HI VISION Preirus Measurement Instruction Manual Edition 14 April 2016

Measurement Instruction Manual

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Ultrasound Diagnostic Scanner HI VISION Preirus Measurement

INSTRUCTION MANUAL

Special Notes to Operators and Maintenance Managers ★ Before using this system, be sure to thoroughly read this manual and make yourself familiar with this system. ★ After reading this manual, keep it in an easily accessible place close to the system.

Tokyo, Japan

Q1E-EA1141-14

This manual describes about the measurement function of the HI VISION Preirus Ultrasound Diagnostic Scanner. About equipment configuration, installation, maintenance, read the separate INSTRUCTION MANUAL HI VISION Preirus Preparation and INSTRUCTION MANUAL HI VISION Preirus Operation.

Convention used in this manual:

Alphanumeric keyboard (option) keys and dialog box buttons are shown in bold letters. Examples:

: Del key,

: OK button

Symbols used in this manual: This symbol indicates an immediate danger that could result in death or serious injury of personnel, total destruction of equipment, or fire if the warning is ignored and the equipment is handled incorrectly. This symbol indicates a potential (latent) danger that could result in death or serious injury of personnel, total destruction of equipment, or fire if the warning is ignored and the equipment is handled incorrectly. The following is an example of a potential danger: (Ex.) Failure to observe this warning could result in death if the cover is opened and a high-voltage terminal is touched. This symbol indicates possible danger that could result in light or moderate injury of personnel, partial equipment damage, or deletion of computer data if the warning is ignored and the equipment is handled incorrectly. This symbol indicates prohibited conditions or actions. The description accompanying this symbol indicates conditions or actions that are prohibited. This symbol indicates precautions to be observed. The description accompanying this symbol indicates conditions that require careful attention or that might be dangerous. This symbol indicates a recommended procedure, condition, or action that requires careful attention when operating the equipment.

This symbol indicates supplementary information.

Cautions on exportation: When exporting this equipment, be sure to check the Foreign Exchange and Foreign Trade Control Law and the regulations related to export control in the United States of America, and perform the necessary procedures. Contact Hitachi or an authorized representative if you have further inquiries.

Revision history: First edition

October 2008

Twelfth edition

May 2014

Fourteenth edition

April 2016

Introduction Thank you for purchasing Hitachi's HI VISION Preirus ultrasound diagnostic scanner. To use this equipment safely and correctly, and to maintain normal performance for a long period, it is essential to have a full understanding of its functions, operation, and maintenance. Read this instruction manual thoroughly before using this equipment.

About the ultrasound diagnostic scanner windows Note that the ultrasound diagnostic scanner windows referred to in this instruction manual might differ from the windows actually displayed.

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Contents Introduction...i Contents ... iii

Chapter 1 - Measuring Functions... 1 1.1 Outline ...1 1.1.1 Basic measurements ...1 1.1.2 Available measurements on factory default ...2 1.1.3 Available measurements imported from the additional settings...5 1.2 Basic operations and starting measurement...10 1.2.1 Keys used for measurement function...10 1.2.2 Configuration of the screen ...11 1.2.3 Starting measurement ...13 1.2.4 Selecting a measurement item ...15 1.2.5 Advanced measurement item selection menu ...17 1.2.6 Multiple measurements...18 1.3 Basic measurement methods...21 1.3.1 Distance ...22 1.3.2 Area ...24 1.3.3 Volume...29 1.3.4 Instantaneous Flow Velocity...31 1.3.5 Doppler trace ...32 1.4 Operations after the examination ...41 1.5 Basic Measurements...41 1.5.1 Calip Measurement...41 1.5.2 Trace Measurement...43 1.5.3 Substitution for Measurement result...45 Q1E-EA1141

