EdgeII_UG_SCH_P book

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2 FUJIFILM SonoSite, Inc th Drive SE Bothell, WA FUJIFILM SonoSite B.V. Joop Geesinkweg AB Amsterdam, FUJIFILM SonoSite Australasia Pty Ltd 114 Old Pittwater Road BROOKVALE, NSW, 2100 SiteLink Edge SonoCalc SonoHD2 SonoMB Steep Needle Profiling SonoSite SonoSite FUJIFILM SonoSite, Inc. DICOM National Electrical Manufacturers Association US 8,956,296; US 8,861,822; US 8,858,436; US 8,834,372; 8,805,047; US 8,527,033; US 8,439,840; US 8,398,408; US 8,355,554; US 8,216,146; US 8,213,467; US 8,147,408; US 8,137,278; US 8,088,071; US 8,066,642; US 8, 052,606; US 7,819,807; US 7,804,970; US 7,740,586; US 7,686,766; US 7,604,596; US 7,591,786; US 7,588,541; US 7,534,211; US 7,449,640; US 7,169,108; US 6,962,566; US 6,648,826; US 6,575,908; US 6, 569,101; US 6,471,651; US 6,416,475; US 6,383,139; US 6,364,839; US 6,203,498; US 6,135,961; US 5,893,363; US5,817,024; US 5,782,769; US 5,722,412; AU:730822; AU:727381; CA 2,372,152; CA:2,371,711; CN ; CN ; CN ; DE ; DE ; DE ; DE ; DE ; DE: ; DE ; EP ; EP ; EP ; EP ; EP ;EP ; EP ; ES ; ES ; ES ; ES ; FR ; FR ; FR ; FR ; FR ; FR ; GB ; GB ; GB ; GB ; GB ; GB ; GB ; IT ; IT ; IT ; IT ; JP ; KR ; KR ; NO ; NO P FUJIFILM SonoSite, Inc.

3 1 SonoSite Edge II USB A B OB...30 OB...31 OB...31 i

4 USB...34 JPEG...35 efilm Lite D...37 M...39 CPD...40 PW CW Steep Needle Profiling ECG D...70 M EMED (Gyn)...97 OB...98 ii

5 MSK TCD EMED MSK A B ECG iii

6 EMC DICOM HIPAA ALARA ALARA MI TI MI TI In Situ iv

7 1 SonoSite Edge II SonoSite Edge II SonoSite Edge II SonoSite Edge II SonoSite Edge II SonoSite Edge II 1

8 FUJIFILM SonoSite SonoSite Edge II

9 2 SonoSite Edge II SonoSite Edge II 134 FUJIFILM SonoSite USB USB SonoSite Edge II 3

10 (ECG) ECG ECG CPD Color (PUBS) in vitro (IVF) CPD (IUGR) 4

11 (Orb) (Oph) FDA Orb Oph 51 SonoSite Edge II 5

12 SonoSite Edge II 1 4 USB SonoSite Edge II 1 3 / 2 4 ECG 6

13 PATIENT 4 2D ( ) M MODE M C COLOR D DOPPLER

14

15 V

16 FUJIFILM SonoSite

17 USB USB USB FAT-32 11

18 USB PC USB PC USB USB USB USB USB USB USB USB USB USB USB USB USB 2-1 USB USB 34 USB USB USB 1 USB 5 2 USB 12

19 NEAR FAR SELECT A SET SAVE CALC ZOOM UPDATE PROGRAM B CALIPER CLIP D DOPPLER C COLOR 5 GAIN AUTO DEPTH CALC FREEZE SAVE M MODE 2D Alphanumeric keys 3 Annotation keys 17 4 Gain NEAR FAR PW 13

20 2-1 GAIN 5 AUTO 6 ZOOM 100% 7 DEPTH UP, DEPTH DOWN 8 SET CALIPER 9 CALCS 10 Touchpad 11 FREEZE 12 SAVE SAVE CALC CLIP 14 Imaging Modes MMODE M DOPPLER COLOR MMODE M M-line M MMODE M DOPPLER D-line DOPPLER CPD/Color CPD/ 2D 15 A & B 16 UPDATE M 17 SELECT 14

21 Forms PATIENT EXAM REVIEW REPORT EMED Gen RES THI PW 2 15

22 ID / 10 USB cm 1cm 5cm CPD SELECT 16

23 / 28 / SELECT SELECT TAB 2 CAPS LOCK 3 SHIFT 4 TEXT 5 PICTO 6 17

24 DELETE ENTER Last First Middle Patient ID Accession Indications Procedure ID User Reading Dr. Referring Dr. Institution DICOM SiteLink AE A & B 18

25 2-3 1 Symbols 2 3 OK 21 CFR FUJIFILM SonoSite FUJIFILM SonoSite FUJIFILM SonoSite FUJIFILM SonoSite 137 FUJIFILM SonoSite Aquasonic 19

26 FUJIFILM SonoSite

27 3 1 SETTINGS 2 Setup Pages Done Reset A B A & B Key,Footswitch A & B A Key A B Key B A Print B none Footswitch (L) Footswitch (R) Save Clip Freeze Save Image Print 22 21

28 FUJIFILM SonoSite 1 USB USB 2 A & B Key, Footswitch A & B Administration 1996 (Health Insurance Portability and Accountability Act, HIPAA) (European Union Data Protection Directive, 95/46/EC) HIPAA 1 Name Administrator 2 Password a FUJIFILM SonoSite 2 3 Login 22

29 User Login 1 2 User Login On On Off 1 Administrator 2 User List Administrator 3 User Information Password Confirm 26 Password changes 4 Save 1 Administrator 2 1 Administrator 2 New 3 User Information Name Password Confirm 26 4 User User 5 Administration Access 6 Save 23

30 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 24

31 4 USB Export USB 1 USB 2 Administrator 3 Import 4 USB Import USB PC 1 Administrator 2 Log Back DICOM (log.txt) USB log.txt 1 USB 2 Log Export USB 3 USB Export Microsoft Word 25

32 1 Event 2 Clear 3 Yes User Login OK 1 2 User Login Guest 1 2 User Login Password 3 OK (A-Z) (a-z) (0-9) Annotations 56 26

33 56 1 Annotations Exam 2 Group A B C 3 Text Add Text Rename Delete 18 Annotations Unfreeze Keep All Text Keep Home Text Clear All Text Keep All Text 57 1 USB 2 Annotations Export USB 3 USB Export USB 1 USB 2 Annotations Import 3 USB Import 27

34 4 Done USB Audio, Battery Key click On Off Beep alert On Off Sleep delay Off 5 10 Power delay Off Cardiac Calculations (TDI) 81 Cardiac Calculations TDI Walls TDI Connectivity SiteLink Image Manager DICOM SiteLink SiteLink Image Manager DICOM SonoSite DICOM 1 2 Connectivity Printer 28

35 Connectivity Internal Storage Capacity Alert DICOM Date and Time Date and Time Date Time 24 1 Date and Time Time Server 2 IP address IP 3 Display Information Patient Header Mode Data System Status 29

36 Network Status System IP address IP Location Ethernet MAC address MAC Wireless connection ) OB OB Calculations OB 98 OB 1 OB Calculations Gestational Age Growth Analysis None 2 More OB 1 USB 2 OB Calculations Export USB 3 USB Export USB OB 30

37 1 USB 2 OB Calculations Import 3 USB Import 4 OK OB OB Calculations OB OB OB Custom Measurements OB 98 OB OB OB OB 1 OB Custom Measurements OB New 2 Name 3 Type 4 Save OB OB 1 OB Custom Measurements OB Custom Measurements 2 Delete Last 3 Yes OB OB Custom Tables OB OB 31

38 GS BPD HC APTD FTA EFW HL CRL OFD TTD AC FL BPD AC EFW HC FL HC/AC OB 1 OB Calculations OB OB Custom Measurements OB Tables 2 / OB OB 1 OB Calculations OB OB Custom Measurements OB Tables 2 Gestational Age Growth Analysis 3 Measurement 32 OB

39 4 New 5 Author 6 7 Save 30 OB 1 OB Calculations OB OB Custom Measurements OB Tables 2 OB 3 Edit Save Delete Yes Presets Doppler Scale cm/s khz Duplex M 1/3 2D, 1/3 Trace 1/2 1/2 1/2 2D, 1/2 Trace 1/2 1/2 Full 2D, Full Trace Live Trace Peak Mean Thermal Index TIS TIB TIC OB TIB TCD TIC TIS Save Key Save 33

40 Image Only Image/Calcs / Units in/ft/lbs cm/m/kg Auto save Pat.Form System Information 135 System Information Patents USB USB Devices USB USB USB 65 USB U FAT32 1 USB Devices USB Export 2 USB Export USB SiteLink SiteLink H.264 MP4 FUJIFILM SonoSite QuickTime 7.0 DICOM DICOM DICOM 34

41 3 JPEG JPEG 35 JPEG SiteLink DICOM 4 SiteLink Sort By Devices 1 USB Devices USB Export 2 USB Export USB AutoExport DICOM FUJIFILM SonoSite USB Devices USB Include private tags FUJIFILM SonoSite SonoSite Edge II DICOM JPEG JPEG BMP "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 pdf USB 35

42 efilm Lite DICOM U efilm Lite efilm Lite Windows DICOM efilm Lite efilm Lite 1 U 2 U 3 efilmlite.bat efilmlite.bat efilmlite efilmlite efilmlite efilmlite PDF efilm Lite 36 USB

43 4 51 2D 2D 2D 1 2D 2 2D 2D 2D 4-1 2D Res Gen Pen -3,

44 4-1 2D LVO LVO 2D Dual Update Update 2D Dual 2D LVO On LVO LVO Off LVO 2D LVO LVO (MI) U/R / U/L / D/L / D/R / 1 10 Guide A B C Back A B C Guide ECG Guide SonoMB (MB) MB On MB MB Off MB SonoMB SonoMB MB SonoMB SNP ECG Steep Needle Profiling 46 SNP ECG 66 ECG FUJIFILM SonoSite ECG 38

45 4-1 2D THI 61 THI x/x 49 M (M Mode) 2D 2D M 1 M M 2 M 2D M 37 2D M 1 M M 200 ms 1 4 Slow Med Fast UPDATE M M M M 39

46 33 CPD (CPD) (Color) CPD Color CPD Color 1 C ROI 2D 2 CPD Color Color Color cm/s 3 ROI SELECT ROI ROI 4 CPD Color CPD Color CPD Color 4-2 CPD Color Color CPD CPD Color Color Show Hide 40

