M7/M7T

Diagnostic Ultrasound System

Operator’s Manual
[Advanced Volume]
Content

Content ....................................................................................................................................i
Intellectual Property Statement .......................................................................................................... I
Preface .............................................................................................................................................. II
Safety Precautions ........................................................................................................................... III

1 Overview ...................................................................................................................... 1-1

1.1 Basic Operations and Buttons.............................................................................................. 1-1
1.2 Measurement Menu ............................................................................................................. 1-2
1.2.1 Menu Title ..................................................................................................................... 1-2
1.2.2 Measurement Location ................................................................................................. 1-3
1.2.3 Measurement Tool ........................................................................................................ 1-3
1.2.4 Other ............................................................................................................................. 1-4
1.3 Measurement, Calculation and Study .................................................................................. 1-5
1.4 Measurement Caliper ........................................................................................................... 1-5
1.5 Result Window ..................................................................................................................... 1-6
1.5.1 Result Display ............................................................................................................... 1-6
1.5.2 Moving Result Window ................................................................................................. 1-6
1.5.3 Result Window Assignment .......................................................................................... 1-6
1.6 Cross-window Measurement................................................................................................ 1-8
1.7 Report ................................................................................................................................... 1-8
1.7.1 Viewing Report ............................................................................................................. 1-8
1.7.2 Editing Report ............................................................................................................... 1-9
1.7.3 Viewing History Report ............................................................................................... 1-11
1.7.4 Printing Report ............................................................................................................ 1-11
1.7.5 Exporting Report ......................................................................................................... 1-11
1.7.6 Fetal Growth Curve..................................................................................................... 1-12

2 Measure Preset ........................................................................................................... 2-1

2.1 Basic Preset Procedures ...................................................................................................... 2-1
2.2 Measurement Parameters Preset ........................................................................................ 2-1
2.3 Obstetric Preset.................................................................................................................... 2-4
2.3.1 Obstetric Formula ......................................................................................................... 2-4
2.3.2 Obstetric Preset Operations ......................................................................................... 2-8
2.4 Measure Preset .................................................................................................................. 2-13
2.4.1 General Measurement Preset .................................................................................... 2-13

i
 2.4.2 Application Measurement Preset................................................................................ 2-16
2.5 Preset of Report Template.................................................................................................. 2-27
2.5.1 Basic Procedures........................................................................................................ 2-27
2.5.2 Creating Report Template ........................................................................................... 2-27
2.5.3 Deleting Report Template ........................................................................................... 2-29
2.5.4 Editing Report Template ............................................................................................. 2-29
2.5.5 Setting Default Template............................................................................................. 2-30
2.5.6 Exporting/ Importing Template .................................................................................... 2-30
2.5.7 Setting Template Order ............................................................................................... 2-30
2.6 Automatic Spectrum Calculation Parameters .................................................................... 2-31

3 General Measurement ................................................................................................ 3-1

3.1 Basic Procedures of General Measurement ........................................................................ 3-1
3.2 2D General Measurements .................................................................................................. 3-1
3.2.1 Depth ............................................................................................................................ 3-1
3.2.2 Distance ........................................................................................................................ 3-2
3.2.3 Angle ............................................................................................................................. 3-3
3.2.4 Area .............................................................................................................................. 3-3
3.2.5 Volume .......................................................................................................................... 3-4
3.2.6 Cross ............................................................................................................................ 3-5
3.2.7 Parallel .......................................................................................................................... 3-6
3.2.8 TLength......................................................................................................................... 3-6
3.2.9 Ratio (D) ....................................................................................................................... 3-6
3.2.10 Ratio (A)........................................................................................................................ 3-7
3.2.11 B-Profile ........................................................................................................................ 3-7
3.2.12 B-Hist ............................................................................................................................ 3-7
3.2.13 Color Vel ....................................................................................................................... 3-8
3.3 M General Measurements .................................................................................................... 3-9
3.3.1 Distance ........................................................................................................................ 3-9
3.3.2 Time .............................................................................................................................. 3-9
3.3.3 Slope ............................................................................................................................. 3-9
3.3.4 Velocity ......................................................................................................................... 3-9
3.3.5 HR ............................................................................................................................... 3-10
3.4 Doppler General Measurements ........................................................................................ 3-10
3.4.1 Time ............................................................................................................................ 3-10
3.4.2 HR ............................................................................................................................... 3-10
3.4.3 D Vel ........................................................................................................................... 3-10
3.4.4 Acceleration ................................................................................................................ 3-11
3.4.5 D Trace ....................................................................................................................... 3-12
3.4.6 PS/ED ......................................................................................................................... 3-14

ii
 3.5 References ......................................................................................................................... 3-15

4 Abdomen ..................................................................................................................... 4-1

4.1 Abdomen Exam Preparations .............................................................................................. 4-1
4.2 Basic Abdomen Measurement Procedures .......................................................................... 4-1
4.3 Abdomen Measurement Tools ............................................................................................. 4-1
4.4 Abdomen Measurement Operations .................................................................................... 4-3
4.5 Abdomen Exam Report ........................................................................................................ 4-4

5 Obstetrics .................................................................................................................... 5-1

5.1 Obstetric Exam Preparations ............................................................................................... 5-1
5.2 Basic Measurement Procedures .......................................................................................... 5-1
5.3 GA ........................................................................................................................................ 5-1
5.3.1 Clinical GA .................................................................................................................... 5-1
5.3.2 Ultrasound GA .............................................................................................................. 5-2
5.4 Obstetric Measurement Tools .............................................................................................. 5-4
5.5 Obstetric Measurement Operations ..................................................................................... 5-8
5.5.1 Measurement Tool Operations ..................................................................................... 5-8
5.5.2 Calculation Tool Operations .......................................................................................... 5-8
5.5.3 Study Tool Operations................................................................................................... 5-9
5.6 Multi-fetus Exam................................................................................................................... 5-9
5.7 Obstetric Exam Report ......................................................................................................... 5-9
5.7.1 Fetal Biophysical Profile ............................................................................................. 5-10
5.7.2 Fetal Growth Curve..................................................................................................... 5-11
5.8 References ......................................................................................................................... 5-12

6 Cardiology ................................................................................................................... 6-1

6.1 Cardiac Exam Preparations ................................................................................................. 6-1
6.2 Basic Cardiac Measurement Procedures ............................................................................ 6-1
6.3 Cardiac Measurement Tools ................................................................................................ 6-1
6.3.1 2D Cardiac Measurements ........................................................................................... 6-2
6.3.2 M Cardiac Measurements ............................................................................................ 6-4
6.3.3 Doppler Cardiac Measurements ................................................................................... 6-6
6.3.4 TDI Cardiac Measurements .......................................................................................... 6-9
6.4 Cardiac Measurement Operations ..................................................................................... 6-10
6.4.1 Measurement Tool Operations ................................................................................... 6-10
6.4.2 Calculation Tool Operations ........................................................................................ 6-10
6.4.3 Study Tool Operations................................................................................................. 6-10
6.5 Cardiac Exam Report ......................................................................................................... 6-32
6.6 References ......................................................................................................................... 6-32

7 Vascular ....................................................................................................................... 7-1

iii
 7.1 Vascular Exam Preparations ................................................................................................ 7-1
7.2 Basic Vascular Measurement Procedures ........................................................................... 7-1
7.3 Vascular Measurement Tools ............................................................................................... 7-1
7.4 Vascular Measurement Operations ...................................................................................... 7-4
7.4.1 Measurement Tool Operations ..................................................................................... 7-4
7.4.2 Calculation Tool Operations .......................................................................................... 7-5
7.4.3 Study Tool Operations................................................................................................... 7-5
7.5 Vascular Exam Report.......................................................................................................... 7-7
7.6 References ........................................................................................................................... 7-7

8 Gynecology ................................................................................................................. 8-1

8.1 Gynecology Exam Preparations ........................................................................................... 8-1
8.2 Basic Gynecology Measurement Procedures ...................................................................... 8-1
8.3 Gynecology Measurement Tools .......................................................................................... 8-1
8.4 Gynecology Measurement Operations................................................................................. 8-2
8.4.1 Measurement Tool Operations ..................................................................................... 8-2
8.4.2 Calculation Tool Operations .......................................................................................... 8-3
8.4.3 Study Tool Operations................................................................................................... 8-3
8.5 Gynecology Exam Report .................................................................................................... 8-4
8.6 References ........................................................................................................................... 8-4

9 Urology ........................................................................................................................ 9-1

9.1 Urology Exam Preparations ................................................................................................. 9-1
9.2 Basic Urology Measurement Procedures ............................................................................ 9-1
9.3 Urology Measurement Tools ................................................................................................ 9-1
9.4 Urology Measurement Operations ....................................................................................... 9-2
9.4.1 Measurement Tool Operations ..................................................................................... 9-3
9.4.2 Calculation Tool Operations .......................................................................................... 9-3
9.4.3 Study Tool Operations................................................................................................... 9-4
9.5 Urology Exam Report ........................................................................................................... 9-5
9.6 References ........................................................................................................................... 9-5

10 Small Parts ................................................................................................................ 10-1

10.1 Small Parts Exam Preparations ......................................................................................... 10-1
10.2 Basic Small Parts Measurement Procedures .................................................................... 10-1
10.3 Small Parts Measurement Tools......................................................................................... 10-1
10.4 Small Parts Measurement Operations ............................................................................... 10-2
10.4.1 Measurement Tool Operations ................................................................................... 10-2
10.4.2 Calculation Tool Operations ........................................................................................ 10-2
10.4.3 Study Tool Operations................................................................................................. 10-3
10.5 Small Parts Exam Report ................................................................................................... 10-3

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 10.6 References ......................................................................................................................... 10-3

11 Orthopedics................................................................................................................11-1
11.1 Orthopedics Exam Preparations ........................................................................................ 11-1
11.2 Basic Orthopedics Measurement Procedures ................................................................... 11-1
11.3 Orthopedics Measurement Tools ....................................................................................... 11-1
11.4 HIP Measurement Operations ............................................................................................ 11-2
11.5 Orthopedics Exam Report .................................................................................................. 11-3
11.6 References ......................................................................................................................... 11-3

12 Emergency ................................................................................................................ 12-1

12.1 Basic Measurement Procedures ........................................................................................ 12-1
12.2 EM Measurement Tools...................................................................................................... 12-1
12.3 EM Exam Report ................................................................................................................ 12-1

v
© 2009-2010 Shenzhen Mindray Bio-medical Electronics Co., Ltd. All Rights Reserved.
For this Operator’s Manual, the issue date is 2010-11.

Intellectual Property Statement

SHENZHEN MINDRAY BIO-MEDICAL ELECTRONICS CO., LTD. (hereinafter called Mindray)
owns the intellectual property rights to this Mindray product and this manual. This manual may
refer to information protected by copyright or patents and does not convey any license under the
patent rights or copyright of Mindray, or of others.

Mindray intends to maintain the contents of this manual as confidential information. Disclosure of
the information in this manual in any manner whatsoever without the written permission of Mindray
is strictly forbidden.

Release, amendment, reproduction, distribution, rental, adaptation, translation or any other

derivative work of this manual in any manner whatsoever without the written permission of Mindray
is strictly forbidden.

IMPORTANT!

1. No part of this manual may be copied or reprinted, in whole or in part, without written
permission.
2. The contents of this manual are subject to change without prior notice and without our
legal obligation.

I
Preface
This manual details the procedures for operating the M7/M7T Diagnostic Ultrasound System.
Carefully read and understand the manual before using the system to ensure its safe and correct
operation.
NOTE: When you operate the system, you can refer to the following manuals:
„ Operator’s Manual (Basic Volume)
„ Acoustic output data

Depending on the software version, the preset settings, and optional configuration, the actual
interfaces may appear different from those shown in this manual.
NOTE: The functions described in this manual are not provided for all systems sold in all
regions. Functions that are available dependents on the specific system you purchased.

All the menus and screens in this manual take the system in full configuration as an example.

Product Differences
M7T: not sold in Canada, and has no B-Profile measurement.

II
Safety Precautions
1. Meanings of Signal Words
In this manual, the signal words Danger, WARNING, CAUTION and NOTE are
used regarding safety and other important instructions. The signal words and their meanings are
defined as follows. Please understand their meanings clearly before reading this manual.

Signal word Meaning

Indicates an imminently hazardous situation that, if not avoided, will
Danger result in death or serious injury.
Indicates a potentially hazardous situation that, if not avoided, could
WARNING result in death or serious injury.
Indicates a potentially hazardous situation that, if not avoided, may
CAUTION result in minor or moderate injury.
Indicates a potentially hazardous situation that, if not avoided, may result in
NOTE
property damage.

2. Meaning of Safety Symbols

Symbol Description

General warning, caution, risk of danger.

3. Safety Precautions
Please observe the following precautions to ensure patient and operator’s safety when using this
system.

CAUTION: 1. Select the proper patient image and measurement tools. Only
the professionals can decide the appropriate measurements
and results.
  2. Confine measurement calipers to the actual Region of Interest
(ROI). Measurements that extend beyond the ROI will be
incorrect.
  3. Before examining a new patient, it is necessary to press the <
End Exam> key to end the current scan and delete the patient
information and data. Otherwise, new patient data will be
combined with the previous patient.
  4. When the system is turned OFF or the < End Exam> key is
pressed, all the data that have not been saved are lost.
  5. Changing modes during a measurement will delete the General
Measurement data.
  6. Pressing the < Freeze> key to unfreeze the image during a
measurement will clear the General Measurement data.
  7. Pressing the < Measure> key during a measurement will clear
the General Measurement data.

III
  8. Pressing the < Clear> key will clear the measurement caliper,
all data in the result window, comments and body mark.
  9. In dual-B imaging mode, the measurement results of the
merged image can be inaccurate. Therefore, the results are
provided for reference only, not for confirming a diagnosis.
  10. Quality of the extended image constructed in iScape
(panoramic imaging) dependents on the skill of operator. Extra
attention should be paid during the iScape measurement since
the results could be inaccurate.
  11. Ensure that measurement data correctly corresponds to the
fetus during the Obstetric Measurement.
  12. Fully understand the functionality of this system by referring to
the Operator’s Manual - Basic Volume.
  13. The auto measurement might not be accurate when the result
doesn’t match the image exactly, please make the
measurement manually.

IV
1 Overview

1.1 Basic Operations and Buttons

Tips: The following descriptions for buttons and keys are used in this manual:
„ < >: Denotes key/ button on the control panel or keyboard. E.g. <Set>.
„ [ ]: Denotes button/item on the screen menu. E.g. [OK].
Click/Select [item/button]: to move the cursor over the item/button and press <Set>.

Basic Measurement Procedures

1. Press <End Exam> to start a new exam.
2. Press <Patient> and input the patient information,
This includes patient ID, name, height, weight etc. Type in manually for a new patient, or load
an existing patient from iStation or Worklist.
The patient information entered is used for measurement data storage, analysis and exam
report. For more details, refer to "Exam Preparation -> Patient Information" in the Operator's
Manual [Basic Volume].
3. Press <Probe> and select a proper exam mode.
For more details, refer to "Exam Preparation" in the Operator's Manual [Basic Volume].
4. Measure preset.
To preset measurement parameters, obstetric formula, general/ application measurement
packages, report, auto spectrum calculation results etc. See “2 Measure Preset” for details.
5. Press <Measure> to start measurement.
6. Select an item from the measurement menu to start.
For general and application measurement items (tools), see "3 General Measurement " and
the chapter of specified application measurements for details.
7. Press <Report> to view the exam report.
For report editing and browsing, see “1.7 Report”;
For report preset, see "2.5 Preset of Report Template".

Button Functions
Keys Basic Operations
To enter/exit the measurement.
Measure
Or, exit from measurement by pressing <Esc> on the keyboard.
To select an item on the measurement menu and press <Set> to activate it.
Set
Press <Set> confirm and end the current operation during measurement.
To switch between the fixed end and active end of the caliper during a
Update
measurement.

Overview 1-1
 Keys Basic Operations
Short press: to return to the previous measurement step, or delete the
caliper backwards.
Clear
Long press: to clear all measurement calipers on the screen and data in the
result window.
Report To enter/ exit the report page.
Cursor To show the cursor.
Trackball Move the cursor.
To enable the commonly used measure function or used for selecting
Multifunctional knob
measurement item by rotating.

For details on key functions, see “System Overview” in the Operator's Manual [Basic Volume].

1.2 Measurement Menu

Menus of General and Application measurement are different. For more information on
measurement menu, refer to "3 General Measurement" and the specified application measurement
chapter.
Measurement menu items are as follows:

Menu Title
Location

Tools

Other

1.2.1 Menu Title

It displays the name of the measurement menu, i.e. name of the measurement package. As shown
in figure below.

1-2 Overview
If multiple measurement packages are set in current exam mode, a “►” displays in the menu title.

Tips: 1. In multi- imaging mode (e.g. B+PW), general measurements of all imaging modes
are available.
2. In application measurement, the Menu Title can be used to toggle between
measurement packages available in current exam mode. See section
“2.4.2 Application Measurement Preset”.

„ To switch to other measurement menu

1. Move the cursor to ►, the submenu pops up and displays other measurement menus
available.
2. Move the cursor to an item and press <Set>.

1.2.2 Measurement Location

The location widgets are used to select locations of the measurement.

z Side (Left/Right): Used to the item (e.g. kidney) that contains measurement of left/ right
side parameters respectively.
z Location (Prox/Mid/Dist): Used to items (e.g. vascular) that contains measurement of
Proximal, Middle or Distal parameters.
„ To Select the Measurement Location
1. Move the cursor to the location widgets (e.g. Side).
2. Press <Set> to select the Measurement location.
Tips: The location widgets are applicable only in application measurement.

1.2.3 Measurement Tool

There are two kinds of measurement tools.
„ General tools: Basic measurement tools in General Measurement, such as the "distance" and
"Area".
„ Application tools: The measurement tools in Application Measurement. These items are
classified and combined in clinical application package such as Abdomen, Obstetric, etc. E.g.
HC (head circumference) in the Obstetric measurement is one of the application tools.
Tips: 1. Actually, most application tools use the general measurement method while
measuring, e.g. an "Area" tool is used when measuring the HC. Only the
application measurement results are recorded in the report.
2. For definition of the measurement, calculation and study, refer to
"1.3 Measurement, Calculation and Study".

Overview 1-3
To Active the Measurement Tool
The procedures are as follows:
1. Move the cursor to the item and press <Set>.
2. A ">>" displays on the right side of the item if a submenu exists.
3. Enter the submenu by pressing <Set>.
4. Start the measurement by clicking an item on the menu.
5. Click [Return] to return to the upper menu after measurement.

Select Measurement Method Online

Some measurement tools (e.g. "Area" in 2D general measurement) have multiple methods to
select.
1. Select "Area" in the menu.
2. Select a method in the drop-down list of the menu, as shown in figure below.

Other Features
Features Descriptions
Current measurement
Highlighted.
tool/item

Performed application item/tool are marked with a "√". (If

Measured item one or some items in a submenu (extended menu) of a
study are already performed, this study will be marked as
measured.)
There is an asterisk posterior to the user-defined
User-defined item
measurement and calculation item for identification.
Page up/down Use the ▲/▼ on the menu.
Greyed out.
Unavailable item
Need switch to the proper imaging mode to enable it.

1.2.4 Other
During application measurement, the [Other] item appears at the bottom of the menu in multi-
imaging mode is used to navigates between menus of different modes. As shown in figure below.

1-4 Overview
Tips: In multi-imaging mode (e.g. B+PW),
During application measurement, switch to measurement menu available for another
mode by [Other].
During general measurement, switch to measurement menu available for another mode
by Menu Title. As shown in figure below.

1.3 Measurement, Calculation and Study

There are three kinds of measurement items.

Measurement
Results of measurements are directly obtained via the measurement tools, which are indicated by
“ ”.E.g. "Distance" in the 2D general measurement, or "HC" in the OB measurement.

Calculation
Results of calculations are automatically derived by the system, using other measured or
calculated values as parameters, they are indicated by “ ”. E.g. EFW (Estimated Fetal Weight) in
the OB measurement.
If all measurements related to a calculation tool are completed, the system will automatically
calculate the result. If some measurement tools are performed again, the system will automatically
update the calculation result using the latest measurement results.

Study
A group of measurements and / or calculations for a specific clinical application. E.g. AFI in the OB
measurement.
Fold/ unfold the study to hide/show the measurement or calculation items included.

1.4 Measurement Caliper

A measurement caliper is a graphics consists of several points and straight line or curve drawn on
the ultrasound image.

Fixed/ Active End

The ends of calipers can be active or fixed. The active end is called a Cursor.

Caliper Color
An active caliper appears green while a fixed one appears white in the system default preset.

Symbols of Caliper Ends

8 symbols are used as the caliper ends circularly, as shown in figure below.

These symbols display in calipers as well as in the result window to indentify different
measurements.

Overview 1-5
NOTE: You can preset the cursor type and color in [System Preset] -> [Meas], see
"2.2 Measurement Parameters Preset" for more information.

1.5 Result Window

Two types of result windows are used to display results numerically or graphically.

1.5.1 Result Display

Set [Result] to "ON" and the latest results display in result window in time sequence.
When viewing the results:
„ If the result window is full, the oldest value will be replaced according to the "first in, first out"
rule.
A maximum of 8 results can display in result window, and a maximum of 2 graphical result
windows can display in the screen.
„ To indentify the measurement results, symbols or numbers are used in the numerical result
window while "No:1" or "No:2" is used in the graphical result window.
NOTE: You can preset the appearance style and contents of the result window in [System]->
[Measure Preset], see the “2.2 Measurement Parameters Preset” for details.

The results can display in the following type:

„ No result displays when a measurement item/tool is activated but without the start point fixed.
„ The result displays as numbers when the value obtained is within the clinical range.
„ The result displays as "value*" when it's out of the clinical range but is still within the
ultrasound range.
„ The result displays as "?" when it is out of the ultrasonic range.

1.5.2 Moving Result Window

To move the result window,
1. Place the cursor on the result window title and press <Set>.
2. Rotate the trackball to place the result window in a desired position.
3. Press <Set> to fix the result window.

1.5.3 Result Window Assignment

An application measurement result can be assigned to a general measurement item from the
result window. The application item can be an existing item in system or a new user-defined one.

Assigning an Existing Application Item

The procedures are as follows:
1. Move the cursor to a general measurement value in the result window, press <Set> when the
item is highlighted in green, the matching list pops up as shown below.

1-6 Overview
 Matching application items that meet the following requirements are displayed:
h Preset in current application package.
h Use the same general measurement tool with the result.
Application items in the Obstetric measurement that use the "Area" method are listed as
shown above.
2. Select an application item in the list, press <Set>.
3. The assigned value displays in the result window and is saved in the exam report.

Tips: You can perform an assignment directly to the latest general measurement result by:
1. Enter an application measurement menu (e.g. Obstetric), when a general
measurement (e.g. "Area") is completed.
2. Click the desired application item (e.g. HC) in the menu. The selected application
item also has to meet the matching rules in step 1.
3. If the application item(s) is/are preset in the current report, the assignment results
will be saved in the report.

Assigning a New Application Item

When no (desired) item displays in the matching list, you can create a new application item. The
procedures are as follows:
1. Select [new] at the bottom of the matching list.
2. The following dialog box pops up.

a) Type in the new name.

b) Select the application region.
3. Click [OK] to assign the general result to the new item.
NOTE: Re-assignment for the assigned general result is not available.

Exiting Result Assignment

Press <Esc> in the keyboard, or select [Cancel] in the matching list to exit.

Auto Spectrum Calculation Assignment

Like a general measurement result, you can assignment the auto spectrum calculation results to
an application item, with the same steps described above.

Overview 1-7
NOTE: The application item to assign should be an item using D trace in current application
package.

1.6 Cross-window Measurement

Cross-window measurement is available in dual-B mode when the left and right windows are
imaging with the same probe, depth and invert mode.

1.7 Report
The report records measurement results, which automatically saved by system after each
measurement.
„ Press <Report> to enter the report dialog box.
„ The default report of the current exam appears.
Measurement items contained in the report are presettable. See "2.5 Preset of Report
Template" for details.
„ After viewing, press <Report>, <Freeze> or <Esc>, or select [Cancel] or [OK] to exit the report
page.

1.7.1 Viewing Report

Items in the report page are described as follows (taking Obstetric report as an example):

1-8 Overview
„ Each measurement contains three latest values and a final value.
„ Value that exceeds the clinical range is displayed as “value !”
„ The report only displays results of the tools that preset in the report template and completed,
as shown in figure below.
„ Select [Previous] or [Next] to flip the pages if the report has more than one page.

1.7.2 Editing Report

Available operations of report editing are as follows:
„ Editing Measurement Data
„ Entering Ultrasound Remarks
„ Selecting Images
„ Analyzing Report Data

Editing Measurement Data

CAUTION: Input appropriate data when editing the measurement values, otherwise
misdiagnose may occur.

„ The 3 measurement values in text boxes are editable, move the cursor to the text box and
press <Set>.
„ The modified value(s) is (are) underlined.
„ The final value display in the [Value] column. Select an option ([Last], [Avg], [Max] or [Min])
from [Method] to determine the method in which the final value is calculated.
„ For result values used to calculate GA (Gestational Age) and SD (Standard Deviation), the
formula used in this calculation can be selected from [Formula]. GA and SD value updates
with the formula change.
NOTE: 1. Only measurement values are editable while calculation values are not.
2. After a measurement value is modified, the average value of the tool and the
corresponding calculation value will be updated automatically.
„ Clearing Data
Click [Clear All] in the report page to clear all measurement data.

Entering Ultrasound Remarks

If [Prompt], [Findings] and [Comments] are selected in the report template, you can input
corresponding information in the report dialog box. For report preset, see "2.5 Preset of Report
Template".

Selecting Images
Image(s) saved in current exam can be added to the report.
1. Click [Image Select] in the report page to pop up the following dialog box.

Overview 1-9
 Left Column: Image(s) saved in current exam.
Right Column: Images selected to add into the report.
2. Select the image.
a) Adding/ Removing the image by pressing:
[>] To add the selected image in the left column into the right column.
[>>] To add all images in the left column into the right column.
[<] To remove selected image in the right column.
[<<] To remove all images in the right column.
b) Adjust the image arrangement.
Select an image in the right column and click [Move Up] or [Move Down] to adjust the
image sequence, in which the images are arranged in the report.
3. Click [OK] to confirm.

Analyzing Report Data

You can preset and edit OB or Vascular anatomy information in the report.
NOTE: If at least one of the ultrasound anatomy items is preset to display, the [Analyze] button
is available in the report. For details, refer to “2.5 Preset of Report Template”.

1. Click [Analyze].
Items of preset ultrasound anatomy (OB or vascular) are listed in the page pop up.
2. Select or type in anatomy descriptions.
Tips: Descriptions of [Fetus Score] can only be selected from the drop-down list.
Use the [Previous]/ [Next] to turn the pages.
3. If [Prompt], [Findings] and [Comments] are selected in the report template, you can input
corresponding information in the report dialog box.
4. Click [OK] to confirm. Analysis information displays following the measurement values in the
report.

1-10 Overview
 CAUTION: Input appropriate data when editing the measurement values, otherwise
misdiagnose may occur.

1.7.3 Viewing History Report

If more than one exam is performed to a patient, a drop-down list of [Exam] appears in the report.
1. Select history exams from the [Exam] drop-down list.
2. According to the exam mode, select a proper template from the [Report Type].
Make sure the template matches the exam mode, otherwise the measurement result will not
display correctly. E.g. an abdomen measurement result will not display in an OB report
template that preset without any abdomen measurement items.
3. Viewing the history report.
NOTE: 1. History reports can be viewed, but cannot be edited.
2. Also, you can view the patient information in iStation, see "Patient Data
Management" in the Operator's Manual [Basic Volume] for details.

1.7.4 Printing Report

Click [Print] in the report page to print the report.
Or, click [Print View] in the report page to preview. In preview page, you can:
Print report: Click [Print].
Page up/down: Select [Prev Page] or [Next] to view the previous or next
page.
Zoom in/out: Select a zoom ratio from the drop-down list.
Exit the preview: Click [Close].

1.7.5 Exporting Report

The reports can be exported in PDF or RTF documents, which can be viewed and edited on a PC.
1. In the report dialog box, select [Export] to pop up the following dialog box.

Overview 1-11
2. Select a drive in the drive list.
3. Select the desired directory. To return to the parent directory, double-click [..].
4. Input the filename for the report to export.
5. Select the file type.
6. Click [OK] to confirm.

You can create, delete or rename the directory by pressing:

[New]: To create a new template.
[Delete]: To delete the selected directory. Multi-selection can be performed
by using <Shift> and <Set> key.
[Rename]: To rename a selected directory.

1.7.6 Fetal Growth Curve

If [Obstetric] in the [Patient Info] is selected in the report template (see "2.5 Preset of Report
Template"), you can view the fetal growth curve by clicking the [Growth] button in the report page.
See “5.7.2 Fetal Growth Curve” for details.

