T 2.7–7.0 MHz H45001YD

H45531HW
H45521DX
6Tc 2.7–7.0 MHz H45551JA
9T 3.1–10.0 MHz H45521DY

a) Vivid 7 Dimension only
b)TEE probe adapter allows using PAMPTE and 6Tv which are
designed for System FiVe and Vivid FiVe scanners
Virus Protection
To minimize virus vulnerability Vivid 7 is configured with a
minimal set of open ports and with all network services not
actively used by the system closed down. This significantly
reduces the risk of a virus attack on Vivid 7
GE is continuously judging the need for additional actions to
reduce vulnerability of equipment, this includes vulnerability
scanning of our products and evaluation of new security
patches for the 3rd party technology used. Microsoft (and
other) security patches that addresses serious issues with
Vivid 7 will be made available to customers after GE verification
of those patches.
Peripherals (options)
Internal peripherals
• SVHS VCR
628
• Full control from system panel
• Frame grabber for playback
• M&A package for video measurements
• B/W video printer with control from system panel
• Color video printer with control from system panel
• USB-2 interface
External
• Ink-jet printer
• Color laser printer
Physical Dimensions
Size Metric Imperial
Heighta 137.5 cm 157.5 cm 54.1 in 62 in
Width 64.0 cm 25.2 in
Depth 90.0 cm 35.4 in
Weightb 190 kg 419 lbs

a) with monitor
b) with monitor, without peripherals
Cart
• Low rolling resistance casters
• Brakes on front casters
• Direction of casters can be locked for improved
maneuverability
• Intelligent Fans: revolution speed is automatically adapted
to the system's internal operating temperature
629
Electrical Specifications
Voltage Frequency Current

(VAC) (Hz) (A)
100–120 50–60 10
230 50–60 5
Safety
• Built to meet the requirements of:
• IEC60601-2-37/A1: 2004
• IEC60601-1/A1/A2: 1995
• IEC60601-1-2: 2001
• IEC60601-1-4: 2000
• UL60601-1: 2003
• CAN/CSA C22.2 No 601.1-M90
• The European Medical Devices Directive (MDD)
93/42/EEC (CE Mark)
• The European Directive for Waste electrical and
electronic equipment (WEEE) 2002/96/EC
• The Vivid 7 ultrasound unit is a Class I device, type CF,
according to Sub-clause 14 of IEC 60601-1 (1998).
• The Vivid 7 ultrasound unit meets the EMC
requirements in EN 55011/A1/A2: 2002 for Group 1.
Class B (10 meters)
Not all features or products described in this document may be

available or cleared for sale in all markets. Please contact your
CAUTION local GE Medical Systems representative to get the latest
information.
© 2001-2006 GE Medical Systems
630
Probe/Application overview
Probe
3S
M3S
5S
7S
10S
7L
10L
12L
M12L
i8L
i13L
3.5C
M4S
4C
6S
3V
9L
Application
Abdominal + + + + +
Breast + +
Cardiac + + + + + + + + + +
Carotid + + + + +
Contrast + + + + + +
Coronary + + + + + + +
Exercise + + + +
Fetal Hearta + + + + + + + + +
LEA + + + + +
LEV + + + + +
LV Contrast + + + + +
LVO Stress + +
MC Contrast + + + +
Muscle Skeleton + +
Neo Head +
Octave SRI + +
Obstetricsa + +
Pediatric + + + + + + +
Pelvic + +
Pharm Stress + + +
Q-Stress + + +
Real Time CPI + +
Only the applications marked with a “a” are approved for fetal use when appropriate
probe is selected. 631
Probe
3S
M3S
5S
7S
10S
7L
10L
12L
M12L
i8L
i13L
3.5C
M4S
4C
6S
3V
9L
Application
Renal + + + + +
Scrotal + +
Small parts + + +
Small rodent + + + +
Transcranial + + +
Thyroid + +
UEA + + + + +
UEV + + + + +
probe is selected.
Probe
8C
E8C
2D
6D
6T/6Tc
9T
PAMPTE
M7C
5C
Application
Abdominal + + +
Breast
Cardiac + + +
Carotid + +
Coronary +
Exercise
Fetal Hearta + + +
LEA +
LEV +
probe is selected.
632
Probe
8C
E8C
2D
6D
6T/6Tc
9T
PAMPTE
M7C
5C
Application
LV Contrast +
LVO Stress
MC Contrast + +
Muscle Skeleton
Neo Head +
Octave SRI
Obstetricsa + + +
Pediatric +
Pelvic + + +
Pharm Stress
Q-Stress
Real Time CPI
Renal + +
Scrotal
Small parts
Small rodent
Transcranial
Thyroid
UEA +
UEV +
probe is selected.
633
GE recommends dedicated probes for use on humans only or
animals only. Mark probes dedicated for animals only with
CAUTION special labels.
If probes are interchanged between humans and animals, GE
strongly recommends that the probes are sterilized between
transitions humans / animals. Observe any national rules and
regulations for handling equipment used on both animals and
humans. Such national restrictions may prohibit transfer of
probes used on animals to humans and vice-versa.
634
Index
Numerics
2D Soft menu controls ..........................................................................................................93
2D-Mode ......................................................................................................................................90
Controls ..................................................................................................................................92
Optimizing ..............................................................................................................................95
Overview ................................................................................................................................90
Using .......................................................................................................................................95
A
Active mode gain
Optimizing Color Mode ....................................................................................................109
Optimizing CW Doppler................................................................................................... 115
Optimizing PW Doppler ................................................................................................... 115
Air filter .......................................................................................................................................581
Angle correction
CW Doppler......................................................................................................................... 113
PW Doppler ......................................................................................................................... 113
Annotations ................................................................................................................................79
Configure ...............................................................................................................................83
Editing .....................................................................................................................................82
Erasing....................................................................................................................................82
Inserting ..................................................................................................................................79
Application
selecting .................................................................................................................................52
Assignable keys .......................................................................................................................55
Automated Function Imaging ..........................................................................................251
Automatic Tissue Optimization (ATO)
2D .............................................................................................................................................93
AVI ................................................................................................................................................346
B
B Flow .........................................................................................................................................149
Backup ........................................................................................................................................416
Baseline 635
Color Mode ..........................................................................................................................105
CW Doppler......................................................................................................................... 112
PW Doppler ......................................................................................................................... 112
TVI .......................................................................................................................................... 119
Biopsy .........................................................................................................................................495
Blood Flow Imaging..............................................................................................................149
Bodymark ....................................................................................................................................85
C
Care and Maintenance .......................................................................................................580
Cine Compound
Strain .....................................................................................................................................140
Strain rate ............................................................................................................................134
Tissue Synchronization Imaging ..................................................................................145
Tissue Tracking..................................................................................................................127
Cineloop .......................................................................................................................................58
Controls ..................................................................................................................................60
Overview ................................................................................................................................58
Saving as AVI .....................................................................................................................346
Using .......................................................................................................................................61
Classifications .........................................................................................................................596
Cleaning
Air filter..................................................................................................................................581
Ultrasound unit ...................................................................................................................581
Color 2D
Using .....................................................................................................................................108
Color maps
2D Mode .................................................................................................................................92
Color Mode ..........................................................................................................................105
CW Doppler......................................................................................................................... 113
M-Mode ..................................................................................................................................98
PW Doppler ......................................................................................................................... 113
Strain .....................................................................................................................................138
Strain rate ............................................................................................................................132
Tissue tracking ...................................................................................................................125
TVI ..........................................................................................................................................120
Color M-Mode
Overview ..............................................................................................................................103
Using .....................................................................................................................................108
636
Color Mode ...............................................................................................................................102
Controls ................................................................................................................................105
Optimizing ............................................................................................................................109
Overview ..............................................................................................................................102
using ......................................................................................................................................108
Color threshold
MC Contrast ........................................................................................................................201
Comments.................................................................................................................................357
Compound ................................................................................................................................148
Compress
2D .............................................................................................................................................93
CW Doppler......................................................................................................................... 113
LV Contrast .........................................................................................................................195
M-Mode ..................................................................................................................................98
Optimizing M-Mode ..........................................................................................................101
PW Doppler ......................................................................................................................... 113
RTCPI ...................................................................................................................................209
Strain rate ............................................................................................................................133
TVI ..........................................................................................................................................120
Connecting peripherals ........................................................................................................12
Connecting the unit ................................................................................................................10
Connectivity..............................................................................................................................550
Buttons..................................................................................................................................560
Dataflow ...............................................................................................................................551
Overview ..............................................................................................................................550
Continuous capture ..............................................................................................................160
Contour
2D .............................................................................................................................................94
M-Mode ..................................................................................................................................98
Contrast Imaging
Abdominal Contrast Imaging .........................................................................................217
Data acquisition .................................................................................................................192
LV Contrast Imaging ........................................................................................................192
MC Contrast Imaging .......................................................................................................197
Rodent Contrast Imaging................................................................................................221
RTCPI ...................................................................................................................................205
Vascular Contrast Imaging .............................................................................................213
Control panel .............................................................................................................................26
CW Doppler.............................................................................................................................. 110 637
Controls ................................................................................................................................ 112
Optimizing ............................................................................................................................ 115
Overview .............................................................................................................................. 110
Using ..................................................................................................................................... 115
D
DDP
2D .............................................................................................................................................94
LV Contrast .........................................................................................................................195
Optimizing 2D .......................................................................................................................95
RTCPI ...................................................................................................................................209
Delete
Examination ........................................................................................................................361
Image ....................................................................................................................................362
Patient record .....................................................................................................................361
Depth
2D .............................................................................................................................................93
Optimizing 2D .......................................................................................................................95
Diagnosis code .......................................................................................................................358
Diagnosis information..........................................................................................................357
DICOM spooler .......................................................................................................................423
DICOM SR ................................................................................................................................389
DICOM verification ...............................................................................................................562
Diff On/Off
2D .............................................................................................................................................94
LV Contrast .........................................................................................................................195
Direct report .............................................................................................................................450
Disk space management ...................................................................................................408
Doppler see PW or CW Doppler
Dual focus
2D .............................................................................................................................................92
Color Mode ..........................................................................................................................105
TVI .......................................................................................................................................... 119
Dynamic range
2D .............................................................................................................................................93
LV Contrast .........................................................................................................................195
M-Mode ..................................................................................................................................99
RTCPI ...................................................................................................................................209
638
E
ECG
Adjusting trace .....................................................................................................................77
Connecting ............................................................................................................................71
Controls ..................................................................................................................................75
Trigging ...................................................................................................................................78
Edge Enhance
LV Contrast .........................................................................................................................195
Event timing .............................................................................................................................244
Examination
Starting ...................................................................................................................................48
Export
Patient records ...................................................................................................................395
F
Flash
RTCPI ...................................................................................................................................208
Focus
2D .............................................................................................................................................92
LV Contrast .........................................................................................................................194
MC Contrast ........................................................................................................................201
M-Mode ..................................................................................................................................98
Optimizing 2D .......................................................................................................................95
RTCPI ...................................................................................................................................208
Footswitch
operation ................................................................................................................................42
Frame rate
2D .............................................................................................................................................92
CW Doppler......................................................................................................................... 114
MC Contrast ........................................................................................................................201
PW Doppler ......................................................................................................................... 114
RTCPI ...................................................................................................................................209
Strain .....................................................................................................................................138
Strain rate ............................................................................................................................132
Tissue Tracking..................................................................................................................125
TVI .......................................................................................................................................... 119
639
Frequency
2D .............................................................................................................................................92
Color Mode ..........................................................................................................................106
CW Doppler......................................................................................................................... 114
LV Contrast .........................................................................................................................194
MC Contrast ........................................................................................................................201
M-Mode ..................................................................................................................................98
PW Doppler ......................................................................................................................... 114
RTCPI ...................................................................................................................................208
Strain .....................................................................................................................................139
Strain rate ............................................................................................................................133
Tissue Tracking..................................................................................................................126
TVI ..........................................................................................................................................120
G
Gain
2D .............................................................................................................................................93
Optimizing 2D .......................................................................................................................95
H
Horizontal sweep
Color M-Mode .....................................................................................................................105
CW Doppler......................................................................................................................... 112
M-Mode ..................................................................................................................................98
PW Doppler ......................................................................................................................... 112
I
Images
Saving as JPEG.................................................................................................................346
Import
Patient records ...................................................................................................................404
Intima-Media Thickness .....................................................................................................270 640
Invert
2D .............................................................................................................................................92
Color Mode ..........................................................................................................................105
CW Doppler......................................................................................................................... 112
PW Doppler ......................................................................................................................... 112
Strain rate ............................................................................................................................132
Tissue Tracking..................................................................................................................125
TVI .......................................................................................................................................... 119
J
JPEG ...........................................................................................................................................346
L
Language
Online manual ....................................................................................................................571
System ..................................................................................................................................571
Lateral Averaging
Color Mode ..........................................................................................................................106
MC Contrast ........................................................................................................................202
Strain .....................................................................................................................................139
Strain rate ............................................................................................................................133
Tissue Tracking..................................................................................................................126
TVI ..........................................................................................................................................121
LogiqView..................................................................................................................................148
Low Velocity Reject see LVR
LPRF ........................................................................................................................................... 113
LVR
Color Mode ..........................................................................................................................106
CW Doppler......................................................................................................................... 112
MC Contrast ........................................................................................................................201
PW Doppler ......................................................................................................................... 112
TVI ..........................................................................................................................................120
641
M
Magneto Optical Disk
Formatting............................................................................................................................562
Measurements ........................................................................................................................222
Configuration ......................................................................................................................285
User-defined formulas .....................................................................................................290
Measurements (Cardiac)
2D ...........................................................................................................................................234
Doppler .................................................................................................................................242
M-Mode ................................................................................................................................238
TSI ..........................................................................................................................................245
Measurements (Vascular)
B-Mode .................................................................................................................................269
Doppler .................................................................................................................................274
M-Mode ................................................................................................................................273
M-Mode ........................................................................................................................................96
Anatomical M-Mode .........................................................................................................100
Controls ..................................................................................................................................98
Conventional M-Mode......................................................................................................100
Curved Anatomical M-Mode ..........................................................................................100
Optimizing ............................................................................................................................101
Overview ................................................................................................................................96
Using .....................................................................................................................................100
Monitor
Brightness ..............................................................................................................................43
Contrast ..................................................................................................................................43
Moving the unit .........................................................................................................................18
MPEG..........................................................................................................................................348
O
On/Off............................................................................................................................................16
P
Patient
Entering information ...........................................................................................................48
Phono
Adjusting trace .....................................................................................................................77
Connecting ............................................................................................................................73
Controls ..................................................................................................................................75
Display trace .........................................................................................................................77
Physiological traces ...............................................................................................................70 642
Power
2D .............................................................................................................................................94
Color Mode ..........................................................................................................................106
CW Doppler......................................................................................................................... 114
LV Contrast .........................................................................................................................195
MC Contrast ........................................................................................................................201
M-Mode ..................................................................................................................................99
PW Doppler ......................................................................................................................... 114
RTCPI ...................................................................................................................................209
Strain rate ............................................................................................................................133
Tissue Synchronization Imaging ..........................................................................140, 145
Tissue Tracking..................................................................................................................126
PRF
MC Contrast ........................................................................................................................201
Print
Patient list ............................................................................................................................354
Printing .......................................................................................................................................510
Printer configuration ......................................................................................................... 511
Probes
Activating .............................................................................................................................486
Care and Maintenance ....................................................................................................488
Cleaning ...............................................................................................................................490
Connecting ....................................................................................................................43, 483
Disconnecting ...............................................................................................................43, 487
Disinfecting ..........................................................................................................................490
Labelling ...............................................................................................................................479
Orientation markers ..........................................................................................................479
Safety ....................................................................................................................................493
Selecting ................................................................................................................................52
Types.....................................................................................................................................474
Pulse Pressure
Adjusting trace .....................................................................................................................77
Pulse Pressure transducer
Connecting ............................................................................................................................73
Controls ..................................................................................................................................75
Display trace .........................................................................................................................77
PW Doppler .............................................................................................................................. 110
Controls ................................................................................................................................ 112
Optimizing ............................................................................................................................ 115
Overview .............................................................................................................................. 110
Using ..................................................................................................................................... 115 643
Q
Quantitative Analysis ...........................................................................................................304
Anatomical M-Mode .........................................................................................................337
Deletion of a trace .............................................................................................................318
Frame disabling .................................................................................................................319
Labelling a sample area ..................................................................................................322
Manual tracking .................................................................................................................316
Optimizing Anatomical M-Mode ...................................................................................339
Optimizing sample area ..................................................................................................321
Optimizing the trace display...........................................................................................323
Overview ..............................................................................................................................308
Sample area ........................................................................................................................315
Strain cursor........................................................................................................................315
To generate a trace ..........................................................................................................315
Trace smoothing ................................................................................................................324
Wash-in curve fitting .........................................................................................................330
Wash-out curve fitting ......................................................................................................335
R
Radial Averaging
Color Mode ..........................................................................................................................106
MC Contrast ........................................................................................................................201
Strain .....................................................................................................................................140
Strain rate ............................................................................................................................133
Tissue Tracking..................................................................................................................126
TVI ..........................................................................................................................................121
Referral reasons ....................................................................................................................357
Reject
2D .............................................................................................................................................93
LV Contrast .........................................................................................................................195
M-Mode ..................................................................................................................................99
Optimizing 2D .......................................................................................................................95
RTCPI ...................................................................................................................................209
Strain .....................................................................................................................................139
Strain rate ............................................................................................................................133
Removable media
Ejecting ...................................................................................................................................65
Formatting..............................................................................................................................63
Report .........................................................................................................................................426
Add an image to.................................................................................................................430 644
Configuration of the Template selection menu ........................................................469
Creating ................................................................................................................................428
Deleting ................................................................................................................................432
Direct report ........................................................................................................................450
Export/Import templates ..................................................................................................471
Print .......................................................................................................................................431
Retrieving .............................................................................................................................432
Save.......................................................................................................................................431
Report designer......................................................................................................................453
Designing a template .......................................................................................................457
Respiration
Adjusting trace .....................................................................................................................77
Connecting ............................................................................................................................71
Controls ..................................................................................................................................75
Display trace .........................................................................................................................77
Restore data ............................................................................................................................416
ROI size
Color Mode ..........................................................................................................................107
MC Contrast ........................................................................................................................202
S
Safety ..........................................................................................................................................586
Biological hazard ...............................................................................................................604
Electrical hazard ................................................................................................................603
Equipment safety...............................................................................................................603
Explosion hazard ...............................................................................................................603
Implosion hazard ...............................................................................................................603
Mechanical hazard............................................................................................................601
Moving hazard ....................................................................................................................604
Pacemaker hazard............................................................................................................605
Patient safety ......................................................................................................................601
Personnel safety ................................................................................................................603
Sample volume
Color Mode ..........................................................................................................................106
CW Doppler......................................................................................................................... 113
MC Contrast ........................................................................................................................201
PW Doppler ......................................................................................................................... 113
Scale
Color Mode ..........................................................................................................................105 645
Strain .....................................................................................................................................138
TVI .......................................................................................................................................... 119
Scanning
Screen layout ........................................................................................................................39
starting ....................................................................................................................................52
Simultaneous
Strain .....................................................................................................................................138
Strain rate ............................................................................................................................132
Tissue tracking ...................................................................................................................125
TVI .......................................................................................................................................... 119
Site requirements ......................................................................................................................9
Soft Menu Rocker ...................................................................................................................55
using ........................................................................................................................................56
Strain ...........................................................................................................................................136
Controls ................................................................................................................................138
Optimizing ............................................................................................................................141
Overview ..............................................................................................................................136
Using .....................................................................................................................................141
Strain cursor.............................................................................................................................315
Strain rate..................................................................................................................................130
Controls ................................................................................................................................132
Optimizing ............................................................................................................................135
Overview ..............................................................................................................................130
Using .....................................................................................................................................135
Stress Echo ..............................................................................................................................151
Acquisition ...........................................................................................................................155
Analysis ................................................................................................................................168
Configuring levels..............................................................................................................186
Creating an image group ................................................................................................187
Deleting a group ................................................................................................................187
Editing template .................................................................................................................181
Labelling a level .................................................................................................................186
Labelling a projection .......................................................................................................186
Quantitative TVI Stress analysis ..................................................................................173
Scoring..................................................................................................................................170
Selecting a template .........................................................................................................153
Timers ...........................................................................................................................159, 186
Tissue Tracking..................................................................................................................179
System
Controls affecting acoustic output................................................................................599
Switching On/Off..................................................................................................................16 646
System setup ...........................................................................................................................514
Application ...........................................................................................................................524
Examination list window ..................................................................................................563
Imaging setup .....................................................................................................................521
Language .............................................................................................................................569
M&A .......................................................................................................................................530
Patient information ............................................................................................................523
Starting system setup ......................................................................................................519
Units.......................................................................................................................................569
User configuration .............................................................................................................575
T
TCPIP..........................................................................................................................................568
TGC see Time Gain Compensation ...............................................................................93
Threshold
Strain .....................................................................................................................................139
Strain rate ............................................................................................................................133
Tissue Tracking..................................................................................................................126
TVI ..........................................................................................................................................120
Tilt
2D .............................................................................................................................................94
LV Contrast .........................................................................................................................195
MC Contrast ........................................................................................................................201
RTCPI ...................................................................................................................................210
Time Gain Compensation (TGC)
2D .............................................................................................................................................93
Optimizing 2D .......................................................................................................................95
Tissue priority
Color Mode ..........................................................................................................................106
Tissue Synchronization Imaging ....................................................................................142
Controls ................................................................................................................................144
Optimizing ............................................................................................................................147
Overview ..............................................................................................................................142
Using .....................................................................................................................................146
Tissue Tracking ......................................................................................................................123
Controls ................................................................................................................................125
Optimizing ............................................................................................................................128
Overview ..............................................................................................................................123
Using .....................................................................................................................................128 647
Tissue Velocity Imaging see TVI
Trackball
Operation ...............................................................................................................................57
Transcranial .............................................................................................................................632
Transparency
Strain .....................................................................................................................................139
Strain rate ............................................................................................................................133
Tissue Tracking..................................................................................................................126
TVI ..........................................................................................................................................120
Trigging
MC Contrast ........................................................................................................................200
RTCPI ...................................................................................................................................208
TSI, see Tissue Synchronization Imaging
TVI ................................................................................................................................................ 117
Controls ................................................................................................................................ 119
Optimizing ............................................................................................................................122
Overview .............................................................................................................................. 117
Using .....................................................................................................................................122
V
Variance
Color Mode ..........................................................................................................................105
Velocity range
CW Doppler......................................................................................................................... 112
PW Doppler ......................................................................................................................... 112
W
Wheels ..........................................................................................................................................18
Width
2D .............................................................................................................................................92
LV Contrast .........................................................................................................................194
RTCPI ...................................................................................................................................208
Worksheet .................................................................................................................................301
XYZ
Zoom .............................................................................................................................................67
648
Vivid 7/EchoPAC PC
Dimension - version 7.x.x
0470
4D and Multi-plane Imaging
GEVU #: FD092081
GEVU Rev. 01
MHLW No: 21300BZY00416000
Copyright © 2007 By General Electric Co.
MANUAL STATUS © GE Medical Systems. All rights reserved. No part of this
01/08/2007
Systems.

Tel.: (+47) 3302 1100 Fax: (+47) 3302 1350
Table of Contents
Table of Contents
Introduction
4D imaging......................................................................................1
Multi-plane Imaging .......................................................................2
Measurement and analysis ...........................................................2
Multi-plane stress echo .................................................................2
Remark concerning the 3V probe.................................................2
Important.........................................................................................3
Conventions used in this manual.................................................4
Chapter 1
4D Imaging
Introduction ....................................................................................6
4D mode overview - Vivid 7...........................................................7
Volume rendering mode screen ............................................7
Slice mode screen.................................................................8
4D mode controls ..................................................................9
Assigned rotaries and keys .................................................10
4D mode assigned controls.................................................11
Additional 4D mode assigned controls ................................14
Soft menu controls ..............................................................16
Trackball controls ................................................................17
Display controls ...................................................................19
Using 4D mode - Vivid 7 ..............................................................21
Parasternal view acquisition................................................21
Apical view acquisition ........................................................22
Full volume acquisition ........................................................23
Rotating/Translating the 4D image......................................25
Zooming ..............................................................................26
Cropping..............................................................................26
9 Slice..................................................................................29
4D mode overview - EchoPAC PC ..............................................32 1
Volume rendering mode screen ..........................................32
Slice mode screen...............................................................33
4D mode control panel ........................................................34
Cropping..............................................................................37
Working with 4D acquisitions - EchoPAC PC ...........................39
9 Slice..................................................................................39
4D LV Volume application ...........................................................41
Starting the 4D LV Volume application — Vivid 7 ...............41
Starting the 4D LV Volume application — EchoPAC PC ....41
Chapter 2
4D Color Flow Imaging
Introduction ..................................................................................43
4D Color Flow mode overview - Vivid 7 .....................................44
Color Flow Volume rendering mode screen ........................44
Color Flow Slice mode screen.............................................45
4D Color Flow mode controls ..............................................46
Assigned rotaries and keys .................................................47
4D Color Flow mode assigned controls...............................48
Additional 4D mode assigned controls ................................49
Soft menu controls ..............................................................50
Trackball controls ................................................................51
Using 4D Color Flow mode - Vivid 7...........................................53
Real time 4D Color flow acquisition.....................................53
Full volume Color Flow acquisition......................................54
6 Slice..................................................................................56
4D Color Flow mode overview - EchoPAC PC ..........................59
Volume rendering mode screen ..........................................59
Slice mode screen...............................................................60
4D mode control panel ........................................................61
Chapter 3
Multi-plane imaging
Introduction ..................................................................................64
2
Multi-plane mode overview - Vivid 7 ..........................................65
Bi-plane mode screen .........................................................65
Tri-plane mode screen ........................................................66
Multi-plane mode controls ...................................................67
Using Multi-plane mode imaging - Vivid 7 .................................75
Scan plane rotation .............................................................76
Tilting scan plane 2 .............................................................76
Zooming ..............................................................................77
Multi-plane mode overview - EchoPAC PC................................80
Bi-plane mode screen .........................................................80
Tri-plane mode screen ........................................................81
The multi-plane control panel ..............................................82
Working with multi-plane acquisitions - EchoPAC PC.............83
Chapter 4
Measurements and Analysis
Introduction ..................................................................................85
Left ventricular volume measurements .....................................86
Tri-plane acquisition ............................................................86
Full volume acquisition ........................................................89
Rotation of the Volume reconstruction ................................90
Bi-plane acquisition .............................................................91
TSI surface model ........................................................................93
To edit the sampling path ....................................................94
Quantitative analysis ...................................................................95
Starting Quantitative analysis from a multi-plane
acquisition ...........................................................................95
Chapter 5
Multi-plane Stress Echo
Introduction ..................................................................................98
Creating a Multi-plane stress test template...............................99
Launching the Template editor..........................................100
Stress Template setup ......................................................100
Stress test acquisition...............................................................102
Baseline acquisitions.........................................................102 3
Low dose and Peak dose level acquisitions......................105
Image analysis............................................................................108
Index
4
Introduction
This user manual describes the 4D and Multi-plane Imaging
applications for the Vivid 7 Dimension and
EchoPAC PC Dimension.
The 2D matrix probe 3V enables real time volume rendering,
simultaneous bi-plane or tri-plane data acquisition (multi-plane
acquisition).
1. Real time Volume acquisition (4D imaging)

2. Real time Bi-plane acquisition
3. Real time Tri-plane acquisition
4D imaging
4D imaging enables real time acquisition and rendering of
volume ultrasound data. Free rotation of the 3-dimensional
image combined with the zoom function and 4D image
optimization controls enhance spatial understanding of the
anatomical structure and function of the heart.
4D imaging is available in combination with B-Mode only.
1
Multi-plane Imaging
Multi-plane imaging displays two (Bi-plane) or three (Tri-plane)
rotated scan planes acquired simultaneously. Free rotation,
tilting (in Bi-plane) of the scan planes and zoom enable the
investigation of anatomical structures from different angles.
Multi-plane imaging is available from B-Mode, Color flow mode
and TVI related modes.
If not otherwise specified, the term multi-plane means either
Bi-plane or Tri-plane.
Measurement and analysis

All cardiac measurements available in B mode are also
available in 4D and Multi-plane.
The 4D and Multi-plane modes enable the creation of a left
ventricular volume reconstruction based on contours drawn
from three cross sections at both end-systole and end-diastole
with calculation of end-systolic and end-diastolic volumes and
ejection fraction.
Multi-plane stress echo

Combined with specially designed Stress echo protocols,
Multi-plane mode enables faster stress tests as several views
can be acquired simultaneously.
Remark concerning the 3V probe

The 3V probe temperature will increase during extensive use,
due to heating from the probe electronics. If the probe reaches
its temperature limit, this will be detected by the system and
scanning will stop. Currently, this limit is set to 42.3 degrees
Celsius, which complies with regulatory instructions relating to
patient comfort and safety. This is reported with a dialog box
and the user has to wait until the temperature is below
acceptable limits before scanning can continue. This does not
in any way indicate probe malfunction. The user has to
unfreeze to start scanning again.
In order to reduce the chance for full freeze due to heating, the
system will reduce power slightly in a temperature interval just 2
below the full freeze limit. Changes to the power level are
reported in the status bar as Setting power level down and
Setting power level up.
The recommended use of this probe for live 4D and full volume
4D scanning is to enter full freeze whenever the probe is not
used for imaging. For other modalities no special actions are
required.
Important
Read and understand all instructions in the Vivid 7 and
EchoPAC PC User manuals before attempting to use the
devices.
3
Conventions used in this manual
Keys and button, on the control panel or alphanumeric
keyboard are indicated by over and underlined text (ex. 2D
refers to the 2D mode key)
Bold type, describes button names on the screen.
Italic type: describes program windows, screens and dialogue
boxes.
Icons, highlight safety issues as follow:

WARNING • Severe personal injury

• Property damage
4
Chapter 1
4D Imaging
• Introduction ................................................................................... ....... 6

• 4D mode overview - Vivid 7 ......................................................... ....... 7
• Volume rendering mode screen ....................................................7
• Slice mode screen ........................................................................8
• 4D mode controls ..........................................................................9
• Using 4D mode - Vivid 7 ............................................................... ..... 21
• Parasternal view acquisition .......................................................21
• Apical view acquisition ................................................................22
• Full volume acquisition ...............................................................23
• Rotating/Translating the 4D image .............................................25
• Zooming ......................................................................................26
• Cropping .....................................................................................26
• 9 Slice .........................................................................................29
• 4D mode overview - EchoPAC PC .............................................. ..... 32
• Volume rendering mode screen ..................................................32
• Slice mode screen ......................................................................33
• 4D mode control panel ................................................................34
• Display controls ..........................................................................36
• Working with 4D acquisitions - EchoPAC PC ............................ ..... 39
• 9 Slice .........................................................................................39
• 4D LV Volume application ........................................................... ..... 41
• Starting the 4D LV Volume application — EchoPAC PC ............41
5
Introduction
The 3V probe enables real time acquisition of volume
ultrasound data. Free rotation of the three-dimensional image
combined with zooming and 4D image optimization controls
enhance spatial understanding of the anatomical structure and
function of the heart.
Two display modes are available, Volume rendering mode for
three dimensional scanning and Slice mode for measurements
and volume reconstruction purpose.
4D imaging is available from B mode only.
6
4D mode overview - Vivid 7
Volume rendering mode screen
The Volume rendering mode displays a volume rendering and
2D images from two perpendicular cut-planes.
1. Volume rendering display from cut-plane 1 (yellow). The volume rendering may be adjusted by
rotating and translating the cut-plane 1.
2. Cut-plane 2 (white): 2D image in the azimuth plane.
3. Cut-plane 3 (green): 2D image in the elevation plane.
4. Orientation window: displays a three-dimensional model with cut-planes position and orientation.
5. Color coded cut-plane markers indicate the other cut-planes position relative to the displayed
cut-plane.
6. View direction marker.
7. Soft menu controls (see page 16)
8. Trackball functions (see page 17)
Figure 1-1: The 4D screen (Volume rendering)

7
Slice mode screen
The Slice mode displays three cut-planes. The cut-planes can
be rotated and translated independently of each other. This
mode is use to perform measurements and volume
reconstruction based on contour traces done on several
cut-planes.
1. Cut-plane 1 (yellow)
2. Cut-plane 2 (white)
3. Cut-plane 3 (green)
4. Color coded cut-plane markers indicate the position of the other cut-planes relative to the displayed
cut-plane.
5. Orientation window: displays a three-dimensional model with cut-planes position.
Figure 1-2: The 4D screen (Slice mode)
8
4D mode controls
Alt. Alt. Alt. Alt.
Width
Upd enu
Ball k
M
Trac
ate
/
1. 4D key 8. Trackball (see page 17)

2. Multiplane key (see page 63) • Rotate/translate volume rendering or selected
3. Assigned 4D rotaries: see next page. cut-plane (Slice mode)
• Scroll through the cineloop
4. Assigned 4D keys: see next page.
9. Clear: resets the orientation to default
5. Zoom/HR Zoom (see page 20)
positions.
6. Layout (see page 19): toggles the display
10. Angle: predefined orientations optimized for
between:
volume rendering.
• Multi screen with volume/slice
• Single screen volume/slice 11. 4D Gain
7. Soft menu 12. 2D Gain
Figure 1-3: The 4D controls on the control panel
9
Assigned rotaries and keys
Volume rendering assigned controls
1. Assigned rotaries 2. Assigned keys

• Width • Slice R
• Frequency • Front/Back
• Focus position • Crop (in Freeze only) R
• Volume size • Box (in Freeze only) R
MORE menu • Cineloop (in Freeze only) R
• Full volume
• Translate R
• 4D Colorize R
• 9 Slice (in Full volume Freeze only) R
MORE menu
• Up/Down R
• Flip R
• Orientation window R
• Cine rotate (in Freeze only) R
Slice mode assigned controls

• Width • Slice exit R
• Rotate R • Reference plane R
• Translate (in Freeze only) R • Cineloop (in Freeze only) R
• Focus position MORE menu
• Volume size • Up/Down R
MORE menu • Orientation window R
• Frequency
Controls marked with R are also available in cine replay.
Figure 1-4: Volume rendering and Slice mode assigned controls
10
4D mode assigned controls
This section describes only the 4D mode controls. The
scanning mode controls are described in the system User
manual.
Width
(Volume rendering and Slice mode, Live)
Controls both elevation and azimuth widths, an increase of the
elevation width results in a decrease of the azimuth width.
Volume size
(Volume rendering and Slice mode, Live)
Controls the size of the volume. Adjusting the volume size may
affect the volume rate.
Rotate
(Slice mode, Live and Replay)
Rotate the selected cut-plane around the z-axis (see
Figure 1-5).
1. Rotate control
Figure 1-5: Cut-plane rotation around the z-axis
Slice/Slice exit
(Volume rendering and Slice mode, Live and Replay)
Toggles the display between Volume rendering (Figure 1-1)
and Slice mode (Figure 1-2).
11
Front/Back
(Volume rendering, Live and Replay)
Tilts the volume in the elevation direction and rotates the view
position in one operation. FRONT/BACK enables volume
rendering display from different angles (Figure 1-6).
1. Front/Back: Volume tilt and View position rotation

A. Volume tilted to the left, view position looking towards the anterior wall.
B. Volume tilted to the right, view position looking towards the inferior wall.
Figure 1-6: Front/Back control on a PLAX volume
Reference plane
Toggles the cut-plane selection between cut-plane 1, 2 or 3.
Crop (Free cropping)

(Volume rendering, Freeze and Replay)
12
Removes all data up front of the active cut-plane. Cropping can
be applied on several parts of the volume by rotating/translating
the active cut-plane (see page 26).
Box (Box cropping)

Removes all data around a user-adjustable box (see page 27).
Full volume
(Volume rendering, Live)
Activates the ECG triggered sub-volume acquisition. This
technique enables the acquisition of a larger volume without
compromising the resolution, by combining several
sub-volumes acquired over two to six heart cycles (see
Figure 1-7). When acquisition is done for the number of heart
cycles set, the process is repeated replacing the oldest
sub-volumes.
+ =
Figure 1-7: ECG triggered volume acquisition (two heart cycles)
4D Colorize
Adjusts the volume rendering color from a color map menu.
Depth encoded color maps
From this menu the user can also select a depth encoded color
map. These color maps use colors to improve the perception of
depth. Selecting the bronze/blue color map will display
structures that are close to the view plane with a bronze color.
Structures that are farther behind will be colored with a gray
13
color, while the structures that are farthest behind will be
colored in blue. Very bright colors are almost white,
independent of the depth.
Stereo vision
4D Stereo vision is a display technique that enhances the
perception of depth in 3D renderings. This is achieved by
mixing two different volume renderings with slightly separated
viewing angles and presenting them separately to the user’s
left and right eyes. This feature requires the use of anaglyph
stereo glasses (glasses with one red and one cyan lens).
Normally you should be able to see the stereoscopic effect
after a few seconds. The effect may gradually improve after a
while. If you are already wearing glasses or lenses you should
not take them off, since the stereo effect then may be greatly
reduced.
Note: Not all users may be able to perceive depth using
stereoscopic display techniques.
Additional 4D mode assigned controls

The following controls are available after pressing MORE.
Up/Down
Flips the volume 180 degrees.
Flip
Flips the view position (Figure 1-8).
14
1. Flip control
A. View position looking downward
B. View position looking upward
Figure 1-8: Flip control
Orientation window
Shows/hides the Orientation window.
Cine rotate
(Volume rendering, Replay)
Rotates back and forth the volume rendering.
15
Soft menu controls
Soft menu controls are related to image quality adjustment.
These controls are accessed using the 4-way rocker on the
control panel. Only the 4D controls are described in this
section, refer to the system user manual for general imaging
controls.
Smoothness
Affects continuity of structures and image noise. Too much
smoothness will blur the image, too little will leave too much
noise.
Shading
Adjusts the shading effect on the image. Shading may improve
three dimensional perception.
Tilt
Tilts the volume in the elevation direction.
1. Tilt control: volume tilting in the elevation direction
Figure 1-9: Tilt control
16
Number of Cycles
(Volume rendering, Live, Full volume acquisition)
Controls the number of cycles the ECG triggered full volume
acquisition is based on. Select between two, three, four or six
cycles. Four cycles is default setting.
DDP (Data Dependent Processing)

Performs temporal processing which reduces random noise
UD Clarity
Enables the user to create a personalized appearance of the
tissue rendering by reducing noise and enhancing boundaries
between different structures. Adjustment toward the left creates
a smoother image. Adjustment toward the right creates a
crisper image.
Volume optimize
Optimizes the volume rendering by adjusting several display
controls simultaneously (e.g Shading, Smoothness... etc.).
Gamma
Adjusts the brightness of midtone values. A higher gamma
value produces an overall darker image, a lower gamma value
a lighter image.
Trackball controls
The trackball has multiple functions. The trackball functions are
organized in several functional groups as shown in the table
below.
The function selected is displayed in the lower right corner of
the screen (Figure 1-10).
• Press SELECT to toggle between the trackball functions
within the active functional group. Groups with several 17
functions are marked with a + symbol.
• Press TRACKBALL to toggle between the functional groups.
1. Trackball key: toggles between trackball functional groups.

2. Select key: toggles between the functions within the active group. Groups
with several functions are marked with a + symbol.
Figure 1-10: The Trackball area
Orientation controls group
Function Description
Press SELECT to toggle between the controls.
Rotate Rotates the volume rendering (see page 25).
Translate Translates the volume rendering (see

page 25).
Cineloop control group
Scroll Scrolls through a cineloop.
18
Display controls
Layout key on the front panel
Toggles the display between multi-screen and single-screen.
• Multi-screen:
• In Volume rendering: displays a volume rendering and
2D images from two perpendicular cut-planes.
• In Slice mode: displays 2D images from three cut-planes
with the selected cut-plane in the main window.
• Single-screen:
• In Volume rendering: displays the volume rendering.
• In Slice mode: display the 2D image of the selected
cut-plane.
1. Display options for Volume rendering

2. Display options for Slice mode
Figure 1-11: 4D mode display options
4D Gain (Active Gain rotary)

Affects the image “depth” or transparency. Too much 4D Gain
applied will take away structures, too little will leave opaque
“Gray clouds” in the ventricle.
19
Zoom
Display zoom
Activated and adjusted by rotating the ZOOM rotary ( ). The
rectangular shape of the zoomed area is displayed in the
Orientation window.
High Resolution (HR) zoom
HR zoom concentrates the image processing to a magnified,
user selectable area in the image, resulting in a higher volume
rate in the selected image area.
To be able to use the HR zoom in 4D imaging the HR zoom
function must be activated in B mode before entering the 4D
imaging mode.
20
Using 4D mode - Vivid 7
1. Select the 3V probe and cardiac application.
2. Create an examination.
Parasternal view acquisition

1. In 2D mode, acquire a PLAX view and optimize the image
quality, using DEPTH, GAIN, TGC...etc.
2. Press 4D.
3. Move the probe up or down so that the anterior wall is just
inside the image in the lower left window in the 4D screen
(Figure 1-12).
Note: In this position the volume is tilted to the left and the view position is looking
towards the anterior wall.
Figure 1-12: PLAX volume rendering
4. Adjust 4D Gain to optimize the depth impression of the

back wall.
5. To display a volume looking towards the inferior wall, press
FRONT/BACK.
The volume is tilted to the right and the view position is
rotated 180 degrees.
21
6. Press FREEZE, 2D FREEZE and rotate the volume to check
the result.
Apical view acquisition

1. In 2D mode, acquire a Apical view and optimize the image
2. Press 4D and follow the same procedure as for the PLAX
view (see page 21).
Make sure to assess the image quality in the reference
views and the volume rendering. Use FRONT/BACK to
display the volume correctly.
the result.
22
Full volume acquisition
Full volume acquisition is based on ECG triggering acquisition
of sub-volumes. This technique enables the acquisition of a
larger volume without compromising the resolution, by
combining several sub-volumes acquired over two, three, four
or six heart cycles (see Figure 1-7, page 13). When acquisition
is done for the number of heart cycles set, the process is
repeated replacing the oldest sub-volumes.
ECG triggering acquisition may by nature contain artifacts.
Artifacts may be caused by:
CAUTION
• Movements of the probe caused by the operator during
acquisition.
• Movements of the patient during acquisition.
• Irregular heart rate during acquisition.
To validate the acquisition, perform a visual inspection in both
the volume rendering and the elevation plane. Stitching artifacts
are shown as visible transitions between the sub-volumes
(Figure 1-13)
To avoid spatial artifacts, make sure that the probe and the
patient are not moving during the acquisition. The patient
should, if possible hold his/her breath. The ECG trace should
be stable.
1. Connect the ECG device and make sure to obtain a stable
ECG trace.
2. In 2D mode, acquire an Apical view and optimize the image
3. Press 4D.
4. Press FULL VOLUME.
The Full volume acquisition is started.
5. You may adjust ANGLE to get different view. The default
top/down view is best for stitching quality assessment.
6. Ask the patient to hold her/his breath at end expiration.
Keep the probe steady and look for stitching artifacts in both
the volume rendering and the elevation plane in the lower
left window of the screen (Figure 1-13).
Attention should be brought on stitching quality during
acquisition rather than volume rendering quality.
23
A: Acquisition with stitching artifacts B: Acquisition without stitching artifacts
1. Elevation plane 1. Elevation plane
2. Volume rendering 2. Volume rendering
Figure 1-13: Stitching quality assessment
When no artifacts are seen over a few heart cycles, press

FREEZE.
24
Note: it is recommended to acquire several heart cycles
and use SELECT CYCLE to select the best one.
7. Once in Freeze, adjust 4D GAIN. Rotate the volume to check
the result and tress IMG. STORE.
Rotating/Translating the 4D image

Translation and rotation can be performed in either Volume
rendering or Slice mode. Press SLICE to toggle between the two
modes.
1. Move the trackball to rotate or translate the cut-plane
according to the trackball function selected.
2. Press SELECT to toggle between Rotate and Translate.
Move the trackball to apply the selected control (see
Figure 1-14).
The default position can be displayed again by pressing
CLEAR.
1. Select the trackball control “Translate” and use the trackball to translate the
cut-plane.
2. Select the trackball control “Rotate” and use the trackball to rotate the
cut-plane (all directions).
Figure 1-14: Rotating/translating the 4D image
25
Zooming
1. Rotate the ZOOM knob clockwise on the control panel.
The volume rendering is magnified. The frame of the
Volume rendering cut-plane in the Orientation window is
updated showing the magnified portion of the volume
(Figure 1-15).
1. Zoomed area
Figure 1-15: The Orientation window in zoom mode
Cropping
There are two cropping tools available: Free cropping tool and
Box cropping tool.
The Free cropping tool removes all data up front of the active
cut-plane. Cropping can be applied on several parts of the
volume by rotating/translating the active cut-plane.
The Box cropping tool removes all data around a
user-adjustable box.
It is not possible to use both cropping tools on the same
acquisition.
Free cropping
The Free cropping tool is available in Volume rendering mode,
when in Freeze or in Replay.
1. While in Volume rendering live mode, press FREEZE.
2. Press CROP.
Note: Pressing CROP will remove any previous Box
cropping operations.
3. Rotate and translate the active cut-plane.
All data above the cut-plane will be removed when
applying crop. 26
4. Press SET to apply crop.
All data up front of the active cut-plane is removed.
5. Repeat steps 3 and 4 to remove other parts of the volume.
Note: press UNDO CROP to undo the cropping actions
stepwise.
Press REMOVE CROP to undo all cropping actions in one
operation.
Box cropping
The Box cropping tool is available in Volume rendering mode,
when in Freeze or in Replay.
1. While in Volume rendering live mode, press FREEZE.
2. Press BOX.
A box frame is displayed with two adjustable sides
(highlighted as red and blue), see Figure 1-16.
Note: Pressing BOX will remove any previous Free
3. Rotate the RED and BLUE assigned rotaries to adjust the
corresponding sides around the structure of interest.
All data outside the box is removed.
4. Rotate the BOX SIDES assigned rotary to select two other
sides of the box.
5. Repeat steps 3 and 4 to adjust the selected sides of the box
until the structure of interest is within the box.
Note: press RESET BOX to undo the box adjustments.
6. Press BOX EXIT to apply and exit box cropping.
27
1. Default cropping box with two active sides (red and blue). The other sides can
be selected for adjustment
2. Cropped volume (from upper and lower sides)
Figure 1-16: Box cropping
28
9 Slice
9 Slice enables simultaneous display of nine short axis views
generated from an Apical full volume acquisition.
9 Slice is available only from a full volume acquisition when in
Freeze.
1. Acquire an apical Full volume view (see page 23).
2. Press FREEZE.
3. Press 9 SLICE.
The 9 Slice screen is displayed showing nine short axis
views (Figure 1-17). The slices are evenly distributed and
maximized in size for best assessment.
1. Upper slice
2. Lower slice
Figure 1-17: 9 Slice screen
If required, zoom in. All slices are zoomed in

simultaneously.
• Adjust TOP and BOTTOM controls to change the slicing
area (Figure 1-18).
29
1. Top: upper slice adjustment
2. Bottom: lower slice adjustment
Figure 1-18: Slice distribution adjustment
• Adjust the AXIS 1 and AXIS 2 controls to rotate the slices

backward/forward and sideways (Figure 1-19), to align
the slices with the anatomical structure.
1. Axis 1: slice rotation backward/forward

2. Axis 2: slice rotation sideways
Figure 1-19: Slice rotation adjustment

30
5. Press IMG. STORE to save.
31
4D mode overview - EchoPAC PC
4D acquisitions from Vivid 7 can be opened and post
processed on the EchoPAC PC workstation. This section
describes the controls and procedures related to 4D mode on
the workstation. Refer to the EchoPAC PC User manual about
general use of the workstation.
1. Volume rendering display from cut-plane 1 (yellow). The volume rendering may be adjusted by
rotating and translating the cut-plane 1.
2. Cut-plane 2 (white): 2D image in the azimuth plane.
3. Cut-plane 3 (green): 2D image in the elevation plane.
5. Color coded cut-plane markers indicate the other cut-planes position relative to the displayed
cut-plane.
6. 4D control panel (Volume rendering mode)
Figure 1-20: The 4D screen (Volume rendering)
32
Slice mode screen
4. Color coded cut-plane markers indicate the position of the other cut-planes relative to the displayed
cut-plane.
7. 4D control panel (Slice mode)
Figure 1-21: The 4D screen (Slice mode)
33
4D mode control panel
Refer to ’4D mode controls’ on page 9 for information on

the 4D related controls. All other general imaging controls
are described in the workstation User manual.
Figure 1-22: The 4D Control panel
34
Rendering controls
In volume rendering, select Rendering to display the rendering controls.
Figure 1-23: Rendering and orientation panel
35
Display controls
Rotation
Rotation using the mouse
1. Place the mouse cursor in the image area.
2. Press and hold down the Left mouse button and drag the
mouse in any direction.
The volume rendering is rotated following the mouse
cursor movement.
To rotate around the Z axis, press and hold down ALT and
drag the mouse to the left or right.
Rotation from the control panel
1. In Volume rendering, Select Rendering.
The Rendering control panel is displayed (see
Figure 1-23).
2. Adjust Rotate X, Rotate Y or Rotate Z to rotate the volume
rendering around the corresponding axis.
Figure 1-24: Rotation around the X, Y and Z axis
Translation
Translation using the mouse
1. Place the mouse cursor in the image area.
2. Press and hold down SHIFT and drag the mouse up or
down.
The volume rendering cut-plane is translated.
Translation from the control panel
1. In Volume rendering, Select Rendering.
Figure 1-23).
2. Adjust the control Translate.
36
Zoom
Zooming
1. Rotate the Mouse wheel to zoom in and out.
OR
Press ARROW UP to zoom in, ARROW DOWN to zoom out.
OR
Adjust Zoom on the control panel.
Zoom panning
1. While in zoom mode, press and hold down the mouse
wheel and drag the mouse.
OR
Press and hold down SHIFT and press the ARROW keys.
Cropping
Free cropping
1. Select Rendering.
Figure 1-23).
2. Select Crop.
Note: Pressing Crop will remove any previous Box
3. Rotate and translate the active cut-plane.
All data above the cut-plane will be removed when
applying crop.
4. Press Set to apply crop.
All data up front of the active cut-plane is removed.
5. Repeat steps 3 and 4 to remove other parts of the volume.
Note: press Undo to undo the cropping actions stepwise.
Press Remove crop to undo all cropping actions in one
operation.
6. Press Crop to exit the Free cropping tool.
Box cropping
1. Select Rendering.
Figure 1-23).
2. Select Box.
A box frame is displayed with two adjustable sides
(highlighted as red and blue), see Figure 1-25. 37
Note: Pressing Box will remove any previous Free
3. Use the Red and Blue controls to adjust the corresponding
sides around the structure of interest.
All data outside the box is removed.
4. Use the Box Sides control to select two other sides of the
box.
5. Repeat steps 3 and 4 to adjust the selected sides of the box
until the structure of interest is within the box.
Note: Press Reset Box to undo all cropping actions in one
operation.
6. Press Box to apply and exit Box cropping tool.
1. Default cropping box with two active sides (red and blue). The other sides can
be selected for adjustment
2. Cropped volume (from upper and lower sides)
Figure 1-25: Box cropping
38
Working with 4D acquisitions - EchoPAC PC
1. In the Search/Create patient window (Archive menu), select
a patient record with 4D acquisitions.
The Examination List window is displayed.
2. Select the desired examination and open (double-click) a
4D acquisition from the clipboard.
OR
Press Image browser and open (double-click) the 4D
acquisition in the Image browser screen.
The Volume rendering mode screen is displayed (see
3. Rotate and translate the volume rendering to display the
structure of interest (see page 36).
4. Optimize the volume rendering using 4D Gain,
Smoothness, Shading controls.
5. If desired, double-click on the image area to display the
volume rendering in a single screen.
6. If desired, zoom in the structure of interest (see page 37).
7. If necessary, use the cropping tools to remove unwanted
structures (see page 37).
8. If desired, press Cine rotate to rotate the volume rendering
back and forth.
9. Press Store to save the changes.
9 Slice
9 Slice enables simultaneous display of nine short axis views
generated from an Apical full volume acquisition.
1. Select an Apical full volume acquisition.
2. Press 9 Slice.
The 9 Slice screen is displayed showing nine short axis
views. The slices are evenly distributed and maximized in
size for best assessment.
simultaneously.
• Adjust Top and Bottom controls to change the slicing
area.
• Adjust the Axis 1 and Axis 2 controls to rotate the slices
39
backward/forward and sideways, to align the slices with
the anatomical structure.
4. Press Store to save.
40
4D LV Volume application
The 4D LV Volume function may be analyzed on the Vivid 7
system or EchoPAC PC workstation using the TomTec
4D LV-Volume application. The 4D LV-Volume application
enables analysis of global and regional volume measurement
from a Full volume tissue acquisition.
The 4D LV-Volume application is an option.
Measurements generated in the 4D LV-Volume application are
saved to the worksheet. The measurements have a specific
TomTec label.
In addition 4D tissue acquisitions can be stored on a removable
media to a format compatible with the TomTec application using
the “Save as” function on the Vivid 7 system or the
EchoPAC PC workstation (File format: VolDicom (*.dcm)).
Refer to the Vivid 7 or EchoPAC PC user manual for additional
information on the “Save as” function.
Starting the 4D LV Volume application

