HI-VISION-Preirus-User-Manual-Q2E-ES1155-15

[Page 1] User Manual Special Notes to Operators and Maintenance Managers ★ Before using this system, be sure to thoroughly read this manual and familiarize yourself with the system. ★ After reading this manual, keep it near the system, in a handy location where you can refer to it easily. Tokyo, Japan Copyright © Hitachi Medical Corporation. 2009-2014. Ａ ll rights reserved. Q2E-ES1155-15

[Page 2] About the ultrasound scanner display Note that the ultrasound scanner display referred to in this User Manual might differ from the display actually displayed.

[Page 3] Turning the Power ON or OFF 1 Panel Key Description 2 Examination screen (Screen buttons) 3 Selecting the Examination Conditions 4 ID Input 5 B Mode 6 M Mode 10 Color Mode 11 Doppler Mode 12 Display 14 Strain Graph 15 Strain Ratio, FLR, Strain Histogram Measurement 16 ECG and Physiologic Module 17 BodyMark 19 Comments and Annotations 20 Basic Measurement 21 Media Handling 24 Formatting 25 Recording and Loading Images 26 Image Search and Play 27 Copy to media and Edit 28 ( i ) Q2E-ES1155

[Page 4] Startup and Exit 29 Adjustment 30 MTI ・ TIC 31 Preparation 32 Startup and Exit 34 Loading volume data 35 Volume data adjustment 36 Corresponding to the SYNAPSE 3D data 37 3D body mark 38 Marking function 39 RVS mode start 40 Adjust 41 Performing when RVS mode is executed 42 Combination of RVS and Contrast mode 43 IMT 44 %WT 45 Color Tissue Tracking 47 LA Tracking 49 ( ii ) Q2E-ES1155

[Page 5] Preparation 51 Scanning, Volume operation 52 Function 53 Volume Data Save and Load 54 HI DEF 3D (Scanning) 55 HI DEF 3D (Function) 56 HI DEF 3D (Multi Slice mode) 57 HI DEF 3D (CFM 3D mode) 58 STIC function 59 3D (Freehand 3D) Preparation 60 Scanning 61 ( ⅲ ) Q2E-ES1155

[Page 6] Turning the Power ON or OFF Turning the Power ON ① Turn the Breaker switch ON. Breaker switch ② Press the ON/STANDBY key. The operation panel lights up, and the device starts up. Start-up Examination screen ready screen ③ Cancel the FREEZE key to start examination. Turning the Power OFF ① Press the ON/STANDBY key. ② Click the OK button in the message. The light of the operation panel goes out completely black when the device shuts down. Before turning the Breaker switch off, make sure that the system has completely shut down. ③ Turn the Breaker switch OFF. 1 Q2E-ES1155

[Page 7] Panel Key Description 『 ON/STANDBY 』 Key 『 Elasto/TDI mode selection 』 Key Powers on or shuts down the Activates Elasto or TDI mode. device. Note that the activated mode depends on the settings. 『 PROBE 』 Key 『 Dual Doppler Mode 』 Key Displays the probe switching dialog Activates Dual Doppler. box. 『 End Exam 』 Key 『 Fine Flow / CFA Mode 』 Key Image Print, transfer images to Switches Fine Flow or CFA on or off. storage servers, and delete Note that the mode depends the measurement results. settings. 『 Patient 』 Key 『 HI Zoom 』 Key Displays dialog boxes for entering or Turns high-definition zoom on or off. modifying patient information. 『 PSS 』 encoder Switches between the image 『 PAN Zoom 』 Key adjustment parameter settings (data Turns PAN zoom on or off. registered from the PSS setup menu). 『 Multi 』 encoder 『 READ 』 Key Operates the function selected from Starts the Filing window. the screen button area. 『 Image Menu 』 Key 『 UPDATE (NEXT) 』 Key Reflects the image adjustment Initiates the sweep of Doppler Mode parameters on screen buttons. or M mode. 『 Function1 』・『 Function2 』 Key Activates the preset option functions or displays a list of options in the form of screen buttons. Panel key colors Illuminated in orange: The key is selected. Illuminated in white: The key can be selected. Not illuminated: The key cannot be selected. 2 Q2E-ES1155

[Page 8] Examination screen (Screen buttons) Area to display tab menu Area to display thumbnail Screen button area. Can be operated by touching directly. How to use the screen buttons Types of screen buttons You can use the screen buttons in any of the Turns the selected following ways: function on or off. - Directly touch the button. ON OFF - Use the pointer by means of the trackball and the ENTER key. Refreshes the screen buttons so that they reflect the selected function menu. Menu You can operate the selected function using the Multi encoder . Or, you can operate also by screen Encoder button Up/Down . Scrolls through functions when the - Use the Function keys on the operation panel. button is pressed. Rotation Executes the selected function when pressed. Push The actual buttons displayed vary depending on the examination mode. Function keys Multi encoder Performs operations related to the Encoder Func. button selected from the screen button area. System Information Display Operating state of Multi encoder is *Possible to operate by screen buttons as well. displayed here. 3 Q2E-ES1155

[Page 9] Selecting the Examination Conditions Selecting the probe and application Press the PROBE key to display the Select Probe/Application window. 1 2 Use the trackball to move the pointer on the window. Present application is displayed here. ① Select the probe to be used. ② Select the application, and then press the ENTER key. The selected application is activated, and the probe is selected. You are ready to scan the patient. Selecting from the default application The default application functionality allows you to assign frequently used application settings for each probe. For details on how to assign application settings for each probe, see the instruction manual for the device. ① Use the trackball to move the pointer on the window. ② Place the pointer over the default application for the desired probe, and then press the ENTER key to select it. The selected application is activated, and the probe is directly selected. You are ready to scan the patient. Creating a new application (Editing) You can add a new setting to the applications registered for each probe of the equipment, or edit the registered application settings. For further details, see the instruction manual. 4 Q2E-ES1155

[Page 10] ID Input Entering patient information ① Press the Patient key to display the Patient Information window. ② Enter the ID from the keyboard. Use the trackball to move the pointer on the window, and then press the ENTER key to select the next item to be entered. Enter patient information, and then click the Save button to save the data. The next time you don’t have to enter ID, you can select from the list of IDs displayed in the lower part of the The item to be entered varies depending on the display format. Standard OB/GYN The ID and name entry fields can be enlarged. To do this, press the Patient key and the Setting button in the lower right corner of the Patient Information Select Large for Font size on page Item setting. ③ After you enter the necessary information or made the necessary changes, place the pointer over the Start Exam button, and then press the ENTER key. Automatic assignment of ID number ① Press the Patient key. ② Press the Start Exam key without inputting ID. ③ Press the OK button from Confirmation screen. ID number is automatically assigned. 5 Q2E-ES1155

[Page 11] B Mode ① B Mode image display Changing frequency Brighter Higher frequency Press the center of the B Mode encoder. Lower frequency * Frequency indication is not displayed Turn the encoder to adjust the gain. according to the mode used. Use the HI-Support key to optimize the B gain and depth- specific gain. Display depth Focus position Shallower display depth Shallower Deeper Deeper display depth Use the DEPTH (MAG.) encoder to change the display size. Focus settings To display the focus-related screen buttons, press the Focus Set. button. Focus Set. To go back to the general menu, press the Focus Set. button again. Focus step Focus width # # Focus Step Focus Width Increase steps Increase width Decrease steps Decrease width Note: Enabled only if the focus width is greater than 1. 6 Q2E-ES1155

[Page 12] B Mode ② Display settings To display the display setting menu, press the Display Set. screen button. Display Set. To go back to the general menu, press the Display Set. button again. Left/Right inversion Up/Down inversion To invert the displayed image horizontally, To invert the displayed image vertically, press the Invert L/R button. press the Invert U/D button. Steering images Changing the depth Image Steering Up/Down Shift Deeper Shallower To change the depth, activate the Up/Down Shift To steer the image, activate the Image Steering button, and then use the trackball. button, and then use the trackball. Image Size Viewing Angle/Display Width # # Image Size Angle Increase size Wider Decrease size Narrower 7 Q2E-ES1155

[Page 13] B Mode ③ Selecting Harmonic Mode Spatial Compound (HI Com) Compound imaging by multidirectional scanning dTHI Use of HI Com When dTHI is on, use the REF FREQ key to shift HI Com ON through the following modes: HdTHI-R: High definition (Standard) mode HI Com OFF HI Com ON/OFF are switched with each pressing of HdTHI-P: High definition Up HI Com button. (Deep scan) mode Steering HI Com dTHI-W-R: High resolution (Standard) mode HI Com HI Com is on. To change the compound direction, use the Down dTHI-W-P: High resolution OBLIQUE toggle. Changes can be made at a (Deep scan) mode maximum of 3 levels in each direction. Left Steering Right dTHI-R: Standard mode OFF dTHI-P: Deep scan mode Level 3 Level 2 Level 1 Level 1 Level 2 Level 3 *Different by probes. ※ Level 3 can be selected only during a linear probe, with the emphasized effect of a puncturing needle. Oblique B Mode image (for linear probe only) HI Com HI Com is off. Trapezoid display (for linear probe only) Trapezoid B Mode Image To switch the trapezoid display mode ON or OFF, press the Trapezoid button. Select of needle guide bracket Registration of a needle guideline needs to be When two or more needle guide brackets are registered for every probe. registered, please choose from the Tool tab menu Please carry out registration by the service and Bracket Select . member. GUIDE 8 Q2E-ES1155

[Page 14] B Mode ④ HI Zoom PAN Zoom This feature allows you to enlarge only the ROI You can enlarge an image and then move it to (region of interest) and render it in high definition. change its display position. This will also increase the frame rate. Press the HI Zoom key. ROI is displayed. Press the PAN Zoom key. Use the trackball to move the ROI to the desired location. Enlarge To change the size of the ROI, press the ENTER key. A dot ( z ) appears at the lower right corner of the ROI. Reduce Use the trackball to change the size of the ROI. If you press the ENTER key again, or do not touch Use the trackball to change the display position of the trackball for over five seconds, the mark the image. disappears, and the ROI can be moved again. Press the PAN Zoom key again to cancel the zoom mode. Press the UPDATE (NEXT) key to the zoom mode. Press the HI Zoom key again to cancel the zoom mode. Frame-by-frame playback of cine Dual display memory To switch between single-window Press the CINE key after freezing the image. and dual-window mode, use the DUAL/SINGLE key. When use the linear probe that can use Up/Down display. * To change Up/Down display, select a Setup-Application-Edit Data-Application Data Setting-B item-Image split. Real-time Cine memory images can be played back by frame Real-time Frozen with a trackball. Frozen Frozen Frozen Real-time Real-time To switch between the Left(Up) and Right(Down) windows, use the L(U) and R(D) keys. 9 Q2E-ES1155

