M-Turbo Ultrasound System User Guide

Transcription

1 TM M-Turbo

2

3 TM M-Turbo

4 SonoSite, Inc th Drive SE Bothell, WA SonoSite Ltd Alexander House 40A Wilbury Way Hitchin Herts SG4 0AP UK M-Turbo SiteLink SonoCalc SonoHD SonoMB SonoSite SonoSite, Inc. DICOM National Electrical Manufacturers Association SonoSite , , , , , , , , , , , , , D456509, D P / SonoSite, Inc. ii

5 ... vii... vii USB A & B IMT iii

6 USB M ECG M (Gyn) IMT iv

7 EMED ECG MI TI v

8 EMC DICOM HIPAA vi

9 M-Turbo M-Turbo SonoSite SonoSite SonoSite SonoSite SonoSite comments@sonosite.com vii

10 SonoSite SonoSite Support & Service +44-(0) viii

11 1 M-Turbo (1) (2) (3) (4) USB (1) (2) I/O (3) (4) ECG 1 1

12 PATIENT 4 2D M MODE M COLOR DOPPLER 96 SonoSite USB USB EN D M Mode M Color CPD THI PW 2D M Mode M Color THI PW TDI PW CW 2

13 (ECG) 2D M Mode M CPD Color THI PW 2D Color CPD THI PW 2D M Mode M Color CPD THI PW CPD Color (PUBS) (IVF) CPD Color (IUGR) 2D M Mode M Color CPD PW TDI PW ) CW 2D M Mode M CPD Color PW 2D M Mode M Color CPD PW 1 3

14 2D M Mode M Color CPD PW

15 V SonoSite

16

17 USB USB PC USB PC USB USB USB USB USB USB USB USB USB USB USB USB USB 1 1 USB USB USB 31 USB USB 1 USB 2 USB 1 7

18 % 5 6 8

19 7 / EMED 1 9

20 Color Doppler 19 MMode M Doppler D-line Doppler 20 M MMode M M-line M MMode M Doppler D-line D Doppler CPD /Color 2D 10

21 Gen Res THI PW

22 9 / 10 USB CPD SELECT / 23 / SELECT SELECT 6 12

23 TAB 2 CAPS LOCK 3 SHIFT 4 TEXT 5 PICTO / DELETE ENTER 1 13

24 DICOM SiteLink Alias AE Title AE A & B Key A & B Footswitch 7 1 Symbols 2 3 OK 14

25 21 CFR SonoSite SonoSite SonoSite SonoSite 98 SonoSite Aquasonic SonoSite

26 16

27 2 SETUP Done A & B A & B Key, Footswitch A & B 1 SETUP 2 A & B Key, Footswitch A & B 3 A Key A B Key B A Print B Record Footswitch (L) Footswitch (R) Save Clip Record Freeze Save Image Print 17 SonoSite 1 Y ECG Y 2 A & B Key, Footswitch A & B 2 17

28 Administration 1996 (Health Insurance Portability and Accountability Act, HIPAA) (European Union Data Protection Directive, 95/46/EC) HIPAA 1 SETUP 2 Administration 3 Name Administrator 4 Password SonoSite SonoSite viii 5 Login User Login 1 2 User Login On On Off 18

29 1 2 User List Administrator 3 User Information Password Confirm 21 Password changes 4 Save 1 2 New 3 User Information Name Password Confirm 21 4 Sonographer User 5 Administration Access 6 Save 1 2 User List 3 User Information 4 Save 1 2 User List 3 Delete 4 Yes 2 19

30 1 2 User List 3 Password Confirm 4 Save 1 USB 2 3 Export USB 4 USB Export USB 1 USB 2 3 Import 4 USB Import 5 Done Event log USB PC 1 2 Log Event log Back 20

31 Event log DICOM (log.txt) USB log.txt 1 USB 2 Log Export USB 3 USB Export Event log Microsoft Word 1 2 Clear 3 Yes User Login User Login OK 1 2 User Login Guest 1 2 User Login Password 3 OK (A-Z) (a-z) (0-9) 2 21

32 SETUP 2 Annotations 3 Exam 4 Group A B C 5 Text Add Text Rename Delete 14 1 SETUP 2 Annotations 3 Unfreeze Keep All Text Keep Home Text Clear All Text Keep All Text 44 22

33 1 USB 2 SETUP 3 Annotations 4 Export USB 5 USB Export USB 1 USB 2 SETUP 3 Annotations 4 Import 5 USB Import 6 Done USB Audio, Battery Sleep Delay Power Delay 1 SETUP 2 Audio, Battery 3 On Off On Off Off 5 10 Off

34 Cardiac Calculations Tissue Doppler Imaging (TDI) 68 1 SETUP 2 Cardiac Calculations 3 TDI Walls TDI Connectivity SiteLink DICOM SiteLink DICOM 1 2 SETUP 3 Connectivity 4 Printer DVD PC 1 SETUP 2 Connectivity 3 DVD Video Mode NTSC PAL 4 Serial Port RS-232 Computer (PC) ASCII PC PC SonoSite EMED 94 5 Yes 6 (RS-232) 24

35 1 SETUP 2 Connectivity 3 Internal Storage Capacity Alert DICOM 1 SETUP 2 Date and Time 3 Date 4 Time 24 Display Information 1 SETUP 2 Display Information 3 Patient Header Mode Data Network Status 2 25

36 IMT IMT Calculations IMT IMT IMT 80 IMT 1 SETUP 2 IMT Calculations IMT 3 IMT Calculations IMT None 4 Region width ( ) Network Status IP Location WLAN Profile WLAN Active WLAN SSID WLAN SSID MAC 1 SETUP 2 Network Status OB Calculations 84 26

37 1 1 SETUP 2 OB Calculations 3 Gestational Age Growth Analysis OB None 4 More 1 USB 2 SETUP 3 OB Calculations 4 Export USB 2 27

38 5 USB Export USB - 1 USB 2 SETUP 3 OB Calculations 4 Import 5 USB Import 6 Done OB Custom Measurements OB Custom Measurements 84 1 SETUP 2 OB Custom Meas 3 New 4 Name 5 Type 6 Save 1 SETUP 2 OB Custom Meas 3 Custom Measurements 4 Delete Last 28

