Aplio 400 Operator Manual

7/23/2019 Aplio 400 Operator Manual

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No. 2B771-044EN*D

IMPORTANT!

Read and understand this manual before operatingthe equipment. After reading, keep this manual in aneasily accessible place.

TOSHIBA MEDICAL SYSTEMS CORPORATION 2011-2012

ALL RIGHTS RESERVED

OPERATION MANUALFOR

DIAGNOSTIC ULTRASOUND SYSTEM

MODEL TUS-A400

MEASUREMENTS VOLUME

(2B771-044EN*D)


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Trademarks

Microsoft Windows XP is a trademark of Microsoft Corporation in the USA and other

countries.

APLIO, Dynamic Flow, ApliPure, MicroPure, and TwinView are trademarks of Toshiba MedicalSystems Corporation.This manual may include trademarks or registered trademarks of other companies.

Note that the trademark symbol "" and the registered trademark symbol "" may or may notbe used in this manual.

IMPORTANT!

1. No part of this manual may be copied or reprinted, in whole or in part,without prior written permission.

2. The contents of this manual are subject to change without prior noticeand without legal obligation.

3. The contents of this manual are correct to the best of our knowledge.Please inform us of any ambiguous or erroneous descriptions, missinginformation, etc.


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Table of Contents

1. Outline of Measurement Functions.................... 1-1

1.1 Switches Used for Measurement................................................. 1-1

1.2 Setting the Measurement................................................................... 1-2

1.3 Modifying a Measurement................................................................. 1-3

1.4 Deleting a Measurement..................................................................... 1-6

1.4.1 Deleting a measurement using the touch panel............................... 1-6

1.4.2 Deleting the selected measurement result......................................... 1-7

1.5 Changing the Result Display Position..................................... 1-8

1.6 Worksheet Screen................................................................................... 1-9

2. 2D-Mode Measurements.................................................... 2-1

2.1 Distance Measurement (Distance).............................................. 2-2

2.2 Curved Line Distance Measurement (Trace Length)..... 2-3

2.2.1 Continuous Trace.......................................................................................... 2-3

2.2.2 Spline Trace..................................................................................................... 2-4

2.3 Angle Measurement (Angle)............................................................ 2-5

2.4

Area/Circumference Measurement (Area)............................. 2-6


2.4.2 Spline Trace..................................................................................................... 2-6

2.4.3 Ellipse................................................................................................................. 2-7

2.4.4 Cross................................................................................................................... 2-8

2.5 Volume Measurement (Volume).................................................. 2-10

2.6 Joint Measurement............................................................................... 2-11


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2.7 MeanIMT Measurement..................................................................... 2-12

2.8 %Stenosis (Distance) Measurement....................................... 2-14

2.9 %Stenosis (Area) Measurement................................................. 2-15

3. M-mode Measurements....................................................... 3-1

3.1 M-Mode Distance Measurement (Distance)......................... 3-2

3.2 Slope Measurement (Slope)............................................................. 3-3

3.3 Time Measurement (Time)................................................................. 3-4

3.4 Heart Rate Measurement (HR)........................................................ 3-5

4. Doppler-Mode Measurements.................................... 4-1

4.1 Velocity Measurement (Velocity)................................................. 4-2

4.2 Acceleration Measurement (Accel)............................................ 4-3

4.3 Time Measurement (Time)................................................................. 4-3

4.4 Heart Rate Measurement (HR)........................................................ 4-3

4.5 Velocity Trace Measurement (Vel Trace)............................... 4-4


4.5.2 Spline Trace..................................................................................................... 4-7

4.5.3 Line Trace......................................................................................................... 4-8

4.5.4 Range.................................................................................................................. 4-9

4.5.5 Auto Range..................................................................................................... 4-11

4.6 PI Measurement (PI Trace).............................................................. 4-12

4.7 RI Measurement...................................................................................... 4-13

4.8 S/D Measurement................................................................................... 4-14

4.9 Flow Volume Trace Measurement (Flow Volume)......... 4-15


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5. Application Measurement (Cardiac).................. 5-1

5.1 Introduction.................................................................................................. 5-1

5.1.1 Starting the application measurement menu..................................... 5-1

5.1.2 Heart rate acquisition methods (Cardiac)........................................... 5-1

5.2 2D-Mode Measurements (Cardiac)............................................. 5-3

5.2.1 LV measurement (MOD Simpson method)/LA measurement (MOD Simpson method)/LA measurement (3-Axis method).......................................................... 5-3

5.2.2 LV measurement (Teichholz method)................................................. 5-11

5.2.3 LV measurement (Cube method).......................................................... 5-16

5.2.4 LV measurement (Gibson method)...................................................... 5-16

5.2.5 LV measurement (Single-plane (aka Area-Length) method)..... 5-17

5.2.6 LV measurement (Biplane method)..................................................... 5-19

5.2.7 LV measurement (Bullet method)......................................................... 5-21

5.3 M-Mode Measurement (Cardiac)................................................ 5-23

5.3.1 Aortic valve measurement (Aortic Valve).......................................... 5-23

5.3.2 Mitral valve measurement (Mitral Valve)............................................ 5-25

5.3.3 LV measurement (Teichholz method)................................................. 5-27

5.3.4 LV measurement (Cube method).......................................................... 5-33

5.3.5 LV measurement (Gibson method)...................................................... 5-33

5.4 Doppler-Mode Measurement (Cardiac).................................. 5-34

5.4.1 Aortic valve measurement (Aortic)...................................................... 5-34

5.4.2 Mitral valve measurement (Mitral)........................................................ 5-42

5.4.3 Pulmonary vein blood flow measurement (Pulmo. Vein)........... 5-49

5.4.4 Tricuspid valve measurement (Tricus.).............................................. 5-51

5.4.5 Pulmonary valve measurement (Pulmo.)........................................... 5-55

5.5 Extra Measurements............................................................................ 5-60


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5.5.1 LV Mass AL (Area-Length)....................................................................... 5-60

5.5.2 LV Mass TE (Truncated Ellipsoid)........................................................ 5-62

5.5.3 PISA................................................................................................................... 5-64

5.5.4 Coronary.......................................................................................................... 5-66

6. Application Measurement (Vascular).............. 6-1

6.1 Carotid1........................................................................................................... 6-1

6.1.1 2D-mode measurement............................................................................... 6-1

6.1.2 Doppler-mode measurement.................................................................... 6-3

6.1.3 Measurement value display on the Worksheet screen.................. 6-4

6.2 Carotid1 (Auto-IMT Measurement).............................................. 6-5

6.2.1 Touch panel menu......................................................................................... 6-5

6.2.2 Measurement method.................................................................................. 6-7

6.2.3 Worksheet screen.......................................................................................... 6-9

7. Obstetric Measurement (OB)....................................... 7-1

7.1 Outline of OB Measurement............................................................ 7-1

7.2 Patient Registration for OB Measurement............................ 7-2

7.3 OB Measurement Menu on the Touch Panel....................... 7-3

7.4 Measurement Methods Specific toOB Measurements................................................................................... 7-5

7.4.1 Amniotic fluid index (AFI).......................................................................... 7-5

7.4.2 NB (Nasal Bone)/NT (Nuchal Translucency)/NF (Nuchal Fold)measurement................................................................................................... 7-6

7.4.3 CTAR measurement...................................................................................... 7-7

7.4.4 Maxilla Angle (Facial Maxilla Angle) measurement........................ 7-9

7.4.5 DV (Ductus Venosus) measurement..................................................... 7-9

7.5 Calculation Items................................................................................... 7-10


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7.6 List of OB Measurements andOB Calculation Items.......................................................................... 7-14

7.7 Measurement Items That Can Be Selected in theGyn. Menu................................................................................................... 7-22

7.8 Updating the OB Date Information During anExamination (GA Input)..................................................................... 7-23

7.9 Trend Graph (Trend)............................................................................ 7-24

7.10 OB Worksheet.......................................................................................... 7-26

7.10.1 OB 2D Worksheet........................................................................................ 7-27

7.10.2

OB Doppler Worksheet.............................................................................. 7-28