iii

1.5.4 Displaying the measurement cursor in two windows simultaneously... 47 1.6 Multipurpose Measurements ... 48 1.6.1 Accel. Measurement... 48 1.6.2 Decel. Measurement ... 51 1.6.3 Velocity Measurement ... 53 1.6.4 V Ave. Measurement... 54 1.6.5 Volume Measurement ... 55 1.6.6 Histogram Measurement... 56 1.6.7 RI, PI Measurement ... 60 1.6.8 FlowVolume Measurement ... 62 1.6.9 D-Profile Measurement... 66 1.6.10 Ratio-Velo, Ratio-Time, Ratio-Dis, Ratio-Area Measurement ... 68 1.6.11 HR Measurement ... 69 1.6.12 Time Measurement ... 71 1.6.13 CFM-Velo. Measurement... 72 1.6.14 B-Distance Measurement... 74 1.6.15 M-Distance Measurement... 75 1.6.16 Angle2Lines Measurement ... 76 1.6.17 Angle3Point Measurement... 79 1.7 Measurements for abdominal, urology, and others ... 82 1.7.1 Angle Measurement ... 82 1.7.2 Urology Measurement ... 85 1.7.3 SVolume Measurement ... 90 1.7.4 Vascularity Measurement... 92 1.7.5 Strain Ratio, FLR Measurement ... 96 1.7.6 Strain Histogram Measurement ... 108 1.8 Measurements for cardiac ...113 1.8.1 M.Simpson Measurement ...113 1.8.2 B-LV Measurement... 124 1.8.3 Dia.Func. Measurement ... 127

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1.8.4 PV flow Measurement ...128 1.8.5 CO Measurement...129 1.8.6 MS Measurement...130 1.8.7 AV-Area Measurement...132 1.8.8 LV Measurement...135 1.8.9 Ao Measurement...141 1.8.10 MV Measurement ...143 1.8.11 TV Measurement ...145 1.8.12 PV Measurement ...147 1.8.13 B-LV/Ao, M-LV/Ao Measurement...149 1.8.14 MV Regurg Measurement ...151 1.8.15 dP/dt Measurement ...153 1.8.16 TV Regurg Measurement...155 1.8.17 Qp/Qs Measurement ...157 1.8.18 RVOT Measurement ...160 1.8.19 RV inflow Measurement...163 1.8.20 Area Length Measurement...165 1.8.21 BI-Plane Measurement ...167 1.8.22 Simpson Measurement ...169 1.8.23 Bullet Measurement...171 1.8.24 PHT Measurement ...173 1.8.25 LVOT Measurement ...175 1.8.26 LV inflow Measurement ...179 1.8.27 B-EF, M-EF (Pombo, Gibson, Teichholz) Measurement...181 1.8.28 MVG-M Measurement ...182 1.8.29 LVMass-AL Measurement...185 1.8.30 LVMass-TE Measurement...187 1.9 Measurements for cardiac (Option measurement) ...190 1.9.1 %WT Measurement ...190 1.9.2 Color Tissue Tracking Measurement ...202 Q1E-EA1141

1.9.3 The display of Bull’s Eye... 219 1.9.4 LA Tracking Measurement ... 225 1.9.5 LA Tracking Viewer... 242 1.10 Measurements for vascular ... 243 1.10.1 Carotid Measurement... 243 1.10.2 Leg A. Measurement... 246 1.10.3 Arm A. Measurement ... 248 1.10.4 %Steno-A Measurement ... 250 1.10.5 %Steno-D Measurement ... 251 1.10.6 IMT Measurement (Option)... 252 1.10.7 %Steno Measurement ... 270 1.11 Obstetric Measurements (OB-STD, OB-Todai, OB-OsakaU, OB-JSUM)... 272 1.11.1 Outline of function ... 272 1.11.2 Outline of operation ... 273 1.11.3 Preset measurement items and report display items... 275 1.11.4 Operation ... 283 1.11.5 Input to DGA ... 283 1.11.6 Twin Measurement... 285 1.11.7 Major abbreviations ... 286 1.11.8 Setting obstetric measurement display items ... 287 1.12 Gynecology, Follicular Measurement ... 288 1.12.1 Gynecology Measurement ... 288 1.12.2 Follicular Measurement ... 290 1.13 Measurement using DICOM SR (Option)... 292 1.13.1 Cardiac Measurement (Cardiac_SR_II)... 293 1.13.2 Obstetrics/Gynecology/Follicular Measurement（OB_SR_II）... 327 1.13.3 Cardiac Measurement (Cardiac_SR) ... 365 1.13.4 Vascular Measurement (Vascular_SR)... 379 1.13.5 Obstetrics/Gynecology/Follicular Measurement (OB_SR)... 426 1.14 Measurement Report Function... 431

