SSeries_1.3_UG_CHT_P book

Transcription

1 SSeries

2

3 S Series

4 Manufacturer FUJIFILM SonoSite, Inc th Drive SE Bothell, WA USA EC Authorized Representative FUJIFILM SonoSite B.V. Joop Geesinkweg AB Amsterdam, The Netherlands Australia Sponsor FUJIFILM SonoSite Australasia Pty Ltd 114 Old Pittwater Road BROOKVALE, NSW, 2100 Australia SSeriesS-CathS-FASTS-GYNS-ICUS-MSKS-NerveS-Women s HealthSiteLinkSonoHDSonoMBSonoSite V-Universal SonoSite SonoSite, Inc. DICOM National Electrical Manufacturers Association SonoSite D456509D461895D D538432D544962D558351D559390D591423D592750D592760AU AU730822CA CA CN ZL CN ZL CN ZL CN ZL DE DE DE DE DE DE DE FR FR FR FR FR FR GB GB GB GB GB GB IT IT IT IT KR528102KR532359NO NO326814NZ542968RCD SP SP SP P /2017 Copyright 2017 by SonoSite, Inc. ii

5 ...vii...vii USB iii

6 USB...16 JPEG D...19 M Mode imaging M...20 CPD...20 PW CW D...34 M...34 (Doppler) EMED (S-FAST)...46 (Gyn) EMED (S-FAST)...50 MSK (S-MSK)...50 iv

7 USB ALARA...74 ALARA MI TI v

8 EMC HIPAA vi

9 SSeries SSeries SonoSite 1 6 SonoSite SonoSite SonoSite SonoSite comments@sonosite.com SonoSite SonoSite service@sonosite.com (0) uk.service@sonosite.com vii

10 viii

11 1 SonoSite S Series S Series S-Cath S-FAST S-GYN S-ICU S-MSK S-Nerve S-Women s Health 51 SonoSite USB USB Patient 4 Mode 2D USB

12 USB RS-232 DVD S- S- 4 DVI Transducer

13 V SonoSite

14 SSeries StandV-Universal Stand USB USB PC USB PC USB Event log USB USB USB USB USB USB 2 USB USB USB USB 4

15 USB USB USB USB USB 1 2 USB USB USB USB USB 1 USB 2 USB

16 GenTHIMB / 8 USB

17 (ROI) USB USB TAB SonoSite USB USB 1 2 Äñ SYMBOLS CAPS LOCK (PRF) x/x SHIFT DELETE 3 Next Prev 4 OK 2D 1 7

18 SonoSite Aquasonic TEEx TEEx 21 CFR SonoSite SonoSite SonoSite SonoSite 53 SonoSite SonoSite Education Key 1 Education Key USB USB USB 2 Patient 3 Review List 4 Videos 5 USB a Select USB USB b Select USB device for media playback USB Education Key USB Type Training Select 8

19 1 2 3 View 4 0 Back 10 Pause Play Forward 10 List Done 2DColor CPD 24 CPD CPD (PUBS) (IVF) CPD Color (IUGR) 1 9

20 (Oph) FDA (Oph) 10

21 2 1 Options Setup 2 Setup Pages Done Reset Administration Event log HIPAA 1 Administration Name Administrator 7 2 Password SonoSite SonoSite vii 3 Login 1996 (Health Insurance Portability and Accountability Act, HIPAA) (European Union Data Protection Directive, 95/46/EC) 2 11

22 User Login 1 2 User Login On On Off 1 2 User List Administrator 3 User Information Password Confirm 13 Password changes 4 Save 1 2 New 3 User Information Name Password Confirm 13 4 User User 5 Administration Access 6 Save 1 2 User List 3 User Information 4 Save 1 2 User List 3 Delete 4 Yes 1 2 User List 3 Password Confirm 4 Save 1 USB 2 3 Export USB 4 USB Export USB 12

23 1 USB 2 3 Import 4 USB Import 5 Restart Event log USB PC 1 2 Log Event log Back (log.txt) USB log.txt 1 USB 2 Log Export User Login User Login OK 1 2 User Login Guest 1 2 User Login Password 3 OK (A-Z) (a-z) (0-9) USB 3 USB Export Event log Microsoft Word 1 2 Clear 3 Yes

24 27 1 Exam 2 Group AB C 3 <New> Text Add Text Rename Delete 7 Unfreeze Keep All Text Keep Home Text Clear All Text Keep All Text 27 1 USB 2 Export USB 3 USB Export USB 1 USB 2 Import 3 USB Import 4 OK USB Audio, Battery On Off On Off Off 5 10 Off Cardiac Calculations Tissue Doppler Imaging (TDI) 38 Cardiac Calculations TDI Walls TDI 14

25 Connectivity SiteLink Image Manager DICOM Transfer Mode Location SiteLink DICOM 1 2 Connectivity Printer DVD 1 Connectivity DVD Video Mode NTSC PAL Serial Port Bar Code Scanner RS (RS-232) RS-232 Date and Time Date 7 Time 24 Display Information Patient Header 28 Mode Data System Status Network Status IP Location MAC Connectivity Internal Storage Capacity Alert 2 15

26 OB Calculations 47 OB Calculations Gestational Age None Presets Depth Markers Type 1 1 Type 2 2 Thermal Index TISTIB TICOB TIB TIS Clip Length Units in/ft/lbs cm/m/kg Language Display Brightness Scheme 1 Scheme 2 Auto save Pat.Form Save Key SAVE Image Only Image/Calcs / Doppler Scale cm/s / khz Duplex M 1/3 2D, 2/3 Trace 1/3 2/3 1/2 2D, 1/2 Trace 1/2 1/2 Full 2D, Full Trace Live Trace Peak Mean System Information 52 System Information Patents USB USB Devices USB USB USB H.264 MP4 SonoSite QuickTime USB Devices USB Export 2 SiteLink JPEG JPEG 3 Sort By Devices 16

27 DICOM SonoSite USB Devices USB Include private tags SonoSite DICOM JPEG JPEG lossy compression BMP SonoCalc IMT BMP SonoCalc IMT Physics in Medicine and Biology, Quality Assessment of DSA, Ultrasound and CT Digital Images Compressed with the JPEG Protocol, D Okkalides et al 1994 Phys Med Biol doi: / /39/9/008 Canadian Association of Radiologists, CAR Standards for Irreversible Compression in Digital Diagnostic Imaging within Radiology, Approved: June

28 18 USB

29 3 LCD Auto Gain 23 2D 2D 1 2D Mode 2D 2 2D Optimize THI SonoMB Res Gen Pen THI SonoMB MB 2D AB C Orientation U/R /U/L /D/L /D/R / Guide Guide AB C L

30 Dual Brightness M Mode imaging M (M Mode) M 1 Mode MModeM 2 M 3 M 2D 19 M Dual Update Select Dual Brightness Brightness M MModeM Mode MMode M Slow Med Fast Update M Mode M Update 2D M M Mode MModeM M 16 CPD CPD Color 1 Color CPD CPD Mode Color CPD CPD ROI Color CPD Color Color / 20

