iViz_1.0_UG_SCH_P book

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2 FUJIFILM SonoSite, Inc th Drive SE Bothell, WA FUJIFILM SonoSite B.V. Joop Geesinkweg AB Amsterdam, FUJIFILM SonoSite Australasia Pty Ltd 114 Old Pittwater Road BROOKVALE, NSW, 2100 iviz SonoSite SonoSite FUJIFILM SonoSite, Inc. FUJIFILM FUJIFILM Corporation Dicom National Electrical Manufacturers Association P FUJIFILM SonoSite, Inc.

3 1 iviz iviz iviz iviz...14 iviz...15 iviz iviz Android Bluetooth iviz...21 i

4 iviz DICOM EMR iviz CVD CPD M...48 ii

5 M...48 M efast...55 FATE...55 RUSH Smartheart Pro...75 iii

6 DICOM iviz D M A B iviz iv

7 iviz EMC DICOM ALARA ALARA MI TI MI TI v

8 IT IT vi

9 1 iviz iviz iviz iviz iviz iviz iviz 1

10 FUJIFILM SonoSite iviz

11 2 iviz iviz iviz 2D DICOM EMR SonoSite iviz iviz (CPD) (CVD) CPD iviz 3

12 iviz ECG iviz Smartheart Pro 12 Smartheart Pro ECG FUJIFILM SonoSite FUJIFILM SonoSite FUJIFILM SonoSite FUJIFILM SonoSite iviz U USB iviz (iviz) USB iviz FUJIFILM SonoSite FUJIFILM SonoSite 2 4

13 iviz 1 6 USB 2 7 / 3 8 LED HDMI 10 5

14 iviz

15 iviz Home iviz Home Home Patient Scan Learn Patient - iviz Scan - Learn - iviz 7

16 iviz 2-4 FREEZE C COLOR 2D Orient Dynamic Range SAVE RES PEN Patient: John Smith ID? P21v: Abdomen MI: 0.0 TI: 0.0 THI DR? 0 Pen MHz 0.00 Opt 89% End Study Depth: 16.4 cm 13% 01/01/ : Scan mode Freeze Android 6 Patient [] 12 8

17 Exam Type 9

18 iviz iviz SAR

19 iviz iviz 1 iviz iviz 2 iviz 11

20 FUJIFILM SonoSite USB (P19927) -20 C 60 C 10 C 40 C USB iviz 131 iviz iviz USB iviz 1 15 iviz 2 USB 12 iviz

21 3 USB iviz iviz 4 5 iviz iviz iviz iviz 13

22 4 60 iviz FUJIFILM SonoSite 1 15 iviz 2 iviz 3 iviz FUJIFILM SonoSite iviz iviz

23 iviz iviz 1 iviz 11 2 Power 3 Lock iviz Home iviz iviz 1 2 Power off OK Power iviz Power iviz 15

24 (mm) Color (cm) Power CPD CVD (cm) % % P21v L38v iviz

25 3 iviz Android iviz Google Android (OS) Android OS Android FUJIFILM SonoSite Android Android 1 Home 2 Home Apps 3 Apps Settings FUJIFILM SonoSite Security PIN IT 1 Android Settings Wi-Fi ON 2 Wi-Fi 3 Done 4 Connect 5 Wi-Fi Connected Android 17

26 Bluetooth 1 Android Settings Bluetooth 2 Bluetooth Bluetooth ON 3 4 Bluetooth Bluetooth 5 Bluetooth iviz iviz 1 Android Settings Date & Time 2 Date & Time Automatic date & time 3 Set date Done 4 Set time Done Android Settings Date & Time 2 24 Date &Time Use 24-hour format Date &Time Use 24-hour format Android

27 < >/< >/< > iviz 1 Android Settings Choose date format 2 1 Android Settings Sound 2 Sound Volumes 3 OK 1 Android Settings Display 2 Display Brightness 3 Auto 4 Android 19

28 iviz 30 1 Android Settings Display 2 Display Sleep 3 iviz 20 Security > Screen > Android None 10 PrintHand Android Wi-Fi 17 1 Android Settings Printing 2 Printing PrintHand 3 OFF 4 Use PrintHand PrintHand OK 5 Add a printer 6 Nearby Printers Nearby Wi-Fi Printers Wi-Fi iviz 20 Android

29 7 8 Driver Needed Select Manually Next Generic 9 10 Install 11 Print Test 12 Finish iviz iviz iviz Settings / DICOM ID EMR IP iviz iviz Home Settings 1 iviz Settings Preferences 2 Preferences Units - iviz iviz 21

30 Thermal Index - TIB - TIC - TIS - Auto Save Patient Form - Clip Recording - Prospective - Save Retrospective - Save Clip Length - Device Orientation - 1 iviz Settings OB Calcs 2 OB Calculations GS - CRL - BPD - Cx Length - HC - Cerebellum AC - FL - HL iviz Settings Labels 22 iviz

31 2 Labels Custom Labels Default Labels 1 Labels 2 3 Add Restore iviz 23

32 DICOM iviz (DICOM) iviz Tricefy DICOM Tricefy Tricefy Tricefy DICOM 1 iviz Settings DICOM Profiles DICOM 2 New Profile 3 General a Profile Name b AE Title AE (AE) AE c Institution Swedish Hospital IP Address IP Subnet Mask Default Gateway Wireless 4 Archive a AE Title AE (AE) AE b IP Address IP IP c Port d Transfer images End of Exam - Manual - e Structured Reports Yes No f Educational Yes No g Active Inactive h Ping i Verify iviz 24 iviz

33 5 Worklist a AE Title AE (AE) AE b IP Address IP IP c Port d Worklist Today - Yesterday - +/- 7 days +/- 7 - e Auto Query On Off f Modality Ultrasound All g Occurs Every h Active Inactive i Ping j Verify iviz 6 DICOM Profiles DICOM On DICOM DICOM DICOM 1 DICOM 2 DICOM DICOM 1 DICOM Edit 2 DICOM 3 Done Tricefy Tricefy iviz 25