47 4-2 CPD Color Low Med High PRF (PRF) Low Med High PRF Low Med High ROI PW 43 PW Color x/x PW CW (PW) (CW) PW CW PW/CW CPD/Color CPD/Color ROI SELECT ROI ROI PW 41

48 PW CW 1 D 2 43 PW SELECT SELECT FAR D 200 ms UPDATE D 33 42

49 PW PW 4-3 PW PW CW CW PW CW TDI TDI x/x TCD Orb TDI On TDI TDI TDI Off TDI PW [PRF] cm/s khz 33 43

50 4-4 Live Trace Live Trace Invert (0-10) Low Med High Slow Med Fast 33 x/x 0.5 cm 1cm 5cm DEPTH UP DEPTH DOWN AUTO 44

51 NEAR 2D Far 2D Gain CPD Color GAIN (ROI) PW CW GAIN NEAR FAR (TGC) FREEZE GAIN 2D Color 1 ZOOM ROI 2 ROI 3 ZOOM ROI 100% 4 5 ZOOM 45

52 SNP Steep Needle Profiling - - Steep Needle Profiling SNP Steep Needle Profiling SonoMBe 4-1 Steep Needle Profiling 4-2 SNP 2D 4-5 SNP rc60xi/rc60xi Armored HFL38xi HFL50x HSL25x L25x L38xi/L38xi Armored 46

53 SNP SNP

54 Steep Needle Profiling Steep Needle Profiling SNP Steep Needle Profiling L/R Flip / 37 2D Shallow Medium Steep 48

55 30 Shallow Medium 40 Steep Off (MBe) SNP Back Steep Needle Profiling SNP SNP SNP SNP Steep Needle Profiling (MB) Steep Needle Profiling Steep Needle Profiling SNP 21 A B 49

56

57 (Orb) Oph FDA Orb Oph Exam Exam Type 探头 a B M PWD CWD 其他 L25x 1, 4 1, 4 ( ) ( ) ( ) 1, 4 1, 4 1, 4 51

58 4-6 探头 a B M PWD CWD 其他 L38xi/ L38xi Armored 1, 4 1, 4 ( ) 1, 4 1, 4 HSL25x 1, 4 1, 4 ( ) ( ) ( ) 1, 4 1, 4 1, 4 1, 4 52

59 表 4-6 探头可用的成像模式和检查 续 成像模式 B M 模式 彩色 多普勒 探头 检查类型 a HFL38xi 腹部 1, 4 儿科 1, 4 小器官 ( 乳 房 甲状腺 睾丸 前列 腺) 1, 4 肌肉骨骼(传 统的) 肌肉骨 骼(浅表上) 1, 4 外周血管 1, 4 腹部 1, 4 儿科 1, 4 小器官 ( 乳 房 甲状腺 睾丸 前列 腺) 1, 4 肌肉骨骼 (传统的) 1, 4 肌肉骨骼 (浅表上) 1, 4 外周血管 1, 4 腹部 1 经阴道 1 HFL50x ICTx 探头可用的成像模式和检查 PWD CWD 其他 53

60 4-6 探头 a B M PWD CWD 其他 C11x rc60xi / rc60xi Armored 1, 2, 4 1, 2, 4 1, 2, 4 ( ) 1, 2, 4 1, 2, 4 54

61 4-6 探头 a B M PWD CWD 其他 P10x ( ) ( ) / ,

62 4-6 探头 a B M PWD CWD 其他 rp19x / rp19x Armored 1, 2 1, 2 1, 2 ( ) / 1, 2 1, 2, 3 1, 2 TEExi 1, (THI) 3 (TDI) 4 SonoMBe) 26 2D 1 TEXT 56

63 2 Home 57 3 DELETE Word Symbols 18 4 Label 26 TEXT 1 TEXT 2 3 Home/Set / 1 2 SELECT SELECT

64 a Hide 1 PICTO 2 x/x SELECT 3 4 SELECT 5 U/L / D/L / D/R / U/R / Hide PATIENT 2 New/End / 58

65 Done 63 ID Connectivity Bar Code Auto Lookup 63 1 PATIENT 2 3 Cancel Done PATIENT 3 New/End / Symbols 18 Last First Middle ID 59

66 Accession Date of birth Gender Indications User Procedure DICOM SonoSite DICOM Back Type 51 LMP Estab. DD OB Gyn OB LMP Estab. DD Gyn LMP Twins OB Twins Twin A A Twin B B Twin A A Twin B B Previous Exams OB Twin A/B A/B Twin A A Twin B B Twin A/B A/B Back Twins Back BP HR Height 33 Weight 33 BSA 60

67 Reading Dr. Referring Dr. Institution Department ID ID Beep Alert SAVE SAVE SAVE Clips controls 2 CLIP Prev/Off Prev/On (1x, 1/2x, 1/4x) Pause 61

68 Left: x x Right: x x x Save Delete 3 CLIP 1 2D Clips Time ECG Time ECG PrevOn PrevOff Prev/On Prev/Off Pro Retro Pro CLIP Retro CLIP FUJIFILM SonoSite 2 USB 62

69 1 REVIEW 2 List Select All Clear All ID 1 2 Edit 3 OK 1 2 Append 63

70 1 2 Review 3 x/x 4 Play Pause 1x 1/2x 1/4x 5 x/x List Done USB USB USB USB Print A A A B

71 2 Print Print USB 59 USB 34 USB 1 USB 2 3 Exp.USB USB USB 4 USB Include patient information on images and clips USB 5 Export USB 5 USB USB U USB 3 Cancel Export 65

72 Delete SiteLink Image Manager DICOM PC DICOM SiteLink Image Manager DICOM SiteLink Image Manager 1 2 Archive 1 2 Info ECG ECG FUJIFILM SonoSite ECG ECG FUJIFILM SonoSite ECG ECG FUJIFILM SonoSite FUJIFILM SonoSite 66 ECG

73 ECG 1 ECG ECG ECG ECG ECG 2D ECG ECG 2 ECG ECG ECG 3 ECG 4-8 ECG / ECG ECG 0-20 ECG Slow Med Fast Line Save 61 ECG ECG / Delay ECG 67

74 68 ECG

75 5 6 M HR 76 1 CALCS CALIPER 69

76 75 SELECT Switch Delete (2D) 2D 2D cm cm 2 cm 70

77 (2D) 2D 8 1 2D CALIPER 2 SELECT 3 69 (2D) 1 2D CALIPER 2 Ellipse Ellipse 3 SELECT 69 (2D) 1 2D CALIPER 2 Manual Manual 3 4 SELECT 5 SET 69 71

78 M M cm / (HR) / (bpm) 200 ms 1 M 4 1 M CALIPER 2 3 SELECT 4 69 M 1 M CALIPER 2 HR 3 SELECT 4 69 (cm/s) 72

79 +/x (RI) cm/s 33 (cm/s) 1 CALIPER /x (RI) RI ACC 1 CALIPER 2 3 SELECT CALIPER 2 Time 3 SELECT 4 SELECT 1 CALIPER 2 Manual 73

80 3 SELECT 4 a Undo b SET CALIPER 2 Auto 3 a b SELECT 4 5 SET 69 (VTI) (Vmax) (PGmean) (Vmean) (PGmax) (EDV) (CO) (PSV) (TAM) +/ / (S/D) (PI) (RI) 74

81 (AT) (TAP) 106 (...) 1 CALCS 2 SELECT a Next Prev (... SELECT 3 Main SELECT 4 CALCS 75

82 CALIPER SAVE CALC Save 61 SAVE Image/Calcs / SAVE SELECT CALIPER SAVE CALC 1 76

83 2 Delete 106 EMED EMED EMED EMED EMED 1 CALCS 2 EMED EMED CALCS 51 77

84 1 2D CALCS 2 A 1 A 2 a Area Red b SELECT c i Undo d SET e D CALCS 2 D 1 D 2 a Dia Red b c

85 2D D 1 D 2 D 3 a 2D CALCS b i Volume Volume Gyn Volume ii iii D (2D)* TAM TAP VF ml/min * 2D 2D 79

86 33 2D C11x (mm) rc60xi P10x (mm) HFL38xi L25x (mm) L38xi (mm) Allan, Paul L. et al. Clinical Doppler Ultrasound, 4th Ed., Harcourt Publishers Limited, (2000) D a 2D CALCS b Vol Flow D c d 76 2 a CALCS b Vol Flow TAM TAP 80

87 c d SELECT e f SET g 76 (Crd) (Gyn) (OB) (SmP) (TCD) (Art)

88 EF EF LVDd 2D M LVDs 2D M EF FS LV (EF) LV LVd LVs A4Cd (2D) A4Cs (2D) A2Cd (2D) A2Cs (2D) RVW (2D) RVD (2D) IVS (2D) LVD (2D) LVPW (2D) RVW (2D) RVD (2D) IVS (2D) LVD (2D) LV LV EF CO SV CI SI CO EF SV LVESV LVEDV IVSFT LVPWFT LVDFS CI SI LV M LVPW (2D)CO CI HR HR a M HR HR 82

89 5-1 Ao/LA Ao 2D M Ao LA/Ao AAo (2D) LA 2D M LVOT D (2D) ACS M LVET M AAo LA LA/Ao LVOT D LVOT ACS LVET MV EF: M EF MV MR EPSS M E A PHT VTI IVRT Adur dp:dt b CW EPSS E E PG A A PG E:A PHT MVA VTI Vmax PGmax Vmean PGmean dp:dt 83

90 5-1 CO IVC LVOT D (2D) HR (Doppler) LVOT VTI Max D 2D M Min D 2D M LA A4C (2D) LA A2C (2D) RA (2D) CO SV CI SI VTI HR LVOT D LA LA RA RA TAPSE TAPSE M TAPSE cm MV (2D) MV LV AV (2D) Epi (2D) Endo (2D) Apical (2D) AV LV Epi Endo 84

91 5-1 AV AV LVOT AI Vmax VTI Vmax VTI PHT Vmax PGmax VTI Vmax PGmax Vmean PGmean Vmax PGmax VTI Vmax PGmax Vmean PGmean AI PHT AI TV TRmax Vmax PGmax E A PHT VTI RA c E E PG A A PG E:A PHT TVA VTI Vmax PGmax Vmean PGmean RVSP 85

92 5-1 PV Vmax Vmax PGmax PISA Qp/Qs VTI AT Ann D (2D) (Color) MR VTI MV VTI LVOT D (2D) RVOT D (2D) LVOT VTI RVOT VTI VTI Vmax PGmax Vmean PGmean AT PISA ERO MV D VTI VMax PGmax Vmean PGmean SV Qp/Qs P. Vein A VMax TDI Adur S D (Sep) e' a' (Lat) e' a' (Inf ) e' a' (Ant) e' a' VMax S/D E(MV)/e' 86

