Technical Publications

EchoPAC Software Only

Version 201

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User Manual
EY092807 — English
Rev. 05

Operating Documentation
Copyright 2014, 2015 By General Electric Co.
Regulatory requirement

This product complies with regulatory requirements of the following European

Directive 93/42/EEC concerning medical devices.

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This manual is a reference for EchoPAC Software Only. It applies to all revisions of
the 201 software for the EchoPAC Software Only.

GE Vingmed Ultrasound AS
Strandpromenaden 45
N-3191 Horten, Norway
Tel.: (+47) 3302 1100 Fax: (+47) 3302 1350
Revision History
Reason for change

DATE
REV (YYYY-MM-DD) REASON FOR CHANGE

Rev. 01 2014-08-05 Initial Release

Rev. 02 2014-10-06 Updated clinical applications, feature descriptions, and

corrected grammatical errors

Rev. 03 2014-12-18 FDR2 Release

Rev. 04 2015-03-03 M3 Release

Rev. 05 2015-09-09 M4 Release

List of Effective Pages

PAGE NUMBER REV

All pages Rev. 05

Please verify that you are using the latest revision of this document. Information
pertaining to this document is maintained on ePDM (GE electronic Product Data
Management). If you need to know the latest revision, contact your distributor, local GE
Sales Representative or in the USA call the GE Ultrasound Clinical Answer Center at
1 800 682 5327 or 1 262 524 5698.

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Regulatory Requirements

Conformance Standards
The GE product families are tested to meet all applicable
requirements in relevant EU Directives and European/
International standards. Any changes to accessories, peripheral
units or any other part of the system must be approved by the
manufacturer: GE Vingmed Ultrasound. Ignoring this advice
may compromise the regulatory approvals obtained for the
product.
According to 93/42/EEC Medical Device Directive, this is a
Class IIa Medical Device.

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EchoPAC Software Only is installed and runs on a commercially
available PC. According to applicable legislation, compliance
with the following EC directives and European Harmonized/
International standards is required for the PC in use:

Standard/Directive Scope

93/68/EEC CE Marking Directive

89/336/EEC Electromagnetic compatibility, EMC Directive

73/23/EEC Low Voltage Directive

2002/96/EC Waste electrical and electronic equipment (WEEE Directive)

2002/95/EC Restriction of the use of certain hazardous substances in

electrical and electronic equipment (ROHS Directive).

UL60950: 2000 US and Canadian standard for information Technology

Equipment

IEC60950: 2001 Safety for Information technology equipment

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Country Specific Approvals
• JAPAN
MHLW Approved Number: 21600BZY00637000
• CHINA
SFDA:
Product Standard Number:

Importer Information
• TURKEY

Certifications
• GE Vingmed Ultrasound is ISO 9001 and ISO 13485
certified.

Original Documentation
• The original document was written in English.

Software License Acknowledgements

• WindowBlinds™ OCX © Stardock ®

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 Table of Contents

Conformance Standards - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - i-2

Country Specific Approvals - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - i-3
Importer Information - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - i-3
Certifications- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - i-3
Original Documentation - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - i-3
Software License Acknowledgements - - - - - - - - - - - - - - - - - - - - - - - - - i-3
Table of Contents
Chapter 1 — Introduction
Overview
Main functionality - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-2
Attention- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-2
Prescription device - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-2
Indications for use - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-3
Important - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-3
Manual contents - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-4
Device labels - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-5
Contact Information
Contacting GE Ultrasound - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-6
Manufacturer - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-12
Chapter 2 — Getting started
Launching EchoPAC Software Only
To start EchoPAC Software Only - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-2
EchoPAC Software Only overview
Chapter 3 — Patient record management
Searching a Patient record
About dataflow - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-3
To find an examination - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-3
Advanced search - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-6
Ending an examination - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-6
Editing Referral reasons, Comments and Diagnosis information
Editing text - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-7
Inserting pre-defined text input - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-7
Diagnosis code - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-8
Editing demographic data
Additional Patient ID - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-11
Creating a new Patient record
Deleting archived information i -5
To delete an examination- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-13
 To delete a patient record - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-13
Moving examinations
Removable media
Intended use- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-16
Supported removable media - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-16
USB desktop hard drive - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-17
Recommendation concerning CD and DVD handling - - - - - - - - - - - - - 3-20
Formatting removable media - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-20
Ejecting removable media - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-22
Transfer of patient records/examinations
Introduction - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-23
Transferring patient records/examinations - - - - - - - - - - - - - - - - - - - - - 3-24
Disk management
Introduction - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-31
Configuring the Disk management function - - - - - - - - - - - - - - - - - - - - 3-32
Running the Disk management function - - - - - - - - - - - - - - - - - - - - - - 3-34
Data Backup and restore
Introduction - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-38
Backup procedure - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-38
Restore procedure - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-42
EchoPAC Share
Introduction - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-45
EchoPAC Share activation - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-45
Configuration – System and presets
General system settings - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-47
System users - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-50
Configuration – Archiving
Configuration of the archiving functions - - - - - - - - - - - - - - - - - - - - - - - 3-53
TCP/IP configuration - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-55
Dataflow- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-57
Default dataflow selection - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-64
Default remote path setting - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-64
XML and MPEG Vue Export configuration - - - - - - - - - - - - - - - - - - - - - 3-65
Additional outputs - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-67
Other - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-70
Chapter 4 — Image Management
Introduction
Image review
Introduction - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-3
Review from the Image browser screen- - - - - - - - - - - - - - - - - - - - - - - - 4-3
Review from the Review screen - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-4
Image optimization
Image analysis screen overview - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-6
Image optimization - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-15
4D imaging optimization- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-18
Saving images and cineloops to a standard format i -6
MPEGVue - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-34
 EZ DICOM CD Viewer - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-34
DICOM spooler
Starting the DICOM spooler - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-38
Configuration – Imaging
Global imaging settings - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 4-40
Chapter 5 — Measurements and analysis
Introduction
General recommendations about measurements - - - - - - - - - - - - - - - - - 5-4
About Measurement results display - - - - - - - - - - - - - - - - - - - - - - - - - - 5-5
Assign and Measure modality
Measure and Assign modality
Measurements on volume renderings - - - - - - - - - - - - - - - - - - - - - - - - 5-10
Measurements on protocol images
Advanced cardiac measurements and analysis
Event timing measurements - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5-12
TSI Measurements - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5-13
Automated Function Imaging - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5-19
AutoEF measurements - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5-40
Pediatric Z score measurement study - - - - - - - - - - - - - - - - - - - - - - - - 5-46
4D/Multi-plane LV measurements and analysis
Introduction - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5-47
4D Automated Left Ventricular Quantification- - - - - - - - - - - - - - - - - - - 5-47
Manual left ventricular volume measurements - - - - - - - - - - - - - - - - - - 5-61
4D LV volume and 4D RV volume
Starting the 4D LV volume and the 4D RV volume applications from
EchoPAC Software Only - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5-67
4D MV-Assessment
Starting the 4D MV-Assessment application - - - - - - - - - - - - - - - - - - - 5-68
4D Auto AVQ
Introduction - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5-69
Requirements - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5-69
Starting the 4D Auto AVQ tool - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5-69
Slice alignment - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5-71
LVOT segmentation - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5-71
Measurements - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5-73
Approval- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5-74
Advanced vascular measurements and analysis
Intima-Media Thickness - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5-75
OB measurements
OB graphs - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5-79
Measurement package configuration
Basic operations - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5-85
Measurement package configuration - example - - - - - - - - - - - - - - - - - 5-86
User-defined formulas - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5-89
Advanced settings- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5-96
Normal values- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5-103 i -7
 Measurement result table
Minimizing the Measurement result table- - - - - - - - - - - - - - - - - - - - - 5-106
Moving the Measurement result table - - - - - - - - - - - - - - - - - - - - - - - 5-106
Deleting measurements - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 5-106
Chapter 6 — Stress Echo
Introduction
Review of protocol studies
Image selection for analysis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 6-4
Stress Echo analysis
Conventional Stress Echo acquisition - - - - - - - - - - - - - - - - - - - - - - - - - 6-6
Multi-plane Stress Echo analysis - - - - - - - - - - - - - - - - - - - - - - - - - - - - 6-8
4D Stress Echo analysis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 6-10
Quantitative TVI Stress echo analysis
Introduction - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 6-14
Accessing QTVI Stress analysis tools - - - - - - - - - - - - - - - - - - - - - - - - 6-16
Vpeak measurement - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 6-16
Tissue Tracking - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 6-19
Quantitative analysis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 6-19
References- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 6-19
AFI Stress
Introduction - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 6-20
AFI Stress analysis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 6-20
Reviewing a stored Bull's eye at any stress level - - - - - - - - - - - - - - - - 6-22
Editing/creating a Stress Echo protocol template
Introduction - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 6-24
Entering the Template editor screen - - - - - - - - - - - - - - - - - - - - - - - - - 6-24
Editing/Creating a template - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 6-25
Multi-plane Stress Echo Template setup - - - - - - - - - - - - - - - - - - - - - - 6-28
Chapter 7 — Quantitative Analysis
Introduction
Starting Q Analysis
Q Analysis overview
Q Analysis screen - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7-4
Using Q Analysis
Generation of a trace- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7-8
Frame disabling - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7-11
Optimization - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7-12
Switching modes or traces - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7-17
Curve fitting analysis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7-17
Anatomical M-Mode - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7-25
Chapter 8 — Worksheet
Introduction
Overview - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 8-2
Using the Worksheet
To select a type of value - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 8-3 i -8
To exclude or include measurements - - - - - - - - - - - - - - - - - - - - - - - - - 8-3
To delete measurements - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 8-3
 To change a measurement value - - - - - - - - - - - - - - - - - - - - - - - - - - - - 8-4
Chapter 9 — Report
Introduction
Working with the report function
To choose another report template - - - - - - - - - - - - - - - - - - - - - - - - - - - 9-3
To change patient information - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 9-4
Images in the report - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 9-4
To print a report - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 9-5
To store a report - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 9-5
Report sign-off - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 9-5
Retrieving an archived report - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 9-7
Deleting an archived report - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 9-7
Structured Findings
Prerequisite - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 9-8
Starting Structured Findings - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 9-9
Using Structured Findings - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 9-10
Structured Findings configuration - - - - - - - - - - - - - - - - - - - - - - - - - - - 9-13
Report designer
Introduction - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 9-24
Accessing the Report designer - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 9-24
Report designer overview - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 9-25
Designing a report template - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 9-27
Report templates management
Configuration of the Template selection menu - - - - - - - - - - - - - - - - - - 9-41
Export/Import of Report templates - - - - - - - - - - - - - - - - - - - - - - - - - - 9-42
Chapter 10 — 2D Strain
Introduction
Acquisition
Starting 2D Strain
Defining a ROI - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 10-4
2D Strain processing
Tracking validation - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 10-13
Timing - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 10-13
2D Strain quantitative analysis
About the results - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 10-16
Trace analysis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 10-17
Result analysis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 10-24
Torsion analysis - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 10-25
Data management
The 2D Strain result file - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 10-28
Other files- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 10-29
File management - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 10-29
2D Strain – Frequently asked questions
Chapter 11 — Appendix
Short-cuts i -9
Keyboard short-cuts - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 11-2
Mouse short-cuts - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 11-4
 System self-test
System malfunction - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 11-6
Bookmarking a system malfunction- - - - - - - - - - - - - - - - - - - - - - - - - - 11-6
Generating a log file - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 11-6
Advanced log options - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 11-7
Index

i-10
 Chapter 1

Introduction

EchoPAC Software Only is intended for diagnostic

review and analysis of ultrasound images, patient
record management and reporting.
EchoPAC Software Only allows post-processing of raw
data images from GE ultrasound scanner and DICOM
ultrasound images.

1 -1
 Overview

Main functionality
EchoPAC Software Only offers the following functionality:
• Read/display DICOM ultrasound and GE raw data images.
• Ultrasound image optimization, as on a scanner.
• Measurement and analysis
• Advanced quantitative analysis, based on raw data such as
quantitative TVI, contrast and stress analysis (research
options)
• Image storage
• Patient record database
• Report generator

Attention
Read and understand all instructions in the User's Manual
before attempting to use EchoPAC Software Only. Keep the
manual with the equipment at all time. Periodically review the
procedures for operation and safety precautions.
NOTE: Not all features or products described in this document may be
available or cleared for sale in all markets. Please contact your
local GE representative to get the latest information.
NOTE: Please note that orders are based on the individually agreed
upon specifications and may not contain all features listed in this
manual.
NOTE: All references to standards / regulations and their revisions are
valid at the time of publication of the user manual.

Prescription device

CAUTION For USA only:

CAUTION: Federal law restricts this device to sale or use by or 1 -2
on the order of a physician.
Indications for use
EchoPAC Software Only is indicated for diagnostic review and
analysis of ultrasound images acquired via B (2D), M, Color M
modes, Color, Power, Pulsed and CW Doppler modes, Coded
Pulse, Harmonic and Real time 3D.
Specific clinical applications include:
• Adult cardiac
• Pediatric cardiac
• Fetal/obstetrics
• Abdominal (incl. renal and GYN/pelvic)
• Pediatrics
• Small organ (incl. breasts, testes, and thyroid)
• Adult and neonatal cephalic
• Peripheral vascular
• Musculoskeletal conventional
• Urology/prostate

CAUTION EchoPAC Software Only should be used in compliance with

law. Some jurisdictions restrict certain uses, such as gender
determination.

Important

CAUTION Computer hardware running EchoPAC Software Only and

accessories must not be placed inside the patient environment,
unless it is in compliance with IEC60601-1-1 (2000).

1. Patient environment

Figure 1-1. Patient environment 1 -3

Manual contents
The EchoPAC Software Only User manual is organized to
quickly provide the information needed for patient management
and ultrasound image post processing using
EchoPAC Software Only.

Finding information

Table of Contents, lists the main topics and their location.

Headers and Footers, give the chapter name and page
number.
Index, provides an alphabetical and contextual list of topics.

Conventions used in this manual

The following typographic conventions are used in the indication

of different types of information:
Bold type: describes button name on the screen.
Italic type: describes program windows, screens and dialogue
boxes.
The following icons, highlight safety issues as follow:

DANGER Indicates that a specific hazard is known to exist which through

inappropriate conditions or actions will cause:
• Severe or fatal personal injury
• Substantial property damage

WARNING Indicates that a specific hazard is known to exist which through

inappropriate conditions or actions may cause:
• Severe personal injury
• Substantial property damage

CAUTION Indicates that a potential hazard may exist which through

inappropriate conditions or actions will or can cause:
• Minor injury
• Property damage
1 -4
 NOTE: Indicates precautions or recommendations that should be used
in the operation of the ultrasound system, specifically:
• Maintaining an optimum system environment
• Using this Manual
• Notes to emphasize or clarify a point

Device labels
The following table describes the purpose and location of safety
labels and other important information provided on the
equipment.

Symbols

Label Purpose Location

Indicates that the product is in compliance EchoPAC Software Only

with all relevant European Directives and DVD.
0123 under surveillance by Notified Body 0123.

For USA only: EchoPAC Software Only

Caution: Federal law restricts this device to DVD.
sale by or on the order of a physician.

Symbol indicating that the Instructions for Use EchoPAC Software Only
are supplied in electronic form. Documentation DVD.

Date of manufacture EchoPAC Software Only

DVD.

Manufacturer name and address EchoPAC Software Only

DVD.

Catalog or part number EchoPAC Software Only

DVD.

Unique Device Identification (UDI). Every EchoPAC Software Only

device has a unique marking for identification. DVD.
Scan or enter the UDI information into the
patient health record as required by
governing laws.

1 -5
 Contact Information

Contacting GE Ultrasound
For additional information or assistance, please contact your
local distributor or the appropriate support resource listed on the
following pages:
INTERNET http://www.gehealthcare.com
http://www3.gehealthcare.com/en/Products/Categories/
Ultrasound/Ultrasound_Probes
Clinical Questions For information in the United States, Canada, Mexico, and parts
of the Caribbean, call the Customer Answer Center.
TEL: (1) 800-682-5327 or (1) 262-524-5698
In other locations, contact your local Applications, Sales, or
Service Representative.
Service Questions For service in the United States, call GE CARES.
TEL: (1) 800-437-1171
In other locations, contact your local Service Representative.
Information To request technical product information in the United States,
Requests call GE.
TEL: (1) 800-643-6439
In other locations, contact your local Applications, Sales, or
Service Representative.
Placing an Order To order accessories, supplies, or service parts in the United
States, call the GE Technologies Contact Center.
TEL: (1) 800-558-5102
In other locations, contact your local Applications, Sales, or
Service Representative.

1 -6
AMERICAS

ARGENTINA GE Healthcare TEL: 11-5298-2400

Nicolas Vedia 3616, piso 5
Buenos Aires

BRAZIL GE Healthcare do Brasil Comércio e Serviços para

Equipamentos Médico- Hospitalares Ltda
Av. Das Nações Unidas, 8501
3º andar parte - Pinheiros
São Paulo SP – CEP: 05425-070
C.N.P.J.: 02.022.569/0001-83
TEL: 3067-8493 FAX: (011) 3067-8280

CANADA GE Healthcare
Ultrasound Service Engineering
9900 Innovation Drive
Wauwatosa, WI 53226
TEL: (1) 800-668-0732
Customer Answer Center TEL: (1) 262-524-5698

LATIN & SOUTH GE Healthcare

AMERICA Ultrasound Service Engineering
9900 Innovation Drive
Wauwatosa, WI 53226
TEL: (1) 262-524-5300
Customer Answer Center TEL: (1) 262-524-5698

MEXICO GE Sistemas Medicos de Mexico S.A. de C.V.

Rio Lerma #302, 1º y 2º Pisos
Colonia Cuauhtemoc FAX: (5) 211-4631
06500-Mexico, D.F.
TEL: (5) 228-9600

USA GE Healthcare
Ultrasound Service Engineering
9900 Innovation Drive
Wauwatosa, WI 53226
TEL: (1) 800-437-1171 FAX: (1) 414-721-3865

1 -7
ASIA

ASIA PACIFIC GE Healthcare Asia Pacific

JAPAN 4-7-127, Asahigaoka
Hinoshi, Tokyo
191-8503, Japan
TEL: +81 42 585 5111

AUSTRALIA Building 4B, 21 South St

Rydalmere NSW 2116
Australia
TEL: 1300 722 229

CHINA GE Healthcare - China

No. 1, Yongchang North Road
Beijing Economic & Technology Development Area
Beijing 100176, China
TEL: (8610) 5806 8888 FAX: (8610) 6787 1162

KOREA GE Healthcare Korea

8F, POBA Gangnam Tower, 343
Hakdong-ro, Gangnam-gu
Seoul, 135-820, Korea
TEL: +82 2 6201 6119

NEW ZEALAND 8 Tangihua Street

Auckland 1010
New Zealand
TEL: 0800 434 325

SINGAPORE ASEAN
1 Maritime Square #13-012
HarbourFront Center
Singapore 099253
TEL: +65 6291 8528

1 -8
EUROPE and MIDDLE EAST

For all other European countries not listed, please contact your
local GE distributor or the appropriate support resource listed on
www.gehealthcare.com.
AUSTRIA General Electric Austria GmbH
Filiale GE Healthcare Technologies
EURO PLAZA, Gebäude E
Wienerbergstrasse 41A-1120 Vienna
TEL: (+43) 1 97272 0 FAX: (+43) 1 97272 2222

BELGIUM & GE Healthcare BVBA

LUXEMBURG Eagle Building
Kouterveldstraat 20
1831 DIEGEM
TEL: (+32) 2 719 7204 FAX: (+32) 2 719 7205

CZECH REPUBLIC GE Medical systems CR s.r.o

Vyskocilova 1422/1a
140 28 Praha

DENMARK GE Medical Systems Ultrasound

Park Alle 295, 2605 Brøndby
TEL: (+45) 43 295 400 FAX: (+45) 43 295 399

ESTONIA & GE Healthcare Finland Oy

FINLAND Kuortaneenkatu 2, 000510 Helsinki
P.O.Box 330, 00031 GE Finland
TEL: (+358) 10 39 48 220 FAX: (+358) 10 39 48 221

FRANCE GE Medical Systems SCS

24 Avenue de l'Europe - CS20529
78457 Velizy Villacoublay Cedex
TEL: (+33) 13 449 50 00 FAX: (+33) 13 44 95 202

GERMANY GE Healthcare GmbH

Beethovenstrasse 239
42655 Solingen
TEL: (+49) 212-28 02-0 FAX: (+49) 212-28 02 380

GREECE GE Healthcare
8-10 Sorou Str. Marousi
Athens 15125 Hellas
TEL: (+30) 210 8930600 FAX: (+30) 210 9625931

1 -9
 HUNGARY GE Hungary Zrt. Ultrasound
Division, Akron u. 2.
Budaors 2040 Hungary
TEL: (+36) 23 410 314 FAX: (+36) 23 410 390

IRELAND NORTHERN IRELAND

GE Healthcare
Victoria Business Park
9, Westbank Road, Belfast BT3 9JL.
TEL: (+44) 28 90229900

REPUBLIC OF IRELAND
GE Healthcare
3050 Lake Drive, Citywest Business Campus
Dublin 24
TEL: (+353) 1 4605500

ITALY GE Medical Systems Italia spa

Via Galeno, 36, 20126 Milano
TEL: (+39) 02 2600 1111 FAX: (+39) 02 2600 1599

NETHERLANDS GE Healthcare
De Wel 18 B, 3871 MV Hoevelaken
PO Box 22, 3870 CA Hoevelaken
TEL: (+31) 33 254 1290 FAX: (+31) 33 254 1292

NORWAY GE Healthcare
Tåsenveien 71, 0873 Oslo
TEL: (+47) 2202 0800

GE Healthcare
Strandpromenaden 45,
P.O. Box 141, 3191 Horten
TEL: (+47) 33 02 11 16

POLAND GE Medical Systems Polska

Sp. z o.o., ul. Woloska 9
02-583 Warszawa, Poland
TEL: (+48) 22 330 83 00 FAX: (+48) 22 330 83 83

PORTUGAL General Electric Portuguesa SA

SA. Avenida do Forte, n° 6-6A
Edificio Ramazzotti, 2790-072 Carnaxide
TEL: (+351) 21 425 1300 FAX: (+351) 21 425 1343

1-10
 RUSSIA GE Healthcare
12th floor, 10C, Presnenskaya nab.
Moscow 123317 Russia
TEL: (+7) 495 739 69 31 FAX: (+7) 495 739 69 32

SPAIN GE Healthcare España

C/ Gobelas 35-37
28023 Madrid
TEL: (+34) 91 663 2500 FAX: (+34) 91 663 2501

SWEDEN GE Healthcare Sverige AB

FE 314, SE-182 82 Stockholm, Sweden
TEL: (+46) 8 559 50010

SWITZERLAND GE Medical Systems (Schweiz) AG

Europastrasse 31,
8152 Glattbrugg
TEL: (+41) 1 809 92 92 FAX: (+41) 1 809 92 22

TURKEY GE Healthcare Türkiye

Istanbul Office
Levent Ofis
Esentepe Mah. Harman Sok.
No:8 Sisli-Istanbul
TEL: +90 212 398 07 00 FAKS: +90 212 284 67 00

Ankara Office
Mustafa Kemal Mah.
2158.Sok No:9
Çankaya-Ankara
TEL: +90 312 289 77 00 FAKS: +90 312 289 78 02

UNITED ARAB GE Healthcare Holding ME SA

EMIRATES (UAE) Dubai Internet City, Building No. 18
P. O. Box # 11549, Dubai
U.A.E
TEL: (+971) 4 429 6161
FAX (+971) 4 429 6200/01/02

UNITED KINGDOM GE Healthcare

71 Great North Road
Hatfield, Hertfordshire, AL9 5EN
TEL: (+44) 1707 263570 FAX: (+44) 1707 260065

1-11
Manufacturer

GE Vingmed Ultrasound AS
Strandpromenaden 45
N-3191 Horten, Norway
Tel.: (+47) 3302 1100 Fax: (+47) 3302 1350

1-12
 Chapter 2

Getting started

‘Launching EchoPAC Software Only’ on page 2-2

‘EchoPAC Software Only overview’ on page 2-3

2 -1
 Launching EchoPAC Software Only

To start EchoPAC Software Only

1. Double click on the EchoPAC Software Only icon on the
computer’s Desktop.
The program undergoes an initialization sequence and the
Operator login dialogue box is displayed (see Figure 2-1).
2. Enter the required information and press Log on.
The Archive screen is displayed with the default dataflow
selected (see Figure 3-1 on page 3-4).

1. Select the operator

2. Enter password

Figure 2-1. The Operator login window

2 -2
 EchoPAC Software Only overview

EchoPAC Software Only is built on several main screens that

can be entered by selecting the tabs on the top of the window.

Tab Function

Archive Archive screen

• Search for a patient record / exam
• Create a patient record
• Patient record management

Patient Patient info and exam screen

• Patient info
• Examination info
• Medical info

Image Browser • Displays a thumbnail overview of all images stored for the
current patient record.

Review • Displays all images of the selected examination

Protocol • Review protocol based examinations

Analysis • Image optimization

• Measurements
• Quantitative analysis

Worksheet • Measurement listing

Report • Summarizes data from an examination

Config • EchoPAC Software Only configuration

Help • Displays on-line user documentation

Exit • Exit or Log off EchoPAC Software Only.

2 -3
 Chapter 3

Patient record management

‘Searching a Patient record’ on page 3-3

‘Editing Referral reasons, Comments and Diagnosis

information’ on page 3-7

‘Editing demographic data’ on page 3-10

‘Creating a new Patient record’ on page 3-12

‘Deleting archived information’ on page 3-13

‘Moving examinations’ on page 3-14

‘Removable media’ on page 3-16

‘Transfer of patient records/examinations’ on page 3-23

‘Disk management’ on page 3-31

‘Data Backup and restore’ on page 3-38

‘EchoPAC Share’ on page 3-45

3 -1
‘Configuration – System and presets’ on page 3-47
‘Configuration – Archiving’ on page 3-53

3 -2
 Searching a Patient record

When the login procedure is completed, the Archive screen is

displayed (see Figure 3-1).

About dataflow
The connectivity on EchoPAC Software Only is based on the
dataflow concept. Each dataflow defines the transfer of patient
information from an input source to the unit, and from the unit to
an output source. Patient information can include demographic
data and images, as well as reports and Measurement and
Analysis data. A dataflow is a set of pre-configured services.
When beginning a search, the user selects a pre-configured
dataflow (see page 3-57 about connectivity) that will
automatically customize EchoPAC Software Only to work
according to the services associated to the dataflow and search
in the archive associated.

To find an examination
1. In the Archive screen select the desired dataflow.
2. Type the patient Last Name, and/or ID or another query that
identifies the patient.
When default configured, the system automatically
searches to see if the patient is already in the archive. The
result of this search is displayed in the Patient list.
3. Highlight the examination in the Exam list.
NOTE: Select the Patient tab to display a list of patient records
instead of the examinations.
4. Select a patient record/examination and press Open
Patient or double-click on the patient record/examination to
review.
The Patient info and exam screen is displayed (see
Figure 3-2).

3 -3
 CAUTION In a network environment other than DICOM server, if the user
tries to open a patient record or an examination that is already
opened by another user, a dialog is displayed to let you open
the exam as read only.

1. Select archive and other pre-defined services.

2. Change user.
3. Display either patient or examination list.
4. New patient: create new patient record
Open patient: review selected patient record
Add exam: create new exam
Transfer: import/export patient record
Delete: delete selected patient record or examination
Disk management: manage hard disk space

The Archive screen may be slightly different depending on the Dataflow selected

Figure 3-1. The Archive screen

3 -4
1. Patient information
2. Examination information
3. Clipboard with images for the selected examination
4. List of examinations
5. List of available information to display on screen
6. Add exam: create a new examination.
Delete exam: delete the selected examination.
Archive: the current examination is ended and the Archive screen is displayed. Any searching criteria
previously entered are remembered.
End exam: the examination is ended and the Archive screen is displayed ready for a new search.

Figure 3-2. The Patient info and exam screen

3 -5
Advanced search
To restrain the search to a specific patient group, one or more
additional filters may be applied to the search. The table below
shows the filters available from the Patient list and Exam list.
NOTE: Filters available are dependent of the dataflow selected. Search
criteria for DICOM Worklist or Query/Retrieve dataflows are set
when configuring the DICOM device.

Advanced searching filters

Patient list Exam list

Last name Last name

First name First name

Patient ID Patient ID

Date of birth Category

Born before and/or after Today’s examinations

Gender Diagnosis codes

Examination before and/or after

Stress

No reports

Images

Diagnosing physician

Exam ID

Exam description

Location

Ending an examination
1. Press the Patient tab to display the Patient info and exam
screen.
2. Press one of the following buttons.
• Archive: the examination is ended and the Archive
screen is displayed. Any searching criteria previously
entered are remembered.
• End exam: the examination is ended and the Archive
screen is displayed ready for a new search.
3 -6
Editing Referral reasons, Comments
and Diagnosis information

The user can edit the actual text in the Patient info and exam
screen using the alphanumeric keyboard and by inserting
pre-defined text input.

CAUTION The user is responsible for patient demographic data,

diagnostic information or any other patient related information
entered in the database.

Editing text
1. In the Patient info and exam screen (Figure 3-2), place the
cursor in the required field.
2. Using the alphanumeric keyboard, edit the information.

Inserting pre-defined text input

1. In the Patient info and exam screen, press next to the
field to edit.
The Insert text window is displayed (see Figure 3-3).
The pre-defined text list is organized in a three level
hierarchy. Selecting one item in the first column displays
pre-defined text entries related to the selected text in the
second and third columns.
2. Navigate through the pre-defined text list by selecting items
in the columns and double-click on the desired pre-defined
text to be inserted. If an entry in the third column is inserted,
the selected text in the second column is also inserted.
Press More>> to display the full text for the selected entry.

3 -7
 Figure 3-3. The Insert text window

Diagnosis code

Adding Diagnosis codes

1. In the Patient info and exam screen, press next to the

Code field.
The Code list is displayed.
2. Select the codes to enter.
The codes selected are displayed in the Patient info and
exam screen.

Removing entered Diagnosis codes

1. In the Patient info and exam screen, press next to the

Code field.
The Code list is displayed.
2. Uncheck the codes to remove.

Creating a Diagnosis code

1. In the Patient info and exam screen, press next to the

Code field.
The Code list is displayed.
2. Select New code.
The New code window is displayed.
3. Enter the new code.
4. Press OK to exit.
3 -8
Diagnostic codes can also be created and deleted from the
configuration package:
1. Press Config (F2) to access the configuration package.
2. In the Configuration package, select the category Report
and the Tab sheet Diag. Codes.

Figure 3-4. The Diagnostic codes sheet

To create a diagnostic code:

1. Select New code.
2. In the Code field, enter a name for the diagnostic code.
3. In the Full text field, enter the code text.
To delete a diagnostic code:
1. In the Code list field, select the diagnostic code to delete.
2. Select Delete.

3 -9
 Editing demographic data

Patient information (name, contact information and patient IDs)

can be edited from the Patient info and exam screen.

CAUTION Do NOT use '\' or '^' in patient information fields, as these

characters might cause problems with some DICOM devices.

1. Select a patient record (see page 3-3) and press Open

patient.
The Patient info and exam screen is displayed (refer to
Figure 3-2 on page 3-5).
2. Edit the information using the keyboard or by choosing a
new selection from the drop-down menus.

3-10
Additional Patient ID
The EchoPAC Software Only system supports an additional field
for Patient ID number.

To create/remove an additional Patient ID

1. In the Patient info and exam screen, make sure that the
option Additional info is checked in order to display the
Patient IDs field.

Figure 3-5. The Patient IDs field

2. To create an additional Patient ID, press Add.

The Add Patient ID window is displayed.
3. Enter a Patient ID and your identifier as issuer and press
OK.
The new Patient ID is displayed in the Patient IDs field.
To make this new Patient ID the primary ID, select the
Primary radio button next to the ID. A confirmation window
is displayed. Press OK to confirm.
4. To remove an additional Patient ID, select the Patient ID and
press Remove. A confirmation window is displayed. Press
OK to confirm.
NOTE: A Primary Patient ID cannot be removed.

