B-K Medical Pro Focus 2202 User Manual Download Page 4

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New Patient Information from a DICOM Worklist . . . . . . . . . . . . . . . .  37
Entering Dates  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  39
Keeping Image Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  40
Keeping Patient-Related Data  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  40

Connecting and Selecting Transducers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

Connecting a Transducer  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  40
Selecting a Transducer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  41
Selecting the Scanning Plane . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  42

Pro Packages and Diagnostic Setups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

Selecting a Pro Package or Diagnostic Setup. . . . . . . . . . . . . . . . . . . . . 42
Saving a Diagnostic Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

Selecting or Changing the Scanning Mode . . . . . . . . . . . . . . . . . . . . . . . . . .  43
Performing a Biopsy or Puncture Procedure (including Brachytherapy) . . .  43
Using the PCU (Palm Control Unit) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  45

Attaching the PCU . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  45
Checking the PCU  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  46
Putting Sterile Covers on the PCU . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  46

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

Part 2

Working with the Image

Chapter 3

The User Interface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

Keyboard Panel Controls. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

Controls on the Screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

Point and Click . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68

Foot Switch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  69
Palm Control Unit (PCU)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  70
Transducers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  72

Chapter 4

Working with the Image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

Image Orientation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Freezing the Image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

Summary of Contents for Pro Focus 2202

Page 1: ...English BB1279 A June 2005 Pro Focus 2202 Extended User Guide ...

Page 2: ...y and function of the system Any modification of or installation of software without written permission from B K Medical will immediately void any warranty supplied by B K Medical Such changes will also void any service contract and result in charges to the customer for restoration of the original Pro Focus 2202 system Trademarks DICOM is the registered trademark of the National Electrical Manufac...

Page 3: ...tions 24 Service and Repair 25 Connecting Other Equipment 25 Computer Security 26 Acoustic Output 26 General 26 Monitor Display 28 Thermal and Mechanical Indices 28 Acoustic Output Measurement 29 Functions Affecting Acoustic Output 29 Default Acoustic Output 30 References 30 Chapter 2 Getting Started 33 General Information 33 Adjusting the Keyboard Panel and Monitor 34 Turning the Scanner On and O...

Page 4: ...ing the PCU Palm Control Unit 45 Attaching the PCU 45 Checking the PCU 46 Putting Sterile Covers on the PCU 46 References 47 Part 2 Working with the Image Chapter 3 The User Interface 51 Keyboard Panel Controls 51 The Control Panel 52 The Trackball and Trackball Keys 53 Basic Keys 56 B Mode Keys 57 B Mode Adjustment Keys 58 Power and Color Mode Keys 59 Doppler and M Mode Keys 60 Doppler Adjustment...

Page 5: ...Picture in Picture PiP 82 Using the Video Window 83 Using PiP 84 Chapter 5 Making Measurements 87 Measurements and Calculations 87 Making a Measurement General Procedure 87 Clearing a Measurement 88 Clearing All Measurements 88 B Mode and Color Mode Measuring Tools 88 Doppler Mode Measuring Tools 95 Chapter 6 Documentation 99 What are documents 99 Patient Archiving 99 The Document Browser 100 Savi...

Page 6: ... 115 Password Protection of the Database 115 Part 3 Imaging Modes Chapter 7 B Mode 2D Imaging 119 Overview 119 Adjusting MI 119 Adjusting the Scan Area 120 Depth 120 Width 120 Gain 120 Focus 122 Autofocus 123 Dynamic Range Contrast 123 Zoom 123 Panning 124 Persistence 125 Edge Enhancement 125 Auto 125 Line Density 126 Multibeam 126 Resolution 126 Extended Resolution 126 B Mode Frequency MFI 127 B ...

Page 7: ...lor Flow Mapping 137 Overview 137 Color Flow Mapping 137 Submodes 137 Adjusting the Thermal Index Limit 138 Adjusting MI 138 Turning Color Mode On or Off 138 Adjusting the Color Mode Image 139 Color Box 139 Gain 140 Range 140 Wall Filter 140 Color Mode Frequency 141 Persistence 141 Auto 141 Line Density 142 Color Quality Shots per Estimate 142 2D Filter 142 Color Priority 143 Invert 143 Color Mapp...

Page 8: ... Baseline 151 Steering 151 Chapter 11 Doppler Mode Spectral Doppler 153 Overview 153 Pulsed Wave Doppler PW 153 Adjusting the Thermal Index Limit 153 Adjusting MI 153 Turning Doppler Mode On or Off 153 Audio Volume 155 Adjusting the Doppler Mode Image 155 Doppler Indicator 155 Trace Overlay 155 Steering 155 Angle Correction 156 Gain 156 Range 157 Wall Filter 157 Invert 157 Baseline 158 Sweep Speed...

Page 9: ...gning User Defined Keys 170 Customizing Menus 171 System Setup 171 General Setup 171 Clip Storage and Cine Setup 173 3D Setup 174 Printer Setup 175 Password Setup 176 Measurements 178 User Defined Measurements 178 Measurement Group Setup 183 Curves 184 Miscellaneous Measurement Setup 187 Marks Bodymarks Labels Puncture Guides 189 Bodymark Setup 189 Label Setup 191 Brachy Matrix Setup 193 Miscellan...

Page 10: ...ducers and Diagnostic Setups 211 Patient Setup 212 Labels and Bodymarks 212 General Reports 212 Measurements 212 B Mode Measurements 213 D Mode Doppler Measurements 214 Doppler Spectra 215 Stenosis 217 VF Volume Flow 217 TAM Time Average Mean 218 RI and PI Resistance Index and Pulsatility Index 219 Real Time Measurements 220 Noise Limit 221 Carotid Velocities 221 Calculations 222 Calculation Formu...

Page 11: ...40 Measurements 240 B Mode Measurements 241 Doppler Mode Measurements 241 Real Time Measurements 242 Surgery Reports 242 Labels and Bodymarks 242 Chapter 18 OB Gyn Pro Package 243 Introduction 243 Transducers and Diagnostic Setups 243 Gestational Age and Expected Date of Confinement 244 Patient Setup 244 Labels and Bodymarks 244 Making Measurements 244 Calculation Methods 245 General Information 2...

Page 12: ...8 Cine Image Review 278 Making Measurements 278 B Mode Measurements 280 Doppler Mode Measurements 281 M Mode Measurements 284 ECG 285 Connecting the Electrodes 285 Checking the Cables 286 Using ECG 286 Reviewing ECG 287 Chapter 20 3D Imaging 289 Introduction to 3D Ultrasound 289 3D on the Pro Focus 289 Controlling Transducer Movement 290 Computer Controlled Positioning 290 Anorectal Transducer 205...

Page 13: ... Settings 311 4 Up View 311 6 Up View 312 Part 6 Appendixes Appendix A Glossary 315 Appendix B Technical Guide 321 Operating Environment 321 The Rear of the Scanner 321 Cables Types and Lengths 323 Monitors 324 Audio Input and Output 324 Documentation Accessories 325 Connecting to a Surgical Rack 326 Foot Switch Connector 331 Electrical Connections 331 Power Supply Cord 331 Connecting Other Equipm...

Page 14: ...14 ...

Page 15: ...Part 1 Basics ...

Page 16: ......

Page 17: ...ant safety information that you should be aware of before you use the scanner The remaining chapters also contain safety information About this User Guide The chapters in this user guide are divided into Parts Part 1 Basics contains information you need to know before you start scanning Part 2 Working with the Image describes the user interface and how to work with it It also contains general info...

Page 18: ... conventions are used in this manual FREEZE a function something you can do by using the keyboard panel or the graphical user interface on the screen Freq text that can be selected or clicked on the screen Power a key on the keyboard panel Book Titles names of books and scientific journals 1 References Literature references are found at the end of the chapter Terminology Many of the terms and abbr...

Page 19: ...Doppler Doppler mode spectral Doppler mode for information about the spectrum of flow velocities as a function of time CW Doppler mode continuous wave Doppler for information about high velocity flow M mode for information about tissue motion as a function of time Pro Packages Pro Packages contain default Diagnostic Setups and calculation formulas that make it quick and convenient to use the scann...

Page 20: ...he chassis Should be connected to corresponding terminals on other equipment to eliminate potential differences Ground earth Additional protective ground earth Type BF BF Isolated from ground Maximum patient leakage current under Normal condition 100µA Single fault condition 500µA Type B B Maximum patient leakage current under Normal condition 100µA Single fault condition 500µA Sealing Dust and im...

Page 21: ...Caution Large variations in temperature or humidity may cause water to condense inside the scanner If this happens the scanner may fail to operate properly Always let the scanner come to room temperature before you plug it in Wait at least 2 hours after the scanner has been subjected to major changes in temperature or humidity If there is visible evidence of condensation wait at least 8 hours Befo...

Page 22: ...nd connection will probably also exceed the limits specified in EN IEC 60601 1 WARNING When the equipment is used with 230V and you believe the leakage current would be within the UL limit if you were using 120V power to the equipment must come from an installation or supply unit with a center tapped 240V single phase circuit This will make sure that chassis leakage current during single fault con...

Page 23: ...rements An ultrasound scanner intentionally receives RF electromagnetic energy for the purpose of its operation The transducers are very sensitive to frequencies within their signal frequency range 0 5MHz to 35MHz Therefore RF equipment operating in this frequency range can affect the ultrasound image However if disturbances occur they will appear as white lines in the ultrasound picture and canno...

Page 24: ... Cord on page 331 The equipment must only be connected to a grounded AC power supply or wall outlet that meets EN IEC NEC requirements or applicable local regulations The examination room s grounding system should be checked regularly by a qualified electronics engineer or hospital safety personnel Never use extension cables The increased length of the cable will increase the resistance of the pro...

Page 25: ... keyboard The keyboard panel or monitor can break if subjected to heavy weights or impact WARNING Service and repair of B K Medical electromedical equipment must be carried out only by the manufacturer or its authorized representatives B K Medical reserves the right to disclaim all responsibility for the operating safety reliability and performance of equipment serviced or repaired by other partie...

Page 26: ...irements for medical equipment this equipment must be placed outside the patient environment 1 5m from the bed for example The equipment must fulfill the relevant EN standard or other applicable national or international standard The power for the equipment must come from the auxiliary power output on the scanner You can use the isolated auxiliary power outlets on the scanner to connect equipment ...

Page 27: ...parameter measured is listed in the user guide for each transducer For definitions of the parameters refer to the Food and Drug Administration FDA Guide 7 as well as EN 60601 2 37 3 and AIUM NEMA standards 8 9 In North America the FDA requires all ultrasound equipment to be cleared before it is marketed in the United States The routes or tracks available for clearance by the FDA are well defined T...

Page 28: ...st expected temperature increase in degrees Celsius It is based on an average level of blood perfusion The displayed TI may underestimate the temperature rise in poorly perfused tissues you must take this into account when deciding on the maximum TI you will allow Conversely in areas with a rich perfusion of blood the temperature increase will be less than the displayed TI indicates Variable Defin...

Page 29: ...the user should be aware of the hypothetical possibilities of adverse effects 10 12 13 Fetal scanning Current scientific and clinical concern over possible adverse effects is particularly focused on fetal ultrasound scanning It is due to the increased sensitivity of mammalian cells and organs at this phase of their development and the fact that such a risk could have profound implications on publi...

Page 30: ... default setup when the scanner is turned on again The default setup may be factory defined or defined by the user The factory defined default setup values of acoustic output for each transducer are listed in the General Transducer Information BB0555 manual These setups have been optimized to give the best compromise between low acoustic output and enough power to obtain the image features as quic...

Page 31: ...nd Systems and Transducers FDA Center for Devices and Radiological Health September 1997 8 Acoustic Output Measurement Standard for Diagnostic Ultrasound Equipment AIUM NEMA 1998 9 Standard for Real Time Display of Thermal and Mechanical Acoustic Output Indices on Diagnostic Ultrasound Equipment AIUM NEMA 1998 10 Medical Ultrasound Safety AIUM 1994 11 ALARA Training Program Ultrasound III Training...

Page 32: ...32 Chapter 1 ...

Page 33: ...roved by a qualified electrical engineer or hospital safety personnel See Installation on page 24 The controls you need to operate the scanner are located on the front Figure 2 1 The front of the scanner release handle USB connector CD drive standby switch hooks for cables handle on monitor release handle transducer holders reading lights ...

Page 34: ...nt Angle To change the viewing angle of the monitor Use the handle on the front of the monitor to swivel it from side to side and tilt the screen up or down Turning the Scanner On and Off To turn the scanner on and off use the green standby switch on the front of the scanner To turn the scanner on Press the standby switch ONCE A startup screen with progress bar is displayed Wait until the startup ...

Page 35: ...to call a technician However under certain unusual circumstances the scanner will operate but the date will be incorrectly set to a default date Adjusting the Brightness of the Screen Your scanner may be used with different levels of room lighting Whenever the lighting changes significantly you should recalibrate the screen brightness To calibrate the screen brightness 1 Freeze the image 2 Press A...

Page 36: ... open the Patient window Press IDr or Click Enter Patient or the name of the previous patient in the identification area on the screen The Patient window opens Figure 2 3 The Patient window Change the Pro Package first Some fields in the Patient window are different depending on which Pro Package is selected Therefore if you want to change the Pro Package make sure you do it before you enter infor...

Page 37: ...s Using the Patient Window TAB to move between fields After you have entered information in a field press Tab to move from field to field You can also move the cursor to a field by clicking the field ENTER closes window Do not press Enter Return unless you want to close the window Enter on the keyboard is the same as OK in the window Re opening Patient window If you decide to enter more patient da...

Page 38: ... you can scroll down to see the rest of the list Sorting To sort the worklist by name or any other column in the worklist click the column heading To select a patient from the worklist 1 Click the row that contains the patient 2 Click Select Patient The window closes The ultrasound image on the screen is not frozen Saving description with image If you want the description from the worklist to be s...

Page 39: ...Setup window but you probably will not need to change it See Date Time on page 172 Use number keys Use the number keys on the keyboard to enter dates NOTE You cannot type letters in a date field even when the month is displayed in letters In the example in Table 2 1 you must type 11 for the month even it if is displayed as Nov To enter dates in date fields 1 Put the cursor at the beginning of the ...

Page 40: ...ious patient Patient related data include the following Diagnostic Setup Bodymark Measurements Labels To keep patient related data Check Keep patient related data in the Patient window The scanner uses the patient related data from the previous patient NOTE You must check both Keep image settings and Keep patient related data if you want to return to the previous frozen image when you close the Pa...

Page 41: ...the transducer holders hold gel containers ready for use Selecting a Transducer You can choose to scan with any of the transducers that are connected to the scanner The type number of the transducer currently selected is displayed together with the scanning frequency in the Identification area at the top of the screen See page 67 Type number displayed must match number on transducer socket for mec...

Page 42: ...nd select the value you want or point at T or S and press The scanning plane in the selected view is updated to the one you select Pro Packages and Diagnostic Setups Each Pro Package contains all the measurement and calculation tools you need for a particular application area It also contains appropriate Diagnostic Setups for the various transducers that can be used with the Pro Package Each trans...

Page 43: ...g in B mode unless something else is specified in the Pro Package you are using To add modes to B mode press the key for the mode you want to add Performing a Biopsy or Puncture Procedure including Brachytherapy When you use a puncture guide to perform a biopsy or puncture procedure a puncture line is superimposed on the image When you use a transducer for brachytherapy a brachytherapy needle guid...

