SSeries_1.3_UG_CHS_P book

Transcription

1 SSeries

2

3 S Series S-Nerve, S-FAST, S-ICU, S-MSK, S-Cath, S-GYN, S-Women s Health C11x, C60x, HFL38x, HFL50x, ICTx, L25x, L38xi, P10x, P21x, SLAx YZB/USA

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 SSeries S-Cath S-FAST S-GYN S-ICU S-MSK S-Nerve S-Women s Health SiteLink SonoHD SonoMB SonoSite V-Universal SonoSite SonoSite, Inc. DICOM National Electrical Manufacturers Association SonoSite D456509D D509900D538432D544962D558351D559390D591423D592750D AU AU CA 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 KR KR NO NO NZ RCD SP SP SP P / SonoSite, Inc. ii

5 ...vii...vii USB Audio, Battery Connectivity Display Information...15 Network Status...15 OB Calculations...15 iii

6 Presets...16 System Information...16 USB Devices USB...16 JPEG D...19 MMode...20 CPD Color...20 PW CW Doppler D...32 M-Mode EMED (S-FAST)...44 (Gyn)...44 OB EMED (S-FAST)...48 MSK (S-MSK)...48 iv

7 USB ALARA...72 ALARA MI TI 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 49 SonoSite USB USB Patient 4 Mode 2D USB

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

13 1 2 3 SonoSite Audio, Battery 2 240V

14 S Series V-Universal USB USB PC USB PC USB USB USB USB USB hub USB USB 2 USB USB USB USB 4

15 USB USB USB USB USB 2 1 USB USB 16 USB Devices USB USB USB 1 USB 5 2 USB

16 Gen THI MB ID / 8 USB cm 1cm 5cm 16 Presets

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

18 SonoSite Aquasonic TEEx TEEx 21 CFR SonoSite SonoSite SonoSite SonoSite 51 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 Training Type Select Image Gallery 8

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

20 10

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

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

23 4 USB Import 5 Restart 1 2 User Login OK USB PC 1 Administrator 2 Log Back log.txt USB log.txt 1 USB 2 Log Export USB 1 2 User Login Guest 1 2 User Login Password 3 OK (A-Z) (a-z) (0-9) 3 USB Export Microsoft Word 1 2 Clear 3 Yes User Login 12 Annotations Annotations Exam 2 Group A B C 2 13

24 3 <New> Text Add Text Rename Delete 7 Annotations Unfreeze Keep All Text Keep Home Text Clear All Text Keep All Text 26 1 USB 2 Annotations Export USB 3 USB Export USB 1 USB 2 Annotations Import 3 USB Import 4 OK USB Audio, Battery Audio, Battery Key click On Off Beep alert On Off Sleep delay Off 5 10 Power delay Off Cardiac Calculations (TDI) 36 Cardiac Calculations TDI Walls TDI 14 Audio, Battery

25 Connectivity 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) Connectivity Internal Storage Capacity Alert Date and Time Date 7 Time 24 Display Information Display Information Patient Header 27 Mode Data System Status Network Status Network Status IP MAC OB Calculations OB Calculations 45 OB 2 15

26 OB Calculations Gestational Age None Presets Presets Depth Markers Type 1 1 Type 2 2 Thermal Index TIS TIB TICOB TIB TIS Clip Length Units in/ft/lbs cm/m/kg Language Display Brightness Scheme 1 1 Scheme 2 2 Auto save Pat. Form Save Key Save Image Only Image/Calcs / Doppler Scale cm/s khz Duplex M Mode Doppler 1/3 2D 2/3 Trace1/2 2D 1/2 Trace Full 2D Full Trace Live Trace Peak Mean System Information System Information 50 System Information Patents USB Devices USB USB Devices USB USB USB H.264 MP4 SonoSite QuickTime USB Devices USB Export 2 SiteLink JPEG JPEG 3 Sort By Devices DICOM SonoSite USB Devices Include private tags SonoSite DICOM 16 Presets

27 JPEG JPEG 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 Devices USB

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

30 Dual Brightness MMode (M Mode) 2D 2D M-line 1 Mode MMode 2 M-line 3 2D MMode 19 2D M Mode 2D Dual Update Select 2D Dual Brightness Brightness Presets 1 M-line MMode Mode MMode 200 ms 1 4 Slow Med Fast Update M Mode M Mode Update 2D 2D M-line M-Mode Mode MMode M-line 16 Presets CPD Color CPD Color CPD Color 1 Color CPD CPD Mode Color CPD CPD ROI 2D Color CPD Color Color cm/s 20