93 5-1 a. HR 88 (HR) M 72 M b. dp:dt 100 cm/s 300 cm/s c. 106 EF 1 2D M CALCS LV 1 2D CALCS 2 EF... LV Vol (EF) LV (EF) 3 a b SELECT c (LV) Undo d SET e 76 LVd LVs 1 2D M CALCS

94 4 SELECT 5 SELECT 6 SELECT SELECT 7 76 (HR) ECG 1 CALCS HR 2 SELECT 3 76 Ao LA AAo LVOT D 1 2D M CALCS IVC 1 2D M CALCS 2 88

95 TAPSE 1 M CALCS MV AV 1 2D CALCS 2 Area MV AV 3 SELECT 4 a Undo 5 SET D CALCS 2 Atria 3 SELECT 4 a Undo 5 SET

96 LV 1 2D CALCS 2 LV Mass LV 3 EPI Endo a b SELECT c i Undo d SET e 76 4 Apical CALCS 2 MV TV TDI P. Vein 3 a b c 76 90

97 (VTI) VTI CALCS 2 MV AV TV PV LVOT VTI 3 SELECT 4 a Undo 5 SET (RVSP) 1 CALCS 2 TV TRmax RA 106 RA 5 RVSP MV AI TV (PHT) 1 CALCS 2 MV AV TV PHT SELECT 91

98 3 MV EF AV 4 76 (PISA) PISA 2D Color 1 (2D) a 2D CALCS b PISA Ann D c d 76 2 (Color) a Color CALCS b Radius c d 3 CALCS 4 MR VTI MV VTI a PISA MR VTI MV VTI b SELECT c i Undo d SET e 74 92

99 (IVRT) 1 CALCS MV IVRT 2 3 SELECT : (dp:dt) dp:dt CW 300 cm/s 43 1 CW CALCS 2 MV dp:dt : 100 cm/s cm/s 4 SELECT 300 cm/s cm/s 6 76 (AVA) AVA 2D 1 2D LVOT a 2D CALCS b LVOT D c d 76 93

100 2 LVOT Vmax AV Vmax 90 AV Vmax Vmax VTI 91 CALCS AV VTI Qp/Qs Qp/Qs 2D 1 2D CALCS 2 LVOT D RVOT D a Qp/Qs / LVOT D RVOT D b c 76 3 CALCS 4 LVOT VTI RVOT VTI a Qp/Qs / LVOT VTI RVOT VTI b SELECT c Undo d SET e (SV) (SI) SV SI 2D SI (BSA) 94

101 1 SI Height Weight BSA 58 2 LVOT (2D) a 2D CALCS b Ao/LA / LVOT D c d 76 3 LVOT 91 CALCS AV LVOT VTI 74 (CO) (CI) CO CI CI (BSA) 1 Height Weight BSA (SV) (SI) SV 3 88 (HR) HR PW Angle Correction 1L/min 1L/min 95

102 4 LVOT (2D) a 2D CALCS b CO LVOT D c d 76 Presets Live Trace a b Trace Above Below c SELECT SET Trace d (TDI) 1 TDI 43 PW 2 CALCS 3 TDI a b c 76 96

103 (Gyn) (Gyn) D CALCS 2 Gyn 3 a b c D CALCS 2 Follicle 3 a Right Fol Left Fol b

104 OB EFW EDD OB EFW OB OB OB 99 OB OB 31 OB 31 OB 98

105 5-2 a YS GS Hansmann, Nyberg, Tokyo U. CRL Hadlock, Hansmann, Osaka, Tokyo U. BPD Chitty, Hadlock, Hansmann, Osaka, Tokyo U. OFD HC TTD APTD Hansmann Chitty, Hadlock, Hansmann Hansmann, Tokyo U. b Tokyo U. b AC Hadlock, Hansmann, Tokyo U. FTA Osaka FL Chitty, Hadlock, Hansmann, Osaka, Tokyo U. HL Jeanty Jeanty TCD CM Lat V CxLen (EFW) c HC, AC, FL Hadlock 1 BPD, AC, FL Hadlock 2 AC, FL Hadlock 3 BPD, TTD Hansmann BPD, FTA, FL Osaka U. BPD, AC Shepard BPD, TTD, APTD, FL Tokyo U. 99

106 5-2 HC/AC Campbell FL/AC FL/BPD FL/HC Hadlock Hohler Hadlock 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 Brenner, Hadlock, Jeanty Campbell a. AUA b. Toyko U APTD TTD EFW c. (Estimated Fetal Weight) EFW 30 OB Hadlock EFW d. (Growth Analysis) (Report Graphs) LMP Estab. DD (2D) 2D AFI 1 OB LMP Estab.DD Twins 2 2D CALCS 100

107 3 a b Twin A A Twin B B c d 76 M 1 M CALCS 2 FHR 3 4 SELECT MCA S/D, RI SD, RI S/D, RI, PI* SD, RI, PI Umb A S/D, RI SD, RI S/D, RI, PI* SD, RI, PI * MCA Umba PI MCA/UmbA 1 OB LMP Estab.DD 2 CALCS 101

108 3 a MCA UmbA b S/D, RI SELECT S/D, RI, PI SELECT SET c 76 S/D, RI S/D, RI, PI MSK d:d MSK 78 MSK D CALCS 2 Right Left Hip Angle Baseline 3 SET 69 Line A Line A 4 Line A 76 Line B Line B 5 Line B 102

109 d:d 1 2D CALCS 2 Right Left 3 d:d Ratio d:d Fem Hd 4 SELECT SET

110 5-3 CCA Prox s d Mid Dist Bulb s d s d s d ICA Prox s d Mid Dist s d s d ECA Prox s d Mid Dist VArty s d s d s d 5-4 CCA Prox s d Mid Dist Bulb s d s d s d 104

111 5-4 ICA Prox s d Mid Dist s d s d ECA Prox s d Mid Dist VArty s d s d s d ICA/CCA 1 CALCS 2 Left Right 3 a b SELECT c d

112 OB (###) 1 REPORT 2 1/x TCD Details Summary 3 SAVE Done 1 Details 2 Delete ICA/CCA Ratio ICA/CCA RA Summary RA 5 RA RVSP 106

113 TCD TAP TCD 1 Details TAP Delete Twin A/B A/B Compare 2 Delete a SELECT Delete 1 Anatomy Checklist 2 TAB BPP NST 107

114 LMP Estab. DD 1 Graphs Graphs / / 1/x 2 SAVE 3 Report Done EMED MSK EMED EMED EMED 1 REPORT 2 EMED 3 Worksheet x/x 108

115 MSK MSK 1 REPORT 2 MSK 3 Worksheet a x/x b SAVE 109

116 110

117 6 2D D a b (cm) < ±2% + 1% 0-26 cm < ±2% + 1% 0-35 cm < ±2% + 1% 0-44 cm c < ±4% + ( 2%/ ) * % cm 2 d < ±3% + (1.4%/ ) * % cm a. b. 0.7 db/cm MHz RMI 413a c. % = ((1 + ) * (1 + ) - 1) * % d. % =( 2 (2 ) * 100) + 0.5% 111

118 6-2 M M < +/- 2% + 1% a b 0-26 cm < +/-2% + 1% c d < +/- 2% + ( c * /100) % d bpm a. b. 0.7 db/cm MHz RMI 413a c. d. FUJIFILM SonoSite 6-3 PW a < +/- 2% + 1% b 0.01 cm/ cm/ sec < +/- 2% + 1% b 0.01 khz-20.8 khz < +/-2% + 1% c a. FUJIFILM SonoSite b. c. 112

119 AIUM (ACC) cm/s 2 Zwiebel, W.J. Introduction to Vascular Ultrasonography. 4th ed., W.B. Saunders Company, (2000), 52. ACC = abs (delta velocity/delta time) (AT) msec Oh, J.K., J.B. Seward,andA.J. Tajik. The Echo Manual. 3rd Edition, Philadelphia: Lippincott, Williams, and Wilkins, (2007), a - b (AVA) cm 2 Oh, J.K., J.B. Seward, and A.J. Tajik. The Echo Manual. 3rd Edition., Philadelphia: Lippincott, Williams, and Wilkins, (2007), 73, 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 = * *

120 = = (CI) l/min/m 2 Oh, J.K., J.B. Seward, and A.J. Tajik. The Echo Manual. 3rd Edition., Philadelphia: Lippincott, Williams, and Wilkins, (2007), CI = CO/BSA CO = BSA = (CO) l/min Oh, J.K., J.B. Seward, and A.J. Tajik The Echo Manual. 3rd Edition., Philadelphia: Lippincott, Williams, and Wilkins, (2007), CO = (SV * HR)/1000 CO = SV = (ml) HR = (CSA) cm 2 Oh, J. K., J. B. Seward, and A. J. Tajik. The Echo Manual. 3rd Edition. Philadelphia: Lippincott Williams and Wilkins, (2007), CSA = * D 2 D = msec Oh, J. K., J. B. Seward, and A. J. Tajik. The Echo Manual. 3rd Edition. Philadelphia: Lippincott Williams and Wilkins, (2007), a - b 114

121 :(dp:dt) mmhg/s Otto, C.M. Textbook of Clinical Echocardiography. 2nd ed., W.B. Saunders Company, (2000), 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 Oh, J.K., J.B. Seward, and A.J. Tajik. The Echo Manual. 3rd Edition, Boston: Philadelphia: Lippincott Williams and Wilkins, (2007), ERO = MV /MR Vel * 100 (EF) Schiller, N.B., Shah, P.M., Crawford, M.,et. al. "Recommendations for Quantitation of the Left Ventricle by Two- Dimensional Echocardiography."Journal of American Society of Echocardiography. September-October (1989), 2:36 EF = ((LVEDV - LVESV)/LVEDV) * 100% EF = LVEDV = LVESV = (ET) msec ET = 115