Page 44: ...r brachy matrix 1 Click the Type number or brachy matrix name displayed at the bottom of the scan area The Puncture Guide menu appears It contains the puncture guides and brachy matrices that are available for the selected transducer WARNING For brachytherapy make sure that the brachy matrix type and coordinates indicated on the screen Brachy 5 mm in Fig 2 7 agree with the actual matrix template y...

Page 45: ...r is already running the PCU requires 12 seconds to calibrate the mouse stick Do not use the PCU in particular do not touch the mouse stick for 12 seconds after power is applied If you do not wait 12 seconds the cursor may drift on the screen and you will have to unplug the PCU plug it in again and wait 12 seconds to get control of the cursor Attaching the PCU To connect a Palm Control Unit PCU to...

Page 46: ...ontrol Unit PCU on page 202 Putting Sterile Covers on the PCU Sterile covers one for the PCU and one for the cable are available for use with the PCU The package containing the sterile covers UA0029 contains a PCU cover a cable cover clips and some tape Latex sensitivity The procedure for putting on the sterile covers is illustrated in Fig 2 10 To put sterile covers on the PCU and cable 1 Always w...

Page 47: ... or tape 5 Check that the cover has not been damaged by this procedure If it has repeat the procedure with a new cover Figure 2 10 Putting on the PCU cover and cable cover References 1 Allergic Reactions to Latex Containing Medical Devices FDA Department of Health and Human Services FDA Medical Alert March 29 1991 ...

Page 48: ...48 Chapter 2 ...

Page 49: ...Part 2 Working with the Image ...

Page 50: ......

Page 51: ...optional Palm Control Unit PCU This chapter gives an overview of the various controls and how they are used in general Detailed information about using individual controls is contained in Chapter 4 Working with the Image and the chapters that deal with the various scanning modes Keyboard Panel Controls The Pro Focus keyboard panel contains both an alphanumeric keyboard and a control panel with spe...

Page 52: ...nel Each control key has a backlighted label that is visible when the functionality of the key is available Keys turn green to indicate an active function There are several types of control keys categorized according to how you use them Keyboard Control panel ...

Page 53: ...with the 2 A Select keys and the key can be used to operate the on screen controls Key Type Example Action Trackball Trackball Rolling the trackball moves a cursor on the screen Pressing the key adjusts a value or moves a cursor stepwise up or down pressing the side increases the value pressing the side decreases it A long press repeats the action Press Color Pressing the key activates a function ...

Page 54: ...onvenient for you Adjusting the Trackball The trackball should move smoothly If it is too tight or too loose use the trackball adjustment tool QA0228 to adjust it Figure 3 4 Using the trackball adjustment tool The tool is stored in the keyboard base below the keyboard panel To adjust the trackball movement place both ends of the tool into the small holes in the black ring of the trackball housing ...

Page 55: ... on page 53 This is indicated in this user guide as click long Key key When the pointer points at a control on the screen pressing changes settings such as values or sizes A single press increases or decreases values stepwise A continuous press causes the value to keep changing Pressing the right side of the key increases a value pressing the left side decreases it If the key is pressed for more t...

Page 56: ...eys Key Name Key Type Action p Freeze Press Freezes and unfreezes the image See Freezing the Image on page 73 v Print Press Starts one of the user defined documentation functions For more information see User Defined Keys on page 169 y Save Press Starts one of the user defined documentation functions For more information see User Defined Keys on page 169 i Cancel Press Cancels the present procedur...

Page 57: ...y Type Action Gain B Gain Cine Turn Adjusts the overall gain If the image is frozen turning activates the Cine scroll For more information See Cine on page 80 f B mode Press If other modes than B are active return to B mode only If only B mode is active return to last mode combination a 3D Press Turns 3D imaging on if the 3D Pro Package is installed If 3D is already active it steps through the dif...

Page 58: ...a A long press turns zoom off if it is on See Zoom on page 123 n Dynamic Range Rocker Adjusts the B mode dynamic range of the image See Dynamic Range Contrast on page 123 x Resolution Rocker Increases the resolution decreases the scanning frame rate or vice versa when you are scanning in B mode or Color mode G Width Rocker Adjusts the sector width See Width on page 120 Decreasing the width increas...

Page 59: ...Gain Turn Adjusts CFM Color gain if Color mode is active or Power gain if Power mode is active Power Power Mode Press Turns Power mode power Doppler on and off The trackball and key are assigned to the color box when Power mode is turned on Color Color Mode Press Turns Color mode color Doppler CFM on and off The trackball and key are assigned to the color box when Color mode is turned on j Color B...

Page 60: ...spectral Doppler is active k Doppler Mode Press Turns Doppler mode on and off The trackball and key are assigned to the Doppler gate when Doppler mode is turned on u M Mode Press Turns M mode on and off The trackball and key are assigned to the M line when M mode is turned on m D M Cursor Press In B mode turns on the Doppler gate so that you can position it before you activate Doppler mode Press a...

Page 61: ...ler Adjustment keys are grouped on the left side of the control panel For detailed information about using them see the chapters about the various Doppler modes and M mode Figure 3 10 The Doppler Adjustment keys on the control panel Doppler Adjustment keys ...

Page 62: ...ctive moves only the Doppler mode spectrum baseline F Wall Filter Rocker Adjusts the wall filter If both Doppler and Color modes are active moves only the Doppler mode spectrum baseline B Sound Rocker Adjusts the Doppler audio speaker volume and the video speaker volume during playback D Steer Rocker Changes the beam angle in Color mode Power mode and PW Doppler See Steering on page 155 b Angle Ro...

Page 63: ...Press Opens the Calculations menu on the screen See Measurements and Calculations on page 87 and User Defined Keys on page 169 tP2 Measure Press Opens the Measurement menu on the screen If the menu is already open starts the measurement at the top of the first open measurement group See Measurements and Calculations on page 87 and User Defined Keys on page 169 P3 P4 P5 P6 User defined Press The fu...

Page 64: ...biopsy line on or off See Performing a Biopsy or Puncture Procedure including Brachytherapy on page 43 C Split Screen Press Splits the screen so two view are displayed If the screen is already split pressing C shifts between which view is active A long press turns split screen off if it is on See Split Screen on page 74 g Bodymark Press Opens the Bodymark window so you can place a bodymark on the ...

Page 65: ...llaneous keys Key Name Key Type Action r ID Press Opens the Patient window for entering data about a new patient For more information see Setting up a New Patient on page 36 c Transducer Pro Package Press Opens the Pro Package menu on the screen so you can choose a transducer a Pro Package or Diagnostic Setup For more information See Selecting a Pro Package or Diagnostic Setup on page 42 d Auto Pr...

Page 66: ...anned Therefore if you move resize or invert the scan area you may have to use the sliders to readjust the TGC in order to get the best image Keyboard In addition to the control keys the keyboard panel contains an alphanumeric keyboard for entering information into the system The F1 to F10 keys are user definable keys The F8 and F10 keys have default functions assigned F8 and F10 Table 3 12 Defaul...

Page 67: ...ducer and the name of the Pro Package and Diagnostic Setup Data area The Data area is on the left side It displays data that must be documented with the image Information displayed in this area is automatically updated The Data area has a data section at the top that contains the relevant settings for image parameters It has a measurement section at the bottom The measurement section displays the ...

Page 68: ...st it with the key but you cannot move it To move a graphical control you must select it Click select Point at an on screen control and press A When a control is selected moving the trackball resizes or moves it Pressing A again cancels the selection making it possible to use the trackball to move the pointer Drag Use the trackball to move a cursor or graphical control Table 3 13 Color coding of c...

Page 69: ...you want You can also use to scroll up and down in the list and then press A NOTE Not all softkeys may be visible Click the expand symbol to see the all items in a menu To change the setup for how menus appear see Chapter 13 Setting Up and Customizing Your System Slider softkeys Some softkeys have a slider that you move with the trackball On Off softkeys Some softkeys have only two values On and O...

Page 70: ...rom the keyboard panel The PCU plugs into a socket on the back of the scanner See page 45 for important information about waiting 12 seconds before using the PCU and about checking the part number Figure 3 16 The PCU Some of the PCU controls work like particular keys on the control panel Some work differently Table 3 14 contains an overview of the PCU controls and which control panel keys they rel...

Page 71: ...e or Color mode frequencies for the selected transducer If B mode only is active press to toggle through the B mode frequencies A long press opens the Pro Package Menu window see page 43 so you can select a different transducer Pro Package or Diagnostic Setup w w Puncture See Puncture on page 64 P1 P2 P1 P2 User defined User defined keys To assign functions to these keys see page 170 K K Measure U...

Page 72: ...l See Trackball with Select Keys on page 54 If you push the mouse stick farther from the center position the cursor moves faster k k Doppler Mode See Doppler Mode on page 60 A long press on this key steps through the partial freeze states z z Scale See Scale on page 62 C Gain Gain Color Power Gain Gain M Doppler Gain Doppler gain If Doppler mode is active and not partially frozen press to modify D...

Page 73: ... view are inverted horizontally or vertically NOTE When you change image orientation you may need to adjust the TGC settings for the B mode image See TGC on page 121 Freezing the Image To freeze the image press p or click Freeze You can also use the button on the transducer itself see the transducer user guide for information about this All images on the screen are frozen If you press p again the ...

Page 74: ...ws can be scanning To split the screen Press C The screen is split to display 2 scan images If you are using a single plane transducer the 2 views contain the same scanning view If you are using a biplane transducer each view displays the image from one scanning plane To select one of the views Click in the view you want to select or Press C to select the view that is not currently selected To rem...

Page 75: ...ng at the same an anatomical structure That is it will move with the image A label with no arrow will stay on the same part of the screen and not move with the image You can add more than one label to an image Placing Labels Your system can be set up so that you can type labels directly on the image or select a label from the label catalog See Label Setup on page 191 To label the image Type the la...

Page 76: ... want and decided whether it should have an arrow attached press Enter or click OK The Label menu disappears and the label itself appears on the image in the default position Arrows You can place arrows anywhere on the image to indicate a region of particular interest You label the arrow To place an arrow on the image 1 Press F10 An arrow appears 2 If you want to label the arrow type the label The...

Page 77: ...el text in the Edit field 3 Click Save Label You can also use the Label Setup window to create or delete labels in a catalog See Label Setup on page 191 Editing a label on the image To edit a label on the image 1 Click the label on the image to select it 2 Press F9 The Label menu appears with the text of the selected label in the Edit field 3 Edit the label text 4 To save the edited label to the l...

Page 78: ...e scanning position Figure 4 2 Bodymark with scanning plane indicator Scanning plane indicator The scanning plane indicator consists of a long bar and small square The orientation of the bar indicates the orientation of the probe on the body and the square indicates the part of the probe that corresponds to the upper left of the scanned image on the screen Bodymarks are organized in catalogs You s...

Page 79: ... other catalogs 2 Click the bodymark you want The Bodymark window closes and the bodymark appears on the screen with a scanning plane indicator You can rotate or drag the scanning plane indicator to a different position Moving a Bodymark To move a bodymark click it drag it to the position you want and click again Adjusting the Scanning Plane Indicator To adjust the scanning plane indicator click i...

Page 80: ... The bodymark position and the scanning plane indicator position and angle are all saved as default for the Pro Package Whenever you place a bodymark on an image while using the current Pro Package it will appear in this default position You can move it of course Removing a Bodymark To remove a bodymark from the screen Point at the bodymark and click long or Press long g Unless you delete it or re...

Page 81: ...t side of the screen The current image Frame number is displayed in the Cine menu Image frame numbers NOTE Higher numbers are farther in the past The image scanned most recently is number 1 To review the images Click Frame under Cine and drag the slider to select the frame number or Select the cursor by clicking on it and press or drag to scroll through the images NOTE goes to the next image lower...

Page 82: ...setting the Start and Stop markers in the Cine menu To Set a Start or Stop Marker 1 Click on Frame 2 Drag the Frame slider to select the required frame number 3 Click the marker you want to set NOTE The image chosen for the Start marker must be older the Frame number must be higher than the image chosen for the Stop marker Figure 4 4 Cine Menu with Start and Stop markers Playback Speed You can adj...

Page 83: ...ow is open but the main image is an ultrasound image press on the PCU to toggle the state see Fig 4 6 on page 86 To close the video window Click Video under Image on the right side of the screen or Press long on the PCU The video window covers the ultrasound image Therefore you cannot use any keys or on screen controls that affect the ultrasound image when the video window is open NOTE You cannot ...

Page 84: ... on the screen one large and one small The PiP window is the smaller window If the main image on the screen is an ultrasound image the PiP window contains an external video image If the main image is a video image the PiP window contains an ultrasound image Video Source Connector Equipment Attached Example S Video Camera S VHS video camera S Video VCR S VHS VCR S Video AUX A different S VHS video ...

Page 85: ...ns on PiP with a video image in the smaller window A second press transposes the images so that the video image is in the big window and the ultrasound image is in the smaller PiP window A third press turns off PiP but leaves the video image on the screen A fourth press goes back to the initial PiP state with the ultrasound image big and the video image in the PiP window Further presses toggle aro...

Page 86: ...ible sizes To reposition the PiP window 1 Click inside the window 2 Drag the frame to the position you want 3 Click The PiP window moves to the new frame position If you decide you do not want to move the window press Esc or i The frame is not selected anymore To change the size of the PiP window Move the cursor so that it is inside the window and press to increase or decrease the window size or C...

Page 87: ... measurements Freeze the image The names of all available measurements are displayed under Measurements to the right of the image If the list is not visible click Measurements to expand the list To see more measurements scroll with the trackball Making a Measurement General Procedure The sections following this one contain detailed descriptions for using the various measuring tools Image must be f...

Page 88: ...r is positioned the depth is replaced by the appropriate measurement result Clearing a Measurement There are 3 ways to clear a measurement and any current calculations that use the measurement To clear a measurement do one of the following Point at the marker and press long A Point at the measurement result and press long A Press Esc while the measurement is selected on the screen Clearing All Mea...

Page 89: ...Angle Measuring Tool On a B mode or Color mode image you can measure 1 angle or 2 angles The angle measuring tool works slightly differently from the other measuring tools The numbers in the instructions below refer to the numbers on the markers in Fig 5 2 To measure an angle 1 Click Angle A marker appears 2 Position the marker and click A second marker appears with a line connecting the two marke...

Page 90: ...nes NOTE If you click somewhere on the measuring tool that is not on a particular marker moving the trackball moves marker 1 Circle Measuring Tool On a B mode or Color mode image you can position 2 markers to measure a circle Position the markers in the usual way As you move the second marker the circle is continuously redrawn on the screen Position first marker and click Line appears Position mar...

Page 91: ...marker 3 Repeat with the other marker if necessary Figure 5 4 Repositioning one of the circle markers To move the entire circle without changing its size 1 Click inside or on the circle 2 Drag it 3 Click again Moving a circle Figure 5 5 Moving a circle you have drawn Position first marker First marker positioned position second marker Second marker positioned All markers positioned First marker se...

Page 92: ...positioning an ellipse marker After the markers have been positioned you can move any of them by clicking and dragging to a new location Click again NOTE Moving marker 1 or 2 in an ellipse will automatically move marker 3 Figure 5 7 Repositioning markers in an ellipse you have drawn To move the entire ellipse without changing its size or orientation 1 Click inside or on the ellipse 2 Drag it Posit...