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

32 1 D-line 2 Doppler Mode Doppler 200 ms Update Doppler Update 2D 2D D-line Mode Doppler D-line 16 Presets PW Doppler CW PW Gate PW Doppler CW Doppler PW/TDI Steering Scale Baseline Invert TDI PW Doppler PW Doppler PRF cm/s khz 16 Presets Live Trace Live Trace Invert Angle Angle Angle PW Doppler Volume (0-10) Wall Filter Low Med High 22

33 Sweep Speed Live Trace Slow Med Fast 16 Presets 2 Reset 0.5 cm 1cm 5cm 16 Presets Depth Depth 2D 19 2D 1 Near 2D Far 2D Gain CPD Color Gain (ROI) Freeze 2D Color 1 Zoom ROI 2 ROI 3 Zoom ROI 100% On 4 On 3 23

34 (Oph) FDA Oph Options Exam Exam Type 27 SSeries 1 2D 2 M-Mode 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 24

35 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 S-ICU C11x Abd Neo Vas C60x 3 Abd HFL38x SmP Vas Ven L25x L38x Vas Ven SmP Vas Ven L38xi P10x P21x 3 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 C60x 3 Nrv HFL38x Nrv Vas HFL50x Nrv L25x L38x L38xi SLAx Nrv Vas Nrv Vas Nrv Vas Nrv Vas 3 25

36 S-Women s Health C60x 3 HFL38x 13 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. Res Gen Pen TEEx SonoSite SonoSite 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 26

37 1 Options Annotate 2 Picto 3 x/x U/L / D/L / D/R / U/R / Hide Show Back D Patient 2 New/End / Done 29 Auto save Pat Form On 16 Presets D Patient 2 3 Cancel Done D Patient 3 New/End / Last, First, Middle ID Accession Date of birth Gender Indications User 3 27

38 Procedure Worklist Query DICOM Worklist DICOM Type BP HR Height 16 Presets Weight 16 Presets BSA LMP, Estab. DD OB Gyn OB LMP Estab. DD Gyn LMP Reading Dr. Referring Dr. Institution 15 Save Save Save 16 Presets Clip 16 Presets SonoSite vii SonoSite Beep Alert 14 Audio, Battery 1 28

39 1 2D Patient 2 Review 3 List Select All USB Clear All USB ID 1 2 Edit 3 OK 1 2 Append 1 2 Review 3 4 Play Pause 5 x/x List Done 3 29

40 Print Print USB USB USB USB Print Print USB 27 USB 16 USB Devices USB 1 USB 4 USB 2 3 Exp.USB USB USB 4 USB Include patient information on images and clips USB 5 Export USB 5 USB Cancel Export 1 2 Delete SiteLink DICOM PC DICOM SiteLink SiteLink DICOM 1 2 Archive 1 2 Info 30

41 D 35 1 Calcs Calipers Switch 4 31

42 Delete / 2D cm 1 2D Calipers A (2D) 31 cm 2 cm 1 2D Calipers 3 32 (2D) D Calipers 2 Manual 3 4 Undo 5 Set A 32 (2D) 31 (2D) Add Caliper Ellipse Manual B C M-Mode MMode (cm)/ (HR) bpm 200 ms 1 2 Ellipse 32

43 (M Mode) 1 MMode Calipers (M Mode) 1 MMode Calipers 2 HR Save HR 46 (M Mode) (M Mode) Add Caliper B C HR cm/s 16 Presets (cm/s) 1 Calipers 2 31 (A/B) (RI) 1 Calipers (Doppler) 31 1 Calipers 2 Time 4 33

44 (Doppler) 1 Calipers 2 PHT (Doppler) (Doppler) 1 Calipers 2 Manual 3 4 Undo (Doppler) (Doppler) 34 (Doppler) 1 Calipers 2 Auto 3 4 Set 35 (Doppler) (VTI) (Vmax) (PGmean) (PSV) (TAM)* +/ / (S/D) (PI) (EDV) (AT) (RI) (PGmax) 34