7.10.3 Gyn Worksheet............................................................................................. 7-29

7.10.4 Comment screen.......................................................................................... 7-30

7.10.5 Anatomy function........................................................................................ 7-32

7.10.6 Data List........................................................................................................... 7-34

7.11 Data Storage.............................................................................................. 7-39

8. Measurements on a Stored Image....................... 8-1

8.1 Measurements on ER Images......................................................... 8-3

8.2 Measurements on ER Images for Which ManualCalibration Is Required........................................................................ 8-5

8.3 Manual Calibration Required Before the Start ofEach Measurement............................................................................... 8-10

8.4 Worksheet Display................................................................................ 8-11

8.5 Accuracy of Measurement When Manual CalibrationIs Used........................................................................................................... 8-12

9. Measurement Data Storage........................................... 9-1

9.1 Storing Measurement Data in the DICOM SR Format... 9-1

9.1.1 Data transfer.................................................................................................... 9-1


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9.1.2 Displaying the stored data......................................................................... 9-3

10. OB Measurement Chart Data..................................... 10-1

10.1 Gestational Age Chart...................................................................... 10-11

10.2 Growth Analysis Chart.................................................................... 10-68

10.3 Identical Chart...................................................................................... 10-129

10.4 Charts for Creating Trend Graphs........................................ 10-178

11. Presetting............................................................................................. 11-1

11.1 Setting Presets........................................................................................ 11-1

11.2 Details of Each Preset........................................................................ 11-3

11.2.1 Appl Meas....................................................................................................... 11-3

11.2.2 Meas. Window............................................................................................... 11-4

11.2.3 2D-Mode Meas.............................................................................................. 11-6

11.2.4

D-Mode Meas................................................................................................. 11-7

11.2.5 D-Mode Meas. 2.......................................................................................... 11-13

11.2.6 Worksheet..................................................................................................... 11-14

11.2.7 Meas. Marker................................................................................................ 11-16

11.2.8 Meas. Marker2............................................................................................. 11-17

11.2.9 Meas. Operation......................................................................................... 11-18

11.2.10 Annotation.................................................................................................... 11-20

11.2.11 LV (2D)............................................................................................................ 11-21

11.2.12 LV (M).............................................................................................................. 11-22

11.2.13 Cardiac Doppler.......................................................................................... 11-23

11.2.14 LV Mass.......................................................................................................... 11-24

11.2.15 Carotid1 Doppler........................................................................................ 11-25

11.2.16 Carotid1 Meas. Type................................................................................. 11-27


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11.2.17 Carotid1 Meas. Tool.................................................................................. 11-28

11.2.18 Auto IMT......................................................................................................... 11-29

11.2.19 Body Mark..................................................................................................... 11-30

11.2.20 Meas. Data Display.................................................................................... 11-31

11.2.21 OB/Gyn Report............................................................................................ 11-32

11.2.22 OB/Gyn Report 2........................................................................................ 11-33

11.2.23 OB Evaluated - OB Calc.......................................................................... 11-34

11.2.24 OB Evaluated - OB Calc. 2..................................................................... 11-35

11.2.25 OB Evaluated - OB Calc. 3..................................................................... 11-37

11.2.26 OB Evaluated - D OB Calc...................................................................... 11-39

11.2.27 OB Display.................................................................................................... 11-40

11.2.28 OB Behavior................................................................................................. 11-41

11.2.29 OB 2D Tool................................................................................................... 11-42

11.2.30 OB/Gyn D Meas.......................................................................................... 11-43

11.2.31

Gyn Meas...................................................................................................... 11-44

11.3 Confirmation of the Automatic MeasurementStart Item.................................................................................................... 11-45

12. Registration of User-ProgrammedMeasurements............................................................................... 12-1

*


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1. Outline of Measurement Functions

1.1 Switches Used for Measurement

No. Switch Function

Moves the marker.

The trace lines can be modified using the dial located aroundthe trackball.

Sets the start and end points.

Starts the next measurement.

Starts a basic measurement. (The default measurement that isstarted differs according to the mode.)

2D mode : Distance

M mode : Distance

PW/CW mode : Velocity

Starts a basic measurement. (The default measurement that isstarted differs according to the mode and the customizedsetting.)

2D mode : Area

M mode : Slope

PW/CW mode : Vel Trace

Starts an application measurement. (The measurement to bestarted must be preset in advance.)

Modifies trace lines.

Rotates the line marker to adjust the angle.

Freezes the image.

Displays the application measurement results on the Worksheetscreen. (The screen to be displayed differs depending on thesetting.)


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NOTE: 1. The measurements that start when the corresponding switch is pressedand the methods for setting the measurement data differ depending on thepreset.The data used for calculation and the display of calculation results alsodiffer depending on the preset.

Refer to section 11 "Presetting" and set the desired presets before usingthe above switches.

2. The default basic measurement can be changed as needed. Contact yourToshiba service representative.

1.2 Setting the Measurement

When the measurement is set on an image in the current examination, the color of themeasurement markers is changed to cyan.

When the measurement is set on an image stored for a previous examination, the colorof the measurement markers is changed to white.

CAUTION: Be sure to perform measurement within the displayed images.If an area outside an image is included in a measurement, anincorrect result may be output.

NOTE: 1. Both and can be used to set (register) the measurement.

When is used, the measurement result is set and the next

measurement is started.

However, when "Fixed by [SET] only" in [Vel, Auto Range Tool] of theMeas. Operation preset is set to ON, the preset setting takes precedence

and must be used to set the measurement result.

Note that pressing a measurement item switch on the touch panel (otherthan Velocity measurement of the basic measurements) also sets themeasurement result.

2. The application measurement results are not displayed on the Worksheetscreen if the measurement data has not been set.

3. In basic measurement mode, the measured data is lost when the systempower is turned OFF or the exam data has been changed.

4. The results of basic measurements are not displayed on the Worksheetscreen.

5. Only a part of the calculation results are displayed on the measurementresult screen in application measurement mode. To check all themeasurement results (calculation results), use the Worksheet screen.

6. It is possible to preset whether or not the line connecting the start point and

end point is displayed before the measurement is set in distancemeasurement and area measurement.


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1.3 Modifying a Measurement

A measurement data item can be modified by pressing even after the

measurement data is set and the measured value is displayed, provided that or

another measurement switch has not been pressed.

Perform the procedures below to modify the measurement data.

Step 1:

Start modification.

Step 2:

Move the startpoint.

Step 3:

Finish modificationof the start point.

Step 4:

Modify the endpoint.

Press .

The start point(first point) changes toa marker.

Change theposition of the

start point using

.

A

Press .

A

The newly measureddata is set.

To modify the endpoint, press

and follow

the sameprocedure.


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Step 1:

Start modification.

Step 2:

Undo the trace tothe desired point.

Step 3:

Draw the traceagain.

Step 4:

Set the newlymeasured data.

Press .

The start point (firstpoint) changes to amarker.

Rotate to

undo the trace tothe desired point.

From that point,draw the traceagain using

.

Press .


To modify the endpoint, press

and follow

the sameprocedure.

* During velocity trace measurement in PW/CW mode, rotate counterclockwise

to undo the trace.


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The above procedures cannot be used to modify measurements obtained using theSpline Trace method.

To modify such measurements, press and then move the marker.

Step 1:

Start modification.

Step 2:

Select the markerto be modified.

Step 3:

Move the marker.

Step 4:

Set the newlymeasured data.

Press .

An arrow is displayed.

Move the arrownear the marker tobe modified.

The color of theselected markerchanges to red.

Press .

Move the markerto the desiredposition using

.

Press .



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1.4 Deleting a Measurement

1.4.1 Deleting a measurement using the touch panel

*1: Refer to subsection 7.3 for the function of [Clear All] in OB measurement mode.


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1.4.2 Deleting the selected measurement result

Perform the procedures below to delete the selected measurement result.

Step 1:

Start

Step 2:

Select the measurementresult to be deleted.

Step 3:

Delete themeasurement result.

Press .

An arrow is displayed.

Move the arrow nearthe marker for themeasurement result tobe deleted.