34 DICOM DICOM DICOM (OFF) [] iviz Name DOB Study Dates / 1 iviz Settings Patient Search???? 2 Patient Search 3 ID 1 iviz Settings Patient Search???? 2 Patient Search ID 3 30 EMR FUJIFILM Synapse EMR iviz FUJIFILM Synapse EMR IP FUJIFILM Synapse EMR EMR EMR PDF FUJIFILM Synapse EMR FUJIFILM SonoSite 26 iviz

35 EMR 1 iviz Settings EMR 2 Host Name EMR 3 IP Address IP EMR IP 4 Port EMR iviz SonoSite / iviz HDMI iviz 27

36 28

37 4 EMR iviz iviz iviz iviz ID ID ID 33 Home Patient Patient iviz / EMR 26 EMR iviz iviz 29

38 Patient Search Patient Name - / Date of Birth - Study Dates - Study Dates Set the date - Set the range - Study Date 1 Patient Search Search 5 iviz ID 26 30

39 1 Patient Search Name Patient Name 2 ID iviz iviz / EMR 26 EMR Schedule Patient Schedule 31

40 Patient Schedule iviz 1 Select Next 6 PACS 7 Share 1 Select

41 1 29 Patient Search New Study 2 3 Notes 4 Exam Type 5 Exam Purpose 6 Procedure Code 7 Procedure Meaning 8 Reading Doctor 9 Referring Doctor 10 Study Date 11 Save 29 iviz End Study 33

42 1 iviz Studies iviz 2 3 a Select b 4 5 Local PACS PACS - DICOM Tricefy - Tricefy Tricefy iviz USB - USB 6 Next 7 PACS 8 Share USB 34

43 Measurements Edit Notes 7 Save 8 Cancel 35

44 Print 4 Print iviz EMR Save and Send to EMR EMR 36

45 5 iviz USB iviz iviz Freeze [] Home Scan iviz Home Freeze 37

46 iviz Color 2D Color Color Depth 2D Color Box Color Gain 2D Color Mode M Mode M Motion Mode 38

47 Kremkau, Frederick W. Diagnostic Ultrasound: Principles and Instruments. 8th ed., W.B. Saunders Company, (Nov. 10, 2010). 2D 2D 2D [] M Mode [M ] M Mode M 2D M 2D Color 2D 42 M 2D M Mode M 2D M Mode M 48 M 39

48 iviz iviz iviz 5-1 P21v L38v 1 Exam Type 2 40

49 FUJIFILM SonoSite Aquasonic Aquasonic FUJIFILM SonoSite

50 2D iviz 8 2D iviz 2D M Mode M 2D 2D Color Color Depth 2D Color Box Color Gain 42

51 2D iviz 1 Color Box 2 Resize 3 Move 4 43

52 1 2 CVD CPD C iviz (CVD) (CPD) CVD - CVD CPD - CPD CVD CPD CVD CPD iviz 44

53 1 Color Gain 2 Color Gain 45

54 1 Scale Scale 2 CPD Invert 46

55 1 Wall Filter H Wall Filter M L 2 H - M - L - 1 Flow 2 H - M - L - 47

56 M M Mode M 2D M Mode M 2D M M M iviz M M M M M M M Update M Mode M M M Mode M Update 48 M

57 1 Update 2 Speed S Speed M F 3 S - M - F - SonoSite 49

58 1 Orient 2 / / Orient iviz Res - Pen - THI - (THI) P21v 50

59 1 Opt Opt 2 THI 1 Depth 51

60 2 Depth iviz Overall Gain - Near/Far Gain / - 1 Overall Gain 52

61 2 Overall Gain Reset 3 Reset / 1 Near/Far Gain / 2 Near/Far Gain / 3 1 Dynamic Range 53

62 2 0 Dynamic Range iviz 1 2 PLAX PSAX IVC 54

63 efast (efast) RUQ LUQ FATE (FATE) PLAX PSAX IVC 55

64 RUSH (RUSH) PLAX PSAX IVC RUQ /LUQ 56

65 6 iviz ID 29 iviz 4 SAVE SAVE 1 FREEZE 2 57

66 ID 29 SAVE SAVE 1 SAVE Preferences 21 2 SAVE 1 Patient Images and Clips 58

67 iviz Text Labels 59

68 3 a +Arrow + b c 4 a Right Medial b 5 12 a b Done c 6 Save iviz Studies iviz

69 4 a Select b 5 Delete USB 1 iviz Studies iviz a Select b 5 6 Local PACS PACS - DICOM Trice - Tricefy Tricefy iviz USB - USB - Printer

70 7 Next 8 PACS 9 Share 62

71 Measurements 63

72 1 Measurements 2 General Distance Measurements 1 Measurements 2 General Ellipse 64

73 Measurements 65

74 1 Measurements 2 General Trace Measurements 66

75 iviz 33 Exam Type OB iviz Measurements 1 Measurements 67

76 2 General Volume a Length b 68

77 c 4 a Measurements b Width c d 5 a Measurements b Height c d 69

78 Cardiac LV Diastole RVWd 2D M RVDd 2D M IVSd 2D M LVDd 2D M LVPWd 2D M Systole RVWs 2D M RVDs 2D M IVSs 2D M LVDs 2D M LVPWs 2D M MVA (2D) AVA (2D) CO CI EF SV SI LVESV LVEDV IVS LVPWFT LVDFS LV M MV AV 6 LVd LVs 1 Exam Type Cardiac 2 2D Measurements 3 Cardiac 4 LV 70

79 5 6 Ao LA ACS LVET M 1 Exam Type Cardiac 2 M-Mode M Measurements 3 Cardiac 4 LA/Ao 5 6 MV AV 1 Exam Type Cardiac 2 2D Measurements 3 Cardiac 4 Area MVA AVA (HR) 1 Exam Type Cardiac 2 M-Mode M Measurements 3 Cardiac 4 HR HR 71