31 2 ROI Position Size ROI 3 CPD Color CPD Color Flow Sensitivity Low Med High PRF Scale PRF PRF Scale Flow Sensitivity Color Suppress Invert Show Hide Steering Wall Filter Variance ROI PW Doppler 22 Low Med High PW CW PW CW PW CW PW/CW / CPD/Color / CPD/Color / ROI ROI ROI PW CW 1 Mode Doppler 3 21

32 2 PW Doppler 22 PW Angle Doppler Mode Doppler Update Doppler Update 2D Mode Doppler 16 PW Doppler CW PW PW/TDI / Steering Angle Angle PW Doppler TDI PW Doppler

33 Scale Invert Volume PRF / 16 Live Trace Invert Live Trace (0-10) Depth Depth 2D 19 1 Near 2D Wall Filter Sweep Speed Low Med High Slow Med Fast Live Trace 16 Far 2D Gain CPD Color Gain (ROI) 2 Reset 3 23

34 Freeze 2D Color 1 Zoom ROI 2 ROI 3 Zoom ROI 100% On 4 On (Oph) FDA (Oph) Options Exam Type Exam 28 24

35 SSeries Transducer 1 2D 2 CPD Color PW Doppler CW Doppler S-Cath C60x 3 Abd HFL38x L25x L38x L38xi HFL50x P10x Bre SmP Vas Ven Sup Vas Ven Bre SmP Vas Ven Bre SmP Vas Ven Bre SmP Abd Crd Neo P21x 3 Abd S-FAST C60x 3 Abd HFL38x SmP Vas Ven HFL50x SmP ICTx Gyn OB L25x Oph Sup Vas Ven L38x SmP Vas Ven L38xi SmP Vas Ven P21x 3 Abd Crd OB S-GYN C60x 3 Gyn OB HFL38x Bre Vas ICTx Gyn OB L38x Bre Vas L38xi Bre Vas P21x 3 OB 3 25

36 S-ICU C11x Abd Neo Vas C60x 3 Abd HFL38x SmP Vas Ven L25x L38x L38xi P10x P21x 3 Vas Ven SmP Vas Ven SmP Vas Ven Abd Crd Neo Abd Crd S-MSK C60x 3 Abd Msk Nrv HFL38x Msk HFL50x Msk L25x Msk L38xi Msk SLAx Msk Nrv S-Nerve C11x Nrv Vas S-Women s Health C60x 3 Nrv HFL38x Nrv Vas HFL50x Nrv L25x L38x L38xi SLAx C60x 3 HFL38x Nrv Vas Nrv Vas Nrv Vas Nrv Vas Gyn OB Bre Vas HFL50x Bre ICTx Gyn OB L38x L38xi Bre Vas Bre Vas P21x 3 OB TEEx 4 Crd 1. Abd = Bre = Crd = Gyn = Msk = Neo = Nrv = OB = Oph = SmP = Sup = Vas = Ven = 2. 2D ResGen Pen 3. (Tissue Harmonic Imaging) TEEx SonoSite SonoSite 26

37 13 1 Options Annotate 2 Home 3 7 Label 13 Back 1 Options Annotate 2 3 Home/Set / Back 1 Options Annotate 2 Arrow Back 2D Arrow Hide Show Back 1 Options Annotate 2 Picto 3 x/x U/L /D/L /D/R / U/R / Hide Show Back 3 27

38 49 1 Patient 2 New/End / Done 30 Auto save Pat Form On Patient 2 3 Cancel Done Patient 3 New/End / Patient Last First Middle ID Accession Indications User Procedure Worklist Query DICOM DICOM Exam Type BP HR 16 28

39 16 BSA LMP Estab. DD LMP Estab. DD Reading Dr. Referring Dr. Institution SonoSite SonoSite vii Beep Alert Save Save Save 16 Clip Patient 2 Review 3 List 3 29

40 Select All USB UP ARROW DOWN ARROW SPACEBAR Clear All USB SPACEBAR ID 1 2 Edit 3 OK 1 2 Append 1 2 Review Play Pause 5 x/x List Done USB USB USB USB Print Print 30

41 Print Print USB 28 USB USB 16 1 USB USB Exp.USB USB 4 USB Include patient information on images and clips USB 5 Export USB USB Cancel Export 1 2 Delete DICOM SiteLink PCDICOM SiteLink SiteLink DICOM 1 2 Archive 1 2 Info 3 31

42 32

43 Calcs Calipers Switch 4 33

44 Delete / 2D 1 Calipers A cm 2 cm 1 Calipers Calipers 2 Manual 3 4 Undo 5 Set A Add Caliper Ellipse Manual B C M M / (HR) / (bpm) Ellipse 34

45 M 1 M Calipers M 1 M Calipers 2 HR Save HR M 48 M Add Caliper B C HR (Doppler) cm/s / 16 / 1 Calipers 2 33 (A/B) (RI) 1 Calipers Calipers 2 Time

46 1 Calipers 2 PHT Calipers 2 Manual 3 4 Undo Calipers 2 Auto 3 4 Set 36 (VTI) (Vmax) (PGmean) (PSV) (TAM)* +/ / (S/D) (PI) (EDV) (AT) (RI) (PGmax) Add Caliper Time Manual Auto B C 36

47 49 SSeries 49 (...) 1 Calcs 2 Next Prev (...) 3 Calcs Calipers Save Calc 29 Image/Calcs / Save Delete

48 28 (Crd) SSeries S-Cath S-FAST S-ICU 133 LV LVd LVs RVW RVD IVS LVD LVPW RVW RVD IVS LVD LVPW CO CI HRa CO EF SV LVESV LVEDV IVSFT LVPWFT LVDFS CI SI Ao/LA MV LV LVd LVs HR Ao M AAo LA M LVOT D ACS M LVET M EF M EPSS M RVW M RVD M IVS M LVD M LVPW M RVW M RVD M IVS M LVD M LVPW M HR a Ao LA/Ao AAo LA LA/Ao LVOT D LVOT ACS LVET EF EPSS CO EF SV LVESV LVEDV IVSFT LVPWFT LVDFS CI SI LV AV AV MV MV 38

49 LV Vol (EF) PISA A4Cd A4Cs A2Cd A2Cs Epi Endo Apical Ann D MR/VTI MV/VTI LV LV EF CO SV CI SI LV Epi Endo D Apical D PISA ERO MV Regurgitant Volume Regurgitant Fraction CO TDI LVOT D e a e a e a e a e a CO SV CI SI VTI HR LVOT D P. Vein A VMax Adur S D E(MV)/e VMax S/D Qp/Qs LVOT D RVOT D LVOT VTI RVOT VTI D VTI VMax PGmax Vmean PGmean SV Qp/Qs 4 39

50 MV MV MR E A Adur PHT VTI IVRT dpdt b E E PG A A PG E:A PHT MVA Decel time VTI Vmax PGmax Vmean PGmean dp:dt AV Vmax Vmax PGmax Ao/LA VTI VTI Vmax LVOT VTI Vmax AV LVOT D VTI Vmax PGmax Vmean PGmean AVA AV VTI SV AV VTI CO Ao/LA HR LVOT D HR a LVOT Vmax Vmax PGmax AV AI VTI PHT VTI Vmax PGmax Vmean PGmean AI PHT AI TV TRmax Vmax PGmax E A PHT VTI RA c E E PG A A PG E:A PHT MVA Decel time VTI Vmax PGmax Vmean PGmean RVSP Ao/LA LVOT D 40