3-11
 Creating a new Patient record

1. In the Archive screen select the desired dataflow.

2. Type the patient Last Name, and/or ID.
NOTE: The unit can be configured to automatically generate a
patient ID (see page 3-53).
When default configured, the system automatically
searches to see if the patient is already in the archive. The
result of this search is displayed in the Patient list.
3. To create a new patient record, press New Patient.
The Create new patient record window is displayed.

Figure 3-6. The Create new patient record window

4. Enter additional patient information if required and press

Create.

CAUTION Do NOT use '\' or '^' in patient information fields, as these

characters might cause problems with some DICOM devices.

3-12
 Deleting archived information

To delete an examination
1. In the Archive screen (Exam tab selected), search and
highlight the examination(s) to delete (see page 3-3).
2. Press Delete.
A dialogue window is displayed asking for confirmation.
3. Press OK to delete the selected examination.

To delete a patient record

1. In the Archive screen, select the Patient tab.
2. Search and highlight the patient record(s) to delete (see
page 3-3).
3. Press Delete.
A dialogue window is displayed asking for confirmation.
4. Press OK to delete the patient record.

3-13
 Moving examinations

An examination can be moved from one patient record to

another. This feature should only be used if an examination was
performed and stored to a wrong patient record.
1. In the Archive screen select the Exam tab to display the
examination list (see Figure 3-1 on page 3-4).
2. Search for the examination to move.
3. Right-click on the examination to move.
4. Select Move Exam From Patient in the context menu.

Figure 3-7. Context menu - Move exam from patient

5. Select the Patient tab to display the patient list.

6. Search the target patient record.
7. Right-click on the target patient record.
8. Select Move Exam To Patient in the context menu.

3-14
 Figure 3-8. Context menu - Move exam to patient

A warning message is displayed asking the user to confirm

the action to perform.
9. Select OK.

3-15
 Removable media

Intended use
Removable media can be used for the following purposes:
• Long-term image storage: The final destination of the
images, after they are moved out of the system harddisk by
using the Disk Management feature (see page 3-31).
• Backup of patient database and system configuration
presets (see page 3-38)
• Patient archive sneakernet: Copy a set of patient records
between a scanner and EchoPAC Software Only using the
Transfer feature (see page 3-23) with removable media.
• DICOM transfer to copy a set of patient records to/from a
third party DICOM review station.
• MPEGVue export: Review exported images on a Windows
computer (see page 4-34).
• XML export: Exports demographics, measurements, and
reporting data from the unit to a third party reporting
application using removable media (see page 3-23).
• Copy of system configuration presets between two units
using the Backup/Restore feature (see page 3-38).
• Save images as JPEG, MPEG, AVI, DICOM, or RawDICOM
for review on a regular computer.

Supported removable media

• CD-R
• DVD-R
• USB Flash card
• USB external desktop hard drive (Iomega Ultramax or
ICY BOX USB desktop hard drive) (option)

3-16
 CAUTION USB Flash card:
• Use only shielded USB Flash cards that are verified for
EMC performance according to EN55011/EN55022. The
use of other USB Flash cards may cause interference on
the system itself or on other electronic devices.

NOTE: User without Windows administrator rights are normally

prevented from using removable media with
EchoPAC Software Only unless the Windows Policy setting
“Devices: Allowed to format and eject removable media” is set to
“Administrators and Interactive Users”. If required, contact your
network administrator to adjust the Windows local policy
accordingly.

USB desktop hard drive

NOTE: Only connect one USB desktop hard drive to the
EchoPAC Software Only at a time.

CAUTION If connected to EchoPAC Software Only, the USB desktop hard

drive must not be placed inside the patient environment (refer
to local regulation and IEC60601-1-1 (2000)).

1. Patient environment

Figure 3-9. Patient environment

Iomega Ultramax desktop hard drive (option)

The Iomega Ultramax desktop hard drive is an external desktop

hard drive that can be connected to EchoPAC Software Only via
USB. It is configured as RAID 1, so the content is mirrored on
two hard disk drives.
3-17
Iomega Ultramax unit connection
1. Connect the Iomega Ultramax unit to
EchoPAC Software Only using the USB cable provided with
the unit. The USB cable must be connected to the combined
USB/eSATA (Duolink) socket at the rear of the
Iomega Ultramax unit (Figure 3-10).
NOTE: Do not use any of the other USB sockets (USB hub) at the
rear of the Iomega Ultramax unit.
2. Connect the cable from the power supply to the DC IN
connector on the rear of the Iomega Ultramax unit
(Figure 3-10).
Connect the power cord from the power supply to the mains
AC outlet.

1. USB/eSATA (Duolink) connector

2. DC IN Power connector
3. On/Off switch

Figure 3-10. Iomega Ultramax unit, rear view

3-18
ICY BOX desktop hard drive (option)

The ICY BOX desktop hard drive is an external desktop hard

drive that can be connected to EchoPAC Software Only via
USB. It is configured as RAID 1, so the content is mirrored on
two hard disk drives.

ICY BOX unit connection

1. Verify that the volume configuration is set to RAID 1 as
shown below.

Mode Switch 1 Switch 2

JBOD OFF OFF

RAID 0 ON OFF

RAID 1 OFF ON

Note: When changing the RAID mode, push the button over the switches to
confirm the new setting.

Figure 3-11. RAID 1 setup (rear side)

2. Connect the ICY BOX unit to EchoPAC Software Only using

the USB cable provided with the unit. The USB cable must
be connected to the USB 3.0 socket at the rear of the
ICY BOX unit (Figure 3-12).
3. Connect the cable from the power supply to the DC
connector on the rear of the ICY BOX unit (Figure 3-12).
Connect the power cord from the power supply to the mains
AC outlet.

3-19
 Figure 3-12. ICY BOX unit, rear view

Recommendation concerning CD and DVD handling

To avoid data loss, never touch the recordable surface of a disk.
Handle the disk only by the outer edge. Do not place it face
down on a hard surface. Fingerprints or scratches will make the
disk unusable. Before usage, verify that the disk surface has no
visible scratches. If there are any scratches, do NOT use the
disk.

Formatting removable media

To format removable media:
1. Insert the media in the drive.
2. Press Config (F2).
The Configuration package is opened.
3. Select the category Connectivity and select the sheet
Tools (Figure 3-13).

3-20
 Figure 3-13. The Tools sheet

4. Select the removable media from the Media drop-down

menu (CD-R, DVD-R or USB device).
5. Enter a name for the removable media in the Label field.
NOTE: Only the following characters and signs can be used when
labeling a media: A - Z, a - z, 0 - 9, “_” and “-”. Do not use
more than 11 characters or signs. Do not use space.
6. Select Format.
A confirmation window is displayed.

CAUTION The formatting process will erase any data present on the
media.

7. Select OK to continue.
8. Wait for the display of the Information window indicating that
the formatting process is completed.
9. Select OK.
10. Eject the media as described below.

3-21
Ejecting removable media
1. Press ALT+E to eject the disk.
NOTE: Do not eject CD/DVD using the button on the CD/DVD drive.
The Eject device menu is displayed (Figure 3-14).

Figure 3-14. The Eject device menu

2. Select the relevant media.

The selected media is ejected.

3-22
 Transfer of patient records/
examinations

Introduction
The Transfer function on EchoPAC Software Only enables
transfer of patient records/examinations between archives as
listed below:

Transfer

From To Note

1. Local archive Removable media Perform transfer 1 and 2 to transfer

data between systems via a
2. Removable media Local archive removable media (CD/DVD or USB
device).

3. Local archive Remote archive Transfer data from the local archive
to an ImageVault server, a DICOM
server or EchoPAC Software Only

4. Remote archive Local archive Transfer data from an ImageVault

server, a DICOM server or
EchoPAC Software Only to the local
archive.

5. Remote archive Removable media Transfer data from an ImageVault

server, a DICOM server or
EchoPAC Software Only to a
removable media (CD/DVD or USB
device).

6. Removable media Remote archive Transfer data from a removable

media (CD/DVD or USB device) to an
ImageVault server, a DICOM server
or EchoPAC Software Only.

7. Remote archive Remote archive Transfer data between remote

archives (ImageVault server, DICOM
server or EchoPAC)

3-23
 CAUTION If an examination is opened, it must be closed before
performing transfer of patient records/examinations.

Transferring patient records/examinations

1. If transferring data from/to a removable media, insert the
media in the drive.
2. Press Archive.
The Archive screen is displayed (see Figure 3-1 on
page 3-4).
3. Press Transfer.
The Transfer screen is displayed.

1. Search for the data to transfer.

2. Transfer from.
3. Transfer to.
4. Transfer either patient records or examinations.
5. Add selected/all items to the transfer list.
6. List of data to transfer.
7. Additional functions:
• Anonymize: remove patient information to the transferred items (only available for DICOM data
transfer to removable media).
• Delete after copy: remove transferred items after transfer (not available with all services).
8. Perform data transfer.
3-24
Figure 3-15. The Transfer screen
 4. If a search for patient records or examinations was
performed in the Archive screen before entering the
Transfer screen, the found items are displayed in the
Transfer screen.
If no search was performed before entering the Transfer
screen, select a source archive from the Source drop-down
menu and search for the patients records or examinations to
transfer.
The following source archives are available:
• Local Archive - Int.HD: Transfer data from the local
archive.
• Remote Archive - Remote HD: Transfer data from the
configured remote archive.
• DICOM USB Harddisk/Memstick: Transfer DICOM
data from an USB device. Only available when an USB
device is mounted.
• DICOM Query retrieve: Transfer DICOM data from a
Query/Retrieve DICOM server.
• USB Harddisk/Memstick: Transfer data from an USB
device. This source should be used when transferring
data from a Vivid E9 or an EchoPAC Software Only with
software version 113 or earlier. Only available when an
USB device is mounted.
• CD/DVD Archive: Transfer data from a CD/DVD. This
source should be used when transferring data from a
Vivid E9 or an EchoPAC Software Only with software
version 113 or earlier.
5. Select one of the following available destinations from the
Destination drop-down menu:
• DICOM Local HD: Transfer DICOM data only to a local
export folder under Archive directory.
Check Anonymize and enter a Prefix if you want to
remove all patient related information to the transferred
data. Patient name and ID are replaced by the prefix
followed by an increasing number. The prefix should not
contain any patient identifying data.
NOTE: Anonymization is only available for DICOM data transfer
to the local export folder or removable media.
Annotations or other visible patient information in the
images will not be anonymized.
• DICOM CD/DVD: Transfer DICOM data only to a CD/
DVD-R/W.
Check Anonymize and enter a Prefix if you want to 3-25
remove all patient related information to the transferred
 data. Patient name and ID are replaced by the prefix
followed by an increasing number. The prefix should not
contain any patient identifying data.
• DICOM USB Harddisk/Memstick: Transfer DICOM
data only to an USB device. Only available when an
USB device is mounted.
Check Anonymize and enter a Prefix if you want to
remove all patient related information to the transferred
data. Patient name and ID are replaced by the prefix
followed by an increasing number. The prefix should not
contain any patient identifying data.
• Remote Archive - Remote HD: Transfer raw and
DICOM data to an ImageVault server or
EchoPAC Software Only.
• Export to XML: Transfer demographics, measurements
and reporting data to XML file. The export destination
must be configured (see page 3-65).
• DICOM Print: Prints images to a DICOM printer via
DICOM spooler.
• MPEGVue: Transfer examinations to MPEGVue format
readable from a regular computer. Ultrasound images
are stored as MPEG, and reports as CHM files. The
export destination must be configured (see page 3-65).
• DICOM Storage: Transfer DICOM data only to a
DICOM server via DICOM spooler.
• USB Harddisk/Memstick: Transfer data to an USB
device. This destination should be used when
transferring data intended to be imported in a Vivid E9
or an EchoPAC Software Only with software version 113
or earlier. Only available when an USB device is
mounted.
• CD/DVD Archive: Transfer data to a CD/DVD. This
destination should be used when transferring data
intended to be imported in a Vivid E9 or an
EchoPAC Software Only with software version 113 or
earlier.
6. The following situations may occur if the destination media
is a CD/DVD:
• If the destination media needs to be formatted the
following window is displayed asking the user whether
to format the media.

3-26
 Figure 3-16. Media formatting window

Enter a new label and select OK.

NOTE: Only the following characters and signs can be used
when labeling a media: A - Z, a - z, 0 - 9, “_” and “-”. Do
not use more than 11 characters or signs. Do not use
space.
The media is formatted and ready to use.
• If the CD/DVD is not empty, the Add files window is
displayed.

Figure 3-17. Add files windows

Select OK.
The system is preparing the media to allow addition of
new files.
NOTE: If Eject is selected, the user is prompted to insert
another media. If No is selected, the Transfer window is
displayed (Figure 3-15), where the user can select
another destination.
7. Press Add to list to make the selected items ready for
transfer, or press Add all to make all available items ready
for transfer.
Depending on the source and destination selected the
following may be available:
3-27
 • Delete after copy: the item selected will be deleted
from the source archive after transfer to the destination
archive.
• Anonymize: remove patient related information from
the items transferred. You may enter a Prefix to replace
the patient name and ID with the prefix followed by an
increasing number. The prefix should not contain any
patient identifying data.
8. Press Copy.
NOTE: If Delete after copy is selected the user will be asked to
confirm the action.
9. If one or more patient records or examinations are already
present in the destination archive, the Matching patient/
exam data window is displayed.

Figure 3-18. The Matching patient/exam data window

10. Select between:

• Transfer only exams that are not in the destination.
• Transfer all, overwrite the matching patients and
exams.
• Go to advanced options.
• Cancel transfer
The Advanced option window is displayed.

3-28
 Figure 3-19. The Advanced option window

Select the items to overwrite.

Overwrite patient information. The exams are not overwritten.

Overwrite examinations. The patient information is not

overwritten.

Overwrite both patient information and examinations.

Press Transfer.
The transfer operation is started. The Copying patients
window is displayed showing the progression of the transfer.

3-29
 Figure 3-20. The Copying patients window

Each successfully transferred item is marked with a check

mark in the transfer list.

Figure 3-21. List of transferred items

NOTE: Press Clear transferred to clear the list of transferred

items.
11. Press Close to return to the Archive screen.

3-30
 Disk management

Introduction
The Disk management function allows the user to manage hard
disk space while maintaining the patient database on the
system. The Disk management function can be used to move,
copy or delete images and move or copy reports from the oldest
patient records. The Disk management function has also an
auto-purge feature that will automatically delete images and
reports that have already been copied if the local hard disk is
getting full.
Three different disk management scenarios are possible
depending on the system configuration:
• Disk management is set to move files: the user runs the
Disk management function on a regular basis to move
images and reports from older patient records to removable
media or to a network volume. Using this setting, moved
images and reports are deleted from the local hard drive and
copied to the specified destination. This scenario prevents
the local disk to fill up and keeps images and reports from
the most recent patient records on the local disk. Using this
scenario, the user can control what should remain on the
system while keeping the disk free space at an operational
level.
• Disk management is set to copy files: the user runs the Disk
management function on a regular basis to copy images
and reports from older patient records to removable media
or to a network volume. To prevent the local disk to fill up,
the auto-purge function automatically deletes files that were
previously copied when the disk free space has reached the
minimum allowed limit. This scenario lets the system
automatically manage the disk space on the system.
NOTE: When using this setting, the original images will be retrieved
from the local hard drive as long as they are available there.
When the images are deleted from the local hard drive by
the auto-purge function, the copied images will be retrieved.
• Disk management is set to delete files: the user runs the
3-31
Disk management function on a regular basis to delete
images from older patient records.
 NOTE: Ensure that you have established a data management protocol
for your office/institution. The user MUST manage the
removable media used when running Disk management by
keeping a log and by creating a media filing system.
A person should be in charge of performing the process. The
Disk management system can be set up so that a reminder is
displayed at regular intervals.
It is always highly recommended to take a backup of moved/
copied files, which is the responsibility of the customer. The unit
does not offer functionality for taking backup of images and
reports saved on long-term storage media.

Configuring the Disk management function

Configuration of the Disk management system can only be done
by user with administration rights.
1. Press Config (F2).
If required log on as administrator.
2. Select the category Connectivity.
3. In the Connectivity category, select the sheet Disk
management.

3-32
 1. Sets the reminder time interval for running Disk management.
2. Sets the files to be managed based on the examination dates.
3. Sets the Disk management to copy, move or delete images.
4. Sets the destination device.
5. Starts Disk management.

Figure 3-22. The Disk management sheet

Disk management schedule setting

1. Next to Reminder interval, specify the number of days/

weeks you want the system to prompt you to perform disk
management.
This setting should be set based on the activity of your
office/institution.

Data management settings

1. Select a number of days, weeks or months next to Manage

files older than. Only files older than the specified setting
will be copied, moved or deleted.
If Today (all files) is selected, all files will be copied or
moved.
2. Next to Operation check:
• Copy: the images and reports from the examinations 3-33
older than the specified setting defined in step 1 are
 copied to the specified destination. Using this setting,
the files will exist in two locations, the local hard drive
and the destination.
• Move: the images and reports from the examinations
older than the specified setting defined in step 1 are
copied to the specified destination, verified and then
deleted from the local hard drive. Using this setting, the
files will exist in one location, the destination media.
They are removed from the local hard drive.
• Delete: the images from the examinations older than
the specified setting defined in step 1 are deleted from
the hard drive.

Destination device setting

1. Next to Destination device, select a removable media or a

network share folder.
NOTE: When a network share folder is selected the path to the
folder must be entered. Press Check to verify the
connection.

CAUTION If using removable media, it is recommended to use dedicated

media to the Disk management process. Removable media
used for data backup must not be used when performing Disk
management.
Do not use the same removable media on several systems.

Running the Disk management function

The Disk management function can be run at any time. In
addition, the user may be prompted to run Disk management if
the time since the last Disk management operation performed
has reached the setting for the Reminder interval (see
page 3-33), or if the local hard drive is about to be full.
Disk management can be run from the Archive screen (see
below) or from Config/Connectivity/Disk management
(Figure 3-22 on page 3-33).

Manual start of Disk management

1. Press Archive.
The Archive screen is displayed.
3-34
2. Press Disk management.
 The Disk management window is displayed (Figure 3-23).

Figure 3-23. The Disk management window

The Disk management operation will either copy, remove or

delete files from the local archives depending on the Disk
management configuration (see page 3-32). Make sure the
correct configuration is set.
Prepare the destination device(s). If a connected USB
device is used, make sure the correct device is selected.
If using CD/DVD, the operation may require several disks as
specified in the Disk management window. Make sure that
the specified number of disks are available.
NOTE: CD/DVD do not need to be formatted.
3. Press Start.
The Disk management processing files window is displayed
showing progression of the process (Figure 3-24).

3-35
 Figure 3-24. The Copying files window

If using CD/DVD as destination device, the system

automatically formats the disks if required. If the media is
formatted the user will be asked to enter a label for the
media.
NOTE: The media label should have an identification of the system
the Disk management is run from.
NOTE: Disk management is aborted if the destination device
contains a database backup or exported patient data.
The information displayed on the Disk management
processing files window is updated while the files are being
copied.
4. If more than one media is necessary a dialogue window is
displayed asking the user to insert a new media.
Press OK after the new media is inserted.
The operation is resumed.
5. When all the files are copied, the Disk management
completed window is displayed (Figure 3-25), showing the
list of processed examinations, the media used and a
detailed log.

3-36
Figure 3-25. The Disk management completed window

• Select Print exam list to print the list of processed

examinations.
• Select Print media list to print the list of media.
• Select Print details to print the detailed log.
6. Make sure that all media are physically labeled according to
the list displayed in the Disk management completed
window. The media label should also have an identification
of the system the Disk management was run from.
7. Press OK.
See page 3-38 to perform a database backup.

3-37
 Data Backup and restore

Introduction
The Backup/Restore function enables the user to:
• Copy/Restore the patient archive.
• Copy/Restore the system configuration. The Copy/Restore
system configuration feature enables the user to configure
several units with identical presets, providing that the units
have the same software version.
To minimize accidental loss of data, perform backup of the
patient archive stored on the local harddrive at least once a
week.

WARNING GE is not responsible for lost data if the suggested backup

procedures are not followed and will not aid in the recovery of
lost data.

There is no backup function for the images or reports (no

creation of a safety copy). For long-term storage, images and
reports should be moved to a USB HD or to a network shared
folder using the Disk management procedure (see page 3-31).

CAUTION DO NOT use the local harddrive for long-term image storage.

NOTE: Only users with Windows administrator rights have access to the
restore function.

Backup procedure
1. Press Archive.
2. In the Archive screen, select the dataflow Local Archive -
Int. HD.
3. Press Config (F2). 3-38
4. Select the category Admin.
 5. Select the Backup sheet.

Figure 3-26. The Backup sheet

6. In the Backup sheet select as needed:

• Patient archive to backup the patient records.
• System configuration to copy system settings and
user presets.
7. Select a removable media or a shared network folder as
destination.
NOTE: To be able to select a network share folder, the path (of type:
\\server-name\share-name) must have been entered in the
Remote path field.
8. If the backup is done to a removable media, insert a
dedicated media in the drive.
9. Select Start backup.
The following situations may occur:
• The system is checking that the removable media is
inserted. If not, a dialogue window is displayed
prompting the user to insert a media.
3-39
 Figure 3-27. The Insert media window

Insert the media and select OK.

• If using a CD/DVD, the system is checking if the media
needs to be formatted. If yes, a dialogue window is
displayed prompting the user to enter a media label.

Figure 3-28. The Enter media label window

Type in a label for the media and select OK.

NOTE: Only the following characters and signs can be used
when labeling a media: A - Z, a - z, 0 - 9, “_” and “-”. Do
not use more than 11 characters or signs. Do not use
space.
NOTE: If you select Eject you can perform the backup using
another removable media. If you select Cancel the
backup operation is stopped.
• The system is checking if there is already a backup or a
Disk management copy on the media. If the following
error message is displayed, the disk is ejected and the
user is asked to use a new media that does not contain
any backup or Disk management data.
3-40
 Figure 3-29. The Replace current media window

Insert a new media and select OK.

NOTE: To reuse a Backup CD/DVD when performing a new
archive backup, the media has to be re-formatted first.
10. During backup, progress windows are displayed showing
the current operation being performed.

Figure 3-30. The Backup progress window

11. At the end of the process, the Backup completed window is

displayed.

Figure 3-31. The Backup completed window 3-41

 Select OK.
The Backup result is displayed on the Backup sheet.
12. Make sure to physically label the media. An identification of
the system should also be noted on the media and a backup
log should be kept.
File the media in a safe place.

Restore procedure
1. Press Config (F2).
2. Select the category Admin.
3. Select the Restore sheet.

Figure 3-32. The Restore sheet

4. In the Restore sheet select as needed:

• Patient archive to restore the patient archive.
• System configuration to restore all system settings 3-42
and user presets.
 OR
• One or several system configuration items to restore
parts of the system settings and user presets (see
Figure 3-32).
5. If restore is done from a backup on a removable media,
insert the media in the drive. Make sure that Restore from
Source Device is selected.
6. Select the appropriate Source device.

CAUTION The Restore procedure will OVERWRITE the existing data

on the local harddrive. Make sure to insert the correct
media and select the correct source device.

7. Select Restore now.

Depending on the selection of items to be restored, one or
two restore confirmation windows are displayed:

A B

a. Displayed if the patient archive is to be b. Displayed if any of the system settings are to
restored. be restored.

Figure 3-33. The Restore confirmation window

8. Ensure that the correct source is selected an select OK.

The selected items are copied to the systems.
9. If connectivity configuration settings are restored the
following information window is displayed.

3-43
 Figure 3-34. Information window

10. Select OK.

The System shutdown window is displayed.

Figure 3-35. The System shutdown window

11. Select OK to shut down the system.

12. Restart the system.
If connectivity configuration settings have been restored,
make sure to save the TCP/IP settings: select Config/
Connectivity/TCPIP and select Save settings. The system
needs to be restarted again.

3-44
 EchoPAC Share

Introduction
EchoPAC Share is an option that enables the
EchoPAC Software Only to be used as a server for up to four
different GE clients.
The following GE devices can be connected:
• Vivid E95
• Vivid E90
• Vivid E80
• Vivid S70
• Vivid S60
• Vivid E9
• Vivid E7
• Vivid S5/S6
• Vivid q
• Vivid i
• Vivid T8/T8 Pro
• Vivid 7 (v. 2.x or higher)
• EchoPAC Software Only (v. 4.x or higher)
The GE clients connect directly via proprietary protocol to
EchoPAC Software Only for both storage and retrieval of patient
and image data. Without the option EchoPAC Share, only one
single GE client can be connected to the workstation.

EchoPAC Share activation

The EchoPAC Share activation requires Windows administrator
rights.
1. Start EchoPAC Software Only and log on as administrator.
2. Press Config (F2).
3. Select the Admin category and System Admin subgroup.
4. In the System Admin sheet, press New. 3-45
5. Enter the EchoPAC Share option key and press Save.
 6. Exit EchoPAC Software Only.

Port settings

The following ports need to be opened.

EchoPAC Software Only with EchoPAC Share installed

• 2638 (TCP)
Open either
• 139 (TCP), 137 (UDP), 138 (UDP) if NetBIOS is enabled.
or
• 445 (TCP) if NetBIOS is disabled.

Clients connecting to EchoPAC Software Only with EchoPAC Share installed

• 5050 (TCP) to 5060 (TCP)

Activation on Windows 7 computers

The procedure described below is required only once after

entering the option key.
1. Press the Windows Start button and enter cmd in the
Search field.
2. Right-click cmd.exe and select Run as Administrator.
Login as administrator if required.
The Command window is opened.
3. Type %TARGET_ROOT%\bin\EchoPACStarter.exe in the
Command window and press Enter.
EchoPAC Software Only is started with enabled
EchoPAC Share option.

3-46
 Configuration – System and presets

General system settings

1. Press Config (F2) and log on as administrator if required.
2. Select the System category and Settings subgroup.
The Settings sheet is displayed.

Figure 3-36. The Settings sheet

3-47
Location

1. Hospital: Enter the hospital name. This information is

displayed on the scanning screen's Title bar and on the
image properties of all saved images.
2. Department: Enter the department name. This information
is displayed on the image properties of all saved images.

3-48
Date and time

Changes will be effective only after rebooting the system.

1. Date: Select the correct date from the pop-up window.
2. Time: Select either hour, minute or second, and then press
the arrow head buttons to set the time.
3. Time Format: Select the desired format (24 or 12 AM/PM)
from the pop-up menu.
4. Date Format: Select the desired format (EU or US) from the
pop-up menu.

Language, units and video settings

Changes will be effective only after rebooting the system.

• Language: select the desired language for the system from
the pop-up menu.
• Manual Language: select the desired language for the
Online manual. If not available the English manual will be
displayed as default.
• Units: select the desired units (Metric or US) from the
pop-up menu.

3-49
System users

Figure 3-37. The Users sheet

The system requires operator registration.

3-50
 The users are divided in groups with different rights as shown
below.

Right (see definition below)

Preset admin

Store report
Print report
Diagnose

Service
Create

Admin
Delete

Group

Cardiologist + + + + Activated with

a Dongle
Physician + +

Sonographer + +

Fellow + +

Sys Admin + + + +

Hosp admin + +

GE admin + + + +

Diagnosing physician +

Referring doctor

The rights associated to the user groups are:

Right Definition

Create Create and update patient record, examination, user and referring
members.
Transfer patient records and examinations.
Move examinations.

Delete Delete patient record, examination, user and referring members.

Diagnose Make the Diagnosing physician available in the Patient info and exam
screen. Sign off report.

Preset admin Make application presets protected.

Delete protected application presets.

Print report • Print a report

Store report • Store reports, sign and unsign reports

Admin • System administration

Service • Access to the service platform

1. Press Config (F2) and log on as administrator if required.

3-51
2. Select the Admin category and Users subgroup.
 The Users sheet is displayed.

Creating a user or a referring member

1. Press New.
2. Enter the user’s information.
3. Select the type of user/referring member in Member of
Group(s).

CAUTION To be able to login on the system, the group Operator

MUST be selected.

Editing a user configuration

1. Select the actual user in the User list.

2. Make the desired changes.
3. Press Config (F2) to exit the Configuration management
package.

Deleting a user

1. Select the actual user in the User list.

2. Press Delete.
The user is removed from the User list.

Auto logon and auto screen lock

Auto logon
1. Select the desired logon setup from the pull down menu:
• Disabled: No default user is selected when logging on.
• Last user: The last user is selected automatically when
logging on.
• A specific user: Select one of the users to be the
default user when logging on.

Auto screen lock

1. Set the time span (from 10 min.) for the system to
automatically get locked when not in use. When the system
is locked, the current user may either log on again or the
3-52
system may be restarted by a different user.
 Configuration – Archiving

Configuration of the archiving functions

1. Press Config (F2) and log on as administrator if required.
2. Select the Connectivity category and Formats subgroup.
The Format sheet is displayed.

Figure 3-38. The Formats sheet

3-53
Configuration of the Patient, Worklist and Examination list in the Archive
screen

1. In the List type drop-down menu, select the list to edit.

2. To add a column to the list:
• Select a column to display in the Available columns field
and press to add it to the list.
• Press / to move the column.
3. To remove a column from the list:
• Select the column to remove in the Show columns field
and press .
NOTE: The columns First name, Last name, Patient ID, Last
exam and Exam date cannot be removed for the lists.

Patient management presets

The following settings related to patient management can be

adjusted:

Setting Description

Automatic generation of patient ID In the Archive screen (see Figure 3-1 on page 3-4),
: A Patient ID is automatically generated by the
system.
: A Patient ID is required and must be entered by the
user when creating a new patient record in the archive.

Request acknowledge of End Exam action : The user is asked to confirm action when ending
an examination.

Go directly to scanning from search: : The unit goes directly to the Scanning screen after
creating a patient record.
: The unit displays the Patient info and exam screen
after creating a patient record for further information
entry. The user must press Patient or one of the
scanning keys on the Control panel to enter the
Scanning screen.

Exam screen/Report headings Enter user-defined headings for Comments, Diagnosis

and Referral reasons fields in the Patient info and
exam screen.

3-54
 Setting Description

DICOM images Select between:

• No extra info
• Add visible patient info in the DICOM images:
displays patient information (name, date of birth and
ID) on DICOM images.
• Add title bar: adds the Title bar to the DICOM
images.
Use high DICOM resolution: when enabled, DICOM
images are stored using a higher pixel density. Use this
setting when exporting to systems accessed by high
definition DICOM viewing stations.
Note: Using high DICOM resolution will double the file
size of the DICOM data when using standard
compression settings. Such files will consume more
disk space and also slow down storage, recall and
transfer of files.
Movie optimized: temporal filtering on DICOM images
for enhanced image representation on DICOM
workstations.
Color management: provides a selection of gamma
settings for optimized representation of the Vivid
images on DICOM workstations.

TCP/IP configuration
To be able to use the network functions when connected to a
hospital network, the system must have a proper network
address. Typically source for this information is the network
administrator.
NOTE: Only users with Windows administrator rights can perform TCP/
IP configuration.
1. Press Config (F2) and log on as administrator.
2. Select the Connectivity category and TCP/IP subgroup.
The TCPIP subgroup is displayed.

3-55
1. Section My Computer
Computer name: not editable
IP address: press Network Settings to edit the IP address in Windows
AE Title: default = Computer name
Port number: default = 104
2. Section Server Config
Add, modify or remove server connections (EchoPAC Software Only, EchoServer, ImageVault).
3. Path and Configurable remote path user section: see page 3-64.
4. Save TCP/IP settings. The changes will be effective after the system is rebooted.
5. DICOM section: check Detailed DICOM Log to log connection activity against the DICOM server.
Useful if experiencing problems with connection to the DICOM server.