39 5 Yes OB Custom Tables Gestational Age Table Measurements CRL GS BPD OFD HC AC FL APTD TTD FTA 5 BPD HC AC FL EFW HC/AC 1 SETUP 2 OB Custom Meas. OB Calculations 3 Tables 4 / 1 SETUP 2 OB Custom Meas. OB Calculations 3 Tables 4 Gestational Age [ ] Growth Analysis [ ] 5 Measurement 6 New 7 Author 8 9 Save

40 1 SETUP 2 OB Custom Meas. OB Calculations 3 Tables 4 5 Edit Save Delete Presets 1 SETUP 2 Presets 3 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 Thermal Index ( ) TIS TIB TICOB TIB TCD TIC TIS Save Key SAVE Image Only Image/Calcs / Dynamic Range Units in/ft/lbs // cm/ m/kg // Language 30

41 Color Scheme Auto save Pat. Form System Information 96 1 SETUP 2 System Information USB USB Devices USB USB USB USB 51 1 SETUP 2 USB Devices USB 3 Export 4 USB Export USB SiteLink SiteLink H.264 MP4 SonoSite QuickTime 7.0 DICOM DICOM DICOM 5 JPEG JPEG SiteLink DICOM 6 SiteLink Sort By Devices 2 31

42 Reset

43 3 LCD UP DEPTH DOWN DEPTH AUTO GAIN NEAR FAR GAIN [TGC] PW CW GAIN CPD Color GAIN (ROI) NEAR FAR FREEZE 3 33

44 LEFT ARROW RIGHT ARROW 2D Color 1 ZOOM ROI 2 ROI 3 ZOOM ROI 100% 4 ZOOM 42 EXAM Exam Type 45 34

45 1 2D 2-3, -2, -1, 0, +1, +2, +3. LVO LVO Dual UPDATE UPDATE Dual 2D LVO On LVO LVO Off LVO LVO LVO (MI) U/R / U/L / D/L / D/R / 3 35

46 SonoHD (S) SonoMB (MB) 1 10 SonoSite Biopsy ECG L25x S S SonoHD SonoHD S SonoHD MB MB SonoMB SonoMB MB SonoMB ECG 52 SonoSite ECG 48 THI M (M Mode) M 1 MMODE M M 36

47 2 M 3 M 35 M 1 M MMODE M Slow [ ] Med [ ] Fast [ ] UPDATE M M MMODE M M 30 CPD Color CPD Color 1 COLOR ROI 2 CPD Color Color Color / 3 ROI SELECT ROI ROI

48 CPD Color PRF (PRF) PRF ROI

49 PW CW PW CW PW/CW / CPD/Color / CPD/Color / ROI SELECT ROI ROI PW PW CW 1 DOPPLER 2 40 PW Doppler SELECT SELECT SELECT 1 2 DOPPLER UPDATE DOPPLER

50 PW TDI TDI TDI On TDI TDI TDI off TDI

51 [PRF] / 30 (0-10)

52 1 2 M 3 3 C11x Abd X X X X Neo X X X X Nrv X X X X Vas X X X X C60x OB X X X X Gyn X X X X Abd X X X X Nrv X X X X HFL38x Bre X X X X SmP X X X X Vas X X X X Msk X X X X IMT X X X X Nrv X X X X Ven X X X X ICTx Gyn X X X X OB X X X X 42

53 1 2 M 3 3 L25x Msk X X X X Vas X X X X Nrv X X X X Sup X X X X Ven X X X X L38x Bre X X X X SmP X X X X Vas X X X X IMT X X X X Nrv X X X X Ven X X X X P21x Abd X X X X OB X X X X Crd X X X X 1. Abd = Bre = Crd = Gyn = IMT = Intima Media ThicknessMsk = Neo = Nrv = OB = SmP = Sup = Vas = Ven = 2. Res Gen Pen 3. CPD Color Color PRF

54 1 TEXT 2 Home 44 3 DELETE Word Symbols 14 4 Label (1/x) 22 TEXT 1 TEXT 2 3 Home/Set / 1 ARROW 2 SELECT SELECT 3 4 ARROW ARROW Hide 44

55 1 PICTO 2 x/x SELECT 3 4 SELECT 5 U/L / D/L / D/R / U/R / Dual Hide 92 1 PATIENT 2 New Done 1 PATIENT

56 4 Cancel Done PATIENT 3 End Exam New 45 Symbols 14 (Middle) 46

57 BP BSA A B A B A/ B A B A/B ( IMT IMT 3 47

58 DICOM DICOM DICOM DICOM SAVE SAVE SAVE 30 1 Clips Clips 49 2 CLIP Prev/Off Prev/On (1x, 1/2x, 1/4x) Pause Left: x x Right: x x x 48

59 Save Delete Clips Clips 1 Clips 2 USB USB USB USB SonoSite SonoSite viii USB 3 49

60 1 1 REVIEW 2 List Select All Clear All 50

61 1 2 Review 3 x/x 4 Play Pause 1x 1/2x 1/4x 5 x/x List Done Print A A A B Print Print USB USB USB 31 1 USB 2 3 Exp. USB USB USB 3 51

62 4 USB Export USB USB USB Cancel Export 1 2 Delete DICOM SiteLink PC DICOM SiteLink 1 2 Archive ECG ECG SonoSite ECG ECG SonoSite ECG ECG SonoSite SonoSite ECG 1 ECG ECG ECG ECG ECG ECG 2 ECGECG ECG 3 52

63 ECG / ECG ECG 0-20 ECG 48 ECG ECG 3 53

64 54

65 M HR 62 1 CALCS CALIPER

66 SELECT Switch Delete 56

67 1 1 CALIPER 2 SELECT CALIPER 2 Ellipse Ellipse 3 SELECT

68 1 CALIPER 2 Manual Manual 3 4 SELECT 5 SET 55 M M Distance /Time Heart Rate (HR)/ (bpm) 200 M 1 M CALIPER 2 3 SELECT 4 55 M 1 M CALIPER 2 HR 3 4 SELECT 5 58

69 55 M 88 Velocity / Pressure Gradient Elapsed Time +/x Ratio +/x Resistive Index Acceleration cm/s / 30 / 1 CALIPER /x 1 CALIPER 2 3 SELECT CALIPER 2 Manual 3 SELECT 4 59