A B

The color of the selectedmarker changes to red.

Press .

The measurement resultassociated with theselected marker is deleted.


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1.5 Changing the Result Display Position

is displayed during measurement. Press this switch to display the menu for

changing the measurement result display position.

*1: Each time is pressed, the result display position is changed as

shown below.


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1.6 Worksheet Screen

After performing application measurement, press to display the Worksheet

screen*1.

*1: If the system is set not to start up the Worksheet screen by pressing , press

on page 3/3 of the OTHER menu.

On this screen, the measurement and calculation results obtained in the applicationmeasurement are displayed.

CAUTION: 1. If the measurement data displayed on the Worksheet screen is edited,the data that precedes editing is overwritten and lost.

2. When is pressed, the message "Calculating" is displayed until the

Worksheet screen is displayed. If many items have been measured,"Calculating" may remain displayed for several tens of seconds toseveral minutes. Do not operate the main panel or touch panel whilethis message is displayed.

3. When more than one measurement has been performed using differentapplication presets, the application preset for which the results are to bedisplayed can be selected from the pull-down menu on the Worksheetscreen. If the number of application presets used is large, there may bea delay of several tens of seconds to several minutes before the resultsfor the selected application preset are displayed. Do not operate themain panel or touch panel during this period.

NOTE: 1. If "Mean of Measurements" is selected for the "Measurement Value DisplayMethod" on the Worksheet tab of the Preset menu, the mean of themeasurements is displayed in the worksheet.If only one measurement has been executed, the result of themeasurement is displayed in the Mean field.

2. If "Most Recent Measurement" is selected for "Measurement Value DisplayMethod" on the Worksheet tab of the Preset menu, only the most recentmeasurement value is displayed on the Worksheet screen.

3. If two or more measurements have been performed for a single item, besure to check each measurement result using the worksheet function.If an unexpected measurement value is obtained, it will affect the meanvalue.

4. If a result for a measurement item is deleted in the worksheet edit windowwith "Most Recent" selected, the result of the immediately precedingmeasurement is displayed.


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NOTE: 5. If a result for a measurement item is deleted in the worksheet edit windowand no other results remain for the item, the measurement item, the meanvalue of the item, and the calculation results obtained using themeasurement value (or mean value) are all deleted automatically.To redisplay these values, the item must be measured again.

Before deleting the contents of the worksheet edit window, confirm thatrequired data will not be deleted.When entering or editing data for measurement items, be sure to enter thevalues and units correctly.

6. Measurement or calculation data cannot be saved unless a patient ID isregistered for the patient.Be sure to register the patient ID before starting measurement.

7. Confirm that no unexpected values are displayed on the Worksheet screenbefore saving the data.

8. The measured value for some items displayed on the Worksheet screencan be edited, provided that the examination has not yet been completed.Once the measured data is saved, however, the data cannot be edited.Confirm the results on the worksheet before saving the data.The values displayed in white in the blue boxes can be edited.

9. Do not turn ON the measurement switch while the Worksheet screen isdisplayed.

10. Only a part of the calculation results are displayed on the measurementresult screen in application measurement mode. To check all themeasurement results (calculation results), use the Worksheet screen.

*


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2. 2D-Mode MeasurementsThis section describes basic measurements in 2D mode.

* The Joint measurement switch is not displayed when Heart1, Heart2, or Heart3 isselected as Application Preset.


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2.1 Distance Measurement (Distance)

The straight-line distance between two points is measured on the 2D-mode image.

Distance : Dist A 999.9 (mm)

Step 1:

Set the start point.

Step 2:

Move the end point.

Step 3:

Set the end point.

Select .

Move the marker to themeasurement start

point using .

Press to set the

start point.

Move the marker to themeasurement end point

using .

Press to set the

end point.

A

* To perform the same type of measurement again, press and then repeat

steps to .


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2.2 Curved Line Distance Measurement (Trace Length)

The length of a curved line is measured by tracing along the curved line.

The trace method can be changed using the dial provided under .

Method Description

Continuous Trace The user traces a curved line freehand from the specifiedstart point to the end point using the trackball.

Spline Trace A curved line is traced by interpolating three or more user-specified points (including the start and end points) using aspline curve.


2.2.1 Continuous Trace

Step 1:


Step 2:

Draw the trace.

Step 3:

Set the trace.

Press and

select [ContinuousTrace].

Move the marker using

.

Press .

Draw the trace using

. Press .

A

During tracing, the trace can be modified by rotating or .

The trace is deleted.

The deleted portion ofthe trace is restored.


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2.2.2 Spline Trace

Step 1:


Step 2:

Draw the trace.

Step 3:

Set the trace.

Press and

select [Spline Trace].


.

Press .


.

Press .

Repeat the above

procedure to setmultiple points.

Press twice at

the same point.

A





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2.3 Angle Measurement (Angle)

The angle between two straight lines is measured. Both the acute and obtuse anglesare displayed.

Acute : Angle2 A 99 (deg)

Obtuse : Angle1 A 999 (deg)

Step 1:

Set the first marker.

Step 2:

Move the secondmarker.

Step 3:

Set the secondmarker.

Select .


.

Rotate the marker

using to adjust

the angle.

Press .

Move the second

marker using .

A

Rotate the marker

using .

Press .

A

A


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2.4 Area/Circumference Measurement (Area)

The area and circumference of a region are measured in 2D mode.


Measurement method Area measurement method

Continuous Trace The path traced by operating the trackball along thecircumference of the target object is used to calculate theapproximate area/circumference.

Spline Trace The interpolated curve for the set points is used to calculatethe approximate area/circumference.

Ellipse Elliptical approximation is used to calculate the approximatearea/circumference.

Cross Arcs are used to calculate the approximatearea/circumference.


For the measurement procedure, refer to subsection 2.2 "Curved Line DistanceMeasurement (Trace Length)".

Area : Area A 999.99 (cm2) Circumference : Circ A 999.9 (mm)

2.4.2 Spline Trace

For the measurement procedure, refer to subsection 2.2 "Curved Line DistanceMeasurement (Trace Length)".

Area : Area A 999.99 (cm2) Circumference : Circ A 999.9 (mm)


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2.4.3 Ellipse

Area : Area A 999.99 (cm2) Long-axis length : Dist1 A 999.9 (mm)

Circumference : Circ A 999.9 (mm) Short-axis length : Dist2 A 999.9 (mm)

Step 1:


Step 2:

Set the diameterof the circle.

Step 3:

Set the ellipse.

Step 4:

Set the trace.

Press

and select[Ellipse].

Move the marker

using .

Press .

Adjust thediameter of thecircle using

.

Press to

set the diameter ofthe circle.

Adjust the size ofthe ellipse using

.

Press .

A

Step 1:

Start modification.

Step 2:


Step 3:

Modify the ellipse.

Step 4:

Finishmodification.

Press .

A

Move the arrownear the ellipse,place the arrow onthe point to bemodified, and

press .

(When the arrowis moved to theellipse, the majoraxis and minoraxis of the ellipseare displayed.)

A

Adjust the size ofthe ellipse using

.

Press .

A

To change the

length of the otheraxis, repeat thesame procedurefor the other axis.


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2.4.4 Cross

Area : Area A 999.99 (cm2) Long-axis length : Dist1 A 999.9 (mm)

Circumference : Circ A 999.9 (mm) Short-axis length : Dist2 A 999.9 (mm)

Step 1:

Set the first point.

Step 2:

Set the secondpoint.

Step 3:

Set the start pointof the

perpendicular line.

Step 4:

Set the end pointof the

perpendicular line.

Press

and select [Cross].

Move the marker

using .

Press .

Move the marker

using .

Press .

A dashed lineperpendicular to theline connecting thefirst point and thesecond point isdisplayed.

Adjust the positionand length of theperpendicular line

using .

Press .

Adjust the endpoint position ofthe perpendicular

line using .

Press .

A


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Step 1:

Start modification.

Step 2:


Step 3:

Move the markerto the desired

position.

Step 4:

Finishmodification.

Press . Place the arrowon the marker tobe modified.