80 5 6 Obstetrics OB 82 iviz EFW EDD EFW 72

81 7-1 a YS GS Hansmann, Nyberg, Tokyo U. CRL BPD HC Hadlock, Hansmann, Osaka, Tokyo U. Chitty, Hadlock, Hansmann, Osaka, Tokyo U. Chitty, Hadlock, Hansmann AC Hadlock, Hansmann, Tokyo U. FL HL Chitty, Hadlock, Hansmann, Osaka, Tokyo U. Jeanty Cereb D CM Lat Vent Cx Len (EFW) c HC, AC, FL Hadlock 1 BPD, AC, FL Hadlock 2 AC, FL Hadlock 3 BPD, TTD Hansmann BPD, FTA, FL Osaka U. BPD, AC Shepard BPD, TTD, APTD, FL Tokyo U. HC/AC Campbell FL/AC Hadlock FL/BPD Hohler FL/HC Hadlock Q 1, Q 2, Q 3, Q 4 Jeng 73

82 7-1 d BPD Chitty, Hadlock, Jeanty HC Chitty, Hadlock, Jeanty AC Chitty, Hadlock, Jeanty FL Chitty, Hadlock, Jeanty EFW Brenner, Hadlock, Jeanty HC/AC Campbell a AUA b Tokyo U. APTD TTD EFW c (EFW) EFW Hadlock EFW d LMP DD (2D) 2D AFI 1 Exam Type OB 2 2D Measurements 3 OB 4 a b c M (HR) 1 Exam Type OB 2 M-Mode M Measurements 3 OB 74

83 4 HR HR 5 6 Save Save Smartheart Pro iviz SHL Smartheart Pro 12 ECG SonoSite Smartheart Pro Smartheart Pro iviz 12 ECG Smartheart iviz Wi-Fi Bluetooth Smartheart 17 Smartheart iviz Exam Type ECG ECG Smartheart ECG iviz Smartheart Smartheart FUJIFILM SonoSite Smartheart Pro 75

84 Smartheart iviz iviz 17 1 iviz Smartheart 2 Smartheart iviz Smartheart 3 Smartheart Smartheart 1 Exam Type EKG12 12 EKG Smartheart 2 ECG 3 ECG Smartheart ECG iviz ECG 1 ECG ECG results ECG iviz Shortcuts 2 iviz 3 ECG Smartheart Pro

85 8 2D

86 8-1 2D 2D a b (cm) c % = 1 + * * % d % = 2 2 * % < ±2% + 1% < ±2% + 1% < ±2% + 1% < ±4% + 2%/ * % < ±3% + 1.4%/ * % 0-26 cm 0-35 cm 0-44 cm cm cm 8-2 M M < +/- 2% + 1% a b 0-26 cm < +/-2% + 1% c d < +/- 2% + e * /100 % f bpm a b 0.7 db/cm MHz RMI 413a c % = 1 + * * % d % = 2 2 * % e f FUJIFILM SonoSite 78

87 (AIUM) (BSA) m 2 Grossman, W. Cardiac Catheterization and Angiography. Philadelphia: Lea and Febiger, (1980), 90. BSA = * * = = (CI) l/min/m 2 Oh, J.K., J.B. Seward, A.J. Tajik. The Echo Manual. 2nd Edition, Boston: Little, Brown and Company, (1999), 59. CI = CO/BSA CO = BSA = (CO) l/min Oh, J.K., J.B. Seward, A.J. Tajik. The Echo Manual. 2nd ed., Lippincott, Williams, and Wilkins, (1999), 59. CO = (SV * HR)/1000 CO = SV = HR = (CSA)cm 2 Reynolds, Terry. The Echocardiographer's Pocket Reference. 2nd ed., School of Cardiac Ultrasound, Arizona Heart Institute, (2000), 383. CSA = * D 2 D = (EF) Oh, J.K., J.B. Seward, A.J. Tajik. The Echo Manual. 2nd ed., Lippincott, Williams, and Wilkins, (1999), 40. EF = ((LVEDV - LVESV)/LVEDV) * 100% EF = LVEDV = LVESV = 79

88 (HR) bpm HR = M (IVS) Laurenceau, J. L., M.C. Malergue. The Essentials of Echocardiography. Le Hague: Martinus Nijhoff, (1981), 71. IVSFT = ((IVSS - IVSD)/IVSD) * 100% IVSS = IVSD = / (LA/Ao) Teichholz, L.E., T. Kreulen, M.V. Herman, et. al. Problems in echocardiographic volume determinations: echocardiographic-angiographic correlations in the presence or absence of asynergy. American Journal of Cardiology, (1976), 37:7. LVESV = (7.0 * LVDS 3 )/(2.4 + LVDS) LVESV = LVDS = LVEDV = (7.0 * LVDD3)/(2.4 + LVDD) LVEDV = LVDD = gm Oh, J.K., J.B. Seward, A.J. Tajik. The Echo Manual. 2nd Edition, Boston: Little, Brown and Company, (1999), 39. LV = 1.04 [(LVID + PWT + IVST)3 LVID3] * LVID = PWT = IVST = 1.04 = 0.8 = ml Schiller, N.B., P.M. Shah, M. Crawford, et.al. Recommendations for Quantitation of the Left Ventricle by Two-Dimensional Echocardiography. Journal of American Society of Echocardiography. September-October 1989, 2:362. π V = -- 4 n i = 1 L a i b i -- n V = ml a = b = n = (n=20) L = i = 80

89 ml Schiller, N.B., P.M. Shah, M. Crawford, et.al. Recommendations for Quantitation of the Left Ventricle by Two-Dimensional Echocardiography. Journal of American Society of Echocardiography. September-October 1989, 2:362. V = a = n = (n=20) L = i = (LVD) Oh, J.K., J.B. Seward, A.J. Tajik. The Echo Manual. Boston: Little, Brown and Company, (1994), LVDFS = ((LVDD - LVDS)/LVDD) * 100% LVDD = LVDS = (LVPWFT) Laurenceau, J. L., M.C. Malergue. The Essentials of Echocardiography. Le Hague: Martinus Nijhoff, (1981), 71. LVPWFT = ((LVPWS - LVPWD)/LVPWD) * 100% LVPWS = LVPWD = (SI) cc/m 2 Mosby s Medical, Nursing, & Allied Health Dictionary, 4th ed., (1994), SI = SV/BSA SV = BSA = (SV) 2D M ml Oh, J.K., J.B. Seward, A.J. Tajik. The Echo Manual. 2nd ed., Boston: Little, Brown and Company, (1994), 44. SV = (LVEDV - LVESV) SV = LVEDV = LVEDSV = 81

