| A. Moving the system-Foot Pedal Positions |
| 1. Up position- locks rear wheels and allows for moving the system in a straight line. |
| 2. Middle position- unlocks all wheels and allows for moving the system in a side to side manner. |
| 3. Down position- locks all the wheels. |
| |
| B. Adjusting the Monitor (proper adjustment will ensure image quality) |
| 1. Turn the dial on the right to 2. |
| 2. Turn the dial on the left fully counter-clockwise until the screen is dark. |
| For black backgrounds, turn the dial clockwise until you can clearly distinguish between the bottom grayscale bar on the right side of
the screen and the background. |
| For gray backgrounds, turn the dial clockwise until you can barely distinguish between the bottom two grayscale bars on the right side of the screen. |
| |
| C. Connecting the Transducer |
| 1. With the latch in the vertical position, insert the transducer connector into
the port and turn the latch clockwise 90 degrees to lock it into position. |
| * The probe may automatically activate and calibrate, if so, skip step 2. |
| 2. Activate the transducer by highlighting -Probe- on the left touch screen. |
| - a menu will appear in the middle of the left touch screen showing each
connected transducer according to the port it is plugged into. Select the appropriate transducer by highlighting it. |
| A. VCR- located on the left side of the system. |
| 1. Insert the tape. |
| 2. Highlight -VCR- on the left touch screen. You will see all the VCR controls in the middle of the left touch screen. |
| 3. Highlight -Search- in conjunction with the rotary dial below it to look
for the end of the previous study. |
| - turn the dial clockwise to search forward |
| - turn the dial counterclockwise to search backwards |
| To keep track of studies by assigning start times and noting end times, use the
-tape number- function to enter in the start time when beginning a new study. |
| |
| B. Entering Patient Information |
| 1. Press the -Patient I.D.- hard key located above the keyboard. |
| - The information screen will appear on the monitor with new patient already highlighted. Press -Enter- and this will advance you to the
first line. |
| * Only the first four lines of the information screen will appear on the monitor while performing the study. |
| 2. Use the keyboard to enter the information. When finished, press the
-Patient I.D.- hard key again. The patient information will appear on monitor. |
| A. Presets |
| 1. Select your preset by highlighting -Preset- on the left touch screen. |
| 2. Highlight your customized preset and this will bring up all your default settings. |
| * Be sure to highlight your preset even if it is already highlighted. |
| |
| B. Adjusting the appearance of your image. |
| 1. Frequency Fusion- located on the right touch screen is controlled by the
rotary dial below it. |
| - the icon located on the lower left of the monitor displays the current
frequency fusion setting. |
| 2. Frequency Fusion Setting 1 represented by the -P- on the icon is for |
| penetration. Use for more difficult patients. |
| 3. Frequency Fusion Setting 3 represented by the -T- on the icon is for
tissue texture. This is the setting in which the system creates the image
by using the lower frequencies and higher frequencies equally. |
| 4. Frequency Fusion Setting 5 represented by the -R- on the icon is for
resolution. Use for easy to image patients for increased resolution. |
| |
| C. Other 2-D Controls (the values for overall gain, compress and depth are displayed on the left side of the monitor.) |
| 1. Overall gain- rotary dial is located above the TGC sliders. Turning the
rotary dial clockwise will increase the overall brightness of the image throughout the entire sector and counterclockwise decreases the overall brightness of the image. |
| 2. Compress- rotary dial is located above the TGC sliders. Turning the rotary dial clockwise will increase the dynamic range (displays more shades of gray) of the returning echoes and counterclockwise decreases the dynamic range (image becomes more black and white, less gray). |
| 3. Depth- rotary dial is located on the right side of the systems imaging controls. Turn the rotary dial clockwise to increase the depth. |
| *Increasing depth will decrease frame rate, therefore set depth so that the image fills most of the sector. (Optimizes image) |
| 4. TGCs- (Time Gain Compensation controls) located on the right side of the keyboard. Moving the individual sliders toward the right will
increase the brightness of the image at specific depths within the sector and moving them to the left decreases the brightness. |