45 (Doppler) Add Caliper 2 Next Prev (...) 3 Time Calcs Manual Auto B C Calipers 47 SSeries 47 (...) Save Calc 28 Save Image/Calcs / 16 Presets 1 Calcs

46 1 2 Delete LV LVd LVs Ao/LA RVW (2D) RVD (2D) IVS (2D) LVD (2D) LVPW (2D) RVW (2D) RVD (2D) IVS (2D) LVD (2D) LVPW (2D) CO CI HRa Ao 2D MMode AAo (2D) CO EF SV LVESV LVEDV IVSFT LVPWFT LVDFS CI SI Ao LA/Ao AAo SSeries LA 2D MMode LVOT D (2D) LA LA/Ao LVOT D LVOT S-Cath S-FAST S-ICU ACS (M Mode) LVET (M Mode) ACS LVET 129 MV EF: (M Mode) EPSS (M Mode) EF EPSS 36

47 LV LVd LVs HR RVW (M Mode) RVD (M Mode) IVS (M Mode) LVD (M Mode) LVPW (M Mode) RVW (M Mode) RVD (M Mode) IVS (M Mode) LVD (M Mode) LVPW (M Mode) HR a CO EF SV LVESV LVEDV IVSFT LVPWFT LVDFS CI SI LV AV (2D) AV PISA Qp/Qs Ann D (2D) (Color) MR/VTI (Doppler) MV/VTI (Doppler) LVOT D (2D) RVOT D (2D) LVOT VTI (Doppler) RVOT VTI (Doppler) PISA ERO MV D VTI VMax PGmax Vmean PGmean SV Qp/Qs LV Vol (EF) LV MV (2D) A4Cd (2D) A4Cs (2D) A2Cd (2D) A2Cs (2D) Epi (2D) Endo (2D) Apical (2D) MV LV Vol LV EF CO SV CI SI LV Epi Endo D CO LVOT D (2D) (Doppler) TDI (Wall) e a (Doppler) (Wall) e a (Doppler) (Wall) e a (Doppler) (Wall) e a (Doppler) (Wall) e a (Doppler) CO SV CI SI VTI HR LVOT D E(MV)/e 4 37

48 P. Vein A (Doppler) VMax MV MV MR Adur (Doppler) S (Doppler) D (Doppler) E (Doppler) A (Doppler) Adur (Doppler) PHT (Doppler) VTI (Doppler) IVRT (Doppler) dp:dt b (CW Doppler) VMax S/D E E PG A A PG E:A PHT MVA VTI Vmax PGmax Vmean PGmean dp:dt AV Vmax (Doppler) Vmax PGmax Ao/LA VTI (Doppler) VTI Vmax LVOT (Doppler) VTI Vmax AV (Doppler) LVOT D (2D) VTI Vmax PGmax Vmean PGmean AVA AV VTI (Doppler) SV Ao/LA LVOT D (2D) AV VTI (Doppler) CO Ao/LA HR LVOT D (2D) HR a LVOT Vmax (Doppler) Vmax PGmax VTI (Doppler) VTI Vmax PGmax Vmean PGmean AV AI PHT (Doppler) AI PHT AI 38

49 TV TRmax (Doppler) Vmax PGmax E (Doppler) A (Doppler) PHT (Doppler) VTI (Doppler) RA E E PG A A PG E:A PHT MVA VTI Vmax PGmax Vmean PGmean RVSP PV Vmax (Doppler) Vmax PGmax VTI (Doppler) AT (Doppler) VTI Vmax PGmax Vmean PGmean AT a. HR 43 (HR) M Mode 33 (M Mode) b. 100 cm/s 300 cm/s c. 48 LVd LVs 1 2D MMode Calcs Ao LA AAo LVOT D 1 2D MMode Calcs LV 1 2D Calcs 2 a b c (LV) Undo d e

50 MV AV 1 2D Calcs 2 Area MV AV 3 4 Undo 5 Set 6 35 LV 1 2D Calcs 2 LV Mass 3 EPI Endo a b c Undo d Set e 35 4 Apical Calcs 2 MVTVTDI P. Vein 3 a b c (VTI) VTI 36 1 Calcs 2 VTI MV AV TV PV LVOT 3 4 Undo 5 Set (Doppler) (RVSP) 1 Calcs 2 TV TRmax RA 48 5 RA RVSP 40