1-12 Overview
2 Measure Preset
Before measuring, preset the following parameters:
z Measurement Parameters Preset
z Obstetric Preset
z General Measurement Preset
z Application Measurement Preset
z Preset of Report Template

2.1 Basic Preset Procedures

The basic measure preset procedures are as follows:
1. Enter the Preset:
z Press <Setup>; or,
z Select [Other] -> [Setup] in the imaging menu.
E.g. select [B] -> [Other] -> [Setup].
Tips: If the menu does not display, press <Menu> on the control panel to show the image
menu.
2. Preset the measurement parameters.
Enter [Setup] -> [System Preset] -> [Meas] to preset the Measure ruler, result window, etc.
See "2.2 Measurement Parameters Preset" for details.
3. Preset the Obstetric formula.
Enter [Setup] -> [System Preset] -> [OB].
Preset the GA (Fetal Gestational Age), FG (Fetal Growth) and the Fetal Weight. See
"2.3 Obstetric Preset" for details.
4. Measure preset.
Enter [Setup] -> [Measure Preset] -> [Caliper] and [Measure] to preset the measurement menu,
items and soft key. See "2.4 Measure Preset" for details.
5. Preset the report template.
Enter [Setup] -> [Measure Preset] -> [Report] to create, edit, import or export the report
template. See "2.5 Preset of Report Template" for details.
6. Preset the automatic spectrum calculation parameters.
Enter [Setup] -> [Measure Preset] -> [Parameter] to preset the result parameter in auto
spectrum calculation. See "2.6 Automatic Spectrum Calculation Parameters" for details.
7. Return from the setup to make the settings taking effect.
Select [Return] on the [Setup] menu to return from the setup.
NOTE: The settings take effect only by clicking [Return] to exit the [Setup] menu.

2.2 Measurement Parameters Preset

Basic operation steps are as follows:

Measure Preset 2-1

1. Press <Setup> to show the [Setup] menu.
2. Select [Setup] -> [System Preset] -> [Measure Preset] to preset the following parameters:
z Measurement Caliper
z Result Window
z ICA/CCA
z Unit
z Follicle
You can click [Load Factory] to restore the factory setups.
3. Click [OK] to confirm.

The following are function descriptions of the parameters.

Measurement Caliper

You can preset:

Tools Descriptions
Types of cursor displays on the measurement caliper and result
window. Value options:
„ Number: the cursor always displays as "+" while different
Cursor Type
measurements are marked with numbers.
„ Symbols: the cursor displays sequentially in 8 symbols to
indentify different measurements.
Cursor Size The size of the cursor. Value options: Large, Medium, Small
The number of cardiac cycles in the heart rate calculation. (In heart
Heart Beat rate measurement, the number of cardiac cycle should math the
preset number.)
Active Ruler Color Set color of the active ruler.
Inactive Ruler Color Set color of the inactive ruler.
Whether to display the dotted line between the two ends of a caliper
Cursor Line Display
after a measurement is completed.
Whether to display the dotted lines to indicate the long axis and short
Ellipse Cross Line Display
axis in ellipse measurement method.

2-2 Measure Preset

Result Window

You can preset:

Tools Descriptions
Background color of the result window.
Result Background
Value options: transparent/ gray
Presets whether to display all the measurement or the current
Result Display
measurement.
Set the method to calculate volume flow. Value: TAMAX/
Vol Flow Method
TAMEAN.
Active Font Color Set the font color of active item.
Inactive Font Color Set the font color of inactive item.
Clear results while deleting Presets whether to clear measure results when a caliper is
caliper removed.

ICA/CCA

Presets the calculation method of flow velocity ratio of ICA (Internal Carotid Artery) and CCA
(Common Carotid Artery). Value options:
h Prox PS (proximal)
h Mid PS (middle)
h Distal PS (distal)
NOTE: The preset method applies to both left and right side vessel.

Unit
Presets the units of Distance, Area, Volume, Time, Velocity, Slope, and Acceleration.

Measure Preset 2-3

Follicle
Set the method to calculate the follicle diameter and volume. Value options:
Follicle Diam 3 distances/ 2 distances
Follicle Vol 3 distances/ 2 distances/ 1 distance

2.3 Obstetric Preset

Basic procedures:
1. Press <Setup> to show the [Setup] menu.
2. Select [System Preset] -> [OB].
You can preset Fetal Gestational Age (GA), Fetal Growth (FG) and Fetal Weight (EFW)
formula.
See "2.3.2 Obstetric Preset Operations" for details.
3. After setting, click [OK] to exit the [System Preset] page.
4. Continue other presets; or click [Return] on the [Setup] menu to make the settings take effect.

2.3.1 Obstetric Formula

The obstetric formulae are used in GA, EFW calculations and Fetal Growth Curve.

GA and FG Formulae
GA will be automatically calculated after the corresponding measurements are completed. The
system will recalculate the GA after new measurements are completed.
Tips: 1. For preset of the default formula, See "Set the default formula."
2. For more information about GA and Fetal Growth Curve, see "5 Obstetrics".

GA and FG formulae are shown in table below:

Note: “/” means no formula provided for the item.
Tools GA FG
Tokyo Tokyo
Rempen Hellman
GS
Hansmann Rempen
China Hansmann
Tokyo
Jeanty
Tokyo
Hadlock
Hadlock
Nelson
Robinson
CRL Robinson
Rempen
Rempen
Hansmann
Hansmann
ASUM
China
ASUM

2-4 Measure Preset

Tools GA FG
Tokyo Tokyo
Hadlock Hadlock
Jeanty Kurtz
Hansmann Sabbagha
Merz Hansmann
BPD Rempen Merz
ChittyOI Rempen
Osaka ChittyOI
China Osaka
Nicolaides Nicolaides
ASUM ASUM
Hadlock Hadlock
Jeanty Merz
Hansmann Hansmann
HC
ChittyPL ChittyPL
Nicolaides Nicolaides
ASUM ASUM
Hadlock
Jeanty
Hadlock
Merz
AC Nicolaides
ChittyPL
ASUM
Nicolaides
ASUM
Tokyo
Hadlock Tokyo
Jeanty Hadlock
Hohler Merz
Merz Hansmann
Hansmann O'Brien
FL
Warda Warda
Chitty Chitty
Osaka Osaka
China Nicolaides
Nicolaides ASUM
ASUM
Merz
Hansmann
Hansmann
OFD Nicolaides
Nicolaides
ASUM
ASUM
APAD / Merz
TAD / Merz

Measure Preset 2-5

 Tools GA FG
FTA Osaka Osaka
THD Hansmann Hansmann
APTD / /
YS / /
TTD / /
Jeanty Merz
HUM
ASUM ASUM
Ulna / Merz
Tibia / Merz
Merz
RAD /
Jeanty
Merz
FIB /
Jeanty
CLAV Yarkoni Yarkoni
Goldstein
Hill
TCD Hill
Nicolaides
Nicolaides
OOD Jeanty /
Vertebrae / /
NT / /
Cist Magna / Nicolaides
Hadlock1
Hadlock2
Hadlock3
Hadlock4
Tokyo
EFW1 Shepard
Hadlock
Hansmann
Tokyo
Brenner
William
Hadlock1
Hadlock2
Hadlock3
Hadlock4
Tokyo
EFW2 Shepard
Hadlock
Hansmann
Tokyo
Brenner
William

2-6 Measure Preset

 Tools GA FG
Mean Sac Diam Daya /
MCA PI / JSUM
MCA RI / JSUM
Umb A PI / JSUM
Umb A RI / JSUM
AFI / Moore

Fetal Weight Formulae

EFW is a calculation item. If all tools required for EFW formula have been performed, EFW will be
obtained automatically. The system will recalculate the EFW after new measurements are
completed.
Tips: Formulae of EFW1 and EAW2 of GA/ FG are different from those in the [Fetal Weight]
page.
„ EFW formulae of GA/ FG are used to perform the GA calculation or the Fetal Growth
Curve based on EFW.
„ EFW formulae in the [Fetal Growth] page are used in EFW calculation based on
some OB measure results (e.g. AC).

The Fetal Weight formulae are shown in the following table:

Units
Formulae Descriptions
EFW Item

EFW= 10^(1.304+ (0.05281*AC)+ (0.1938*FL)- (0.004*AC*FL)) g cm

Hadlock1
SD=0.154*EFW SD Type=±2SD g g
EFW= 10^(1.335 -(0.0034*AC*FL) + (0.0316*BPD) +
g cm
Hadlock2 (0.0457*AC) + (0.1623*FL))
SD=0.146*EFW SD Type=±2SD g g
EFW= 10^(1.326-(0.00326*AC*FL)+ (0.0107*HC)+
g cm
Hadlock3 (0.0438*AC)+ (0.158*FL))
SD=0.148*EFW SD Type=±2SD g g
EFW= 10^(1.3596- (0.00386*AC*FL)+ (0.0064*HC+
g cm
Hadlock4 (0.00061*BPD*AC)+ (0.0424*AC)+ (0.174*FL))
SD=0.146*EFW SD Type=±2SD g g
EFW (Kg) = 10^(-1.7492+ (0.166*BPD)+ (0.046*AC)-
kg cm
Shepard (2.646*AC*BPD/1000))
SD=0.202*EFW SD Type=±2SD g g
Merz1 EFW=-3200.40479+(157.07186*AC)+(15.90391*(BPD^2)) g cm
Merz2 EFW=0.1*(AC^3) g cm
EFW = (-1.05775*BPD)+ (0.0930707*(BPD^2)+
Hansmann kg cm
(0.649145*THD)- (0.020562*(THD^2)+ 0.515263
Tokyo EFW=(1.07*(BPD^3))+(3.42*APTD*TTD*FL) g cm

Measure Preset 2-7

 Formulae Descriptions Units

Osaka EFW=(1.25674*(BPD^3))+(3.50665*FTA*FL)+6.3 g cm
Campbell EFW (Kg) = EXP (-4.564+(0.282*AC)-(0.00331* (AC^2))) kg cm

Weight Percentile for Age

The Clinical Percentile (CP) and Ultrasound Percentile (UP) will be calculated and displayed in the
report in the following format according to the formula selected for EFW calculation.
z CP(Calc Method)(Formula) ××%: Where Calc Method may be LMP, PRV, IVF, BBT,
and EDD;
z UP(Calc Method)(Formula) ××%: Where Calc Method may be AUA, CUA.
Wherein the Formula can be preset in [Setup]-> [System Preset]-> [OB]-> [Fetal Weight]->
[EFW-GP].
E.g. CP (LMP)(Hadlock) 73.4%.
„ Clinical Percentile (CP)
Find the average value and calculate the threshold range in the formula (to calculate EFW) in
the FG table according to the clinical GA (obtained in patient information such as LMP, IVF).
If the actual EFW value is in the following range, keep calculating; otherwise, the CP will not
be displayed.
Average EFW x1.25 > EFW > Average EFW x0.75
E.g. EFW-GP(LMP) is EFW Clinical Percentile calculated from the LMP obtained from the
patient information.

„ Ultrasound Percentile (UP)

It has the same calculation method with CP except to use the ultrasound GA instead of clinical
GA.
Eg. EFW-GP(AUA) and EFW-GP(CUA) is EFW Clinical Percentile calculated from the AUA
and CUA respectively.

2.3.2 Obstetric Preset Operations

2.3.2.1 Basic Procedures
Basic procedures in the OB preset are as follows:
1. Enter the [Setup] -> [System Preset] -> [OB] page.
2. Set the default formula.
a) In the [Fetal Gestational Age], [Fetal Growth] or [Fetal Weight] page, select an OB
Items in the left column.
b) Select a formula in the right column.
c) Click [Default], the default formulae is marked with a √.
Following operations are also available to the formula (for more details, see the corresponding
section):
h Creating Formula/ table
h Browsing Formula/ table
h Editing Formula/ table
h Deleting Formula/ table

2-8 Measure Preset

 In [Fetal Gestational Age] page, you can select whether to display SD or EDD in the obstetric
result.
In the [Fetal Growth] page, you can select the number and layout of the growth curves display
in the report.
3. Set the fetal weight display.
a) Enter the [Fetal Weight] page.
b) Select the [Fetal Weight Unit]:
Select Metric, English or English & Metric from the drop-down list.
c) Preset whether to display the EFW in the result window and exam report.
Select/ deselect the [Display] check box before the item.
d) Select the formula to calculate the weight percentile.
Select the formula from the drop-down list of [EFW-GP].
4. Click [OK] to confirm.
Click [Load Factory] to restore the factory setups.

2.3.2.2 Creating Formula

You can create a new GA or FG formula (table), the following takes adding GA table as an example.
1. In the [OB] page, select an item in the left column.
2. Select [Add] to enter the [Add New OB GA Table] dialog box. As shown in figure below.

Four methods are available in creating a new table:

h Create an empty OB GA table
h Add an OB GA formula
h Import an OB GA Table or Formula
h Copy an Existing OB GA Table or Formula

Create an empty OB GA table

1. Select “Create an empty OB GA table” in the [Add New OB GA Table] dialog box.
2. Enter the Author Name.

Measure Preset 2-9

3. Select [OK] to enter the new formula table.

4. Select the SD (Standard Deviation) Type.

h None
h ±1SD
h ±2SD
h 3%~97%
h 5%~95%
5. Select the unit of Meas Value, GA and SD.
h GA or SD values display in XXwXXd while setting to Week&Day.
h GA or SD values display in XXXXd while setting to Days.
6. Add/ Edit data.
Move the cursor to the position to add/ edit data, press <Set> and input data in the
editable box. As shown in figure below.

NOTE: 1. The unit will be added automatically after the GA or SD value in entered.
2. The MeasValue and GA is constrained, but SD(-) and SD(+) can be null or zero.
3. Values in the [MeasValue] should be ascending series.
4. The range of GA is 0 to 365 and the SD range is 0 to 70 days (0 to 10 weeks).

7. Click [OK] to complete the OB GA table creation.

2-10 Measure Preset

Add an OB GA formula
1. Select “Add an OB GA formula” in the [Add New OB GA Table] dialog box.
2. Enter the Author Name.
3. Click [OK] to pop up the [OB GA Formula] dialog box. As shown in figure below.

4. Select the SD (Standard Deviation) Type.

h None;
h ±1SD
h ±2SD
h 3%~97%
h 5%~95%
5. Select the GA Unit and Deviation Unit.
6. Input the GA Formula and Deviation (±).
Double click an item in the [Meas Item] list to input the item to the formula or deviation
input box.
Descriptions to the functions are shown in the following table.
7. Verify the formula. Click [Verify] to verify the input value.

Function descriptions:
(NOTE: number, power and base in the upper table refer to numbers or variables.)
Functions Syntax Descriptions
sin sin(number) The sine of number.
cos cos(number) The cosine of number
tan tan(number) The tangent of number
atan atan(number) The arctangent of number
exp exp(number) The power of e with exponent number

Measure Preset 2-11

 Functions Syntax Descriptions
min(number1,
min The minimal of number1, number2, …
number2,…)
max(number1,
max The minimal of number1, number2, …
number2,…)
pow pow (number, power) Power value of number
sqr sqr(number) Square value of number
ln ln(number) Natural logarithm of number
log log(number) Logarithm of number (based as 10)
sqrt sqrt(number) Square root value of number
abs abs(number) Absolute value of number
The circumference ration, with accuracy of 15
PI /
digits

Import an OB GA Table or Formula

1. Select “Import an OB GA Table or Formula” in the [Add New OB GA Table] dialog box.
2. Select [OK] to pop up the [Load Data] dialog box.
3. Select the drive and file path the data located.
4. Select the data file to load.
5. Click [OK] to confirm.

Copy an Existing OB GA Table or Formula

1. Select “Copy an Existing OB GA Table or Formula” in the [Add New OB GA Table] dialog box.
2. Select a formula in the list.
3. Input the Author Name.
4. Click [OK] to pop up the [OB GA Table] dialog box.
5. Modify the table according to step 4, 5 and 6 in "Create an empty OB GA table".
6. Click [OK] to confirm.

2.3.2.3 Browsing Formula

Formulae provided by the system can be browsed, but cannot be edited or deleted.
1. In the [OB] page, select the OB item from the left column.
2. Select the formula to be edited in the right column.
3. Select [Browse] to view data in the table.

2.3.2.4 Editing Formula

Only user-defined formula is editable.
1. In the [OB] page, select the OB item from the left column.
2. Select the formula to be edited in the right column.
3. Click [Edit] to enter the editing status.
4. Modify the table according to step 4, 5 and 6 in "Create an empty OB GA table".

2-12 Measure Preset

2.3.2.5 Deleting Formula
Only user-defined formulae can be deleted.
1. In the [OB] page, select the OB item from the left column.
2. Select the formula to be edited in the right column.
3. Select [Delete] to delete the formula.

2.4 Measure Preset

Basic Procedures:
1. Press <Setup> to show the [Setup] menu.
2. Select [Measure Preset] in the [Setup] menu.
3. Preset the general measurement, application measurement and the soft key.
For details, refer to "2.4.1 General Measurement Preset", "2.4.2 Application Measurement
Preset" and "2.4.3 Soft Key Preset".
4. Click [OK] to confirm.
5. Continue other presets; or click [Return] on the [Setup] menu to make the settings take effect.

2.4.1 General Measurement Preset

You can preset the General Measurement packages for 2D (B / Color / Power / DirPower Mode), M
Mode, or Doppler (PW / CW) Mode respectively.
1. Select the [Caliper] in the [Measure Preset] page. As shown in figure below.

Measure Preset 2-13

2. Select an Exam Mode.
NOTE: The general measurement menu preset here are exam mode-related. E.g. change of
OB general measure preset will not affects the Adult ABD general measurement
menu.
3. Select the [2D], [M] or [Doppler] tab sheet to go to the corresponding preset.
[Available Items]: available general measurement tools configured by the system in the current
scanning mode, but they are not assigned yet.
[Selected Items]: displays the tools to be added to the menu.
4. Add/ Remove the item.
Add/ Remove the general measurement item by the following buttons:
[>] To add the tool selected from the [Available Items] into the [Selected Items].
To add all tools (need not selected) in the [Available Items] into the [Selected
[>>]
Items].
To remove the tool selected from the [Selected Items] to the [Available
[<]
Items].
To remove all tools in the [Selected Items] to the [Available Items]. You need
[<<]
not select any item before removing.
5. Set the default item.
Select an item in the [Selected Items], click [Default]. The item is marked with a √.
The default item is activated automatically while entering this general measurement menu.
6. Adjust the item position.
Select an item in the right column and click [Up]/ [Down] to adjust the sequence in which the
items are arranged in the corresponding general measurement menu.
7. Modify the property of measurement item.
The [Property] dialogue box varies by measurement items. The following takes D trace as an
example to show how to set the properties of a measurement tool.
a) Enter the [Measure Preset] -> [Caliper] -> [Doppler] page.
b) Select [D Trace] in the [Selected Items] and click [Property] to pop up the following
dialog box.

2-14 Measure Preset

Descriptions of the attributes are shown in the following table.
Attributes Descriptions
Results obtained from D trace are listed. The selected items will be displayed in
the result window.
„ If PV is selected, other results become deselected (except the temporary
result “velocity”).
„ Some results such as PS and ED can derived via simply method (e.g.
Item Name & Velocity); but others such as TAMAX can only derived via complicated
Result method like Manual, Spline, Auto etc.
z Only Vel in the [Method] is available if only PS or ED is selected.
z Only 2 PT in the [Method] is available if both PS and ED are selected
(with others deselected).
z More complicated methods to obtain PS and TAMAX simultaneously
are available if both PS and TAMAX are selected.
Select a default measurement method for the tool if more than one method is
Meas Method
available.
Select a default method for the tool if more than one method is available.
Online Select If deselected, measure method for this tool is set to the default one and cannot
be selected during measuring.
[Move Up] /
Adjusts the position of the item in the item list as well as in the result window.
[Move down]
When [Online Select] is deselected, results displayed in the window can be
added to the measurement menu in different ways.
„ [Extend Sub Menu]: The selected results will display in the sub-menu of D
Menu
trace in the measurement menu.
„ [Composite Menu]: The selected results will display in the measurement
menu independently.
c) Click [OK] to confirm the setting.
8. Select the measure sequence.

Measure Preset 2-15

 h [Repeat]: after the current measurement is completed, the system automatically
activates the current tool again.
h [Next]: after the current measurement is completed, the system automatically
activates the next tool in the menu.
h [None]: after the current measurement is completed, the cursor can be moved on the
whole screen. And the cursor will automatically return to the menu of the
corresponding measurement.
9. Click [OK] to confirm.

2.4.2 Application Measurement Preset

2.4.2.1 Basic Procedures
1. Select the [Measure] in the [Measure Preset] page. As shown in figure below.

2. Select an Exam Mode.

3. Select the 2D, M or Doppler scanning mode.
If [Use same menu for all scan modes] is selected, all items for 2D, M and Doppler mode
display in the [Available Items] list.
4. Choose or edit the Measurement Package.
Generally, the corresponding package appears in the [Measure Package] when the [Exam
Mode] is selected.
z If no package appears, a default measurement package for the current exam mode needs
to be added. You can input the package name directly in the [Measure Package] text box
then add items into it; or click [Advanced] to enter the dialog box to add a new package.
z If the package appears is not the one desired, click [Advanced] and select a new default
package for current exam mode.

2-16 Measure Preset

 For details about creating, deleting and setting default package, see “2.4.2.2 Measurement
Package Preset”.
5. Select an application region from the drop-down list under [Available Items].
6. Select [Measurement], [Calculate], [Study] or [All] from the drop-down list under [Available
Items], the corresponding items appear in the list.
For details about measurement, calculation and study, refer to "1.3 Measurement, Calculation
and Study".
7. Preset the measurement menu.
For details on adding, creating and setting default item, see “2.4.2.3 Preset of Measurement
Menu”.
8. Select the measure sequence.
h [Repeat]: after the current measurement is completed, the system automatically
activates the current tool again.
h [Next]: after the current measurement is completed, the system automatically
activates the next tool in the menu.
h [None]: after the current measurement is completed, the cursor can be moved on the
whole screen. And the cursor will automatically return to the menu of the
corresponding measurement.
9. Click [OK] to confirm.

2.4.2.2 Measurement Package Preset

During measurement, the preset package displays in menu. Items in package are presettable and
may belong to different application region.
1. In the [Measure Preset] page, select an exam mode from [Exam Mode].
2. Click [Advanced] to enter the following page.

Measure Preset 2-17

Where,
„ [Available Items]: shows application packages configured in the system but not assigned to the
current mode yet.
„ [Selected Items]: shows application packages assigned to the current exam mode. If more
than one package is assigned to the current exam mode, you can switch measurement
package via the menu title in the measuring status. See section “1.2.1 Menu Title”.
The package editing includes Creating Package, Add/ Remove the item, Deleting Measurement
Package, Setting Default Package, Adjusting Package Position.

Creating Package
1. Click [New].
2. Input name for the new package in the dialog box pop up.
3. Click [OK] to confirm.
New package displays in the [Available Items] list as shown in the following figure.

Adding/ Removing Package

Adding/ removing the package by pressing:
To add the package selected from the [Available Items] into the [Selected
[>]
Items].
To add all packages (need not be selected) in the [Available Items] into the
[>>]
[Selected Items].
To remove the package selected from the [Selected Items] to the [Available
[<]
Items].
To remove all packages (need not be selected) in the [Selected Items] to the
[<<]
[Available Items].

Deleting Package
1. Select a package in the [Available Items] list.
2. Click [Delete].
Tips: To delete an item in [Selected Items], you need to remove it to the [Available Items] first.

Setting Default Package

1. Select a package in the [Selected Items] list, click [Default].
2. The default package is marked with a √.

Tips: 1. The default package displays when entering the [Measure Preset] page.
2. The measurement menu of the default package (corresponding to the exam mode)
displays when entering the measuring status.

Adjusting Package Position

Select a package in the [Selected Items] and click [Move Up]/ [Move Down] to adjust the sequence
of the package in which the menu are arranged.

2-18 Measure Preset

2.4.2.3 Preset of Measurement Menu
In the [Measure Preset] -> [Selected Items] field.
The following operations are available.
„ Adding/ Removing Item
„ Setting Default Item
„ Adjusting Item Position
„ Setting Item Property
NOTE: Before editing the measurement item, make sure that the [Exam Mode], [Measure
Package], scanning mode (2D, M or Doppler), application region (e.g. Abdomen,
Obstetric etc.) and the item type (Measurement, Calculation or Study) are correctly
selected. See step 2, 3, 4, 5 or 6 in “Application Measurement Preset” for details.

Adding/ Removing Item

„ Adding Item
You can add measurements, calculations or study items in the [Available Items] to the [Selected
Items] column or the study item in the [Selected Items] column (added items display as sub-item in
the study). The selected items displays in the menu.

Add/ Remove the general measurement item by the following buttons:

[>] To add the tool selected from the [Available Items] into the [Selected Items].
To add all tools (need not selected) in the [Available Items] into the [Selected
[>>]
Items].
To remove the tool selected from the [Selected Items] to the [Available
[<]
Items].
To remove all tools in the [Selected Items] to the [Available Items]. You need
[<<]
not select any item before removing.

Tips: To display the measurement tools in the study as submenu, select [Extended Menu].
For more details about submenu, see "1.2.3 Measurement Tool".
For how to set study property, see "Modify the property of measurement item."

Setting Default Item

You can set a measurement, calculation or study in the [Selected Items] as the default item. The
default item will be activated automatically while entering the measurement menu containing it.
1. Select an item in the [Selected Items].
2. Click [Default], and the defaulted item is marked with a √ .
To deselect the default tool, select it and click [Default] or set another item as default.
Tips: If a certain study is set to the default item, it displays the submenu of the study
automatically when entering this measurement menu.

Adjusting Item Position

You can adjust the position of the measurement, calculation or study in the [Selected Items] list.

Measure Preset 2-19

1. Select an item in the [Selected Items].
2. Click [Up]/ [Down].
The order in the list is also the item position in the menu.

Setting Item Property

You can set the property of measurement and study (the property of calculation items are
unchangeable).
„ Modify the property of measurement item
Procedures of setting the application measurement item property is similar as the general
measurement item, see step 7 “Modify the property of measurement item” in the "2.4.1 General
Measurement Preset" for references.
The differences are:
z You can add/ delete / modify user-defined calculation in the result list of the item. See
"User-defined Measurement" and "User-defined Calculation" for details.
z You can select a method from the [CalcMethod] column as the default calculation method
for a result value.

„ Modify the property of study item

1. Select a study in the [Select Items] list.
2. Click [Property] to pop up the following dialog box.

2-20 Measure Preset

Descriptions of the attributes in the dialog box are shown in the following table.
Attributes Descriptions
Measuring order of the items in the study. Value options:
z [Repeat]: after the current measurement is completed, the system
automatically activates the current tool again.
Measure z [Next]: after the current measurement is completed, the system
Sequence automatically activates the next tool in the menu.
z [None]: after the current measurement is completed, the cursor can be
moved on the whole screen. And the cursor will automatically return to
the menu of the corresponding measurement.
Extended Menu Display the measurement items in the study as submenu.

2.4.2.4 User-defined Measurement

1. Enter [Measure Preset] -> [Measure] page, and make sure the [Exam Mode] and [Measure
Package] are correctly selected.
2. Select the position to place the user-defined measurement item on the right column. (Select
the study firstly if you want to add user-defined item into a study).
3. Click [New].
The “Measurement Custom Wizard” dialog box pops up, as shown in the following figure.

Measure Preset 2-21

 Available functions:
h Add user-defined measurement
h Add user-defined calculation
h Add user-defined study

User-defined Measurement
1. Input Name in the "Measurement Custom Wizard" dialog box, select the [AppRegion],
choose [Add Meas] and click [Next].
2. Select the [Tool Type], [Meas Method] and the Measure Result.

2-22 Measure Preset

 Descriptions of the attributes in the dialog box are shown in the following table.
Attributes Descriptions
General measurement tool type of the user-defined item. E.g. select Area if you
Tool Type
want to add a new item to measure the area.
The measurement methods of the chosen tool. E.g. measurement methods of
Meas Method
Area are Ellipse, Trace, Spline and Cross.
If selected, you can choose different fetus in the measurement menu (available
Has Multi-Fetus
in Obstetric application region only).
Has Left-Right If selected, you can choose left or right side in the measurement menu.
Has Prox-Mid- If selected, you can choose proximal, middle or distal in the measurement
Dist menu.
Choose the result(s) to be displayed in the result window. The result name is
changeable.
Measure Result
Move the cursor onto an item and press <Set>, then input the name in the text
box.
Add a calculation item
„ With the user-defined formula and the parameters derived from the current
[Add] result item of the measurement.
„ This new calculation appears as one of the current results.
See "User-defined Calculation" for details.
[Delete] Delete the selected result item.
[Modify] Used to modify the formula or parameters in the user-defined calculation.
[Move Up] /
Adjusts the position of the item in the list as well as in the result window.
[Move Down]

Measure Preset 2-23

 3. Click [Complete] to finish the setting. The user-defined measurement item lists in the
menu. An asterisk appears posterior to the user-defined item for identification.

User-defined Calculation
The user-defined calculation is derived from arithmetic operations, in which the parameters are
measurement or calculation results obtained in measurement items existing in system or user-
defined.
1. Input Name in the "Measurement Custom Wizard" dialog box, select the [AppRegion], choose
[Add Calc] and click [Next].
2. Edit the formula.