51 LVd LVs 1 M Calcs AoLAAAo LVOT D 1 M PV Vmax Vmax PGmax VTI AT Calcs 2 VTI Vmax PGmax Vmean PGmean AT a. (HR) 45 M M 35 b. 100 / 300 / c LV 1 Calcs 2 a b c (LV) d e Undo 37 MV AV 1 Calcs 2 Area MV AV 3 4 Undo 5 Set Calcs 2 LV Mass 3 EPI Endo a b 4 41

52 c d e Undo Set 37 4 Apical Calcs 2 MVTVTDI P. Vein 3 a b c (VTI) VTI 38 1 Calcs 2 MVAVTVPV LVOT VTI 3 4 Undo 5 Set (RVSP) 1 Calcs 2 TV TRmax RA 50 RA 5 RVSP MVAI TV (PHT) 1 Calcs 2 MVAV TV PHT 3 SELECT 4 MV EF AV

53 (PISA) PISA 1 Ann D a Calcs b PISA Ann D c 33 d 37 2 a Calcs b Radius c d 3 Calcs 4 MR VTI MV VTI a PISA MR VTI MV VTI b c Undo d Set e 36 (IVRT) 1 Calcs 2 MV IVRT (dp:dt) (dp:dt)cw Doppler 300 / 23 1 CW Doppler Calcs 2 MV dp:dt 100 / / 300 / /

54 (AVA) AVA 1 LVOT a Calcs b c Ao/LA LVOT D 33 d 37 2 LVOT AV Vmax 42 AV Vmax VTI (VTI) 42 AV VTI Qp/Qs Qp/Qs 1 Calcs 2 LVOT D RVOT D a b Qp/Qs LVOT D RVOT D 33 c 37 3 Calcs 4 LVOT VTI RVOT VTI a b c d e Qp/Qs LVOT VTI RVOT VTI Undo Set (SV) (SI) SV SI SI Body Surface Area 1 SI Height Weight BSA 28 2 LVOT a Calcs b LVOT D c 33 d 37 3 (VTI) 42 AV VTI 36 44

55 (HR) 1 Calcs 2 HR (CO) (CI) CO CI Stroke Volume Heart Rate CI Body Surface Area 1 CI Height Weight BSA 28 2 SV (SV) (SI) 44 3 HR (HR) 45 1L/min 1 LVOT a Calcs b CO LVOT D c 33 d 37 2 Live Trace a b Sweep Speed Slow Med c Trace Above Below 4 45

56 d e Set (TDI) 1 TDI PW Doppler 22 2 Calcs 3 TDI a b c EMED (S-FAST) EMED EMED EMED (S-FAST) 50 EMED 24 EMED 1 Calcs (Gyn) (Gyn) Uterus Ovary Follicle Volume (Gyn) Exam Type Gyn SSeries S-FAST S-GYN S-Women s Health 1 Calcs 2 Gyn 3 a b 33 c 37 46

57 10 1 Calcs 2 Follicle 3 a b c Right Fol Left Fol EFW EDD EFW Exam Type OB SSeries S-FAST S-GYN S-Women s Health OB OB a YS GS Hansmann, Nyberg, Tokyo U. OB 47 CRL BPD OFD HC Hadlock, Hansmann, Osaka, Tokyo U. Chitty, Hadlock, Hansmann, Osaka, Tokyo U. Hansmann Chitty, Hadlock, Hansmann 28 TTD APTD AC FTA Hansmann, Tokyo U. b Tokyo U. b Hadlock, Hansmann, Tokyo U. Osaka FL Chitty, Hadlock, Hansmann, Osaka, Tokyo U. 4 47

58 HL TCD CM Lat V CxLen Jeanty Jeanty HC, AC, FL Hadlock 1 (EFW) c 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 (Amniotic Fluid Index) FL/AC FL/BPD FL/HC Q 1, Q 2, Q 3, Q 4 Hadlock Hohler Hadlock Jeng a. AUA b. Tokyo U.APTD TTD EFW c. Estimated Fetal Weight EFW 16 Hadlock 12 3 EFW AFICxLenYS 1 LMP Estab.DD 2 Calcs 3 a b 33 c 37 M 1 M Calcs 2 FHR

59 28 S-FAST EMED EMED (S-FAST) 50 (#) 133 Bre Gyn SSeries S-Cath S-GYN S-Women s Health S-FAST S-GYN S-Women s Health D 1 D 2 D 3 a Calcs b i Volume Volume Gyn Volume ii 33 iii 37 1 Options Report Patient Report 2 x/x Done Delete 4 49

60 1 Details 2 Delete RA Summary RA RA 5 RVSP EMED (S-FAST) MSK (S-MSK) MSK MSK MSK 1 Options Report 2 Worksheet x/x Comments 3 Save EMED EMED EMED 1 Options Report 2 Worksheet x/x 50 EMED (S-FAST)

61 5 SonoSite SonoSite vii 10 LCD CPD C: SonoSite SonoSite SonoSite Color OB OB MSK EMED MSK EMED MSK EMED SonoSite SonoSite Connectivity 15 DVD DVD DVD SonoSite SonoSite SonoSite vii 16 System Software ARM version ARM PCBA serial number PCBA Transducer Software (REF) C60x 5 51

62 1 2 Enter license number 3 Done SonoSite SonoSite vii 53 SonoSite SonoSite vii 1 55 (Association for Professionals in Infection Control and Epidemiology, APIC) (U.S. Food and Drug Administration, FDA) 21 CFR SonoSite 52

63 LCD LCD

64 SonoSite SonoSite USB Sani-Cloth HBSani-Cloth Wipes 70% 4 USB 1 USB 2 Sani-Cloth Wipes 54

65 1 EPA FDA 510(k) CE EPA TEEx TEEx 1 C60x ICTx L38x P10x P21x SLAx HFL38x HFL50x C11x L25x L38xi AbcoCide 14 Accel Plus 5 55 Accel TB Accel Wipes Aidal Plus Airkem A-33 Alkacide Alkazyme Anioxy-Twin

66 56 1 C60x ICTx L38x P10x P21x SLAx HFL38x HFL50x C11x L25x L38xi Anioxyde 1000 Aquatabs (1000) Aquatabs (2000) Aquatabs (5000) Ascend Asepti-HB Asepti-Steryl Asepti-Wipes Bacillocid rasant / Bacoban Ethanol Isopropanol Bacoban WB Benzalkonium chloride Diethylenglycol Banicide Cavicide Caviwipes Chlor-Clean Cidalkan Alkylamine, isopropanol Cidalkan Lingettes

67 1 C60x ICTx L38x P10x P21x SLAx HFL38x HFL50x C11x L25x L38xi Cidex Cidex OPA Cidex Plus Cleanisept Clorox Wipes Control III Coverage Spray DentaSept DisCide Wipes DisOPA 5 57 Dispatch (NaCl Hypochlorite) Dynacide PA Echo Clean Lingettes End-Bac II Endosporine Endozime AW Plus Envirocide