Press .

Move the markerto the desiredposition using

.

Press .

To move another

marker, repeat the

same procedurefor the othermarker.


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2.5 Volume Measurement (Volume)

The volume is measured using elliptical approximation with three axes set.

Volume : Volume A 999.9 (cm3) Axis : Dist1 A 999.9 (mm)

Axis : Dist2 A 999.9 (mm)

Axis : Dist3 A 999.9 (mm)

Step 1:

Set the first and secondlines.

Step 2:

A perpendicular planeis displayed.

Step 3:

Set the third line on theperpendicular plane.

Select .

Follow the sameprocedure as fordistance measurement(Distance) to set thesecond line.

A

A

A cross-sectional plane

perpendicular to theplane on which step 1has been performed isdisplayed.

Select again.

Follow the same

procedure as fordistance measurement(Distance).

A

Press .

* In volume measurement, the measurement values are not cleared (even if the imageis unfrozen) until measurement of the three axes is completed.

However, the values are cleared if is pressed or Exam Review mode is entered.


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2.6 Joint Measurement

The angles between the base line and two lines (angles and ) are measured.

Angle between the base line and the first line : Alpha A 999 (deg)

Angle between the base line and the second line : Beta A 999 (deg)

Step 1:

Set the first marker.

Step 2:

Move the secondmarker.

Step 3:

Set the secondmarker.

Select .


.

Rotate the marker

using to adjust

the angle.

Press .

The second line isdisplayed with a centermarker.

Move the second

marker using .

Rotate the marker

using .

Press .

The second linechenges to a dottedline and the third line isdisplayed with a centermarker.

Move the third marker

using .

Rotate the marker

using .

Press .

AA

A


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2.7 MeanIMT Measurement

Three distance measurements are performed and the mean value is calculated.

This method is intended to measure the thickness of the intima-media complex of thecarotid artery.

Mean : MeanIMT A 999.9 (mm) Distance 1 : Dist1 A 999.9 (mm)

Distance 2 : Dist2 A 999.9 (mm)

Distance 3 : Dist3 A 999.9 (mm)

NOTE: Result display for IMT measurement

1. When "Double Digits" is selected for Thickness (IMT) Precision in thepreset menu, the IMT measurement value is displayed to two decimalplaces.Depending on the characteristics of the image, however, it may not bepossible to obtain an accurate value to two decimal places. Use themeasurement and calculation values displayed to two decimal places onlyfor reference.

2. If "Double Digits" is selected, a single quotation mark (') is added to themeasurement values displayed on the screen and the calculation resultsobtained based on the measurement values.

Limitations: Although markers can be moved in steps of 1 pixel on thescreen, this does not correspond to an indicated value changeof 0.01 due to the resolution of ultrasound images. Theindicated value changes in increments of greater than 0.01 asa mark is moved.


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Step 1:

Set the first distance.

Step 2:

Set the second andthird distances.

Step 3:

Determine themeasurement results.

Select .


.

* One graduation on thehorizontal axis represents5 mm.

Rotate the marker to

the desired angle using

.

Press to set the

upper marker position.

Move the lower marker

using and then

press .

Press to display

the next marker.

Set the second andthird distances using

the same procedure asfor the first distance.

* The second and thirdmarkers are displayed ata position 1 cm to theright or left of the firstmarker.

When themeasurement for thethird position iscompleted, the meanvalue of the threemeasurements isdisplayed.


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2.8 %Stenosis (Distance) Measurement

The stenosis ratio (%Stenosis) is calculated based on two distance measurementsusing the formulas below.

If Dist1 > Dist2

1/)21(% DistDistDistDistS

If Dist1 < Dist2

2/)12(% DistDistDistDistS

2)1(4/ DistAreal 2)2(4/2 DistArea

If Dist1 > Dist2

1/)21(% AreaAreaAreaAreaS

If Dist1 < Dist22/)12(% AreaAreaAreaAreaS

%Stenosis : %S Dist A 99.9 (%) Distance : Dist1 A 999.9 (mm)

Distance : Dist2 A 999.9 (mm)

%Stenosis : %S Area A 99.9 (%) Area : Area1 A 9999.9 (mm )

Area : Area2 A 9999.9 (mm )

Press and then perform measurement.

Refer to subsection 2.1 "Distance Measurement (Distance)" for the measurementprocedure.


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2.9 %Stenosis (Area) Measurement

Measure Lumen (luminal area) and then Residual (residual luminal area). In Lumenmeasurement, the area is measured using elliptical approximation. In Residualmeasurement, the area is measured using the Continuous Trace method of manualtracing.

The stenosis ratio (%Stenosis) is calculated based on these two area measurementsusing the formula below.

If the residual area is larger than the luminal area (which is impossible in actual clinicalexaminations), the result is displayed as a negative value.

ALumen/A)ResidualA(LumenAArea%S

%Stenosis : %S Area A 99.9 (%) Luminal area : Lumen A 999.9 (mm2)

Residual luminal area : Residual A 999.9 (mm )

Step 1:

Measure the lumen(maximum area).

Step 2:

Display the marker forresidual luminal area

measurement.

Step 3:

Measure the residualluminal area

(minimum area).

Select .

Follow the same

procedure for Ellipse inarea/circumferencemeasurement (Area) tomeasure the lumen(maximum area).

Press to display

the marker for residualluminal area (minimumarea) measurement.

Follow the sameprocedure as forContinuous Trace for

area/circumferencemeasurement (Area) tomeasure the residualluminal area (minimumarea).

Press to set the

residual luminal area(minimum area).The %Stenosis (Area)value is displayed.

*


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3. M-mode Measurements


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3.1 M-Mode Distance Measurement (Distance)

The distance between two points is measured on the M-mode image.


Step 1:


Step 2:

Move the end point.

Step 3:

Set the end point.

Select .

Move the intersectionpoint of the marker

using .

Press .


using .

Press .

A


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3.2 Slope Measurement (Slope)

The slope of the line between two points is measured.

Slope =(Distance)

(Time)

Slope : Slope 999.9 (mm/s) Time : Time A 9.999 (sec)


Step 1:


Step 2:

Move the end point.

Step 3:

Set the end point.

Select .

Move the intersection

point of the marker

using .

Press .


using .

Press .

A


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3.3 Time Measurement (Time)

The time between two points is measured.

Time : Time A 9.999 (sec)

Step 1:


Step 2:

Move the end point.

Step 3:

Set the end point.

Select .

Move the marker using.

Press .


. Press .

A A


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3.4 Heart Rate Measurement (HR)

The heart rate (bpm) is calculated based on the heartbeats displayed on the monitor.

Heart rate : HR 999 (bpm) Number of beats : Beat A 9

Time : Time A 9.999 (sec)

Step 1:

Set the value for Beat.

Step 2:


Step 3:

Set the end point.

Select .

Rotate under

to set the

value for Beat. Set thevalue according to thenumber of heartbeats inthe range to bemeasured.


.

Press .


.

Press .

A A

*


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4. Doppler-Mode Measurements


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4.1 Velocity Measurement (Velocity)

The velocity is measured on the Doppler-mode image.

Velocity : Vel 999.9 (cm/s)

Velocity : Vel A 999.9 (cm/s) Pressure gradient : PG A 999.9 (mmHg)

Step 1:Set the measurement point.

Step 2:Set the measurement.

Select .

Move the intersection point

of the marker using .

Press .

A


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4.2 Acceleration Measurement (Accel)

The velocity slope (acceleration) between two points is measured on the Doppler-modeimage.

The result display differs depending on the items selected in Application Type.

Acceleration : Accel A 999.9 (cm/s2) Time : Time A 9.999 (sec)

Velocity : Vel1 A 999.9 (cm/s)

Velocity : Vel2 A 999.9 (cm/s)

Acceleration : Accel A 999.9 (cm/s2) Time : Time A 9.999 (sec)Velocity : Vel1 A 999.9 (cm/s) Pressure gradient : PG1 A 999.9 (mmHg)

Velocity : Vel2 A 999.9 (cm/s) Pressure gradient : PG2 A 999.9 (mmHg)

Step 1:


Step 2:

Move the end point.