90 (AFI) Jeng, C. J., et al. Amniotic Fluid Index Measurement with the Four Quadrant Technique During Pregnancy. The Journal of Reproductive Medicine, 35:7 (July 1990), (AUA) AUA (AUA) (EDD) / / EDD = AUA (LMP) (EDD) LMP / / EDD = LMP (EFW) Hadlock, F., et al. Estimation of Fetal Weight with the Use of Head, Body, and Femur Measurements, AProspective Study. American Journal of Obstetrics and Gynecology, 151:3 (February 1, 1985), Hansmann, M., et al. Ultrasound Diagnosis in Obstetrics and Gynecology. New York: Springer-Verlag, (1986), 154. Osaka University. Ultrasound in Obstetrics and Gynecology. (July 20, 1990), Shepard M.J., V. A. Richards, R. L. Berkowitz, et al. An Evaluation of Two Equations for Predicting Fetal Weight by Ultrasound. American Journal of Obstetrics and Gynecology, 142:1 (January 1, 1982), University of Tokyo, Shinozuka, N. FJSUM, et al. Standard Values of Ultrasonographic Fetal Biometry. Japanese Journal of Medical Ultrasonics, 23:12 (1996), 880, Equation 1. (LMP) LMP GA(LMP) = - LMP 82

91 (LMPd) (GA) EDD (GA) LMP GA(LMPd) = - LMPd (AC) Hadlock, F., et al. Estimating Fetal Age: Computer-Assisted Analysis of Multiple Fetal Growth Parameters. Radiology, 152: (1984), Hansmann, M., et al. Ultrasound Diagnosis in Obstetrics and Gynecology. New York: Springer-Verlag, (1986), 431. University of Tokyo, Shinozuka, N. FJSUM, et al. Standard Values of Ultrasonographic Fetal Biometry. Japanese Journal of Medical Ultrasonics, 23:12 (1996), cm 30.0 cm (AC) FUJIFILM SonoSite AC AC (BPD) Chitty, L. S. and D.G. Altman. New charts for ultrasound dating of pregnancy. Ultrasound in Obstetrics and Gynecology 10: (1997), , Table 3. Hadlock, F., et al. Estimating Fetal Age: Computer-Assisted Analysis of Multiple Fetal Growth Parameters. Radiology, 152: (1984), Hansmann, M., et al. Ultrasound Diagnosis in Obstetrics and Gynecology. New York: Springer-Verlag, (1986), 440. Osaka University. Ultrasound in Obstetrics and Gynecology. (July 20, 1990), 98. University of Tokyo, Shinozuka, N. FJSUM, et al. Standard Values of Ultrasonographic Fetal Biometry. Japanese Journal of Medical Ultrasonics, 23:12 (1996), 885. (CM) Mahony, B.; P. Callen, R. Filly, and W. Hoddick. The fetal cisterna magna. Radiology, 153: (December 1984),

92 (CRL) Hadlock, F., et al. Fetal Crown-Rump Length: Re-evaluation of Relation to Menstrual Age (5-18 weeks) with High-Resolution, Real-Time Ultrasound. Radiology, 182: (February 1992), Hansmann, M., et al. Ultrasound Diagnosis in Obstetrics and Gynecology. New York: Springer-Verlag, (1986), 439. Osaka University. Ultrasound in Obstetrics and Gynecology. (July 20, 1990), 20 and 96. Tokyo University. Gestational Weeks and Computation Methods. Ultrasound Imaging Diagnostics, 12:1 (1982-1), 24-25, Table 3. (FL) Chitty, L. S. and D.G.Altman. New charts for ultrasound dating of pregnancy. Ultrasound in Obstetrics and Gynecology 10: (1997), , Table 8, 186. Hadlock, F., et al. Estimating Fetal Age: Computer-Assisted Analysis of Multiple Fetal Growth Parameters. Radiology, 152: (1984), Hansmann, M., et al. Ultrasound Diagnosis in Obstetrics and Gynecology. New York: Springer-Verlag, (1986), 431. Osaka University. Ultrasound in Obstetrics and Gynecology. (July 20, 1990), University of Tokyo, Shinozuka, N. FJSUM, et al. Standard Values of Ultrasonographic Fetal Biometry. Japanese Journal of Medical Ultrasonics, 23:12 (1996), 886. (FTA) Osaka University. Ultrasound in Obstetrics and Gynecology. (July 20, 1990), (GS) Hansmann, M., et al. Ultrasound Diagnosis in Obstetrics and Gynecology. New York: Springer-Verlag, (1986). Nyberg, D.A., et al. Transvaginal Ultrasound. Mosby Yearbook, (1992), 76. Nyberg Tokyo University. Gestational Weeks and Computation Methods. Ultrasound Imaging Diagnostics, 12:1 (1982-1). 84