68 58 1 C60x ICTx L38x P10x P21x SLAx HFL38x HFL50x C11x L25x L38xi Enzol Expose Gigasept AF Gigasept FF Bersteinsaure Gluteraldehyde SDS Hexanios / Hi Tor Plus Hibiclens (Chlorhexidine) Kodan Tücher Kohrsolin ff Korsolex basic Korsolex extra / Lem-O-Quat / LpHse Lysol Lysol IC Madacide 1 Matar

69 1 C60x ICTx L38x P10x P21x SLAx HFL38x HFL50x C11x L25x L38xi MetriCide 14 MetriCide 28 MetriCide OPA Plus MetriZyme Mikrobak forte Mikrozid Wipes / Nuclean / (Biguanide) Precise Prevention Rely+On PeraSafe Ruthless 5 59 Sagrosept Wipe Salvanios ph 7 Sani-Cloth HB Sani-Cloth Plus Sekusept Sklar Sporicidin

70 60 1 C60x ICTx L38x P10x P21x SLAx HFL38x HFL50x C11x L25x L38xi Sporicidin Wipes Staphene Steranios Steranios 20% Super Sani-Cloth T-Spray T-Spray II / TASK 105 TBQ Tor Transeptic Tristel Tristel Duo Tristel Solo Hexamethylenebiguanide Tristel Wipes Vesphene II /- Virex II 256 Virex TB

71 1 C60x ICTx L38x P10x P21x SLAx HFL38x HFL50x C11x L25x L38xi Virox 5 Virufen Wavicide -06 Wavicide-01 Wex-Cide 3A (100%) 3A DNK Guanidinium-chloride (3%) 5 61 (NaCl Hypochlorite) = = =

72 62

73 6 ALARA a,b,c (MSD) MSD MSD MSD MSD d MSD e,f a. Magnavita, N., L. Bevilacqua, P. Mirk, A. Fileni, and N. Castellino. Work-related Musculoskeletal Complaints in Sonologists. Occupational Environmental Medicine. 41:11 (1999), b. Craig, M. Sonography:An Occupational Hazard? Journal of Diagnostic Medical Sonography. 3 (1985), c. Smith, C.S., G.W. Wolf, G. Y. Xie, and M. D. Smith. Musculoskeletal Pain in Cardiac Ultrasonographers: Results of a Random Survey. Journal of American Society of Echocardiography. (May1997), d. Wihlidal, L.M. and S. Kumar. An Injury Profile of Practicing Diagnostic Medical Sonographers in Alberta. International Journal of Industrial Ergonomics. 19 (1997), e. Habes, D.J. and S. Baron. Health Hazard Report University of Medicine and Dentistry of New Jersey. (1999). f. Vanderpool, H.E., E.A. Friis, B.S. Smith, and K.L. Harms. Prevalence of Carpal Tunnel Syndrome and Other Work-related Musculoskeletal Problems in Cardiac Sonographers. Journal of Medicine. 35:6 (1993),

74 64

75 MSD MSD Class I I Type BF BF IPX-7 AP/APG Class I I I (Ground bond testing) I (Ground bond testing) S Series V-Universal 6 65

76 EN Class I I / Type BF BF Canadian Standards Association (CSA)European Norm Harmonized Standards Underwriters Laboratories (UL) safety standards (UL) 8 EN Hospital OnlyHospital Grade / (MPSO) S Series V-Universal 66

77 5 SonoSite SonoSite SonoSite SonoSite SonoSite I SSeries V-Universal / SonoSite JACHO / AAMI-ES1 NFPA 99 OR IEC IEC IEC SonoSite 6 67

78 5 / 0 40 C 60 C

79 SonoSite 20 C 60 C SonoSite SonoSite SonoSite SonoSite 21 CFR ALARA MI TI SonoSite 0.3 db/cm/mhz SonoSite 6 69

80 IEC :2001 (EMC) EMC (RF) (EMI) EMI EMI EMI EMI EMI EMI EMI IEC EMC SonoSite SonoSite SonoSite SonoSite SonoSite SonoSite (ESD) ESD ESD 70

81 1 2 EMC 1 - RF ClSPR 11 RF ClSPR 11 IEC / IEC Group 1 1 Class A A Class A A SonoSite RF RF SonoSite 2 - IEC (ESD) IEC KV4.0KV6.0KV 2.0KV4.0KV8.0KV 2.0KV4.0KV 6.0KV 2.0KV4.0KV 8.0KV 30% IEC KV 1KV 2KV 1KV IEC KV1.0KV2.0KV 0.5KV1.0KV 0.5KV1.0KV 2.0KV 0.5KV1.0KV 6 71

82 2 - IEC IEC >5% U T >95% U T % U T 60% U T 5 70% U T 30% U T 25 >5% U T >95% U T 5 >5% U T >95% U T % U T 60% U T 5 70% U T 30% U T 25 >5% U T >95% U T 5 SonoSite SonoSite IEC RF IEC / 3 / SonoSite 3Vrms 150 khz 80 MHz 3Vrms SonoSite RF RF IEC Vim 80 MHz 2.5 GHz d = 1.2 P 3 / d = 1.2 P 80 MHz 800 MHz d = 2.3 P 800 MHz 2.5 GHz P (W) d (m) 72

83 2 - IEC RF IEC RF a b IEC No. 417-IEC-5140 Source of non-ionizing radiation U T a. /AM FM RF SonoSite RF SonoSite SonoSite b. 150 khz 80 MHz 3V/m FCC FCC

84 ALARA ALARA ALARA ALARA ALARA 2D CPD Color THI ALARA EN (ISPTA)720 mw/cm 2 ISPTA 50 /TI 1.0 MI 0.23 (MI) (TI) 1.0 MI TI MI TI 76 ALARA MI TI MI TI BS EN :2001Annex HH HH 74

85 PRF Kremkau, Frederick W. Diagnostic Ultrasound: Principles and Instruments. 7th ed., W.B. Saunders Company, (Oct. 17, 2005). 6 75

86 MI TI MI TI MI TI MI TI MI TI 3MI Transducer C11x C60x HFL38x HFL50x ICTx L25x L38x L38xi P10x P21x SLAx TEEx Depth MI MI 76

87 4 Transducer Box Width Box Height CPD Box Depth PRF Depth Optimize PW C11x C60x HFL38x HFL50x ICTx Exam Gyn L25x L38x L38xi P10x P21x SLAx TEEx TI TI 6 77

88 MI TI AIUM 5 TI MI 1.0 5TI MI 1.0 2D MMode M CPD / Color PW Doppler CW Doppler C11x/8-5 MI TICTIB TIS C60x/5-2 MI TICTIB TIS HFL38x/13-6 MI TICTIB TIS HFL50x/15-6 MI TICTIB TIS ICTx/8-5 MI TICTIB TIS L25x/13-6 MI TICTIB TIS L38x/10-5 MI TICTIB TIS L38xi/10-5 MI TICTIB TIS P10x/8-4 MI TICTIB TIS P21x/5-1 MI TICTIB TIS 78

89 5TI MI 1.0 2D MMode M CPD / Color PW Doppler CW Doppler SLAx/13-6 MI MI MI TI 0.1 TI ALARA TISonoSite AIUM TI 80 TICTIB TIS TEEx/8-3 MI TICTIB TIS 95%95% MI MI +18% -25% %95% TI TI +21% -40% dB 3dB MI TI