51 MV AI TV (PHT) 1 Calcs 2 MV AV TV PHT 3 SELECT 4 MV EF AV 5 35 (PISA) PISA 2D Color 1 Ann D (2D) a 2D Calcs b c PISA Ann D 31 d 35 2 (Color) a Color Calcs b Radius c d 3 Calcs 4 MR VTI MV VTI (Doppler) a PISA MR VTI MV VTI b c Undo d Set e 34 (Doppler) (IVRT) 1 Calcs 2 MV IVRT (dp:dt) dp:dt CW Doppler 300 cm/s 22 1 CW Doppler Calcs 2 MV dp:dt 100 cm/s 4 41

52 3 100 cm/s 300 cm/s cm/s 5 35 (AVA) AVA 2D Doppler 1 LVOT (2D) a 2D Calcs b c Ao/LA LVOT D 31 d 35 2 LVOT AV (Doppler) Vmax 40 AV Vmax VTI 40 (VTI) AV VTI Qp/Qs Qp/Qs 2D Doppler 1 2D Calcs 2 LVOT D RVOT D a b Qp/Qs LVOT D RVOT D 31 c 35 3 Calcs 4 LVOT VTI RVOT VTI a b c d e Qp/Qs LVOT VTI RVOT VTI Undo Set (Doppler) (SV) (SI) SV SI 2D Doppler SI (BSA) 1 SI Height Weight BSA 27 2 LVOT (2D) a 2D Calcs b LVOT D 42

53 c 31 d 35 3 (Doppler) 40 (VTI) AV VTI 34 (Doppler) (HR) 1 Calcs 2 HR (CO) (CI) CO CI CI (BSA) 1 CI Height Weight BSA 27 2 SV 42 (SV) (SI) 1L/min 1 LVOT (2D) a 2D Calcs b c PW Doppler Angle Correction CO LVOT D 31 d 35 2 (Doppler) a b Sweep Speed Slow Med 3 HR 43 (HR) 4 43

54 c Trace Above Below d Set e (TDI) 1 TDI 22 PW Doppler 2 Calcs 3 TDI a b c EMED (S-FAST) EMED EMED 48 EMED (S-FAST) EMED 24 EMED 1 Calcs (Gyn) (Gyn) (Gyn) Gyn SSeries S-FAST S-GYN S-Women s Health 1 2D Calcs 2 Gyn 3 a b 31 c 35 44

55 D Calcs 2 Follicle 3 a b c Right Fol Left Fol OB EFW EDD OB EFW OB OB OB OB SSeries S-FAST S-GYN S-Women s Health OB Calculations OB a YS GS CRL BPD OFD HC TTD APTD AC FTA FL Hansmann, Nyberg, Tokyo U. Hadlock, Hansmann, Osaka, Tokyo U. Chitty, Hadlock, Hansmann, Osaka, Tokyo U. Hansmann Chitty, Hadlock, Hansmann Hansmann, Tokyo U. b Tokyo U. b Hadlock, Hansmann, Tokyo U. Osaka Chitty, Hadlock, Hansmann, Osaka, Tokyo U. 4 45

56 OB HL Tibia 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 BPD TTD APTD FL Shepard Tokyo U. HC/AC Campbell FL/AC FL/BPD FL/HC Hadlock Hohler Hadlock Q 1, Q 2, Q 3, Q 4 Jeng a. AUA b. Toyko U APTD TTD EFW c. (Estimated Fetal Weight) EFW 15 OB Calculations Hadlock EFW (2D) 2D AFI CxLen YS 1 OB LMP Estab.DD 2 2D Calcs 3 a b c (M Mode) 1 MMode Calcs 2 FHR

57 27 Bre Gyn SSeries S-Cath S-GYN S-Women s Health S-FAST S-GYN S-Women s Health 2D D 1 D 2 D 3 a 2D Calcs b i Volume (Gyn) Volume Gyn Volume ii iii S-FAST EMED 48 EMED (S-FAST) (#) Options Report Patient Report 2 x/x Done Delete 4 47

58 1 Details 2 Delete RA Summary RA 5 RA 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 48 EMED (S-FAST)

59 5 SonoSite vii SonoSite 10 LCD CPD Color OB OB MSK EMED MSK EMED MSK EMED SonoSite SonoSite Connectivity 15 C: SonoSite SonoSite SonoSite SonoSite vii SonoSite 16 System Information DVD DVD DVD SonoSite ARM PCBA (REF) C60x 5 49