Page 93: ...position it To delete the marker you have just positioned Press on the key To undo the deletion Press Closing the polygon When you have positioned the final marker you want to use double click it to indicate that it is the final marker in the polygon A line is drawn from it to the first marker No new marker appears after you double click the final one Figure 5 9 Drawing a polygon After the markers...

Page 94: ...tool on the screen A drawing cursor appears 2 Drag it to where you want to start drawing Click A second marker appears where you clicked 3 Drag it to draw the shape you want Erasing what you have drawn To delete backward from the cursor press on the key The cursor is automatically moved back To undo the deletion press Marker repositioned All markers positioned Marker selected WARNING If the sides ...

Page 95: ...time as a dimension To avoid getting a negative result successive markers must be positioned to the right not the left of any already positioned markers Positioning 2 Point Markers on a Doppler Mode Image While you are positioning a marker 2 cursor lines are displayed One is horizontal and one vertical intersecting at the marker position Figure 5 14 Positioning 2 point markers on a Doppler mode im...

Page 96: ... markers Positioning 2 Vertical Line Markers on a Doppler Mode Image Two vertical line markers can be positioned on a Doppler mode image to measure intervals To position the vertical markers 1 Click the measuring tool A marker appears on the image 2 Drag this to the position you want Click Another marker appears 3 Drag it to the correct position Click Figure 5 16 Positioning vertical markers on a ...

Page 97: ...g point marker appears where you clicked 3 Drag the drawing cursor to draw the shape you want You can only drag to the right you cannot drag to the left Erasing what you have drawn To delete backward from the cursor press on the key The cursor is automatically moved back To undo the deletion press 4 When you have finished drawing click the drawing cursor Figure 5 18 Drawing a freehand curve on a D...

Page 98: ...98 Chapter 5 ...

Page 99: ...does not have unlimited storage capacity Each document that you save to the patient archiving system takes up space on the hard disk The scanner checks the space on the hard disk each time you enter a new patient ID If the hard disk is getting full you will be notified when there is no more than 1 GB available space on the hard disk when there is no more than 500 MB available on the hard disk when...

Page 100: ...of the screen Figure 6 1 The document browser window The Image Bar The image bar contains thumbnails of the available documents A small icon in the upper left corner of each thumbnail identifies the document type and whether it is archived internally or externally Table 6 1 Documentation type icons If the browser contains so many images that the thumbnails cannot fit on the screen you can use arro...

Page 101: ...ed to the patient archiving system Tool Function View Displays the currently selected document 2D scanned image 2D video clip of scans 3D data set Pro Package report Delete Deletes the currently selected document See page 106 Copy CD Copy Flash Copies the selected documents to an external storage device Note All copy save keys on the control panel and any on screen copy controls are disabled when ...

Page 102: ... 173 To see other documents in the patient archiving system click View History The Archive window opens See The Archive Window on page 103 To select or unselect a document Click the document A colored frame surrounds the documents that are selected To view a document Double click the document in the browser The document is displayed in the scan area and any other documents you have selected are de...

Page 103: ...rchive window 1 Click View History in the toolbar at the bottom of the screen If the patient archiving system is password protected and you are not logged on this option is not visible 2 Click the Archive tab The Archive window opens Video Clip Control Function Play Pause Works when clip is paused Point at this and press to go one frame forward or press to go one frame back If you click this a sli...

Page 104: ...he Patient Information area contains patient IDs names and other information about patients in the patient archive It also contains the date of the last examination for each patient You can filter the information so that only certain patients are displayed Table 6 4 explains the various ways you can filter the patient list Patient Information Comment Window Examination Information ...

Page 105: ... patients who have any examination before the date you enter Patients with exams after A date See Entering Dates on page 39 All patients who have any examination after the date you enter Patients data including Smith 1975 Patients named Smith Smiths Smithson Whitesmith and those with other names containing Smith All patients born in 1975 Patient with patient ID the exact patient ID The patient wit...

Page 106: ...played in date order with the newest comments at the top To enter a comment 1 Click in the comment window The current date and time are displayed at the top of the window 2 Type the comment under the date and time 3 Click Save above the comment window NOTE You can edit previously saved comments Deleting Patients or Documents You can delete documents from the scanner if they have not been archived ...

Page 107: ...ete in the toolbar below the document browser 3 You are asked to confirm that you want to delete the documents 4 Click Yes The selected documents are deleted Externally Stored Documents You can also use the document browser to look through documents that you have copied or archived to a CD or flash memory device To view externally stored documents 1 Insert a CD into the CD drive or insert a flash ...

Page 108: ...atabase is copied to the storage medium Copying Documents You can copy documents to a CD or a flash memory device See Using CDs on page 109 and Using Flash Memory on page 111 To copy individual documents or all the documents associated with a specific examination or patient to a CD or flash memory device 1 Click to select the patient the examination or the individual documents you want to copy 2 C...

Page 109: ...345 that was captured on October 22 2004 at 1 54 26 P M 13 54 26 Supported CD types The following media are supported CD R recommended for most purposes CD RW Caution Be careful when you use the CD drive Insert discs carefully Do not use force Do not push the drive to close it use the button on the drive when you insert or eject a disc Using CDs There are certain restrictions about copying and arc...

Page 110: ...mage on the right side of the screen The following window appears Figure 6 5 The Burn CD window 3 If you are burning a copy you must type a label name If you are burning an archive CD you cannot specify the label name 4 Click Burn The progress bar tells you when the burning is finished The keyboard panel and on screen controls are disabled while the CD is being burned You can also use this window ...

Page 111: ...COM is installed on your scanner Can t measure on a DICOM image NOTE You cannot make measurements on a DICOM image because the picture geometry information that would be required is not stored with the image Saving or Printing to a DICOM Network When you archive or save to a Picture Archiving and Communications System PACS the information is temporarily saved on the scanner s internal hard disk Wh...

Page 112: ...nnect the scanner to a functioning network with access to the requested services print or storage at least once every 5 work days Otherwise the internal hard disk may overflow When the disk is full the following message appears Figure 6 8 DICOM message when hard disk is full DICOM Status A DICOM status indicator appears at the bottom right of the screen It has a little light next to it ...

Page 113: ... the indicator the status window appears You have the following options Clear All clear all pending documents Retry try to send again Close do nothing Printing Documents You can print documents on a local printer or if DICOM is installed on your scanner send them to be printed on a DICOM printer Printing on a DICOM Printer To print on a DICOM printer 1 In the document browser click to select the d...

Page 114: ...emarks to a report You can save a report to the patient archiving system and view or save it in the same way as you view or save other documents See page 101 Displaying a Report To create a report Press F8 Report or a user defined key The report appears on the screen Figure 6 10 An OB report The contents of the report will vary depending on the Pro Package and the measurements you have made If the...

Page 115: ... American Health Insurance Portability and Accountability Act of 1996 sets standards for handling patient data and medical records To comply with these standards the patient archive database on the scanner can be password protected with a user specific ID username and password If you copy the database to a CD and try to open it with Microsoft Access you will be prompted for a different password if...

Page 116: ... in Emergency State In an emergency someone without a password may need to use the scanner and there may not be time to type in a name and patient ID In this case when the login window appears click Emergency This puts the scanner in the emergency state In the emergency state a default patient ID EmergencyID is used You can capture images and clips but they will all have EmergencyID as the patient...

Page 117: ...Part 3 Imaging Modes ...

Page 118: ......

Page 119: ...can be used in combination with other scanning modes See Combination Modes on page 128 To return to scanning with B mode alone after you have been using it in combination with other modes press f Figure 7 1 B mode image Adjusting MI You can adjust the maximum allowed MI mechanical index To adjust the MI limit Click MI above Gain on the left side of the screen and drag the slider ...

Page 120: ...ble at the top of the image There are two ways to adjust image depth To adjust image depth Make sure the cursor is located within the image and press or Press the Depth l key to increase or decrease depth NOTE Pressing the end of the key up decreases the depth increases the magnification When the depth has been adjusted Zoom Pan is visible under Image on the right side of the screen together with ...

Page 121: ... set at the factory or one you have set up yourself See Chapter 13 Setting Up and Customizing Your System The TGC sliders adjust the relative gain of the image at different tissue depths Each slider adjusts a specific part 1 8th of the TGC curve the topmost control adjusts the top 1 8th of the image NOTE The sliders operate relative to their center position when they are all centered the default T...

Page 122: ...icates the depth of the image that is in best focus the focal point If there is more than one focal point composite focus the number of triangles indicates the number of focal points but not necessarily their position because this is automatically optimized You can adjust both the position and range of the area in best focus You can also select the number of focus zones To adjust focus position To...

Page 123: ... is always centered in the displayed image To turn autofocus on or off Click Autofocus on the right side of the screen Dynamic Range Contrast You can adjust the dynamic range contrast of the ultrasound image from 50 to 90 dB To adjust dynamic range Press n Dyn Range to increase or decrease the level or Click Dyn Range under General on the left side of the screen and drag the slider or point at Dyn...

Page 124: ...r using the key When the image has been zoomed Zoom Pan is visible under Image on the right side of the screen together with a small indicator light To return to the original image Press H Panning Panning is moving the image so that different parts of the total scan are displayed on the screen You can pan in any direction though only as far as the scan area of the individual transducer permits To ...

Page 125: ...cement is a way of emphasizing contours so that edges stand out more clearly You can select the degree of edge enhancement of the ultrasound image To adjust edge enhancement Click Edge under General on the left side of the screen and select the value you want or point at Edge and press The available values range from 0 no enhancement to 7 maximum enhancement The current setting is displayed on the...

Page 126: ...e from 1 to 5 The current setting is displayed on the screen next to Line Density Multibeam Multibeam is a method for increasing the frame rate by receiving signals from several directions at the expense of resolution Multibeam is not available when Auto is turned on To select the multibeam level Click Multibeam under General on the left side of the screen and select the value you want or point at...

Page 127: ...ncy or Click the current scanning frequency for example 5 0 MHz in the Identification area of the screen and select the value you want or point at the frequency and press The view must be scanning when you do this B Mode Gray Scale Several gray scales can be used to display a B mode image Different gray scales may make various aspects of the image clearer To select the gray scale in B mode 1 Point...

Page 128: ...ination Press the key for the mode you want to remove To return from a combined mode to B mode only Press f NOTE Pressing f several times lets you toggle back and forth between B mode and any combined mode Harmonic Imaging Tissue Harmonic Imaging True Echo Harmonics TEH True Echo Harmonics TEH is B K Medical s trademarked name for tissue harmonic imaging Using it can reduce noise and improve the c...

Page 129: ...lt to scan patients Increased contrast resolution Reduced effect of grating lobes Limitations Best in mid range depth the specific depth range for which harmonic imaging works best depends on the transducer as well as other factors Reduced penetration Reduced lateral resolution To turn harmonic imaging on Make sure that B mode imaging is turned on Press q or Click Harmonic under General on the lef...

Page 130: ...ve or print the image You can move the time to a new location on the image by clicking and dragging it NOTE When you freeze the image the time on the image is frozen but the time next to the green light keeps running When you unfreeze the image the time on the image is updated to be correct To stop the timer Click the time under Image on the right side of the screen or Press K The time value in th...

Page 131: ...sed in combination with B mode To turn M mode on or off Press u Selecting any other mode will also turn off M mode To return to scanning with B mode alone press f Figure 8 1 M mode image The M mode image When M mode is selected the screen will be divided into two windows see Fig 8 1 You can adjust how the two windows are displayed See Doppler and M Mode Screen Layout on page 169 B mode image M mod...

Page 132: ...s not possible to change the ruler Sweep Speed You can control the speed at which the M mode image sweeps across the screen To adjust the sweep speed 1 Click on sweep in the right side of the screen 2 Drag to the desired value and click The available values range from 2 slowest to 8 fastest Gain To adjust the gain brightness of the scanned image use a combination of the M Doppler Gain and the TGC ...

Page 133: ...age will be reflected in the M mode image NOTE Only a single focal zone is possible in M mode Autofocus Autofocus ensures that the center of the focal range is always centered in the displayed image To turn autofocus on or off Click Autofocus on the right side of the screen A small green light next to Autofocus indicates that the function is turned on Dynamic Range Contrast You can adjust the dyna...

Page 134: ...n and select the value you want or point at Edge and press The available values range from 0 no enhancement to 7 maximum enhancement The current setting is displayed on the screen next to Edge M mode Frequency MFI If an MFI Multi Frequency Imaging transducer is selected you can select the scanning transmitted frequency The current scanning frequency is displayed at the top of the screen M mode use...

Page 135: ... scale in M mode Click the gray scale bar to the right of the M mode image and select the gray scale you want or point at the color bar and press The gray scale bar to the right of the M mode image is replaced by the one you select ...

Page 136: ...136 Chapter 8 ...

Page 137: ... one See Invert on page 143 or Color Mapping on page 143 Color mode can only be used in combination with B mode Whenever Color mode is active a color box is superimposed on the B mode image The color box defines the area of the B mode image for which flow information is available Submodes Three submodes are available in Color mode scanning Velocity Variance Velocity Variance You can select the sub...

Page 138: ...issue TIC cranial TIB bone TI limit not exceeding the factory set limits To select tissue type Click the TI type displayed and select TIB TIC or TIS or point at TI and press To adjust the TI limit Click the limit displayed after the TI type and select the value you want The current TI is displayed as TIx z z y y where x is S C or B y y is the limit you select and z z is the actual TI Adjusting MI ...

Page 139: ... mode scan The color box outlines the area of the tissue in which flow information is available You can adjust the size and position of the color box to examine flow in various parts of the B mode image The view must be scanning when you do this To resize the color box 1 Point at the box or select it by clicking inside it or pressing j 2 Press or Click a corner of the box and drag the corner To mo...

Page 140: ...p through the available ranges or Click PRF under Color on the left side of the screen and select the value you want or point at PRF and press The color bar is updated to correspond to the new range of velocities The current setting is displayed on the screen next to PRF Wall Filter A wall filter is used to eliminate low frequency artifacts such as Doppler shifts arising from respiratory and cardi...

Page 141: ...o this To adjust Color mode persistence Click Persist under Color on the left side of the screen and select the level you want or point at Persist and press The available values range from 1 no averaging to 8 maximum averaging The current setting is displayed on the screen next to Persist Auto Increasing the resolution of an ultrasound image results in a reduction in frame rate The system can auto...

Page 142: ...itted in each waveform packet shots per estimate at the expense of decreasing the frame rate The view must be scanning when you do this Shots Per Est is not available when Auto is turned on To adjust the color quality select shots per estimate Click Shots per Est under Color on the left side of the screen and select the value you want or point at Shots per Est and press The available values range ...

Page 143: ... coding or to return to the default Press Inverse to toggle between the default and inverted color coding The color coding in the Color mode image inverts The color bar to the right of the image is inverted to show the new color coding Color Mapping Various color scales can be used to display a Color mode image To select the color scale in Color mode Click the color bar to the right of the image a...

Page 144: ... adjust the baseline Press Baseline e to move the baseline up or down The color bar is updated The frequency axis on the color bar is updated Steering You can steer the Doppler beam of a linear transducer to vary the beam angle This can be useful for examining flow in blood vessels parallel to the transducer surface To adjust the beam angle Press Steer D You can choose left steering right steering...