— Vivid 7
1. In a 4D Full volume tissue acquisition, press MEASURE.
2. Select Volume and 4D LV Volume in the Measurement
menu.
The 4D LV-Volume application is started.
Refer to the TomTec 4D LV-Volume User manual for proper
use of the application.
Starting the 4D LV Volume application

— EchoPAC PC
1. In a 4D Full volume tissue acquisition, select 4D LV
Volume on the control panel.
The 4D LV-Volume application is started.
Refer to the TomTec 4D LV-Volume User manual for proper
use of the application.
Note: the 4D LV Volume application can also be started
from the Measurement menu as described for the Vivid 7
above, and from the Rendering and orientation panel
(Figure 1-23).
41
Chapter 2
4D Color Flow Imaging
• Introduction ................................................................................... ..... 43

• 4D Color Flow mode overview - Vivid 7 ...................................... ..... 44
• Color Flow Volume rendering mode screen ...............................44
• Color Flow Slice mode screen ....................................................45
• 4D Color Flow mode controls .....................................................46
• Using 4D Color Flow mode - Vivid 7 ........................................... ..... 53
• Full volume Color Flow acquisition .............................................54
• 6 Slice .........................................................................................56
• 4D Color Flow mode overview - EchoPAC PC ........................... ..... 59
• Real time 4D Color flow acquisition ............................................53
• Volume rendering mode screen ..................................................59
• Slice mode screen ......................................................................60
• 4D mode control panel ................................................................61
42
Introduction
The 4D Color Flow Imaging mode enables real time volume
rendering display with color flow data. 4D Color Flow imaging
based on Full volume acquisition is available.
43
4D Color Flow mode overview - Vivid 7
Color Flow Volume rendering mode
screen
1. Volume rendering display with Color Flow

2. 2D Color Flow image in the azimuth plane
3. 2D Color Flow image in the elevation plane
5. Soft menu controls (see page 50)
Figure 2-1: 4D Color Flow screen (Volume rendering)
44
Color Flow Slice mode screen
Figure 2-2: 4D Color Flow screen (Slice mode)
45
4D Color Flow mode controls
Both Tissue and Color flow mode controls are available. Press
ACTIVE MODE to toggle between the two modes.
Alt. Alt. Alt. Alt.
13
Width
Upd enu
Ball k
M
Trac
ate
/
1. 4D key 8. Trackball (see page 51)

2. Multiplane key • Rotate/translate volume rendering or selected
3. Assigned 4D rotaries: see next page. cut-plane (Slice mode)
• Scroll through the cineloop
4. Assigned 4D keys: see next page.
9. Clear: resets the orientation to default
5. Zoom (see page 20)
positions.
6. Layout (see page 19): toggles the display
10. Angle: predefined orientations optimized for
between:
volume rendering.
• Multi screen with volume/slice
• Single screen volume/slice 11. Color Gain
7. Soft menu (see page 50) 12. 2D Gain

13. Color key
Figure 2-3: 4D Color Flow mode controls on the control panel
46
Color Flow Volume rendering assigned controls

• Scale • Slice R
• Baseline R • Invert
• Volume size • Crop (in Freeze only) R
MORE menu • Box (in Freeze only) R
• Cineloop (in Freeze only) R
• Translate R
• 4D CF Prepare
• Full Volume
• Color map R
• 6 Slice (in Full volume Freeze only) R (page 56)
MORE menu
• Up/Down R
• Flip R
• Cine rotate (in Freeze only) R
• Variance
• 4D Colorize R
Color Flow Slice mode assigned controls

• Rotate R • Slice exit R
• Translate (in Freeze only) R • Reference plane R
• Cineloop (in Freeze only) R
MORE menu
• Up/Down R
Figure 2-4: Color Flow Volume rendering and Slice mode assigned
controls
47
4D Color Flow mode assigned controls
Scale
acquire the data for color flow mapping. The Scale (Nyquist
limit) should be adjusted so that no aliasing occurs, while still
having good resolution of velocities. The Nyquist limit should
be somewhat above the maximum velocity found in the data.
Baseline
Adjusts the color map to emphasize flow either toward or away
from the probe.
Volume size
The volume size control enables the adjustment of the color
ROI. ROI adjustment may affect volume rate and/or resolution.
Slice/Slice exit
Toggles the display between Volume rendering and Slice
mode.
Invert
velocities to be inverted.
Variance
Controls the amount of variance data added to a color display.
Variance enables computer-aided detection of turbulent flow
(e.g. jets or regurgitation).
4D Colorize
Adjusts the volume rendering color from a color map menu.
Reference plane
Toggles the cut-plane selection between cut-plane 1, 2 or 3.
48
Crop (Free cropping)
See page 12.
Box (Box cropping)

See page 13.
4D CF Prepare and Full volume

Enables preparation and acquisition of a color flow full volume
based on ECG triggered sub-volume acquisitions of color flow
data. Depending on the adjustment, four or seven heart cycles
are acquired. The 4D CF Prepare control enables the user to
adjust the probe placement for optimized color flow acquisition
from a bi-plane display before acquiring the Full volume with
color flow data (see page 54).
Color maps
Displays a menu of color map options. Each color map is
assigning different color hues to different velocities.
6 Slice
6 Slice enables simultaneous display of six evenly distributed
short axis views and two long axis views (in the azimuth and
elevation planes) generated from an Apical full volume color
flow acquisition (see page 56).
Additional 4D mode assigned controls

The following controls are available after pressing MORE.
Up/Down
Flips the volume 180 degrees.
Flip
Flips the view position.
Orientation window
Shows/hides the Orientation window.
49
Cine rotate
Rotates back and forth the volume rendering.
Soft menu controls

Soft menu controls are related to image quality adjustment.
These controls are accessed using the 4-way rocker on the
control panel. Only the 4D controls are described in this
section, refer to the system user manual for general imaging
controls.
Number of cycles
Controls the number of heart cycles the ECG triggered color
flow full volume acquisition is based on. Select between four or
seven heart cycles.
Low velocity reject

Enables the extent of low velocity removal to be adjusted.
Flow transparency
(Volume rendering, Replay only)
Adjusts the color flow data transparency level. Higher setting
may provide a better visualization of flow turbulences.
Tissue transparency
Adjusts the transparency level of the tissue structure. Maximum
setting makes the tissue information invisible, leaving only color
flow data displayed.
Flow direction
Enables to show/hide positive and/or negative velocities.
Smoothness
50
Smooths color rendering. Smoothness affects continuity of
color display and image noise.
Trackball controls
The trackball has multiple functions. The trackball functions are
organized in several functional groups as shown in the table
below.
The function selected is displayed in the lower right corner of
the screen.
within the active functional group. Groups with several
functions are marked with a + symbol.
Orientation controls group
Rotate Rotates the volume rendering/slice.
Translate Translates the volume rendering/slice.
Scroll Scrolls through a cineloop.
Speed Adjust cine replay speed
Display controls
Color key
Starts/stops the color mode. In 4D color freeze, pressing COLOR
show/hide the color data.
Layout key on the front panel

This control is working the same way as in 4D Mode (see
page 19). 51
Active mode Gain
With Color flow mode activated: gain amplifies the overall
strength of echoes processed in the Color Flow window
Zoom
See page 20.
52
Using 4D Color Flow mode - Vivid 7
Color Flow can be enabled in 2D mode before entering
4D mode or when in 4D mode.
Real time 4D Color flow acquisition

1. Select the 3V probe and cardiac application.
3. Press 4D and COLOR.
The 4D Color Flow mode is started.
4. Acquire a volume.
the result.
Tissue structures may obscure relevant flow information. If
required, increase TISSUE TRANSPARENCY setting.
CAUTION
Color flow data may obscure other relevant color flow
information (e.g jet). If required adjust FLOW TRANSPARENCY
setting.
In some settings the volume rate can be less than 10 volumes per
second. This may lead to small display mismatch between the
color and tissue data. This is because of the rapid movement of
structures (e.g. valves) compared to the time lag between the
tissue and the color volume acquisitions.
53
Full volume Color Flow acquisition
Full volume Color Flow acquisition is based on ECG triggered
sub-volume acquisitions of color flow data. Depending on the
adjustment, four or seven heart cycles are acquired.
Full volume Color Flow acquisition is done in two steps:
• Step 1: positioning of the probe for optimal full volume
acquisition with color flow data. This is done from a Bi-plane
screen displaying azimuth and elevation planes.
• Step 2: acquisition over seven heart beats.
ECG triggering acquisition may by nature contain artifacts. The

triggering works by acquiring the whole tissue volume during the
CAUTION first heart beat, followed by a series of color sub-volumes that
are stitched together (three or six). Consequently, the tissue
volume is updated only each fourth or seventh heart beat, and
only the color data may have stitching artifacts.
acquisition.
To validate the acquisition, perform a visual inspection in both
the volume rendering and the elevation plane. Stitching artifacts
are shown as visible transitions between the sub-volumes in the
color flow data.
1. Connect the ECG device and make sure to obtain a stable

ECG trace.
2. Adjust Num. Cycles to either four or seven cycles.
3. In 4D Color Flow mode, press 4D CF PREPARE.
A Bi-plane screen is displayed. Acquire an apical view.
4. Adjust the probe position to display optimal color flow image
in both planes. You may:
• adjust VOLUME SIZE to change the color ROI size.
• change the position of the ROI using the trackball (POS).
5. Ask the patient to hold her/his breath at end expiration.
Keep the probe steady and press FULL VOLUME. The Full
volume acquisition is started. the tissue color volume are
build up over four/seven heart cycles. Make sure to keep
the probe steady during the entire acquisition. 54
Press FREEZE.
6. In Freeze, look for stitching artifacts in the color flow data in
both the volume rendering and the elevation plane in the
lower left window of the screen.
7. Press 2D FREEZE, rotate the volume to check the result.
Depending on the result, you may press 4D CF PREPARE
and make a new acquisition.
55
6 Slice
The purpose of the 6 slice mode is to be able to measure the
size of the minimal area of a regurgitant flow jet, typically
through the mitral valves.
6 Slice enables simultaneous display of six short axis views
generated from an Apical full volume Color Flow acquisition
and two apical long axis views.
6 Slice is available only from a full volume color flow acquisition
when in Freeze.
1. Acquire an apical Full volume view (see page 54).
2. Press FREEZE.
3. Press 6 SLICE.
The 6 Slice screen is displayed (Figure 2-5). The six slices
are evenly distributed and maximized in size for best
assessment.
1. Upper slice
2. Lower slice
Figure 2-5: 6 Slice screen

simultaneously. 56
• Adjust TOP and BOTTOM controls to change the slicing
area (Figure 2-6).
1. Top: upper slice adjustment

2. Bottom: lower slice adjustment
Figure 2-6: Slice distribution adjustment
• Adjust the AXIS 1 and AXIS 2 controls to rotate the slices

backward/forward and sideways (Figure 2-7), to align
the slices with the anatomical structure.
57
1. Axis 1: slice rotation backward/forward
2. Axis 2: slice rotation sideways
Figure 2-7: Slice rotation adjustment
• Adjust ROTATE to rotate all six slices around the center

axis.
• Adjust TRANSLATE to move all six slices up or down.
5. Press IMG. STORE to save.
6. Press 6 SLICE EXIT.
58
4D Color Flow mode overview - EchoPAC PC
4D Color Flow mode acquisitions from Vivid 7 can be opened
and post processed on the EchoPAC PC workstation. The
controls are the same as in the Vivid 7 (see page 48). The
procedures related to the 4D Color Flow mode are similar to
the 4D mode (see page 32).
1. Volume rendering display with Color Flow

2. Cut-plane 2 (white): 2D image in the azimuth plane
3. Cut-plane 3 (green): 2D image in the elevation plane
5. 4D control panel (Color Flow Volume rendering mode)
Figure 2-8: 4D Color Flow screen (Volume rendering)
59
Slice mode screen
5. 4D control panel (Color Flow Slice mode)
Figure 2-9: 4D Color Flow screen (Slice mode)
60
4D mode control panel
Refer to ’4D Color Flow mode assigned controls’ on

page 48 for information on the 4D Color Flow related
controls. All other general imaging controls are described
in the workstation User manual.
Figure 2-10: 4D Color Flow Control panel
61
Rendering controls
In volume rendering, select Rendering to display the rendering controls.
Figure 2-11: Rendering and orientation panels
62
Chapter 3
Multi-plane imaging
• Introduction ................................................................................... ..... 64

• Multi-plane mode overview - Vivid 7 ........................................... ..... 65
• Bi-plane mode screen .................................................................65
• Tri-plane mode screen ................................................................66
• Multi-plane mode controls ...........................................................67
• Using Multi-plane mode imaging - Vivid 7 .................................. ..... 75
• Scan plane rotation .....................................................................76
• Tilting scan plane 2 .....................................................................76
• Zooming ......................................................................................77
• Multi-plane mode overview - EchoPAC PC ................................ ..... 80
• Bi-plane mode screen .................................................................80
• Tri-plane mode screen ................................................................81
• The multi-plane control panel .....................................................82
• Working with multi-plane acquisitions - EchoPAC PC ............. ..... 83
63
Introduction
Multi-plane mode displays two (Bi-plane) or three (Tri-plane)
rotated cross sections acquired simultaneously. This mode
enables the investigation of anatomical structures from
different angles.
Multi-plane mode enables the creation of a left ventricular
volume reconstruction based on contours drawn from three
cross sections at both end-systole and end-diastole with
calculation of end-systolic and end-diastolic volumes and
ejection fraction (see Chapter 4, ’Measurements and Analysis’
on page 84).
Combined to specially designed Stress echo protocols, the
Multi-plane mode enables faster stress examination as two
projections can be acquired simultaneously (see Chapter 5,
’Multi-plane Stress Echo’ on page 97).
Multi-plane mode is available from B-Mode, Color flow mode
and TVI related modes.
64
Multi-plane mode overview - Vivid 7
Bi-plane mode screen
1. Scan plane 1 (yellow): default reference scan plane. This scan plane is fixed, cannot be tilted or
rotated.
2. Scan plane 2 (white): this scan plane is by default perpendicular to scan plane 1 along the scanning
axis. This scan plane can be either tilted or rotated.
3. Geometric model: displays both scan planes in a projection and the rotation angle (A1) and tilt angle
(T) values for the scan plane 2 relative to the scan plane 1.
4. Scan plane marker for scan plane 2: crossing line of scan plane 2 in scan plane 1.
Figure 3-1: The Bi-plane imaging mode screen
65
Tri-plane mode screen
1. Scan plane 1 (yellow): default reference scan plane. This scan plane is fixed, cannot be rotated.
2. Scan plane 2 (white): this scan plane can be rotated using the trackball.
3. Scan plane 3 (green): this scan plane can be rotated using the trackball.
4. Geometric model: displays all the scan planes in a projection.
5. Navigator: displays rotation angle values for the scan planes 2 (A1) and 3 (A2) relative to the scan
plane 1.
Figure 3-2: The Tri-plane imaging mode screen
66
Multi-plane mode controls
Alt. Alt. Alt. Alt.
Width
1. Multi-plane key 6. Clear: resets the rotation and/or tilt angle of

2. Mode specific assigned rotaries: see next scan plane 2 and 3.
pages. 7. Angle: in Bi-plane mode, rotates scan plane 2
3. Mode specific assigned keys: see next pages. to a pre-defined angle relatively to scan plane 1.
4. Zoom
5. Trackball
• Tilt scan plane 2 (Bi-plane mode only).
• Rotate scan plane 2 and 3
• Zoom adjustment.
• Scroll through the cineloop.
Figure 3-3: The Multi-plane controls on the control panel
67
¨Multi-plane B mode assigned controls

• Angle 1 (Tri-plane) • Up/Down R
• Angle 2 (Tri-plane) • Reference Plane R
• Width (Bi-plane) • Tri-plane
• Frequency (Bi-plane) • Cineloop (in Freeze only) R
• Focus position • B Color maps R
• Frame rate ALT menu
ALT menu • Curved Anatomical M Mode R
• Angle 1 (Bi-plane) • Q Analysis (in Freeze only)
• Width (Tri-plane) • Anatomical M Mode
• Frequency (Tri-plane) • Tissue Tracking
• Strain rate
• Strain
ALT + MORE menu
• TSI
Multi-plane Color flow mode assigned controls

• 2D Width • Invert R
• Scale • Variance R
• Baseline R • Reference Plane R
• Frame rate • Tri-plane
• Color map R
• Angle 1
• Angle 2 (Tri-plane) MORE menu
• Up/Down R
ALT menu
• Same as Multi-plane B mode
ALT + MORE menu
• Same as Multi-plane B mode
Figure 3-4: Multi-plane B mode and CF modes assigned controls
68
Multi-plane TVI mode assigned controls

• Scale • TSI R
• Baseline R • Reference Plane R
• Angle 1 • TVI visible R
• Angle 2 (Tri-plane) ALT menu
• Curved Anatomical M Mode R
• Q Analysis (in Freeze only)
• Anatomical M Mode
• Tissue Tracking
• Strain rate
• Strain
ALT + MORE menu
• TSI
Multi-plane Tissue Tracking mode assigned controls

• Track scale R • TSI R
• Track end R • Reference Plane R
• Color maps R
• Angle 1
• Same as Multi-plane TVI
Figure 3-5: Multi-plane TVI and TT modes assigned controls
69
Multi-plane Strain imaging mode assigned controls

• Strain scale R • TSI R
• Strain end R • Reference Plane R
• Angle 1 • Color maps R
• Curved Anatomical M Mode
• Q Analysis (in Freeze only)
• Anatomical M Mode
• Tissue Tracking
• Strain rate
• Strain
ALT + MORE menu
• TSI
Multi-plane Strain rate imaging mode assigned controls

• 2D Width • Same as Multi-plane Strain imaging
• SRI scale R
• Frame rate
MORE menu
• Same as Multi-plane Strain imaging
Multi-plane Tissue Synchronization Imaging mode assigned controls

• 2D Width • TSI R
• Frame rate • Reference Plane R
MORE menu • Tri-plane
• TSI start • Cineloop (in Freeze only)
• Color maps R
• TSI end
ALT menu
• Same as Multi-plane Strain imaging
Figure 3-6: Multi-plane SI, SRI and TSI modes assigned controls 70
Multi-plane mode assigned controls
This section describes only the Multi-plane mode controls. The
scanning mode controls are described in the system User
manual.
Tri-plane
(All modes, Live)
Toggles between Bi-plane and Tri-plane mode.
Reference Plane
(All modes, Live and Replay)
In Tri-plane mode, toggles the reference plane between scan
plane 1, 2 or 3.
The reference plane may also be selected using the trackball
when the Pointer trackball tool selected (see below).
Trackball controls
The trackball has multiple functions depending on the
scanner’s state (Live/Freeze, zoom/unzoom, Bi-plane/Tri-plane
mode and selected scanning mode). The trackball functions
are organized in several functional groups as shown in the
table below. The function selected is highlighted in the lower
right corner of the screen.
within the active functional group.
Scan planes rotation controls group
Function State Description
Pos Bi-plane, Live, Unzoom Tilts the scan plane 2 (white) around
the top of the sector.
Angle 1 Bi-plane/Tri-plane, Live, Adjusts the angle between the scan

Unzoom planes 2 (white) and scan plane 1
(yellow). Scan plane 2 is rotated
around the crossing line between
the scan planes. Scan plane 1 is
fixed. 71
Scan planes rotation controls group
Angle 2 Tri-plane, Live, Unzoom Adjusts the angle between the scan
planes 3 (green) and scan plane 1
(yellow). Scan plane 1 is fixed.
Scan plane selection
Pointer All states Selects the reference scan plane.
Zoom mode controls group
Pos Zoom, Live/Freeze Moves the zoom area.
Size Zoom, Live/Freeze, 2D Resizes the zoom area.
Color/TVI modes ROI controls group
Pos CFM, TVI modes, Moves the color sector.

Live/Freeze, In Bi-plane CFM mode, if scan
Zoom/Unzoom plane 1 (yellow) is selected as
reference scan plane, both color
sectors are moved. If scan plane 2
(white) is selected as reference scan
plane its color sector is moved
independently. In Tri-plane CFM
mode, all sectors are moved at the
same time.
Size CFM, TVI modes, Resizes the color sector.

Live/Freeze, All sectors are resized at the same
Zoom/Unzoom time
72
Scroll Freeze, Zoom/Unzoom Scrolls through a cineloop.
Display controls
Layout key
• In Bi-plane mode, toggles the display between the default
Bi-plane dual screen and a single screen showing the
selected scan plane.
• In Tri-plane mode, toggles the display between the default
Tri-plane quad screen, a quad screen with enlarged
Geometric model and a single screen showing the selected
scan plane.
1. Display options for Bi-plane mode

2. Display options for Tri-plane mode
Figure 3-7: Multi-plane mode display options
73
Zoom
Display zoom
Activated and adjusted by rotating the ZOOM rotary ( ). An
orientation preview showing the outlined magnified area is
displayed in the upper right corner of the screen. The position
and size of the magnified area are adjusted with the trackball
when in B mode (see page 77).
High Resolution (HR) zoom
HR zoom concentrates the image processing to a magnified
user selectable portion of the image, resulting in an improved
image quality in the selected image portion.
HR zoom is activated and adjusted by pressing and rotating the
zoom rotary ( ). An orientation preview showing the outlined
magnified area is displayed in the upper right corner of the
screen. The position and size of the magnified area are
adjusted with the trackball.
Other controls
Clear key
Resets all scan planes to the default position.
Angle key
In Bi-plane mode, toggles the position of scan plane 2 between
the default position and a pre-defined angle relatively to scan
plane 1.
74
Using Multi-plane mode imaging - Vivid 7
1. Select the 3V probe.
3. Press MP on the control panel.
The Bi-plane B mode screen is displayed.
4. Press TRI-PLANE to select between bi-plane or tri-plane
acquisition.
5. Adjust the angle increment between scan planes as
described below.
6. If in Bi-plane mode, adjust the scan plane 2 tilt angle as
described below.
7. To activate another scanning mode:
• Press COLOR to activate CF mode.
• Press TVI to activate TVI mode.
• In TVI mode, press TSI to activate TSI mode.
• Press ALT and either TISSUE TRACKING, STRAIN or STRAIN
RATE to activate the corresponding mode in Multi-plane
imaging.
8. Zoom in the structure of interest (see page 77).
Note: scan plane rotation or tilting cannot be done when in
zoom mode.
9. Press IMG. STORE to save the acquisition.
75
Scan plane rotation
The angle increment of scan plane 2 or 3 relative to the scan
plane 1 (fixed) can be adjusted with the trackball. The rotation
is done around the crossing line between the scan planes.
Scan plane rotation is available only in Unzoom live mode.
1. Press SELECT until the desired trackball function is
selected:
• Angle 1: rotation of scan plane 2 (white)
• Angle 2: rotation of scan plane 3 (green, Tri-plane)
2. Use the trackball to rotate the corresponding scan plane
around the probe center axis.
Figure 3-8: Rotation of Scan plane 2 (Bi-plane mode)
3. To reset the scan planes to the original default position,

press CLEAR.
Tilting scan plane 2

In Bi-plane mode, the scan plane 2 can be tilted around the top
of the scanning sector using the trackball. Tilting is available
only in Unzoom live mode.
1. In Bi-plane mode, press SELECT until the trackball function
Pos is selected.
2. Use the trackball to tilt the scan plane 2.
76
Figure 3-9: Tilting of scan plane 2 (Bi-plane mode)
3. To reset the scan planes to the original default position,

press CLEAR.
Zooming
Activating the zoom
1. Rotate the ZOOM knob clockwise on the control panel.
All scan plane images are zoomed in. A Navigation
window is displayed with a frame highlighting the zoomed
area (see Figure 3-10).
77
1. Magnified scan planes
2. Navigation window in Zoom mode
3. Zoomed area
Figure 3-10: Zoom mode screen (Tri-plane mode)
Adjusting the zoomed area

The zoomed are can be moved within the sector or resized.
1. In zoom mode, press SELECT to toggle the trackball function
to Pos and use the trackball to freely move the zoomed
area within the scan plane.
2. Press SELECT to toggle the trackball function to Size and
use the trackball to adjust the size of the zoomed area
(B mode only).
78
Note: If the trackball function Ptr (mouse pointer) or Scroll
(when in Freeze) is selected, press TRACKBALL until the
trackball functions Pos or Size is selected.
79
Multi-plane mode overview - EchoPAC PC
Multi-plane acquisitions from Vivid 7 can be opened and post
processed on the EchoPAC PC workstation. This section
describes the controls and procedures related to Multi-plane
mode on the workstation. Refer to the EchoPAC PC User
manual about general use of the workstation.
Bi-plane mode screen
1. Scan plane 1 (yellow): default reference scan plane.

2. Scan plane 2 (white): the tilt or rotation angle is set during acquisition.
3. Geometric model: displays both scan planes in a projection and the rotation angle (A1) and tilt angle
(T) values for the scan plane 2 relative to the scan plane 1.
4. Scan plane marker for scan plane 2: crossing line of scan plane 2 in scan plane 1.
5. Multi-plane control panel
Figure 3-11: The Bi-plane mode screen
80
Tri-plane mode screen
1. Scan plane 1 (yellow): default reference scan plane.

2. Scan plane 2 (white): the rotation angle is set during acquisition.
3. Scan plane 3 (green): the rotation angle is set during acquisition.
4. Geometric model: displays all three scan planes in a projection and/or reconstructed volume.
5. Navigator: displays rotation angle values for the scan planes 2 (A1) and 3 (A2) relative to the scan
plane 1.
6. Multi-plane control panel
Figure 3-12: The Tri-plane mode screen
81
The multi-plane control panel
The controls in multi-plane mode are similar to the controls

for the associated scanning mode (B mode, Color or TVI
related modes). Refer to the workstation User manual for
additional informations on these controls.
Figure 3-13: The Multi-plane Control panel 82

Working with multi-plane acquisitions -
EchoPAC PC
1. In the Search/Create patient window (Archive menu), select
a patient record with multi-plane acquisitions.
The Examination List window is displayed.
2. Select the desired examination and open (double-click) a
multi-plane acquisition from the clipboard.
OR
Press Image browser and open (double-click) the
multi-plane acquisition in the Image browser screen.
The Multi-plane mode screen (bi-plane or tri-plane) is
displayed.
3. Perform image optimization and measurements.
4. Press Store to save the changes.
83
Chapter 4
Measurements and Analysis
• Introduction ................................................................................... ..... 85

• Left ventricular volume measurements ...................................... ..... 86
• Tri-plane acquisition ....................................................................86
• Full volume acquisition ...............................................................89
• Rotation of the Volume reconstruction ........................................90
• Bi-plane acquisition .....................................................................91
• TSI surface model ......................................................................... ..... 93
• Quantitative analysis .................................................................... ..... 95
• Starting Quantitative analysis from a multi-plane acquisition ......95
84
Introduction
All cardiac measurements available in 2D are also available in
4D (when in Slice mode) and Multi-plane modes. In addition,
the 4D and Multi-plane modes enable the creation of a left
ventricular volume reconstruction based on contours drawn
from three cross-sections at both end-systole and end-diastole
with calculation of the end-systolic and end-diastolic volumes
and the ejection fraction.
Left ventricular volume measurement may also be performed in
Bi-plane mode based on contours drawn at both end-systole
and end-diastole.
Refer to the scanner’s or the workstation’s User Manual for
more information about 2D measurements.
From the TSI Tri-plane mode the user can create a TSI surface
model of the left ventricle.
All these features are available on both Vivid 7 and
EchoPAC PC.
85
Left ventricular volume measurements
Tri-plane acquisition
This procedure describes the calculation and reconstruction of
the left ventricular volume from a Tri-plane acquisition.
1. In Tri-plane mode, acquire an Apical 4 chamber view in
scan plane 1 (yellow).
2. Rotate scan plane 2 and 3 to display an Apical 2 chamber
view in scan plane 2 (white) and an Apical long axis view in
scan plane 3 (green).
3. Press FREEZE.
4. Press MEASURE.
The Measurement menu is displayed.
5. In the Measurement menu select Volume and Tri-plane.
The Measurement screen is displayed with the Ejection
fraction tool selected (see Figure 4-1).
The end diastolic frame of the current cardiac cycle is
displayed and the cursor is moved to the reference scan
plane.
86
1. Ejection fraction tool for Tri-plane
2. Scan plane 1 (yellow): Apical 4 chamber view
3. Scan plane 2 (white): Apical 2 chamber view
4. Scan plane 3 (green): Apical long axis view
5. Volume reconstruction
Figure 4-1: The Tri-plane measurement screen
6. If desired, press LAYOUT twice to display the reference scan

plane in a single screen.
7. Place the cursor to the start point for the trace.
8. Press SELECT and draw a contour of the left ventricle.
To edit the contour while drawing:
• Follow the contour backward to erase it and redraw.
• Press UNDO or BACKSPACE to erase the contour
stepwise and redraw.
• Press DELETE to remove the entire contour and redraw.
9. Press SELECT to complete the contour.
The cursor is automatically moved to the next scan plane.
The crossing point of the trace done in the first scan plane
is marked in the second scan plane.
87
10. Draw a contour of the left ventricle in scan plane 2 and 3
following the same procedure.
When the last end-diastolic contour is drawn, an
end-systolic frame is automatically displayed. The system
automatically enters scroll mode. Using the trackball,
ensure that the correct end-systolic frame is displayed.
Press SELECT to leave scroll mode.
11. Repeat steps 7 to 10 to draw a contour of the left ventricle
at end-systole in all the scan planes.
The measurement results, including end-diastolic and
end-systolic volumes and the left ventricular ejection
fraction, are displayed in the Measurement result table.
Note: Other measurements may be displayed by
configuring the Measurement menu, refer to the scanner’s
or workstation’s User manual for more information about
Measurement menu configuration.
12. If in single screen mode, press LAYOUT to display the
Volume reconstruction of the left ventricle in the Geometric
model.
13. Press LAYOUT again to display an enlarged Geometric
model.
The Volume reconstruction can be rotated in all directions
(see page 90).
88
Full volume acquisition
This procedure describes the calculation and reconstruction of
the left ventricular volume from a Full volume acquisition.
ECG triggering acquisition may by nature contain artifacts, that
may have impact on the measurements.
CAUTION
acquisition.
See recommendations on page 23 to avoid stitching artifacts
during full volume acquisition.
It is recommended to specify in the Comments for the
examination that the measurements are performed in a Full
volume acquisition.
1. Using the Full volume acquisition mode (see page 23),

acquire a 4D Apical 4 chamber image.
2. Press FREEZE.
3. Orientate the reference cut-plane to display an Apical
4 chamber (see ’Rotating/Translating the 4D image’ on
page 25).
4. Press MEASURE.
5. In the Measurement menu select Volume and Tri-plane.
The Measurement screen is displayed with the Ejection
fraction tool selected.
6. Follow the procedure described in ’Tri-plane acquisition’ on
page 86from step 6.
89
Rotation of the Volume reconstruction
The volume reconstruction displayed in the Geometric model
can be rotated in any directions.
1. Place the pointer in the Geometric model.
2. Press and hold down SELECT and use the trackball to rotate
the volume reconstruction.
90
Bi-plane acquisition
This procedure describes the calculations of the left ventricular
volume from a Bi-plane acquisition. The volume calculation is
based on the Method of disk.
1. In Bi-plane mode, acquire an Apical 4 chamber view in scan
plane 1(yellow).
2. If required, rotate scan plane 2 to display an Apical
2 chamber view.
3. Press FREEZE.
4. Using the trackball, scroll through the cineloop to display
the end-diastolic frame.
5. Press MEASURE.
6. In the Measurement menu select Volume and Bi-plane.
The Trace tool for the Left ventricular end-diastolic volume
for the Apical 4 chamber view is selected (see Figure 4-2).
1. Trace tools
Figure 4-2: The Volume measurement screen (Bi-plane)
7. In scan plane 1 (yellow), place the cursor to the start point

for the trace. 91
8. Press SELECT and draw a contour of the left ventricle.
9. Move the cursor to the apex and press SELECT to measure
the length.
The trace tool for the Left ventricular end-diastolic volume
for the Apical 2 chamber view is selected.
10. Repeat steps 8 and 9 in the scan plane 2 (measurement in
the Apical 2 chamber view).
The trace tool for the Left ventricular end-systolic volume
for the Apical 4 chamber view is selected.
11. Using the trackball, scroll through the cineloop to display
the end-systolic frame in the same heart cycle.
12. Press TRACKBALL to activate the M&A tool.
13. Repeat steps 7 to 10 to perform the end-systolic
measurements in the Apical 4 chamber and 2 chamber
views.
The Ejection fraction (Bi-plane) and the end-diastolic and
end-systolic left ventricular volumes are calculated.
92
TSI surface model
A Surface model representation of the left ventricle with TSI
color coding can be generated from a TSI Tri-plane acquisition
by applying a sampling path in the myocardium. The sampling
path is created by placing control points in the myocardium.
1. In Tri-plane TSI mode, acquire an Apical 4 chamber view in
scan plane 1 (yellow).
2. Rotate scan plane 2 and 3 to display an Apical 2 chamber
view in scan plane 2 (white) and an Apical long axis view in
scan plane 3 (green).
3. Press FREEZE.
4. Press MEASURE.
5. In the Measurement menu select TSI surface.
The Mapping tool is selected (see Figure 4-3).
1. Mapping tool for Geometry model

2. TSI surface model
Figure 4-3: The Measurement screen (Geometry model)
93
6. In scan plane 1 (yellow), place the cursor to the start point
for the sampling path starting in the myocardium.
7. Move the cursor following the myocardium and press
SELECT to place new points.
By creating several control points the sampling path can
be bent to follow the myocardium.
8. Press SELECT twice to end the sampling path.
9. Create a sampling path in scan plane 2 and 3.
A TSI color coded surface model is displayed in the
Geometric model.
10. To create a dynamic model, scroll to another frame in the
same heart cycle and create a sampling path in each scan
plane.
11. Press 2D FREEZE to run the model.
To edit the sampling path

1. Place the cursor over a control point.
2. Press SELECT twice (double-click) and move the control
point to a new position using the trackball.
3. Press SELECT to place the control point to its new position.
94
Quantitative analysis
Multi-plane acquisitions (all modes) can be further analyzed in
the Quantitative analysis software package. Refer to the
scanner’s or the workstation’s User manual for additional
information on Quantitative analysis.
This section describes how to launch the Quantitative analysis
software package from the Multi-plane mode and the features
that are specific to multi-plane acquisitions.
Starting Quantitative analysis from a

multi-plane acquisition
1. From a Multi-plane (Bi-plane or Tri-plane) acquisition, press
FREEZE.
2. Press ALT and press the assigned key Q ANALYSIS.
The Quantitative analysis screen is displayed showing the
selected scan plane and the Geometric model.
3. To change scan plane, press Reference Image.
95
1. Selected scan plane
2. Geometric model
Figure 4-4: The Quantitative analysis screen
96
Chapter 5
Multi-plane Stress Echo
• Introduction ................................................................................... ..... 98

• Creating a Multi-plane stress test template ............................... ..... 99
• Launching the Template editor .................................................100
• Stress Template setup ..............................................................100
• Stress test acquisition ................................................................. ... 102
• Baseline acquisitions ................................................................102
• Low dose and Peak dose level acquisitions .............................105
• Image analysis .............................................................................. ... 108
97
Introduction
The Multi-plane mode can be used with specially designed
stress templates (factory or user-defined) that enables
simultaneous acquisition of several projection planes into each
cell in the template.
Two factory multi-plane stress templates are available:
• Pharm. 4x2 Multiplane: consists of:
• Four levels: Baseline, Low dose, Peak dose and
Recovery
• Two columns:
- A Tri-plane mode column with simultaneous
acquisition of Apical 4 chamber, Apical 2 chamber and
Apical long axis views.
- A Bi-plane mode column with simultaneous acquisition
of Parasternal long axis and Parasternal short axis
views.
• Pharm. 4x3 Biplane: consists of:
• Four levels: Baseline, Low dose, Peak dose and
Recovery
• Three columns:
of Apical 4 chamber, and Apical 2 chamber views.
of Apical 4 chamber and Apical long axis views.
views.
Note: this template acquires the 5 standard projections
using only biplane acquisition, this results in higher
resolution / framerate than using triplane. The probe is
fixed on the 4 chamber projection when acquiring both
apical biplane recordings (only the second plane is
changing).
The following section describes:
• The basic procedure to create a Multi-plane
pharmacological stress template
• The Multi-plane stress acquisition based on the Multi-plane
pharmacological stress template 98
• The Multi-plane stress analysis
Note: Not all Stress Echo features are described in the
following example, refer to the system User manual for
additional information on Stress Echo.
Creating a Multi-plane stress test template

The following example describes the creation of a
pharmacological protocol template consisting of:
• Three levels:
• Baseline
• Low dose
• Peak dose
• Two columns:
• A Tri-plane mode column with simultaneous acquisition
of Apical 4 chamber, Apical 2 chamber and Apical long
axis views.
• A Bi-plane mode column with simultaneous acquisition
views.
99
Launching the Template editor
1. Press PROTOCOL.
2. Select Template.
3. Select Template editor.
The Template editor screen is displayed.
Figure 5-1: The Template editor screen
Stress Template setup

1. In the Grid size field, adjust the Number of levels to three
and the Number of projection views (columns) to two.
2. From the Label drop-down menu of the first column select
the label Tri Ap 4 2 LAX.
With this setting the system will automatically launch the
Tri-plane mode enabling simultaneous acquisition of Apical
4 chamber, 2 chamber and Long axis views in all levels in
the first column.
100
3. From the Label drop-down menu of the second column
select the label Bi PLAX PSAX.
With this setting the system will automatically launch the
Bi-plane mode enabling simultaneous acquisition of
Parasternal long axis and short axis views in all levels in
the second column.
4. Enter the labels for the three levels.
5. Make sure that Smart stress is checked. This will ensure
that all acquisition settings defined at Baseline will be
preserved in the next levels, including rotation and tilt angle
settings.
6. Delete any existing predefined groups (in case the template
is based on an existing template with groups already
defined).
7. Select all the views from the first column and select New
group.
The Group name window is displayed.
Note: You should not mix bi-plane and tri-plane recordings
in the same analysis group.
8. Give the group a name (e.g. Apical) and press OK.
9. Likewise create a group for all the views from the second
column (e.g. Parasternal).
10. All other settings should be as shown in Figure 5-1.
Refer to the system User manual for additional information
on stress template creation.
11. Select Save as template and give the template a name
(e.g Pharm. 3x2 Multiplane).
12. Select OK in the Template editor screen.
The new template is selected and the Protocol screen is
displayed.
101
Stress test acquisition
Baseline acquisitions
1. Scan plane 1 (yellow): acquire an Apical 4 chamber view.

2. Scan plane 2 (white): an Apical 2 chamber view is displayed.
3. Scan plane 3 (green): an Apical long axis view is displayed.
4. Active cell
Figure 5-2: The Baseline acquisition screen (Apical acquisition)
1. When in the Protocol screen with the Multi-plane stress

template selected, press Begin/Cont to start the stress test
acquisition.
2. The first Baseline view acquisition screen displays a
Tri-plane mode. The positions of the scan planes are set so 102
that the acquisition of an Apical 4 chamber view in scan
plane 1(yellow) displays an Apical 2 chamber in scan
plane 2 (white) and an Apical long axis in scanplane 3
(green).
If required, fine tune the angle of scan plane 2 and 3 to get
optimal views in these scan planes and adjust the image
quality.
3. Press IMAGE STORE.
This template is set to preview cineloop before storing, use
the cineloop controls to select and adjust the most
appropriate heart cycle. Press IMAGE STORE or SELECT to
save the cineloop.
4. The second Baseline view acquisition screen displays a
Bi-plane mode. The acquisition of a Parasternal long axis
view in scan plane 1 (yellow) displays a Parasternal short
axis in scan plane 2 (white).
If required, fine tune the position of scan plane 2 to display
a mid short axis view (on level with papillary muscles) and
adjust the image quality.
103
1. Scan plane 1 (yellow): acquire a Parasternal long axis view.
2. Scan plane 2 (white): a Parasternal short axis view is displayed.
3. Active cell
Figure 5-3: The Baseline acquisition screen (Parasternal acquisition)

Select and adjust the most appropriate heart cycle. Press
IMAGE STORE or SELECT to save the cineloop.
The acquisition screen for the first Low dose level view is
displayed.
104
Low dose and Peak dose level
acquisitions
1. Scan plane 1 (yellow): acquire an Apical 4 chamber view.

2. Scan plane 2 (white): an Apical 2 chamber view is displayed.
3. Scan plane 3 (green): an Apical long axis view is displayed.
4. Active cell
5. Baseline acquisition corresponding to the current acquisition.
Figure 5-4: The Low dose acquisition screen (Apical acquisition)
1. When Show reference is enabled in the template, the

corresponding Baseline view is displayed on the left side of
the screen during Low dose and Peak dose acquisitions.
Acquire an Apical 4 chamber view in scan plane 1. The
angle and image adjustments done during Baseline 105
acquisition are automatically set for this acquisition (Smart
stress enabled).
The second Low dose level acquisition view (Bi-plane
mode) is displayed with the corresponding Baseline
acquisition.
1. Scan plane 1 (yellow): acquire a Parasternal long axis view.

2. Scan plane 2 (white): a Parasternal short axis view is displayed.
3. Active cell
4. Baseline acquisition corresponding to the current acquisition.
Figure 5-5: The Low dose acquisition screen (Parasternal acquisition)

106
3. Acquire a Parasternal long axis view in scan plane 1. The
position/angle and image adjustments done during
Baseline acquisition are automatically set for this
acquisition.
The acquisition screen for the first Peak dose level
acquisition view (Tri-plane mode) and corresponding base
line acquisition are displayed.
5. Repeat step 1 to 4 to acquire Peak dose view.
6. The Stress template is set to start analysis automatically.
When the last acquisition is stored a dialogue window is
displayed asking the user to start analysis. Select Yes to
start the protocol analysis.
107
Image analysis
This section describes the basic procedure for image analysis
for the current example. Refer to the system User manual for
additional information on stress echo image analysis.
1. Scan plane 1 (yellow): Apical 4 chamber, Baseline

2. Scan plane 1 (yellow): Apical 4 chamber, Low dose
3. Scan plane 1 (yellow): Apical 4 chamber, Peak dose
4. Corresponding Wall segment diagrams
5. Previous next images/group
Figure 5-6: The Stress echo analysis screen (Apical group,

4 chamber acquisition)
1. When starting analysis, the Stress echo analysis screen is

displayed, showing the first scan plane from the images in
the first group (Apical 4 chamber for all three levels,
acquired in scan plane 1 (yellow) in Tri-plane mode) and
the corresponding wall segment diagrams.
2. Perform segment scoring.
108
3. Select the Right arrow in the lower right corner of the
screen to display the next scan planes from the images in
the first group (Apical 2 chamber for all three levels,
acquired in scan plane 2 (white) in Tri-plane mode).
the first group (Apical long axis for all three levels, acquired
in scan plane 3 (green) in Tri-plane mode).
screen to display the first scan plane from the images in the
second group (Parasternal long axis for all three levels,
acquired in scan plane 1 (yellow) in Bi-plane mode).
the second group (Parasternal short axis for all three levels,
acquired in scan plane 2 (white) in Bi-plane mode).
10. Press NEW EXAM or ARCHIVE and select END EXAM.
The examination is stored.
109
Index
Numerics
4D
Controls ..............................................................................................................................9, 46
Overview ............................................................................................................................7, 44
Using 4D mode ....................................................................................................................21
4D Color Flow ...........................................................................................................................42
4D LV-Volume application ..................................................................................................41
C
Crop .........................................................................................................................................12, 49
Cropping
Using Cropping (EchoPAC PC) ......................................................................................37
Using Cropping (vivid 7)....................................................................................................26
F
Full volume ...............................................................................................................13, 23, 49, 54
M
Measurements
Left ventricular volume ......................................................................................................86
TSI surface model ...............................................................................................................93
Multiplane mode
Controls ..................................................................................................................................67
Overview ................................................................................................................................65
Using .......................................................................................................................................75
R
Reference plane.................................................................................................................12, 48
Rotate............................................................................................................................................25
S
Shading
4D image ................................................................................................................................16
Smoothness
4D image ................................................................................................................................16 110
Stereo vision ..............................................................................................................................14
Stress Echo ................................................................................................................................97
Acquisition ...........................................................................................................................102
Analysis ................................................................................................................................108
Creating a template ............................................................................................................99
T
Tilt
4D image ................................................................................................................................16
Translate ......................................................................................................................................25
XYZ
Zoom
4D imaging ............................................................................................................................20
Multiplane mode ..................................................................................................................74
111
Vivid 7 Dimension/Vivid 7 PRO

Version 7.x.x
0470
Reference Manual
Volume 2
GEVU #: FD092077
GEVU Rev. 01
Copyright 2007 By General Electric Co.
MANUAL STATUS GE Medical Systems. All rights reserved. No part of this
01/08/2007
Systems.