90 115 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, Standard for Real-Time Display of Thermal and Mechanical Acoustic Output Indices on Diagnostic Ultrasound Equipment, NEMA UD Guidance on the interpretation of TI and MI to be used to inform the operator, Annex HH, BS EN reprinted at P

91 6 (23 C ± 3 C) EN ( C) ( C) C11x C60x HFL38x HFL50x L25x L38x L38xi P10x P21x ICTx SLAx TEEx (bioeffects) (AIUM) (Bioeffects Considerations for the Safety of Diagnostic Ultrasound, J Ultrasound Med., Sept. 1988: Vol. 7, No. 9 Supplement) Stowe (Bioeffects and Safety of Diagnostic Ultrasound) Acoustic Output Measurement Standard for Diagnostic Ultrasound Equipment (NEMA UD2-2004) Standard for Real-Time Display of Thermal and Mechanical Acoustic Output Indices on Diagnostic Ultrasound Equipment (NEMA UDe3-2004) = [e -(0.23alf) ] = = e = a = (db/cm MHz) 6 81

92 = 0.53 = 0.66 = 0.79 = 0.43 = 0.55 l = cm f = // MHz 0.3 = [e -(0.069lf ) ] 0.3 db/cm MHz 3cm 1dB/cmMHz 82

93 1990 MI MI 2.0 2D MModeM MI C F 1.5 C (2.7 F) 7 C (12.6 F) I SPTA 500 / Bioeffects and Safety of Diagnostic Ultrasound (AIUM, 1993)

94 7C11x CPD/Color / MI TIC A aprt 1 A aprt >1 (a) (a) 1.0 p r.3 (MPa) # W 0 (mw) # 38.8 [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) z bp (cm) z sp (cm) # d eq (z sp ) (cm) f c (MHz) # # 4.37 A aprt X (cm) # 1.12 Y (cm) # 0.50 PD (μsec) # PRF (Hz) # p max (MPa) # d max (cm) FL x (cm) # 4.29 I max (W/cm 2 ) # (a) <1 (b) # / TIS TIB FL y (cm) # PRF / /5.1 5/ / 84

95 8C11x PW Doppler MI TIC A aprt 1 A aprt >1 (a) p r.3 (MPa) # W 0 (mw) [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) z bp (cm) z sp (cm) # 1.06 d eq (z sp ) (cm) 0.24 f c (MHz) # A aprt X (cm) Y (cm) PD (μsec) # PRF (Hz) # p max (MPa) # d max (cm) 0.23 FL x (cm) I max (W/cm 2 ) # TIS TIB FL y (cm) PRF (a) <1 (b) # / 6 85

96 9C60x 2D MI TIC A aprt 1 A aprt >1 1.0 (a) (b) p r.3 (MPa) 1.69 W 0 (mw) # # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) z bp (cm) z sp (cm) 4.7 d eq (z sp ) (cm) f c (MHz) 2.84 # # A aprt X (cm) # # Y (cm) # # PD (μsec) PRF (Hz) 5440 p max (MPa) d max (cm) FL x (cm) # # FL y (cm) # # I max (W/cm 2 ) / /13 4 5MB (Multi Beam) (a) <1 (b) # / TIS TIB 86

97 10C60x TIS M MI TIC A aprt 1 A aprt >1 1.0 (a) (a) (b) p r.3 (MPa) 1.62 W 0 (mw) # # # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) z bp (cm) z sp (cm) 4.7 # d eq (z sp ) (cm) # f c (MHz) 2.85 # # # A aprt X (cm) # # # Y (cm) # # # PD (μsec) PRF (Hz) 800 p max (MPa) d max (cm) # FL x (cm) # # I max (W/cm 2 ) Pen MB (Multi Beam) TIB FL y (cm) # # (a) <1 (b) # / 6 87

98 11C60x PW Doppler MI TIC A aprt 1 A aprt >1 (a) (a) 3.1 (b) p r.3 (MPa) # W 0 (mw) # # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) z bp (cm) z sp (cm) # d eq (z sp ) (cm) 0.51 f c (MHz) # # # A aprt X (cm) # # Y (cm) # 1.3 # PD (μsec) # PRF (Hz) # p max (MPa) # d max (cm) FL x (cm) # # I max (W/cm 2 ) # 1 2PRF 3 4 (a) <1 (b) # / TIS TIB FL y (cm) # #

99 12HFL38x CPD/Color / MI TIC A aprt 1 A aprt >1 1.1 (a) (b) p r.3 (MPa) W 0 (mw) # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) z bp (cm) z sp (cm) 1.2 d eq (z sp ) (cm) f c (MHz) # A aprt X (cm) # Y (cm) # PD (μsec) PRF (Hz) 2597 p max (MPa) d max (cm) FL x (cm) # I max (W/cm 2 ) //PRF /3.3 /393 4/ TIS TIB FL y (cm) # (a) <1 (b) # / 6 89

100 13HFL38x PW Doppler MI TIC A aprt 1 A aprt > (b) p r.3 (MPa) 2.37 W 0 (mw) # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) z bp (cm) z sp (cm) d eq (z sp ) (cm) 0.33 f c (MHz) # A aprt X (cm) # Y (cm) # PD (μsec) 1.29 PRF (Hz) 1008 p max (MPa) d max (cm) 0.46 FL x (cm) 3.72 # I max (W/cm 2 ) (a) <1 (b) # / TIS TIB FL y (cm) 2.5 # / / // // PRF

101 14HFL50x TIS 2D MI TIC A aprt 1 A aprt >1 1.2 (a) (b) p r.3 (MPa) 3.14 W 0 (mw) # # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) z bp (cm) z sp (cm) 1.4 d eq (z sp ) (cm) f c (MHz) 6.75 # # A aprt X (cm) # # Y (cm) # # PD (μsec) PRF (Hz) 7653 p max (MPa) 4.35 d max (cm) FL x (cm) # # I max (W/cm 2 ) Pen MB TIB FL y (cm) # # (a) <1 (b) # / 6 91

102 15HFL50x M MI TIC A aprt 1 A aprt >1 1.2 (a) (a) (b) p r.3 (MPa) 3.14 W 0 (mw) # # # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) z bp (cm) z sp (cm) 1.4 # d eq (z sp ) (cm) # f c (MHz) 6.75 # # # A aprt X (cm) # # # Y (cm) # # # PD (μsec) PRF (Hz) 1600 p max (MPa) 4.35 d max (cm) # FL x (cm) # # I max (W/cm 2 ) Pen (a) <1 (b) # / TIS TIB FL y (cm) # # 92

103 16HFL50x CPD/Color / MI TIC A aprt 1 A aprt >1 1.3 (a) (b) p r.3 (MPa) 3.05 W 0 (mw) # # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) z bp (cm) z sp (cm) 1.2 d eq (z sp ) (cm) f c (MHz) 5.36 # # A aprt X (cm) # # Y (cm) # # PD (μsec) PRF (Hz) 8233 p max (MPa) 3.81 d max (cm) FL x (cm) # # I max (W/cm 2 ) / /3.3 4PRF TIS TIB FL y (cm) # # (a) <1 (b) # / 6 93