122 (HR) bpm HR = M (IVS) Laurenceau, J. L., M.C. Malergue. The Essentials of Echocardiography. Le Hague: Martinus Nijhoff, (1981), 71. IVSFT = ((IVSS - IVSD)/IVSD) * 100% IVSS = IVSD = (IVRT) msec Oh, J. K., J. B. Seward, and A. J. Tajik. The Echo Manual. 3rd Edition. Philadelphia: Lippincott Williams and Wilkins, (2007), a - b IVC Lyon M, Verma N. "Ultrasound guided volume assessment using inferior vena cava diameter. "Open Emerg Med J. (2010) 3: (IVCd exp - IVCd insp)/ivcd exp (exp) = (Max D) (insp) = (Min D) / (LA/Ao) Feigenbaum, H. Echocardiography. Philadelphia: Lea and Febiger, (1994), 206, Figure Lang R. et al. "Recommendations for Cardiac Chamber quantification by Echocardiography in Adults: An update from the American Society of Echocardiography and European Association of Cardiovascular Imaging. "J Am Soc Echocardiography, January (2015), LA Vol = p/4(h) S(D1)(D2) 116

123 LA Vol = ml h = LA D1 = D2 = (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 2D Oh, J.K., J.B. Seward, and A.J. Tajik. The Echo Manual. 3rd Edition, Philadelphia: Lippincott Williams and Wilkins, (2007), LV = 1.05 * {[(5/6) * A1 * (a + d + t)] - [(5/6) * A2 * (a + d)]} A1 = (Epi) A2 = (Endo) a = d = t = gm M Mode Oh, J.K., J.B. Seward, and A.J. Tajik. The Echo Manual. 3rd Edition, Philadelphia: Lippincott Williams and Wilkins, (2007), 115. LV = 1.04 [(LVID + PWT + IVST) 3 - LVID 3 ] *

124 LVID = PWT = IVST = 1.04 = 0.8 = ml Schiller, N.B., P.M. Shah, M. Crawford, et.al. "Recommendations for Quantitation of the Left Ventricle by Two- Dimensional Echocardiography." Journal of American Society of Echocardiography. September-October 1989, 2:362. V = π -- 4 n i = 1 L a i b i -- n 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 i = 1 2 L a i -- n V = a = n = (n=20) L = i = n 118

125 (LVD) Oh, J.K., J.B. Seward, and A.J. Tajik. The Echo Manual. 3rd Edition, Philadelphia: Lippincott Williams and Wilkins, (2007), 115. 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) cm/s Vmean = (MVA) cm 2 Oh, J.K., J.B. Seward, and A.J. Tajik. The Echo Manual. 3rd Edition, Philadelphia: Lippincott, Williams, and Wilkins, (2007), MVA = 220/PHT PHT = 220 MV cc/sec Oh, J.K., J.B. Seward, and A.J. Tajik. The Echo Manual. 3rd Edition, Boston: Philadelphia: Lippincott Williams and Wilkins, (2007), = PISA * Va 119

126 PISA = Va = (PGr) mmhg Oh, J.K., J.B. Seward, and A.J. Tajik. The Echo Manual. 3rd Edition, Philadelphia: Lippincott, Williams, and Wilkins, (2007), 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) msec Reynolds, Terry. The Echocardiographer's Pocket Reference. 2nd Edition, School of Cardiac Ultrasound, Arizona Heart Institute, (2000), 391. PHT = DT * 0.29 DT = (PISA) cm 2 Oh, J.K., J.B. Seward, and A.J. Tajik. The Echo Manual. 3rd Edition, Boston: Philadelphia: Lippincott Williams and Wilkins, (2007), PISA = 2π r 2 2 π = 6.28 r = 120

127 Qp/Qs Oh, J.K., J.B. Seward, and A.J. Tajik. The Echo Manual. 3rd Edition, Boston: Philadelphia: Lippincott Williams and Wilkins, (2007), Qp/Qs = SV Qp /SV Qs RVOT SV = RVOT CSA* RVOT VTI = π/4 * RVOT 2 * RVOT VTI LVOT SV = LVOT CSA * LVOT VTI = π/4 * LVOT 2 * LVOT VTI (RF) Oh, J.K., J.B. Seward, and A.J. Tajik. The Echo Manual. 3rd Edition, Boston: Philadelphia: Lippincott Williams and Wilkins, (2007), RF = RV/ MV SV RV = MV SV = CSA * VTI CSA = (RV) cc Oh, J.K., J.B. Seward, and A.J. Tajik. The Echo Manual. 3rd Edition, Boston: Philadelphia: Lippincott Williams and Wilkins, (2007), RV = ERO * MR VTI/100 Lang R, Bierig M, et al. "Recommendations for chamber quantification: a report from the American Society of Echocardiography s guidelines and standards committee and the chamber quantification writing group, Developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology." J Am Soc Echocardiography. (2005), 18: Wang Y, Gutman J, et al. "Right atrial volume in a normal adult population by two-dimensional echocardiography." Chest, (1984), 86: RA Vol = p/4(h) S(D1)2 RA Vol = RA Vol/BSA (ml/l2) 121

128 RA Vol = ml h = RA D1 = (RVSP) mmhg Oh, J. K., J. B. Seward, and A. J. Tajik. The Echo Manual. 3rd Edition, Philadelphia: Lippincott Williams and Wilkins, (2007), 66. RVSP = 4 * (Vmax TR) 2 + RAP RAP = S/D Reynolds, Terry. The Echocardiographer's Pocket Reference. 2nd Edition, 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 Edition, (1994), SI = SV/BSA SV = BSA = (SV) ml Oh, J.K., J.B. Seward, and A.J. Tajik. The Echo Manual. 3rd Edition,Philadelphia: Lippincott, Williams, and Wilkins, (2007), SV = (CSA * VTI) CSA = LVOT VTI = LVOT 122

129 (SV) 2D M ml Oh, J.K., J.B. Seward, and A.J. Tajik. The Echo Manual. 2nd Edition, Boston: Little, Brown and Company, (1994), 44. SV = (LVEDV - LVESV) SV = LVEDV = LVEDSV = TAPSE Rudski L, Lai W, et al. "Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography. "J Am Soc Echocardiogr. (2010), (TVA) Oh, J.K., J.B. Seward, and A.J. Tajik. The Echo Manual. 3rd Edition, Philadelphia: Lippincott, Williams, and Wilkins, (2007), TVA = 220 / PHT (VTI) cm Reynolds, Terry. The Echocardiographer's Pocket Reference. 2nd Edition, 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 123

130 (AUA) (EDD) / / EDD = + (280 - 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, (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) LMP GA(LMPd) = - LMPd 124

131 (Estab. DD) (LMPd) / / LMPd(Estab. DD) = Estab. DD (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. FUJIFILM SonoSite 20.0 cm 30.0 cm (AC) AC AC (BPD) Chitty, L. S. and D.G. Altman. "New charts for ultrasound dating of pregnancy." Ultrasound in Obstetrics and Gynecology 10: (1997), , Table 3. Hadlock, F., et al. "Estimating Fetal Age: Computer-Assisted Analysis of Multiple Fetal Growth Parameters." Radiology, 152: (1984), Hansmann, M., et al. Ultrasound Diagnosis in Obstetrics and Gynecology. New York: Springer-Verlag, (1986), 440. Osaka University. Ultrasound in Obstetrics and Gynecology. (July 20, 1990), 98. University of Tokyo, Shinozuka, N. FJSUM, et al. "Standard Values of Ultrasonographic Fetal Biometry." Japanese Journal of Medical Ultrasonics, 23:12 (1996), 885. (CM) Mahony, B.; P. Callen, R. Filly, and W. Hoddick. "The fetal cisterna magna." Radiology, 153: (December 1984),

132 (CRL) Hadlock, F., et al. "Fetal Crown-Rump Length: Re-evaluation of Relation to Menstrual Age (5-18 weeks) with High-Resolution, Real-Time Ultrasound. "Radiology, 182: (February 1992), Hansmann, M., et al. Ultrasound Diagnosis in Obstetrics and Gynecology. New York: Springer-Verlag, (1986), 439. Osaka University. Ultrasound in Obstetrics and Gynecology. (July 20, 1990), 20 and 96. Tokyo University. "Gestational Weeks and Computation Methods." Ultrasound Imaging Diagnostics, 12:1 (1982-1), 24-25, Table 3. (FL) Chitty, L. S. and D.G.Altman. "New charts for ultrasound dating of pregnancy. "Ultrasound in Obstetrics and Gynecology 10: (1997), , Table 8, 186. Hadlock, F., et al. "Estimating Fetal Age: Computer-Assisted Analysis of Multiple Fetal Growth Parameters." Radiology, 152: (1984), Hansmann, M., et al. Ultrasound Diagnosis in Obstetrics and Gynecology. New York: Springer-Verlag, (1986), 431. Osaka University. Ultrasound in Obstetrics and Gynecology. (July 20, 1990), University of Tokyo, Shinozuka, N. FJSUM, et al. "Standard Values of Ultrasonographic Fetal Biometry." Japanese Journal of Medical Ultrasonics, 23:12 (1996), 886. (FTA) Osaka University. Ultrasound in Obstetrics and Gynecology. (July 20, 1990), (GS) Hansmann, M., et al. Ultrasound Diagnosis in Obstetrics and Gynecology. New York: Springer-Verlag, (1986). Nyberg, D.A., et al. "Transvaginal Ultrasound." Mosby Yearbook, (1992), 76. Nyberg Tokyo University. "Gestational Weeks and Computation Methods." Ultrasound Imaging Diagnostics, 12:1 (1982-1). 126

133 (HC) Chitty, L. S. and D.G. Altman. "New charts for ultrasound dating of pregnancy." Ultrasound in Obstetrics and Gynecology 10: (1997), , Table 5, 182. Hadlock, F., et al. "Estimating Fetal Age: Computer-Assisted Analysis of Multiple Fetal Growth Parameters." Radiology, 152: (1984), Hansmann, M., et al. Ultrasound Diagnosis in Obstetrics and Gynecology. New York: Springer-Verlag, (1986), 431. (HL) Jeanty, P.; F. Rodesch; D. Delbeke; J. E. Dumont. "Estimate of Gestational Age from Measurements of Fetal Long Bones." Journal of Ultrasound in Medicine.3: (February 1984), (OFD) Hansmann, M., et al. Ultrasound Diagnosis in Obstetrics and Gynecology. New York: Springer-Verlag, (1986), 431. Jeanty, P.; F. Rodesch; D. Delbeke; J. E. Dumont. "Estimate of Gestational Age from Measurements of Fetal Long Bones." Journal of Ultrasound in Medicine. 3: (February 1984), (TTD) Hansmann, M., et al. Ultrasound Diagnosis in Obstetrics and Gynecology. New York: Springer-Verlag, (1986), 431. (AC) Chitty, Lyn S. et al. "Charts of Fetal Size: 3. Abdominal Measurements." British Journal of Obstetrics and Gynaecology 101: (February 1994), 131, Appendix: AC-Derived. Hadlock, F., et al. "Estimating Fetal Age: Computer-Assisted Analysis of Multiple Fetal Growth Parameters." Radiology, 152: (1984), Jeanty P., E. Cousaert, and F. Cantraine. "Normal Growth of the Abdominal Perimeter." American Journal of Perinatology, 1: (January 1984), ( Hansmann, Hackeloer, Staudach, Wittman. Ultrasound Diagnosis in Obstetrics and Gynecology. Springer-Verlag, New York, (1986), 179, Table 7.13.) 127