Page 145: ...ach direction Power mode can only be used in combination with B mode Whenever Power mode is active a color box is superimposed on the B mode image The color box defines the area of the B mode image for which flow information is available Submodes Two submodes are available in Power mode scanning Power power Doppler Power Velocity directional power Doppler You can select the submode you want The vi...

Page 146: ...ck MI above General on the left side of the screen and drag the slider Turning Power Mode On or Off When you turn on Power mode B mode must be scanning To turn on Power mode Press Power The color box appears Figure 10 1 The Power mode color box superimposed on a B mode image To turn off Power mode Press Power ...

Page 147: ...ain of the Power mode image The view must be scanning when you do this To adjust Power mode gain Turn the Color Power Gain dial or Click Gain under Power on the left side of the screen and drag the slider or point at Gain and press The current Power gain setting a percentage is displayed on the screen next to Gain Range As in Color mode you can vary the PRF pulse repetition frequency to select the...

Page 148: ...nning frequency The view must be scanning when you do this To select the Power mode frequency Press Frequency c to step through the frequency options or Click MFI under Power on the left side of the screen and select the value you want or point at MFI and press The current value is displayed on the screen next to MFI NOTE The current scanning frequency displayed at the top of the screen is always ...

Page 149: ...color resolution but a slower refresh rate The view must be scanning when you do this Line density is not available when Auto is turned on To adjust Power mode line density Click Line Density under Power More on the left side of the screen and select the value you want or point at Line Density and press The available values range from 1 to 5 The current setting is displayed on the screen next to L...

Page 150: ...Prty under Power on the left side of the screen and drag the slider The current setting is displayed on the screen next to Color Prty NOTE High color priority gives color in more areas low color priority reduces the number of areas that are colored Invert In the Power Velocity submode as in Color mode you can invert the way color is assigned to velocity flow information To invert the color coding ...

Page 151: ... Power More on the left side of the screen and select the value you want or point at Multibeam and press The available values are 1 and 2 The current setting is displayed on the screen next to Multibeam Baseline In the Power Velocity submode as in Color mode you can reposition the baseline To adjust the baseline Press Baseline e to move the baseline up or down The color bar is updated The frequenc...

Page 152: ...152 Chapter 10 ...

Page 153: ...frequency components Adjusting the Thermal Index Limit Before you use Doppler mode check that the TI settings are appropriate The current TI tissue type and limit are displayed just under the B K Medical logo in the upper left corner of the screen For information about adjusting the TI see Adjusting the Thermal Index Limit on page 138 Adjusting MI You can adjust the maximum allowed MI mechanical i...

Page 154: ... Doppler indicators three examples A diagonal line relative to the Doppler line indicates a sample volume with angle correction see Angle Correction on page 156 The thick lines are areas in which no Doppler information is available and the horizontal dotted lines show the false sample volume in HPRF see page 157 To turn off Doppler mode Press k or f Doppler line Doppler gate sample volume angle co...

Page 155: ...cm on the left side of the screen and drag to the desired value or Click the Doppler indicator or press m and drag the gate The sample volume line moves along with the gate Sample volume size To resize the Doppler gate Click mm on the left side of the screen and drag to the desired value Point at the Doppler indicator or click it or press m and then press Trace Overlay Trace overlay displays a mea...

Page 156: ...ng the trackball or Click the angle correction value degrees under Doppler on the left side of the screen and drag the slider or point at the value and press or Press and hold Angle b until the desired value is reached NOTE The value will stop at 60 degrees Release Angle b and press again to adjust the angle further The current setting in degrees is displayed at the bottom of the list under Dopple...

Page 157: ...Doppler line shows the actual sample volume false sample volumes indicated by holes in the line and dead space areas where Doppler information cannot be achieved at the current PRF indicated by a thick line See Fig 11 2 on page 154 The false sample volumes should always be placed outside a vessel The thick parts of the line see Fig 11 2 on page 154 can be moved by adjusting the range When HPRF is ...

Page 158: ...ome aliasing problems To adjust the baseline Press Baseline e to move the baseline up or down The frequency axis is updated to match the spectrum Sweep Speed You can adjust the sweep speed to change the number of cycles of the spectrum displayed on the full time axis The available values range from 2 slowest to 8 fastest To select the sweep speed Click Sweep on the right side of the screen and sel...

Page 159: ...e screen For information about adjusting the TI see Adjusting the Thermal Index Limit on page 138 Adjusting MI You can adjust the maximum allowed MI mechanical index To adjust the MI limit Click MI above Gain on the left side of the screen and drag the slider Turning CW Doppler Mode On or Off When you turn on CW Doppler mode B mode must be scanning To turn on Doppler mode Press CW k The CW Doppler...

Page 160: ... mode image CW Doppler Sample Region The CW Doppler Sample Region is the area where the Doppler focusing is concentrated When CW Doppler is turned on the CW Doppler Sample Region indicator is superimposed on the B mode scan Fig 12 2 shows information available in Doppler indicators Figure 12 2 CW Doppler Sample Region indicator CW Doppler image appears here ...

Page 161: ... scan You can adjust the position of the sample region to get information from sample volumes in various parts of the B mode image The system must be scanning when you do this To move the CW Doppler Sample Region 1 Select CW Doppler Sample Region by clicking on it or by pressing m 2 Drag to the desired position or press to move the sample region Trace Overlay Trace overlay displays a mean peak or ...

Page 162: ...through the available values The current setting is displayed on the screen next to Wall Filter Invert In CW Doppler mode you can invert the spectrum on the screen To invert the spectrum or to return to the default Press Inverse to toggle between the default and inverted color coding The frequency axis is inverted to match the spectrum Baseline In CW Doppler mode you can reposition the baseline Th...

Page 163: ... Mode 163 To select the sweep speed Click Sweep on the right side of the screen and select the submode you want or point at Sweep and press The current setting is displayed on the screen next to Sweep The time axis is updated ...

Page 164: ...164 Chapter 12 ...

Page 165: ...Part 4 Setting up and Maintaining Your System ...

Page 166: ......

Page 167: ...t is easy to enter and select exactly the information you need and so that the default setups are the way you want them Pro Package and Diagnostic Setup You can customize the Pro Packages and Diagnostic Setups to suit your needs To open the setup window for Pro Packages and Diagnostic Setups 1 Click Setup under Image on the right side of the screen to open the various setup windows 2 Click the Pro...

Page 168: ... Setup restore factory default Diagnostic Setups If you click this a table appears for you to select the ones you want to restore save the active Diagnostic Setup with a name you choose import or export Diagnostic Setups Importing or Exporting Diagnostic Setups You can export Diagnostic Setups to a flash memory device or CD and then import them to another Pro Focus scanner After a software upgrade...

Page 169: ...l The size of the Doppler or M mode image can be small medium or large To open Screen Layout Setup window 1 Click Setup under Image on the right side of the screen to open the various setup windows 2 Click the Split tab The Screen Layout Setup window appears Figure 13 3 The Screen Layout Setup window User Defined Keys You can assign functions you commonly use to one of the many user definable keys...

Page 170: ...ssigning User Defined Keys To assign functions to the user defined keys and foot switch pedals 1 On the left side of the Key Assignment Setup window click the Pro Package you want If you click All Pro Packages the key assignment will be valid for all Pro Packages 2 On the right side click the name of the key you want to define 3 Click the that appears to the right to see a drop down menu of the po...

Page 171: ...which menu groups you have open In this window you can also adjust the brightness of the key labels on the control panel System Setup The General Setup Clip Storage Setup 3D Setup Printer Setup Password Setup and Version Information windows are grouped under the System tab The Version Information window contains information about the scanner hardware and software The other windows are described be...

Page 172: ... the usual Microsoft Windows Date Time Properties setup window You cannot change existing time stamps Change date or time To change the date or time Click Date Time in the General Setup window See Fig 13 5 A message appears stating that existing time stamps cannot be changed When you accept the statement the Date Time Properties window appears Change date or time format To change the date or time ...

Page 173: ...e ways in which the clip browser and cine functions work To open the Clip Storage and Cine Setup window 1 Click Setup under Image on the right side of the screen to open the various setup windows 2 Click the System tab and then the Clip Storage Cine tab The Clip Storage Setup window opens Figure 13 6 The Clip Storage Setup window ...

Page 174: ...er you type a frame rate in the field Clip length Sets the length of clips that are stored in seconds The maximum possible length depends on the frame rate you have set Click Apply after you type a clip length in the field Capture while not scanning Check this if you want to be able to capture clips while the image is frozen Clear buffer on freeze Check this to have the clip buffer cleared when yo...

Page 175: ...rwriting user views Printer Setup You can set up the paper size for your printers in the Printer Setup window To open the Printer Setup window 1 Click Setup under Image on the right side of the screen to open the various setup windows 2 Click the System tab and then in the new window that appears the Printers tab The Printer Setup window opens ...

Page 176: ...administrative privileges you can add or remove users reset their passwords and enable or disable password protection The default superuser name and password are Name administrator Password superuser To open the Password Setup window 1 Click Setup under Image on the right side of the screen to open the various setup windows 2 Click the System tab and then the Password tab The Password Setup window...

Page 177: ...ur password NOTE Your username and password must each be no longer than 16 characters The username is not case sensitive but the password is case sensitive Case sensitive means that B is not the same as b If you are a superuser you will have the options shown in Fig 13 10 Figure 13 10 The Password Setup window for the superuser Click here to change password ...

Page 178: ... define new measurements that you can then use to measure features of ultrasound images To define measurements you use the Measurement Definition Setup window page 179 Organizing measure ments You can also arrange the measurements in groups and change the order in which they appear on the screen For this you use the Measurement Group Setup window page 184 In the Miscellaneous Measurement Setup win...

Page 179: ...window You have the following options in the Measurement Definition Setup window Type of User Defined Measurement MeasurementBased On This About the Calculation Results B Mode Measurement 1 or no B mode measuring tool Formula can use results of other measurements 1 D Mode Measurement 1 or no Doppler mode measuring tool Formula can use results of other measurements 1 Gestational Age 1 B mode measur...

Page 180: ...n then edit it to create a new user defined measurement Edit Opens the Measurement Definition Wizard so you can edit the selected user defined measurement Delete Deletes the selected user defined measurement You are asked to confirm the deletion Import Imports a measurement from an external storage device If the measurement depends on other measurements you are prompted to import them too Export E...

Page 181: ...e on images from different scanning planes you probably do not want it removed 4 Select a measuring tool Fetal weight measurements skip this step The tools that are available depend on the type of measurement you are defining Enter name for new measurement here Enter a description for measurement here Otherwise measurement name will be used as description Check here if you want measurement result ...

Page 182: ...le 13 4 An example of a formula is 3 1419 Distance Distance_mm 2 2 Gestational age measurements skip this step Click to select the attribute of the tool area or diameter of a circle for example required Click to select the curve the measurement is based on required Click to select a measurement type CRL for example optional Click these to insert operators Note that because of the way thescannercal...

Page 183: ...p Setup window 1 Click Setup under Image on the right side of the screen to open the various setup windows 2 Click the Measurements tab and then the Measurement Groups tab The Measurement Group Setup window opens with a list of Pro Packages on the left a list of measurement groups in the middle and a list of measurements on the right Part of Formula Syntax Tool tool name attribute value Dependency...

Page 184: ...move each one up and down in the list that will appear on the screen next to the scanned image You can also add and name new measurement groups in this window Curves You use the Curve Setup window to define a curve or to edit an existing user defined one To open the Curve Setup window 1 Click Setup under Image on the right side of the screen to open the various setup windows 2 Click the Measuremen...

Page 185: ... is expanded Click to collapse the list again Child and parent curves NOTE The percentile curves are called child curves The curve that they are related to and displayed with is called the parent curve Information fields When the window opens no curve is selected The information fields are blank and you can use them to create a new curve When a curve in the list is selected the information fields ...

Page 186: ...ick to select a parent curve from a list Curve Type The type of curve Gestational Age Fetal Weight From Gestational Age None some other type or not a specific type Measurements based on a GA curve will be available in the reports The default FW curve will also be available in the reports X Axis A label for the x axis of the curve Y Axis A label for the y axis of the curve Curve Values The curve va...

Page 187: ...the screen to open the various setup windows Option What it does Save Saves a curve that you have edited or defined Copy Creates a copy of the selected curve Child curves are not included in the copy and must be copied separately Curve Type X axis Y axis and points are copied Display Name Reference Name and Parent Curve are left blank so you can fill them in to create a new curve Delete Deletes th...

Page 188: ...cked to the color box if you leave this box unchecked the color box will not move when you drag the Doppler gate whether gray scales are hidden in B mode whether Doppler real time calculations are displayed all the time the color for the Doppler peak or mean trace curve to change the color click the colored box and select the color you want or create a custom color the FW GA curve that is used as ...

Page 189: ...og to another delete bodymarks labels from a catalog change the order in which bodymarks labels in a catalog are displayed set a default position for bodymarks and scanning plane indicator and labels Bodymark Setup To make changes to the bodymark setup you use the Bodymark Setup window To open the Bodymark Setup window 1 Click Setup under Image on the right side of the screen to open the various s...

Page 190: ...ings Importing Bodymarks from a File to a Catalog You can import bodymarks from a bitmap bmp file to any of the bodymark catalogs Images that you import must be 100 x 100 pixels larger images will be scaled black and white color images will give unpredictable results To import bodymarks to a catalog 1 Open the Bodymark Setup window and select the catalog you want to import to 2 Click Insert file A...

Page 191: ...ed bodymark is inserted at the beginning of the catalog on the right side of the Bodymark Setup window Deleting a bodymark To delete a bodymark from a catalog 1 Click the bodymark in the Bodymark Setup window 2 Click Remove Changing the order To move a bodymark up or down in the catalog 1 Click the bodymark to select it 2 Click Up or Down The bodymark moves up or to the left or down or to the righ...

Page 192: ...then customize it to contain the labels you want to use You can remove any catalogs you do not want to use To add a label catalog 1 Click New 2 Type a name for the new catalog in the box that appears The new catalog empty of labels appears on the right side of the window You can now add labels to the category See Importing Labels from a File to a Catalog on page 193 To remove a label catalog 1 Cli...

Page 193: ...talog Adding a Label to a Catalog or Removing One You can organize the label catalogs as you like adding and deleting labels changing the order in which they appear in the catalog deleting ones you don t need and so on To delete a label from a catalog 1 In the Label Setup window select the catalog 2 Click the label in the list 3 Click Remove Changing the order To move a label up or down in the cat...

Page 194: ...wn menu 2 Click Save to save your setting Miscellaneous Marks Setup You can customize some aspects of how bodymarks and labels work for each Pro Package You do this in the Miscellaneous Marks Setup window To open the Miscellaneous Marks Setup window 1 Click Setup under Image on the right side of the screen to open the various Setup windows 2 Click the Labels Marks tab and then in the window that a...

Page 195: ...ber of degrees in the field and click Apply or press Enter Patient Window Setup You can change some of the fields in the Patient window so that you record the information you need about each patient The Patient window can contain different fields for each Pro Package To make changes to the Patient window you use the Patient Setup window To open the Patient Setup window 1 Click Setup under Image on...

Page 196: ...m DICOM 3D Picture in Picture PiP When you purchase one of these options you will receive a 16 character license key To activate the option you will have to type the license key into the License Manager window To open the License Manager window 1 Click Setup under Image on the right side of the screen to open the various setup windows 2 Click the License tab The License Manager window opens ...