104 17HFL50x PW Doppler MI TIC A aprt 1 A aprt > (b) p r.3 (MPa) 2.69 W 0 (mw) # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) z bp (cm) z sp (cm) d eq (z sp ) (cm) 0.33 f c (MHz) # A aprt X (cm) # Y (cm) # PD (μsec) 1.29 PRF (Hz) 1008 p max (MPa) 3.23 d max (cm) 0.22 FL x (cm) 3.72 # I max (W/cm 2 ) 308 (a) <1 (b) # / TIS TIB FL y (cm) 2.44 # PRF

105 18ICTx PW Doppler MI TIC A aprt 1 A aprt >1 (a) (a) 1.2 (a) p r.3 (MPa) # W 0 (mw) # # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) z bp (cm) z sp (cm) # 1.6 d eq (z sp ) (cm) f c (MHz) # # 4.36 # A aprt X (cm) # 0.6 # Y (cm) # 0.5 # PD (μsec) # PRF (Hz) # p max (MPa) # d max (cm) FL x (cm) # # I max (W/cm 2 ) # 1 2 3PRF 4 TIS TIB FL y (cm) # # 3 1 (a) <1 (b) # / 6 95

106 19L25x PW Doppler MI TIC A aprt 1 A aprt >1 (a) (a) 1.4 (b) p r.3 (MPa) # W 0 (mw) # 28.3 # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) z bp (cm) z sp (cm) # 0.8 d eq (z sp ) (cm) 0.31 f c (MHz) # # 6.00 # A aprt X (cm) # 0.76 # Y (cm) # 0.30 # PD (μsec) # PRF (Hz) # p max (MPa) # d max (cm) 0.23 FL x (cm) # # I max (W/cm 2 ) # (a) <1 (b) # / TIS TIB FL y (cm) # # 1 / / 2 6 3PRF

107 20L38x CPD/Color / MI TIC A aprt 1 A aprt > (b) p r.3 (MPa) 2.89 W 0 (mw) 66.6 # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) z bp (cm) z sp (cm) 1.1 d eq (z sp ) (cm) f c (MHz) # A aprt X (cm) 0.54 # Y (cm) 0.4 # PD (μsec) PRF (Hz) 9547 p max (MPa) 3.48 d max (cm) FL x (cm) 1.5 # I max (W/cm 2 ) TIS TIB FL y (cm) 2.5 # 1 2 Bre 3PRF / /3.1 /3.1 5/ Def/Def/ Def (a) <1 (b) # / 6 97

108 21L38x PW Doppler MI TIC A aprt 1 A aprt > (b) p r.3 (MPa) W 0 (mw) # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) z bp (cm) z sp (cm) d eq (z sp ) (cm) f c (MHz) # A aprt X (cm) # Y (cm) # PD (μsec) 1.29 PRF (Hz) 1008 p max (MPa) d max (cm) FL x (cm) 5.54 # (a) <1 (b) # / TIS TIB FL y (cm) 2.5 # I max (W/cm 2 ) Vas Vas PRF

109 22L38xi/10-5 TIS 2D MI TIC A aprt 1 A aprt >1 1.5 (a) (b) p r.3 (MPa) 3.54 W 0 (mw) # # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) z bp (cm) z sp (cm) 1.0 d eq (z sp ) (cm) f c (MHz) 5.76 # # A aprt X (cm) # # Y (cm) # # PD (μsec) PRF (Hz) 7551 p max (MPa) 4.32 d max (cm) FL x (cm) # # I max (W/cm 2 ) / MB / TIB FL y (cm) # # (a) <1 (b) # / 6 99

110 23L38xi/10-5 M MI TIC A aprt 1 A aprt >1 1.5 (a) 1.1 (b) p r.3 (MPa) 3.54 W 0 (mw) # 37.1 # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) z bp (cm) z sp (cm) d eq (z sp ) (cm) 0.49 f c (MHz) 5.76 # 5.20 # A aprt X (cm) # 1.86 # Y (cm) # 0.40 # PD (μsec) PRF (Hz) 1600 p max (MPa) 4.32 d max (cm) 0.49 FL x (cm) # # (a) <1 (b) # / TIS TIB FL y (cm) # # I max (W/cm 2 ) Pen

111 24L38xi/10-5 CPD/Color / MI TIC A aprt 1 A aprt > (b) p r.3 (MPa) 3.30 W 0 (mw) 47.5 # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) z bp (cm) z sp (cm) 0.8 d eq (z sp ) (cm) f c (MHz) # A aprt X (cm) 0.66 # Y (cm) 0.40 # PD (μsec) PRF (Hz) 2885 p max (MPa) 3.79 d max (cm) FL x (cm) 1.86 # I max (W/cm 2 ) CVD/CPD CVD 2 Bre 3/ TIS TIB FL y (cm) 1.50 # / / 3.8 4/ / / / / / (a) <1 (b) # / 6 101

112 25L38xi/10-5 PW Doppler MI TIC A aprt 1 A aprt > (b) p r.3 (MPa) 2.56 W 0 (mw) # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) z bp (cm) z sp (cm) d eq (z sp ) (cm) 0.49 f c (MHz) # A aprt X (cm) # Y (cm) # PD (μsec) 1.22 PRF (Hz) 1008 p max (MPa) 2.97 d max (cm) 0.45 FL x (cm) 5.54 # I max (W/cm 2 ) 342 (a) <1 (b) # / TIS TIB FL y (cm) 1.50 # 1 Bre/Vas Bre/Vas Bre/Vas PRF

113 26P10x TIS Color MI TIC A aprt 1 A aprt >1 1.0 (a) 1.3 p r.3 (MPa) 2.02 W 0 (mw) # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) z bp (cm) z sp (cm) 2.4 d eq (z sp ) (cm) f c (MHz) 3.90 # 3.91 A aprt X (cm) # Y (cm) # 0.7 PD (μsec) 0.70 PRF (Hz) 2772 p max (MPa) 2.80 d max (cm) FL x (cm) # 2.48 I max (W/cm 2 ) TIB FL y (cm) # //PRF /3.7/ 772 /2.0/ / / / (a) <1 (b) # / 6 103

114 27P10x PW Doppler MI TIC A aprt 1 A aprt > p r.3 (MPa) 2.03 W 0 (mw) [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) z bp (cm) z sp (cm) d eq (z sp ) (cm) 0.32 f c (MHz) A aprt X (cm) Y (cm) PD (μsec) 1.28 PRF (Hz) 1563 p max (MPa) 2.70 d max (cm) 0.25 FL x (cm) I max (W/cm 2 ) 233 (a) <1 (b) # / TIS TIB FL y (cm) Crd Crd Crd PRF/TDI 1563/ / 15625/ 5208/

115 28P10x CW Doppler MI TIC A aprt 1 A aprt >1 (a) (a) p r.3 (MPa) # W 0 (mw) # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) z bp (cm) z sp (cm) # 0.7 d eq (z sp ) (cm) 0.36 f c (MHz) # # A aprt X (cm) # Y (cm) # PD (μsec) # PRF (Hz) # p max (MPa) # d max (cm) 0.27 FL x (cm) # 0.92 I max (W/cm 2 ) # TIS TIB FL y (cm) # Crd Crd (a) <1 (b) # / 6 105