[Page 15] M Mode M Mode display Omni-directional M Mode (ODM Mode) display Press the center of the M Mode encoder. To switch ODM Mode ON or OFF, press the ODM Press the M Mode encoder again to exit M button displayed during M Mode. Mode. Brighter Normal M Mode ODM Mode Turn the encoder to adjust the gain. To play the M Mode cine memory images frame by frame, freeze the display, and then turn the M ODM ODM Mode encoder. (If this causes the gain to change, press the center of the encoder and then turn it.) Moving the M Mode cursor Rotating and moving the ODM cursor line Use the trackball to move the cursor right or left. Turn the Angle encoder so that the cursor line rotates around the { mark. Press the center of the encoder to turn the cursor line 45 degrees at a time. Use the trackball to move the cursor line position. Dual ODM display To switch between Single Directional ODM and Dual Directional ODM, press the Dual ODM button. The ODM image indicated by the ODM Symbols mark . Dual ODM The ODM image indicated by the ODM Symbols mark . Use the UNDO key to select the ODM cursor to be moved. The selected cursor is highlighted in yellow. During Dual ODM you can use screen buttons to switch between the two cursor line control options. Independent Both cursors have their own rotation center, and therefore move separately. Independent Both cursors share the same rotation center, and therefore move together. 10 Q2E-ES1155

[Page 16] Color Mode Color Doppler (CFI Mode) display Tissue Doppler image (TDI Mode) display Press the center of the CFI Mode encoder. Press the Elasto/TDI Mode encoder to switch TDI To exit CFI Mode, press the CFI Mode encoder again. Mode ON or OFF. Turn the encoder to adjust the Brighter gain. * Depending on the probe or Turn the encoder to adjust the gain. application being executed, this might cause the Elasto to be activated. For details, see the Instruction Manual. Switching between the Power Doppler Changing the position and size of the (CFA Mode) and Fine Flow modes color box Press the Fine Flow/CFA Mode key. To exit Fine Flow mode, press the Fine Flow/CFA Mode key again. Turn the CFI Mode encoder to adjust the gain. Use the trackball to move the color box. Fine Flow and CFA are switched by each pressing of a screen button. To CFA To Fine Flow To change the size of the ROI, press the ENTER Fine Flow mode is selected. CFA is selected. (High-definition blood flow key. A dot ( z ) appears at the lower right corner of power display) the ROI. Use the trackball to change the size of the ROI. Changing the velocity range Parallel display of colored and black-and- white images Higher velocity To switch the parallel display ON or OFF, press the Dual CFM button. Lower velocity Dual CFM OFF Dual CFM ON Oblique color box (for linear probe only) Dual CFM Dual CFM * Depending on the linear probe application being executed, Tilt the OBLIQUE key in the direction to which you this might cause the Up/Down image be activated. want to tilt the ROI. 11 Q2E-ES1155

[Page 17] Doppler Mode ① Doppler Mode display To activate Pulse Doppler, press the PW Mode encoder. To activate Continuous Wave Doppler, press the CW Mode key. To exit the current mode, press the same encoder or key again. When you cannot get the Doppler wave form just by Doppler cursor, press UPDATE (NEXT) key to start the sweep of Doppler wavform. To adjust the gain, turn the PW Mode encoder. Use the trackball to move the Doppler cursor. If the Doppler cursor is not yellow, press the TRACKBALL key to turn it yellow, and then move the cursor. Pulse repetition frequency (PRF) Sample gate adjustment adjustment Greater Wider PRF Less Narrower PRF Wall filter Volume adjustment Higher volume You can change the signal removal level. Remove higher frequency # Sound Volume Lower volume Remove lower frequency Select the Sound Volume button, and then use the Multi encoder to adjust the volume. Switching of simultaneous Real-time Angle correction display Press the encoder to bring up the angle bar. Slightly turn the encoder to adjust the bar so that it Simult. Real-time Frozen is aligned with the direction of blood flow. OFF Frozen Real-time Clockwise Simult. blood flow. Counterclockwise Simult. ON Real-time Every time the encoder is pushed, the display in Real-time registered angle, reversing, and erasing of the angle bar are repeated. 12 Q2E-ES1155

[Page 18] Doppler Mode ② Dual Doppler Mode display Press the Dual Doppler Mode key. Turn the PW Mode encoder to adjust the gain. If only the Doppler cursor is displayed with no waveform shown, press the UPDATE (NEXT) key. Moving and changing the Doppler cursor Press UNDO key to switch the priority of Doppler cursor. The cursor is displayed in yellow when it is active. Doppler image corresponding to Doppler cursor 1 Move yellow Doppler cursor with a trackball. Doppler image corresponding to Doppler cursor 2 Once frozen, you can also change the Doppler cursor by pressing the screen button marked Sel.Dop. . Sel. Dop.;D1 Sel. Dop.;D2 Doppler image of Doppler image of the upper window is the lower window is displayed displayed Combinations of Dual Doppler images Use screen buttons to switch between combinations of Dual Doppler images. PW/PW PW/TDI TDI/TDI PW PW TDI PW TDI TDI D1:PW D2:PW D1:PW D2:TDI D1:TDI D2:TDI 13 Q2E-ES1155

[Page 19] Display Display Elasto Mode To turn the Elasto mode ON or OFF, press the Elasto/TDI Mode key. * Depending on the probe or application that is being executed, the TDI is activated. * When using mechanical compression unit (option) for intraluminal probe, select “E_Balloon_Urology” in “Select Probe with Application” screen, and boot up the Elasto Mode. Parallel display of the Elasto Mode and B Mode images The Dual Elasto screen button switches the display. * Depending on the linear probe application being executed, this might cause the Up/Down image be activated. Dual Elasto Dual Elasto ROI adjustment ① Make sure that the mark is selected and illuminated in yellow in the trackball priority section in the lower right of the examination window. If not selected, press the TRACKBALL key to select the trackball. ② Use the trackball to move the ROI or change its size. To switch between the two functions, press the ENTER key. The ROI size is fixed. Use the trackball to move If the z mark appears in the lower right corner of the ROI to the desired location. the ROI, you can change the size of the ROI. Use the trackball to adjust the size of the ROI. The ROI can be adjusted not only in real time image but also in frozen image. Press the ROI ReConfig. button, and then set the ROI as described in steps 1 ROI ReConfig. and 2 above. Pressing the ROI ReSet button returns the ROI to its state immediately after the freeze. Canceling Frozen Use the trackball to the freeze state causes the ROI to select the frame. return to the location before the freeze. Image quality adjustment High ： Image quality priority To adjust the Elasto frequency, use the REF FREQ key. (Depending on the probe, the frequency might be fixed.) Low ： Sensitivity priority To make other adjustments, press the Image Menu key, and then use the displayed screen buttons. Prev.Page Next E-Dyn. MapL MapR Frame Rata Frame Rej. Noize Rej. Persistence Density 14 Q2E-ES1155

[Page 20] Strain Graph About Strain Graph The strain graph displays the variation over time of tissue strain caused by compression in real time. Pressing the tissue which you want to image so that the periods and amplitudes of the Strain Graph are constant makes it possible to create a stable Elasto Mode image. Pressing probe (applying pressure to tissue) → Positive value Withdrawing probe (releasing pressure from tissue) → Negative value * Stronger pressure increases the amplitude. Gentler pressure reduces the amplitude. Display Strain Graph 【 Freeze OFF 】 【 Freeze ON 】 Sector mode Select Strain Graph Sector Press the Sector button and use the encoder to set the number of sectors. If the frame is changed with the trackball, the sector box operates Sector synchronizing with the time phase bar. * Sector mode is activated by specifying 1 or more for the sector setting. Frame selection Recording video image at the time of Sector mode When Recording Multi Images using the REC2 key during the freeze, Multi Images in the Sector are recorded automatically. Frame Select Function This function displays Elastography images under stable compression automatically. Each time the Frame select button or UPDATE (NEXT) key is pressed, three candidate images extracted by the system are displayed in rotation. Frame select;# * When executing by means of the UPDATE (NEXT) key, before executing change the trackball priority to cine memory frame-by- frame playback or to the pointer. Stable pressure Unstable pressure Image is selected automatically. 15 Q2E-ES1155

[Page 21] Strain Ratio, FLR, Strain Histogram Measurement About strain ratio and FLR measurement The strain ratio measurement allows you to use an Elasto mode image to measure the “strain” and “compare the strain”. For the breast, setting the ROI as shown in the left figure allows you ROI － B to estimate the strain in both the fat and lesion regions and then Fat calculate the FLR, or the fat-lesion ratio. Lesion A …The mean strain within the region surrounded by ROI-A ROI － A B …The mean strain within the region surrounded by ROI-B B/A…The comparison of strain within ROI-A to ROI-B (Strain Ratio) Measurement results * The strain is expressed as a percentage (%). For example, if a 100-mm object has a strain of 1 mm, the strain is expressed as 1%. Strain Ratio ① Select a Str. Ratio from Measurement Menu. ② Move the cross cursor displayed in the center of the screen to the desired starting point of ROI-A, and then press the ENTER key. ③ Move the next displayed cross cursor to the desired end point of the ROI-A, and then press the ENTER key to draw the ROI. The measurement results are displayed when ROI-A is set. ④ A cross cursor appears outside ROI-A. Repeat steps 2 and 3 above to set ROI-B. FLR * In Dual Elasto mode, ROI-A and ROI-B can be specified in either the left or right (up or down) ① Select a FLR from Measurement Menu. ② Move the cursor to the center of a lesion using the trackball, and then press the ENTER key. Lesion and Fat are detected automatically. ROI size change and relocation To change the ROI size, use the ENTER key and the trackball to ● :Partial size change move the control point. The control point is displayed by placing (available only if Shape the cursor on top of the ROI frame. If ROI Shape; Ellipse is Change; Part is selected) selected, the size adjustment mode varies depending on the „ :Size change without shape of the control point. changing the shape To move the ROI, move the cursor to inside the ROI. The ROI + :Size change in the can be moved after the cursor changes to a four-directional diagonal direction arrow. Strain Histogram measurement Use an Elasto mode image to display the histograms of relative strain values (minimum:0, maximum:255) within a given region and calculate feature values of Elasto mode images. C … Circumference of specified region MEAN … Average relative strain value Frequency SD … Standard deviation of relative strain value ％ AREA … Area ratio of low-strain region Relative strain value COMP … Average complexity of each low-strain region Measurement results 16 Q2E-ES1155