| Adjust the TGC's toward the center in a smooth curve such as
this: |
| 5. LGCs- (Lateral Gain controls) located above the keyboard. Moving a slider up will increase the brightness of the image along
individual vertical scan lines within the sector. Moving the sliders down will decrease the brightness. |
| 6. Focal Zones- When -Focus- is highlighted on the touch screen, the rotary dial below it controls the position of the focus indicated by
the carets alongside the sector image. |
| - the ultrasound beam is the narrowest at the level of the focus (narrow beam = increased lateral resolution). |
| 7. Postproc- Located on the left touch screen and is controlled by the rotary
dial below. This function affects the softness and brightness of the grayscale image. |
| -turn the rotary dial clockwise to soften the image by adding more grayscale. |
| -turn the rotary dial counterclockwise to add more contrast (black and white) to the image. |
| |
| C. Zoom: Let's take a closer look by using the zoom function |
| 1. Highlight -Zoom- on the right touch screen and the zoom preview box
appears on the monitor. |
| 2. Press -Size- hard key above the trackball to adjust the size of the box. |
| 3. Press -Position- hard key above the trackball to reposition the box. |
| 4. Now highlight -Zoom- again to turn the magnification on. Notice
the increased frame rate (Hz) on the left side of the monitor. ( increased frame rate = increased temporal resolution ) |
| The imaging modes are located along the top of the right touch screen. Each mode can be enabled by simply highlighting the desired mode. The menu below is mode smart, so if you select color, the menu changes to display all of the color functions, if you select PW then PW controls will be displayed. |
| A. Mmode |
| * Preproc- Adjusts the amount of contrast (setting 1 is the smoothest and setting 3 is the most black to white). |
| * Postproc- Affects the softness and brightness. Adjust according to your visual preference. |
| * To adjust sweep speed- keep touching -Sweep- on the right touch
screen to toggle through to the desired speed. (25,50,100) |
| |
| B. Color |
| - When you turn color on, the color box appears on the monitor and the the
-Position- hard key is automatically lit. Use the trackball to move
the color box throughout the sector. Resize the box by pressing the -Size- hard key in conjunction with moving the trackball. |
| * Press the -Enter- hard key to lock the color box in place. The
trackball now controls the Mmode/Doppler cursor. |
| - Color -Gain- is located on the lower left side of the right touch screen. When highlighted is controlled by the rotary dial below it. |
| - Scale- Adjust the color scale using the rotary dial below it. Turn the
rotary dial counterclockwise to lower the scale to see slow flow and clockwise to increase the scale to see higher velocities. |
| 1. Troubleshooting Color Doppler |
| Not Sensitive (Do each step in progression. Stop when optimized.) |
| * Adjust color -Gain- (could be too low) |
| * Lower -Scale- for slower heart rate=slower velocities |
| * Decrease -Filter- located on the far right of the right touch screen |
| * Increase -Density- located on the right touch screen. Turn the rotary dial clockwise so the ^ symbol is all the way to the right next to the + symbol. |
| Color is too Speckled |
| * Decrease -Gain- by turning the rotary dial counterclockwise. |
| * Increase -Smoothing- by turning the rotary dial clockwise which will increase in number. |
| Need a Higher Frame Rate |
| * Decrease the sector by highlighting -B/W Suppress- on the right
touch screen. |
| * Decrease the width of the color box by pressing the -Size- hard key
in conjunction with moving the trackball. |
| * Decrease -Density- by turning the corresponding rotary dial counterclockwise so the ^ symbol moves toward the - symbol. |
| * Use a smaller packet size by touching -Packet- then turning the corresponding rotary dial counterclockwise to S. |
| * Decrease -Scale- by turning the corresponding rotary dial counterclockwise. |
| * Decrease -Depth- by turning the rotary dial located on the far right of the imaging controls counterclockwise. |
| |
| B. Pulsed Wave Doppler |
| 1. Place the doppler cursor using the trackball. Touch -PW- on the right
touch screen. This will immediately give you the spectral trace on the bottom of the monitor and the 2-D image at the upper right corner of the
monitor. |
| - Highlight -2D Live- to freeze the spectral trace and reposition the cursor. Touch
-2D Live- again to reactivate the spectral trace. |