Tel.: (+47) 3302 1100 Fax: (+47) 3302 1350
Table of Contents
Table of Contents
Chapter 1
Measurements
Measurement overview..................................................................2
Cardiac measurements .........................................................2
Measurement formulas................................................................15
Formulas–Generic...............................................................15
Formulas–Cardiac ...............................................................17
Formulas–Vascular .............................................................58
Formulas–OB ......................................................................60
Measurement accuracy ...............................................................69
General................................................................................69
Sources of error...................................................................69
Optimizing Measurement Accuracy.....................................71
Chapter 2
OB Tables
ASUM.............................................................................................74
Berkowitz ......................................................................................75
Brenner .........................................................................................76
Campbell .......................................................................................76
Eriksen ..........................................................................................77
Goldstein.......................................................................................78
Hadlock .........................................................................................79
Hansmann.....................................................................................86
Hellman .........................................................................................95
Hill..................................................................................................95
Hohler............................................................................................96
Jeanty............................................................................................96
JSUM ...........................................................................................108
Kurtz ............................................................................................112
Mayden........................................................................................113
Mercer .........................................................................................114
Merz .............................................................................................115
Moore ..........................................................................................125
Nelson .........................................................................................125
Osaka ..........................................................................................126
Paris ............................................................................................130
Rempen .......................................................................................133
Robinson.....................................................................................138
Tokyo...........................................................................................138
Tokyo Shinozuka........................................................................142
Williams.......................................................................................149
Yarkoni ........................................................................................149
Chapter 3
Acoustic information
The real-time display of acoustic output indices....................152
Thermal Index ...................................................................152
Mechanical Index ..............................................................153
Track 3 ALARA Educational Program......................................154
Default Settings and Output Levels .........................................154
Controls Affecting Acoustic Output.........................................155
Track 3 Summary Table ....................................................156
Acoustic Parameters as Measured in Water ...........................158
Definitions, symbols and abbreviations .............................158
Explanation of Footnotes...................................................181
Multiple focal-zones...........................................................181
Operating Conditions.........................................................181
Acoustic Output Reporting Tables for Track 3/
IEC60601-2-37............................................................................. 182
Transducer Model: 3S .......................................................183
Transducer Model: M3S ....................................................189
Transducer Model: M4S ....................................................195
Transducer Model: 10S .....................................................219
Transducer Model: 3V .......................................................225
Transducer Model: 3.5C....................................................232
Transducer Model: 4C.......................................................237
Transducer Model: M7C....................................................247
Transducer Model: 7L .......................................................257
Transducer Model: 9L .......................................................262
Transducer Model: 10L .....................................................267
Transducer Model: 12L .....................................................272
Transducer Model: M12L ..................................................277
Transducer Model: E8C ....................................................282
Transducer Model: 6T .......................................................287
Transducer Model: 6Tc .....................................................293
Transducer Model: 9T .......................................................299
Transducer Model: P2D ....................................................305
Transducer Model: P6D ....................................................307
Transducer Model: i13L.....................................................309
Transducer Model: i8L.......................................................314
Chapter 4
Electromagnetic Compatibility
Electromagnetic emissions.......................................................320
Electromagnetic immunity ........................................................321
Separation distances .................................................................325
Appendix
Statements on the safety of ultrasound...................................327
AIUM Statement on Clinical Safety ...................................327
AIUM Statement on Mammalian in Vivo Ultrasonic Biological
Effects ...............................................................................327
Medical Ultrasound Safety - AIUM............................................328
Track 3 ALARA Educational Program ...............................328
Chapter 1
Measurements
• Measurement overview ................................................................ ....... 2

• Cardiac measurements .................................................................2
• Measurement formulas ................................................................ ..... 15
• Formulas–Generic ......................................................................15
• Formulas–Cardiac ......................................................................17
• Formulas–Vascular .....................................................................58
• Formulas–OB ..............................................................................60
• Measurement accuracy ................................................................ ..... 69
• General .......................................................................................69
• Sources of error ..........................................................................69
• Optimizing Measurement Accuracy ............................................71
1
Measurement overview
The following table shows the cardiac measurements available
on the Vivid 7 ultrasound unit.
Cardiac measurements
Abbreviation Definition Unit
%FS LV Fractional Shortening, 2D %
%FS LV Fractional Shortening, M-mode %
%IVS Thck IVS Fractional Shortening, 2D %
%IVS Thck IVS Fractional Shortening, M-mode %
%LVPW Thck LV Posterior Wall Fractional Shortening, 2D %
%LVPW Thck LV Posterior Wall Fractional Shortening, M-mode %
Ao Arch Diam Aortic Arch Diameter cm
Ao asc Ascending Aortic Diameter cm
Ao Desc Diam Descending Aortic Diameter cm
Ao Isthmus Aortic Isthmus cm
Ao Root Diam Aortic Root Diameter cm
Ao Root Diam Aortic Root Diameter, M-mode cm
AR ERO PISA: Regurgitant Orifice Area cm2
AR Flow PISA: Regurgitant Flow ml/s
AR PHT AV Insuf. Pressure Half Time ms
AR Rad PISA: Radius of Aliased Point cm
AR RF Regurgitant fraction over the Aortic Valve %
AR RV PISA: Regurgitant Volume Flow ml
AR Vel PISA: Aliased Velocity m/s
AR Vmax Aortic Insuf. Peak Velocity m/s
AR VTI Aortic Insuf. Velocity Time Integral cm
ARed max PG Aortic Insuf. End-Diastole Pressure Gradient mm Hg

2
ARed Vmax Aortic Insuf. End-Diastolic Velocity m/s
AV Acc Slope Aortic Valve Flow Acceleration m/s2
AV Acc Time Aortic Valve Acceleration Time ms
AV AccT/ET AV Acceleration to Ejection Time Ratio
AV CO Cardiac Output by Aortic Flow l/min
AV Cusp Aortic Valve Cusp Separation, 2D cm
AV Cusp Aortic Valve Cusp Separation, M-mode cm
AV Dec Time Aortic Valve Deceleration Time ms
AV Diam Aortic Diameter, 2D cm
AV max PG Aortic Valve Peak Pressure Gradient mm Hg
AV mean PG Aortic Valve Mean Pressure Gradient mm Hg
AV SV Stroke Volume by Aortic Flow ml
AV Vmax Aortic Valve Peak Velocity m/s
AV Vmean AV Mean Velocity m/s
AV VTI Aortic Valve Velocity Time Integral cm
AVA (Vmax) AV Area by Continuity Equation by Peak V cm2
AVA (VTI) AV Area by Continuity Equation VTI cm2
AVA Planimetry Aortic Valve Area cm2
AVET Aortic Valve Ejection Time ms
AVET Aortic Valve Ejection Time, M-mode ms
CO (A-L A2C) CO 2CH, Single Plane, Area-Length l/min
CO (A-L A4C) CO 4CH, Single Plane, Area-Length l/min
CO (Biplane CO, Bi-Plane, MOD l/min
CO (bullet) CO, Bi-Plane, Bullet l/min
CO (MOD A2C) CO 2CH, Single Plane, MOD(Simpson) l/min
CO (MOD A4C) CO 4CH, Single Plane, 4CH, MOD(Simpson) l/min

3
CO(Cube) Cardiac Output, 2D, Cubic l/min
CO(Cube) Cardiac Output, M-mode, Cubic l/min
CO(Teich) Cardiac Output, 2D, Teicholtz l/min
CO(Teich) Cardiac Output, M-mode, Teicholtz l/min
D-E Excursion MV Anterior Leaflet Excursion cm
D-E Excursion Mitral Valve D-E Slope cm
EDV (bullet) LV Volume, Diastolic, Bi-Plane, Bullet ml
EDV(Cube) Left Ventricle Volume, Diastolic, 2D, Cubic ml
EDV(Cube) Left Ventricle Volume, Diastolic, M-mode, Cubic ml
EDV(Teich) Left Ventricle Volume, Diastolic, 2D, Teicholz ml
EDV(Teich) Left Ventricle Volume, Diastolic, M-mode, ml

Teicholz
EF (A-L A2C) Ejection Fraction 2CH, Single Plane, Area-Length %
EF (A-L A4C) Ejection Fraction 4CH, Single Plane, Area-Length %
EF (Biplane) Ejection Fraction, Bi-Plane, MOD %
EF (bullet) Ejection Fraction 2CH, Bi-Plane, Bullet %
EF (MOD A2C) Ejection Fraction 2CH, Single Plane, %

MOD(Simpson)
EF (MOD A4C) Ejection Fraction 4CH, Single Plane, 4CH, %

MOD(Simpson)
E-F Slope Mitral Valve E-F Slope m/s
EF(Cube) Ejection Fraction, 2D, Cubic %
EF(Cube) Ejection Fraction, M-mode, Cubic %
EF(Teich) Ejection Fraction, 2D, Teicholtz %
EF(Teich) Ejection Fraction, M-mode, Teicholtz %
EPSS E-Point-to-Septum Separation, M-mode cm
EPSS 2D E-Point-to-Septum Separation, 2D cm
ERO Effective Regurgitant Orifice cm2 4

ESV (bullet) LV Volume, Systolic, Bi-Plane, Bullet ml
ESV(Cube) Left Ventricle Volume, Systolic, 2D, Cubic ml
ESV(Cube) Left Ventricle Volume, Systolic, M-mode, Cubic ml
ESV(Teich) Left Ventricle Volume, Systolic, 2D, Teicholz ml
ESV(Teich) Left Ventricle Volume, Systolic, M-mode, Teicholz ml
HR AV Heart Rate, Dop BPM
HR Heart Rate, 2D, Teicholtz bpm
HR Heart Rate for 2CH study bpm
HR Heart Rate for 4CH study bpm
HR Heart Rate for 2CH AL study bpm
HR Heart Rate for 2CH MOD study bpm
HR Heart Rate for 4CH AL study bpm
HR Heart Rate for 4CH MOD study bpm
HR Heart Rate for Bullet study bpm
HR Heart Rate for BiPlane MOD study bpm
HR LV Heart Rate, Dop bpm
HR Heart Rate, M-mode, Teicholtz bpm
HR Heart Rate bpm
IVC Inferior Vena Cava cm
IVCT Isovolumic Contraction Time ms
IVRT Isovolumic Relaxation Time ms
IVSd Interventricular Septum Thickness, Diastolic, 2D cm
IVSd IVS Thickness, Diastolic, M-mode cm
IVSs Interventricular Septum Thickness, Systolic, 2D cm
IVSs IVS Thickness, Systolic, M-mode cm
LA Diam Left Atrium Diameter, 2D cm
LA Diam Left Atrium Diameter, M-mode cm 5

LA Diam Right Atrium Diameter, 2D cm
LA Major Left Atrium Major cm
LA Minor Left Atrium Minor cm
LA/Ao LA Diameter to AoRoot Diameter Ratio, 2D
LA/Ao LA Diameter to AoRoot Diameter Ratio, M-mode
LAEDV(A-L) LA End Diastolic Volume, Area-Length ml
LAEDV Index(A-L) LA End Diastolic Volume Index, Area-Length ml/m2
LAESV(A-L) LA End Systolic Volume, Area-Length ml
LAESV Index(A-L) LA End Systolic Volume Index, Area-Length ml/m2
LAEDV (MOD A4C) LA Volume, Single Plane, MOD ml
LAESV (MOD A4C) LA Volume, Systolic, Single Plane, MOD ml
LIMP Left Index of Myocardial Performance
LVA (s) Left Ventricular Area, Systolic, 2CH cm2
LVAd (A2C) Left Ventricular Area, Diastolic, 2CH cm2
LVAd (A4C) Left Ventricular Area, Diastolic, 4CH cm2
LVAd(sax) LV area, SAX, Diastolic cm2
LVAend (d) LV Endocardial Area, SAX cm2
LVAepi (d) LV Epicardial Area, SAX cm2
LVAs (A4C) Left Ventricular Area, Systolic, 4CH cm2
LVAs(sax) LV area, SAX, Systolic cm2
LVd Mass LV Mass, Diastolic, 2D g
LVd Mass LV Mass, Diastolic, M-mode g
LVd Mass Index LV Mass Index, Diastolic, 2D g/m2
LVd Mass Index LV Mass Index, Diastolic, M-mode g/m2
LVEDV (A-L A2C) LV Volume, Diastolic, 2CH, Area-Length ml
LVEDV (A-L A4C) LV Volume, Diastolic, 4CH, Area-Length ml

6
LVEDV (MOD A2C) LV Volume, Diastolic, Single Plane, 2CH, MOD ml
LVEDV (MOD A4C) LV Volume, Diastolic, Single Plane, 4CH, MOD ml
LVEDV (MOD BP) LV Volume, Diastolic, Bi-Plane, MOD ml
LVESV (A-L A2C) LV Volume, Systolic, 2CH, Area-Length ml
LVESV (A-L A4C) LV Volume, Systolic, 4CH, Area-Length ml
LVESV (MOD A2C) LV Volume, Systolic, Single Plane, 2CH, MOD ml
LVESV (MOD A4C) LV Volume, Systolic, Single Plane, 4CH, MOD ml
LVESV (MOD BP) LV Volume, Systolic, Bi-Plane, MOD ml
LVESV (MOD LAX) LV Volume, Diastolic, Apical View, LAX, MOD ml
LVESV (MOD LAX) LV Volume, Systolic, Apical View, LAX, MOD ml
LVET Left Ventricle Ejection Time ms
LVIDd LV Internal Dimension, Diastolic, 2D cm
LVIDd LV Internal Dimension, Diastolic, M-mode cm
LVIDs LV Internal Dimension, Systolic, 2D cm
LVIDs LV Internal Dimension, Systolic, M-mode cm
LVLd (apical) Left Ventricular Length, Diastolic, 2D cm
LVLs (apical) Left Ventricular Length, Systolic, 2D cm
LVOT Area Left Ventricle Outflow Tract Area cm2
LVOT CO Cardiac Output by Aortic Flow l/min
LVOT Diam Left Ventricular Outflow Tract Diameter cm
LVOT max PG LVOT Peak Pressure Gradient mm Hg
LVOT mean PG LVOT Mean Pressure Gradient mm Hg
LVOT SI Stroke Volume Index by Aortic Flow ml/m2
LVOT SV Stroke Volume by Aortic Flow ml
LVOT Vmax LVOT Peak Velocity m/s
LVOT Vmean LVOT Mean Velocity m/s

7
LVOT VTI LVOT Velocity Time Integral cm
LVPWd Left Ventricular Posterior Wall Thickness, cm

Diastolic, 2D
LVPWd Left Ventricular Posterior Wall Thickness, cm

Diastolic, M-mode
LVPWs Left Ventricular Posterior Wall Thickness, cm

Systolic, 2D
LVPWs Left Ventricular Posterior Wall Thickness, cm

Systolic, M-mode
LVs Mass LV Mass, Systolic, 2D g
LVs Mass LV Mass, Systolic, M-mode g
LVs Mass Index LV Mass Index, Systolic, 2D g/m2
LVs Mass Index LV Mass Index, Systolic, M-mode g/m2
LAAd (A2C) Left Atrium Area, Apical 2C cm2
LAAd (A4C) Left Atrium Area, Apical 4C cm2
MCO Mitral Valve closure to Opening ms
MP Area Mitral Valve Prosthesis cm2
MR Acc Time MV Regurg. Flow Acceleration s
MR ERO PISA: Regurgitant Orifice Area cm2
MR Flow PISA: Regurgitant Flow ml/s
MR max PG Mitral Regurg. Peak Pressure Gradient mm Hg
MR Rad PISA: Radius of Aliased Point cm
MR RF Regurgitant fraction over the Mitral Valve %
MR RV PISA: Regurgitant Volume Flow ml
MR Vel PISA: Aliased Velocity m/s
MR Vmax Mitral Regurg. Peak Velocity m/s
MR Vmax PISA: CW Peak Velocity m/s
MR Vmean Mitral Regurg. Mean Velocity m/s

8
MR VTI Mitral Regurg. Velocity Time Integral cm
MR VTI PISA: CW Velocity Time Integral cm
MV A Dur Mitral Valve A-Wave Duration ms
MV A Velocity MV Velocity Peak A m/s
MV Acc Slope Mitral Valve Flow Acceleration m/s2
MV Acc Time Mitral Valve Acceleration Time ms
MV Acc/Dec Time MV: Acc.Time/Decel.Time Ratio
MV an diam Mitral Valve Annulus Diameter, 2D cm
MV CO Cardiac Output by Mitral Flow l/min
MV Dec Slope Mitral Valve Flow Deceleration m/s2
MV Dec Time Mitral Valve Deceleration Time ms
MV E Velocity MV Velocity Peak E m/s
MV E/A Ratio Mitral Valve E-Peak to A-Peak Ratio
MV max PG Mitral Valve Peak Pressure Gradient mm Hg
MV mean PG Mitral Valve Mean Pressure Gradient mm Hg
MV PHT Mitral Valve Pressure Half Time ms
MV SI Stroke Volume Index by Mitral Flow ml/m2
MV SV Stroke Volume by Mitral Flow ml
MV Time to Peak Mitral Valve Time to Peak ms
MV Vmax Mitral Valve Peak Velocity m/s
MV Vmean MV Mean Velocity m/s
MV VTI Mitral Valve Velocity Time Integral cm
MVA Mitral Valve Area cm2
MVA By PHT Mitral Valve Area according to PHT cm2
MVA by plan Mitral Valve Area, 2D cm2
MVET Mitral Valve Ejection Time ms

9
P Vein A Pulmonary Vein Velocity Peak A (reverse) m/s
P Vein A Dur Pulmonary Vein A-Wave Duration ms
P Vein D Pulmonary Vein End-Diastolic Peak Velocity m/s
P Vein S Pulmonary Vein Systolic Peak Velocity m/s
PAEDP Pulmonary Artery Diastolic Pressure mm Hg
PE(d) Pericard Effusion, M-mode cm
PEs Pericard Effusion, 2D cm
PR max PG Pulmonic Insuf. Peak Pressure Gradient mm Hg
PR mean PG Pulmonic Insuf. Mean Pressure Gradient mm Hg
PR PHT Pulmonic Insuf. Pressure Half Time ms
PR Vmax Pulmonic Insuf. Peak Velocity m/s
PR VTI Pulmonic Insuf. Velocity Time Integral cm
PRend max PG Pulmonic Insuf. End-Diastole Pressure Gradient mm Hg
PRend Vmax Pulmonic Insuf. End-Diastolic Velocity m/s
Pulmonic Diam Pulmonary Artery Diameter, 2D cm
PV Acc Slope Pulmonic Valve Flow Acceleration m/s2
PV Acc Time Pulmonic Valve Acceleration Time ms
PV Acc Time/ET Ratio PV Acceleration to Ejection Time Ratio
PV an diam Pulmonic Valve Annulus Diameter, 2D cm
PV Ann Area Pulmonic Valve Area cm2
PV CO Cardiac Output by Pulmonic Flow l/min
PV CO Cardiac Output by Pulmonic Flow l/min
PV max PG Pulmonic Valve Peak Pressure Gradient mm Hg
PV mean PG Pulmonic Valve Mean Pressure Gradient mm Hg
PV SV Stroke Volume by Pulmonic Flow ml
PV Vmax Pulmonary Artery Peak Velocity m/s

10
PV Vmax Pulmonic Valve Peak Velocity m/s
PV Vmean PV Mean Velocity m/s
PV VTI Pulmonic Valve Velocity Time Integral cm
PVA (VTI) Pulmonary Artery Velocity Time Integral cm2
PVein S/D Ratio Pulmonary Vein SD Ratio
PVET Pulmonic Valve Ejection Time ms
PVPEP Pulmonic Valve Pre-Ejection Period ms
PVPEP/ET Ratio PV Pre-Ejection to Ejection Time Ratio
Qp/Qs Pulmonic-to-Systemic Flow Ratio
RA Major Right Atrium Major, 2D cm
RA Minor Right Atrium Minor, 2D cm
RAEDV A2C Right Atrium End Diastolic Volume, Apical 2 cm3

chamber
RAEDV A-L RA End Diastolic Volume (A-L) ml
RAEDV MOD RA Volume Diastolic, Single Plan, MOD ml
RAEDV MOD RA End Diastolic Volume (MOD) ml
RAESV A-L RA End Systole Volume (A-L) ml
RAESV MOD RA Volume, Systolic, Single Plane, MOD ml
RAESV MOD RA End Systole Volume (MOD) ml
RALd Right Atrium Length, Diastole cm
RALs RA Length, systole cm
RIMP Right Index of Myocardial Performance
RJA (A4C) Regurgitant jet area cm2
RJA/LAA Regurgitant jet area ratio RJA/LAA
RV Major Right Ventricle Major cm
RV Minor Right Ventricle Minor cm
RVAWd Right Ventricle Wall Thickness, Diastolic, 2D cm

11
RVAWs Right Ventricle Wall Thickness, Systolic, 2D cm
RVET Right Ventricle Ejection Time s
RVIDd Right Ventricle Diameter, Diastolic, 2D cm
RVIDd Right Ventricle Diameter, Diastolic, M-mode cm
RVIDs Right Ventricle Diameter, Systolic, 2D cm
RVIDs Right Ventricle Diameter, Systolic, M-mode cm
RVOT Area Right Ventricle Outflow Tract Area cm2
RVOT Diam RV Output Tract Diameter, 2D cm
RVOT Diam RV Output Tract Diameter, M-Mode cm
RVOT max PG RVOT Peak Pressure Gradient mm Hg
RVOT meanPG RVOT Mean Pressure Gradient mm Hg
RVOT SI LV Stroke Volume Index by Pulmonic Flow ml/m2
RVOT SV Stroke Volume by Pulmonic Flow ml
RVOT Vmax RVOT Peak Velocity m/s
RVOT Vmean RVOT Mean Velocity m/s
RVOT VTI RVOT Velocity Time Integral cm
RVSP Right Ventricle Systolic Pressure mm Hg
RVWd Right Ventricle Wall Thickness, Diastolic, M-mode cm
RVWs Right Ventricle Wall Thickness, Systolic, M-mode cm
RAA (d) Right Atrium Area, 2D, Diastole cm2
RAA (s) Right Atrium Area, 2D, Systole cm2
SI (A-L A2C) LV Stroke Index, Single Plane, 2CH, Area-Length ml/m2
SI (A-L A4C) LV Stroke Index, Single Plane, 4CH, Area-Length ml/m2
SI (Biplane) LV Stroke Index, Bi-Plane, MOD ml/m2
SI (bullet) LV Stroke Index, Bi-Plane, Bullet ml/m2
SI (MOD A2C LV Stroke Index, Single Plane, 2CH, MOD ml/m2

12
SI (MOD A4C LV Stroke Index, Single Plane, 4CH, MOD ml/m2
SI (Teich) LV Stroke Index, Teicholz, 2D ml/m2
SI (Teich) LV Stroke Index, Teicholz, M-mode ml/m2
SV (A-L A2C) LV Stroke Volume, Single Plane, 2CH, ml

Area-Length
SV (A-L A4C) LV Stroke Volume, Single Plane, 4CH, ml

Area-Length
SV (Biplane) LV Stroke Volume, Bi-Plane, MOD ml
SV (bullet) LV Stroke Volume, Bi-Plane, Bullet ml
SV (MOD A2C) LV Stroke Volume, Single Plane, 2CH, ml

MOD(Simpson)
SV (MOD A4C) LV Stroke Volume, Single Plane, 4CH, ml

MOD(Simpson)
SV(Cube) LV Stroke Volume, 2D, Cubic ml
SV(Cube) LV Stroke Volume, M-mode, Cubic ml
SV(Teich) LV Stroke Volume, 2D, Teicholtz ml
SV(Teich) LV Stroke Volume, M-mode, Teicholtz ml
Systemic Diam Systemic Vein Diameter, 2D cm
Systemic Vmax Systemic Vein Peak Velocity m/s
Systemic VTI Systemic Vein Velocity Time Integral cm
TCO Tricuspid Valve Closure to Opening ms
TR max PG Tricuspid Regurg. Peak Pressure Gradient mm Hg
TR mean PG Tricuspid Regurg. Mean Pressure Gradient mm Hg
TR Vmax Tricuspid Regurg. Peak Velocity m/s
TR Vmean Tricuspid Regurg. Mean Velocity m/s
TR VTI Tricuspid Regurgitation Velocity Time Integral cm
TV A dur Tricuspid Valve A-Wave Duration ms
TV A Velocity Tricuspid Valve A Velocity m/s

13
TV Acc Time Tricuspid Valve Time to Peak ms
TV Ann Area Tricuspid Valve Area cm2
TV ann diam Tricuspid Valve Annulus Diameter, 2D cm
TV Area Tricuspid Valve Area, 2D cm2
TV CO Cardiac Output by Tricuspid Flow l/min
TV Dec Slope Tricuspid Valve Flow Deceleration m/s2
TV E Velocity Tricuspid Valve E Velocity m/s
TV E/A Ratio Tricuspid Valve E-Peak to A-Peak Ratio
TV max PG Tricuspid Valve Peak Pressure Gradient mm Hg
TV mean PG Tricuspid Valve Mean Pressure Gradient mm Hg
TV mean PG Tricuspid Valve Mean Pressure Gradient mm Hg
TV PHT Tricuspid Valve Pressure Half Time ms
TV SV Stroke Volume by Tricuspid Flow ml
TV Vmean TV Mean Velocity m/s
TV VTI Tricuspid Valve Velocity Time Integral cm
VSD max PG VSD Peak Pressure Gradient mm Hg
VSD Vmax VSD Peak Velocity m/s
14
Measurement formulas
Formulas–Generic
Calc Input Measurements

Mnemonic Calc Name Formula
BSA Body Surface Area Patient weight (kg) and height (m)
BSA=0.007184 x Weight0.425 x Height0.725
BSA Body Surface Area Patient weight (kg)
BSA=0.1 x Weight0.667
MaxPG Maximum two Doppler blood flow peak velocities

PressureGradient
MaxPG[mmHg]=4x(v1^2-v2^2)
MeanPG Mean Pressure flow velocities from one time marker to

Gradient another time marker in a Doppler display
MeanPG[mmHg]=n4x (Vi^2)/n i=1
% Stenosis Stenosis Ratio two areas (by ellipse, trace, circle or distance)
% Stenosis= [1-(Aresidual/ Alumen)]x100
PI Pulsatility Index two Doppler blood flow peak velocities and

TAMAX
PI=(Vmax-Vdiastole)/TAMAXa
RI Resistivity Index two Doppler blood flow peak velocities
RI=(Vmax-Vdiastole)/Vmaxa
HR Heart Rate one 2 beat time interval

(beats/minute)
HR[BPM]=120[sec]/2beat time [sec]
A/B Ratio Velocities Ratio two Doppler blood flow peak velocities
A/B=V1/V2
a) Vdiastole = Vmin or Vend-diastole (depends on preset selection)
15
TAMAX Time Averaged two time marks in a Doppler display

Maximum Velocity
(Trace Method is Peak
or manual)
TAMAX=sum{Vt} from t1 to t2/(t2-t1) [cm/s or

m/s]
TAMIN Time Averaged two time marks in a Doppler display

Minimum Velocity
(Trace method is Floor)
TAMIN=sum{Vt} from t1 to t2/(t2-t1) [cm/s or

m/s]
TAMEAN Time Averaged Mean two time marks in a Doppler display

Velocity (Trace method
is Mean)
TAMEAN=sum{Vt} from t1 to t2/(t2-t1) [cm/s

or m/s]
Calc Name Input Measurements Formula
Volume (spherical) one distance Vol[ml]=(S/6)xd^3
Volume (prolate two distances, d1>d2 Vol[ml]= (S/6)xd1xd2^2

spheroidal)
Volume (prolate one ellipse, d1 major axis, Vol[ml]= (S/6)xd1xd2^2

spheroidal) d2 minor axis
Volume (spheroidal) three distances Vol[ml]= (S/6)xd1xd2xd3
Volume (spheroidal) one distance d1, one ellipse, Vol[ml]= (S/6)xd1xd2xd3

d2 ma jor axis, d3 minor axis
16
Formulas–Cardiac
The following table lists the cardiac calculations. The folders
where to find the calculations and related measurements are
indicated in brakets "[ ]".
%FS [Dimension, Cube/Teicholz]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: (({LVIDd}-{LVIDs})/{LVIDd})
Needs measurement: LVIDd [Dimension, Cube/Teicholz], LVIDs [Dimension,
Cube/Teicholz]
Measured by: LVs [2DLV], LVIDs [2DCALIPER], EF(Cube) [AUTOCALC]
%FS [Generic, Dimension]

Mode: MM:CM:AMM:CAMM:VRMM
Formula: (({LVIDd}-{LVIDs})/{LVIDd})
Needs measurement: LVIDd [Generic, Dimension], LVIDs [Generic, Dimension]
Measured by: LV Study [MMLV], LVIDs [MMDISCALIPER]
Belenkie, Israel, et al., “Assessment of Left Ventricular Dimensions and Function by
Echocardiography,” American Journal of Cardiology, June 1973, Vol. 31.
%IVS Thck [Dimension]

Formula: (({IVSs}-{IVSd})/{IVSd})
Needs measurement: IVSs [Dimension], IVSd [Dimension]
Measured by: LVs [2DLV], IVSs [2DCALIPER]
Roelandt, Joseph, Practical Echocardiology, Ultrasound in medicine Series, Vol. 1,
Denis White, ed., Research Studies Press, 1977, p. 130.Schiller, N. B., et al.,
“Recommendations for Quantification of the LV by Two-Dimensional Echocardiography,”
J Am Soc Echo, Sept-Oct 1989, Vol. 2, No. 5, p.364.
%IVS Thck [Dimension]

Formula: (({IVSs}-{IVSd})/{IVSd})
Needs measurement: IVSs [Dimension], IVSd [Dimension]
Measured by: IVSs [MMDISCALIPER]
17
%LVPW Thck [Dimension]
Formula: (({LVPWs}-{LVPWd})/{LVPWd})
Needs measurement: LVPWs [Dimension], LVPWd [Dimension]
Measured by: LVs [2DLV], LVPWs [2DCALIPER]
%LVPW Thck [Dimension]

Formula: (({LVPWs}-{LVPWd})/{LVPWd})
Needs measurement: LVPWs [Dimension], LVPWd [Dimension]
Measured by: LVPWs [MMDISCALIPER]
Belenkie, Israel, et al., “Assessment of Left Ventricular Dimensions and Function by
Echocardiography,” American Journal of Cardiology, June 1973, Vol. 31. Roelandt,
Joseph, Practical Echocardiology, Ultrasound in Medicine Series, Vol. 1, Denis White,
ed., Research Studies Press, 1977, p. 129.
Ao st junct/Ao [Dimension]
Formula: {Ao st junct}/{Ao Diam}
Needs measurement: Ao st junct [Dimension], Ao Diam [Dimension]
Measured by: Ao st junct [2DCALIPER]
Ao/LA [Generic, Dimension]

Formula: {Ao Diam}/{LA Diam}
Needs measurement: Ao Diam [Generic, Dimension], LA Diam [Generic, Dimension]
Measured by: LA/Ao [MMLAAO]
AP Area [Aortic]
Mode: CW:PW:VRCW:VRPW
Formula: {LVOT Diam}^2*0.785*({LVOT VTI}/{AP VTI})
Needs measurement: LVOT Diam [Aortic], LVOT VTI [Aortic], AP VTI [Aortic]
Measured by: AP Area [SDMANTRACE]
AR RF [PISA]
Mode:CF:CW:PW:VRCW:VRPW
Formula: {AR RV}/{AV SV}
Needs measurement: AV Diam [Dimension], AV Trace [Aortic], AR Flow [PISA], AR
Trace [PISA]
Measured by: AR RF [AUTOCALC]
18
AR ERO [PISA]
Mode: CF:CW:PW:VRCW:VRPW
Formula: {AR Flow}/{AR Vmax}
Needs measurement: AR Flow [PISA], AR Vmax [PISA]
Measured by: AR Trace [AUTOCALC]
AR RV [PISA]
Formula: {AR Flow}/{AR Vmax}*{AR VTI}
Needs measurement: AR Flow [PISA], AR Vmax [PISA], AR VTI [PISA]
Measured by: AR Trace [AUTOCALC]
AV Acc Time/ET Ratio [Aortic]

Formula: {AV AccT}/{AVET}
Needs measurement: AV AccT [Aortic], AVET [Aortic]
Measured by: AVET [SDTIMECALIPER]
AV Area [Dimension]
Formula: 3.14/4*{AV Diam}^2
Needs measurement: AV Diam [Dimension]
Measured by: AV Diam [2DCALIPER]
AV CI [Aortic]
Formula: (({AV Diam}^2*0.785*{AV VTI})*{HR}/60)/{BSA}
Needs measurement: AV Diam [Aortic], AV VTI [Aortic], HR [Aortic]
Measured by: AV Trace [SDMANTRACE]
AV CO [Aortic]
Formula: ({AV Diam}^2*0.785*{AV VTI})*{HR}/60
Needs measurement: AV Diam [Aortic], AV VTI [Aortic], HR [Aortic]
AV SI [Aortic]
Formula: ({AV Diam}^2*0.785*{AV VTI})/{BSA}
Needs measurement: AV Diam [Aortic], AV VTI [Aortic]
Measured by: AV Trace [SDMANTRACE] 19
AV SV [Aortic]
Formula: {AV Diam}^2*0.785*{AV VTI}
Needs measurement: AV Diam [Aortic], AV VTI [Aortic]
AVA (VTI) [Aortic]

Mode: 2D:CW:PW:VRCW:VRPW
Formula: 3.14/4*{LVOT Diam}^2*{LVOT VTI}/{AV VTI}
Needs measurement: LVOT Diam [Aortic], LVOT VTI [Aortic], AV VTI [Aortic]
Measured by: AV Trace [AUTOCALC]
AVA Vmax [Aortic]

Formula: 3.14/4*{LVOT Diam}^2*abs({LVOT Vmax}/{AV Vmax})
Needs measurement: LVOT Diam [Aortic], LVOT Vmax [Aortic], AV Vmax [Aortic]
Measured by: AV Vmax [AUTOCALC]
AVA Vmax [Aortic]

AVA Vmax, Pt [Aortic]

Measured by: AV Vmax [AUTOCALC]
AVA Vmax, Pt [Aortic]

20
CI A-L A2C [Single Plane A2C, AutoBiplane]
Mode: 2D:CF:TT:SI:SRI:VR2D:Trace
Formula: (({LVEDV A-L A2C}-{LVESV A-L A2C})*{HR}/60)/{BSA}
Needs measurement: LVEDV A-L A2C [Single Plane A2C, AutoBiplane], LVESV A-L
A2C [Single Plane A2C, AutoBiplane], HR [Single Plane A2C, AutoBiplane]
Measured by: R-R [2DCALIPER], A2C [2DAUTOVOLUME]
CI A-L A2C [Single Plane A2C]

Formula: (({LVEDV A-L A2C}-{LVESV A-L A2C})*{HR}/60/Auto)/{BSA}
Needs measurement: LVEDV A-L A2C [Single Plane A2C], LVESV A-L A2C [Single
Plane A2C], HR [Single Plane A2C]
Measured by: LVESV A2C [2DVOLUMETRACE]
CI A-L A4C [Single Plane A4C, AutoBiplane]

CI A-L A4C [Single Plane A4C]

CI A-L LAX [Single Plane LAX, AutoBiplane]

Formula: (({LVEDV A-L LAX}-{LVESV A-L LAX})*{HR}/60)/{BSA}
Needs measurement: LVEDV A-L LAX [Single Plane LAX, AutoBiplane], LVESV A-L
LAX [Single Plane LAX, AutoBiplane], HR [Single Plane LAX, AutoBiplane]
Measured by: R-R [2DCALIPER], AutoVolume [2DAUTOVOLUME]
CI Biplane [Biplane]
Formula: d = biplane({LVLd A4C},{LVDisks},{LVLd A2C},{LVDisks})
Needs measurement: LVLd A4C [Biplane], LVLd A2C [Biplane], LVLs A4C [Biplane],
LVLs A2C [Biplane], HR [Biplane]
Measured by: R-R [2DCALIPER]
21
CI bp el [Biplane Ellipse]
Formula: ((d-s)*{ECG/HeartRate}/60)/{BSA} where:
s = (8/(3*3.14159))*{LVAs(A4C)}*{LVAs(sax MV)}/{2D/LVIDs}
d = (8/(3*3.14159))*{LVAd A4C}*{LVAd (sax MV)}/{LVIDd}
Needs measurement: LVAd A4C [Biplane Ellipse], LVAd (sax MV) [Biplane Ellipse],
LVIDd [Biplane Ellipse], LVAs A4C [Biplane Ellipse], LVAs sax MV [Biplane Ellipse],
LVIDs [Biplane Ellipse], HR [Biplane Ellipse]
CI bullet [Bullet]
s =5/6*{LVAs(sax)}*{LVLs(apical)}
d = 5/6*{LVAd sax)}*{LVLd apical}
Needs measurement: LVAd sax) [Bullet], LVLd apical [Bullet], LVAs sax) [Bullet], LVLs
apical [Bullet], HR [Bullet]
CI MOD A2C [Single Plane A2C, AutoBiplane]

Formula: (({LVEDV MOD A2C}-{LVESV MOD A2C})*{HR}/60)/{BSA}
Needs measurement: LVEDV MOD A2C [Single Plane A2C, AutoBiplane], LVESV MOD
CI MOD A2C [Single Plane A2C]

Needs measurement: LVEDV MOD A2C [Single Plane A2C], LVESV MOD A2C [Single
CI MOD A4C [Single Plane A4C, AutoBiplane]

22
CI MOD A4C [Single Plane A4C]
CI MOD LAX [Single Plane LAX, AutoBiplane]

Formula: (({LVEDV MOD LAX}-{LVESV MOD LAX})*{HR}/60)/{BSA}
Needs measurement: LVEDV MOD LAX [Single Plane LAX, AutoBiplane], LVESV MOD
CI mod sim [Modified Simpson]

s = ({LVLs(apical)}/9)*((4*{LVAs(sax MV)})+(2*{LVAs(sax PM)})+
sqrt({LVAs(sax MV)}*{LVAs(sax PM)}))
d = ({LVLd apical}/9)*((4*{LVAd (sax MV)})+(2*{LVAd sax PM})+
sqrt({LVAd (sax MV)}*{LVAd sax PM}))
Needs measurement: LVLd apical [Modified Simpson], LVAd (sax MV) [Modified
Simpson], LVAd sax PM [Modified Simpson], LVLs apical [Modified Simpson], LVAs sax
MV [Modified Simpson], LVAs sax PM [Modified Simpson], HR [Modified Simpson]
CI(Cube) [Dimension, Cube/Teicholz]

s = {2D/LVIDs}^3 d = {LVIDd}^3
Cube/Teicholz], HR [Dimension, Cube/Teicholz]
CI(Cube) [Generic, Dimension]

Formula: ((dv-sv)*{MM/HeartRate}/60)/{BSA} where:
sv = {MM/LVIDs}^3 dv = {LVIDd}^3
Needs measurement: LVIDd [Generic, Dimension], LVIDs [Generic, Dimension], HR
[Generic, Dimension]
Measured by: Heartrate [MMTIMECALIPER]
23
CI(Teich) [Dimension, Cube/Teicholz]
s = 7/(2.4+{2D/LVIDs})*{2D/LVIDs}^3 d = 7/(2.4+{LVIDd})*{LVIDd}^3
CI(Teich) [Generic, Dimension]

Formula: ((dv-sv)*{MM/HeartRate}/60)/{BSA} where:
sv = 7/(2.4+{MM/LVIDs})*{MM/LVIDs}^3 dv = 7/(2.4+{LVIDd})*{LVIDd}^3
CO A-L A2C [Single Plane A2C, AutoBiplane]

Formula: ({LVEDV A-L A2C}-{LVESV A-L A2C})*{HR}/60
CO A-L A2C [Single Plane A2C]

CO A-L A4C [Single Plane A4C, AutoBiplane]

24
CO A-L A4C [Single Plane A4C]
CO A-L LAX [Single Plane LAX, AutoBiplane]

Formula: ({LVEDV A-L LAX}-{LVESV A-L LAX})*{HR}/60
CO A-L LAX [Single Plane LAX]

Formula: ({LVEDV A-L LAX}-{LVESV A-L LAX})*{HR}/60
Needs measurement: LVEDV A-L LAX [Single Plane LAX], LVESV A-L LAX [Single
Plane LAX], HR [Single Plane LAX]
Measured by: LVESV LAX [2DVOLUMETRACE]
CO Biplane [Biplane]
Needs measurement: LVLd A4C [Biplane], LVLd A2C [Biplane], LVLs A4C [Biplane],
LVLs A2C [Biplane], HR [Biplane]
CO bp el [Biplane Ellipse]
Formula: (d-s)*{ECG/HeartRate}/60 where:
LVIDs [Biplane Ellipse], HR [Biplane Ellipse]
25
CO bullet [Bullet]
Needs measurement: LVAd sax) [Bullet], LVLd apical [Bullet], LVLs apical [Bullet], HR
[Bullet]
CO MOD A2C [Single Plane A2C, AutoBiplane]

Formula: ({LVEDV MOD A2C}-{LVESV MOD A2C})*{HR}/60
CO MOD A2C [Single Plane A2C]

CO MOD A4C [Single Plane A4C, AutoBiplane]

CO MOD A4C [Single Plane A4C]

26
CO MOD LAX [Single Plane LAX, AutoBiplane]
Formula: ({LVEDV MOD LAX}-{LVESV MOD LAX})*{HR}/60
CO MOD LAX [Single Plane LAX]

Formula: ({LVEDV MOD LAX}-{LVESV MOD LAX})*{HR}/60
Needs measurement: LVEDV MOD LAX [Single Plane LAX], LVESV MOD LAX [Single
Plane LAX], HR [Single Plane LAX]
Measured by: LVESV LAX [2DVOLUMETRACE]
CO mod sim [Modified Simpson]

s = ({LVLs(apical)}/9)*((4*{LVAs(sax MV)})+(2*{LVAs(sax
d = ({LVLd apical}/9)*((4*{LVAd (sax MV)})+(2*{LVAd sax PM}) +
MV [Modified Simpson], LVAs sax PM [Modified Simpson], HR [Modified Simpson]
CO(A-L) [Generic]
Mode: 2D:CF:TT:SI:SRI:Trace
Formula: ({EDV(A-L)}-{ESV(A-L)})*{HR}/60
Needs measurement: ESV(A-L) [Generic], HR [Generic]
CO(Cube) [Dimension, Cube/Teicholz]

s = {2D/LVIDs}^3
d = {LVIDd}^3
27
CO(Cube) [Generic, Dimension]
Formula: (dv-sv)*{MM/HeartRate}/60 where:
sv = {MM/LVIDs}^3
dv = {LVIDd}^3
CO(Teich) [Dimension, Cube/Teicholz]

s = 7/(2.4+{2D/LVIDs})*{2D/LVIDs}^3
d = 7/(2.4+{LVIDd})*{LVIDd}^3
CO(Teich) [Generic, Dimension]

Formula: (dv-sv)*{MM/HeartRate}/60 where:
sv = 7/(2.4+{MM/LVIDs})*{MM/LVIDs}^3
dv = 7/(2.4+{LVIDd})*{LVIDd}^3
EDV bp el [Biplane Ellipse]

Formula: (8/(3*3.14159))*{LVAd A4C}*{LVAd (sax MV)}/{LVIDd}
LVIDd [Biplane Ellipse]
Measured by: LVEF BP-EL [AUTOCALC]
EDV bullet [Bullet]

Formula: 5/6*{LVAd sax)}*{LVLd apical}
Needs measurement: LVAd sax) [Bullet], LVLd apical [Bullet]
Measured by: LVEF Bullet [AUTOCALC]
28
EDV mod sim [Modified Simpson]
Formula: ({LVLd apical}/9)*((4*{LVAd (sax MV)})+(2*{LVAd sax PM})+
Simpson], LVAd sax PM [Modified Simpson]
Measured by: EF mod sim [AUTOCALC]
EDV(Cube) [Dimension, Cube/Teicholz]

Formula: {LVIDd}^3
Needs measurement: LVIDd [Dimension, Cube/Teicholz]
Measured by: LVd [2DLV], LVIDd [2DCALIPER], EF(Cube) [AUTOCALC]
EDV(Cube) [Generic, Dimension]

Formula: {LVIDd}^3
Needs measurement: LVIDd [Generic, Dimension]
Measured by: LV Study [MMLV], LVIDd [MMDISCALIPER]
EDV(Teich) [Dimension, Cube/Teicholz]

Formula: 7/(2.4+{LVIDd})*{LVIDd}^3
Needs measurement: LVIDd [Dimension, Cube/Teicholz]
Measured by: LVd [2DLV], LVIDd [2DCALIPER], EF(Cube) [AUTOCALC]
EDV(Teich) [Generic, Dimension]

Formula: 7/(2.4+{LVIDd})*{LVIDd}^3
Needs measurement: LVIDd [Generic, Dimension]
Measured by: LV Study [MMLV], LVIDd [MMDISCALIPER]
EF A-L A2C [Biplane, Single Plane A2C, AutoBiplane]

Formula: ({LVEDV A-L A2C}-{LVESV A-L A2C})/{LVEDV A-L A2C}
Needs measurement: LVEDV A-L A2C [Biplane, Single Plane A2C, AutoBiplane],
LVESV A-L A2C [Biplane, Single Plane A2C, AutoBiplane]
Measured by: EF SP A2C [AUTOCALC], LVESV A2C [2DVOLUMETRACE], A2C
[2DAUTOVOLUME]
29
EF A-L A4C [Biplane, Single Plane A4C, AutoBiplane]
Formula: ({LVEDV A-L A4C}-{LVESV A-L A4C})/{LVEDV A-L A4C}
[2DAUTOVOLUME]
EF A-L LAX [Single Plane LAX, AutoBiplane]

Formula: ({LVEDV A-L LAX}-{LVESV A-L LAX})/{LVEDV A-L LAX}
LAX [Single Plane LAX, AutoBiplane]
Measured by: LVESV LAX [2DVOLUMETRACE], EF SP LAX [AUTOCALC],
AutoVolume [2DAUTOVOLUME]
EF Biplane [Biplane, AutoBiplane]

Needs measurement: LVLd A4C [Biplane, AutoBiplane], LVLd A2C [Biplane,
AutoBiplane], LVLs A4C [Biplane, AutoBiplane], LVLs A2C [Biplane, AutoBiplane]
Measured by: EF Biplane [AUTOCALC]
EF mod sim [Modified Simpson]

Formula: ({LVLd apical}/9)*((4*{LVAd (sax MV)})+(2*{LVAd sax PM})+
MV [Modified Simpson], LVAs sax PM [Modified Simpson]
EF(A-L) [Generic]
Formula: ({EDV(A-L)}-{ESV(A-L)})/{EDV(A-L)}
Needs measurement: ESV(A-L) [Generic], EDV(A-L) [Generic]
Measured by: EF Volume [AUTOCALC]
30
EF(Cube) [Dimension, Cube/Teicholz]
Formula: (d-s)/d where: s = {2D/LVIDs}^3 d = {LVIDd}^3
Cube/Teicholz]
EF(Cube) [Generic, Dimension]

Formula: (dv-sv)/dv where:
sv = {MM/LVIDs}^3
dv = {LVIDd}^3
EF(MOD) [Generic]
Formula: ({EDV(MOD)}-{ESV(MOD)})/{EDV(MOD)}
Needs measurement: EDV(MOD) [Generic], ESV(MOD) [Generic]
EF(Teich) [Dimension, Cube/Teicholz]

Formula: (d-s)/d where:
s = 7/(2.4+{2D/LVIDs})*{2D/LVIDs}^3
d = 7/(2.4+{LVIDd})*{LVIDd}^3
Cube/Teicholz]
EF(Teich) [Generic, Dimension]

Formula: (dv-sv)/dv where:
31
ESV bp el [Biplane Ellipse]
Formula: (8/(3*3.14159))*{LVAs A4C}*{LVAs sax MV}/{LVIDs}
Needs measurement: LVAs A4C [Biplane Ellipse], LVAs sax MV [Biplane Ellipse], LVIDs
[Biplane Ellipse]
ESV bullet [Bullet]

Formula: 5/6*{LVAs sax)}*{LVLs apical}
Needs measurement: LVAs sax) [Bullet], LVLs apical [Bullet]
ESV mod sim [Modified Simpson]

Formula: ({LVLs apical}/9)*((4*{LVAs sax MV})+(2*{LVAs sax
PM})+ sqrt({LVAs sax MV}*{LVAs sax PM}))
Needs measurement: LVLs apical [Modified Simpson], LVAs sax MV [Modified
Simpson], LVAs sax PM [Modified Simpson]
ESV(Cube) [Dimension, Cube/Teicholz]

Formula: {LVIDs}^3
Needs measurement: LVIDs [Dimension, Cube/Teicholz]
ESV(Cube) [Generic, Dimension]

Formula: {LVIDs}^3
Needs measurement: LVIDs [Generic, Dimension]
ESV(Teich) [Dimension, Cube/Teicholz]

Formula: 7/(2.4+{LVIDs})*{LVIDs}^3
Needs measurement: LVIDs [Dimension, Cube/Teicholz]
32
ESV(Teich) [Generic, Dimension]
Formula: 7/(2.4+{LVIDs})*{LVIDs}^3
Needs measurement: LVIDs [Generic, Dimension]
HR (Generic, Dimension, Biplane, Modified Simpson, Cube/Teicholz, Single Plane A4C,

Single Plane A2C, Single Plane LAX, Bullet, Biplane Ellipse)
Mode: 2D:CF:TT:SI:SRI:Trace:VR2D
Formula: 60/{R-R}
Needs measurement: R-R [Generic, Dimension, Biplane, Modified Simpson,
Cube/Teicholz, Single Plane A4C, Single Plane A2C, Single Plane LAX, Bullet, Biplane
Ellipse]
Measured by: R-R [2DCALIPER] Used to calculate:
CO(A-L),CO(Teich),CI(Teich),CO(Cube),CI(Cube),CO Biplane,CI Biplane,CO mod
sim,CI mod sim,CI A-L A4C,CO MOD A4C,CI MOD A4C,CI A-L A2C,CO A-L A2C,CI A-L
A2C,CO MOD A2C,CI MOD A2C,CO A-L LAX,CI A-L LAX,CO MOD LAX,CI MOD
LAX,CO bullet,CI bullet,CO bp el,CI bp el
HR [Generic, Dimension]
Formula: 60/{Time}
Needs measurement: Time [Generic, Dimension]
Measured by: Heartrate [MMTIMECALIPER]Used to calculate:
CO(Cube),CO(Teich),CI(Teich),CI(Cube)
Dorland’s Illustrated Medical Dictionary, ed. 27, W. B. Sanders Co., Philadelphia, 1988,
p. 1425.
HR [Generic]
Formula: 60/{Time}
Needs measurement: Time [Generic]
Measured by: Heartrate [SDTIMECALIPER]
IVSd/LVPWd [Dimension]
Formula: {IVSd}/{LVPWd}
Needs measurement: IVSd [Dimension], LVPWd [Dimension]
Measured by: LVPWd [MMDISCALIPER]
Roelandt, Joseph, Practical Echocardiology, Ultrasound in Medicine Series, Vol. 1,
Denis White, ed., Research Studies Press, 1977, p. 270.
33
LA/Ao [Generic, Dimension]
Formula: {LA Diam}/{Ao Diam}
Needs measurement: LA Diam [Generic, Dimension], Ao Diam [Generic, Dimension]
Measured by: LA/Ao [MMLAAO]
Roelandt, Joseph, Practical Echocardiology, Ultrasound in Medicine Series, Vol. 1,
Denis White, ed., Research Studies Press,
1977, p. 270.
Schiller, N.B., et al., “Recommendations for Quantification of the LV by Two-Dimensional
Echocardiography,” J Am Soc Echo, Sept-Oct 1989, Vol. 2, No. 5, p. 364.
LIMP [Mitral Valve, Aortic]

Formula: ({MCO}-{AVET})/{AVET}
Needs measurement: MCO [Mitral Valve, Aortic], AVET [Mitral Valve, Aortic]
Measured by: LIMP [AUTOCALC]
Nishimura RA et.al. Doppler Echocardiography: theory, instrumentation, technique and
application. Mayo Clinic Proc 1985; 60:321-343
Yoganathan AP, et al. Review of hydrodynamic principles for the cardiologist:
Application to the study of blood flow and jets by imaging techniques. J Am Coll Cardio
1988; 12:1344-1353
LVCI Dopp [Aortic]

Mode: PW:VRPW
Formula: ({LVOT Diam}^2*0.785*{LVOT VTI}*{HR}/60)/{BSA}
Needs measurement: LVOT Diam [Aortic], LVOT VTI [Aortic], HR [Aortic],
Measured by: LVOT Trace [SDMANTRACE]
LVCO Dopp [Aortic]

Mode: PW:VRPW
Formula: {LVOT Diam}^2*0.785*{LVOT VTI}*{HR}/60
Needs measurement: LVOT Diam [Aortic], LVOT VTI [Aortic], HR [Aortic]
LVd Mass (ASE) [Generic]

Formula: ((1.04*(({IVSd}+{LVIDd}+{LVPWd})^3-({LVIDd})^3))*0.8+0.6)/1000
Needs measurement: IVSd [Generic], LVIDd [Generic], LVPWd [Generic]
Measured by: LV Study [MMLV]
34
LVd Mass [Dimension]
Formula: ((1.04*(({IVSd}+{LVIDd}+{LVPWd})^3-({LVIDd})^3))-13.6)/1000
Needs measurement: IVSd [Dimension], LVIDd [Dimension], LVPWd [Dimension],
LVIDd [Dimension]
Measured by: LVPWd [2DCALIPER]
LVd Mass [Generic, Dimension]

Formula: ((1.04*(({IVSd}+{LVIDd}+{LVPWd})^3-({LVIDd})^3))-13.6)/1000
Needs measurement: IVSd [Generic, Dimension], LVPWd [Generic, Dimension], LVIDd
Measured by: LV Study [MMLV], LVPWs [MMDISCALIPER]
LVd Mass A-L [Mass]

Formula: 1.05*5/6*({LVAd(sax epi)}*({LVLd(apical)}+t)-{LVAd(sax
PM)}*{LVLd(apical)})/1000 where:
t = sqrt({LVAd sax EPI}/3.14159)-sqrt({LVAd sax PM}/3.14159)
Needs measurement: LVAd sax EPI [Mass], LVAd sax PM [Mass], LVLd apical [Mass]
Measured by: LVMass(d) [AUTOCALC]
LVd Mass I A-L [Mass]

Formula: m/{BSA} where:
m = 1.05*5/6*({LVAd(sax epi)}*({LVLd(apical)}+t)-{LVAd(sax PM)}*{LVLd(apical)})/1000
t = sqrt({LVAd sax EPI}/3.14159)-sqrt({LVAd sax PM}/3.14159)
Needs measurement: LVAd sax EPI [Mass], LVAd sax PM [Mass], LVLd apical [Mass]
Measured by: LVMass(d) [AUTOCALC]
LVd Mass Ind (ASE) [Generic]

Formula: (((1.04*(({IVSd}+{LVIDd}+{LVPWd})^3-({LVIDd})^3))*0.8+0.6)/1000)/{BSA}
Needs measurement: IVSd [Generic], LVIDd [Generic], LVPWd [Generic]
35
LVd Mass Index [Dimension]
Formula: m/{BSA} where m =
((1.04*(({IVSd}+{LVIDd}+{LVPWd})^3-({LVIDd})^3))-13.6)/1000
Needs measurement: IVSd [Dimension], LVIDd [Dimension], LVPWd [Dimension],
LVIDd [Dimension]
Measured by: LVPWd [2DCALIPER]
LVd Mass Index [Generic, Dimension]

Formula: (((1.04*(({IVSd}+{LVIDd}+{LVPWd})^3-({LVIDd})^3))-13.6)/1000)/{BSA}
Needs measurement: IVSd [Generic, Dimension], LVIDd [Generic, Dimension], LVPWd
LVEDV MOD BP [Biplane, AutoBiplane]

Formula: biplane({LVLd A4C},{LVDisks},{LVLd A2C},{LVDisks})
AutoBiplane]
Echocardiography, “J Am Soc Echo, Sept-Oct 1989, Vol. 2, No. 5. p. 364.
LVEF BP-EL [Biplane Ellipse]

LVIDs [Biplane Ellipse]
LVEF Bullet [Bullet]

Needs measurement: LVAd sax) [Bullet], LVLd apical [Bullet], LVLs apical [Bullet]
Measured by: LVEF Bullet [AUTOCALC] 36
LVEF MOD A2C [Biplane, Single Plane A2C, AutoBiplane]
Formula: ({LVEDV MOD A2C}-{LVESV MOD A2C})/{LVEDV MOD A2C}
Needs measurement: LVEDV MOD A2C [Biplane, Single Plane A2C, AutoBiplane],
LVESV MOD A2C [Biplane, Single Plane A2C, AutoBiplane]
[2DAUTOVOLUME]
LVEF MOD A4C [Biplane, Single Plane A4C, AutoBiplane]

Formula: ({LVEDV MOD A4C}-{LVESV MOD A4C})/{LVEDV MOD A4C}
[2DAUTOVOLUME]
LVEF MOD LAX [Single Plane LAX, AutoBiplane]

Formula: ({LVEDV MOD LAX}-{LVESV MOD LAX})/{LVEDV MOD LAX}
LVESV MOD BP [Biplane, AutoBiplane]

Formula: biplane({LVLs A4C},{LVDisks},{LVLs A2C},{LVDisks})
Needs measurement: LVLs A4C [Biplane, AutoBiplane], LVLs A2C [Biplane,
AutoBiplane]
LVIDd Index [Dimension]

Formula: {LVIDd}/{BSA}
Needs measurement: LVIDd [Dimension],
Measured by: LVIDd [2DCALIPER]
37
LVIDd Index [Dimension]
Formula: {LVIDd}/{BSA}
Needs measurement: LVIDd [Dimension]
Measured by: LVIDd [MMDISCALIPER]
LVIDs Index [Dimension]

Formula: {LVIDs}/{BSA}
Needs measurement: LVIDs [Dimension]
Measured by: LVIDs [2DCALIPER]
LVIDs Index [Dimension]

Formula: {LVIDs}/{BSA}
Needs measurement: LVIDs [Dimension]
Measured by: LVIDs [MMDISCALIPER]
LVOT Area [Dimension]

Formula: 3.14/4*{LVOT Diam}^2
Needs measurement: LVOT Diam [Dimension]
Measured by: LVOT Diam [2DCALIPER]
LVOT Diam [Aortic]

Formula: {LVOT Diam}
Needs measurement: LVOT Diam [Aortic]
Measured by: AP Area [SDMANTRACE] Used to calculate: AP Area
LVOT Diam [Mitral Valve]