[Page 22] ECG and Physiologic Module ① option Attach an electrode to the patient's Control of the waveform body To adjust the position of the waveform, press the Case of Clip electrode; ECG Pos. button, and turn the Multi encoder . Red (R) : right hand Black (RF) : right leg Green (LF) : left leg # ECG Pos. Case of disposable electrode; Red (R) : right shoulder Black (RF) : right waist Green (LF) : left waist Displaying an ECG trace Press the PHYSIO key to display the ECG screen button. ECG Down Up * You can change the To adjust the amplitude of the waveform, press position even the ECG Gain button, and then turn the Multi after a freeze. encoder . To change the sweep speed of the waveform, ECG Gain press the SWEEP SPEED key. Fast Slow Press the ECG Invert button, then ECG waveform inverted. Small Large ECG Invert Screen buttons ECG display Adjust ECG Adjust ECG ECG Invert ECG Filter ON/OFF wave amplitude Position R-R Detection R-R unit Display R-R time ECG Auto gain ON/OFF detect filter * S,M,L means display * R-R Detection is a function of Adjustment of RRp/RRpp ratio. Tachycardia/Brad size of ECG wave. automatically analysis interval ycardia cut filter time of R to R. 17 Q2E-ES1155

[Page 23] ECG and Physiologic Module ② option R-R Detection (for arrhythmia) When freeze is engaged, the system automatically detects each R-R interval in the ECG waveform where the ratio of the preceding R-R interval and second preceding R-R interval is 1. R-R Detection procedure ① When ECG is on, record the image to cine memory and turn freeze on. ② Press the R-R Detection button. The R-R intervals which meets the condition will be detected. The The color changes of the R-R interval in the ECG color of the detected intervals in the ECG waveform where (Preceding R-R interval) / (Second waveform changes. preceding R-R interval) =1. (When selected a sector;2 ) *If no interval is detected, the first frame button and last frame button on the cine playback bar cannot be pressed. ③ Use the RRp/RRpp button to adjust the detection conditions. * When the R-R Detection button is on, R-R detection is performed automatically at the time when freeze is turned on. The color changes of the R-R interval in the ECG waveform where (Maximum R-R interval) / (Minimum R-R interval) =1. (When selected a sector;3 ) R-R Detection Details In B mode, when the time bar reaches the detected interval, the details of the preceding R-R interval and second preceding R-R interval are displayed. (In M Mode or Doppler Mode, the details are displayed when the detected interval is shown on the screen.) Time phase bar Number of the detected sector of Total detected sectors in the Ratio the time phase bar position cine memory R-R interval time Adjusting the interval detection Tachy/Brady Filter The R-R intervals which are detected can be Tachy/Brady Filter button is only detected target heart adjusted. rate within 60-100BPM. Broader search conditions Display R-R time R-R Interval(ms) button is display R-R time under the ECG. Narrower search conditions * The conditions cannot be changed during measurement or during real-time Doppler measurement. 18 Q2E-ES1155

[Page 24] BodyMark When using dual-window mode, you can use the L or R key to select the window in which the body mark (probe mark) is to be set. Adjusting the probe mark Rotate Turn the PROBE MARK encoder to rotate the probe mark. Move ① Make sure the mark is selected in the trackball priority section in the lower part of the examination window. If not selected, press the PROBE MARK encoder to select this mark. ② Use the trackball to move the probe mark to the desired location. Changing the BodyMark Selecting the BodyMark ① Clicking the BodyMark screen button displays screen buttons representing the pre-registered body marks. ② Select the target BodyMark . Push the screen button of BodyMark In the ball of a finger. It is necessary to enlarge the contact area. You can also select a body mark by pressing the PROBE MARK encoder. You can scroll through the pre-registered body marks by pressing the encoder. (Example) Clear Screen buttons BodyMark : Displays the body mark-related screen buttons. Mark Move : Allows you to move the display position of the body mark by using the trackball. Variable area (displays body marks as well as category names indicating the specific section of the body) c d : Scroll through the pages in the variable area. BodyMark Region : Mark Display : Displays the category name indicating a specific section of the body. Clears body marks displayed in Abdomen / Breast / Head/Neck / Urology / Cardiovascular / Organ / the examination window. Upper limb / Lower limb / Obstetrics / Gynecology 19 Q2E-ES1155

[Page 25] Comments and Annotations A comment can be entered directly from the keyboard. An annotation can be selected from the menu showing a list of registered text entries. Comments Activation and input Press the Char. key from the keyboard to display a cursor. Use the trackball to move the cursor to the target location, and then cursor enter the desired text. ABCD Press the Char. key again to finish entering the comment. Setting the home position of the comment Moving a comment cursor Place the cursor over the entered text, and then Move the cursor to any given location, and then press the ENTER key. A yellow frame appears press the Home Posi. screen button to set the home around the text. The text can then be moved. cursor location. From the next time on, the cursor will automatically appear in this location. ABCD Inputting arrows by using the keyboard ABCD ABCD To input an arrow, hold down the Ctrl key and press one of the following alphanumeric keys: Press the ENTER key again to fix the location. A/N Key I O K L C V B N Arrow Annotations Press the either ANNOTATION key on the operation panel or Annot. key on the keyboard. From the displayed list, select the target text, use the trackball to move it to the desired location, and then press the ENTER key. Press the either ANNOTATION key or Annot. key again to finish entering the annotation. Liver I Liver or or Liver Both the cursor and the menu disappear, and entering of the annotation ends. Deleting text Deleting all text Deleting a single line Press the CLEAR key from either the operation To delete a single line of text, place the cursor over panel or the keyboard to delete all comments the text to be deleted, and then press the Shift and (annotations) from the examination window. Del keys together. or * This will also cause the measurements to be deleted. 20 Q2E-ES1155

[Page 26] Basic Measurement ① The basic measurement methods are caliper measurement and trace measurement. Other special measurements are available by either pressing the MEAS. MENU key or by selecting one of the screen buttons. Caliper measurement The measurement to be executed B Mode : Distance M Mode : Depth difference, time, and slope D Mode : Speed (pressure gradient) and time Measurement result Measurement procedure ① Press the CALIP key to display the caliper mark . ② Press the ENTER key to set the start point, and then move the next caliper mark to the end point. Press the UNDO key to set the end point and go back to moving the start point again. ③ Press the ENTER key to set the caliper. After a caliper mark has been set, a new caliper mark appears so that the next measurement can be specified. In Doppler Mode, press the CALIP key to switch between speed measurement and time measurement. (Measurement mode can Caliper;Time Caliper;Velocity also be changed by using the screen button.) Trace measurement Measurement that is executed B Mode : Area M Mode : Distance, circumference, and area D Mode : Average flow velocity Measurement result In B mode, press the Trace key to switch between Manual and Ellipse area measurement method. (Measurement Mode Trace;Manual Trace;Ellipse can also be changed by using the screen button.) Manual trace procedure ① Press the TRACE key to display the caliper mark . ② Press the ENTER key to fix the start point, and then use the trackball to trace the target region. Press the UNDO key to erase the trace line in reverse. ③ Press the ENTER key to close the trace line and end the measurement. After an area has been set, a new caliper mark appears so that the next measurement can be specified. Ellipse trace procedure (b) ① Press the TRACE key to display the caliper mark. ② Press the ENTER key to set the caliper, move the next caliper mark to the next desired location, and (c) then press the ENTER key to set the caliper mark. (a) Adjust the frame size by using the trackball. Press the UNDO key to readjust (a), (b), (c), and (d) (d) in the figure to the right. (a) Frame size ③ Press the ENTER key to set the ellipse and end the (b) Location of the 1st caliper mark measurement. After an area has been set, a new (c) Frame size caliper mark appears so that the next measurement (d) Location of the 2nd caliper mark can be specified. Deleting measurements Press the CLEAR key to delete the measurements displayed in the examination window. *This will also cause the comments (annotations) to be deleted. 21 Q2E-ES1155

[Page 27] Basic Measurement ② Real-time Doppler measurement Starting and exiting the real-time measurement Real-time Real-time Real-time Measurement result Press the TRACE key while In the case of Abdomen Press the CLEAR key observing the Doppler waveform, application, measurement to end the processing. trace processing starts up, the items are Vp, Vd, Vm, PI, measurement results is updating RI ,VTI. in real-time. Editing a real-time trace Press TRACKBALL key to change the display of trackball function. Operate screen buttons when mark is selected (yellow highlighted) as trackball priority (displayed in the lower right of examination window). Threshold : Adjusts the threshold so that the Dir. : Available trace direction options include up, trace line fits the waveform. down, and up/down. Smooth Line : Performs smoothing processing Average. : Display measurement result by averaging in the direction of temporal axis. heartbeats. FlowVolume measurements ① Press MEAS. MENU key and start FlowVolume from the list that appears. ② Tracing starts automatically. If the trace line is correct, freeze the image. The most recent single heartbeat is used as the section to measure. Move the section to measure as required. ③ Use the UPDATE (NEXT) key to finalize the detection waveform. ④ Measure blood vessel diameter using the CSA measurement caliper that appears next. FlowVolume is displayed. Moving section to measure and cine memory for PW waveform Turn the PW Mode encoder. The cine memory moves with the section to measure. Moving cine memory Turn the CINE key and use the trackball. * During cine memory movement, the waveform on the right of the screen is measured. 22 Q2E-ES1155

[Page 28] Basic Measurement ③ Continues FlowVolume measurement. Specification of the section to measure ① Set trace type of screen button as Section . ② Set the displayed caliper on the contraction starting point of subject waveform, and press ENTER key. ③ Move the line displayed next to end diastolic period, and circle 1 waveform. * To average heartbeats, press Average of screen button, and designate average heartbeat. * The up-and-down direction which traces can be chosen in a caliper position. Upper Lower Both （ Above a baseline ） （ Below a baseline ） （ Near a baseline ） * Press ENTER key to plot Vp (peak velocity) and Vd (end diastolic velocity) and display measurement value. Angle measurement Angle 3 point measurement ① Press the MEAS. MENU key and select Angle3Point , then set the first caliper by ENTER key. ② Position the second caliper to set an axis. ③ Use the third caliper to find the target angle and press the ENTER key. ④ The measurement result shows the angle and 3 caliper distance. Export/Import function for additional measurement ① Press the Pointer key ,then display a pointer. ② Select Setup tab menu. ③ Select Measure . ④ Select Measurement Export/Import button. ⑤ High light a measurement domain to import is chosen from the system frame. ⑥ After choosing additional settings, select a measurement to import , press the import button. * For the method for setting, see the Preirus Measurement INSTRUCTION MANUAL. 23 Q2E-ES1155