Descriptions of the attributes in the dialog box are shown in the following table.
Attributes Descriptions
Formula Displays the user-defined formula.
Verify Used to verify the input value.
All available measurement items of the application region selected in the
Meas Item
previous step.
Calculator/
Used to input numbers and functions in the formula.
Function
Calculate Result Used to set the Unit and the range of result.

E.g. to input the function sin (xx).

a) Click [sin] in the [Function] field. Then "sin ()" displays in the [Formula] input box.
b) Double click an item in the [Meas Item] list to put it into the bracket of sin (). E.g. sin
([Aorta PS]).

2-24 Measure Preset

NOTE: 1. Operator of the trigonometric functions is in degree, not radian.
2. The accuracy of PI is 15 digits.
3. Verify the formula and select the unit and range of the result, then click [Complete].
4. Click [Next] to set the measuring order of the items in the calculation if more than one
measurement items are set as parameter in the formula.

5. Select the item in the [Operation List], then click [Move Up]/ [Move Down] to adjust the position.
6. Click [Complete] to return to the [Measure Preset] page.
The new added user-defined calculation displays in the [Selected Items] list. An asterisk
appears posterior to the user-defined item for identification.

User-defined Study
The user-defined study is to create an empty study, and add measurement, calculation or study
tools (existing in system or user-defined) into it.

Measure Preset 2-25

1. Input Name in the "Measurement Custom Wizard" dialog box, select the [AppRegion], choose
[Add Study] and click [Next].
2. Click [Complete] and the empty study new added displays in the [Selected Items].
3. Select the user-defined study, add items into it. See "Adding/ Removing Item" for details.

Removing User-defined Item

„ Removing measurement/ calculation item
1. Select the user-defined measurement/ calculation item from the [Available Items] list.
2. Click [Delete]. The item is removed from Selected Items and Available Items.
„ Removing study item
1. Select a user-defined study from the [Selected Items] list.
2. Click [<] to delete it.

Importing/ Exporting User-defined Data

Click [Import Custom]/ [Export Custom] in the [Measure Preset] page to import/ export the user-
defined item data.

2.4.3 Soft Key Preset

Soft keys in the soft menu of the current exam mode can be preset in [Measure Preset].
1. Click [SoftKey Preset] in [Measure Preset] page and the following dialog box pops up.

1. Select [Image Mode] (2D/ M or Doppler).

2. The soft key preset will be applied to all exam modes if [Apply to all ExamModes] is selected.

2-26 Measure Preset

3. Preset the soft key by the following buttons.
Add the selected item in [Available Items] to a free space in the [Selected
[>]
Items].
Add all items (no more than 5 and need not be selected) in [Available Items] to
[>>]
the [Selected Items].
[<] Remove the selected item in [Selected Items] to the [Available Items].
Remove all items (need not be selected) in [Selected Items] to the [Available
[<<]
Items].
[left]/[right]/[
Move
Move the selected item in [Selected Items] to left/right/up/down.
Up]/[Move
Down]
[Add Blank
Add a blank line (with five blank keys) to the [Selected Items] field.
Line]
[Del Blank Delete a blank line from the [Selected Items] field (disabled when there is no
Line] blank line available).
4. Click [OK] to return to the [Measure Preset] page after setting the softkey.

2.5 Preset of Report Template

NOTE: Editing, importing, exporting and deleting are not supported by IVF and the EM reports.

2.5.1 Basic Procedures

1. Select [Report] in the [Measure Preset] page.
2. Select an Exam Mode.
The report template should match the exam mode.
3. Manage the report template. Available operations:
h Creating Report Template
h Deleting Report Template
h Editing Report Template
h Setting Default Template
h Exporting/ Importing Template
h Setting Template Order
4. Click [OK] and exit the [Measure Preset] page after setting.
5. Continue other presets; or click [Return] on the [Setup] menu to make the settings take effect.

2.5.2 Creating Report Template

1. Enter [Measure Preset] -> [Report] page.
2. Click [New] to enter the editing dialog box of report template.

Measure Preset 2-27

Descriptions of attributes and functions are shown in table below.

Attributes Descriptions
Report Name Name of the report template.
Selects the category of patient information to be displayed in the report.
Patient information items displays in the report are different for each
Patient Info category. (If “Obstetric” is selected, item OB in the [Ultrasound anatomy]
will be selected automatically; same with the vascular anatomy items
when “Vascular” is selected in the [Patient Info].)
Ultrasound Image Select numbers and arrangement of images display in the report.
Anatomical Graphic Select the vascular graphics that added into the report.
Select what items to be displayed in the report and how the items are
Measure Result
grouped.
Whether to display the anatomy information.
Ultrasound Anatomy If one (or all) anatomy item is selected, you can enter the anatomy
options page when clicking the [Analyze] button in the report, and the
[Growth] button will appear in the report if OB is selected.
Whether to display Comments, Prompt and Findings in the report.
Ultrasound Remark
If selected, the corresponding item will appear in the report.

3. Select an application region from the drop-down list under [Available Items].

2-28 Measure Preset

4. Select [Measurement], [Calculate], [Study] or [All] from the drop-down list under [Available
Items], the corresponding items appear in the list.
5. Adding/ Removing items.
Use the [>] or [>>] button to add single or all items in the [Available Items] list.
Only the tools appear in the right column and are completed in the ultrasound exam can be
displayed in the report.
See “Adding/ Removing Item” for details.
6. Add the study.
See "Adding Study" for details.
7. Adjusting the item position.
Select an item in the [Select Items] list, click [Move Up]/ [Move Down] to adjust the position of
the item in the list as well as in the report template.
8. Click [OK] to confirm.

Adding Study
You can add new study into the report template in the following procedures:
1. Click [Add Study] in the [Measure Report Preset] page to pop up the following dialog box.

Tips: Select an item in the [Selected Items] list and click [Add Study], the new added study
displays as a sub-study of the selected one.
2. Input study name in the text box.
3. Click [OK] to confirm. New added study appears in the [Selected Items] list.

2.5.3 Deleting Report Template

1. Enter [Measure Preset] -> [Report] page.

2. Select the template to delete, Click [Delete].
3. Click [OK] to delete the selected template.
4. Click [OK] in the [Report] tab sheet to confirm the settings.

2.5.4 Editing Report Template

1. Enter [Measure Preset] -> [Report] page.

2. Select the template to be modified in the list.
3. Select [Edit] to enter the [Measure Report Preset] dialog box.
See section “2.5.2 Creating Report Template” for editing the template.
4. Click [OK] in the [Report] tab sheet to confirm the settings.

Measure Preset 2-29

2.5.5 Setting Default Template
1. Enter [Measure Preset] -> [Report] page.
2. Select an exam mode from [Exam Mode].
3. Select a report template in the list.
4. Click [Default] to set the selected template as the default report of the current exam mode.
5. Similarly, set default report template for other exam mode.
Tips: The report template should match the exam mode to make sure the correct display of
the measurement results in the report.
6. Click [OK] to confirm.

2.5.6 Exporting/ Importing Template

2.5.6.1 Exporting Template
1. Enter [Measure Preset] -> [Report] page.
2. Select the template to export in the list, Click [Export].
3. Select drive and directory in the window pop up.
Select [New], [Delete] or [Rename] to manage the directory. See “1.7.5 Exporting Report”.
4. Input the file name in [File].
5. Click [OK] to export the template.

2.5.6.2 Importing Template

1. Enter [Measure Preset] -> [Report] page.
2. Click [Import].
3. Select drive and directory in the window pop up.
Select [New], [Delete] or [Rename] to manage the directory. See “1.7.5 Exporting Report”.
4. Select the report template to be imported in the right side file list.
5. Click [OK] to import the template.
a) If the imported report template already exists, the following dialog box pops up.

Tips: It's the Report Name of the template (not the file name of DAT file) to determine whether
the template is existed.
b) Select [OK] to replace the existed template; or, select [Cancel] to abandon.

2.5.7 Setting Template Order

1. Enter [Measure Preset] -> [Report] page.
2. Select the template to move in the list.
3. Select [Move Up] or [Move Down] to move the selected template.
4. Click [OK] to confirm the order.

2-30 Measure Preset

2.6 Automatic Spectrum Calculation
Parameters
The system has parameter automatic calculation function, this means you can obtain a group of
clinical indices by tracing Doppler spectrum. The function can be performed in real-time, in frozen
image and in cine status (including the cine files). It can be preset whether the automatically
calculated value will be displayed in the result window or not.
NOTE: Heart Rate obtained by auto spectrum calculation may be of deviation, please adopt
manual measurement or ECG function (optional) to get the precise value.

1. Enter [Measure Preset] -> [Parameter] page.

2. Move the cursor to an item and press <Set> to select it.

3. Click [OK] to confirm.

Measure Preset 2-31

3 General Measurement
General Measurement Tools:
„ 2D (B/ Color/ Power/ DirPower) Mode
„ M General Measurements
„ Doppler(PW/ CW) Mode

3.1 Basic Procedures of General

Measurement
1. Preset the general measurement parameters and start the exam.
2. Select the imaging mode (B/M/Doppler), then scan and freeze the image.
3. Enter the 2D/M/Doppler general measurement menu.
You can preset which key to press to enter the menu, see “Key Config” in the Operator's
Manual [Basic Volume] for details.
4. Select an item from the general measurement menu to start the measurement.

Tips: 1. The following operations are performed on frozen image by default since some
items (e.g. B-Hist) are available only on freeze image.
2. The order of the measurement items is presettable, see "2.4.1 General
Measurement Preset" for details.

3.2 2D General Measurements

3.2.1 Depth
Function:
z Sectorial surface probe: The depth is the distance from the center of sector to the cursor.
z Convex array or linear array probe: The depth is the distance from the transducer surface
to the measuring cursor in the direction of ultrasonic wave.

Method 1
1. Make sure the depth result is preset to display in the item property.
From several measurement items can depth be obtained, take "distance" as an example.

General Measurement 3-1

 See step 7 in "2.4.1 General Measurement Preset" for how to preset item property.
2. Select the item on a 2D image. The real-time depth value displays in the result window, as
shown in the following figure.

Tips: The real-time depth displays in the result window only before the <Set> key is pressed to
fix the starting point. History value of the depth is not displayed in the result window.

Method 2
1. Preset Depth in the item property of the general measurement item. See section "Adding/
Removing Item".
2. Click [Depth] in the measurement menu, and the cursor appears on the screen.
3. Use the trackball to move the cursor to the desired point.
4. Press <Set> to set the measurement point and the result displays in the result window.

3.2.2 Distance
Function: Measures the distance between two points on the image.
1. Click [Distance] in the measurement menu, and the cursor appears on the screen.
2. Move the cursor to the starting point with the trackball.
3. Press <Set> to set the starting point.
4. Move the cursor to the end point with the trackball. Here,
Press <Clear> to cancel setting the starting point. Or,
Press <Update> to switch between the fixed end and the active end of the caliper.
5. Press <Set> to set the end point.

3-2 General Measurement

3.2.3 Angle
Function: Measures the angle of two crossing planes on the image and the range is: 0°- 180°.
1. Click [Angle] in the measurement menu, and the cursor appears on the screen.
2. Set two line segments as described in "3.2.2 Distance".
The angle appears in the result window after setting the line segments.

3.2.4 Area
Function: measures the area and circumference of a closed region on the image. Four
measurement methods are available:
„ Ellipse: Fix an ellipse region by two equal-cut perpendicular axes.
„ Trace: Fix a closed region by free tracing.
„ Spline: Fix a spline curve by a series of points (12 points at most).
„ Cross: Fix a closed region with two axes perpendicular to each other. The starting point and
the end point of the axes can both be fixed freely.
Tips: These four methods are also applicable to other measurement items, and will not be
repeated when mentioned below. The operations are as follows.

Ellipse
1. Select [Ellipse] from the drop-down list on the right of [Area] in the measurement menu. The
cursor appears on the screen.
2. Move the cursor to an area of interest.
3. Press <Set> to set the starting point of the first axis of the ellipse.
4. Move the cursor to position the end point of the first axis of the ellipse. Here,
Press <Update> to switch between the fixed end and the active end of the first axis. Or,
Press <Clear> to cancel the start point of the first axis.
5. Press <Set> to set the end point of the first axis of the ellipse. The second axis appears on the
screen.
6. Move the trackball will increase or decrease the ellipse from the fixed axis. Move the trackball
to trace the area of interest as closely as possible.
Or, press the <Update> or <Clear> key to return to the step before setting the first axis.
7. Press <Set> to anchor the ellipse region, and the measure result will be displayed in the
results window.

Trace
1. Select [Trace] from the drop-down list on the right of [Area] in the measurement menu. The
cursor appears on the screen.
2. Move the cursor to an area of interest.
3. Press <Set> to fix the starting point.
4. Move the cursor along the target to trace the outline of the target.
To modify the trace line, please rotate the <Multi-Functional knob>:
Anticlockwise: to cancel a series of points.
Clockwise: to resume a series of points.
5. Press <Set> and the trace line will be closed with a straight line connecting the starting and
end points. The trace will also be closed when the cursor is very near to the starting point.

General Measurement 3-3

Spline
1. Select [Spline] from the drop-down list on the right of [Area] in the measurement menu. The
cursor appears on the screen.
2. Move the cursor to an area of interest.
3. Press <Set> to set the first reference point of the spline.
4. Move the cursor along the area of interest and press <Set> to anchor the second reference
point.
5. Roll the trackball and a spline defined by three points of the first, second reference points and
the active cursor appears on the screen.
6. Move the cursor along the edge of the target and set more reference points (12 at most) to
make the spline approach the target region as close as possible.
To correct a previous point, press <Clear>.
7. Press <Set> twice to anchor the last reference point. The spline is fixed and the results display
in the result window.

Cross
1. Select [Cross] from the drop-down list on the right of [Area] in the measurement menu. The
cursor appears on the screen.
2. Move the cursor to an area of interest.
3. Press <Set> to fix the starting point of the first axis.
4. Use the trackball to position the end point of the first axis and then press <Set>. Here,
Press <Update> to switch between the starting point and the end point of the first axis. Or,
Press <Clear> to cancel setting the starting point of the first axis.
5. Press <Set> to set the end point of the first axis. The second axis (perpendicular to the first
axis) of cross appears on the screen.
6. Move the trackball and press <Set> to fix the starting point of the second axis.
7. Move the cursor to the end point of the second axis. Here,
Press <Update> to switch between the starting point and the end point of the first axis. Or,
Press <Clear> to cancel setting the starting point of the first axis.
8. Press <Set> to set the end point of the second axis and fix the region. The results appear in
the result window.

3.2.5 Volume
Function: Measures the volume of the target object.
Method:
„ 3Dist
To calculate the object's volume with 3 axes of two images scanned in the plane perpendicular
to each other in B mode. Calculation formulae are as follow:
π
V olume ( cm 3 )＝ × D1( cm ) × D 2 ( cm ) × D 3( cm )
6
Where, D1, D2, D3 are the length of three axes of the target object.
„ Ellipse
To calculate the object's volume by its horizontal section area. Calculation formula is as follow:
π
V olume ( cm 3 )＝ × a ( cm ) × b 2 ( cm )
6
Where, a is the length of the major axis of the ellipse while b the minor.

3-4 General Measurement

„ EDist
To calculate the object's volume by its horizontal and vertical section area. Calculation formula
is as follow:
π
V olume ( cm 3 )＝ × a ( cm ) × b ( cm ) × m ( cm )
6
Here, a, b and m indicate the length of the major, minor and the third axis of the ellipse
respectively.

Operations:

3Dist
1. Select [3Dist] from the drop-down list on the right of [Volume] in the measurement menu. The
cursor appears on the screen.
2. Here, D1, D2, D3 are length of three axes of the target object.
See "3.2.2 Distance" for detailed procedures.
Generally, D1, D2, D3 should belong to different scanning plane.

Ellipse
1. Select [Ellipse] from the drop-down list on the right of [Volume] in the measurement menu. The
cursor appears on the screen.
2. The procedures are similar to that of Ellipse in the volume measurement, see "3.2.4 Area" for
details.

EDist
1. Select [EDist] from the drop-down list on the right of [Volume] in the measurement menu. The
cursor appears on the screen.
2. Use the Ellipse method to measure the vertical section area.
The procedures are similar to that of Ellipse in the Area measurement, see "3.2.4 Area" for
details.
3. Unfreeze the image. Rescan the area of interest perpendicular to the previous image.
4. Measure the length of the third axis with the Distance measurement method, see
"3.2.2 Distance" for detailed procedures.

3.2.6 Cross
Function: measures the lengths of line segments A and B perpendicular to each other.
1. Click [Cross] in the measurement menu, and the cursor appears on the screen.
2. Move the cursor to the measure starting point.
3. Press <Set> to set the starting point of the first line segment.
4. Use the trackball to position the end point of the first axis and then press <Set>. Here,
Press <Update> to switch between the starting point and the end point of the first axis. Or,
Press <Clear> to cancel setting the starting point of the first axis.
5. Press <Set> to set the starting point of the first line segment. The second line segment
perpendicular to the fixed line segment appears on the screen.
6. Move the cursor to the starting point of the second line segment.
7. Press <Set> to set the starting point of the second line segment. Or, press the <Update> or
<Clear> to return to the last step.
8. Move the cursor to the end point of the second line segment. Here,

General Measurement 3-5

 Press <Update> to switch between the starting point and the end point of the second axis.
Or,
Press <Clear> to cancel setting the starting point of the second axis.
9. Press <Set> to confirm the end point of the second line segment.

3.2.7 Parallel
Function: Measures the distance between every two line segments of five parallel line segments,
namely, four distances in total.
1. Select [Parallel] in the measurement menu, and then two lines perpendicular to each other
appear on the screen. The intersection is the starting point of the line segment.
2. Rotate the Multifunctional Knob to change the angle of the lines and press <Set> to confirm.
3. Move the cursor to the starting point of the line segment.
4. Press <Set> to confirm the starting point and the first line.
5. Move the cursor, press <Set> to confirm the other four parallel lines, when the last parallel line
is set, also the end point of the line that is perpendicular to the five parallel lines is confirmed.
During the measurement, press <Set> twice to set the last parallel line and complete the
measurement.

3.2.8 TLength
Function: Measures the length of a curve on the image. Measurement methods available include
Trace and Spline.

Trace
1. Select [Trace] from the drop-down list on the right of [TLength] in the measurement menu. The
cursor appears on the screen.
2. Move the cursor to an area of interest.
3. Press <Set> to fix the starting point.
4. Move the cursor along the target to trace the outline of the target.
To modify the trace line, please rotate the <Multi-Functional knob>:
Anticlockwise: to cancel a series of points.
Clockwise: to resume a series of points.
5. Press <Set> to anchor the end point of the trace line.

Spline
1. Select [Spline] from the drop-down list on the right of [TLength] in the measurement menu.
The cursor appears on the screen.
2. Move the cursor to an area of interest.
3. Press <Set> to fix the starting point.
4. Move the trackball along the target and press <Set> to anchor the second, third, fourth …
points. A maximum of 12 points can be anchored.
To correct a previous point, press <Clear>.
5. Press <Set> twice to set the end point of the spline.

3.2.9 Ratio (D)

Function: Measures the lengths of two line segments and then calculates their ratio.
1. Click [Ratio (D)] in the measurement menu, and the cursor appears on the screen.

3-6 General Measurement

2. Measure the length of the two line segments, see "3.2.2 Distance" for detailed procedures.
The result displays in the result window after the measurement of the second line is
completed.

3.2.10 Ratio (A)

Function: Measures the area of two closed regions and then calculates their ratio. The methods
are Ellipse, Trace, Cross, Spline.
1. Select method from the drop-down list on the right of [Ratio (A)] in the menu. The cursor
appears on the screen.
2. Measure the area of the two closed regions, see "3.2.4 Area" for detailed procedures.

3.2.11 B-Profile
Function: measures the gray distribution of ultrasonic echo signals on a line.
Tips: B-Profile must be performed on the frozen image.

1. Click [B-Profile] in the measurement menu, and the cursor appears on the screen.
2. Set a line segment, see "3.2.2 Distance" for detailed procedures.
The result is shown in figure below:

Where,
No: The number of the graph. Value: 1 or 2.
The last two results will be displayed on the screen.
Gmax: The maximum gray.
Gmin: The minimum gray.
Gmean: The average gray.
Gsd: The variance of gray.

3.2.12 B-Hist
Function: Measures and counts the gray distribution of ultrasonic echo signals within a closed
region. The methods to set a closed region are Ellipse, Trace, Spline and Rect (Rectangle).
Tips: B-Hist must be performed on the frozen image.

Rect
Rect sets a rectangle with two points on the cross. The operations are:
1. Click [B-Hist] in the measurement menu, and the cursor appears on the screen.
2. Move the cursor to the first vertex of the rectangle, press <Set>.
3. Move the cursor to the second vertex of the rectangle, press <Set>. The result is shown in the
following figure:

General Measurement 3-7

Where,
Horizontal axis: The gray of the image
The vertical axis: The gray distribution percentage.
No: The number of the graph. The last two results will be displayed
on the screen.
N: The total pixel number in the area to be measured.
M: M ＝∑Di / N；
MAX: MAX = the pixel number in the maximum gray/ N×100%
SD: Standard deviation. SD=(∑Di2/N-(∑Di/N)2)1/2
Di: The gray at each pixel point;
∑Di: The total grays of all pixels.

Ellipse
See "Ellipse" in the "3.2.4 Area" for detailed procedures.

Trace
See "Trace" in the "3.2.4 Area" for detailed procedures.

Spline
See "Spline" in the "3.2.4 Area" for detailed procedures.

3.2.13 Color Vel

Tips: 1. Color Vel must be performed on the frozen image in color mode.
2. This measurement item is meant for a general estimation, not for accurate
measurement.

Function: measures the velocity of blood flow on the Color Mode image.
1. Click [Color Vel] in the measurement menu, and the cursor appears on the screen.
2. Move the cursor to the point to be measured for blood flow velocity.
3. Press <Set> to fix the point, a floating line is displayed in the direction parallel to the ultrasonic
wave beam at that point.
The compensation angle is 0°at the moment; you can change the angle (0°-80°) by
rotating the Multifunctional Knob to align the floating line in the direction same to that of
blood flow at the point to be measured.
4. Press <Set> to set the direction of the blood flow, and the result displays in the result window.

3.2.14 VF Diam
Function: measures the distance between two points on the image to obtain the vessel flow
diameter.
1. Select [VF Diam] from the 2D general measurement menu, and the cursor appears on the
screen.
2. Move the cursor to the starting point with the track ball.
3. Press the <Set> key to fix the starting point.
4. Move the cursor to the end point with the track ball.

3-8 General Measurement

 Press <Update> to switch between the fixed end and active end of the caliper. Or,
Press <Clear> to cancel setting the starting point.
5. Press the <Set> key to confirm the end point.

3.3 M General Measurements

3.3.1 Distance
Function: Measures the distance between two points on the M Mode image.
1. Click [Distance] in the measurement menu, and two dotted lines perpendicular to each other
appear on the screen.
2. Move the crossing point of the dotted lines to the measurement starting point and press <Set>.
3. Move the crossing point to the end point, and then the crossing point can only be moved in
vertical direction. Here,
Press <Update> to switch between the fixed end and active end of the caliper. Or,
Press <Clear> to cancel setting the starting point.
4. Press <Set> to set the end point.

3.3.2 Time
Function: Measures the time interval between two points on the M Mode image.
1. Click [Time] in the measurement menu, and two dotted lines perpendicular to each other
appear on the screen.
2. Move the crossing point of the dotted lines to the measurement starting point and press <Set>.
3. Move the crossing point to the measurement end point. The crossing point can only be moved
in the horizontal direction. Here,
Press <Update> to switch between the fixed end and active end of the caliper. Or,
Press <Clear> to cancel setting the starting point.
4. Press <Set> to set the end point.

3.3.3 Slope
Function: Measures the distance and time between two points on the M Mode image and
calculates the slope between the two points.
1. Click [Slope] in the measurement menu, and two dotted lines perpendicular to each other
appear on the screen.
2. Move the crossing point of the dotted lines to the measurement starting point and press <Set>.
3. Move the crossing point to the measurement end point. The cross point is connected to the
starting point by a dashed line. Here,
Press <Update> to switch between the fixed end and active end of the caliper. Or,
Press <Clear> to cancel setting the starting point.
4. Press <Set> to set the end point.

3.3.4 Velocity
Function: Measures the distance and time between two points on the M Mode image and then
calculates the average velocity between the two points.

General Measurement 3-9

1. Click [Velocity] in the measurement menu, and two dotted lines perpendicular to each other
appear on the screen.
2. Move the crossing point of the dotted lines to the measurement starting point and press <Set>.
3. Move the crossing point to the end point, and then the crossing point can only be moved in
vertical direction.
Here, Press <Update> to switch between the fixed end and active end of the caliper. Or,
Press <Clear> to cancel setting the starting point.
4. Press <Set> to set the end point.

3.3.5 HR
Function: Measures the time of n (n≤8) cardiac cycles on the M Mode image and calculates the
heart rate.
The number of cardiac cycles “n” can be preset in the [System Preset] -> [Meas Param] preset
dialog box, see "2.2 Measurement Parameters Preset" for details.

CAUTION: During the measurement, the number of cardiac cycles between the
measurement starting and end points must be exactly the same as
preset. Otherwise, misdiagnosis may occur.

1. Click [HR] in the measurement menu, and two dotted lines perpendicular to each other appear
on the screen.
2. Select n cardiac cycles.
The HR result in the result window, as shown in the figure below, displays the measured heart
rate value and the preset number of cardiac cycles. As shown in figure below.
HR 76(2) Bpm
Number of
Cardiac Cycles
Heart Rate

3.4 Doppler General Measurements

3.4.1 Time
Function: Measures the time interval between two points on the Doppler image.
The operations are similar to the Time measurement in M Mode. See "3.3.2 Time" for details.

3.4.2 HR
Function: measures the time interval between n (n≤8) cardiac cycles on the M Mode image and
calculates the number of heart beats per minute (BPM).
The operations are similar to the Heart Rate measurement in M Mode. See "3.3.5 HR" for details.

3.4.3 D Vel
Function: measures the velocity, pressure gradient and correction angle of a certain point on the
Doppler spectrum.

3-10 General Measurement

Method 1
1. Make sure the depth result is preset to display in the item property.
Several measurement items can obtain depth, take Doppler "HR" as an example, as shown in
the following figure.

See step 7 in "2.4.1 General Measurement Preset" for how to preset item property.
2. Select the measurement item (preset with D velocity result displaying) in the measurement
menu. The real-time velocity value displays in the result window, as shown in the following
figure.

Tips: The real-time velocity displays in the result window only before the <Set> key is pressed
to fix the starting point. History value of the velocity is not displayed in the result window.

Method 2
1. Click [D Vel] in the measurement menu, and the cursor appears on the screen.
2. Move the cursor to the point to be measured for velocity.
3. Press <Set> and the result displays in the result window.

3.4.4 Acceleration
Function: Measures the velocities of two points and their time interval on the Doppler image, and
calculates the acceleration, pressure gradient, velocity difference and correction angle.
1. Click [Acceleration] in the measurement menu, and the cursor appears on the screen.
2. Move the cursor to the first point to be measured for velocity.
3. Press <Set> to fix the first point.
4. Move the cursor to the second point to be measured for velocity.
5. Press <Set> to fix the second point. The results displays in the result window.

General Measurement 3-11

 Results displayed in the result window can be preset in the measurement item property, as
shown in the following figure.
See step 7 in "2.4.1 General Measurement Preset" for how to preset item property.

3.4.5 D Trace
Function: measures clinical indices through tracing Doppler spectrum. Measurement methods
available are Trace, Spline, Auto, Vel (Velocity) and 2 PT (Two Points).
The sketch map of Doppler spectrum is shown as below:

NOTE: The heartbeat of the traced spectrum should equal to that is preset, otherwise the
obtained HR (Heart Rate) is incorrect. See "2.2 Measurement Parameters Preset" for
relevant preset.

Result parameters
Results obtained from D trace are:
Parameters Descriptions
The highest velocity of the red blood cells crossing the
PS Peak Systolic Velocity
sample volume.
Measures the blood velocity at the end of the cardiac
ED End-Diastolic Velocity
cycle.
MD Min-Diastolic Velocity Minimum absolute Velocity in diastolic cycle.
Vel / Flow velocity
The average flow velocity in the whole traced Doppler
spectrum.
Average „ TAMAX (Time Averaged Maximum Velocity):
/
(Tb − Ta )
Tb
velocity TAMAX( cm / s )＝ ∫ V ( t ) dt
Ta

„ TAMEAN (Time Averaged Mean Velocity): Obtained

by auto spectrum calculation.
Peak Pressure It is the corresponding pressure gradient of the peak
PPG
Gradient systolic velocity. PPG (mmHg) = 4 × PS (m/s)2

3-12 General Measurement

Parameters Descriptions
Average pressure gradient in the whole traced Doppler
spectrum.