Formula: {LVOT Diam}
Needs measurement: LVOT Diam [Mitral Valve]
Measured by: MP Area [SDMANTRACE] Used to calculate: MP Area
LVOT VTI [Aortic]

Formula: {LVOT VTI}
Needs measurement: LVOT VTI [Aortic]
Measured by: AP Area [SDMANTRACE] Used to calculate: AP Area 38
LVOT VTI [Mitral Valve]
Formula: {LVOT VTI}
Needs measurement: LVOT VTI [Mitral Valve]
Measured by: MP Area [SDMANTRACE] Used to calculate: MP Area
LVPEP/ET [Aortic]
Formula: {LVPEP}/{LVET}
Needs measurement: LVPEP [Aortic], LVET [Aortic]
Measured by: LVET [SDTIMECALIPER]
LVPEP/ET [Time]
Formula: {LVPEP}/{LVET}
Needs measurement: LVPEP [Time], LVET [Time]
Measured by: LVET [MMTIMECALIPER]
LVs Mass (ASE) [Generic]

Formula: ((1.04*(({IVSs}+{LVIDs}+{LVPWs})^3-({LVIDs})^3))*0.8+0.6)/1000
Needs measurement: IVSs [Generic], LVIDs [Generic], LVPWs [Generic]
LVs Mass [Dimension]

Formula: ((1.04*(({IVSs}+{LVIDs}+{LVPWs})^3-({LVIDs})^3))-13.6)/1000
Needs measurement: IVSs [Dimension], LVIDs [Dimension], LVPWs [Dimension]
Measured by: LVPWs [2DCALIPER]
LVs Mass [Generic, Dimension]

Formula: ((1.04*(({IVSs}+{LVIDs}+{LVPWs})^3-({LVIDs})^3))-13.6)/1000
Needs measurement: IVSs [Generic, Dimension], LVIDs [Generic, Dimension], LVPWs
39
LVs Mass A-L [Mass]
Formula: 1.05*5/6*({LVAs(sax epi)}*({LVLs(apical)}+t)-{LVAs(sax
PM)}*{LVLs(apical)})/1000 where:
t = sqrt({LVAs sax EPI}/3.14159)-sqrt({LVAs sax PM}/3.14159)
Needs measurement: LVAs sax EPI [Mass], LVAs sax PM [Mass], LVLs apical [Mass]
Measured by: LVMass(s) [AUTOCALC]
LVs Mass Ind (ASE) [Generic]

Formula: (((1.04*(({IVSs}+{LVIDs}+{LVPWs})^3-({LVIDs})^3))*0.8+0.6)/1000)/{BSA}
Needs measurement: IVSs [Generic], LVIDs [Generic], LVPWs [Generic]
LVs Mass Ind A-L [Mass]

m = 1.05*5/6*({LVAs(sax epi)}*({LVLs(apical)}+t)-{LVAs(sax PM)}*{LVLs(apical)})/1000
t = sqrt({LVAs sax EPI}/3.14159)-sqrt({LVAs sax PM}/3.14159)
Needs measurement: LVAs sax EPI [Mass], LVAs sax PM [Mass], LVLs apical [Mass]
Measured by: LVMass(s) [AUTOCALC]
LVs Mass Index [Dimension]

m = ((1.04*(({IVSs}+{LVIDs}+{LVPWs})^3-({LVIDs})^3))-13.6)/1000
Needs measurement: IVSs [Dimension], LVIDs [Dimension], LVPWs [Dimension]
Measured by: LVPWs [2DCALIPER]
LVs Mass Index [Generic, Dimension]

Formula: (((1.04*(({IVSs}+{LVIDs}+{LVPWs})^3-({LVIDs})^3))-13.6)/1000)/{BSA}
Needs measurement: IVSs [Generic, Dimension], LVIDs [Generic, Dimension], LVPWs
40
LVSI Dopp [Aortic]
Mode: PW:VRPW
Formula: {LVOT Diam}^2*0.785*{LVOT VTI}/{BSA}
Needs measurement: LVOT Diam [Aortic], LVOT VTI [Aortic],
LVSV Dopp [Aortic]

Mode: PW:VRPW
Formula: {LVOT Diam}^2*0.785*{LVOT VTI}
Needs measurement: LVOT Diam [Aortic], LVOT VTI [Aortic]
MP Area [Mitral Valve]

Formula: {LVOT Diam}^2*0.785*({LVOT VTI}/{MP VTI})
Needs measurement: LVOT Diam [Mitral Valve], LVOT VTI [Mitral Valve], MP VTI [Mitral
Valve]
Measured by: MP Area [SDMANTRACE]
MR ERO [PISA]
Formula: {MR Flow}/{MR Vmax}
Needs measurement: MR Flow [PISA], MR Vmax [PISA]
Measured by: MR Trace [AUTOCALC]
MR RF [PISA]
Mode:CF:CW:PW:VRCW:VRPW
Formula: {MR RV}/{MV SV}
Needs measurement: MV Ann Diam [Dimension], MV Trace [Mitral Valve], MR Flow
[PISA], MR Trace [PISA]
Measured by: MR RF [AUTOCALC]
MR RV [PISA]
Formula: {MR Flow}/{MR Vmax}*{MR VTI}
Needs measurement: MR Flow [PISA], MR Vmax [PISA], MR VTI [PISA]
Measured by: MR Trace [AUTOCALC]
41
MV AccT/DecT [Mitral Valve]
Formula: {MV AccT}/{MV DecT}
Needs measurement: MV AccT [Mitral Valve], MV DecT [Mitral Valve]
Measured by: MV AccT [SDCALIPER]
MV Area [Dimension]
Formula: 3.14/4*{MV Ann Diam}^2
Needs measurement: MV Ann Diam [Dimension]
Measured by: MV Ann Diam [2DCALIPER]
MV CI [Mitral Valve]
Formula: {MV Ann Diam}^2*0.785*{MV VTI}*{HR}/60/{BSA}
Needs measurement: MV Ann Diam [Mitral Valve], MV VTI [Mitral Valve], HR [Mitral
Valve]
Measured by: MV Trace [SDMANTRACE]
MV CO [Mitral Valve]
Formula: {MV Ann Diam}^2*0.785*{MV VTI}*{HR}/60
Needs measurement: MV Ann Diam [Mitral Valve], MV VTI [Mitral Valve], HR [Mitral
Valve]
MV E/A Ratio [Mitral Valve]

Formula: {MV E Vel}/{MV A Vel}
Needs measurement: MV E Vel [Mitral Valve], MV A Vel [Mitral Valve]
Measured by: MV A Vel [SDPTCALIPER], MV A Vel [AUTOCALC]
MV SI [Mitral Valve]
Formula: {MV Ann Diam}^2*0.785*{MV VTI}/{BSA}
Needs measurement: MV Ann Diam [Mitral Valve], MV VTI [Mitral Valve],
42
MV SV [Mitral Valve]
Formula: {MV Ann Diam}^2*0.785*{MV VTI}
Needs measurement: MV Ann Diam [Mitral Valve], MV VTI [Mitral Valve]
MVA (VTI) [Mitral Valve]

Formula: 3.14/4*{LVOT Diam}^2*{LVOT VTI}/{MV VTI}
Needs measurement: LVOT Diam [Mitral Valve], LVOT VTI [Mitral Valve], MV VTI [Mitral
Valve]
Measured by: MV Trace [AUTOCALC]
MVA By PHT [Mitral Valve]

Formula: 22/({MV PHT})
Needs measurement: MV PHT [Mitral Valve]
Measured by: MV E/A Velocity [SDEA3], MV PHT [SDCALIPER]
Hatle, L. et al, “Non-invasive Assessment of Atrioventricular Pressure Halftime by
Doppler Ultrasound,” Circulation, Vol. 60, 1979, pp 1096-1104.
P Vein S/D Ratio [Pulmonary Vein]

Mode: PW:VRPW
Formula: {P Vein S}/{P Vein D}
Needs measurement: P Vein S [Pulmonary Vein], P Vein D [Pulmonary Vein]
Measured by: P Vein D [SDPTCALIPER]
PAEDP [Pulmonic]
Formula: {PRend PG}+{RAP}
Needs measurement: PRend PG [Pulmonic], RAP [Pulmonic]
Measured by: PRend Vmax [AUTOCALC]
PR ERO [PISA]
Formula: {PR Flow}/{PR Vmax}
Needs measurement: PR Flow [PISA], PR Vmax [PISA]
Measured by: PR Trace [AUTOCALC]
43
PR RV [PISA]
Formula: {PR Flow}/{PR Vmax}*{PR VTI}
Needs measurement: PR Flow [PISA], PR Vmax [PISA], PR VTI [PISA]
Measured by: PR Trace [AUTOCALC]
Pulmonic CO [Shunts, Congenital Heart]

Formula: {Pulmonic SV}*{Pulmonic HR}/60
Needs measurement: Pulmonic SV [Shunts, Congenital Heart], Pulmonic HR [Shunts,
Congenital Heart]
Measured by: Pulmonic VTI [SDMANTRACE]
Pulmonic SV [Shunts, Congenital Heart]

Formula: 3.14159/4*{Pulmonic Diam}^2*{Pulmonic VTI}
Needs measurement: Pulmonic Diam [Shunts, Congenital Heart], Pulmonic VTI [Shunts,
Congenital Heart]
Measured by: Pulmonic VTI [SDMANTRACE], Pulmonic VTI [SDMANTRACE] Used to
calculate: Pulmonic CO
Hatle, Liv, Angelsen, Bjorn., Doppler Ultrasound in Cardiology: Physical Principles and
Clinical Applications, ed. 2, Lea and Febiger, Philadelphia, Pennsylvania, 1985, p. 306.
PV A/MV A Dur [Pulmonary Vein]

Mode: PW:VRPW
Formula: {P Vein A Dur}/{MV A Dur}
Needs measurement: P Vein A Dur [Pulmonary Vein], MV A Dur [Pulmonary Vein]
Measured by: P Vein A Dur [SDTIMECALIPER]
PV A/MV VTI [Pulmonary Vein]

Mode: PW:VRPW
Formula: {P Vein A Dur}/{MV VTI}
Needs measurement: P Vein A Dur [Pulmonary Vein], MV VTI [Pulmonary Vein]
PV AccT/ET [Pulmonic]
Formula: {PV AccT}/{PVET}
Needs measurement: PV AccT [Pulmonic], PVET [Pulmonic]
Measured by: PVET [SDTIMECALIPER]
44
PV A-MV A Dur [Pulmonary Vein]
Mode: PW:VRPW
Formula: {P Vein A Dur}-{MV A Dur}
Needs measurement: P Vein A Dur [Pulmonary Vein], MV A Dur [Pulmonary Vein]
PV Area [Dimension]
Formula: 3.14/4*{PV Ann Diam}^2
Needs measurement: PV Ann Diam [Dimension]
Measured by: PV Ann Diam [2DCALIPER]
PV CI [Pulmonic, Valvular PS]

Formula: (({PV Ann Diam}^2*0.785*{PV VTI})*{HR}/60)/{BSA}
Needs measurement: PV Ann Diam [Pulmonic, Valvular PS], PV VTI [Pulmonic, Valvular
PS], HR [Pulmonic, Valvular PS]
Measured by: PV Trace [SDMANTRACE]
PV CO [Pulmonic, Valvular PS]

Formula: ({PV Ann Diam}^2*0.785*{PV VTI})*{HR}/60
PS], HR [Pulmonic, Valvular PS]
PV SI [Pulmonic, Valvular PS]

Formula: ({PV Ann Diam}^2*0.785*{PV VTI})/{BSA}
PS]
Gorge, G., et al., “High Resolution Two-dimensional Echocardiography Improves
Quantification of Left Ventricular Function, “J Am Soc Echo, 1992, Vol. 5, pp. 125-134.
PV SV [Pulmonic, Valvular PS]

Formula: {PV Ann Diam}^2*0.785*{PV VTI}
PS]
45
PVA (Vmax) [Pulmonic]
Formula: 3.14/4*{RVOT Diam}^2*{RVOT Vmax}/{PV Vmax}
Needs measurement: RVOT Diam [Pulmonic], RVOT Vmax [Pulmonic], PV Vmax
[Pulmonic]
Measured by: PV Vmax [AUTOCALC]
PVA (Vmax) [Pulmonic]

Formula: 3.14/4*{RVOT Diam}^2*{RVOT Vmax}/{PV Vmax}
Needs measurement: RVOT Diam [Pulmonic], RVOT Vmax [Pulmonic], PV Vmax
[Pulmonic]
Measured by: PV Trace [AUTOCALC]
PVA (VTI) [Pulmonic]

Formula: 3.14/4*{RVOT Diam}^2*{RVOT VTI}/{PV VTI}
Needs measurement: RVOT Diam [Pulmonic], RVOT VTI [Pulmonic], PV VTI [Pulmonic]
Measured by: PV Trace [AUTOCALC]
Qp/Qs [Shunts, Congenital Heart]

Formula: 3.14159/4*{Pulmonic Diam}^2*{Pulmonic VTI}/(3.14159/4*{Systemic
Diam}^2*{Systemic VTI})
Needs measurement: Pulmonic Diam [Shunts, Congenital Heart], Pulmonic VTI [Shunts,
Congenital Heart], Systemic Diam [Shunts, Congenital Heart], Systemic VTI [Shunts,
Congenital Heart]
Measured by: Qp/Qs [AUTOCALC]
RIMP [Pulmonic, Tricuspid Valve]

Formula: ({TCO}-{PVET})/{PVET}
Needs measurement: TCO [Pulmonic, Tricuspid Valve], PVET [Pulmonic, Tricuspid
Valve], PVET [Pulmonic, Tricuspid Valve]
Measured by: RIMP [AUTOCALC]
RVOT Area [Dimension]

Formula: 3.14/4*{RVOT Diam}^2
Needs measurement: RVOT Diam [Dimension]
Measured by: RVOT Diam [2DCALIPER]
46
RVOT CI [Pulmonic, Valvular PS]
Mode: PW:VRPW
Formula: (({RVOT Diam}^2*0.785*{RVOT VTI})*{HR}/60)/{BSA}
Needs measurement: RVOT Diam [Pulmonic, Valvular PS], RVOT VTI [Pulmonic,
Valvular PS], HR [Pulmonic, Valvular PS],
Measured by: RVOT Trace [SDMANTRACE]
RVOT CO [Pulmonic, Valvular PS]

Mode: PW:VRPW
Formula: ({RVOT Diam}^2*0.785*{RVOT VTI})*{HR}/60
Valvular PS], HR [Pulmonic, Valvular PS]
RVOT SI [Pulmonic, Valvular PS]

Mode: PW:VRPW
Formula: ({RVOT Diam}^2*0.785*{RVOT VTI})/{BSA}
Valvular PS],
RVOT SV [Pulmonic, Valvular PS]

Mode: PW:VRPW
Formula: {RVOT Diam}^2*0.785*{RVOT VTI}
Valvular PS]
RVPEP/ET [Pulmonic]
Formula: {RVPEP}/{RVET}
Needs measurement: RVPEP [Pulmonic], RVET [Pulmonic]
Measured by: RVET [SDTIMECALIPER]
RVPEP/ET [Time]
Formula: {RVPEP}/{RVET}
Needs measurement: RVPEP [Time], RVET [Time]
Measured by: RVET [MMTIMECALIPER]
47
RVSP [Tricuspid Valve]
Formula: {TR maxPG}+{RAP}
Needs measurement: TR maxPG [Tricuspid Valve], RAP [Tricuspid Valve]
Measured by: TR Vmax [AUTOCALC]
SI A-L A2C [Biplane, Single Plane A2C, AutoBiplane]

Formula: ({LVEDV A-L A2C}-{LVESV A-L A2C})/{BSA}
[2DAUTOVOLUME]
SI A-L A4C [Biplane, Single Plane A4C, AutoBiplane]

Formula: ({LVEDV A-L A4C}-{LVESV A-L A4C})/{BSA}
[2DAUTOVOLUME]
SI A-L LAX [Single Plane LAX, AutoBiplane]

Formula: ({LVEDV A-L LAX}-{LVESV A-L LAX})/{BSA}
SI Biplane [Biplane, AutoBiplane]

48
SI bp el [Biplane Ellipse]
Formula: (d-s)/{BSA} where:
SI bullet [Bullet]
Formula: (d-s)/{BSA} where:
Needs measurement: LVAd sax) [Bullet], LVLd apical [Bullet], LVLs apical [Bullet],
SI MOD A2C [Biplane, Single Plane A2C, AutoBiplane]

Formula: ({LVEDV MOD A2C}-{LVESV MOD A2C})/{BSA}
[2DAUTOVOLUME]
SI MOD A4C [Biplane, Single Plane A4C, AutoBiplane]

Formula: ({LVEDV MOD A4C}-{LVESV MOD A4C})/{BSA}
[2DAUTOVOLUME]
SI MOD LAX [Single Plane LAX, AutoBiplane]

Formula: ({LVEDV MOD LAX}-{LVESV MOD LAX})/{BSA}
AutoVolume [2DAUTOVOLUME] 49
SI mod sim [Modified Simpson]
Formula: d-s/{BSA} where:
s = ({LVLs(apical)}/9)*((4*{LVAs(sax MV)})+(2*{LVAs(sax PM)})+
sqrt({LVAs(sax MV)}*{LVAs(sax PM)}))
d = ({LVLd apical}/9)*((4*{LVAd (sax MV)})+(2*{LVAd sax PM})+
Gorge, G., et al., “High Resolution Two-dimensional Echocardiography Improves
Quantification of Left Ventricular Function, “J Am Soc Echo, 1992, Vol. 5, pp. 125-134.
SI(A-L) [Generic]
Formula: ({EDV(A-L)}-{ESV(A-L)})/{BSA}
Needs measurement: ESV(A-L) [Generic]
SI(Cube) [Dimension, Cube/Teicholz]

Formula: (d-s)/{BSA} where: s = {2D/LVIDs}^3 d = {LVIDd}^3
Cube/Teicholz]
SI(Cube) [Generic]
Formula: (dv-sv)/{BSA} where: sv = {MM/LVIDs}^3 dv = {LVIDd}^3
Needs measurement: LVIDd [Generic], LVIDs [Generic],
SI(MOD) [Generic]
Formula: ({EDV(MOD)}-{ESV(MOD)})/{BSA}
50
SI(Teich) [Dimension, Cube/Teicholz]
Formula: (d-s)/{BSA} s = 7/(2.4+{2D/LVIDs})*{2D/LVIDs}^3 d =
7/(2.4+{LVIDd})*{LVIDd}^3
Cube/Teicholz]
SI(Teich) [Generic]
Formula: (dv-sv)/{BSA} where:
sv = 7/(2.4+{MM/LVIDs})*{MM/LVIDs}^3 dv = 7/(2.4+{LVIDd})*{LVIDd}^3
Needs measurement: LVIDd [Generic], LVIDd [Generic], LVIDs [Generic]
SV A-L A2C [Biplane, Single Plane A2C, AutoBiplane]

Formula: {LVEDV A-L A2C}-{LVESV A-L A2C}
[2DAUTOVOLUME]
SV A-L A4C [Biplane, Single Plane A4C, AutoBiplane]

Formula: {LVEDV A-L A4C}-{LVESV A-L A4C}
[2DAUTOVOLUME]
SV A-L LAX [Single Plane LAX, AutoBiplane]

Formula: {LVEDV A-L LAX}-{LVESV A-L LAX}
51
SV Biplane [Biplane, AutoBiplane]
SV bp el [Biplane Ellipse]
Formula: d = (8/(3*3.14159))*{LVAd A4C}*{LVAd (sax MV)}/{LVIDd}
SV bullet [Bullet]
Formula: d-s where:
s = 5/6*{LVAs(sax)}*{LVLs(apical)}
Needs measurement: LVAd sax) [Bullet], LVLd apical [Bullet], LVLs apical [Bullet]
SV MOD A2C [Biplane, Single Plane A2C, AutoBiplane]

Formula: {LVEDV MOD A2C}-{LVESV MOD A2C}
[2DAUTOVOLUME]
SV MOD A4C [Biplane, Single Plane A4C, AutoBiplane]

Formula: {LVEDV MOD A4C}-{LVESV MOD A4C}
[2DAUTOVOLUME]
52
SV MOD LAX [Single Plane LAX, AutoBiplane]
Formula: {LVEDV MOD LAX}-{LVESV MOD LAX}
SV mod sim [Modified Simpson]

Formula: ({LVLd apical}/9)*((4*{LVAd (sax MV)})+(2*{LVAd sax PM})+sqrt({LVAd (sax
MV)}*{LVAd sax PM}))
Pombo, J.F., “Left Ventricular Volumes and Ejection by Echocardiography,” Circulation
1971, Vol 43, pp. 480-490
SV(A-L) [Generic]
Formula: {EDV(A-L)}-{ESV(A-L)}
Needs measurement: ESV(A-L) [Generic]
SV(Cube) [Dimension, Cube/Teicholz]

Formula: d-s where: s = {2D/LVIDs}^3 d = {LVIDd}^3
Cube/Teicholz]
SV(Cube) [Generic, Dimension]

Formula: dv-sv where: sv = {MM/LVIDs}^3 dv = {LVIDd}^3
53
SV(MOD) [Generic]
Formula: {EDV(MOD)}-{ESV(MOD)}
SV(Teich) [Dimension, Cube/Teicholz]

Formula: d-s where:
s = 7/(2.4+{2D/LVIDs})*{2D/LVIDs}^3
d = 7/(2.4+{LVIDd})*{LVIDd}^3
Cube/Teicholz]
SV(Teich) [Generic, Dimension]

Formula: dv-sv where:
Systemic CO [Shunts, Congenital Heart]

Formula: {Systemic SV}*{Systemic HR}/60
Needs measurement: Systemic SV [Shunts, Congenital Heart], Systemic HR [Shunts,
Congenital Heart]
Measured by: Systemic VTI [SDMANTRACE]
Systemic SV [Shunts, Congenital Heart]

Formula: 3.14159/4*{Systemic Diam}^2*{Systemic VTI}
Needs measurement: Systemic Diam [Shunts, Congenital Heart], Systemic VTI [Shunts,
Congenital Heart]
Measured by: Systemic VTI [SDMANTRACE], Systemic VTI [SDMANTRACE] Used to
calculate: Systemic CO
Calafiore P, MBBS, Stewart WJ, Doppler Echocardiographic Quantitation of Volumetric
Flow Rate, Cardiology Clinics, vol. 8, No. 2, 1990
54
TR ERO [PISA]
Formula: {TR Flow}/{TR Vmax}
Needs measurement: TR Flow [PISA], TR Vmax [PISA]
Measured by: TR Trace [AUTOCALC]
TR RV [PISA]
Formula: {TR Flow}/{TR Vmax}*{TR VTI}
Needs measurement: TR Flow [PISA], TR Vmax [PISA], TR VTI [PISA]
Measured by: TR Trace [AUTOCALC]
TV AccT/DecT [Tricuspid Valve]

Formula: {TV AccT}/{TV Dec Time}
Needs measurement: TV AccT [Tricuspid Valve], TV Dec Time [Tricuspid Valve]
Measured by: TV AccT [SDCALIPER]
TV Area [Dimension]
Formula: 3.14/4*{TV Ann Diam}^2
Needs measurement: TV Ann Diam [Dimension]
Measured by: TV Ann Diam [2DCALIPER]
TV CI [Tricuspid Valve]
Formula: (({TV Ann Diam}^2*0.785*{TV VTI})*{HR}/60)/{BSA}
Needs measurement: TV Ann Diam [Tricuspid Valve], TV VTI [Tricuspid Valve], HR
[Tricuspid Valve]
Measured by: TV Trace [SDMANTRACE]
The Merc Manual of Diagnosis and Therapy, ed. 15, Robert Berkon, ed., Merck and Co.,
Rahway, NJ, 1987, p. 387
Echocardiography, “J Am Soc Echo, Sept-Oct 1989, Vol. 2, No. 5. p. 364.
55
TV CO [Tricuspid Valve]
Formula: ({TV Ann Diam}^2*0.785*{TV VTI})*{HR}/60
Needs measurement: TV Ann Diam [Tricuspid Valve], TV VTI [Tricuspid Valve], HR
[Tricuspid Valve]
Calafiore, P., Stewart, W.J., “Doppler Echocardiographic Quantitation of Volumetric Flow
Rate, “ Cardiology Clinics, May 1990, Vol. 8, No. 2, pp. 191-202.
TV E/A Ratio [Tricuspid Valve]

Formula: {TV E Vel}/{TV A Vel}
Needs measurement: TV E Vel [Tricuspid Valve], TV A Vel [Tricuspid Valve]
Measured by: TV A Vel [SDPTCALIPER]
TV SI [Tricuspid Valve]
Mode: CW:PW:VRCW:VRPWFormula: ({TV Ann Diam}^2*0.785*{TV VTI})/{BSA}
Needs measurement: TV Ann Diam [Tricuspid Valve], TV VTI [Tricuspid Valve]
TV SV [Tricuspid Valve]
Formula: {TV Ann Diam}^2*0.785*{TV VTI}
Needs measurement: TV Ann Diam [Tricuspid Valve], TV VTI [Tricuspid Valve]
TVA (Vmax) [Tricuspid Valve]

Formula: 3.14/4*{RVOT Diam}^2*{RVOT Vmax}/{TV Vmax}
Needs measurement: RVOT Diam [Tricuspid Valve], RVOT Vmax [Tricuspid Valve], TV
Vmax [Tricuspid Valve]
Measured by: TV Vmax [AUTOCALC]
TVA (Vmax) [Tricuspid Valve]

Formula: 3.14/4*{RVOT Diam}^2*{RVOT Vmax}/{TV Vmax}
Needs measurement: RVOT Diam [Tricuspid Valve], RVOT Vmax [Tricuspid Valve], TV
Vmax [Tricuspid Valve]
Measured by: TV Trace [AUTOCALC]
56
TVA (VTI) [Tricuspid Valve]
Formula: 3.14/4*{RVOT Diam}^2*{RVOT VTI}/{TV VTI}
Needs measurement: RVOT Diam [Tricuspid Valve], RVOT VTI [Tricuspid Valve], TV
VTI [Tricuspid Valve]
Measured by: TV Trace [AUTOCALC]
Vcf mean [Dimension]

Formula: ({LVIDd}-{LVIDs})/({LVIDd}*{LVET})
Needs measurement: LVIDd [Dimension], LVIDs [Dimension], LVET [Dimension]
Measured by: Vcf [MMTIMECALIPER]
Vcf mn (corr) [Dimension]

Formula: ({LVIDd}-{LVIDs})/({LVIDd}*({LVET}/sqrt({Time})))
Needs measurement: LVIDd [Dimension], LVIDs [Dimension], LVET [Dimension], Time
[Dimension]
Measured by: Vcf [MMTIMECALIPER]
57
Formulas–Vascular
Vascular Calculation Formulas

RT ECA Right External Carotid one Doppler blood flow peak velocity
Artery Velocity
RT ECA=v1[cm/s or m/s]
RT CCA Right Common Carotid one Doppler blood flow peak velocity
Artery Velocity
RT CCA=v1[cm/s or m/s]
RT BIFURC Right Carotid Bifurcation one Doppler blood flow peak velocity
Velocity
RT BIFURC=v1[cm/s or m/s]
RT ICA Right Internal Carotid one Doppler blood flow peak velocity
Artery Velocity
RT ICA=v1[cm/s or m/s]
RT Right Internal Carotid two Doppler blood flow peak velocities

ICA/CCA Artery Velocity/Common
Carotid Artery Velocity
Ratio
RT ICA/CCA=VICA/VCCA
LT ECA, LT Same as above, for Left Same as above

CCA, LT Carotid Artery
BIFURC,
LT ICA, LT
ICA/CCA
A/B Ratio Velocities Ratio two Doppler blood flow peak velocities
A/B=V1/V2
% Stenosis Stenosis Ratio two areas (by ellipse, trace, circle or

distance)
% Stenosis=[1-(Aresidual/ Alumen)]x100
58
S/D Ratio Systolic Velocity/Diastolic two Doppler blood flow peak velocities
Velocities Ratio
S/D=Vsystole/Vdiastolea
PI Pulsatility Index two Doppler blood flow peak velocities and

TAMAX
PI=(Vmax-Vdiastole)/TAMAXa
RI Resistivity Index two Doppler blood flow peak velocities
RI=(Vmax-Vdiastole)/ Vmaxa
HR Heart Rate (beats/minute) one 2 beat time interval (measured manually

or automatically)
HR[BPM]=120[sec]/2 beat time[sec]

59
Formulas–OB
OB Calculation Formulas
Calc Input Measurements Author

Mnemonic Calc Name Formula Reference
AC Abdominal circumference by trace, ellipse, circle or Hadlock et

Circumferen two distances al,
ce Radiology,
152:497-50
AC=13.3+1.61 (GA) -0.00998 (GA)2 1, 1984
BPD Biparietal one distance
Diameter
BPD = -3.08+0.41 (GA) - 0.000061 (GA)3
CRL Crown Rump one distance

Length
CRL=1.684969+ 0.315646xd1+
0.049306xd1^2+ 0.004057xd1^3+
0.000120456xd1^4
FL Femur one distance

Length
FL = -3.91 + 0.427 (GA) - 0.0034 (GA)2
GS Gestational three distances

Sac
GS [wk] = 1.42450142 * (d1+d2+d3)/3+

3.6225
HC Head circumference by trace, ellipse, circle or

Circumferen two distances
ce
HC=-11.48 + 1.56 (GA) - 0.0002548 (GA)3
60
HC Head one ellipse Hansmann,

Circumferen Ultrasound
ce Diagnosis in
Obstetrics
and
Gynecology
438-9, 1985
HC [mm] = 2.325 * (BPD [mm]^2 + OFD

[mm]^2)^0.5
EF Ejection two distances on M-Mode (End-diastolic n/a

Fraction dimension and End-systolic dimension on
M-Mode)
EF = (1 - Ds^3 / Dd^3)
61
CUA Hadlock Formulas
Calc Calc
Mnemonic Name Formula
CUAa Composite 1. CUA (BPD) = 9.54 + 1.482 * BPD + 0.1676 * BPD2

Ultrasound
Age 2. CUA (HC) = 8.96 + 0.540 * HC + 0.0003 * HC3
3. CUA (AC) = 8.14 + 0.753 * AC + 0.0036 * AC2
4. CUA (FL) = 10.35 + 2.460 * FL + 0.170 * FL2
5. CUA (BPD, HC) = 10.32 + 0.009 * HC2 + 1.3200
* BPD + 0.00012 * HC3
6. CUA (BPD, AC) = 9.57 + 0.524 * AC + 0.1220 *
BPD2
7. CUA (BPD, FL) = 10.50 + 0.197 * BPD * FL +
0.9500 * FL + 0.7300 * BPD
8. CUA (HC, AC) = 10.31 + 0.012 * HC2 + 0.3850 *
AC
9. CUA (HC, FL) = 11.19 + 0.070 * HC * FL + 0.2630
* HC
10. CUA (AC, FL) = 10.47 + 0.442 *AC + 0.3140 * FL2
-0.0121 * FL3
11. CUA (BPD, HC, AC) = 10.58 + 0.005 * HC2 +
0.3635 * AC + 0.02864 * BPD * AC
12. CUA (BPD, HC, FL) = 11.38 = 0.070 * HC * FL +
0.9800 * BPD
13. CUA (BPD, AC, FL) = 10.61 + 0.175 * BPD * FL +
0.2970 * AC + 0.7100 * FL
14. CUA (HC, AC, FL) = 10.33 + 0.031 * HC * FL +
0.3610 * HC + 0.0298 * AC * FL
15. CUA (BPD, HC, AC, FL) = 10.85 + 0.060 * HC *
FL + 0.6700 * BPD + 0.1680 * AC
Author Reference: Hadlock, Radiology, 1984 152:497-501
a) Formulas are used only if Hadlock HC, FL, AC and BPD are used and CUA is selected
as the preset in the CUA/AUA for Hadlock preset in the System M&A Preset Menu. If
other authors are used, CUA automatically changes to AUA and an average value is
displayed.
62
EFW Calculation Formulas

EFW Estimated AC and HC Hadlock,

Fetal Weight Radiology,
150:535,
1984
EFW [kg] = 10^ (1.182+(0.0273*HC

[cm])+(0.07057*AC [cm] - (0.00063*AC
[cm]^2)-(0.0002184*AC [cm] * HC [cm]))
EFW Estimated BPD, AC, and FL Hadlock,

Fetal Weight AJOG,
151:333,
1985
EFW [g]=10^(1.335-(0.0034*AC [cm] * FL

[cm]) + (0.0316 * BPD [cm]) + (0.0457 * AC
[cm]) + (0.1623 * FL [cm]
EFW Estimated AC, HC, and FL Hadlock,

Fetal Weight AJOG,
151:333,
1985
EFW [g]=10^(1.326-(0.00326 * AC [cm] *

FL [cm]) + (0.0107 * HC [cm]) + (0.0438 *
AC [cm]) + (0.158 * FL [cm]))
EFW Estimated AC, HC, BPD, FL Hadlock,

Fetal Weight AJOG,
151:333,
1985
EFW [g] = 10^(1.3596- (0.00386 * AC [cm]

* FL [cm]) + (0.0064 * HC [cm]) + (0.00061
* BPD [cm] * AC [cm]) + (0.0424 * AC [cm])
+ (0.174 * FL [cm]))
63
EFW Estimated AC and FL Hadlock,

Fetal Weight Radiology,
150:535,
1984
EFW [g] = 10^(1.304 + 0.05281 * AC [cm]

+ 0.1938 * FL [cm] - 0.004 * AC [cm] * FL
[cm])
EFW Estimated EFW [g] = -3200.40479 + 157.07186 * AC Merz

Fetal Weight [cm] + 15.90391 * BPD [cm]^2
EFW Estimated EFW [g] = 0.515263 -0.105775 * BPD Hansmann

Fetal Weight [mm] + (0.000930707 * BPD [mm]^2 +
0.0649145 * TTD [mm] - 0.00020562 *
TTD [mm]^2
EFW Estimated AC and BPD Shepard,

Fetal Weight AJOG,
142:47,
1982
EFW [kg] = 10^(-1.7492 + 0.166 * BPD

[cm] + 0.046 * AC [cm] - 2.646 * AC [cm] *
BPD [cm]/1000)
EFW Estimated BPD [cm] and AC [cm] Shepard/W

Fetal Weight arsoff
EFW [g] = 10^(1.7288+0.09184 * BPD

[cm] + 0.02581 * AC [cm] + 0.00011 * BPD
[cm] * AC [cm])
EFW Estimated BPD [cm] and AC [cm] Richards/B

Fetal Weight erkowitz
EFW [g] =10^(3-1.7492 + (0.166 * BPD

[cm]) + (0.04 * A [cm]) - (0.002646 * AC
[cm] * BPD [cm]))
EFW Estimated EFW [g] = 1.07 * BPD [cm]^3 + 3.42 * Tokyo

Fetal Weight APTD [cm] * TTD [cm] * FL [cm] University
64
EFW Estimated BPD, AxT, FL [cm] Tokyo

Fetal Weight Shinozuka
EFW1 [g] =1.07 * BPD [cm]^3 + 3.42 * AxT

[cm2] * FL [cm]
EFW Estimated BPD, AC, FL [cm] Tokyo

EFW2 [g] = 1.07 * BPD [cm]^3 + 0.30 * AC

[cm]^2 * FL [cm]
EFW Estimated BPD, AxT, LV [cm] Tokyo

EFW3 [g] = 1.07 * BPD [cm] ^3 + 2.91 *

AxT [cm2] * LV [cm]
65
Amniotic Fluid Index (AFI)
The normal values are considered to be:
• 36-40 weeks
• 0-5 cm = very low
• 5.1-8.0 cm = low
• 8.1-18.0 cm = normal Sagittal
• >18.0 = high
Dr. Rutherford/Dr. Phelan, Obstetrics and Gynecology, Volume 70,

No. 3, Part 1, p.353-6, Sept. 1987.
• 28-40 weeks
• 15.0 cm = average
• >20.0 - 24.0 = hydramnios
Transverse
• <5.0-6.0 = Oligohydramnios
Dr. C.C. Smith, The Female Patient, Volume 15, p.85-97, March 1990.
66
Formulas–GYN
GYN Calculation Formulas
Calc Input
Mnemonic Calc Name Measurements Formula
UT-L Uterine Length one distance Ut-L[cm or mm]=d1
UT-H Uterine Height one distance Ut-H[cm or mm]=d1
UT-W Uterine Width one distance Ut-W[cm or mm]=d1
UT-Volume Uterine Volume
UtPFD Uterus
Portio-Fundus
Distance
UtAP Anterior-Posterior
Uterus Diameter
UtQ Transverse Uterus

Diameter
Endo Endometrium one distance Endo[cm or mm]=d1

Thickness
Lt. Ov-L Left Ovarian Length one distance Lt. Ov-L[cm or mm]=d1
Lt. Ov-H Left Ovarian Height one distance Lt. Ov-H[cm or mm]=d1
Lt. Ov-W Left Ovarian Width one distance Lt. Ov-W[cm or mm]=d1
Lt. Ov-Volume Left Ovarian Volume
Rt. Ov-L Right Ovarian one distance Rt. Ov-L[cm or mm]=d1

Length
Rt. Ov-H Right Ovarian Height one distance Rt. Ov-H[cm or mm]=d1
Rt. Ov-W Right Ovarian Width one distance Rt. Ov-W[cm or mm]=d1
Rt. Right Ovarian

Ov-Volume Volume
Lt. Ov-RI Left Ovarian Vessel two Doppler blood Lt. Ov-RI=
Resistive Index flow peak (Vmax-Vdiastole)/Vmaxa
velocities
67
Calc Input
Mnemonic Calc Name Measurements Formula
Ut-RI Uterine Vessel two Doppler blood Ut-RI=

Resistive Index flow peak (Vmax-Vdiastole)/Vmaxa
velocities
Rt. Ov-RI Right Ovarian two Doppler blood Rt. Ov-RI=

Vessel Resistive flow peak (Vmax-Vdiastole)/Vmaxa
Index velocities
LtOvFo[ml] Left Ovary Follicles One distanceb D1[cm]3 x S/6
Two distancesb D1[cm]2 x D2x[cm] S/6

: (D1<D2)
D1[cm] x D2[cm] 2x S/6

: (D2<D1)
Three distances D1[cm] x D2[cm]x D3[cm]

x S/6
RtOvFo[ml] Right Ovary Follicles One distanceb D1[cm]3 x S/6
Two distancesb D1[cm]2 x D2[cm] x S/6

: (D1 <D2)
D1[cm] x D2[cm]2 x S/6

: (D2 <D1)
Three distances D1[cm] x D2[cm] x

D3[cm] x S/6
Lt. Ov-PI Left Ovarian Vessel

Pulsatility Index
Rt. Ov-PI Right Ovarian

Vessel Pulsatility
Index
b) To calculate LtOvFo or RtOvFo with one (or two distances), press the CLEAR key after
the first (or second distance) measurement(s).
68
Measurement accuracy
General
When using the Measurement and Analysis (M&A) package, it
is important to keep in mind the different aspects that affect the
accuracy of the measurements. These include acoustical
properties, patient echogenicity, measurement tools and
algorithms, scanner setup (especially Field-of-view or Range
settings), probe type used, and operator inputs.
Sources of error
Image Quality
The accuracy of each measurement is highly dependent on
image quality. Image quality is highly dependent on system
design, operator variability, and patient echogenicity. The
operator variability and patient echogenicity are independent of
the ultrasound system.
Operator variability
See also ’Optimiz- One of the largest potential sources of error is operator
ing Measurement variability. A skilled operator can reduce this by optimizing the
Accuracy’ on image quality for each type of measurement. Clear
page 71for recom-
mended techniques.
identification of structures, good probe alignment and correct
cursor placement is important. Because of pixel resolution, the
accuracy of a measurement decreases with decreasing
distance on screen. Therefore it is important when scaling the
object on the screen to avoid measuring objects that are too
small.
Image measurement
The accuracy in lateral direction is limited by the beam width
and the beam positioning. The radial accuracy is mainly limited
by the acoustic pulse length.
69
Doppler alignment
If alignment is not Errors in velocity measurements increase with the cosine of the
possible, you may angle between the measured flow and the ultrasound beam.
use the Angle Cor- For example, an alignment error of 20 degrees, will give a 6%
rection control to
compensate if the
under-estimation of the velocities, while an error of 40 degrees
flow direction is will cause the under-estimation to be 24%.Optimize transducer
known. position to align the beam with the flow direction.
Screen pixel resolution

The display screen is composed of an array of square picture
elements (pixels). The smallest resolvable unit is +/- 1pixel.
This pixel error is only significant when measuring short
distances on the screen. By observing good scanning
practices, the settings of the field of view should be such that
the measured distance covers a relatively large portion of the
screen. When such scaling is impossible, the pixel error may
come into play. The pixel error is +/- 0.2% of the full ultrasound
area in the User Screen.
Algorithms
Some formulae used in clinical calculations are based on
assumptions or approximations. For example the volume
calculations from 2D or M mode assume a certain, ‘ideal’ shape
of the heart chamber, while the actual shape can vary quite
much between individuals. Also, formulae taking several “raw”
measurements as inputs are prone to increased errors,
depending on the combination of input variable accuracies. For
example, the Cardiac Output formula from Doppler is sensitive
to errors in the entered Diameter, since this will be squared in
the formula.
Speed of Sound in Tissue

The average value 1540 meters / second is used for all
calculations. Depending on the tissue structures, this
generalization may give errors from 2% (typical) to 5% (much
fatty tissue layers present).
70
Optimizing Measurement Accuracy
Probe selection
Select a transducer appropriate for the application, and
optimize the transducer frequencies used. Higher imaging
frequencies give better resolution, but less penetration than
lower frequencies. Lower Doppler frequencies can measure
higher max velocities, and at greater depths, but with less
velocity resolution than higher Doppler frequencies.
Field of View
All display modes should be adjusted so that the area of
interest covers as large portion of the display as possible. Use
Depth, Angle, Zoom, Horizontal Sweep and Velocity
controls to optimize the different modes.
Cursor Placement
Avoid placement of All measurements are dependent on the accuracy of their
the cursor near the “input” data. Consistency and precision in placing cursors and
array edges when drawing traces correctly on the images are important.
using convex or lin-
ear probes.
Measurement Uncertainties
The accuracy percentages reported below are based on data
taken with optimum control settings, using calibrated phantoms
and test equipment. The table below only includes errors
related to the system with probes.
The calibration was done for the basic measurable parameters:
Distance, Time and Velocity.
Independent sources of uncertainty contribute to a total
uncertainty by a RMS (Root Mean Square) combination of the
sources. Refer to the discussions above regarding
measurement accuracy and sources of error when reading the
table below.
Measurement Range Accuracy Comments
2D Calipers
Distance 1 - 10 cm 7%
> 10 cm 5% 71
Measurement Range Accuracy Comments
M-mode Calipers
Distance 1 - 10 cm 7%
dt 0.5 - 1.5 s 0.5% With optimal sweep

speed setting
Spectrum Calipers
Velocity 0.2 - 1.5 m/s 6%
dt 0.5 - 1.5 s 0.5% With optimal sweep

speed setting
72
Chapter 2
OB Tables
• ASUM ............................................................................................. ..... 74

• Berkowitz ....................................................................................... ..... 75
• Brenner .......................................................................................... ..... 76
• Campbell ....................................................................................... ..... 76
• Eriksen ........................................................................................... ..... 77
• Goldstein ....................................................................................... ..... 78
• Hadlock .......................................................................................... ..... 79
• Hansmann ..................................................................................... ..... 86
• Hellman .......................................................................................... ..... 95
• Hill .................................................................................................. ..... 95
• Hohler ............................................................................................ ..... 96
• Jeanty ............................................................................................ ..... 96
• JSUM .............................................................................................. ... 108
• Kurtz .............................................................................................. ... 112
• Mayden .......................................................................................... ... 113
• Mercer ............................................................................................ ... 114
• Merz ............................................................................................... ... 115
• Moore ............................................................................................. ... 125
• Nelson ............................................................................................ ... 125
• Osaka ............................................................................................. ... 126
• Paris ............................................................................................... ... 130
• Rempen ......................................................................................... ... 133
• Robinson ....................................................................................... ... 138
• Tokyo ............................................................................................. ... 138
• Tokyo Shinozuka .......................................................................... ... 142
• Williams ......................................................................................... ... 149
• Yarkoni .......................................................................................... ... 149 73
ASUM
Table 2-1: AC: ASUM, Deler (Fetal Age)Unit: AC (mm); Age (Days); 2SD (Days)
AC Age 2SD AC Age 2SD AC Age 2SD AC Age 2SD
<35 n/a —— 126 126 10 228 189 14 331 252 18

35 70 8 137 133 10 240 196 14 342 259 18
46 77 8 149 140 10 251 203 14 354 266 20
57 84 8 160 147 10 263 210 14 365 273 20
69 91 8 171 154 10 274 217 14 377 280 20
80 98 9 183 161 10 285 224 16 >377 n/a ——
92 105 9 194 168 12 297 231 16
103 112 9 206 175 12 308 238 18
114 119 9 217 182 12 320 245 18
Table 2-2: BPD: ASUM, Aust NZ, Obstet Gynaecol 1989: 29:26 (Fetal Age)Unit: BPD
(mm); Age (Week); 2SD (Week - * signifies No Data)
BPD Age 2SD BPD Age 2SD BPD Age 2SD BPD Age 2SD
<20 n/a —— 40 123 8 61 171 13 82 225 18

20 84 4 41 126 9 62 173 13 83 228 18
21 86 4 42 128 9 63 176 14 84 231 19
22 88 4 43 130 9 64 178 14 85 234 0
23 90 4 44 132 9 65 181 14 86 237 0
24 92 5 45 134 9 66 183 14 87 240 0
25 94 5 46 136 10 67 186 15 88 244 0
26 95 5 47 139 10 68 188 15 89 247 0
27 97 5 48 141 10 69 191 15 90 251 0
28 99 5 49 143 10 70 193 15 91 255 0
29 101 6 50 145 11 71 196 16 92 259 0
30 103 6 51 147 11 72 199 16 93 264 0
31 105 6 52 149 11 73 201 16 94 270 0
32 107 6 53 152 11 74 204 16 95 276 0
33 109 7 54 154 12 75 206 17 96 284 0
34 111 7 55 157 12 76 209 17 97 292 0
35 113 7 56 159 12 77 212 17 98 301 0
36 115 7 57 161 12 78 214 17 >98 n/a ——
37 117 8 58 164 13 79 217 17
38 119 8 59 166 13 80 220 18
39 121 8 60 169 13 81 222 18
74
Table 2-3: CRL: ASUM, Silva et al 1991.6 (Fetal Age)Unit: CRL (mm); Age (Days); 2SD (*
No Data available)
CRL Age 2SD CRL Age 2SD CRL Age 2SD CRL Age 2SD
<2 n/a —— 16 56 * 34 71 * 58 86 *
2 42 * 17 57 * 36 72 * 60 87 *
3 43 * 18 58 * 37 73 * 62 88 *
4 44 * 19 59 * 38 74 * 64 89 *
5 45 * 20 60 * 40 75 * 66 90 *
6 46 * 22 61 * 41 76 * 68 91 *
7 47 * 23 62 * 43 77 * 70 92 *
8 48 * 24 63 * 45 78 * 72 93 *
9 49 * 25 64 * 46 79 * 74 94 *
10 50 * 26 65 * 48 80 * 76 95 *
11 51 * 27 66 * 50 81 * 78 96 *
12 52 * 29 67 * 51 82 * 80 97 *
13 53 * 30 68 * 53 83 * 82 98 *
14 54 * 31 69 * 55 84 * >82 n/a ——
15 55 * 33 70 * 57 85 *
Berkowitz
Table 2-4: BD: Berkowitz (Fetal Age)Unit: BD (mm); Age (Day); SD (mm)
BD Age SD BD Age SD BD Age SD BD Age SD
<13 n/a —— 25 112 0 38 155 0 51 217 0

13 81 0 26 116 0 39 159 0 52 223 0
14 82 0 27 120 0 40 162 0 53 230 0
15 84 0 28 124 0 41 166 0 54 237 0
16 86 0 29 128 0 42 169 0 55 244 0
17 88 0 30 130 0 43 173 0 56 251 0
18 91 0 31 132 0 44 179 0 57 258 0
19 95 0 32 135 0 45 185 0 58 266 0
20 98 0 33 138 0 46 191 0 59 275 0
21 102 0 34 142 0 47 197 0 >59 n/a ——
22 105 0 35 145 0 48 202 0
23 109 0 36 149 0 49 207 0
24 110 0 37 152 0 50 212 0
75
Brenner
Table 2-5: EFW: Brenner (Fetal Growth)GP, Table/Graph Range = 10%: 90%Age
(Weeks); Mini/Mean/Max (grams)
Age Min Mean Max Age Min Mean Max
21.0 280 410 860 33.0 1480 2010 2690

22.0 320 480 920 34.0 1670 2220 2880
23.0 370 550 990 35.0 1870 2430 3090
24.0 420 640 1080 36.0 2190 2650 3290
25.0 490 740 1180 37.0 2310 2870 3470
26.0 570 860 1320 38.0 2510 3030 3610
27.0 660 990 1470 39.0 2680 3170 3750
28.0 770 1150 1660 40.0 2750 3280 3870
29.0 890 1310 1890 41.0 2800 3360 3980
30.0 1030 1460 2100 42.0 2830 3410 4060
31.0 1180 1630 2290 43.0 2840 3420 4100
32.0 1310 1810 2500 44.0 2790 3390 4110
Campbell
Table 2-6: HC/AC Ratio: Campbell, Br J Obstet Gynaecol 1977, 84:165-174 (Fetal
Growth)Unit: GA (Weeks); Min/Max (Index)
GA Min Max GA Min Max GA Min Max
<13 n/a —— 23 1.05 1.21 35 0.93 1.11

13 1.14 1.31 25 1.04 1.22 37 0.92 1.05
15 1.05 1.39 27 1.05 1.22 39 0.87 1.06
17 1.07 1.29 29 0.99 1.21 41 0.93 1.00
19 1.09 1.26 31 0.96 1.17 >42 n/a n/a
21 1.06 1.25 33 0.96 1.11
76
Eriksen
Table 2-7: TAD: Eriksen (Fetal Age)Unit: TAD (mm); Age (Day); SD (mm)
TAD Age SD TAD Age SD TAD Age SD TAD Age SD
<23 n/a —— 45 134 0 68 182 0 91 232 0