[Page 29] Media Handling Supported Media Supported media: DVD-RAM, DVD-R*, USB memory devices, and USB hard disk (USB-HDD). The use of reliable DVD-RAM media is recommended. (For details on the model names of the recommended media, see the Instruction Manual HI VISION Preirus ~Preparation~. ) * Note that no additional data can be written to a DVD-R disk. Disk ejection Press the EJECT key. * Do not eject the disk by pressing the EJECT key on the drive. USB (memory or hard disks) removal Application Manual Edit Patient ① From the tab menu on the left side of the screen, Mode Adjust Media select Tool and then Remove Hardware . Remove Har ・・・ Tool Simplified T ・・・ * The Safely Remove Hardware window is displayed. DVD-RAM USB Memory ② Select the hardware to be removed, and then Measure USB HDD press the Stop button. Cine Memory * The Stop a Hardware device window is displayed. Display Annotation Account Menu ③ Click the OK button. Physiology Video/ORIG * Hardware can be removed. PinP ④ Click the Close button. 24 Q2E-ES1155

[Page 30] Formatting Formatting media ① Select an image in the filing window, and then click Copy . The menu shown in the figure to the right is displayed. ② Click d under Destination , select the media, and then select Format . A message is displayed. ③ Click the Yes button if you agree with the message. Select the media to be formatted. ④ Follow the following message to start formatting. You can also format media by selecting Tool and then Media from the tab menu. 【 Copy menu window 】 Select the Media Formatting in the Media Window and then Media Format button . There is no need to format a DVD-R. For details on how to copy to DVD-R, see the instruction manual HI VISION Preirus ~Operation~. Formatting a DVD-RAM Formatting USB memory (USB-HDD) 1) Enter the name of DVD 1) Select FAT32 . into Volume Label. * The Volume Label can use only the alphanumeric only by 11 characters. 2) Enter the name of USB into Volume Label. 2) Select the check box. 3) Clear the check box. 【 Format window 】 【 Format window 】 Click the Start button. Click the Start button. Click OK butt0n if you agree with the message, and then execute formatting. * Do not operate the device or shut the power off until When the message the message is displayed. indicating the completion of formatting is displayed, click the OK button. Click Close button of the Format window If you want to proceed to copying images, click OK button in the copy menu window to initiate image transfer. 25 Q2E-ES1155

[Page 31] Recording and Loading Images Recording single and multi image Recording single image Press the REC1 key. ※ Measurement on review image of the Elasto Mode image is possible by saving the Strain data at the same time. To save the strain data, tick the checkbox Save strain data with a Single Image in the Image Filling tab under General items in the Region Data Setting window . Recording multi images ① Press the REC2 key after the freeze. ② Follow the instructions. Use the trackball to select the first frame you want to display as a multi image, and then press the ENTER key. Next, select the last frame. * The assignment of keys and the method of loading might vary depending on the settings. (For details, see the instruction manual HI VISION Preirus ~Operation~ .) Recording multi image real-time (option) Recording multi image * While recording the multi image, the transfer progress is displayed in the lower part of the Press the REC2 key during observation. screen (system information display area). Stopping multi image recording To stop recording, either press the REC2 key again or press the FREEZE key. multi images Prolonged multi image recording * In prolonged multi image recording mode, you can record multi images even during the freeze. Press the assigned REC# key. * The image can be recorded either directly to the DVD-RAM or to the device's HDD. Stopping prolonged multi image recording * The assigned key might vary depending on the Press the assigned REC# key again to stop settings. recording. Displaying the Filing window ① Press the READ key during the freeze to display the Filing window. * Start searching for images from 2, 3 4 3, and 4 in the Filing window above. * Images selected from 3 and 4 are displayed in 5 ( List View ). ② Select Location. ③ Select Patient. ④ Select the Study Date. ⑤ Images are displayed in List View . 2 3 4 26 Q2E-ES1155

[Page 32] Image Search and Play Searching images Example: Searching by Study Term ① Press the READ key during the freeze to display the Filing window. ① Click ▼ in the Search field and select Study Term . ② Click d in the Search field of the Filing window to ② Click ▼ and select start and end dates of select the search method. search from the calendar and press the Search button. ③ The thumbnails display the found data. Playing images Selecting and playing images ① Using the trackball and the ENTER key, select the thumbnail representing the image you want to play. * Press the ENTER key to select the ② Click the Retrieve button to play the image. image. A check mark is displayed on the selected image. Switching between the Retrieve window and Filing window Press the Filing button to go back to the Filing Switching between multi-window and single- Switching the images (pages) window views Press the screen button to switch images(pages). Press the screen button to switch views. Prev. Page Next Page To Single To Multi To the previous To the next image(page) image(page) Playing and stopping multi images Switching between the Retrieve window and (AVI/MPEG2) Examination window Use the screen button to play or stop the Press either the READ or FREEZE key to go back to multi image. the examination window. Play Stop 27 Q2E-ES1155

[Page 33] Copy to media and Edit Copying an image (examination data) to media Press the READ key during the freeze to display the Filing window. ① Select the image or ② Click the Copy button. ③ Select the transfer destination examination data to and click the OK button. be transferred. Trimming multi image ① Play the multi image to be edited in the Filing window in single-window mode. ② Using the trackball, display the first frame of the segment to be cut out. ③ Click the Select Start button. Select Start ④ Similarly, display the last frame, and then press the Select End button. Select End ⑤ Click the File Operation button. File Operation Select Start Select End ⑥ Press the Trim button, and then select the transfer destination to save as a new file. Trim Masking patient information ① From the Filing window, select the images whose information you want to masking, and then click the Convert button. ② Click d under Destination , select the media. ③ Select the Without personal information check box, and then select the OK button. A message is displayed. ④ Select the Yes button if you agree with the message. 28 Q2E-ES1155

[Page 34] Startup and Exit Selecting an application For Sonazoid Ⓡ , Hitachi recommends selecting an application whose name starts with Contrast-Mid. For SonoVue Ⓡ , Hitachi recommends selecting an application whose name starts with Contrast-Low. Select an application for contrast. 1 ① Select a probe. ② Select an application. (There is no need to press OK button.) Starting up contrast option Press the F1(Function1) or F2(Function2) key to display the following menu, and contrast echo operations become possible: Body Mark Contrast T.Start User Define Measurement Menu;Contrast If the above menu is not displayed, select the Contrast button to display the menu. Starting up contrast harmonic Press the Contrast button to change to the contrast harmonic mode. Contrast Contrast * Make the screen button OFF to turn OFF contrast harmonic mode. Contrast harmonic OFF Contrast harmonic ON Body Mark Contrast T.Start Alternate I.Flash MTI To FI User Define * Display of screen buttons would change. M M Contents of buttons differ according to the Measurement UCI Flash Frame Rate Menu;Contrast situation. Color Contrast images (CWPI: Color Wideband Pulse Inversion) When both the Contrast button and the Color Mode encoder are turned ON, the mode becomes CWPI (Color Contrast mode). CWPI is color display of contrast enhanced signal, it means easy to Contrast get visual reorganization of contrast agent. CFI ON When a Contrast mode is turn on, it will change three kind of display mode by push the CFI key. Color overlay mode Color stand-alone mode B mode Exiting Contrast Echo Option Press same keys as used for starting up ( F1 or F2 ) to exit Contrast Echo Option. * In case Contrast Echo Option is not exited, press the Contrast button. 29 Q2E-ES1155

[Page 35] Adjustment Changing Alternate mode (monitor mode) This is a function for displaying, in real-time and in parallel, both a contrast harmonic image that effectively extracts the contrast agent and a fundamental image with low MI (monitor image) that extracts the tissues of a living body. Fundamental Contrast image image Press the Alternate button. (Monitor image) Alternate Alternate Alternate OFF Alternate ON 【 Alternate Window 】 Choices during dual-window display (alternate mode) You can independently adjust MI and gain for the left (Contrast image) and the right (Monitor image). ① Select the window you want to adjust by using the L(U) key or the R(D) key. Contrast Fundamental image Contrast image Monitor image image (Monitor image) ② Adjust MI and gain by using their respective keys. MI gain of MI gain of Contrast image Monitor image * Setting like MI, gain, etc of each window can be checked at the bottom of examination window. (Refer to the right image) 【 Alternate Window 】 Changing contrast harmonic frequency How to adjust MI You can change frequencies by using the REF You can change MI by using the US POWER key. FREQ key. Increase MI dCHI-W-R: Priority given to high resolution Reduce MI dCHI-W-P: Priority given to depth sensitivity Starting up the timer This is a useful function for monitoring the time elapsed after the injection of a contrast agent. Press the T.Start ( Timer Start ) button to T.Start T.Clear display the elapsed time in the bottom right of the window. Press the T.Clear ( Timer Clear ) button to T.Clear T.Start reset the counter to 00:00. 30 Q2E-ES1155

[Page 36] MTI ・ TIC MTI (Micro Bubble Trace Imaging) MTI improves the visibility of the effects of a contrast agent and the visibility of where blood vessels architecture by displaying, per frame and through superposition, the shadowed parts of a contrast image. ① Press the MTI button to start superposition. ② Press the Flash button, system transmit to destroy the contrast agent by high MI and you can observe to reperfusion. MTI MTI Flash MTI OFF MTI ON TIC (Time Intensity Curve) TIC is a function for drawing, based on recorded an AVI file, a time brightness level curve that shows the relationship between contrast brightness level and time. It is helpful in observing the changes in brightness level over time. ① On the Filing window, play an AVI file for TIC. ② Select the TIC button. Image TIC ROI playback setting window window TIC 【 Filing window 】 【 Image playback window 】 【 TIC ROI setting window 】 ③ Select an ROI shape from the following and place an ROI where you want to watch the changes in brightness level . ④ Select the Analysis button in the bottom right of the window. ダミー 【 TIC ROI setting window 】 【 TIC analysis window 】 31 Q2E-ES1155