Average PG (mmHg ) = ∫ 4(V (t )) dt (T b−Ta )

Tb 2

Average Ta

Pressure / „ MPG: Maximum Pressure Gradient. It is the

Gradient corresponding pressure gradient of the peak systolic
velocity.
„ MMPG: Mean velocity Mean Pressure Gradient.
(Obtained during auto-spectrum calculation.)
Velocity-time Integral. It is the integral of the product of
Doppler instantaneous velocity and the total time interval.
VTI Velocity-Time Integral
VTI (m)＝∫ V (t )dt
Tb

Ta

It is the time of the blood velocity accelerating from the

end of diastole to the systolic peak. Generally, it's the
AT Acceleration Time time interval between the end of the first cardiac cycle
and the peak of the next cardiac cycle. Choose the first
peak when two peaks existing the systolic cycle.
DT Deceleration Time Deceleration Time.
Calculates the heart rate per minute by measuring the
HR Heart Rate
time interval of one cardiac cycle.
PS/ED.
S/D /
S/D (No unit) = PS (m/s) / ED (m/s)
ED/PS.
D/S /
D/S (No unit) = ED (m/s) / PS (m/s)
Pulsatile Index.
PI Pulsative Index
PI (No unit) = |(PS (m/s) – ED (m/s)) / TAMAX (m/s)|
Resistance index. RI (No unit) = |(PS (m/s) – ED (m/s)) /
RI Resistive Index
PS (m/s)|
Correction angle is the spectrum angle during
measurement, which is a result obtained from a non D
θ /
trace measurement tool and usually be displayed
together with the spectral measurement results.
The peak velocity in systolic or diastolic cycle (with no
difference), which is the highest velocity of the red blood
PV Peak Velocity
cell(s) that cross the sample volume, and it can be used
to examine the venous vessel.
NOTE:
1. In the formulae above, T means time, the unit is s; V means the velocity at each point during T,
the unit is cm/s; a is the traced starting point, while b is the traced end point.
2. The above parameters are all the information obtained in D trace, while in application, the
system only displays part of them according to operation and preset.

General Measurement 3-13

Measurement Method
In D trace item property, you can preset to display one or more results. See step 7 in
"2.4.1 General Measurement Preset" for how to preset item property.)

The measurement method varies by the result selected.

„ Velocity
Function: measures the velocity, pressure gradient and correction angle of a certain point on
the Doppler spectrum.
The operations are similar to the Time measurement in M Mode. See "3.4.3 D Vel" for details.
„ 2 PT
1. Select [2 PT] on the measurement menu, the cursor displays as a big “+”.
2. Move the cursor to the starting point to be measured and press <Set> to fix the point.
3. Move the cursor to the end point to be measured and press <Set> to fix the point.
„ Trace
1. Select [Trace] from the drop-down list on the right of [D Trace] in the measurement menu.
2. Move the cursor to the starting point to be measured and press <Set> to fix the point.
3. Move the cursor around the object.
Move the cursor right: draw a trace line overlapping the spectrum as much as possible.
Move the cursor left (or rotate the <Multifunctional Knob> anticlockwise to correct the
trace line already drawn.
4. Trace the end point to be measured and press <Set> to fix the point.

„ Spline
1. Select [Spline] from the drop-down list on the right of [D Trace] in the measurement menu.
2. Move the cursor to the starting point to be measured and press <Set> to fix the point.
3. Move the cursor along the edge of the desired region. Continue to fix the second, third …
point (50 points at most) of spectrum.
4. Press <Set> twice to anchor the last reference point. Or,
The measurement ends automatically when there are 50 reference points.
„ Auto
Auto D trace must be performed on the frozen image.
1. Select [Auto] from the drop-down list on the right of [D Trace] in the measurement menu,
the measure cursor appears on the screen.
2. Move the cursor to the starting point to be measured and press <Set> to fix the point.
3. Press <Set> to anchor the end point of the trace line. The spectrum between the start
point and the end point is traced.

3.4.6 PS/ED
Function: measures the Peak Systolic (PS) and End Diastolic (ED) velocities on the Doppler
spectrum, and calculates their resistance index (RI), S/D and correction angle.
1. Click [PS/ED] in the measurement menu, and the cursor appears on the screen.
2. Move the cursor to the Systolic Peak and press <Set> to fix the point.
3. Move the cursor to the Diastolic End and press <Set> to fix the point.
Results displayed in the result window can be preset in the measurement item property,
as shown in the following figure.

3-14 General Measurement

 See step 7 in "2.4.1 General Measurement Preset" for how to preset item property.

3.5 References
3Dist Volume: Emamian, S.A., et al., "Kidney Dimensions at Sonography: Correlation With
Age, Sex, and Habitus in 665 Adult Volunteers," American Journal of Radiology,
January, 1993, 160:83-86.

HR (M general Dorland’s Illustrated Medical Dictionary, ed. 27, W. B. Sanders Co.,

measurement): Philadelphia,1988, p. 1425.

PG: Powis, R., Schwartz, R. Practical Doppler Ultrasound for the Clinician. Williams
& Wilkins, Baltimore, Maryland, 1991, p. 162.

Acceleration: Starvos, A.T., et.al. “Segmental Stenosis of the Renal Artery Pattern Recognition
of Tardus and Parvus Abnormalities with Duplex Sonography.” Radiology,
184:487-492, 1992.

Taylor,K.W.,Strandness,D.E.Duplex Doppler Ultrasound.Churchill-Livingstone,

New York,1990.
PPG: Yoganathan, Ajit P., et al., "Review of Hydrodynamic Principles for the
Cardiologist:Applications to the Study of Blood Flow and Jets by Imaging
Techniques," Journal of the American College of Cardiology, 1988, Vol. 12, pp.
1344-1353

MPG: Yoganathan, Ajit P., et al., "Review of Hydrodynamic Principles for the
Cardiologist:Applications to the Study of Blood Flow and Jets by Imaging
Techniques," Journal of the American College of Cardiology, 1988, Vol. 12, pp.
1344-1353

General Measurement 3-15

VTI: Degroff, C. G. Doppler Echocardiography. Third Edition. Lippincott-Raven,
Philadelphia, 1999, p. 102-103

RI: Burns, P.N., "The Physical Principles of Doppler and Spectral Analysis," Journal
of Clinical Ultrasound, November/December 1987, Vol. 15, No. 9, p. 586

PI: Burns, Peter N., "The Physical Principles of Doppler and Spectral Analysis,"
Journal of Clinical Ultrasound, November/December 1987, Vol. 15, No. 9, p. 585

S/D: Ameriso S, et al., “Pulseless Transcranial Doppler Finding in Takayasu’s

Arteritis,” J Clin Ultrasound, September 1990; 18:592-6

D/S: Ameriso S, et al., “Pulseless Transcranial Doppler Finding in Takayasu’s

Arteritis,” J Clin Ultrasound, September 1990; 18:592-6

3-16 General Measurement

4 Abdomen

4.1 Abdomen Exam Preparations

Make the following preparations before measurement:
1. Confirm that the current probe is appropriate.
2. Check if the current date of the system is correct.
3. Press <Patient>, register the patient information in [Patient Info] -> [ABD] dialog box.
For more details, refer to "Exam Preparation -> Patient Information" in the Operator's Manual
[Basic Volume].
4. Switch to the correct exam mode.

4.2 Basic Abdomen Measurement Procedures

1. Press <Patient>, register the patient information in [Patient Info] -> [ABD] dialog box.
2. Press <Measure> to enter the Application Measurements.
If the current menu is not the one containing Abdomen Measurement tools, move the cursor to
the menu title and select the package having Abdomen Measurement tools.
3. Select measurement tool in the menu to start the measurement.
See section "4.3 Abdomen Measurement Tools" and steps in "3 General Measurement" for
measurement methods.
4. Press <Report> to view the exam report, see "4.5 Abdomen Exam Report" for details.

4.3 Abdomen Measurement Tools

NOTE: Measurement tools mentioned below are configured in the system. The application
measurement packages provided in this system are generally different combinations of
measurement tools. For more information about package preset, see "2.4.2.2 Application
Measurement Preset".

Measurement, calculation and study measurement items in 2D and Doppler mode (no M mode
measurement item) are list below:

2D Abdomen Measurements
Types Tools Descriptions Methods or Formulae
Liver /
Renal L Renal Length
Renal H Renal Height Distance in 2D General
Measurement
Measurements
Renal W Renal Width
Renal Cortical
Cortex
Thickness

Abdomen 4-1
 Types Tools Descriptions Methods or Formulae
Adrenal L Adrenal Length
Adrenal H Adrenal Height
Adrenal W Adrenal Width
CBD Common bile duct
Portal V Diam Portal Vein Diameter
CHD Common hepatic duct
GB L Gallbladder Length
GB H Gallbladder Height
Gallbladder wall
GB wall th
thickness
Panc duct Pancreatic duct
Panc head Pancreatic head
Panc body Pancreatic body
Panc tail Pancreatic tail
Spleen /
Aorta Diam Aorta Diameter
Aorta Bif /
Distance in 2D General
Iliac Diam Iliac Diameter Measurements
Previous-Bladder
Pre-BL L
Length
Measurement Pre-BL H Previous-Bladder Height
Pre-BL W Previous-Bladder Width
Posterior-Bladder
Post-BL L
Length
Posterior-Bladder
Post-BL H
Height
Post-BL W Posterior-Bladder Width
Renal Vol Renal Volume See “Renal Vol” (9 Urology)
Previous-Bladder
Pre-BL Vol See “Pre-BL Vol” (9 Urology)
Volume
Calculation
Posterior-Bladder
Post-BL Vol See “Post-BL Vol” (9 Urology)
Volume
Mictur.Vol Micturated Volume See “Mictur.Vol” (9 Urology)
Kidney / See “Kidney” (9 Urology)
Study Adrenal / See “Adrenal” (9 Urology)
Bladder / See “Bladder” (9 Urology)

4-2 Abdomen
Doppler Abdomen Measurements
Types Tools Descriptions Methods or formulae
Ren A Org Renal Artery Origin
Arcuate A Arcuate Artery
Segment A Segmental Artery
Interlobar A Interlobar Artery
Renal A Renal Artery
M Renal A Main Renal Artery
Renal V Renal Vein
Aorta /
Celiac Axis /
Superior Mesenteric
SMA
Artery D trace in General D
Measurement
C Hepatic A Common Hepatic Artery measurements

Hepatic A Hepatic Artery

Splenic A Splenic Artery
IVC Inferior Vena Cava
Portal V Portal Vein
M Portal V M Portal Vein
Hepatic V Hepatic Vein
M Hepatic V Middle Hepatic Vein
Splenic V Splenic Vein
Superior Mesenteric
SMV
Vein
Calculation / /
Study / /

4.4 Abdomen Measurement Operations

Tips: 1. See the table in "4 Abdomen Measurement Tools" above for measurement tools
and methods.
2. For the definitions of measurement, calculation and study, refer to
"1.3 Measurement, Calculation and Study".
3. The order of the measurement items is presettable, see "2.4.2 Application
Measurement Preset" for details.

1. Select the item/tool in the measurement menu.

2. Perform the measurement referring to the methods in table above.

Abdomen 4-3
4.5 Abdomen Exam Report
During or after a measurement, press <Report> on the Control Panel to browse the report.
For details about report browsing, printing and exporting etc, see "1.7 Report".

4-4 Abdomen
5 Obstetrics
Obstetric measurements are used to estimate the GA and EDD, to calculate the growth indices,
including the EFW. The growth estimation is determined by growth curve and fetal biophysical
profile.

5.1 Obstetric Exam Preparations

Make the following preparations before measurement:
1. Confirm that the current probe is appropriate.
2. Check if the current date of the system is correct.
3. Press <Patient>, register the patient information in [Patient Info] -> [OB] dialog box.
For more details, refer to "Exam Preparation -> Patient Information" in the Operator's Manual
[Basic Volume].
4. Switch to the correct exam mode.

CAUTION: Ensure the date of the system is correct, otherwise, GA and EDD
calculated will be wrong.

5.2 Basic Measurement Procedures

1. Press <Patient>, register the patient information in [Patient Info] -> [OB] dialog box.
The clinical GA is calculated when the corresponding data input in this page, see
"5.3.1 Clinical GA" for details.
2. Press <Measure> to enter the Application Measurements.
If the current menu is not the one having Obstetric Measurement tools, move the cursor to the
menu title and select the package having Obstetric Measurement tools.
3. Select measurement tool in the menu to start the measurement.
See the table in "5.4 Obstetric Measurement Tools" below for measurement tools.
See section "5.5 Obstetric Measurement Operations" and steps in "3 General Measurement"
for measurement methods.
4. Press <Report> to view the exam report, see "5.7 Obstetric Exam Report" for details.

5.3 GA
5.3.1 Clinical GA
The GA (Gestational Age) and EDD (Estimated Delivery Date) are calculated according to clinical
parameter(s).
1. Press <Patient>, register the patient information in [Patient Info] -> [OB] dialog box.
The system automatically calculates the GA and EDD after enter the relative information.

Obstetrics 5-1
The calculating methods are listed as follows:
z LMP: input the LMP, the system will calculate the GA and EDD.
z IVF: After you enter IVF, the system will calculate GA and EDD.
z PRV: input the date and GA of the last exam, the system will calculate a new GA and EDD.
z BBT: After you enter BBT, the system will calculate GA and EDD.
z EDD: input the EDD, the system will calculate GA and LMP.
2. The clinical GA is shown at the head of the obstetric report.
Tips: The latest EDD and GA calculation is considered as the final value if more than one EDD
and GA calculations are valid.

5.3.2 Ultrasound GA
Ultrasound GA and ultrasound EDD are calculated according to the parameters obtained in
measurements.
„ GA in OB Items
„ AUA (Average Ultrasound Age)
„ CUA (Composite Ultrasound Age)

GA in OB Items
The GA in the OB items is calculated by the related GA tables/ formulae, it is independent from the
clinical GA.
1. You can preset the GA formulae and whether to display SD and EDD or not in [System Preset]
-> [OB], see “2.3 Obstetric Preset” for details.
2. The GA and other measurement values display in the result window after a measurement.
If the Diagnostic GA exceeds the threshold, an OOR (out of range) displays in the result
window and this result is not recorded in the report.
3. The GA of an OB item displays in the right side of the item measurements.
4. For result values used to calculate GA (Gestational Age) and EDD (Estimated Date of
Delivery), the formula used in this calculation can be selected from [Formula].
Tips: SD is also calculated through GA table/ formulae, it displays in the result window and
report only when the system has clinical GA.

AUA
AUA is the average of valid GAs that are calculated according to biparietal diameter (BPD), head
circumference (HC), abdomen circumference (AC), humerus length (HL), Gestational Sac (GS),
crown rump length (CRL) etc.
1. All valid values of all above items will be involved in AUA calculation in the system default
method.
2. Clicking the check boxes at the right side of related items to select whether to involve the item
in AUA calculation or not. The AUA value varies by the selection.

5-2 Obstetrics
CUA
CUA is calculated according to formulae based on some measurement items (the involved items
are among biparietal diameter (BPD), head circumference (HC), abdomen circumference (AC),
and humerus length (HL)). To calculate CUA, all the GA formulae of the parameters involved must
be Hadlock, the unit of the parameters is cm, and unit of CUA is week. The formulae are listed as
follows:
1. CUA(BPD) = 9.54+1.482*BPD+0.1676*BPD2
2. CUA(HC) = 8.96+0.540*HC+0.0003*HC3
3. CUA(AC) = 8.14+0.753*AC+0.0036*AC2
4. CUA(FL) = 10.35+2.460*FL+0.170*FL2
5. CUA(BPD, HC) = 10.32+0.009*HC2+1.3200*BPD+0.00012*HC3
6. CUA(BPD, AC) = 9.57+0.524*AC+0.1220*BPD2
7. CUA(BPD, FL) = 10.50+0.197*BPD*FL+0.9500*FL+0.7300*BPD
8. CUA(HC, AC) = 10.31+0.012*HC2+0.3850*AC
9. CUA(HC, FL) = 11.19+0.070*HC*FL+0.2630*HC
10. CUA(AC, FL) =10.47+0.442*AC+0.3140*FL2 - 0.0121*FL3
11. CUA(BPD, HC, AC) = 10.58+0.005*HC2 +0.3635*AC+ 0.02864*BPD*AC
12. CUA(BPD, HC, FL) = 11.38+0.070*HC*FL+0.9800*BPD
13. CUA(BPD, AC, FL) = 10.61+0.175*BPD*FL+0.2970*AC+0.7100*FL
14. CUA(HC, AC, FL) = 10.33+0.031*HC*FL+0.3610*HC+0.0298*AC*FL
15. CUA(BPD, HC, AC, FL)=10.85+0.060*HC*FL+0.6700*BPD+0.1680*AC
The default method to calculate CUA is to use the formula that involves more measurement items.
Also, you can select the parameters by clicking the check boxes at the right side of the related
items.

OB Growth Percentile
The obstetric growth percentile is used to estimate the fetal growth. It calculates the difference
between ultrasound measurement results and the measurement results corresponding to the
clinical GA in the FG table. The percentile will not be calculated when there is no clinical GA, or no
FG table, or the SD Type of the FG table is set to “None”.

The premise is: data in the FG table are (approximately) normal distributed, and support “lower-
limit < average value < upper-limit”.

The system does not calculate the OB growth percentile if:

Obstetrics 5-3
„ A FG table is not normal distributed.
„ There is no upper/ lower deviation set in the FG table.
„ The FG table has the upper/ lower deviation set, but certain clinical GA value has no upper/
lower deviation or the deviation value is not plus. The fetal growth curve is not affected. E.g.
Jeanty FG table of RAD.

The OB growth percentile is displayed in the result window, measurement report, exported
PDF/RTF report and the OB structured report, and it supports print viewing and printing.

5.4 Obstetric Measurement Tools

The system supports the following 2D/M/Doppler obstetric measurements.
NOTE: Measurement tools mentioned below are configured in the system. The application
measurement packages provided in this system are generally different combinations of
measurement tools. For more information about package preset, see "2.4.2.2 Application
Measurement Preset".

2D Obstetric Measurements
Types Tools Descriptions Methods or formulae
GS Gestational Sac Diameter Distance in 2D General
YS Yolk Sac Measurements

Line (same as Distance in 2D

CRL Crown Rump Length General Measurements), Trace,
Spline
Distance in 2D General
NT Nuchal Translucency
Measurements
BPD Biparietal Diameter
OFD Occipital Frontal Diameter

Measurement HC 1 Head Circumference

AC Abdominal Circumference
Distance in 2D General
FL Femur Length Measurements
Abdominal Transversal
TAD
Diameter
Anteroposterior Abdominal
APAD
Diameter
TCD Cerebellum Diameter Distance in 2D General
Cist Magna Cist Magna Measurements
LVW Lateral Ventricle Width

1
Head Circumference: in HC measurement, if the measure cursor of BPD appears on the screen, then the
measurement starting point will be automatically posited at the measure cursor starting point of the last BPD; if you
use “Ellipse” to measure the HC, the measure cursor of the last BPD will be the first axis of the ellipse in the default
status.

5-4 Obstetrics
 Types Tools Descriptions Methods or formulae
HW Hemisphere Width
OOD Outer Orbital Diameter
IOD Inter Orbital Diameter
HUM Humerus Length
Ulna Ulna Length
RAD Radius Length
Tibia Tibia Length
FIB Fibula Length
CLAV Clavicle Length
Vertebrae Length of Vertebrae
MP Middle Phalanx Length
Foot Foot Length
Ear Ear Length
Anteroposterior trunk
APTD
diameter
TTD Transverse trunk diameter
Fetal Trunk Cross-sectional Area in 2D General
FTA
Area Measurements
Distance in 2D General
THD Thoracic Diameter
Measurements
Measurement
HrtC Heart Circumference Area in 2D General
TC Thoracic circumference Measurements

Distance in 2D General
Umb VD Umbilical Vein Diameter
Measurements
F-kidney Fetal kidney Length
Mat Kidney Matrix Kidney Length
Distance in 2D General
Cervix L Cervical Length
Measurements
AF Amniotic Fluid
NF Nuchal Fold
Orbit Orbit
PL Thickness Placental Thickness
Sac Diam1 Gestational Sac Diameter 1
Sac Diam2 Gestational Sac Diameter 2 Distance in 2D General
Sac Diam3 Gestational Sac Diameter 3 Measurements

AF1 Amniotic Fluid 1

AF2 Amniotic Fluid 2
AF3 Amniotic Fluid 3

Obstetrics 5-5
 Types Tools Descriptions Methods or formulae
AF4 Amniotic Fluid 4
Left Ventricular Internal
LVIDd
Diameter at End-diastole
Left Ventricular Internal
LVIDs
Diameter at End-systole
LV Diam Left Ventricular Diameter
LA Diam Left Atrium Diameter
Right Ventricular Internal
RVIDd
Diameter at End-diastole
Right Ventricular Internal
RVIDs
Diameter at End-systole
RV Diam Right Ventricular Diameter
RA Diam Right Atrium Diameter
Interventricular Septal
IVSd
Thickness at End-diastole
Interventricular Septal
IVSs
Thickness at End-systole
Interventricular Septal
IVS
Thickness

Measurement LV Area Left Ventricular Area

LA Area Left Atrium Area
Distance in 2D General
RV Area Right Ventricular Area
Measurements
RA Area Right Atrium Area
Ao Diam Aorta Diameter
Main Pulmonary Artery
MPA Diam
Diameter
Right Ventricular Outflow
LVOT Diam
Tract Diameter
Right Ventricular Outflow
RVOT Diam
Tract Diameter
Mean Sac Mean Gestational Sac The average value of three sac
Diam Diameter diameters
Measure the maximum AFs of
the four amniotic fluid pockets of
AFI / pregnant woman.
Calculation AFI = AF1+AF2+AF3+AF4
EFW1 Estimated Fetal Weight 1 EFW is calculated by the default
EFW formulae, based on multiple
measured parameters, See
EFW2 Estimated Fetal Weight 2 “2.3.1 Obstetric Formula”. The
formulae can be reselected in the
OB report.

5-6 Obstetrics
 Types Tools Descriptions Methods or formulae
HC/AC / HC/AC
FL/AC / FL/AC×100
FL/BPD / FL / BPD ×100%
AXT / APTD × TTD
CI / BPD / OFD ×100%
FL/HC / FL/AC×100
HC(c) / HC(c) = 2.325×(BPD2 + OFD2)1/2
HrtC/TC / HrtC / TC
TCD/AC / TCD / AC
LVW/HW / LVW / HW × 100%
LVD/RVD / LV Diam/RV Diam
LAD/RAD / LA Diam/RA Diam
AoD/MPAD / Ao Diam/MPA Diam
LAD/AoD / LA Diam/Ao Diam
Measures AF1, AF2, AF3, AF4,
Study AFI(Auto) /
calculates AFI

M Obstetric Measurements
Types Tools Descriptions Methods or formulae
Heart Rate in M General
FHR Fetal Heart Rate
Measurements
Left ventricular short-axis
LVIDd
diameter at end diastole
Left ventricular short-axis
LVIDs
diameter at end systole
Right ventricular short-axis
Measurement RVIDd
diameter at end diastole Distance in 2D General
Right ventricular short-axis Measurements
RVIDs
diameter at end systole
interventricular septal
IVSd
thickness at en diastole
interventricular septal
IVSs
thickness at en systole
Calculation / /
Study / /

Doppler Obstetric Measurements

Types Tools Descriptions Methods or formulae
Measurement Umb A Umbilical Artery D trace in General D

Obstetrics 5-7
 Types Tools Descriptions Methods or formulae
Duct Veno Ductus Veno measurements
Placenta A Placenta Artery
MCA Middle Cerebral Artery
Fetal Ao Fetal Aorta
Desc Aorta Descending Aorta
Ut A Uterine Artery
Ovarian A Ovarian Artery
FHR Fetal Heart Rate
Calculation / /
Study / /

5.5 Obstetric Measurement Operations

Operations of measurement, calculation and study are described by examples.
Tips: 1. See the table in "5.4 Obstetric Measurement Tools" above for measurement tools
and methods.
2. For the definitions of measurement, calculation and study, refer to
"1.3 Measurement, Calculation and Study".
3. The order of the measurement items is presettable, see "2.4.2 Application
Measurement Preset" for details.

5.5.1 Measurement Tool Operations

Take the HC measurement as an example.
1. Select the [HC] item/tool in the measurement menu.
See “Select Measurement Method Online” for details on how to select method online.
2. Measure area according to the Area method in 2D General Measurements.
Measurement results, GA calculation and OB growth percentile display in the result window.
You can preset whether to display SD and EDD or not in [System Preset] -> [OB] -> [Fetal
Gestational Age].
For more details about GA, see “5.3 GA”.

5.5.2 Calculation Tool Operations

Take the HC/AC measurement as an example.
1. Select the [HC/AC] item/tool in the measurement menu.
2. Measure the HC and AC according to the Area method in 2D General Measurements.
The second measurement is activated automatically when the first one is completed. The
results display in the result window after measurement.

5-8 Obstetrics
5.5.3 Study Tool Operations
The operation of AFI measurement is as follows.
1. Select [AFI] in the measurement menu. Enter the submenu.
Tips: Whether to display the submenu or not can be preset, see “Setting Item Property” for
details.
2. Measure the maximum AFs of the four amniotic fluid pockets of pregnant woman, and AFI is
calculated automatically.

5.6 Multi-fetus Exam

The system allows multi-fetus (3 at most) examination.
NOTE: Ensure that the Fetus displayed in the multi-fetus measurement menu is the one on
which you are intended to perform the measurements.
Similar to the OB measurement,
1. Set the number of fetuses in [Gestations] via [Patient Info] -> [OB].
If the [Gestations] is set to 2 or 3, the [Fetus] widget displays in the OB measurement menu ,
as shown in the figure below.

You can switch among [Fetus A], [Fetus B] or [Fetus C] via the widget.
2. Perform measurement to the fetus respectively.
The measurement results in the result window are marked with fetus label A, B or C.

3. In the Obstetric report, select [Fetus A], [Fetus B], or [Fetus C] to switch among results of
different fetuses.
4. In the [Obstetric Growth Curve] dialog box, select [A], [B], or [C] on the lower part to display
the growth curves of different fetuses.
z Data of Fetus A/ Fetus B/ Fetus C: Three symbols are used on the growth
curves to indentify measurement data of different fetuses.
z History/ current data: Symbol size is used to distinguish them, with the history data
appeared in smaller symbol.

5.7 Obstetric Exam Report

During or after a measurement, press <Report> on the Control Panel to browse the report.
See "5.6 Multi-fetus Exam" for multi-fetus exam report.
For details about report browsing, printing and exporting etc, see "1.7 Report".

Obstetrics 5-9
5.7.1 Fetal Biophysical Profile
Fetal Biophysical Profile means to first obtain a few indexes related to fetal growth through
experiment or measurement and then evaluate the hazardous situation that the fetus is facing by
grading these indexes respectively.

1. Select [OB] of the Ultrasound Anatomy in the report template preset page.

See section "2.5 Preset of Report Template".

2. Click [Analyze] in the OB report page, the fetus Score is listed after the fetal analysis.

The scoring criteria the system provides are based on Vintzileos formula, as shown in table
below.
Fetal growth Observation
0 score 2 score Remarks
index time
Reactive FHR
<2, or Reactive FHR ≥15bpm,
FHR 30 minutes
≤15bpm duration≥15s, ≥2
times
FM ≥3 times
The score(s)
(Continuous
FM ≥2 fetal movements 30 minutes can be
movement is
manually
deemed to 1 time)
input into the
No FBM or FBM≥1 times; system.
FBM 30 minutes
duration≤30s duration≥30s
Limbs and spine
Limbs stretch, no
FT stretch-bend ≥1 /
bend, fingers loose
times
No AF, or AF volume One or more AF
AF /
<2×2cm volume > 2×2cm

Fetal scoring results criteria:

5-10 Obstetrics
 Total scores Growth condition
8-10 scores Normal, chronic asphyxia risk low
4-6 scores Chronic asphyxia risk suspicious
0-2 scores Chronic asphyxia risk high
3. Scores of each index as well as the total score will be appended to the report.

5.7.2 Fetal Growth Curve

Fetus growth curve means to compare the measured data of the fetus with the normal growth
curve to judge whether the fetus is in normal growth state. Data of growth curve is all sourced from
Fetal Growth Table.
1. Select [Obstetric] of the [Patient Info] in the report template preset page, and the button
[Growth] in the report viewing page is available.
See section "2.5 Preset of Report Template".
2. Enter patient information and obstetric information in [Patient Info] -> [OB] dialog box.
3. Perform one or more tools of fetal growth parameters.
4. Click [Growth] in the report page to display the Obstetric Growth Curve dialog box. The dialog
box displays the growth curve and the position of measurement value.

Obstetrics 5-11
„ Two drop-down lists above the curve display the measurement item/tool and formula of the
curve, which can be changed.
„ Three symbols are used on the growth curves to indentify measurement data of
different fetuses.
„ Current and history data of one fetus are displayed in the same symbol with the history data
appeared in smaller size.
„ Click the [Print] check box to determine whether to include the growth curve in the printed
report or not.
„ The green dotted line indicates the clinical GA on the X-axis.
„ Select the number and layout of the curves from [Display Mode].
1*1: one curve displays in the screen.
2*1: two curves (up/ down) display in the screen.
2*2: four curves display in the screen.
„ Click [Prev Page]/ [Next] to turn the growth curve pages.
5. Click [OK] to confirm the setting and exit the page.

Tips: If the patient ID is blank, clinical GA is not calculated, or the measurement value is
not valid, measurement values will not be displayed on the curve.