Page 197: ...d System Settings You can export or import a Pro Package to or from an external storage device When you do this the bodymarks labels user defined key assignments Doppler M Mode screen layout measurement groups and patient window setup that are associated with the Pro Package are exported or imported A fetal weight curve may also be included if appropriate You can also import or export system setti...

Page 198: ...ort a triangle appears to the right of it see Fig 13 23 Click the triangle to choose whether you want to export to a CD or a flash memory device NOTE If you export to a flash memory device make sure that it is not set to be write protected 3 Type in a file name when you are prompted 4 Press Enter NOTE See Using CDs on page 109 and Using Flash Memory on page 111 To import a Pro Package or system se...

Page 199: ...DICOM license from B K Medical before a qualified service technician can install DICOM on your scanner The 2202 Service Manual BI2201 contains instructions for service personnel to use when setting up your DICOM system Changing setup If DICOM is enabled on your scanner various DICOM setup windows can be accessed by clicking the DICOM tab after you click Setup under Image on the right side of the s...

Page 200: ...200 Chapter 13 ...

Page 201: ... panel is not watertight Be careful not to spill any liquids gels or moist substances on the keyboard panel Figure 14 1 The keyboard panel with holders for transducers and scanning gel WARNING Users of this equipment have an obligation and responsibility to provide the highest possible degree of infection control to patients co workers and themselves To avoid cross contamination follow all infecti...

Page 202: ...tap water at a maximum temperature of 40 C 104 F using a brush if necessary Keep the bioburden1 at a minimum Caution Keep all plugs and sockets absolutely dry at all times Transducers and Puncture Attachments Please refer to the General Transducer Information BB0555 manual for instructions for cleaning transducers and puncture attachments Disinfection For disinfecting ultrasound equipment B K Medi...

Page 203: ... destroyed Figure 14 2 The PCU plug with water tight cover removed and screwed tightly on STERRAD After the PCU has been cleaned as described on page 202 it can be processed using the STERRAD System Caution The watertight PCU plug cover MUST NOT be screwed on while the PCU undergoes the STERRAD process Caution After each processing you must check the PCU for surface pits and cracks STERIS SYSTEM 1...

Page 204: ...tional Mover UA0550 After you use the Endocavity Rotational Mover ECRM wipe away any residual ultrasound gel with a clean damp cloth You can use a suitable disinfectant to clean the ECRM further Do not immerse or autoclave Pullback Mover UA0552 Please refer to the pullback mover operations manual for instructions for disinfecting the Pullback Mover WARNING When using ethylene oxide always follow t...

Page 205: ...e program All the equipment necessary for carrying out preventive maintenance can be obtained from B K Medical Palm Control Unit Maintenance The PCU should be checked by a B K Medical service representative after every 150 times of disinfection by immersion Area Action taken Users Comments and Corrections Correct faults observed by the users Modifications to the System In accordance with Service I...

Page 206: ...rix Monitor the needle tip echo and measure the deviation from the matrix point shown on the monitor 7 Decide whether the accuracy is acceptable 8 If the accuracy is not acceptable contact your local B K Medical service center Disposing of the Scanner When the scanner is scrapped at the end of its life national rules for the various materials in each individual country must be followed The scanner...

Page 207: ...5 A13 1996 Medical electrical equipment Part 1 General requirements for safety 3 UL 2601 1 2003 Medical Electrical Equipment Part 1 General Requirements for safety 4 CSA C22 2 No 601 1 M90 2001 Medical Electrical Equipment Part 1 General Require ments for safety ...

Page 208: ...208 Chapter 14 ...

Page 209: ...Part 5 Pro Packages ...

Page 210: ......

Page 211: ...ith the Image Abbreviations used in measurements and calculations are defined in the Glossary starting on page 315 The information in this chapter may not correspond to the Pro Package on your scanner because Pro Packages can be customized See Chapter 13 Setting Up and Customizing Your System Transducers and Diagnostic Setups This Pro Package supports the following B K Medical transducer types and...

Page 212: ...urements For detailed instructions for using the measuring tools see Measurements and Calculations starting on page 87 Transducer Diagnostic Setup 8661 5 0MHz Vaginal 6 5MHz Vaginal 7 5MHz Vaginal 8662 Neuro 1 Neuro 2 Pediatric 8667 6 0MHz Prostate 8 0MHz Prostate 10 0MHz Prostate 8801 Abd pen Abd persist Abd res Bladder Kidney Sonovue 8802 Abd pen Abd persist Abd res Bladder Kidney 8803 Abd pen A...

Page 213: ...e you want it or draw with the drawing tool If another marker is needed it appears after you position the previous one 3 Continue to position all needed markers After you have positioned all the markers the result appears to the left of the image at the bottom B Mode Measurements Table 15 2 B mode measurements in the General Pro Package Measurement Description Measuring Tool Distance 2 markers Ang...

Page 214: ...osition of marker 1 or 2 1 marker for each V1 V2 2 markers for V1 and V2 dV Velocity difference 2 markers for V1 and V2 dT Time difference 2 markers ACC Acceleration velocity 2 markers for V1 and V2 TAM Time Average Mean 2 markers or freehand curve VF Area Volume Flow Area VF Dist VF Circle VF Ellipse Distance Circle Ellipse VF Volume Flow Distance or area measuring tool for VF Area and drawing fo...

Page 215: ...city PS ED Measure PS then ED Stenosis ST Dist 1 Transverse diameter of the vessel lumen before the stenosis Distance ST Dist 2 Transverse diameter of the lumen at the stenotic part of the vessel When you measure this after measuring ST Dist 1 stenosis is calculated formula on page 259 Distance ST Area 1 Area of vessel lumen before the stenosis Used to calculate stenosis Ellipse or freehand ST Are...

Page 216: ...Doppler angle is active or not WARNING Drawings of Doppler curves manual and automatic are meant as tools for positioning cursors so that measurements based on the curves can be calculated automatically The General Pro Package contains no facilities for checking whether the automatic measurements are reasonable Curves drawn on very noisy spectra may lead to misplacement of measurement cursors Make...

Page 217: ... use areas to calculate stenosis make one area measurement to measure each of the following total lumen of the vessel residual lumen of the vessel The result on the screen is continuously updated while you position the second ellipse or drawing VF Volume Flow VF Volume flow is calculated by multiplying the time average mean velocity TAM by a defined cross section of a vascular structure The cross ...

Page 218: ...ing TAM on the Doppler spectrum To measure TAM on an automatically drawn curve 1 Click Auto then make sure that TAM is selected 2 Position 2 line markers to specify the time interval over which the frequency values are averaged See Fig 15 2 The TAM value is displayed to the left of the image You can also draw a Doppler curve manually on the spectrum and use it to measure TAM NOTE Make sure that th...

Page 219: ... the ratio between PS Vps and ED Ved The advantage of using indices rather than absolute velocities is that the indices are independent of the insonation angle Table 15 5 Formulas for the main Doppler indices The correct placement of markers for measuring RI and PI is indicated in Fig 15 1 Mean in the Pulsatility index formula is the averaged max flow velocity RI Resistance Index To calculate RI a...

Page 220: ...race appears to be a good fit to the spectrum so that the basis for the automatic calculation is correct Manual To measure PI manually 1 Click PI 2 Position the marker on the start systolic SS frequency and click 3 Draw a curve that traces a line along the whole maximum spectrum through the peak systolic PS frequency the minimum diastolic MD and onto the end diastolic ED frequency 4 Click The PI m...

Page 221: ...ou want are selected 3 Unfreeze the image NOTE If you freeze the image when real time measurements are selected the real time results are also frozen NOTE When real time measurements are turned on automatic curve tracing is also turned on Make sure that the trace appears to be a good fit to the spectrum so that the basis for the real time calculation is correct Noise Limit You can reduce the noise...

Page 222: ...velocity is measured at the peak systolic point of the cardiac cycle End diastolic velocity determined at the point of maximum stenosis The end diastolic velocity is measured at the end point of the cardiac cycle Calculations Calculation Formulas The system uses the following formulas to calculate various values For a definition of variables used in the formulas see Table 15 7 ...

Page 223: ...ean A B Ratio Stuart Index Pulsatility Index PI Heart Rate HR per minute Stenosis Distance Stenosis Area Volume Flow dF F t2 F t1 dV V t2 V t1 Facc Fmax t2 Fmax t1 t2 t1 Acc Vmax t2 Vmax t1 t2 t1 RI Fmax tPS Fmax tED Fmax tPS TAM t d Vmean t t t1 t2 t2 t1 A B Fmax tPS Fmax tED PI tED tSS Fmax tPS Fmax tMD dt Fmax t t tSS tED HR Number of Cycles 60 tED tSS Stenosis dist D1 D2 D1 100 Stenosis area A...

Page 224: ...the Doppler spectrum Variable Definition Fmax maximum frequency at a particular time tSS time of start of the systole tPS time of peak systole tMD time of minimum diastole tED time of end diastole t1 t2 2 points in time t2 t1 time difference between 2 measured points dt time between spectral lines A area of the vessel A1 D1 transverse area diameter of the vessel lumen before the stenosis A2 D2 tra...

Page 225: ...d to that introduced by the other factors listed above Therefore it is not taken into consideration Noise reduction Selecting too high a noise reduction level introduces an unnecessary error part of the spectrum itself is removed along with the noise The amount of this error depends on the shape of the spectrum Curve definition and Doppler spectrum The generation of automatic curves includes a smo...

Page 226: ... RImin RI where RImax 1 025 Fmax tPS 0 975 Fmax tED 1 025 Fmax tPS and RImin 0 975 Fmax tPS 1 025 Fmax tED 0 975 Fmax tPS Example Fmax tPS 10 Fmax tED A RI 1 and Fmax tPS 2 Fmax tED A RI 10 A PI A Fmax tPS Fmax tMD A Fmax t t tSS tED Assuming Fmax tPS Fmax tMD Provides A Fmax tPS Fmax tMD A Fmax 5 A PI A Fmax A Fmax t t tSS tED 10 A A B A B A 2 A Fmax 10 A HR A time ...

Page 227: ...tails about placing measurement markers for Doppler measurements see Doppler Spectra starting on page 252 Abbreviations used in measurements and calculations are defined in the Glossary starting on page 315 The information in this chapter may not correspond to the Pro Package on your scanner because Pro Packages can be customized See Chapter 13 Setting Up and Customizing Your System Transducers an...

Page 228: ...logs are also available when using the Urology Pro Package See Labelling Parts of the Image on page 75 for information about using labels and Using Bodymarks on page 78 for information about using bodymarks Reports For information about Urology reports see Reports on page 114 Transducer Diagnostic Setups 8551 10 0MHz Prostate 8 6MHz Prostate 7 5MHz Prostate 6 0 MHz Prostate 8658 7 5MHz Prostate 6 ...

Page 229: ...of the measurements are contained in submenus If there is a triangle following the name of the measurement click the triangle to see the various options for making that measurement Click the option you want A small green light appears to the left of the currently selected measurement in the list The appropriate measuring marker or tool appears on the image 2 Position the marker where you want it o...

Page 230: ...te Volume Height H Height Distance Width W Width Distance Length L Length Distance Ellipse Pr Vol Prostate Volume Ellipse Planimetry Freehand Pr Vol Prostate Volume Freehand drawing Planimetry Ellipse Pr Vol Prostate Volume Ellipse PSAD Pr Vol Prostate Volume PSAD Volume measurement and type PSA value Adenoma Volume Height H Height Distance Width W Width Distance Length L Length Distance Ellipse A...

Page 231: ...pse Kd Vol Kidney Volume Ellipse Bladder Volume Height H Height Distance Width W Width Distance Length L Length Distance Ellipse Bl Vol Bladder Volume Ellipse T area Freehand T area Transverse Area Freehand drawing T area Ellipse T area Transverse Area Ellipse L area Freehand L area Longitudinal Area Freehand drawing L area Ellipse L area Longitudinal Area Ellipse Empiric Volume Bl Vol Bladder Vol...

Page 232: ...f marker 1 or 2 1 marker for each F1 F2 Index 2 markers for F1 and F2 dF Frequency difference 2 markers for F1 and F2 dT Time difference 2 markers General angle correction on V1 V2 Velocity at position of marker 1 or 2 1 marker for each V1 V2 Index 2 markers for V1 and V2 dV Velocity difference 2 markers for V1 and V2 dT Time difference 2 markers TAM Time Average Mean 2 markers or freehand curve V...

Page 233: ...ges for HWL calculations To make a measurement in the other part of a split screen Press C or Move the cursor to the other screen and click Planimetry For this method you record a number of parallel B mode images that cover the organ to be measured On each image you draw a curve that traces the outline of the structure Thus you create a set of parallel section measurements of the structure These p...

Page 234: ...gan volume The planimetry method is only available for the prostate and adenoma To make a planimetry calculation 1 Record a B mode image at one end of the organ 2 Advance the transducer one step 3 Freeze the image 4 Click Planimetry Ellipse or Planimetry Freehand and draw an ellipse or freehand drawing to outline the organ 5 Repeat 2 through 4 until you have covered the entire organ The Volume is ...

Page 235: ...the prostate and type in a value for the PSA Prostate Specific Antigen The PSA is divided by the volume to give the PSAD This method is discussed in an article by Benson et al 3 in which the method was used in a study of over 500 patients To calculate PSAD 1 Click PSAD in the Prostate Volume measurement submenu If you have not entered the PSA value in the Patient window you are prompted to enter i...

Page 236: ...is HWL Factor 0 523 Kidney HWL Factor 0 523 Bladder HWL Factor 0 570 The factor for kidney testis prostate and adenoma implies that the organs have a true ellipsoid shape For the bladder the factor 0 57 is found to be more precise 4 Planimetry PA Area of the recorded parallel section Stepsize Distance between parallel sections default step size is 5mm i Step number Volume 1 3 PA i PA i 1 PA i PA i...

Page 237: ...lculation methods In the table A accuracy Table 16 8 Accuracy of urology calculation methods References 1 Littrup PJ Williams CR Egglin TK Kane RA Determination of prostate volume with tran srectal US for cancer screening Part II Accuracy of in vitro and in vivo techniques Radi ology 179 49 53 1991 Calculation Accuracy Assumptions HWL A A H A W A L 3 x A B mode distance Formula used to calculate v...

Page 238: ... 1982 3 Benson MC Whang IS Olsson CA McMahon DJ Cooner WH The use of prostate spe cific antigen density to enhance the predictive value of intermediate levels of serum prostate specific antigen The Journal of Urology Vol 147 817 821 March 1992 4 Brunn J Ruf G Sonografische Zystometrie Deutsche Med 105 1507 1503 1980 ...

Page 239: ...er because Pro Packages can be customized See Chapter 13 Setting Up and Customizing Your System Palm Control Unit If you are using this Pro Package with the optional Palm Control Unit see Using the PCU Palm Control Unit on page 45 and Palm Control Unit PCU on page 70 for details of how to use the PCU Surgical Rack If you using this Pro Package with the Rack Docking System see Connecting to a Surgi...

Page 240: ...ge 78 for information about using bodymarks Reports For information about Surgical reports see Reports on page 114 Measurements For detailed instructions for using the measuring tools see Measurements and Calculations starting on page 87 To make a measurement 1 Click its name under Measurements to the right of the image Some of the measurements are contained in submenus Transducer Diagnostic Setup...