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1.14.1 Overview of the measurement report function ...431 1.14.2 Usage notes...431 1.14.3 Displaying measurement reports ...432 1.14.4 Basic operations...441 1.14.5 Graphic display of obstetric measurement...451 1.14.6 Graphic operation of obstetric measurement ...455 1.14.7 Input and output of Measurement result ...458 1.15 Measurement on review image from image memory...460 1.16 Measurements which support the output of a CSV file format...461

Chapter 2 - Measurement Setup... 463 2.1 Configuration of Measurement Setup ...463 2.2 Measurement Setup menu...466 2.2.1 Starting Measurement Setup menu ...466 2.2.2 Measurement Type...468 2.2.3 Functions of Measurement Setup menu...478 2.3 Measurement Edit Menu ...480 2.3.1 Basic operation ...481 2.3.2 Measurement Item Edition area...483 2.3.3 Link Setup ...496 2.3.4 Edition of Obstetric table...522 2.4 Special menu...529 2.4.1 OB ...529 2.4.2 Import menu of OB table...530 2.4.3 Export menu of OB table...531 2.4.4 Unique ID menu ...532 2.4.5 Setting menu for traces ...534 2.4.6 Display Settings...535 2.4.7 Other...536 2.5 Examples of measurement edition...538 Q1E-EA1141

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2.5.1 Display or non-display of measurement item ... 538 2.5.2 Change of display order in Measurement menu and Result Display area... 542 2.5.3 New creation of measurement (by using Single Tool) ... 544 2.5.4 New creation of measurement (by using Link Tool)... 551 2.6 Common memory in Region... 564 2.6.1 Common memory of Single tool... 565 2.6.2 Common memory of Link tool ... 568 2.6.3 Factory default ... 571 2.7 Measurement Export/Import function ... 572 2.7.1 Opening Measurement Import/Export window ... 572 2.7.2 Details of window... 572 2.7.3 Export of measurement ... 574 2.7.4 Import of measurement ... 574 2.7.5 Replacement of measurement ... 574 2.8 Measurement Tool ... 576 2.8.1 Outline of measurement tool... 576 2.8.2 Setting Measurement tool ... 588

Chapter 3 - Measurement Precision...597 3.1 Procedures for performing high precision measurements ... 597 3.2 Factors in Measurement Deviations... 598 3.3 Ignorable Deviations... 598 3.4 Accuracy of Measurement Tools ... 599 3.5 Standard Measurement ... 603 3.6 Measurements from B-mode Image... 605 3.7 M-mode Measurement with Schema... 606 3.8 Doppler Measurements ... 607 3.9 Left Ventricular Cardiac Function Measurements ... 609

viii

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Appendix A Stored table data and fetal weight calculation equation ...611 Appendix B

Notes for Customers Using Older

Versions... 647 INDEX ... 649

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Chapter 1 - Measuring Functions

Chapter 1 - Measuring Functions 1.1 Outline This system has various measurements written in the following tables.

1.1.1 Basic measurements················································································ Calip measurement and Trace measurement is invoked by the special key. Table 1.1-1 Name

Basic measurements Meaning

Calip

B mode :

Measuring distance between two

Display Mode * B, M, D

points. M mode :

Note Invoked by the

Described section 1.5.1

CALIP key CALIP

Measuring depth difference between two points, time, and velocity (slope).