93 (HC) Chitty, L. S. and D.G. Altman. New charts for ultrasound dating of pregnancy. Ultrasound in Obstetrics and Gynecology 10: (1997), , Table 5, 182. Hadlock, F., et al. Estimating Fetal Age: Computer-Assisted Analysis of Multiple Fetal Growth Parameters. Radiology, 152: (1984), Hansmann, M., et al. Ultrasound Diagnosis in Obstetrics and Gynecology. New York: Springer-Verlag, (1986), 431. (HL) Jeanty, P.; F. Rodesch; D. Delbeke; J. E. Dumont. Estimate of Gestational Age from Measurements of Fetal Long Bones. Journal of Ultrasound in Medicine. 3: (February 1984), (OFD) Hansmann, M., et al. Ultrasound Diagnosis in Obstetrics and Gynecology. New York: Springer-Verlag, (1986), 431. Jeanty, P.; F. Rodesch; D. Delbeke; J. E. Dumont. Estimate of Gestational Age from Measurements of Fetal Long Bones. Journal of Ultrasound in Medicine. 3: (February 1984), (TTD) Hansmann, M., et al. Ultrasound Diagnosis in Obstetrics and Gynecology. New York: Springer-Verlag, (1986), 431. (AC) Chitty, Lyn S. et al. Charts of Fetal Size: 3.Abdominal Measurements. British Journal of Obstetrics and Gynaecology 101: (February 1994), 131, Appendix: AC-Derived. Hadlock, F., et al. Estimating Fetal Age: Computer-Assisted Analysis of Multiple Fetal Growth Parameters. Radiology, 152: (1984), Jeanty P., E. Cousaert, and F. Cantraine. Normal Growth of the Abdominal Perimeter. American Journal of Perinatology, 1: (January 1984), Hansmann, Hackeloer, Staudach, Wittman. Ultrasound Diagnosis in Obstetrics and Gynecology. Springer-Verlag, New York, (1986), 179, Table

94 (BPD) Chitty, Lyn S. et al. Charts of Fetal Size: 2. Head Measurements. British Journal of Obstetrics and Gynaecology 101: (January 1994), 43, Appendix: BPD-Outer-Inner. Hadlock, F., et al. Estimating Fetal Age: Computer-Assisted Analysis of Multiple Fetal Growth Parameters. Radiology, 152: (1984), Jeanty P., E. Cousaert, and F. Cantraine. A Longitudinal Study of Fetal Limb Growth. American Journal of Perinatology, 1: (January 1984), , Table 5. Hansmann, Hackeloer, Staudach, Wittman. Ultrasound Diagnosis in Obstetrics and Gynecology. Springer-Verlag, New York, (1986), 176, Table 7.8. (EFW) Brenner, William E.; D. A. Edelman; C. H. Hendricks. A standard of fetal growth for the United States of America, American Journal of Obstetrics and Gynecology, 126: 5 (November 1, 1976), ; Table II. Hadlock F., et al. In Utero Analysis of Fetal Growth: A Sonographic Weight Standard. Radiology, 181: (1991), Jeanty, Philippe, F. Cantraine, R. Romero, E. Cousaert, and J. Hobbins. A Longitudinal Study of Fetal Weight Growth. Journal of Ultrasound in Medicine, 3: (July 1984), , Table 1. Hansmann, Hackeloer, Staudach, and Wittman. Ultrasound Diagnosis in Obstetrics and Gynecology. Springer-Verlag, New York, (1986), 186, Table (FL) Chitty, Lyn S. et al. Charts of Fetal Size: 4.Femur Length. British Journal of Obstetrics and Gynaecology 101: (February 1994), 135. Hadlock, F., et al. Estimating Fetal Age: Computer-Assisted Analysis of Multiple Fetal Growth Parameters. Radiology, 152: (1984), Jeanty P, E. Cousaert, and F. Cantraine. A Longitudinal Study of Fetal Limb Growth. American Journal of Perinatology, 1: (January 1984), , Table 5. Hansmann, Hackeloer, Staudach, Wittman. Ultrasound Diagnosis in Obstetrics and Gynecology. Springer-Verlag, New York, (1986), 182, Table

95 (HC) Chitty, Lyn S., et al. Charts of Fetal Size: 2. Head Measurements. British Journal of Obstetrics and Gynaecology 101: (January 1994), 43, Appendix: HC-Derived. Hadlock, F., et al. Estimating Fetal Age: Computer-Assisted Analysis of Multiple Fetal Growth Parameters. Radiology, 152: (1984), Jeanty P, E. Cousaert, and F. Cantraine. A longitudinal study of Fetal Head Biometry. American J of Perinatology, 1: (January 1984), , Table 3. Hansmann, Hackeloer, Staudach, Wittman. Ultrasound Diagnosis in Obstetrics and Gynecology. Springer-Verlag, New York, (1986), 176, Table 7.8. (HC)/ (AC) Campbell S., Thoms Alison. Ultrasound Measurements of the Fetal Head to Abdomen Circumference Ratio in the Assessment of Growth Retardation, British Journal of Obstetrics and Gynaecology, 84: (March 1977), FL/AC Hadlock F.P., R. L. Deter, R. B. Harrist, E. Roecker, and S.K. Park. A Date Independent Predictor of Intrauterine Growth Retardation: Femur Length/Abdominal Circumference Ratio, American Journal of Roentgenology, 141: (November 1983), FL/BPD Hohler, C.W., and T.A. Quetel. Comparison of Ultrasound Femur Length and Biparietal Diameter in Late Pregnancy, American Journal of Obstetrics and Gynecology, 141:7 (Dec ), FL/HC Hadlock F.P., R. B. Harrist, Y. Shah, and S. K. Park. The Femur Length/Head Circumference Relation in Obstetric Sonography. Journal of Ultrasound in Medicine, 3: (October 1984), HC/AC Campbell S., Thoms Alison. Ultrasound Measurements of the Fetal Head to Abdomen Circumference Ratio in the Assessment of Growth Retardation, British Journal of Obstetrics and Gynaecology, 84: (March 1977),

96 88

97 9 LED LED M 2D M Mode M 2D M 48 M SAVE Preferences 21 SAVE iviz iviz LED iviz LED iviz 89

98 LED LED LED 9-1 LED 60 LED LED 9-2 LED LED LED 60 LED 30 LED LED USB LED USB USB 90

99 iviz 9-3 The signal path has stopped because the transducer is not connected. The temperature sensor is not working, either in the transducer or the system. The system temperature is too high. The transducer temperature is too high Home 2 Home Scan Patient