134 (BPD) Chitty, Lyn S. et al. "Charts of Fetal Size: 2. Head Measurements." British Journal of Obstetrics and Gynaecology 101: (January 1994), 43, Appendix: BPD-Outer-Inner. Hadlock, F., et al. "Estimating Fetal Age: Computer-Assisted Analysis of Multiple Fetal Growth Parameters." Radiology, 152: (1984), Jeanty P., E. Cousaert, and F. Cantraine. "A Longitudinal Study of Fetal Limb Growth." American Journal of Perinatology, 1: (January 1984), , Table 5. ( Hansmann, Hackeloer, Staudach, Wittman. Ultrasound Diagnosis in Obstetrics and Gynecology. Springer-Verlag, New York, (1986), 176, Table 7.8.) (EFW) Brenner, William E.; D. A. Edelman; C. H. Hendricks. "A standard of fetal growth for the United States of America," American Journal of Obstetrics and Gynecology, 126: 5 (November 1, 1976), ; Table II. Hadlock F., et al. "In Utero Analysis of Fetal Growth: A Sonographic Weight Standard." Radiology, 181: (1991), Jeanty, Philippe, F. Cantraine, R. Romero, E. Cousaert, and J. Hobbins. "A Longitudinal Study of Fetal Weight Growth." Journal of Ultrasound in Medicine, 3: (July 1984), , Table 1. ( Hansmann, Hackeloer, Staudach, and Wittman. Ultrasound Diagnosis in Obstetrics and Gynecology. Springer-Verlag, New York, (1986), 186, Table 7.20.) (FL) Chitty, Lyn S. et al. "Charts of Fetal Size: 4. Femur Length. "British Journal of Obstetrics and Gynaecology 101: (February 1994), 135. Hadlock, F., et al. "Estimating Fetal Age: Computer-Assisted Analysis of Multiple Fetal Growth Parameters." Radiology, 152: (1984), Jeanty P, E. Cousaert, and F. Cantraine. "A Longitudinal Study of Fetal Limb Growth." American Journal of Perinatology, 1: (January 1984), , Table 5. ( Hansmann, Hackeloer, Staudach, Wittman. Ultrasound Diagnosis in Obstetrics and Gynecology. Springer-Verlag, New York, (1986), 182, Table 7.17.) (HC) Chitty, Lyn S., et al. "Charts of Fetal Size: 2. Head Measurements." British Journal of Obstetrics and Gynaecology 101: (January 1994), 43, Appendix: HC-Derived. 128

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 Head Biometry." American J of Perinatology, 1: (January 1984), , Table 3. ( Hansmann, Hackeloer, Staudach, Wittman. Ultrasound Diagnosis in Obstetrics and Gynecology. Springer-Verlag, New York, (1986), 176, Table 7.8.) (HC)/ (AC) Campbell S., Thoms Alison. "Ultrasound Measurements of the Fetal Head to Abdomen Circumference Ratio in the Assessment of Growth Retardation," British Journal of Obstetrics and Gynaecology, 84: (March 1977), FL/AC Hadlock F.P., R. L. Deter, R. B. Harrist, E. Roecker, and S.K. Park. "A Date Independent Predictor of Intrauterine Growth Retardation: Femur Length/Abdominal Circumference Ratio," American Journal of Roentgenology, 141: (November 1983), FL/BPD Hohler, C.W., and T.A. Quetel. "Comparison of Ultrasound Femur Length and Biparietal Diameter in Late Pregnancy," American Journal of Obstetrics and Gynecology, 141:7 (Dec ), FL/HC Hadlock F.P., R. B. Harrist, Y. Shah, and S. K. Park. "The Femur Length/Head Circumference Relation in Obstetric Sonography." Journal of Ultrasound in Medicine, 3: (October 1984), HC/AC Campbell S., Thoms Alison. "Ultrasound Measurements of the Fetal Head to Abdomen Circumference Ratio in the Assessment of Growth Retardation," British Journal of Obstetrics and Gynaecology, 84: (March 1977), /x S/D +/x = abs ( A/ B) 129

136 A = + B = x (ACC) Zwiebel, W.J. Introduction to Vascular Ultrasonography, 4th ed., W.B. Saunders Company, (2000), 52. ACC = abs (delta velocity/delta time) (ET) 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 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(cm 2 )/A1(cm 2 )) * 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(cm)/D1(cm)) * 100 D1 = cm D2 = cm 130

137 (PGr) mmhg Oh, J.K., J.B. Seward, A.J. Tajik. The Echo Manual. 2nd ed., Lippincott, Williams, and Wilkins, (1999), * 2 E (E PG) EPG = 4 * PE 2 A (A PG) APG = 4 * PA2 (PGmax) PGmax = 4 * PV2 (PGmean) PGmean = 4 * Vmax 2 (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) cm/s TAM = 131

138 (TAP) cm/s TAP = (Vol) Beyer, W.H. Standard Mathematical Tables, 28th ed., CRC Press, Boca Raton, FL, (1987), 131. cm 3 = (4/3) * π * /2 * /2 * /2 (VF) ml/m Allan, Paul L. et al. Clinical Doppler Ultrasound, 4th ed., Harcourt Publishers Limited. (2000), VF = CSA * TAM *.06 VF = CSA * TAP *

139 7 FUJIFILM SonoSite 2 10 CPD Color PRF OB OB Connectivity 133

140 ensure the USB device is valid USB USB USB ensure the USB device contains valid data USB USB USB Incompatible power supply The external video is not functional Maximum number of procedure entries reached Unable to save image or clip. You have reached the maximum number of images/clips allowed for a single patient FUJIFILM SonoSite 134

141 FUJIFILM SonoSite 2 34 ARM PCBA PCBA 1 2 Enter license number 3 Done 4 5 Enter license number 6 Done FUJIFILM SonoSite 2 8 FUJIFILM SonoSite 135

142 136

143 8 FFSS 2 (PPE) FUJIFILM SonoSite FUJIFILM SonoSite FUJIFILM SonoSite FUJIFILM SonoSite 137

144 FUJIFILM SonoSite A A 139 A 138

145 8-1 B B 143 B A 1/ SaniCloth AF3* SaniCloth Plus PI-Spray II C11x HFL38xi HFL50x HSL25x ICTx L25x L38xi P10x P11x rc60xi rp19x C11x HFL38xi HFL50x HSL25x ICTx L25x L38xi P10x P11x rc60xi rp19x C11x HFL38xi HFL50x HSL25x ICTx L25x L38xi P10x P11x rc60xi rp19x * (PPE) 139

146 FUJIFILM SonoSite FUJIFILM SonoSite 140

147 2/2 (PPE) 8-3 FUJIFILM SonoSite Cidex Cidex OPA C11x HFL38xi HFL50x HSL25x ICTx L25x L38xi P10x P11x rc60xi rp19x C11x HFL38xi HFL50x HSL25x ICTx L25x L38xi P10x P11x rc60xi rp19x 23 o C 45 3 x 1 23 o C 12 3 x

148 cm cm Cidex OPA FUJIFILM SonoSite 142

149 B SaniCloth AF3* SaniCloth Plus PI-Spray II C11x HFL38xi HFL50x HSL25x ICTx L25x L38xi P10x P11x rc60xi rp19x C11x HFL38xi HFL50x HSL25x ICTx L25x L38xi P10x P11x rc60xi rp19x C11x HFL38xi HFL50x HSL25x ICTx L25x L38xi P10x P11x rc60xi rp19x * (PPE) FUJIFILM SonoSite 143

150 FUJIFILM SonoSite 144

151 1 2 3 Sani-Cloth HB Sani-Cloth Wipes 70% 4 1 Cidex 10:1 5.25% 2 ECG ECG ECG 1 2 EGC 3 145

152 4 FUJIFILM SonoSite 5 ECG ECG 146

153 9 ALARA 10 (MSD) 1,2,3 (MSD) MSD MSD MSD MSD 4 MSD 5,6 1. Magnavita, N., L. Bevilacqua, P. Mirk, A. Fileni, and N. Castellino. "Work-related Musculoskeletal Complaints in Sonologists." Occupational Environmental Medicine. 41:11 (1999), Craig, M. "Sonography:An Occupational Hazard?"Journal of Diagnostic Medical Sonography. 3 (1985), 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), Wihlidal, L.M. and S. Kumar. "An Injury Profile of Practicing Diagnostic Medical Sonographers in Alberta." International Journal of Industrial Ergonomics. 19 (1997), Habes, D.J. and S. Baron. "Health Hazard Report " University of Medicine and Dentistry of New Jersey. (1999). 6. 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),

154 148

155 MSD MSD EN Class I I / BF CF 172 ECG EN

156 ECG / (TTC) 150

157 (MPSO) 8 FUJIFILM SonoSite FUJIFILM SonoSite FUJIFILM SonoSite FUJIFILM SonoSite / - FUJIFILM SonoSite FUJIFILM SonoSite 151

158 Class I I BF CF IPX-7 IPX-8 AP/APG Class I I Class I I ECG /ECG 8 152

159 0 40 C 60 C 6 SonoSite 2 153

160 FUJIFILM SonoSite FUJIFILM SonoSite FUJIFILM SonoSite FUJIFILM SonoSite 21 CFR ALARA MI TI FUJIFILM SonoSite 0.3 db/cm/mhz - FUJIFILM SonoSite 154

161 P10x P17x P21x P10x P17x P21x 155

162 IEC :2001 (EMC) FUJIFILM SonoSite FUJIFILM SonoSite FUJIFILM SonoSite FUJIFILM SonoSite 159 EMC RF (EMI) EMI EMI EMI EMI EMI EMI EMI IEC EMC 156

163 SonoSite Edge II IEEE GHz GHz ISM 16 db (CCK) (DQPSK) (DBPSK) IEEE b 13 dbm (ODFM) IEEE g (ESD) ESD ESD ESD 157

164 ESD ESD TTC (TTC) ESD ESD ESD ESD IEC d 158

165 9-1 RF SonoSite Edge II SonoSite Edge II (RF) SonoSite Edge II RF SonoSite Edge II (W) m 150 khz 80 MHz d=1.2 P 80 MHz 800 MHz d=1.2 P 800 MHz 2.5 GHz d=2.3 P (d) (m) P (W) 80 MHz 800 MHz FUJIFILM SonoSite SonoSite Edge II IEC :2007 FUJIFILM SonoSite SonoSite Edge II SonoSite Edge II 159