5.8 References
GS Rempen A., 1991
Arztliche Fragen. Biometrie in der Fruhgraviditat (i.Trimenon): 425-430.

Hansmann M, Hackelöer BJ, Staudach A

Ultraschalldiagnostik in Geburtshilfe und Gynäkologie 1985

Hellman LM, Kobayashi M, Fillisti L, et al. Growth and development of the human
fetus prior to the 20th week of gestation. Am J Obstet Gynecol 1969; 103:784-800.

Studies on Fetal Growth and Functional Developments, Takashi Okai, Department of

Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo

China
Written by Zhou Yiongchang & Guo Wanxue
in Chapter 38 of "Ultrasound Medicine" (3rd edition) Science & Technology Literature
Press, 1997

CRL Rempen A., 1991

Arztliche Fragen. Biometrie in der Fruhgraviditat (i.Trimenon): 425-430.

Hansmann M, Hackelöer BJ, Staudach A

Ultraschalldiagnostik in Geburtshilfe und Gynäkologie 1985

Hadlock FP, et al. Fetal Crown-Rump Length: Reevaluation of Relation to Menstrual

5-12 Obstetrics
 Age (5-18 weeks) with High-Resolution Real-time US. Radiology 182:501-505.

Jeanty P, Romero R. "Obstetrical Sonography", p. 56. New York, McGraw-Hill, 1984.

Nelson L. Comparison of methods for determining crown-rump measurement by

realtime ultrasound. J Clin Ultrasound February 1981; 9:67-70.

Robinson HP, Fleming JE. A critical evaluation of sonar crown rump length
measurements. Br J Obstetric and Gynaecologic September 1975; 82:702-710.

Fetal Growth Chart Using the Ultrasonotomographic Technique

Keiichi Kurachi, Mineo Aoki
Department of Obstetrics and Gynecology, Osaka University Medical School
Revision 3 (September 1983)

Studies on Fetal Growth and Functional Developments

Takashi Okai Department of Obstetrics and Gynecology, Faculty of Medicine,
University of Tokyo

China
Written by Zhou Yiongchang & Guo Wanxue
in Chapter 38 of "Ultrasound Medicine" (3rd edition) Science & Technology Literature
Press, 1997

BDP Merz E., Werner G. & Ilan E. T., 1991 Ultrasound in Gynaecology and Obstetrics
Textbook and Atlas 312, 326-336.

Rempen A., 1991 Arztliche Fragen. Biometrie in der Fruhgraviditat (i.Trimenon): 425-
430.

Hansmann M, Hackelöer BJ, Staudach A Ultraschalldiagnostik in Geburtshilfe und

Gynäkologie 1985

Jeanty P, Romero R. "Obstetrical Ultrasound." McGraw-Hill Book Company, 1984,

pp. 57-61.

Sabbagha RE, Hughey M. Standardization of sonar cephalometry and gestational

age. Obstetrics and Gynecology October 1978; 52:402-406.

Kurtz AB, Wapner RJ, Kurtz RJ, et al. Analysis of bipariental diameter as an accurate
indicator of gestational age. J Clin Ultrasound 1980;8:319-326.

Fetal Growth Chart Using the Ultrasonotomographic Technique, Keiichi Kurachi,

Mineo Aoki, Department of Obstetrics and Gynecology, Osaka University Medical
School Revision 3 (September 1983)

Studies on Fetal Growth and Functional Developments, Takashi Okai, Department of

Obstetrics 5-13
 Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo

Chitty LS, Altman DG British Journal of Obstetrics and Gynaecology January 1994,
Vol.101 P29-135.

China
Written by Zhou Yiongchang & Guo Wanxue
in Chapter 38 of "Ultrasound Medicine" (3rd edition) Science & Technology Literature
Press, 1997
OFD Merz E., Werner G. & Ilan E. T., 1991
Ultrasound in Gynecology and Obstetrics Textbook and Atlas 312, 326-336.

Hansmann M, Hackelöer BJ, Staudach A

Ultraschalldiagnostik in Geburtshilfe und Gynäkologie 1985

HC Merz E., Werner G. & Ilan E. T., 1991

Ultrasound in Gynecology and Obstetrics Textbook and Atlas 312, 326-336.

Jeanty P, Romero R. "Obstetrical Ultrasound." McGraw-Hill Book Company, 1984.

Hansmann M, Hackelöer BJ, Staudach A

Ultraschalldiagnostik in Geburtshilfe und Gynäkologie 1985

Chitty LS, Altman DG

British Journal of Obstetrics and Gynaecology January 1994, Vol.101
P29-135.

AC Merz E., Werner G. & Ilan E. T., 1991

Ultrasound in Gynaecology and Obstetrics Textbook and Atlas 312, 326-336.

Jeanty P, Romero R. A longitudinal study of fetal abdominal growth, "Obstetrical

Ultrasound." MacGraw-Hill Book Company, 1984.
Chitty LS, Altman DG
British Journal of Obstetrics and Gynaecology January 1994, Vol.101
P29-135.

FL Merz E., Werner G. & Ilan E. T., 1991

Ultrasound in Gynaecology and Obstetrics Textbook and Atlas 312, 326-336.

Hansmann M, Hackelöer BJ, Staudach A

Ultraschalldiagnostik in Geburtshilfe und Gynäkologie 1995

Warda A. H., Deter R. L. & Rossavik, I. K., 1985.

Fetal femur length: a critical re-evaluation of the relationship to menstrual age.
Obstetrics and Gynaecology, 66,69-75.

O'Brien GD, Queenan JT (1981)

5-14 Obstetrics
 Growth of the ultrasound femur length during normal pregnancy,
American Journal of Obstetrics and Gynecology 141:833-837.

Jeanty P, Rodesch F, Delbeke D, Dumont J. Estimation of gestational age from

measurements of fetal long bones. Journal of Ultrasound Medicine
February 1984; 3:75-79.

Hohler C., Quetel T. Fetal femur length: equations for computer calculation of
gestational age from ultrasound measurements. American Journal of Obstetrics and
Gynecology June 15, 1982; 143 (No. 4):479-481.

Keiichi Kurachi, Mineo Aoki

Department of Obstetrics and Gynecology, Osaka University Medical School
Revision 3 (September 1983)

Studies on Fetal Growth and Functional Developments

Takashi Okai Department of Obstetrics and Gynecology, Faculty of Medicine,
University of Tokyo

Chitty LS, Altman DG

British Journal of Obstetrics and Gynaecology January 1994, Vol.101
P29-135.

China
Written by Zhou Yiongchang & Guo Wanxue in Chapter 38 of "Ultrasound Medicine"
(3rd edition) Science & Technology Literature Press, 1997

TAD Merz E., Werner G. & Ilan E. T., 1991

Ultrasound in Gynaecology and Obstetrics Textbook and Atlas 312, 326-336.

APAD Merz E., Werner G. & Ilan E. T., 1991

Ultrasound in Gynecology and Obstetrics Textbook and Atlas 312, 326-336.

THD Hansmann M, Hackelöer BJ, Staudach A

Ultraschalldiagnostik in Geburtshilfe und Gynäkologie 1985

FTA Fetal Growth Chart Using the Ultrasonotomographic Technique

Keiichi Kurachi, Mineo Aoki
Department of Obstetrics and Gynecology, Osaka University Medical School
Revision 3 (September 1983)

HUM Merz E., Werner G. & Ilan E. T., 1991

Ultrasound in Gynaecology and Obstetrics Textbook and Atlas 312, 326-336.

Jeanty P, Rodesch F, Delbeke D, Dumont J. Estimation of gestational age from

measurements of fetal long bones. Journal of Ultrasound Medicine February 1984;
3:75-79.
CLAV “Clavicular Measurement: A New Biometric Parameter for

Obstetrics 5-15
 Fetal Evaluation.” Journal of Ultrasound in Medicine 4:467-470, September 1985.
TCD Goldstein I, et al. Cerebellar measurements with ultrasonography in the evaluation of
fetal growth and development. Am J Obstet Gynecol 1987; 156:1065-1069.

Hill LM, et al. Transverse cerebellar diameter in estimating gestational age in the
large for gestational age fetus, Obstet Gynecol 1990; 75:981-985.

Ulna Merz E., Werner G. & Ilan E. T., 1991

Ultrasound in Gynaecology and Obstetrics Textbook and Atlas 312, 326-336.

Tibia Merz E., Werner G. & Ilan E. T., 1991

Ultrasound in Gynaecology and Obstetrics Textbook and Atlas 312, 326-336.

RAD Merz E., Werner G. & Ilan E. T., 1991

Ultrasound in Gynaecology and Obstetrics Textbook and Atlas 312, 326-336.

FIB Merz E., Werner G. & Ilan E. T., 1991

Ultrasound in Gynaecology and Obstetrics Textbook and Atlas 312, 326-336.

OOD Jeanty P, Cantraine R，Cousaert E，et al.

J Ultrasound Med 1984; 3: 241-243.
GAdays=1.5260298+0.595018*BOmm-6.205*10-6*BO2mm
BO=binocular distance

Ultrasou Hadlock,Radiology,1984 152:497-501

nd GA
Hadlock Hadlock FP, et al. Estimating Fetal Age: Computer-Assisted Analysis of Multiple
(BPD, Fetal Growth Parameters. Radiology 1984:152: 497-501.
HC, AC
and FL)

Estimated Fetal Weight (EFW)

Merz E., Werner G. & Ilan E. T., 1991 Ultrasound in Gynaecology and Obstetrics Textbook and
Atlas 312, 326-336.

Hansmann M, Hackelöer BJ, Staudach A Ultraschalldiagnostik in Geburtshilfe und Gynäkologie

1995

Campbell S, Wilkin D. "Ultrasonic Measurement of Fetal Abdomen Circumference in the Estimation

of Fetal Weight." Br J Obstetrics and Gynaecology September 1975; 82 (No. 9):689-697.

Hadlock F, Harrist R, et al. Estimation of fetal weight with the use of head, body, and femur
measurements - a prospective study. American Journal of Obstetrics and Gynecology February 1,
1985; 151 (No. 3):333-337.

Shepard M, Richards V, Berkowitz R, Warsof S, Hobbins J. An Evaluation of Two Equations for

Predicting Fetal Weight by Ultrasound. American Journal of Obstetrics and Gynecology January
1982; 142 (No. 1): 47-54.

5-16 Obstetrics
Fetal Growth Chart Using the Ultrasonotomographic Technique Keiichi Kurachi, Mineo Aoki
Department of Obstetrics and Gynecology, Osaka University Medical School Revision 3
(September 1983)

Studies on Fetal Growth and Functional Developments Takashi Okai Department of Obstetrics and
Gynecology, Faculty of Medicine, University of Tokyo

Fetal Biophysical Profile

Antory M. intzileos, MD, Winston A. Campbell, Chareles J. Ingardia, MD, and David J. Nochimson,
MD, Fetal Biophysical Parameters Distribution and Their Predicted Values , Obstetrics and
Gynecology Journal 62:271, 1983

Weight Percentile for Age

Hadlock FP，Harrist R, Martinez-Poyer J. In utero analysis of fetal growth: A sonographic standard.
Radiology 1991;181:129-133.

AFI
Thomas R,Moore MD, Jonathan E, Cayle MD. The amniotic fluid index in normal human
pregnancy. American journal of Obstetrics and Gynecology May 1990; 162: 1168-1173.

Obstetrics 5-17
6 Cardiology

6.1 Cardiac Exam Preparations

Make the following preparations before measurement:
1. Confirm that the current probe is appropriate.
2. Check if the current date of the system is correct.
3. Press <Patient>, input patient information in [Patient Info] -> [CARD] page.
For more details, refer to "Exam Preparation -> Patient Information" in the Operator's Manual
[Basic Volume].
4. Switch to the correct exam mode.

6.2 Basic Cardiac Measurement Procedures

1. Press <Patient>, input patient information in [Patient Info] -> [CARD] page.
2. Press <Measure> to enter the Application Measurement.
If the current menu is not the one containing Cardiac Measurement tools, move the cursor to
the menu title and select the package containing Cardiac Measurement tools.
3. Select measurement tool in the menu to start the measurement.
See the table in "6.3 Cardiac Measurement Tools" for measurement tools.
See section "6.4 Cardiac Measurement Operations" and steps in "3 General Measurement" for
measurement methods.
4. Press <Report> to view the exam report, see "6.5 Cardiac Exam Report" for details.

6.3 Cardiac Measurement Tools

The system supports the following cardiac measurements:
NOTE: 1. Measurement tools mentioned below are configured in the system. The application
measurement packages provided in this system are generally different
combinations of measurement tools. For more information about package preset,
see "2.4.2.2 Application Measurement Preset".
2. The heartbeat of the traced spectrum in VTI measurement should equal to that is
preset, otherwise the obtained HR (Heart Rate) is incorrect. See "2.2 Measurement
Parameters Preset" for relevant preset.
3. Some application items in the measurement preset library (and matching list in
result assignment) are displayed different from that in the measurement menu and
result window.
In preset library (and matching list in result assignment), the item is followed with
the word indicating the mode or location. Such as LA Diam (2D) means that the
item is measured during 2D mode; LA Diam(LA Vol A-L) means that the item is
contained in a study named LV Vol(A-L).

Cardiology 6-1
6.3.1 2D Cardiac Measurements
Types Tools Descriptions Methods or formulae
LA Diam Left Atrium Diameter
LA Major Left Atrium major Diameter
LA Minor Left Atrium minor Diameter
Distance in 2D General
RA Major Right Atrium major Diameter
Measurements
RA Minor Right Atrium minor Diameter
LV Major Left Ventricular major Diameter
LV Minor Left Ventricular minor Diameter
Right Ventricular major
RV Major
Diameter Distance in 2D General
Right Ventricular minor Measurements
RV Minor
Diameter
LA Area Left Atrium area
RA Area Right Atrium area
Left Ventricular area at end-
LV Area(d)
diastole
Left Ventricular area at end- Area in 2D General
LV Area(s) Measurements
systole
Right Ventricular area at end-
RV Area(d)
Measurement diastole
Right Ventricular area at end-
RV Area(s)
systole
Left Ventricular Internal
LVIDd
Diameter at end-diastole
Left Ventricular Internal
LVIDs
Diameter at end-systole
Right Ventricular Diameter at
RVDd
end-diastole
Right Ventricular Diameter at
RVDs
end-systole
Left Ventricular Posterior wall Distance in 2D General
LVPWd
thickness at end-diastole Measurements
Left Ventricular Posterior wall
LVPWs
thickness at end-systole
Right Ventricular Anterior wall
RVAWd
thickness at end-diastole
Right Ventricular Anterior wall
RVAWs
thickness at end-systole
Interventricular Septal
IVSd
thickness at end-diastole

6-2 Cardiology
 Types Tools Descriptions Methods or formulae
Interventricular Septal
IVSs
thickness at end-systole
Ao Diam Aorta Diameter
Ao Arch Diam Aorta arch Diameter
Ao Asc Diam Ascending Aorta Diameter
Ao Desc Diam Descending Aorta Diameter
Ao Isthmus Aorta Isthmus Diameter
Ao st junct Aorta ST junct Diameter
Ao Sinus Diam Aorta Sinus Diameter
Duct Art Diam Ductus Arteriosus Diameter
Pre Ductal Previous ductal Diameter
Post Ductal Posterior ductal Diameter
ACS Aortic Valve Cusp Separation
Left Ventricular Outflow Tract Distance in 2D General
LVOT Diam
Diameter Measurements
AV Diam Aorta Valve Diameter
Area in 2D General
AVA Aortic Valve Area
Measurements
PV Diam Pulmonary valve Diameter

Measurement LPA Diam Left pulmonary Artery Diameter

Right pulmonary Artery
RPA Diam
Diameter
Distance in 2D General
Main pulmonary Artery Measurements
MPA Diam
Diameter
Right Ventricular Outflow Tract
RVOT Diam
Diameter
MV Diam Mitral Valve diameter
Area in 2D General
MVA Mitral Valve area
Measurements
MCS Mitral Valve Cusp Separation
Distance between point E and
Distance in 2D General
EPSS Interventricular Septum when
Measurements
mitral valve is fully open
TV Diam Tricuspid valve Diameter
Area in 2D General
TVA Tricuspid Valve Area
Measurements
Inferior vena cava inspiration
IVC Diam(Insp)
Diameter Distance in 2D General
Inferior vena cava expiration Measurements
IVC Diam(Expir)
Diameter

Cardiology 6-3
 Types Tools Descriptions Methods or formulae
Superior vena cava inspiration
SVC Diam(Insp)
Diameter
SVC Superior vena cava expiration
Diam(Expir) Diameter
LCA Left Coronary Artery
RCA Right Coronary Artery
Ventricular Septal defect
Measurement VSD Diam
Diameter
ASD Diam Atrial Septal defect Diameter
Patent ductus Arteriosus Distance in 2D General
PDA Diam
Diameter Measurements
PFO Diam Patent Oval Foramen Diameter
PEd Pericardial Effusion at diastole
PEs Pericardial Effusion at systole
Left Atrium Diameter/Aorta LA Diam (cm) / Ao Diam
LA/Ao
Diameter (cm)
Calculation
Aorta Diameter/Left Atrium Ao Diam (cm) / LA Diam
Ao/LA
Diameter (cm)
Study See below

6.3.2 M Cardiac Measurements

Types Tools Descriptions Methods or formulae
LA Diam Left Atrium Diameter
Left Ventricular Internal
LVIDd
Diameter at end-diastole
Left Ventricular Internal
LVIDs
Diameter at end-systole
Right Ventricular Diameter at
RVDd
end-diastole
Right Ventricular Diameter at
RVDs Distance in M General
Measurement end-systole
Measurements
Left Ventricular Posterior wall
LVPWd
thickness at end-diastole
Left Ventricular Posterior wall
LVPWs
thickness at end-systole
Right Ventricular Anterior wall
RVAWd
thickness at end-diastole
Right Ventricular Anterior wall
RVAWs
thickness at end-systole

6-4 Cardiology
Types Tools Descriptions Methods or formulae
Interventricular Septal
IVSd
thickness at end-diastole
Interventricular Septal
IVSs
thickness at end-systole
Ao Diam Aorta Diameter
Ao Arch Diam Aorta arch Diameter
Ao Asc Diam Ascending Aorta Diameter
Ao Desc Diam Descending Aorta Diameter
Ao Isthmus Aorta Isthmus Diameter
Ao st junct Aorta ST junct Diameter
Ao Sinus Diam Aorta Sinus Diameter
Left Ventricular outflow tract
LVOT Diam
Diameter
ACS Aortic valve Cusp Separation
LPA Diam Left pulmonary Artery Diameter
Right pulmonary Artery
RPA Diam
Diameter
Main pulmonary Artery
MPA Diam
Diameter
Right Ventricular outflow tract
RVOT Diam
Diameter
Amplitude of the Mitral Valve E
MV E Amp
wave
Amplitude of the Mitral Valve A
MV A Amp
wave
MV E-F Slope Mitral Valve E-F slope Slope in M General
MV D-E Slope Mitral Valve D-E slope Measurements

Amplitude of the Mitral Valve

MV DE
DE wave
MCS Mitral Valve Cusp Separation
Distance in M General
Distance between point E and
EPSS Measurements
the interventricular septum
PEd Pericardial effusion at diastole
PEs Pericardial effusion at systole
Left Ventricular pre-ejection
LVPEP
period
LVET Left Ventricular ejection time Time in 2D General
Right Ventricular pre-ejection Measurements
RVPEP
period
RVET Right Ventricular ejection time

Cardiology 6-5
 Types Tools Descriptions Methods or formulae
Heart Rate in M General
HR Heart Rate
Measurements
Left Atrium diameter/Aorta LA Diam (cm) / Ao Diam
LA/Ao
diameter (cm)
Calculation
Aorta Diameter/Left Atrium Ao Diam (cm) / LA Diam
Ao/LA
Diameter (cm)
Study See below

6.3.3 Doppler Cardiac Measurements

Types Tools Descriptions Methods or formulae
Mitral Valve Maximum
MV Vmax
Velocity
D Vel in Doppler General
MV E Vel Mitral Valve E-wave Velocity Measurements
MV A Vel Mitral Valve A-wave Velocity
Mitral Valve E-wave Velocity-
MV E VTI
Time Integral
Mitral Valve A-wave Velocity- D Trace in Doppler General
MV A VTI
Time Integral Measurements
Mitral Valve Velocity-Time
MV VTI
Integral
Mitral Valve Acceleration
MV AccT
Measurement Time Acceleration in Doppler
Mitral Valve Deceleration General Measurements
MV DecT
Time
IVRT Isovelocity Relaxation Time
Isovelocity Compression
IVCT Time in Doppler General
Time
Measurements
MV E Dur Mitral Valve E-wave Duration
MV A Dur Mitral Valve A-wave Duration
Left Ventricular Outflow Tract D Vel in Doppler General
LVOT Vmax
Velocity Measurements
Left Ventricular Outflow Tract D trace in Doppler General
LVOT VTI
Velocity-Time Integral measurements
Left Ventricular Outflow Tract Time in Doppler General
LVOT AccT
Acceleration Time Measurements
Ascending Aorta Maximum
AAo Vmax
Velocity
Measurement
Descending Aorta Maximum D Vel in Doppler General
DAo Vmax
Velocity Measurements
Aorta Valve Maximum
AV Vmax
Velocity

6-6 Cardiology
Types Tools Descriptions Methods or formulae
Aorta Valve Velocity-Time D trace in Doppler General
AV VTI
Integral measurements
Left Ventricular Pre-ejection
LVPEP
Period
LVET Left Ventricular Ejection Time
Time in Doppler General
Aorta Valve Acceleration Measurements
AV AccT
Time
Aorta Valve Deceleration
AV DecT
Time
Right Ventricular Ejection
RVET
Time Time in Doppler General
Right Ventricular Pre-ejection Measurements
RVPEP
Period
Tricuspid Valve Maximum
TV Vmax
Velocity
Tricuspid Valve E-wave Flow D Vel in Doppler General
TV E Vel
Velocity Measurements
Tricuspid Valve A-wave Flow
TV A Vel
Velocity
Tricuspid Valve Velocity-Time D trace in Doppler General
TV VTI
Integral measurements
Tricuspid Valve Acceleration
TV AccT
Time Acceleration in Doppler
Tricuspid Valve Deceleration General Measurements
TV DecT
Time
Tricuspid Valve A-wave Time in Doppler General
TV A Dur
Duration Measurements
Right Ventricular Outflow D Vel in Doppler General
RVOT Vmax
Tract Maximum Velocity Measurements
Right Ventricular Outflow D trace in Doppler General
RVOT VTI
Tract Velocity-Time Integral measurements
Pulmonary Valve Maximum D Vel in Doppler General
PV Vmax
Velocity Measurements
Pulmonary Valve Velocity- D trace in Doppler General
PV VTI
Time Integral measurements
Pulmonary Valve Acceleration in Doppler
PV AccT
Acceleration Time General Measurements
Main Pulmonary Artery
MPA Vmax
Maximum Velocity
Right Pulmonary Artery D Vel in Doppler General
RPA Vmax
Maximum Velocity Measurements
Left Pulmonary Artery
LPA Vmax
Maximum Velocity

Cardiology 6-7
 Types Tools Descriptions Methods or formulae
Pulmonary Vein S-wave Flow
PVein S Vel
Velocity
Pulmonary Vein D-wave Flow D Vel in Doppler General
PVein D Vel
Velocity Measurements
Pulmonary Vein A-wave Flow
PVein A Vel
Velocity
Pulmonary Vein A-wave Time in Doppler General
PVein A Dur
Duration Measurements
Pulmonary Vein S-wave
PVein S VTI
Velocity-time Integral D trace in Doppler General
Pulmonary Vein D-wave measurements
PVein D VTI
Velocity-time Integral
Pulmonary Vein Deceleration Time in Doppler General
PVein DecT
Time measurements
Inferior Vena Cava
IVC Vel (Insp)
Inspiration Maximum Velocity
Inferior Vena Cava Expiration
IVC Vel (Expir)
Maximum Velocity
Superior Vena Cava D Vel in Doppler General
SVC Vel (Insp)
Inspiration Maximum Velocity Measurements
Superior Vena Cava
SVC Vel (Expir)
Expiration Maximum Velocity
Mitral Valve Regurgitation
MR Vmax
Maximum Velocity
Mitral Valve Regurgitation D trace in Doppler General
MR VTI
Velocity-Time Integral measurements
Mitral Valve Stenosis D Vel in Doppler General
MS Vmax
Maximum Velocity Measurements
dP/dt Rate of Pressure change dP/dt Measurement
Aortic Valve Regurgitation D Vel in Doppler General
AR Vmax
Maximum Velocity Measurements
Aortic Valve Regurgitation D trace in Doppler General
AR VTI
Velocity-Time Integral measurements
Aortic Valve Regurgitation Acceleration in Doppler
AR DecT
Deceleration Time General Measurements
Aortic Valve Regurgitation
AR PHT Doppler measurement
Pressure Half Time
Aortic Valve Regurgitation
AR Ved
Velocity at end-Diastole D Vel in Doppler General
Tricuspid Valve Regurgitation Measurements
TR Vmax
Maximum Velocity
Tricuspid Valve Regurgitation D trace in Doppler General
TR VTI
Velocity-Time Integral measurements

6-8 Cardiology
 Types Tools Descriptions Methods or formulae
Pulmonary Valve
D Vel in Doppler General
PR Vmax Regurgitation Maximum
Measurements
Velocity
Pulmonary Valve
D trace in Doppler General
PR VTI Regurgitation Velocity-Time
measurements
Integral
Pulmonary Valve
PR PHT Regurgitation Pressure Half Doppler Measurement
Time
Pulmonary Valve
PR Ved Regurgitation Velocity at end-
Diastole
Ventricular Septal Defect
VSD Vmax
Maximum Velocity
Atrial Septal Defect
ASD Vmax
Maximum Velocity D Vel in Doppler General
Measurements
Patent Ductus Arteriosus
PDA Vel(d)
Velocity at End-diastole
Patent Ductus Arteriosus
PDA Vel(s)
Velocity at End-systole
Coarc Pre-Duct Coarctation of Pre-Ductus
Coarc Post-Duct Coarctation of Post-Ductus
HR Heart Rate
Select from the pop-up
dialog box or input a value
RAP Right Atrium Pressure
manually. See RAP
measurement in “RVSP”
MV E Vel (cm/s) / MV A Vel
MV E/A Mitral Valve E-Vel/A-Vel
(cm/s)
Mitral Valve Orifice Area MVA(PHT) (cm2) = 220 / MV
MVA(PHT)
Calculation (PHT) PHT (ms)
TV E/A Tricuspid Valve E-Vel/A-Vel
Tricuspid Valve Orifice Area
TVA(PHT)
(PHT)
Study See below

6.3.4 TDI Cardiac Measurements

The following measurement items are performed in TDI mode.
Types  Tools  Descriptions  Methods or formulae
Ea(medial) Mitral Valve medial Early diastolic motion
D Vel in Doppler
Measurement Aa(medial) Mitral Valve medial Late diastolic motion General
Measurements
Sa(medial) Mitral Valve medial Systolic motion

Cardiology 6-9
 Types  Tools  Descriptions  Methods or formulae
ARa(medial) Mitral Valve medial Acceleration Rate
DRa(medial) Mitral Valve medial Deceleration Rate
Ea(lateral) Mitral Valve lateral Early diastolic motion
Aa(lateral) Mitral Valve lateral Late diastolic motion
D Vel in Doppler
Sa(lateral) Mitral Valve lateral Systolic motion General
Measurements
ARa(lateral) Mitral Valve lateral Acceleration Rate
DRa(lateral) Mitral Valve lateral Deceleration Rate
Calculation / /
Study See below

6.4 Cardiac Measurement Operations

Tips: 1. See the table in "6.3 Cardiac Measurement Tools" above for measurement tools and
methods.
2. For the definitions of measurement, calculation and study, refer to
"1.3 Measurement, Calculation and Study".
3. The order of the measurement items is presettable, see "2.4.2 Application
Measurement Preset" for details.
4. Measurements of some tools described in this Chapter are to be performed in
several imaging modes, please select appropriate imaging modes in measurement.

6.4.1 Measurement Tool Operations

1. Select the item/tool in the measurement menu.
2. Perform the measurement referring to methods in table above.

6.4.2 Calculation Tool Operations

1. Select the item/tool in the measurement menu.
2. The system calculates and displays the results after relating measurement items have been
completed.