| - Adjust the -Baseline- by turning the corresponding rotary dial. |
| * Clockwise moves the baseline up. |
| * Counterclockwise moves the baseline down. |
| * This will allow you to display higher velocities (increases Nyquist limit) either below or above the baseline depending upon which direction you move the baseline. |
| - Adjust the -Scale- by turning the corresponding rotary dial. |
| * Clockwise increases the scale. |
| -can display higher velocities by increasing the Nyquist limit |
| * Counterclockwise decreases the scale. |
| - Use -Gain- located on the right touch screen to adjust the amplitude. |
| * Clockwise increases the amplitude of the received signal. |
| * Counterclockwise decrease the amplitude of the received signal. |
| - To adjust the grayscale of the spectral trace use -Compress-
& -Reject- in conjunction with each other. These controls and their corresponding rotary dials are located on the right touch screen |
| |
| C. Continuous Wave Doppler |
| 1. Touch -CW- on the right touch screen to enable CW
doppler. |
| - The continuous wave doppler controls are identical to the pulsed wave doppler controls. |
| A. "Quick Calcs" |
| 1. The clinician can make and display a set of standard measurements and
calculations without going into the Analysis package. In other words these measurements are "generic' and not associated with an anatomical
label. (Ex. max velocity vs. AoV max velocity) |
| 2. Use the -Caliper- hard key to initiate a "quick calc" measurement. A
caliper will appear on the monitor. Proceed accordingly based on the measurement desired: |
| -for a length measurement- place the first caliper using the trackball where you want to make the measurement then press the
-Caliper- hard key again. Another caliper will appear on the monitor- place that caliper where desired. Press the
-Enter- hard key to lock the measurement into place. |
| - for a area measurement- place the first caliper using the trackball where
you want to make the measurement then press the -Trace- hard key. Begin tracing the structure by using the trackball (use the
-Erase- hard key to back up during the trace measurement). Press the
-Enter- hard key to finish the measurement and lock it into place. |
| - for a velocity measurement- place the first caliper where you would like
to obtain velocity information. Press the -Enter- hard key to finish the
measurement and lock it into place. |
| - for a slope measurement- place the first caliper at the max velocity then
press the -Caliper- hard key again. Place the second caliper on the portion of the spectral waveform in which you would like to derive the slope information then press the
-Enter- hard key to complete the measurement. |
| - for a mean pressure gradient- place the first caliper on the baseline of the
spectral waveform you want to get a pressure gradient from then press the
-Trace- hard key. Trace the waveform and press the -Enter- hard
key to complete the measurement. |
| * The "quick calc" results will appear on the left side of the monitor. A symbol such as solid +, solid x, open + or open x will correspond with each measurement made. |
| * Up to 4 measurements can be made on the screen at one time. |
| * Remember - "Quick Calc" measurements will not be in any of the reports because they are generic* |
| |
| B. Analysis |
| 1. Highlight -Analysis- on the left touch screen to get into the analysis package. |
| -The analysis package is mode smart meaning if you are in 2-D mode then only
2-D measurements will be displayed and if you are in doppler mode only doppler measurements are displayed. |
| 2. The current measurements in the analysis package are located at the bottom of the
left touch screen. Highlight the measurement you would like to make- this will
automatically bring up a cursor on the monitor. Proceed with the measurement accordingly using the same technique as with "quick
calcs". Press the -Enter- hard key to complete the measurement. |
| - The measurement will now be in the analysis package and will appear in the appropriate report. |
| - If the measurement is a part of a calculation equation it will be carried over to all imaging modes requiring this specific measurement. |
| - Reports are mode and anatomically specific. Highlight -Reports- on the left touch screen then highlight which report you would like to view. |
| * If you don't see -Reports- on the left touch screen make sure all of the measurements on the lower left touch screen are
un-highlighted - this will bring up the -Reports- function. |
| Enables you to acquire images in loop form (dynamic and still frame).