70 4 Undo BACKSPACE 5 SET CALIPER 2 Auto 3 4 SELECT 5 6 SET 55 Neo / (VTI) X (Vmax) X X X X (PGmean) X (Vmean) X (PGmax) X 60

71 Neo / (CO) X (PSV) X (TAM)* X +/ / (S/D) X X X X (PI) X X X X (EDV) X X X X (AT) X (RI) X X X X (TAP) X X * TAM (...) 1 CALCS 4 61

72 2 Next Prev (...) SELECT 3 SELECT CALCS CALIPER SAVE CALC Save 48 SAVE Image/Calcs / SAVE SELECT CALIPER SAVE CALC 62

73 1 2 Delete C11x C60x HFL38x L25x L38x P21x IMT IMT 4 63

74 2 1 CALCS 2 A 1 A 2 a Area Red b SELECT c Undo BACKSPACE d SET e 62 1 CALCS 2 D 1 D 2 a Dia Red b 55 64

75 c C11x C60x HFL38x ICTx L25x L38x P21x D 1 D 2 D 3 a CALCS b i Volume ii 55 iii

76 45 C11x C60x HFL38x L25x L38x P21x 173 D TAM VF 1/ C11x C60x

77 HFL38x L25x L38x P21x Allan, Paul L. et al. Clinical Doppler Ultrasound, 4th Ed., Harcourt Publishers Limited, (2000) a CALCS b Vol Flow D c 55 d 62 2 a CALCS b Vol Flow TAM c SELECT d e SELECT f g SET h Cardiac Gynecology IMT OB Small Parts Vascular 4 67

78 45 P21x 173 LVd LVs RVW RVD IVS LVD LVPW RVW RVD IVS LVD LVPW HR a CO CI CO EF SV LVESV LVEDV IVSFT LVPWFT LVDFS CI SI 68

79 LV Ao M Ao LA/Ao AAo AAo LA M LA LA/Ao LVOT D LVOT D LVOT ACS M ACS LVET M LVET EF M EF EPSS M EPSS LVd LVs RVW M RVD M IVS M LVD M LVPW M RVW M RVD M IVS M LVD M LVPW M CO EF SV LVESV LVEDV IVSFT LVPWFT LVDFS CI SI HR HR a LV AV AV MV MV 4 69

80 LV LV PISA Qp/Qs A4Cd A4Cs A2Cd A2Cs Epi Endo Apical Ann D MR/VTI MV/VTI LVOT D RVOT D LVOT VTI RVOT VTI LV LV EF CO SV CI SI LV Epi Endo D Apical D PISA ERO MV D VTI VMax PGmax Vmean PGmean SV Qp/Qs 70

81 MV E A E E PG A A PG E:A PHT PHT MVA VTI VTI Vmax PGmax Vmean PGmean IVRT IVRT MV >MR dp:dt b dp:dt AV Vmax Vmax PGmax VTI VTI Vmax PGmax Vmean PGmean LVOT VTI Vmax AVA AV VTI Vmax LV LVOT D AV VTI SV LV LVOT D 4 71

82 AV VTI CO LV HR LVOT D HR a LVOT Vmax Vmax PGmax VTI VTI Vmax PGmax Vmean PGmean AV > AI PHT AI PHT AI TV TRmax Vmax PGmax RA c RVSP PV Vmax Vmax PGmax VTI VTI Vmax PGmax Vmean PGmean a. (HR) 78 M M 58 b. 100 / 300 / c. 92 LVd LVs 1 M CALCS

83 4 SELECT 5 SELECT 6 SELECT SELECT 7 62 Ao LA AAo LVOT D 1 M CALCS LV 1 CALCS 2 a b SELECT c (LV) Undo BACKSPACE d SET e 62 MV AV 1 CALCS 2 Area MV AV 3 SELECT 4 Undo BACKSPACE 5 SET

84 LV 1 CALCS 2 LV Mass LV 3 EPI Endo a b SELECT c Undo BACKSPACE d SET e 62 4 Apical CALCS 2 MV TV TDI 3 a b 55 c 62 (VTI) VTI 68 1 CALCS 2 MV AV PV LVOT VTI 3 SELECT 74

85 4 Undo BACKSPACE 5 SET (RVSP) 1 CALCS 2 TV TRmax RA 92 RA 5 RVSP MV AV (PHT) 1 CALCS 2 MV AV PHT 3 SELECT 4 MV EF AV 5 62 (PISA) PISA 1 Ann D a CALCS b PISA Ann D c 55 d

86 2 a CALCS b Radius c d 3 CALCS 4 MR VTI MV VTI a PISA MR VTI MV VTI b SELECT c Undo BACKSPACE d SET e 60 (IVRT) 1 CALCS 2 MV IVRT 3 4 SELECT (dp:dt) (dp:dt) CW Doppler 300 / 41 1 CW Doppler CALCS 76

87 2 MV dp:dt 100 / / 4 SELECT 300 / / 6 62 (AVA) AVA 1 LVOT a CALCS b LVOT D c 55 d 62 2 LVOT AV Vmax 74 AV Vmax VTI (VTI) 74 AV VTI Qp/Qs Qp/Qs 1 CALCS 2 LVOT D RVOT D a Qp/Qs LVOT D RVOT D b 55 c 62 3 CALCS 4 77

88 4 LVOT VTI RVOT VTI a Qp/Qs LVOT VTI RVOT VTI b SELECT c Undo BACKSPACE d SET e (SV) (SI) SV SI SI Body Surface Area 1 SI Height Weight BSA 45 2 LVOT a CALCS b LVOT D c 55 d 62 3 (VTI) 74 AV VTI 60 (HR) Heart Rate ECG 1 CALCS 2 HR 3 78

89 4 SELECT (CO) (CI) CO CI Stroke Volume Heart Rate CI Body Surface Area 1 CI Height Weight BSA 45 2 SV (SV) (SI) 78 3 HR (HR) 78 (TDI) 1 TDI 40 2 CALCS 3 TDI a b 55 c 62 (Gyn) (Gyn) Uterus Ovary Follicle Volume (Gyn) C60x ICTx Gyn Gyn 4 79