Doppler mode : Measuring flow velocity at caliper cursor. Trace

B mode :

Measuring areas and circumferential lengths by tracing.

M mode :

B, M, D

Invoked by the

1.5.2

TRACE key

Measuring the area and

TRACE

circumferential length of a circle with the distance between two points as its diameter. Doppler mode : Measuring mean flow velocity by tracing Doppler waveforms.

Calip measurement is available on Freeze ON and Freeze OFF. Trace measurement is available on Freeze ON and Freeze OFF when the mode is Doppler mode, but it is available only on Freeze ON when the mode is except for Doppler mode.

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Chapter 1 - Measuring Functions

1.1.2 Available measurements on factory default ·············································· Following measurements are available on factory default. These measurements are invoked from the MEAS. MENU key Table 1.1-2

MEAS. MENU

or screen buttons.

Measurements for general, urology and others (Region name : General)

Name

Meaning

Display Mode

Note

Option

Described section

Str. Ratio

Strain Ratio measurements

Elasto

FLR

Fat Lesion Ratio measurements

Elasto

Str. Histo.

Strain Histogram measurements

Elasto

Accel.

Measuring flow acceleration.

1.6.1

V Ave.

Calculating average flow velocity.

1.6.4

1.6.5

Volume

Measuring volumes by area-length method, ellipse approximation method, and biplane method.

Measurement *4 Option Measurement *4 Option Measurement *5

1.7.5 1.7.5 1.7.6

Histogram

Histogram measurements.

1.6.6

Angle

Angle measurements

1.7.1

1.7.2

Urology

Volume measurement, etc. such as bladder and prostate

RI,PI

Measuring vascular Doppler

1.6.7

FlowVolume

Measuring vascular Doppler

B+D

1.6.8

Angle2Lines

The Angle between two line segments

1.6.16

Angle3Point

The Angle between three points

1.6.17

Table 1.1-3 Name M.Simpson B-LV

Measurements for cardiac (Region name : Cardiac) *6 Meaning

Volume measurement by dual cross section cylindrical approximation Measuring left ventricle in B mode

Display Mode *1

Note

Described section

1.8.1

1.8.2

1.8.3

1.8.4

1.8.5

Doppler Measurement at the Left Ventricle Inflow Dia.Func.

Tract, Evaluation of Left Ventricle Diastolic Function

PV flow

Measuring Doppler of Pulmonary Vein Doppler Measurement at the Left Ventricle Outflow

Tract, Calculation of Cardiac Output

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Chapter 1 - Measuring Functions

Name

Meaning

Display Mode *1

Note

Described section

Doppler Measurement in Mitral Valve Orifice

1.8.6

AV-Area

Measurement of area of aortic valve port

D+B *2

1.8.7

Measuring left ventricle in M mode.

M *2

1.8.8

Measuring aortic valve in M mode.

M *2

1.8.9

Measuring mitral valve in M mode.

M *2

1.8.10

Measuring tricuspid valve in M mode.

M *2

1.8.11

Measuring pulmonary valve in M mode.

M *2

1.8.12

M-EF

Measuring volume by Teichholz's rule.

1.8.27

MV Regurg

Regurgitant volume of mitral valve

D+CFM-B *2

1.8.14

1.8.15

dP/dt

Measurement of change of pressure difference over time

TV Regurg

Regurgitant volume of tricuspid valve

D+CFM-B *2

1.8.16

Qp/Qs

Pulmonary flow / Systemic flow

D+B *2

1.8.17

%WT

Tissue Tracking

B (Multi image) *3

1.9.1

RV inflow

Measuring Doppler of right ventricular inflow tract. D

1.8.19

Generic

Group of Multipurpose Measurements

B, M, D

1.6

Time

Time interval measurement

M, D

1.6.12

Measuring heart rate.

M, D

1.6.11

PHT

Measuring pressure half-time (PHT).

1.8.24

Accel.