100 1 2 3 Power off OK 4 FUJIFILM SonoSite IP AE FUJIFILM SonoSite 2 DICOM iviz DICOM FAQ / DICOM Refresh Archived Status DICOM USB USB DICOM studies transferred successfully DICOM Studies transferred successfully USB / DICOM studies transferred successfully DICOM EMR EMR Report sent to EMR EMR iviz 100 iviz DICOM DICOM iviz DICOM DICOM 92

101 DICOM 1 DICOM Archive Ping DICOM 2 DICOM DICOM Archive Verify DICOM Ping Verify DICOM a iviz a ivizsettings b DICOM Configuration DICOM c DICOM General d AE IP iviz b c a Archive b AE IP c d a Worklist b AE IP c 3 DICOM/PACS/ iviz DICOM ICOM 4 FUJIFILM SonoSite 2 5 DICOM DICOM iviz DICOM 93

102 iviz DICOM iviz DICOM/PACS 10 FUJIFILM SonoSite iviz / iviz 1 USB 2 Wi-Fi 17 3 Android Settings About iviz iviz 4 Updates 5 Refresh 6 update 7 Apply update Update 8 iviz Android Settings About iviz iviz iviz version iviz 94

103 iviz - 2D SonoSite Gammex 403GS Phantom Gammex 413A Phantom.7 db/cm SonoSite P21v/5-1 MHz L38v/4-9.5 MHz Gammex 403 GS Phantom 413A Phantom 1 15 iviz P21v/5-1 MHz 6 7 Scan 8 iviz 95

104 9 2D #1 #1 12 SAVE SAVE 15 2D 2D 2D 1 2D P21v/5-1 MHz 2 3 #1 4 2D Freeze 8 Freeze 96 iviz

105 1 2 3 Measurements 4 General 5 Distance cm Measurements 4 General 5 Distance cm iviz 97

106 /-2% +/-2% 2D 1 cm 2D Freeze SAVE Freeze (Color) 1 P21x/5-1 MHz 2D 2 Color (ROI) 3 ROI 98 iviz

107 4 ROI 5 Depth 6 Gain ROI 7 ROI M M 1 P21x/5-1 MHz 2D 2 2D M Mode M M 3 M Mode M 4 5 Update M 6 M / / iviz 99

108 100 iviz

109 10 iviz iviz FUJIFILM SonoSite iviz 102 iviz iviz 101

110 FUJIFILM SonoSite (PPE) 102

111 FUJIFILM SonoSite 2 FUJIFILM SonoSite iviz iviz 10-1 / 104 A 107 B 103

112 A B P21 SaniCloth AF3 SaniCloth SaniCloth Plus SaniCloth HB Super SaniCloth T-Spray II (PI-Spray II)

113 3 a b c d e

114 2 a b c d 3 FUJIFILM SonoSite 106

115 B P21v L38v SaniCloth AF3 SaniCloth SaniCloth Plus Saniwipe HB T-Spray II (PI-Spray II)

116 3 a b c d e FUJIFILM SonoSite 108

117 2 3 4 FUJIFILM SonoSite 10-4 Cidex 23 C 45 Cidex OPA 23 C

118 iviz iviz 104 iviz iviz 102 iviz FUJIFILM SonoSite FUJIFILM SonoSite 110 iviz

119 11 ALARA 12 (WRMSD) 1, 2, 3, 4 / (WRMSD) WRMSD WRMSD 1 WRMSD WRMSD iviz 111

120 112

121 2 15 WRMSDs 5 1 Coffin, C.T. (2014). Work-related musculoskeletal disorders in sonographers: A review of causes and types of injury and best practices for reducing injury risk. Reports in Medical Imaging, 7, Evans, K., Roll, S., & Baker, J. (2009). Work-related musculoskeletal disorders (WRMSD) among registered diagnostic medical sonographers and vascular technologists: A representative sample. Journal of Diagnostic Medical Sonography, 25, National Institute for Occupational Safety and Health (2006). Preventing work-related musculoskeletal disorders in sonography [DHSS (NIOSH) Publication Number ]. Cincinnati, OH: Department of Health and Human Services. 4 Society of Diagnostic Medical Sonography (2003, May). Industry standard for the prevention of work-related musculoskeletal disorders in sonography. Plano, TX. 5 Alaniz, J, & Veile, B.L. (2013).Stretching for sonographers: A literature review of sonographer-reported musculoskeletal injuries. Journal of Diagnostic Medical Sonography, 29,

122 IEC iviz 41 C 43 C 48 C 10 C 40 C -20 C 60 C 10 C 40 C 10 IEC II / BF 131 iviz 114

123 iviz FUJIFILM SonoSite FUJIFILM SonoSite FUJIFILM SonoSite / FUJIFILM SonoSite FUJIFILM SonoSite 105 II BF II 115

124 96 FUJIFILM SonoSite iviz FUJIFILM SonoSite 116

125 FUJIFILM SonoSite -20 C 60 C FUJIFILM SonoSite FUJIFILM SonoSite FUJIFILM SonoSite iviz FUJIFILM SonoSite 117

126 FUJIFILM SonoSite FUJIFILM SonoSite ALARA MI TI FUJIFILM SonoSite.3 db/cm/mhz (LCD) LCD 118

127 IEC :2007 IEC :2014 (EMC) :2014 iviz ME RF iviz iviz iviz / EMC RF (EMI) EMI EMI EMI EMI EMI EMI EMI IEC EMC 119

128 FUJIFILM SonoSite FUJIFILM SonoSite FUJIFILM SonoSite FUJIFILM SonoSite FUJIFILM SonoSite iviz R&TTE (1999/5/EC) FCC 15 (1) (2) iviz IEEE a/b/g/n LAN Bluetooth 4.0 combo GHz GHz GHz HT20 CCK OFDM MCS0 MCS3 MCS5 MCS7 MCS8 MCS11 MCS11 MCS13 MCS GHz HT20 OFDM MCS0 MCS3 MCS5 MCS7 MCS8 MCS11 MCS13 MCS15 ERP 17.9 dbm iviz ESD (ESD) ESD ESD ESD 120