Figure 3-39. TCP/IP subgroup

3. Select Network settings to configure:

• The IP address for the system
• The subnet mask for the system
• The IP address for the Default Gateway
4. Press Save settings and reboot the system. 3-56
Create or modify a server IP address

Follow the steps below if the IP address settings for the server
need to be modified or created:
1. In the Server config section, select the server and press
Modify (or press Add if creating a new IP address), see
Figure 3-39 on page 3-56.
The Server config window is displayed.

Figure 3-40. The Server config window

2. Enter the name and/or IP address of the server and press

OK.
3. Press Save settings.

Dataflow
Communication between the EchoPAC Software Only
ultrasound unit and other information providers on the network
takes the form of dataflows. Each dataflow defines the transfer
of patient information and images from an input source to the
unit, and from the unit to one or several output sources.

Dataflows available

A set of pre-defined dataflows is available on the unit as listed in

the table below.

Dataflow Description

LocalArchive-Int.HD The local database is used for patient archiving.

Images are stored to internal harddrive.

DICOM MOD 5.25 Read DICOM 5.25" Magneto Optical Disk

Read DICOM Media from the 5.25'' MO-drive.
Read only dataflow, no data can be stored.
3-57
 Dataflow Description

DICOM MOD 3.5 Read DICOM 3.5" Magneto Optical Disk

Read DICOM Media from the 3.5'' MO-drive.
Read only dataflow, no data can be stored.

RemoteArchive - RemoteHD A remote database (either on

EchoPAC Software Only or a server) is used for
patient archiving. Images are stored to a network
image volume (either internal HD on
EchoPAC Software Only or a server).

DICOM CD/DVD read Read DICOM Media from the CD/DVD-drive.

Read only dataflow, no data can be stored.

DICOM Query Retrieve Retrieve images from a DICOM server based on

query parameters.

DICOM USB Harddisk/Memstick Read Read DICOM data from an USB device. Read
only dataflow, no data can be stored.

LocalArchive - Int HD/DICOM Server The local archive is used for patient archiving.
Images are stored to the internal hard drive and to
a DICOM server.
Some of the measurements are stored if
DICOM SR is turned on.

Remote Archive - Remote HD/DICOM Server A remote database is used for patient archiving.
Images are stored to a network image volume and
to a DICOM server.
Some of the measurements are stored if
DICOM SR is turned on.

DICOM Query Retrieve - DICOM Server Retrieve images from a DICOM server based on
query parameters. Images are stored to a DICOM
server.
Some of the measurements are stored if
DICOM SR is turned on.

Dataflow adjustments

1. Press Config (F2) and log on as administrator if required.

2. Select the Connectivity category and Dataflow subgroup.
The Dataflow sheet is displayed.

3-58
 1. Select a dataflow to configure.
2. Default: use selected dataflow as default (see page 3-64).
Direct Store: store data directly to archive.
Hidden: hide selected dataflow from the list of available dataflow in the Archive screen and in the
source and destination lists of the file transfer function.
3. Option for the search function in the Archive screen: select between
• None: no direct search performed while entering data
• All patients: direct search is performed among all patients in the database.
• Today’s patient: direct search is performed among today’s patients.
4. Input/output devices assigned to the current dataflow.
5. Adjust the settings for the selected assigned device.

Figure 3-41. The Dataflow sheet

Adjusting the assigned devices

1. Select the dataflow to configure.

2. Select the input or output device to configure.
3. Press Properties.
The Properties window is displayed.
4. Adjust the device specific parameters as desired (see table
below). Not all the settings listed below apply to all devices.

General settings Definition

Name Free text: give a descriptive name for the device.

IP address Select from drop-down menu (if available)

Database Location Automatically selected according to the IP address

File destination Automatically selected according to the IP address 3-59

 General settings Definition

Type Choose between R (Read), R/W (Read/Write), W (Write) and

No Media.

MPPS Modality Perform Procedure Step: send information (typically to a HIS)

that a scheduled exam has been started, performed or interrupted.

Image settings Definition

Allow raw data : Save data in both raw and DICOM format.
: Save data in DICOM format only.

Raw Compression Enables compression of raw data images upon storage and export. Raw
compression is active only if the setting Allow raw data is checked.

Max Frame rate Select 25, 30 or Full (original acquisition) from the pop-up menu.

Compression Select compression type or no compression.

Quality Set picture quality from 1 to 100%. A low picture quality level allows high
data compression, while a high picture quality restrains the
compression.

Allow Multiframe : Allow cineloop storage.

Connection settings Definition

Retry Set maximum number of connection retries, time interval between

tentative and time-out.

DICOM settings Definition

AE Title The Application Entity Title is set during DICOM configuration. Refer to
the network specifications.

Port The Port no. is allocated during DICOM configuration. Refer to your
network specifications.

Verification Verify the connection to another DICOM application.

Storage commitment Send a request to a PACS, asking it to permanently archive image(s).

MPPS Modality Perform Procedure Step: send information (typically to a HIS)

that a scheduled exam has been started, performed or interrupted.

3-60
 DICOM settings Definition

DICOM SR settings • Allow SR: enable DICOM SR.

• Allow SR private data: include current exam data in a private format
within DICOM SR to retain measurements and complete exam
information when recalling an exam from a DICOM environment. This
is especially important if EchoPAC Plug-in is used in the DICOM
environment or if any exam at any later time is expected to be recalled
to Vivid or EchoPAC Software Only using DICOM Query/Retrieve. If
the DICOM server does not allow the private data format within
DICOM SR files, this feature should be disabled.
• Signed Doppler velocities: send signed Doppler velocities.
• Use older SR version: when checked a Use older SR version
pull-down menu is displayed. The current exam data will be sent in the
same format as the selected SR version. Details about format and
content of the SR version can be found in the corresponding user
manual of the selected version.
See also ‘DICOM SR’ on page 3-61.

DICOM SR

DICOM Structured Reporting (SR) is a standardized format for

medical results. EchoPAC Software Only supports the
specialized form for Echo Ultrasound (“TID 5200
Echocardiography Procedure Report”) and Vascular Ultrasound
(“TID 5100 Vascular Ultrasound Procedure Report”) for M&A
results.
With the DICOM SR support, M&A for an exam can be sent at
the end of the exam or when exported from local archive. The
destination can be either a server on the network (Storage SCP)
or a removable media (DICOM Media) depending on the
DICOM dataflow selected.
“TID 5200 Echocardiography Procedure Report” is sent if the
exam contains M&A from category Cardiac or Pediatric (Heart).
“TID 5100 Vascular Ultrasound Procedure Report” is sent if the
exam contains M&A from category Vascular or Abdominal. If the
exam contains M&A from both Cardiac/Pediatric (Heart) and
Vascular/Abdominal categories, two SR documents are sent.
“TID 5200 Echocardiography Procedure Report” and “TID 5100
Vascular Ultrasound Procedure Report” do not support all M&A
results from EchoPAC Software Only. They are limited to the
following:
• No unassigned measurement.

3-61
 Refer to the EchoPAC Software Only Reference manual for
a complete list of supported parameters.
• The following modes: 2D, M-mode, Color Flow, PW Doppler,
CW Doppler, 3D and TDI.
• Not Modified Simpson method or Bullet methods.
Refer to the EchoPAC Software Only Reference manual for
a complete list of supported methods.
• Basic derivations (Average, Last, Min and Max), no
references between the derived measurements and the
ones they were made from.
• Wall Motion Scoring: individual segment scores only
according to 16-segment model, no graded Hypokinesis
(only Hypokinesis is used).
DICOM SR must be activated for each DICOM device.
1. Press Config (F2) and log on as administrator if required.
2. Select the Connectivity category and Dataflow subgroup.
The Dataflow sheet is displayed.
3. Select the DICOM dataflow to configure in the Dataflow
pull-down menu.
4. Select a DICOM storage device and press Properties.
The Properties window for the selected DICOM storage
device is displayed.

3-62
 Figure 3-42. DICOM storage properties window

5. Check the option Allow SR to enable DICOM SR.

The following additional options are available:
• Allow SR private data: include current exam data in a
private format within DICOM SR to retain
measurements and complete exam information when
recalling an exam from a DICOM environment. This is
especially important if EchoPAC Plug-in is used in the
DICOM environment or if any exam at any later time is
expected to be recalled to Vivid or
EchoPAC Software Only using DICOM Query/Retrieve.
If the DICOM server does not allow the private data
format within DICOM SR files, this feature should be
disabled.
• No images: no images are sent, only M&A.
• Signed Doppler velocities: send signed Doppler
velocities.
• Use older SR version: when checked a Use older SR
version pull-down menu is displayed. The current exam
data will be sent in the same format as the selected SR 3-63
version. Details about format and content of the SR
 version can be found in the corresponding user manual
of the selected version.
These settings apply to both “TID 5200 Echocardiography
Procedure Report” and “TID 5100 Vascular Ultrasound
Procedure Report”
6. Select OK.

Default dataflow selection

1. Press Config (F2) and log on as administrator if required.
2. Select the Connectivity category and Dataflow subgroup.
The Dataflow sheet is displayed (see Figure 3-43).
3. Select the desired dataflow in the Dataflow pull-down menu
and check the option Default.
4. Press Config to exit the Configuration management
package.

1. Select a dataflow
2. Default option for the selected dataflow

Figure 3-43. Default dataflow setting

Default remote path setting

The user can define a default remote path for a network shared
folder (\\server-name\share-name). The default remote path can
then be selected as a destination archive for the following
operations:
• Export traces function in Q-Analysis
• Export of system error log file
• Export of report templates
• Save as function for images
• Save as function for reports 3-64
 To define a default remote path:
1. Press Config (F2) and log on as administrator if required.
2. Select the Connectivity category and TCP/IP subgroup.
The TCT/IP sheet is displayed.

Figure 3-44. The TCP/IP sheet

3. In the Remote Path section, enter a remote path of a shared

folder on the network.
To check the connection, press Check.
4. In the Configurable Remote path user section enter the user
name and password required to access the shared folder.

XML and MPEG Vue Export configuration

The destination for transfer of patient records to XML and MPEG
Vue formats must be configured prior to use. See ‘Transferring
patient records/examinations’ on page 3-24 for a description of 3-65
the transfer function.
 To configure the Transfer function:
1. Press Config (F2) and log on as administrator.
2. Select the Connectivity category and Dataflow subgroup.
The Dataflow sheet is displayed (Figure 3-45).
3. Select the dataflow Misc. Export.

Figure 3-45. The Dataflow sheet (Misc. Export)

Transfer to MPEG Vue and XML format - configuration

1. Select either the XML Export Service or MPEG Vue

Service device and press Properties.
The corresponding properties window is displayed.

3-66
 Figure 3-46. The MPEG Vue and XML Export Service properties window

2. Select a removable media or a network volume remote path

as the destination in the Destination pull-down menu.
3. If Remote path is selected, enter the remote path and press
Check to verify the connection.
4. Select OK and press Config.

Additional outputs
The Additional outputs sheet deals with configuration of the
Alt. store 1 and Alt. store 2 buttons. Several outputs (e.g.
Laser print, DICOM storage...etc.) can be associated to the
buttons (i.e. pressing Alt. store 1 can result in printing to a
printer and storage to a DICOM media).

3-67
 1. Select between Alt store 1 and Alt store 2 buttons.
2. Available output devices that can be assigned to the current button.
3. Output devices assigned to the current button.
4. Add or remove selected device to/from the current button.
5. Adjust the device settings of the selected assigned device.
6. Select the type of images to produce and adjust image settings.
7. Printer configuration

Figure 3-47. The Additional outputs sheet

Alt. store 1 / Alt. store 2 button configuration

1. In Button field select Alt. store 1 or Alt. store 2.

2. Select an output device in the Available output field and 3-68
press the Right arrow button to assign the device to the
selected button.
 The Properties window for the selected device is displayed,
if configurable.
3. Adjust the device specific parameters and select OK.
4. Adjust the image specific parameters (see table below).

Image parameters

Format Select between:

• Raw DICOM
• DICOM

Image compression Select compression mode or no compression.

Quality When JPEG compression is selected, adjust the picture quality

between 1 and 100%. A low picture quality level allows high data
compression, while a high picture quality restrains the compression.

Image frames Select between:

• Single: stores single frame only
• Multiple: stores cineloops
• Secondary Capture: stores a screen shot

Capture Area Select between:

1. Video Area (1)

2. Whole Screen (2)

To remove a device, select the device in the Selected devices

field and press the Left arrow button.

Note regarding TomTec application

To be able to store secondary capture from the TomTec
application to the EchoPAC Software Only clipboard, the
Alt. store 2 button must be configured as follows:
• Output device: Store to clipboard
• Image frames: Secondary Capture
• Capture area: Whole screen

3-69
Other

Figure 3-48. The Other sheet

Database maintenance

1. Press View Audit Log.

The Audit log viewer window is displayed.
2. Adjust the filters as required and press Search.
A log is generated showing the activity on the unit.

Figure 3-49. The Audit log viewer

3. Press Save results to save the log file.

The Save as window is displayed. 3-70
4. Select the destination media and enter a file name.
 5. Press Save to save the log file.

Activity report

The Activity report function enables the creation of a report

based on study type and user for a defined time frame.
1. Press View activity report.
The Activity report window is displayed.
2. Adjust the time frame, select the type of studies and users.
3. Select whether to print or save the report as a file.
4. Press Send to create the report.

Figure 3-50. The Activity report window

Unlock patients

If for any reason an examination is not properly finished, the

patient record is locked and cannot be opened again unless it is
unlocked.
To unlock patient records:
1. Press Config (F2).
2. Select the Connectivity category and the Other subgroup.
3. In the Other sheet, select the patient record(s) to unlock. 3-71
 You can search for a specific patient record or a group of
patient record using the searching filters.
4. Select Unlock to unlock the selected patient record(s) or
select Unlock all to unlock all patient records listed.
A Confirmation window is displayed.
5. Select OK.

3-72
 Chapter 4

Image Management

‘Introduction’ on page 4-2

‘Image review’ on page 4-3

‘Image optimization’ on page 4-6

‘Saving images and cineloops to a standard format’ on

page 4-32

‘DICOM spooler’ on page 4-38

‘Configuration – Imaging’ on page 4-40

4 -1
 Introduction

EchoPAC Software Only allows post-processing of DICOM

ultrasound images and raw data images from GE ultrasound
scanners.
The main features of the EchoPAC Software Only image
analysis package are:
• Image optimization: adjust image settings such as:
Compress, Reject, Tissue priority, zooming, image rotation,
cineloop replay adjustment...etc. 4D image optimization can
perform Cropping, Slicing, Translation, Rotation... etc.
• Measurement and Analysis: perform either single
measurement with post-assignment or pre-assigned
measurements (see ‘Measurements and analysis’ on
page 5-1).
• Review and analyze protocol studies such as Stress echo
examinations including quantitative stress echo analysis
(see ‘Stress Echo’ on page 6-1).
• Quantitative analysis of Tissue Velocity, Tissue Tracking
and contrast imaging data (see ‘Quantitative Analysis’ on
page 7-1).

CAUTION The images and calculations provided by the system are

intended for use by competent users, as a diagnostic tool. They
are explicitly not to be regarded as the sole basis for clinical
diagnosis. Users are expected to study the literature and reach
their own professional conclusions regarding the clinical utility
of the system

4 -2
 Image review

Introduction
Images can be reviewed from the Image browser screen or from
the Images review screen.
• The Image browser screen displays a thumbnail overview of
all stored images sorted by examination session for the
current patient.
• The Image review screen displays all images for the current
examination.

Review from the Image browser screen

The procedure described below allows the analysis of images
belonging to different examinations for a selected patient record.
1. In the Patient info and exam screen, press Image browser
menu button.
The Image browser screen is displayed (see Figure 4-1)
showing thumbnails of stored images for the actual patient
sorted by examination.
2. Select the images to analyze or press Analyze to review all
images.

4 -3
1. Missing image

Figure 4-1. The Image browser screen

If an image is stored on removable media, the Image browser

screen will show a symbol instead of the image thumbnail.
When such images are selected for analysis, the image needs
to be restored from the removable media before it can be
analyzed. The system will then display dialogs explaining and
guiding through the image restore process.

Review from the Review screen

1. In the Patient info and exam window, select an examination
and press the Review menu button.
The Review screen is displayed showing all images for the
current examination (see Figure 4-2).
2. Use the Review page controls to browse through all
images.
3. Select the images of interest and press Analyse.

4 -4
 Figure 4-2. The Review screen

To delete an image

Images can be deleted from the Review screen or from the

clipboard.
From the Review screen:
1. In the Review screen, select the images to delete.
2. Press Delete.
A warning message is displayed asking the user to confirm
the action to perform.
3. Select Yes.
From the clipboard:
1. Press the Right mouse button over the clipboard cell
displaying the image to delete.
2. Select Delete clipboard cell from the context menu.
A warning message is displayed asking the user to confirm
the action to perform.
3. Select Yes.

4 -5
 Image optimization

After images have been selected for analysis, they are opened
in the Image analysis screen. This screen is where image
optimization can be performed.

Image analysis screen overview

The Image analysis screen consists of:
• a Display window showing up to 12 ultrasound images
(single frame and cineloop), see Figure 4-3.
• a Control panel for image optimization and analysis. The
control panel is mode-dependent.
• a top bar with often used controls (e.g. image store)
• a clipboard giving access to all images from the current
examination.

4 -6
1. Display window
2. Control panel
3. Top bar
4. Clipboard

Figure 4-3. The Analysis screen

4 -7
The Top bar

The following functions are available from the Top bar.

• Store: stores the currently active image to disk.
• Alt. Store 1 and 2: stores the image to an alternative media.
This function is configurable.

The Control panel

The Control panel gives access to image optimization and

analysis controls.
Using the three tabs the Control panel can be switched
between:
• Controls: displays the image optimization and analysis
controls (see below).
• Measure: activates the Measurement & Analysis (M&A)
calculation program (pre-assigned measurements, see
‘Measurements and analysis’ on page 5-1).
• Caliper: activates the measurement tools (unassigned
measurement, see ‘Measurements and analysis’ on
page 5-1).

4 -8
Image optimization Control panel

The controls available are mode dependent and

grouped into functional groups. Each group can
be collapsed or expanded to only display the
controls of interest.
Select the arrow in front of the functional group
heading to expand or collapse the group.

4 -9
Figure 4-4. The Control panel
Functional groups

Main controls

Run/Stop Starts/stops the cineloop.

Frame/Speed • Frame: selects the frame to display when in Freeze.

• Speed: adjusts cinespeed when the cineloop is running.

2D Gain Adjusts the 2D gain applied to the 2D image.

Gain In combined mode, adjusts the gain of the combined mode.

Commands

Q Analysis Starts Q Analysis (see page 7-1).

Findings Starts Structured Findings (see page 9-8).

Store Stores the currently active image to disk.

Alt Store 1 and 2 Stores the image to an alternative media. This function is configurable.

Modes

In combined mode, selects the mode to display.

Image settings

Displays the mode specific image controls.

Up/Down Flips the image 180 degrees.

Left/Right Creates a mirror image of the original image. The left/right reference marker V
moves to the other side of the image.

Color Maps Selects mode specific color map from the pop-up menu.

Invert Enables the color scheme assigned to positive and negative velocities to be
inverted.

Invert (TSI) Invert is available for TEE acquisitions. When applied, the time to peak negative
velocity is calculated (instead of the time to peak positive velocity). Invert makes
it possible to use TSI on TEE acquisitions where the image sector is inverted.

Variance Controls the amount of variance data added to a color display. Variance enables
computer-aided detection of turbulent flow (e.g. jets or regurgitation).

4-10
 Image settings

Baseline • CF
Adjusts the color map to emphasize flow either toward or away from the probe.
• Doppler
Enables the Doppler baseline to be shifted up and down. The default Doppler
baseline is set at the center of the vertical aspect of the Doppler display,
dividing evenly the flow toward and away from the probe. By adjusting the
baseline a larger portion of the analysis is assigned to the flow direction
present.
• TVI
Adjusts the color map to emphasize tissue motion either toward or away from
the probe.

Simultaneous Enables simultaneous display of 2D image and color image.

Apply to all Applies changes on all opened images.

Works for the following controls: Up/Down, Left/Right, Invert, Variance,
Persistence, Tissue priority, Gain, Compress, Reject, Baseline, Mode selection
and Color Map.

Reset Restores all controls to original setting.

Compare Displays a copy of the selected cineloop. Enables frame by frame comparison of
the selected cineloop (independent scrolling).

Layout Toggles the display priority of 2D Mode or Doppler/M-Mode and top/bottom or

side-by-side (1) display with 2D priority (2) or time-motion priority (3) or
time-motion only (4) when using combined mode.

TVI visible Turns TVI display on/off.

Compress Controls the amount of contrast.

DDP Performs temporal processing which reduces random noise without affecting the
motion of significant tissue structures.

Reject Discards low levels echoes when increased.

Zoom Magnifies the image display in both frozen and live (see ‘Zoom function’ on
page 4-15).

UD Clarity Enables the user to create a personalized appearance of the tissue. A decrease
of UD Clarity creates a smoother image, though keeping boundaries sharp. An
increase of UD Clarity creates a crisper image.

Edge Enhance Controls image processing related to the extent of edge enhancement applied to
an image.

Horizontal sweep Controls the time scale in the time-motion display.

Tissue Priority Emphasizes either the color of the color mode or the greyscale tissue detail of
the 2D image. 4-11
Angle Correct Enables stepwise angle correction (by 2 degrees) of the Doppler velocity scale.
 Image settings

Transparency Controls the degree of transparency of the color display.

Threshold Controls the level of greyscale intensity that is used as a threshold for color.

TT Start (Tissue Controls the time after ECG R-peak when the mode specific calculation starts.
Tracking)
Strain Start (Strain)

TT End (Tissue Controls he time after Track or Strain End when the mode specific calculation
Tracking should end.
Strain End (Strain):

TT scale Controls the color cut-off value of max displacement displayed.

SI length Determines the Strain/Strain rate sample volume size.

SRI reject Adjusts the cut-off level of the low tissue velocity to be discarded. Rejected
SI reject values are uncolored (Strain) or green (Strain rate).

Cine compound Calculates and displays cineloops generated from a temporal averaging of
multiple consecutive heart cycles.

SI scale Defines the scale for the color coding for strain or strain rate.
SRI scale

TSI Cut-off Controls the cut-off time: using this control it is possible to color all parts of the
TSI image that have a time to peak less than a certain cut-off time.

Number of images

1 to 12 Selects the number of images to display.

Cineloop

Displays the cineloop controls (see ‘Cineloop’ on page 4-16).

Annotation

Enables the insertion/deletion of body marks, arrows and text in the selected
image.

4D Controls

Depth/Color maps • Adjusts the volume rendering color from a color map menu.
• Depth color maps: these color maps use colors to improve the perception of
depth. Selecting the Depth bronze/blue color map will display structures that are
close to the view plane with a bronze color. Structures that are farther behind will
be colored with a gray color, while the structures that are farthest behind will be
colored in blue. Very bright colors are almost white, independent of the depth.

4-12
 4D Controls

Stereo Vision Stereo Vision: 4D Stereo vision is a display technique that enhances the perception
of depth in 3D renderings. This is achieved by mixing two different volume
renderings with slightly separated viewing angles and presenting them separately
to the user’s left and right eyes. Two types of stereo visions are supported:
anaglyph stereo vision and polarized stereo vision (see ‘Stereo vision’ on
page 4-25 for more information).

4D Home Sets the cut-planes and crop planes to the default position.

Angle Sets the cut-planes and crop planes to predefined positions.

Cine rotate Displays the volume rendering of a cardiac cycle that rotates continuously back and
forth.

Flexi-Slice Toggles the display between Volume rendering and Slice mode.

Laser Lines Enables the visualization of the 2D image locations in the volume rendering. The
2D image locations are shown as overlaying red or color coded lines following the
surface in the volume rendering. The color of the laser lines (white or green)
corresponds to the color coding used for the 2D images.

2-Click Crop Crop mode where two parallel crop planes are applied in the volume rendering. The
position and viewing direction are defined by clicking in two locations either in the
2D reference images or in the volume rendering. 2-click crop enables to quickly
extract any views for visualization of 4D structures.

Crop tool Enters the crop mode (see page 4-24).

View Crop Crop mode where the view plane and the crop plane always coincide.

Parallel Crop Crop mode where two parallel crop planes are applied (see page 4-24).

Flip Crop Sets the crop plane so that the opposite volume is cropped and the viewing
direction is flipped 180 degrees.

Multi Slice Enables simultaneous display of equidistant short axis views generated from a
volume acquisition. Alternative displays are available by pressing Layout on the
Control panel.

4D Views Enables quick access to standard 2D and 4D views. 4D Views is available in

Freeze and replay.

Dynamic Dynamic is a tissue tracking tool. When Dynamic is on the cropping plane applied
to the volume rendering is moving together with the tissue structure through the
entire heart cycle.
Available only for transthoracic acquisitions.

HD Live HD Live is an advanced visualization method that simulates light propagation and
scattering through tissue. The end result is rendered images with realistic looking
soft shadows.

UD Clarity Enables the user to create a personalized appearance of the tissue. A lower setting
creates a smoother image, though keeping boundaries sharp. A higher setting
creates a crisper image.

4D Clarity Selectable spatial filtering algorithm for noise reduction and smoothing both in 4D
and in extracted 2D slices. 4-13
 4D Controls

Volume optimize One touch button that optimizes the volume rendering by adjusting several display
controls simultaneously (e.g Shading, Smoothness... etc.).

Smoothness Affects continuity of structures and image noise in the volume rendering. Too much
smoothness will blur the image, too little will leave too much noise.

Shading Adjusts the shading effect on the volume rendering. Shading may improve three
dimensional perception.

Gamma Adjusts the brightness of midtone values. A higher gamma value produces an
overall darker image, a lower gamma value a brighter image.

Up/Down Flips the volume upside-down. Not available when alignment has been approved.

4-14
Image optimization
1. Select the image of interest.
The control panel displays the mode specific controls.
2. If applicable, press Stop to freeze the image and scroll
through the cineloop using the Speed/Frame control or by
dragging the frame marker on the ECG to display the
desired image.
3. In combined mode, press Layout until the desired display is
shown.
4. Adjust the mode specific image controls to optimize the
display.
5. Press Store to save the changes.

Zoom function

1. Adjust the Zoom control on the Control panel.

OR
Press Arrow up key to zoom in and Arrow down key to
zoom out
OR
Scroll mouse wheel up to zoom in and down to zoom out.
A portion of the selected image is magnified and a situation
picture is displayed showing the outlined zoom region.
2. Press and hold down Shift and use the Arrow keys to move
the zoomed area.
OR
Press mouse wheel and drag.

4-15
Cineloop

1.

1. Left marker (cineloop start) 2. Right marker (cineloop end)

2. Current frame 3. Cine speed

Figure 4-5. Cineloop display

The cineloop boundaries can be adjusted by dragging the left

and right markers on the ECG or by using the cineloop controls
as described below.

To run/stop a cineloop
1. Press Run/Stop or Alt + R or Space bar.

Cineloop adjustment
1. Select a cineloop.
2. If necessary, press Run/Stop to freeze the cineloop.
3. Press Cineloop.
The cineloop controls are displayed on the control panel.
4. Using the Cycle select control, move from heart beat to
heart beat to select the heart cycle of interest.
NOTE: To jump directly to the first or to the last heart beat press the
First cycle or Last cycle button.
5. Using the Num cycles, adjust the number of heart cycle to
incorporate to the cineloop.
6. Using the Left marker and Right right controls, trim or
expand the cineloop boundaries.
7. Check Sync to synchronize all the cineloops.

4-16
Generated Anatomical M-Mode

Anatomical M-Mode (AMM) displays can be generated from raw

data 2D, 2D Color and TVI images.

To generate Anatomical M-Mode images

1. In the Image analysis screen, select a 2D, 2D Color or TVI
image.
2. Select MM or AMM.
The Display window is updated with an M-Mode image. The
2D sector displays a time motion cursor for the AMM.
3. Adjust the AMM cursor position and angle as shown in
Figure 4-6.
All other controls are similar to conventional M-Mode (see
page 4-8 and followings).

1. AMM cursor angle adjustment 2. AMM cursor position adjustment

Figure 4-6. Adjustment of the AMM cursor

4-17
4D imaging optimization

Rotating/Translating the view plane or crop plane

Rotation and translation can be performed in either Volume

rendering or Flexi-Slice mode. Press Flexi-Slice to toggle
between the two modes.

Volume rendering mode

In Volume rendering mode, rotation applies to the viewing
direction onto the volume rendering. When View Crop on the
Control panel is selected, the viewing direction and the crop
plane rotate together. When View crop is deselected rotation
applies only to the viewing direction.
Rotation:
1. Place the mouse cursor in the image area.
2. Press and hold down the Left mouse button and drag the
mouse in any direction.
• Rotation with View crop selected: viewing direction and
crop plane always coincide.
• Rotation with View crop deselected: the viewing
direction rotates around the volume rendering. The crop
plane is not rotated.
To rotate around the Z axis, press and hold down Alt and
drag the mouse to the left or right, or place the cursor right
outside the top or bottom of the rendering and drag the
mouse to the left or right. the cursor is changed to .
Translation:
1. Place the mouse cursor in the image area.
2. Press and hold down Shift and drag the mouse up or down
to translate a crop plane into the volume.
Alternatively, adjust Translate on the Control panel.

Flexi-Slice mode
In Flexi-Slice mode each cut-plane may be rotated or translated
independently.
1. Press Yellow, White or Green on the Control panel to
select the Reference plane.
The volume rendering is updated accordingly.
2. Place the cursor at one of the extremities of a cut-plane 4-18
intersection line in one of the cut-planes. The cursor is
changed to . Drag to rotate the cut-plane.
 3. Place the cursor in the middle section of a cut-plane
intersection line. The cursor is changed to . Drag to
translate the cut-plane.
4. Place the cursor at the intersection between two cut-plane
lines. the cursor is changed to . Both cut-planes are
translated simultaneously.
5. Click on a point in the volume rendering to move the
intersection of the two other cut-planes to that location.
• If Depth Mode is turned on: the reference plane is also
moved inside the volume rendering to the
corresponding selected depth.
• If Depth Mode is turned off: the reference plane is kept
at the current depth.
6. Place the cursor at the outer area of one of the cut-planes.
The cursor is changed to . Drag to rotate the cut-plane
image. The cut-plane lines remain fixed.
7. Place the cursor in the inner area of one of the cut-planes.
The cursor is changes to . Drag to pan the cut-plane
image. The cut-plane lines remain fixed.

Zoom

Zooming
1. Rotate the Mouse wheel to zoom in and out.
OR
Press Arrow up to zoom in, arrow down to zoom out.
OR
Adjust Zoom on the control panel.

4D Views

4D Views enables quick access to standard 2D and 4D views.

4D Views requires slice alignment before standard views can be
selected.
1. Press 4D Views on the Control panel.
The Slice alignment screen is displayed.

4-19
 Figure 4-7. Slice alignment screen

Alignment – Transthoracic acquisition

1. Press Auto Align on the Control panel.
The standard views are displayed with the left ventricle
centered to the center axis.
Further adjustment of the alignment can be done using the
mouse.
• Place the cursor outside one of the extremities of the
slice intersection lines in the Apical short axis view. The
cursor is changed to .Drag to rotate all apical views
around the main axis.
• Place the cursor at one of the extremities of the Apical
2 chamber slice intersection line (white) in the Apical
short axis view. The cursor is changed to .Drag to
rotate the Apical 2 chamber slice around the main axis.
• Place the cursor at one of the extremities of the Apical
long axis slice intersection line (green) in the Apical
short axis view. The cursor is changed to .Drag to
rotate the Apical long axis slice around the main axis.
• Place the cursor at one of the extremities of a slice
intersection line in one of the apical views. The cursor is 4-20
 changed to .Drag to tilt all slices around a
perpendicular axis to the apical view.
• Place the cursor in the middle section of a slice
intersection line in one of the apical views. The cursor is
changed to . Drag to pan all slices.
• Place the cursor on the blue intersection lines in one of
the apical views. The cursor is changed to . Drag to
translate the short axis plane.
NOTE: Press 4D Home to remove the alignment and display the
original probe position or a previously approved alignment.
2. Press Approve when alignment is done.
NOTE: Press Delete on the Control panel to remove any previously
approved alignment and exit the Slice alignment function.
3. Select the desired standard view on the Control panel.