Measuring flow acceleration.

1.6.1

Decel.

Measurement of blood flow deceleration

1.6.2

Velocity

Measuring flow velocity and pressure gradient.

1.6.3

V Ave.

Calculating average flow velocity.

1.6.4

CFM-Velo.

Measuring CFM Flow velocity.

CFM-B, M

1.6.13

B-Distance

B-mode Distance Measurement

1.6.14

M-Distance

M-mode Distance Measurement

1.6.15

CTT

Color Tissue Tracking measurement

B (Multi image) *3

1.9.2

LA Tracking

Left Atrium Tracking

B (Multi image) *3

1.9.4

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Chapter 1 - Measuring Functions

Table 1.1-4 Name

Measurements for vascular (Region name : Vascular) Meaning

Display Mode *1

Note

Described section

Option

Str. Ratio

Strain Ratio measurements

Elasto

Accel.

Measuring flow acceleration.

1.6.1

V Ave.

Calculating average flow velocity.

1.6.4

RI,PI

Measuring vascular Doppler

1.6.7

FlowVolume

Measuring vascular Doppler

D+B

1.6.8

Carotid

Measuring a level of blood vessel stenosis.

B, D

1.10.1

Leg A.

Measuring the blood flow velocity.

1.10.2

Arm A.

Measuring the blood flow velocity.

1.10.3

%Steno-A

Calculating %Stenosis from area ratio.

1.10.4

%Steno-D

Calculating %Stenosis from diameter ratio.

1.10.5

IMT

Intima media thickness measurement

Table 1.1-5 Name

1.7.5

Measurement *4

Option measurement *3

1.10.6

Measurements for obstetrics and Gynecology (Region name : OB&GYN) Meaning

Display Mode *1

Note Option

Described section

Str. Ratio

Strain Ratio measurements

Elasto

OB-STD

Obstetrical Measurement Package(Standard)

B, M, D

1.11

Gynecology

Volume measurement, etc. such as uterus or ovary.

B, D

1.12.1

Follicular

Volume measurement, etc. such as follicular.

B, D

1.12.2

Measurement *4

1.7.5

Doppler trace (Auto trace method) can be conducted when the FREEZE function is both on and off. Other measurements are only enabled when the FREEZE function is on.

Do not use these measurements while reviewing the TDI images. Note that these measurements are hidden while TDI is ON but not being reviewed.

The option software is required to use.

It is possible to use the measurement only at Elasto mode. (It needs the optional Real-time Tissue Elastography Software.)

It is possible to use the measurement only at Elasto mode. (It needs the optional Real-time Tissue Elastography Software and Strain Histogram measurement Software.)

To display ECG waveform, an optional device sold separately is required.

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Chapter 1 - Measuring Functions

1.1.3 Available measurements imported from the additional settings ··············· After import from the additional settings on the Import/Export menu, the following measurements are available. They are not available on the factory default. Please refer to 2.7 Measurement Export/Import function for the method of import. These measurements are invoked from the MEAS. MENU key Table 1.1-6

MEAS. MENU

or screen buttons.

Measurements for general, urology and others (Region name : General)

Name

Meaning

Display Mode *1

Note

Described section

Measuring the instantaneous mean flow D-Profile

velocity, %-WINDOW, etc. of a Doppler waveform at a

1.6.9

user-selected point along the time axis. Ratio-Velo

Calculating velocity ratio.

1.6.10

Ratio-Time

Calculating time ratio.

M, D

1.6.10

Ratio-Dis

Calculating distance ratio.

1.6.10

Ratio-Area

Calculating area ratio.

1.6.10

Measuring heart rate.

M, D

1.6.11

SVolume

Measuring by adding micro-volume sliced evenly.

1.7.3

Time

Time interval measurement

M, D

1.6.12

Vascularity

Doppler power measurements

CFA-B

1.7.4

CFM-Velo.

Measuring CFM Flow velocity.