129 iviz 30 cm RF iviz (RF) iviz RF iviz 11-1 (W) 150 khz 80 MHz d=1.2 P m 80 MHz 800 MHz d=1.2 P 800 MHz 2.5 GHz d=2.3 P d (m) P (W) 121

130 FUJIFILM SonoSite iviz IEC :2007 IEC :2014 FUJIFILM SonoSite iviz iviz iviz iviz iviz iviz USB iviz P21v L38v iviz / U 1.5 m 1.2 m 1.2 m =1.8 m DC =1.9 m 122

131 iviz (EMC) USB CISPR iviz YY IEC :2014 iviz GB iviz GB 4824 GB / GB A iviz 123

132 11-3 iviz ESD GB/T ±6kV ±8kV ±6kV ±8kV 30 GB/T ±2kV ±2kV GB/T ±1kV ±2kV ±1kV ±2kV GB/T < 5% U T 0.5 ( U T > 95% ) 40% U T 5( U T 60% ) 70% U T 25 ( U T 30% ) < 5% U T 5s ( U T > 95% ) < 5% U T 0.5 ( U T > 95% ) 40% U T 5 ( U T 60% ) 70% U T 25 ( U T 30% ) < 5% U T 5s ( U T > 95% ) iviz 50/60Hz GB/T A/m 3 A/m U T 124

133 11-4 iviz GB/T GB/T V 150kHz - 80MHz 3 V/m 80MHZ - 2.5GHZ 3 V 3 V/m d =1.2 P 150kHz-80MHz d =1.2 P 80MHz-800MHz d =2.3 P 800MHz-2.5GHz P W d m a b 180MHz 800MHz 2 a / b 150kHz-80MHz3V/ M 125

134 11-5 iviz W 150kHz - 80MHz d = 1.2 P /m 80MHz - 800MHz d = 1.2 P 800MHz - 2.5GHz d = 2.3 P d m P W 180MHz 800MHz 2 FCC FCC bgn Bluetooth LE iviz IEC IEC iviz 126

135 iviz 6 iviz 6 iviz IIa IIb III 93/42/EEC REF 93/86/EEC iviz 127

136 10 FCC SN LCM UL 128 iviz

137 RF ISO mm mm 26.9 mm mm mm 28.6 mm mm mm mm 129

138 10-40 C 15-95% hpa / 30 /30 1. USB C 15-95% hpa C 15-95% hpa Vac 0.3 A 50/60 Hz 7.4 V dc 2 A USB PN P Vac 0.3A 50/60 Hz 5 V dc 2 A 10 W II 130

139 7.4 V 2.0 Ah (14.8 Wh) Vdc, A, 50/60 Hz; 15 Vdc, 3.33A 50W 15 V dc 3.33A 8.4 V dc 1.6A IPX-7 AP/APG ANSI/AAMI ES :2005/(R) 2012 A1: CAN/CSA C22.2 No : IEC : IEC : IEC 61157: JIS T0601-1:

140 EMC CISPR 11 (ISM) B IEC : NEMA UD IEC : IEC 62359: AAMI/ANSI/ISO : (2009) AAMI/ANSI/ISO In Vitro (2009) AAMI/ANSI/ISO (2002) RTCA DO-160G, Radio Technical Commission for Aeronautics, Environmental Conditions and Test Procedures for Airborne Equipment, Section 21.0 Emission of Radio Frequency Energy, Category B. 118 RTCA DO-160G 21.0 B 118 DICOM NEMA PS 3.15 (DICOM) - 15 (HIPAA) 45 CFR 160, General Administrative Requirements 45 CFR 164, Security and Privacy IEC TR IT (2012) 132

141 FCC15.247:2015 FCC2.1093:2015 EN EN EN 62311:2008 EN / AS/NZS RCM 133

142 134

143 12 ALARA ALARA ALARA ALARA ALARA ALARA 2D CPD 2D ALARA 138 ALARA 135

144 ALARA (ISPTA) 720 mw/cm2 (MI) (TI) 1.0 MI TI ALARA MI TI BS EN :2001 HH MI TI MI TI 136 MI TI AIUM Medical Ultrasound Safety AIUM 3 Kremkau, Frederick W. Diagnostic Ultrasound: Principles and Instruments. 7th ed., W.B.Saunders Company, (Oct. 17, 2005). MI TI MI TI MI TI MI TI MI TI 12-1 MI P21v L38v MI 136

145 12-2 TI (TIS TIC TIB) CPD PRF P21v L38v AIUM MI TI 138 TI MI TI MI 1.0 2D/M / P21v MI TIC TIB TIS L38v MI TIC TIB TIS MI 1.0 MI 0.1 TI TI 0.1 TI TI ALARA TI FUJIFILM SonoSite AIUM TI MI TI MI 95% MI 95% MI +17% -25% +0.2 TI 95% TI 95% TI +29% -42% +0.2 MI TI

146 145 MI TI - - Information for Manufacturers Seeking Marketing Clearance of Diagnostic Ultrasound Systems and Transducers, FDA, Medical Ultrasound Safety, American Institute of Ultrasound in Medicine (AIUM), Acoustic Output Measurement Standard for Diagnostic Ultrasound Equipment, NEMA UD Acoustic Output Measurement and Labeling Standard for Diagnostic Ultrasound Equipment, American Institute of Ultrasound in Medicine, (23 C ± 3 C) EN ( C) P21v L38v 20.4 ( 27 C) 9.2 ( 10 C) 16.0 ( 27 C) 8.6 ( 10 C) 138

147 AIUM Bioeffects Considerations for the Safety of Diagnostic Ultrasound, J Ultrasound Med., Sept. 1988: Vol. 7, No. 9 Supplement) Stowe Journal of Ultrasound in Medicine American Institute of Ultrasound in Medicine (AIUM) (NEMA UD2-2004) IEC : IEC 62359: In Situ In Situ In Situ= [e -(0.23alf) ] In Situ = In Situ = e = a = (db/cm MHz) (a) = 0.53 = 0.66 = 0.79 = 0.43 = 0.55 l = cm f = / / MHz In Situ 0.3 In Situ In situ = [e -(0.069lf) ] In Situ 139