60 1 2 Enter license number 3 Done SonoSite vii SonoSite (APIC) (FDA) 51 SonoSite vii SonoSite CFR SonoSite 50

61 LCD LCD SonoSite 5 51

62 cm 7 8 SonoSite USB Sani-Cloth HB Sani-Cloth Wipes 70% 4 USB 1 USB 2 Sani-Cloth Wipes 52

63 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 53 Accel TB Accel Wipes Aidal Plus Airkem A-33 Alkacide Alkazyme

64 54 1 C60x ICTx L38x P10x P21x SLAx HFL38x HFL50x C11x L25x L38xi Anioxy-Twin Anioxyde 1000 Aquatabs (1000) Aquatabs (2000) Aquatabs (5000) Ascend Asepti-HB Asepti-Steryl Asepti-Wipes Bacillocid rasant / Bacoban Bacoban WB Diethylenglycol Banicide Cavicide Caviwipes Chlor-Clean Cidalkan Cidalkan Lingettes

65 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 55 Dispatch NaCl Hypochlorite Dynacide PA Echo Clean Lingettes End-Bac II Endosporine Endozime AW Plus Envirocide

66 56 1 C60x ICTx L38x P10x P21x SLAx HFL38x HFL50x C11x L25x L38xi Enzol Expose Gigasept AF Gigasept FF Bersteinsaure Gluteraldehyde SDS Hexanios (Polyhexanide)/ Hi Tor Plus Hibiclens Kodan Tücher Kohrsolin ff Korsolex basic Korsolex extra / Lem-O-Quat / LpHse Lysol Lysol IC Madacide 1

67 1 C60x ICTx L38x P10x P21x SLAx HFL38x HFL50x C11x L25x L38xi Matar MetriCide 14 MetriCide 28 MetriCide OPA Plus MetriZyme Mikrobak forte Mikrozid Wipes / Nuclean / (Biguanide) Precise Prevention Rely+On PeraSafe 5 57 Ruthless Sagrosept Wipe Salvanios ph 7 Sani-Cloth HB Sani-Cloth Plus Sekusept Sklar

68 58 1 C60x ICTx L38x P10x P21x SLAx HFL38x HFL50x C11x L25x L38xi Sporicidin 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 /o-phenylphenate

69 1 C60x ICTx L38x P10x P21x SLAx HFL38x HFL50x C11x L25x L38xi Virex II 256 Virex TB Virox 5 Virufen Wavicide -06 Wavicide-01 Wet Wipe Disinfection Wex-Cide (3%) 5 59 NaCl Hypochlorite 3A 3A (100%) ALL = = =

70 60

71 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),

72 62

73 MSD MSD Class I I BF IPX-7 AP/APG Class I I Class I I S Series V-Universal 6 63

74 EN Class II /BF Canadian Standards Association (CSA) European Norm Harmonized Standards Underwriters Laboratories (UL) safety standards (UL) 8 EN Hospital Only Hospital Grade / ( MPSO S Series V-Universal 64

75 5 SonoSite SonoSite SonoSite SonoSite SSeries V-Universal /- SonoSite JACHO / AAMI-ES1 NFPA 99 OR IEC IEC IEC (ITE) SonoSite 6 65

76 5 / 0 C 40 C 60 C 6 66

77 SonoSite -20 C 60 C SonoSite SonoSite SonoSite SonoSite 21 CFR ALARA MI TI SonoSite 0.3 db/cm/mhz SonoSite 6 67

78 (LCD) LCD IEC :2001 (EMC) EMC (RF) (EMI) EMI EMI EMI EMI EMI EMI EMI IEC EMC SonoSite SonoSite SonoSite SonoSite SonoSite (ESD) ESD ESD 68

79 1 2 EMC 1 - RF ClSPR 11 RF ClSPR 11 IEC / IEC Group 1 1 Class A A Class A A SonoSite RF SonoSite 2 - IEC (ESD) IEC KV4.0KV6.0KV 2.0KV4.0KV8.0KV 2.0KV 4.0KV 6.0KV 2.0KV 4.0KV 8.0KV 30% IEC KV 1KV 2KV 1KV IEC KV1.0KV2.0KV 0.5KV 1.0KV 0.5KV 1.0KV 2.0KV 0.5KV 1.0KV 6 69