116 29P21x 2D MI TIC A aprt 1 A aprt >1 1.5 (a) 2.1 p r.3 (MPa) 2.03 W 0 (mw) # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) z bp (cm) z sp (cm) 3.4 d eq (z sp ) (cm) f c (MHz) 1.83 # 1.94 A aprt X (cm) # 1.9 Y (cm) # 1.3 PD (μsec).842 PRF (Hz) 4444 p max (MPa) 2.53 d max (cm) FL x (cm) # I max (W/cm 2 ) 194 (a) <1 (b) # / TIS TIB FL y (cm) # Crd Crd 2 / Pen

117 30P21x TIS M MI TIC A aprt 1 A aprt >1 1.5 (a) p r.3 (MPa) 2.10 W 0 (mw) # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) z bp (cm) z sp (cm) d eq (z sp ) (cm) f c (MHz) 1.93 # A aprt X (cm) # Y (cm) # PD (μsec) PRF (Hz) 800 p max (MPa) d max (cm) FL x (cm) # I max (W/cm 2 ) TIB FL y (cm) # 5.5 / / / / 2 / Pen / MB (a) <1 (b) # / 6 107

118 31P21x CPD/Color / MI TIC A aprt 1 A aprt > p r.3 (MPa) 2.03 W 0 (mw) [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) z bp (cm) z sp (cm) 3.4 d eq (z sp ) (cm) f c (MHz) A aprt X (cm) Y (cm) PD (μsec) PRF (Hz) 2038 p max (MPa) 2.53 d max (cm) FL x (cm) I max (W/cm 2 ) (a) <1 (b) # / TIS TIB FL y (cm) / 2 Crd 3/ / /

119 32P21x PW Doppler MI TIC A aprt 1 A aprt > p r.3 (MPa) 1.73 W 0 (mw) [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) 3.1 z bp (cm) 2.8 z sp (cm) d eq (z sp ) (cm) 0.49 f c (MHz) A aprt X (cm) Y (cm) PD (μsec) PRF (Hz) 1562 p max (MPa) 2.50 d max (cm) 0.49 FL x (cm) I max (W/cm 2 ) 216 TIS TIB FL y (cm) Crd Crd Crd Crd PRF (a) <1 (b) # l / 6 109

120 33P21x CW Doppler MI TIC A aprt 1 A aprt >1 (a) p r.3 (MPa) # W 0 (mw) [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) 1.20 z bp (cm) 1.31 z sp (cm) # d eq (z sp ) (cm) 0.49 f c (MHz) # A aprt X (cm) Y (cm) PD (μsec) # PRF (Hz) # p max (MPa) # d max (cm) 0.45 FL x (cm) (a) <1 (b) # / TIS TIB FL y (cm) I max (W/cm 2 ) # 1 Crd Crd Crd

121 34SLAx PW Doppler MI TIC A aprt 1 A aprt >1 (a) (a) 1.1 (b) p r.3 (MPa) # W 0 (mw) # # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) z bp (cm) z sp (cm) # 1.2 d eq (z sp ) (cm) 0.15 f c (MHz) # # 6.00 # A aprt X (cm) # 0.48 # Y (cm) # 0.30 # PD (μsec) # PRF (Hz) # p max (MPa) # d max (cm) 0.15 FL x (cm) # # TIS TIB FL y (cm) # # I max (W/cm 2 ) # 1 Vas 2 5 3PRF ((a) <1 (b) # / 6 111

122 35TEEx PW Doppler MI TIC A aprt 1 A aprt >1 (a) (a) 1.7 (b) p r.3 (MPa) # W 0 (mw) # # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) z bp (cm) z sp (cm) # 0.6 d eq (z sp ) (cm) 0.34 f c (MHz) # # 3.84 # A aprt X (cm) # # Y (cm) # 0.9 # PD (μsec) # PRF (Hz) # p max (MPa) # d max (cm) 0.34 FL x (cm) # # (a) <1 (b) # / TIS TIB FL y (cm) # # I max (W/cm 2 ) # 1 Crd 2 1 3PRF

123 36TEEx CW Doppler MI TIC A aprt 1 A aprt >1 (a) (a) 1.2 (b) p r.3 (MPa) # W 0 (mw) # # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) z bp (cm) z sp (cm) # 1.1 d eq (z sp ) (cm) 0.39 f c (MHz) # # 4.00 # A aprt X (cm) # # Y (cm) # 0.9 # PD (μsec) # PRF (Hz) # p max (MPa) # d max (cm) 0.34 FL x (cm) # # I max (W/cm 2 ) # TIS TIB FL y (cm) # # Crd 3 (a) <1 (b) # / 6 113

124 37 I SPTA.3 TI TI MI I TIS TIB TIC A aprt P r.3 Wo W.3 (z 1 ) I SPTA.3 (z 1 ) milliwatts/cm 2 MI W/cm 2 TIS TIS TIB cm 2 MI TIS z 1 z 1 /cm z 1 [min(w.3 (z), I TA.3 (z) x 1 cm 2 )] z >zbp cm z bp 1.69 cm z sp d eq (z) fc ( A aprt) p r.3 z sp = z b.3 z ( 4 ( π) )(( Wo) ( ITA( z) )) I TA (z) z cm MHz A aprt PD (x) (y) MI 114

125 37 PRF MI Hz p max d max FL cm (x) (y) cm Output Display Standard % 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% % 6 115

126 39 (AC) 1 93/42/EEC VII 1 IIa IIb III 93/42/EEC LOT C US CSA ANSI/UL REF 93/86/EEC STERILE EO 116

127 39 (DC) FCC GEL STERILE R 6 117

128 39 SN BF B = F = (UL) RoHS / / CCC Mark 118

129 39 LCD WARNING: Connect Only Accessories and Peripherals Recommended by SonoSite SonoSite 6 119

130 120

131 D a < ±2% 1% < ±2% 1% < ±2% 1% b (cm) c < ±4% + 2%/ * % < ±3% + 1.4%/ * % a. b. 0.7 db/cm MHz RMI 413a c. % = ((1 + ) * (1 + ) 1) * % d. % = ( 2 (2 ) * 100) + 0.5% 7 121

132 AIUM Acceleration (ACC) in cm/s 2 Zwiebel, W.J. Introduction to Vascular Ultrasonography. 4th ed., W.B. Saunders Company, (2000), 52. ACC = abs Δ/Δ (AT) msec Oh, J.K., J.B. Seward, A.J. Tajik. The Echo Manual. 2nd ed., Lippincott, Williams, and Wilkins, (1999), 219. Aortic Valve Area (AVA) by Continuity Equation in cm 2 Reynolds, Terry. The Echocardiographers Pocket Reference. 2nd ed., School of Cardiac Ultrasound, Arizona Heart Institute, (2000), 393, 442. A 2 = A 1 * V 1 /V 2 A 2 = Ao A 1 = LVOT V 1 = LVOT V 2 = Ao LVOT = AVA (PV LVOT /PV AO ) * CSA LVOT (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 Echocardiographers Pocket Reference. 2nd ed., School of Cardiac Ultrasound, Arizona Heart Institute, (2000), 383. CSA = * D 2 D = msec Reynolds, Terry. The Echocardiographers Pocket Reference. 2nd ed., School of Cardiac Ultrasound, Arizona Heart Institute, (2000), 453. a - b AVA (VTI LVOT /VTI AO ) * CSA LVOT 122