Alignment – Transesophageal acquisition

1. Perform slice alignment using the mouse.
• Place the cursor outside one of the extremities of the
slice intersection lines in the short axis view. The cursor
is changed to .Drag to rotate all views around the
main axis.
• Place the cursor at one of the extremities of the
2 chamber slice intersection line (white) in the short axis
view. The cursor is changed to .Drag to rotate the
2 chamber slice around the main axis.
• Place the cursor at one of the extremities of the
Mid-esophageal (ME) long axis slice intersection line
(green) in the short axis view. The cursor is changed to
.Drag to rotate the ME long axis slice around the
main axis.
• Place the cursor at one of the extremities of a slice
intersection line in one of the long axis views. The
cursor is changed to .Drag to tilt all slices around a
perpendicular axis to the view.
• Place the cursor in the middle section of a slice
intersection line in one of the long axis views. The
cursor is changed to . Drag to pan all slices.
• Place the cursor on the blue intersection lines in one of
the long axis views. The cursor is changed to . Drag
to translate the short axis plane.
NOTE: Press 4D Home to remove the alignment and display the
original probe position or a previously approved alignment.
4-21
2. Press Approve when alignment is done.
NOTE: Press Delete on the Control panel to remove any previously
approved alignment and exit the Slice alignment function.
3. Select the desired standard view on the Control panel.

4-22
Dynamic

Dynamic is a tissue tracking tool. When Dynamic is on the

cropping plane applied to the volume rendering is moving
together with the tissue structure through the entire heart cycle.
Only longitudinal displacements relative to the basal LV are
detected. Dynamic tool may enable a better visualization of
anatomical structures (e.g. MV annulus) through the entire heart
cycle.
Dynamic is only available with transthoracic acquisitions.
NOTE: When Dynamic is on the icon is displayed on screen.

CAUTION Use Dynamic only on apical greyscale acquisitions.

Do not compare measurements performed on static and
dynamic slices.

2-click cropping

2-click crop enables to quickly extract any views for visualization

of 4D structures. Two crop planes are created by clicking twice
in one of the 2D images or in the volume rendering.
1. Press 2-Click Crop on the Control panel.
2. Place the cursor in one of the 2D views (or the volume
rendering) and press the left mouse button to create the first
crop plane.
3. Move the cursor to a new location. The volume rendering is
updated simultaneously showing the cropped view.
4. Press the left mouse button to create the second crop plane.
NOTE: If desired repeat the procedure to create a new cropped
view.
5. To remove 2-click crop, press Clear on the Control panel.

4-23
Parallel cropping

Parallel cropping applies two parallel crop planes in the volume

rendering. This setting can be useful for valves and shunts
renderings.
When using Parallel Crop, both crop planes move together,
when translating and rotating. The thickness of the parallel crop
is adjusted using the Thickness control.
Press Dynamic to display the structure dynamically through the
entire heart cycle.
To remove parallel cropping, press Parallel Crop again.

Crop tool

The volume rendering can be cropped to only display the

structure of interest.
There are two crop planes that can be adjusted in each of the
azimuth, elevation, and short axis planes.

Azimuth crop plane 1

1. Cropping plane selection on the Control panel.

2. Active crop plane in the volume rendering.
3. Crop plane intersection. The X symbols indicate the cropped side.

4-24
Figure 4-8. Crop plane 1 in the azimuth plane
 1. Press Crop tool on the Control panel.
2. Press Select side on the Control panel to select the crop
plane to adjust.
3. Press Rotate Crop to activate rotation of the crop plane
using the mouse.
4. To rotate the crop plane: press and hold down the left
mouse button and drag the mouse.
To translate the crop plane: press and hold down Shift,
press and hold down the left mouse button and drag the
mouse up or down.
Use the Rotate red and Rotate blue controls on the Control
panel to fine tune the adjustment of the crop plane.
The Rotate Red control rotates the crop plane about the red
indicator in the center of the crop plane. Similarly, the
Rotate Blue control rotates the crop plane about the blue
indicator. The Spin Red&Blue control changes the
orientation of the red and blue indicators, to facilitate
cropping in oblique angles.
5. Other possible adjustments:
• Press Flip crop to remove the data on the other side of
the current crop plane. The viewing direction is flipped
180 degrees.
• Press Parallel crop to add a crop plane parallel to the
current crop plane. This setting can be useful for valves
and shunts renderings.
When using Parallel Crop, both crop planes move
together, when translating and rotating. The thickness of
the parallel crop is adjusted using the Thickness
control.
To remove parallel cropping, press Parallel Crop again.
Press Reset Active to undo the adjustments made on the
current active crop plane.
Press En face view to display a straight forward view of the
active crop plane.
6. On the Control panel, press Select side to select another
crop plane and make the required adjustments as described
above.
7. Press Crop tool to exit the cropping mode.

Stereo vision

4D Stereo Vision is a display technique that enhances the

4-25
perception of depth in the 4D renderings. This is achieved by
mixing two different volume renderings with slightly separated
 viewing angle and presenting them separately to the user’s left
and right eyes.
Two stereo display modes are supported.
• Anaglyph stereo vision: can be displayed on any monitor
and requires anaglyph stereo glasses (glasses with one red
and one cyan lens).
• Polarized stereo vision: can be displayed only on an
external monitor supporting this display (currently only Sony
LMD-2451MT is supported). The monitor has to be
connected to the digital video output on the computer.
Polarized stereo vision requires polarized stereo glasses. In
Stereo Vision mode the rendered image will degrade slightly
when viewed without polarized stereo glasses or on a
monitor that does not support row interlaced stereo.
Polarized stereo vision is available as an option. Anaglyph
stereo vision is available as default on the system.
Stereo vision is started by pressing Stereo vision on the Control
panel. Either anaglyph or polarized stereo vision is started
depending on the configuration (see below).
Make sure to use the correct glasses.

1. 3D anaglyph glasses 2. Circular polarizer 3D glasses

Figure 4-9. 3D glasses

NOTE: Not all users may be able to perceive depth using stereoscopic
display techniques.

4-26
Stereo vision configuration
Anaglyph stereo vision is the default stereo display mode and
does not require further configuration. Polarized stereo vision
must be enabled and the display options configured before it
can be used.
Connecting the Sony LMD-2451MT monitor

CAUTION Read thoroughly the monitor’s user manual before attempting

to use the monitor.

1. Connect the external monitor to the system using the

included Optical Isolation DVI cable (CAT#: H45571SA).
2. Connect the external monitor to the mains as described in
the monitor’s user manual.

To enable polarized stereo vision

1. Make sure the Sony LMD-2451MT monitor is connected to
the system and turned on.
2. First time use or when changing resolution: on the Sony
LMD-2451MT monitor, press the Control button on the right
side to display the control panel and press F1 until 3D mode
is activated (Figure 4-10).

4-27
 1. Press Control button.
2. Press F1 until the 3D mode is activated.
3. 3D mode active.

Figure 4-10. Activate 3D mode on the Sony LMD-2451MT

monitor

3. Press Config (F2) on the Control panel.

4. Select Imaging/Global.
5. Check the option Polarized.

Multi-Slice

Multi-Slice enables simultaneous display of equidistant short

axis views generated from an Apical 4D acquisition. The user
can select to display 5, 7, 9 or 12 slices.
1. Select an Apical 4D acquisition.
2. Press Multi-Slice.
The Multi Slice screen is displayed showing equidistant
short axis views (Figure 4-11). The short axis views are
evenly distributed and maximized in size for best
assessment (e.g image quality, presence and visibility of all
walls, stitching artifacts when using real time multi beat
acquisition). Apical views are displayed on the left side for
orientation purpose (not available in 9 slice display mode).

4-28
1. Upper slice
2. Lower slice

Figure 4-11. Multi Slice screen

NOTE: Press Layout on the Control panel or use the dedicated

buttons to get the following display alternatives.

4-29
1. 5 Slice 3. 9 Slice
2. 7 Slice 4. 12 Slice

Figure 4-12. Multi Slice alternative displays

If required, apply zoom. All short axis views are zoomed in

simultaneously.
3. The following adjustments can be done:
• Place the cursor in the middle section of the top or
bottom slice intersection line in one of the apical views.
The cursor is changed to . Drag to change the slicing
area.
Alternatively, adjust Top and Bottom controls on the
Control panel.
• Place the cursor at one of the extremities of the top or
bottom slice intersection line in one of the apical views.
The cursor is changed to . Drag to rotate the slices
backward/forward and sideways, to align the slices with
the anatomical structure.
Alternatively, adjust the Axis 1 and Axis 2 controls on
the control panel.
4-30
• Adjust Translate to move all slices up or down.
 NOTE: The default position can be displayed again by pressing
4D Home on the Control panel.
4. When imaging the left ventricle, press Dynamic on the
Control panel. The nine slices display the structure
dynamically through the entire heart cycle (only available
with thoracic acquisitions).
NOTE: When Dynamic is on the icon is displayed on screen.
NOTE: Dynamic Multi-Slice is only available on computer with
nVidia graphics card with support for CUDA and with a
driver supporting CUDA 2.3.
5. Press Store to save.
6. Press Done to exit.

Note regarding 4D Color Flow display.

CAUTION Tissue structures may obscure relevant flow information. If

required, increase Tissue transparency setting.
Color flow data may obscure other relevant color flow
information (e.g. jet). If required adjust Flow transparency
setting.
In some settings the volume rate can be less than 10 volumes
per second. This may lead to small display mismatch between
the color and tissue data. This is because of the rapid
movement of structures (e.g. valves) compared to the time lag
between the tissue and the color volume acquisitions. Tissue
data should only be used as guidance for the localization of the
flow data.

4-31
Saving images and cineloops to a
standard format

Images and cineloops can be saved to a removable media or a

shared network folder in the following standard formats:
• Still images: JPEG, MPEG, DICOM and RawDICOM (Raw
data + DICOM) and HDF
• Cineloops: AVI, MPEG, DICOM and RawDICOM (Raw data
+ DICOM) and HDF
1. In the Image analysis screen, select the required image or
loop.
2. Press the Right mouse button.
The System menu is displayed.

Figure 4-13. The System menu

3. Select Save as.

The Save as menu is displayed.

4-32
 Figure 4-14. The Save as window

4. Select the desired destination from the Save in archive

pull-down menu.
5. Enter a file name in the File name field.
If the image or cineloop is saved as DICOM or RawDICOM
the file name is automatically generated to follow the
DICOM standard.
6. Select between:
• Store Image only: saves the active image or cineloop
only.
• Store Secondary capture: creates a screen capture of
the entire screen.
• Store Quad view: saves all images or cineloop when in
quad view.
NOTE: Store Secondary capture and Quad view are not
available when storing RawDICOM.
• Check Anonymous Patient ID to anonymize the file
(only available for DICOM formats).
7. Select the image compression type (JPEG or RIe) or no
compression.
8. Enter in the desired Image quality (between 10 and 100).
A high quality setting will give a lower compression.
9. In the Save as type field select one of the following formats:
• RawDICOM: saves the still image or cineloop in both
GE raw format and DICOM format.
• DICOM: saves the still image or cineloop in pure 4-33
DICOM format.
 • JPEG: saves a still image in JPEG format.
• MPEG: saves the still image or cineloop in MPEG
format.
• AVI: saves the cineloop in AVI format.
• HDF: saves the image or cineloop in HDF (Hierarchical
Data Format). HDF is a portable data format for
exchange of scientific numerical and graphical data.
More information about HDF format at: http://
www.hdfgroup.org/.
A tool for viewing HDF files can be downloaded from
http://www.hdfgroup.org/hdf-java-html/hdfview/.
10. Press Save.
A file is saved in the selected archive.
NOTE: Images can also be stored as MPEG format on a removable
media using the Export function as described on page 4-34.

MPEGVue
MPEGVue enables the user to export or save one or several
examinations (images and reports) into MPEG format (images)
and Compiled HTML format (reports) readable from a regular
Windows computer together with a special MPEG viewer.
MPEG exported exams can be created using the Transfer
function (MPEGVue), see ‘Transfer of patient records/
examinations’ on page 3-23.

Creating a MPEGvue exam

1. Export the actual patient record as described on page 3-24.

Make sure to select MPEGvue as export destination.

Reviewing a MPEG exported exam

A MPEG exam can be read from any computer with

Windows 98/2000/XP/7, provided that DirectX 8.1 or later and
Windows Media Player 7.1 or later are installed.

EZ DICOM CD Viewer
This feature is an option that enables to export a self-contained
DICOM viewer to a removable media along with the selected
images when transferring images to a DICOM removable media. 4-34
 NOTE: This viewer is NOT intended to be a diagnostic tool. It is only
meant to be used for reference. See further explanation in the
“EZ DICOM CD Viewer Quick Start Guide” provided by SST
Group Inc.

Details of EZ DICOM CD Viewer

When the EchoPAC Software Only system includes the

EZ DICOM CD Viewer option, it allows the user to transfer
examinations to DICOM removable media together with a
DICOM viewer.
Placing the media in any PC automatically starts-up the DICOM
viewer to allow users to view images and loops contained in the
examinations available on that media. There is no need to
perform any installation on the viewing PC station, as the
DICOM viewer is self-contained on the inserted media.
NOTE: Minimal requirements for the Viewing PC are Windows 2000 or
higher (Windows XP Pro, Windows Vista, or Windows 7 (32 or
64 bit)).
The self-contained DICOM viewer is an off-the-shelf product
named EZ DICOM CD Viewer produced by SST Group Inc.
(see: www.sstgroup-inc.com).
The self-contained DICOM viewer contains a built-in quick help
user manual. Read this manual to learn more about the different
functions of the viewer. Translations of the user manual to
different languages are available to the user.
The User Interface may be set to a different language using a
special Language icon in the EZ DICOM CD Viewer.

Configuring the EZ DICOM CD Viewer

The user can configure the system to enable or disable the

embedding of the DICOM viewer on the media.
1. Make sure the DICOM Viewer option is installed.
2. Press Config (F2).
3. Select the Connectivity category and the Dataflow
subgroup.
The Dataflow sheet is displayed.
4. Select a dataflow for a DICOM removable media (i.e DICOM
CD/DVD, DICOM USB Harddisk/Memstick)

4-35
 Figure 4-15. Dataflow sheet

5. Select the DICOM Media output an press Properties.

The DICOM Media Properties window is displayed.
6. Check the option Add DICOM Viewer.
The DICOM Viewer will be exported when transferring
examination to the corresponding DICOM removable media.

4-36
Figure 4-16. DICOM Media Properties window

4-37
 DICOM spooler

DICOM spooler displays the current DICOM output jobs. The

jobs may be Storage, Print, Modality Performed Procedure Step
or Storage Commitment. The DICOM spooler is used for
checking the current job's status when a job is saved or when
the total spooler status on the right of the Archive window
displays an error.
From the DICOM spooler the user can also:
• Delete non-active jobs.
• Resend a job that has failed or is in hold.
• Send a job that has failed or is in hold, to a new destination.
• Hold a job that is not active.
The job's status displayed in the DICOM spooler window can be:
• Pending: the job is complete, waiting to be active.
• Hold: the job is complete, but suspended, waiting for an
user action.
• Append: the job is incomplete, waiting for more images
(Direct store function).
• Active: the job is complete and connected to the destination
device.
• Failed: the job is complete but one or more images failed to
transmit to the destination device.
• Done: the job is saved to the destination device. The jobs
that are done are removed from the spooler after a few
minutes.

Starting the DICOM spooler

1. Press Alt + S on the alphanumeric keyboard.
The DICOM spooler window is displayed (see Figure 4-17).
The DICOM spooler window is automatically updated. Press
Refresh to update the information displayed at any time.

4-38
 Figure 4-17. The DICOM job spooler window

Deleting a job

1. Select the job(s) to delete in the DICOM job spooler window.

NOTE: Only non-active jobs can be deleted.
2. Press Delete.

Resending a job

1. Select the job(s) to re-send in the DICOM job spooler

window.
NOTE: Only jobs that failed or are in hold can be resent.
2. Press Resend.

Sending a job to a new destination

1. Select the job(s) to send in the DICOM job spooler window.

NOTE: Only jobs that failed or are in hold can be sent to a new
destination.
2. Press Send to....
A dialogue window is displayed.
3. Select the new destination from the Destination pull-down
menu.
4. Press Send.

Holding a job

1. Select the job(s) to hold in the DICOM job spooler window.

NOTE: Only inactive jobs can be set on hold.
2. Press Hold. 4-39
3. To undo hold, press Resend.
 Configuration – Imaging

Global imaging settings

1. Press Config (F2) and log on if required.
2. Select Imaging/Global.

4-40
 Figure 4-18. The Global sheet

Parameter Description

Stereo vision Polarized: when selected, polarized stereo vision is enabled.

Anaglyph: when selected, anaglyph stereo vision is enabled.
Automatic: when selected polarized stereo vision is activated if
the monitor is supporting this display. If not, anaglyph stereo
vision is enabled.
See ‘Stereo vision’ on page 4-25 for more information.

Crop images In the Analysis screen, removes top and bottom of the image
when more than two images have been selected.

Doppler • Show KHz scale: when selected, displays the KHz scale on the
left side of the Doppler spectrum.
• PW/CW: Link baseline and gain controls: when selected,
baseline and gain settings are preserved when toggling
between PW and CW Doppler modes.

Patient Info • Title bar Line 1 & 2: selects from the drop-down menu the
patient information to display on the Title bar.
• Anonymous patient: when checked, no patient information is
displayed on the Title bar.

Scan Info • Select the scan information to be displayed on the upper left
corner of the image area.

4-41
 Chapter 5

Measurements and analysis

‘Introduction’ on page 5-3

‘Assign and Measure modality’ on page 5-7

‘Measure and Assign modality’ on page 5-9

‘Measurements on protocol images’ on page 5-11

‘Advanced cardiac measurements and analysis’ on

page 5-12

‘4D/Multi-plane LV measurements and analysis’ on

page 5-47

‘4D LV volume and 4D RV volume’ on page 5-67

‘4D MV-Assessment’ on page 5-68

‘4D Auto AVQ’ on page 5-69

‘Advanced vascular measurements and analysis’ on

page 5-75
5 -1
‘OB measurements’ on page 5-79
‘Measurement package configuration’ on page 5-85

‘Measurement result table’ on page 5-106

5 -2
 Introduction

EchoPAC Software Only provides functionality for two

measurement conventions:
• Assign and Measure: the user activates the Measure
mode, selects and then performs a pre-labeled
measurement.
• The user is guided through the study: an auto-sequence
functionality automatically selects the next
measurement in a study.
• The selected measurement is highlighted in the
Measurement menu.
• The performed measurement is indicated in the
Measurement menu.
The studies and their parameters are user-configurable. The
user can create its own studies containing the relevant
measurements (see page 5-85).
• Measure and Assign: the user activates the Measure or
Caliper mode, then selects and performs a generic
measurement. After completion, the user assigns a label to
the measurement.

CAUTION Only assigned measurements are saved when ending the

examination.

After doing measurements, the system automatically makes the

calculations related to the measurements performed.
Measurements and calculations are displayed in the
Measurements result table (see page 5-106).
Assigned measurements and calculations are automatically
gathered into a Worksheet and used to populate the patient
report.

5 -3
General recommendations about measurements
• When doing time-measurements in Doppler or M-Mode, it is
recommended to freeze the 2D image during acquisition.
• Distance and area measurements should be done on
greyscale 2D images or slice mode images if in 4D, not on
color flow or TVI-based images. Similarly, in M-Mode,
distance measurements should be done on greyscale
M-mode images and not on color M-mode images. If doing
Color M-Mode measurements of propagation of flow, please
refer to your specific laboratory protocols.

Measurements on multi beat 4D acquisitions

Multi beat 4D acquisitions are based on ECG gated acquisition

of at least two sub-volumes.
ECG gated acquisition may by nature contain artifacts, that may
have impact on the measurements.
Artifacts may be caused by:
• Movements of the probe caused by the operator during
acquisition.
• Movements of the patient during acquisition, including
movements caused by respiration.
• Irregular heart rate during acquisition.
To validate the acquisition, press Multi-Slice and perform a
visual inspection. Stitching artifacts are shown as visible
transitions between the sub-volumes (Figure 5-1).
It is recommended to specify in the Comments for the
examination that the measurements are performed on a
Multi-beat 4D acquisition.

5 -4
 Figure 5-1. Stitching artifacts

About Measurement results display

Be aware of the following:
• Measurement results display
By default the system always displays absolute values for
parameters measured in Doppler. This means that values
from above and below baseline will all be displayed as
positive results.
For Cardiac this behavior cannot be changed. For
non-Cardiac the Absolute Value setting can be turned off in
Config -> Meas/Text -> Advanced, by setting the attribute
Absolute Value to Off.
• Calculated parameters
For calculated parameters the system uses signed values in
calculation formulas, and displays the absolute value of the
result.
• When a parameter is measured several times the individual
values for the parameter will be listed in the m1, m2...
columns in the worksheet. The Value column in the
worksheet will contain a derived value for the parameter,
5 -5
e.g. the average of the individual values (Figure 5-2).
 When calculating formula derived parameters, the m1, m2...
columns in the worksheet contain calculated values based
on the individual input parameter values in the same column
(Figure 5-2). The Value column contains calculated values
based on the input parameter values in the Value column.

Figure 5-2. Measurement result window (A) and Worksheet (B)

The Measurement result window always displays values

from the m1, m2... columns.
It is therefore recommended to consult the worksheet (see
page 8-1) to get an overview of measured and calculated
parameters.

5 -6
Assign and Measure modality

1. Measurement category for the current application

2. Study
3. Opened study
4. Performed measurement
5. Pre-selected measurement

Figure 5-3. Example of a measurement study

1. Press Measure on the control panel.

The Measurement menu is displayed, showing the
measurement category for the current application
(Figure 5-3).
To change Measurement category:
1. Select the heading in the Measurement menu and choose
another category.
To perform measurements from a study:
1. Select the study (folder) in the Measurement menu.
The study folder is opened and the first measurement is
selected.
2. Perform the measurement. Follow the instructions displayed
on screen. 5 -7
Make sure to follow the current medical practices when
placing the specific points on the image.
If the folder is configured with auto-sequence measurement
(see page 5-86), the next measurement in the study is
pre-selected. To skip a pre-selected measurement, select
another measurement.
Completed measurements are marked with a check mark.

5 -8
 Measure and Assign modality

Figure 5-4. Measurement tools from the Caliper tab

1. Press Caliper on the Control panel and select the desired

measurement tool.
Or
Press Measure and select the desired measurement tool in
the Generic folder in Measurement menu.
2. Perform the measurement. Follow the instructions displayed
on screen.
Make sure to follow the current medical practices when
placing the specific points on the image.
NOTE: The system supports up to 15 separate measurements per
M&A session. When exceeding this limit the measurements
are still correct but will no longer have unique labelling for
the tool graphics and results.
3. To assign a label, select the measurement in the
Measurement result table and select the required label.

5 -9
 1. Label menu

Assignment

1. Assigned measurement

Figure 5-5. Measurement assignment

Measurements on volume renderings

Distance and area measurements can be done on 4D volume
renderings from a 4D acquisition.
1. Perform a distance or area measurement on a 4D
acquisition by selecting either Distance (Crop plane) or
Area (Crop plane) measurement tool.

CAUTION When measuring on a volume rendering, the measurement

is actually performed on the displayed crop plane and the
depth information is NOT taken into account.
It is recommended to use parallel crop (see ‘Parallel
cropping’ on page 4-24) with a short distance between the
crop planes.
Be aware that the Gain adjustment (2D and 4D Gain) may
impact the display of the anatomical structures to measure.

5-10
 Measurements on protocol images

When performing measurements on images acquired in a

protocol, the measurement results will be associated with the
protocol level of the image. Average values will be calculated for
each protocol level.
For example you may measure LVOT Diam for images acquired
outside protocol and for images on each level of an
Exercise 2x4 protocol, leading to the following results in
worksheet:

Parameter Value Method m1 m2

LVOT Diam 1.0 cm Average 1.1 0.9

LVOT Diam, Rest 1.1 cm Average 1.0 1.2

LVOT Diam, Peak 1.2 cm Average 1.2

CAUTION Measurement results associated with a stress level will not be

updated if the image is moved to another stress level at a later
time. Images should be correctly placed in the protocol before
performing measurements.

5-11
 Advanced cardiac measurements
and analysis

Event timing measurements

Event timing can be performed on a Doppler spectrum or an
M-Mode acquisition showing the corresponding valves. The
procedure is similar in both modes. In addition event timing can
be done on traces in Q Analysis. The measurements are shown
as dashed lines in the Analysis window and Anatomical M-Mode
window in Q Analysis.
Event timing enables the time measurement for opening and
closure of the Aortic and Mitral valves, as referred to the
automatically detected QRS marker, which normally is on the
rising slope of the R-wave.
1. Select the spectrum or M-Mode image to be measured.
2. Press Measure on the Control Panel.
3. Select Event Timing in the Measurement menu.
The following event timing measurements are available
(with the first measurement on the list selected):
• AVO: Aortic Valve Opening
• AVC: Aortic Valve Closure
• MVO: Mitral Valve Opening
• MVC: Mitral Valve Closure
4. Place the cursor to the corresponding point on the spectrum
for the selected measurement.
5. Press the Left mouse button to anchor the point.
The event timing measurement (ms) is displayed in the
Measurement result table.
When an event timing measurement is performed, the QRS
markers are displayed on the ECG trace and correct QRS
marker position should be verified before the Event Timing
measurements are performed.
5-12
TSI Measurements
Each sample in the TSI image represents the time to the
maximum velocity within the chosen TSI search interval from
TSI Start to TSI End.
The TSI search interval may be adjusted as follows:
1. Press Config (F2) and select the category Measure/Text.
2. In the Measure category, select the sheet Advanced.
3. In the Application specific parameters section adjust TSI
start and TSI end parameters by selecting a new value from
the combo menu displayed upon selection.
There are two automatic TSI time to peak measurement tools:
• Generic TSI Time to peak measurement: displays the TSI
value at the location point set by the user.
• Segmental TSI Time to peak measurement: measures the
time to peak velocity in specific wall segments and gets
automatically calculated TSI indexes based on these
measurements. The measurements may be presented in a
color coded Bull's eye diagram.
Alternatively, time to peak measurement can be done in
Q Analysis by manually measuring the time between the QRS
marker and the peak velocity on the velocity trace.

CAUTION TSI is only recommended for adult cardiac images acquired

with the following probes: M5Sc-D, M5S-D, 6T, 6Tc, 3V-D, 4V-D
or 6VT-D. The measurement accuracies of the TSI
time-to-peak values reported in the Reference manual are
verified with these probes.

Generic Time to peak measurement

1. Open a TSI apical loop.

2. Press Measure.
3. In the Measurement menu, select Generic and Time to
peak (see Figure 5-6).
The TSI loop freezes at the TSI end frame.
4. Place a point in the middle of a basal or mid-level
myocardial segment in the TSI image.
The Time to peak and Peak velocity values for the segment
are displayed in the Measurement result window.
5-13
 NOTE: To judge the quality of your data at the measuring point in
the 2D image the TSI trace may be used (see ‘TSI trace’ on
page 5-15). See also the Caution text on page 5-18.

Figure 5-6. TSI Generic Time to peak measurement screen

Segment Time to peak measurements

1. Open TSI loops from all three apical views.

2. Press Measure and select the TSI time study.
The TSI loop freezes at the TSI end frame.
The first measurement in the study is automatically selected
(see Figure 5-7).
3. Place a point in the middle of the corresponding segment in
the TSI image.
The Time to peak value for the segment is displayed in the
Measurement result window.
4. Perform a measurement for all basal and mid-level
segments in all three apical views.
In addition to the Time to peak value for each segment, the
following TSI indexes are calculated:
• Septal lateral delay: difference in Time to peak velocity
in the basal lateral wall and basal septum.
• Septal posterior delay: difference in Time to peak
velocity in the basal posterior wall and the basal
antero-septum. 5-14
 • Basal seg. max diff.: difference between the maximum
and minimum time to peak measurements in the six
basal segments. Requires at least four of the six basal
segment measurements.
• Basal standard deviation: the standard deviation of the
time to peak measurements in the six basal segments.
Requires at least four of the six basal segment
measurements.
• All seg. max diff.: difference between the maximum and
minimum time to peak measurements in all the
measured basal and mid level segments. Requires at
least eight of the twelve segmental measurements.
• All segments standard deviation: the standard deviation
of the time to peak measurements in all measured basal
and mid level segments. Requires at least eight of the
twelve segmental measurements.
The TSI indexes indicate degrees of asynchrony in time to
peak velocity.
5. Select TSI Bull’s eye report in the Measurement menu.
The measurements are displayed in a color coded bull’s eye
diagram together with a list of the calculated TSI indexes.

Figure 5-7. Segment Time to peak measurements screen

TSI trace
5-15
The TSI Time to peak measurement can be verified and
eventually manually changed from the TSI trace.
 1. Double click on the measurement point.
The ROI and the corresponding TSI curve are displayed
(see Figure 5-8).
2. Press the Left mouse button to anchor the ROI and trace.
3. If required, select a new peak location in the trace.
4. Click in the acquisition window to exit the TSI trace.

1. TSI ROI
2. TSI trace
3. TSI Time to peak marker

Figure 5-8. TSI trace

Time to peak measurement in Q Analysis

1. From a TSI apical loop, press Q Analysis.

2. Place a sample area in a myocardial segment.
A velocity trace is displayed in the Analysis window (see
Figure 5-9).
3. Press Measure.
4. In the Measurement menu, select Generic and Time.
5. In the Analysis window, measure the time from the yellow
QRS marker to the peak velocity of the velocity trace.

5-16
1. Time measurement tool
2. Sample area
3. QRS marker
4. Time to peak measurement

Figure 5-9. Manual TSI Time to peak measurement in Q Analysis

NOTE: It is possible to do a Generic or a Segment Time to peak

measurement from within Q Analysis and compare the result
with a manual Time to peak measurement. To access the
corresponding measurement tool in Q Analysis you may have to
press Active mode to display the relevant Measurement menu.

5-17
CAUTION The Time to peak measurement in Q Analysis may differ from
the TSI Time to peak measurements due to the following
considerations:
• The TSI Time to peak measurements find the maximum
velocity only within the TSI search interval. If the desired
peak on the velocity trace is outside the TSI search
interval, the TSI Time to peak measurements will return a
different result than the manual Time to peak
measurement.
• If the maximum velocity is at one of the ends of the TSI
search interval, the TSI time to peak measurements return
the time of the end of the TSI search interval. In some
cases the falling flank of an iso-volumic contraction peak at
the time of TSI Start or the rising flank of a post-systolic
contraction peak at the time of TSI End may be detected.
In a manual measurement the time to a peak within the TSI
search interval with a lower velocity than the velocity at the
end of the interval may be measured instead. The color
map TSI Trace may be used to identify regions in the
image where the peak detection is near the ends of the TSI
search interval. The TSI Trace tool should be used to verify
TSI measurements in the identified regions.
• If there are two or more peaks of comparable velocity
within the TSI search interval, or a poor signal quality, the
TSI Time to peak measurements may return the time to a
different peak than what a manual method would do.
Typically in these situations, the TSI image will show a
wide range of colors over a small spatial region.