Step 3:

Set the end point.

Select .


.

Press .


. Press .

A

"Accel" is displayed for thevelocity in the directionaway from the baseline."Decel" is displayed for thevelocity in the direction

toward the baseline.

4.3 Time Measurement (Time)

The measurement procedure is the same as for M-mode time measurement.

Refer to subsection 3.3 "Time Measurement (Time)".

4.4 Heart Rate Measurement (HR)

The measurement procedure is the same as for M-mode heart rate measurement.Refer to subsection 3.4 "Heart Rate Measurement (HR)".


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4.5 Velocity Trace Measurement (Vel Trace)

The velocity and other items are measured by tracing the Doppler waveform.


Trace method Description

Continuous Trace The user traces the Doppler waveform freehand from thespecified start point to the end point using the trackball.

Spline Trace The Doppler waveform within the specified range is traced byinterpolating three or more user-specified point using a splinecurve.

Line Trace The user traces the Doppler waveform using straight line

segments.Range The Doppler waveform in the specified range is traced

automatically.

Trace method Description

Continuous Trace The user traces the Doppler waveform freehand from thespecified start point to the end point using the trackball.

Spline Trace The Doppler waveform within the specified range is traced by

interpolating three or more user-specified points using aspline curve.

Line Trace The user traces the Doppler waveform using straight linesegments.

Range The Doppler waveform in the specified range is tracedautomatically.

Auto Range The Doppler waveform is automatically traced by recognizingthe number of heartbeats without specifying the range.


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The user traces the Doppler waveform freehand from the specified start point to the end

point using .


Maximum velocity : Vmax A 999.9 (cm/s) PI : PI A 99.99*1

Minimum velocity : Vmin A 999.9 (cm/s) RI : RI A 99.99*2

Velocity at end diastole : Ved A 999.9 (cm/s) S/D : S/D A 99.99

Mean velocity : Vm A 999.9 (cm/s)

*1: Whether Vmin or Ved is used for calculating PI can be preset.

eakVmin)/Vm_p(VmaxPI

peakVmVedVmaxPI _/)(

*2: Whether Vmin or Ved is used for calculating RI can be preset.

Vmin)/Vmax(VmaxRI

Ved)/Vmax(VmaxRI

Velocity Time Integral : VTI A 999.9 (cm)

Peak velocity : VP A 999.9 (cm/s)

Mean velocity : VM A 999.9 (cm/s)

Peak pressure gradient : PPG A 999.9 (mmHg)

Mean pressure gradient : MPG A 999.9 (mmHg)


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Step 1:


Step 2:

Trace the Dopplerwaveform.

Step 3:

Set the trace.

Press and

select [ContinuousTrace].


.

Press .

Trace the Dopplerwaveform using .

Press .





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4.5.2 Spline Trace

The Doppler waveform is traced by setting at least three points, including the start andend points, and connecting them with a spline curve.

Same as described in subsection 4.5.1 "Continuous Trace".

Step 1:


Step 2:


Step 3:

Set the trace.

Press and

select [Spline Trace].


.

Press .

Move the marker forthe second point using

.

Press .

Repeat the aboveprocedure to setmultiple points.

Press twice at

the same point.





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4.5.3 Line Trace

The Doppler waveform is traced by setting at least three points, including the start andend points, and connecting them with line segments.

Same as described in subsection 4.5.1 "Continuous Trace".

Step 1:


Step 2:


Step 3:

Set the trace.

Press and

select [Line Trace].


.

Press .

Move the marker forthe second point using

.

Press .

Repeat the aboveprocedure to setmultiple points.

Press twice at

the same point.





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4.5.4 Range

The Doppler waveform in the specified range is traced automatically.


Maximum velocity : Vmax A 999.9 (cm/s)

Minimum velocity : Vmin A 999.9 (cm/s)

Velocity at end diastole : Ved A 999.9 (cm/s)

Mean velocity for peak trace : Vm_peak A 999.9 (cm/s)

Mean velocity for mean trace : Vm_mean A 999.9 (cm/s)

PI : PI A 99.99

RI : RI A 99.99

S/D : S/D A 99.99


peakVmVminVmaxPI _/)(



VmaxVminVmaxRI /)(

Vmax/)Vmax( VedRI

Velocity Time Integral : VTI A 999.9 (cm)

Peak velocity : VP A 999.9 (cm/s)

Mean velocity : VM A 999.9 (cm/s)




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When [Range] is selected, the following switches for setting parameters are displayed.

Use these switches during measurement as required.

Step 1:


Step 2:

Perform auto-tracing.

Step 3:

Adjust the trace line.

Press and

select [Range].


.

Press .


.

Press .

Auto-tracing is performed.

Adjust the trace line asrequired using theparameter switches.


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4.5.5 Auto Range

The Doppler waveform for the specified number of heartbeats is traced automaticallywithout specifying the range.




Mean velocity for peak trace : Vm_peak A 999.9 (cm/s)

Mean velocity for mean trace : Vm_mean A 999.9 (cm/s)

PI : PI A 99.99

RI : RI A 99.99

S/D : S/D A 99.99


peakVmVminVmaxPI _/)(



VmaxVminVmaxRI /)(

VmaxVedVmaxRI /)(

The number of waveforms to be recognized is 1 to 8.

If the number of waveforms specified is greater than that displayed on the monitorwhen [Auto Range] is started, the maximum number of available waveforms isrecognized.

If the number of heartbeats is set to "8" on the touch panel, but only five waveformsare displayed on the screen, the range of auto-tracing is automatically set to the fiveheartbeats.

When the number of heartbeats is changed by rotating , the value set in [Beat]

on the touch panel is updated accordingly.

The number of heartbeats last set is saved for each application preset.The saved number of heartbeats is used the next time Auto Range measurement isstarted.

If no waveform is recognized, the screen displays a marker for the trace start point asin Range measurement.


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4.6 PI Measurement (PI Trace)

The PI and other items are measured by tracing the Doppler waveform.

Whether Vmin or Ved is used for calculating PI can be preset.

eakVmin)/Vm_p-(Vmax=PI

akVed)/Vm_pe-(Vmax=PI

PI : PI A 9.99




Mean velocity : Vm A 999.9 (cm/s) *1

*1: When "Range" (auto trace) is selected, the mean velocity is displayed in thefollowing format.

Vm_peak 999.9 (cm/s)

The measurement procedure is the same as for velocity trace measurement (Vel Trace).

Refer to subsection 4.5 "Velocity Trace Measurement (Vel Trace)".


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4.7 RI Measurement

RI is calculated by measuring the velocity at two points.

Whether Vmin or Ved is used for calculating RI can be preset.

Vmin)/Vmax-(Vmax=RI

Ved)/Vmax-(Vmax=RI

The result display differs depending on the items selected in the preset.

RI : RI A 9.99



RI : RI A 9.99



Step 1:Set the maximumvelocity point.

Step 2:Set the minimumvelocity point.

Step 3:Set the trace.

Select .

Move the marker to the

maximum velocity point

using .

Press .

Move the marker to theminimum velocity point

using .

Press .


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4.8 S/D Measurement

S/D is calculated by measuring the velocity at two points.

Vmax/VedS/D

S/D : S/D A 9.99



Step 1:

Set the maximumvelocity point.

Step 2:

Set the end-diastolicvelocity point.

Step 3:

Set the trace.

Select .

Move the marker to themaximum velocity point

using .

Press .

Move the marker to theend-diastolic velocity

point using .

Press .


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4.9 Flow Volume Trace Measurement (Flow Volume)

The flow velocity is measured by tracing the Doppler waveform in Doppler mode, andthe elliptical area is obtained by measuring the lengths of the major axis and minor axisof the vessel in 2D mode. Based on these measurement results, the flow volume iscalculated.

The following trace methods are provided. Each time is pressed, the trace

method is switched.

The default trace method can be changed in the preset.

The calculation formulas can also be selected in the preset.

Switch on the touch panel Trace method

Flow Vol. Vel Trace The user traces the Doppler waveform freehand from the

specified start point to the end point using the trackball.Flow Vol. Auto Trace The Doppler waveform in the specified range is traced

automatically.