90 1 CALCS 2 Gyn 3 a b 55 c 62 1 CALCS 2 Follicle 3 a Right Fol Left Fol b 55 c 62 IMT IMT IMT (CCA) (ICA) 45 IMT L38x HFL38x IMT IMT 80

91 IMT IMT IMT IMT 26 IMT Right-IMT IMT Left-IMT IMT Plaque Ant N Ant F Lat N Lat F Post N Post F IMT 1 IMT 2 IMT 3 IMT 4 IMT 5 IMT 6 IMT 7 IMT 8 IMT 1 CALCS 2 3 IMT 4 IMT

92 IMT IMT IMT 1 IMT IMT 82

93 IMT IMT 1 CALCS 2 3 Edit Manual Sketch Trace 4 a SELECT b SELECT Undo BACKSPACE c SET 5 62 IMT IMT 1 CALCS 2 3 Edit Manual Sketch 4 a SELECT b SELECT Undo BACKSPACE c SET d IMT 82 e

94 EFW EDD EFW C60x ICTx P21x OB OB OB AUA EDD by AUA EDD by LMP (Average Ultrasound Age) AUA (Average Ultrasound Age) (Estimated Date of Delivery) (Last Menstrual Period) (Estimated Date of Delivery) 84

95 EFW Estab.DD GA by LMP GA by LMPd LMP LMPd UA (Estimated Fetal Weight) EFW EFW (Established Due Date) LMPd (Gestational Age by Last Menstrual Period) (LMP) (Gestational Age by derived Last Menstrual Period) (Last Menstrual Period) (derived Last Menstrual Period) (Ultrasound Age) 4 85

96 a GS Hansmann, Nyberg, Tokyo U. CRL Hadlock, Hansmann, Osaka, Tokyo U. BPD OFD HC TTD APTD Chitty, Hadlock, Hansmann, Osaka, Tokyo U. Hansmann Chitty, Hadlock, Hansmann Hansmann, Tokyo U. b Tokyo U. b AC Hadlock, Hansmann, Tokyo U. FTA FL Osaka (EFW) c HC, AC, FL Hadlock 1 BPD, AC, FL Hadlock 2 AC, FL Hadlock 3 BPD, TTD Chitty, Hadlock, Hansmann, Osaka, Tokyo U. Hansmann BPD, FTA, FL Osaka U. BPD, AC Shepard BPD, TTD, APTD, FL Tokyo U. HC/AC Campbell FL/AC Hadlock FL/BPD FL/HC Hohler Hadlock 86

97 (Amniotic Fluid Index) Q 1, Q 2, Q 3, Q 4 Jeng d BPD Chitty, Hadlock, Jeanty HC Chitty, Hadlock, Jeanty AC FL EFW HC/AC Chitty, Hadlock, Jeanty Chitty, Hadlock, Jeanty Hadlock, Jeanty Campbell a. AUA b. Tokyo U. APTD TTD EFW c. Estimated Fetal Weight EFW 26 Hadlock EFW d. Report Graphs Growth Analysis LMP Estab. DD AFI 1 LMP Estab.DD Twins 2 CALCS 4 87

98 3 a Twin A A Twin B B b 55 c 62 M 1 M CALCS 2 FHR 3 4 SELECT S/D, RI SD RI S/D, RI, PI* S/D, RI SD RI * S/D, RI, PI* SD RI PI SD RI PI 88

99 PI MCA/UmbA / 1 LMP Estab.DD 2 CALCS 3 a MCA UmbA b S/D, RI SELECT c S/D, RI, PI SELECT SET 62 S/D, RI S/D, RI, PI Small Parts d:d 65 d:d HFL38x L38x 1 CALCS 2 Right Left 3 Hip Angle Baseline 4 SET 55 Line A Line A 5 Line A 62 Line B Line B 4 89

100 6 Line B d:d 1 CALCS 2 Right Left 3 d:d Ratio d:d Fem Hd 4 SELECT 5 SET HFL38x L25x L38x P10x Vascular Vascular Vascular Vascular 90

101 173 CCA Prox s d Mid s d Dist s d s d ICA Prox s d Mid s d Dist s d ECA Prox s d Mid s d Dist s d VArty s d ICA/CCA 1 CALCS 2 Left Right 3 a b c SELECT d e

102 Cardiac OB Vascular (###) 1 REPORT 2 1/x 3 SAVE Done 1 REPORT 2 1/x Details Summary Details Delete 3 Ratio ICA/CCA 4 RA RA RA 5 RVSP 1 REPORT 2 Twin A/B A/B 92

103 1 REPORT 2 Compare 1 REPORT 2 3 Delete SELECT Delete 3 1 REPORT 2 Anatomy Demonstrated TAB SPACEBAR 4 93

104 1 REPORT 2 (BPP) NST LMP Estab.DD 1 REPORT 2 Graphs 3 Graphs / / 1/x 4 SAVE 5 Report Done EMED 1 DVD PC 24 2 Send Rep. EMED 1 REPORT 2 EMED 3 AAA FAST Gallbladder Kidney 94

105 5 SonoSite SonoSite viii CPD Color OB DVD 10 LCD OB Connectivity 24 DVD DVD SonoSite 5 95

106 C: SonoSite SonoSite SonoSite SonoSite SonoSite viii 31 ARM PCBA (REF) C60x 1 2 Enter license number 3 Done SonoSite SonoSite viii 96

107 98 SonoSite SonoSite viii SonoSite (Association for Professionals in Infection Control and Epidemiology, APIC) 21 CFR / (Association for Professionals in Infection Control and Epidemiology, APIC) (U.S. Food and Drug Administration, FDA) 5 97

108 LCD LCD SonoSite (Association for Professionals in Infection Control and Epidemiology, APIC) (U.S. Food and Drug Administration, FDA) 98

109 SonoSite

110 7 8 SonoSite Theracide 4 1 Cidex 10:1 5.25% 2 ECG ECG ECG ECG

111 3 Cidex Green Theracide

112 1 EPA FDA 510(k) CE Quick Link Documentation 1 C60x/ICTx/ L38x/P21x HFL38x C11x/ L25x AbcoCide 14 A A A U Accel Wipes A A A U Accel Plus N N N U Accel TB N N N U Aidal Plus A A A U Alkacide A A A U Alkazyme A A A U Aquatabs (1000) A N A U Aquatabs (2000) A N A U Aquatabs (5000) N N N U Anioxyde 1000 N N N U Ascend A A A U Asepti-HB A A A U 102