166 9-2 SonoSite Edge II C11x rc60xi/rc60xi Armored HFL38xi HFL50x HSL25x ICTx L25x L38xi/L38xi Armored P10x rp19x/rp19x Armored TEExi 1.8 m 1.7 m 1.7 m 1.7 m 2.4 m 1.7 m 2.3 m 1.7 m 1.8 m 1.8 m 2.2 m 1.5 m PowerPack PowerPack 1 m 1 m 1.8 m 160

167 9-2 SonoSite Edge II ECG ECG ECG 0.6 m 1.8 m 2.4 m SonoSite Edge II SonoSite Edge II Petite DC AC 3 m 1.8 m 3 m 2 m 1 m PowerPark USB 161

168 EMC GB SonoSite Edge II GB4824 GB / GB A 不适用 SonoSite Edge II / 162

169 9-4 - IEC (ESD) GB/ T ± 6.0KV ± 8.0KV ± 6.0KV ± 8.0KV 30% GB/ T ± 2KV ± 1KV / ± 2KV ± 1KV / >1kV GB/T ± 1KV ± 2KV ± 1KV ± 2KV GB/ T <5% U T 5s U T >95% 40% U T 5 U T 60% 70% U T 25 U T 30% <5% U T 5s U T >95% 40% U T 5 U T 60% 70% U T 25 U T 30% Edge II Edge II 5% U T 5s UT T 95% 5% U T 5s U T 95% 50/ 60 Hz GB/ T A/m 3 A/m 163

170 9-4 - IEC GB/T GB/T V ( 150 khz 80 MHz 3 V/m 80 MHz~2.5 GHz 3 V ( Edge II d = 1.2 P d = 1.2 P 80 MHz~800 MHz d = 2.3 P 800 MHz~2.5 GHz 3 V/m P-- (W) d -- (m) a b IEC No. 417-IEC- 5140: 80 MHz 800 MHz a. / AM FM FUJIFILM SonoSite RF FUJIFILM SonoSite Edge II FUJIFILM SonoSite Edge II b. 150 khz 80 MHz 3 V/m U T 164

171 FCC FCC Rules 15 FCC Rules 15 SonoSite Edge II IEC IEC SonoSite Edge II 9-5 (AC) I 93/42/EEC Annex VII 165

172 9-5 I IIa IIb III 93/42/EEC "C" "US" CSA ANSI/UL REF 93/86/EEC 166

173 9-5 (DC) FCC GEL 167

174 9-5 STERILE R STERILE EO SN 168

175 9-5 BF B = F = CF (UL) RoHS / CCC WARNING: Connect Only Accessories and Peripherals Recommended by SonoSite FUJIFILM SonoSite, 169

176 33 cm 31.5 cm 6.3 cm 4.6 kg rc60xi 24.6 cm 18.5 cm 30.7 cm C 15-95% hPa C 35 C 30 / C 15-95% R.H hPa C 15-95% R.H hPa

177 V 50/60 Hz 100 VAC 2.0 A #1 15V 5.0 A #2 12V 2.3 A 75 w 171

178 EMC 9-6 AAMI ES : C1(2009) + A2(2010) CSA C22.2 No TC 2(2011) IEC : C1 (2006) + C2(2007) CSA C :08 IEC (ed. 2.0) CSA C IEC :2010 Medical electrical equipment, Part 1: General requirements for basic safety and essential performance (3 rd edition plus Corrigendum 1 and Corrigendum 2) AAMI ES : C1(2009) + A2(2010) A2 Medical electrical equipment Part 1: General requirements for basic safety and essential performance (3 rd edition plus Corrigendum 1 and Corrigendum 2) CSA C22.2 No TC 2(2011) Medical electrical equipment, Part 1: General requirements for basic safety and essential performance (3 rd edition plus Corrigendum 1 and Corrigendum 2) IEC : C1(2006) + C2(2007) Medical electrical equipment - Part 2-37: Particular requirements for the basic safety and essential performance of ultrasonic medical diagnostic and monitoring equipment CSA C : Medical electrical equipment - Part 2-37: Particular requirements for the basic safety and essential performance of ultrasonic medical diagnostic and monitoring equipment IEC (ed. 2.0) Medical Electrical Equipment part 1-6: General requirements for basic safety and essential performance - Collateral standard: Usability CSA C Medical Electrical Equipment part 1-6: General requirements for basic safety and essential performance - Collateral standard: Usability IEC :

179 9-7 EMC IEC :2007 CISPR 11:2009 General Requirements for Basic Safety and Essential Performance-Collateral Standard - Industrial, Scientific, and Medical (ISM) Radio-Frequency Equipment Electromagnetic Disturbance Characteristics-Limits and Methods of Measurement (ISM) - 1 A AAMI/ANSI/ISO :2009, Biological evaluation of medical devices Part 1:Evaluation and testing (2009) AAMI/ANSI/ISO : [2009] AAMI/ANSI/ISO , Biological evaluation of medical devices Part 5:Tests for In Vitro cytotoxicity (2009) AAMI/ANSI/ISO In Vitro [2009] AAMI/ANSI/ISO , Biological evaluation of medical devices Part 10:Tests for irritation and delayedtype hypersensitivity (2002) AAMI/ANSI/ISO [2002] AAMI/ANSI/ISO , Biological evaluation of medical devices Part 11:Tests for systemic toxicity (2006) AAMI/ANSI/ISO [2006] AAMI/ANSI/ISO , Biological evaluation of medical devices Part 12:Sample preparation and reference materials (2007) AAMI/ANSI/ISO [2007] RTCA DO-160E, Radio Technical Commission for Aeronautics, Environmental Conditions and Test Procedures for Airborne Equipment, Section 21.0 Emission of Radio Frequency Energy, Category B B 173

180 DICOM NEMA PS 3.15:2000(DICOM) - 15 X-Porte DICOM DICOM HIPAA HIPAA The Health Insurance and Portability and Accountability Act, Pub.L. No (1996). 45 CFR 160, General Administrative Requirements 45 CFR 164, Security and Privacy 174

181 10 ALARA ALARA ALARA ALARA ALARA 2D CPD Color THI ALARA EN ALARA 175

182 (ISPTA) 720 mw/cm 2 ISPTA 50 mw/cm 2 TI 1.0 MI 0.23 (MI) (TI) 1.0 MI TI 177 MI TI ALARA MI TI MI TI BS EN :2001:Annex HH HH PRF Kremkau, Frederick W. Diagnostic Ultrasound:Principles and Instruments.7th ed., W.B.Saunders Company, (Oct. 17, 2005). 176

183 MI TI MI TI MI TI MI TI MI TI 10-1 MI C11x rc60xi/rc60xi Armored HFL38xi HFL50x HSL25x ICTx L25x L38xi/L38xi Armored P10x MI TI 177

184 10-1 MI rp19x/rp19x Armored TEExi MI MI 10-2 TI CPD PRF PW C11x rc60xi/rc60xi Armored (PRF) HFL38xi HFL50x 178 MI TI

185 10-2 TI CPD PRF PW HSL25x ICTx L25x L38xi/L38xi Armored P10x rp19x/rp19x Armored (PRF) (PRF) (PRF) (PRF) TEExi (PRF) TI TI MI TI 179

186 MI TI AIUM TI MI TI MI ³ 1.0 / M / C11x/8-5 MI TIC TIB TIS rc60xi/5-2 rc60xi Armored/5-2 MI TIC TIB TIS HFL38xi/13-6 MI TIC TIB TIS HFL50x/15-6 MI TIC TIB TIS HSL25x/13-6 MI TIC TIB TIS ICTx/8-5 MI TIC TIB TIS L25x/13-6 MI TIC TIB TIS L38xi/10-5 L38xi Armored/10-5 MI TIC TIB TIS P10x/8-4 MI TIC TIB TIS 180

187 10-3 TI MI ³ 1.0 / M / rp19x/5-1 rp19x Armored/5-1 MI TIC TIB TIS TEExi/8-3 MI TIC TIB TIS MI 1.0 MI 0.1 TI TI -0.1 TI TI ALARA TI FUJIFILM SonoSite AIUM TI 182 MI TI MI 95% MI 95% MI +18% -25% +0.2 TI 95% TI 95% TI +21% -40% dB 3dB MI TI

188 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 (23 C ± 3 C) EN ( C) C11x rc60xi/ rc60xi Armored HFL38xi HFL50x HSL25x L25x L38xi/ L38xi Armored P10x rp19x/ rp19x Armored

189 10-5 ( C) ICTx TEExi (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) In Situ In Situ In Situ= [e -(0.23alf) ] In Situ = In Situ = e = a = (db/cm MHz) 183

190 = 0.53 = 0.66 = 0.79 = 0.43 = 0.55 l = cm f = // MHz In Situ 0.3 In Situ In Situ = [e -(0.069lf ) ] In Situ In Situ 184

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

192 TI MI

193 10-6C11x M.I. TIS A aprt <1 A aprt >1 TIB (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) 1.70 [email protected] (cm) # d eq (Z sp ) (cm) 0.23 F c (MHz) # # A aprt X (cm) # Y (cm) # PD (μsec) # PRF (Hz) # p max (MPa) # d max (cm) 0.22 FL x (cm) # 1.52 I max (W/cm 2 ) # TIC FL y (cm) # Nrv Nrv 2 1 mm 7 mm PRF (a) <1 (b) # / 187

194 10-7rC60xi/rC60xi Armored M.I. TIS A aprt <1 A aprt >1 TIB 1.5 (a) (b) p r.3 (MPa) 2.31 W 0 (mw) # # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) Z bp (cm) Z sp (cm) [email protected] (cm) 4.3 d eq (Z sp ) (cm) F c (MHz) 2.36 # # A aprt X (cm) # # Y (cm) # # PD (μsec) PRF (Hz) 3584 p max (MPa) 3.29 d max (cm) FL x (cm) # # I max (W/cm 2 ) MB FL y (cm) # # Res 11 cm 5 THI (a) <1 (b) # / TIC 188