[Page 37] Preparation ① Real-time Virtual Sonography (RVS) allows the real-time creation of cross-section (virtual) images that match the ultrasonic image reflecting the position and inclination of the probe. Cross-section images are retrieved out of the volume data (CT/MR/US) that has been captured beforehand. Virtual images are intended only for reference purposes. No puncture procedure or diagnosis must be determined based solely on the observation of the virtual image. Attaching the magnetic sensor EUP-C715/C514, EUP-C532, EUP-L65 and EUP-L73S/L74M/L75 The attachment to fix the magnetic sensor is different in each probe. Raised line Orientation marks Raised line Attachment L73S （ For C715 ） Orientation mark of C715 L74M the magnetic sensor C514 C532 L65 L75 When attaching the magnetic sensor, make sure that the orientation mark of the sensor is aligned with the raised line of the attachment. Connect the attachment to the probe, with its raised line aligned with the orientation mark of the probe. In EUP-L65, hang hook of the attachment on raised line of the probe and fix. Attachment installation of L65 EUP-B512, EUP-B514 Orientation mark of Orientation mark of the magnetic the magnetic sensor sensor B512 B514 Attach the orientation mark of the magnetic sensor facing towards the outer side of the probe. * The color and shape of the sensor is different depending on the specification. 32 Q2E-ES1155

[Page 38] Preparation ② Attaching the magnetic sensor EUP-B712, EUP-B715, EUP-C511, EUP-O732T, EUP-U533, EUP-CC531, EUP-CC531S, EUP-V53W, EUP-V73W Orientation mark of Orientation mark of Orientation mark of the magnetic sensor the magnetic sensor the magnetic sensor Attachment B712 B715 C511 Orientation mark of the magnetic sensor Orientation mark of the magnetic sensor U533 Orientation mark of the magnetic sensor Slide the attachment. Attachment O732T U533 CC531 V53W V73W CC531S Attach the orientation mark of the magnetic sensor facing towards the inner side of the probe. * The color and shape of the sensor is different depending on the specification. Positioning Set the transmitter to the stable position so that the distance between transmitter and magnetic sensor is kept to 20~76cm. Transmitter Transmitter flexible stand 33 Q2E-ES1155

[Page 39] Startup and Exit Use the RVS compatible probe. To use RVS in combination with Contrast*, execute the probe application for Contrast (for example, Contrast-Mid-Abd) before starting RVS. * The contrast function is required. RVS Startup ① Make sure that the RVS sensor unit and that the lamp is illuminated in green. ② Press the key ( F1 or F2 ) to which the RVS is assigned. Press the F2 key to which list is allocated, and then use the screen button. Options list menu 3D 4D Contrast Wide View Stress RVS 【 Image Library window 】 【 RVS Setting window 】 ④ ⑥ ③ Check the warning message. ④ Set the angle of transmitter against the body position and body axis of the patient, and press OK button. ⑤ Select the target data from the Image Library window and press the Load button. * A list of DICOM volume data saved on the internal hard disk is displayed. ⑥ Assign volume data from the RVS Setting window , set a probe point and press the Start button. The RVS mode window opens and the RVS top menu screen buttons are displayed. BodyMark Create US Volume US Capture Volume;# Icon Menu Virtual Freeze US Freeze User Define Measurement To Contrast RVS Setting Registration Reset Settings 1st Point Connection Menu;RVS RVS top menu * You can also use the Close button in the Image Library window and the RVS Setting window to change the RVS mode with the RVS top menu screen buttons. Detailed descriptions of operations ⑤ and ⑥ are provided on the following pages. RVS Exit RVS can be terminated by pressing the same key ( F1 or F2 ) that has been used to start up RVS. Just as with the startup process, if this does not directly cause the RVS to shut down, press the screen button marked RVS to terminate RVS. 34 Q2E-ES1155

[Page 40] Loading volume data Saving volume data to and deleting volume data from the internal hard disk 【 Image Library window 】 【 Import window 】 RVS Setting ① Press the Import button of the Image Library window to open the Import window . ② Select the folder in which the volume data is stored from the Import window . ③ Click the Import button, the volume data is stored the hard disk. ④ When the required folders have been imported, press the Close button to return to the Image Library window . The imported data is added to the list. Saving volume data from DICOM server (Q/R Viewer option required) ① Press the Q/R button in 【 Image Library window 】 【 Q/R Viewer window 】 the Image Library window to open the Q/R ① Viewer window . ② Select the target DICOM data from the Q/R Viewer window . ③ ③ Press the Save button to store the data on the internal hard disk. ④ When data has been saved, press the X button in the top right corner to close the Q/R Viewer window and return to the Image Library window . The saved data is added to the list. Deleting volume data Delete no longer needed volume data from the internal hard disk as necessary. Perform deleting and backup operations by pressing the Image Library Manager button at the bottom of the Image Library window . * For details refer to the separate instruction manual entitled "Real-time Virtual Sonography Software EZU-RV8 Position Sensor Unit (Magnetic Sensor Unit for Real-time Virtual Sonography) EZU-RV3S." Loading volume data 【 Image Library window 】 【 RVS Setting window 】 ① Select the target data from the Image Library window and press the Load button. The RVS Setting window opens. Switch the examination to ② Double-click the ENTER key on the display different thumbnails. target DICOM folder displayed as a thumbnail to load volumes in order of Vol. 1 to 4. When an icon like the one shown at right appears beside a thumbnail, select the icon to Pressing the Save button in the RVS display the image files. This Setting window will save the currently allows you to select files displayed settings as a data set. separately and load the The saved data set can be loaded from volume data using only the the Dataset tab. required files. 35 Q2E-ES1155

[Page 41] Volume data adjustment Position alignment between volumes To display all the loaded volume data on a single screen, select the Multi tab. ① Set the misalignment volume to “Async”. ③ Adjust the vertical and horizontal directions of the ② Adjust the depth direction of the volume. volume. Place the pointer over the image, press the Set the adjustment point +A at the same locations of each volume. The point appears whenever ENTER key, and then roll the trackball up and clicking the Adjustment point button. down to switch to different cross-sections in the * If the volumes are “Sync”, set the adjustment points at only depth direction. Press the ENTER key again to one of the volumes. fix the position. ④ Click the Adjust button. + A + A + A + A Image adjustment Click a target icon from the trackball priority column. Move the pointer over the image and push the ENTER key. Then, the adjustment with the trackball becomes possible. Press the ENTER key again to fix. * To make adjustment by volume, sever the links between volumes. Slice by slice advance Movement of image Outward Arbitrary direction Inward Adjusting the image display size Adjusting the Window width and level Reduce Window level ↓ Window Window width ↑ width ↓ Enlarge Window level ↑ Initialization of image setting WW/WL value and display position can be initialized from pop up menu. Put the pointer on the image and press the UNDO key to display popup menu. 36 Q2E-ES1155

[Page 42] Corresponding to the SYNAPSE 3D data The SYNAPSE 3D analysis image can be fused with the CT base image etc. Fusion Reading ① Like normal volume data, import the SYNAPSE 3D analysis image (DICOM image) to the system hard disk as well, and select the image from the list in the Image Library window . ② Double click the thumbnail display of the RVS Setting window to read the normal volume data. Thumbnail ③ Drag and drop the thumbnail of the SYNAPSE 3D analysis result onto the data that you wish to fuse with in the volume data already read in ② . ④ The Parts color setting window is displayed. Make adjustments where necessary and then press the OK button. ⑤ The Fusion registration window is displayed. Make adjustments where necessary and then close the screen with the Registration button and Close button. ⇒ Refer to the various screen explanations below for the adjustments in ④ and ⑤ . Parts color setting window Fusion registration window Adjust the color of each part Adjust the relationship between the position of the and the transparency level to base image and the position of the fusion color image be used in the MPR image from the Fusion registration window . display from the Parts color setting window . Base image Color image Fusion image Select the button to open the display area display area display area color setting dialog box . Adjust the transparency level. ① Align the display positions in the depth direction of The Parts color the base image and color image. setting window can also be opened from Change the slicing by moving the trackball the icon in the Fusion up and down in the respective image display registration window . areas. Press the OK button to transit ② Set the adjustment point at the same to the Fusion registration position of the base image and color image. window . Or move the image positions so that both images are aligned. ③ Press the Registration button and then the Close button. Parts Selection 【 Parts select window 】 Select the parts for the fusion from the Parts select window . Select the fusion items from the list with the ENTER key and tick off the items. Up to 8 types of parts can be selected. 37 37 Q2E-ES1155

[Page 43] 3D body mark 3D body mark From the RVS Settings window , click the 3D Object Setting button to bring up the 3D Object Setting window . Overview of how to create a 3D body mark Select the volume to make the body mark from the pull-down menu. To create a body mark, several parameters must be set from both Body Surface and Internal Body tabs. Ex. ） Body Surface Internal Body Superimposed Image ＋ ＝ Volume MIP Opacity rendering （ Cutting ） Surface:70 / Internal:100 When fusing the SYNAPSE 3D analysis image, the adjustable items in the Internal Body tab differ from those in the Body Parameters of image quality Surface tab. Parameters can be set individually for Body Surface and Internal Body . Select the type of rendering mode. Enter the threshold value and opacity figure. Adjust the WW/WL by scrolling the slider with the trackball while pressing down the Enter key. Adjust the transparency level of each part by scrolling the slider. Parameters of adjustment Select the icon of your choice from the dialog (left fig.) Move the pointer over the image and press the ENTER key. Rotate Pan Zoom Cut Inside Cut Outside This rotation icon rotates the 3D in any given direction. To position the image in one of the general orientations, select one of the view angles listed in the pull-down menu. It is necessary to display the pop-up menu to return the area cut by the cut icon. Place the pointer over the image and press the UNDO key to display it. Click Undo Cutting . 38 Q2E-ES1155