113 1 C60x/ICTx/ L38x/P21x HFL38x C11x/ L25x Asepti-Steryl A A A U Asepti-Wipes A A A A Bacillocid rasant / A A A U Banicide A U A U Betadine N N A U A A A U Cavicide A A A U Caviwipes A A N A Chlor-Clean A N A U Cidex A A A A Cidex OPA A A A U Cidex Plus A A A A Cleanisept A A A A Clorox Wipes A A A U Control III A A N U Coverage Spray A A N N DentaSept N N N U Denatured Alcohol N N N U DisCide Wipes A A A N DisCide Ultra Disinfecting Towelettes U U U N 5 103

114 1 C60x/ICTx/ L38x/P21x HFL38x C11x/ L25x DisOPA A A A A Dispatch A A A U End-Bac II A A A A Endozime AW Plus A A A U Envirocide A U N U Enzol A A A U Expose A A A U Gigasept AF A A A U Gigasept FF Bersteinsaure N N N U Gluteraldehyde SDS A U A U Hexanios / A A A U Hi Tor Plus A A N U Hibiclens A A A U A A A A N N N U Kodan Tcher A A A N Kohrsolin ff A U A U Korsolex basic N N N U LpHse A A A U Lysol N N N U Lysol IC A N A U 104

115 1 C60x/ICTx/ L38x/P21x HFL38x C11x/ L25x Madacide 1 A A N N Matar A U A U MetriCide 14 A A A U MetriCide 28 A A A U MetriZyme A A A U Mikrobak forte A A A U Mikrozid Wipes / A A A N Nuclean / A A A U Precise N N N U Ruthless A A N U Sagrosept Wipe A A A U Salvanios ph 7 A A A U Sani-Cloth HB A A N A Sani-Cloth Plus A A A A Sklar A A N U Sporicidin A A A U Sporicidin Wipes A A A N Staphene A N A N Steranios A A A U Super Sani-Cloth N N N N T-Spray A A N N 5 105

116 1 C60x/ICTx/ L38x/P21x HFL38x C11x/ L25x T-Spray II / A A A U TASK 105 A A A U TBQ A A A U Theracide Plus A A A A Theracide Plus Wipes A A A A Tor A A N U Transeptic N N N U Tristel A A A U Tristel Wipes N N N A Vesphene II / A A A U Virex II 256 A A A U Virex TB A A N N Virox 5 A A A A Wavicide-01 N N N U Wavicide -06 A A A U Wex-Cide A A A U A = N = U = 106

117 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),

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119 MSD MSD BF CF IPX-7 IPX-8 AP/APG ECG /ECG 6 109

120 EN / BF (Canadian Standards Association) (European Norm Harmonized Standards) (UL) (Underwriters Laboratories (UL) safety standards) 8 EN (MPSO) 5 110

121 SonoSite SonoSite SonoSite SonoSite SonoSite / SonoSite SonoSite / / SonoSite JACHO / AAMI-ES1 NFPA 99 IEC IEC IEC ITE SonoSite 5 / 6 111

122 0 C 40 C 60 C 12 SonoSite -20 C 60 C SonoSite SonoSite SonoSite 112

123 P10/P17 P10 P17 SonoSite 21 CFR ALARA MI TI SonoSite 0.3 db/cm/mhz SonoSite 6 113

124 IEC :2001 (EMC) EMC (RF) (EMI) EMI EMI EMI EMI EMI EMI EMI IEC EMC SonoSite SonoSite SonoSite SonoSite SonoSite (ESD) 1 2 EMC 114

125 1 - RF ClSPR 11 RF SonoSite RF RF ClSPR 11 IEC / IEC A A SonoSite 6 115

126 2: - IEC (ESD) IEC % IEC IEC IEC >5% U T >95% U T % U T 60% U T 5 >5% U T >95% U T % U T 60% U T 5 SonoSite 70% U T 70% U T 30% U T 25 30% U T 25 >5% U T >5% U T >95% U T 5 >95% U T 5 IEC / 3 / SonoSite 116

127 2: - IEC RF IEC Vrms Vrms SonoSite RF RF IEC Vim d = 1.2 P 3 / d = 1.2 P d = 2.3 P P (W) d (m) RF a b IEC No. 417-IEC-5140 U T a. / AM FM RF SonoSite RF SonoSite SonoSite b / 6 117

128 ALARA ALARA ALARA CPD Color THI ALARA EN (ISPTA) 720 / Orb ISPTA 50 / TI 1.0 MI 0.23 (MI) (TI) 1.0 MI TI MI TI 119 ALARA MI TI MI TI BS EN :2001 HH 118

129 PRF 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 LCD 6 119

130 MI TI MI TI 3 C11x C60x HFL38x ICTx L25x L38x P21x 4 PRF C11x C60x HFL38x ICTx L25x L38x P21x 120

131 MI TI AIUM 5 TI MI / M / C11x/8-5 MI C60x/5-2 MI HFL38x/13-6 MI ICTx/8-5 MI L25x/13-6 MI L38x/10-5 MI 6 121

132 5 1.0 / M / P21x/5-1 MI MI 1.0 MI 0.1 TI CPD Color MMode M PW TI 0.1 ALARA TI SonoSite AIUM TI 123 (MI) 90% MI 90% MI +16% 31% +0.2 (TI) 90% TI 90% TI +26% 50% dB 3dB MI TI

133 144 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 * EN (a) 1 B IEC C (a) 2 IEC C (a) 1 B IEC C 6 123

134 * 23 C 3 C 6 EN C11x C60x HFL38x L25x L38x P21x C 9.0 C 9.5 C 9.5 C 9.6 C 9.0 C C 18.0 C 19.0 C 18.2 C 20.0 C 20.0 C 7 IEC ICTx C C (bioeffects) (AIUM) (Bioeffects Considerations for the Safety of Diagnostic Ultrasound, J Ultrasound Med., Sept. 1988: Vol. 7, No. 9 Supplement) J Ultrasound Med 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 ) ] 124

135 = = e = a = (db/cm MHz) = 0.53 = 0.66 = 0.79 = 0.43 = 0.55 l = f = // 0.3 = [e -(0.069lf) ] 0.3 db/cm MHz 3 1dB/cmMHz 6 125