6.4.3 Study Tool Operations

6.4.3.1 Left Ventricular Function
This group of studies is to estimates the Left Ventricular (LV) diastolic and systolic capabilities by a
series of clinical indices measured on B or M image. Except for calculating left ventricular volume
and end diastole and end systole, they may calculate the following indices (not all indices are
calculated in every study, see Study Results table in each study for reference).
Result Descriptions Formulae
SV Stroke Volume SV(ml) = EDV(ml)-ESV(ml)
CO Cardiac Output CO(l/min) = SV(ml)×HR(bpm)/ 1000

6-10 Cardiology
 Result Descriptions Formulae
EF Ejection Fraction EF(No unit) = SV(ml)/ EDV(ml)
SI SV Index SI(No unit) = SV(ml)/ Body Surface Area (m2)
CI Cardiac output CI(No unit) = CO(l/min)/Body Surface Area (m2)
Fractional
FS FS (No unit) = (LVIDd (cm) – LVIDs [cm]) / LVIDd (cm)
Shortening
Mean Velocity of
MVCF = (LVIDd(cm) – LVIDs(cm)) / (LVIDd (cm) × LVET
MVCF Circumferential
(s) / 1000)
Fiber Shortening

S-P Ellipse
„ Study Items
Tools Descriptions Operations
Left Ventricular Long-axis Length at End- Distance in 2D General
LVLd apical
diastole in apical view Measurements
Left Ventricular Long-axis Area at End- Area in 2D General
LVAd apical
diastole in apical view Measurements
Left Ventricular Long-axis Length at End- Distance in 2D General
LVLs apical
systole in apical view Measurements
Left Ventricular Long-axis Area at end- Area in 2D General
LVAs apical
systole in apical view Measurements
HR in M/Doppler General
HR Heart Rate
measurements

„ Study Results
Tools Descriptions Formulae

End-diastolic Left 8 LVAd apical(cm 2 ) 2

EDV(SP Ellipse) EDV(SP Ellipse)(ml )＝ ×
Ventricular Volume 3π LVLd apical(cm)

End-systolic Left 8 LVAs apical(cm 2 ) 2

ESV(SP Ellipse) ESV(SP Ellipse)(ml )＝ ×
Ventricular Volume 3π LVLs apical(cm)
SV(SP Ellipse) Stroke Volume
CO(SP Ellipse) Cardiac Output
EF(SP Ellipse) Ejection Fraction See table in “6.4.3.1 Left Ventricular Function”
SI(SP Ellipse) SV Index
CI(SP Ellipse) CO Index

Cardiology 6-11
„ Operating Procedures
1. Select [S-P Ellipse] in the measurement menu.
2. In apical long-axis view at end-diastole, measure the following parameters:
LVLd apical
LVAd apical
EDV value is then calculated.
3. In apical long-axis view at end-systole, measure the following parameters:
LVLs apical
LVAs apical
ESV value is then calculated.
The system calculates SV and EF;
If height and weight have been input already, SI is calculated.
4. Measure HR (heart rate) in M/ Doppler mode.
The CO and CI are calculated automatically.

B-P Ellipse
„ Study Items
Tools Descriptions Operations
Left Ventricular Internal Diameter at End-
LVIDd
diastole Distance in 2D General
Left Ventricular Internal Diameter at End- Measurements
LVIDs
systole
Left Ventricular Area at Mitral Valve level at
LVAd sax MV
End-diastole in Short-axis view
Left Ventricular Area at Mitral Valve level at
LVAs sax MV
End-systole in Short-axis view Area in 2D General
Left Ventricular Long-axis Area at End-diastole Measurements
LVAd apical
in apical view
Left Ventricular Long-axis Area at end-systole in
LVAs apical
apical view
HR in M/Doppler General
HR Heart Rate
measurements
„ Study Results
Tools Descriptions Formulae
End-diastolic Left
EDV(BP Ellipse) *1
Ventricular Volume
End-systolic Left
ESV(BP Ellipse) *2
Ventricular Volume
SV(BP Ellipse) Stroke Volume
CO(BP Ellipse) Cardiac Output
See table in “6.4.3.1 Left Ventricular
EF(BP Ellipse) Ejection Fraction
Function”
SI(BP Ellipse) SV Index
CI(BP Ellipse) CO Index

6-12 Cardiology
*1 means:

EDV(BP Ellipse)( ml )＝ 8 × LVAd apical( cm 2 ) × LVAd sax MV( cm 2 ) LVIDd ( cm )

3π
*2 means:

ESV(BP Ellipse)( ml )＝ 8 × LVAs apical( cm 2 ) × LVAs sax MV( cm 2 ) LVIDs( cm )

3π
„ Operating Procedures
1. Select [B-P Ellipse] in the menu.
2. In left ventricular short-axis view, measure the following parameters:
At end diastole: LVIDd
At end systole: LVIDs
3. In short-axis view at mitral valve level, measure the following parameters:
At end diastole: LVAd sax MV
At end systole: LVAs sax MV
4. In apical long-axis view, measure the following parameters:
LVAd apical, the EDV is calculated
LVAs apical, the ESV is calculated
The system calculates SV and EF after LVAs apical has been measured;
If height and weight have been input already, SI is calculated.
5. Measure HR (heart rate) in M/ Doppler mode.
The CO and CI are calculated automatically.

Bullet
„ Study Items
Tools Descriptions Operations
Left Ventricular Long-axis Length at End-
LVLd apical
diastole in apical view Distance in 2D General
Left Ventricular Long-axis Length at End- Measurements
LVLs apical
systole in apical view
Left Ventricular Area at Mitral Valve level at
LVAd sax MV
End-diastole in Short-axis view Area in 2D General
Left Ventricular Area at Mitral Valve level at Measurements
LVAs sax MV
End-systole in Short-axis view
HR in M/Doppler General
HR Heart Rate
measurements

„ Study Results
Tools Descriptions Formulae
End-diastolic Left
EDV(Bullet) EDV(ml)= 5/6×LVLd apical(cm)×LVAd sax MV(cm2)
Ventricular Volume
End-systolic Left
ESV(Bullet) ESV(ml)= 5/6×LVLs apical(cm)×LVAs sax MV(cm2)
Ventricular Volume

Cardiology 6-13
 Tools Descriptions Formulae
SV(Bullet) Stroke Volume
CO(Bullet) Cardiac Output
EF(Bullet) Ejection Fraction See table in "6.4.3.1 Left Ventricular Function"
SI(Bullet) SV Index
CI(Bullet) CO Index
„ Operating Procedures
1. Select [Bullet] in the measurement menu.
2. In apical long-axis view, measure the following parameters:
At end diastole: LVLd apical
At end systole: LVLs apical.
3. In short-axis view at mitral valve level, ，measure the following parameters:
At end diastole: LVAd sax MV, the EDV is calculated
At end systole: LVAs sax MV, the ESV is calculated
The system calculates SV and EF;
If height and weight have been input already, SI is calculated.
4. Measure HR (heart rate) in M/ Doppler mode.
The CO and CI are calculated automatically.

Mod.Simpson
„ Study Items
Tools Descriptions Operations
Left Ventricular Long-axis Length at End-diastole in
LVLd apical
apical view Distance in 2D General
Left Ventricular Long-axis Length at End-systole in Measurements
LVLs apical
apical view
Left Ventricular Area at Mitral Valve level at End-
LVAd sax MV
diastole in Short-axis view
Left Ventricular Area at Mitral Valve level at End-
LVAs sax MV
systole in Short-axis view Area in 2D General
Left Ventricular Area at Papillary Muscle level at Measurements
LVAd sax PM
end-diastole in short axis view
Left Ventricular Area at Papillary Muscle level at
LVAs sax PM
end-systole in short axis view
HR in M/Doppler General
HR Heart Rate
measurements

„ Study Results
Tools Descriptions Formulae
EDV(Simpson) End-diastolic Left Ventricular Volume *1
ESV(Simpson) End-systolic Left Ventricular Volume *2

6-14 Cardiology
 Tools Descriptions Formulae
SV(Simpson) Stroke Volume
CO(Simpson) Cardiac Output
See table in "6.4.3.1 Left Ventricular
EF(Simpson) Ejection Fraction
Function"
SI(Simpson) SV Index
CI(Simpson) CO Index

*1 means:
LVLd apical[cm] ⎛⎜ 4 × LVAd sax MV[cm ] + 2 × LVAd ⎞
2

EDV [mL] = × ⎟ 1000

9 ⎜ sax PM [cm ] + LVAd sax MV[cm ] × LVAd sax PM[cm ] ⎟
2 2 2
⎝ ⎠
*2 means:
LVLs apical[cm] ⎛⎜ 4 × LVAs sax MV [cm ] + 2 × LVAs ⎞
2

ESV [mL] = × ⎟ 1000

9 ⎜ sax PM [cm ] + LVAs sax MV[cm ] × LVAs sax PM[cm ] ⎟
2 2 2
⎝ ⎠

„ Operating Procedures
1. Select [Mod.Simpson] in the measurement menu.
2. In apical long-axis view, measure the following parameters:
At end diastole: LVLd apical
At end systole: LVLs apical
3. In short-axis view at mitral valve level, measure the following parameters:
At end diastole: LVAd sax MV
At end systole: LVAs sax MV
4. In short-axis view at papillary muscle level, measure the following parameters:
At end diastole: LVAd sax PM, the EDV is calculated
At end systole: LVAs sax PM, the ESV is calculated
The system calculates SV and EF;
If height and weight have been input already, SI is calculated.
5. Measure HR (heart rate) in M/ Doppler mode.
The CO and CI are calculated automatically.

Simpson SP
This method includes two studies: Simp SP(A4C) and Simp SP(A2C).
„ Study Items
Tools Descriptions Operations
End-diastolic Left Ventricular Volume
EDV(A2C/A4C)
(apical 2-chamber/ 4-chamber) Simpson measurement (Trace/
End-systolic Left Ventricular Volume Spline/ Auto)
ESV(A2C/A4C)
(apical 2-chamber/ 4-chamber)
HR in M/Doppler General
HR Heart Rate
measurements

Cardiology 6-15
„ Study Results
Tools Descriptions Formulae
LVLd apical(cm) 20 2
EDV(ml )＝π × × ∑ ri (cm)
20 i =1

End-diastolic Left LVLd apical: Left Ventricular Long-axis Length at

EDV(Simp SP)
Ventricular Volume End-diastole in apical view, i.e. the long-axis
length obtained in measurement.
ri : Radiuses obtained from diastolic measurement
LVLs apical(cm) 20 2
ESV(ml )＝π × × ∑ ri (cm)
20 i =1

End-systolic Left LVLs apical: Left Ventricular Long-axis Length at

ESV(Simp SP)
Ventricular Volume End-systole in apical view, i.e. the long-axis length
obtained in measurement.
ri : Radiuses obtained from systolic measurement
SV Stroke Volume
CO Cardiac Output

EF Ejection Fraction See table in “6.4.3.1 Left Ventricular Function“

SI SV Index
CI CO Index

„ Operating Procedures
1. Select [Simp SP] in the measurement menu.
2. Measure the endocardium.
Measure the left ventricular endocardium at end-diastolic, and set the long axis, the EDV
is obtained;
Measure the left ventricular endocardium at end-systolic, and set the long axis, the ESV is
obtained;
The system calculates SV and EF;
If height and weight have been input already, SI is calculated.
3. Measure HR (heart rate) in M/ Doppler mode.
The CO and CI are calculated automatically.
„ Measurement Methods
The endocardium can be measured using trace, spline or auto.
z Trace
Trace the endocardium along the edge of the target area using the method similar to the
“Trace“ method in 2D Area measurements; and then set the long axis.
z Spline
Set reference points (up to 12) along the edge of the endocardium using the method similar to
the “Spline” method in 2D Area measurements; and then set the long axis.
z Auto
(1) Set point A and B using the trackball and <Set> key, where in,
h A: Left ventricular interventricular septal and mitral valve junction;

6-16 Cardiology
 h B: Left ventricular wall and mitral valve junction;
(2) After setting A and B, the cursor positions automatically at point D where is considered as
the apical part by system detecting, also the long axis (line segment CD) and the line that
traces the endocardium are displayed at the same time. Where in,
h C: Midpoint of A and B.
h D: Apical part of left ventricle.
You can:
z Adjust the long axis
a) Rotate the trackball to position the cursor on the long axis (which turns yellow), and
then press <Set>;
b) Rotate the trackball, adjust the point D (with point C unchanged) after the cursor
changes to .
z Adjust the trace line
a) Rotate the trackball to position the cursor on the trace line (which turns yellow), and
then press <Set>;
b) Rotate the trackball, move the cursor along the endocardium edge to adjust the line
after the cursor changes to (with ABD points unchanged).
D

A C B

(3) Press <Set> outside the line to confirm the adjustment.

Simpson BP
„ Study Items
Tools Descriptions Operations
End-diastolic Left Ventricular
EDV(A2C)
Volume (apical 2-chamber)
End-systolic Left Ventricular
ESV(A2C) Simpson measurement (Trace/ Spline/ Auto)
Volume (apical 2-chamber)
See “Simpson SP” for endocardium
End-diastolic Left Ventricular measurement
EDV(A4C)
Volume (apical 4-chamber)
End-systolic Left Ventricular
ESV(A4C)
Volume (apical 4-chamber)
HR Heart Rate HR in M/Doppler General measurements

Cardiology 6-17
„ Study Results
Tools Descriptions Formulae
EDV(Simpson BP) End-diastolic Left Ventricular Volume *1
ESV(Simpson BP) End-systolic Left Ventricular Volume *2
SV(Simpson BP) Stroke Volume
CO(Simpson BP) Cardiac Output
See table in “6.4.3.1 Left
EF(Simpson BP) Ejection Fraction
Ventricular Function”
SI(Simpson BP) SV Index
CI(Simpson BP) CO Index

*1 means:
{ ( ), ( )}
EDV(ml)＝π × MAX LVLd2i cm LVLd4i cm
20

20 ∑
× (r2i (cm) × r4i (cm))
i =1

*2 means:

MAX{LVLs2i (cm), LVLs4i (cm)}

20

20 ∑
ESV(ml)＝π × × (r2i (cm) × r4i (cm))
i =1

Calculate the LV volume on the apical 2-chamger view image:

20
LVLd ( cm )
EDV 2 ( ml )＝ π × 2i
20
× ∑
i =1
2
r2 i ( cm )

20
LVLs ( cm )
ESV 2 ( ml )＝ π × 2i
20
× ∑r
i =1
2i
2
( cm )

Calculate the LV volume on the apical 4-chamger view image:

20
LVLd ( cm )
EDV 4 ( ml )＝ π × ∑
2
4i × r4 i ( cm )
20 i =1

20
LVLs ( cm )
ESV 4 ( ml )＝ π × 4i
20
× ∑r
i =1
4i
2
( cm )

Where,
LVLd 2i – Left ventricular long-axis length at end diastole at apical two-chamber view, which is
the long-axis length obtained by EDV(A2C) measurement
LVLd 4i – Left ventricular long-axis length at end diastole at apical four-chamber view, which is
the long-axis length obtained by EDV(A4C) measurement
LVLs 2 i – Left ventricular long-axis length at end systole at apical two-chamber view, which is
the long-axis length obtained by ESV(A2C) measurement
LVLs 4 i – Left ventricular long-axis length at end systole at apical four-chamber view, which is
the long-axis length obtained by ESV(A4C) measurement
r2i – Radiuses obtained by EDV(A2C) or ESV(A2C) at apical two-chamber view
r4i – Radiuses obtained by EDV(A4C) or ESV(A4C) at apical two-chamber view

CAUTION: When using Simpson BP to measure LV function, be sure to keep

the apical four-chamber view and apical two-chamber view
perpendicular. Otherwise the measurement result will be incorrect.

6-18 Cardiology
„ Operating Procedures
1. Select [Simpson BP] in the measurement menu.
2. In apical two-chamber view, measure the following parameters:
Left ventricular endocardium at end-diastolic, and set the long axis, the EDV(A2C) is obtained;
Left ventricular endocardium at end-systolic, and set the long axis, the ESV(A2C) is obtained;
3. In apical four-chamber view, measure the following parameters:
Left ventricular endocardium at end-diastolic, and set the long axis, the EDV(A4C) is obtained;
Left ventricular endocardium at end-systolic, and set the long axis, the ESV(A4C) is obtained;
If height and weight have been input already, SV, EF and SI are calculated.
4. Measure HR (heart rate) in M/ Doppler mode.
The CO and CI are calculated automatically.

Cube
„ Study Items
Tools Descriptions Operations
End-diastolic Left Ventricular
Diastole
Measurement FoldLine in 2D mode
End-systolic Left Ventricular Parallel method in M mode
Systole
Measurement
Left Ventricular Internal Diameter at
LVIDd
End-diastole Distance in 2D/M General
Left Ventricular Internal Diameter at Measurements
LVIDs
End-systole
HR Heart Rate HR in M/Doppler General measurements

„ Study Results
Tools Descriptions Formulae
Interventricular Septal Thickness at End-
IVSd
diastole
Left Ventricular Internal Diameter at End-
LVIDd
diastole
Left Ventricular Posterior Wall Thickness at
LVPWd
End-diastole Distance in 2D/M General
Interventricular Septal Thickness at End- Measurements
IVSs
systole
Left Ventricular Internal Diameter at End-
LVIDs
systole
Left Ventricular Posterior Wall Thickness at
LVPWs
End-systole
EDV(Cube) End-diastolic Left Ventricular Volume EDV(ml)= LVIDd(cm)3
ESV(Cube) End-systolic Left Ventricular Volume ESV(ml)= LVIDs(cm)3

Cardiology 6-19
 Tools Descriptions Formulae
SV(Cube) Stroke Volume
CO(Cube) Cardiac Output
EF(Cube) Ejection Fraction
FS(Cube) Fractional Shortening See table in “6.4.3.1 Left
Ventricular Function”
Mean Velocity of Circumferential Fiber
MVCF(Cube)
Shortening
SI(Cube) SV Index
CI(Cube) CO Index

„ Operating Procedures
1. Select [Cube] in the measurement menu.
2. Measure Diastole in 2D or M mode.
The IVSd, LVIDd. LVPWd and EDV are obtained.
3. Measure Systole in 2D or M mode.
IVSs, LVSs, LVIDs, LVPWs and ESV are obtained.
The system calculates SV, EF and FS;
4. Measure HR (heart rate) in M/ Doppler mode.
If height and weight have been input already, SI, CO and CI are calculated.
MVCF is calculated if LVEF is measured.

Teichholz
„ Study Items
Tools Descriptions Operations
End-diastolic Left Ventricular
Diastole
Measurement FoldLine in 2D mode
End-systolic Left Ventricular Parallel method in M mode
Systole
Measurement
Left Ventricular Internal Diameter
LVIDd
at End-diastole Distance in 2D/M General
Left Ventricular Internal Diameter Measurements
LVIDs
at End-systole
HR Heart Rate HR in M/Doppler General measurements

„ Study Results
Tools Descriptions Formulae
Interventricular Septal Thickness
IVSd
at End-diastole
Left Ventricular Internal Diameter Distance in 2D/M General
LVIDd
at End-diastole Measurements
Left Ventricular Posterior Wall
LVPWd
Thickness at End-diastole

6-20 Cardiology
 Tools Descriptions Formulae
Interventricular Septal Thickness
IVSs
at End-systole
Left Ventricular Internal Diameter
LVIDs
at End-systole
Left Ventricular Posterior Wall
LVPWs
Thickness at End-systole
End-diastolic Left Ventricular EDV(ml)=(7×(LVIDd(cm))3)/(2.4+LVIDd
EDV(Teichholz)
Volume (cm))
End-systolic Left Ventricular ESV(ml)=(7×(LVIDs(cm))3)/(2.4+LVIDs(
ESV(Teichholz)
Volume cm))
SV(Teichholz) Stroke Volume
CO(Teichholz) Cardiac Output
EF(Teichholz) Ejection Fraction
FS(Teichholz) Fractional Shortening See table in “6.4.3.1 Left Ventricular
Function”
Mean Velocity of Circumferential
MVCF(Teichholz)
Fiber Shortening
SI(Teichholz) SV Index
CI(Teichholz) CO Index
„ Operating Procedures
See table above for methods and formulae of the measurement items.
See section "Cube" for measurement procedures.

Gibson
„ Study Items
Tools Descriptions Operations
End-diastolic Left Ventricular
Diastole
Measurement FoldLine in 2D mode
End-systolic Left Ventricular Parallel method in M mode
Systole
Measurement
Left Ventricular Internal Diameter
LVIDd
at End-diastole Distance in 2D/M General
Left Ventricular Internal Diameter Measurements
LVIDs
at End-systole
HR Heart Rate HR in M/Doppler General measurements

„ Study Results
Tools Descriptions Formulae
Interventricular Septal
IVSd Distance in 2D/M General Measurements
Thickness at End-diastole

Cardiology 6-21
 Tools Descriptions Formulae
Left Ventricular Internal
LVIDd
Diameter at End-diastole
Left Ventricular Posterior Wall
LVPWd
Thickness at End-diastole
Interventricular Septal
IVSs
Thickness at End-systole
Left Ventricular Internal
LVIDs
Diameter at End-systole
Left Ventricular Posterior Wall
LVPWs
Thickness at End-systole
End-diastolic Left Ventricular EDV(ml)＝π × (0.98 × LVIDd(cm) + 5.90) × LVIDd(cm)2
EDV(Gibson) 6
Volume
End-systolic Left Ventricular ESV(ml )＝π × (1.14 × LVIDs(cm) + 4.18) × LVIDs(cm)2
ESV(Gibson) 6
Volume
SV(Gibson) Stroke Volume
CO(Gibson) Cardiac Output
EF(Gibson) Ejection Fraction
SI(Gibson) SV Index
See table in “6.4.3.1 Left Ventricular
CI(Gibson) CO Index Function”
Mean Velocity of
MVCF(Gibson) Circumferential Fiber
Shortening
FS(Gibson) Fractional Shortening

„ Operating Procedures
See table above for methods and formulae of the measurement items.
See section "Cube " for measurement procedures.

6.4.3.2 Left Ventricular Mass (LV Mass)

Estimates the Index of Left Ventricular Mass (LV Mass-I) by calculating the LV Mass.
LV MASS-I (No unit) = LV Mass (g) / Body Surface Area (m2)

LV Mass (Cube)
„ Study Items
Tools Descriptions Operations
IVSd Interventricular Septal Thickness at End-diastole
Distance in 2D/M
LVIDd Left Ventricular Internal Diameter at End-diastole General
Measurements
LVPWd Left Ventricular Posterior Wall Thickness at End-diastole

6-22 Cardiology
„ Study Results
Tools Descriptions Formulae
LV Mass (g) = 1.04 × ((LVPWd(cm) + IVSd(cm) +
LV Mass (Cube) Left Ventricular Mass
LVIDd(cm))3 - LVIDd(cm)3) - 13.6
Index of Left See LV Mass-I formula in “Left Ventricular Mass (LV
LV MASS-I (Cube)
Ventricular Mass Mass)”

„ Operating Procedures
1. Select [LV Mass (Cube)] in the measurement menu.
2. At end diastole, measure the following parameters:
IVSd
LVIDd
LVPWd
The LV Mass (Cube) is calculated.
If height and weight have been input already, LV Mass-I(Cube) is calculated.

LV Mass (A-L)
„ Study Items
Tools Descriptions Operations
Left Ventricular Epicardial Area at Papillary
LVAd sax Epi
Muscle level at end-diastole in Short-axis view Area in 2D General
Left Ventricular Endocardial Area at Papillary Measurements
LVAd sax Endo
Muscle level at end-diastole in Short-axis view
Left Ventricular Long-axis Length at End- Distance in 2D General
LVLd apical
diastole in apical view Measurements
„ Study Results
Tools Descriptions Formulae
LV Mass (A-L) Left Ventricular Mass *1
Index of Left See LV Mass-I formula in “Left Ventricular Mass (LV
LV MASS-I (A-L)
Ventricular Mass Mass)”
*1 means:
LV Mass(g) = 1.05 × 5/6 × ( LVAd sax Epi(cm 2 ) × (LVLd apical(cm) + t(cm))
- LVAd sax Endo (cm 2 ) × LVL(cm))
Where,
t (cm) = (LVAdsax Epi(cm2 ) /π ) - (LVAdSax Endo(cm2 )/π )

„ Operating Procedures
1. Select [LV Mass (A-L)] in the measurement menu.
2. In long-axis view at end diastole, measure LVLd apical；
3. In short-axis view at papillary muscle level at end diastole, measure the following parameters:
Endocardium area: LVAd sax Endo;
Epicardium area: LVAd sax Epi

Cardiology 6-23
 The LV Mass (A-L) is calculated.
If height and weight have been input already, LV Mass-I(A-L) is calculated.

LV Mass (T-E)
„ Study Items
Tools Descriptions Operations
Left Ventricular Epicardial Area at Papillary
LVAd sax Epi
Muscle level at end-diastole in Short-axis view Area in 2D General
Left Ventricular Endocardial Area at Papillary Measurements
LVAd sax Endo
Muscle level at end-diastole in Short-axis view
Semi-major axis from widest minor axis radius to
a
apex Distance in 2D General
Truncated semi-major axis from widest minor Measurements
d
axis radius to mitral annulus plane
„ Study Results
Except for values in upper table, the following results can be obtained in this study:
Tools Descriptions Formulae
LV Mass (T-E) Left Ventricular Mass *1
Index of Left See LV Mass-I formula in “Left Ventricular Mass (LV
LV MASS-I (T-E)
Ventricular Mass Mass)”
*1 means:
2(a + t) d3 2a d3
LV Mass(g) = 1.05π × {(b + t) 2 × [ +d- ] - b 2
× ( + d - )}
3 3(a + t) 2 3 3a 2
Where, units of a, b, d, t are cm.
a: Semi-major axis from widest minor axis radius to apex
d: Truncated semi-major axis from widest minor axis radius to mitral annulus plane
t: Thickness of the myocardium

t (cm) = (LVAd sax Epi(cm 2 ) /π ) - (LVAd Sax Endo(cm 2 )/π )

b: Short axis radius, usually measured where the radius is largest.

b(cm) = (LVAd Sax Endo(cm 2 )/π )

„ Operating Procedures
1. Select [LV Mass(T-E)] in the measurement menu.
2. In short-axis view at papillary muscle level at end diastole, measure the following parameters:
Endocardium area: LVAd sax Endo;
Epicardium area LVAd sax Epi
3. Measure a and d.
The LV Mass(T-E) is calculated.
If height and weight have been input already, LV Mass-I(T-E) is calculated.

6-24 Cardiology
6.4.3.3 Mitral Valve Area (MVA)
Mitral Valve Area (MVA) can be calculated by two methods: pressure half time (PHT) or velocity-
time integral (VTI).
Tips: MVA Calculation by PHT method should be performed in CW mode, see MVA(PHT) in
“6.3.3 Doppler Cardiac Measurement” for calculation formula.

MVA(VTI)
„ Study Items
Tools Descriptions Operations
Left Ventricular Outflow Tract
LVOT Diam Distance in 2D General Measurements
Diameter
Left Ventricular Outflow Tract
LVOT VTI
Velocity-Time Integral D trace in General D measurements
MV VTI Mitral Valve Velocity-Time Integral

„ Study Results
Except for values in upper table, the following results can be obtained in this study:
Tools Descriptions Formulae
π × LVOT VTI(cm) × LVOT Diam(cm2 ) 2
MVA(VTI) Mitral Valve Area MVA(VTI)(cm 2 ) =
4 × MV VTI(cm)

„ Operating Procedures
See table above for methods and formulae of the measurement items.

6.4.3.4 AVA(VTI)
Aortic Valve Area (AVA) can be calculated by velocity-time integral (VTI). Measurements should be
performed on 2D and Doppler image.
„ Study Items
Tools Descriptions Operations
Left Ventricular Outflow Tract
LVOT Diam Distance in 2D General Measurements
Diameter
Left Ventricular Outflow Tract
LVOT VTI
Velocity-Time Integral
D trace in General D measurements
Aortic Valve Velocity-Time
AV VTI
Integral
„ Study Results
Except for values in upper table, the following results can be obtained in this study:
Tools Descriptions Formulae
π × LVOT VTI(cm) × LVOT Diam(cm2 ) 2
AVA(VTI) Aortic Valve Area AVA(VTI)(cm ) =
2

4 × AV VTI(cm)

Cardiology 6-25
„ Operating Procedures
See table above for methods and formulae of the measurement items.

6.4.3.5 LA Vol
LA Vol (Left Atrium Volume) used to estimate the size of left atrium.

LA Vol(A-L)
Estimates Left Atrium Volume using area and length.
„ Study Items
Tools Descriptions Operations
LA Diam Left Atrium Diameter Distance in 2D General Measurements
Left Atrium Area at
LAA(A2C)
apical 2-chamber view
Area in 2D General Measurements
Left Atrium Area at
LAA(A4C)
apical 4-chamber view
„ Study Results
Except for values in upper table, the following results can be obtained in this study:
Tools Descriptions Formulae
LA Left Atrium 8π
LA Vol(A - L)(ml) = LAA(A4C)(cm 2 ) × LAA(A2C)(cm 2 ) LA Diam(cm)
Vol(A-L) Area 3

„ Operating Procedures
See table above for methods and formulae of the measurement items.

LA Vol (Simp)
Estimates the left atrium volume using Simpson method. Performed at apical two-chamber view
and apical four-chamber view.
„ Study Items and Results
Tools Descriptions Operations
Left Atrium Volume at apical 2-chamber
LA Vol(A2C)
view Same as Simpson SP
Left Atrium Volume at apical 4-chamber measurement
LA Vol(A2C)
view
„ Operating Procedures
See “Simpson SP” for measurement procedures.

6.4.3.6 RA Vol (Simp)

Estimates right atrium volume using Simpson methods, performed at apical four-chamber view.

6-26 Cardiology
„ Study Items and Results
Tools Descriptions Operations
Right Atrium Volume at
RA Vol(A4C) Same as Simpson SP measurement
apical 4-chamber view
„ Operating Procedures
See “Simpson SP” for measurement procedures.