Page 241: ... to position all needed markers After you have positioned all the markers the result appears to the left of the image at the bottom B Mode Measurements Table 17 2 B mode measurements in the Surgery Pro Package Doppler Mode Measurements Table 17 3 Doppler mode measurements in the Surgery Pro Package Measurement Description Measuring Tool Distance 2 markers Ellipse Ellipse Freehand Freehand drawing ...

Page 242: ...bels and Bodymarks For more information about using labels and body marks in this Pro Package see Working with the Image on page 73 Measurement Description Measuring Tool PS Peak Systolic velocity ED End Diastolic velocity MD Minimum Diastolic velocity PI Pulsatility Index RI Resistance Index HR Heart Rate Beats per minute TAM Time Average Mean cm per second TAMX Time Average Maximum cm per second...

Page 243: ...ed in the Glossary starting on page 315 The information in this chapter may not correspond to the Pro Package on your scanner because Pro Packages can be customized See Chapter 13 Setting Up and Customizing Your System Transducers and Diagnostic Setups This Pro Package supports the following B K Medical transducer types and Diagnostic Setups For each transducer the factory default Diagnostic Setup...

Page 244: ...ly See Entering Dates on page 39 Labels and Bodymarks This Pro Package contains a catalog of labels and bodymarks designed for OB Gyn applications Labels and bodymarks from other catalogs are also available when using the OB Gyn Pro Package See Labelling Parts of the Image on page 75 for information about using labels and Using Bodymarks on page 78 for information about using bodymarks Making Meas...

Page 245: ...rker is needed it appears after you position the previous one 3 Continue to position all needed markers After you have positioned all the markers the result appears to the left of the image at the bottom Measurement out of range If the result of a measurement is outside the allowed range of values this is indicated on the screen If this happens you may have made a mistake in your measurement or yo...

Page 246: ...uires FL Distance FL Femur Length Campbell DSOG DSOG BPD FL Hadlock Hansmann Persson Tokyo GA EDC this one requires BPD Distance AC Abdominal Circumference Campbell Hadlock Jeanty FW GA EDC Ellipse freehand polygon or circle AD Abdominal Diameter Persson AC Persson APD ATD GA EDC also MAD APD ATD 2 Ellipse requires ellipse tool to be selected for AC measurement method 2 distances CI Cephalic Index...

Page 247: ... default calculation method is always displayed when the parameters necessary to calculate it have been measured Campbell AC DSOG BPD AD DSOG BPD AD FL Eik Nes BPD ATD Hadlock AC FL Hadlock AC FL BPD Hansmann BPD TT Persson BPD AD Persson BPD AD FL Shepard AC BPD Warsof AC BPD BPD ATD APD MAD GA EDC BPD ATD APD MAD FL GA EDC BPD ATD BPD TT GA EDC BPD ATD APD MAD GA EDC BPD ATD APD MAD FL GA EDC 3 ...

Page 248: ...ax Transverse Diameter Hansmann GA EDC 1 distance THAP Thorax Anteroposterior Diameter Hansmann GA EDC 1 distance HC Head Circumference Campbell Hansmann Hadlock GA EDC Ellipse freehand polygon circle or BPD OFD 2 distances VL Vertebrae Length Tokyo GA EDC 1 distance FBL Fibula Length Hobbins GA EDC 1 distance TBL Tibia Length Hobbins GA EDC 1 distance PL Foot Length Hobbins GA EDC 1 distance FL A...

Page 249: ... methods Table 18 4 Other Obstetrics measurements in the OB Gyn Pro Package APD Abdominal Anteroposterior Diameter GA EDC MAD requires ATD 1 distance GS Gestational Sac Diameter GS average Measure 1 distance 2 distances or 3 distances For 3 click 1 2 and then 3 GS Gestational Sac Diameter Hansmann Hellman Tokyo GA EDC up to 3 distances Measurement continued Method continued Other Results Displayed...

Page 250: ...tance measure several and get average Uterine Height Ut H Distance Uterine Width Ut W Distance Uterine Length Ut L Volume Ut Vol if measure H W and L Distance Right Ovary Height ROH Distance Right Ovary Width ROW Distance Right Ovary Length ROL Volume RO Vol if measure H W and L Distance Left Ovary Height LOH Distance Left Ovary Width LOW Distance Left Ovary Length LOL Volume LO Vol if measure H W...

Page 251: ...tetrics report you can delete some measurements If you delete a measurement in a report an average that uses it is recalculated in the report To delete a measurement from a report 1 Point at the measurement result in the Measurements column If the measurement is one that can be deleted the measurement value is highlighted in red and crossed out 2 Click The measurement is removed from the report Cu...

Page 252: ...Campbell Gestational age GA calculated from biparietal diameter BPD Campbell GA from CRL Table 18 8 Campbell Gestational age GA calculated from crown rump length CRL BPD mm GA Days BPD mm GA Days BPD mm GA Days 20 88 50 143 80 215 25 94 55 154 85 232 30 102 60 165 90 253 35 111 65 177 95 280 40 121 70 188 45 132 75 201 CRL mm GA Days CRL mm GA Days CRL mm GA Days 10 49 37 73 64 89 13 52 40 75 67 9...

Page 253: ...circumference AC FL mm GA Days FL mm GA Days FL mm GA Days 10 89 35 148 60 220 15 101 40 161 65 238 20 112 45 175 70 259 25 123 50 189 75 287 30 135 55 204 HC mm GA Days HC mm GA Days HC mm GA Days 100 96 201 158 300 225 125 112 225 172 325 252 150 127 250 187 350 288 175 143 275 204 AC mm GA Days AC mm GA Days AC mm GA Days 84 100 180 159 280 224 96 107 192 167 292 232 108 114 208 177 304 240 120...

Page 254: ...tal weight FW calculated from abdominal circumference AC AC mm FW g AC mm FW g AC mm FW g 210 899 280 2081 350 3472 220 1032 290 2283 360 3639 230 1179 300 2489 370 3789 240 1339 310 2695 380 3918 250 1510 320 2899 390 4023 260 1692 330 3098 270 1883 340 3290 ...

Page 255: ... biparietal diameter 20 31 mm DSOG BPD FL DSOG GA from BPD and FL Used for fetal age 15 22 weeks with biparietal diameter 32 50 mm and FL DSOG FL DSOG GA from FL DSOG FW BPD AD DSOG FW from BPD and AD DSOG FW BPD AD FL DSOG FW from BPD AD and FL GA 35 72 1 082 CRL 0 5 1 472 CRL 0 09749 CRL 1 5 GA BPD 2 1 39 1 GA BPD 1 21 FL 1 02 49 0 GA FL 2 46 58 7 FW BPD 1 321 AD 1 833 10 2 830 FW BPD 0 972 AD 1...

Page 256: ...Eik Nes FW from ATP and BPD Fetal Weight using ATD and BPD measured in mm BPD mm GA Weeks BPD mm GA Weeks BPD mm GA Weeks 35 15 64 24 89 33 37 5 16 67 25 91 34 40 5 17 70 5 26 93 35 43 5 18 73 5 27 95 36 46 5 19 76 5 28 96 5 37 50 20 79 5 29 97 5 38 53 5 21 82 30 99 39 57 5 22 84 5 31 100 40 61 23 87 32 FW 1 43149 0 001 BPD1 85628 ATD1 34008 ...

Page 257: ...from crown rump length CRL BPD mm GA Days BPD mm GA Days BPD mm GA Days 20 86 48 144 76 215 24 93 52 153 80 227 28 101 56 162 84 240 32 109 60 172 88 253 36 118 64 182 92 266 40 126 68 193 96 280 44 135 72 204 100 294 CRL mm GA Days CRL mm GA Days CRL mm GA Days 2 40 34 72 66 90 6 45 38 75 70 92 10 50 42 78 74 94 14 54 46 80 78 97 18 58 50 82 82 100 22 62 54 84 86 102 26 66 58 86 87 104 30 69 62 8...

Page 258: ... 14 98 41 161 62 223 17 105 44 169 64 230 20 111 46 174 66 237 24 120 49 183 68 245 27 127 51 189 70 252 30 134 54 198 72 260 33 141 56 204 74 268 35 146 58 210 75 272 38 153 60 217 77 280 HC mm GA Days HC mm GA Days HC mm GA Days 97 99 213 162 301 224 110 104 224 168 308 231 124 111 235 175 315 239 138 119 246 182 322 246 151 126 256 188 328 253 164 133 266 195 333 260 177 141 275 202 338 267 189...

Page 259: ...rom BPD AC and FL Fetal Weight using BPD AC and FL measured in cm AC mm GA Days AC mm GA Days AC mm GA Days 73 99 185 160 281 225 86 105 197 168 291 232 99 112 208 175 300 239 112 119 219 182 309 245 125 126 230 189 318 252 137 132 240 196 327 259 150 140 251 203 336 266 162 147 261 210 344 272 174 154 271 217 353 279 FW log 1 3598 0 051 AC 0 1844 FL 0 0037 AC FL FW log 1 4787 0 003343 AC FL 0 001...

Page 260: ...al age GA calculated from femur length FL BPD mm GA Days BPD mm GA Days BPD mm GA Days 25 87 55 151 85 227 30 96 60 162 90 242 35 107 65 174 95 260 40 117 70 185 100 278 44 127 74 197 50 138 80 211 CRL mm GA Days CRL mm GA Days CRL mm GA Days 6 43 30 72 80 99 8 46 40 79 90 104 12 52 50 85 100 110 15 56 60 90 110 116 20 62 70 94 120 123 FL mm GA Days FL mm GA Days FL mm GA Days 10 90 35 147 60 218 ...

Page 261: ...ann Gestational age GA calculated from thorax transverse diameter TT GS mm GA Days GS mm GA Days GS mm GA Days 6 28 24 49 50 69 10 35 34 56 58 77 16 42 44 64 64 84 OFD mm GA Days OFD mm GA Days OFD mm GA Days 40 107 70 158 100 222 45 114 75 167 105 238 50 122 80 176 110 258 55 131 85 185 115 281 60 141 90 196 65 150 95 208 TT mm GA Days TT mm GA Days TT mm GA Days 25 92 55 163 85 234 30 102 60 175...

Page 262: ...from BPD and OFD Fetal Weight calculated from BPD and TT measured in cm THAP mm GA Days THAP mm GA Days THAP mm GA Days 25 96 55 168 85 238 30 108 60 180 90 251 35 120 65 192 95 268 40 132 70 204 99 286 45 144 75 215 50 156 80 226 HC mm GA Days HC mm GA Days HC mm GA Days 140 116 220 161 300 209 150 121 230 167 310 218 160 126 240 172 320 229 170 132 250 177 330 242 180 138 260 183 340 257 190 144...

Page 263: ...n Gestational age GA calculated from the size of the gestational sac GS GS mm GA Days GS mm GA Days GS mm GA Days 10 35 28 53 46 71 12 37 30 55 48 73 14 39 32 57 50 75 16 41 34 59 52 77 18 43 36 61 54 79 20 45 38 63 56 81 22 47 40 65 58 83 24 49 42 67 60 85 26 51 44 69 ...

Page 264: ...A calculated from crown rump length CRL BPD mm GA Days BPD mm GA Days BPD mm GA Days 25 94 50 143 75 206 30 103 55 154 80 220 35 112 60 166 85 235 40 122 65 179 90 251 45 132 70 192 95 267 CRL mm GA Days CRL mm GA Days CRL mm GA Days 5 44 23 64 41 77 7 47 25 66 43 78 9 50 27 67 45 79 11 52 29 69 47 81 13 55 31 70 49 82 15 57 33 72 51 83 17 59 34 73 54 85 19 61 37 74 21 62 39 76 ...

Page 265: ...ys FBL mm GA Days 8 89 35 161 54 232 11 96 37 167 55 237 14 103 39 174 57 246 17 110 40 179 58 252 19 115 42 186 59 257 22 122 45 195 60 262 25 131 47 202 61 268 27 136 49 210 62 273 30 145 51 219 63 279 32 151 52 223 PL mm GA Days PL mm GA Days PL mm GA Days 7 77 34 142 61 218 10 88 37 149 64 227 13 97 40 156 67 236 16 105 43 164 70 244 19 112 46 172 73 253 22 118 49 181 76 261 25 124 52 190 79 2...

Page 266: ...calculated from tibia length TBL TBL mm GA Days TBL mm GA Days TBL mm GA Days 7 84 32 153 54 226 10 92 35 162 55 230 12 98 37 167 57 239 14 105 40 176 58 244 17 111 42 182 60 253 20 120 44 189 61 258 22 125 46 195 63 267 25 134 48 202 64 272 27 139 50 210 66 281 30 148 52 218 ...

Page 267: ...Days BPD mm GA Days 28 98 52 146 76 206 30 102 54 151 78 212 32 106 56 155 80 218 34 109 58 160 82 224 36 113 60 164 84 231 38 117 62 169 86 237 40 121 64 174 88 244 42 125 66 179 90 250 44 129 68 185 92 257 46 133 70 190 95 268 48 137 72 195 50 142 74 201 CRL mm GA Days CRL mm GA Days CRL mm GA Days 5 44 23 64 41 77 7 47 25 66 43 78 9 50 27 67 45 79 11 52 29 69 47 81 13 55 31 70 49 82 15 57 33 71...

Page 268: ...dominal circumference AC AC mm GA Days AC mm GA Days AC mm GA Days 57 84 163 154 262 223 67 91 173 161 271 231 77 98 184 168 279 238 88 105 195 175 286 245 98 112 205 182 293 252 109 119 215 189 300 260 119 126 225 196 306 267 130 133 235 203 311 273 141 140 244 210 316 280 152 147 254 217 ...

Page 269: ...age GA calculated from biparietal diameter BPD BPD mm GA Days BPD mm GA Days BPD mm GA Days 27 98 57 161 81 224 31 106 60 168 83 231 34 111 63 175 85 237 38 119 66 182 87 245 41 125 69 190 89 252 45 134 71 195 91 261 48 140 74 203 92 265 51 147 76 209 94 274 54 154 79 218 95 279 ...

Page 270: ...rsson FW from BPD and AD Persson FW from BPD AD FL CRL mm GA Days CRL mm GA Days CRL mm GA Days 10 54 40 76 64 90 15 58 45 80 68 92 25 66 50 83 72 94 30 69 56 86 76 96 35 73 60 88 80 98 GA 2 405 BPD 0 015 BPD 2 0 000165 BPD 3 40 1 GA 6 95 FL 0 202 FL 2 0 00337 FL 3 0 0000181 FL 4 30 7 FW BPD 1 3211 AD 1 8327 10 2 8299 FW BPD 0 9721 AD 1 7430 FL 0 3668 10 2 6465 ...

Page 271: ...9 39 121 64 171 89 221 40 123 65 173 90 223 41 125 66 175 92 228 42 127 67 177 93 230 43 129 68 179 94 232 44 131 69 181 96 237 45 133 70 183 97 239 46 135 71 185 98 241 47 137 72 187 100 246 48 139 73 189 101 248 49 141 74 191 103 253 50 143 75 193 104 255 51 145 76 195 105 257 52 147 77 197 106 260 53 149 78 199 107 262 54 151 79 201 109 267 55 153 80 203 110 270 56 155 81 205 111 273 57 157 82 ...