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

81 2 - IEC IEC RF a b IEC No. 417-IEC-5140Source of non-ionizing radiation U T 80 MHz 800 MHz a. / AM FM SonoSite RF SonoSite SonoSite b. 150 khz 80 MHz 3V/m FCC FCC Rules

82 ALARA ALARA ALARA ALARA ALARA 2D CPD Color THI ALARA EN (ISPTA)720 mw/cm 2 ISPTA 50 mw/cm2ti 1.0 MI 0.23 (MI) (TI) 1.0 MI TI 74 MI TI ALARA MI TI MI TI BS EN :2001Annex HH HH 72

83 PRF Kremkau, Frederick W. Diagnostic Ultrasound: Principles and Instruments. 7th ed., W.B. Saunders Company, (Oct. 17, 2005). 6 73

84 MI TI MI TI MI TI MI TI MI TI 3MI C11x C60x HFL38x HFL50x ICTx L25x L38x L38xi P10x P21x SLAx TEEx Depth MI MI 74

85 4TI TIS TIC TIB CPD PRF Depth Optimize PW C11x C60x (PRF) HFL38x HFL50x ICTx Gyn (PRF) L25x (PRF) L38x L38xi (PRF) P10x (PRF) P21x (PRF) SLAx (PRF) TEEx (PRF) TI TI 6 75

86 MI TI AIUM 5 TI MI 1.0 5TI MI 1.0 2D MMode CPD/ Color PW Doppler CW Doppler C11x/8-5 MI TIC TIB TIS C60x/5-2 MI TIC TIB TIS HFL38x/13-6 MI TIC TIB TIS HFL50x/15-6 MI TIC TIB TIS ICTx/8-5 MI TIC TIB TIS L25x/13-6 MI TIC TIB TIS L38x/10-5 MI TIC TIB TIS L38xi/10-5 MI TIC TIB TIS P10x/8-4 MI TIC TIB TIS P21x/5-1 MI TIC TIB TIS SLAx/13-6 MI TIC TIB TIS 76

87 5TI MI 1.0 2D MMode CPD/ Color PW Doppler CW Doppler TEEx/8-3 MI MI 1.0 MI 0.1 TI TI 0.1 TI TI ALARA TISonoSite AIUM TI 78 MI TI MI 95% MI 95% MI +18% -25% +0.2 TI 95% TI 95% TI +21% -40% dB 3dB MI TI TIC TIB TIS 112 MI TI / / 6 77

88 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 C ± 3 C EN ( C) ( C) C11x C60x HFL38x HFL50x L25x L38x L38xi P10x P21x ICTx SLAx TEEx

89 (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) = 0.53 = 0.66 = 0.79 = 0.43 = 0.55 l = cm f = // MHz 0.3 = [e -(0.069lf ) ] 6 79

90 0.3 db/cm MHz 3cm 1dB/cmMHz 1990 MI MI 2.0 M MI C 4 C 1.5 C 7 C I SPTA 500 mw/cm 2 Bioeffects and Safety of Diagnostic Ultrasound (AIUM, 1993) TI MI

91 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 ) # TIS TIB FL y (cm) # Abd 3PRF / /5.1 5/ / (a) <1 (b) # / 6 81

92 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 ) # (a) <1 (b) # / TIS TIB FL y (cm) mm 1 mm 1 mm 3PRF

93 9C60x TIS 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) # # I max (W/cm 2 ) Abd/OB / 13 cm 4THI 5MB TIB FL y (cm) # # (a) <1 (b) # / 6 83

94 10C60x M Mode 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 cm 4MB (a) <1 (b) # / TIS TIB FL y (cm) # # 84

95 11C60x TIS 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) # # TIB FL y (cm) # # I max (W/cm 2 ) # 1 Abd 2PRF 3 12 mm 4 1 (a) <1 (b) # / 6 85

96 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 ) Color 2 3//PRF Low/3.3 cm/393 4/ (a) <1 (b) # / TIS TIB FL y (cm) # 86

97 13HFL38x TIS 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 ) Bre/Vas SmP/IMT TIB FL y (cm) 2.5 # Vas/Ven/ IMT Vas/Ven/IMT 2 1 mm 12 mm 12 mm 3PRF (a) <1 (b) # / 6 87

98 14HFL50x 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 (a) <1 (b) # / TIS TIB FL y (cm) # # 88