[Page 44] Marking function Function to set a marker to the region where users would like to mark (e.g. tumor on the volume data.) 3 types of markers (Sphere, Line, and Target). Sphere marker and Line marker disappear when going out of the marking region. On the other hand, Target marker is displayed bigger in same situation, and users can tell how much the marker is away from the target from its extent. Marker settings Marker setting from RVS settings window Pick out one center section of the area (ex. Mass) that tries to be marked. Move the pointer over the image and push the ENTER key to pick out the cross section. Then, it becomes possible with trackball. ① Click the icon of the marker to set. ② The pointer changes to a cursor shape in the image ＋ ＋ Sphere display area. Move this caliper to the position to mark. Sphere, Target: Move to the center of region to mark. Target Line: Move to the edge of region to mark. ③ Press the ENTER key, and then move the trackball to adjust the size of the marker. ＋ ＋ Line * No need to adjust the size in the use of target marker. ④ Press the ENTER key again to fix the marker. In case of putting multiple markers, repeat the procedure of ①～④ . Marker setting while RVS mode is performed Select the type of marker from icon menu and follow the same procedure as the above Icon menu mentioned one. Movement and size change of marker Put the pointer on the marker, press ENTER key, and display squares on 4 corners of the marker. By dragging, it is possible to move the marker, and change the size of it (hold the squares). Display, Nondisplay, Delete of marker Delete of marker Display/Nondisplay of marker Put the pointer on the image display area, press Display of marker on US image can be switched UNDO key to display the popup menus to delete from icon menu. the marker, and select it. Put the pointer on the marker and press UNDO key to display the popup menu to delete a marker one by one. To change of display switch of marker on US image can be set Disp. US Marker . 39 Q2E-ES1155

[Page 45] RVS mode start Initial alignment According to the probe point setting, the volume data taken beforehand is correlated with the body position of the patient during real-time ultrasound examination. There are Plane Start, Point Start, and 3 Point Start in the method. For example, ideal reference points are the xiphoid process for the abdomen, nipple for the breast, or internal urethral orifice for the prostate. Plane Start and Point Start ① Pick out the cross section of the Xiphoid process. Confirm the Paging button has been selected, and move the trackball to adjust the depth position. Xiphoid process Xiphoid process * If multiple series have been loaded, align their display positions with one another and keep them linked. ② Click the Probe point button, move the cursor over the skin image directly above the xiphoid process, and then press the ENTER key to fix. RVS mode ③ Click the Start button to proceed to the RVS mode. * Virtual plane during ④ Put the center of probe on the xiphoid process of Plane Start depending on the settings. patient to display the same section as the one of virtual image. ⑤ Press screen button Plane Start to start RVS. Freeze In case of Plane Start, no need to display same section image in the step of ④ . The screen button in Plane Start ⑤ is displayed as Point Start . Xiphoid process 3 Point Start Follow the procedure described above for Plane Patient Start and Point Start to set three probe points to serve as guides, and then proceed to the RVS mode. Real-time Press screen button 3 Point Start to set the center of the probe over the position indicated by the three The RVS starts. To go back to the RVS Settings probe points following the instructions given in the window , press the RVS Setting screen button. message Switching the screen button menu Menu;RVS While in contrast mode, you can switch between the three screen-button menus by pressing the Menu;### button. Switch to the menu appropriate for performing the necessary operation. Menu;ModeDepend BodyMark Create US Volume US Capture Volume;# Icon Menu Virtual Freeze US Freeze User Define RVS menu Measurement To Contrast RVS Setting Registration Reset Settings 1st Point Plane Start Menu;RVS Menu;Contrast Switching the displayed volume If multiple volumes have been loaded, you can switch between virtual images for observation. Volume;# Click the Volume button to scroll through images starting from 1. 40 Q2E-ES1155

[Page 46] Adjust Function to adjust the section when a gap appears between the virtual image and US image in scanning. To make adjustments, you can use either Plane Adjust or, for positioning using internal or external marks, use Point Adjust. Plane Adjust Adjustment by Virtual Freeze Adjustments of virtual image cross-sectional and display positions can be performed ① Press the Virtual Freeze button Virtual Freeze through probe scanning and also by using the to freeze the virtual image. trackball. ② Take US image which matches the frozen virtual Select the type of movement from icon menu, image. and make adjustment by trackball. ③ Press the Plane Adjust button to release frozen image, and Plane Adjust Inward and outward synchronize the virtual image and US image. Adjustment by US freeze Vertically and horizontally ① Press the US Freeze button to US Freeze freeze US image. When either of above icons is selected, ② Move the probe to display the virtual image which rotation of virtual image is possible. matches the frozen US image. Virtual image rotates around ③ Press the Plane Adjust button to Z axis by M Mode encoder release frozen image, and Plane Adjust synchronize the virtual image and * This operation can be performed not only in virtual US image. freeze image, but also in real-time image. Point Adjust Simple Adjust Place a point mark on the same section of a virtual image and US image and press the ENTER key respectively to lock it in place (in any order). Press the UNDO key before companion to the point mark is locked, the adjust point can be canceled. * The point mark is displayed as a pointer outside of the examination window. When a pointer moved inside the examination window does not turn into a point mark, select the 1st Point screen button. Adding adjustment points 1st Point The screen buttons allow you to increase adjustment points. Like 2nd Point during Simple Adjust, set a 2nd and 3rd adjustment points to 3rd Point ensure more accurate alignment. To return to Simple Adjust state, press the To Simple Adjust screen To Simple Adjust button. Indicates current adjustment state. Use of Simple Adjust is recommended for alignment when Blank indicates Plane Adjust state. the observation region is changed or probe position is largely moved. To return to the initial location state, press the Registration Reset screen button. Registration Reset To reset the probe points, press the RVS Setting . RVS Setting 41 Q2E-ES1155

[Page 47] Performing when RVS mode is executed Registration Function This function allows you to save and load misalignment data. Store: Press this icon to save the current misalignment data (sync data) of the virtual image and US image. Restore: Press this icon to display thumbnails showing saved misalignment data in the lower part of the screen. Clicking a thumbnail loads the misalignment data and this data is used to start synchronizing virtual and US images. Last Registration: The instrument automatically stores the most recent adjustment. Click this thumbnail to load misalignment data. Independent scale adjustment Virtual images and US images can be displayed at different depths. Press the screen button the Settings and turn off the Depth Sync . Depth Sync. Enables both screens sharing changes in depth. Settings Enables independent display of depth Depth Sync. in each screen. Use the L(U)/R(D) keys to select the image whose size you want to adjust. Capturing the US volume *Digital Capture Card Unit is needed to capture US volume data. ① Press the US Capture button. The probe moves and scans at constant speed. US Capture Capturing operation can be canceled by pressing the Cancel button, which is displayed during the capture. ② The data captured up until the US Capture button is pressed the second time will be loaded. ③ After reconstruction, the virtual image of the US volume data is displayed automatically. US Volume US image Virtual image In case of replacing the current volume data by the US volume data to be captured newly, delete the previous data from pop up menu and perform the US Capture . Volume data storage Not only the volume data which is displayed as the present virtual image, but all data sets used for examination are to be stored. ① Select Save Volume icon from icon menu, and display the dialogue. *The Save Volume icon has the same function as the Save button in the RVS Setting window . ② Input data set name, and press OK button. * When US volume data is saved independently and there are no other data sets, the window for setting the transmitter angle of patient posture and body axis appears. Make correct settings, enter the name of the data set and press the OK button. 42 Q2E-ES1155

[Page 48] Combination of RVS and Contrast mode To use RVS in combination with Contrast, execute the probe application for Contrast (for example, Contrast-Mid-Abd) before starting RVS. Screen buttons The following screen buttons are available for RVS and Contrast, respectively: RVS menu BodyMark Create US Volume US Capture Volume;# Icon Menu Virtual Freeze US Freeze User Define Measurement To Contrast RVS Setting Registration Reset Settings 1st Point Plane Start Menu;RVS Contrast menu BodyMark Contrast T.Start Alternate I.Flash MTI To FI User Define Measurement To Virtual UCI Flash Frame Rate Menu;Contrast * The layout of the buttons varies depending on the settings. Switching between the RVS mode window and Contrast mode window During alternate mode (monitor mode) To switch between the RVS mode and Contrast mode windows , use the To Virtual/To Contrast buttons. Contrast mode window RVS mode window To Virtual Monitor image Contrast image Virtual Image US image (US image of To Contrast extremely low MI) The image selected during Contrast mode is displayed as the US image (right side) in the RVS mode window . During non-alternate mode (non-monitor mode) The To Virtual/To Contrast buttons are disabled. Disabling alternate mode (monitor mode) from the Contrast mode window causes the Contrast image to be displayed in single-window state. To return to the RVS mode window , press the DUAL/SINGLE key. Contrast mode window RVS mode window Virtual Image Contrast image US image Contrast image Alternate Alternate mode (monitor mode) disabled 43 Q2E-ES1155

[Page 49] IMT option IMT measurement is the measurement to calculate the thickness of the internal media complex (IMC) of a carotid artery through automatic trace processing. “Trace method” and “three-point method”, which calculate only the mean value of three points are available. How to set an ROI Press Measurement Menu , and start L-IMT/R-IMT L-IMT from the items displayed. ① Move and set the ROI to the position where R-IMT IMC is placed lower than the center of ROI. ② Set the positions A, B, and C of the three-point measurement to the position where the blood vessel has no noise in its inside, and the IMC and tunica externa can be distinguished clearly. ③ Press ENTER key to fix the position of ROI. Measurement result is displayed when ENTER key is pressed again. Moving the ROI Rotate Move the cursor into the ROI and Turn the Angle key while press the ENTER key, and the the ROI is displayed with a ROI becomes movable. Press solid line for rotation. ENTER again to fix the ROI. Resize Move the cursor on the vertical line of either sides of ROI, or either of horizontal lines (top or bottom of ROI), and press ENTER key to resize the ROI. Correction of trace method Correction of trace line Manual correction Each of the red line (intima trace line) ① Select the Manual Correction button, the OK and the blue line (externa trace line) button is pressed after checking the displayed can be moved up and down. message. ② Move the cursor over a control point you want to correct and press the ENTER key, and the control point becomes movable. ③ After moving the point , again push the ENTER key to put on that point. 44 Q2E-ES1155

[Page 50] %WT ① option This performs measurement by using B Mode video (moving images). Pixels of two points (left ventricular wall) specified by the user are automatically traced, and based on the results of that tracing, changes in the distance between the two points are calculated. From the distance between the two specified points and from the distance of the maximum wall thickness, the rate of wall thickness increase (%WT) will be calculated. Acquisition image data for Starting %WT measurement measurement (%WT/CTT/LAT) Press the Measurement Menu key, select %WT * Need a real time archive unit and ECG. from the displayed items, and start %WT . Set the acquiring image parameter of filing menu. ① Press TAB MENU, Setup → Filing → Cardiac ② Select R-R out , Number 1 , then close a menu. Saving dynamic images Placing tracing points Press the REC2 key after the freeze. The latest R-R interval frame is automatically captured. First frame Last frame * Set measurement pairs on the top frame of the recorded This measurement is possible only for data video of one heartbeat. recorded in AVI file format, and not possible for real-time or cine memory images. ① Specify two points for the endocardial wall and epicardial wall as a pair by using the cursor. ② Specify all the regions you want to measure and press Start button to start the analysis. Start Re-measurement Move the cursor over the position of a Press the READ key to open the Image Filing measurement point, and the cursor's shape changes to the following. If you press the UNDO Select a AVI file used for measurement from the key, the measurement pair is deleted and new image list and press the Retrieve button or positions can be specified. (It is possible to correct directly press double click on the image. multiple pairs) 45 Q2E-ES1155