5-18
Automated Function Imaging

Introduction

Automated Function Imaging (AFI) is a decision support tool for

global and regional assessment of the LV systolic function. AFI
is a tool derived from 2D Strain, which calculates the myocardial
tissue deformation based on feature tracking on 2D grey scale
loops.
AFI is performed on apical views in the following order: apical
long-axis, 4-chamber and 2-chamber view, following an on
screen guided workflow (see also Figure 5-10). The apical views
may be acquired sequentially in 2D mode, or simultaneously in
Tri-plane mode.
AFI is also available for standard mid-esophageal views
acquired with a TEE probe.
The result is presented as a Bull's eye display showing color
coded and numerical values for peak systolic full wall
longitudinal strain, PSS (Peak Systolic Strain), TTP (Time To
Peak global longitudinal strain) and traces.
All values are stored to the worksheet. In addition, Global Strain
for each view, Average Global Strain for the whole LV, standard
deviation of the segmental Time To Peak Strain and the Aortic
Valve Closure time used in the analysis are stored to the
worksheet.

5-19
APLAX 4-Ch 2-Ch Step

Acquired views

Automatic ROI creation

Tracking validation

AVC timing adjustment

Parametric image result

Trace and Bull’s eye result

Figure 5-10. AFI workflow

5-20
Acquisition

CAUTION AFI is only recommended for adult cardiac images acquired

with the following probes: M5Sc-D, M5S-D, 6T, 6Tc, 3V-D, 4V-D
or 6VT-D. The measurement accuracies of the longitudinal
strain values reported in the Reference manual are verified with
these probes.

Automated functional Imaging is performed on 2D grey scale

cineloops of an Apical long axis (APLAX) view, an Apical
4 chamber view and an Apical 2 chamber view.
The views can be acquired either sequentially in 2D mode or
simultaneously in Tri-plane mode.
For optimal result the acquisitions should conform to the
following recommendations:
• All three apical views should be acquired sequentially in
order to get similar heart rate in all views.
• The frame rate should be between 40 and 80 frames per
second. A higher frame rate is recommended for high heart
rate.
• The scanner should be configured to store 100 ms before
and after each heart cycle.
• The entire myocardium should be visible.
• The acquisitions should have a depth range that covers the
entire left ventricle.

Starting AFI

Starting AFI from sequential acquisition

1. Open an APLAX view and press Measure.
2. In the Measurement menu, select AFI.
The View selection menu is displayed (see Figure 5-11).

5-21
 Figure 5-11. Measurement and View selection menus

Starting AFI from simultaneous acquisition (Tri-plane

acquisition)
1. Open a Tri-plane acquisition and press Measure.
2. In the Measurement menu, select AFI.
The AFI application is started displaying the APLAX view.

CAUTION When performing AFI on all three apical views, the user is
asked to start with the APLAX view. This allows manual
adjustment of the Aortic Valve Closure (AVC) event timing that
is used in the calculation of the longitudinal systolic strain in all
apical views.

AFI on the APLAX view

1. Select APLAX in the View selection menu.

A ROI (region of interest) following the endocardium is
created and the Tracking validation screen is displayed.

5-22
1. Display Quick Tips on tracking quality assessment
2. The ROI divided in segments
3. The Scoring table
• : acceptable tracking
• : not acceptable tracking
4. Bull’s eye icon:
• Green sectors with yellow border: views being analyzed.
• Green sectors: views already analyzed.
• Black sectors: views not analyzed.

Figure 5-12. Tracking validation screen

2. Pay attention to the left/right orientation of the image:

compare the LV wall names with a visual inspection of the
image.
If the image orientation is wrong create a new ROI manually
as described in the section ‘To create a new ROI’ on
page 5-26. Make sure to place the basal points correctly
relative to the image landmarks when defining the ROI.
NOTE: You may alternatively exit AFI, invert the image and start
AFI again.
5-23
 The ROI is divided into segments. The tracking quality for
each segment is automatically evaluated and summarized
in the Scoring table (see Figure 5-12).
The tracking for each segment must be visually controlled
and validated as described below.

Tracking validation

CAUTION Poor tracking quality may lead to incorrect measurement

results. The tracking for each segment must be visually
controlled and validated.

Poor tracking quality could result from a variety of causes.

Select Quick tips (see Figure 5-12) to get tips on the most
common causes for bad tracking. The common causes for bad
tracking are:
• Erroneous placement of the basal points when defining the
ROI. If the basal points are placed too far from the annular
region, the ROI segments at the annular base will not move
together with the underlying 2D image throughout the entire
heart beat (see example cineloops in the Quick tips).
• Erroneous placement of the apex point when defining the
ROI. The point should be placed so that the resulting ROI
covers mainly the myocardium. If the apex point is placed
too high, the ROI will mainly cover the epicardium resulting
in poor tracking (see example cineloops in the Quick tips).
• Too narrow ROI width. Narrowing the ROI too much will
result in poor tracking due to lack of tissue data in the ROI
(see example cineloops in the Quick tips).
• Too much clutter. Images with too much static clutter will
result in poor tracking (see example cineloops in the Quick
tips).
1. Inspect each segment and make sure that the center line is
moving together with the underlying 2D image.
The tracking quality is automatically evaluated for each
segment and displayed in the Scoring table.
The tracking in each segment is scored as either Acceptable
( ) or Not acceptable ( ).
If the tracking needs to be improved for some segments, the
user can modify the ROI or create a new ROI as described
in ‘ROI adjustment’ on page 5-25.
The user may override the tracking quality evaluation done
by the system by clicking on the evaluation result in the
5-24
Scoring table.
 2. Once the tracking quality has been controlled for all
segments, press Approve in the Scoring table.
The user is asked to confirm or adjust the AVC timing setting
(see ‘Timing validation’ on page 5-30).

ROI adjustment
If the automatic ROI is not optimal resulting in poor tracking, the
user can either adjust the ROI or create a new ROI as described
below.

To adjust the ROI

1. Press Recalc.
2. The following adjustments can be done to the existing ROI:
• Adjust ROI Width.
• Adjust the shape of the existing ROI: move the cursor
over the inner ROI border, select an anchor point and
move it to a new location. The shape of the ROI is
updated accordingly.

Figure 5-13. Selected anchor point on the inner ROI border

Data processing is started automatically if the cursor is not

moved for a few seconds.
NOTE: If the ROI needs to be adjusted make sure to make the
changes immediately after the ROI is displayed, before the
auto processing of the ROI begins.
NOTE: The timing when auto processing of the ROI will start is
configurable (from Config/Meas-Text/Advanced/AFI auto
processing).

5-25
 Figure 5-14. AFI auto processing configuration

The Tracking validation screen is displayed.

3. Perform Tracking validation (see ‘Tracking validation’ on
page 5-24).

To create a new ROI

1. Press Recalc.
2. Press New ROI to re-define the ROI.
The system automatically displays a frame where the
endocardial border is usually clearly visible. To use another
frame, adjust Ref frame.
3. To define a ROI, place three points at the endocardial
border; two annular points and one at the apex (see
Figure 5-15). Follow the indications displayed next to the
pointer and on the Status bar when placing the three points.
NOTE: The Yo-yo function is turned on to help find correct location
for the points.

5-26
 Figure 5-15. Defining a ROI

After placing the apex point the ROI is displayed.

NOTE: Correct ROI definition is important for an accurate strain
measurement. The system has an adaptive ROI function:
using the endocardial three points as a guide, the system
will analyze the image and automatically adapt the ROI to
an optimal position.
Data processing is started automatically if the cursor is not
moved for a few seconds.
The Tracking validation screen is displayed.
4. Perform Tracking validation (see ‘Tracking validation’ on
page 5-24).

Quick tips when re-creating the ROI

Correct ROI definition is crucial to get good tracking. Refer to
the example displayed in the Tip window for correct point
placements. To display additional guidelines, select Click for

5-27
 Tip. Make sure to follow the recommendations when placing the
three points (see below).

Base Correct Wrong

1. Correct position of the base

points.
2. The ROI extends into the
aortic tract.

Apex Correct Wrong

1. Correct position of the Apex

point.
2. The apex point is placed too
high. The ROI is extending
beyond the epicardium.

5-28
 Apex Correct Wrong

1. Correct position of the Apex

point.
2. The upper right border of the
ROI is way too much into the
chamber cavity.

Bulges Correct Wrong

1. Correct ROI.
2. ROI should not be bulging or
follow the papillary muscle.
To edit the ROI, see ‘ROI
adjustment’ on page 5-25.

5-29
 General Correct Wrong

The left ventricle must be visible

through the entire cycle.
1. End systole frame: the entire
left ventricle is displayed.
2. End diastole frame: the
annulus is not displayed.

Timing validation
Timing information may be crucial to accurate diagnosis. The
most important event timing is the aortic valve closure (AVC),
since it is part of the definition of the end systolic strain
parameter.
Determination of the AVC timing by the system is as follows,
depending on the situation:
• If AVC timing has been measured by the operator (through
an event timing measurement, see page 5-12) prior to
running AFI, the system is using this data.
• If event timing is not available, an automatic AVC estimate is
used, determined by the temporal contraction of all LV
segments (Strain curves).
• From the APLAX view, the user can adjust the estimated
AVC timing. The adjusted AVC timing will then be used in
the other apical views when running AFI on these views.
This option is only available from the APLAX view.

AVC timing adjustment

This procedure is available in the APLAX view only.
1. After validation of the tracking quality, the frame for the
current AVC setting (automatic or event timing
measurement) is displayed and highlighted on the ECG.
2. To keep the current AVC setting, press the Left mouse
button. To change the AVC setting, use the mouse to scroll
along the ECG and display another frame, then press the
Left mouse button.
5-30
 If the AVC setting was changed, a Confirmation window is
displayed. Select one of the following options:
• Manual to accept the manual AVC setting.
• Event timing to discard the manual AVC setting (if for
example the AVC setting was not possible to assess
from the APLAX view). The AVC event timing
measurement will then be used.
NOTE: This choice is only visible if AVC event timing has been
done.
• Auto to discard the manual AVC setting and use the
automatic AVC timing.
The Parametric systolic strain APLAX view is displayed (see
Figure 5-16).

Figure 5-16. Parametric systolic strain APLAX view

NOTE: The image will not be saved unless the user press Store.
Press Quad screen to display a quad screen (see
Figure 5-17) showing:
• 2D image with the ROI
• 2D image with full wall Peak systolic strain parametric
data
• Segmental curves with peak marker
• M-Mode image with strain parametric data

5-31
 Figure 5-17. Quad screen for the APLAX view

NOTE: The Quad screen will not be saved unless Store is pressed.

5-32
AFI on A4-Ch and A2-Ch views

The procedure for AFI on Apical 4-chamber and 2-chamber

views is similar to the one used in the APLAX view.
For sequential acquisition
1. Open the apical view from the clipboard.
2. Select the corresponding view in the View selection menu
(see Figure 5-11).
3. Validate tracking (see page 5-24).

For simultaneous acquisition (Tri-plane acquisition)

1. Press Next view on the Control panel to display the next
Apical view.
2. Validate tracking (see page 5-24).
NOTE: The AVC timing setting defined in the APLAX view is used by
the system when running AFI on the other apical views.

Results

For the APLAX and apical 4-chamber views the following results
are available:
• Single screen (see Figure 5-16) displaying a 2D image with
strain parametric data.
• Quad screen (see Figure 5-17) displaying:
• 2D image with the ROI
• 2D image with full wall Peak systolic strain parametric
data
• M-Mode image with strain data
• Segmental curves

5-33
CAUTION If auto-AVC is used as AVC timing calculation method
when running AFI (see page 5-30), the strain values
displayed in the Quad screen for the APLAX and
4 Chamber views may differ from the strain values
obtained after the system has performed the final
calculation from all three views. The reason for this is that
the Auto-AVC calculation derived from all three views is
most accurate and may be different from the intermediate
AVC calculations used for each view. The strain values
displayed in the Quad screen on APLAX and 4 Chamber
views are therefore preliminary values (a warning text
about this is displayed on the Quad screen). Only final
strain values should be reported. Note: If you enter Quad
screen again after all three loops have been processed, the
strain values will be correct.

When performing AFI on all three apical views the following

results are also available:
• Bull’s Eye and Traces screen (Figure 5-18) displaying:
• Segmental curves for each three Apical views
• Bull’s eye presentation with segmental full wall Peak
systolic strain color coding and segmental Peak systolic
strain values.
• Bull’s Eye Only screen (see Figure 5-19) displaying:
• Bull’s eye presentation with segmental full wall Peak
systolic strain color coding and segmental Peak systolic
strain values.
NOTE: The Bull’s eye can be configured to display either 18 or
17 segments (from Config/Meas-Text/Advanced/AFI
Segment model).
NOTE: Press BE Maps to select another color map for the
Bull’s eye.
The system can be configured so that the user can also
choose to display other color maps (from Config/
Meas-Text/Advanced/AFI):
- Post Systolic Index (PSI) color coding and segmental
PSI values in the Bull's eye
- Time-to-peak strain (TTP) color coding and segmental
TTP values in the Bull's eye
Both of these color maps are based on the global peaks
(as supposed to systolic peaks).
5-34
• Global Strain (GS) values for all three apical views.
 In a given view the Global Strain (GS), also called
Global Longitudinal Peak Strain (GLPS), is defined as
the percentage of maximal contraction over the whole
cardiac cycle of the entire myocardial wall relative to its
end diastolic length.
• Averaged Global Strain value from all three apical view
data.
• AVC measurement (either automatic, event timing
measurement or manual, see page 5-30)
• PSD: Peak Strain Dispersion (included in AFI and 2D
Strain (EchoPACTM )) is an index that displays variability
in time-to-peak (TTP) longitudinal strain. The index is
the standard deviation of the TTP strain (of all
segments) over the whole cycle. The TTP bulls-eye is
useful in association with PSD as the color scheme
uses green color to indicate normal contraction with a
peak around AVC, blue color to indicate early
contraction, and yellow to red color to indicate late
contraction.

Getting the results

When approving the tracking in the Apical 2-chamber the Bull’s
Eye and Traces screen with segmental curves and Bull’s eye is
displayed (Figure 5-18). When observing the traces, the user
may want to reject (or approve) traces previously approved. This
can be done by right clicking a segment in the bull's eye. A
popup menu will appear allowing a segment to be approved or
rejected. Select Bull’s eye only to display the Bull’s Eye Only
screen (Figure 5-19).

CAUTION Segments and peak detection should be checked to make sure

that non-physiological traces are excluded in the calculation of
indices.
This is in particular important when using the TTP color map,
as wrong Peaks will influence the PSD index significantly.
Peaks detected in very early systole and late diastole should
be checked, and traces rejected if they are considered
non-physiological.

5-35
 Figure 5-18. Bull's Eye and Traces screen

Figure 5-19. Bull’s Eye Only screen

To save the results, exit AFI and answer yes to the question “Do
you want to store?”. Once the results are saved, the
measurements are available in the Worksheet and can be used 5-36
 in the report. The system remembers the AFI process done for
the three views.
If the tracking quality of a segment was scored as Not
acceptable ( ), the colorimetric display on the Bull’s eye
is greyed (see Figure 5-20).

1. Segment with tracking quality scored as Not acceptable ( ).

Figure 5-20. Colorimetric display

Peak detection
The peak systolic strain detection for each segment can be
verified and eventually manually changed.
To adjust the peak detection:
1. Press BE+Traces.
The Bull's Eye and Traces screen is displayed (see
Figure 5-18) showing:
• Trace plots for all three loops
• Bull's Eye with Peak systolic strain values
2. To change the peak marker position on a curve:
• Select the peak marker (square point) on one of the
curves and move it to a new position.
OR
• Place the cursor on a segment in the Bull's Eye. The
corresponding curve is highlighted.
Click on the segment to select the corresponding peak
marker and move it to a new position.
A letter “S” or “G” next to the peak marker (square point)
indicates if the systolic or global peak is being moved.
The peak type is determined by the selected color map
(systolic for PSS, global for PSI and TTP). 5-37
 The position of the AVC marker can also be checked in the
Bull's Eye and Traces screen. If needed, the APLAX view
should be reprocessed to change the AVC time.

About the results

Be aware of the following:
• Clinical assessments should be made based on both color
and segmental full wall Peak systolic strain values.
• The Save As function is intended for research purposes and
should not be used to archive diagnostic data.
• To populate the worksheet and the report the Bull’s Eye
Only screen must be saved.
• All results shown (curves, colors and values) are based on
drift compensated values. Any strain drifting is linearly
compensated throughout the cycle. If the drift compensation
in a given segment is too high, the tracking quality is
automatically set to Not acceptable (X).
• If the tracking quality was scored as Not acceptable (X) in
more than one segment, the Global Strain value is not
calculated.

Reprocessing data
The data from one or several views from a saved AFI analysis
may be reprocessed. When reprocessing an AFI analysis new
result screens are created.
1. Double-click on the Bull’s eye thumbnail.
A quad screen is displayed showing the three apical views
and the Bull’s eye diagram.
2. Select the view to reprocess and perform the analysis as
described on page 5-22.

AFI configuration
It is possible to configure some of the AFI controls to modify the
workflow slightly.
1. Press Config (F2), select the category Meas/Text and the
Advanced subgroup.
The Advanced sheet is displayed.

5-38
Parameter Value

• AFI Auto processing Off or delay time in seconds

• AFI Auto BE Screen BE review / BE traces
• AFI Default Color Palette Red-Blue or green-yellow-red
• AFI/AutoEF ROI method Auto ROI or 3-point method
• AFI segment model 17 or 18 segments
• AFI BE Mode PSS, PSI & PSS, PSS & TTP, PSS, PSI & TTP
• AFI/AutoEF YOYO Play or Stop

Figure 5-21. AFI configuration

5-39
AutoEF measurements

Introduction

Automated Ejection Fraction (AutoEF) is a semi-automatic

measurement tool used for measurement of the global EF
(Ejection fraction). The AutoEF tool is used as an optional
decision support tool.
The AutoEF tool is derived from a 2D speckle tracking algorithm,
which tracks and calculates the myocardial tissue deformation
based on feature tracking on 2D grey scale loops.
AutoEF is performed on either one or both apical 4-chamber or
2-chamber views, in any order.
The result is presented as Ejection Fraction value, calculated by
Simpson MOD for each view and MOD Bi-plane Ejection
Fraction for the whole LV. All values are stored to the worksheet.

Acquisition

CAUTION AutoEF is only recommended for adult cardiac images

acquired with the following probes: M5Sc-D, M5S-D, 3V-D or
4V-D. The measurement accuracies of the 2D Auto EF
measurement values reported in the Reference manual are
verified with these probes.

AutoEF can be performed on 2D grey scale cineloops of Apical

4 chamber and/or Apical 2 chamber views.
For optimal result the acquisitions should conform to the
following recommendations:
• The frame rate should be between 37 and 80 frames per
second. A higher frame rate is recommended for high heart
rate.
• The scanner should be configured to store at least 100 ms
before and after each heart cycle.
• If the acquisition has more than one heart cycle, the
analysis will be done on the second last heart cycle.
• The entire myocardium should be visible.
• A depth range that includes the entire left ventricle should
be used.

5-40
Starting AutoEF

1. Open any one of the stored apical views and press

Measure.
2. Press Measure on the Control panel and select the AutoEF
study.
The View selection menu is displayed (Figure 5-22).

Figure 5-22. Measurement and View selection menus

3. Select the name of the current view: 4-ch or 2-ch.

A trace following the endocardial border is created and the
EF result screen is displayed (Figure 5-23).
The tracking must be visually controlled and validated as
described below.

5-41
EF results

Figure 5-23. The EF results screen

The running loop is shown on the left. A green dotted line marks
the inner border of the chamber. In case of poor tracking, the
system automatically displays parts of the border in red.
The frames with the maximal volume (ED) and minimal volume
(ES) are displayed on the right side.
NOTE: Press EF Dual to only display the ED and ES frames.
The End Diastolic volume (EDV), the End Systolic Volume
(ESV) and the resulting Ejection Fraction (EF) are displayed.
Results for each view are summarized in a table on the right
side.

5-42
Tracking Validation

CAUTION Poor tracking quality may lead to incorrect measurement

results. The tracking must be visually controlled and validated.

If the tracking results are visually correct press the red Approve
button on screen. The calculated values are stored and
available in the worksheet and can be used in a report.
The following can be done if tracking needs correction:
• Press EF dual to display ES and ED frames side-by-side.
• Adjust ES frame and ED frame controls if different frames
need to be selected for ES and ED.
• Edit misaligned points on the endocardial border trace as
described on ‘Editing the endocardial border trace’ on
page 5-44.
• Create a new endocardial border trace (see ‘Create a new
trace’ on page 5-44).
Possible causes of poor tracking
• Erroneous placement of the basal points when defining the
border. If the basal points are placed too far from the
annular region, the border segments at the annular base will
not move together with the underlying 2D image throughout
the entire heart beat.
• Erroneous placement of the apex point when defining the
border. The point should be placed so that the resulting
border trace covers mainly the endocardium. If the apex
point is placed too high, the border trace will mainly cover
the epicardium resulting in poor tracking.
• Too much clutter. Images with too much static clutter will
result in poor tracking.

Trace adjustment of the endocardial border

If the automatic endocardial border detection is not optimal the
user can either adjust the trace or create a new trace as
described below.

5-43
Editing the endocardial border trace
1. Press Recalc.
The initial endocardial border trace is displayed.
2. If required, use the Left/Right Edge shift controls to
delineate separately the left or right portions of the
endocardial border visually as best as possible. These
controls are not available if the endocardial border trace is
adjusted.
3. You may adjust the trace by moving the cursor over the
endocardial border trace, select an anchor point and drag it
to a new location. The shape of the endocardial border trace
is updated accordingly.

Figure 5-24. Moving an anchor on the trace

Create a new trace

1. Press Recalc.
The initial endocardial border trace is displayed.
2. Press New ROI.
The system automatically displays a frame where the
endocardial border is usually clearly visible. To use another
frame, adjust Ref frame.
3. To trace the endocardial border, place three points at the
endocardial border; two annular points at the base and one
at the apex. Follow the indications displayed on the screen
when placing the three points.
After placing the third point on the Apex an endocardial
border is automatically traced (Figure 5-25).
NOTE: Correct border tracing is important for an accurate EF
measurement. The system has an adaptive border tracing 5-44
function: using the endocardial three points as a guide, the
system will analyze the image and automatically adapt the
 border tracing to an optimal position.
NOTE: The Yo-yo function is turned on to help finding correct
location for the points.

Figure 5-25. Tracing the endocardial border

4. Data processing is configured by default to start

automatically if the cursor is not moved for a few seconds. If
the trace needs to be adjusted make sure to make the
changes immediately after the ROI is displayed. See
‘Editing the endocardial border trace’ on page 5-44 for more
information on how to edit the trace.
NOTE: The auto processing function is configurable (from Config/
Meas-Text/Advanced/AFI/AutoEF auto processing).
The data is processed and the EF result screen is displayed.

Exit AutoEF

1. Press Exit on the Control panel.

A dialog is displayed asking the user about storage of the
loop.
• Press Yes to store the loop.
• Press No to discard the loop.

5-45
Pediatric Z score measurement study
Calculated Z Scores are used to normalize pediatric heart
measurements to the patient's body size. Z Score values are
calculated based on “Regression Equations for Calculation
of Z Scores of Cardiac Structures in a Large Cohort of
Healthy Infants, Children, and Adolescents: An
Echocardiographic Study”, M.D. Pettersen et.al. The
parameters defined in this publication are calculated when
present in the Dimension folder both for M-mode and 2D
images.
BSA value must be known. BSA is automatically calculated
when entering the patient's height and weight in the Patient info
and exam screen.
In addition, all Z Score values from the above publication are
found in a separate Z Scores folder. By default this Z scores
folder is hidden in the Measurement menu. To display the
Z scores folder, see ‘Configuration of the Measurement menu’
on page 5-87. Please note that Z Score values from the
Z Scores folder are not averaged together with the values in the
Dimension folder.
1. Open a pediatric cardiac acquisition.
Make sure the height and weight of the patient was entered
in the Patient info and exam screen.
2. Press Measure and select the Z Scores folder (only
available from the Pediatric Heart measurement category, if
turned on).
3. In the Z Scores folder select the measurement to perform.
4. Make the measurement.
The Z0 and Z values are displayed in the Measurement
result table.

Figure 5-26. Pediatric cardiac measurement with Z Score

5-46
 4D/Multi-plane LV measurements
and analysis

Introduction
Depending on the data set, the following 4D/multi-plane LV
analysis tools are available on the EchoPAC Software Only:

Data set

Tool 4D Tri-plane Tri-plane TSI

4D Automated LV Quantification page 5-47 - -

Tri-plane LV Volume page 5-61 page 5-61 -

measurement

Bi-plane LV Volume - page 5-63 -

measurement

TSI surface model - - page 5-65

4D Automated Left Ventricular Quantification

The 4D Auto LVQ (Automated Left Ventricular Quantification)
tool enables the estimation of the left ventricular volumes and
the ejection fraction in 4D data sets based on automatic border
detection. The tool also enables estimation of left ventricular
mass and strain (only with transthoracic 4D acquisitions). The
automatic border detection is created after placing two points in
an end-diastolic apical view, one at the center of the LV base
and one at the apex.

Requirements

The tool cannot be used on 4D acquisitions with volume rate

equal or lower than 12 vps.

5-47
 CAUTION Do not use the 4D Auto LVQ tool in these cases:
• For volume measurements: The acquisition has a volume
rate lower than 20% of the heart rate, e.g., 12 vps at
60 bpm, 20 vps at 100 bpm and 30 vps at 150 bpm.
• For 4D Strain measurements: The acquisition has a
volume rate lower than 40 percent of the heart rate, e.g.,
24 vps at 60 bpm, 40 vps at 100 bpm and 60 vps at
150 bpm.
• The image quality is poor.
• The acquisition has stitching artifacts (see ‘Measurements
on multi beat 4D acquisitions’ on page 5-4 on how to avoid
stitching artifacts).
• The acquisition has significant reverberation artifacts.
• A significant part (more than 25%) of the left ventricular
wall is outside the ultrasound sector.
The tool must not be used on other chambers than the human
adult left ventricle.

Starting the 4D Automated Left Ventricular Quantification tool

1. Open a Full volume acquisition.

2. Press Measure.
3. Select Volume/4D Auto LVQ (Figure 5-27-A).
The Measurement menu is displayed with the Alignment
tool selected (Figure 5-27-B).

A B

5-48
Figure 5-27. Measurement menu
 The main screen displays three apical and a short axis
views.

Figure 5-28. Slice alignment screen

Slice alignment

Slice alignment is used to identify the long axis of the left

ventricle, the three standard apical views and the
atrio-ventricular plane. Slice alignment performed and approved
before running 4D Auto LVQ is used by default, otherwise the
slice alignment is performed automatically. If necessary the auto
alignment can be further adjusted as follows:
1. Tilt and/or translate the apical views using the controls on
the Control panel or the mouse until the left ventricle is
centered to the center axis.
2. Rotate the apical views using the controls on the Control
panel or the mouse until the standard views are displayed.
NOTE: Auto alignment is not available with transesophageal
acquisitions, only manual alignment as described in
‘Alignment – Transesophageal acquisition’ on page 4-21.
See page 4-19 for more information on Slice alignment. 5-49
End-diastolic volume contour detection

1. Select EDV (End-Diastolic Volume).

The default screen displays three apical views, three short
axis views and an interactive view (Figure 5-29).
The system automatically displays the loops at the
estimated end diastolic frame.
2. If the automatic end diastolic frame detection is not optimal,
use the Move ED control to set the new end diastolic frame.
3. In one of the apical views, place two points: one at the
center of the LV base and one at the apex.
NOTE: Alternative methods for doing contour detection: press Auto
Init on the Control panel to draw the contour automatically
without placing any points, or press Manual and place two
basal and one apical point in all three apical views.
A contour is automatically drawn in all views (see
Figure 5-29).
NOTE: Erroneous contour detection of the left ventricle may lead to
incorrect measurement results. The contour detection
should be visually checked and edited if required.
The contour detection should be checked in all slices.
NOTE: Press Layout several times on the Control panel to display
the apical slices in large size one by one.
The contour detection quality can be visualized by moving
the cursor through the LV and observe the contour detection
in the interactive view. The position of the interactive view
updates according to the cursor position in the other views.
To lock the interactive view, press Up or Down arrow key
on the keyboard. When the interactive view is locked the
position can be controlled using the Up and Down arrow
keys on the keyboard or the Move view control on the
Control panel. Press Enter on the keyboard or Unlock view
on the Control panel to unlock the view again.
Adjust Contour visibility to change the display intensity of
the contour (or hide it).
To run the cineloop, press Run on the Control panel.
To stop the cineloop, press Go To ED on the Control panel.
The end diastolic frame is displayed.
To edit the contours, see ‘Contour adjustment’ on
page 5-52.
To reset the contours and start over, press Reset.
5-50
The following measurements are available:
 • End diastolic volume
• Sphericity Index
NOTE: You can press Store at any point during the procedure.

1. Apical views
2. Short axis views
3. Interactive view

Figure 5-29. Left ventricle contour detection (end-diastole)

End-systolic Volume contour detection

1. Select ESV (End-Systolic Volume).

The system automatically displays the loop at the estimated
end systolic frame within the same heart cycle.
2. If the automatic end systolic frame detection is not optimal,
use the Move ES control to set the new end systolic frame.
3. In one of the apical views, place two points: one at the
center of the LV base and one at the apex.
A contour is drawn in all views.
NOTE: If the Auto or Manual contour detection method was used to
define the EDV contour (see step 3 on page 5-50) the same 5-51
method is used for the ESV contour detection.
 NOTE: Erroneous contour detection of the left ventricle may lead to
incorrect measurement results. The contour detection
should be visually checked and edited if required.
The contour detection should be checked in all slices.
NOTE: Pess Layout several times on the Control panel to display
the apical slices in large size one by one.
The contour detection quality can be visualized by moving
the cursor through the LV and observe the contour detection
in the interactive view. The position of the interactive view
updates according to the cursor position in the other views.
To lock the interactive view, press Up or Down arrow key
on the keyboard. When the interactive view is locked the
position can be controlled using the Up and Down arrow
keys on the keyboard or the Move view control on the
Control panel. Press Enter on the keyboard or Unlock view
on the Control panel to unlock the view again.
Adjust Contour visibility to change the display intensity of
the contour (or hide it).
To run the cineloop, press Run on the Control panel.
To stop the cineloop, press Go To ES on the Control panel.
The end systolic frame is displayed.
To edit the contours, see ‘Contour adjustment’ on
page 5-52.
To reset the contours and start over, press Reset.
The following measurements are available:
• End diastolic volume
• End systolic volume
• Ejection Fraction
• Sphericity Index
• Cardiac Output
• Stroke Volume
• Heart Rate

Contour adjustment

The contour detection should be checked. If the contour

detection is not optimal, it can be adjusted by adding attracting
points to the contour. An attracting point will pull the contour
toward that point.
1. Place the cursor at the location where to add a point.
5-52
 NOTE: Attracting points can be added in any slice. Make sure to
lock the interactive view if adding attractive points in the
interactive view.
2. Press the Left mouse button.
A point is added and the contour is modified (Figure 5-30).
3. To delete an attracting point, double click on the point or
press Undo.

a. Original contour b. Modified contour

1. Original attracting points 2. Added attracting point

Figure 5-30. Contour adjustment

Volume waveform

Display and adjustment

1. Press Volume waveform.
The data is processed and the Result screen is displayed
(Figure 5-31) showing:
• The four running views with dynamic contours
• A volume waveform curve with end diastolic and end
systolic markers
• A dynamic LV surface model
• The Measurement result table
NOTE: Press Layout on the Control panel to display a large LV
surface model.
2. Press Go to ED on the Control panel to display the end
diastolic frame.
Press Go to ES on the Control panel to display the end
systolic frame.
3. The contour detection may still be adjusted:
• Press Stop or click on any view to stop the cineloops. 5-53
Scroll to the correct frame.
 • Add or remove attracting points to modify the contour as
described in ‘Contour adjustment’ on page 5-52.
• Press Volume waveform to reprocess the data.
4. The end diastolic and end systolic markers on the volume
waveform curve can be adjusted:
• Adjust Move ED and Move ES controls to move the end
diastolic and end systolic markers on the curve.
The measurement results are updated.
The following measurements are available:
• End diastolic volume
• End systolic volume
• Ejection Fraction
• Sphericity Index
• Cardiac Output
• Stroke Volume
• Heart Rate

Figure 5-31. The Volume waveform screen

5-54
LV mass

1. Press LV Mass (Left ventricular mass).

The end diastolic frame is displayed and an epicardial
contour is automatically drawn. The ED mass calculation is
displayed in the Measurement result table.