133 (dp:dt) mmhg/s Otto, C.M. Textbook of Clinical Echocardiography. 2nd ed., W.B. Saunders Company, (2000), 117, / E:A cm/sec E:A = E/ A E/Ea Reynolds, Terry. The Echocardiographers Pocket Reference. 2nd ed., School of Cardiac Ultrasound, Arizona Heart Institute, (2000), 225. (IVS) Laurenceau, J. L., M.C. Malergue. The Essentials of Echocardiography. Le Hague:Martinus Nijhoff, (1981), 71. IVSFT = ((IVSS IVSD)/IVSD) * 100% IVSS = IVSD = (IVRT) msec Reynolds, Terry. The Echocardiographers Pocket Reference. School of Cardiac Ultrasound, Arizona Heart Institute, (1993), 146. a - b E /Ea E = E Ea = E E (ERO) mm 2 Reynolds, Terry. The Echocardiographers Pocket Reference. 2nd ed., School of Cardiac Ultrasound, Arizona Heart Institute, (2000), 455. ERO = 6.28 (r 2 ) * Va/MR Vel r = Va = (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 = (ET) msec ET = msec (HR) bpm HR = M 3 / (LA/Ao) Feigenbaum, H. Echocardiography. Philadelphia: Lea and Febiger, (1994), 206, Figure (Teichholz) ml 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 * LVDD 3 )/(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 LVID 3 ] * LVID = PWT = IVST = 1.04 = 0.8 = 7 123

134 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 = V = a = b = n = (n=20) L = L = 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 V = a = n = (n=20) L = L = (LVD) Oh, J.K., J.B. Seward, A.J. Tajik. The Echo Manual. Boston: Little, Brown and Company, (1994), LVDFS = ((LVDD LVDS)/LVDD) * 100% n π -- 4 L a i b -- i n i = 1 n i = 1 2 a -- L i n 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 = (Vmean) cm/s Vmean = (MVA) cm 2 Reynolds, Terry. The Echocardiographers Pocket Reference. 2nd ed., School of Cardiac Ultrasound, Arizona Heart Institute, (2000), 391, 452. MVA = 220/PHT PHT = 220 MV cc/sec Reynolds, Terry. The Echocardiographers Pocket Reference. 2nd ed., School of Cardiac Ultrasound, Arizona Heart Institute, (2000), 396. = 6.28 (r 2 ) * Va r = Va = (PGr) mmhg Oh, J.K., J.B. Seward, A.J. Tajik. The Echo Manual. 2nd ed., Lippincott, Williams, and Wilkins, (1999), 64. PGr = 4 * () 2 E (E PG) EPG = 4 * PE 2 A (A PG) APG = 4 * PA 2 (PGmax) 124

135 PGmax = 4 * PV 2 (PGmean) PGmean = / (PHT) msec Reynolds, Terry. The Echocardiographers Pocket Reference. 2nd ed., School of Cardiac Ultrasound, Arizona Heart Institute, (2000), 391. (RVSP) mmhg Reynolds, Terry. The Echocardiographers Pocket Reference. School of Cardiac Ultrasound, Arizona Heart Institute, (1993), 152. RVSP = 4 * (Vmax TR) 2 + RAP S/D RAP = PHT = DT * 0.29 DT = (PISA) cm 2 Oh, J.K., J.B. Seward, A.J. Tajik. The Echo Manual. 2nd ed., Boston: Little, Brown and Company, (1999), 125. PISA = 2π r 2 2 π = 6.28 r = Reynolds, Terry. The Echocardiographers Pocket Reference. 2nd ed., School of Cardiac Ultrasound, Arizona Heart Institute, (2000), 217. S /D S = S D = D (SI) cc/m 2 Mosbys Medical, Nursing, & Allied Health Dictionary, 4th ed., (1994), Qp/Qs Reynolds, Terry. The Echocardiographers Pocket Reference. 2nd ed., School of Cardiac Ultrasound, Arizona Heart Institute, (2000), 400. Qp/Qs = SV Qp /SV Qs SV (RF) Oh, J.K., J.B. Seward, A.J. Tajik. The Echo Manual. Boston: Little, Brown and Company, (1999), 125. RF = RV/ MV SV RV = MV SV = (RV) cc Reynolds, Terry. The Echocardiographers Pocket Reference. School of Cardiac Ultrasound, Arizona Heart Institute, (2000), 396, 455. RV = ERO * MR VTI SI = SV/BSA SV = BSA = (SV) ml Oh, J.K., J.B. Seward, A.J. Tajik. The Echo Manual. 2nd ed., Lippincott, Williams, and Wilkins, (1999), 40, 59, 62. SV = (CSA * VTI) (TVA) CSA = LVOT VTI = Reynolds, Terry. The Echocardiographers Pocket Reference. 2nd ed., School of Cardiac Ultrasound, Arizona Heart Institute, (2000), 55, 391, 452. TVA = 220 / PHT 7 125

136 M (SV) 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 = (VTI) cm Reynolds, Terry. The Echocardiographers Pocket Reference. 2nd ed., School of Cardiac Ultrasound, Arizona Heart Institute, (2000), 383. VTI = abs ( [n]) cm (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, A Prospective 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, (1985), 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) (GA) LMP GA(LMP) = LMP (Estab. DD) (LMPd) (GA) (Estab. DD) (GA) LMP GA(LMPd) = LMPd (Estab. DD) (LMPd) // LMPd(Estab. DD) = Estab. DD

137 (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, (1985), 431. University of Tokyo, Shinozuka, N. FJSUM, et al. Standard Values of Ultrasonographic Fetal Biometry. Japanese Journal of Medical Ultrasonics, 23:12 (1996), 885. (APTD) University of Tokyo, Shinozuka, N. FJSUM, et al. Standard Values of Ultrasonographic Fetal Biometry. Japanese Journal of Medical Ultrasonics, 23:12 (1996), 885. (BPD) SonoSite (AC) AC AC 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, (1985), 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. (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, (1985), 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, (1985), 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),

138 (GS) Hansmann, M., et al. Ultrasound Diagnosis in Obstetrics and Gynecology. New York: Springer-Verlag, (1985). 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). (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, (1985), 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, (1985), 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, (1985), 431. University of Tokyo, Shinozuka, N. FJSUM, et al. Standard Values of Ultrasonographic Fetal Biometry. Japanese Journal of Medical Ultrasonics, 23:12 (1996), 885. 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), (Vol) Beyer, W.H. Standard Mathematical Tables, 28th ed., CRC Press, Boca Raton, FL, (1987),

139 8 C11x/ C60x/ HFL38x/ HFL50x/15-6 MHz 1.7 ICTx/ L25x/ L38x/ L38xi/10-5 MHz 1.7 P10x/8-4 MHz 1.8 P21x/ SLAx/13-6 MHz 1.8 Education keys SiteLink Image Manager 3.1 Sono TEEx/8-3 MHz 2.2 2D 256 CPD 256 Color 256 MModeM PW CW (Tissue Doppler Imaging, TDI) Tissue Harmonic Imaging (THI) EN USB Sony DVD 8 129