23 91 0 46 136 0 69 184 0 92 234 0
24 93 0 47 138 0 70 186 0 93 236 0
25 95 0 48 140 0 71 188 0 94 239 0
26 97 0 49 142 0 72 190 0 95 241 0
27 99 0 50 144 0 73 192 0 96 243 0
28 101 0 51 146 0 74 195 0 97 245 0
29 103 0 52 148 0 75 197 0 98 247 0
30 105 0 53 150 0 76 199 0 99 250 0
31 107 0 54 152 0 77 201 0 100 252 0
32 109 0 55 154 0 78 203 0 101 254 0
33 111 0 56 156 0 79 206 0 102 256 0
34 113 0 57 158 0 80 208 0 103 259 0
35 115 0 58 161 0 81 210 0 104 261 0
36 117 0 59 163 0 82 212 0 105 263 0
37 119 0 60 165 0 83 214 0 106 266 0
38 120 0 61 167 0 84 217 0 107 268 0
39 122 0 62 169 0 85 219 0 108 270 0
40 124 0 63 171 0 86 221 0 109 273 0
41 126 0 64 173 0 87 223 0 110 275 0
42 128 0 65 175 0 88 225 0 111 277 0
43 130 0 66 177 0 89 228 0 112 280 0
44 132 0 67 179 0 90 230 0 >112 n/a ——
77
Goldstein
Table 2-8: TCD: Goldstein et a, Am J OB/GYN, May 1987 (Fetal Growth)Unit: TCD
(Weeks); Age/Quat1/Mean/Quat3/Max (mm)
Age Min Quat1 Mean Quat3 Max
15 10 12 14 15 16
16 14 16 16 16 17
17 16 17 17 18 18
18 17 18 18 19 19
19 18 18 19 19 22
20 18 19 20 20 22
21 19 20 22 23 24
22 21 23 23 24 24
23 22 23 24 25 26
24 22 24 25 27 28
25 23 21.5 28 28 29
26 25 28 29 30 32
27 26 28.5 30 31 32
28 27 30 31 32 34
29 29 32 34 36 38
30 31 32 35 37 40
31 32 35 38 39 43
32 33 36 38 40 42
33 32 36 40 43 44
34 33 38 40 41 44
35 31 37 40.5 43 47
36 36 29 43 52 55
37 37 37 45 52 55
38 40 40 48.5 52 55
39 52 52 52 55 55
78
Hadlock
Table 2-9: AC: Hadlock, Radiology 1984, Vol. 152:497 (Fetal Age)Unit: AC (mm); Age
(Week); 2SD (Week)
<50 n/a —— 135 19.0 r 2.1 225 26.9 r 2.2 315 35.4 r 3.0
50 12.0 r 1.7 140 19.4 r 2.1 230 27.4 r 2.2 320 35.9 r 3.0
55 12.4 r 1.7 145 19.8 r 2.1 235 27.8 r 2.2 321 36.0 r 3.1
60 12.8 r 1.7 150 20.2 r 2.1 240 28.3 r 2.2 325 36.4 r 3.1
65 13.2 r 1.7 155 20.7 r 2.1 245 28.7 r 2.2 330 36.9 r 3.1
70 13.6 r 1.7 160 21.1 r 2.1 250 29.2 r 2.2 335 37.4 r 3.1
75 14.0 r 1.7 165 21.5 r 2.1 255 29.7 r 2.2 340 37.9 r 3.1
80 14.4 r 1.7 170 22.0 r 2.1 258 30.0 r 2.2 345 38.4 r 3.1
85 14.8 r 1.7 175 22.4 r 2.1 259 30.1 r 3.0 350 38.9 r 3.1
90 15.2 r 1.7 180 22.9 r 2.1 260 30.2 r 3.0 355 39.4 r 3.1
95 15.6 r 1.7 185 23.3 r 2.1 265 30.6 r 3.0 360 39.9 r 3.1
100 16.0 r 1.7 190 23.7 r 2.1 270 31.1 r 3.0 365 40.4 r 3.1
105 16.4 r 1.7 192 23.9 r 2.1 275 31.6 r 3.0 370 40.9 r 3.1
110 16.9 r 1.7 193 24.0 r 2.2 280 32.0 r 3.0 375 41.4 r 3.1
115 17.3 r 1.7 195 24.2 r 2.2 285 32.5 r 3.0 380 42.0 r 3.1
120 17.7 r 1.7 200 24.6 r 2.2 290 33.0 r 3.0 385 42.5 r 3.1
123 17.9 r 1.7 205 25.1 r 2.2 295 33.5 r 3.0 >385 n/a ——
124 18.0 r 2.1 210 25.5 r 2.2 300 34.0 r 3.0
125 18.1 r 2.1 215 26.0 r 2.2 305 34.5 r 3.0
130 18.5 r 2.1 220 26.4 r 2.2 310 34.9 r 3.0
Table 2-10: AC: Hadlock, AJR; 139: 367-370; 1982 (Fetal Age)Unit: AC (mm); Age
(Days); SD (Days)
AC Age SD AC Age SD AC Age SD AC Age SD
<47 n/a —— 138 133 14 230 189 15 305 241 21

47 84 13 144 136 14 235 192 15 310 245 21
53 87 13 151 140 14 241 196 15 314 248 21
60 91 13 157 143 14 246 199 15 319 252 21
67 94 13 163 147 14 251 203 15 323 255 18
74 98 13 174 154 14 256 206 15 328 259 18
80 101 13 180 157 14 261 210 15 332 262 18
87 105 13 186 161 14 266 213 21 337 266 18
93 106 13 192 164 14 271 217 21 341 269 18
100 112 13 197 168 14 276 220 21 344 273 18
106 115 13 203 171 15 281 224 21 349 276 18
113 119 13 208 175 15 286 227 21 353 280 18
119 122 13 214 178 15 291 231 21 >353 n/a ——
126 126 13 219 182 15 296 234 21
132 129 14 225 185 15 300 238 21
79
Table 2-11: BPD: Hadlock, Radiology 1984, Vol. 152:497 (Fetal Age) aUnit: BPD (mm);
Age (Week); 2SD (Week)
<14 n/a —— 36 17.0 r 1.2 59 24.1 r 2.2 82 33.0 r 3.1

14 11.9 r 1.2 37 17.3 r 1.2 60 24.5 r 2.2 83 33.4 r 3.1
15 12.1 r 1.2 38 17.6 r 1.2 61 24.8 r 2.2 84 33.8 r 3.1
16 12.3 r 1.2 39 17.9 r 1.2 62 25.2 r 2.2 85 34.2 r 3.1
17 12.5 r 1.2 40 18.1 r 1.7 63 25.5 r 2.2 86 34.7 r 3.1
18 12.8 r 1.2 41 18.4 r 1.7 64 25.9 r 2.2 87 35.1 r 3.1
19 13.0 r 1.2 42 18.7 r 1.7 65 26.3 r 2.2 88 35.6 r 3.1
20 13.2 r 1.2 43 19.0 r 1.7 66 26.6 r 2.2 89 36.0 r 3.2
21 13.4 r 1.2 44 19.3 r 1.7 67 27.0 r 2.2 90 36.5 r 3.2
22 13.6 r 1.2 45 19.6 r 1.7 68 27.4 r 2.2 91 36.9 r 3.2
23 13.8 r 1.2 46 19.9 r 1.7 69 27.7 r 2.2 92 37.4 r 3.2
24 14.1 r 1.2 47 20.2 r 1.7 70 28.1 r 2.2 93 37.8 r 3.2
25 14.3 r 1.2 48 20.5 r 1.7 71 28.5 r 2.2 94 38.3 r 3.2
26 14.5 r 1.2 49 20.8 r 1.7 72 28.9 r 2.2 95 38.7 r 3.2
27 14.8 r 1.2 50 21.1 r 1.7 73 29.3 r 2.2 96 39.2 r 3.2
28 15.0 r 1.2 51 21.5 r 1.7 74 29.7 r 2.2 97 39.7 r 3.2
29 15.2 r 1.2 52 21.8 r 1.7 75 30.1 r 3.1 98 40.2 r 3.2
30 15.5 r 1.2 53 22.1 r 1.7 76 30.5 r 3.1 99 40.6 r 3.2
31 15.7 r 1.2 54 22.4 r 1.7 77 30.9 r 3.1 100 41.1 r 3.2
32 16.0 r 1.2 55 22.8 r 1.7 78 31.3 r 3.1 101 41.6 r 3.2
33 16.3 r 1.2 56 23.1 r 1.7 79 31.7 r 3.1 102 42.1 r 3.2
34 16.5 r 1.2 57 23.4 r 1.7 80 32.1 r 3.1 103 42.6 r 3.2
35 16.8 r 1.2 58 23.8 r 1.7 81 32.5 r 3.1 >103 n/a ——
a.Variability of GA estimate by BPD at term is r 2 SD (6 weeks)
80
Table 2-12: BPD: Hadlock, J Ultrasound Med 1:97-104, April 1982 (Fetal Age)Unit: BPD
(mm); Age (Days ); SD (Days)
<20 n/a —— 40 126 10 61 175 9 82 233 14

20 85 6 41 128 10 62 177 9 83 237 14
21 88 6 42 130 10 63 180 9 84 239 14
22 90 6 43 132 10 64 183 9 85 243 14
23 92 6 44 134 10 65 185 9 86 246 14
24 93 6 45 137 10 66 188 9 87 249 14
25 95 6 46 139 10 67 190 9 88 253 25
26 97 6 47 141 10 68 193 9 89 256 25
27 99 6 48 144 10 69 196 9 90 259 25
28 102 6 49 146 10 70 198 9 91 263 25
29 103 6 50 148 10 71 201 9 92 266 25
30 105 6 51 151 10 72 204 9 93 270 25
31 107 6 52 153 10 73 207 9 94 272 25
32 109 6 53 155 10 74 209 9 95 276 25
33 111 6 54 158 10 75 213 14 96 279 25
34 113 6 55 160 10 76 216 14 97 284 25
35 116 6 56 162 10 77 218 14 98 287 25
36 118 6 57 163 10 78 221 14 99 291 25
37 120 6 58 167 10 79 224 14 100 294 25
38 122 6 59 169 9 80 228 14 >100 n/a ——
39 124 6 60 172 9 81 230 14
Table 2-13: CI: Hadlock, AJR, 137: 83, 1981 (Fetal Growth)
Min (Index) Max (Index)
70 86
81
Table 2-14: CRL: Hadlock, Radiology 1992, Vol. 182:501 (Fetal Age)Unit: CRL (mm); Age
(Week); SD (Week)
CRL Age SD CRL Age SD CRL Age SD CRL Age SD
<2 n/a —— 32 10.1 r 0.5 63 12.7 r 0.6 94 15.3 r 0.7

2 5.7 r 0.3 33 10.2 r 0.5 64 12.8 r 0.6 95 15.3 r 0.7
3 5.9 r 0.3 34 10.3 r 0.5 65 12.8 r 0.6 96 15.4 r 0.7
4 6.1 r 0.3 35 10.4 r 0.5 66 12.9 r 0.6 97 15.5 r 0.7
5 6.2 r 0.3 36 10.5 r 0.5 67 13.0 r 0.6 98 15.6 r 0.7
6 6.4 r 0.3 37 10.6 r 0.5 68 13.1 r 0.6 99 15.7 r 0.7
7 6.6 r 0.3 38 10.7 r 0.5 69 13.1 r 0.6 100 15.9 r 0.7
8 6.7 r 0.3 39 10.8 r 0.5 70 13.2 r 0.6 101 16.0 r 0.7
9 6.9 r 0.3 40 10.9 r 0.5 71 13.3 r 0.6 102 16.1 r 0.7
10 7.1 r 0.3 41 11.0 r 0.5 72 13.4 r 0.6 103 16.2 r 0.7
11 7.2 r 0.3 42 11.1 r 0.5 73 13.4 r 0.6 104 16.3 r 0.7
12 7.4 r 0.3 43 11.2 r 0.5 74 13.5 r 0.6 105 16.4 r 0.7
13 7.5 r 0.3 44 11.2 r 0.5 75 13.6 r 0.6 106 16.5 r 0.7
14 7.7 r 0.3 45 11.3 r 0.5 76 13.7 r 0.6 107 16.6 r 0.7
15 7.9 r 0.4 46 11.4 r 0.5 77 13.8 r 0.6 108 16.7 r 0.7
16 8.0 r 0.4 47 11.5 r 0.5 78 13.8 r 0.6 109 16.8 r 0.7
17 8.1 r 0.4 48 11.6 r 0.5 79 13.9 r 0.6 110 16.9 r 0.8
18 8.3 r 0.4 49 11.7 r 0.5 80 14.0 r 0.6 111 17.0 r 0.8
19 8.4 r 0.4 50 11.7 r 0.5 81 14.1 r 0.6 112 17.1 r 0.8
20 8.6 r 0.4 51 11.8 r 0.5 82 14.2 r 0.6 113 17.2 r 0.8
21 8.7 r 0.4 52 11.9 r 0.5 83 14.2 r 0.6 114 17.3 r 0.8
22 8.9 r 0.4 53 12.0 r 0.5 84 14.3 r 0.6 115 17.4 r 0.8
23 9.0 r 0.4 54 12.0 r 0.5 85 14.4 r 0.6 116 17.5 r 0.8
24 9.1 r 0.4 55 12.1 r 0.5 86 14.5 r 0.6 117 17.6 r 0.8
25 9.2 r 0.4 56 12.2 r 0.5 87 14.6 r 0.6 118 17.7 r 0.8
26 9.4 r 0.4 57 12.3 r 0.5 88 14.7 r 0.7 119 17.8 r 0.8
27 9.5 r 0.4 58 12.3 r 0.5 89 14.8 r 0.7 120 17.9 r 0.8
28 9.6 r 0.4 59 12.4 r 0.6 90 14.9 r 0.7 121 18.0 r 0.8
29 9.7 r 0.4 60 12.5 r 0.6 91 15.0 r 0.7 >121 n/a ——
30 9.9 r 0.4 61 12.6 r 0.6 92 15.1 r 0.7
31 10.0 r 0.4 62 12.6 r 0.6 93 15.2 r 0.7
Table 2-15: EFW: Hadlock (Fetal Age)Unit: EFW (grams); Mean (Weeks); SD (grams)
EFW Mean 2SD EFW Mean 2SD EFW Mean 2SD
<35 n/a —— 399 21 51 2162 33 275

35 10 4 478 22 61 2377 34 302
45 11 6 568 23 72 2595 35 330
58 12 7 670 24 85 2813 36 357
73 13 9 785 25 101 3028 37 385
93 14 12 913 26 116 3236 38 411
117 15 15 1055 27 134 3435 39 436
146 16 19 1210 28 154 3619 40 460
181 17 23 1379 29 175 3787 41 481
223 18 28 1559 30 198 >3787 n/a ——
273 19 35 1751 31 222
331 20 42 1953 32 248
82
Table 2-16: FL: Hadlock, Radiology 1984, Vol. 152:497 (Fetal Age)Unit: FL (mm); Age
(Week); 2SD (Week)
FL Age 2SD FL Age 2SD FL Age 2SD FL Age 2SD
<6 n/a —— 25 17.6 r 1.4 45 24.9 r 2.1 65 33.5 r 3.0

6 11.9 r 1.4 26 17.9 r 1.4 46 25.3 r 2.1 66 34.0 r 3.0
7 12.2 r 1.4 27 18.2 r 1.8 47 25.7 r 2.1 67 34.5 r 3.0
8 12.4 r 1.4 28 18.6 r 1.8 48 26.1 r 2.1 68 34.9 r 3.0
9 12.7 r 1.4 29 18.9 r 1.8 49 26.5 r 2.1 69 35.4 r 3.0
10 13.0 r 1.4 30 19.3 r 1.8 50 26.9 r 2.1 70 35.9 r 3.0
11 13.3 r 1.4 31 19.6 r 1.8 51 27.3 r 2.1 71 36.4 r 3.1
12 13.5 r 1.4 32 20.0 r 1.8 52 27.7 r 2.1 72 36.9 r 3.1
13 13.8 r 1.4 33 20.3 r 1.8 53 28.2 r 2.1 73 37.4 r 3.1
14 14.1 r 1.4 34 20.7 r 1.8 54 28.6 r 2.1 74 37.9 r 3.1
15 14.4 r 1.4 35 21.0 r 1.8 55 29.0 r 2.1 75 38.4 r 3.1
16 14.7 r 1.4 36 21.4 r 1.8 56 29.5 r 2.1 76 38.9 r 3.1
17 15.0 r 1.4 37 21.8 r 1.8 57 29.9 r 2.1 77 39.4 r 3.1
18 15.3 r 1.4 38 22.2 r 1.8 58 30.3 r 3.0 78 39.9 r 3.1
19 15.6 r 1.4 39 22.5 r 1.8 59 30.8 r 3.0 79 40.4 r 3.1
20 16.0 r 1.4 40 22.9 r 1.8 60 31.2 r 3.0 80 40.9 r 3.1
21 16.3 r 1.4 41 23.3 r 1.8 61 31.7 r 3.0 81 41.4 r 3.1
22 16.6 r 1.4 42 23.7 r 1.8 62 32.1 r 3.0 82 42.0 r 3.1
23 16.9 r 1.4 43 24.1 r 2.1 63 32.6 r 3.0 83 42.5 r 3.1
24 17.2 r 1.4 44 24.5 r 2.1 64 33.1 r 3.0 >83 n/a ——
Table 2-17: FL: Hadlock, AJR 138: 875-878, May 1982 (Fetal Age)Unit: FL (mm); Age
(Days); 2SD (Days)
FL Age SD FL Age SD FL Age SD FL Age SD
<10 n/a —— 27 125 6 45 171 10 63 226 10

10 90 6 28 127 6 46 174 10 64 230 10
11 92 6 29 130 6 47 177 10 65 233 10
12 94 6 30 132 6 48 180 10 66 237 10
13 95 6 31 134 6 49 183 10 67 239 10
14 97 6 32 137 6 50 185 10 68 243 10
15 99 6 33 139 6 51 189 10 69 246 10
16 101 6 34 142 6 52 192 10 70 250 10
17 104 6 35 145 6 53 195 10 71 253 11
18 106 6 36 147 6 54 197 10 72 257 11
19 108 6 37 150 6 55 201 10 73 260 11
20 110 6 38 153 6 56 204 10 74 264 11
21 112 6 39 155 6 57 207 10 75 268 11
22 114 6 40 157 6 58 210 10 76 272 11
23 116 6 41 160 6 59 213 10 77 275 11
24 118 6 42 163 6 60 216 10 78 279 11
25 120 6 43 166 6 61 220 10 79 283 11
26 123 6 44 169 10 62 223 10 >79 n/a ——
83
Table 2-18: HC: Hadlock, Radiology 1984, Vol. 152:497 (Fetal Age)Unit: HC (mm); Age
(Week); 2SD (Week)
HC Age 2SD HC Age 2SD HC Age 2SD HC Age 2SD
<55 n/a —— 135 17.0 r 1.2 215 23.6 r 1.5 290 31.9 r 3.0
55 12.0 r 1.2 140 17.3 r 1.2 219 23.9 r 1.5 295 32.6 r 3.0
60 12.3 r 1.2 145 17.7 r 1.2 220 24.0 r 2.1 300 33.3 r 3.0
65 12.6 r 1.2 149 18.0 r 1.2 225 24.5 r 2.1 305 33.9 r 3.0
70 12.8 r 1.2 150 18.1 r 1.5 230 25.0 r 2.1 310 34.6 r 3.0
75 13.1 r 1.2 155 18.4 r 1.5 235 25.5 r 2.1 315 35.3 r 3.0
80 13.4 r 1.2 160 18.8 r 1.5 240 26.1 r 2.1 319 35.9 r 3.0
85 13.7 r 1.2 165 19.2 r 1.5 245 26.6 r 2.1 320 36.1 r 2.7
90 14.0 r 1.2 170 19.6 r 1.5 250 27.1 r 2.1 325 36.8 r 2.7
95 14.3 r 1.2 175 20.0 r 1.5 255 27.7 r 2.1 330 37.6 r 2.7
100 14.7 r 1.2 180 20.4 r 1.5 260 28.3 r 2.1 335 38.3 r 2.7
105 15.0 r 1.2 185 20.8 r 1.5 265 28.9 r 2.1 340 39.1 r 2.7
110 15.3 r 1.2 190 21.3 r 1.5 270 29.4 r 2.1 345 39.9 r 2.7
115 15.6 r 1.2 195 21.7 r 1.5 274 29.9 r 2.1 350 40.7 r 2.7
120 16.0 r 1.2 200 22.2 r 1.5 275 30.0 r 3.0 355 41.6 r 2.7
125 16.3 r 1.2 205 22.6 r 1.5 280 30.7 r 3.0 360 42.4 r 2.7
130 16.6 r 1.2 210 23.1 r 1.5 285 31.3 r 3.0 >360 n/a ——
Table 2-19: HC: Hadlock, AJR 138: 649-653, 1982 (Fetal Age)Unit: HC (mm); Age (Days);
2SD (Days)
HC Age SD HC Age SD HC Age SD HC Age SD
<69 n/a —— 169 136 11 260 196 16 322 252 19

69 84 9 175 140 11 264 199 16 325 255 24
75 87 9 181 143 11 269 203 16 328 259 24
81 91 9 187 147 11 273 206 16 331 262 24
88 94 9 193 150 11 278 210 16 334 266 24
96 98 9 198 154 11 282 213 19 337 269 24
103 101 9 204 157 11 286 217 19 340 273 24
110 105 9 209 161 11 291 220 19 343 276 24
117 108 9 215 164 11 294 224 19 345 280 24
124 112 9 220 168 11 298 227 19 348 286 24
131 115 9 225 171 16 302 231 19 351 287 24
137 119 9 230 175 16 306 234 19 353 290 24
144 122 9 240 182 16 309 238 19 354 294 24
150 126 9 245 185 16 312 241 19 >354 n/a ——
157 129 11 250 189 16 316 245 19
163 133 11 255 192 16 319 248 19
84
Table 2-20: FL/HC Ratio: Hadlock, J Ultrasound Med 1984, 3: 439-442 (Fetal
Growth)Unit: GA (Weeks)
GA Min Max GA Min Max GA Min Max
<15 n/a —— 24 18.7 20.9 34 19.4 21.8

15 15.3 17.1 25 18.7 20.3 35 20.1 22.3
16 13.3 16.5 26 18.6 20.4 36 20.1 22.1
17 14.6 17.6 27 18.6 20.4 37 20.8 22.6
18 15.8 18.0 28 18.8 20.6 38 20.9 22.7
19 16.1 18.3 29 19.6 20.8 39 20.6 23.4
20 16.8 19.8 30 19.2 21.4 40 20.7 22.5
21 15.9 20.3 31 19.3 21.3 41 21.6 23.2
22 18.4 20.2 32 19.1 21.3 42 20.1 23.9
23 19.2 20.8 33 19.9 21.5 >42 n/a n/a
Table 2-21: FL/AC Ratio: Hadlock (Fetal Growth)Unit: Age (Weeks)
Age Min (Index) Max (Index)
21 20 24
42 20 24
85
Hansmann
Table 2-22: AC: Hansmann (Fetal Age) (Hansmann:M & Al:Geburtsh, u, Frauenheilk
39:656, 1979) Unit: AC (mm); Age (Weeks/Days); SD (mm)
<53 n/a —— 99 15w2d 0 146 20w2d 0 193 25w2d 0

53 11w1d 0 100 15w3d 0 147 20w2d 0 194 25w3d 0
54 11w2d 0 101 15w4d 0 148 20w3d 0 195 25w4d 0
55 11w2d 0 102 15w5d 0 149 20w3d 0 196 25w4d 0
56 11w3d 0 103 15w5d 0 150 20w4d 0 197 25w5d 0
57 11w3d 0 104 15w6d 0 151 20w4d 0 198 25w5d 0
58 11w4d 0 105 16w0d 0 152 20w5d 0 199 25w6d 0
59 11w4d 0 106 16w0d 0 153 20w6d 0 200 26w0d 0
60 11w5d 0 107 16w1d 0 154 21w0d 0 201 26w0d 0
61 11w6d 0 108 16w2d 0 155 21w1d 0 202 26w1d 0
62 12w0d 0 109 16w3d 0 156 21w2d 0 203 26w2d 0
63 12w1d 0 110 16w3d 0 157 21w2d 0 204 26w3d 0
64 12w2d 0 111 16w4d 0 158 21w3d 0 205 26w3d 0
65 12w2d 0 112 16w5d 0 159 21w3d 0 206 26w4d 0
66 12w3d 0 113 16w6d 0 160 21w4d 0 207 26w5d 0
67 12w3d 0 114 16w6d 0 161 21w4d 0 208 26w6d 0
68 12w4d 0 115 17w0d 0 162 21w5d 0 209 26w6d 0
69 12w5d 0 116 17w1d 0 163 21w6d 0 210 27w0d 0
70 12w5d 0 117 17w2d 0 164 22w0d 0 211 27w1d 0
71 12w6d 0 118 17w2d 0 165 22w1d 0 212 27w2d 0
72 12w6d 0 119 17w3d 0 166 22w2d 0 213 27w2d 0
73 13w0d 0 120 17w3d 0 167 22w3d 0 214 27w3d 0
74 13w0d 0 121 17w4d 0 168 22w4d 0 215 27w4d 0
75 13w1d 0 122 17w4d 0 169 22w5d 0 216 27w4d 0
76 13w2d 0 123 17w5d 0 170 22w5d 0 217 27w5d 0
77 13w2d 0 124 17w6d 0 171 22w6d 0 218 27w5d 0
78 13w3d 0 125 18w0d 0 172 23w0d 0 219 27w6d 0
79 13w3d 0 126 18w1d 0 173 23w1d 0 220 28w0d 0
80 13w4d 0 127 18w2d 0 174 23w2d 0 221 28w0d 0
81 13w4d 0 128 18w3d 0 175 23w2d 0 222 28w1d 0
82 13w5d 0 129 18w3d 0 176 23w3d 0 223 28w2d 0
83 13w6d 0 130 18w4d 0 177 23w3d 0 224 28w3d 0
84 14w0d 0 131 18w5d 0 178 23w4d 0 225 28w4d 0
85 14w1d 0 132 18w6d 0 179 23w4d 0 226 28w5d 0
86 14w2d 0 133 18w6d 0 180 23w5d 0 227 28w5d 0
87 14w2d 0 134 19w0d 0 181 23w6d 0 228 28w6d 0
88 14w3d 0 135 19w1d 0 182 24w0d 0 229 29w0d 0
89 14w3d 0 136 19w2d 0 183 24w1d 0 230 29w1d 0
90 14w4d 0 137 19w2d 0 184 24w2d 0 231 29w2d 0
91 14w5d 0 138 19w3d 0 185 24w3d 0 232 29w2d 0
92 14w5d 0 139 19w3d 0 186 24w4d 0 233 29w3d 0
93 14w6d 0 140 19w4d 0 187 24w5d 0 234 29w3d 0
94 14w6d 0 141 19w4d 0 188 24w5d 0 235 29w4d 0
95 15w0d 0 142 19w5d 0 189 24w6d 0 236 29w4d 0
96 15w0d 0 143 19w6d 0 190 25w0d 0 237 29w5d 0
97 15w1d 0 144 20w0d 0 191 25w1d 0 238 29w6d 0
98 15w2d 0 145 20w1d 0 192 25w2d 0 239 30w0d 0
86
Table 2-22: AC: Hansmann (Fetal Age) (Hansmann:M & Al:Geburtsh, u, Frauenheilk
39:656, 1979)(Continued)Unit: AC (mm); Age (Weeks/Days); SD (mm)
240 30w1d 0 261 32w3d 0 282 34w4d 0 303 36w5d 0

241 30w2d 0 262 32w3d 0 283 34w4d 0 304 36w6d 0
242 30w3d 0 263 32w4d 0 284 34w5d 0 305 37w0d 0
243 30w3d 0 264 32w4d 0 285 34w6d 0 306 37w1d 0
244 30w4d 0 265 32w5d 0 286 35w0d 0 307 37w2d 0
245 30w5d 0 266 32w6d 0 287 35w1d 0 308 37w3d 0
246 30w6d 0 267 33w0d 0 288 35w2d 0 309 37w3d 0
247 30w6d 0 268 33w1d 0 289 35w3d 0 310 37w4d 0
248 31w0d 0 269 33w2d 0 290 35w3d 0 311 37w5d 0
249 31w1d 0 270 33w3d 0 291 35w4d 0 312 37w6d 0
250 31w2d 0 271 33w3d 0 292 35w5d 0 313 37w6d 0
251 31w3d 0 272 33w4d 0 293 35w6d 0 314 38w0d 0
252 31w3d 0 273 33w5d 0 294 35w6d 0 315 38w1d 0
253 31w4d 0 274 33w6d 0 295 36w0d 0 316 38w2d 0
254 31w5d 0 275 33w6d 0 296 36w1d 0 317 38w4d 0
255 31w6d 0 276 34w0d 0 297 36w2d 0 318 38w5d 0
256 31w6d 0 277 34w1d 0 298 36w2d 0 319 39w0d 0
257 32w0d 0 278 34w2d 0 299 36w3d 0 320 39w1d 0
258 32w1d 0 279 34w2d 0 300 36w3d 0 >320 n/a ——
259 32w2d 0 280 34w3d 0 301 36w4d 0
260 32w2d 0 281 34w3d 0 302 36w4d 0
87
Table 2-23: BPD: Hansmann (Fetal Age)Ultrasound Diagnosis in Obstetrics &
Gynecology, 438-439, 1985Known LMP (left)—Unknown LMP (right)Unit: BPD (mm); Age
(Weeks/Days); 2SD (mm [Known LMP] or day [Unknown LMP])
<14 n/a —— 60 22w6d 5 <14 n/a —— 60 23w2d 10

14 10w0d 0 61 23w1d 5 14 9w1d 7 61 23w4d 10
15 10w1d 0 62 23w4d 5 15 9w3d 7 62 24w0d 10
16 10w2d 0 63 23w6d 5 16 9w5d 7 63 24w2d 10
17 10w5d 0 64 24w1d 6 17 10w0d 7 64 24w4d 10
18 10w6d 0 65 24w4d 6 18 10w2d 7 65 24w6d 10
19 11w1d 0 66 24w6d 6 19 10w4d 7 66 25w1d 11
20 11w3d 0 67 25w1d 6 20 10w6d 7 67 25w3d 12
21 11w5d 0 68 25w3d 6 21 11w1d 7 68 25w6d 10
22 12w0d 0 69 25w5d 6 22 11w3d 7 69 26w1d 10
23 12w2d 0 70 26w1d 6 23 11w5d 7 70 26w3d 10
24 12w4d 5 71 26w3d 6 24 12w0d 7 71 26w5d 12
25 12w6d 5 72 26w6d 6 25 12w2d 7 72 27w1d 11
26 13w1d 5 73 27w1d 6 26 12w4d 7 73 27w3d 13
27 13w2d 5 74 27w3d 6 27 12w6d 7 74 27w6d 12
28 13w4d 4 75 27w6d 6 28 13w1d 7 75 28w1d 12
29 13w6d 4 76 28w1d 6 29 13w3d 8 76 28w4d 13
30 14w1d 4 77 28w4d 6 30 13w5d 7 77 28w6d 13
31 14w3d 4 78 28w6d 6 31 14w0d 8 78 29w2d 15
32 14w4d 4 79 29w2d 6 32 14w2d 8 79 29w5d 16
33 14w6d 4 80 29w5d 6 33 14w4d 9 80 30w0d 15
34 15w2d 4 81 30w0d 6 34 15w0d 9 81 30w3d 15
35 15w4d 4 82 30w3d 6 35 15w2d 8 82 31w0d 15
36 15w6d 4 83 30w5d 6 36 15w4d 9 83 31w2d 16
37 16w1d 4 84 31w2d 6 37 16w0d 8 84 31w6d 17
38 16w3d 4 85 31w5d 6 38 16w2d 9 85 32w2d 17
39 16w5d 4 86 32w1d 6 39 16w4d 9 86 32w5d 18
40 17w0d 4 87 32w4d 6 40 17w0d 9 87 33w2d 20
41 17w2d 4 88 33w0d 7 41 17w2d 9 88 33w5d 19
42 17w4d 4 89 33w3d 7 42 17w4d 9 89 34w2d 19
43 17w6d 4 90 33w6d 7 43 17w6d 9 90 34w5d 19
44 18w1d 4 91 34w3d 7 44 18w1d 9 91 35w1d 25
45 18w3d 4 92 34w6d 7 45 18w4d 9 92 35w6d 24
46 18w5d 4 93 35w3d 7 46 18w6d 9 93 36w5d 21
47 19w0d 4 94 36w0d 7 47 19w1d 10 94 37w3d 19
48 19w2d 5 95 36w3d 7 48 19w3d 10 95 38w3d 22
49 19w4d 5 96 37w1d 7 49 19w5d 10 96 38w6d 25
50 19w6d 5 97 37w6d 7 50 20w0d 10 97 39w0d 22
51 20w1d 5 98 38w4d 7 51 20w3d 10 98 39w2d 20
52 20w3d 5 99 39w3d 7 52 20w5d 10 99 39w3d 22
53 20w6d 5 100 40w3d 7 53 21w0d 11 100 39w4d 20
54 21w1d 5 101 41w3d 7 54 21w3d 10 101 39w5d 20
55 21w2d 5 >101 n/a —— 55 21w5d 10 102 39w6d 19
56 21w4d 5 56 22w0d 9 103 40w0d 19
57 21w6d 5 57 22w2d 9 104 40w1d 19
58 22w2d 5 58 22w5d 9 105 40w2d 17
59 22w4d 5 59 23w0d 10 >105 n/a ——
88
Table 2-24: CRL: Hansmann (Fetal Age) Ultrasound Diagnosis in Obstetrics &
Gynecology, 438-439, 1985Unit: CRL (mm); Age (Weeks/Days); 2SD (mm [Known LMP]
or day [Unknown LMP])
Known LMP
<13 n/a —— 54 12w0d 15 96 15w3d 11 138 19w2d 15

13 7w4d 0 55 12w1d 16 97 15w3d 11 139 19w3d 15
14 7w5d 0 56 12w1d 16 98 15w4d 11 140 19w4d 15
15 8w0d 0 57 12w2d 16 99 15w4d 11 141 19w4d 16
16 8w1d 0 58 12w2d 16 100 15w5d 11 142 19w5d 16
17 8w2d 0 59 12w3d 16 101 15w5d 10 143 19w5d 16
18 8w3d 0 60 12w3d 16 102 15w6d 10 144 19w6d 16
19 8w4d 7 61 12w4d 15 103 15w6d 10 145 20w0d 16
20 8w5d 7 62 12w4d 15 104 16w0d 10 146 20w1d 17
21 8w6d 8 63 12w5d 15 105 16w1d 10 147 20w2d 17
22 9w0d 8 64 12w5d 15 106 16w2d 10 148 20w2d 17
23 9w1d 10 65 12w6d 15 107 16w2d 10 149 20w3d 17
24 9w2d 10 66 12w6d 15 108 16w3d 10 150 20w4d 17
25 9w3d 11 67 13w0d 15 109 16w3d 10 151 20w4d 0
26 9w4d 11 68 13w1d 15 110 16w4d 10 152 20w5d 0
27 9w4d 11 69 13w1d 15 111 16w4d 11 153 20w5d 0
28 9w5d 11 70 13w2d 15 112 16w5d 11 154 20w6d 0
29 9w6d 11 71 13w3d 15 113 16w5d 11 155 21w0d 0
30 10w0d 12 72 13w3d 15 114 16w6d 11 156 21w0d 0
31 10w0d 12 73 13w4d 15 115 17w0d 11 157 21w1d 0
32 10w1d 12 74 13w4d 15 116 17w1d 12 158 21w1d 0
33 10w2d 12 75 13w5d 15 117 17w2d 12 159 21w2d 0
34 10w3d 12 76 13w5d 15 118 17w2d 12 160 21w3d 0
35 10w3d 13 77 13w6d 15 119 17w3d 12 161 21w3d 0
36 10w4d 13 78 13w6d 15 120 17w3d 12 162 21w4d 0
37 10w5d 13 79 14w0d 15 121 17w4d 13 163 21w4d 0
38 10w5d 13 80 14w0d 15 122 17w5d 13 164 21w5d 0
39 10w6d 13 81 14w1d 13 123 17w5d 13 165 21w6d 0
40 10w6d 13 82 14w1d 13 124 17w6d 13 166 21w6d 0
41 11w0d 14 83 14w2d 13 125 18w0d 13 167 22w0d 0
42 11w1d 14 84 14w2d 13 126 18w1d 14 168 22w0d 0
43 11w1d 14 85 14w3d 13 127 18w1d 14 169 22w1d 0
44 11w2d 14 86 14w3d 13 128 18w2d 14 170 22w1d 0
45 11w2d 14 87 14w4d 13 129 18w2d 14 171 22w2d 0
46 11w3d 14 88 14w4d 13 130 18w3d 15 172 22w2d 0
47 11w3d 15 89 14w5d 13 131 18w4d 15 173 22w3d 0
48 11w4d 15 90 14w6d 13 132 18w4d 15 174 22w3d 0
49 11w4d 15 91 14w6d 12 133 18w5d 15 175 22w4d 0
50 11w5d 15 92 15w0d 12 134 18w6d 15 >175 n/a ——
51 11w5d 15 93 15w0d 12 135 19w0d 15
52 11w6d 15 94 15w1d 12 136 19w1d 15
53 11w6d 15 95 15w2d 12 137 19w1d 15
Unknown LMP
89
Table 2-24: CRL: Hansmann (Fetal Age) (Continued)Ultrasound Diagnosis in Obstetrics &
Gynecology, 438-439, 1985Unit: CRL (mm); Age (Weeks/Days); 2SD (mm [Known LMP]
<6 n/a —— 22 9w1d 7 54 12w3d 9 106 16w2d 13

6 6w1d 7 23 9w2d 7 56 12w4d 9 110 16w4d 14
7 6w2d 7 24 9w3d 7 58 12w5d 9 113 17w0d 14
8 6w4d 7 26 9w5d 7 60 12w6d 9 116 17w2d 14
9 6w6d 7 28 10w0d 8 63 13w0d 10 120 17w4d 14
10 7w0d 7 30 10w2d 8 66 13w2d 10 123 18w0d 14
11 7w2d 7 32 10w3d 8 70 13w3d 10 126 18w2d 14
12 7w3d 7 34 10w5d 8 73 13w5d 11 130 18w6d 14
13 7w4d 7 36 10w6d 8 76 13w6d 11 133 19w1d 15
14 7w6d 7 38 11w1d 8 80 14w1d 11 136 19w4d 16
15 8w0d 7 40 11w2d 8 83 14w2d 12 140 20w0d 16
16 8w2d 7 42 11w3d 8 86 14w4d 12 143 20w3d 16
17 8w3d 7 44 11w4d 9 90 14w6d 12 146 20w6d 16
18 8w4d 7 46 11w6d 9 93 15w1d 12 150 21w3d 16
19 8w5d 7 48 12w0d 9 96 15w3d 12 >150 n/a ——
20 8w6d 7 50 12w1d 9 100 15w5d 12
21 9w0d 7 52 12w2d 9 103 16w0d 13
Table 2-25: FL: Hansmann (Fetal Age)Ultrasound Diagnosis in Obstetrics and

Gynecology, 438-439, 1985Known/Unknown LMP; Unit: FL (mm); Age (Weeks/Days);
2SD (Week)
FL Age 2SD FL Age 2SD FL Age 2SD FL Age 2SD
<12 n/a —— 28 18w4d 4 45 24w6d 5 62 32w1d 5

12 13w4d 0 29 18w6d 4 46 25w2d 5 63 32w5d 5
13 13w6d 0 30 19w2d 4 47 25w4d 5 64 33w1d 6
14 14w1d 0 31 19w4d 4 48 26w0d 5 65 33w5d 6
15 14w3d 0 32 20w0d 4 49 26w3d 5 66 34w1d 6
16 14w5d 5 33 20w3d 4 50 26w6d 5 67 34w5d 6
17 15w1d 5 34 20w5d 4 51 27w3d 5 68 35w1d 6
18 15w2d 4 35 21w1d 5 52 27w5d 5 69 35w5d 6
19 15w5d 4 36 21w3d 5 53 28w1d 5 70 36w1d 6
20 16w0d 4 37 21w6d 5 54 28w4d 5 71 36w5d 6
21 16w2d 4 38 22w1d 5 55 29w0d 5 72 37w2d 6
22 16w4d 4 39 22w4d 5 56 29w3d 6 73 37w6d 6
23 16w6d 4 40 22w6d 5 57 29w6d 6 74 38w3d 7
24 17w2d 4 41 23w2d 5 58 30w2d 6 75 39w0d 7
25 17w4d 4 42 23w5d 5 59 30w5d 5 >75 n/a ——
26 17w6d 4 43 24w0d 5 60 31w2d 5
27 18w2d 4 44 24w3d 5 61 31w5d 5
90
Table 2-26: GS: Hansmann (Fetal Age)Hansmann: M and Al: Geburtsh, u, Frauenheilk
39: 656, 1979Unit: GS (mm); Age (Days); SD (mm)
GS Age SD GS Age SD GS Age SD GS Age SD
<10 n/a —— 24 47 5 39 61 5 54 76 5
10 33 5 25 48 5 40 62 5 55 77 5
11 34 5 26 49 5 41 63 5 56 78 5
12 35 5 27 50 5 42 64 5 57 79 5
13 36 5 28 51 5 43 65 5 58 80 5
14 37 5 29 52 5 44 66 5 59 81 5
15 38 5 30 53 5 45 67 5 60 82 5
16 39 5 31 54 5 46 68 5 61 83 5
17 40 5 32 55 5 47 69 5 62 84 5
18 41 5 33 56 5 48 70 5 63 85 5
19 42 5 34 57 5 49 71 5 64 86 5
20 43 5 35 58 5 50 72 5 65 87 5
21 44 5 36 58 5 51 73 5 >65 n/a ——
22 45 5 37 59 5 52 74 5
23 46 5 38 60 5 53 75 5
Table 2-27: HC: Hansmann (Fetal Age)Ultrasound Diagnosis in Obstetrics and

Gynecology, 438-439, 1985Known/Unknown LMP; Unit: HC (mm); Age (Weeks/Days);
2SD (mm)
HC Age 2SD HC Age 2SD HC Age 2SD HC Age 2SD
<105 n/a —— 165 18w4d 16 230 23w5d 18 295 29w5d 19

105 13w3d 0 170 19w0d 16 235 24w1d 18 300 30w2d 19
110 14w0d 0 175 19w3d 16 240 24w4d 18 305 30w5d 19
115 14w3d 14 180 19w5d 16 245 25w0d 18 310 31w2d 19
120 14w6d 14 185 20w1d 17 250 25w3d 18 315 32w1d 20
125 15w3d 14 190 20w4d 17 255 25w6d 18 320 32w5d 20
130 15w5d 14 195 21w0d 17 260 26w2d 18 325 33w3d 20
135 16w1d 14 200 21w2d 17 265 26w5d 18 330 34w2d 20
140 16w4d 14 205 21w5d 17 270 27w1d 18 335 35w1d 20
145 17w0d 15 210 22w1d 17 275 27w4d 19 340 36w2d 20
150 17w3d 15 215 22w4d 17 280 28w1d 19 345 37w6d 20
155 17w6d 16 220 23w0d 17 285 28w5d 19 >345 n/a ——
160 18w1d 16 225 23w3d 17 290 29w1d 19
91
Table 2-28: OFD: Hansmann (Fetal Age)Ultrasound Diagnosis in Obstetrics and
Gynecology, 438-439, 1985Known/Unknown LMP; Unit: OFD (mm); Age (Weeks/Days);
2SD (mm)
OFD Age 2SD OFD Age 2SD OFD Age 2SD OFD Age 2SD
<34 n/a —— 54 18w4d 5 75 23w2d 7 96 29w0d 8

34 13w3d 0 55 18w6d 5 76 23w4d 7 97 29w3d 8
35 13w5d 0 56 19w0d 6 77 23w6d 7 98 29w5d 8
36 14w0d 0 57 19w2d 6 78 24w1d 7 99 30w0d 8
37 14w2d 5 58 19w3d 6 79 24w2d 7 100 30w3d 8
38 14w4d 5 59 19w5d 6 80 24w4d 7 101 30w5d 8
39 14w6d 5 60 20w0d 6 81 24w6d 7 102 31w1d 8
40 15w1d 5 61 20w1d 6 82 25w1d 7 103 31w4d 8
41 15w3d 5 62 20w2d 6 83 25w2d 7 104 32w0d 8
42 15w5d 5 63 20w4d 6 84 25w4d 7 105 32w3d 8
43 16w0d 5 64 20w6d 6 85 25w6d 7 106 32w6d 8
44 16w1d 5 65 21w0d 6 86 26w1d 7 107 33w3d 8
45 16w3d 5 66 21w2d 6 87 26w3d 7 108 33w6d 8
46 16w4d 5 67 21w4d 6 88 26w5d 7 109 34w3d 8
47 16w6d 5 68 21w5d 6 89 27w0d 7 110 35w0d 8
48 17w1d 5 69 22w0d 6 90 27w2d 7 111 35w4d 8
49 17w3d 5 70 22w1d 7 91 27w4d 8 112 36w2d 8
50 17w4d 5 71 22w3d 7 92 27w6d 8 113 37w0d 8
51 17w6d 5 72 22w4d 7 93 28w1d 8 114 38w0d 8
52 18w1d 5 73 22w6d 7 94 28w3d 8 115 39w0d 8
53 18w2d 5 74 23w1d 7 95 28w5d 8 >115 n/a ——
92
Table 2-29: TAD: Hansmann (Fetal Age)Hansmann: M and Al: Geburtsh, u, Frauenheilk
39: 656, 1979Unit: TAD (mm); Age (Days); SD (mm)
<20 n/a —— 41 130 4 63 179 4 85 232 5

20 87 4 42 132 4 64 182 4 86 235 5
21 89 4 43 135 4 65 184 4 87 237 5
22 91 4 44 137 4 66 186 4 88 240 5
23 93 4 45 139 4 67 188 4 89 242 5
24 95 4 46 141 4 68 191 5 90 245 5
25 97 4 47 143 4 69 193 5 91 247 5
26 99 4 48 146 4 70 195 5 92 250 5
27 101 4 49 148 4 71 198 5 93 252 5
28 103 4 50 150 4 72 200 5 94 255 5
29 105 4 51 152 4 73 203 5 95 258 5
30 107 4 52 155 4 74 205 5 96 261 5
31 109 4 53 157 4 75 208 5 97 264 5
32 111 4 54 159 4 76 210 5 98 267 5
33 113 4 55 161 4 77 212 5 99 270 5
34 115 4 56 164 4 78 215 5 100 273 5
35 117 4 57 166 4 79 217 5 101 276 5
36 119 4 58 168 4 80 220 5 102 279 5
37 122 4 59 170 4 81 222 5 103 282 5
38 124 4 60 173 4 82 225 5 >103 n/a ——
39 126 4 61 175 4 83 227 5
40 128 4 62 177 4 84 230 5
93
Table 2-30: ThD: Hansmann (Fetal Age)Ultrasound Diagnosis in Obstetrics and
Gynecology, 438-439, 1985Known/Unknown LMP; Unit: ThD (mm); Age (Weeks/Days);
2SD (mm)
ThD Age 2SD ThD Age 2SD ThD Age 2SD ThD Age 2SD
<20 n/a —— 41 18w5d 5 63 25w5d 7 85 33w1d 9

20 12w4d 0 42 19w0d 5 64 26w1d 7 86 33w4d 9
21 12w6d 0 43 19w3d 5 65 26w3d 7 87 33w6d 9
22 13w1d 0 44 19w5d 5 66 26w5d 7 88 34w2d 9
23 13w3d 0 45 19w6d 5 67 27w0d 7 89 34w4d 9
24 13w4d 4 46 20w2d 5 68 27w3d 8 90 35w0d 9
25 13w6d 4 47 20w4d 6 69 27w5d 8 91 35w3d 10
26 14w1d 4 48 20w6d 6 70 28w0d 8 92 35w5d 10
27 14w3d 4 49 21w2d 6 71 28w3d 8 93 36w1d 10
28 14w6d 4 50 21w4d 6 72 28w5d 8 94 36w3d 10
29 15w1d 4 51 21w6d 6 73 29w1d 8 95 36w6d 10
30 15w2d 4 52 22w1d 6 74 29w3d 8 96 37w1d 10
31 15w4d 4 53 22w4d 6 75 29w5d 8 97 37w4d 10
32 15w6d 4 54 22w6d 6 76 30w1d 8 98 38w1d 11
33 16w2d 4 55 23w1d 6 77 30w3d 8 99 38w4d 11
34 16w4d 4 56 23w3d 6 78 30w5d 8 100 38w6d 11
35 16w6d 4 57 23w6d 7 79 31w1d 8 101 39w3d 12
36 17w1d 5 58 24w1d 7 80 31w3d 8 102 39w6d 14
37 17w3d 5 59 24w3d 7 81 31w5d 8 103 40w2d 14
38 17w5d 5 60 24w6d 7 82 32w1d 9 104 40w5d 14
39 18w1d 5 61 25w1d 7 83 32w4d 9 105 41w2d 14
40 18w3d 5 62 25w3d 7 84 32w6d 9 >105 n/a ——
94
Hellman
Table 2-31: GS: Hellman (Fetal Age)A/OG 103: 789, 1969Unit: GS (mm); Age (Week); SD
(Week)
<10 n/a —— 23 6.9 r 1.0 37 8.9 r 1.0 51 10.9 r 1.0

10 5.0 r 1.0 24 7.0 r 1.0 38 9.0 r 1.0 52 11.0 r 1.0
11 5.2 r 1.0 25 7.2 r 1.0 39 9.2 r 1.0 53 11.2 r 1.0
12 5.3 r 1.0 26 7.3 r 1.0 40 9.3 r 1.0 54 11.3 r 1.0
13 5.5 r 1.0 27 7.5 r 1.0 41 9.5 r 1.0 55 11.5 r 1.0
14 5.6 r 1.0 28 7.6 r 1.0 42 9.6 r 1.0 56 11.6 r 1.0
15 5.8 r 1.0 29 7.8 r 1.0 43 9.7 r 1.0 57 11.7 r 1.0
16 5.9 r 1.0 30 7.9 r 1.0 44 9.9 r 1.0 58 11.9 r 1.0
17 6.0 r 1.0 31 8.0 r 1.0 45 10.0 r 1.0 59 12.0 r 1.0
18 6.2 r 1.0 32 8.2 r 1.0 46 10.2 r 1.0 60 12.2 r 1.0
19 6.3 r 1.0 33 8.3 r 1.0 47 10.3 r 1.0 >60 n/a ——
20 6.5 r 1.0 34 8.5 r 1.0 48 10.5 r 1.0
21 6.6 r 1.0 35 8.6 r 1.0 49 10.6 r 1.0
22 6.8 r 1.0 36 8.8 r 1.0 50 10.7 r 1.0
Hill
Table 2-32: TCD: Hill (Fetal Age)Obstet Gyn, 75: 981-984, 1990Unit: TCD (mm); Age
(Weeks); SD (Week)
TCD Age SD TCD Age SD TCD Age SD
<14 n/a —— 28 24.9 r 1.01 43 33.9 r 1.2

14 15.2 r 0.5 29 25.5 r 1.01 44 34.4 r 1.2
15 15.8 r 0.5 30 26.2 r 1.01 45 34.8 r 1.2
16 16.5 r 0.5 31 26.9 r 1.01 46 35.3 r 1.2
17 17.2 r 0.5 32 27.5 r 1.01 47 35.7 r 1.2
18 17.9 r 0.5 33 28.1 r 1.01 48 36.1 r 1.6
19 18.6 r 0.9 34 28.8 r 1.01 49 36.5 r 1.6
20 19.3 r 0.9 35 29.4 r 1.01 50 36.8 r 1.6
21 20.0 r 0.9 36 30.0 r 1.2 51 37.2 r 1.6
22 20.7 r 0.9 37 30.6 r 1.2 52 37.5 r 1.6
23 21.4 r 0.9 38 31.2 r 1.2 54 38.0 r 1.6
24 22.1 r 0.9 39 31.8 r 1.2 55 38.3 r 1.6
25 22.8 r 0.9 40 32.3 r 1.2 56 38.5 r 1.6
26 23.5 r 0.9 41 32.8 r 1.2 >56 n/a ——
27 24.2 r 1.01 42 33.4 r 1.2
95
Hohler
Table 2-33: FL: Hohler (Fetal Growth)Communications in Brief, 143: 479-481, 1982
Age (Weeks) Min (Index) Max (Index)
23 71 87
40 71 87
Jeanty
Table 2-34: AC: Jeanty (Fetal Age)Jeanty, Radiology 143: 513, 1982Unit: AC (mm); Age
(Day); SD (mm)
<50 n/a —— 115 122 22 185 169 22 255 218 22

50 79 22 120 125 22 190 172 22 260 222 22
55 82 22 125 129 22 195 176 22 265 226 22
60 85 22 130 132 22 200 179 22 270 230 22
65 89 22 135 135 22 205 182 22 275 234 22
70 92 22 140 139 22 210 186 22 280 239 22
75 95 22 145 142 22 215 189 22 285 244 22
80 99 22 150 146 22 220 192 22 290 249 22
85 102 22 155 149 22 225 196 22 295 254 22
90 105 22 160 152 22 230 199 22 300 259 22
95 109 22 165 156 22 235 203 22 305 265 22
100 112 22 170 159 22 240 206 22 310 272 22
105 115 22 175 162 22 245 210 22 315 279 22
110 119 22 180 166 22 250 214 22 >315 n/a ——
Table 2-35: BD: Jeanty (Fetal Age)Jeanty: Radiology 143: 513, 1982Unit: BD (mm); Age
(Days); SD (mm)
BD Age SD BD Age SD BD Age SD BD Age SD
<15 n/a —— 28 127 0 42 185 0 56 243 0