136 1990 MI MI 2.0 MMode M MI C 1.5 C 7 C I SPTA 500 / (Bioeffects and Safety of Diagnostic Ultrasound (AIUM, 1993)

137 8 C11x/8-5 / TIS TIB TIC A aprt 1 A aprt >1 (a) (a) 1.2 p r.3 # W 0 # [W.3 (z 1 ),I TA.3 (z 1 )] z 1 z bp z sp # d eq (z sp ) f c # # 4.38 A aprt X # 0.36 Y # 0.5 PD # PRF # p max # d max FL x # 1.56 FL y # 2.5 I max / # PRF / Med/2.0 5 / / (a) <1 (b) # / 6 127

138 9 C11x/8-5 TIS TIB TIC A aprt 1 A aprt >1 (a) (a) p r.3 # W 0 # [W.3 (z 1 ),I TA.3 (z 1 )] z 1 z bp z sp # 1.1 d eq (z sp ) f c # # A aprt X # Y # PD # PRF # p max # d max FL x # 0.77 FL y # 2.5 I max / # PRF (a) <1 (b) # / 128

139 10 C60x/5-2 TIS TIB TIC A aprt 1 A aprt >1 1.0 (a) (b) p r W 0 # # [W.3 (z 1 ),I TA.3 (z 1 )] z 1 z bp z sp 5.3 d eq (z sp ) f c 2.86 # # A aprt X # # Y # # PD PRF 7923 p max d max FL x # # FL y # # I max / THI (a) <1 (b) # / 6 129

140 11 C60x/5-2 M TIS TIB TIC A aprt 1 A aprt >1 1.0 (a) (a) (b) p r W 0 # # # [W.3 (z 1 ),I TA.3 (z 1 )] z 1 z bp z sp 4.7 # d eq (z sp ) # f c 2.85 # # # A aprt X # # # Y # # # PD PRF 800 p max d max # FL x # # FL y # # I max / MB (Multi Beam) (a) <1 (b) # / 130

141 12 C60x/5-2 TIS TIB TIC A aprt 1 A aprt >1 (a) (a) 3.1 (b) p r.3 # W 0 # # [W.3 (z 1 ),I TA.3 (z 1 )] z 1 z bp z sp # d eq (z sp ) 0.51 f c # # # A aprt X # # Y # 1.3 # PD # PRF # p max # d max FL x # # FL y # # I max / # 1 Abd 2 PRF (a) <1 (b) # / 6 131

142 13 HFL38x/13-6 / TIC A aprt 1 A aprt > (b) p r W # [W.3 (z 1 ),I TA.3 (z 1 )] z 1 z bp z sp 1.2 d eq (z sp ) f c # A aprt X 0.44 # Y 0.4 # PD PRF 2597 p max d max FL x 1.32 # FL y 2.5 # I max / Color Color 2 3 // /3.3 / 393 /2.7/ / / (a) <1 (b) # / TIS TIB 132

143 14 HFL38x/13-6 TIC A aprt 1 A aprt >1 (a) (b) p r.3 # W # [W.3 (z 1 ),I TA.3 (z 1 )] z 1 z bp z sp # 1.1 d eq (z sp ) 0.33 f c # # A aprt X # Y # PD # PRF # p max # d max 0.46 FL x 3.72 # FL y 2.5 # I max / # 1 / // / PRF TIS TIB (a) <1 (b) # / 6 133

144 15 ICTx/8-5 TIS TIB TIC A aprt 1 A aprt >1 (a) (a) 1.2 (a) p r.3 # W 0 # # [W.3 (z 1 ),I TA.3 (z 1 )] z 1 z bp z sp # 1.6 d eq (z sp ) f c # # 4.36 # A aprt X # 0.6 # Y # 0.5 # PD # PRF # p max # d max FL x # # FL y # # I max / # PRF 4 1 (a) <1 (b) # / 134

145 16 L25x/13-6 TIS TIB TIC A aprt 1 A aprt >1 (a) (a) 1.6 (b) p r.3 # W 0 # # [W.3 (z 1 ),I TA.3 (z 1 )] z 1 z bp z sp # 0.6 d eq (z sp ) f c # # 6.00 # A aprt X # 0.16 # Y # 0.3 # PD # PRF # p max # d max FL x # # FL y # # I max / # 1 // PRF (a) <1 (b) # / 6 135

146 17 L38x/10-5 / TIC A aprt 1 A aprt > (b) p r W # [W.3 (z 1 ),I TA.3 (z 1 )] z 1 z bp z sp 1.1 d eq (z sp ) f c # A aprt X 0.54 # Y 0.4 # PD PRF 9547 p max 3.48 d max FL x 1.5 # FL y 2.5 # I max / Bre 3 PRF / /3.1 Med/3.1 5 / Def/ Def/Def (a) <1 (b) # / TIS TIB 136

147 18 L38x/10-5 TIS TIB TIC A aprt 1 A aprt > (b) p r W # [W.3 (z 1 ),I TA.3 (z 1 )] z 1 z bp z sp d eq (z sp ) f c # A aprt X # Y # PD 1.29 PRF 1008 p max d max FL x 5.54 # FL y 2.5 # I max / PRF (a) <1 (b) # / 6 137

148 19 P21x/5-1 TIS TIB TIC A aprt 1 A aprt > (b) p r W # [W.3 (z 1 ),I TA.3 (z 1 )] z 1 z bp z sp 5.1 d eq (z sp ) f c # A aprt X # Y 1.3 # PD PRF 4421 p max d max FL x 1.55 # FL y 5.5 # I max / / 2 / 3 4.7/ THI (a) <1 (b) # / 138

149 20 P21x/5-1 M TIS TIB TIC A aprt 1 A aprt >1 1.5 (a) (a) (a) p r W 0 # # # [W.3 (z 1 ),I TA.3 (z 1 )] z 1 z bp z sp # d eq (z sp ) # f c 1.93 # # # A aprt X # # # Y # # # PD PRF 800 p max d max # FL x # # FL y # # I max / / THI 5 MB / 7.5 (a) <1 (b) # / 6 139