Figure 5-32. The ED mass screen

Adjust Contour visibility to change the display intensity of

the contour (or hide it).
To run the cineloop, press Run on the Control panel.
To stop the cineloop, press Go To ED on the Control panel.
The end diastolic frame is displayed.
2. The epicardial and endocardial contours may be adjusted
by adding/removing attracting points as described in
‘Contour adjustment’ on page 5-52. Adjustment of the
contours can only be done on the end diastolic frame.
NOTE: Toggle between Endo, Epi and Endo + Epi on the Control
panel to select the contour to adjust.

5-55
 The following measurements are available:
• End diastolic volume
• End systolic volume
• Ejection Fraction
• Sphericity Index
• Cardiac Output
• Stroke Volume
• Heart Rate
• End diastolic mass
• End diastolic mass index (if BSA is known)

4D Strain

4D Strain enables calculation of myocardial deformation

parameters based on tissue tracking in 4D tissue data sets.
Calculation is performed after defining a region of interest (ROI)
that covers the left ventricular myocardium.
NOTE: Poor tracking quality may lead to incorrect measurement results.
The tracking for each segment must be visually controlled
before approving the results.

4D Strain ROI
1. Press 4D Strain ROI.
The end systolic frame is displayed and a ROI based on
endocardial and epicardial contours is automatically
created.
To run the cineloop, press Run on the Control panel.
To stop the cineloop, press Go To ES on the Control panel.
The end systolic frame is displayed.
2. The epicardial and endocardial contours may be adjusted
by adding/removing attracting points as described in
‘Contour adjustment’ on page 5-52. Adjustment of the
contours can only be done on the end systolic frame.
NOTE: Toggle between Endo, Epi and Endo + Epi on the Control
panel to select the contour to adjust.

5-56
 The following measurements are available:
• End diastolic volume
• End systolic volume
• Ejection Fraction
• Sphericity Index
• Cardiac Output
• Stroke Volume
• Heart Rate
• End diastolic mass
• End diastolic mass index (if BSA is known)
• End systolic mass
• End systolic mass index (if BSA is known)

4D Strain results
1. Press 4D Strain results.
The 4D Strain result screen is displayed (Figure 5-33)
showing:
• Apical and short axis views with segmented ROI.
• Segmental and global curves showing a graphical
display of the selected parameter as a function of time.
• An adjustable color coded Bull's eye representation with
tracking quality indication and segmental values.
NOTE: Segments marked with an “X” are rejected.
To stop the cineloop, press Go To ES on the Control panel.
The end systolic frame is displayed.
To run the cineloop, press Run on the Control panel.
2. The tracking for each segment must be visually controlled
before approving the results. Inspect each segment and
make sure that it is moving together with the underlying 2D
image.
NOTE: Press Layout several times on the Control panel to display
the apical slices in large size one by one.
Press Up or Down arrow key on the keyboard or adjust the
control Segment on the Control panel to highlight each
segment individually and assess the tracking quality.
A segment with poor tracking can be removed from the
calculation of the global value for the selected parameter:
press the Enter key on the keyboard or Reject segment on
the Control panel to remove the highlighted segment. The 5-57
curve of the rejected segment is removed and the rejected
 segment is marked with an “X” on the Bull’s eye
representation. The global value for the selected parameter
is not calculated if more than three segments are rejected.
NOTE: If the tracking is not good, it is possible to go back to the
Strain ROI stage and edit the ROI and reprocess.
NOTE: To approve a segment previously rejected, highlight the
rejected segment and press Enter on the keyboard or
Approve segment on the Control panel.
3. Press the following buttons on the Control panel to display
the results for other parameters.
• Longitudinal Strain
• Circumferential Strain
• Area Strain
• Radial Strain (assuming Volume Conservation)
• Rotation/Twist
• Torsion
4. The Bull’s eye has several display modes that can be
toggled between:
• Peak: showing the values based on peak detection of
the curves.
• Dynamic Peak: showing semi dynamic update of color
while looping. The color update stops when the peak
has been reached.
• Dynamic: showing dynamic update of the color while
looping.
NOTE: The Bull's eye can be configured to display either
17 segments or ASE 17 segments models (from Config/
Meas-Text/Advanced/AutoLVQ Segment model)
The default Bull’s eye model for Twist/Rotation and Torsion
parameters is a 3 segment model. A 17 segment model can
be displayed by pressing Segmental on the Control panel.
5. Press Export results to save the results in CSV format,
readable in Microsoft Excel, or in HDF format, readable in
HDF viewer. See page 4-34 for more information about HDF
format. Both file types contain the segmental traces, but the
HDF file in addition contains the midwall quadrilateral strain
mesh.
NOTE: Exported data is without any guarantee of validity. It is used
at own risk, and should be manually cross-checked against
the values shown on screen to ensure correctness. In case
of discrepancy between exported values and values shown 5-58
on screen, then the values on screen are the official valid
 ones that should be reported. The content and data format
of the exported files are subject to change. GE may change
the definitions of the file format given in this document
according to new development needs or by other
circumstances.

1. Apical and short axis views with segmented ROI.

2. Segmental and global curves
3. Bull’s eye representation
4. Selected parameter
5. Selected segment (ROI, curve and Bull’s eye)
6. Rejected segment
7. Global value for the selected parameter

Figure 5-33. The 4D Strain result screen

Approval

1. Press Approve & Exit to store the measurements shown in

the Measurement result table.
The measurements are transferred to the Worksheet.
To exit without approving, press Cancel.
NOTE: Measurements that are not approved will not be saved. 5-59
 CAUTION The measurement should not be approved if a significant part
(more than 25%) of the left ventricular wall or the detected
contours are outside the ultrasound sector.

Calculation formula and measurement accuracy

Refer to the Reference manual for calculation formula and

measurement accuracy information.

5-60
Manual left ventricular volume measurements

Tri-plane acquisition

This procedure describes the calculation and reconstruction of

the left ventricular volume from a Tri-plane acquisition. The
Tri-plane acquisition should be a Tri-plane greyscale acquisition,
not a Tri-plane color acquisition.
1. Open an Apical 4 chamber view acquired in Tri-plane mode.
2. Press Stop.
3. Press Measure.
The Measurement menu is displayed.
4. In the Measurement menu select Volume and Tri-plane.
The Measurement screen is displayed with the Ejection
fraction tool selected (see Figure 5-34).
The end diastolic frame of the current cardiac cycle is
displayed and the cursor is moved to the reference scan
plane.

1. Ejection fraction tool for Tri-plane

2. Scan plane 1 (yellow): Apical 4 chamber view
3. Scan plane 2 (white): Apical 2 chamber view
4. Scan plane 3 (green): Apical long axis view
5. Volume reconstruction

Figure 5-34. The Tri-plane measurement screen 5-61

 5. Place the cursor to the start point for the trace.
6. Press the Left mouse button and draw a contour of the left
ventricle.
To edit the contour while drawing:
• Follow the contour backward to erase it and redraw.
• Press Undo or Backspace to erase the contour
stepwise and redraw.
• Press Delete to remove the entire contour and redraw.
7. Press the Left mouse button to complete the contour.
The cursor is automatically moved to the next scan plane.
The crossing point of the trace done in the first scan plane is
marked in the second scan plane.
8. Draw a contour of the left ventricle in scan plane 2 and 3
following the same procedure.
When the last end-diastolic contour is drawn, an
end-systolic frame is automatically displayed. Using the
arrow keys, ensure that the correct end systolic frame is
displayed.
9. Repeat steps 5 to 8 to draw a contour of the left ventricle at
end-systole in all the scan planes.
The measurement results, including end-diastolic and
end-systolic volumes and the left ventricular ejection
fraction, are displayed in the Measurement result table.
NOTE: Other measurements may be displayed by configuring the
Measurement menu, refer to the scanner’s or workstation’s
User manual for more information about Measurement
menu configuration.

Multi beat 4D acquisition

This procedure describes the calculation and reconstruction of

the left ventricular volume from a Multi beat 4D acquisition.

CAUTION ECG gated acquisition may by nature contain artifacts, that

may have impact on the measurements.
See ‘Measurements on multi beat 4D acquisitions’ on page 5-4
for more information about stitching artifacts.

1. Open an Apical 4 chamber view acquired in Multi-beat

acquisition mode.
2. Press Stop.
5-62
 3. Orientate the reference cut-plane to display an Apical
4 chamber.
4. Press Measure.
The Measurement menu is displayed.
5. In the Measurement menu select Volume and Tri-plane.
The Measurement screen is displayed with the Ejection
fraction tool selected.
6. Follow the procedure described in ‘Tri-plane acquisition’ on
page 5-61 from step 5.

Rotation of the Volume reconstruction

The volume reconstruction displayed in the Geometric model

can be rotated in any directions.
1. Place the pointer in the Geometric model.
2. Press and hold down Left mouse button and use the
mouse to rotate the volume reconstruction.

Bi-plane acquisition

This procedure describes the calculations of the left ventricular

volume from a Bi-plane acquisition. The volume calculation is
based on the Method of disk.
1. Open an Apical 4 chamber view acquired in Bi-plane mode.
2. If required, rotate scan plane 2 to display an Apical
2 chamber view.
3. Press Stop.
4. Scroll through the cineloop to display the end-diastolic
frame.
5. Press Measure.
The Measurement menu is displayed.
6. In the Measurement menu select Volume and Bi-plane.
The Trace tool for the Left ventricular end-diastolic volume
for the Apical 4 chamber view is selected (see Figure 5-35).

5-63
1. Trace tools

Figure 5-35. The Volume measurement screen (Bi-plane)

7. In scan plane 1 (yellow), place the cursor to the start point

for the trace.
8. Press the Left mouse button and draw a contour of the left
ventricle.
9. Move the cursor to the apex and press the Left mouse
button to measure the length.
The trace tool for the Left ventricular end-diastolic volume
for the Apical 2 chamber view is selected.
10. Repeat steps 8 and 9 in the scan plane 2 (measurement in
the Apical 2 chamber view).
The trace tool for the Left ventricular end-systolic volume for
the Apical 4 chamber view is selected.
11. Scroll through the cineloop to display the end-systolic frame
in the same heart cycle.
12. Repeat steps 7 to 10 to perform the end-systolic
measurements in the Apical 4 chamber and 2 chamber
views.
The Ejection fraction (Bi-plane) and the end-diastolic and
end-systolic left ventricular volumes are calculated.

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TSI surface model

A Surface model representation of the left ventricle with TSI

color coding can be generated from a TSI Tri-plane acquisition
by applying a sampling path in the myocardium. The sampling
path is created by placing control points in the myocardium.
1. Open an Apical 4 chamber view acquired in Tri-plane TSI
mode.
2. Press Stop.
3. Press Measure.
The Measurement menu is displayed.
4. In the Measurement menu select Surface Map.
The Mapping tool is selected (see Figure 5-36).

1. Mapping tool for Geometry model

2. TSI surface model

Figure 5-36. The Measurement screen (Geometry model)

5. In scan plane 1 (yellow), place the cursor to the start point

for the sampling path starting in the myocardium.
6. Move the cursor following the myocardium and press the
Left mouse button to place new points.
By creating several control points the sampling path can be
bent to follow the myocardium.
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7. Double-click to end the sampling path.
8. Create a sampling path in scan plane 2 and 3.
 A TSI color coded surface model is displayed in the
Geometric model.
9. To create a dynamic model, scroll to another frame in the
same heart cycle and create a sampling path in each scan
plane.
10. Press Run to run the model.

To edit the sampling path

1. Place the cursor over a control point.
2. Double-click and move the control point to a new position.
3. Press the Left mouse button to place the control point to its
new position.

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 4D LV volume and 4D RV volume

The 4D LV function and the 4D RV function may be analyzed on

the EchoPAC Software Only using the TomTec 4D LV volume
and 4D RV volume applications. These applications enable
analysis of global and regional volume measurements. These
applications are options to the EchoPAC Software Only.
Measurements from the 4D LV volume and 4D RV volume
applications are available in the worksheet after completing the
analysis.
In addition 4D tissue acquisitions can be stored on a removable
media to a format compatible with the TomTec workstation,
using the Save as function on the EchoPAC Software Only (File
format: VolDicom (*.dcm)).

Starting the 4D LV volume and the 4D RV volume applications from

EchoPAC Software Only
1. Open a 4D tissue acquisition.
The Volume rendering screen is displayed.
2. Press Measure.
3. Select Volume/4D LV volume or Volume/4D RV volume.
The corresponding application is started.
Refer to the TomTec User manual for proper use of the
application.
NOTE: EchoPAC Software Only is not accessible while running
these applications.

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 4D MV-Assessment

The morphology and function of the mitral valve can be

assessed in 4D transthoracic and transesophageal acquisitions
using the TomTec 4D MV-Assessment application. This
application is an option to the EchoPAC Software Only.
Measurements from the 4D MV-Assessment application are
available in the worksheet after completing the analysis. The
number of parameters displayed in the worksheet may vary
depending on the steps that were completed during the
4D MV-Assessment analysis.
In addition, 4D tissue acquisitions can be stored on a removable
media to a format compatible with the TomTec workstation,
using the Save as function on the EchoPAC Software Only (File
format: VolDicom (*.dcm)).

Starting the 4D MV-Assessment application

1. Open a 4D tissue acquisition.
2. Press Measure.
3. Select Valve/4D MV-Assessment.
The 4D MV-Assessment application is started.
Refer to the TomTec User manual for proper use of the
application.
Measurements will only be transferred to the worksheet if
the option to save data is selected when ending the
4D MV-Assessment application.
NOTE: EchoPAC Software Only is not accessible while running this
application.

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 4D Auto AVQ

Introduction
The 4D Auto AVQ (4D Automated Aortic Valve Quantification)
tool allows the user to perform computer assisted alignment of
4D TEE images of the Left Ventricular Outflow Tract (LVOT) as
well as segmentation of the LVOT and aortic root. Upon
completion of the segmentation the tool will provide metrics for
the aortic annulus diameter and area.

Requirements
The 4D Auto AVQ tool is available on 4D trans-esophageal
echocardiographic (TEE) tissue data sets in replay mode only.
The tool cannot be used on acquisitions with volume rate equal
or lower than 12 vps.

CAUTION Do not use the 4D Auto AVQ tool if:

• The image quality is poor.
• The acquisition has stitching artifacts.
• The acquisition has significant reverberation artifacts.

The tool must not be used on other structures than the aortic
valve.

Starting the 4D Auto AVQ tool

1. Open a 4D TEE acquisition. The acquisitions should be
made from mid-esophagus roughly centered on the aortic
valve using 4D Zoom.
2. Press Measure.
3. Select Valve/4D Auto AVQ (Figure 5-37).

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 Figure 5-37. Selection of the 4D Auto AVQ tool

The Measurement menu is displayed with the Alignment

tool selected (Figure 5-38).

Figure 5-38. Measurement menu

The main screen displays two long axis slices (90 degree
rotated with respect to each other), a short axis view at the
annulus plane and a free view (Figure 5-39).

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 Figure 5-39. Slice alignment screen

Slice alignment
The alignment of the LVOT is done automatically, presenting to
the user two long axis slices (90-degree rotated with respect to
each other) and short axis view at the annulus plane
(Figure 5-39).
1. To select another frame adjust the Frame control.
2. If necessary the auto alignment can be further adjusted by
rotating any of the views and by moving the annulus plane.

LVOT segmentation
1. Select LVOT segmentation.
The default screen displays two long axis views, one short
axis view, an interactive view and a surface model
(Figure 5-40).
The LVOT is automatically segmented and the result is
presented in the mid-systolic frame (defined as 15% of the
R-R interval). The segmentation is shown as curves where
the 3D LVOT boundary intersects the 2D slices as well as a 5-71
surface model.
 2. The LVOT segmentation should be checked in all slices. To
visualize the LVOT segmentation in all slices, move the blue
line through the LVOT in one of the long axis views and
observe the segmentation in the interactive view. The
position of the interactive view updates according to the blue
line position in the long axis view.
3. The LVOT segmentation may be adjusted by adding
attracting points in the interactive view.
• Press Enter to lock the interactive view.
• Place the cursor at the location where to add a point.
• Press the Left mouse button.
A point is added and the segmentation is modified.
• To delete an attracting point, double click on the point.

1. Long axis view

2. Short axis view
3. Interactive view
4. 3D surface model

Figure 5-40. LVOT segmentation

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Measurements
1. Select Measurements.
The final segmentation result is shown along with a graph
showing the aortic annulus area in relation to the SAX plane
lateral position (distance from aortic valve).
Two layouts are available by use of the Layout button in the
user interface on EchoPAC Software Only (see
Figure 5-41).
The user can freeze the loop and navigate the frames. A
green vertical line will appear at the measurement frame
(see Figure 5-41).
The following measurements are available:
• AA diameter: diameter calculated based on the
perimeter of the segmentation in the aortic annulus
plane at mid-systole
• AA max diameter: length of the major semi-axis of an
ellipse fit to the aortic annulus at mid-systole.
• AA min diameter: length of the minor semi-axis of an
ellipse fit to the aortic annulus at mid-systole
• AA area: area of the detected aortic annulus at
mid-systole

1. Measurement frame indicator

2. Layout button 5-73
Figure 5-41. Aortic valve measurements screen
Approval
1. Press Approve and exit to store the measurements shown
in the Measurement result table.
The measurements are transferred to the Worksheet.
To exit without approving, press Cancel.
NOTE: Measurements that are not approved will not be saved.

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 Advanced vascular measurements
and analysis

Intima-Media Thickness

Introduction

The Intima-Media Thickness (IMT) is calculated based on

automatic contour detection of the Intima and Media layers on a
user-defined search region along the vessel wall. Multiple IMT
measurements are made between pairs of intima and adventitia
points along the wall (Figure 5-42). IMT can be measured both
on the posterior and the anterior walls of the vessel. IMT should
be done on 2D mode images, not on Color mode images.
The IMT measurement is available with linear probes only.
NOTE: Due to the physical properties of ultrasound imaging, the
posterior IMT measurement is generally more accurate than the
anterior IMT measurement.
The following parameters are calculated:
• Average IMT
• Maximum IMT
• Minimum IMT
• Standard deviation of IMT measurements
• Number of successful IMT measurements

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 1. Vessel lumen 3. Lumen-Intima boundary
2. Vessel wall 4. Media-Adventitia boundary
5. Multiple IMT measurements

Figure 5-42. IMT measurement (Posterior wall)

IMT Measurement procedure

The following procedure describes the posterior IMT

measurement.
1. Open a longitudinal scan of the carotid artery.
2. Select Stop.
3. Scroll to an end-diastolic frame where the intima layer is
clearly visible.
4. Press Measure.
5. Select the appropriate IMT measurement. If measuring the
IMT of the posterior wall of the right common carotid select
Rt and CCA IMT Post (Figure 5-43).

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 Figure 5-43. IMT Measurement menu (Right Common Carotid
Posterior IMT measurement tool)

6. Place the cursor in the artery closer to the posterior wall and
press the Left mouse button to anchor the start of the search
region (Figure 5-44, left).
7. Move the cursor parallel to the artery to define the end point
of the search region. Make sure the Intima and Media layers
are within the search region (indicated by the lower dotted
line in Figure 5-44, left).
Press the Left mouse button to anchor the point. For the
posterior wall the contour detector searches for the leading
of the edges of the intima and adventitia layers. The
detected contours are drawn in the image (Figure 5-44,
right).
The measurement calculations are displayed in the
Measurement result table.
NOTE: If the Intima and Media layers are not within the search
region, the contour is not drawn. Select (double click) and
move the anchored points closer to the Intima layer.

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 1. Measurement segment 2. IMT trace

Figure 5-44. IMT Measurement segment and traces

8. If the contour is not optimal, adjust Trace Fit to modify the

traces according to different threshold values.
If the contour is still not optimal, try to perform the IMT
measurement on another frame, preferably close to the end
diastole.

IMT trace approval

NOTE: Erroneous contour detection of the Intima and Media layers may
lead to incorrect measurement results. The contour detection
should be visually checked and edited if required.
Since the IMT measurements are done semi-automatically, the
operator has to approve the detection by visual inspection
before storing the results in worksheet and report.
1. If the traces fit both layers of the posterior wall, approve the
measurement by selecting Transfer in the Measurement
menu.
Once transferred, the calculations can be viewed in the
worksheet and report.
NOTE: Measurements that are not approved will not be saved.
NOTE: Any image adjustments (e.g Gain or zoom) on approved
(transferred) measurements will unassign the
measurements. Press Transfer to approve the
measurements again.

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 OB measurements

1. From an obstetric exam on a scan in Freeze, press

Measure.
2. Select the desired study.
3. Perform the required measurements from the selected
study.
Follow the on-screen indications when performing
measurements.

OB graphs
OB Graphs allow you to assess fetal growth compared to a
normal growth curve. When a patient has completed two or
more ultrasound exams, you can also use the graphs to look at
fetal trending. For multi-gestational patients you can show
curves for all fetuses and compare the growth on the graphs.
The EchoPAC Software Only provides the following two basic
types of graphs:
• Fetal Growth Curve graphs – shows one measurement
per graph. These graphs show the normal growth curve,
positive and negative standard deviations or applicable
percentiles, and ultrasound age of the fetus using the
current measurement. For multi-gestational pregnancies,
you can show curves for all fetuses. If previous exam data is
available, the graph can show fetal trending.
• Fetal Growth Bar graph – shows the ultrasound age and
the gestational age based on patient data. Plots all
measurements on one graph.

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 CAUTION The system provides calculations (e.g. estimated fetal weight)
and charts based on published scientific literature. The
selection of the appropriate chart and clinical interpretation of
calculations and charts are the sole responsibility of the user.
The user must consider contraindications for the use of a
calculation or chart as described in the scientific literature. The
diagnosis, decision for further examinations and medical
treatment must be performed by qualified personnel following
good clinical practice.

To view OB graphs

1. Press Worksheet.
2. Press Graph.
The Fetal growth curve graph is displayed (Figure 5-45).
The horizontal axis shows the fetal age in weeks. The
system determines this age from the data entered in the
Patient info and exam screen. Depending on the
measurement selected the vertical axis displays
measurements (mm or cm), ratios (%) or fetal weight (g).
The Fetal growth curve graph shows the following
information for the selected measurement:
• The normal growth curve
• The standard deviations or relevant percentiles
• The gestational age of the fetus, using patient data
(vertical dotted line)
• Using the current ultrasound measurement data, where
the fetus is on the growth curve
From the OB graphs screen, the user can enter relevant
information in the Fetus position and Placenta fields.

5-80
 Figure 5-45. Fetal growth curve graph

To select the measurement

1. Select the measurement in the Measurement type field.
A list of available measurements is displayed.
2. Select the measurement to display.
To scroll through all Fetal growth curve graphs, adjust
Graph change.

To edit the Gestational age (GA)

1. Select the GA (LMP) value.
An editing window is displayed.
2. Enter a new value and select OK.
The GA (LMP) label is changed to GA(GA) showing the new
value entered. This information is also updated in the
Patient info and exam screen. In addition the EDD (LMP) is
updated to EDD (GA) with new calculated value.

To view single or quad screen

1. Press Quad to display four graphs simultaneously.
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 2. To select the measurements to display in the quad screen,
select the drop-down button on the left of each graph and
select the desired measurement.
3. Press Single to display single graph screen again.

Figure 5-46. Fetal growth curve graph: quad screen

5-82
Fetal trending

When you have ultrasound data from more than one exam of a
patient, you can use the data to look at fetal trending on the
Fetal growth curve graphs. Fetal trending requires that a LMP
value is entered in the Patient info and exam screen.
1. Press Worksheet.
2. Press Graphs and select the desired measurement to
display.
3. Press Plot both.
The system automatically finds the data from previous
ultrasound exams, and displays it on the graph with the
present data.

Figure 5-47. Fetal trending graph

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Fetal growth bar graph

The fetal growth bar graph shows current exam measurements

and the normal growth range based on the gestational age. It
shows all measurements on one graph.
1. Press Worksheet.
2. Press Graph.
3. Press Bar.
The fetal growth bar graph is displayed.

Figure 5-48. Fetal growth bar graph

• The horizontal axis shows the gestational weeks.

• The red vertical line shows the gestational age using the
patient data.
• The blue dotted vertical line shows the ultrasound age
using the current measurements.
• The yellow x shows the ultrasound age for each
measurement.
• The green rectangle shows the normal age range for the
measurement.

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Measurement package configuration

There are many more measurements and parameters in the

measurement package than shown in the default Measurement
menu. Use the configuration system to set up the
measurements that should be available in the Measurement
menu and which parameters should be calculated.
A list of all cardiac calculations with needed measurements and
location in the Measurement package can be found in the
Reference manual.

Basic operations

Opening the Measurement configuration package

1. Press Config (F2) and select the category Measure/Text.

The Measurement menu sheet is displayed (Figure 5-49).

Display of the Measurement categories

1. Press M&A categories in the Configuration window.

The M&A categories are displayed in a pop-up window.
2. Check the categories to be displayed.
Uncheck the categories to hide.
To select a Measurement category in the Measurement menu:
1. Select the heading of the Measurement menu.
The measurement categories are displayed in a sub-menu.
2. Select the Measurement category to display.

Moving an item in the Measurement menu

1. Select an entry in the Measurement menu.

2. Press or to move the selection up or down inside
the Measurement menu.
5-85
Deleting an item in the Measurement menu

Only user-created items can be deleted.

1. Select an entry to delete in the Measurement menu.
2. Press to delete the item.

Display/hide a folder or a measurement in the Measurement menu

The Measurement menu (Folders and Measurements) can be

configured to display only the entries (folders and
measurements) of interest.
To hide a folder or a measurement:
1. Uncheck the actual folder or measurement in the Folder or
Measurement field in the Configuration window.
To display a hidden folder or measurement:
1. Check the actual folder or measurement in the Folder or
Measurement field in the Configuration window.

Auto-sequence of measurements within a folder

1. In the Measurement menu sheet, select a folder in the

Measurement menu.
2. Check Auto sequence.
When performing the first measurement in the folder, the
next measurement is automatically selected.

Creating a user-defined folder

1. If the folder is to be inside another folder, select the actual

folder in the Measurement menu.
2. Press Add folder.
The Measurement menu is updated.
3. Enter the folder name in the Name text field.

Measurement package configuration - example

The following example based on calculation of AV CO (Cardiac
Output by Aortic Flow) describes how to configure the
measurement package so that necessary measurements and
the resulting calculations are displayed on screen.
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 Calculation of Cardiac Output by Aortic Flow requires the
measurement of:
• AV diameter located in the folder Dimension (2D mode)
• AV VTI located in the folder Aortic (Doppler AV Trace).
• Heart rate
If a calculated parameter (e.g. AV CO in AV Trace
measurement) requires another parameter to be calculated (e.g.
AV Diam) the user must first measure the required parameter
(e.g. AV Diam) before the dependent parameter (e.g AV CO in
AV Trace) gets calculated.

Configuration of the Measurement menu

If the AV diameter measurement is not present in the folder

Dimension in the Measurement menu, follow the following
procedure:
1. Press Config (F2) and select the category Measure/Text.
The Measurement menu sheet is displayed (see
Figure 5-49).
2. AV Diam is a 2D measurement, make sure that 2D is
checked in the Measurement sheet.
3. Select folder Dimension in the Measurement menu.
A list of all available measurements for the selected folder is
displayed in the Measurement menu sheet.
4. Check the box in front of AV Diam.
The AV Diam measurement is displayed in the folder
Dimension in the Measurement menu.
5. For the AV VTI measurement, check Doppler in the
Measurement menu sheet and select the folder Aortic in
the Measurement menu.
6. Check the box in front of AV Trace.
The AV Trace measurement is displayed in the folder Aortic
in the Measurement menu.

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 1. Select the scanning mode for the measurement to add to the Measurement menu.
2. Select the folder for the measurement to add.
3. Select the measurement to add.

Figure 5-49. Configuration of the Measurement menu

Configuration of the Measurement result table

If AV CO calculation is not displayed in the Measurement result

table, follow the following procedure:
1. Press Config (F2) and select the Config category Measure/
Text.
The Measurement menu sheet is displayed.
2. The AV CO calculation is based on Doppler AV Trace
measurement in the folder Aortic, check Doppler in the
Measurement menu sheet and select the folder Aortic.
A list of all available measurements and calculations for the
selected folder is displayed in the Measurement menu
sheet.
NOTE: Entries in green are calculated measurements.
3. In the Measurement menu sheet, double-click on the
AV Trace measurement.
A list of all available output parameters for the AV Trace
measurement is displayed in the Measurement menu sheet.
4. Check the box in front of AV CO. 5-88
 The AV CO calculation will be displayed in the Measurement
result table.

User-defined formulas
User-defined formulas can be created using existing
measurements or by defining new measurements. The following
example describes the creation of a formula based on existing
measurements.

CAUTION GE does not take any responsibility for the correctness of the
user-defined studies, parameters or functions.

User-defined formula - example

The workflow for user-defined formula is:

• If the user-defined formula is based on several
measurements of different types, create a user-defined
folder in the Measurement menu so that all measurements
and the formula are grouped together. If the formula is
based on a single measurement you may select an existing
appropriate folder.
• Add the measurement(s) needed for the formula to the
user-defined (or existing) folder.
• Create the formula based on the added measurements.
The following procedure describes the creation of user-defined
LIMP formula as follows: My LIMP = (MCO-AV ET)/AV ET.

Creation of a user-defined folder

1. Select the appropriate scanning mode.

2. Create a folder in the Measurement menu. 5-89
Figure 5-50. The Measurement menu sheet (Add folder)
 1. Press Config (F2) and select the category Measure.
2. MCO and AV ET are Doppler measurements, select
Doppler in the Measurement menu sheet.
3. Select Add folder.
4. Give the folder a name (e.g. “My Folder”).

Adding measurements

1. Select the user-defined folder.

2. Press Add measurement.

Figure 5-51. The Measurement menu sheet (Add measurement)

1. Select the user-defined folder (e.g. “My Folder”) in the

Measurement menu.
2. Press Add Measurement in the Measurement menu sheet.
The Add measurement window is displayed.

Figure 5-52. The Add measurement window

3. MCO and AV ET are measurements that already exist on

the system, check Use copy of and select MCO from the
drop down menu.
4. Select OK to add the MCO measurement.
5. Repeat steps 2 to 4 to add the AV ET measurement.

5-90
Creation of the formula

1. Select the last measurement.

2. Double click and enter the formula name.
3. Select “=” to create the formula.

Figure 5-53. The Measurement menu sheet

The formula for this example is as follows:

My LIMP = (MCO-AV ET)/AV ET
1. In the user-defined folder (e.g.”My folder”), select the last
measurement created (e.g. AV ET).
2. Click beneath the last line in the Parameter list in the
Measurement menu sheet to add a new line.
3. Double-click (Name) and enter the name for the formula
(e.g. My LIMP).
4. Select .
The Edit formula window is displayed.

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 Figure 5-54. The Edit formula window

5. Select “(“ from the Operators drop-down menu.

6. In the Doppler drop-down list, select
MCO [My Folder, MCO].
Make sure to select the measurement located in the
user-defined folder (e.g. “My Folder”).
7. Select “-“ from the Operators drop-down menu.
8. In the Doppler drop-down list, select
AV ET [My Folder, AVET].
9. Select “)“ from the Operators drop-down menu.
10. Select “/“ from the Operators drop-down menu.
NOTE: Operators may also be entered using the alphanumeric
keyboard.
11. In the Doppler drop-down list, select
AV ET [My Folder, AVET].
The Formula line should display: ({MCO}-{AVET})/{AVET}.
No units are necessary since the formula is a ratio (‘About
units’ on page 5-95).
12. Press Check to make sure that the syntax for the formula is
correct.

User-defined measurements
Some user-defined formula may require measurements that do
not exist on the system. The following example based on a
generic distance measurement illustrates how to create
user-defined measurements.