6.4.3.7 LVIMP
LVIMP (Left Ventricular Index of Myocardial Performance) is used to analyze the integrative
ventricular diastolic and systolic capabilities.
„ Study Items
Tools Descriptions Operations
MV C-O dur Mitral Valve close-open Duration
Time in M/Doppler General Measurements
LVET Left Ventricular Ejection Time
„ Study Results
Except for values in upper table, the following results can be obtained in this study:
Tools Descriptions Formulae

Left Ventricular Index of MV C - O dur(s) - LVET(s)

LVIMP LVIMP(Noun it) =
Myocardial Performance LVET(s)

„ Operating Procedures
See table above for methods and formulae of the measurement items.

6.4.3.8 RVSP
RVSP measures the right ventricular systolic pressure.
„ Study Items
Tools Descriptions Operations
Tricuspid Valve Regurgitation
TR Vmax D Vel in Doppler General Measurements
Maximum Velocity
RAP Right Atrium Pressure See below
„ Study Results
Except for values in upper table, the following results can be obtained in this study:
Tools Descriptions Formulae
Tricuspid Valve Regurgitation
TR PGmax TR PGmax (mmHg) = 4 × TR Vmax (m/s)2
Pressure Gradient

Right Ventricular Systolic TV C - O dur(s) - RVET(s)

RVSP RVIMP(Nounit) =
Pressure RVET(s)

„ Operating Procedures
1. Select [RVSP] in the measurement menu.

Cardiology 6-27
2. Measure TR Vmax in Doppler mode.
The TR PGmax is calculated.
3. Select [RAP] in the [RVSP] sub-menu, and select (or enter) the pressure in the dialog box
popped up. As shown in figure below:

Range of input values is [0, 50.0mmHg].

4. Click [OK] after selecting (or inputting) the pressure, the RAP is obtained.
RVSP is calculated.

6.4.3.9 PAEDP
PAEDP measures the pulmonary artery end diastolic pressure.
„ Study Items
Tools Descriptions Operations
Pulmonary Valve
TR PR Ved Regurgitation Velocity at end- D Vel in Doppler General Measurements
Diastole
RAP Right Atrium Pressure See RAP measurement in “RVSP”
„ Study Results
Except for values in upper table, the following results can be obtained in this study:
Tools Descriptions Formulae
Pulmonary Valve Regurgitation
PR PGed Pressure Gradient at end- /
Diastole
Pulmonary Pressure at end- RVSP(mmHg) = RAP ( mmHg ) + 4 × (TR V max( m / s )) 2
PAEDP
Diastole

„ Operating Procedures
See table above for methods and formulae of the measurement items.

6.4.3.10 RVIMP
Measurement of RVIMP (Right Ventricular Index of Myocardial Performance) is similar to that of
LVIMP.
„ Study Items
Tools Descriptions Operations
TV C-O dur TV A Dur close-open Duration Time in Doppler General

6-28 Cardiology
 Tools Descriptions Operations
RVET Right Ventricular Ejection Time Measurements

„ Study Results
Except for values in upper table, the following results can be obtained in this study:
Tools Descriptions Formulae

Right Ventricular Index of TV C - O dur(s) - RVET(s)

RVIMP RVIMP(Nounit) =
Myocardial Performance RVET(s)

„ Operating Procedures
See table above for methods and formulae of the measurement items.

6.4.3.11 Qp/Qs
Flow ration of pulmonary circulation and systemic circulation.
„ Study Items
Tools Descriptions Operations
AV Diam Aorta Valve Diameter Distance in 2D General
PV Diam Pulmonary Valve Diameter Measurements

AV VTI Aortic Valve Velocity-Time Integral D Trace in Doppler General

PV VTI Pulmonary Valve Velocity-Time Integral Measurements

„ Study Results
Except for values in upper table, the following results can be obtained in this study:
Tools Descriptions Operations
AV HR Aortic Valve Heart Rate
AV SV Aortic Valve Stroke Volume Obtained from AV VTI measurement
AV CO Aortic Valve Cardiac Output
PV HR Pulmonary Valve Heart Rate
PV SV Pulmonary Valve Stroke Volume Obtained from PV VTI measurement
PV CO Pulmonary Valve Cardiac Output
Flow ration of Pulmonary circulation Qp/Qs(No unit) = PV CO(l/min)/AV
Qp/Qs
and Systemic circulation CO(l/min)
Flow difference of Pulmonary Qp-Qs(No unit) = PV CO(l/min) - AV
Qp-Qs
circulation and Systemic circulation CO(l/min)
„ Operating Procedures
See table above for methods and formulae of the measurement items.

6.4.3.12 PISA
PISA (Proximal Isovelocity Surface Area) is used in quantitative analysis of the mitral valve
regurgitation (PISA MR), aortic valve regurgitation (PISA AR), tricuspid valve regurgitation (PISA
TR), and pulmonary valve regurgitation (PISA PR) in color mode.

Cardiology 6-29
The PISA measurement procedures are as follows:
1. Start PISA, move the semicircular caliper by rotating the trackball.
2. Fix the center of the semicircular by pressing <Set>.
3. Adjust the radius length orientation of the semicircular by rotating the trackball.
4. Press <Set> to fix the caliper.

PISA MR
Mitral valve regurgitation (PISA MR) needs to be measured in Color and Doppler mode.
„ Study Items
Tools Descriptions Operations
MR Rad Mitral Valve Stenosis Radius PISA measurement
Mitral Valve Regurgitation
MR VTI D Trace in Doppler General Measurements
Velocity-Time Integral
„ Study Results
Tools Descriptions Formulae
Mitral Regurgitation
MR Vmax Obtained from MR VTI measurement
Maximum Velocity
Mitral Valve
Regurgitation MR Als.Vel(m/s)=(|max positive vel on color bar(m/s)|+|max
MR Als.Vel
Aliasing Maximum negative vel on color bar(m/s|)/2
Velocity

Mitral Regurgitation 2πMR Rad(cm)2 × MR Als.Vel(cm/s)

MR Flow MR Flow(ml)= × MR VTI(cm)
Flow MRV max(cm/s)

MR Flow Mitral Regurgitation

MR Flow Rate(ml/s) = 2πMR Rad(cm)2 × MR Als.Vel(cm/s)
Rate Flow Rate
Mitral Valve MR Flow(ml)
MR Fraction Regurgitation MRF(Nounit) = × 100%
MV SV(ml)
Fraction
„ Operating Procedures
1. Enter color mode, adjust the color map until the aliasing appears.
2. Select [PISA MR] in the measurement menu.
3. Measure MR Rad using PISA caliper.
The MR Als.Vel is calculated.
4. Measure the MR spectrum by D trace to obtain:
MR Vmax
MR VTI
MR Flow and MR Flow Rate are calculated automatically.
If MV SV is measured, MR Fraction will be calculated automatically.

PISA AR
Estimates aortic valve regurgitation using PISA.
See “PISA MR” for study items, results and measurement procedures.

6-30 Cardiology
PISA TR
Estimates tricuspid valve regurgitation using PISA.
See “PISA MR” for study items, results and measurement procedures.

PISA PR
Estimates pulmonary valve regurgitation using PISA.
See “PISA MR” for study items, results and measurement procedures.

6.4.3.13 TDI
MV medial and MV lateral reflect the motive capabilities of the cardiac muscle.

MV medial
„ Study Items
Tools Descriptions Operations
Sa(medial) Mitral Valve medial Systolic motion
D Vel in Doppler General
Ea(medial) Mitral Valve medial Early diastolic motion
Measurements
Aa(medial) Mitral Valve medial Late diastolic motion
ARa(medial) Mitral Valve medial Acceleration Rate Acceleration in Doppler General
DRa(medial) Mitral Valve medial Deceleration Rate Measurements

„ Study Results
Tools Descriptions Formulae
Ea(medial)
Ea/Aa(medial) MV medial E-Vel/ A-Vel Ea/Aa(medial)(Nounit) =
Aa(medial)
Obtained from ARa(medial)
ATa(medial) MV medial E-wave Acceleration Time
measurement
Obtained from DRa(medial)
DTa(medial) MV medial E-wave Deceleration Time
measurement
„ Operating Procedures
See table above for methods and formulae of the measurement items.

MV lateral
„ Study Items
Tools Descriptions Operations
Sa(lateral) Mitral Valve lateral Systolic motion
D Vel in Doppler General
Ea(lateral) Mitral Valve lateral Early diastolic motion
Measurements
Aa(lateral) Mitral Valve lateral Late diastolic motion
ARa(lateral) Mitral Valve lateral Acceleration Rate Acceleration in Doppler General
DRa(lateral) Mitral Valve lateral Deceleration Rate Measurements

Cardiology 6-31
„ Study Results
Tools Descriptions Formulae
Ea(laterall)
Ea/Aa(lateral) MV lateral E-Vel/ A-Vel Ea/Aa(lateral)(Nounit) =
Aa(laterall)
Obtained from ARa(lateral)
ATa(lateral) MV lateral E-wave Acceleration Time
measurement
Obtained from DRa(lateral)
DTa(lateral) MV lateral E-wave Deceleration Time
measurement
„ Operating Procedures
See table above for methods and formulae of the measurement items.

6.5 Cardiac Exam Report

During or after a measurement, press <Report> on the Control Panel to browse the report.
For details about report browsing, printing and exporting etc, see "1.7 Report".

6.6 References
Body Surface Are (BSA):
„ DuBois, D., DuBois, E.F., "A Formula to Estimate the Approximate Surface Area if Height and
Weight Be Known," Nutrition, Sept-Oct 1989, Vol. 5, No. 5, pp. 303-313.
EDV(S-P Ellipse):
„ Folland, E.D., et al., "Assessment of Left Ventricular Ejection Fraction and Volumes by Real-
Time, Two-Dimensional Echocardiography," Circulation, October 1979, Vol. 60, No.4, pp. 760-
766
ESV(S-P Ellipse):
„ Folland, E.D., et al., "Assessment of Left Ventricular Ejection Fraction and Volumes by Real-
Time, Two-Dimensional Echocardiography," Circulation, October 1979, Vol. 60, No.4, pp. 760-
766.
Stroke Volume (SV):
„ Gorge, G., et al., "High Resolution Two-dimensional Echocardiography Improves the
Quantification of Left Ventricular Function", Journal of the American Society of
Echocardiography, 1992, 5: 125-34.
„ Roelandt, Joseph, Practical Echocardiology, vol. 1 of Ultrasound in Medicine Series, ed. Denis
White, Research Studies Press, 1977, p. 124.
Ejection Fraction (EF):
„ Pombo, J.F., "Left Ventricular Volumes and Ejection by Echocardiography," Circulation, 1971,
Vol. 43, pp. 480-490.
Stroke Volume Index (SI):
„ Gorge, G., et al., "High Resolution Two-dimensional Echocardiography Improves the
Quantification of Left Ventricular Function", Journal of the American Society of
Echocardiography, 1992, 5: 125-34.
„ Roelandt, Joseph, Practical Echocardiology, vol. 1 of Ultrasound in Medicine Series, ed. Denis
White, Research Studies Press, 1977, p. 124.
Cardiac Output (CO):

6-32 Cardiology
„ Belenkie, Israel, et al., "Assessment of Left Ventricular Dimensions and Function by
Echocardiography," American Journal of Cardiology, June 1973, Vol. 31
Cardiac output Index (CI):
„ The Merck Manual of Diagnosis and Therapy, ed. 15, Robert Berkon, ed., Merck and Co.,
Rahway, NJ, 1987, p. 378.
„ Schiller, N.B., et al., “Recommendations for Quantification of the LV by Two-Dimensional
Echocardiography,” J Am Soc Echo, Sept.-Oct., 1989, Vol. 2, No. 5,p. 364.
EDV(B-P Ellipse):
„ Folland, E.D., et al., "Assessment of Left Ventricular Ejection Fraction and Volumes by Real-
Time, Two-Dimensional Echocardiography," Circulation, October 1979, Vol. 60, No.4, pp. 760-
766
ESV(B-P Ellipse):
„ Folland, E.D., et al., "Assessment of Left Ventricular Ejection Fraction and Volumes by Real-
Time, Two-Dimensional Echocardiography," Circulation, October 1979, Vol. 60, No.4, pp. 760-
766
EDV (Bullet):
„ Folland, E.D., et al., "Assessment of Left Ventricular Ejection Fraction and Volumes by Real-
Time, Two-Dimensional Echocardiography," Circulation, October 1979, Vol. 60, No.4, pp. 760-
766
ESV (Bullet):
„ Folland, E.D., et al., "Assessment of Left Ventricular Ejection Fraction and Volumes by Real-
Time, Two-Dimensional Echocardiography," Circulation, October 1979, Vol. 60, No.4, pp. 760-
766
EDV (Simpson):
„ Weyman, Arthur E., Cross-Sectional Echocardiography, Lea & Febiger, 1985, p. 295.Folland,
E.D., et al., "Assessment of Left Ventricular Ejection Fraction and Volumes by Real-Time, Two-
Dimensional Echocardiography," Circulation, October 1979, Vol. 60, No.4, pp. 760-766
ESV (Simpson):
„ Weyman, Arthur E., Cross-Sectional Echocardiography, Lea & Febiger, 1985, p. 295.Folland,
E.D., et al., "Assessment of Left Ventricular Ejection Fraction and Volumes by Real-Time, Two-
Dimensional Echocardiography," Circulation, October 1979, Vol. 60, No.4, pp. 760-766
EDV (Simpson SP):
„ Schiller, N.B., et al., "Recommendations for Quantification of the LV by Two-Dimensional
Echocardiography," Journal of the American Society of Echocardiography, Sept-Oct 1989,
Vol.2, No. 5, p. 364
ESV (Simpson SP:
„ Schiller, N.B., et al., "Recommendations for Quantification of the LV by Two-Dimensional
Echocardiography," Journal of the American Society of Echocardiography, Sept-Oct 1989,
Vol.2, No. 5, p. 364
EDV (Simpson BP):
„ Schiller, N.B., et al., "Recommendations for Quantification of the LV by Two-Dimensional
Echocardiography," Journal of the American Society of Echocardiography, Sept-Oct 1989,
Vol.2, No. 5, p. 364
ESV (Simpson BP):
„ Schiller, N.B., et al., "Recommendations for Quantification of the LV by Two-Dimensional
Echocardiography," Journal of the American Society of Echocardiography, Sept-Oct 1989,
Vol.2, No. 5, p. 364
EDV (Cube):

Cardiology 6-33
„ Dodge, H.T., Sandler, D.W., et al., "The Use of Biplane Angiography for the Measurement of
Left Ventricular Volume in Man," American Heart Journal, 1960, Vol. 60, pp. 762-776.
„ Belenkie, Israel, et al., "Assessment of Left Ventricular Dimensions and Function by
Echocardiography," American Journal of Cardiology, June 1973, pg. 31.
ESV (Cube):
„ Dodge, H.T., Sandler, D.W., et al., "The Use of Biplane Angiography for the Measurement of
Left Ventricular Volume in Man," American Heart Journal, 1960, Vol. 60, pp. 762-776.
„ Belenkie, Israel, et al., "Assessment of Left Ventricular Dimensions and Function by
Echocardiography," American Journal of Cardiology, June 1973, pg. 31.
Fractional Shortening (FS):
„ Belenkie, Israel, et al., "Assessment of Left Ventricular Dimensions and Function by
Echocardiography," American Journal of Cardiology, June 1973, Vol. 31.
MVCF:
„ Colan, S.D., Borow, K.M., Neumann, A., “Left Ventricular End-Systolic Wall Stress-Velocity of
Fiber Shortening Relation: A Load-Independent Index of Myocardial Contractility,” J Amer Coll
Cardiol, October, 1984, Vol. 4, No. 4,pp. 715-724.
„ Snider, A.R., Serwer, G.A., Echocardiography in Pediatric Heart Disease, Year Book Medical
Publishers, Inc., Littleton, MA, 1990, p. 83.
Teichholz:
„ Teichholz, L.E., et al., "Problems in Echocardiographic Volume Determinations:
Echocardiographic-Angiographic Correlations in the Presence or Absence of Asynergy,"
American Journal of Cardiology, January 1976, Vol. 37, pp. 7-11
LVMW:
„ John H. Phillips, “Practical Quantitative Doppler Echocardiography” , CRC Press, 1991, .Page
96.
LV MASS-I:
„ John H. Phillips, “Practical Quantitative Doppler Echocardiography” , CRC Press, 1991, .Page
96.
LA/Ao:
„ Roelandt, Joseph, Practical Echocardiology, Ultrasound in Medicine Series, Vol. 1,Denis White,
ed., Research Studies Press, 1977, p. 270.
„ Schiller, N.B., et al., “Recommendations for Quantification of the LV by Two-Dimensional
Echocardiography,” J Am Soc Echo, Sept-Oct, 1989, Vol. 2, No. 5,p. 364.
MV CA/CE:
„ Maron, Barry J., et al., “Noninvasive Assessment of Left Ventricular Diastolic Function by
Pulsed Doppler Echocardiography in Patients with Hypertrophic
„ Cardiomyopathy, J Am Coll Cardio, 1987, Vol. 10, pp. 733-742.
MV E/A:
„ Maron, Barry J., et al., "Noninvasive Assessment of Left Ventricular Diastolic Function by
Pulsed Doppler Echocardiography in Patients with Hypertrophic Cardiomyopathy," Journal of
the American College of Cardiology, 1987, Vol. 10, pp. 733-742.
Pressure Half Time (PHT):
„ Oh, J.K., Seward, J.B., Tajik, A.J. The Echo Manual. Boston: Little, Brown and Company, 1994,
p.59-60
Mitral valve area:

6-34 Cardiology
„ Goldberg, Barry B., Kurtz, Alfred B., Atlas of Ultrasound Measurements, Year Book Medical
Publishers, Inc., 1990, p. 65.
„ Stamm, R. Brad, et al., “Quantification of Pressure Gradients Across Stenotic Valves by
Doppler Ultrasound,” J Am Coll Cardiol, 1983, Vol. 2, No. 4,pp. 707-718.
Right Ventricular Systolic Pressure:
„ Stevenson, J.G., "Comparison of Several Noninvasive Methods for Estimation of Pulmonary
Artery Pressure," Journal of the American Society of Echocardiography, June 1989, Vol. 2, pp.
157-171.
„ Yock, Paul G. and Popp, Richard L., "Noninvasive Estimation of Right Ventricular Systolic
Pressure by Doppler Ultrasound in Patients with Tricuspid Regurgitation," Circulation, 1984,
Vol. 70, No. 4, pp. 657-662.

Cardiology 6-35
7 Vascular

7.1 Vascular Exam Preparations

Make the following preparations before measurement:
1. Confirm that the current probe is appropriate.
2. Check if the current date of the system is correct.
3. Press <Patient>, input patient information in [Patient Info] -> [VAS] page.
For more details, refer to "Exam Preparation -> Patient Information" in the Operator's Manual
[Basic Volume].
4. Switch to the correct exam mode.

7.2 Basic Vascular Measurement Procedures

1. Press <Patient>, input patient information in [Patient Info] -> [VAS] page.
2. Press <Measure> to enter the Application Measurement.
If the current menu is not the one having Vascular Measurement tools, move the cursor to the
menu title and select the package having Vascular Measurement tools.
3. Select measurement tool in the menu to start the measurement.
See table in "7.3 Vascular Measurement Tools" below for measurement tools.
See section "7.4 Vascular Measurement Operations" and steps in "3 General Measurement"
for measurement methods.
4. Press <Report> to view the exam report, see "7.5 Vascular Exam Report" for details.

7.3 Vascular Measurement Tools

Vascular measurements are mainly used for carotid, cerebral, upper and lower extremities vessels.
The system supports the following 2D and Doppler vascular measurements.
NOTE: Measurement tools mentioned below are configured in the system. The application
measurement packages provided in this system are generally different combinations of
measurement tools. For more information about package preset, see "2.4.2.2 Application
Measurement Preset".

2D Vascular Measurements
Types Tools Descriptions Methods or formulae
Vascular
Vas Diam Distance in 2D General Measurements
Measurement Diameter
Vas Area Vascular Area Area in 2D General Measurements

Vascular 7-1
 Types Tools Descriptions Methods or formulae
Vessel
Normal(D)
Diameter
Distance in 2D General Measurements
Residual
Resid(D)
Diameter
Normal(A) Vessel Area
Area in 2D General Measurements
Resid(A) Residual Area
Common
CCA IMT Carotid Artery
IMT
Bulb IMT Bulbillate IMT
Internal Carotid ROI measurement in IMT
ICA IMT
Artery IMT
External
ECA IMT Carotid Artery
IMT
Stenosis Stenosis D (No unit) = (Normal Diam(cm) –
Stenosis D
Diameter Resid Diam (cm)) / Normal Diam (cm) × 100%
Stenosis A (No unit) = (Normal Area(cm2) –
Stenosis A Stenosis Area
Resid Area (cm2)) / Normal Area (cm2) × 100%
Vol Flow(D) (ml/min) = |Vas TAMAX (cm/s)| × (π
Vol × Vas Diam (cm)2/ 4) × 60 (s)
Calculation Volume Flow
Flow(Diam)-
Diameter Vas TAMAX - Time Averaged Maximum Velocity,
TAMAX
obtained from Vas Trace measurement.
Vol Flow(A) (ml/min) = |Vas TAMAX (cm/s)| ×
Vol Vas Area (cm2) × 60 (s)
Volume Flow
Flow(Area)-
Area Vas TAMAX - Time Averaged Maximum Velocity,
TAMAX
obtained from Vas Trace measurement.
Volume Flow /
Stenosis /
Study See below
Intima-Media
IMT
Thickness

Doppler Vascular Measurements

Types Tools Descriptions Methods or formulae
CCA Common Carotid Artery
Bulb Bulbillate
ICA Internal Carotid Artery
Measurement ECA External Carotid Artery D trace in General D measurements
Vert A Vertebral Artery
Innom A Innominate Artery
Subclav A Subclavian Artery

7-2 Vascular
Types Tools Descriptions Methods or formulae
Axill A Axillary Artery
Brachial A Brachial Artery
Ulnar A Ulnar Artery
D trace in General D measurements
Radial A Radial Artery
Subclav A Subclavian Artery
Axill V Axillary Vein
Cephalic V Cephalic Vein
Basilic V Basilic Vein
Ulnar V Ulnar Vein
Radial V Radial Vein
C.Iliac A Common Iliac Artery
Ex.Iliac A External Iliac Artery
CFA Common Femoral Artery
Superficial Femoral
SFA
Artery
Pop A Popliteal Artery
Tibial Peroneal Trunk D trace in General D measurements
TP Trunk A
Artery
Peroneal A Peroneal Artery
P.Tib A Posterior Tibial Artery
A.Tib A Anterior Tibial Artery
Dors.Ped A Dorsalis Pedis Artery
C.Iliac V Common Iliac Vein
Ex.Iliac V External Iliac Vein
Femoral V Femoral Vein
Saph V Great Saphenous Vein
Pop V Popliteal Vein
Tibial Peroneal Trunk
TP Trunk V
Vein
Sural V Sural Vein
Soleal V Soleal Vein
Peroneal V Peroneal Vein D trace in General D measurements
P.Tib V Posterior Tibial Vein
A.Tib V Anterior Tibial Vein
ACA Anterior Cerebral Artery
MCA Middle Cerebral Artery

Vascular 7-3
 Types Tools Descriptions Methods or formulae
Posterior Cerebral
PCA
Artery
AComA Ant.communicating br.
PComA Post.communicating br.
BA Basilar Artery
IIA Internal Iliac Artery
PFA Deep Femoral Artery
Ba V Basilar Vein
Brachial V Brachial Vein
IIV Internal Iliac Vein
D trace in General D measurements
CFV Common Femoral Vein
SFV Superficial Femoral Vein
PFV Deep Femoral Vein
SSV Small Saphenous Vein
Vas Trace Vascular Trace
ASP Ankle Systolic Pressure
Brachial Systolic Type in
BSP
Pressure
Calculation / /
Volume Flow /
Study See below
ABI Ankle Brachial Index

7.4 Vascular Measurement Operations

Tips: 1. See the table in "7.3 Vascular Measurement Tools" above for measurement tools
and methods.
2. For the definitions of measurement, calculation and study, refer to
"1.3 Measurement, Calculation and Study".
3. The order of the measurement items is presettable, see "2.4.2 Application
Measurement Preset" for details.
4. Measurements of some tools described in this Chapter are to be performed in
several imaging modes, please select appropriate imaging modes in measurement.

7.4.1 Measurement Tool Operations

1. Select the item/tool in the measurement menu.
2. Perform the measurement referring to methods in table above.

7-4 Vascular
7.4.2 Calculation Tool Operations
Stenosis D
Function: Measures Normal Diam and Resid Diam, calculates Stenosis D.
1. Select [Stenosis D] in the measurement menu.
2. Use the method of Distance measurement of 2D General Measurements to measure
Normal(D) and Resid(D).
Stenosis D is calculated automatically.

Stenosis A
Function: Measures Normal Area and Resid Area, calculates Stenosis A.
1. Select [Stenosis A] in the measurement menu.
2. Use the method of Area measurement of 2D General Measurements to measure Normal(A)
and Resid(A).
Stenosis A is calculated automatically.

Vol Flow(Diam)-TAMAX
Function: measures Vas Trace and Vas Diam, calculates Vol Flow (Diam)-TAMAX.
1. Switch to Doppler mode, select [Vol Flow (Diam)-TAMAX] in the measurement menu.
2. Use the method of D Trace of Doppler General Measurements to measure Vas TAMAX.
3. Use the Distance method in 2D General Measurements to measure Vas Diam.
The system calculates Vol Flow (Diam)-TAMAX.

Vol Flow(Area)-TAMAX
Function: measures Vas Trace and Vas Area, calculates Vol Flow(Area)-TAMAX.
1. Select [Vol Flow (Area)-TAMAX] in the measurement menu.
2. Use the method of D Trace of Doppler General Measurements to measure Vas TAMAX.
3. Use the Area method in 2D General Measurements to measure Vas Area.
The system calculates Vol Flow (Area)-TAMAX.

7.4.3 Study Tool Operations

Volume Flow
Function: measures blood flow through a certain vascular cross section per unit time.
Select [Volume Flow] in the measurement menu.
1. Use the method of D Trace of Doppler General Measurements to measure Vas Trace.
2. Use the Distance method in 2D General Measurements to measure Vas Diam. The system
calculates Vol Flow (Diam)-TAMAX.
3. Use the Area method in 2D General Measurements to measure Vas Area. The system
calculates Vol Flow (Area)-TAMAX.

Stenosis
Function: measures and calculates stenosis diameter and stenosis area.
1. Select [Stenosis] in the measurement menu.
2. Use the method of Distance measurement of 2D General Measurements to measure
Normal(D) and Resid(D). Stenosis D is calculated automatically.

Vascular 7-5
3. Use the method of Area measurement of 2D General Measurements to measure Normal(A)
and Resid(A). Stenosis A is calculated automatically.

IMT
NOTE: 1. The IMT function is unavailable on the product not configured with IMT.
2. IMT measurement is available on frozen (or history) linear array image only.

Function: IMT (Intima-Media Thickness) measures the distance between LI (Lumen-Intima) and
MA (Media-Adventia).
The IMT values at 4 positions: CCA (common Carotid Artery), ICA (Internal Carotid Artery), ECA
(External Carotid Artery) and Bulb (Bulbillate) need to be measured here.
1. Enter IMT exam mode, scan and freeze the image (or review a history image).
2. Select [IMT] in the measurement menu and enters the IMT measurement.
3. Select the side (Left/ Right), angle and vessel wall (Near/ Far).
4. Select an item such as [ICC IMT], the ROI box displays on screen.
It appears as when Near is selected;
It appears as when Far is selected;
Tips 1. Make sure that you select the right vessel wall (Near/ Far) before IMT
measurement; otherwise the intima may be recognized incorrectly due to different
algorithm that applied in near/ far wall recognition.
2. Enter [Setup]-> [Measure Preset], and the Angle and ROI Width of an IMT item can
be preset in the property dialog box of the measurement item.

5. Move ROI box to the desired position, press <Set>. Two auto trace lines appear in the box.
The ROI box is green while you can:
z Adjust the size of the ROI box.
z Erase the trace lines inside the box by pressing <Clear>. (Long press <Clear>: to clear all
measurement calipers on the screen.)
z Trace manually
a) Move the cursor to a trace line. The trace line turns yellow. Press <Set>.
b) Move the cursor along the interface of vessel. Press <Set> to confirm the trace after
re-adjusting.
6. Press <Set> outside the box to confirm the adjustment result after the manual-trace is
completed. The results are recorded in IMT report.
The system calculates:
h IMT Max
h IMT Min
h IMT Mean
h IMT SD
h IMT ROI Length
h IMT Measure Length
h IMT Quality Index
Quality Index indicates the reliability of one measurement, the manual trace or re-scan an
image with clear endocardium edges are recommended if the Quality Index value is small.

7-6 Vascular
Tips: To achieve a good tracing result, try to place the ROI box parallel with vessel and adjust
the box size to reduce unwanted interferences.
For multiple measurements in the same side, vessel and angle, the system calculates the
following parameters in report:
h Average Mean IMT
h Average Max IMT
h Standard deviation
Also it provides Composite Mean IMT, which is an overall mean value of all IMT mean values
derived from the measured items.