195 10-8rC60xi/rC60xi Armored M M.I. TIS A aprt <1 A aprt >1 TIB 1.3 (a) 1.0 (b) p r.3 (MPa) 2.18 W 0 (mw) 69.8 # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) Z bp (cm) Z sp (cm) 4.20 [email protected] (cm) 4.3 d eq (Z sp ) (cm) 0.69 F c (MHz) 2.66 # 2.89 # A aprt X (cm) # 2.25 # Y (cm) # 1.20 # PD (μsec) PRF (Hz) 800 p max (MPa) 3.25 d max (cm) 0.49 FL x (cm) # # I max (W/cm 2 ) 290 FL y (cm) # # 1 Msk 2 Pen Pen cm 9.2 cm 4 THI (a) <1 (b) # / TIC 189

196 10-9rC60xi/rC60xi Armored / M.I. TIS A aprt <1 A aprt >1 TIB (b) p r.3 (MPa) 2.21 W 0 (mw) # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) Z bp (cm) Z sp (cm) [email protected] (cm) 4.3 d eq (Z sp ) (cm) F c (MHz) # A aprt X (cm) 0.66 # Y (cm) 1.20 # PD (μsec) PRF (Hz) 1265 p max (MPa) 3.07 d max (cm) # FL x (cm) 2.50 # I max (W/cm 2 ) 342 FL y (cm) 6.50 # 1 2 CVD CVD 3 2D //THI Gen/11 cm/ Gen/4.7 cm/ 4 /PRF /342 /3125 5/ / - / - (a) <1 (b) # / TIC 190

197 10-10rC60xi/rC60xi Armored M.I. TIS A aprt <1 A aprt >1 TIB (b) p r.3 (MPa) 1.73 W 0 (mw) # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) 4.0 Z bp (cm) 4.0 Z sp (cm) 3.60 [email protected] (cm) 4.5 d eq (Z sp ) (cm) 0.94 F c (MHz) # A aprt X (cm) # Y (cm) # PD (μsec) PRF (Hz) 1302 p max (MPa) 2.43 d max (cm) 0.54 FL x (cm) # I max (W/cm 2 ) 267 FL y (cm) 6.50 # mm 7 mm 7 mm PRF (a) <1 (b) # / TIC 191

198 10-11HFL38xi MI TIS A aprt <1 A aprt >1 TIB 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) [email protected] (cm) 1.2 d eq (Z sp ) (cm) F c (cm) 5.36 # # Z bp (MHz) # # A aprt X (cm) # # Y (cm) PD (μsec) PRF (Hz) 2127 p max (MPa) 3.81 d max (cm) FL x (cm) # # FL y (cm) # # I max (W/cm 2 ) MB Res 3.3 cm N/A 5 (a) <1 (b) # / TIC 192

199 10-12HFL38xi M MI TIS A aprt <1 A aprt >1 TIB 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) # [email protected] (cm) 1.4 d eq (Z sp ) (cm) # F c (cm) 6.75 # # # Z bp (MHz) # # # A aprt X (cm) # # # Y (cm) PD (μsec) PRF (Hz) 1600 p max (MPa) 4.35 d max (cm) # FL x (cm) # # FL y (cm) # # I max (W/cm 2 ) Nrv Pen 4.0 cm (a) <1 (b) # / TIC 193

200 10-13HFL38xi / MI TIS A aprt <1 A aprt >1 TIB 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) [email protected] (cm) 1.2 d eq (Z sp ) (cm) F c (MHz) 5.36 # # A aprt X (cm) # # Y (cm) # # PD (μsec) PRF (Hz) 2223 p max (MPa) 3.81 d max (cm) FL x (cm) # # FL y (cm) # # I max (W/cm 2 ) D / 4 //PRF SmP CVD Res/ 3.3 cm /401 5/ / (a) <1 (b) # / TIC 194

201 10-14HFL38xi MI TIS A aprt <1 A aprt >1 TIB (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) 1.10 [email protected] (cm) 1.0 d eq (Z sp ) (cm) 0.34 F c (MHz) # A aprt X (cm) # Y (cm) # PD (μsec) PRF (Hz) 1008 p max (MPa) 3.23 d max (cm) 0.25 FL x (cm) 3.72 # FL y (cm) 2.44 # I max (W/cm 2 ) Nrv Art Art 2 1mm 1mm 1mm PRF (a) <1 (b) # / TIC 195

202 10-15HFL50x MI TIS A aprt <1 A aprt >1 TIB 1.3 (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) [email protected] (cm) 1.2 d eq (Z sp ) (cm) F c (MHz) 5.36 # # A aprt X (cm) # # Y (cm) # # PD (μsec) PRF (Hz) 2733 p max (MPa) 3.81 d max (cm) FL x (cm) # # FL y (cm) # # I max (W/cm 2 ) MBe (a) <1 (b) # / TIC 196

203 10-16HFL50x M M.I. TIS A aprt <1 A aprt >1 TIB 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 ) FL y (cm) # # Pen (a) <1 (b) # / TIC 197

204 10-17HFL50x / M.I. TIS A aprt <1 A aprt >1 TIB 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 ) / FL y (cm) # # /3.3 4 PRF (a) <1 (b) # / TIC 198

205 10-18HFL50x MI TIS A aprt <1 A aprt >1 TIB (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 # FL y (cm) 2.44 # I max (W/cm 2 ) mm 1 mm 1 mm 3 PRF (a) <1 (b) # / TIC 199

206 10-19HSL25x M.I. TIS A aprt <1 A aprt >1 TIB 1.2 (a) (b) p r.3 (MPa) 2.87 W 0 (mw) # # [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) 6.11 # # A aprt X (cm) # # Y (cm) # # PD (μsec) PRF (Hz) 1061 p max (MPa) 3.39 d max (cm) FL x (cm) # # I max (W/cm 2 ) 478 FL y (cm) # # 1 Nrv/Msk/ Ven/Art MBe (a) <1 (b) # / TIC 200

207 10-20HSL25x / M.I. TIS A aprt <1 A aprt >1 TIB 1.0 (a) (b) p r.3 (MPa) 2.35 W 0 (mw) # # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) Z bp (cm) Z sp (cm) [email protected] (cm) 0.8 d eq (Z sp ) (cm) F c (MHz) 6.11 # # A aprt X (cm) # # Y (cm) # # PD (μsec) PRF (Hz) 3079 p max (MPa) 2.78 d max (cm) FL x (cm) # # I max (W/cm 2 ) D / 4 //PRF FL y (cm) # # Sup CVD / 3.1 cm /401 5/ / (a) <1 (b) # / TIC 201

208 10-21HSL25x M.I. (a) <1 (b) # / TIS A aprt <1 A aprt >1 TIB (a) (a) 1.5 (b) p r.3 (MPa) # W 0 (mw) # 28.1 # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) Z bp (cm) Z sp (cm) 0.75 [email protected] (cm) # d eq (Z sp ) (cm) 0.30 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) 0.21 FL x (cm) # # I max (W/cm 2 ) # 1 2 FL y (cm) # # Nrv 8 mm PRF 1953 TIC 202

209 10-22ICTx M.I. TIS A aprt <1 A aprt >1 TIB (a) (a) 1.2 (a) p r.3 (MPa) # W 0 (mw) # # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) Z bp (cm) Z sp (cm) # 1.6 d eq (Z sp ) (cm) F c (MHz) # # 4.36 # A aprt X (cm) # 0.6 # Y (cm) # 0.5 # PD (μsec) # PRF (Hz) # p max (MPa) # d max (cm) FL x (cm) # # I max (W/cm 2 ) # PRF FL y (cm) # # 3mm 4 1 (a) <1 (b) # / TIC 203

210 10-23L25x M.I. TIS A aprt <1 A aprt >1 TIB 1.2 (a) (b) p r.3 (MPa) 2.87 W 0 (mw) # # [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) 6.11 # # A aprt X (cm) # # Y (cm) # # PD (μsec) PRF (Hz) 1061 p max (MPa) 3.39 d max (cm) FL x (cm) # # I max (W/cm 2 ) 478 FL y (cm) # # 1 Nrv/Msk/ Ven/Art MBe (a) <1 (b) # / TIC 204

211 10-24L25x / M.I. TIS A aprt <1 A aprt >1 TIB 1.0 (a) (b) p r.3 (MPa) 2.35 W 0 (mw) # # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) Z bp (cm) Z sp (cm) [email protected] (cm) 0.8 d eq (Z sp ) (cm) F c (MHz) 6.11 # # A aprt X (cm) # # Y (cm) # # PD (μsec) PRF (Hz) 5261 p max (MPa) 2.78 d max (cm) FL x (cm) # # I max (W/cm 2 ) D / 4 /PRF FL y (cm) # # CVD / 3.1 cm /779 5/ / (a) <1 (b) # / TIC 205

212 10-25L25x M.I. TIS A aprt <1 A aprt >1 TIB (a) (a) 1.7 (b) p r.3 (MPa) # W 0 (mw) # 32.1 # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) Z bp (cm) Z sp (cm) # 0.75 d eq (Z sp ) (cm) 0.30 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) 0.21 FL x (cm) # # FL y (cm) # # I max (W/cm 2 ) # 1 Art/Ven/ Nrv 2 8 mm 3 PRF (a) <1 (b) # / TIC 206

213 10-26L38xi/L38xi Armored M.I. TIS A aprt <1 A aprt >1 TIB 1.5 (a) (b) p r.3 (MPa) 3.30 W 0 (mw) # # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) Z bp (cm) Z sp (cm) [email protected] (cm) 0.8 d eq (Z sp ) (cm) F c (MHz) 4.82 # # A aprt X (cm) # # Y (cm) # # PD (μsec) PRF (Hz) 1312 p max (MPa) 3.79 d max (cm) FL x (cm) # # I max (W/cm 2 ) MB FL y (cm) # # Nrv Res 2.0 cm N/A 5 (a) <1 (b) # / TIC 207

214 10-27L38xi/L38xi Armored M M.I. TIS A aprt <1 A aprt >1 TIB 1.5 (a) 1.2 (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) 0.90 [email protected] (cm) 1.0 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) # # I max (W/cm 2 ) 776 FL y (cm) # # 1 Art Art 2 Gen Pen cm 7.3 cm (a) <1 (b) # / TIC 208

215 10-28L38xi/L38xi Armored / M.I. TIS A aprt <1 A aprt >1 TIB (b) p r.3 (MPa) 3.30 W 0 (mw) 49.0 # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) Z bp (cm) Z sp (cm) [email protected] (cm) 0.8 d eq (Z sp ) (cm) F c (MHz) # A aprt X (cm) 0.54 # Y (cm) 0.40 # PD (μsec) PRF (Hz) 2190 p max (MPa) 3.79 d max (cm) FL x (cm) 1.50 # I max (W/cm 2 ) 605 FL y (cm) 1.50 # 1 Art 2 CVD CVD 3 2D / /2.0 cm /3.1 cm 4 /PRF /393 /2315 5/ / / - (a) <1 (b) # / TIC 209