Page 272: ...Weight using BPD and AC measured in cm Shepard FW from BPD and AC BPD mm GA Days BPD mm GA Days BPD mm GA Days 20 85 48 143 76 216 24 93 52 153 80 228 28 101 56 162 84 240 32 109 60 172 88 253 36 118 64 182 92 266 40 126 68 193 96 280 44 135 72 204 CRL mm GA Days CRL mm GA Days CRL mm GA Days 4 42 32 71 60 88 8 48 36 74 64 90 12 53 40 76 68 92 16 58 44 79 72 94 20 61 48 81 76 96 24 65 52 84 80 98 ...

Page 273: ...l diameter BPD Tokyo GA from CRL Table 18 42 Tokyo Gestational age GA calculated from crown rump length CRL BPD mm GA Days BPD mm GA Days BPD mm GA Days 20 84 53 153 79 222 24 91 56 161 82 232 27 98 59 168 84 240 31 105 62 176 85 244 34 112 65 184 87 254 38 120 67 189 88 259 41 127 70 197 89 266 44 133 72 202 90 272 47 139 75 210 50 146 77 216 CRL mm GA Days CRL mm GA Days CRL mm GA Days 15 56 46 ...

Page 274: ...in cm Warsof FW from BPD and AC FL mm GA Days FL mm GA Days FL mm GA Days 31 140 48 189 62 237 33 147 50 195 64 246 35 154 52 201 65 250 38 162 55 211 67 261 40 167 57 218 68 266 43 175 59 225 69 273 46 183 60 229 70 280 GS mm GA Days GS mm GA Days GS mm GA Days 10 28 27 48 48 70 16 35 34 56 57 77 22 42 41 63 67 84 VL mm GA Days VL mm GA Days VL mm GA Days 37 148 59 196 75 246 40 153 62 203 77 255...

Page 275: ...ting point values are used to calculate FW and GA Thus rounding errors in calculations are negligible compared to the other error sources NOTE It is the responsibility of the physician to evaluate accuracies in each specific patient case References 1 Data from Prof Campbell s Dept Kings College Hospital London SE5 2 DSOG Danish Society of Obstetrics and Gynaecology Biometriguidelines http www dsog...

Page 276: ...iversity Journal of Fetal Growth Japan 1988 37 1140 45 20 Persson PH Obstetrisk Ultralyd 36 92 93 1997 Swedish Working Group in Gynecology ULTRAARG 21 Robinson H Flemming J British Journal of Obstetrics and Gynaecology 1975 82 702 22 Shepard MJ et al American Journal of Obstetrics and Gynecology 1982 147 47 54 23 Shinozuka N et al Jpn J Med Ultrasonics 1996 23 12 877 888 24 Warsof et al American J...

Page 277: ...rticularly Chapter 4 Working with the Image and Chapter 11 Doppler Mode Spectral Doppler Abbreviations used in measurements and calculations are defined in the Glossary starting on page 315 The information in this chapter may not correspond to the Pro Package on your scanner because Pro Packages can be customized See Chapter 13 Setting Up and Customizing Your System Transducers and Diagnostic Setu...

Page 278: ...ng bodymarks Reports For information about Cardiac reports see Reports on page 114 Cine Image Review Cine image review lets you review a series of the most recently recorded images in this Pro Package For information about how to review or make measurements from a cine image see Cine on page 80 Making Measurements For detailed instructions for using the measuring tools see Measurements and Calcula...

Page 279: ... to the left of the currently selected measurement in the list The appropriate measuring marker or tool appears on the image 2 Position the marker where you want it or draw with the drawing tool If another marker is needed it appears after you position the previous one 3 Continue to position all required markers After you have positioned all the markers the result appears to the left of the image ...

Page 280: ...dex LV IVSd Interventricular Septal Thickness diastole 2 markers LVDd Left Ventricular Internal Diameter diastole 2 markers LVPWd Left Ventricle Posterior Wall Thickness diastole 2 markers IVSs Interventricular Septal Thickness systole 2 markers LVDs Left Ventricle Internal systole 2 markers LVPWs Left Ventricle Posterior Wall Thickness systole 2 markers Aortic Valve B AO diameter d Aortic Root Di...

Page 281: ...ents are in cm s if it is turned off the measurements are in kHz For information about the Doppler correction angle and how to change it see Angle Correction on page 156 LVOT diameter s Left Ventricular Outflow Tract Diameter systole 2 markers RVOT diameter s Right Ventricular Outflow Tract Diameter systole 2 markers Measurement Description continued Measuring Tool ...

Page 282: ...ime 2 vertical lines ET Ejection Time 2 vertical lines Aortic Valve D PFV AV Aortic Valve Peak Flow Velocity 1 marker VTI AV Aortic Valve Velocity Time Integral Freehand ET Ejection Time 2 vertical lines PFV LVOT Left Ventricle Outflow Tract Peak Flow Velocity 1 marker VTI LVOT Left Ventricle Outflow Tract Velocity Time Integral Freehand between two vertical lines LVOT diameter s Left Ventricle Ou...

Page 283: ...o Package RI PI PS Peak systolic velocity 1 marker ED End diastolic velocity 1 marker RI Resistance Index PS ED PS Measure PS then ED PS ED Peak Systolic Velocity End Diastolic Velocity PS ED Measure PS then ED Auto PS ED RI PS ED Measurement Description continued Measuring Tool ...

Page 284: ...e 2 Markers LVPWd Left Ventricle Posterior Wall Thickness diastole 2 Markers RVDd Right Ventricle Internal Diameter diastole 2 Markers IVSs Interventricular Septal Thickness systole 2 Markers LVDs Left Ventricular Internal Diameter systole 2 Markers LVPWs Left Ventricle Posterior Wall Thickness systole 2 Markers RVDs Right Ventricle Internal Diameter systole 2 Markers HR 3 Heart Rate based on 3 cy...

Page 285: ... scanner see Fig 19 1 The ECG electrodes and electrode connector cable can be purchased from B K Medical For more information see Appendix C Specifications Figure 19 1 Connecting the ECG electrodes to the scanner WARNING Do not use the ECG module UA2203 for diagnostic or monitoring purposes It is intended for correlation of heart cycle to ultrasound imaging only WARNING Not for direct cardiac appl...

Page 286: ...it takes for the ECG curve to sweep from left to right across the image To adjust sweep speed Click Sweep on the right side of the screen and drag to select the required speed The available values range from 2 seconds to 8 seconds ECG Size You can change the size of the displayed ECG curve To adjust ECG size Click Size on the right side of the screen and drag to select the required size The availa...

Page 287: ...art Rate and drag to select the required number of cycles Refractory Time Refractory time sets the period following the R peak in which no new R peak is acknowledged This can be used to discriminate the R peak from the S peak in difficult situations To adjust refractory time Click Hold on the right side of the screen and drag to the required value The available values range from 0 to 2000 ms in st...

Page 288: ...288 Chapter 19 ...

Page 289: ...age 196 Password Protection If your patient archiving system is password protected see Password Protection of the Database on page 115 you cannot use the 3D system unless you are logged in Emergency In an emergency you can put the scanner into an Emergency state and acquire 3D data sets but you cannot save them with any patient ID other than EmergencyID See Emergency State on page 116 Scanning Mod...

Page 290: ... the pullback mover for the 1850 and 8808 transducers the endocavity rotational mover ECRM for the 8658 biplane transducer Anorectal Transducer 2050 The 2050 transducer has a built in mover for 3D acquisition For information about setting up and attaching the 2050 transducer see the 2050 transducer user guide The Pullback Mover The pullback mover UA0552 is designed for use with the 1850 and 8808 t...

Page 291: ...adle to the mover 1 Use the 2 alignment pins to attach the cradle to the mover 2 Tighten the captured screw to hold the cradle and mover firmly together Figure 20 3 Attaching the cradle to the mover To detach the cradle from the mover Turn the screw counterclockwise until the 2 components separate The transducer should fit tightly into the cradle see Fig 20 5 To mount the transducer 1 Slide the 86...

Page 292: ...low full and smooth rotation Hold the cable with your left hand while you support the ECRM with your right hand As the ECRM rotates collecting data the cable wraps around the ECRM handle Connecting to the scanner To connect the ECRM to the scanner Plug it into the mover socket on the scanner front See Fig 2 5 on page 41 Operating the ECRM Two of the buttons on the ECRM handle are used to control 3...

Page 293: ...res To make a 3D scan 1 Check all the connections 2 Connect the relevant mover if needed 3 Choose the Diagnostic Setup you want 4 Optimize the 2D image 5 Turn on 3D If you have not entered a Patient ID the Patient window opens 6 Set the image capture settings that you want 7 Adjust the ROI markers to include the area of interest to be scanned Once you have defined the image capture settings you ca...

Page 294: ...en To turn on 3D Press a or Click You can also use set up a user defined key or foot pedal switch to start 3D See User Defined Keys on page 169 If you have not entered a valid patient ID you will be prompted to do so NOTE You cannot acquire 3D data sets unless you have entered a patient ID The default patient ID is NoID To turn off 3D Press long a or the user defined 3D key or Click long Setting U...

Page 295: ...3D data set Table 20 1 3D image capture settings 3D Image Capture Settings Description Mover Mover type Extent Extent of the scan Spacing Spacing between frames of the 3D acquisition Direction Scanning direction See below Rest Position This sets the rest position of the transducer when you are using the ECRM See page 296 Time Time required for the acquisition You cannot change this directly Frames...

Page 296: ...ll Click to release the cursor when the box is where you want it Resizing the ROI box To resize the box increase or decrease the area covered by the 3D acquisition press when the box is selected Rest Position Position scanning plane here on the anatomy of interest before you start to acquire a 3D data set Action of the transducer and ECRM Mid default Middle of anatomical object Move quickly to Sta...

Page 297: ...that will appear after you have acquired the 3D data set To the right of View under 3D on the right side of the screen is the view that will appear If you want a different view click the triangle to the right to select from a list Figure 20 10 3D data set views If you click 3D Setup no 3D view automatically appears after the data set is acquired Saving 3D Settings When you finish setting up the 3D...

Page 298: ...a 3D Acquisition Starting 3D acquisition To start the 3D acquisition Press a or Click or Acquire or Press a user defined key A progress bar appears Figure 20 12 The 3D Acquisition window with progress bar NOTE During 3D acquisition most keys and on screen controls are disabled You can use only the FREEZE function screen or control panel and a or i on the control panel Aborting 3D acquisition To ab...

Page 299: ... the image Figure 20 13 Viewing a 3D volume Viewing a 3D Data Set There are 6 different ways you can view the 3D data set They are described later in this chapter Cube see page 304 Render see page 307 MIP Maximum Intensity Projection see page 309 Transparency see page 310 4 Up see page 311 6 Up see page 312 Before you acquire the 3D data set you can select the view that appears when acquisition is...

Page 300: ...left side of the screen under 3D View The current view is indicated by a little green light To change the view click the one you want NOTE Scanning is frozen when any view of the 3D volume is displayed Enhancing a 3D View When a 3D view is displayed you can use various options under Settings on the left side of the screen to enhance the appearance of the 3D volume and make it easier to see the str...

Page 301: ...n what you are doing Rotating To rotate a volume in any direction 1 Point outside the volume The cursor looks like this 2 Hold the A key down while you drag the cursor and rotate the volume You can also rotate the intersecting planes view in the 4 Up and 6 Up views Moving a Plane In and Out of the Volume You can move a selected plane in and out of the volume to slice the volume so that a plane ins...

Page 302: ...s red 2 Hold the A key down while you drag the cursor to tilt the cut plane You can then move the tilted cut plane in and out slice as described before Moving the Volume To move the volume 1 Move the cursor so that it is inside the volume 2 Hold down the Shift key on the keyboard and the A key on the control panel The cursor looks like a hand 3 Drag the volume to the position you want while holdin...

Page 303: ...dit the label only delete it You can add additional labels 5 When you have added all the labels you want click Label again 6 A window appears for you to name the view with the annotation You can update the current view to include the annotation or you can give it a new name Arrow To add an arrow to a 3D view 1 Click Arrow under Annotations on the right side of the screen or press F10 The cursor ap...

Page 304: ...nnotations are saved in a User View A User View is specific to a 3D volume Table 20 4 Options under User Views Cube View This is a texture mapped representation of the volume It is the default view Figure 20 14 The 3D Cube View window User Views New Name the current settings to have them saved as a named user view You are prompted for a name Update Click this if you want to update the current user...

Page 305: ...n the points of the measurement See Table 20 5 When you click or double click in the case of a polygon the final point for the measurement a number appears next to the lines you have drawn The number is used to label the measurement results The results appear under Measurements on the left side of the screen Table 20 5 Measurements on a 3D data set Measurement Type What to Do Result Distance Click...

Page 306: ...will not restore measurements that were deleted with Clear All Measuring Volumes You measure a volume by drawing polygons around the area of interest on slices taken throughout the Cube The method for drawing polygons is not the same as for 2D images To make a volume measurement on a 3D Cube 1 Click Volume under Measurements on the right side of the screen 2 Click Step Size and set the distance be...

Page 307: ... volume so you can better see the areas of interest See page 308 Figure 20 15 The 3D Render View WARNING Measurements obtained with the 3D system and used in diagnosis must be carefully and thoughtfully performed to ensure accurate quantitative assessment Before you perform a calculation make sure that all necessary calibrations and measurements are made If you suspect that the 3D system s calibra...

Page 308: ...culpting tools let you remove unwanted data from a Render view Sculpting tools can only be used on gray scale volumes when there is no color in the volume There are two sculpting tools the cutting tool which you can use to cut away the outside of the volume or to cut a hole inside the volume the shaving tool To use the sculpting tools 1 Click Remove under Sculpture on the right side of the screen ...

Page 309: ...ving tool 1 Click on one plane of the volume 2 Hold down A while you move the cursor over the area to be shaved The longer you hold A down the more surface is removed 3 Release A when you are finished Displaying Sculpture Results You can toggle between a view showing the result of sculpting and the unsculpted view Click Display Sculpture under Sculpture on the right side of the screen MIP View Max...

Page 310: ...endering which is only possible when you have acquired the 3D scan using Color or Power mode lets you adjust the relative transparencies of the color and the gray scale parts of the volume This can allow hidden features to become visible Figure 20 17 The 3D Transparency View window ...

Page 311: ... displayed Luminance Controls the brightness of structures within the volume Moving the slider to the left increases brightness Photorealistic Adjusts the photorealistic parameter used in the rendering This can only be used on gray scale volumes Color Level Moving the slider to the left makes the color information more transparent Gray Level Moving the slider to the left makes the gray scale infor...

Page 312: ...20 6 Up View In addition to the views in the 4 Up view this view contains a Cube view and a sixth view which is the view most recently displayed MIP Render Transparency or Cube Figure 20 19 The 3D 6 Up View window ...

Page 313: ...Part 6 Appendixes ...

Page 314: ......

Page 315: ...tection is not high enough compared to the flow speed The problem only exists with pulsed wave Doppler detection Ao Aorta AOD Aortic root diameter APD Abdominal anteroposterior diameter array transducer A transducer that consists of a set of transducer elements each capable of transmitting and receiving ultrasound ATD Abdominal transverse diameter AVD Aortic valve diameter B A ED PS bodymark A sma...

Page 316: ... in the color mapping relative measure for each sample volume in Color mode No color means either No flow in the sample volume very low flow speed or Amount of reflection from flowing material which might have a high flow speed is below threshold set by the Color mode gain The Color mode signal flow speed is dependent on the angle of the ultrasound beam relative to the flow direction combination m...