15 73 0 29 131 0 43 189 0 57 247 0
16 77 0 30 135 0 44 193 0 58 251 0
17 81 0 31 139 0 45 197 0 59 256 0
18 85 0 32 143 0 46 201 0 60 260 0
19 89 0 33 147 0 47 206 0 61 264 0
20 93 0 34 152 0 48 210 0 62 268 0
21 97 0 35 156 0 49 214 0 63 272 0
22 102 0 36 160 0 50 218 0 64 276 0
23 106 0 37 164 0 51 222 0 65 281 0
24 110 0 38 168 0 52 226 0 >65 n/a ——
25 114 0 39 172 0 53 231 0
26 118 0 40 177 0 54 235 0
27 122 0 41 181 0 55 239 0
96
Table 2-36: BPD: Jeanty (Fetal Age)Jeanty: Radiology 143: 513, 1982Unit: Meas (mm);
Min/Mean/Max (Weeks/Days); Table/Graph Range: 5%:95%
Meas Min Mean Max Meas Min Mean Max
<10 n/a n/a n/a 53 18w4d 21w1d 23w6d

10 6w4d 9w1d 11w6d 54 18w6d 21w4d 24w1d
11 6w6d 9w4d 12w1d 55 19w1d 21w6d 24w4d
12 7w0d 9w5d 12w3d 56 19w4d 22w1d 24w6d
13 7w2d 10w0d 12w5d 57 19w6d 22w4d 25w1d
14 7w4d 10w2d 12w6d 58 20w1d 22w6d 25w4d
15 7w6d 10w4d 13w1d 59 20w4d 23w1d 25w6d
16 8w1d 10w6d 13w3d 60 20w6d 23w4d 26w1d
17 8w3d 11w1d 13w5d 61 21w1d 23w6d 26w4d
18 8w4d 11w2d 14w0d 62 21w4d 24w1d 26w6d
19 8w6d 11w4d 14w1d 63 21w6d 24w4d 27w1d
20 9w1d 11w6d 14w4d 64 22w1d 24w6d 27w4d
21 9w3d 12w1d 14w6d 65 22w4d 25w2d 27w6d
22 9w5d 12w3d 15w0d 66 22w6d 25w4d 28w2d
23 9w6d 12w4d 15w2d 67 23w2d 26w0d 28w4d
24 10w1d 12w6d 15w4d 68 23w5d 26w3d 29w0d
25 10w4d 13w1d 15w6d 69 24w0d 26w5d 29w3d
26 10w5d 13w3d 16w1d 70 24w3d 27w1d 29w6d
27 11w0d 13w5d 16w3d 71 24w6d 27w4d 30w1d
28 11w2d 14w0d 16w4d 72 25w1d 27w6d 30w4d
29 11w4d 14w1d 16w6d 73 25w4d 28w2d 30w6d
30 11w6d 14w4d 17w1d 74 26w0d 28w5d 31w2d
31 12w1d 14w6d 17w3d 75 26w3d 29w1d 31w5d
32 12w2d 15w1d 17w5d 76 26w6d 29w4d 32w1d
33 12w4d 15w2d 18w0d 77 27w1d 29w6d 32w4d
34 12w6d 15w4d 18w2d 78 27w4d 30w2d 33w0d
35 13w1d 15w6d 18w4d 79 28w0d 30w5d 33w3d
36 13w4d 16w1d 18w6d 80 28w4d 31w1d 33w6d
37 13w5d 16w3d 19w1d 81 28w6d 31w4d 34w2d
38 14w0d 16w5d 19w3d 82 29w2d 32w0d 34w5d
39 14w2d 17w0d 19w5d 83 29w6d 32w4d 35w1d
40 14w4d 17w2d 19w6d 84 30w1d 32w6d 35w4d
41 14w6d 17w4d 20w1d 85 30w5d 33w3d 36w0d
42 15w1d 17w6d 20w4d 86 31w1d 33w6d 36w4d
43 15w3d 18w1d 20w6d 87 31w4d 34w2d 37w0d
44 15w5d 18w3d 21w1d 88 32w1d 34w6d 37w3d
45 16w0d 18w5d 21w3d 89 32w4d 35w2d 37w6d
46 16w2d 19w0d 21w5d 90 33w0d 35w5d 38w3d
47 16w4d 19w2d 22w0d 91 33w4d 36w1d 38w6d
48 16w6d 19w4d 22w2d 92 34w0d 36w5d 39w3d
49 17w1d 19w6d 22w4d 93 34w4d 37w1d 39w6d
50 17w4d 20w2d 22w6d 94 35w0d 37w5d 40w3d
51 17w6d 20w4d 23w1d 95 35w4d 38w2d 40w6d
52 18w1d 20w6d 23w4d >95 n/a n/a n/a
97
Table 2-37: BPD: Jeanty (Fetal Growth)Jeanty: Radiology 143: 513, 1982Unit: Age
(Weeks/Days); Min/Mean/Max (mm); Table/Graph Range: 5%:95%
10.0+0 9 14 18 26.0+0 62 67 71
11.0+0 13 17 22 27.0+0 65 70 74
12.0+0 16 21 25 28.0+0 68 72 77
13.0+0 20 24 29 29.0+0 70 75 79
14.0+0 23 28 32 30.0+0 73 77 82
15.0+0 27 31 36 31.0+0 75 79 84
16.0+0 30 35 39 32.0+0 77 82 86
17.0+0 34 38 43 33.0+0 79 84 88
18.0+0 37 42 46 34.0+0 81 86 90
19.0+0 40 45 49 35.0+0 83 87 92
20.0+0 44 48 53 36.0+0 84 89 93
21.0+0 47 51 56 37.0+0 86 90 95
22.0+0 50 55 59 38.0+0 87 91 96
23.0+0 53 58 62 39.0+0 88 93 97
24.0+0 56 61 65 40.0+0 89 93 98
25.0+0 59 64 68
Table 2-38: CRL: Jeanty (Fetal Age)Jeanty: Radiology 143: 513, 1982Unit: CRL (mm);
Age (Days); SD (mm)
<5 n/a —— 17 58 5 30 69 7 43 77 7
5 44 4 18 59 5 31 70 7 44 78 7
6 45 4 19 60 5 32 70 7 45 79 7
7 46 4 20 61 5 33 71 7 46 79 7
8 48 4 21 62 6 34 72 7 47 80 7
9 50 4 22 63 6 35 73 7 48 81 7
10 51 4 23 64 6 36 73 7 49 81 7
11 52 4 24 65 6 37 74 7 50 82 7
12 53 4 25 66 6 38 75 7 51 83 7
13 54 4 26 67 7 39 76 7 52 83 7
14 55 4 27 67 7 40 76 7 53 84 7
15 56 5 28 67 7 41 76 7 54 85 7
16 57 5 29 68 7 42 77 7 >54 n/a ——
98
Table 2-39: FIB: Jeanty (Fetal Growth)Fetal Limb Bimetry (Letter), Radiology 147:602,
1983Unit: Age (Weeks); Min/Mean/Max (mm); Table/Graph Range: 5%:95%
11 2 2 2 26 32 39 43
12 5 5 5 27 35 41 47
13 8 8 8 28 36 43 47
14 6 11 10 29 40 45 50
15 10 14 18 30 38 47 52
16 6 17 22 31 40 48 57
17 7 19 31 32 40 50 56
18 10 22 28 33 43 51 59
19 18 24 30 34 46 52 56
20 18 27 30 35 51 54 57
21 24 29 34 36 51 55 56
22 21 31 37 37 55 56 58
23 23 33 44 38 54 57 59
24 26 35 41 39 55 58 62
25 33 37 42 40 54 59 62
99
Table 2-40: FL: Jeanty (Fetal Age)Jeanty: Radiology 143: 513, 1982Unit: Meas (mm);
<14 n/a n/a n/a 48 24w0d 26w1d 28w3d

14 11w5d 13w6d 16w1d 49 24w3d 26w4d 28w6d
15 12w0d 14w1d 16w3d 50 24w6d 27w0d 29w1d
16 12w3d 14w4d 16w6d 51 25w1d 27w3d 29w4d
17 12w5d 14w6d 17w1d 52 25w4d 27w6d 30w0d
18 13w0d 15w1d 17w3d 53 26w0d 28w1d 30w3d
19 13w3d 15w4d 17w6d 54 26w3d 28w4d 30w6d
20 13w5d 15w6d 18w1d 55 26w6d 29w1d 31w2d
21 14w1d 16w2d 18w4d 56 27w2d 29w4d 31w5d
22 14w3d 16w4d 18w6d 57 27w5d 29w6d 32w1d
23 14w5d 16w6d 19w1d 58 28w1d 30w2d 32w4d
24 15w1d 17w2d 19w4d 59 28w4d 30w5d 32w6d
25 15w3d 17w4d 19w6d 60 28w6d 31w1d 33w2d
26 15w6d 18w0d 20w1d 61 29w3d 31w4d 33w6d
27 16w1d 18w2d 20w4d 62 29w6d 32w0d 34w1d
28 16w4d 18w5d 20w6d 63 30w1d 32w3d 34w4d
29 16w6d 19w0d 21w1d 64 30w5d 32w6d 35w1d
30 17w1d 19w3d 21w4d 65 31w1d 33w2d 35w4d
31 17w4d 19w6d 22w0d 66 31w4d 33w5d 35w6d
32 17w6d 20w1d 22w2d 67 32w0d 34w1d 36w3d
33 18w2d 20w4d 22w5d 68 32w3d 34w4d 36w6d
34 18w5d 20w6d 23w1d 69 32w6d 35w0d 37w1d
35 19w0d 21w1d 23w3d 70 33w2d 35w4d 37w5d
36 19w3d 21w4d 23w6d 71 33w5d 35w6d 38w1d
37 19w6d 22w0d 24w1d 72 34w1d 36w3d 38w4d
38 20w1d 22w3d 24w4d 73 34w4d 36w6d 39w0d
39 20w4d 22w5d 24w6d 74 35w1d 37w2d 39w4d
40 20w6d 23w1d 25w2d 75 35w4d 37w5d 39w6d
41 21w2d 23w4d 25w5d 76 36w0d 38w1d 40w3d
42 21w5d 23w6d 26w1d 77 36w3d 38w4d 40w6d
43 22w1d 24w2d 26w4d 78 36w6d 39w1d 41w2d
44 22w4d 24w5d 26w6d 79 37w2d 39w4d 41w5d
45 22w6d 25w0d 27w1d 80 37w6d 40w0d 42w1d
46 23w1d 25w3d 27w4d >80 n/a n/a n/a
47 23w4d 25w6d 28w0d
100
Table 2-41: FL: Jeanty (Fetal Growth)Jeanty: Radiology 143: 513, 1982Unit: Age
12.0+0 4 8 13 27.0+0 45 49 54
13.0+0 6 11 16 28.0+0 47 52 56
14.0+0 9 14 18 29.0+0 50 54 59
15.0+0 12 17 21 30.0+0 52 56 61
16.0+0 15 20 24 31.0+0 54 59 63
17.0+0 18 23 27 32.0+0 56 61 65
18.0+0 21 25 30 33.0+0 58 63 67
19.0+0 24 28 33 34.0+0 60 65 69
20.0+0 26 31 36 35.0+0 62 67 71
21.0+0 29 34 38 36.0+0 64 68 73
22.0+0 32 36 41 37.0+0 65 70 74
23.0+0 35 39 44 38.0+0 67 71 76
24.0+0 37 42 46 39.0+0 68 73 77
25.0+0 40 44 49 40.0+0 70 74 79
26.0+0 42 47 51
101
Table 2-42: HC: Jeanty (Fetal Age)Jeanty: Radiology 143: 513, 1982Unit: Meas (mm);
<80 n/a n/a n/a 225 22w3d 24w3d 26w2d

80 11w3d 13w2d 15w2d 230 22w6d 24w6d 26w6d
85 11w5d 13w5d 15w4d 235 23w3d 25w3d 27w2d
90 11w7d 13w7d 15w6d 240 23w6d 25w6d 27w6d
95 12w2d 14w2d 16w2d 245 24w3d 26w3d 28w2d
100 12w4d 14w4d 16w4d 250 24w7d 26w6d 28w6d
105 12w7d 14w6d 16w6d 255 25w4d 27w3d 29w3d
110 13w2d 15w2d 17w1d 260 26w0d 28w0d 29w7d
115 13w4d 15w4d 17w4d 265 26w4d 28w4d 30w4d
120 13w6d 15w6d 17w6d 270 27w1d 29w1d 31w1d
125 14w2d 16w2d 18w1d 275 27w6d 29w5d 31w5d
130 14w4d 16w4d 18w4d 280 28w3d 30w2d 32w2d
135 14w7d 16w6d 18w6d 285 28w7d 30w7d 32w6d
140 15w2d 17w2d 19w2d 290 29w4d 31w4d 33w4d
145 15w5d 17w4d 19w4d 295 30w2d 32w1d 34w1d
150 16w0d 17w7d 19w7d 300 30w6d 32w6d 34w6d
155 16w3d 18w3d 20w2d 305 31w4d 33w4d 35w3d
160 16w6d 18w5d 20w5d 310 32w2d 34w1d 36w1d
165 17w1d 19w1d 21w1d 315 32w6d 34w6d 36w6d
170 17w4d 19w4d 21w3d 320 33w4d 35w4d 37w4d
175 17w7d 19w6d 21w6d 325 34w2d 36w2d 38w2d
180 18w3d 20w2d 22w2d 330 35w0d 37w0d 38w7d
185 18w6d 20w5d 22w5d 335 35w6d 37w5d 39w5d
190 19w1d 21w1d 23w1d 340 36w4d 38w4d 40w3d
195 19w4d 21w4d 23w4d 345 37w2d 39w2d 41w2d
200 20w1d 22w0d 23w7d 350 38w1d 40w0d 42w0d
205 20w4d 22w3d 24w3d 355 38w6d 40w6d 42w6d
210 20w7d 22w7d 24w6d 360 39w5d 41w5d 43w4d
215 21w3d 23w3d 25w3d >360 n/a n/a n/a
220 21w6d 23w6d 25w6d
102
Table 2-43: HC: Jeanty (Fetal Growth)Jeanty: Radiology 143: 513, 1982Unit: Age
12.0+0 51 75 100 27.0+0 228 252 277

13.0+0 64 88 112 28.0+0 238 262 286
14.0+0 76 101 125 29.0+0 247 271 296
15.0+0 89 113 138 30.0+0 256 281 305
16.0+0 101 126 150 31.0+0 265 289 313
17.0+0 114 138 163 32.0+0 273 297 322
18.0+0 126 151 175 33.0+0 281 305 329
19.0+0 138 163 187 34.0+0 288 312 336
20.0+0 150 175 199 35.0+0 294 319 343
21.0+0 162 187 211 36.0+0 300 325 349
22.0+0 174 198 223 37.0+0 306 330 355
23.0+0 185 210 234 38.0+0 311 335 359
24.0+0 196 221 245 39.0+0 315 339 364
25.0+0 207 232 256 40.0+0 319 343 367
26.0+0 218 242 266
103
Table 2-44: HL: Jeanty (Fetal Age)Obstetrical Ultrasound, Table 13.9, 1984Unit: Meas
(mm); Min/Mean/Max (Weeks/Days); Table/Graph Range: 5%:95%
<10 n/a n/a n/a 40 21w4d 24w2d 27w1d

10 9w6d 12w4d 15w2d 41 22w0d 24w6d 27w4d
11 10w1d 12w6d 15w4d 42 22w4d 25w2d 28w0d
12 10w3d 13w1d 15w6d 43 23w0d 25w5d 28w4d
13 10w6d 13w4d 16w1d 44 23w4d 26w1d 29w0d
14 11w1d 13w6d 16w4d 45 24w0d 26w5d 29w4d
15 11w3d 14w1d 16w6d 46 24w4d 27w1d 30w0d
16 11w6d 14w4d 17w2d 47 25w0d 27w5d 30w4d
17 21w1d 14w6d 17w4d 48 25w4d 28w1d 31w0d
18 12w4d 15w1d 18w0d 49 26w0d 28w6d 31w4d
19 12w6d 15w4d 18w2d 50 26w4d 29w2d 32w0d
20 13w1d 15w6d 18w5d 51 27w1d 29w6d 32w4d
21 13w4d 16w2d 19w1d 52 27w4d 30w2d 33w1d
22 13w6d 16w5d 19w3d 53 28w1d 30w6d 33w4d
23 14w2d 17w1d 19w6d 54 28w5d 31w3d 34w1d
24 14w5d 17w3d 20w1d 55 29w1d 32w0d 34w5d
25 15w1d 17w6d 20w4d 56 29w6d 32w4d 35w2d
26 15w4d 18w1d 21w0d 57 30w2d 33w1d 35w6d
27 15w6d 18w4d 21w3d 58 30w6d 33w4d 36w3d
28 16w2d 19w0d 21w6d 59 31w3d 34w1d 36w6d
29 16w5d 19w3d 22w1d 60 32w0d 34w6d 37w4d
30 17w1d 19w6d 22w4d 61 32w4d 35w2d 38w1d
31 17w4d 20w2d 23w0d 62 33w1d 35w6d 38w5d
32 18w0d 20w5d 23w4d 63 33w6d 36w4d 39w2d
33 18w3d 21w1d 23w6d 64 34w3d 37w1d 39w6d
34 18w6d 21w4d 24w2d 65 35w0d 37w5d 40w4d
35 19w2d 22w0d 24w6d 66 35w4d 38w2d 41w1d
36 19w5d 22w4d 25w1d 67 36w1d 38w6d 41w5d
37 20w1d 22w6d 25w5d 68 36w6d 39w4d 42w2d
38 20w4d 23w3d 26w1d 69 37w3d 40w1d 42w6d
39 21w1d 23w6d 26w4d >69 n/a n/a n/a
104
Table 2-45: Radius: Jeanty (Fetal Growth)Fetal Limb Bimetry (Letter), Radiology 147:602,
1983Unit: Age (weeks); Min/Mean/Max (mm); Table/Graph Range: 5%:95%
<11 n/a n/a n/a 26 30 37 41

11 5 5 5 27 33 39 45
12 7 7 7 28 33 40 45
13 10 10 10 29 36 42 47
14 8 13 12 30 34 43 49
15 12 15 19 31 34 44 53
16 9 18 21 32 37 45 51
17 11 20 29 33 41 46 51
18 14 22 26 34 39 47 53
19 20 24 29 35 38 48 57
20 21 27 28 36 41 48 54
21 25 29 32 37 45 49 53
22 24 31 34 38 45 49 53
23 26 32 39 39 46 50 54
24 27 34 38 40 46 50 54
25 31 36 40 >40 n/a n/a n/a
105
Table 2-46: TIB: Jeanty (Fetal Age)Obstetrical Ultrasound, Table 13.9, 1984Unit: Meas
<10 n/a n/a n/a 40 22w3d 25w2d 28w1d

10 10w4d 13w3d 16w2d 41 22w6d 25w5d 28w4d
11 10w6d 13w5d 16w4d 42 23w2d 26w1d 29w1d
12 11w1d 14w1d 17w0d 43 23w5d 26w4d 29w4d
13 11w4d 14w3d 17w2d 44 24w1d 27w1d 30w0d
14 11w6d 14w6d 17w5d 45 24w4d 27w4d 30w4d
15 12w1d 15w1d 18w0d 46 25w1d 28w0d 30w6d
16 12w4d 15w4d 18w3d 47 25w4d 28w4d 31w3d
17 13w0d 15w6d 18w6d 48 26w1d 29w0d 31w6d
18 13w2d 16w1d 19w1d 49 26w4d 29w3d 32w2d
19 13w5d 16w4d 19w4d 50 27w0d 29w6d 32w6d
20 14w1d 17w0d 19w6d 51 27w4d 30w3d 33w2d
21 14w4d 17w3d 20w2d 52 28w0d 30w6d 33w6d
22 14w6d 17w6d 20w5d 53 28w4d 31w3d 34w2d
23 15w1d 18w1d 21w1d 54 29w0d 31w6d 34w6d
24 15w4d 18w4d 21w3d 55 29w4d 32w3d 35w2d
25 16w0d 18w6d 21w6d 56 30w0d 32w6d 35w6d
26 16w3d 19w2d 22w1d 57 30w4d 33w3d 36w2d
27 16w6d 19w5d 22w4d 58 31w0d 33w6d 36w6d
28 17w1d 20w1d 23w0d 59 31w4d 34w3d 37w2d
29 17w4d 20w4d 23w4d 60 32w0d 34w6d 37w6d
30 18w1d 21w0d 23w6d 61 32w4d 35w3d 38w2d
31 18w4d 21w3d 24w2d 62 33w0d 35w6d 38w6d
32 18w6d 21w6d 24w5d 63 33w4d 36w4d 39w3d
33 19w2d 22w1d 25w1d 64 34w1d 37w0d 39w6d
34 19w5d 22w4d 25w4d 65 34w4d 37w4d 40w3d
35 20w1d 23w1d 26w0d 66 35w1d 38w0d 41w0d
36 20w4d 23w4d 26w3d 67 35w5d 38w4d 41w4d
37 21w0d 23w6d 26w6d 68 36w1d 39w1d 42w0d
38 21w4d 24w3d 27w2d 69 36w6d 39w5d 42w4d
39 21w6d 24w6d 27w5d >69 n/a n/a n/a
106
Table 2-47: ULNA: Jeanty (Fetal Age)Obstetrical Ultrasound, Table 13.9, 1984Unit: Meas
<10 n/a n/a n/a 38 22w1d 25w1d 28w1d

10 10w1d 13w1d 16w1d 39 22w4d 25w4d 28w5d
11 10w4d 13w4d 16w4d 40 23w1d 26w1d 29w1d
12 10w6d 13w6d 16w6d 41 23w4d 26w5d 29w5d
13 11w1d 14w1d 17w2d 42 24w1d 27w1d 30w2d
14 11w4d 14w4d 17w5d 43 24w5d 27w5d 30w6d
15 11w6d 15w0d 18w0d 44 25w1d 28w2d 31w2d
16 12w2d 15w3d 18w3d 45 25w6d 28w6d 31w6d
17 12w5d 15w5d 18w6d 46 26w2d 29w3d 32w3d
18 13w1d 16w1d 19w1d 47 26w6d 29w6d 33w0d
19 13w4d 16w4d 19w4d 48 27w3d 30w4d 33w4d
20 13w6d 16w6d 20w0d 49 28w0d 31w1d 34w1d
21 14w2d 17w2d 20w3d 50 28w4d 31w4d 34w5d
22 14w5d 17w5d 20w6d 51 29w1d 32w1d 35w2d
23 15w1d 18w1d 21w1d 52 29w5d 32w6d 35w6d
24 15w4d 18w4d 21w4d 53 30w2d 33w3d 36w3d
25 16w0d 19w0d 22w1d 54 30w6d 34w0d 37w0d
26 16w3d 19w3d 22w4d 55 31w4d 34w4d 37w5d
27 16w6d 19w6d 22w6d 56 32w1d 35w1d 38w2d
28 17w2d 20w2d 23w3d 57 32w6d 35w6d 38w6d
29 17w5d 20w6d 23w6d 58 33w3d 36w3d 39w4d
30 18w1d 21w1d 24w2d 59 34w0d 37w1d 40w1d
31 18w4d 21w5d 24w6d 60 34w4d 37w5d 40w6d
32 19w1d 22w1d 25w1d 61 35w2d 38w2d 41w3d
33 19w4d 22w5d 25w5d 62 35w6d 39w0d 42w0d
34 20w1d 23w1d 26w1d 63 36w4d 39w4d 42w5d
35 20w4d 23w4d 26w5d 64 37w1d 40w2d 43w2d
36 21w1d 24w1d 27w1d >64 n/a n/a n/a
37 21w4d 24w4d 27w5d
107
JSUM
Table 2-48: AC, JSUM, J Med Ultrasound Vol.28 No.5 (2001)Unit: AC (cm); Age (w+d);
SD (cm)
Age AC Age 1SD Age AC Age 1SD
16 10.4 16+0 0.57 30 24.2 30+0 1.24

17 11.4 17+0 0.62 31 25.1 31+0 1.29
18 12.5 18+0 0.67 32 25.9 32+0 1.33
19 13.5 19+0 0.71 33 26.8 33+0 1.38
20 14.5 20+0 0.76 34 27.6 34+0 1.43
21 15.5 21+0 0.81 35 28.4 35+0 1.48
22 16.5 22+0 0.86 36 29.2 36+0 1.52
23 17.5 23+0 0.90 37 29.9 37+0 1.57
24 18.5 24+0 0.95 38 30.6 38+0 1.62
25 19.5 25+0 1.00 39 31.3 39+0 1.67
26 20.5 26+0 1.05 40 31.9 40+0 1.71
27 21.4 27+0 1.10 41 32.5 41+0 1.76
28 22.4 28+0 1.14 42 33.1 42+0 1.81
29 23.3 29+0 1.19
Table 2-49: BPD, JSUM, J Med Ultrasound Vol.28 No.5 (2001)Unit: BPD (mm); Age
(w+d); SD (mm)
Age BPD Age 1SD Age BPD Age 1SD
10 12.6 10+0 2.29 27 67.4 27+0 3.23

11 15.9 11+0 2.34 28 70.1 28+0 3.29
12 19.3 12+0 2.40 29 72.6 29+0 3.35
13 22.7 13+0 2.45 30 75.1 30+0 3.40
14 26.1 14+0 2.51 31 77.4 31+0 3.46
15 29.5 15+0 2.57 32 79.6 32+0 3.51
16 32.9 16+0 2.62 33 81.7 33+0 3.57
17 36.3 17+0 2.68 34 83.6 34+0 3.62
18 39.6 18+0 2.73 35 85.3 35+0 3.68
19 43.0 19+0 2.79 36 86.9 36+0 3.74
20 46.2 20+0 2.84 37 88.3 37+0 3.79
21 49.5 21+0 2.90 38 89.6 38+0 3.85
22 52.6 22+0 2.96 39 90.6 39+0 3.90
23 55.7 23+0 3.01 40 91.5 40+0 3.96
24 58.8 24+0 3.07 41 92.2 41+0 4.01
25 61.7 25+0 3.12 42 92.6 42+0 4.07
26 64.6 26+0 3.18
108
Table 2-50: CRL, JSUM, J Med Ultrasound Vol.28 No.5 (2001)Unit: GA (week+day); CRL
(mm)
CRL
GA 5% 10% 50% 90% 95%
7W+0 5.7 6.8 10.1 16.0 17.2

7W+2 6.0 7.3 10.5 15.7 16.4
7W+4 6.5 8.1 11.3 16.0 16.6
7W+6 7.2 9.0 12.5 17.0 17.5
8W+1 8.1 10.2 14.0 18.4 19.1
8W+3 9.1 11.6 15.8 20.4 21.3
8W+5 10.3 13.1 17.8 22.7 24.0
9W+0 11.7 14.9 20.0 25.4 27.0
9W+2 13.3 16.7 22.5 28.3 30.3
9W+4 15.1 18.7 25.0 31.4 33.7
9W+6 17.1 20.9 27.6 34.6 37.3
10W+1 19.2 23.1 30.3 37.8 40.7
10W+3 21.5 25.4 33.1 41.0 44.1
10W+5 24.1 27.9 35.8 44.1 47.1
11W+0 26.7 30.4 38.4 47.0 49.8
11W+2 29.6 32.9 40.9 49.6 52.1
11W+4 32.7 35.5 43.3 51.9 53.8
Table 2-51: EFW, JSUM, J Med Ultrasound Vol.28 No.5 (2001)Unit: EFW (g); Age (w+d);
1SD (g)
Age EFW Age 1SD Age EFW Age 1SD
18 187 18+0 30.13 30 1,470 30+0 185.98

19 247 19+0 40.47 31 1,635 31+0 202.09
20 313 20+0 51.30 32 1,805 32+0 218.68
21 387 21+0 62.61 33 1,980 33+0 235.75
22 469 22+0 74.39 34 2,156 34+0 253.30
23 560 23+0 86.66 35 2,333 35+0 271.33
24 660 24+0 99.41 36 2,507 36+0 289.84
25 771 25+0 112.64 37 2,676 37+0 308.83
26 892 26+0 126.35 38 2,838 38+0 328.30
27 1,023 27+0 140.53 39 2,989 39+0 348.25
28 1,163 28+0 155.20 40 3,125 40+0 368.68
29 1,313 29+0 170.35 41 3,244 41+0 389.59
109
Table 2-52: FL, JSUM, J Med Ultrasound Vol.28 No.5 (2001)Unit: FL (mm); Age (w+d);
SD (mm)
Age FL Age 1SD Age FL Age 1SD
16 20.1 16+0 2.64 30 53.8 30+0 3.11

17 22.7 17+0 2.67 31 55.8 31+0 3.15
18 25.3 18+0 2.71 32 57.8 32+0 3.18
19 27.8 19+0 2.74 33 59.6 33+0 3.21
20 30.4 20+0 2.77 34 61.4 34+0 3.25
21 32.9 21+0 2.81 35 63.0 35+0 3.28
22 35.4 22+0 2.84 36 64.6 36+0 3.31
23 37.9 23+0 2.88 37 66.0 37+0 3.35
24 40.3 24+0 2.91 38 67.4 38+0 3.38
25 42.7 25+0 2.94 39 68.6 39+0 3.42
26 45.0 26+0 2.98 40 69.6 40+0 3.45
27 47.3 27+0 3.01 41 70.6 41+0 3.48
28 49.6 28+0 3.04 42 71.4 42+0 3.52
29 51.7 29+0 3.08
Table 2-53: MCA PI values with advance in gestationJSUM, J Med Ultrasound Vol.28
No.5 (2001)Unit: Age (Weeks)
Age 5% 10% 50% 90% 95% Age 5% 10% 50% 90% 95%
20 1.271 1.270 1.440 1.880 1.990 31 1.446 1.515 1.933 2.436 2.489
21 1.318 1.329 1.537 1.986 2.091 32 1.425 1.493 1.915 2.420 2.468
22 1.359 1.381 1.623 2.080 2.182 33 1.397 1.464 1.887 2.394 2.435
23 1.393 1.426 1.699 2.164 2.261 34 1.363 1.427 1.849 2.356 2.390
24 1.421 1.463 1.765 2.236 2.328 35 1.324 1.383 1.800 2.308 2.335
25 1.444 1.493 1.820 2.298 2.385 36 1.277 1.331 1.741 2.248 2.268
26 1.459 1.515 1.865 2.348 2.430 37 1.225 1.272 1.671 2.178 2.191
27 1.469 1.530 1.899 2.388 2.465 38 1.167 1.205 1.591 2.096 2.102
28 1.473 1.537 1.923 2.416 2.488 39 1.102 1.131 1.501 2.004 2.001
29 1.470 1.537 1.937 2.434 2.499 40 1.031 1.050 1.400 1.900 1.890
30 1.461 1.530 1.940 2.440 2.500 41 0.954 0.961 1.289 1.786 1.767
Table 2-54: MCA RI values with advance in gestationJSUM, J Med Ultrasound Vol.28
Age 5% 10% 50% 90% 95% Age 5% 10% 50% 90% 95%
20 0.717 0.718 0.775 0.842 0.871 31 0.769 0.789 0.865 0.922 0.928
21 0.731 0.735 0.793 0.857 0.883 32 0.762 0.783 0.862 0.920 0.925
22 0.742 0.749 0.808 0.871 0.894 33 0.755 0.775 0.857 0.916 0.920
23 0.753 0.761 0.821 0.883 0.903 34 0.745 0.766 0.851 0.911 0.914
24 0.761 0.772 0.833 0.894 0.911 35 0.733 0.754 0.843 0.904 0.907
25 0.767 0.780 0.743 0.903 0.918 36 0.720 0.740 0.833 0.895 0.898
26 0.772 0.787 0.851 0.910 0.923 37 0.705 0.725 0.821 0.885 0.888
27 0.775 0.791 0.857 0.916 0.927 38 0.688 0.707 0.808 0.873 0.876
28 0.776 0.793 0.862 0.920 0.929 39 0.669 0.688 0.793 0.859 0.863
29 0.775 0.794 0.865 0.922 0.930 40 0.649 0.666 0.775 0.844 0.849
30 0.773 0.792 0.865 0.923 0.930 41 0.627 0.643 0.757 0.827 0.833
110
Table 2-55: UMA PI values with advance in gestationJSUM, J Med Ultrasound Vol.28
Age 5% 10% 50% 90% 95% Age 5% 10% 50% 90% 95%
20 1.118 1.144 1.390 1.620 1.688 31 0.766 0.821 0.986 1.161 1.285
21 1.075 1.106 1.340 1.565 1.641 32 0.747 0.802 0.965 1.135 1.261
22 1.034 1.069 1.293 1.513 1.597 33 0.731 0.785 0.947 1.112 1.238
23 0.996 1.034 1.249 1.464 1.554 34 0.716 0.770 0.931 1.091 1.218
24 0.959 1.001 1.207 1.417 1.514 35 0.704 0.757 0.918 1.073 1.199
25 0.925 0.970 1.168 1.373 1.475 36 0.694 0.746 0.907 1.057 1.182
26 0.893 0.941 1.131 1.331 1.438 37 0.686 0.736 0.899 1.044 1.168
27 0.863 0.913 1.097 1.292 1.404 38 0.681 0.728 0.893 1.033 1.155
28 0.836 0.887 1.065 1.255 1.371 39 0.677 0.722 0.890 1.025 1.145
29 0.810 0.863 1.036 1.221 1.341 40 0.676 0.718 0.890 1.020 1.136
30 0.787 0.841 1.010 1.190 1.312 41 0.677 0.716 0.892 1.017 1.129
Table 2-56: UMA RI values with advance in gestationJSUM, J Med Ultrasound Vol.28
Age 5% 10% 50% 90% 95% Age 5% 10% 50% 90% 95%
20 0.698 0.722 0.778 0.820 0.846 31 0.535 0.589 0.648 0.700 0.746
21 0.680 0.707 0.763 0.808 0.836 32 0.524 0.580 0.640 0.690 0.738
22 0.663 0.692 0.749 0.796 0.826 33 0.513 0.573 0.632 0.681 0.730
23 0.646 0.679 0.735 0.785 0.816 34 0.503 0.565 0.625 0.672 0.723
24 0.630 0.665 0.722 0.774 0.807 35 0.494 0.559 0.619 0.663 0.716
25 0.615 0.653 0.710 0.763 0.798 36 0.485 0.552 0.613 0.654 0.708
26 0.600 0.640 0.698 0.752 0.788 37 0.477 0.547 0.608 0.645 0.702
27 0.586 0.629 0.687 0.741 0.780 38 0.469 0.542 0.603 0.636 0.695
28 0.572 0.618 0.676 0.730 0.771 39 0.462 0.538 0.599 0.628 0.688
29 0.559 0.608 0.666 0.720 0.762 40 0.456 0.534 0.596 0.620 0.682
30 0.547 0.598 0.657 0.710 0.754 41 0.450 0.531 0.593 0.612 0.676
111
Kurtz
Table 2-57: BPD: Kurtz (Fetal Age)Journal of Clinical Ultrasound, 8: 319-326, 1980Unit:
BPD (mm); Age (Days); SD (mm)
BPD Age SD BPD Age SD BPD Age SD BPD Age SD
<21 n/a —— 40 125 4 60 168 5 80 222 5

21 84 4 41 127 4 61 170 5 81 225 5
22 87 4 42 129 4 62 173 5 82 229 5
23 91 4 43 131 4 63 175 5 83 232 5
24 93 4 44 133 4 64 178 5 84 235 5
25 95 4 45 135 4 65 181 5 85 238 5
26 97 4 46 137 4 66 183 5 86 241 5
27 99 4 47 139 4 67 186 5 87 244 5
28 101 4 48 141 4 68 188 5 88 248 5
29 103 4 49 143 4 69 191 5 89 252 5
30 105 4 50 145 4 70 194 5 90 257 5
31 107 4 51 147 4 71 196 5 91 262 5
32 109 4 52 149 4 72 199 5 92 267 5
33 111 4 53 151 4 73 201 5 93 272 5
34 113 4 54 153 4 74 204 5 94 276 5
35 115 4 55 155 5 75 207 5 95 280 5
36 117 4 56 157 5 76 210 5 96 284 5
37 119 4 57 160 5 77 213 5 97 288 5
38 121 4 58 162 5 78 216 5 98 293 5
39 123 4 59 165 5 79 219 5 >98 n/a ——
112
Mayden
Table 2-58: IOD: Mayden (Fetal Age)Am J Obstet Gynecol 144:289, 1982Unit: Meas
(mm); Mean (Weeks)
Meas Mean Meas Mean Meas Mean Meas Mean
5 11.6 11 17.9 16 24.3 19 32.5

5 11.6 12 18.4 16 24.7 19 33.0
6 12.1 12 18.9 16 25.2 19 33.5
6 12.6 12 19.4 16 25.2 19 34.0
6 12.6 13 19.4 17 25.7 19 34.4
7 13.1 13 19.9 17 26.2 19 35.0
7 13.6 13 20.4 17 26.2 19 35.4
7 13.6 13 20.4 17 26.7 19 35.9
8 14.1 14 20.9 17 27.2 19 36.4
8 14.6 14 21.3 17 27.6 19 36.9
8 14.6 14 21.3 17 28.1 19 37.3
9 15.0 14 21.8 18 28.6 19 37.8
9 15.5 14 22.3 18 29.1 19 38.3
9 15.5 15 22.3 18 29.6 19 38.3
10 16.0 15 22.8 18 30.0 19 39.3
10 16.5 15 23.3 18 30.6 19 39.8
10 16.5 15 23.3 18 31.0
10 17.0 15 23.8 18 31.5
11 17.5 16 24.3 18 32.0
Table 2-59: OOD: Mayden (Fetal Age)Am J Obstet Gynecol 144:289, 1982Unit: Meas
(mm); Mean (Weeks)
Meas Mean Meas Mean Meas Mean Meas Mean
13 11.6 28 17.9 42 24.3 52 32.5

14 11.6 30 18.4 43 24.7 53 33.0
15 12.1 31 18.9 43 25.2 54 33.5
16 12.6 32 19.4 44 25.2 54 34.0
17 12.6 32 19.4 44 25.7 54 34.4
17 13.1 33 19.9 45 26.2 55 35.0
18 13.6 34 20.4 45 26.2 55 35.4
19 13.6 34 20.4 46 26.7 56 35.9
20 14.1 35 20.9 46 27.2 56 36.4
21 14.6 36 21.3 47 27.6 57 36.9
21 14.6 36 21.3 47 28.1 57 37.3
22 15.0 37 21.8 48 28.6 58 37.8
23 15.5 38 22.3 48 29.1 58 38.3
24 15.5 38 22.3 49 29.6 58 38.3
25 16.0 39 22.8 50 30.0 59 39.3
25 16.5 40 23.3 50 30.6 59 39.8
26 16.5 40 23.3 51 31.0
27 17.0 41 23.8 51 31.5
27 17.5 41 24.3 52 32.0
113
Mercer
Table 2-60: Ft: Mercer (Fetal Age)Am J Obstet Gynecol, 156: 350-355, 1987Unit: Meas
(mm); Min/Mean/Max (Weeks); Table/Graph Range: 2SD
<10 n/a n/a n/a 50 24.3 26.4 28.4

10 11.5 12.5 13.5 52 24.9 27.1 29.3
12 12.1 13.1 14.2 54 25.7 27.9 30.1
14 12.7 13.8 14.9 56 26.4 28.4 30.9
16 13.3 14.4 15.5 58 27.1 29.4 31.8
18 13.9 15.1 16.3 60 27.8 30.2 32.6
20 14.5 15.7 17.0 62 28.5 31.0 33.5
22 15.1 16.4 17.7 64 29.3 31.8 34.3
24 15.7 17.1 18.4 66 30.0 32.6 35.2
26 16.3 17.7 19.1 68 30.7 33.4 36.1
28 16.9 18.4 19.9 70 31.5 34.2 36.9
30 17.6 19.1 20.6 72 32.2 35.0 37.8
32 18.2 19.8 21.4 74 33.0 35.9 38.7
34 18.9 20.5 22.1 76 33.8 36.8 39.6
36 19.5 21.2 22.9 78 34.5 37.5 40.5
38 20.2 21.9 23.7 80 35.3 38.4 41.4
40 20.8 22.7 24.5 82 36.1 39.2 42.4
42 21.5 23.4 25.2 84 36.9 40.1 43.3
44 22.2 24.1 26.0 86 37.7 41.0 44.2
46 22.9 24.9 26.8 >86 n/a n/a n/a
48 23.6 25.6 27.6
114
Merz
Table 2-61: AC: Merz (Fetal Age) Habilitationsschrift, Mainz University Women’s Hospital,
1988, Unit: Meas (mm); Min/Mean/Max (Weeks); Table/Graph Range: 5%:95%
<56 n/a n/a n/a 146 19w1d 20w5d 22w1d

56 10w6d 12w1d 13w2d 148 19w2d 20w6d 22w3d
58 11w1d 12w2d 13w4d 150 19w4d 21w1d 22w4d
60 11w2d 12w4d 13w5d 152 19w5d 21w1d 22w6d
62 11w4d 12w5d 13w6d 154 19w6d 21w3d 23w0d
64 11w5d 12w6d 14w1d 156 20w1d 21w4d 23w1d
66 11w6d 13w1d 14w2d 158 20w1d 21w6d 23w3d
68 12w0d 13w2d 14w4d 160 20w3d 22w0d 23w4d
70 12w1d 13w4d 14w5d 162 20w4d 22w1d 23w6d
72 12w3d 13w4d 14w6d 164 20w6d 22w3d 24w0d
74 12w4d 13w6d 15w1d 166 21w0d 22w4d 24w1d
76 12w6d 14w0d 15w2d 168 21w1d 22w6d 24w3d
78 12w6d 14w1d 15w4d 170 21w2d 23w0d 24w4d
80 13w1d 14w3d 15w5d 172 21w4d 23w1d 24w6d
82 13w2d 14w4d 15w6d 174 21w5d 23w2d 25w0d
84 13w4d 14w6d 16w1d 176 21w6d 23w4d 25w1d
86 13w5d 15w0d 16w2d 178 22w1d 23w5d 25w3d
88 13w6d 15w1d 16w4d 180 22w1d 23w6d 25w4d
90 14w0d 15w3d 16w5d 182 22w3d 24w1d 25w6d
92 14w1d 15w4d 16w6d 184 22w4d 24w2d 26w0d
94 14w3d 15w5d 17w1d 186 22w6d 24w4d 26w1d
96 14w4d 15w6d 17w2d 188 23w0d 24w5d 26w3d
98 14w6d 16w1d 17w4d 190 23w1d 24w6d 26w4d
100 14w6d 16w2d 17w5d 192 23w2d 25w0d 26w6d
102 15w1d 16w4d 17w6d 194 23w4d 25w1d 27w0d
104 15w2d 16w5d 18w1d 196 23w5d 25w3d 27w1d
106 15w4d 16w6d 18w2d 198 23w6d 25w4d 27w3d
108 15w5d 17w1d 18w3d 200 24w1d 25w6d 27w4d
110 15w6d 17w2d 18w4d 202 24w2d 26w0d 27w6d
112 16w0d 17w3d 18w6d 204 24w3d 26w1d 27w6d
114 16w1d 17w4d 19w0d 206 24w4d 26w3d 28w1d
116 16w3d 17w6d 19w1d 208 24w6d 26w4d 28w2d
118 16w4d 18w0d 19w3d 210 25w0d 26w6d 28w4d
120 16w6d 18w1d 19w4d 212 25w1d 27w0d 28w5d
122 17w0d 18w3d 19w6d 214 25w2d 27w1d 28w6d
124 17w1d 18w4d 20w0d 216 25w4d 27w2d 29w1d
126 17w2d 18w6d 20w1d 218 25w5d 27w4d 29w2d
128 17w4d 19w0d 20w3d 220 25w6d 27w5d 29w4d
130 17w5d 19w1d 20w4d 222 26w1d 27w6d 29w5d
132 17w6d 19w2d 20w6d 224 26w2d 28w1d 29w6d
134 18w0d 19w4d 21w0d 226 26w3d 28w2d 30w1d
136 18w1d 19w5d 21w1d 228 26w4d 28w4d 30w2d
138 18w3d 19w6d 21w3d 230 26w6d 28w5d 30w4d
140 18w4d 20w1d 21w4d 232 27w0d 28w6d 30w5d
142 18w6d 20w2d 21w6d 234 27w1d 29w0d 30w6d
144 19w0d 20w4d 22w0d 236 27w3d 29w1d 31w1d
115
Table 2-61: AC: Merz (Fetal Age)(Continued)Habilitationsschrift, Mainz University
Women’s Hospital, 1988, Unit: Meas (mm); Min/Mean/Max (Weeks); Table/Graph Range:
238 27w4d 29w3d 31w2d 298 33w0d 35w1d 37w1d

240 27w5d 29w4d 31w4d 300 33w1d 35w2d 37w3d
242 27w6d 29w6d 31w5d 302 33w3d 35w4d 37w4d
244 28w1d 30w0d 31w6d 304 33w4d 35w5d 37w6d
246 28w2d 30w1d 32w1d 306 33w5d 35w6d 38w0d
248 28w3d 30w3d 32w2d 308 33w6d 36w1d 38w1d
250 28w4d 30w4d 32w4d 310 34w1d 36w2d 38w3d
252 28w6d 30w6d 32w5d 312 34w2d 36w4d 38w4d
254 29w0d 30w6d 32w6d 314 34w4d 36w4d 38w6d
256 29w1d 31w1d 33w1d 316 34w4d 36w6d 39w0d
258 29w3d 31w2d 33w2d 318 34w6d 37w0d 39w1d
260 29w4d 31w4d 33w4d 320 35w0d 37w1d 39w3d
262 29w5d 31w5d 33w5d 322 35w1d 37w3d 39w4d
264 29w6d 31w6d 33w6d 324 35w3d 37w4d 39w6d
266 30w1d 32w1d 34w1d 326 35w4d 37w6d 40w0d
268 30w2d 32w2d 34w2d 328 35w5d 38w0d 40w1d
270 30w4d 32w4d 34w4d 330 35w6d 38w1d 40w3d
272 30w4d 32w5d 34w5d 332 36w1d 38w3d 40w4d
274 30w6d 32w6d 34w6d 334 36w2d 38w4d 40w6d
276 31w0d 33w0d 35w1d 336 36w4d 38w5d 41w0d
278 31w1d 33w1d 35w2d 338 36w5d 38w6d 41w1d
280 31w3d 33w3d 35w4d 340 36w6d 39w1d 41w3d
282 31w4d 33w4d 35w5d 342 37w0d 39w2d 41w4d
284 31w5d 33w6d 35w6d 344 37w1d 39w4d 41w6d
286 31w6d 34w0d 36w1d 346 37w3d 39w5d 42w0d
288 32w1d 34w1d 36w2d 348 37w4d 39w6d 42w1d
290 32w2d 34w3d 36w4d >348 n/a n/a n/a
292 32w4d 34w4d 36w5d
294 32w4d 34w5d 36w6d
296 32w6d 34w6d 37w1d
116
Table 2-62: AC: Merz (Fetal Growth) Habilitationsschrift, Mainz University Women’s
Hospital, 1988Unit: Age (Weeks); Min/Mean/Max (mm); Table/Graph Range 5%:95%)
12.5 50 62 74 27.5 202 222 242

13.0 55 67 80 28.0 207 227 247
13.5 60 73 85 28.5 212 232 252
14.0 65 78 91 29.0 217 237 257
14.5 71 83 96 29.5 221 242 263
15.0 76 89 102 30.0 226 247 268
15.5 81 94 108 30.5 231 252 273
16.0 86 100 114 31.0 235 257 278
16.5 91 105 119 31.5 240 262 283
17.0 96 111 125 32.0 244 266 288
17.5 102 116 131 32.5 249 271 293
18.0 107 122 136 33.0 253 276 298
18.5 112 127 142 33.5 258 280 303
19.0 117 132 148 34.0 262 285 308
19.5 122 138 153 34.5 266 289 313
20.0 127 143 159 35.0 270 294 317
20.5 133 149 165 35.5 275 298 322
21.0 138 154 170 36.0 279 303 327
21.5 143 159 176 36.5 283 307 331
22.0 148 165 181 37.0 287 311 336
22.5 153 170 187 37.5 290 315 340
23.0 158 175 193 38.0 294 319 344
23.5 163 181 198 38.5 298 323 348
24.0 168 186 204 39.0 301 327 352
24.5 173 191 209 39.5 305 331 356
25.0 178 196 215 40.0 308 334 360
25.5 183 202 220 40.5 311 338 364
26.0 188 207 226 41.0 314 341 367
26.5 193 212 231 41.5 317 343 370
27.0 198 217 236
117
Table 2-63: BPD: Merz (Fetal Age)Habilitationsschrift, Mainz University Women’s
Hospital, 1988Unit: BPD (mm); % Age (Weeks/Days)
<21 n/a n/a n/a 62 22w1d 24w1d 26w1d

21 10w5d 12w1d 13w5d 63 22w4d 24w4d 26w4d
22 10w6d 12w3d 13w6d 64 22w6d 24w6d 26w6d
23 11w1d 12w5d 14w1d 65 23w1d 25w1d 27w1d
24 11w4d 13w0d 14w4d 66 23w4d 25w4d 27w4d
25 11w5d 13w1d 14w5d 67 23w6d 25w6d 27w6d
26 12w0d 13w4d 15w0d 68 24w1d 26w1d 28w2d
27 12w1d 13w6d 15w3d 69 24w3d 26w4d 28w4d
28 12w4d 14w1d 15w5d 70 24w5d 26w6d 28w6d
29 12w5d 14w2d 15w6d 71 25w1d 27w1d 29w2d
30 13w0d 14w4d 16w1d 72 25w4d 27w4d 29w5d
31 13w2d 14w6d 16w4d 73 25w6d 27w6d 30w0d
32 13w4d 15w1d 16w6d 74 26w1d 28w2d 30w3d
33 13w6d 15w3d 17w0d 75 26w4d 28w4d 30w5d
34 14w0d 15w5d 17w3d 76 26w6d 29w0d 31w1d
35 14w2d 16w0d 17w5d 77 27w1d 29w3d 31w4d
36 14w4d 16w2d 18w0d 78 27w4d 29w6d 32w0d
37 14w6d 16w4d 18w1d 79 27w6d 30w1d 32w2d
38 15w1d 16w6d 18w4d 80 28w2d 30w4d 32w5d
39 15w3d 17w1d 18w6d 81 28w5d 30w6d 33w1d
40 15w5d 17w3d 19w1d 82 29w1d 31w2d 33w4d
41 15w6d 17w5d 19w4d 83 29w4d 31w5d 33w6d
42 16w1d 18w0d 19w6d 84 29w6d 32w1d 34w2d
43 16w4d 18w2d 20w1d 85 30w2d 32w4d 34w6d
44 16w6d 18w4d 20w3d 86 30w5d 32w6d 35w1d
45 17w1d 18w6d 20w5d 87 31w0d 33w2d 35w4d
46 17w3d 19w1d 21w0d 88 31w4d 33w6d 36w1d
47 17w4d 19w3d 21w1d 89 31w6d 34w1d 36w4d
48 17w6d 19w5d 21w4d 90 32w2d 34w4d 36w6d
49 18w1d 20w0d 21w6d 91 32w6d 35w1d 37w3d
50 18w4d 20w3d 22w1d 92 33w1d 35w4d 37w6d
51 18w6d 20w5d 22w4d 93 33w4d 35w6d 38w1d
52 19w1d 21w0d 22w6d 94 34w0d 36w3d 38w6d
53 19w3d 21w2d 23w1d 95 34w4d 36w6d 39w2d
54 19w5d 21w4d 23w4d 96 34w6d 37w2d 39w5d
55 20w0d 21w6d 23w6d 97 35w3d 37w6d 40w1d
56 20w2d 22w1d 24w1d 98 35w6d 38w2d 40w5d
57 20w4d 22w4d 24w3d 99 36w3d 38w6d 41w1d
58 20w6d 22w6d 24w5d 100 36w6d 39w2d 41w6d
59 21w1d 23w1d 25w1d 101 37w2d 39w6d 42w2d
60 21w4d 23w4d 25w4d 102 37w6d 40w2d 42w6d
61 21w6d 23w6d 25w6d >102 n/a n/a n/a
118
Table 2-64: BPD: Merz (Fetal Growth)Habilitationsschrift, Mainz University Women’s
12.5 21 25 29 27.5 68 73 78
13.0 23 26 30 28.0 69 74 79
13.5 24 28 31 28.5 71 76 81
14.0 25 29 33 29.0 72 77 82
14.5 27 31 35 29.5 73 78 84
15.0 28 32 36 30.0 74 80 85
15.5 30 34 38 30.5 76 81 86
16.0 31 35 39 31.0 77 82 88
16.5 33 37 41 31.5 78 83 89
17.0 35 39 43 32.0 79 85 90
17.5 36 40 45 32.5 80 86 91
18.0 38 42 46 33.0 81 87 92
18.5 40 44 48 33.5 82 88 93
19.0 41 46 50 34.0 83 89 95
19.5 43 47 52 34.5 84 90 96
20.0 45 49 53 35.0 85 91 97
20.5 46 51 55 35.5 86 92 97
21.0 48 52 57 36.0 87 92 98
21.5 49 54 59 36.5 87 93 99
22.0 51 56 60 37.0 88 94 100
22.5 53 57 62 37.5 89 95 101
23.0 54 59 64 38.0 89 95 101
23.5 56 61 65 38.5 90 96 102
24.0 57 62 67 39.0 90 96 103
24.5 59 64 69 39.5 91 97 103
25.0 61 65 70 40.0 91 97 103
25.5 62 67 72 40.5 91 97 104
26.0 64 68 73 41.0 91 98 104
26.5 65 70 75 41.5 92 98 104
27.0 66 71 77
119
Table 2-65: FL: Merz (Fetal Age)Habilitationsschrift, Mainz University Women’s Hospital,
1988Unit: FL (mm); % Age (Weeks/Days)
<10 n/a n/a n/a 46 23w4d 25w3d 27w1d