CFM-B, M

1.6.13

Table 1.1-7 Name

Measurements for cardiac (Region name : Cardiac) *4 Meaning

Display Mode *1

Note

Described section

PHT

Measuring pressure half-time (PHT).

1.8.24

Velocity

Measuring flow velocity and pressure gradient.

1.6.3

LV Gibson

Measuring left ventricle by GIBSON

1.8.8

LV Pombo

Measuring left ventricle by POMBO

1.8.8

B-LV/Ao

B-mode Image Measurement

1.8.13

M-LV/Ao

B-mode Image Measurement

1.8.13

M-EF Gibson

Measuring volume by GIBSON's rule.

1.8.27

M-EF Pombo

Measuring volume by POMBO's rule.

1.8.27

Area Length

Measuring volume by area-length method.

1.8.20

1.8.21

1.8.22

BI-Plane Simpson

Measuring volume by biplane ellipse approximation method. Measuring volume by SIMPSON's rule.

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Chapter 1 - Measuring Functions

Name

Meaning

Display Mode *1

Note

Described section

Bullet

Measuring volume by bullet approximation method.

1.8.23

B-EF

Measuring volume by Teichholz's rule.

1.8.27

B-EF Gibson

Measuring volume by GIBSON's rule.

1.8.27

B-EF Pombo

Measuring volume by POMBO's rule.

1.8.27

LVOT

Measuring Doppler of left ventricular outflow tract.

D+B *2

1.8.25

LV inflow

Measuring Doppler of left ventricular inflow tract.

D+B *2

1.8.26

RVOT

Measuring Doppler of right ventricular outflow tract

D+B *2

1.8.18

LV Gib.M

Measuring left ventricle by GIBSON

M *2

1.8.8

LV Manu

Measuring left ventricle in M mode.

M *2

1.8.8

LV Pom. M

Measuring left ventricle by POMBO

M *2

1.8.8

MVG-M

MVG Measurement

TDI-M

1.8.28

LVMass-AL

Ventricular mass measurement by the area-length method B

LVMass-TE

Ventricular mass measurement by the truncated-ellipsoid method

Table 1.1-8

Meaning Calculating %Stenosis from area ratio.

Table 1.1-9

1.8.30

Measurements for vascular (Region name : Vascular)

Name %Steno

1.8.29

Display Mode *1 B

Meaning

Display Mode *1

Obstetrical Measurement Package(Todai)

B, M, D

OB-OsakaU

Obstetrical Measurement Package(OsakaU)

B, M, D

Obstetrical Measurement Package (Plan of Japan’s standard)

Meaning

Described section

1.11

B, M, D

Display Mode

Echo LV

Measuring left ventricle

B, M, D

Echo LA

Measuring left atrium

B, M, D

Echo RV

Measuring right ventricle

B, M, D

Echo RA

Measuring right atrium

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Note

DICOM SR - Measurements for cardiac (Region name: Cardiac_SR_II) *3

Name

section 1.10.7

OB-Todai

Table 1.1-10

Described

Measurements for obstetrics and Gynecology (Region name : OB&GYN)

Name

OB-JSUM

Note

Described section

1.13.1

Chapter 1 - Measuring Functions

Name

Meaning

Display Mode

Echo AV

Measuring aortic valve

B, D

Echo MV

Measuring mitral valve

B, M, D

Echo PV

Measuring pulmonary valve

B, D

Echo TV

Measuring tricuspid valve

B, D

Echo Ao

Measuring aorta

B, M

Echo PArtery

Measuring pulmonary artery

B, D

Echo IVC

Measuring vena cava

B, M, D

Echo PVein

Measuring pulmonary vein

B, D

Echo CS

Measuring cardiac shunt

B, D

Echo Cong

Measuring congenital disease

B, D

Table 1.1-11

Note

Described section

1.13.1

DICOM SR - Measurements for obstetrics and gynecology (Region name:

OB_SR_II) *3 Name

Meaning

Display Mode *1

Fetal_Vasc