99 15HFL50x TIS M Mode 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 TIB FL y (cm) # # (a) <1 (b) # / 6 89

100 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 (a) <1 (b) # / TIS TIB FL y (cm) # # 90

101 17HFL50x TIS 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 # TIB FL y (cm) 2.44 # I max (W/cm 2 ) mm 1 mm 1 mm 3PRF (a) <1 (b) # / 6 91

102 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) # # (a) <1 (b) # / TIS TIB FL y (cm) # # I max (W/cm 2 ) # 1 2 3mm 3PRF

103 19L25x TIS 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) # # TIB FL y (cm) # # I max (W/cm 2 ) # 1 Vas/Ven/Nrv 2 6 mm 3PRF (a) <1 (b) # / 6 93

104 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 ) (a) <1 (b) # / TIS TIB FL y (cm) 2.5 # 1 Color CPD 2 Bre 3PRF / /3.1 Med/3.1 5/ Def/Def/ Def 94

105 21L38x TIS 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 # TIB FL y (cm) 2.5 # I max (W/cm 2 ) Vas Vas 2 1mm 12mm 12mm 3PRF (a) <1 (b) # / 6 95

106 22L38xi/10-5 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 ) Gen/ Pen cm 4MB / (a) <1 (b) # / TIS TIB FL y (cm) # # 96

107 23L38xi/10-5 TIS M Mode 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) # # TIB FL y (cm) # # I max (W/cm 2 ) Gen Pen cm cm (a) <1 (b) # / 6 97

108 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 32D / (a) <1 (b) # / TIS TIB FL y (cm) 1.50 # / cm / 3.8 cm 4/PRF / Low / / / 98

109 25L38xi/10-5 TIS 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 TIB FL y (cm) 1.50 # 1 Bre/Vas Bre/Vas Bre/Vas 2 1 mm 1 mm 1 mm 3PRF (a) <1 (b) # / 6 99

110 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 ) 252 TIB FL y (cm) # Color Color 2 Neo Abd 3//PRF 4/ Low / 3.7/ 772 / Tall Med / 2.0/ 2315 / (a) <1 (b) # / 100

111 27P10x TIS 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 TIB FL y (cm) Crd Crd Neo Crd 2 1 mm 7 mm 12 mm 1 mm 3PRF/TDI 1563/ / 15625/ 5208/ (a) <1 (b) # / 6 101

112 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 (a) <1 (b) # / TIS TIB FL y (cm) # 5.0 I max (W/cm 2 ) # 1 Crd Crd

113 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 TIS TIB FL y (cm) # Crd Crd 2 Gen/ Pen Pen cm 27 cm 4THI (a) <1 (b) # / 6 103

114 30P21x M Mode 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 ) (a) <1 (b) # / TIS TIB FL y (cm) # Abd/OB Abd/OB Abd/OB/ Crd 2 Gen/Res Pen cm 10/13 cm 27 cm 4THI 5MB 104

115 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 ) 194 TIS TIB FL y (cm) Color CPD Color/CPD 2 Crd 3PRF/ / / Med Med 5THI 6 Short and Narrow Short and Narrow (a) <1 (b) # / 6 105

116 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 (a) <1 (b) # / TIS TIB FL y (cm) Crd Crd Crd Crd 2 1 mm 3 mm 14 mm 1 mm 3PRF

117 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) TIS TIB FL y (cm) I max (W/cm 2 ) # 1 Crd Crd Crd (a) <1 (b) # / 6 107

118 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) # # (a) <1 (b) # / TIS TIB FL y (cm) # # I max (W/cm 2 ) # 1 Vas 2 5 mm 3PRF

119 35TEEx TIS 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) # # TIB FL y (cm) # # I max (W/cm 2 ) # 1 Crd 2 1mm 3PRF (a) <1 (b) # / 6 109

120 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) # # (a) <1 (b) # / TIS TIB FL y (cm) # # I max (W/cm 2 ) # 1 Crd

121 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 milliwatt TIS z 1 milliwatt z 1 / z 1 [min(w.3 (z), I TA.3 (z) x 1 cm 2 )] z > zbpcm ( A aprt) z bp 1.69 cm z sp d eq (z) fc A aprt MI p r.3 TIB TIB z sp = z b.3 cm z ( 4 ( π) )(( Wo) ( ITA( z) )) I TA (z) z cm MHz (x) (y) 6 111