10 11w1d 12w2d 13w4d 47 24w0d 25w6d 27w4d
11 11w4d 12w5d 13w6d 48 24w3d 26w1d 28w0d
12 11w6d 13w0d 14w1d 49 24w5d 26w4d 28w2d
13 12w1d 13w2d 14w4d 50 25w1d 26w6d 28w5d
14 12w3d 13w5d 15w0d 51 25w4d 27w2d 29w1d
15 12w5d 14w0d 15w2d 52 25w6d 27w5d 29w4d
16 13w1d 14w3d 15w5d 53 26w1d 28w1d 30w0d
17 13w3d 14w5d 16w0d 54 26w4d 28w4d 30w4d
18 13w6d 15w1d 16w3d 55 27w0d 29w0d 31w0d
19 14w1d 15w3d 16w5d 56 27w3d 29w3d 31w3d
20 14w4d 15w6d 17w1d 57 27w6d 29w6d 31w6d
21 14w6d 16w1d 17w3d 58 28w1d 30w1d 32w1d
22 15w1d 16w4d 17w6d 59 28w4d 30w4d 32w4d
23 15w3d 16w6d 18w1d 60 29w0d 31w0d 33w0d
24 15w6d 17w1d 18w4d 61 29w4d 31w4d 33w4d
25 16w1d 17w4d 19w1d 62 29w6d 31w6d 33w6d
26 16w3d 17w6d 19w3d 63 30w2d 32w2d 34w2d
27 16w6d 18w2d 19w6d 64 30w6d 32w6d 34w6d
28 17w1d 18w4d 20w1d 65 31w1d 33w1d 35w1d
29 17w4d 19w0d 20w4d 66 31w4d 33w4d 35w4d
30 17w6d 19w3d 20w6d 67 32w0d 34w1d 36w1d
31 18w1d 19w5d 21w1d 68 32w3d 34w4d 36w4d
32 18w4d 20w1d 21w4d 69 32w6d 35w0d 37w1d
33 18w6d 20w4d 22w1d 70 33w2d 35w3d 37w4d
34 19w1d 20w6d 22w3d 71 33w6d 35w6d 38w0d
35 19w4d 21w1d 22w6d 72 34w1d 36w2d 38w3d
36 20w0d 21w4d 23w1d 73 34w4d 36w6d 39w0d
37 20w2d 21w6d 23w4d 74 35w1d 37w2d 39w4d
38 20w5d 22w2d 23w6d 75 35w4d 37w5d 39w6d
39 21w0d 22w5d 24w3d 76 36w0d 38w1d 40w3d
40 21w3d 23w1d 24w6d 77 36w4d 38w5d 40w6d
41 21w5d 23w3d 25w1d 78 37w0d 39w1d 41w3d
42 22w1d 23w6d 25w4d 79 37w3d 39w4d 41w6d
43 22w4d 24w1d 25w6d 80 37w6d 40w1d 42w2d
44 22w6d 24w4d 26w3d >80 n/a n/a n/a
45 23w1d 25w0d 26w6d
120
Table 2-66: FL: Merz (Fetal Growth)Habilitationsschrift, Mainz University Women’s
12.5 6 9 12 27.5 48 52 57
13.0 8 11 14 28.0 49 53 58
13.5 10 13 16 28.5 50 55 59
14.0 11 15 18 29.0 51 56 60
14.5 13 16 20 29.5 52 57 61
15.0 15 18 21 30.0 53 58 62
15.5 16 20 23 30.5 54 59 63
16.0 18 21 25 31.0 55 60 64
16.5 19 23 26 31.5 56 61 66
17.0 21 24 28 32.0 57 62 67
17.5 22 26 29 32.5 58 63 68
18.0 24 27 31 33.0 59 64 69
18.5 25 29 32 33.5 60 65 70
19.0 27 30 34 34.0 61 66 71
19.5 28 32 35 34.5 62 67 72
20.0 29 33 37 35.0 63 68 73
20.5 31 35 38 35.5 64 69 74
21.0 32 36 40 36.0 65 70 74
21.5 33 37 41 36.5 66 70 75
22.0 35 39 42 37.0 66 71 76
22.5 36 40 44 37.5 67 72 77
23.0 37 41 45 38.0 68 73 78
23.5 39 43 46 38.5 69 74 79
24.0 40 44 48 39.0 69 74 79
24.5 41 45 49 39.5 70 75 80
25.0 42 46 50 40.0 71 76 81
25.5 43 48 52 40.5 71 76 81
26.0 45 49 53 41.0 72 77 82
26.5 46 50 54 41.5 72 77 83
27.0 47 51 55
121
Table 2-67: HC: Merz (Fetal Age) Habilitationsschrift, Mainz University Women’s Hospital,
1988Unit: HC (mm); % Age (Weeks/Days)
>72 n/a n/a n/a 172 17w6d 19w2d 20w6d

72 11w0d 12w1d 13w1d 174 17w6d 19w3d 20w6d
74 11w1d 12w2d 13w4d 176 18w0d 19w4d 21w1d
76 11w1d 12w3d 13w4d 178 18w1d 19w6d 21w3d
78 11w2d 12w4d 13w5d 180 18w2d 19w6d 21w4d
80 11w4d 12w5d 13w6d 182 18w4d 20w1d 21w5d
82 11w4d 12w6d 14w0d 184 18w4d 20w1d 21w6d
84 11w5d 12w6d 14w1d 186 18w6d 20w3d 22w0d
86 11w6d 13w1d 14w2d 188 19w0d 20w4d 22w1d
88 12w0d 13w1d 14w3d 190 19w1d 20w5d 22w2d
90 12w1d 13w2d 14w4d 192 19w2d 20w6d 22w4d
92 12w2d 13w4d 14w5d 194 19w4d 21w1d 22w5d
94 12w3d 13w4d 14w6d 196 19w4d 21w1d 22w6d
96 12w4d 13w5d 14w6d 198 19w5d 21w3d 23w0d
98 12w5d 13w6d 15w1d 200 19w6d 21w4d 23w2d
100 12w6d 14w0d 15w1d 202 20w0d 21w5d 23w3d
102 12w6d 14w1d 15w4d 204 20w1d 21w6d 23w4d
104 13w0d 14w2d 15w4d 206 20w3d 22w1d 23w6d
106 13w1d 14w3d 15w5d 208 20w4d 22w1d 23w6d
108 13w2d 14w4d 15w6d 210 20w5d 22w3d 24w1d
110 13w3d 14w5d 16w0d 212 20w6d 22w4d 24w2d
112 13w4d 14w6d 16w1d 214 21w0d 22w5d 24w3d
114 13w5d 15w0d 16w2d 216 21w1d 22w6d 24w4d
116 13w6d 15w1d 16w3d 218 21w3d 23w1d 24w6d
118 14w0d 15w2d 16w4d 220 21w4d 23w2d 25w0d
120 14w1d 15w3d 16w5d 222 21w6d 23w4d 25w1d
122 14w1d 15w4d 17w0d 224 21w6d 23w4d 25w2d
124 14w2d 15w5d 17w1d 226 22w1d 23w6d 25w4d
126 14w3d 15w6d 17w1d 228 22w1d 24w0d 25w6d
128 14w4d 16w0d 17w3d 230 22w3d 24w1d 26w0d
130 14w5d 16w1d 17w4d 232 22w4d 24w3d 26w1d
132 14w6d 16w2d 17w5d 234 22w5d 24w4d 26w2d
134 15w0d 16w3d 17w6d 236 22w6d 24w5d 26w4d
136 15w1d 16w4d 18w0d 238 23w1d 24w6d 26w5d
138 15w2d 16w5d 18w1d 240 23w2d 25w1d 26w6d
140 15w4d 16w6d 18w2d 242 23w4d 25w2d 27w1d
142 15w4d 17w0d 18w3d 244 23w5d 25w4d 27w2d
144 15w6d 17w1d 18w4d 246 23w6d 25w5d 27w4d
146 15w6d 17w2d 18w5d 248 24w1d 25w6d 27w5d
148 16w0d 17w4d 19w0d 250 24w1d 26w0d 27w6d
150 16w1d 17w4d 19w1d 252 24w3d 26w1d 28w0d
152 16w2d 17w6d 19w2d 254 24w4d 26w3d 28w1d
154 16w3d 17w6d 19w3d 256 24w6d 26w4d 28w3d
156 16w4d 18w1d 19w4d 258 25w0d 26w6d 28w4d
158 16w5d 18w1d 19w5d 260 25w1d 27w0d 28w6d
160 16w6d 18w3d 19w6d 262 25w3d 27w1d 29w0d
162 17w0d 18w4d 20w0d 264 25w4d 27w3d 29w1d
164 17w1d 18w5d 20w1d 266 25w6d 27w4d 29w3d
166 17w2d 18w6d 20w2d 268 26w0d 27w6d 29w4d
168 17w4d 19w0d 20w4d 270 26w1d 28w1d 30w0d
122
170 17w4d 19w1d 20w4d 272 26w3d 28w2d 30w1d
Table 2-67: HC: Merz (Fetal Age)(Continued)Habilitationsschrift, Mainz University
Women’s Hospital, 1988Unit: HC (mm); % Age (Weeks/Days)
274 26w4d 28w4d 30w3d 322 32w0d 34w1d 36w1d

276 26w6d 28w5d 30w4d 324 32w2d 34w3d 36w4d
278 27w0d 28w6d 30w6d 326 32w4d 34w5d 36w6d
280 27w1d 29w1d 31w0d 328 32w6d 34w6d 37w0d
282 27w3d 29w2d 31w1d 330 33w1d 35w1d 37w2d
284 27w5d 29w4d 31w4d 332 33w2d 35w4d 37w5d
286 27w6d 29w6d 31w5d 334 33w4d 35w6d 38w0d
288 28w1d 30w0d 31w6d 336 33w6d 36w1d 38w2d
290 28w2d 30w1d 32w1d 338 34w1d 36w3d 38w4d
292 28w4d 30w4d 32w3d 340 34w3d 36w4d 38w6d
294 28w6d 30w5d 32w4d 342 34w5d 36w6d 39w1d
296 29w0d 30w6d 32w6d 344 35w0d 37w1d 39w3d
298 29w1d 31w1d 33w0d 346 35w2d 37w4d 39w5d
300 29w3d 31w3d 33w3d 348 35w4d 37w6d 40w1d
302 29w4d 31w4d 33w4d 350 35w6d 38w1d 40w4d
304 29w6d 31w6d 33w6d 352 36w1d 38w4d 40w6d
306 30w1d 32w1d 34w1d 354 36w4d 38w6d 41w1d
308 30w2d 32w2d 34w2d 356 36w6d 39w1d 41w3d
310 30w4d 32w4d 34w4d 358 37w1d 39w4d 41w6d
312 30w6d 32w6d 34w6d 360 37w4d 39w6d 42w1d
314 31w1d 33w1d 35w1d 362 37w6d 40w1d 42w3d
316 31w3d 33w3d 35w3d 364 38w1d 40w4d 42w6d
318 31w4d 33w4d 35w4d >364 n/a n/a n/a
320 31w6d 33w6d 36w0d
123
Table 2-68: HC: Merz (Fetal Growth) Habilitationsschrift, Mainz University Women’s
12.5 80 92 104 27.5 253 268 284

13.0 84 96 108 28.0 258 273 289
13.5 89 101 113 28.5 263 278 294
14.0 94 106 119 29.0 268 283 299
14.5 100 112 124 29.5 272 288 303
15.0 105 118 130 30.0 277 292 308
15.5 111 124 137 30.5 281 297 313
16.0 117 130 143 31.0 285 301 317
16.5 123 136 149 31.5 289 305 321
17.0 130 143 156 32.0 293 309 325
17.5 136 149 162 32.5 297 313 329
18.0 142 155 168 33.0 300 316 333
18.5 148 162 175 33.5 303 320 336
19.0 155 168 181 34.0 307 323 340
19.5 161 174 188 34.5 310 326 343
20.0 167 181 194 35.0 313 329 346
20.5 173 187 201 35.5 315 332 349
21.0 180 193 207 36.0 318 335 352
21.5 186 200 214 36.5 320 337 354
22.0 192 206 220 37.0 322 339 356
22.5 198 212 226 37.5 324 341 359
23.0 204 218 232 38.0 326 343 361
23.5 210 224 238 38.5 327 345 362
24.0 216 230 244 39.0 329 346 364
24.5 221 236 250 39.5 330 348 365
25.0 227 241 256 40.0 331 349 366
25.5 232 247 262 40.5 332 349 367
26.0 238 253 267 41.0 332 350 368
26.5 243 258 273 41.5 332 350 369
27.0 248 263 278
124
Moore
Table 2-69: AFI: MooreUnit: Age (Days); Min/Max (mm); Table/Graph Range (2.5%:
97.5%)
Age Min Max CRL Age SD CRL Age SD
16 73 201 25 89 240 34 72 278

17 77 211 26 89 242 35 70 279
18 80 220 27 85 245 36 68 279
19 83 225 28 86 249 37 66 275
20 86 230 29 84 254 38 65 269
21 88 233 30 82 258 39 64 255
22 89 235 31 79 263 40 63 240
23 90 237 32 77 269 41 63 216
24 90 238 33 74 274 42 63 192
Nelson
Table 2-70: CRL: Nelson (Fetal Age), Journal of Clinical Ultrasound, 9: 67-70, 1981, Unit:
CRL (mm); GA (Days)
CRL GA CRL GA CRL GA CRL GA CRL GA
14 59 34 71 54 83 74 95 94 107
15 60 35 72 55 84 75 96 95 108
16 61 36 73 56 85 76 97 96 109
17 61 37 73 57 85 77 97 97 109
18 62 38 74 58 86 78 98 98 110
19 62 39 74 59 86 79 98 99 110
20 63 40 75 60 87 80 99 100 111
21 64 41 76 61 88 81 100 101 112
22 64 42 76 62 88 82 100 102 112
23 65 43 77 63 89 83 101 103 113
24 65 44 77 64 89 84 101 104 113
25 66 45 78 65 90 85 102 105 114
26 67 46 79 66 91 86 103 106 115
27 67 47 79 67 91 87 103 107 115
28 68 48 80 68 92 88 104 108 116
29 68 49 80 69 92 89 104 109 116
30 69 50 81 70 93 90 105 110 117
31 70 51 82 71 94 91 106 111 118
32 70 52 82 72 94 92 106
33 71 53 83 73 95 93 107
125
Osaka
Table 2-71: BPD: Osaka (Fetal Age), Osaka University Method 1989, 3 by Univ. Osaka,
Unit: BPD (mm); Age (Days); SD (mm)
<13 n/a — 33 107 2.4 54 152 3.0 75 203 3.5

13 70 1.9 34 109 2.5 55 154 3.0 76 206 3.5
14 71 1.9 35 112 2.5 56 157 3.0 77 209 3.5
15 73 1.9 36 114 2.5 57 159 3.1 78 212 3.5
16 75 1.9 37 116 2.5 58 161 3.1 79 214 3.6
17 77 2.0 38 118 2.6 59 164 3.1 80 217 3.6
18 78 2.0 39 120 2.6 60 166 3.1 81 220 3.6
19 80 2.0 40 122 2.6 61 168 3.2 82 224 3.6
20 82 2.1 41 124 2.7 62 171 3.2 83 227 3.6
21 84 2.1 42 126 2.7 63 173 3.2 84 230 3.7
22 86 2.1 43 128 2.7 64 175 3.2 85 234 3.7
23 88 2.1 44 130 2.7 65 178 3.3 86 237 3.7
24 90 2.2 45 132 2.8 66 180 3.3 87 238 3.7
25 92 2.2 46 135 2.8 67 182 3.3 88 245 3.7
26 94 2.2 47 137 2.8 68 185 3.3 89 249 3.8
27 96 2.3 48 139 2.8 69 187 3.3 90 254 3.8
28 98 2.3 49 141 2.9 70 190 3.4 91 259 3.8
29 99 2.3 50 143 2.9 71 193 3.4 92 265 3.8
30 101 2.3 51 145 2.9 72 195 3.4 93 273 3.9
31 103 2.4 52 148 2.9 73 198 3.4 94 280 3.9
32 105 2.4 53 150 3.0 74 200 3.5 >94 n/a —
Table 2-72: CRL: Osaka (Fetal Age), Osaka University Method 1989, 3 by Univ. Osaka,
Unit: CRL (mm); Age (Days); SD (mm)
<9 n/a —— 23 65 4.0 38 75 5.5 53 84 6.9

9 50 1.7 24 66 4.1 39 76 5.7 54 85 7.0
10 52 2.0 25 66 4.1 40 76 5.7 55 85 7.0
11 53 2.2 26 67 4.3 41 77 5.8 56 86 7.2
12 55 2.5 27 68 4.5 42 77 5.8 57 86 7.2
13 56 2.6 28 69 4.6 43 78 6.0 58 87 7.3
14 57 2.8 29 69 4.6 44 79 6.1 59 87 7.3
15 58 2.9 30 70 4.8 45 79 6.1 60 88 7.5
16 59 3.1 31 71 4.9 46 80 6.3 61 89 7.6
17 60 3.2 32 71 4.9 47 80 6.3 62 89 7.6
18 61 3.4 33 72 5.1 48 81 6.4 63 90 7.8
19 62 3.5 34 73 5.2 49 82 6.6 >63 n/a ——
20 63 3.7 35 73 5.2 50 83 6.7
21 63 3.7 36 74 5.4 51 83 6.7
22 64 3.8 37 74 5.4 52 83 6.7
126
Table 2-73: EFW: Osaka (Fetal Age), Osaka University Method 1989, 3 by Univ. Osaka,
Unit: EFW (grams); Age (Days); SD (grams)
EFW Age SD EFW Age SD EFW Age SD EFW Age SD
<137 n/a —— 590 160 81 1420 203 171 2360 242 268
137 112 29 600 160 81 1440 204 174 2380 243 271
140 113 29 610 161 83 1460 205 176 2400 244 274
150 115 29 620 162 85 1480 206 178 2420 245 276
160 116 30 630 162 85 1500 207 181 2440 245 276
170 118 30 640 163 87 1520 208 183 2460 246 279
180 120 31 650 164 89 1540 209 185 2480 247 282
190 121 32 660 164 89 1560 210 188 2500 248 285
200 123 33 670 165 91 1580 210 188 2520 249 288
210 124 34 680 165 91 1600 211 190 2540 249 288
220 126 35 690 166 92 1620 212 192 2560 250 290
230 127 36 700 167 94 1640 213 195 2580 251 293
240 128 37 720 168 96 1660 214 197 2600 252 296
250 130 39 740 169 98 1680 215 200 2620 253 299
260 131 40 760 170 100 1700 216 202 2640 254 302
270 132 41 780 171 102 1720 216 202 2660 254 302
280 133 42 800 173 106 1740 217 204 2680 255 305
290 134 43 820 174 108 1760 218 207 2700 256 308
300 135 44 840 175 110 1780 219 209 2720 257 311
310 136 45 860 176 112 1800 220 212 2740 258 314
320 137 46 880 177 114 1820 220 212 2760 259 317
330 138 48 900 178 116 1840 221 214 2780 259 317
340 139 49 920 179 118 1860 222 217 2800 260 320
350 140 50 940 180 120 1880 223 219 2820 261 323
360 141 51 960 181 123 1900 224 222 2840 262 326
370 142 53 980 182 125 1920 224 222 2860 263 329
380 143 54 1000 183 127 1940 225 224 2880 264 332
390 144 56 1020 185 131 1960 226 227 2900 265 335
400 145 57 1040 186 133 1980 227 229 2920 266 339
410 146 58 1060 187 135 2000 228 232 2940 266 339
420 147 60 1080 188 138 2020 229 234 2960 267 342
430 148 61 1100 189 140 2040 229 234 2980 268 345
440 149 63 1120 190 142 2060 230 237 3000 269 348
450 149 63 1140 191 144 2080 231 239 3020 270 352
460 150 65 1160 192 146 2100 232 242 3040 271 355
470 151 66 1180 193 149 2120 233 244 3060 272 358
480 152 68 1200 194 151 2140 233 244 3080 273 362
490 153 69 1220 195 153 2160 234 247 3100 274 365
500 153 69 1240 195 153 2180 235 250 3120 275 369
510 154 71 1260 196 155 2200 236 252 3140 276 372
520 155 73 1280 197 158 2220 236 252 3160 277 376
530 155 73 1300 198 160 2240 237 255 3180 278 379
540 156 74 1320 199 162 2260 238 257 3200 279 383
550 157 76 1340 200 164 2280 239 260 3220 280 387
560 157 76 1360 201 167 2300 240 263 >3220 n/a —
570 158 78 1380 202 169 2320 241 265
580 159 80 1400 203 171 2340 241 265
127
Table 2-74: FL: Osaka (Fetal Age), Osaka University Method 1989, 3 by Univ. Osaka,
Unit: FL (mm); Age (Days); SD (mm)
<9 n/a —— 25 127 2.3 42 172 2.6 59 227 2.9

9 91 2.1 26 130 2.3 43 175 2.6 60 230 2.9
10 93 2.1 27 132 2.3 44 178 2.6 61 235 2.9
11 95 2.1 28 135 2.4 45 181 2.6 62 239 2.9
12 97 2.2 29 137 2.4 46 184 2.6 63 242 3.0
13 99 2.2 30 140 2.4 47 186 2.6 64 247 3.0
14 102 2.2 31 142 2.4 48 190 2.7 65 250 3.0
15 104 2.2 32 145 2.4 49 193 2.7 66 255 3.0
16 106 2.2 33 147 2.4 50 196 2.7 67 258 3.0
17 108 2.2 34 150 2.4 51 199 2.7 68 260 3.1
18 110 2.2 35 152 2.5 52 202 2.6 69 269 3.1
19 113 2.2 36 155 2.5 53 205 2.8 70 274 3.1
20 115 2.3 37 158 2.5 54 209 2.8 71 279 3.2
21 118 2.3 38 162 2.5 55 212 2.8 >71 n/a ——
22 120 2.3 39 163 2.5 56 216 2.8
23 122 2.3 40 166 2.5 57 220 2.8
24 125 2.3 41 169 2.6 58 223 2.9
Table 2-75: FTA: Osaka (Fetal Age), Osaka University Method 1989, 3 by Univ. Osaka,
Unit: FTA (mm2); Age (Days); SD (mm2)
FTA Age SD FTA Age SD FTA Age SD FTA Age SD
<560 n/a —— 2600 159 330 4800 205 560 7000 246 800
560 98 120 2700 162 340 4900 207 570 7100 248 820
600 100 120 2800 164 350 5000 209 580 7200 250 830
700 103 130 2900 166 360 5100 211 590 7300 252 840
800 108 150 3000 168 370 5200 213 600 7400 254 860
900 113 160 3100 170 380 5300 215 610 7500 256 870
1000 115 170 3200 173 390 5400 216 620 7600 258 880
1100 117 170 3300 175 400 5500 218 630 7700 260 900
1200 122 190 3400 177 410 5600 220 640 7800 262 910
1300 125 200 3500 179 420 5700 222 650 7900 264 930
1400 128 210 3600 181 430 5800 224 670 8000 265 930
1500 130 220 3700 183 440 5900 226 680 8100 268 960
1600 134 230 3800 185 450 6000 227 680 8200 270 970
1700 137 240 3900 187 460 6100 229 700 8300 273 990
1800 139 250 4000 189 470 6200 231 710 8400 274 1000
1900 142 260 4100 191 480 6300 233 720 8500 276 1010
2000 145 270 4200 193 490 6400 235 730 8600 279 1040
2100 147 280 4300 195 500 6500 237 750 8660 280 1040
2200 150 290 4400 197 510 6600 238 750 >8660 n/a ——
2300 152 300 4500 199 520 6700 240 760
2400 155 310 4600 201 530 6800 242 780
2500 157 330 4700 203 540 6900 244 790
128
Table 2-76: HL: Osaka (Fetal Age), Osaka University Method 1989, 3 by Univ. Osaka,
Unit: HL (mm); Age (Days); SD (mm)
HL Age SD HL Age SD HL Age SD HL Age SD
<10 n/a —— 23 123 2.2 37 164 2.4 51 217 2.6

10 91 2.0 24 126 2.2 38 167 2.4 52 222 2.6
11 93 2.0 25 129 2.2 39 170 2.4 53 227 2.7
12 96 2.0 26 132 2.2 40 174 2.4 54 232 2.7
13 98 2.1 27 134 2.2 41 178 2.4 55 237 2.7
14 100 2.1 28 137 2.2 42 182 2.5 56 242 2.7
15 103 2.1 29 140 2.3 43 185 2.5 57 248 2.8
16 105 2.1 30 143 2.3 44 188 2.5 58 254 2.8
17 108 2.1 31 145 2.3 45 192 2.5 59 260 2.8
18 110 2.1 32 149 2.3 46 196 2.5 60 267 2.9
19 113 2.1 33 151 2.3 47 200 2.5 61 275 2.9
20 115 2.1 34 155 2.3 48 204 2.6 62 280 2.9
21 117 2.1 35 158 2.3 49 208 2.6 >62 n/a ——
22 121 2.2 36 161 2.4 50 213 2.6
129
Paris
Table 2-77: BPD: Paris (Fetal Age), Unit: BPD (mm); Age (Days); SD (mm)
<13 n/a —— 33 110 3 54 158 4 75 210 5

13 77 3 34 113 3 55 161 4 76 213 5
14 78 3 35 115 3 56 163 4 77 217 5
15 79 3 36 117 3 57 165 4 78 220 5
16 80 3 37 119 3 58 168 4 79 224 5
17 81 3 38 121 3 59 170 4 80 227 5
18 82 3 39 123 3 60 172 4 81 231 5
19 83 3 40 126 4 61 175 4 82 234 5
20 84 3 41 128 4 62 177 4 83 238 5
21 85 3 42 130 4 63 179 4 84 242 5
22 87 3 43 133 4 64 182 4 85 247 5
23 89 3 44 135 4 65 184 4 86 252 5
24 91 3 45 137 4 66 187 4 87 256 5
25 93 3 46 140 4 67 189 4 88 261 5
26 95 3 47 142 4 68 192 4 89 266 5
27 97 3 48 144 4 69 194 4 90 287 5
28 100 3 49 147 4 70 197 4 >90 n/a ——
29 102 3 50 149 4 71 199 4
30 104 3 51 151 4 72 202 4
31 106 3 52 154 4 73 204 4
32 108 3 53 156 4 74 207 4
Table 2-78: CRL: Paris (Fetal Age), Unit: CRL (mm); Age (Days); SD (mm)
<5 n/a —— 25 64 7 46 78 7 67 90 7
5 42 4 26 65 7 47 79 7 68 90 7
6 43 4 27 66 7 48 79 7 69 91 7
7 44 4 28 66 7 49 80 7 70 91 7
8 46 4 29 67 7 50 80 7 71 91 7
9 47 4 30 68 7 51 81 7 72 92 7
10 49 4 31 69 7 52 82 7 73 92 7
11 50 4 32 70 7 53 82 7 74 93 7
12 51 4 33 70 7 54 83 7 75 93 7
13 52 4 34 71 7 55 84 7 76 94 7
14 53 4 35 71 7 56 84 7 77 94 7
15 54 4 36 72 7 57 85 7 78 94 7
16 55 5 37 73 7 58 85 7 79 95 7
17 56 5 38 73 7 59 86 7 80 95 7
18 57 5 39 74 7 60 86 7 81 96 7
19 58 6 40 74 7 61 87 7 82 96 7
20 59 6 41 75 7 62 87 7 83 97 7
21 60 6 42 76 7 63 88 7 84 97 7
22 61 6 43 76 7 64 88 7 85 98 7
23 63 6 44 77 7 65 89 7 >85 n/a ——
24 63 7 45 77 7 66 89 7
130
Table 2-79: FL: Paris (Fetal Age), Unit: FL (mm); Age (Days); SD (mm)
<15 n/a —— 31 137 5 48 183 5 65 238 5

15 98 4 32 139 5 49 186 5 66 241 5
16 100 4 33 142 5 50 189 5 67 245 5
17 102 4 34 145 5 51 192 5 68 248 5
18 105 4 35 148 5 52 194 5 69 252 5
19 107 4 36 150 5 53 197 5 70 255 5
20 109 4 37 153 5 54 200 5 71 259 5
21 112 4 38 156 5 55 203 5 72 262 5
22 114 4 39 159 5 56 206 5 73 266 5
23 116 4 40 161 5 57 210 5 74 271 5
24 119 4 41 164 5 58 213 5 75 276 5
25 121 4 42 167 5 59 217 5 76 281 5
26 123 4 43 170 5 60 219 5 77 287 5
27 126 5 44 172 5 61 221 5 >77 n/a ——
28 128 5 45 175 5 62 224 5
29 131 5 46 178 5 63 231 5
30 134 5 47 181 5 64 234 5
Table 2-80: Ft: Paris (Fetal Age), Unit: Ft (mm); Age (Days); SD (mm)
Ft Age SD Ft Age SD Ft Age SD Ft Age SD
<13 n/a —— 29 133 4 46 173 4 63 221 4

13 91 2 30 135 4 47 175 4 64 224 4
14 94 2 31 137 4 48 178 4 65 227 4
15 97 2 32 140 4 49 180 4 66 231 5
16 100 2 33 142 4 50 183 4 67 234 5
17 103 3 34 144 4 51 185 4 68 238 5
18 106 3 35 147 4 52 188 4 69 242 5
19 109 3 36 149 4 53 190 4 70 246 5
20 112 4 37 151 4 54 193 4 71 250 5
21 114 4 38 154 4 55 196 4 72 254 5
22 116 4 39 156 4 56 199 4 73 258 5
23 119 4 40 158 4 57 202 4 74 262 5
24 121 4 41 161 4 58 205 4 75 266 6
25 123 4 42 163 4 59 208 4 >75 n/a ——
26 126 4 43 165 4 60 211 4
27 128 4 44 168 4 61 215 4
28 130 4 45 170 4 62 218 4
131
Table 2-81: TAD: Paris (Fetal Age), Unit: TAD (mm); Age (Days); SD (mm)
<10 n/a —— 32 116 0 55 171 0 78 229 0

10 84 0 33 118 0 56 174 0 79 232 0
11 84 0 34 120 0 57 176 0 80 234 0
12 85 0 35 122 0 58 179 0 81 237 0
13 86 0 36 124 0 59 181 0 82 239 0
14 87 0 37 126 0 60 184 0 83 242 0
15 87 0 38 128 0 61 186 0 84 245 0
16 88 0 39 131 0 62 189 0 85 248 0
17 89 0 40 133 0 63 191 0 86 252 0
18 90 0 41 136 0 64 194 0 87 255 0
19 91 0 42 138 0 65 196 0 88 259 0
20 92 0 43 141 0 66 199 0 89 262 0
21 94 0 44 143 0 67 201 0 90 266 0
22 96 0 45 146 0 68 204 0 91 269 0
23 98 0 46 148 0 69 207 0 92 273 0
24 100 0 47 151 0 70 209 0 93 276 0
25 102 0 48 153 0 71 212 0 94 280 0
26 104 0 49 156 0 72 214 0 95 283 0
27 106 0 50 158 0 73 217 0 96 287 0
28 108 0 51 161 0 74 219 0 >96 n/a ——
29 110 0 52 163 0 75 222 0
30 112 0 53 166 0 76 224 0
31 114 0 54 169 0 77 227 0
132
Rempen
Table 2-82: BPD: Rempen (Fetal Age), Der Frauenarzt 32, 4 (1991) 425-30’ Known LMP
(left)—Unknown LMP (right), Unit: BPD (mm); Age (Weeks/Days); 2SD (mm [Known LMP]
<2 n/a —— 15 10w2d 4 <3 n/a —— 16 10w4d 8

2 6w2d 4 16 10w5d 4 3 6w6d 8 17 10w6d 8
3 6w4d 4 17 11w0d 4 4 7w1d 8 18 11w1d 8
4 6w6d 4 18 11w2d 4 5 7w3d 8 19 11w3d 8
5 7w1d 4 19 11w5d 4 6 7w5d 8 20 11w5d 8
6 7w4d 4 20 12w0d 4 7 8w0d 8 21 12w0d 8
7 7w6d 4 21 12w2d 4 8 8w2d 8 22 12w2d 8
8 8w1d 4 22 12w4d 4 9 8w4d 8 23 12w4d 8
9 8w3d 4 23 13w0d 4 10 8w6d 8 24 12w6d 8
10 8w5d 4 24 13w2d 4 11 9w1d 8 25 13w1d 8
11 9w1d 4 >24 n/a —— 12 9w3d 8 26 13w3d 8
12 9w3d 4 13 9w5d 8 27 13w5d 8
13 9w5d 4 14 10w0d 8 >27 n/a ——
14 10w0d 4 15 10w2d 8
Table 2-83: BPD: Rempen (Fetal Growth), Der Frauenarzt 32, 4 (1991) 425-30, Unit: Age
(Weeks/Days); Mean (mm); 2SD (mm); Table/Graph Range (5%:95%)
Age Mean SD Age Mean SD Age Mean SD
6w2d 2.0 3.7 8w5d 9.8 3.7 11w1d 17.4 3.7

6w3d 2.5 3.7 8w6d 10.3 3.7 11w2d 17.9 3.7
6w4d 3.0 3.7 9w0d 10.7 3.7 11w3d 18.3 3.7
6w5d 3.4 3.7 9w1d 11.2 3.7 11w4d 18.7 3.7
6w6d 3.9 3.7 9w2d 11.6 3.7 11w5d 19.2 3.7
7w0d 4.3 3.7 9w3d 12.1 3.7 11w6d 19.6 3.7
7w1d 4.8 3.7 9w4d 12.5 3.7 12w0d 20.0 3.7
7w2d 5.3 3.7 9w5d 13.0 3.7 12w1d 20.5 3.7
7w3d 5.7 3.7 9w6d 13.4 3.7 12w2d 20.9 3.7
7w4d 6.2 3.7 10w0d 13.9 3.7 12w3d 21.3 3.7
7w5d 6.7 3.7 10w1d 14.3 3.7 12w4d 21.8 3.7
7w6d 7.1 3.7 10w2d 14.8 3.7 12w5d 22.2 3.7
8w0d 7.6 3.7 10w3d 15.2 3.7 12w6d 22.6 3.7
8w1d 8.0 3.7 10w4d 15.7 3.7 13w0d 23.1 3.7
8w2d 8.5 3.7 10w5d 16.1 3.7 13w1d 23.5 3.7
8w3d 8.9 3.7 10w6d 16.5 3.7 13w2d 23.9 3.7
8w4d 9.4 3.7 11w0d 17.0 3.7
133
Table 2-84: CRL: Rempen (Fetal Age), Der Frauenarzt 32, 4 (1991) 425-30, Known LMP
(left)—Unknown LMP (right), Unit: CRL (mm); Age (Weeks/Days); 2SD (mm [Known LMP]
<1 n/a —— 40 10w5d 8 <2 n/a —— 41 10w5d 7

1 5w5d 8 41 10w6d 8 2 6w0d 6 42 10w6d 6
2 5w6d 8 42 11w0d 8 3 6w1d 6 43 11w0d 7
3 6w0d 8 43 11w0d 8 4 6w2d 6 44 11w0d 7
4 6w1d 8 44 11w1d 8 5 6w3d 6 45 11w1d 6
5 6w2d 8 45 11w2d 8 6 6w4d 6 46 11w2d 7
6 6w3d 8 46 11w2d 8 7 6w5d 6 47 11w2d 7
7 6w4d 8 47 11w3d 8 8 6w6d 6 48 11w3d 6
8 6w6d 8 48 11w4d 8 9 7w0d 6 49 11w4d 7
9 6w6d 8 49 11w4d 8 10 7w1d 6 50 11w4d 6
10 7w0d 8 50 11w5d 8 11 7w2d 6 51 11w5d 6
11 7w2d 8 51 11w6d 8 12 7w3d 6 52 11w5d 7
12 7w2d 8 52 12w0d 8 13 7w4d 7 53 11w6d 6
13 7w4d 8 53 12w0d 8 14 7w5d 7 54 12w0d 7
14 7w4d 8 54 12w1d 8 15 7w6d 7 55 12w0d 7
15 7w5d 8 55 12w2d 8 16 7w6d 7 56 12w1d 6
16 7w6d 8 56 12w2d 8 17 8w0d 7 57 12w1d 7
17 8w0d 8 57 12w3d 8 18 8w1d 6 58 12w2d 6
18 8w1d 8 58 12w3d 8 19 8w2d 6 59 12w3d 7
19 8w2d 8 59 12w4d 8 20 8w3d 6 60 12w3d 6
20 8w3d 8 60 12w5d 8 21 8w4d 7 61 12w4d 7
21 8w4d 8 61 12w5d 8 22 8w5d 7 62 12w4d 6
22 8w5d 8 62 12w6d 8 23 8w5d 7 63 12w5d 7
23 8w6d 8 63 13w0d 8 24 8w6d 7 64 12w5d 7
24 8w6d 8 64 13w0d 8 25 9w0d 6 65 12w6d 6
25 9w0d 8 65 13w1d 8 26 9w1d 6 66 12w6d 7
26 9w1d 8 66 13w2d 8 27 9w2d 7 67 13w0d 6
27 9w2d 8 >66 n/a —— 28 9w3d 7 68 13w0d 7
28 9w3d 8 29 9w3d 7 69 13w1d 6
29 9w4d 8 30 9w4d 7 70 13w1d 7
30 9w4d 8 31 9w5d 7 71 13w2d 7
31 9w5d 8 32 9w6d 7 72 13w2d 6
32 9w6d 8 33 9w6d 7 73 13w3d 7
33 10w0d 8 34 10w0d 6 74 13w3d 6
34 10w1d 8 35 10w1d 6 75 13w4d 7
35 10w1d 8 36 10w2d 7 76 13w4d 6
36 10w2d 8 37 10w2d 7 77 13w4d 7
37 10w3d 8 38 10w3d 6 78 13w5d 6
38 10w4d 8 39 10w4d 6 >78 n/a ——
39 10w4d 8 40 10w5d 7
134
Table 2-85: CRL: Rempen (Fetal Growth), Der Frauenarzt 32, 4 (1991) 425-30, Unit: Age
5w5d 1.2 7.8 8w2d 18.9 7.8 10w6d 41.3 7.8

5w6d 2.1 7.8 8w3d 20.0 7.8 11w0d 42.6 7.8
6w0d 3.0 7.8 8w4d 21.1 7.8 11w1d 44.0 7.8
6w1d 3.8 7.8 8w5d 22.3 7.8 11w2d 45.4 7.8
6w2d 4.7 7.8 8w6d 23.5 7.8 11w3d 46.9 7.8
6w3d 5.7 7.8 9w0d 24.6 7.8 11w4d 48.3 7.8
6w4d 6.6 7.8 9w1d 25.8 7.8 11w5d 49.8 7.8
6w5d 7.5 7.8 9w2d 27.0 7.8 11w6d 51.2 7.8
6w6d 8.5 7.8 9w3d 28.3 7.8 12w0d 52.7 7.8
7w0d 9.5 7.8 9w4d 29.5 7.8 12w1d 54.2 7.8
7w1d 10.5 7.8 9w5d 30.7 7.8 12w2d 55.7 7.8
7w2d 11.5 7.8 9w6d 32.0 7.8 12w3d 57.3 7.8
7w3d 12.5 7.8 10w0d 33.3 7.8 12w4d 58.8 7.8
7w4d 13.5 7.8 10w1d 34.6 7.8 12w5d 60.3 7.8
7w5d 14.6 7.8 10w2d 35.9 7.8 12w6d 61.9 7.8
7w6d 15.6 7.8 10w3d 37.2 7.8 13w0d 63.5 7.8
8w0d 16.7 7.8 10w4d 38.5 7.8 13w1d 65.1 7.8
8w1d 17.8 7.8 10w5d 39.9 7.8 13w2d 66.7 7.8
135
Table 2-86: GS: Rempen (Fetal Age), Der Frauenarzt 32, 4 (1991) 425-30, Known LMP
(left)—Unknown LMP (right), Unit: GS (mm); Age (Weeks/Days); 2SD (mm [Known LMP]
GS Age 2SD GS Age 2SD GS Age 2SD GS Age 2SD
<1 n/a —— 38 9w1d 11 <1 n/a —— 38 9w1d 10

1 4w4d 11 39 9w2d 11 1 4w5d 10 39 9w2d 10
2 4w5d 11 40 9w4d 11 2 4w6d 10 40 9w3d 10
3 4w6d 11 41 9w5d 11 3 5w0d 10 41 9w4d 10
4 5w0d 11 42 9w6d 11 4 5w1d 10 42 9w5d 10
5 5w0d 11 43 10w0d 11 5 5w2d 10 43 9w6d 10
6 5w1d 11 44 10w1d 11 6 5w2d 10 44 9w6d 10
7 5w2d 11 45 10w2d 11 7 5w3d 10 45 10w0d 10
8 5w3d 11 46 10w3d 11 8 5w4d 10 46 10w1d 10
9 5w3d 11 47 10w4d 11 9 5w5d 10 47 10w2d 10
10 5w4d 11 48 10w6d 11 10 5w5d 10 48 10w3d 10
11 5w5d 11 49 11w0d 11 11 5w6d 10 49 10w4d 10
12 5w6d 11 50 11w1d 11 12 6w0d 10 50 10w5d 10
13 6w0d 11 51 11w2d 11 13 6w1d 10 51 10w6d 10
14 6w0d 11 52 11w4d 11 14 6w2d 10 52 11w0d 10
15 6w1d 11 53 11w5d 11 15 6w2d 10 53 11w1d 10
16 6w2d 11 54 12w0d 11 16 6w3d 10 54 11w2d 10
17 6w3d 11 55 12w1d 11 17 6w4d 10 55 11w3d 10
18 6w4d 11 56 12w2d 11 18 6w5d 10 56 11w4d 10
19 6w5d 11 57 12w4d 11 19 6w6d 10 57 11w5d 10
20 6w6d 11 58 12w5d 11 20 6w6d 10 58 11w6d 10
21 6w6d 11 59 13w0d 11 21 7w0d 10 59 12w0d 10
22 7w0d 11 60 13w1d 11 22 7w1d 10 60 12w1d 10
23 7w1d 11 >60 n/a —— 23 7w2d 10 61 12w2d 10
24 7w2d 11 24 7w3d 10 62 12w3d 10
25 7w3d 11 25 7w4d 10 63 12w4d 10
26 7w4d 11 26 7w4d 10 64 12w5d 10
27 7w5d 11 27 7w5d 10 65 12w6d 10
28 7w6d 11 28 7w6d 10 66 13w0d 10
29 8w0d 11 29 8w0d 10 67 13w1d 10
30 8w0d 11 30 8w1d 10 68 13w2d 10
31 8w1d 11 31 8w2d 10 69 13w3d 10
32 8w2d 11 32 8w3d 10 70 13w4d 10
33 8w3d 11 33 8w3d 10 71 13w5d 10
34 8w4d 11 34 8w4d 10 72 14w0d 10
35 8w5d 11 35 8w5d 10 73 14w1d 10
36 8w6d 11 36 8w6d 10 >73 n/a ——
37 9w0d 11 37 9w0d 10
136
Table 2-87: GS: Rempen (Fetal Growth), Der Frauenarzt 32, 4 (1991) 425-30, Unit: Age
4w4d 0.5 10.5 7w4d 26.2 10.5 10w4d 46.6 10.5

4w5d 1.8 10.5 7w5d 27.3 10.5 10w5d 47.4 10.5
4w6d 3.2 10.5 7w6d 28.4 10.5 10w6d 48.2 10.5
5w0d 4.5 10.5 8w0d 29.5 10.5 11w0d 49.0 10.5
5w1d 5.8 10.5 8w1d 30.5 10.5 11w1d 49.8 10.5
5w2d 7.1 10.5 8w2d 31.6 10.5 11w2d 50.6 10.5
5w3d 8.4 10.5 8w3d 32.6 10.5 11w3d 51.4 10.5
5w4d 9.7 10.5 8w4d 33.6 10.5 11w4d 52.1 10.5
5w5d 10.9 10.5 8w5d 34.6 10.5 11w5d 52.9 10.5
5w6d 12.2 10.5 8w6d 35.6 10.5 11w6d 53.6 10.5
6w0d 13.4 10.5 9w0d 36.6 10.5 12w0d 54.3 10.5
6w1d 14.6 10.5 9w1d 37.6 10.5 12w1d 55.1 10.5
6w2d 15.9 10.5 9w2d 38.5 10.5 12w2d 55.8 10.5
6w3d 17.1 10.5 9w3d 39.5 10.5 12w3d 56.4 10.5
6w4d 18.3 10.5 9w4d 40.4 10.5 12w4d 57.1 10.5
6w5d 19.4 10.5 9w5d 41.3 10.5 12w5d 57.8 10.5
6w6d 20.6 10.5 9w6d 42.2 10.5 12w6d 58.4 10.5
7w0d 21.7 10.5 10w0d 43.1 10.5 13w0d 59.1 10.5
7w1d 22.9 10.5 10w1d 44.0 10.5 13w1d 59.7 10.5
7w2d 24.0 10.5 10w2d 44.9 10.5 13w2d 60.3 10.5
7w3d 25.1 10.5 10w3d 45.7 10.5
137
Robinson
Table 2-88: CRL: Robinson (Fetal Age), Br J Gynecol, 82: 702, 1975, Unit: CRL (mm);
Age (Days); SD (mm)
<7 n/a —— 26 64 5 46 78 7 66 90 7
7 45 4 27 65 5 47 79 7 67 90 7
8 46 4 28 66 6 48 79 7 68 91 7
9 47 4 29 67 6 49 80 7 69 91 7
10 48 4 30 68 6 50 81 7 70 91 7
11 50 4 31 69 7 51 82 7 71 92 7
12 52 4 32 69 7 52 83 7 72 92 7
13 53 4 33 70 7 53 83 7 73 93 7
14 54 4 34 70 7 54 83 7 74 93 7
15 55 4 35 71 7 55 84 7 75 93 7
16 56 4 36 72 7 56 84 7 76 94 7
17 57 4 37 72 7 57 84 7 77 94 7
18 58 4 38 73 7 58 85 7 78 95 7
19 59 4 39 74 7 59 85 7 79 95 7
20 60 4 40 74 7 60 86 7 80 96 7
21 60 4 41 75 7 61 86 7 81 97 7
22 61 4 42 75 7 62 87 7 82 98 7
23 62 4 43 76 7 63 88 7 >82 n/a ——
24 63 5 44 77 7 64 89 7
25 64 5 45 77 7 65 90 7
Tokyo
Table 2-89: APTDxTTD: Tokyo (Fetal Age), Tokyo University Method 1986, 6 by
University Tokyo, Unit: Meas (cm2); Age (Weeks/Days); SD (Days)
Meas Age SD Meas Age SD Meas Age SD
<10 n/a —— 38 25w6d ± 10d 68 33w3d ± 15d

10 16w1d ± 8d 40 26w3d ± 11d 70 33w6d ± 16d
12 17w0d ± 8d 42 27w0d ± 11d 72 34w2d ± 16d
14 17w6d ± 8d 44 27w3d ± 11d 74 34w6d ± 17d
16 18w4d ± 8d 46 28w0d ± 12d 76 35w3d ± 17d
18 19w3d ± 8d 48 28w4d ± 12d 78 35w6d ± 17d
20 20w1d ± 8d 50 29w0d ± 12d 80 36w3d ± 18d
22 20w6d ± 9d 52 29w3d ± 13d 82 37w0d ± 18d
24 21w4d ± 9d 54 30w0d ± 13d 84 37w4d ± 18d
26 22w2d ± 9d 56 30w3d ± 13d 86 38w1d ± 18d
28 22w6d ± 9d 58 31w0d ± 14d 88 38w5d ± 19d
30 23w4d ± 9d 60 31w3d ± 14d 90 39w2d ± 19d
32 24w1d ± 10d 62 31w6d ± 14d >90 n/a ——
34 24w5d ± 10d 64 32w3d ± 15d
36 25w2d ± 10d 66 32w6d ± 15d
138
Table 2-90: APTDxTTD by Gestational Age: Tokyo, Tokyo University Method 1986, 6 by
University Tokyo
Weeks -1.64 SD -1.5 SD -1.28 SD Mean +1.28 SD +1.5 SD +1.64 SD
16.0 7.0 7.4 7.9 11.2 14.6 15.1 15.5

17.0 8.7 9.0 9.7 13.3 17.0 17.6 18.0
18.0 10.5 10.9 11.6 15.6 19.6 20.3 20.7
19.0 12.5 13.0 13.7 18.1 22.4 23.2 23.6
20.0 14.7 15.2 16.1 20.8 25.5 26.3 26.8
21.0 17.1 17.6 18.5 23.6 28.8 29.6 30.2
22.0 19.6 20.2 21.2 26.7 32.2 33.2 33.8
23.0 22.2 22.9 23.9 29.9 35.9 36.9 37.5
24.0 25.0 25.7 26.8 33.2 39.7 40.8 41.5
25.0 27.9 28.6 29.8 36.7 43.6 44.8 45.6
26.0 30.9 31.7 33.0 40.3 47.7 49.0 49.8
27.0 33.9 34.8 36.2 44.1 52.0 53.3 54.2
28.0 37.1 38.0 39.4 47.9 56.3 57.8 58.7
29.0 40.3 41.3 42.8 51.8 60.8 62.3 63.3
30.0 43.5 44.5 46.2 55.7 65.3 66.9 68.0
31.0 46.8 47.9 49.6 59.7 69.9 71.6 72.7
32.0 50.0 51.2 53.0 63.8 74.5 76.4 77.6
33.0 53.3 54.5 56.5 67.8 79.2 81.2 82.4
34.0 56.5 57.8 59.9 71.9 83.9 86.0 87.3
35.0 59.7 61.1 63.3 75.9 88.6 90.8 92.2
36.0 62.8 64.3 66.6 79.9 93.3 95.6 97.0
37.0 65.9 67.4 69.8 83.9 97.9 100.3 101.9
38.0 68.8 70.4 72.9 87.7 102.5 105.0 106.7
39.0 71.6 73.3 76.0 91.5 107.0 109.7 111.4
40.0 74.3 76.1 78.9 95.1 111.4 114.2 116.0
41.0 76.8 78.6 81.6 98.6 115.7 118.6 120.5
42.0 79.1 81.1 84.1 102.0 119.8 122.9 124.8
139
Table 2-91: BPD: Tokyo (Fetal Age), Tokyo University Method 1986, 6 by University
Tokyo, Unit: BPD (mm); Age (Days); SD (Days)
<20 n/a —— 38 123 ±5 57 164 ±6 76 213 ±8