Page 317: ...nal age clinical GAu Gestational age by ultrasound graphical control An on screen control that is graphical unlike a softkey Graphical controls are located in the image area of the screen Examples are the zoom box color box focus indicator Doppler gate GS Gestational sac diameter HC Head circumference HIPAA Health Insurance Portability and Accountability Act of 1996 American law that sets rules fo...

Page 318: ...me of a surgical operation phased array A technique to control the scan area by using time delays on an array transducer PI Pulsatility index see page 256 PL Foot pes length planimetry Measuring the surface area and perimeter of an object by tracing its boundaries Power Doppler A real time signal representing the size of reflection from material that is flowing The Power mode is normally super imp...

Page 319: ...t spectral Doppler See Doppler mode SS Start systole See page 253 standby switch The switch on the front of the scanner body used for turning the scanner on and off each day TAM Time Average Mean see page 254 TBL Tibia length TEH True echo harmonics B K Medical s trademarked term for its tissue harmonic imaging system TGC Time gain control THAP Thorax anteroposterior diameter TI Thermal index The ...

Page 320: ...k Format VL Vertebrae length voxel A three dimensional pixel A volume pixel wall filter A wall filter is used to eliminate low frequency artifacts in Color Power and Doppler modes It cuts off all frequencies below its cutoff frequency See page 140 Term Explanation ...

Page 321: ... The Rear of the Scanner The rear of the scanner body see Fig B 1 and Fig B 2 contains a large number of connectors for connecting different equipment Condition Limits Ambient operating temperature 10 C to 40 C 50 F to 104 F Humidity max 85 RH non condensing Atmospheric pressure between 700 hPa and 1060 hPa WARNING Follow the guidelines in EN60601 1 1 1 when you connect the scanner to other equipm...

Page 322: ... Figure B 1 The scanner s rear panel audiovisual connectors out see Fig B 2 power supply socket see Fig B 11 auxiliary power outlets see Fig B 12 auxiliary connectors see Fig B 2 audiovisual connectors in see Fig B 2 ...

Page 323: ...this scanner are on a CD BZ2100 that accompanies this user guide The CD also contains a list of accessories used in testing for EMC compliance scanner monitor documentation trigger connectors digital video camera and or digital video recorder in out LAN DICOM PCU via adaptor foot switch color video printer or external video monitor RGBS source e g camera CD writer in monitor base external VGA moni...

Page 324: ...nectors Symbol Connector Part number Type and Maximum Length Color Composite Out AO0142 Shielded 3 m Color Composite In AO0142 Shielded 3 m B W Composite Out AO0142 Shielded 3 m S VHS In EL4003 included in EU4009 Shielded 2 m S VHS Out EL4003 included in EU4009 Shielded 2 m Audio In EL4017 included in EU4009 Shielded 2 m Audio Out EL4017 included in EU4009 Shielded 2 m VGA 2 Out AO1382 Shielded 2 ...

Page 325: ...ing Other Equipment on page 25 Always use the cables specified in Appendix C Specifications PAL NTSC The format for the video output that is sent to a video printer or video recorder can be either PAL or NTSC To set the format for video output from the scanner 1 Make sure that the PAL NTSC switch on the rear of the printer is set to the appropriate format 2 Open the General Setup window see page 1...

Page 326: ...g images see Chapter 6 Documentation Connecting to a Surgical Rack Using the optional Rack Docking System you can connect the scanner to a surgical rack quickly with just one connector Then monitors in the operating room can easily be used to view the ultrasound image This is especially advantageous if you are using the optional Picture in Picture PiP functionality For further details on PiP See T...

Page 327: ... on the surgical rack Caution When the docking cable is not connected to the docking box the blind connector must be firmly in place on the docking box Otherwise the surgical rack will not operate correctly when the scanner is not attached See page 329 for instructions about attaching the blind connector WARNING When you connect other equipment to the scanner thus creating a medical system always ...

Page 328: ... docking cable with connectors The scanner connectors on the docking cable are numbered Attach each scanner connector to the connector on the rear of the scanner according to the numbers shown in Fig B 6 Docking box Blind connector Wire cable These numbered scanner connectors are attached to the rear of the scanner See Fig B 6 for numbering scheme Attach this docking box connector to the front of ...

Page 329: ...rgical rack The connectors on the back panel of the docking box Fig B 9 correspond to connectors on the rear of the scanner Connections on front To connect the cable or blind connector to the docking box 1 Press the docking box connector see Fig B 5 on the cable or the blind connector attached to the docking box by a wire cable firmly into the connector on the docking box Figure B 7 Attaching the ...

Page 330: ...back panel Holder for Docking Cable and PCU The cable holder Fig B 10 is attached to the rear of the scanner by 2 metal tabs inserted into small holes on the right side and by 2 screws M4x8 on the left side The scanner connector end of the cable is screwed to the cable holder with 2 screws M3x8 For an explanation of the sockets and their symbols see Video Documentation Equipment on page 325 ...

Page 331: ...wer supply cord that is specific to your region The connector see Fig B 11 is on the lower left side of the rear panel Figure B 11 The connector for the power supply cord Part of the scanner connector end of the cable is screwed on here Attach docking cable scanning connectors here Cable holder Holder for PCU Cable holder attached to scanner here with 2 screws WARNING Use only the power supply cor...

Page 332: ...rrents plug all other equipment into the isolated auxiliary power outlets on the bottom right of the rear panel There are 4 auxiliary outlets as shown in Fig B 12 Figure B 12 Auxiliary power outlets WARNING Never try to remove or change the plug on the power supply cord WARNING When you connect other equipment that uses the line voltage such as a video printer video recorder endoscopic camera cont...

Page 333: ...lization terminal below the auxiliary power outlets see Fig B 12 is connected to the scanner chassis It can be connected to corresponding terminals on other equipment to eliminate potential differences Do NOT use it for additional protective grounding Dismantling the Scanner for Transportation Caution The front panel and the monitor can be removed to allow easy transportation see Fig B 13 Figure B...

Page 334: ...ly connector and the USB connector for the circuit in the monitor base 4 Remove the sliding cover 5 Loosen the two black screws on the back of the scanner under the monitor 6 Lift the monitor base carefully out of the groove To replace the monitor 1 Slide the monitor base into the groove 2 Tighten the black screws 3 Reconnect to the scanner References 1 EN 60601 1 1 2001 Medical electrical equipme...

Page 335: ...Mode steerable B mode CW continuous wave Doppler steerable Transducer Center Frequency Range Single element transducers 5 10 MHz 360 rotating single element transducers option 5 20 MHz Linear and convex array transducers 2 15 MHz Features Fully digital Clip browser Tissue Harmonic Imaging Fully integrated 3D option Split screen vertical and horizontal Palm Control Unit PCU option Simultaneous live...

Page 336: ...ics Ultrasound image 512 x 480 pixels 256 gray levels plus 256 colors Graphics overlay 800 x 600 pixels 32 bit true color Presentation images can be mirrored up down and left right Sweep Speed 2 14 seconds per screen Size zoom 1 x 1cm to 25 x 25cm in tissue the number of steps and maximum size depend on the transducer Frame Rate 150 Hz automatically optimized depending on the transducer Preprocess...

Page 337: ...ave Doppler Sample volume size 1 20mm Units cm s or kHz Flow inversion Yes Flow offset Yes Pulse Repetition Frequency PRF 1 15kHz Wall filter Digital filter Cutoff frequency 1 10 of PRF Detectable speed 0 13cm sec 4 6 m sec at 0 Display B W or color FFT spectra 256 levels Frequency resolution Max 7 8Hz PRF 1kHz Time resolution Max 4 msec Angle correction 1 steps Doppler audio output 2 x 1W Power D...

Page 338: ...color scales Color Doppler interleave factor 64 lines Continuous Wave Doppler Range 1 3 30kHz Wall filter Digital filter Cutoff frequency 1 20 of PRF Detectable speed 0 31cm sec 9 2m sec at 0 Steerable Doppler Angle 20 Doppler continued Measurement Facilities Trackball Point move and measure Pro Packages General OB Gyn Surgery Urology Cardiac Connection Possibilities Transducers 4 active sockets L...

Page 339: ...ntation trigger 2 units Signal input Audio stereo line level Composite color video CVBS S video Y C RGB video Communication RS232 serial channel 3 x USB 2 0 2 x IEEE1394a FireWire 10 100 Ethernet Isolated auxiliary power outlets 100 230V AC equal to input voltage max total output available for use 350 VA DICOM network optional Connection Possibilities continued Power Voltage 100 230V AC Frequency ...

Page 340: ...ng and storage humidity Max 85 RH non condensing Operating pressure 700 1060 hPa normal atmospheric pressure Chemical resistance of console during disinfection Wiping with Sodium hypochlorite up to 2 in water Chlorhexidine gluconate 5 in water Chlorhexidine 1 5 and cetrimide 15 in water Chlorhexidine 0 5 in ethanol 70 Glutaraldehyde 2 solution Ethanol 70 in water Isopropanol 70 in water Approximat...

Page 341: ...cal s transducer program please contact your local sales representative UA1215 Foot switch EJ4000 Plug for isolated auxiliary power outlets UA0610 Scanning gel 5 L WQ0739 Scanning gel 290ml DZ9756 Transducer holder inlay UA2410 Palm Control Unit PCU UA1271 Adaptor for PCU UA0029 Sterile PCU and cable cover UA2206 DICOM option license UA2205 Picture in Picture PIP option license UA2207 3D option li...

Page 342: ...d upgrade DP0889 Paper holder UA0955 Scanner cover Documentation Accessories EQ4072 Printing paper for EQ4098 UP 110HG EQ4080 Digital recorder Sony DSR 20MDP EQ4081 Video tape DVCAM 60min Sony DVM 60EX2 EQ4099 Digital color printer Sony UP D23MD EQ4093 Color printing pack UPC 21S small image size for Sony UP D23MD EQ4094 Color printing pack UPC 21L large image size for Sony UP D23MD EU4009 Cable s...

Page 343: ...tic Compatibility Requirements and tests 3 EN 60601 2 37 2001 A1 2005 Medical electrical equipment Part 2 37 Particular requirements for the safety of ultrasonic medical diagnostic and monitoring equipment 4 UL 2601 1 2003 Medical Electrical Equipment Part 1 General Requirements for safety 5 CSA C22 2 No 601 1 M90 2001 Medical Electrical Equipment Part 1 General Require ments for safety Approvals ...

Page 344: ...344 Appendix C ...

Page 345: ...01 password protection 289 Patient ID 301 Photorealistic Render setting 308 311 Preset options 301 Presets 300 pullback mover 290 Render Settings Render view 308 Render view 307 rest position 296 ROI 296 ROI markers 295 rotating the volume 301 scanning direction 296 scanning overview 293 settings 297 settings saving 297 slicing the cube 301 Span animation 302 Speed animation 302 starting an acquis...

Page 346: ...puncture guide 43 puncture line 43 bladder volume 229 B mode autofocus 123 133 depth 120 dynamic range contrast 123 133 extended resolution 126 focus 122 133 frequency 127 134 gain 120 132 gray scale 127 134 line density 126 multibeam 126 panning 124 134 persistence 125 resolution 126 TGC 121 133 B mode key 57 B mode Adjustment keys 58 B mode keys 57 B mode measurements in the General Pro Package ...

Page 347: ...ine density 142 multibeam 143 persistence 141 range 140 shots per estimate 142 steering 144 submodes 137 turning on and off 138 wall filter 140 Color Mode key 59 Color Mode keys 59 color priority 143 Color Power Gain key 59 combination mode 128 316 composite focus See multiple focus condensation and scanner malfunction 21 connecting other equipment 25 contrast See dynamic range control button tran...

Page 348: ...on B mode image 153 159 picture 154 160 Doppler keys 60 Doppler measurements choosing units for 188 in the General Pro Package 215 Doppler mode aliasing 158 162 angle correction 156 audio volume 155 161 baseline 158 162 fetal scanning 30 gain 156 161 HPRF 157 invert 157 162 PW 62 range 157 sample volume 154 sweep speed 158 162 turning off 154 161 turning on 153 159 wall filter 157 162 Doppler Mode...

Page 349: ...t 250 equipment connecting other 25 ES correct placement of marker 216 definition 317 ESD precautions 22 symbol 20 22 ethylene oxide gas ETO 204 ETO See ethylene oxide gas explosion hazards 22 Export in Curve Setup window 187 Export Import window 197 198 exporting Pro Package or system setting 198 extended resolution 126 F F10 key 66 F8 key 66 factory setup restoring 172 FBL measurement definition...

Page 350: ...dlock tables 257 259 handle on monitor 33 Hansmann tables 260 262 hard disk clearing space on 99 patient archiving quota 99 space problems 99 Harmonic key 57 harmonic imaging 128 HC measurement 248 317 HC AC measurement 248 heart rate averaging ECG 287 Hellman tables 263 HIPAA definition 317 Hobbins tables 264 266 Hold ECG refractory time 287 hooks for cables 33 hospital name setting 171 HPRF 157 ...

Page 351: ...t 250 License Manager window 196 197 licenses 196 line density B mode 126 color mode 142 power mode 149 LMP 244 318 long click 55 long press 53 long press transducer control button 72 Luminance 3D Render Setting 308 311 M M Doppler Gain key 60 MAD 246 247 248 249 318 magnetic shielding 23 maintenance PCU 205 preventive program for 205 scanner 205 transducer 206 MD minimum diastole correct placemen...

Page 352: ...orientation image 73 P PACS 111 Palm Control Unit See PCU panning B mode 124 134 parent curve 185 186 Password Setup window changing password 177 for superuser 177 with password protection disabled 178 Patient Archiving and Communications Sys tem See PACS patient archiving system description 99 patient ID entering 36 Patient information from DICOM worklist 37 Patient Setup window 195 196 Patient w...

Page 353: ...y 53 Prev Exam Date 244 preventive maintenance program 205 PRF 62 140 318 PRF pulse repetition frequency 147 157 Print key 56 Printer Setup window 176 printing to DICOM printer 113 Pro Package about 42 changing in Patient window 37 creating new 199 definition 318 deleting 199 exporting and importing 198 renaming 199 selecting 42 43 Pro Package Menu window 43 Pro Package Setup window 167 prostate v...

Page 354: ...157 with angle correction 154 Save in Curve Setup window 187 Save key 56 Save Diagnostic Setups window 297 saving a Diagnostic Setup 43 Scale key 62 Scale PCU key 72 scanner cleaning 201 disposal 206 maintenance 205 removal of front panel 334 removal of keyboard 333 removal of monitor 334 transportation 333 turning on and off 34 scanner front picture 33 scanning mode selecting and changing 43 scan...

Page 355: ...kness 3D Render setting 308 311 thumbnails in internal clip browser 68 102 TI Thermal Index and ALARA 28 blood perfusion and 28 definition 319 formula 28 TIB 319 TIC 319 time average mean See TAM Time Gain Control 65 time changing 172 timer 129 TIS 319 tissue harmonic imaging advantages 129 description 128 129 limitations 129 using 129 tissue priority color mode 143 150 power mode 150 Tokyo tables...

Page 356: ...easurement 250 Uterine Width measurement 250 V vascular calculations accuracies 225 226 correct placement of markers 216 formulas 222 223 Video Setup window 83 84 video splitter 324 View in Curve Setup window 187 View Exam 102 VL measurement 248 320 volume measurement 3D making 306 voxel definition 320 W wall filter color mode 140 definition 320 Doppler mode 157 162 power mode 148 Wall Filter key ...

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