Flow Vol. Auto Range The Doppler waveform in the recognized range is tracedautomatically.


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Flow volume : Flow Vol A 9.99(L/min) *1Maximum velocity : Vmax A 999.9 (cm/s)



Mean velocity for peak trace : Vm_peak A 999.9 (cm/s) *5

Mean velocity for mean trace : Vm_mean A 999.9 (cm/s) *5

Time-mean velocity : Vm A 999.9 (cm/s) *6

PI : PI A 9.99 *2

RI : RI A 9.99 *3

S/V : S/D A 9.99 *4

Elliptical area : Area A 99.9 (mm2)

Length of the major axis of the vessel : Dist1 A 99.9 (mm)Length of the minor axis of the vessel : Dist2 A 99.9 (mm)

*1: Either of the following two methods can be preset to calculate the flow volume.The trace for the item (Vm_peak or Vm_mean) to be used for calculating the flowvolume is displayed in light blue.The trace for the item not used for calculation is displayed in dark blue.

1000/100/)(min)/(60)/(_min)/( 2mmAreasscmpeakVmLVolFlow

1000/100/)(min)/(60)/(_min)/( 2mmAreasscmmeanVmLVolFlow


eakVmin)/Vm_p(VmaxPI

akVed)/Vm_pe(VmaxPI


Vmin)/Vmax(VmaxRI

Ved)/Vmax(VmaxRI

*4: S/D calculation formula

Vmax/VedS/D

*5: This item is measured and displayed when Auto Trace or Auto Range is selectedas the trace method.

*6: This item is measured and displayed when Vel Trace is selected as the tracemethod.


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Stroke volume : SV A 99.9 (mL)

Heart rate : HR A 999 (bpm)

Cardiac output : CO A 9.99 (L/min)

Velocity Time Integral : VTI 999.9 (cm/s)Peak velocity : VP A 999.9 (cm/s)



Elliptical area : Area A 999.9 (mm )

Length of the major axis of the vessel : Dist1 A 99.9 (mm)

Length of the minor axis of the vessel : Dist2 A 99.9 (mm)

* When the ECG unit is used, the heart rate is displayed automatically when the flowvolume measurement is determined.

Step 1:

Select the velocitytracing method.

Step 2:

Perform tracing using theselected method.

Step 3:

Perform measurementfor the luminal area(elliptical areameasurement).

Press to

select the method.

Perform tracing usingthe selected method.

Performmeasurement for theluminal area (ellipticalarea measurement).Refer to subsection2.4.3 "Ellipse".

(a) Perform freehandtracing. (a) Press and

perform tracing

using .

Refer to subsection4.5.1 "ContinuousTrace".

(b) Perform automatictracing. (b) Press to

specify the range.Refer to subsection4.5.4 "Range".

(c) Perform automatictracing using theAuto Rangefunction.

* This is availableonly whenApplication Typeis Heart1, Heart2,or Heart3.

(c) Press to

perform automatictracing for thewaveform of thespecified cardiaccycle.Refer to subsection4.5.5 "Auto Range"

*


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5. Application Measurement(Cardiac)

5.1 Introduction

5.1.1 Starting the application measurement menu

Select Adult Heart on the Patient Registration screen or select one of Heart 1 to Heart 3

in the Application preset menu. Then press . The menu for application

measurement is displayed on the touch panel. Press the switch for the desiredmeasurement.

The application measurement menu that is displayed when is pressed differs

according to the preset. The measurement marker settings can also be changed by

presetting.

5.1.2 Heart rate acquisition methods (Cardiac)

The heart rate is measured during LV measurement, aortic valve measurement, mitralvalve measurement, and pulmonary valve measurement. The heart rate can beobtained by the following three methods.

(1) Acquiring the heart rate automatically from the ECG

When the optional ECG unit is used and measurement is performed for an item inwhich the heart rate is required, the heart rate is displayed automatically.

(2) Calculating the heart rate based on the Range measurement result (in M mode andDoppler mode)

Refer to the section describing heart rate measurement in the basic measurements(M mode/Doppler mode).

(3) Entering the heart rate manually

Enter the heart rate value.

Select .


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NOTE: 1. In dual-display mode, the heart rate for the most recently frozen image isdisplayed. For example, if the image on the left was frozen most recently,the heart rate for that image is also displayed on the image on the right.

2. When a patient with an unstable heart rate, such as a patient with atrial

fibrillation, is to be examined, enter a heart rate using the Manual Inputdialog box.

3. The heart rate value displayed on the 2D (including Color) + PW/CWscreen is the heart rate obtained at the time the PW/CW image is stopped.

For example, when the PW/CW image is stopped by pressing and

the 2D image is then frozen, the displayed heart rate value is the heart rateat the time the PW/CW image was stopped, not at the time the Freezeswitch was pressed.

4. Confirm that the ECG waveform is displayed correctly. If the ECGwaveform is not displayed correctly, an incorrect heart rate value may bedisplayed due to noise.

5. When an ECG is not used, turn OFF the ECG monitor. Otherwise, anincorrect heart rate value may be displayed due to noise from the ECGmonitor.


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5.2 2D-Mode Measurements (Cardiac)

5.2.1 LV measurement (MOD Simpson method)/LA measurement (MODSimpson method)/LA measurement (3-Axis method)

LV measurement (MOD Simpson method)

The endocardial contour of the left ventricle (LV) is traced on the apical long-axiscross-sectional images (two-chamber view and four-chamber view) acquired in 2Dmode and the left ventricular long axis is specified. The LV volume is then calculatedas the sum of the volumes of 20 elliptical disks perpendicular to the LV long axis.LV volume calculation is also possible using only a two-chamber or four-chambercross-sectional image. In this case, the LV volume is calculated as a sum of thevolumes of 20 circular disks set on the corresponding image.

Switch Item to be measured Result display

2ch Diast Tracing of the end-diastolic LV endocardial contour on

the two-chamber cross-sectional image and setting of theLV long-axis position

LVAd2 (cm2)

LVLd2 (mm)EDV2 (mL)

2ch Syst Tracing of the end-systolic LV endocardial contour on thetwo-chamber cross-sectional image and setting of the LVlong-axis position

LVAs2 (cm2)

LVLs2 (mm)

ESV2 (mL)

4ch Diast Tracing of the end-diastolic LV endocardial contour onthe four-chamber cross-sectional image and setting of theLV long-axis position

LVAd4 (cm2)

LVLd4 (mm)

EDV4 (mL)

4ch Syst Tracing of the end-systolic LV endocardial contour on thefour-chamber cross-sectional image and setting of the LVlong-axis position

LVAs4 (cm2)

LVLs4 (mm)

ESV4 (mL)

HR Heart rate HR (bpm)


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Item name Calculation formula Calculation output Unit

EDV

1000

1

204

20

)( 1i

4i2i DistanceDistanceLVLd

LVLd : The LV long-axis length at enddiastole in the two-chamber or four-chamber view (whichever is longer)

Distance2i : Disk diameter in the two-chamberview

Distance4i : Disk diameter in the four-chamberview

LV volume at enddiastole

(mL)

ESV

1000

1

204

20

)( 1i

4i2i DistanceDistance

LVLs

LVLs : The LV long-axis length at endsystole in the two-chamber or four-

chamber view (whichever is longer)Distance2i : Disk diameter in the two-chamber

view


LV volume at endsystole

(mL)

SV ESVEDV Stroke volume (mL)

CO1000

1 SVHR Cardiac output (L/min)

EF )/(100 EDVSV Ejection fraction (%)

SI BSASV/ SV index (mL/m2)

CI BSACO/ CO index (L/min/m2

)SV4 44 ESVEDV (mL)

CO41000

14 SVHR (L/min)

EF4 )4/4(100 EDVSV (%)

SI4 BSASV /4 (mL/m2)

CI4 BSACO /4 (L/min/m2)

SV2 22 ESVEDV (mL)

C02

1000

12 SVHR (L/min)

EF2 )2/2(100 EDVSV (%)

SI2 BSASV /2 (mL/m2)

CI2 BSACO /2 (L/min/m2)

LVLd Diff2

)24(100

LVLd

LVLdLVLd Difference in LVlong-axis lengthat end diastole

(%)

LVLs Diff2

)24(100

LVLs

LVLsLVLs Difference in LVlong-axis lengthat end systole

(%)

BSA Refer to the Operation Manual volume. Body surfacearea (m2

)


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The LA volume can be measured using one of the following two types ofmeasurement.