216 10-29L38xi/L38xi Armored M.I. TIS A aprt <1 A aprt >1 TIB (b) p r.3 (MPa) 2.59 W 0 (mw) # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) Z bp (cm) Z sp (cm) 1.20 [email protected] (cm) 0.7 d eq (Z sp ) (cm) 0.49 F c (MHz) # A aprt X (cm) # Y (cm) # PD (μsec) PRF (Hz) 1008 p max (MPa) 2.86 d max (cm) 0.46 FL x (cm) 5.54 # I max (W/cm 2 ) 323 FL y (cm) 1.50 # 1 Art Nrv Nrv 2 1mm 1mm 1mm PRF (a) <1 (b) # / TIC 210

217 10-30P10x / M.I. TIS A aprt <1 A aprt >1 TIB (a) (a) 1.1 p r.3 (MPa) # W 0 (mw) # 42.2 [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) Z bp (cm) Z sp (cm) [email protected] (cm) # d eq (Z sp ) (cm) F c (MHz) # # 3.89 A aprt X (cm) # 0.99 Y (cm) # 0.70 PD (μsec) # PRF (Hz) # p max (MPa) # d max (cm) FL x (cm) # 6.74 I max (W/cm 2 ) # D // 4 /PRF TIC FL y (cm) # 5.00 CVD / 8.9 cm/ /2033 5/ / - (a) <1 (b) # / 211

218 10-31P10x M.I. TIS A aprt <1 A aprt >1 TIB p r.3 (MPa) 1.92 W 0 (mw) [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) Z bp (cm) Z sp (cm) 0.80 [email protected] (cm) 2.1 d eq (Z sp ) (cm) 0.31 F c (MHz) A aprt X (cm) Y (cm) PD (μsec) PRF (Hz) 1562 p max (MPa) 2.54 d max (cm) 0.24 FL x (cm) I max (W/cm 2 ) 200 TIC FL y (cm) mm 7 mm 12 mm 1 mm PRF TDI (a) <1 (b) # / 212

219 10-32P10x M.I. TIS A aprt <1 A aprt >1 TIB (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) 0.70 [email protected] (cm) # d eq (Z sp ) (cm) 0.36 F c (MHz) # # A aprt X (cm) # Y (cm) # PD (μsec) # PRF (Hz) # p max (MPa) # d max (cm) 0.27 FL x (cm) # 0.92 I max (W/cm 2 ) # TIC FL y (cm) # (a) <1 (b) # / 213

220 10-33rP19x/rP19x Armored M.I. TIS A aprt <1 A aprt >1 TIB 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) [email protected] (cm) 4.8 d eq (Z sp ) (cm) F c (MHz) A aprt X (cm) Y (cm) PD (μsec) PRF (Hz) 6186 p max (MPa) 2.92 d max (cm) FL x (cm) I max (W/cm 2 ) 184 FL y (cm) Gen Res Pen 3 10 cm 10 cm 4.7 cm 4 MB/THI Off/Off Off/Off / 5 N/A N/A (a) <1 (b) # / TIC 214

221 10-34rP19x/rP19x Armored M M.I. TIS A aprt <1 A aprt >1 TIB 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) 4.33 [email protected] (cm) 4.8 d eq (Z sp ) (cm) 0.43 F c (MHz) 1.99 # A aprt X (cm) # Y (cm) # PD (μsec) PRF (Hz) 800 p max (MPa) 2.92 d max (cm) 0.42 FL x (cm) # 9.82 I max (W/cm 2 ) 184 FL y (cm) # TCD 2 Gen Res Res cm 10 cm 16 cm 4 THI (a) <1 (b) # / TIC 215

222 10-35rP19x/rP19x Armored / M.I. TIS A aprt <1 A aprt >1 TIB 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) [email protected] (cm) 4.8 d eq (Z sp ) (cm) F c (MHz) A aprt X (cm) Y (cm) PD (μsec) PRF (Hz) 505 p max (MPa) 2.92 d max (cm) FL x (cm) I max (W/cm 2 ) 184 FL y (cm) TCD 2 /THI CVD/ CVD/ CVD/ 3 2D // / 10 cm/ / 7.5 cm/ TIC / 16 cm/ 4 /PRF /300 /3125 /5208 5/ / / / (a) <1 (b) # / 216

223 10-36rP19x/rP19x Armored M.I. TIS A aprt <1 A aprt >1 TIB p r.3 (MPa) 1.94 W 0 (mw) [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) 2.5 Z bp (cm) 2.5 Z sp (cm) 3.35 [email protected] (cm) 3.0 d eq (Z sp ) (cm) 0.80 F c (MHz) A aprt X (cm) Y (cm) PD (μsec) PRF (Hz) 1562 p max (MPa) 2.42 d max (cm) 0.62 FL x (cm) I max (W/cm 2 ) 180 FL y (cm) mm 12 mm 12 mm 1mm PRF 1562 Hz 1562 Hz 1562 Hz 3906 Hz 5 TDI (a) <1 (b) # / TIC 217

224 10-37rP19x/rP19x Armored M.I. TIS A aprt <1 A aprt >1 TIB (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) 0.90 [email protected] (cm) # d eq (Z sp ) (cm) 0.64 F c (MHz) # A aprt X (cm) Y (cm) PD (μsec) # PRF (Hz) # p max (MPa) # d max (cm) 0.61 FL x (cm) I max (W/cm 2 ) # TIC FL y (cm) (a) <1 (b) # / 218

225 10-38TEExi M.I. TIS A aprt <1 A aprt >1 TIB (a) (a) 1.4 (b) p r.3 (MPa) # W 0 (mw) # 35.8 # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) Z bp (cm) Z sp (cm) 2.57 [email protected] (cm) # d eq (Z sp ) (cm) 0.29 F c (MHz) # # 3.81 # A aprt X (cm) # 0.90 # Y (cm) # 0.90 # PD (μsec) # PRF (Hz) # p max (MPa) # d max (cm) 0.28 FL x (cm) # # I max (W/cm 2 ) # 1 2 FL y (cm) # # 1mm PRF 2604 (a) <1 (b) # / TIC 219

226 10-39TEExi M.I. TIS A aprt <1 A aprt >1 TIB (a) (a) 1.7 (b) p r.3 (MPa) # W 0 (mw) # 34.4 # [W.3 (z 1 ),I TA.3 (z 1 )] (mw) z 1 (cm) Z bp (cm) Z sp (cm) 1.1 [email protected] (cm) # d eq (Z sp ) (cm) 0.34 F c (MHz) # # 4.00 # A aprt X (cm) # 0.43 # Y (cm) # 0.90 # PD (μsec) # PRF (Hz) # p max (MPa) # d max (cm) 0.34 FL x (cm) # # I max (W/cm 2 ) # 1 FL y (cm) # # 2 2 (a) <1 (b) # / TIC 220

227 Ispta.3 TI TI MI TIS TIB TIC Aaprt Pr.3 Wo W.3(z1) ISPTA.3(z1) z1 zbp zsp mw/cm 2 MI W/cm 2 TIS TIS TIB - cm 2 MI mw TIS scan z 1 mw z 1 / min(w.3 (z), I TA.3 (z) x 1 cm 2 )] z > zbp cm ( ) 1.69 Aaprt cm MI p r.3 TIB TIB z sp = z b.3 cm deq(z) z ( 4 ( π) )(( Wo) ( ITA( z) )), I TA (z) z cm fc Aaprt MHz (x) (y) cm 221

228 PD PRF p deq@piimax FL MI MI Hz (x) (y) Output Display Standard 6.4 % 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% % 222

229 Recommended Ultrasound Terminology, Third Edition (American Institute of Ultrasound in Medicine AIUM) 2011 in situ LCD MI/TI NTSC PAL SonoHD2 SonoMB Steep Needle Profiling bone thermal index, TIB (MI) (ALARA) cranial bone thermal index, TIC (skinline) (MI) (TI) (National Television Standards Committee) PAL NTSC 2D 2D 2D 2D MI MI 10 / 223

230 (TI) soft tissue thermal index, TIS (phased array transducer) 1 C TI / C (60) rc60xi L (38) L38xi rp19x 224

231 11-1 +/ "+" /" " A A PG A2Cd A2Cs A4Cd A4Cs AAA AAo abs AC ACA ACC ACoA ACS Adur AFI AI AI PHT AL Ann D ANT F ANT N Ao "A" "A" "A" 225

232 11-1 AoD Apical APTD AT AUA AV AV AVA BA Bifur BP BPD BPM Bre BSA CCA CI CM CO CPD CRL CW CxLen D AUA OB 226

233 11-1 DCCA DECA DICA Dist dp:dt E E PG E:A E/e' ECA ECG ECICA ECVA EDD EDD by AUA EDD by LMP EDV EF EF:SLOPE EFW Endo Epi : "E" "E" E-A E = E e' LMP E-F EFW EFW 227

234 11-1 EPSS Estab.DD ET FH FHR FL FM FS FTA GA GA by LMP GA by LMPd GS Gyn HC HL HR ICA IVC IVRT IVS IVSd IVSFT "E" LMP LMPd SO (LMP) Estab. DD (LMPd) 228

235 11-1 IVSs LA LA/Ao LAT F LAT N Lat V LMP LMP LMPd LV LV LV LV Volume LVd LVD LVDd LVDFS LVDs LVEDV LVESV LVET LVO LVOT LVOT / EDD Estab. DD 229

236 11-1 LVOT D LVOT VTI LVPW LVPWd LVPWFT LVPWs LVs MB MCA MCCA MECA MI MICA Mid MM MR PISA MR/VTI Msk MV MV MV MV MV/VTI MV MVA SonoMB M / / 230

237 11-1 MV ERO MV PISA Neo Nrv NST NTSC OA OB OFD Oph P. PAL PCAp PCCA PCoA PECA PGmax PGmean PGr PHT PI PICA PISA Plaq POST F 231

238 11-1 POST N PRF Prox PSV PV PW Qp/Qs RA ( ) RI RVD RVDd RVDs RVOT D RVOT VTI RVSP RVW RVWd RVWs S S/D SI SM SmP SO Sup SonoHD / 232

239 11-1 SV TAM TAP TAPSE TCD TDI THI TI TICA TO M TRmax ( ) TT TTD TV TVA UA Umb A VA VArty Vas VF Vmax Vmean Vol 233

240 11-1 VTI YS 234

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242 P *P *