[Page 51] %WT ② option Checking the locus image The playback function allows you to evaluate the movement of measured points. Stopping playback Starting playback Press Speed button to change the playback speed. Review Speed Displaying graphs Select a suitable tab to change graphs. (Distance, Strain and Graph Data) Change the graphs only for the List All . Saving data Saving the locus image RevCapture The video is automatically played back (traced and displayed) from its measurement start frame to the measurement end frame, and saved as a new video. (This requires optional digital video recording software.) Outputting measurement data You can output the following measurement data in CSV file format • Distance per pixel [mm/pixel] • %WT [%] of each measurement pair • Maximum thickness [mm] of each measurement pair • Initial thickness [mm] of each measurement pair • Thickness [mm] of each frame for each measurement pair • Coordinates on the window of each frame for each measurement value ① Press the Save file button. ② Select the drive on which the data is to be saved. 46 Q2E-ES1155

[Page 52] Color Tissue Tracking ① option Color Tissue Tracking (hereafter CTT) is a function for calculating the radial strain of a cardiac short axis image. CTT automatically determines a tracing point from the ROI specified on an AVI file. Calculated strain and strain values will be displayed by using color images and time sequence graphs. Acquire image data used for measurement Configure the same save settings as %WT. Extract a short axis image of BASAL, MID, or APICAL and save a short axis level as close to a perfect circle as possible as an image for Bull’s eyes display. Press the READ key to open the Image Filing Select a moving image used for measurement from the image list and press the Retrieve button to play back that video. For a Bull's Eye display, review the three sections simultaneously. Select CTT measurement ① Press the Meas. Menu key, select CTT from the items displayed, and start CTT. ② Select a short axis level to be analyzed. ③ You can change the thickness of the ROI. The default value is 0.8 cm. Press the ENTER key to show the ROI. 47 Q2E-ES1155

[Page 53] Color Tissue Tracking ② option Adjusting the ROI ① Align the measurement cursor with ② Move the trackball to adjust ③ Press the Start button. the intima, click the ENTER key, the intima elliptically and align the measurement cursor also click the ENTER key. with the intima on the opposite side, and click the ENTER key. Command functions Changing the image and graph positions Changing the %WT value and color You can change the display positions of video To change the %WT value, retype the value in the images and graphs. dialog box. To change the color, click the color box *Measurement on graphs is enabled only when to display the color palette. Choose a color you graphs are displayed in large size on the right side. prefer. Analysis of trimming For a AVI file of two heartbeats or more, you can perform an analysis between the specific frames of each heartbeat. Use the frame bar (frame 1 to frame 45 in the figure) to specify a start point and an end point. Use the pointer to move the frame bar. Saving measurement data Resetting the ROI Press the Save button to save the measurement You can correct the ROI. result data (used for Bull's Eye) in CSV file format. The ROI returns to the pre-analysis status. Saving a AVI file on basic area Saving AVI file on full area A CTT video (moving images) is created from For a AVI file, you can save all frames synchronized the analyzed video. You can check the created with a graph's time bar. video from the Image Filing window. 48 Q2E-ES1155

[Page 54] LA Tracking ① option LA Tracking (hereafter LAT) is tracking system of traced line on an B-mode AVI file. LAT calculates the area and volume from the analyzed result, and displays the change graph of time. Acquire image data used for measurement Configure the same save settings as %WT. Extract short axis images of the apex 4-chamber * For P-P capturing, use the manual (hereafter A4C) or the apex 2-chamber (A2C) and transfer to capture images by save the images for one heartbeat. For Bi plane specifying any single heartbeat. measurement, save images in the order A2C to A4C. Press the READ key to open the Image Filing window. Select the AVI file to be used for measurement from the image list and press the Retrieve button or double click to play back that file. For Bi plane measurements, play back the two sections simultaneously. LAT measurement Press the MEAS. MENU key, select LA Tracking from the items displayed, and start LAT. ① When the cursor exists the image area, tracing is always possible. ② Click at the start point and repeat clicking at several points along the curve. Fit the trace line into the left atrium and double-click at the end point. ③ Check that the ROI is set on the top frame. You can set two ROIs (A and B) in a single For Bi plane measurement, select between A4C and A2C for the type of cross-section. 49 Q2E-ES1155

[Page 55] LA Tracking ② option Command functions Start analyze Press the Start button to perform LAT analysis. For Bi plane measurements, switch between A4C and A2C for AVI file. Analysis of trimming For a AVI file of two heartbeats or more, you can perform an analysis between the specific frames of each heartbeat. Use the frame bar (frame 1 to frame 45 in the figure) to specify a start point and an end point. Use the pointer to move the frame bar. Changing the image and graph positions Changing the graph type You can change the display positions of video images and graphs by using the icons. The graph type can be changed to such types as volume, area, and volume change speed. Also, use check boxes to change the graph display type as you wish. Saving measurement data Press Save button to output the measurement result data in CSV file format. Select a drive to save the data. (Data saved here can be loaded in graph form again.) Saving AVI file on full area Saving a AVI file on basic area A LAT moving images is created from the analyzed For a AVI file, you can save all frames image. You can check the created video from the synchronized with a graph's time bar. Filing window. 50 Q2E-ES1155

[Page 56] Preparation Starting up the 4D software ① Select a 3D-specific probe and an application. ② Press the F1 or F2 key to start the 4D software. If the 4D software is not started, select the 4D screen button to display the menu. Exiting the 4D software Press the F1 or F2 key again while the 4D software is active to exit. In case 4D Option is not exited, press 4D screen button. Setting the 3D region Extract a sagittal section of the fetus by using the 3D ROI Setting window in the ViewLine figure, and set the ViewLine and the 3D ROI. * The ViewLine is a useful function that lets you specify which surface to start with when observing a 3D image. * ViewLine is set up to bring close to an fetus nose and mouth as much as possible. 3D ROI Adjusting the ViewLine The position of ViewLine is adjusted with a trackball. 【 3D ROI Setting window 】 Turn the Angle encoder to adjust rotation and curvature of the ViewLine. * Each press of the Angle encoder switches the function between rotation and curvature. Adjust Adjust rotation curvature Press the HI-Support key to start the ISTracking function for the system to automatically set the ViewLine (broken line). The type of ISTracking can be switched between Assist and FullAuto with the screen button. IST Type;Assist IST Type;FullAuto Performs 3D image cuts Performs 3D image cuts with with both manual and automatic ViewLine only. automatic ViewLine. Adjusting the 3D ROI ① Press the TRACKBALL key to change the trackball function to 3D ROI. ② Adjust the position of the 3D ROI by using the trackball. Select the Select the Assigned ③ Press the ENTER key to enable size adjustments. ViewLine 3D ROI trackball function Press the ENTER key to change trackball functions. Move the 3D ROI Resize the 3D ROI 51 Q2E-ES1155

[Page 57] Scanning, Volume operation Setting the direction of head In the 3D ROI Setting window , select a screen button for the head side of the fetus. Top;Right Top;Left * Select which side of the window, right or left, is to display the head side of the fetus. 【 3D ROI Setting window 】 * A 3D image is displayed with the selected side as its top. Top;Right Top;Front Top;Back Top;Left * The orientation of the 3D image changes with each press of the screen button. Starting 4D scanning Press the UPDATE (NEXT) key, 4D scanning is started. 【 3D ROI Setting window 】 【 2D-3D window 】 * When the fetus has moved, returning to the 3D ROI Setting window makes position adjustments easy. Removing the noise of a 3D image 3D single image display Turn the B Mode encoder to the right while the Press the R(D) key to change to the 3D single real-time 3D image is being displayed to remove image display ( 3D window ). image signals of a certain brightness level or lower. Threshold ;20 Threshold ;65 【 2D-3D window 】 【 3D window 】 Check that the B Mode encoder priority is as shown in the figure on the left. Press the B Mode key to change functions. Rotating a 3D image Use the following encoder to rotate a 4D (3D) image: X direction Y direction Z direction 52 Q2E-ES1155

[Page 58] Function How to find a good image among 3D cine images Press the CINE key and you can select a good image by using the trackball among the 3D cine images, immediately before the freeze. Adjusting the light position When the rendering mode is set to 4Dshading , move the trackball to move the position of the light. If the trackball function is set to a different function, press the TRACKBALL key to select Light Position Adjustment. Select the Select the Light Assigned ViewLine Position Adjustment trackball function Light position: Left lateral Light position: Right lateral Shade: Right lateral Shade: Left lateral Cutting out the unnecessary part of a 3D image ① After the freeze, select the Cut Menu screen button to display the menu. Cut Reset Cut;Inside Cut Menu Cut Menu Cut Menu Trace;Manual ② Move the cursor, press the ENTER key to start tracing, specify the range of the unnecessary part by using the trackball, and then press the ENTER key to exit. The volume data within the specified range will be cut out. You can also remain the region Cut;Inside Cut;Outside surrounding the specified range by using the screen button. Please set several points that are linked Trace;Manual Trace;Plot together to specify the cut region. Manual Plot How to reset the cut-out part You can also restore the original state of the Press the UNDO key to restore the Cut Reset cut-out region by using a screen button. previous state. Finish cutting and close the cut menu Cut Menu Press the Cut Menu screen button again to finish cutting and close the menu related to cutting. 53 Q2E-ES1155

[Page 59] Volume Data Save and Load Saving 3D Volume data Press the Save Volume screen button during the freeze. Save Volume You can save the currently displayed 3D Volume data. Load 3D Volume data ① Press the Read key during the freeze to display the Filing window. Hereafter, the procedure is explained based on thumbnails. ② Select a volume data and select the Retrieve button. Filing menu 【Ｆｉｌｉｎｇ window 】 The 3D Volume data is marked with the icon on the left. ③ Press the Edit Volume screen button to edit or process the volume data. Edit Volume By using saved volume data, you can perform various operations such as 3D image quality adjustments, the cut function, and MPR display, and Multi Slice display. Switching from the 3D Edit window to the Filing window Press the Edit Volume screen button and press the Filing button. Edit Volume Filing Edit Volume menu Filing menu 【 3D Edit window 】 【Ｆｉｌｉｎｇ window 】 54 Q2E-ES1155