148 In Situ In Situ 0.3 db/cm MHz In Situ In Situ 3 cm In Situ 1 db/cm MHz 1990 MI MI 2.0 2D M MI C 4 C 1.5 C 7 C ISPTA 500 mw/cm2 Bioeffects and Safety of Diagnostic Ultrasound (AIUM, 1993) TI MI P21v2D P21vM P21v/

149 12-5 P21v2D M.I. TIS A aprt 1 A aprt >1 TIB 1.4 (a) (b) p r.3 (MPa) 1.83 W 0 (mw) # - - # W.3 (z 1 ),I TA.3 (z 1 )] (mw) - z 1 (cm) - z bp (cm) - z sp (cm) - z@pll.3max (cm) 4.5 d eq (z sp ) (cm) - f c (MHz) 1.81 # # A aprt X (cm) # # Y (cm) # # PD (μsec) PRF (Hz) 2580 p max (MPa) 2.43 d max (cm) - FL x (cm) # - - # FL y (cm) # - - # I max (W/cm 2 ) OB 2 THI (a) <1 (b) # - / TIC 141

150 12-6 P21vM M.I. TIS A aprt 1 A aprt >1 TIB (a) - (a) (b) p r.3 (MPa) 1.83 W 0 (mw) - # # # W.3 (z 1 ),I TA.3 (z 1 )] (mw) - z 1 (cm) - z bp (cm) - z sp (cm) # z@pll.3max (cm) # - # # d eq (z sp ) (cm) - # - # # f c (MHz) # - # # A aprt X (cm) - # - # # Y (cm) - # # PD (μsec) PRF (Hz) 600 p max (MPa) 2.43 d max (cm) # FL x (cm) - # - # FL y (cm) - # - # I max (W/cm 2 ) THI (a) <1 (b) # - / TIC 142

151 12-7 P21v/ M.I. TIS A aprt 1 A aprt >1 TIB 1.3 (a) (b) p r.3 (MPa) 1.70 W 0 (mw) - # - # W.3 (z 1 ),I TA.3 (z 1 )] (mw) - z 1 (cm) - z bp (cm) - z sp (cm) - z@pll.3max (cm) 4.4 d eq (z sp ) (cm) - f c (MHz) 1.81 # # A aprt X (cm) # # Y (cm) # # PD (μsec) PRF (Hz) 640 p max (MPa) 2.24 d max (cm) - FL x (cm) # - - # FL y (cm) # - - # I max (W/cm 2 ) CVD 3 2D / THI/ 3 4 /PRF / 0 5/ / (a) <1 (b) # - / TIC 143

152 12-8L38v /CPD TIS TIB M.I. A aprt 1 A aprt 1 TIC 1.1 a b p r.3 (MPa) 2.50 W 0 (mw) # W. 3 (z 1 ) I TA.3 (z 1 )] (mw) - z 1 (cm) - z bp (cm) - z sp (cm) - z@pii.3max (cm) 1.3 d eq (z sp ) (cm) - f c MHz 4.83 # # A aprt X cm # # Y cm # # PD μsec PRE Hz 2197 p max MPa 3.11 d max cm - FL x cm # - - # FL y cm # - - # I max W/cm

153 12-8L38v /CPD TIS TIB M.I. A aprt 1 A aprt 1 TIC D/ 4 /PRF 5/ MSK CVD / 3 /0 / a1 b # / % 95% Pr 1.9% ±11.2% Pr.3 1.9% ±12.2% Wo 3.4% ±10% fc 0.1% ±4.7% PII 3.2% % PII.3 3.2% % 145

154 A aprt cm 2 d eq (z) z I TA (z) z cm d max A aprt fc FL I MImax I SPTA.3 I SPTA.3 z 1 MI PD P r.3 p max PRF TI TI TIB TIC TIS W 3 (z 1 ) Wo z 1 (x) (y) cm MHz (x) (y) MI W/cm 2 mw/cm 2 z 1 / MI MI MI Hz TIB TIS TIS z 1 mw mw TIS scan min(w 3 (z 1 ), I TA.3 (z) x 1 cm 2 )] z zbp cm 146

155 z bp 1.69 (A apr t ) z sp MI p r.3 TIB TIB z sp = z b.3 cm AIUM 2008 Recommended Ultrasound Terminology, Third Edition AIUM in situ LCD MI/TI SonoMB TIB TIC TIS (ALARA) (MI) (MI) (TI) 2D 2D C (60) C60xp MI MI

156 / (TI) 1 C TI 136 (TDI) / L (38) 148

157 13 IT IT DICOM (PACS) DICOM (MWL) IT a/b/g/n Bluetooth 4.0 DICOM PACS MWL DICOM WLAN WLAN iviz iviz WLAN iviz USB U USB iviz TCP/IP WLAN DICOM Tricefy HTTPS /web 443 HTTP web

158 DICOM MWL > iviz > PACS (DICOM MWL) DICOM * iviz DICOM IT IT IT iviz IT PACS PACS iviz IT PACS iviz TCP/IP DICOM MWL iviz / MWL MWL iviz TCP/IP DICOM iviz iviz 150 IT

159 13-1 IT iviz iviz iviz 1 IT IT IEC : IT IT IP 1 IT IT 151

160 13-2P21v P21v B M PWD CWD B+M; B+CD 1 2 B+M; B+CD 1 2 B+M; B+CD B+M; B+CD 1 2 B+M; B+CD IT

161 13-2P21v P21v B M PWD CWD THI IT 153

162 13-3L38v B M PWD CWD B+M; B+CD 1 B+M; B+CD 1 B+M; B+CD B+M; B+CD 1 B+M; B+CD IT

163 13-3L38v B M PWD CWD B+M; B+CD 1 1. IT 155

164 iviz P21v L38v USB U USB 5 /FUJIFILM SonoSite, Inc th Drive SE, Bothell, Washington, 98021, United States th Drive SE, Bothell, Washington, 98021, United States IT

165

166 P *P *