122 37 PD PRF p max d max FL MI MI Hz 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% % 112

123 39 (AC) 1 93/42/EEC Annex VII 1 IIa IIb III 93/42/EEC LOT CUS CSA ANSI/UL REF 93/86/EEC STERILE EO 6 113

124 39 (DC) FCC GEL STERILE R 114

125 39 SN BF B = F = (UL) RoHS / CCC 6 115

126 39 LCD WARNING: Connect Only Accessories and Peripherals Recommended by SonoSite SonoSite 116

127 D a < ±2% + 1% < ±2% + 1% < ±2% + 1% b (cm) c < ±4% + 2% / * % c < ±3% + 1.4% / * % cm a. b. 0.7 db/cm MHz RMI 413a c. % = ((1 + ) * (1 + ) 1) * % d. % = ( 2 (2 ) * 100) + 0.5% 7 117

128 (Acquisition Error) (Algorithmic Error) AIUM (ACC) cm/s 2 Zwiebel, W.J. Introduction to Vascular Ultrasonography. 4th ed., W.B. Saunders Company, (2000), 52. ACC = abs / (AT) msec Oh, J.K., J.B. Seward, A.J. Tajik. The Echo Manual. 2nd ed., Lippincott, Williams, and Wilkins, (1999), 219. (AVA) cm 2 Reynolds, Terry. The Echocardiographer s Pocket Reference. 2nd ed., School of Cardiac Ultrasound, Arizona Heart Institute, (2000), 393, 442. A 2 = A 1 * V 1 /V 2 A 2 = A 1 = LVOT V 1 = LVOT V 2 = LVOT = AVA (PV LVOT /PV AO ) * CSA LVOT AVA (VTI LVOT /VTI 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 Echocardiographer s Pocket Reference. 2nd ed., School of Cardiac Ultrasound, Arizona Heart Institute, (2000), 383. CSA = * D 2 D = msec Reynolds, Terry. The Echocardiographer s Pocket Reference. 2nd ed., School of Cardiac Ultrasound, Arizona Heart Institute, (2000), 453. a - b 118

129 : (dp:dt) mmhg/s Otto, C.M. Textbook of Clinical Echocardiography. 2nd ed., W.B. Saunders Company, (2000), 117, mmhg/ E:A cm/sec E:A = E/ A E/Ea Reynolds, Terry. The Echocardiographer s Pocket Reference. 2nd ed., School of Cardiac Ultrasound, Arizona Heart Institute, (2000), 225. E /Ea E = E Ea = E E (ERO) mm 2 Reynolds, Terry. The Echocardiographer s 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 = (HR) bpm HR = M Mode (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 Echocardiographer s Pocket Reference. School of Cardiac Ultrasound, Arizona Heart Institute, (1993), 146. a - b / (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 Mass = 1.04 [(LVID + PWT + IVST) 3 LVID 3 ] * LVID = PWT = IVST = 1.04 = 0.8 = 7 119

130 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 = i = 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 = 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% 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 Echocardiographer s 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 Echocardiographer s 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) 120

131 PGmax = 4 * PV 2 (PGmean) PGmean = / (PHT) msec Reynolds, Terry. The Echocardiographer s Pocket Reference. 2nd ed., School of Cardiac Ultrasound, Arizona Heart Institute, (2000), 391. (RVSP) mmhg Reynolds, Terry. The Echocardiographer s 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 Echocardiographer s Pocket Reference. 2nd ed., School of Cardiac Ultrasound, Arizona Heart Institute, (2000), 217. S / D S = S D = D (SI) cc/m 2 Mosby s Medical, Nursing, & Allied Health Dictionary, 4th ed., (1994), Qp/Qs Reynolds, Terry. The Echocardiographer s 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 Echocardiographer s Pocket Reference. School of Cardiac Ultrasound, Arizona Heart Institute, (2000), 396, 455. RV = ERO * MR VTI SI = SV/BSA SV = BSA = (SV) Doppler 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 Echocardiographer s Pocket Reference. 2nd ed., School of Cardiac Ultrasound, Arizona Heart Institute, (2000), 55, 391, 452. TVA = 220 / PHT 7 121

132 (SV) 2D MMode 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 Echocardiographer s 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

133 (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 20.0 cm 30.0 cm (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),

134 (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),