20 85 ±6 39 125 ±5 58 167 ±6 77 216 ±8
21 87 ±6 40 127 ±5 59 169 ±6 78 218 ±8
22 89 ±6 41 129 ±5 60 171 ±6 79 221 ±8
23 92 ±6 42 131 ±5 61 174 ±7 80 225 ±8
24 94 ±6 43 133 ±5 62 176 ±7 81 228 ±8
25 96 ±6 44 135 ±5 63 179 ±7 82 231 ±8
26 98 ±6 45 138 ±6 64 181 ±7 83 234 ±9
27 100 ±6 46 140 ±6 65 183 ±7 84 238 ±9
28 102 ±6 47 142 ±6 66 186 ±7 85 241 ±9
29 102 ±6 48 144 ±6 67 188 ±7 86 245 ±9
30 106 ±5 49 146 ±6 68 191 ±7 87 249 ±9
31 108 ±5 50 148 ±6 69 194 ±7 88 253 ±9
32 110 ±5 51 151 ±6 70 196 ±7 89 258 ±9
33 112 ±5 52 153 ±6 71 199 ±8 90 262 ±9
34 114 ±5 53 154 ±6 72 201 ±8 >90 n/a ——
35 116 ±5 54 157 ±6 73 204 ±8
36 118 ±5 55 160 ±6 74 207 ±8
37 120 ±5 56 162 ±6 75 210 ±8
Table 2-92: CRL: Tokyo (Fetal Age), Tokyo University Method 1986, 6 by University
Tokyo, Unit: CRL (mm); Age (Days); SD (Days)
<13 n/a —— 22 64 ±7 32 73 ±7 42 81 ±7
13 55 ±8 23 65 ±7 33 74 ±7 43 81 ±7
14 56 ±9 24 66 ±7 34 74 ±7 44 82 ±7
15 57 ± 10 25 67 ±7 35 75 ±7 45 83 ±7
16 58 ±8 26 68 ±7 36 76 ±7 46 84 ±7
17 59 ±9 27 68 ±7 37 77 ±7 47 84 ±7
18 60 ± 10 28 69 ±7 38 78 ±7 48 85 ±7
19 61 ±8 29 70 ±7 39 78 ±7 49 86 ±7
20 62 ±9 30 71 ±7 40 79 ±7 50 86 ±7
21 63 ±7 31 72 ±7 41 80 ±7 >50 n/a ——
140
Table 2-93: FL: Tokyo (Fetal Age), Tokyo University Method 1986, 6 by University Tokyo,
Unit: FL (mm); Age (Days); SD (mm)
<33 n/a —— 43 175 ±6 54 210 ±7 65 251 ±8

33 143 ±6 44 178 ±6 55 214 ±7 66 256 ±8
34 146 ±6 45 181 ±6 56 217 ±7 67 260 ±8
35 149 ±6 46 185 ±7 57 220 ±7 68 266 ±7
36 153 ±6 47 188 ±7 58 224 ±7 69 271 ±7
37 156 ±6 48 191 ±7 59 228 ±8 70 278 ±7
38 159 ±6 49 194 ±7 60 231 ±8 71 286 ±6
39 162 ±6 50 197 ±7 61 235 ±8 >71 n/a ——
40 166 ±6 51 200 ±7 62 239 ±8
41 169 ±6 52 204 ±7 63 243 ±8
42 172 ±6 53 207 ±7 64 247 ±8
Table 2-94: GS: Tokyo (Fetal Age), Tokyo University Method 1986, 6 by University Tokyo,
Unit: GS (mm); Age (Days); SD (Days)
<12 n/a —— 22 43 ±7 33 56 ±0 44 66 ±0
12 31 ±7 23 44 ±7 34 57 ±0 45 67 ±0
13 32 ±7 24 46 ±7 35 58 ±0 46 68 ±0
14 33 ±7 25 47 ±7 36 59 ±0 47 69 ±0
15 34 ±7 26 48 ±8 37 60 ±0 48 70 ±0
16 36 ±7 27 49 ±9 38 61 ±0 49 71 ±0
17 37 ±7 28 50 ± 10 39 62 ±0 50 72 ±0
18 38 ±7 29 51 ±0 40 63 ±0 >50 n/a ——
19 40 ±7 30 52 ±0 41 64 ±0
20 41 ±7 31 53 ±0 42 65 ±0
21 42 ±7 32 55 ±0 43 65 ±0
Table 2-95: LV: Tokyo (Fetal Age), Tokyo University Method 1986, 6 by University Tokyo,
Unit: LV (mm); Age (Days); SD (Days)
LV Age SD LV Age SD LV Age SD LV Age SD
<44 n/a —— 55 181 ±7 67 217 ± 10 79 260 ± 10

44 154 ±5 56 183 ±8 68 220 ± 10 80 264 ± 10
45 157 ±5 57 186 ±8 69 224 ± 10 81 267 ± 10
46 159 ±5 58 189 ±8 70 227 ± 11 82 271 ± 10
47 161 ±5 59 192 ±8 71 231 ± 11 83 275 ± 10
48 163 ±5 60 195 ±9 72 234 ± 11 84 278 ± 10
49 166 ±6 61 198 ±9 73 238 ± 11 85 282 ± 10
50 168 ±6 62 201 ±9 74 241 ± 11 86 285 ± 10
51 171 ±6 63 204 ±9 75 245 ± 11 >86 n/a ——
52 173 ±6 64 207 ± 10 76 249 ± 11
53 176 ±7 65 210 ± 10 77 252 ± 11
54 178 ±7 66 213 ± 10 78 256 ± 11
141
Tokyo Shinozuka
Table 2-96: AC: Tokyo Shinozuka (Fetal Age), Shinozuka Jpn J Med Ultrasonics vol 23:
12 1996, Unit: AC (cm); Age (Weeks/Days); SD (cm)
AC Age 1SD AC Age 1SD AC Age 1SD
<10 n/a —— 18 23w3d 0.9 27 33w1d 1.4

10 15w3d 0.5 19 24w3d 1.0 28 34w2d 1.4
11 16w4d 0.6 20 25w3d 1.0 29 35w4d 1.5
12 17w4d 0.6 21 26w3d 1.1 30 37w0d 1.6
13 18w4d 0.7 22 27w3d 1.1 31 38w2d 1.6
14 19w4d 0.7 23 28w4d 1.2 32 39w6d 1.7
15 20w3d 0.8 24 29w4d 1.2 33 41w2d 1.8
16 21w3d 0.8 25 30w5d 1.3 >33 n/a ——
17 22w3d 0.9 26 31w6d 1.3
Table 2-97: AC: Tokyo Shinozuka (Fetal Growth), Shinozuka Jpn J Med Ultrasonics vol
23: 12 1996, Unit: Age (Weeks/Days); Min/Mean/Max (cm); Table/Graph Range: 1.64SD
16 9.3 10.9 12.5 30 22.0 24.7 27.3

17 10.3 12.0 13.6 31 22.8 25.6 28.3
18 11.2 13.0 14.7 32 23.5 26.5 29.2
19 12.2 14.0 15.8 33 24.3 27.3 30.1
20 13.1 15.1 16.9 34 25.0 28.1 31.0
21 14.0 16.1 18.0 35 25.7 28.9 31.9
22 15.0 17.1 19.1 36 26.4 29.7 32.7
23 15.9 18.1 20.2 37 27.0 30.4 33.5
24 16.8 19.1 21.2 38 27.6 31.1 34.3
25 17.7 20.1 22.3 39 28.2 31.8 35.0
26 18.6 21.0 23.3 40 28.8 32.4 35.7
27 19.5 22.0 24.4 41 29.3 33.0 36.4
28 20.3 22.9 25.4 42 29.7 33.6 37.0
29 21.1 23.8 26.4
142
Table 2-98: AxT (APTDxTTD): Tokyo Shinozuka (Fetal Age), Shinozuka Jpn J Med
Ultrasonics vol 23: 12 1996, Unit: AxT (mm); Age (Weeks/Days); SD (cm2)
AxT Age 1SD AxT Age 1SD AxT Age 1SD
<10 n/a —— 38 25w6d 5.5 68 33w3d 8.8

10 16w1d 2.5 40 26w3d 5.7 70 33w6d 9.1
12 17w0d 2.7 42 27w0d 6.0 72 34w2d 9.3
14 17w6d 2.9 44 27w3d 6.1 74 34w6d 9.6
16 18w4d 3.1 46 28w0d 6.4 76 35w3d 9.9
18 19w3d 3.4 48 28w4d 6.6 78 35w6d 10.1
20 20w1d 3.6 50 29w0d 6.8 80 36w3d 10.2
22 20w6d 3.8 52 29w3d 7.0 82 37w0d 10.7
24 21w4d 4.0 54 30w0d 7.2 84 37w4d 11.0
26 22w2d 4.3 56 30w3d 7.4 86 38w1d 11.3
28 22w6d 4.4 58 31w0d 7.7 88 38w5d 11.7
30 23w4d 4.7 60 31w3d 7.9 90 39w2d 12.0
32 24w1d 4.9 62 31w6d 8.1 >90 n/a ——
34 24w5d 5.1 64 32w3d 8.4
36 25w2d 5.3 66 32w6d 8.6
Table 2-99: AxT (APTDxTTD): Tokyo Shinozuka (Fetal Growth), Shinozuka Jpn J Med
Ultrasonics vol 23: 12 1996, Unit: Age (Weeks); Min/Mean/Max (cm2); Table/Graph
Range: 1.64SD
16 7.0 11.2 15.5 30 43.5 55.7 68.0

17 8.7 13.3 18.0 31 46.8 59.7 72.7
18 10.5 15.6 20.7 32 50.0 63.8 77.6
19 12.5 18.1 23.6 33 53.3 67.8 82.4
20 14.7 20.8 26.8 34 56.5 71.9 87.3
21 17.1 23.6 30.2 35 59.7 75.9 92.2
22 19.6 26.7 33.8 36 62.8 79.9 97.0
23 22.2 29.9 37.5 37 65.9 83.9 101.9
24 25.0 33.2 41.5 38 68.8 87.7 106.7
25 27.9 36.7 45.6 39 71.6 91.5 111.4
26 30.9 40.3 49.8 40 74.3 95.1 116.0
27 33.9 44.1 54.2 41 76.8 98.6 120.5
28 37.1 47.9 58.7 42 79.1 102.0 124.8
29 40.3 51.8 63.3
143
Table 2-100: BPD: Tokyo Shinozuka (Fetal Age), Shinozuka Jpn J Med Ultrasonics vol
23: 12 1996, Unit: BPD (mm); Age (Weeks/Days); SD (mm)
BPD Age 1SD BPD Age 1SD BPD Age 1SD
<13 n/a —— 39 17w6d 2.7 66 26w3d 3.2

13 10w1d 2.3 40 18w1d 2.7 67 26w6d 3.2
14 10w3d 2.3 41 18w3d 2.8 68 27w2d 3.3
15 10w5d 2.3 42 18w5d 2.8 69 27w4d 3.3
16 11w0d 2.3 43 19w0d 2.8 70 28w0d 3.3
17 11w2d 2.4 44 19w2d 2.8 71 28w3d 3.3
18 11w4d 2.4 45 19w4d 2.8 72 28w5d 3.3
19 11w6d 2.4 46 20w0d 2.8 73 29w1d 3.4
20 12w1d 2.4 47 20w2d 2.9 74 29w4d 3.4
21 12w3d 2.4 48 20w4d 2.9 75 30w0d 3.4
22 12w6d 2.4 49 20w6d 2.9 76 30w3d 3.4
23 13w1d 2.5 50 21w1d 2.9 77 30w6d 3.4
24 13w3d 2.5 51 21w3d 2.9 78 31w2d 3.5
25 13w5d 2.5 52 21w6d 2.9 79 31w5d 3.5
26 14w0d 2.5 53 22w1d 3.0 80 32w1d 3.5
27 14w2d 2.5 54 22w3d 3.0 81 32w5d 3.6
28 14w4d 2.5 55 22w5d 3.0 82 33w1d 3.6
29 14w6d 2.6 56 23w1d 3.0 83 33w5d 3.6
30 15w1d 2.6 57 23w3d 3.0 84 34w2d 3.6
31 15w3d 2.6 58 23w5d 3.1 85 34w6d 3.7
32 15w5d 2.6 59 24w1d 3.1 86 35w3d 3.7
33 16w0d 2.6 60 24w3d 3.1 87 36w0d 3.7
34 16w2d 2.6 61 24w5d 3.1 88 36w5d 3.8
35 16w4d 2.7 62 25w1d 3.1 89 37w4d 3.8
36 16w6d 2.7 63 25w3d 3.1 90 38w3d 3.9
37 17w1d 2.7 64 25w5d 3.2 >90 n/a ——
38 17w4d 2.7 65 26w1d 3.2
144
Table 2-101: BPD: Tokyo Shinozuka (Fetal Growth), Shinozuka Jpn J Med Ultrasonics vol
23: 12 1996, Unit: Age (Weeks); Min/Mean/Max (mm); Table/Graph Range: 1.64SD
10 10.5 14.3 18.1 27 63.4 68.7 74.1

11 13.7 17.6 21.5 28 65.9 71.4 76.8
12 17.0 21.0 25.0 29 68.3 73.9 79.4
13 20.4 24.4 28.5 30 70.6 76.3 81.9
14 23.7 27.8 32.0 31 72.8 78.5 84.2
15 27.0 31.2 35.5 32 74.8 80.6 86.5
16 30.3 34.6 39.0 33 76.7 82.6 88.5
17 33.5 38.0 42.4 34 78.5 84.5 90.4
18 36.8 41.3 45.8 35 80.1 86.1 92.2
19 40.0 44.6 49.2 36 81.5 87.6 93.8
20 43.2 47.9 52.6 37 82.7 89.0 95.2
21 46.3 51.1 55.9 38 83.8 90.1 96.5
22 49.3 54.2 59.1 39 84.6 91.1 97.5
23 52.3 57.3 62.3 40 85.3 91.8 98.4
24 55.2 60.3 65.3 41 85.8 92.4 99.0
25 58.0 63.2 68.4 42 86.0 92.8 99.5
26 60.8 66.0 71.3
Table 2-102: CRL: Tokyo Shinozuka (Fetal Age), Shinozuka Jpn J Med Ultrasonics vol 23:
12 1996, Unit: CRL (mm); Age (Weeks/Days); SD (mm)
CRL Age 1SD CRL Age 1SD CRL Age 1SD
<5 n/a —— 20 8w6d 3.7 36 10w6d 5.9

5 6w3d 1.1 21 9w0d 3.9 37 11w0d 6.0
6 6w4d 1.3 22 9w1d 4.0 38 11w0d 6.0
7 6w6d 1.6 23 9w2d 4.2 39 11w1d 6.2
8 7w0d 1.7 24 9w3d 4.3 40 11w2d 6.3
9 7w1d 1.9 25 9w4d 4.5 41 11w3d 6.5
10 7w2d 2.0 26 9w4d 4.5 42 11w3d 6.5
11 7w3d 2.2 27 9w5d 4.6 43 11w4d 6.6
12 7w4d 2.3 28 9w6d 4.8 44 11w5d 6.8
13 7w5d 2.5 29 10w0d 4.9 45 11w6d 6.9
14 7w6d 2.6 30 10w1d 5.1 46 11w6d 6.9
15 8w1d 2.9 31 10w2d 5.2 47 12w0d 7.1
16 8w2d 3.1 32 10w3d 5.4 48 12w1d 7.2
17 8w3d 3.3 33 10w4d 5.5 49 12w1d 7.2
18 8w4d 3.4 34 10w5d 5.7 50 12w2d 7.4
19 8w5d 3.6 35 10w6d 5.9 >50 n/a ——
145
Table 2-103: CRL: Tokyo Shinozuka (Fetal Growth), Shinozuka Jpn J Med Ultrasonics vol
23: 12 1996, Unit: Age (Weeks/Days); Mean (mm); SD (mm); Table/Graph Range: 1.64SD
7w0d 7.9 1.7 9w1d 21.2 4.0 11w2d 40.0 6.3

7w1d 8.6 1.9 9w2d 22.3 4.2 11w3d 41.4 6.5
7w2d 9.3 2.0 9w3d 23.4 4.3 11w4d 42.9 6.6
7w3d 10.1 2.2 9w4d 24.5 4.5 11w5d 44.4 6.8
7w4d 10.9 2.3 9w5d 25.7 4.6 11w6d 45.9 6.9
7w5d 11.7 2.5 9w6d 26.8 4.8 12w0d 47.4 7.1
7w6d 12.5 2.6 10w0d 28.0 4.9 12w1d 49.0 7.2
8w0d 13.4 2.8 10w1d 29.3 5.1 12w2d 50.6 7.4
8w1d 14.3 2.9 10w2d 30.5 5.2 12w3d 52.2 7.5
8w2d 15.2 3.1 10w3d 31.8 5.4 12w4d 53.9 7.7
8w3d 16.1 3.3 10w4d 33.1 5.5 12w5d 55.5 7.8
8w4d 17.1 3.4 10w5d 34.4 5.7 12w6d 57.2 8.0
8w5d 18.1 3.6 10w6d 35.8 5.9 13w0d 58.9 8.2
8w6d 19.1 3.7 11w0d 37.1 6.0
9w0d 20.1 3.9 11w1d 38.5 6.2
Table 2-104: EFW: Tokyo Shinozuka (Fetal Age), Shinozuka Jpn J Med Ultrasonics vol
23: 12 1996, Unit: EFW (grams); Age (Weeks/Days); SD (grams)
EFW Age 1SD EFW Age 1SD EFW Age 1SD
<250 n/a —— 1200 28w3d 162 2200 34w2d 258

250 19w3d 45 1250 28w5d 166 2250 34w4d 264
300 20w0d 51 1300 29w1d 173 2300 34w6d 269
350 20w4d 58 1350 29w3d 177 2350 35w1d 274
400 21w2d 66 1400 29w5d 181 2400 35w3d 279
450 21w5d 71 1450 30w0d 186 2450 35w5d 284
500 22w2d 78 1500 30w2d 191 2500 35w7d 290
550 22w6d 85 1550 30w5d 197 2550 36w2d 295
600 23w2d 90 1600 30w7d 202 2600 36w4d 301
650 23w6d 98 1650 31w2d 207 2650 36w6d 306
700 24w2d 103 1700 31w4d 211 2700 37w2d 314
750 24w5d 109 1750 31w6d 216 2750 37w4d 320
800 25w2d 116 1800 32w1d 221 2800 37w6d 325
850 25w5d 122 1850 32w3d 226 2850 38w1d 331
900 26w1d 128 1900 32w5d 231 2900 38w4d 340
950 26w4d 134 1950 32w7d 236 2950 38w6d 345
1000 26w6d 138 2000 33w1d 238 3000 39w2d 354
1050 27w2d 145 2050 33w3d 243 >3000 n/a ——
1100 27w5d 151 2100 33w5d 248
1150 28w0d 155 2150 34w0d 253
146
Table 2-105: EFW: Tokyo Shinozuka (Fetal Growth), Shinozuka Jpn J Med Ultrasonics vol
23: 12 1996, Unit: Age (Weeks); Min/Mean/Max (grams); Table/Graph Range: 1.64SD
18 158 216 274 30 1234 1552 1870

19 204 279 355 31 1375 1720 2064
20 256 349 442 32 1520 1892 2265
21 314 427 539 33 1667 2068 2469
22 381 513 645 34 1814 2244 2675
23 456 609 761 35 1960 2420 2880
24 541 714 888 36 2102 2592 3083
25 634 830 1026 37 2236 2758 3280
26 737 956 1175 38 2360 2915 3469
27 849 1092 1334 39 2471 3059 3647
28 970 1237 1504 40 2565 3187 3809
29 1099 1391 1683 41 2639 3296 3952
Table 2-106: FL: Tokyo Shinozuka (Fetal Age), Shinozuka Jpn J Med Ultrasonics vol 23:
12 1996, Unit: FL (mm); Age (Weeks/Days); SD (mm)
FL Age 1SD FL Age 1SD FL Age 1SD
<20 n/a —— 37 22w2d 2.9 55 30w5d 3.1

20 16w1d 2.6 38 22w5d 2.9 56 31w2d 3.2
21 16w3d 2.7 39 23w1d 2.9 57 31w6d 3.2
22 16w6d 2.7 40 23w4d 2.9 58 32w3d 3.2
23 17w1d 2.7 41 24w0d 2.9 59 33w0d 3.2
24 17w3d 2.7 42 24w3d 2.9 60 33w3d 3.2
25 17w6d 2.7 43 24w6d 2.9 61 34w0d 3.2
26 18w1d 2.7 44 25w3d 3.0 62 34w4d 3.3
27 18w3d 2.7 45 25w6d 3.0 63 35w1d 3.3
28 18w6d 2.7 46 26w2d 3.0 64 35w5d 3.3
29 19w1d 2.7 47 26w5d 3.0 65 36w2d 3.3
30 19w4d 2.8 48 27w2d 3.0 66 37w0d 3.3
31 20w0d 2.8 49 27w5d 3.0 67 37w4d 3.4
32 20w2d 2.8 50 28w2d 3.1 68 38w1d 3.4
33 20w5d 2.8 51 28w5d 3.1 69 38w5d 3.4
34 21w1d 2.8 52 29w2d 3.1 70 39w3d 3.4
35 21w3d 2.8 53 29w5d 3.1 >70 n/a ——
36 21w6d 2.8 54 30w2d 3.1
147
Table 2-107: FL: Tokyo Shinozuka (Fetal Growth), Shinozuka Jpn J Med Ultrasonics vol
23: 12 1996, Unit: Age (Weeks); Min/Mean/Max (mm); Table/Graph Range: 1.64SD
16 17.1 21.4 25.8 30 49.7 54.8 60.0

17 19.6 24.0 28.4 31 51.6 56.8 62.0
18 22.1 26.5 31.0 32 53.5 58.7 64.0
19 24.6 29.1 33.6 33 55.2 60.5 65.8
20 27.1 31.6 36.2 34 56.9 62.2 67.6
21 29.5 34.1 38.8 35 58.4 63.8 69.2
22 31.9 36.6 41.3 36 59.9 65.3 70.8
23 34.3 39.1 43.8 37 61.2 66.7 72.2
24 36.7 41.5 46.3 38 62.4 68.0 73.6
25 39.0 43.9 48.7 39 63.5 69.1 74.7
26 41.3 46.2 51.1 40 64.4 70.1 75.8
27 43.5 48.4 53.4 41 65.3 71.0 76.7
28 45.6 50.6 55.7 42 65.9 71.7 77.5
29 47.7 52.8 57.9
148
Williams
Table 2-108: EFW: Williams (Fetal Growth), Unit: Age (Weeks); Min/Mean/Max (grams)
22.0 320 513 746 34.0 1728 2394 3132

23.0 365 589 861 35.0 1974 2628 3333
24.0 417 675 989 36.0 2224 2849 3521
25.0 477 773 1132 37.0 2455 3052 3706
26.0 546 882 1289 38.0 2642 3227 3867
27.0 627 1005 1463 39.0 2790 3364 3994
28.0 720 1143 1653 40.0 2881 3462 4080
29.0 829 1298 1859 41.0 2946 3524 4127
30.0 955 1484 2136 42.0 3011 3589 4185
31.0 1100 1695 2402 43.0 3044 3626 4221
32.0 1284 1920 2673 44.0 3043 3633 4233
33.0 1499 2155 2910
Yarkoni
Table 2-109: CLA:Yarkoni S, Journal of Ultrasound in Medicine, 4:467-470, 1985
(Fetal Age), Unit: Meas (mm); Min/Mean/Max (Weeks/Days)
11 8w3d 13w6d 17w2d 29 23w2d 28w5d 32w1d

12 9w1d 14w4d 18w1d 30 24w0d 29w4d 34w0d
13 10w0d 14w3d 19w6d 31 25w6d 29w2d 34w6d
14 11w6d 15w2d 20w5d 32 26w5d 30w1d 35w4d
15 12w5d 16w1d 21w4d 33 27w4d 31w0d 35w3d
16 12w3d 18w0d 21w3d 34 27w3d 32w6d 36w2d
17 13w2d 18w5d 22w2d 35 28w1d 33w5d 37w1d
18 14w1d 19w4d 23w0d 36 29w0d 33w3d 39w0d
19 16w0d 19w3d 24w6d 37 30w6d 34w2d 39w5d
20 16w6d 20w2d 25w5d 38 31w5d 35w1d 40w4d
21 17w4d 21w1d 26w4d 39 32w4d 37w0d 40w3d
22 17w3d 22w6d 26w2d 40 32w2d 37w6d 41w2d
23 18w2d 23w5d 27w1d 41 33w1d 38w4d 42w0d
24 19w1d 24w4d 28w0d 42 35w0d 38w3d 43w6d
25 21w0d 24w3d 29w6d 43 35w6d 39w2d 44w5d
26 21w5d 25w1d 30w5d 44 36w5d 40w1d 45w4d
27 22w4d 26w0d 30w3d 45 36w3d 41w6d 45w3d
28 22w3d 27w6d 31w2d
149
Chapter 3
Acoustic information
• The real-time display of acoustic output indices ...................... ... 152

• Thermal Index ...........................................................................152
• Mechanical Index ......................................................................153
• Track 3 ALARA Educational Program ........................................ ... 154
• Default Settings and Output Levels ............................................ ... 154
• Controls Affecting Acoustic Output ........................................... ... 155
• Track 3 Summary Table ...........................................................156
• Acoustic Parameters as Measured in Water .............................. ... 158
• Definitions, symbols and abbreviations ....................................158
• Explanation of Footnotes ..........................................................181
• Multiple focal-zones ..................................................................181
• Operating Conditions ................................................................181
• Acoustic Output Reporting Tables for Track 3/IEC 60601-2-37 ... 182
• Transducer Model: 3S ..............................................................183
• Transducer Model: M3S ...........................................................189
• Transducer Model: M4S ...........................................................195
• Transducer Model: 10S ............................................................219
• Transducer Model: 3V ..............................................................225
• Transducer Model: 3.5C ...........................................................232
• Transducer Model: 4C ..............................................................237
• Transducer Model: M7C ...........................................................247
• Transducer Model: 7L ...............................................................257 150
• Transducer Model: 9L ...............................................................262
• Transducer Model: 10L .............................................................267
• Transducer Model: 12L .............................................................272
• Transducer Model: M12L ..........................................................277
• Transducer Model: E8C ............................................................282
• Transducer Model: 6T ...............................................................287
• Transducer Model: 6Tc .............................................................293
• Transducer Model: 9T ...............................................................299
• Transducer Model: P2D ............................................................305
• Transducer Model: P6D ............................................................307
• Transducer Model: i13L ............................................................309
• Transducer Model: i8L ..............................................................314
151
The real-time display of acoustic output
indices
The Vivid 7 has real-time display features according to Track 3
in the FDA 510(k) Guidance of 1997.It displays both a thermal
(TI) and a mechanical (MI) index in all operating modes. These
two indices are intended to estimate the potential for thermal
and mechanical bioeffects induced by ultrasound. Both TI and
MI are displayed with increments of 0.1. Neither are displayed if
the value is below 0.4. The displayed (estimated) TI and MI are
nominal values.
Thermal Index
W
TI is defined as: TI = W0
deg
where: W0 is the time-averaged acoustic power and Wdeg is the

estimated power necessary to raise the target tissue one
degree C.
The displayed TI is an estimate of temperature increase of soft
tissue or bone, presented to make it easier for the operator to
implement the ALARA (As Low As Reasonably Achievable)
principle. There are three thermal index categories:
• TIS: Soft tissue thermal index. The main TI category. Used
for applications that do not image bone.
• TIB: Bone thermal index (bone located in a focal region).
Used for fetal application.
• TIC: Cranial bone thermal index (bone located close to the
surface). Used for transcranial application.
The Vivid 7 chooses the correct category based on mode of
operation and chosen application, and presents only one TI to
the operator. It is therefore important that the operator chooses
the right application.
Vivid 7 has an internal limit of 3.0 on TI. IEC87 has suggested
some time dependent thresholds that are partly implemented
on Vivid 7 as color-coding of the thermal index. The
color-coding scheme together with the thermal exposure times
in the table below are not meant as limits on TI or exposure
time, but as an aid for the operator. Note that Vivid 7 does not 152
monitor the thermal exposure time. The displayed TI is coded
like this:
TI Color Recommended thermal exposure time
0.0 – 0.4 Dimmed -
0.4 – 1.5 White -
1.5 – 2.0 White < 12 h
2.0 – 3.0 White <1h
Mechanical Index
MI is the estimated likelihood of tissue damage due to
cavitation. MI is defined as:
Pr.3(Zsp)
MI =
c
where pr.3 is the derated (attenuated) peak rarefactional

(negative) pressure (MPa) and fc is the center frequency
(MHz).
The MI will not exceed a value of 1.9 according to Track 3 in
the FDA 510(k) guidance of 1997.
Display Accuracy and Acoustic Measurement

Uncertainties
The display accuracy and measurement precision of the output
display are summarized in the table below.
Accuracy of the output display (TI, MI) parameters depends on
the measurement system precision, the acoustic model used to
calculate the parameters and variation in the acoustic output of
probes and systems. The measurement precision and overall
accuracy of the measurements have been assessed by
determining both the random and the systematic uncertainties
and given in percent at 95% confidence level.
Estimated
Parameter accuracya Measurement precision
M/Color/PW/CW 2D/CFM mode
Pressure, MI ±25% ±15% 153

Estimated
Parameter accuracya Measurement precision
M/Color/PW/CW 2D/CFM mode
Power, TI ±50% ±30% ±40%
Frequency ±1% ±1%
a. Accuracy = (Measured value - displayed value)/displayed value *

100%
Track 3 ALARA Educational Program

The user should be familiar with the enclosed document
“Medical Ultrasound Safety” (see XXX), published by AIUM
(American Institute of Ultrasound in Medicine). This document
is acceptable to FDA as meeting the content of the ALARA
educational program. ALARA is an acronym for the principle of
prudent use of diagnostic ultrasound by obtaining the
diagnostic information at an output that is As Low As
Reasonably Achievable.
In addition to the AIUM document, the sections “The real-time
display of acoustic output indices” on page 2 and “Controls
Affecting Acoustic Output” on page 5 should be studied
carefully in order to implement ALARA.
Default Settings and Output Levels

he default acoustic output level will not exceed a thermal index
(TI) of 3.0 or a mechanical index (MI) of 1.5.
The maximum default TI is 50% of the maximum possible TI
(6.0) and the maximum default MI is 80% of the maximum
possible MI (1.9).
The output level will not exceed the default level until the user
intentionally increases the power level by adjusting the power
control on the system.
The output level will return to default each time
• a new probe is chosen
• a new application is chosen
• a new patient is chosen. 154
Controls Affecting Acoustic Output
The initial means by which the user can affect acoustic output
are by 1) selecting a probe, 2) selecting an application (exam
category) and then 3) selecting the imaging mode or particular
imaging characteristics. After these selections are made, the
only user control that can affect the output is the acoustic
output control. This is achieved through an acoustic output
control scheme in which all parameters that directly or indirectly
affect acoustic output are fed to the control algorithm. The
algorithm estimates all relevant parameters and compares
them to the FDA limits.
Output levels remain below the limits with a 95% confidence
margin. The absolute maximum allowable output for all
applications is:
• ISPTA d 720 mW/cm2
• MI d 1.9
• TI d 6
Figure 3-1: The Vivid 7 Acoustic Output Control Scheme
The following table summarizes the mode/probe combinations

for which the global maximum displayed MI or TI may be
155
greater than 1.0. For each probe/mode combination checked, a
Track 3 acoustic output table exists.
Not all probes listed may be supported wordwide. Please refer
to your local language User Manual for an overview of the
probes that are supported in your country.
Track 3 Summary Table
Operating Mode Transducer Model
3S M3S M4S 5S 6S 7S 10S
B-Mode (2D) Yes Yes Yes Yes Yes Yes Yes
M-Mode Yes Yes Yes Yes Yes Yes Yes
Pulsed Doppler (PW) Yes Yes Yes Yes Yes Yes Yes
CW Doppler (CW) Yes Yes Yes Yes Yes Yes Yes
Color Flow Yes Yes Yes Yes Yes Yes Yes
Color M-Mode Yes Yes Yes Yes Yes Yes Yes
3.5C 5C 7L
6T 6Tc (358C) 4C (548C) (546L) 9L
B-Mode (2D) Yes Yes Yes Yes Yes Yes Yes
M-Mode Yes Yes Yes Yes Yes Yes Yes
CW Doppler (CW) Yes Yes - - - - -
Color Flow Yes Yes Yes Yes Yes Yes Yes
Color M-Mode Yes Yes Yes Yes Yes Yes Yes
10L 12L 2D 6D
(739L) (LA39) M12L (P2D) (P6D) i13L i8L
B-Mode (2D) Yes Yes Yes - - Yes Yes

156
10L 12L 2D 6D
(739L) (LA39) M12L (P2D) (P6D) i13L i8L
M-Mode Yes Yes Yes - - Yes Yes
CW Doppler (CW) - - - Yes Yes - -
Color Flow Yes Yes Yes - - Yes Yes
Color M-Mode Yes Yes - - - Yes Yes
8C M7C 9T 3V E8C
B-Mode (2D) Yes Yes Yes Yes Yes
M-Mode Yes Yes Yes Yes Yes
Pulsed Doppler (PW) Yes Yes Yes Yes Yes
CW Doppler (CW) - - Yes Yes -
Color Flow Yes Yes Yes Yes Yes
Color M-Mode Yes Yes Yes Yes Yes
157
Acoustic Parameters as Measured in Water
Definitions, symbols and abbreviations
The following definitions, symbols and abbreviations are used
in the acoustic output reporting tables in this chapter:
FDA IEC Meaning—IEC 60601-2-37 / FDA & NEMA UD2, UD3
a a Acoustic Attenuation Coefficient / Derating factor (usually 0.3

dB/cm-MHz)
Aaprt Aaprt -12db Output Beam Area / Active aperture area
CMI Normalizing Coefficient
Deq Deq Equivalent Aperture Diameter / (same)
d-6 d-6 Pulse Beam Width / Beam diameter at –6 dB
deq deq Equivalent Beam Diameter
fc ƒawf Acoustic Working Frequency / Center frequency
Ipa Ipa Pulse-Average Intensity
Ipa.3 Ipa,a Attenuated Pulse-Average Intensity
PII Ipi Pulse-Intensity Integral
PII.3 Ipi,a Attenuated Pulse-Intensity Integral
ITA Ita(z) Temporal-Average Intensity
ITA.3(Z) Ita,a(z) Attenuated Temporal-Average Intensity / (at depth z)
ISPTA(Z) Izpta(z) Spatial-Peak Temporal-Average Intensity
ISPTA.3(Z) Izpta,a(z) Attenuated Spatial-Peak Temporal-Average Intensity
MI MI Mechanical Index
Wo P Output Power / Time average acoustic power at the source
W.3(Z) Pa Attenuated Output Power / Time average acoustic power

derated to depth z
Wo1 P1 Bounded Output Power / Power emitted from the central 1cm
of aperture 158
FDA IEC Meaning—IEC 60601-2-37 / FDA & NEMA UD2, UD3
PII pi Pulse Pressure Squared Integral / Pulse intensity integral
pr pr Peak-Rarefactional Acoustic Pressure / (same)
pr.3 pra Attenuated Peak-Rarefactional Acoustic Pressure / (same)
PRF prr Pulse Repetition Rate / Pulse repetition frequency
TI TI Thermal Index / (same)
TIB TIB Bone Thermal Index / (same)
TIC TIC Cranial-Bone Thermal Index / (same)
TIS TIS Soft-Tissue Thermal Index / (same)
PD td Pulse Duration / (same)
x-12,y-12 X, Y -12 dB Output Beam Dimensions / (same)
Z z Distance from the Source to a Specified Point / (same)
Zsp zb Depth for TIB / Depth at which the relevant index is maximum
Zbp zbp Break-Point Depth / (same)
Zsp zs Depth for TIS / Depth at whcih the relevant index is maximum
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
Explanation of Footnotes
The mechanical and thermal indices may be replaced by one of
the following footnotes because of the reasons listed:
• a: Display of this index is not required for this operating
mode.
• b: This probe is not intended for transcranial or neonatal
cephalic uses.
• c: This formulation for TIS is less than that for an alternate
formulation in this mode.
If so, the table entries are replaced by a “#”, meaning: no data
are provided for this operating condition since the maximum
reported value is not reported for the reason listed.
If neither an index or a footnote is given, this means that the
index is irrelevant for this transducer/mode combination.
Multiple focal-zones
When using multiple focal-zones on Vivid 7, the time in one
frame is divided between the different focal-zones. When
measuring this, the MI is found as the maximum MI of all
zones:
MI = max (MI)
all zones
while the TI and W0 is found as the time-weighted sum of all

zones:
TI = Σ TI
all zones
zone
. tzone
W0 = ΣW 0
zone
. tzone
all zones
tzone is the time fraction used per zone in a frame.
Some of the parameters in the acoustic output report tables will

have one value per zone. In this case, the range of the
parameter values is reported. The number of zones and which
zone has the greater MI is also given in the tables.
Operating Conditions
All table entries are with the operating conditions specified at
the end of the table.
181
Acoustic Output Reporting Tables for
Track 3/IEC 60601-2-37
Not all probes listed may be supported wordwide. Please refer
to your local language User Manual for an overview of the
probes that are supported in your country.
182
Transducer Model: 3S
Operating Mode: 2D
See explanation of measurements with several focal zones on

page 181. 183
Operating Mode: M-Mode
184
Operating Mode: CF
185
Operating Mode: CM
186
Operating Mode: PW
187
Operating Mode: CW
188
Transducer Model: M3S
Operating Mode: 2D

page 181. 189
190
Operating Mode: CF
191
Operating Mode: CM
192
Operating Mode: PW
193
Operating Mode: CW
194
Operating Mode: 2D

page 181. 195
196
Operating Mode: CF
197
Operating Mode: CM
198
Operating Mode: PW
199
Operating Mode: CW
200
Operating Mode: 2D

page 181. 201
202
Operating Mode: CF
203
Operating Mode: CM
204
Operating Mode: PW
205
Operating Mode: CW
206
Operating Mode: 2D

page 181. 207
208
Operating Mode: CF
209
Operating Mode: CM
210
Operating Mode: PW
211
Operating Mode: CW
212
Operating Mode: 2D

page 181. 213
214
Operating Mode: CF
215
Operating Mode: CM
216
Operating Mode: PW
217
Operating Mode: CW
218
Operating Mode: 2D

page 181. 219
220
Operating Mode: CF
221
Operating Mode: CM
222
Operating Mode: PW
223
Operating Mode: CW
224
Transducer Model: 3V
Operating Mode: 4D / Multi-plane

page 181. 225
Operating Mode: 2D
226
227
Operating Mode: CF
228
Operating Mode: CM
229
Operating Mode: PW
230
Operating Mode: CW
231
Transducer Model: 3.5C
Operating Mode: 2D

page 181. 232
233
Operating Mode: CF
234
Operating Mode: CM
235
Operating Mode: PW
236
Transducer Model: 4C
Operating Mode: 2D

page 181. 237
238
Operating Mode: CF
239
Operating Mode: CM
240
Operating Mode: PW
241
Operating Mode: 2D

page 181. 242
243
Operating Mode: CF
244
Operating Mode: CM
245
Operating Mode: PW
246
Transducer Model: M7C
Operating Mode: 2D

page 181. 247
248
Operating Mode: CF
249
Operating Mode: CM
250
Operating Mode: PW
251
Operating Mode: 2D

page 181. 252
253
Operating Mode: CF
254
Operating Mode: CM
255
Operating Mode: PW
256
Transducer Model: 7L
Operating Mode: 2D

page 181. 257
258
Operating Mode: CF
259
Operating Mode: CM
260
Operating Mode: PW
261
Operating Mode: 2D

page 181. 262
263
Operating Mode: CF
264
Operating Mode: CM
265
Operating Mode: PW
266
Operating Mode: 2D

page 181. 267
268
Operating Mode: CF
269
Operating Mode: CM
270
Operating Mode: PW
271
Operating Mode: 2D

page 181. 272
273
Operating Mode: CF
274
Operating Mode: CM
275
Operating Mode: PW
276
Transducer Model: M12L
Operating Mode: 2D

page 181. 277
278
Operating Mode: CF
279
Operating Mode: CM
280
Operating Mode: PW
281
Transducer Model: E8C
Operating Mode: 2D

page 181. 282
283
Operating Mode: CF
284
Operating Mode: CM
285
Operating Mode: PW
286
Transducer Model: 6T
Operating Mode: 2D

page 181. 287
288
Operating Mode: CF
289
Operating Mode: CM
290
Operating Mode: PW
291
Operating Mode: CW
292
Transducer Model: 6Tc
Operating Mode: 2D

page 181. 293
294
Operating Mode: CF
295
Operating Mode: CM
296
Operating Mode: PW
297
Operating Mode: CW
298
Operating Mode: 2D
299
300
Operating Mode: CF
301
Operating Mode: CM
302
Operating Mode: PW
303
Operating Mode: CW
304
Transducer Model: P2D
Operating Mode: PW
a. This probe is shaped as a double D, transmitting on one

element. 305
Operating Mode: CW
306
Operating Mode: PW
a. This probe is shaped as a double D, transmitting on one

element. 307
Operating Mode: CW
308
Transducer Model: i13L
Operating Mode: 2D

page 181. 309
310
Operating Mode: CF
311
Operating Mode: CM
312
Operating Mode: PW
313
Operating Mode: 2D

page 181. 314
315
Operating Mode: CF
316
Operating Mode: CM
317
Operating Mode: PW
318
Chapter 4
Electromagnetic
Compatibility
• Electromagnetic emissions ......................................................... ... 320

• Electromagnetic immunity ........................................................... ... 321
• Separation distances ................................................................... ... 325
Vivid 7 / Vivid 7 PRO is intended for use in the electromagnetic

environment specified in the tables below.
The user of Vivid 7 / Vivid 7 PRO should assure that the device
is used in such an environment.
319
Electromagnetic emissions
Guidance and manufacturer’s declaration – electromagnetic emissions.
Emissions test Compliance Electromagnetic environment - guidance
RF emission Group 1 Vivid 7 / Vivid 7 PRO uses RF energy only for

CISPR 11 its internal function. Therefore, its RF
emissions are very low and are not likely to
EN55011:1998 +
cause any interference in nearby electronic
A1:1999 equipment.
RF emission Class B Vivid 7 / Vivid 7 PRO is suitable for use in all

CISPR 11 establishments, including domestic
establishments and those directly connected
EN55011:1998 +
to the public low-voltage power supply network
A1:1999
that supplies buildings used for domestic
Harmonic emission Class A purposes.
IEC 61000-3-2:2000
Voltage Complies
fluctuations/flicker
emissions
IEC 61000-3-3:1995 +
A1:2001
320
Electromagnetic immunity
Guidance and manufacturer’s declaration – electromagnetic immunity.
Electromagnetic
IEC 60601 Compliance environment -
Immunity test test level level guidance
Electrostatic Floors should be wood,

discharge (ESD) ± 6 kV contact ± 6 kV concrete or ceramic
tile. If floors are
covered with synthetic
IEC ± 8 kV air ± 8 kV material, the relative
61000-4-2:1995
humidity should be at
+A1:1998+A2:2001
least 30 %.
Electrostatic ± 2 kV for ± 2 kV Mains power quality

transient / burst power-supply lines should be that of a
IEC typical commercial or
61000-4-4:1995 hospital environment.
± 1 kV for ± 1 kV
+A1:2001+A2:2001 input/output lines
Surge ± 1 kV differential ± 1 kV Mains power quality

mode should be that of a
typical commercial or
IEC
hospital environment.
61000-4-5:1995 ± 2 kV common ± 2 kV
+A1:2001 mode
< 5% UT
(>95% dip in UT) Compliance for Mains power quality
for 0.5 cycle all test levels. should be that of a
Voltage dips, short 40% UT
hospital environment. If
interruptions and Controlled
(60% dip in UT) for the user of Vivid 7 /
voltage variations shutdown with
5 cycles Vivid 7 PRO requires
on power supply return to
continued operation
input lines pre-disturbance
during power mains
70% UT condition after
interruptions, it is
operator’s
IEC (30% dip in UT) for recommended that
intervention.
61000-4-11:1994 25 cycles Vivid 7 / Vivid 7 PRO is
A1:2001 (Power-on powered from an
switch) uninterruptible power
< 5% UT supply or a battery.
(>95 % dip in UT)
for 5 sec
321
Electromagnetic
IEC 60601 Compliance environment -
Immunity test test level level guidance
Power frequency Power frequency

(50/60 Hz) magnetic fields should
magnetic field be at levels
3 A/m 3A/m
characteristic of a
50 and 60 Hz typical location in a
IEC
61000-4-8:1993
hospital environment.
+A1:2001
NOTE: UT is the a. c. mains voltage prior to application of the test level.
322
IEC 60601 test Compliance Electromagnetic

Immunity test level level environment – guidancec
Portable and mobile RF

communications equipment
should be used no closer to any
part of Vivid 7 / Vivid 7 PRO,
including cables, than the
recommended separation
distance calculated from the
equation applicable to the
frequency of the transmitter.
Recommended separation
distance
Conducted RF 3 Vrms 3 Vrms [V1]
IEC 150 kHz to 80 MHz to

61000-4-6:1996 80 MHz 800 MHz
+A1:2001
800 MHz to
2.5 GHz
where p is the maximum output

power rating of the transmitter in
Conducted RF 3 V/m 3 V/m [E1] watts (W) according to the
transmitter manufacturer and d
IEC 80 MHz to is the recommended separation
61000-4-3:1996 2.5 GHz distance in metres (m).b
+A1:1998
Field strengths from fixed RF
+A2:2001
transmitters, as determined by
an electromagnetic site
survey,a should be less than the
compliance level in each
frequency range.b
Interference may
occur in the vicinity
of equipment
marked with the
following symbol
323
IEC 60601 test Compliance Electromagnetic

Immunity test level level environment – guidancec
NOTE 1: At 80 MHz and 800 MHz, the higher frequency range applies.
NOTE 2: These guidelines may not apply in all situations. Electromagnetic 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
Vivid 7/Vivid 7 PRO is used exceeds the applicable RF compliance level above,
Vivid 7/Vivid 7 PRO should be observed to verify normal operation. If abnormal
performance is observed, additional measures may be necessary, such as re-orienting
or relocating Vivid 7/Vivid 7 PRO.
b Over the frequency range 150 kHz to 80 MHz, field strengths should be less than
3 V/m.
c See examples of calculated separation distances in next table.
324
Separation distances
Recommended separation distances between portable and mobile RF
communications equipment and Vivid 7 / Vivid 7 PRO
Vivid 7/Vivid 7 PRO is intended for use in an electromagnetic environment in which

radiated RF disturbances are controlled. The customer or the user of the
Vivid 7/Vivid 7 PRO can help prevent electromagnetic interference by maintaining a
minimum distance between portable and mobile RF communications equipment
(transmitters) and Vivid 7/Vivid 7 PRO as recommended below, according to the
maximum output power of the communications equipment.
Separation distance according to frequency of transmitter

m
Rated maximum 150 kHz to 80 MHz 80 MHz to 800 MHz 800 MHz to 2.5 GHz
output of
transmitter
W
0.01 0.12 0.12 0.23
0.1 0.38 0.38 0.73
1 1.2 1.2 2.3
10 3.8 3.8 7.3
100 12 12 23
For transmitters rated at a maximum output power not listed above the recommended
separation distance d in metres (m) can be estimated using the equation applicable to
the frequency of the transmitter, where P is the maximum output power rating of the
transmitter in watts (W) according to the transmitter manufacturer.
NOTE 1: At 80 MHz and 800 MHz, the separation distance for the higher frequency
range applies.
NOTE 2: These guidelines may not apply in all situations. Electromagnetic propagation
is affected by absorption and reflection from structures, objects and people.
325
Appendix
• Statements on the safety of ultrasound ..................................... ... 327

• AIUM Statement on Clinical Safety ...........................................327
• AIUM Statement on Mammalian in Vivo Ultrasonic Biological
Effects .......................................................................................327
• Medical Ultrasound Safety - AIUM .............................................. ... 328
• Track 3 ALARA Educational Program ......................................328
326
Statements on the safety of ultrasound
AIUM Statement on Clinical Safety
October 1982, revised March 1983 and October 1983
Diagnostic ultrasound has been in use for over 35 years. Given
its known benefits and recognized efficacy for medical
diagnosis, including use during human pregnancy, the
American Institute of Ultrasound In Medicine herein addresses
the clinical safety of such use:
No confirmed biological effects on patients or instrument
operators caused by exposure at intensities typical of present
diagnostic ultrasound instruments have ever been reported.
Although the possibility exists that such biological effects may
be identified in the future, current data indicate that the benefits
to patients of the prudent use of diagnostic ultrasound outweigh
the risks, if any, that may be present.
AIUM Statement on Mammalian in Vivo

Ultrasonic Biological Effects
August 1976, revised October 1978, reaffirmed
October 1982 and October 1983
In the low megahertz frequency range there have been (as of
this date) no independently confirmed significant biological
effects in mammalian tissues exposed to intensities”a” below
100 mW/cm2. For ultrasound exposure times “b” less than
500 seconds and greater than 1 second, such effects have not
been demonstrated even at higher intensities when the product
of intensity “a” and exposure time “b” is less than
50 Joules/cm2.
1. Spatial peak, temporal average as measured in a free field
in water.
2. Total time, this includes off-time as well as on-time for a
repeated pulse regime.
327
Medical Ultrasound Safety - AIUM
Track 3 ALARA Educational Program
The user should be familiar with the enclosed document
“Medical Ultrasound Safety”, published by AIUM (American
Institute of Ultrasound in Medicine).
This document is acceptable to FDA as meeting the content of
the ALARA educational program.
ALARA is an acronym for the principle of prudent use of
diagnostic ultrasound by obtaining the diagnostic information at
an output that is As Low As Reasonably Achievable.
In addition to the AIUM document, the sections “The real-time
display of acoustic output indices” and “Acoustic Output
Operating Controls” should be studied carefully in order to
implement ALARA.
328
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Technical Publications

Vivid 7 Dimension/Vivid 7 PRO

COMPANY DATA GE VINGMED ULTRASOUND A/S

Devices not to be used near this equipment:

Indications for use

Indicates that a specific hazard exists that, given inappropriate

Indicates that a potential hazard may exist that, given

Software license acknowledgments

• Preparing the unit for use ............................................................ ....... 9

Requirement Temperature Humidity Air Pressure

Operational 10–35 ºC 30–85% 700–1060 hPa

Storage -20–60 ºC 30–95% 700–1060 hPa

Transport -20–60 ºC 30–95% 700–1060 hPa

Connection of additional protective earth conductors or

Voltage level check

Figure 1-1: The rating label

Check the voltage range indicated on the label:

If the mains supply is not within the specified range, do not

1. Ensure that the wall outlet is of appropriate type, and that

Socket Signal type Device type Note

Audio Out Audio VCR Audio Line level 1Vp-p

Trig Out Digital For future use 0 to 3V digital trig pulse

Serial port RS-232 For future use

Remote Remote control For future use

Modem Analog phone Connection to GE

Composite Composite VCR or video Signal level 1Vp-p

S Video Out NTSC/PAL VCR or video Signal level 1Vp-p

SVGA Out RGB high Computer monitor

USB Universal serial Printer

Ethernet 10/100 Base-TX Network device

Switching off the unit

Figure 1-3: The Exit dialogue window

In case of total lock- 2. Select Shutdown.

Figure 1-4: The Circuit breaker and On/Off button

Front Swivel, swivel lock and full lock

Rear Swivel, but do not lock

1. Swivel lock pedal (Free position)

Figure 1-5: The Vivid 7 ultrasound unit pedals

Press on pedal no. 2

To release the brake

Press on pedal no.1

To engage swivel lock

Press on pedal no.1

To release swivel lock

Press on pedal no. 2

Do not move the unit if the keyboard console is in free position.

7. Use two or more persons to move the unit over long

Transporting the unit

Reinstalling at a new location

oC 0 2.5 5 7.5 10 35 40 42.5

Figure 1-6: the Vivid 7 ultrasound system

Probe and gel holders:

Black & white video printer

Console swivel operating handle:

Console lifting operating handle:

Color video printer

Figure 1-7: The control panel (left side).

Figure 1-8: The control panel (right side).

Power On/Off key

Turns the unit on and off.

Displays the Search/Create patient window.

Displays the Select Probe and Application dialog

Displays the Application dialog box that enables