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1. Select the appropriate scanning mode.
2. Select the appropriate folder.
3. Press Add measurement.

Figure 5-55. The Measurement menu sheet

1. Press Config (F2) and select the category Measure.

2. In the Measurement menu sheet, select the appropriate
scanning mode for the measurement to be created (e.g.
2D).
3. Select the appropriate folder in the Measurement menu
(e.g. Dimension).
4. Press Add Measurement in the Measurement menu sheet.
The Add measure window is displayed.

Figure 5-56. The Add measure window

5. Check Blank and press OK.

The Measurement menu sheet is updated.

5-93
1. Enter a name for the measurement.
2. Select the appropriate measurement tool.
3. Double click and enter the formula name.

Figure 5-57. The Measurement menu sheet

6. In the Measurement menu sheet, enter the name for the

measurement (e.g. My Distance).
7. Select the appropriate measurement tool in the drop-down
menu, next to Tool (e.g. 2D Caliper).
8. Double-click (Name) in the appropriate parameter (e.g
Distance) and enter a name for the parameter (e.g. My
Length).
If desired change the unit and the number of decimals for
the measurement by double clicking the values under Unit
and Precision (see also ‘About units’ on page 5-95).

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About units

Be aware of the following:

• All formulas are calculated in SI units (see table below).
• If no unit is specified in the Edit formula window when
defining a formula, the displayed value will be in SI unit.

To define a different unit

1. When creating a formula, enter the unit to use when
displaying the formula output. E.g. if Y in the formula Y=f(x)
is to be displayed in cm, enter cm in the Unit field (see
Figure 5-54 on page 5-92).
The Unit field is case sensitive, make sure to enter the exact
unit as shown in the table below (Alternative unit column).
2. The output of a formula must always be in an SI unit (see
table below). Conversion to the specified display unit is then
done automatically.
Example: an user wants to add a regression formula for
estimating a length B from a measured length A, both in cm.
The formula is: B = 2.4 + 1.1*A.
• As A is a measurement value the system will enter the
formula in the SI unit for length (m). The formula
expects A in cm, and to get that, A must be multiplied by
100:
B = 2.4 + 1.1*A*100
• The formula now gives B in cm. Converting the output
from cm to the SI unit (m), is done by dividing by 100:
B = (2.4 + 1.1*A*100)/100
The output is now in m, and by entering this formula into the
system the user gets the expected result. Measuring an A of
2 cm gives: B = (2.4 + 1.1*0.02*100)/100 = 0.046 m.
Before display of the value it is converted according to the
specified display unit (cm), and the system displays 4.6 cm.
If the selected display unit was set to mm the formula would
give the exact same output, 0.046 m, but the automatic unit
conversion would now instead give a displayed value of
46 mm.

5-95
 Calculation SI Alternative unit
Time s

Ratio %

Frequency bpm

Angle rad

Distance m

Velocity m/s

Acceleration m/s2

Area m2

Volume m3

Volume flow m3/s

Pressure mm Hg*

Pressure/time mm Hg/s

Mass kg

Other

* The correct SI unit for pressure is Pa, but here mm Hg was used as base unit as it is a standard pressure
unit to use in medicine.

Advanced settings

The Advanced sheet

The Advanced sheet enables further configuration of the

Measurement function. The settings are divided into application
specific parameters and global parameters.

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 Figure 5-58. The Advanced sheet

1. If configuring application specific parameters, select an

application from the M&A category pull-down menu.
2. Select the configuration value next to the parameter to
configure.
A pull-down menu is displayed.
3. Select a new value from the pull-down menu.

The Modify calculations sheet

The Modify calculation sheet is used to configure the

calculations to be performed when doing a Doppler vascular
measurements.

5-97
 Figure 5-59. The Modify calculations sheet

The following example describes how to configure the Carotid

Doppler calculations.
1. In the Modify calculations sheet, select Vascular next to
M&A Categories.
The Vascular measurement category is displayed.
2. Select Carotid.
The available calculations are displayed.
3. Check the desired calculations to be performed.
4. Select Save.

The OB table sheet

The OB table sheet enables the creation and edition of

user-defined OB tables. 5-98
 Figure 5-60. The OB table sheet

The following example describes how to create a fetal age

OB-2/3 table based on Bi Parietal Diameter measurements.
1. In the Measure/Text category, select the Measurement
menu.
2. In the Measurement menu sheet, select 2D mode.
3. Select the OB table sheet.
4. In the Measurement menu, select the category Obstetrics
and the OB-2/3 measurement study.
5. In the OB table sheet, check New table.
6. Enter or select the following:
• OB Table Template: when creating a new OB table,
select Template (1 - 7) which you want to use as the
basis of the user programmable OB Table (page 5-101).
When editing an existing user OB table, select the 5-99
desired OB table to edit.
 • Tool type: Select the type of measurement (e.g.
Distance)
• Measure Name: type the name of measurement that
will display in the Measurement menu (e.g. My BPD
Measure).
• Author Name: Type the author’s name (e.g. My Name).
• Table Type: If necessary, select the table type (e.g.
Fetal Age).
• Measure type: select the desired measurement (e.g.
BPD).
7. Select Edit table.
The OB Table spreadsheet is displayed, showing the table
template selected.
8. Enter the Min, Max and Interval values in the Parameters
field.
The system automatically fills in the MEAS column.
9. Enter the input values for the MEAN and SD columns.
10. Select Exit to save.

5-100
The OB table templates

Template 1 (based on Hadlock)

Fetal age format: MEAS MEAN SD

Unit: mm week week

Table range: 1 SD

Graph range: 1 SD

Measurement Value: [cm]

result
GA: [#w#d]

Min: [#w#d]

Max: [#w#d]

Fetal growth Format: AGE MEAN SD

Unit: week mm week

Others are same as above

Template 2 (based on Tokyo)

Fetal age Format: MEAS MEAN SD

Unit: mm day day

Table range: 1 SD

Graph range: 1 SD

Measurement Value: [cm]

result
GA: [#w#d]

SD: [day (+/-)]

Fetal growth Format: AGE MEAN SD

Unit: day mm day

Others are same as above

Template 3 (based on Osaka)

Fetal age Format: MEAS MEAN SD

Unit: mm day mm

Table range: 1 SD

Graph range: 1 SD
5-101
 Template 3 (based on Osaka)

Measurement Value: [cm]

result
GA: [#w#d]

SD: [(mv-pv)/sd]

Fetal growth Format: AGE MEAN SD

Unit: day mm day

Others are same as above

Template 4 (based on several European tables)

Fetal age Format: MEAS MEAN SD

Unit: mm weekday mm

Table range: 5%–95%

Graph range: 5%–95%

Measurement Value: [cm]

result
GA: [#w#d]

GP: [%] Calculated by Fetal growth table. If Fetal growth table is not
edited, GP is not calculated.

Fetal growth Format: AGE MEAN SD

Unit: weekday mm day

Others are same as above

Template 5 (based on several European tables)

Fetal age Format: MEAS MEAN SD

Unit: mm weekday mm

Table range: 1 SD

Graph range: 5%–95%

Measurement Value: [cm]

result
GA: [#w#d]

GP: [%] Calculated by Fetal growth table. If Fetal growth table is not
edited, GP is not calculated.

Fetal growth Format: AGE MEAN SD

Unit: weekday mm day

Others are same as above 5-102

 Template 6 (based on several European tables)

Fetal age Format: MEAS MIN MEAN SD

Unit: mm weekday weekday weekday

Table range: 10%–90%

Graph range: 10%–90%

Measurement Value: [cm]

result
GA: [#w#d]

GP: [%] Calculated by Fetal growth table. If Fetal growth table is not
edited, GP is not calculated.

Fetal growth Format: AGE MIN MEAN SD

Unit: weekday mm mm mm

Others are same as above

Template 7 (based on several European tables)

Fetal age Format: MEAS MEAN SD

Unit: mm weekday mm

Table range: 1 SD

Graph range: 10%–90%

Measurement Value: [cm]

result
GA: [#w#d]

GP: [%] Calculated by Fetal growth table. If Fetal growth table is not
edited, GP is not calculated.

Fetal growth Format: AGE MEAN SD

Unit: weekday mm mm

Others are same as above

Normal values
Normal values can be defined by the user for all parameters. A
Normal value can be either a range or a threshold. Normal
values entered are grouped by measurement category (e.g.
Cardiac, Pediatrics...etc).
Normal values are displayed in the report if the report template
used is configured to display normal values (page 9-33).
5-103
To define a Normal value

1. Measurement category
2. Selected measurement
3. Parameters
4. Press to define Normal value

Figure 5-61. Adding Normal value

1. Press Config (F2) and select the Config category Measure/

Text.
The Measurement menu sheet is displayed (Figure 5-61).
2. In the Measurement menu, browse to the measurement of
interest.
The parameters for the selected measurements are
displayed in the Measurement menu sheet.
NOTE: To change Measurement category, press the Heading in the
Measurement menu and select another Measurement
category.
3. Select in the Normal value column.
The Normal value window is displayed.

5-104
 Figure 5-62. The Normal value window

4. In the Normal value window:

• Select the Normal value type (Range, Above or Below).
• Type in the Normal value.
• Optionally enter a reference for the Normal value.
5. Select OK.
The Normal value is displayed in the Measurement menu
sheet.
To display Normal values and references in the Report, the
Report template must be configured to show Normal values
(‘Inserting a measurement container’ on page 9-33).
Measurements outside the Normal value are highlighted with an
“!” in the report.

5-105
 Measurement result table

The display of the Measurement result table can be minimized

and moved to prevent the table obscuring parts of the
ultrasound image.

Minimizing the Measurement result table

1. Select on the heading of the Measurement result table.
The Measurement result table is minimized to the heading
bar.
Repeat step 1 to maximize the Measurement result table.

Moving the Measurement result table

1. Adjust Move Result Win on the Control panel to move the
Measurement result table around the screen.
NOTE: Alternative: select the heading of the Measurement result
table, move the table to a new location and press Select to
anchor the table.

Deleting measurements
1. Select the measurement to delete in the Measurement
result table.
2. Select Delete measurement in the context menu.

5-106
 Chapter 6

Stress Echo

‘Introduction’ on page 6-2

‘Review of protocol studies’ on page 6-3

‘Stress Echo analysis’ on page 6-6

‘Quantitative TVI Stress echo analysis’ on page 6-14

‘AFI Stress’ on page 6-20

‘Editing/creating a Stress Echo protocol template’ on

page 6-24

6 -1
 Introduction

The EchoPAC Software Only provides an integrated stress echo

package, with the ability to review, perform wall segment scoring
and report for a complete efficient stress echo analysis.
The stress package provides protocol templates for exercise, as
well as, pharmacological stress examinations. In addition to
preset factory protocol templates, templates can be created or
modified to suit user’s needs. Users can define various quad
screen review groups, in any order and combination, that will
suit their normal review protocol. When reviewing stress
examination images, the images are viewed at their original
image quality, and different post-processing and zoom factors
may be applied to the images under review for effective image
optimization. In addition to standard wall motion scoring
analysis, the user can perform quantitative stress analysis
based on tissue velocity information (TVI).

6 -2
 Review of protocol studies

Image acquisitions based on a protocol study (e.g. stress echo

examinations) can be reviewed from the Protocol screen.

1. Level selection
2. Selected loops
3. Projection selection
4. Group of views

Figure 6-1. The Protocol screen

6 -3
Image selection for analysis
Images can be selected manually or from a pre-defined group in
the Protocol screen.

Selection of images from a group

If groups of images have been defined in the protocol template

(page 6-27), the user can select a group of images for analysis
and sequentially analyze all images from all groups from within
the Analysis screen (Figure 6-3 on page 6-7).
1. Move the Mouse cursor over a group in the Group list.
The frame of the images belonging to the group are
highlighted.
2. Press the Left mouse button to open the images in the
Analyze screen (see page 6-7).

1. Select a Projection
2. Select an image
3. Select and open an Image
group

Figure 6-2. Image selection from the Protocol screen

Manual selection of images in the Analysis screen

1. When currently in protocol analysis in the Stress analysis

screen (Figure 6-3), hold down Shift while selecting the
images from the stress template matrix in the lower right
corner of the screen.
2. Select the first image in the Template matrix.
The selected loop is displayed in the Stress analyze screen
and the next window in the quad screen is automatically
selected. 6 -4
3. Repeat step 2 to select other images.
 4. Depress Shift.

Manual selection of images in the Protocol screen

1. In the Protocol screen, click once on the images of interest.

2. Press Analyze to open images in the Analyze screen (see
page 6-7).
NOTE: Alternative: Double click on the last selected image to open
images.

Loop synchronization

1. In the Protocol screen, select the loop to synchronize.

2. Click Sync. Selected.

6 -5
 Stress Echo analysis

Stress Echo analysis consists of viewing previously saved loops

and assigning scores to each cardiac segment, in order to
quantify the function of the muscle, or wall motion.
The usual procedure consists of sequentially opening all image
groups and perform scoring from image to image.
Wall motion scoring is used to evaluate wall motion in each
cardiac segment. The left ventricle myocardium is divided into a
number of segments (e.g. 16 or 18), and each segment is
assigned a score based on visual evaluation/”eye-balling”. The
wall motion scoring results are linked to the stress level of the
image being evaluated. This means that for instance when
scoring a short axis projection and a long axis projection from
the same stress level, then common segments with the same
scoring value will be shown in the respective scoring diagrams.

CAUTION The wall motion scoring result is assigned to the stress level of
the image, but will not be updated if the image is moved to
another stress level in the protocol at a later time. Images
should be correctly placed in the protocol when performing wall
motion scoring.

NOTE: The number of segments (WMS segment model), the range of

scoring values (WMS scoring legend) and the initial scoring
value (WMS initial scoring) may be configured in Config/Meas
Text/Advanced under the Cardiac M&A category.

Conventional Stress Echo acquisition

Starting analysis

1. From The Protocol screen (see Figure 6-1 on page 6-3),

select the first image group.
The Stress Echo analysis screen is displayed (see
Figure 6-3) showing the first four images and the
corresponding scoring diagrams. 6 -6
 1. Selected loop (highlighted frame)
2. Highlighted segment name (see pointer)
3. Change page or enter next image group
4. Display Bull’s eye diagram

Figure 6-3. The stress echo analysis screen (Quad screen)

Wall motion scoring

1. Click on a segment in one of the scoring diagrams.

The Score pop-up list is displayed (see Figure 6-4).
2. Select the score from the Score popup list. The score is
displayed in the relevant segment area in the diagram.
3. Repeat the operation to score relevant segments.
4. Press Next page to access to the next images in the
group or to the next group.

6 -7
 1. Selected segment
2. Selected score

1. Scored segment

Figure 6-4. Segment scoring

Multi-plane Stress Echo analysis

This section describes the basic procedure for image analysis of
Multi-plane Stress Echo acquisition. In a Multiplane Stress Echo
acquisition each cell in the template contains simultaneous
acquisitions of several projection planes.
The example below is based on the following Pharm. 4x2
Multiplane factory template. This template consists of:
• Four levels: Baseline, Low dose, Peak dose and Recovery
• Two columns:
- A Tri-plane mode column with simultaneous acquisition of
Apical 4 chamber, Apical 2 chamber and Apical long axis 6 -8
views.
 - A Bi-plane mode column with simultaneous acquisition of
Parasternal long axis and Parasternal short axis views.

1. Apical 4 chamber, Baseline

2. Apical 4 chamber, Low dose
3. Apical 4 chamber, Peak dose
4. Apical 4 chamber, Recovery
5. Corresponding Wall segment diagrams
6. Previous next images/group

Figure 6-5. Multi-plane Stress Echo analysis screen (Apical group, 4 chamber
acquisition)

1. When starting analysis, the Stress echo analysis screen is

displayed, showing the first scan plane from the images in
the first group (Apical 4 chamber for all levels, acquired in
scan plane 1 (yellow) in Tri-plane mode) and the
corresponding wall segment diagrams.
2. Perform segment scoring.
3. Select the Right arrow in the lower right corner of the
screen to display the next scan planes from the images in
the first group (Apical 2 chamber for all three levels,
acquired in scan plane 2 (white) in Tri-plane mode).
4. Perform segment scoring.
5. Select the Right arrow in the lower right corner of the
screen to display the next scan planes from the images in
the first group (Apical long axis for all three levels, acquired
in scan plane 3 (green) in Tri-plane mode).
6. Perform segment scoring. 6 -9
 7. Select the Right arrow in the lower right corner of the
screen to display the first scan plane from the images in the
second group (Parasternal long axis for all three levels,
acquired in scan plane 1 (yellow) in Bi-plane mode).
8. Perform segment scoring.
9. Select the Right arrow in the lower right corner of the
screen to display the next scan planes from the images in
the second group (Parasternal short axis for all three levels,
acquired in scan plane 2 (white) in Bi-plane mode).
10. Perform segment scoring.
11. Press Patient and select End Exam.
The examination is stored.

4D Stress Echo analysis

This section describes the basic procedure for image analysis of
4D Stress Echo acquisition based on the Pharm. 4x1 4D factory
template. This template consists of:
• Four levels with 4D acquisition: Baseline, Low dose, Peak
dose and Recovery
• One column (projection) with 4D acquisition.
The 4D Stress analysis consists of:
• Apical views analysis: segment scoring from 4 chamber,
2 chamber and Apical long axis views for all stress levels
• Short axis views analysis: segment scoring from apex, mid
and basal Short axis views for all stress levels.

6-10
4D Stress Apical analysis

1. Baseline Apical 4 chamber view

2. Low dose Apical 4 chamber view
3. Peak dose Apical 4 chamber view
4. Recovery Apical 4 chamber view

Figure 6-6. 4D Stress Echo analysis screen (Apical 4 chamber view)

1. When starting analysis, the Stress echo analysis screen is

displayed, showing the Apical 4 chamber for all stress levels
and the corresponding wall segment diagrams.
2. If required, adjust Rotation to rotate the scan plane to get
an optimal Apical 4 chamber view. The rotation is applied
simultaneously in all views.
3. Perform segment scoring.
4. Select the Right arrow in the lower right corner of the
screen or Review page to display the Apical 2 chamber for
all stress levels. The segment diagrams are updated
accordingly.
5. If required rotate the scan planes and perform scoring.
6. Select the Right arrow in the lower right corner of the
6-11
screen or Review page to display the Apical long axis for all
 stress levels. The segment diagrams are updated
accordingly.
7. If required rotate the scan planes and perform scoring.
8. Select the Right arrow in the lower right corner of the
screen or Review page, the Short axis apex view and
corresponding segment diagram for all stress levels are
displayed.

4D Stress Short axis analysis

1. Baseline short axis apex view

2. Low dose short axis apex view
3. Peak dose short axis apex view
4. Recovery short axis apex view
5. Indicator window, the green bar indicates the position of the current short axis view. Can be translated
simultaneously in all views.
6. Indicator window, the yellow bars indicate upper and lower slices. Can be adjusted individually in each
stress level view.

Figure 6-7. 4D Stress Echo analysis screen (Short axis apex view)

1. The default position for the short axis apex view is at 17%
from the upper slice toward the lower slice. Adjust Translate
to translate the short axis apex view up or down. The 6-12
translation is applied in all stress level views simultaneously.
NOTE: If the upper slice is placed at the top of the apex and the
lower slice is placed at the bottom of the basal segments,
then the position at 17% from the upper slice will show the
center of the apical segment.
The upper and lower slices may be adjusted individually in
each stress level view. Adjust the corresponding Top and
Bottom controls to set the upper and lower slices.
The positions of the upper and lower slices and the current
view can be visualized in the Indicator window.
2. Perform segment scoring.
3. Select the Right arrow in the lower right corner of the
screen or Review page to display the short axis mid view
for all stress levels.
The default position for the short axis mid view is at 50%
from the upper slice toward the lower slice. Adjust the short
axis mid view and top/bottom slices as described in step 1
above.
4. Perform segment scoring.
5. Select the Right arrow in the lower right corner of the
screen or Review page to display the short axis basal view
for all stress levels.
The default position for the short axis basal view is at 83%
from the upper slice toward the lower slice. Adjust the short
axis basal view and top/bottom slices as described in step 1
above.
6. Perform segment scoring.
7. Press Archive and select End Exam.
The examination is stored.

6-13
 Quantitative TVI Stress echo
analysis

Introduction

WARNING QTVI Stress analysis is meant as a guide to wall motion

scoring.
Diagnosis must not be based on results achieved by QTVI
Stress analysis only.

The ultrasound unit provides a Quantitative TVI (QTVI) Stress

analysis package based on Tissue velocity information (TVI).
The TVI data is stored in a combined format with grey scale
imaging during stress examination.
When selecting a template supporting TVI data acquisition, the
ultrasound unit will automatically store TVI information,
generally for the apical views of the stress examination.
The QTVI Stress analysis option currently applies only to
Dobutamine stress-echo.
Wall Motion Scoring remains the basis for the diagnosis of CAD
in stress echocardiography. QTVI Stress may be used as a
guidance tool to check this interpretation.
The current version of QTVI Stress is based on the assessment
of peak velocity at peak Dobutamine stress (see reference 1 on
page 6-19). The normal ranges have been validated in the
“average” patient presenting for stress testing. The velocity
cutoff values for the Vpeak measurement will not work in the
following cases:
• Submaximal stress (<85% predicted max HR)
• Patients at extremes of age (<40 or >70)
• Previous myocardial infarction / revascularization
• Previous heart-failure / cardiomyopathy / hypertrophy /
arrhythmia / aortic regurgitation 6-14
 The velocity cutoff values are based on placing the sample
volume at center of each cardiac segment at start of systole, the
left ventricle myocardial segments are defined by the American
Society of Echocardiography 16 segments model. However, the
velocity cutoff model does not cover the apical segments (due to
low velocities and segment orientation), (see note).
NOTE: Velocity measurements in mid and basal segments of the
myocardium will contain contributions from the apical region of
the myocardium. E.g. if measured value in a mid segment is
below the cutoff value for this segment then this might relate to a
reduced function in the mid or apical region.
Tissue Doppler does not have perfect site-specificity because of
tethering by adjacent segments. Thus, although an ischemic
segment has little thickening (and therefore could be expected
to show low velocity), measured velocity may be influenced by
local tethering, reflecting contraction in surrounding segments.
Conversely, a normal segment may have its velocity reduced by
an adjacent segment with reduced velocity. This tethering effect
may decrease the sensitivity for single vessel disease, but
nonetheless the sensitivity and specificity of the cut-offs are
approximately 80% (see reference 1 on page 6-19).
Three different analysis tools based on TVI data are available:
• ‘Vpeak measurement’ on page 6-16, enables the display
of a tissue velocity trace for a selected region of a previously
scored segment through the entire heart cycle. In addition
Vpeak is color-coded on the 2D image. From the velocity
trace, the user can estimate the peak systolic velocity (see
reference 1 on page 6-19).
This tool is available in views from peak levels only and only
when a segment has been scored in one of these views.
• ‘Tissue Tracking’ on page 6-19, enables visualization of
the systolic contraction of the heart by color-coding the
myocardial displacement through the systole.
• ‘Quantitative analysis’ on page 6-19, enables further
quantitative analysis based on multiple tissue velocity
traces.
The quantitative analysis is described in Chapter
‘Quantitative Analysis’ on page 7-1.

6-15
Accessing QTVI Stress analysis tools
The three QTVI Stress analysis tools are entered by pressing a
dedicated button on the scoring diagram (Figure 6-8) of the
selected view. Only views with TVI data acquired will display
QTVI Stress tools buttons on the respective diagrams.

1. Vpeak measurement (V-peak measurement is 2. Tissue Tracking

displayed in views from peak levels and only 3. Quantitative analysis
after scoring.)

Figure 6-8. QTVI Stress tools buttons

Vpeak measurement
This tool enables the user to generate a tissue velocity profile for
a given wall segment through the entire heart cycle and display
color-coded Vpeak in tissue.
From the velocity trace, the user can determine whether the
systolic Vpeak is over or under a clinically determined velocity
threshold (see reference 1 on page 6-19) to confirm the wall
motion scoring.

CAUTION QTVI Stress can be used only in conjunction with wall motion
scoring analysis, as a guiding tool.
When activating QTVI Stress, the measurement applies only to
the currently highlighted segment for the current level and
projection view.

6-16
To display a Vpeak measurement

1. Perform segment scoring as described on page 6-7.

When performing scoring in a view from a peak level, the
Vpeak measurement button (V) is displayed in the
corresponding diagram.
2. In the Scoring diagram, press V.
The cursor is changed to sampling area and the scored
peak views are updated showing:
• A diagram with the current segment highlighted (scoring
bullet with a ring) and the segment's velocity cutoff
(Figure 6-9).
• Color-coded velocity in tissue. The color-coding
convention is as follow:
- Green: Velocities above threshold value + 5%
- Yellow: Velocities near threshold (+/- 5% interval)
- White: Velocities below threshold value - 5%
• A result window to display tissue velocity profile, shown
when moving the sampling area in the view.
3. In the 2D sector, place the sampling point over the wall area
corresponding to the current segment (shown as the
highlighted segment in the diagram).
A tissue velocity profile for the actual segment is generated
in the Result window (Figure 6-9).
4. Use Segment Select to analyze the other segments in the
peak view,
Or
Select another scoring bullet in the diagram in one of the
peak views.

6-17
 1. Tissue velocity profile 4. Vpeak threshold for current segment
2. Sampling point 5. Color-coded tissue velocity:
3. Current segment

Color-coding (velocity thresholds and tissue):

• Green: velocities above threshold value
• Yellow: velocities near threshold (0 to -10% interval)
• White: velocities below threshold value - 10%

Figure 6-9. Vpeak QTVI Stress display

Turn-off the Vpeak measurement tool

1. Select the V button in the peak view scoring diagrams.

V-peak measurement interpretation

The systolic Vpeak in the tissue velocity profile is automatically

detected and highlighted by a vertical bar (Figure 6-9). The
automatically detected Vpeak should be visually verified by the
user. In addition Vpeak thresholds are displayed as color-coded
horizontal lines (Figure 6-9). These thresholds represent
statistical guideline values for peak velocity at peak stress level
(Dobutamine stress procedure) for the three apical views. Only
threshold values for basal and mid-segments for each apical
view are defined (see reference 1 on page 6-19). The result is 6-18
 highlighted by a color-coding of the thresholds lines, the
color-coding in the 2D image and the scoring bullet (Figure 6-9).

Tissue Tracking
Tissue Tracking calculates and color-codes the displacement in
tissue over a given time interval. The displacement is found as
the time integral (sum) of the tissue velocities during the given
time interval. The color-coded displacements calculated in the
myocardium are displayed as color overlay in the respective
acquisition window.
By studying the color patterns generated in the different
segments, the user can confirm the standard segmental wall
motion scoring at peak levels.

To display Tissue Tracking

1. Press T in one of the Wall segment diagram field (usually an

apical view at peak level).
The Tissue Tracking color overlay is displayed in the
Acquisition window.

Quantitative analysis
Quantitative analysis enables further analysis based on multiple
tissue velocity traces. Quantitative analysis is performed using
the Quantitative analysis package described in Chapter
‘Quantitative Analysis’ on page 7-1.

To start quantitative analysis

1. Press Q in one of the Wall segment diagram field (usually

an apical view at peak level) to launch the Quantitative
analysis package (page 7-1).

References
1. Application of Tissue Doppler to Interpretation of
Dubotamine Echocardiography and Comparison With
Quantitative Coronary Angiography. Cain P, Baglin T,
Case C, Spicer D, Short L. and Marwick T H. Am. J. Cardiol.
2001; 87: 525-531

6-19
 AFI Stress

Introduction
Stress protocol analysis may be expanded to include AFI
analysis.
Any stress examination (exercise or pharmacological) that
contains at least the three apical views Apical long-axis
(APLAX), Apical 4-chamber and Apical 2-chamber can be used
for AFI analysis.
The user will need to select a protocol template that is
configured to allow AFI analysis. Refer to ‘Editing/Creating a
template’ on page 6-25 for detailed information regarding stress
template configuration.
The AFI result for each stress level is presented as a Bull's eye
display showing color coded and numerical values for peak
systolic longitudinal strain, PSS (Peak Systolic Strain) and
traces. Bull’s eyes or traces from the different levels can be
viewed side-by-side for comparison. Wall motion scoring can be
performed on the same screen.
Refer to ‘Automated Function Imaging’ on page 5-19 for detailed
information regarding AFI.

CAUTION AFI Stress is only recommended for adult cardiac images

acquired with the M5Sc-D probe. The measurement accuracies
of the longitudinal strain values reported in the Reference
manual is verified with this probe.

AFI Stress analysis

AFI Stress analysis is started from the Protocol screen. The
Protocol screen for a stress template configured for AFI analysis
displays an additional AFI column.

6-20
Figure 6-10. Protocol screen with AFI column

1. While in the Protocol screen, double-click on the AFI cell

located at any stress level to begin the AFI analysis for that
stress level.
AFI analysis is started on the APLAX view of the selected
stress level.
2. Perform AFI analysis on the APLAX view (refer to
‘Automated Function Imaging’ on page 5-19 for more
information concerning AFI analysis).
3. When done, press Process Next on the Control panel.
AFI analysis is started on the 4-chamber view of the
selected stress level.
4. Perform AFI analysis on the 4-chamber view and press
Process Next.
AFI analysis is started on the 2-chamber view of the
selected stress level.
5. Perform AFI analysis on the 2-chamber view.
When done a quad screen showing the results is displayed.
Different Bull’s eye color maps and results may be displayed
as well as traces, refer to ‘Getting the results’ on page 5-35
for more information about the AFI result options.

6-21
 Figure 6-11. AFI result screen

6. To save the results, exit AFI and answer yes to the question
“Do you want to store?”.
The AFI cell for the analyzed level is showing a miniature
Bull’s eye.
7. Repeat the AFI analysis for the other stress levels.

Reviewing a stored Bull's eye at any stress level

1. Press Protocol to display the Protocol screen.
2. In the AFI column, double-click on the Bull’s eye thumbnail
to review.
A quad screen is displayed showing the three apical views
and the Bull’s eye diagram. Different Bull’s eye color maps
and results may be displayed as well as traces, refer to
‘Getting the results’ on page 5-35 for more information about
the AFI result options.

Comparing results from different stress levels

1. Press Protocol to display the Protocol screen.

2. In the AFI column, select up to four Bull’s eye thumbnails,
and press Analyze.
6-22
 The selected Bull’s eyes are displayed side-by-side allowing
the user to compare the results and perform segment
scoring.
NOTE: You can select different color maps for the Bull’s eye on the
Control panel.

Figure 6-12. Bull’s eye comparison

3. Press Traces on the Control panel to compare traces.

NOTE: The Scale control on the Control panel allows adjustment of
the vertical scale of the displayed traces.
4. Press CAMM on the Control panel to compare the Curved
anatomical M-Mode.

6-23
 Editing/creating a Stress Echo
protocol template

Introduction
The stress package provides protocol templates for exercise as
well as pharmacological stress examinations. The user can
create new templates or modify existing templates to suit the
individual needs. Up to ten projections and fourteen stress
levels can be created in a template.
Multi-plane Stress Echo requires specially designed template,
see page 6-28 for more information.
Templates created may be temporary, used only during the
current examination, or saved as new templates, for future use
and reference.
Templates are edited/created from the Template editor screen.

Entering the Template editor screen

1. Press Protocol to enter the stress echo mode.
2. Press Template.
The Template menu is displayed.
3. Select Template Editor.
The Template editor screen is displayed (see Figure 6-13).

6-24
 Figure 6-13. The Template editor screen

Editing/Creating a template

Selecting a base template to edit

1. From the Template drop-down menu on the upper left corner

of the Template editor screen select a base template to edit.
NOTE: Determine the required number of projections and levels
you need and select the most appropriate foundation
template.
The selected template is displayed in the Protocol template
preview field, showing the levels and projections and their
labels.

6-25
Adding/deleting levels and projections

1. Enter the number of levels and projections in the Grid size

field (see Figure 6-13).
The new grid size is displayed in the Protocol template
preview field.
2. Press New Template to create a new template.
Or
Press Save Template to update the base template.
NOTE: Factory templates cannot be changed.