150 21 P21x/5-1 / TIS TIB TIC A aprt 1 A aprt > (b) p r W # [W.3 (z 1 ),I TA.3 (z 1 )] z 1 z bp z sp 4.5 d eq (z sp ) f c # A aprt X # Y 1.3 # PD 1.20 PRF 1063 p max d max FL x 3.68 # FL y 5.5 # I max / Color 2 / (a) <1 (b) # / OB 3 PRF/Depth 300/10 850/7.5 4 Color Optimization 5 THI 6 140

151 22 P21x/5-1 TIS TIB TIC A aprt 1 A aprt > (b) p r W # [W.3 (z 1 ),I TA.3 (z 1 )] z z bp 2.66 z sp d eq (z sp ) 0.49 f c # A aprt X # Y # PD 1.21 PRF p max d max 0.49 FL x # FL y 5.5 # I max / PRF (a) <1 (b) # / 6 141

152 23 P21x/5-1 TIS TIB TIC A aprt 1 A aprt >1 (a) (b) p r.3 # W # [W.3 (z 1 ),I TA.3 (z 1 )] z z bp 1.71 z sp # d eq (z sp ) 0.49 f c # # A aprt X # Y # PD # PRF # p max # d max 0.45 FL x # FL y 5.5 # I max / # (a) <1 (b) # / 142

153 24 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 ) z 1 / MI / MI z 1 z 1 / [min(w.3 (z), I TA.3 (z) x 1 cm 2 )] z > zbp z bp 1.69 Aaprt z sp p r.3 z sp = z b.3 d eq (z) z ( 4 ( π) )(( Wo) ( ITA( z) )) I TA (z) z fc A aprt PD PRF ( ) (x) (y) MI MI 6 143

154 24 p max d max FL (x) (y) (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% % 144

155 26 (AC) 1 93/42/EEC 1 IIa IIb III 93/42/EEC LOT C US CSA ANSI/UL REF 93/86/EEC STERILE EO 6 145

156 26 (DC) FCC GEL STERILE R 146

157 26 SN BF B = F = (UL) 6 147

158 26 RoHS / / ( CCC Mark ) LCD WARNING: Connect Only Accessories and Peripherals Recommended by SonoSite SonoSite 148

159 a b c d < 2% 1% < 2% 1% < 2% 1% < 4% + 2%/ * % < 3% + 1.4%/ * % a. b. 0.7 db/cm MHz RMI 413a c. % = 1 + * * % d. % = 2 * %

160 2 M M (Heart Rate) < +/- 2% b % a < +/- 2% d % c < +/- 2% + c * /100 % d bpm a. b. 0.7 db/cm MHz RMI 413a c. d. SonoSite 3 a < +/- 2% 0.01 / - 1% b 550 / < +/- 2% % b < +/- 2% % c a. SonoSite b. c. 150

161 AIUM (ACC) / Zwiebel, W.J. Introduction to Vascular Ultrasonography. 4th ed., W.B. Saunders Company, (2000), 52. ACC = abs / (AT) Oh, J.K., J.B. Seward, A.J. Tajik. The Echo Manual. 2nd ed., Lippincott, Williams, and Wilkins, (1999), 219. (AVA) 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 = Ao A 1 = LVOT V 1 = LVOT V 2 = Ao LVOT = AVA (PV LVOT /PV AO ) * CSA LVOT AVA (VTI LVOT /VTI AO ) * CSA LVOT 7 151

162 (BSA) Grossman, W. Cardiac Catheterization and Angiography. Philadelphia: Lea and Febiger, (1980), 90. BSA = * * = = (CI) // 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) / 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) Reynolds, Terry. The Echocardiographer s Pocket Reference. 2nd ed., School of Cardiac Ultrasound, Arizona Heart Institute, (2000), 383. CSA = * D 2 D = Reynolds, Terry. The Echocardiographer s Pocket Reference. 2nd ed., School of Cardiac Ultrasound, Arizona Heart Institute, (2000), 453. a - b (dp:dt) / Otto, C.M. Textbook of Clinical Echocardiography. 2nd ed., W.B. Saunders Company, (2000), 117, / 152

163 E:A / E/Ea E:A = E/ A Reynolds, Terry. The Echocardiographer s Pocket Reference. 2nd ed., School of Cardiac Ultrasound, Arizona Heart Institute, (2000), 225. E /Ea (ERO) E = E Ea = E E 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) ET = (HR) bpm HR = M 3 (IVS) Laurenceau, J. L., M.C. Malergue. The Essentials of Echocardiography. Le Hague: Martinus Nijhoff, (1981), 71. IVSFT = ((IVSS IVSD)/IVSD) * 100% IVSS = IVSD = 7 153

164 (IVRT) 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) 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 = 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 = 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 a b -- L i i n n i = 1 154

165 V = a = b = n = (n=20) L = i = 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 a 2 -- L i n n i = 1 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 = (Vmean) / Vmean = 7 155

166 (MVA) 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 / 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) 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) PGmax = 4 * PV 2 (PGmean) PGmean = / (PHT) Reynolds, Terry. The Echocardiographer s Pocket Reference. 2nd ed., School of Cardiac Ultrasound, Arizona Heart Institute, (2000), 391. PHT = DT * 0.29 DT = 156

167 (PISA) 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 = 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) Reynolds, Terry. The Echocardiographer s Pocket Reference. School of Cardiac Ultrasound, Arizona Heart Institute, (2000), 396, 455. RV = ERO * MR VTI (RVSP) Reynolds, Terry. The Echocardiographer s Pocket Reference. School of Cardiac Ultrasound, Arizona Heart Institute, (1993), 152. RVSP = 4 * (Vmax TR) 2 + RAP RAP = (SI) / Mosbyís Medical, Nursing, & Allied Health Dictionary, 4th ed., (1994), SI = SV/BSA SV = BSA = 7 157

168 (SV) 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) CSA = LVOT VTI = M (SV) 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) Reynolds, Terry. The Echocardiographer s Pocket Reference. 2nd ed., School of Cardiac Ultrasound, Arizona Heart Institute, (2000), 383. VTI = abs [n] (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 158

169 (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, (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) (GA) LMP GA(LMP) = LMP (Estab. DD) (LMPd) (GA) (Estab. DD) (GA) Established Due Date LMP GA(LMPd) = LMPd (Estab. DD) (LMPd) / / LMPd(Estab. DD) = Estab. DD