ABI
Function: Calculates Ankle Brachial Index (ABI) by measuring Ankle Systolic Pressure (ASP) and
Brachial Systolic Pressure (BSP) on Doppler image.
ABI = ASP/BSP
NOTE: Need to be measured in left and right side respectively.

Select [ABI] in the measurement menu.

1. Click [ASP] from the [ABI] menu and type in the value.
2. Click [BSP] from the [ABI] menu and type in the value.
The ABI is calculated by the system automatically.

7.5 Vascular Exam Report

During or after a measurement, press <Report> on the Control Panel to browse the report.
For details about report browsing, printing and exporting etc, see "1.7 Report".
An IMT report is applied to record results in IMT measurements, where selecting the patient
conditions (smoker or not, diabetic or not etc.) and modifying the result data are available.

7.6 References
Volume Burns, P.N., "The Physical Principles of Doppler and Spectral Analysis," Journal of
Flow(Diam)- Clinical Ultrasound, November/December 1987, 15(9):587.
TAMAX

Volume Burns, P.N., "The Physical Principles of Doppler and Spectral Analysis," Journal of
Flow(Area)- Clinical Ultrasound, November/December 1987, 15(9):587.
TAMAX

Stenosis D: Honda, Nobuo, et al., "Echo-Doppler Velocimeter in the Diagnosis of Hypertensive

Patients: The Renal Artery Doppler Technique," Ultrasound in Medicine and
Biology, 1986, Vol. 12(12), pp. 945-952.

Stenosis A: Jacobs, Norman M., et al., "Duplex Carotid Sonography: Criteria for Stenosis,
Accuracy, and Pitfalls," Radiology, 1985, 154:385-391.

Vascular 7-7
8 Gynecology

8.1 Gynecology Exam Preparations

Make the following preparations before measurement:
1. Confirm that the current probe is appropriate.
2. Check if the current date of the system is correct.
3. Register patient information in [Patient Info] -> [GYN] dialog box.
For more details, refer to "Exam Preparation -> Patient Information" in the Operator's Manual
[Basic Volume].
4. Switch to the correct exam mode.

8.2 Basic Gynecology Measurement

Procedures
1. Register patient information in [Patient Info] -> [GYN] dialog box.
2. Press <Measure> to enter the Application Measurement.
If the current menu is not the one having Gynecology Measurement tools, move the cursor to
the menu title and select the package having Gynecology Measurement tools.
3. Select measurement tool in the menu to start the measurement.
See table in "8.3 Gynecology Measurement Tools" below for measurement tools.
See section "8.4 Gynecology Measurement Operations" and steps in "3 General
Measurement" for measurement methods.
4. Press <Report> to view the exam report, see "8.5 Gynecology Exam Report" for details.

8.3 Gynecology Measurement Tools

The system supports the following gynecology measurements.
NOTE: Measurement tools mentioned below are configured in the system. The application
measurement packages provided in this system are generally different combinations of
measurement tools. For more information about package preset, see "2.4.2.2 Application
Measurement Preset".

Modes Types Tools Descriptions Methods or formulae

UT L Uterine Length
UT H Uterine Height Same as Distance
Measureme
2D UT W Uterine Width measurement in 2D General
nt
Measurements
Uterine Cervix
Cervix L
Length

Gynecology 8-1
Modes Types Tools Descriptions Methods or formulae
Uterine Cervix
Cervix H
Height
Cervix W Uterine Cervix Width
Endometrium
Endo
Thickness
Ovary L Ovary Length
Ovary H Ovary Height
Ovary W Ovary Width Same as Distance
measurement in 2D General
Follicle1~16 L Follicle 1~16 Length Measurements
Follicle1~16 W Follicle 1~16 Width
Follicle1~16 H Follicle1~16 Height
Ovary Vol Ovary Volume
UT Vol UT Volume
Calculation See below
Uterus Body /
UT-L/ CX-L /
Length, height and width of
Uterus / uterus, endometrium
thickness
Length, height and width of
Uterine Cervix /
Study uterine cervix
Length, height and width of
Ovary /
ovary
Length, height and width of
Follicle 1~16 /
follicle 1~16
M / /
Doppler / /

8.4 Gynecology Measurement Operations

Tips: 1. See the table in "8.3 Gynecology Measurement Tools" above for measurement
tools and methods.
2. For the definitions of measurement, calculation and study, refer to
"1.3 Measurement, Calculation and Study".
3. The order of the measurement items is presettable, see "2.4.2 Application
Measurement Preset" for details.

8.4.1 Measurement Tool Operations

The following procedure takes UT L measurement as an example. Measurements of other items
are similar.
1. Select [UT L] in the measurement menu.

8-2 Gynecology
2. Use the Distance method in 2D General Measurements to measure uterine length.

8.4.2 Calculation Tool Operations

Ovary Vol
Function: measures Ovary L, Ovary H and Ovary W, calculates Ovary Vol.
NOTE: Need to be measured in left and right side respectively.
1. Select [Ovary Vol] in the measurement menu.
2. Use the Distance method in 2D General Measurements to measure Ovary L, Ovary H and
Ovary W. The Ovary Vol is calculated automatically.

UT Vol
Function: measures UT L, UT H and UT W, calculates UT Vol and Uterus Body.
1. Select [UT Vol] in the measurement menu.
2. Use the Distance method in 2D General Measurements to measure UT L, UT H and UT W. UT
Vol and Uterus Body are calculated automatically.

Uterus Body
Function: measures UT L, UT H and UT W, calculates UT Vol and Uterus Body.
Uterus Body (cm) = UT L (cm) + UT H (cm) + UT W (cm)
1. Select [Uterus Body] in the measurement menu.
2. Use the Distance method in 2D General Measurements to measure UT L, UT H and UT W. UT
Vol and Uterus Body are calculated automatically.

UT-L/ CX-L
Function: measures UT L and Cervix L, calculates their ratio UT-L/CX-L.
UT-L/CX-L (No unit) = UT L (cm) / Cervix L (cm)
1. Select [UT-L/CX-L] in the measurement menu.
2. Use the Distance method in 2D General Measurements to measure UT L and Cervix L. The
system calculates UT-L/CX-L.

8.4.3 Study Tool Operations

Uterus
Function: measures UT L, UT H, UT W and Endo, calculates UT Vol, Uterine Body and UT-L/CX-L.
1. Select [Uterus] in the measurement menu.
2. Use the Distance method in 2D General Measurements to measure UT L, UT H, UT W and
Endo.
UT Vol and Uterus Body are calculated automatically.
If Cervix L has been measured, the system also calculates UT-L/CX-L.

Uterine Cervix
Function: measures Cervix L, Cervix H and Cervix W, calculates UT-L/CX-L.
1. Select [Uterine Cervix] in the measurement menu.
2. Use the Distance method in 2D General Measurements to measure Cervix L, Cervix H and
Cervix W.

Gynecology 8-3
Ovary
Function: measures Ovary L, Ovary H and Ovary W, calculates Ovary Vol.
NOTE: Need to be measured in left and right side respectively.
1. Select [Ovary] in the measurement menu.
2. Use the Distance method in 2D General Measurements to measure Ovary L, Ovary H and
Ovary W. The Ovary Vol is calculated automatically.

Follicle
Function: Measures the length, width and height of follicle using method Distance and calculates
the average of length, width and height as well as the follicle volume.
Up to 16 follicles can be measured. Specify the serial numbers of the follicles before measuring a
follicle.
NOTE: Need to be measured in left and right side respectively.
Takes Follicle1 as an example. Measurements of other items are similar.
1. Select [Follicle1] in the measurement menu.
2. Use the method of Distance measurement of 2D General Measurements to measure Follicle1
L, Follicle1 W and Follicle1 H.
The system automatically calculates the average value of Follicle1 L, Follicle1 W and Follicle1
H as well as the volume of Follicle1.
Wherein the calculation methods of the follicle diameter and volume can be preset via [Setup]-
> [System Preset]-> [Meas].

8.5 Gynecology Exam Report

During or after a measurement, press <Report> on the Control Panel to browse the report.
For details about report browsing, printing and exporting etc, see "1.7 Report".

8.6 References
Uterus Feng Kui, Sun Yanling, Li Hezhou. Ultrasonic diagnosis of adenomyosis. Journal
Body: of Henan Medical University, 1995; 30 (2).
UT-L/ CX-L: Ji Jindi, et al. Ultrasonographic study of the intersex problems and the internal
genitalia abnormalities. Journal of China medical ultrasound. 1996, Volume 12,
No8 P40.

8-4 Gynecology
9 Urology

9.1 Urology Exam Preparations

Make the following preparations before performing a urology exam:
1. Confirm that the current probe is appropriate.
2. Check if the current date of the system is correct.
3. Press <Patient>, register the patient information in [Patient Info] -> [URO] dialog box.
For more details, refer to "Exam Preparation -> Patient Information" in the Operator's Manual
[Basic Volume].
4. Switch to the correct exam mode.

9.2 Basic Urology Measurement Procedures

1. Press <Patient>, register the patient information in [Patient Info] -> [URO] dialog box.
2. Press <Measure> to enter the Application Measurements.
If the current menu is not the one having Urology Measurement tools, move the cursor to the
menu title and select the package having Urology Measurement tools.
3. Select measurement tool in the menu to start the measurement.
See table in "9.3 Urology Measurement Tools" below for measurement tools.
See section "9.4 Urology Measurement Operations" and steps in "3 General Measurement" for
measurement methods.
4. Press <Report> to view the exam report, see "9.5 Urology Exam Report" for details.

9.3 Urology Measurement Tools

NOTE: Measurement tools mentioned below are configured in the system. The application
measurement packages provided in this system are generally different combinations of
measurement tools. For more information about package preset, see "2.4.2.2 Application
Measurement Preset".

The system supports the following 2D measurements (no measurement tools in M/Doppler mode).
Types Tools Descriptions Methods or formulae
Renal L Renal Length
Renal H Renal Height
Renal W Renal Width
Distance in 2D General
Measurement Cortex Renal Cortical Thickness
Measurements
Adrenal L Adrenal Length
Adrenal H Adrenal Height
Adrenal W Adrenal Width

Urology 9-1
 Types Tools Descriptions Methods or formulae
Prostate L Prostate Length
Prostate H Prostate Height
Prostate W Prostate Width
Seminal L Seminal Vesicle Length
Seminal H Seminal Vesicle Height
Seminal W Seminal Vesicle Width Distance in 2D General
Testis L Testicular Length Measurements

Testis H Testicular Height

Measurement
Testis W Testicular Width
Ureter /
Pre-BL L Previous-Bladder Length
Pre-BL H Previous-Bladder Height
Pre-BL W Previous-Bladder Width
Distance in 2D General
Post-BL L Posterior-Bladder Length
Measurements
Post-BL H Posterior-Bladder Height
Post-BL W Posterior-Bladder Width
Renal Vol Renal Volume
Prostate Vol Prostate Volume
Testis Vol Testicular Volume
Calculation See below
Pre-BL Vol Previous-Bladder Volume
Post-BL Vol Posterior-Bladder Volume
Mictur.Vol Micturated Volume
Kidney /
Adrenal /
Prostate /
Study See below
Seminal Vesicle /
Testis /
Bladder /

9.4 Urology Measurement Operations

Tips: 1. See the table in "9.3 Urology Measurement Tools" above for measurement tools
and methods.
2. For the definitions of measurement, calculation and study, refer to
"1.3 Measurement, Calculation and Study".
3. The order of the measurement items is presettable, see "2.4.2 Application
Measurement Preset" for details.

9-2 Urology
9.4.1 Measurement Tool Operations
Operations of all Urology measurement tools are the same as Distance measurement of 2D
General Measurements.
The following tools need to measure Left or Right side respectively:
Seminal L Seminal H Seminal W Renal L
Renal H Renal W Cortex Adrenal L
Adrenal H Adrenal W Testis L Testis H
Testis W

The measurement procedures are as follows taking Prostate L measurement as an example:

1. Select [Prostate L] in the measurement menu.
2. Use the Distance of 2D General Measurements to measure Prostate L.

9.4.2 Calculation Tool Operations

Renal Vol
Function: measures Renal L, Renal H and Renal W, calculates Renal Vol.
NOTE: Need to be measured in left and right side respectively.
1. Select [Renal Vol] in the measurement menu.
2. Use the method of Distance measurement of 2D General Measurements to measure Renal L,
Renal H and Renal W. The Renal Vol is calculated automatically.

Prostate Vol
Function: measures Prostate L, Prostate H and Prostate W, calculates Prostate Vol and PPSA. If
[Serum PSA] in [Patient Info] -> [URO] has been input, PSAD (Prostate Special Antigen Density)
will also be calculated.
PPSA (ng/ml) = PPSA Coefficient (ng/ml2) × Prostate Vol (ml)
PSAD (ng/ml2) = Serum PSA (ng/ml) / Prostate Vol (ml)
Here, PPSA Coefficient and Serum PSA are input in [Patient Info] -> [URO] dialog box. The default
value of PPSA Coefficient is 0.12.
1. Select [Prostate Vol] in the measurement menu.
2. Use the Distance method in 2D General Measurements to measure Prostate L, Prostate H
and Prostate W.
The system calculates Prostate Vol and PPSA.
The PSAD displays in the report if the PSA value is input.

Testis Vol
Function: measures Testis L, Testis H and Testis W, calculates Testis Vol.
NOTE: Need to be measured in left and right side respectively.
1. Select [Testis Vol] in the measurement menu.
2. Use the method of Distance measurement of 2D General Measurements to measure Testis L,
Testis H and Testis W. The Testis Vol is calculated automatically.

Urology 9-3
Pre-BL Vol
Function: measures the Pre-BL L, Pre-BL H and Pre-BL W, calculates the Pre-BL Vol.
1. Select [Pre-BL Vol] in the measurement menu.
2. Use the Distance method in 2D General Measurements to measure Pre-BL L, Pre-BL H and
Pre-BL W. The Pre-BL Vol is calculated automatically. The Mictur.Vol is displayed in the report
if the Post-BL Vol is measured.

Post-BL Vol
Function: measures the Post-BL L, Post-BL H and Post-BL W, calculates the Post-BL Vol.
1. Select [Post-BL Vol] in the measurement menu.
2. Use the Distance method in 2D General Measurements to measure Post-BL L, Post-BL H and
Post-BL W. The Post-BL Vol is calculated automatically. The Mictur.Vol is displayed in the
report if the Pre-BL Vol is measured.

Mictur.Vol
Function: measures the Pre-BL Vol and Post-BL Vol, calculates the Mictur.Vol.
1. Select [Mictur.Vol] in the measurement menu.
2. Use the Distance method in 2D General Measurements to measure Pre-BL L, Pre-BL H and
Pre-BL W. The Pre-BL Vol is calculated automatically.
3. Use the Distance method in 2D General Measurements to measure Post-BL L, Post-BL H and
Post-BL W. The Post-BL Vol and Mictur.Vol are calculated automatically.

9.4.3 Study Tool Operations

Kidney
Function: measures Renal L, Renal H and Renal W, calculates Renal Vol.
NOTE: Need to be measured in left and right side respectively.
1. Select the [Kidney] in the measurement menu.
2. Use the method of Distance measurement of 2D General Measurements to measure Renal L,
Renal H and Renal W. The Renal Vol is calculated automatically.
3. Use the method of Distance measurement of 2D General Measurements to measure Cortex.

Adrenal
Function: measures Adrenal L, Adrenal H and Adrenal W.
NOTE: Need to be measured in left and right side respectively.
1. Select the [Adrenal] in the measurement menu.
2. Use the method of Distance measurement of 2D General Measurements to measure Adrenal
L, Adrenal H and Adrenal W.

Prostate
Function: measures Prostate L, Prostate H and Prostate W, calculates Prostate Vol and PPSA. If
[Serum PSA] in [Patient Info] -> [URO] has been input, PSAD (Prostate Special Antigen Density)
will also be calculated.
PPSA (ng/ml) = PPSA Coefficient (ng/ml2) × Prostate Vol (ml)
PSAD (ng/ml2) = Serum PSA (ng/ml) / Prostate Vol (ml)
Here, PPSA Coefficient and Serum PSA are input in [Patient Info] -> [URO] dialog box. The default
value of PPSA Coefficient is 0.12.
1. Select the [Prostate] in the measurement menu.

9-4 Urology
2. Use the Distance method in 2D General Measurements to measure Prostate L, Prostate H
and Prostate W.
The system calculates Prostate Vol and PPSA.
The PSAD displays in the report if the PSA value is input.

Seminal Vesicle
Function: measures Seminal L, Seminal H and Seminal W.
NOTE: Need to be measured in left and right side respectively.
1. Select the [Seminal Vesicle] in the measurement menu.
2. Use the method of Distance measurement of 2D General Measurements to measure Seminal
L, Seminal H and Seminal W.

Testis
Function: measures Testis L, Testis H and Testis W, calculates Testis Vol.
NOTE: Need to be measured in left and right side respectively.
1. Select the [Testis] in the measurement menu.
2. Use the method of Distance measurement of 2D General Measurements to measure Testis L,
Testis H and Testis W. The Testis Vol is calculated automatically.

Bladder
Function: measures Pre-BL L, Pre-BL H, Pre-BL W, Post-BL L, Post-BL H and Post-BL W,
calculates Pre-BL Vol, Post-BL Vol and Mictur.Vol.
1. Select the [Bladder] in the measurement menu.
2. Use the Distance method in 2D General Measurements to measure Pre-BL L, Pre-BL H and
Pre-BL W. The Pre-BL Vol is calculated automatically.
3. Use the Distance method in 2D General Measurements to measure Post-BL L, Post-BL H and
Post-BL W. The Post-BL Vol and Mictur.Vol is calculated automatically.

9.5 Urology Exam Report

During or after a measurement, press <Report> on the Control Panel to browse the report.
For details about report browsing, printing and exporting etc, see "1.7 Report".

9.6 References
PPSA: Peter J. Littrup MD, Fed LeE. MD, Curtis Mettin. PD.Prostate Cancer
Screening: Current Trends and Future Implications. CA-A CANCER
JOURNAL FOR CLINICIANS, Jul/Aug 1992, Vol.42, No.4.

PSAD: MITCHELL C. BENSON, IHN SEONG, CARL A. OLSSON, J, McMahon,

WILLIAM H.COONER. The Use of Prostate Specific Antigen Density to
Enhance the Predictive Value of the Intermediate Levels of Serum Prostate
Specific Antigen. THE JOURNAL OF UROLOGY, 1992, Vol.147, p817-821

Urology 9-5
10 Small Parts
10.1 Small Parts Exam Preparations
Make the following preparations before measurement:
1. Confirm that the current probe is appropriate.
2. Check if the current date of the system is correct.
3. Press <Patient>, register the patient information in [Patient Info] -> [SMP] dialog box.
For more details, refer to "Exam Preparation -> Patient Information" in the Operator's
Manual [Basic Volume].
4. Switch to the correct exam mode.

10.2 Basic Small Parts Measurement

Procedures
1. Press <Patient>, register the patient information in [Patient Info] -> [SMP] dialog box.
2. Press <Measure> to enter the Application Measurements.
If the current menu is not the one having Small Parts Measurement tools, move the cursor to
the menu title and select the package having Small Parts Measurement tools.
3. Select measurement tool in the menu to start the measurement.
See table in "10.3 Small Parts Measurement Tools" below for measurement tools.
See section "10.4 Small Parts Measurement Operations" and steps in "3 General
Measurement" for measurement methods.
4. Press <Report> to view the exam report, see "10.5 Small Parts Exam Report" for details.

10.3 Small Parts Measurement Tools

The system supports the following small parts measurements.
NOTE: Measurement tools mentioned below are configured in the system. The application
measurement packages provided in this system are generally different combinations of
measurement tools. For more information about package preset, see "2.4.2.2 Application
Measurement Preset".

Modes Types Tools Descriptions Methods or formulae

Thyroid L Thyroid Length
Thyroid H Thyroid Height
Thyroid W Thyroid Width Distance in 2D General
2D Measurement
Isthmus H Isthmus height Measurements

Testis L Testicular Length

Testis H Testicular Height

Small Parts 10-1

Modes Types Tools Descriptions Methods or formulae
Testis W Testicular Width
Mass1 D1~3 /
Distance in 2D General
Mass2 D1~3 /
Measurements
Mass3 D1~3 /
Thyroid Vol (cm3) = k × Thyroid L
(cm) × Thyroid H (cm) × Thyroid W
Calculation Thyroid Vol Thyroid Volume (cm)
Where in, k= 0.479 or 0.523
Same formulae as in Thyroid Vol
Thyroid /
calculation
Study Testis / See “Testis”.
Volume (3 Dist) in 2D General
Mass1~3 /
Measurements
M / / / /
Superior Thyroid
STA
Artery D trace in General D
Measurement
Inferior Thyroid measurements
Doppler ITA
Artery
Calculation / / /
Study / / /

10.4 Small Parts Measurement Operations

Tips: 1. See table "10.3 Small Parts Measurement Tools" above for measurement tools
and methods.
2. For the definitions of measurement, calculation and study, refer to
"1.3 Measurement, Calculation and Study".
3. The order of the measurement items is presettable, see "2.4.2 Application
Measurement Preset" for details.

10.4.1 Measurement Tool Operations

Take measurement "Thyroid L" for example; the measurement procedures are as follows:
1. Select [Thyroid L] in the measurement menu.
2. Use the Distance of 2D General Measurements to measure Thyroid L. The value displays in
the result window and exam report.

10.4.2 Calculation Tool Operations

Thyroid Vol
Function: measures Thyroid L, Thyroid H and Thyroid W respectively, and calculates Thyroid Vol.
Tips: Need to be measured in left and right side respectively.

10-2 Small Parts

1. Select [Thyroid Vol] in the measurement menu.
2. Use the Distance of 2D General Measurements to measure Thyroid L, Thyroid H and Thyroid
W.
Two Thyroid Vols are calculated automatically.

10.4.3 Study Tool Operations

Thyroid
Function: measures Thyroid L, Thyroid H and Thyroid W respectively, and calculates Thyroid Vol.
See “10.3 Small Parts Measurement Tools” for calculation formulae.
Tips: Need to be measured in left and right side respectively.
1. Select the [Thyroid] in the measurement menu.
2. Use the Distance tool in 2D General Measurements to measure Thyroid L, Thyroid H and
Thyroid W. The Thyroid Vol is calculated automatically.

Mass
Function: measures Mass D1, Mass D2 and Mass D3 to calculate the Mass Volume. Up to 3
masses can be measured.
Take Mass1 as an example, the procedures are as follows:
1. Select [Mass1] in the measurement menu.
2. Use the Distance tool in the 2D General Measurement to measure Mass1 D1, Mass1 D2 and
Mass1 D3.
The measurements and the calculated Mass Volume are recorded in the report.

Testis
The same as “Testis” in “Urology”.

10.5 Small Parts Exam Report

During or after a measurement, press <Report> on the Control Panel to browse the report.
For details about report browsing, printing and exporting etc, see "1.7 Report".

10.6 References
Thyroid Vol: Volumetrie der Schilddruesenlappn mittels Realtime-Sonographie; J Brunn, U.
(k= 0.479) Block, G. Ruf, et al.; Dtsch.med. Wschr.106 (1981), 1338-1340.)

Thyroid Vol: Gomez JM, Gomea N, et al. Determinants of thyroid volume as measured by
(k=0.523) ultrasonography in healthy adults randomly selected. Clin Endocrinol(Oxf),
2000;53:629-634)

Small Parts 10-3

11 Orthopedics
HIP (Hip Joint Angle) measurement is used in pediatric orthopedics. Such measurement provides
early diagnosis for infant hip joint dislocation.

11.1 Orthopedics Exam Preparations

Make the following preparations before measurement:
1. Confirm that the current probe is appropriate.
2. Check if the current date of the system is correct.
3. Register patient information in [Patient Info] -> [PED] dialog box.
For more details, refer to "Exam Preparation -> Patient Information" in the Operator's Manual
[Basic Volume].
4. Switch to the correct exam mode.

11.2 Basic Orthopedics Measurement

Procedures
1. Register patient information in [Patient Info] -> [PED] dialog box.
2. Press <Measure> to enter the Application Measurements.
If the current menu is not the one having HIP Measurement tools, move the cursor to the
menu title and select the package having HIP Measurement tools.
3. Select measurement tool in the menu to start the measurement.
4. See table in "11.3 Orthopedics Measurement Tools" below for measurement tools.
5. See section "11.4 HIP Measurement Operations" and steps in "3 General Measurement" for
measurement methods.
6. Press <Report> to view the exam report, see "11.5 Orthopedics Exam Report" for details.

11.3 Orthopedics Measurement Tools

NOTE: Measurement tools mentioned below are configured in the system. The application
measurement packages provided in this system are generally different combinations of
measurement tools. For more information about package preset, see "2.4.2.2 Application
Measurement Preset".

HIP
The HIP calculation assists in assessing the development of the infant hip. In this calculation, three
straight lines are superimposed on the image and aligned with the anatomical features. The two
angles are calculated and displayed.
The three lines are:

Orthopedics 11-1
„ The baseline (BL), connecting the osseous acetabular convexity to the point where the joint
capsule and the perichondrium unite with the ilium.
„ The roof line (RL), connecting the lower edge of the ilium to the osseous acetabular convexity.
„ The inclination line (IL), connecting the osseous acetabular convexity to the labrum acetabular.
The angles are:
„ α: the angle between BL and RL.
„ β: the angle between BL and IL
IL

BL
α

RL

Dislocation type can be determined through Graf method, as described in the following table.

DISLOCATION CRITERIA
RESULT
TYPE α β Patient
I α≥60° β＜77° All ages I
Younger than three months of
50°≤α≤59° IIa
age
Three months of age or older
II 50°≤α≤59° β＜55° IIb
than three months
43°≤α≤49° β≤77° All ages IIc
43°≤α≤49° β＞77° All ages IId
III α＜43° β＞77° All ages III
Quantitative angle All
IV measurement cannot be All ages
performed.
Others Others All ages ?????

HIP-Graf
The measurement items, results and procedures are the same with “HIP”.

11.4 HIP Measurement Operations

Tips: For the definitions of measurement, calculation and study, refer to "1.3 Measurement,
Calculation and Study".

1. In B mode, select [HIP] from the measurement menu.

A line appears, and there is a fulcrum on the line.

11-2 Orthopedics
2. Use the trackball to move the line to the position of the hip joint. Then rotate the Multifunctional
Knob to fix the baseline.
3. Press <Set> to confirm and the second line displays.
4. Use the method for adjusting the first line to anchor the RL and press <Set> to fix the RL.
5. Use the same method to fix the third line IL. The angles of α and β come out.
If patient age is entered, dislocation type is also displayed.

11.5 Orthopedics Exam Report

During or after a measurement, press <Report> on the Control Panel to browse the report.
For details about report browsing, printing and exporting etc, see "1.7 Report".

11.6 References
Graf R., “Sonographic diagnosis of hip dysplasia. Principles, sources of error and consequences”
Ultraschall Med. 1987 Feb;8(1):2-8

Schuler P., “Principles of sonographic examination of the hip” Ultraschall Med. 1987 Feb;8(1):9-1

Graf, R. “Fundamentals of Sonographic Diagnosis of Infant Hop Dysplasia.” Journal Pediatric

Orthopedics, Vol. 4, No. 6:735-740,1984.

Graf, R. Guide to Sonography of the Infant Hip. Georg Thieme Verlag, Stuttgart and New York,
1987.

Morin, C., Harcke, H., MacEwen, G. “The Infant Hip: Real-Time US Assessment of Acetabular
Development.” Radiology, 177:673-677, December 1985.

Orthopedics 11-3
12 Emergency
The following optional emergency exam modes are available in current system:
„ EM ABD
„ EM FAST
„ EM OB
„ EM Vascular
„ EM Superficial

12.1 Basic Measurement Procedures

1. Press <Patient>, register patient information in proper page under [Patient Info] screen.
2. Scan the desired ultrasonic views and save image(s).
3. Press <Measure> to enter the Application Measurements.
If the current menu doesn’t contain the desired measurement tools, move the cursor to the
menu title and select the proper package.
4. Select the item/tool to start the measurement.
5. Press <Report> to view and output measurement report.

12.2 EM Measurement Tools

The commonly used measurement tools are contained in the EM package corresponding to each
EM exam mode.

NOTE: 1. Measurement tools in each EM package depend on the specific measurement data
preset for each ultrasound system.
2. For detailed descriptions of the measurement item, please refer to the corresponding
application chapter.
3. For more information about package preset, see "2.4.2.2 Application Measurement
Preset".

12.3 EM Exam Report

During or after a measurement, press <Report> on the Control Panel to browse the report.
Each EM exam mode has its corresponding EM report. Similar to other reports, the following
functions are available in the EM report:

Emergency 12-1
„ Selecting anatomic diagnosis
„ Editing report data and adding remarks
„ Adding/ deleting ultrasound image(s)
„ Changing report template
„ Printing/ previewing the report
„ Exporting Report
For details about report browsing, printing and exporting etc, see "1.7 Report".

12-2 Emergency
P/N: 046-000539-00 (V4.0)