LA measurement (MOD Simpson method)

The endocardial contour of the left atrium (LA) is traced on the apical long-axis cross-

sectional images (two-chamber view and four-chamber view) acquired in 2D modeand the left atrial long axis is specified. The LA volume is then calculated as the sumof the volumes of 20 elliptical disks perpendicular to the LA long axis.

LA volume calculation is also possible using only a two-chamber or four-chambercross-sectional image. In this case, the LA volume is calculated as a sum of thevolumes of 20 circular disks set on the corresponding image.

LA measurement (3-Axis method)

The LA volume is calculated by measuring the width and length of the left atrium onthe apical long-axis cross-sectional image (four-chamber view) that is acquired in 2Dmode and measuring the depth of the left atrium on the left-ventricular long-axisimage.


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LA 4ch Tracing of the LA endocardial contour on thefour-chamber cross-sectional image and setting of the LA

long-axis position

LAa4 (cm2)

LAd4 (mm)

LAV4 (mL)LA 2ch Tracing of the LA endocardial contour on the

two-chamber cross-sectional image and setting of the LAlong-axis position

LAa2 (cm2)

LAd2 (mm)

LAV2 (mL)

LA W Measurement of the width of the left atrium LA W (mm)

LA H Measurement of the length of the left atrium LA H (mm)

LA D Measurement of the depth of the left atrium LA D (mm)


LAV1000

4)Distance(Distance

DiskCount

LAL

DisCount

1=i

4i2i

LAL : The LA long-axis length in the two-chamber or four-chamber view(whichever is longer)

DiskCount : Number of segments for long-axislength (20)

Distance2i : Disk diameter in the two-chamberview


LA volume (mL)

LAVI LAV / BSA LAV index (mL/m2)

LAVI2 LAV2 / BSA 2ch viewLAV index

(mL/m2)

LAVI4 LAV4 / BSA 4ch viewLAV index

(mL/m2)

LAV (AL)*1 8/3/* LAa4 * LAa2 / (L/10)

L: LAd4 or LAd2 (whichever is shorter)

LV volume

(Area-Lengthmethod)

(mL)

LAVI (AL)*1 LAV (AL) / BSA LAV (AL)

Index

(mL/m2)

LA_Vol / 6 * LA W * LA H * LA D / 1000 LA volume (mL)

LA_VI LA_Vol / BSA LA volume index (mL/m2)

*1: When LA Volume calculation is performed using the Simpson method, calculationusing the Area-Length method is also performed. The calculation result obtainedusing the Area-Length method is displayed on the Worksheet screen only.


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* An example of LV measurement (MOD Simpson method) is provided below. For LAmeasurement (MOD Simpson method), trace the endocardium of the left atrium inthe same manner.

(1) Display the end-diastolic four-chamber cross-sectional image.

(2) Press .

(3) Display the page of the application measurement menu.

(4) Press .

(5) Follow steps (a) to (f) to measure the LV volume.

(a) Move the marker to the start point of the LVendocardial contour on the apical long-axis

cross-sectional image, and press .

(b) Trace the endocardial contour using .

(c) Press to complete tracing.

The LV long axis (which starts from the

midpoint of the line connecting the start andend points) and the lines dividing the LVlong axis into 20 segments are displayed.

(d) Adjust the LV long-axis end point (apex)position.

(e) Press . The LV long axis and the segmentation lines are set. The LV

volume is calculated as the sum of the volumes of 20 circular disksperpendicular to the LV long axis.

(f) The segmentation lines are deleted when is operated.

Example of continuous tracingSpline tracing (by setting pointsalong the endocardial contour)is also possible.

The end point can be movedusing the trackball.


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(6) Press to enter cine mode.

* The color of at the bottom right of the monitor changes to blue.

(7) Operate on the cine screen to display the end-systolic four-chamber cross-

sectional image.

(8) Press .

(9) Repeat steps (a) to (f) in (5) to calculate the LVvolume on the end-systolic four-chamber cross-sectional image.

(10) Display the end-diastolic two-chamber cross-sectional image.

(11) Press .

(12) Repeat steps (a) to (f) in (5) to measure the LVvolume on the end-diastolic two-chamber cross-sectional image.

(13) Press to enter cine mode.

(14) Operate on the cine screen to display the end-systolic two-chamber cross-

sectional image.

(15) Press .

(16) Repeat steps (a) to (f) in (5) to measure the LVvolume on the end-systolic two-chamber cross-sectional image.


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(17) Based on the end-diastolic four-chamber and two-chamber cross-sectional imagesand the end-systolic four-chamber and two-chamber cross-sectional images, theLV volumes at end diastole and end systole are displayed as the sum of theelliptical disks.

(18) Perform measurement for LA in the same manner as for LV.

NOTE: 1. The LV endocardium tracing method can be preset as Continuous orSpline Trace.

2. It is possible to preset whether or not the measurement marker remainsdisplayed on the images during frame-advance playback in cine mode.


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5.2.2 LV measurement (Teichholz method)


Diastole RVD Right ventricular diameter RVD (mm)IVSTd Interventricular septal thickness at end

diastoleIVSTd (mm)

LVIDd LV short-axis diameter at end diastole LVIDd (mm)

LVPWTd LV posterior wall thickness at end diastole LVPWTd (mm)

Systole IVSTs Interventricular septal thickness at endsystole

IVSTs (mm)

LVIDs LV short-axis diameter at end systole LVIDs (mm)

LVPWTs LV posterior wall thickness at end systole LVPWTs (mm)



EDV 1000/7 3LVIDd / 10/4.2 LVIDd LV volume at enddiastole

mL

ESV 1000/7 3LVIDs / 10/4.2 LVIDs LV volume at endsystole

mL

SV ESVEDV Stroke volume mL

CO 10001 SVHR Cardiac output L/min

EF EDVSV/100 Ejection fraction %

FS LVIDdLVIDsLVIDd /)(100 Fractionalshortening

%

SI BSASV/ SV index mL/m2

CI BSACO/ CO index L/min/m2

BSA Refer to the Operation Manual volume.

Body surfacearea

m2

LV MASSd

(ASE-Cube)

1000/04.1 33 LVIDdLVPWTdIVSTdLVIDd

LV myocardial

mass at enddiastole

g

LV MASSd(Penn-Cube)

1000/04.1 33 LVIDdLVPWTdIVSTdLVIDd6.13

LV myocardialmass at enddiastole

g

LV MASSd(Teichholz)

10/10/10/4.2

)10/)((0.704.1

3

LVPWTdLVIDdIVSTd

LVPWTdLVIDdIVSTd

10/4.2

)10/(0.7 3

LVIDd

LVIDd


g


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LV MASSd(AV-Cube)

LVIDdLVPWTdIVSTdLVIDd1.040.8 33 [ 0.6]1000/


g

LV MASSs(ASE-Cube)

1000/04.1 33 LVIDsLVPWTsIVSTsLVIDs LV myocardial

mass at endsystole

g

LV MASSs(Penn-Cube)

1000/04.1 33 LVIDsLVPWTsIVSTsLVIDs 6.13

LV myocardialmass at endsystole

g

LV MASSs(Teichholz)

10/10/10/4.2

)10/)((0.704.1

3

LVPWTsLVIDsIVSTs

LVPWTsLVIDsIVSTs

10/4.2

)10/(0.7 3

LVIDs

LVIDs


g

LV MASSs(AV-Cube) 04.1[8.0 33

LVIDsLVPWTsIVSTsLVIDs 6.0]1000/


g

LV MASSdIndex

BSAMASSdLV / LV mass index atend diastole

g/m2

LV MASSsIndex

BSAMASSsLV / LV mass index atend systole

g/m2

* The calculation methods for LV MASSd and LV MASSs can be selected and presetfrom among ASE-Cube, Penn-Cube, Teichholz, and AV-Cube.