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

171 (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) (GS) (HC) Osaka University. Ultrasound in Obstetrics and Gynecology. (July 20, 1990), 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). 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. (OFD) Hansmann, M., et al. Ultrasound Diagnosis in Obstetrics and Gynecology. New York: Springer-Verlag, (1986),

172 (TTD) (AC) (BPD) 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), 885. 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 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) 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

173 (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. (HC) Hansmann, Hackeloer, Staudach, Wittman. Ultrasound Diagnosis in Obstetrics and Gynecology. Springer-Verlag, New York, (1986), 182, Table 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) FL/AC FL/BPD 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), 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), 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),

174 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), /x S/D +/x = abs A/ B A = + B = x (ACC) (ET) Zwiebel, W.J. Introduction to Vascular Ultrasonography, 4th ed., W.B. Saunders Company, (2000), 52. ACC = abs / ET = /d:d Graf, R. Fundamentals of Sonographic Diagnosis of Infant Hip Dysplasia. Journal of Pediatric Orthopedics, Vol. 4, No. 6: , Morin, C., Harcke, H., MacEwen, G. The Infant Hip: Real-Time US Assessment of Acetabular Development. Radiology 177: , December (IMT) Howard G, Sharrett AR, Heiss G, Evans GW, Chambless LE, Riley WA, et al. Carotid Artery Intima-Medial Thickness Distribution in General Populations As Evaluated by B-Mode Ultrasound. ARIC Investigators. Atherosclerosis Risk in Communities. Stroke. (1993), 24: O Leary, Daniel H., MD and Polak, Joseph, F., MD, et al. Use of Sonography to Evaluate Carotid Atherosclerosis in the Elderly. The Cardiovascular Health Study. Stroke. (September 1991), 22, Redberg, Rita F., MD and Vogel, Robert A., MD, et al. Task force #3 What is the Spectrum of Current and Emerging Techniques for the Noninvasive Measurement of Atherosclerosis? Journal of the American College of Cardiology. (June 4, 2003), 41:11,

175 Taylor K.J.W., P.N. Burns, P. Breslau. Clinical Applications of Doppler Ultrasound, Raven Press, N.Y., (1988), Zwiebel W.J., J.A. Zagzebski, A.B. Crummy, et al. Correlation of peak Doppler frequency with lumen narrowing in carotid stenosis. Stroke, 3: (1982), = 1 - A2 /A1 * 100 A1 = A2 = Handa, Nobuo et al., Echo-Doppler Velocimeter in the Diagnosis of Hypertensive Patients: The Renal Artery Doppler Technique, Ultrasound in Medicine and Biology, 12:12 (1986), = 1 - D2 /D1 * 100 D1 = D2 = (PGr) Oh, J.K., J.B. Seward, A.J. Tajik. The Echo Manual. 2nd ed., Lippincott, Williams, and Wilkins, (1999), * E (E PG) EPG = 4 * PE 2 A (A PG) APG = 4 * PA2 (PGmax) PGmax = 4 * PV2 (PGmean) PGmean = 4 * Vmax

176 (PI) Kurtz, A.B., W.D. Middleton. Ultrasound-the Requisites. Mosby Year Book, Inc., (1996), 469. PI = (PSV EDV)/V PSV = EDV = V = (RI) Kurtz, A.B., W.D. Middleton. Ultrasound-the Requisites. Mosby Year Book, Inc., (1996), 467. RI = abs A B / A A = + B = x (TAM) / TAM = (Vol) Beyer, W.H. Standard Mathematical Tables, 28th ed., CRC Press, Boca Raton, FL, (1987), 131. (VF) / Allan, Paul L. et al. Clinical Doppler Ultrasound, 4th ed., Harcourt Publishers Limited. (2000), VF = CSA * TAM *

177 C60x C11x/ C60x/ HFL38x/ ICTx/ L25x/ L38x/ P21x/ D 256 CPD 256 Color 256 MMode M PW CW (Tissue Doppler Imaging (TDI)) THI 8 167

178 ECG 1.8 M (MDSm) Lite II (MDS Lite II) SiteLink Image Manager SonoCalc IMT 3.1 Triple Transducer Connect 168

179 Sony DVD Kensington C 15 95% C 15 95% C 15 95% C 15 95% C 15 95% * C 15 95% *

180 #1 # (VAC) 50/ EN :1997, European Norm, Medical Electrical Equipment Part 1. General Requirements for Safety 1 EN :2001, European Norm, Medical Electrical Equipment Part 1. General Requirements for Safety Section 1-1. Collateral Standard Safety Requirements for Medical Electrical Systems EN : Amendment A1:2005, European Norm, Particular requirements for the safety of ultrasonic medical diagnostic and monitoring equipment CAN/CSA C22.2, No M90, Canadian Standards Association, Medical Electrical Equipment Part 1. General Requirements for Safety (including CSA Supplement 1:1994 and CSA Amendment 2:1998) 1 CEI/IEC 61157:1992, International Electrotechnical Commission, Requirements for the Declaration of the Acoustic Output of Medical Diagnostic Ultrasonic Equipment UL (1st Edition), Underwriters Laboratories, Medical Electrical Equipment-Part 1: UL (UL) 1 General Requirements for Safety IEC: :

181 EMC EN :2001, European Norm, Medical Electrical Equipment. EN :2001 General Requirements for Safety-Collateral Standard - Electromagnetic Compatibility Requirements and Tests CISPR11:2004, International Electrotechnical Commission, International Special Committee on Radio Interference - Industrial, Scientific, and Medical (ISM) Radio-Frequency Equipment Electromagnetic Disturbance Characteristics-Limits and Methods of Measurement (ISM) Group 1 Class A 1 A RTCA/DO-160E:2004, Radio Technical Commission for Aeronautics, Environmental Conditions and Test Procedures for Airborne Equipment, Section 21.0 Emission of Radio Frequency Energy, Category B RTCA/DO-160E B DICOM NEMA PS 3.15:2000, Digital Imaging and Communications in Medicine (DICOM)-Part 15:Security Profiles NEMA PS (DICOM) - 15 HIPAA The Health Insurance and Portability and Accountability Act, Pub.L. No (1996) CFR 160, General Administrative Requirements 45 CFR 164, Security and Privacy 8 171