[Page 60] HI DEF 3D (Scanning) HI DEF 3D is a 3D mode in which observation of still 3D images and MPR images with a higher definition than the real-time 3D mode is made possible through a slow single-swing. Switching between the “Real-time 3D” and “HI DEF 3D” From the screen buttons displayed, Select HI DEF 3D in the 3D ROI Setting window. Note that the screen buttons might differ from the display actually 【 3D ROI Setting window 】 【 3D ROI Setting window 】 displayed depends on option. HI DEF 3D HI DEF 3D Real-time 3D HI DEF 3D mode mode STIC HI DEF Scan Image quality adjustment in the HI DEF 3D mode From the screen buttons displayed, select Swing Speed and make adjustments by using the Multi encoder . L High image quality Swing Speed H High speed Swing angle adjustment in the HI DEF 3D mode From the screen buttons displayed, select Swing Angle and make adjustments by using the Multi encoder . Swing Angle Starting and stopping scan * When scanning is completed, MPR window or 3D Start scanning Single image window are displayed. Press the UPDATE (NEXT) key to start capturing. Stop scanning (cancel) 【 3D Single image window 】 【 MPR window 】 Press the UPDATE (NEXT) key while capturing (While the progress bar is displayed) to stop capturing and return to the 3D ROI Setting window . * The 3D ROI Setting window appears again. Selecting rendering mode Select the Rendering Menu screen button and select a rendering mode. Rendering Menu Opacity Opac.Invert Opac.Advanced Orthogonal 4Dshading 55 Q2E-ES1155

[Page 61] HI DEF 3D (Function) The MPR window's functions Switching between the MPR window and 3D Single Image window Press the MPR Display screen button to perform switching. 【 MPR window 】 【 3D Single image window 】 MPR Display MPR Display Adjusting a Single Cross Section on the MPR window Press the ENTER key to select the Single Cross Section you want to change, and use the trackball to adjust. * The selected Single Cross Section is enclosed in a solid frame. * You can rotate the image and save the volume data in the same way as 4D. * Press the UNDO key to switch between Single Cross Section and Intersection Point operation. Displaying a Single Cross Section on the MPR window Displaying a Single Cross Section on the MPR window selected view from the screen button. MPR_Z MPR_X Use the screen buttons to change Single Cross Sections. MPR_Z MPR_Z MPR_X MPR_Y MPR_Y Rescanning Adjusting the brightness of an MPR cross- sectional image Press the FREEZE key to return to the 3D ROI Setting window . Press the Image Menu key and use the screen button and the Multi encoder to change. MPR Bright 【 MPR window 】 【 3D ROI Setting window 】 56 Q2E-ES1155

[Page 62] HI DEF 3D (Multi Slice mode) Multi Slice mode Switch of MPR window and Multi Slice window Press screen button Multi Slice Display to switch the window. Multi Slice Display Multi Slice Display 【 MPR window 】 【 Multi Slice window 】 Switch of the section to observe (X, Y, Z section) Every time screen button Reference ； # is pushed, the section to observe is switched. Images can be rotated with each encoder similarly to 4D. Reference;X Reference;Y Reference;Z Slice position adjustment Adjust the position of slice line with a trackball. If trackball priority is different, make adjustment after selecting the right mark with TRACKBALL key. Assigned trackball function Press ENTER key or TRACKBALL key to fix slice line. Select the Slice Line Slice window display shift Press Screen Shift screen button, and shift window by window with Multi encoder . Screen Shift Slice interval adjustment Press Slice Setting screen button, and adjust by Increase interval Slice interval screen button and Multi encoder . 2.0 * Unit of value is mm. Slice Setting Slice Interval Slice Thickness Adjustment Thick, cross-sectional images can be displayed in MPR and multi-slice images using the Volume Slice Becomes thicker Imaging function. 2.0 Press the Image Menu key and use the screen Slice Thick.(mm) button and the Multi encoder to change. Single window display of Multi Slice window The section with blue color selected by ENTER key is displayed in single window. If trackball priority is different, make adjustment after pressing TRACKBALL key to switch the function to Screen;Multiple Screen;Single image selection. Assigned Select the Select the trackball function Slice Line Image Select 57 Q2E-ES1155

[Page 63] HI DEF 3D (CFM 3D mode) Blood flow 3D image (CFM 3D mode) ① Press CFI mode encoder or Fine Flow/CFA Mode key. Every time screen button is pressed, Fine Flow and CFA (Power mode) are switched. To CFA To Fine Flow Fine Flow mode CFA mode (High definition (High sensitivity blood flow display) blood flow display) 【 3D ROI Setting Window 】 ② Adjust color gain, color box, velocity range (PRF), etc ③ Press UPDATE(NEXT) key to start capturing. * When scanning is completed, 3D window , MPR window , etc are displayed. Switch of B/W & blood flow 3D image and Blood flow 3D image Press B mode encoder. It is also possible to turn the color signal on and off similarly pushing Fine Flow/CFA Mode key. 【 B/W & blood flow 3D image 】 【 Blood flow 3D image 】 Plane Cut function Blend adjustment of B/W & Blood flow 3D image Select the object to cut by screen button, and move Press Image Menu key, select CFM 3D Blend trackball pressing ENTER key to cut the 3D image to make adjustment. from a plane. Increase CFM ３ D Blend Plane Cut;Both Plane Cut;BW When the blend is high, Color 3D image is displayed preferentially. Press UNDO key to restore the cut plane. 58 Q2E-ES1155

[Page 64] STIC function It is a function to display an arbitrary section as a movie of 1 heartbeat. Ex.MPR display, Multi Slice display. Switching between the “Real-time 3D” and “STIC” From the screen buttons displayed, Select STIC in the 3D ROI Setting window. 【 3D ROI Setting window 】 【 3D ROI Setting window 】 * To view images in STIC mode HI DEF 3D STIC Scan using Color Doppler or Fine Flow, Real-time 3D STIC mode press the respective mode key. mode STIC STIC Image quality adjustment Swing angle adjustment From the screen buttons displayed, select From the screen buttons displayed, select Scan Time and make adjustments by using Swing Angle and make adjustments by the Multi encoder . using the Multi encoder . Time ： Long High image quality 10 45 Scan Time Swing Angle Time ： Short High speed Starting STIC scanning * When scanning is completed, MPR window , Multi Slice Start scanning window , etc are displayed. Press the UPDATE (NEXT) key to start capturing. 【 MPR window 】 【 Multi Slice window 】 Stop scanning (cancel) Press the UPDATE (NEXT) key while capturing (While the progress bar is displayed) to stop capturing and return to the 3D ROI Setting window. * The 3D ROI Setting window appears again. 3D image display Select Display Setting and then Display 3D from screen buttons. Display Set. Display 3D 3D image display OFF 3D image display ON Saving STIC Volume data Press the Save STIC screen button * The STIC data is marked after STIC scan is finished. with the icon on the left. * You can save the currently * The load method of STIC data Save STIC displayed STIC data. is the same as the 4D data. * For review and edit of STIC data, see the HI VISION Preirus Three-dimensional Display Software (Real-Time) INSTRUCTION MANUAL. 59 Q2E-ES1155

[Page 65] 3D (Freehand 3D) Preparation Starting up the 3D software ① Select a 3D-specific probe and an application. ② Press the F1 or F2 key to start the 3D software. If the 3D software is not started, select the 3D screen button to display the menu. Exiting the 3D software Press the F1 or F2 key again while the 3D software is active to exit. In case 3D Option is not exited, press 3D screen button. Setting the 3D region ViewLine Extract a sagittal section of the fetus by using the 3D ROI Setting window in the figure on the right, and set the ViewLine and the 3D ROI. The ViewLine is a useful function that lets you specify which surface to start 3D ROI with when observing a 3D image. Please refer to Preparation of 4D(Real-time 3D). 【 3D ROI Setting window 】 Adjusting the scan distance Increase Specify the distance in the depth direction (the z-direction) of the 3D. 30mm From the screen buttons displayed, select Scan Distance and make Scan Distance adjustments by using the Multi encoder . Specify the scan direction Specify the direction in which the probe will move during the scan. From the screen buttons displayed, select Move Dir and make adjustment. You can select either frontward or backward against the direction of view. Move Dir;Frontward Move Dir;Backward direction direction Monitor Monitor Orientation Mark Orientation Mark :direction of view. 60 Q2E-ES1155

[Page 66] 3D (Freehand 3D) Scanning Starting and stopping scan Press the UPDATE (NEXT) key to start capturing. Once images have started to be collected, move probe in the specified direction. After scanning for the specified distance, press the UPDATE (NEXT) key or Freeze key to stop capturing. * When scanning is completed, MPR window or 3D Starting and ending scan Single image window are displayed. ① Press the UPDATE (NEXT) key to start capturing. ② Press the UPDATE (NEXT) key to end capturing. * A progress bar appeared with remaining time. Please scan complete 【 MPR window 】 【 3D Single image window 】 in time. * You can also use the FREEZE key to end capturing. ※ NOTICE If you move the probe in a direction that is not the specified direction, a mirror 3D image will be created. Stopping scan and Fresh start ① Press the FREEZE key to end capturing. ② Press the FREEZE key to cancel freeze. * Press the 3D Scan Cancel screen button while capturing (While the progress bar is displayed) to stop capturing and return to the 3D ROI Setting window . 3D Scan Cancel Switching the screen button menu in contrast When the optional contrast imaging function is used, under the following conditions, 3D images can also be created from the Contrast Image 1 screen in wideband pulse inversion mode. If any of the following conditions are not satisfied, 3DROI Menu;3D and ViewLine are not displayed and the 3D scan button By pressing the Menu;### cannot be used. screen button, You can Menu;Contrast change between contrast ･ In either Middle or Low Acoustic Pressure Transmission Mode. menu and 3D menu. ・ CWPI (color wideband pulse inversion) mode is not enabled. ・ Alternative mode is not enabled. Menu;Mode Depended ・ MTI (Micro bubble Trace Imaging) mode is not enabled. 30mm Body Mark Move Dir;# Scan Distance Top;# ViewLine;# 3D Scan Cancel User Define Mesurement 3D Scan Menu;# * The layout of the buttons varies depending on the settings. 61 Q2E-ES1155