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[LV Teich.]

* The other method (Cube or Gibson) can be selected as follows.


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(1) Display the end-diastolic LV cross-sectional image.

(2) Press .

(3) Press in the application measurement menu.

(4) Press .

(5) Rotate the measurement marker using .

(6) Perform measurement in parallel using the 2D-mode distance measurementprocedure.

* Either 4-segment (RVD-LVPWTd) or 3-segment (IVSTd-LVPWTd) can be set.

RVD

IVSTd

LVIDd

LVPWTd

Diastole

(7) Display the end-systolic LV cross-sectional image.

(8) Press .

(9) Rotate the measurement marker using .

(10) Perform measurement in parallel using the 2D-mode distance measurementprocedure.

LVIDs

LVPWTs

IVSTs

Systole


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NOTE: 1. Functions of the switch

The LV measurement items set in a measurement sequence can be

started sequentially each time is pressed, without pressing the

corresponding measurement switch on the touch panel.

The measurement items to be started up differ depending on the preset(Type 1/Type 2). In addition, the measurement item to be started up next

by pressing differs depending the measurement item that is

selected first.

Preset type Type 1 Type 2Default

selectionswitch

[Diastole] [RVD] [Diastole] [RVD] [LVIDd]

[Systole]

[IVSTd]

[LVIDd]

[LVPWTd]

[IVSTs]

[LVIDs]

[LVPWTs]

[LVIDs]

[IVSTd]

[LVIDd]

[LVPWTd]

[LVIDs]

[LVIDs]

2. Default angle of the measurement marker

The angle of the measurement marker that is displayed when

is pressed can be preset.

3. Parallel measurement items for Diastole

The segments that are measured in parallel after is

pressed can be preset.


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5.2.3 LV measurement (Cube method)

By pressing on the touch panel, the LV measurement method can be

changed from LV measurement (Teichholz) to LV measurement (Cube). It is alsopossible to set LV measurement (Cube) as the default in the presets.

The measurement items, calculation items, and measurement procedure (measurementpoints) are the same as for the Teichholz method (described in subsection 5.2.2). Onlythe LV volume calculation formula differs from that used in the Teichholz method.

LV volume at end diastole

3

10

LVIDd

EDV

LV volume at end systole3

10

LVIDsESV

5.2.4 LV measurement (Gibson method)

By pressing on the touch panel, the LV measurement method can be

changed from LV measurement (Teichholz) to LV measurement (Gibson). It is alsopossible to set LV measurement (Gibson) as the default in the presets.

The measurement items, calculation items, and measurement procedure (measurementpositions) are the same as for the Teichholz method (described in subsection 5.2.2).Only the LV volume calculation formula differs from that used in the Teichholz method.

LV volume at end diastole

2

1090.5

1098.052.0

LVIDdLVIDdEDV

LV volume at end systole

2

1018.4

1014.152.0

LVIDsLVIDsESV


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5.2.5 LV measurement (Single-plane (aka Area-Length) method)

LV measurement (Single-plane (aka Area-Length)) can be preset instead of LVmeasurement (Teichholz).


LVALd LV long-axis cross-sectional area at end diastole LVALd (cm2)

LVLd LV long-axis length at end diastole LVLd (mm)

LVALs LV long-axis cross-sectional area at end systole LVALs (cm2)

LVLs LV long-axis length at end systole LVLs (mm)



EDV

)10/(

)(

3

8 2

LVLd

LVALd

LV volume at end diastole mL

ESV

)10/(

)(

3

8 2

LVLs

LVALs

LV volume at end systole mL


CO 1000/SVHR Cardiac output L/min





Body surface area m2


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[Diastole]

LVALd (2D-mode areameasurement)

LVLd (2D-mode distancemeasurement)

[Systole]

LVALs (2D-mode areameasurement)

LVLs (2D-mode distancemeasurement)


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5.2.6 LV measurement (Biplane method)

LV measurement (Biplane) can be preset instead of LV measurement (Teichholz).


LVALd LV long-axis cross-sectional area at end diastole LVALd (cm2)

LVAMd LV short-axis cross-sectional area at the mitral valve levelat end diastole

LVAMd (cm2)

LVIDd LV short-axis diameter at end diastole LVIDd (mm)

LVALs LV long-axis cross-sectional area at end systole LVALs (cm2)

LVAMs LV short-axis cross-sectional area at the mitral valve levelat end systole

LVAMs (cm2)

LVIDs LV short-axis diameter at end systole LVIDs (mm)



EDV 8

3 10

LVALd LVAMd

LVIDd ( / ) LV volume at end diastole mL

ESV 8

3 10

LVALs LVAMs

LVIDs ( / ) LV volume at end systole mL

SV ESVEDV Stroke volum mL








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[LV Biplane]

[Diastole]

LVALd (2D-mode areameasurement) LVAMd (2D-mode area

measurement)

LVIDd (2D-modedistance measurement)

[Systole]

LVALs (2D-mode areameasurement)

LVAMs (2D-mode areameasurement)

LVIDs (2D-mode

distance measurement)


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5.2.7 LV measurement (Bullet method)

LV measurement (Bullet) can be preset instead of LV measurement (Teichholz).


LVAMd LV short-axis cross-sectional area at the mitral valve levelat end diastole

LVAMd (cm2)

LVLd LV long-axis length at end diastole LVLd (mm)

LVAMs LV short-axis cross-sectional area at the mitral valve levelat end systole

LVAMs (cm2)

LVLs LV long-axis length at end systole LVLs (mm)



EDV10/

6

5LVLdLVAMd

LV volume at end diastole mL

ESV10/

6

5LVLsLVAMs

LV volume at end systole mL








[LV Bullet]


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LVLd

[Diastole]

LVAMd

LVLs

[Systole]

LVAMs


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5.3 M-Mode Measurement (Cardiac)

5.3.1 Aortic valve measurement (Aortic Valve)

Aortic valve measurement is performed on M-mode images.

ET

Ao Diam

LA Diam

AoV Diam


Ao Diam Aortic diameter Ao Diam (mm)

LA Diam Left atrial diameter LA Diam (mm)

ET Ejection time ET (sec)

AoV Diam Aortic valve diameter AoV Diam (mm)

Item name Calculation formula Result display

LA/AO DiamAoDiamLA / LA/Ao


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[Aortic Valve]

(1) Press .


(3) Press .

(4) Measure the aortic diameter using the M-mode distance measurement procedure.

(5) Press .

(6) Measure the left atrial diameter using the M-mode distance measurementprocedure.

(7) Press .

(8) Measure the aortic valve diameter using the M-mode distance measurementprocedure.

(9) Press .

(10) Measure the ejection time (time during which the aortic valve is open) using theM-mode time measurement procedure.


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5.3.2 Mitral valve measurement (Mitral Valve)

Mitral valve measurement is performed on M-mode images.

>

DE Amp

CE Amp

CA Amp

EPSS

EF Slope

DE Slope


EPSS Distance between the E-point and theinterventricular septum

EPSS (mm)

EF Slope Diastolic descent rate of the mitral valve EF Slope (mm/s)

CE Amp E-wave amplitude CE Amp (mm)

CA Amp A-wave amplitude CA Amp (mm)

DE Amp DE-wave amplitude DE Amp (mm)

DE Slope Mitral valve opening rate DE Slope (mm/s)

Item name Calculation formula Result display

CA/CE AMPCEAMPCA / CA/CE


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[Mitral Valve]

(1) Press .


(3) Press .

Measure the distance between the E-point and the interventricular septum usingthe M-mode distance measurement procedure.

(4) Press .

Measure the diastolic descent rate of the mitral valve using the M-mode slopemeasurement procedure.

(5) Press .

Measure the E-wave amplitude using the M-mode distance measurementprocedure.

(6) Press .

Measure the A-wave

Documents

Aplio 400 Operator Manual