These loops can be stored to and retrieved from optical disk. |
| |
| A. Choose the size and format of your loop by highlighting
-Loop- on the left touch screen. At the bottom of the screen you will see:
-Loop Type- select either beats or time by turning the corresponding rotary dial. |
| *If an EKG is not detected it will automatically default to time. |
| -Beats- or -Time- will be displayed depending upon loop type selected. Use the corresponding rotary dial to choose the preferred
length of the loop. (1 to 10 beats or 2 to 10 seconds) |
| -Format- allows you to select how the images are acquired and displayed. |
| Turn the corresponding rotary dial to the format preferred. |
| - Full format= 1 looped image will appear on the screen. |
| - Vsplit format= 2 looped images will appear on the screen. |
| - Reduced format (quad)= 4 images will appear on the screen. |
| - Cropped format (quad)= 4 images will appear on the screen. (this format differs from the reduced format in that the images are acquired within a specific region. Highlight
-Select Region- on the left touch screen to bring up the specific region box. Position the box using the trackball. |
| * Keep in mind these tips when you are selecting a format: |
| -when storing a loop to optical disk, the full format will give you the flexibility to bring the loop back in the other formats, however, loops stored in
Vsplit, Reduced or Cropped can only be retrieved in the format it was stored as. |
| -Compare- mode is not available in full format. You must be in
Vsplit, Reduced or Cropped format in order to display a looped image(s) and a live image simultaneously. |
| Now optimize your image then simply press -Acquire- |
| 2. Press the -Acquire- hard key or -Acquire- on the touch screen once you
get the image you like. The system will begin acquiring according to the parameters you have pre-selected (loop type, # of beats or seconds and loop format). |
| 3. The looped image will be displayed when acquisition is complete. Press
-Display- or -2D- to return to live imaging. |
| 4. To review the images previously acquired highlight
-Loop- then -Display- on the left touch screen. |
| * in order to compare a previously acquired loop next to a live image, select a
format (with the exception of a full format). Capture a loop by pressing -Acquire-. Once the loop appears on the monitor, come out of display mode by
pressing -Display- or -2D-. Select -Compare- under the loop menu. The looped image will then appear on the monitor next to the live image. |
| 5. To store images to optical disk: |
| - display the loop(s) by pressing -Display- under the loop menu. Select
-Loop Store- on the left touch screen. A comment box will appear on the monitor. |
| Assign a specific label to the loop(s) you are storing (ex. Pre-op MV
regurg.) so that you will be able to identify the images when you retrieve them from optical disk. Select
-Okay- using the trackball. This will cause the image(s) to be stored to the optical disk. |
|
| B. To retrieve images from optical disk: |
| - Highlight -Disk- on the left touch screen. Select
-Disk Retrieve-. The system will read the database on the optical disk and display a list of all the studies. |
| Select the study you wish to retrieve by place the arrow on it with the trackball
then press the -Enter- hard key. |
| * If you would like to retrieve a specific image(s) within a study from optical
disk (particularly for using the compare function) : |
| - before you go under the -Disk- menu be sure that present loops have
been either stored to disk or deleted. |
| -select the format you would like to retrieve the
image(s) into by rotating the dial to the desired format under the -Loop- menu. |
| -go under the -Disk- menu. Select -Disk
Retrieve-. The system will read the database on the optical disk and display a list of all the studies. |
| Select the study you would like to retrieve the
image(s) from by placing the arrow on it and pressing -Enter-. Then place the arrow on
-List Contents- and press -Enter-. |
| -the system will display a list of individual looped images that exist within
the selected study. Place the arrow on the desired image (this is where you will be relying on the labels you created when you originally stored
the image). Press -Enter- then place the arrow on -Okay- and press
-Enter- again. The system will bring up the image on the screen. |
| To use the Compare function: |
| - If the retrieved loop is still on the screen, select
-Display- under the -Loop- menu. You will see -Compare- appear on the left touch screen. |
| Select -Compare-. The retrieved image will appear on the left side of screen and a live image will appear on the right side of the screen. |
| - You can capture the live image into a loop simply by pressing
-Acquire- on the touch screen or the -Acquire- hard key. |