Scan mode selection

1. From the Scan mode drop-down menu, select a scan mode

(e.g. 4D real time or gated, color... etc.) to be associated to
the actual column (projection).

Display timer(s)

1. Check the box(es) to display timer(s) as specified (see

Figure 6-13).

Start analysis automatically

1. Check Auto start analysis to display the Stress Echo

Analysis screen when the last acquisition is performed.

Crop images

1. Check Crop images to enable display cropping of images

recorded as part of the protocol.
Cropping can be turned off for individual cells of the protocol
acquisition by using the Crop button on Control panel.

Smart stress

Check Smart stress to store a subset of the image acquisition

settings (e.g. geometry, zoom, gain, compress, reject,
power...etc) for each view in the protocol. Smart Stress enables
to set image acquisition settings for each view at baseline level
and automatically get the same image settings in the
corresponding views in the next levels. If you want to use Smart 6-26
stress in Continuous capture, you need to use the arrow buttons
to indicate to the system when you are switching views.
Assigning new labels to levels and projections

1. Select a label from the Label drop-down menu or type a new

label.

Configuring levels

The following options can be set up for each level:

Number of cycles to be stored in the cineloop

1. Enter the desired number in the Cycles field.
Up to four cycles/cineloop can be stored.
NOTE: Even if you store more than one cycle, while in analysis of
the Stress echo images the system will by default only
display the last cycle.

Continuous capture
1. Check Continuous capture if continuous image acquisition
throughout the level is desired.
When Continuous capture is selected, preview of cineloop
and reference display (see below) during acquisition are not
possible.

Preview of store
1. Check Preview of store if review and adjustment of
cineloops before storage is desired.

Show reference
1. Check Show reference if the display of the corresponding
reference loop is desired during acquisition (dual screen
mode).

Adding a group

1. In the Protocol template preview field select the cells to be

part of the group.
2. In the Pre-defined group field, press New group.
A dialogue box is displayed asking the user to enter a name
for the new group.
3. Enter the group name.
4. Press OK.
The new group is displayed in the Pre-defined group field. 6-27
Updating an existing group

1. In the Pre-defined group field, select the group to edit.

2. Either select (a) new cell(s) to add to the group or deselect
(an) existing cell(s) to remove from the group.
3. Press Update group in the Pre-defined group field.
The display in the Protocol template preview field is updated
accordingly.

Deleting a group

1. In the Pre-defined group field, select the group to delete.

2. Press Delete group.
The group is removed from the list in the Pre-defined group
field.

Multi-plane Stress Echo Template setup

The following example describes the creation of a Multi-plane
Stress Echo pharmacological protocol template consisting of:
• Three levels:
• Baseline
• Low dose
• Peak dose
• Two columns:
• A Tri-plane mode column with simultaneous acquisition
of Apical 4 chamber, Apical 2 chamber and Apical long
axis views.
• A Bi-plane mode column with simultaneous acquisition
of Parasternal long axis and Parasternal short axis
views.
1. In the Grid size field, adjust the Number of levels to three
and the Number of projection views (columns) to two.
2. From the Label drop-down menu of the first column select
the label Tri Ap 4 2 LAX.
With this setting the system will automatically launch the
Tri-plane mode enabling simultaneous acquisition of Apical
4 chamber, 2 chamber and Long axis views in all levels in
the first column.
3. From the Label drop-down menu of the second column 6-28
select the label Bi PLAX SAX-PM.
 With this setting the system will automatically launch the
Bi-plane mode enabling simultaneous acquisition of
Parasternal long axis and short axis views in all levels in the
second column.
4. Enter the labels for the three levels.
5. Make sure that Smart stress is checked. This will ensure
that all acquisition settings defined at Baseline will be
preserved in the next levels, including rotation and tilt angle
settings.
6. Delete any existing pre-defined groups (in case the template
is based on an existing template with groups already
defined).
7. Select all the views from the first column and select New
group.
The Group name window is displayed.
NOTE: You should not mix bi-plane and tri-plane recordings in the
same analysis group.
8. Give the group a name (e.g. Apical) and press OK.
9. Likewise create a group for all the views from the second
column (e.g. Parasternal).
10. Adjust the other settings as required (see ‘Editing/Creating a
template’ on page 6-25 for additional information.
11. Select Save as template and give the template a name (e.g
Pharm. 3x2 Multiplane).
12. Select OK in the Template editor screen.
The new template is selected and the Protocol screen is
displayed.

6-29
 Chapter 7

Quantitative Analysis

‘Introduction’ on page 7-2

‘Starting Q Analysis’ on page 7-3

‘Q Analysis overview’ on page 7-4

‘Using Q Analysis’ on page 7-8

7 -1
 Introduction

The quantitative analysis (Q Analysis) software package is

designed for analysis of TVI related (Tissue Tracking, Strain,
Strain rate, TSI) and Contrast related raw data.

CAUTION Q Analysis is only recommended for adult cardiac images

acquired with the following probes: M5Sc-D, 6Tc, 4V-D or
6VT-D. The measurement accuracies of the quantitative values
reported in the Reference manual are verified with these
probes.

The main features of these options are:

• Multiple Time-mode specific trace display from selected
points in the myocardium.
• Arbitrary Curved anatomical M-Mode

7 -2
 Starting Q Analysis

1. Open an examination and select a TVI or a contrast loop.

2. Press Q Analysis.
The Quantitative Analysis screen is displayed (see
Figure 7-1).

7 -3
 Q Analysis overview

Q Analysis screen

1. Color cineloop window

2. Tissue cineloop window
3. Analysis window
4. Sample area
5. Time and velocity at cursor position
6. Sample area tools

Figure 7-1. Quantitative analysis window (here with TVI data)

7 -4
The Color cineloop window

Displays TVI, Tissue Tracking, Strain, Strain rate or

Angio color-coded data.
Sample area (1):
Indicates sampling position of the velocity (TVI),
displacement (Tissue Tracking), percent deformation
(Strain), deformation rate (Strain rate) or intensity
(Contrast) trace. The sample area is color-coded: the first
sample area is yellow, the second blue...etc.

The cineloop windows system menu

This menu is displayed by pressing the right mouse
button when the cursor is placed over a sample volume
in one of the Cineloop windows.
• Delete all Sample areas: removes all traces at once.
• Disable frameb: the current frame is excluded from the
cineloop display.
• Set Sample area Shapea: enables resizing of a
selected sample area by setting height, width and tilt
angle. The mouse marker must be pointed at an
anchored sample area.
• Label Sample area...a: sets a descriptive name to the
sample area. The label is useful for identification of the
sample area when exporting data.
a)
Shown only when a sample area is selected • Delete Sample areac: deletes the selected sample
(pointed at). area.
b) With Contrast data only. • Delete anchorc: removes anchoring from a dynamic
c)Shown only when pointing at an anchored sample area (see also page 7-8 and page 7-9).
sample area. • Cancel: exits the System menu.

7 -5
The Tissue cineloop window

Displays 2D data
Sample area (1):
Indicates sampling position of the velocity (TVI),
displacement (Tissue Tracking), percent deformation
(Strain), deformation rate (Strain rate) or intensity
(Contrast) trace. The sample area is color-coded: the first
sample area is yellow, the second blue...etc.

Sample area tools:

• : creates a sample area based on freehand

drawing.

• : creates a sample area with a pre-defined circular/

elliptic shape (configurable, see page 7-12)

The analysis window

TVI:
Displays velocity trace
1. Y axis: velocity scale (cm/s)
2. X axis: Time (s)
3. ECG
4. Time at cursor position
5. Velocity at cursor position
6. Velocity at frame marker position (color coded)
Tissue Tracking:
Displays tissue displacement trace
1. Y axis: displacement scale (mm)
2. X axis: time (s)
3. ECG with Tracking start and Tracking end markers
4. Time at cursor position
5. Displacement at cursor position
6. Displacement at frame marker position (color coded)
Strain rate:
Displays Strain rate trace (rate of deformation (s-1))
1. Y axis: s-1
2. X axis: time (s)
3. ECG
4. Time at cursor position
5. Strain rate at cursor position
6. Strain rate at frame marker position
7 -6
 Strain:
Displays Strain trace (extent of tissue deformation (%))
1. Y axis: percent displacement
2. X axis: time (s)
3. ECG with Strain start and Strain end markers
4. Time at cursor position
5. % deformation at cursor position
6. % deformation at frame marker position (color
coded)
Contrast:
Displays time-intensity curve
1. Y axis: Intensity scale (logarithmic) (dB) or linear
acoustic units (AU).
2. X axis: Time (s) or dT (s), elapsed time from previous
frame.
3. ECG: displays ECG trace, the current frame marker
and the start and stop markers for the cineloop.
4. Time at cursor position
5. Intensity (dB or AU) at cursor position
6. Intensity (dB or AU) at frame marker position (color
coded)

The analysis window System menu:

This menu is displayed by pressing the right mouse button when
the cursor is in the Analysis window.
• Delete all Sample areas: removes all traces at once.
• Analysis signal: toggles trace display between velocity,
displacement, strain rate, stain or greyscale intensity curves.
• Drift compensation: compensates drifting of strain or Tissue
Tracking curves by either resetting the curve to zero at the
tracking start point (cycle resetting) or by linear compensation
throughout the cycle (linear compensation)
• Vertical auto-scaling: selects between full unit range or a range
according to the maximum and minimum values of the displayed
trace(s).
• Vertical unita: toggles between logarithmic (dB) and linear
acoustical units (AU).
• Line style: selects between solid line only or solid line with
square markers at each data point.
• Smoothing: smooths the trace displayed by applying a filter over
a defined time window. Both the filter type and time window are
a) user-selectable. The type of filter available is depending on the
With contrast data only.
b) Shown only in zoom mode. analysis signal displayed.
• Export traces: saves trace data in ASCII format, readable in
spreadsheet programs. If present, trace data for physiological
traces are also exported.
• Curve fittinga: toggles between Wash-in, Wash-out and off.
• Unzoomb: restores full analysis window display when in zoom
mode.
• Cancel: exits the System menu.

7 -7
 Using Q Analysis

Generation of a trace
Up to eight traces can be generated.

About the sample area

The sample area can be in three different states:

• Free sample area: freely moving sample area (QA cursor)
before anchoring.
NOTE: The free sample area disappears when the QA cursor is
moved over a static sample area.
• Static sample area: the free sample area is anchored by
pressing the left mouse button.
• Dynamic anchored sample area: the sample area is
anchored in two or more frames (see Manual tracking
below). In these particular frames, the sample area is
displayed with an anchor. The sample area moves smoothly
between the anchored positions when playing/scrolling the
cineloop.

To generate a trace

Trace from a pre-defined sample area

The shape of the pre-defined sample area is configurable (see
page 7-12).
1. If necessary, select the sample area Shape button .
2. Place the cursor in one of the Cineloop windows.
The cursor is changed to a sample area (white circle).
A preview of the trace is displayed in the Analysis window.
3. Press the Left mouse button to anchor the sample area.
In this frame the sample area is marked with an anchor.
If the cineloop has more than one heart cycle a sample area
will also be anchored in the corresponding frame in the next
7 -8
heart cycles.
The trace is updated accordingly in the Analysis window.
 NOTE: The trace and sample area are color-coded. First generated
trace is yellow, second blue...etc.

The Strain cursor

In Strain and Strain rate modes, the sample area displays a
Strain cursor showing the segment along the beam direction that
is used for Strain and Strain rate calculations. Make sure that the
Strain cursor is within the myocardium when anchoring the
sample area.

Trace from a freehand sample area

1. Select the Pencil button .
2. Place the cursor in one of the Cineloop windows.
The cursor is changed to a cross.
3. Press and hold down the Left mouse button while drawing
a sample area.
4. Release the Left mouse button.
The sample area is automatically closed.
The trace is updated accordingly in the Analysis window.

Manual tracking of the sample area (dynamic anchored sample area)

The sample area can be moved within the loop to ensure that
data in the trace is generated from the same anatomical location
during the cyclic motion of the heart.
1. Freeze the image and set a sample area over a region of
interest.
Note the anatomical location of the sample area.
2. Scroll to a new frame.
3. Drag the sample area to the corresponding anatomical
location in the new frame.
When the sample area is anchored in more than one frame,
linear interpolation is performed, so that the sample area is
smoothly moved between the anchored positions in the
selected frames when running the cineloop.
NOTE: In the original frame and this particular frame the sample
area is marked with an anchor.
4. Scroll through the cineloop and control that the sample area
follows the moving anatomical structure.
5. Add anchored sample areas in several frames to obtain a
more accurate displacement of the sample area.
7 -9
To move a dynamic anchored sample area
1. Freeze the image.
2. Scroll through the cineloop to display one of the frames
where the sample area was anchored..
NOTE: In these frames the sample area is marked with an anchor.
3. Select the sample area to move, in one of the Cineloop
windows.
The sample area is unanchored.
4. Drag the sample area to a new location.
5. Press the Left mouse button to anchor the sample area to
the new location.

Zooming in the Analysis window

1. In the Analysis window, press and hold down the Left

mouse button while dragging the mouse cursor to define
the zooming area.
2. Release the Left mouse button.
The selected area is displayed in the Analysis window.

To unzoom
1. Press the Right mouse button.
The System menu is displayed.
2. Select Unzoom.

Deletion of a trace

The user can delete all traces at once or one at a time.

To delete all traces

1. Press the Right mouse button.
The System menu is displayed.
2. Select Delete all sample areas.

To delete one specific trace

1. Place the mouse cursor on the sample area to delete.
2. Press the Right mouse button.
The System menu is displayed.
3. Select Delete sample area.

7-10
Frame disabling
Frame disabling excludes the actual frame from the cineloop
display. Frame disabling is available only with contrast data.

Disabling frames

1. Select the Frame marker beneath the Analysis window

(see Figure 7-2).
The frame marker turns red (disabled frame).
NOTE: To re-enable a frame: select the corresponding frame
marker.

Disabling successive frames at a time

1. Press the Left mouse button and drag the Mouse cursor
over the frame markers of the frames to disable.
The frame markers turn red (disabled frames).
NOTE: To re-enable successive frames: press the left mouse button
and drag over the frame markers.

ECG triggered frame disabling

In a multi-cycle acquisition, the user may deselect all frames in
all heart cycles but a selected one. This function can be used for
example to select a particular systolic frame for each heart
cycle.
1. Scroll through the cineloop to identify the cardiac phase to
analyze or identify the cardiac phase on the ECG trace.
2. Press the Right mouse button on the frame marker of the
frame of interest in one of the heart cycles (see Figure 7-2).
The System menu is displayed.
3. Select ECG triggering.
All frames in all heart cycles are disabled except for the
selected and corresponding frames in the other heart
cycles.

Re-enabling all frames

1. Press the Right mouse button over the Frame marker axis.
2. Select Enable all frames.
All previously disabled frames are re-enabled.

7-11
 1. Analysis window
2. Frame marker axis
3. Enabled frame (green marker)
4. Disabled frame (red marker)
5. ECG
6. Current frame

Figure 7-2. Frame disabling

Optimization

Optimizing the sample area

The sample area can be reshaped and labeled.

Reshaping a sample area

1. Place the cursor on the sample area to reshape.
2. Press the Right mouse button.
The System menu is displayed.
3. Select Set Sample area shape.
A Dialogue window is displayed where the user can adjust
the height, the width and the angle of the sample area (see
Figure 7-3).

7-12
Figure 7-3. The sample area reshaping window
4. Drag the sliders to adjust the shape of the sample area as
desired.
5. Press OK to return to the Quantitative analysis window and
use the settings for the current analysis only.
OR
Press Set as default to return to the Quantitative analysis
screen and keep the settings as default.

7-13
Labeling a sample area
The sample area label is used to identify data associated to the
sample area when exporting to a spreadsheet program.
1. Place the cursor on the sample area to label.
2. Press the Right mouse button.
The System menu is displayed.
3. Select Label Sample area.
A Dialogue window with a free text field is displayed (see
Figure 7-4).
4. Type a name for the sample area.
5. Press OK to return to the Quantitative analysis screen.

Figure 7-4. The sample area labeling window

Trace display

Y-axis

Auto-scaling
The system can be configured to display the full unit range or a
range according to the maximum and minimum values of the
displayed trace(s) (auto-scaling function). In addition, the
auto-scaling function can be set to be live update (updates while
the sample area is moved) or delayed (updated when the
sample area is anchored).
1. Press the Right mouse button in the Analysis window.
The System menu is displayed.
2. Select Vertical auto-scaling.
The Vertical auto-scaling menu is displayed.

7-14
Figure 7-5. The Vertical Auto-scaling menu
 3. Select the desired option:
• Delayed: auto-scaling takes place after anchoring the
sample area.
• On: auto-scaling while moving the sample area.
• Off: displays full scale.

Vertical units
When analyzing contrast data, the Y-axis can be set to display
either logarithmic scale (dB) or linear, acoustical units (AU) for
both tissue intensity (2D) or Angio intensity data.
1. Press the Right mouse button in the Analysis window.
The Vertical unit menu is displayed.

Figure 7-6. The Vertical unit menu

2. Select the desired option.

7-15
Trace smoothing
The system can smooth the traces displayed by applying a filter
over a defined time window. The type of filter available is
depending on the analysis signal displayed.
1. Press the Right mouse button in the Analysis window.
The System menu is displayed.
2. Select Smoothing.
The Smoothing menu is displayed.
3. Select a smoothing filter.
The trace display is updated.

Cine compound

Cine compound calculates and displays cineloops generated

from a temporal averaging of multiple consecutive heart cycles.
The number of averaged cycles is displayed on the top left
corner.
To apply cine compound:
1. Adjust Cine compound to set the number of heart cycles to
average.
The traces are updated showing averaged data. The
number of heart cycles averaged is displayed on the top left
corner.
2. Press CC Zoom to display the last recorded heart cycle.
3. Press CC Zoom again to unzoom.

7-16
Switching modes or traces
The user can toggle between TVI, Tissue Tracking, Strain rate or
Strain modes to access to the mode specific controls or display
alternative traces from within a selected mode.

To switch mode

1. Select the desired mode (TVI, Tissue Tracking, Strain rate

or Strain) from the Control panel.
The Color cineloop window and the Analysis window are
updated accordingly. The settings specific for the selected
mode can be adjusted from the Control panel.

To switch trace

1. Press the Right mouse button in the Analysis window.

The System menu is displayed.
2. Select Analysis signal.
The Analysis signal menu is displayed.

Figure 7-7. The Analysis signal menu

3. Select the desired trace.

The Analysis window is updated with the selected trace.

Curve fitting analysis

Curve fitting analysis is used to estimate local myocardial
contrast agent concentration rate.
The analysis is based on two algorithms:
• Wash-in curve fitting: find and estimate local contrast
agent concentration rate. 7-17
Exponential wash-in is described by the function:
 y(t)=A[1-e-kt]+B, where:
• A (dB or AU) is the intensity from the contrast agent.
• B (dB or AU) is the intensity at time t = 0 (defined as the
time of left marker). This corresponds to the tissue
(baseline) signal if no contrast is present at the selected
starting point.
Note that A+B = contrast + tissue = plateau level.
• k (1/s) is a time constant.
• Wash-out curve fitting: find and estimate the wash-out rate
of contrast agent locally (e.g. LV or myocardium).
Exponential wash-out is described by the function:
y(t)=Ae-kt+B, where:
• A (dB or AU) is the intensity from the contrast agent.
• B (dB or AU) is the intensity from the tissue = baseline
signal.
Note that A+B is the initial intensity level.
• k (1/s) is a time constant.

1. Intensity (AU)
2. Time (s)

Figure 7-8. Curve fitting examples, A) wash-in, B) wash-out A=900 AU, B=300 AU for
all curves

Wash-in curve fitting analysis

Overview
The purpose of wash-in curve fitting analysis is to find and
estimate local contrast agent concentration rate. This can be
achieved by using the Contrast Low MI application with low 7-18
transmit power (MI 0.1). Applying Flash will destroy most or all
 contrast within the imaging plane. The period of low power
imaging immediately following the flash will contain the
information on how fast contrast agent washes into different
segments of the myocardium. By storing data 5 to 10 seconds
after Flash and performing curve fitting to this data set, the user
can explore myocardial contrast agent concentration rate.

Performing wash-in curve fit

From a contrast examination in Quantitative analysis:
1. Disable frames that are significantly different (i.e. because
of respiration or probe movements), see page 7-11.
2. Place the sample area over the myocardium in one of the
Cineloop windows.
NOTE: Up to eight different sample areas may be generated in the
myocardium.
3. If desired, reshape the sample area as described on
page 7-12.
4. Because of heart motion, the sample area in each frame
has to be adjusted manually to be located inside the
myocardium (Manual tracking of the sample area).
The signals originating from the heart cavities are typically
10 to 20 times stronger than the signals from the
myocardium, and will have a major effect on the averaging
of signals in the sample area.
NOTE: Refer to ‘Manual tracking of the sample area (dynamic
anchored sample area)’ on page 7-9 for further details
5. Browse through the cineloop to ensure that the sample area
is in the same anatomical position in all frames.
6. Adjust Horizontal sweep and scroll through the cineloop to
visualize a specific part of the data, typically the region
immediately after Flash.
7. Adjust Left marker and Right marker to apply curve fitting
to a specific region.
8. Press the Right mouse button in the Analysis window.
The System menu is displayed.
9. Select Curve fitting.
The Curve fitting menu is displayed.

7-19
 Figure 7-9. The Curve fitting menu

10. Select Wash-in.

The Wash-in curve is displayed in the Analysis window (see
Figure 7-10).

1. Parameter window

Figure 7-10. Wash-in curve fitting

Wash-in curve fitting using varying triggering intervals

If the data set contains frames with uneven time intervals, e.g.
triggered images with increasing triggering intervals, it is
possible to plot the data using the time interval (dt) on the
X-axis.
1. Disable unwanted frames. Curve fitting will be performed
using all enabled frames.
NOTE: The frame disabling procedure is explained on page 7-11.
2. Place the sample area over the myocardium in one of the 7-20
Cineloop windows.
 3. Repeat step 2 if other sample areas are desired.
NOTE: Up to eight different sample areas may be generated in the
myocardium.
4. If desired, reshape the sample area as described on
page 7-12.
5. Perform manual tracking of the sample areas on all frames
to ensure that the sample area is inside the myocardium.
NOTE: See page 7-9 for more information on sample area manual
tracking.
6. Press the Right mouse button in the Analysis window.
The System menu is displayed.
7. Select Horizontal scale.
The Horizontal scale menu is displayed.
8. Select dT scaling.
The X-axis in the Analysis window is updated accordingly.
9. Press the Right mouse button in the Analysis window
again.
The System menu is displayed.
10. Select Curve fitting.
The Curve fitting menu is displayed.

Figure 7-11. The Curve fitting menu

11. Select Wash-in.

The Wash-in curve is displayed in the Analysis window.

7-21
 1. Parameter window

Figure 7-12. Wash-in curve fitting after varying triggering interval

Wash-out curve fitting analysis

Overview
The purpose of wash-out curve fitting analysis is to find and
estimate a local wash-out rate. The analysis may be used for
wash-out of contrast from LV or myocardium.

Performing wash-out curve fitting

From a contrast examination in Quantitative analysis:
1. Disable frames that are significantly different (i.e. because
of respiration or probe movements), see page 7-11.
2. Place the sample area over the myocardium in one of the
Cineloop windows.
NOTE: Up to eight different sample areas may be generated in the
myocardium.
3. If desired, reshape the sample area as described on
page 7-12.
4. Because of heart motion, the sample area in each frame
has to be adjusted manually to be located inside the
myocardium (Manual tracking of the sample area).
NOTE: Refer to ‘Manual tracking of the sample area (dynamic
anchored sample area)’ on page 7-9 for further details. 7-22
 The signals originating from the heart cavities are typically
10 to 20 times stronger than the signals from the
myocardium, and will have a major effect on the averaging
of signals in the sample area.
5. Browse through the cineloop to ensure that the sample area
is in the same anatomical position in all frames.
6. Adjust Horizontal sweep and scroll through the cineloop to
visualize a specific part of the data.
7. Adjust Left marker and Right marker to apply curve fitting
to a specific region.
8. Press the Right mouse button in the Analysis window.
The System menu is displayed.
9. Select Curve fitting.
The Curve fitting menu is displayed.

Figure 7-13. The Curve fitting menu

10. Select Wash-out.

The Wash-out curve is displayed in the Analysis window
(see Figure 7-14).

7-23
Figure 7-14. Wash-out curve fit of two sample regions in an
in-vitro experiment

7-24
Anatomical M-Mode

Introduction

M-Mode applied to TVI, Tissue Tracking, Strain rate, Strain or

intensity data (Contrast) calculates and color/codes data
accordingly along a path drawn by the operator.

Using Anatomical M-Mode

1. Press Curved AMM.

2. In one of the Cineloop windows, place the first point of the
path.
3. Move the cursor to the location for the next anchoring point
of the path and press the Left mouse button.
A path with two anchor points will give a straight anatomical
M-Mode profile. By creating more than two anchor points,
the user can bend the path and obtain a curved anatomical
M-Mode profile.
NOTE: To edit a path under construction, move the cursor
backward and retrace the path.
4. Double click the Left mouse button to end the trace.
The color-coded display of the corresponding data
calculated along the path is shown in the Analysis window.
NOTE: Adjust Horiz. Sweep and scroll through the cineloop to
optimize the display to the portion of interest.

Optimizing Anatomical M-Mode

Edition of the curve

The drawn Anatomical M-Mode path can be edited by moving
the anchor points.

To move an anchor point

1. Select the anchor point to move.
2. Move the anchor point to a new position.
3. Press the Left mouse button to anchor the point to its new
location.

7-25
 Chapter 8

Worksheet

‘Introduction’ on page 8-2

‘Using the Worksheet’ on page 8-3

8 -1
 Introduction

The worksheet function enables the user to review, edit, delete

or print data independently of a report. All measurements and
calculations taken during the examination can be viewed at any
time using the worksheet.

Overview

1. Measurement type 4. Measured / calculated values

2. Measurement parameter 5. Value type: Averaging, Max, Min or Last
3. Value calculated according to the value type
selected.

Figure 8-1. Worksheet screen

8 -2
 Using the Worksheet

1. Press Worksheet.
2. Select the Measurement type.
3. To browse through the measurements, select Page Up or
Page Down.

To select a type of value

1. Select the relevant cell in the Mth (Method) column.
A pop-up menu is displayed showing the different options
available.

1. Average of the measurements taken

2. Maximum measurement
3. Minimum measurement
4. Last measurement that was taken

Figure 8-2. Value options

2. Select the required option.

The value is updated accordingly.

To exclude or include measurements

One or more measurement values from a set of measurements
for a parameter can be excluded when doing average
calculation.
1. Place the cursor over the measurement to exclude.
2. Press the Right mouse button and select Exclude value/
Include value in the displayed menu.

To delete measurements 8 -3
1. Place the cursor over the measurement to delete.
 2. Press the Right mouse button.
3. Select:
• Delete value to delete the current value
• Delete set to delete the current set of values
• Delete all to delete all values from the Worksheet.

To change a measurement value

1. Select the measurement to change.
2. Enter a new value.
NOTE: Changed measurements are marked with an asterisk (*).

8 -4
 Chapter 9

Report

‘Introduction’ on page 9-2

‘Working with the report function’ on page 9-3

‘Structured Findings’ on page 9-8

‘Report designer’ on page 9-24

‘Report templates management’ on page 9-40

9 -1
 Introduction

The system enables the creation of patient and examination

reports containing measurements, images and analysis that
were made during the examination. The layout of the reports is
defined by generic templates delivered with the system. Custom
templates can also be made.
Saved reports are read-only. Therefore it is recommended that
the data is carefully reviewed before the report is saved. Use the
worksheet (see page 8-1) to facilitate the review and adjustment
of data before generating a report. The final report can be
printed on a regular printer.

9 -2
 Working with the report function

1. Select Report.
The default template for the current examination is
displayed (see Figure 9-1). The information entered during
the examination is automatically filled in (e.g. Demographic,
Diagnosis, Comments...etc.).

Figure 9-1. The Report screen

To choose another report template

1. Press Template.
The Template selection menu is displayed showing the
available report templates organized by application. 9 -3
 NOTE: The Template selection menu can be configured to display
only the templates of interest (see page 9-41).
2. Do one of the following:
• Select a template from the current application template
list.
• Select another application and select the desired
template from the sub-menu displayed.
The selected template is displayed on the screen.

To change patient information

1. Select the heading of the information to change.
The Patient info and exam screen is displayed.
2. Change the information as required.
3. Press Report when completed.
The user is asked to confirm the changes.
4. Select OK to confirm or Cancel to abort.

Images in the report

1. To add an image to the report, double-click on an image in
the clipboard.
The image is inserted into the first free image container in
the report.
2. To move an image in the report, select and drag the image
to move it to a new image container.
3. To replace an image in the report, select and drag an image
from the clipboard over the image to replace in the report.
4. To remove an image from the report, select and drag the
image to remove outside the report page.

9 -4
To print a report
Only members of the user group “Cardiologist” are allowed to
print a report (see ‘System users’ on page 3-50).
1. Press Print.
The report is printed on the default printer. A status window
is displayed showing the printing process.

To store a report
Only members of the user group “Cardiologist” are allowed to
store a report (see ‘System users’ on page 3-50).
1. Press Store.
The report is stored in the Report archive.

Alternative storage

Reports can also be saved in a user-defined locations in the

following formats:
• Compiled HTML (.CHM) files: readable from Internet
Explorer.
• Portable Document Format (.PDF) files: readable with
Adobe Acrobat reader.
• Text (.TXT) files: only text data is saved; readable with a
text editor.
1. Press Save as.
The Save as dialogue window is displayed.
2. Select the destination folder from the Save in archive pull
down menu.
NOTE: To configure the default remote path, see ‘Default remote
path setting’ on page 3-64.
3. Select PDF, CHM or TXT format.
4. Press Save.

Report sign-off
Report sign-off is used to save a report as read-only. A signed
report cannot be changed unless it is first unsigned.
When signing a report, the examination becomes read-only: the
patient demographic data in the Patient info and exam screen
9 -5
and the diagnostic information in the Examination list window for
 the current examination cannot be changed unless the report is
first unsigned.
The signing and unsigning operations require an authorization
(operator name and password). Only members belonging to
both “Cardiologist” and “DiagPhys” user groups are allowed to
sign off or unsign a report.

To sign off a report

1. Press Sign-off.
The Authorization window is displayed.

Figure 9-2. The Authorization window

2. Enter the operator name and password.

3. Select Authorize.
NOTE: If the operator is not authorized to sign off, an Error
message is displayed. Press Retry to go back to the
Authorization window or Cancel to quit sign-off.
Signed reports display a heading confirming sign-off with the
operator name and the date of signature. In addition the
diagnostic physician name is applied at the end of the
report.
NOTE: The sign-off header is not printed. To get the sign-off
signature inside the report, the report template must contain
the assigned field “Diag.Phys. signoff” (see ‘Inserting
archive information’ on page 9-31).

To unsign a report

1. Press Unsign.
The Authorization window is displayed (see Figure 9-2).
2. Enter the operator name and password.
3. Select Authorize.
9 -6
Retrieving an archived report
1. Press Retrieve.
A list of the available reports for the actual examination is
displayed.
The default name for a report is of type:
<template type>_<store date>_<store time>.
2. Select the report to retrieve.
NOTE: To display the current report, select Show active exam.

Deleting an archived report

Only members of the user group “Cardiologist” are allowed to
delete a report (see ‘System users’ on page 3-50).
1. Press Delete.
A list of the available reports for the actual examination is
displayed.
The default name for a report is of type:
<template type>_<store date>_<store time>.
2. Select the report to delete.

9 -7
 Structured Findings

Structured Findings is a feature that enables the user to insert

pre-configured structured diagnostic statements and codes
(e.g Billing, Accreditation) in the patient report and create a
conclusion based on the inserted statements.

Prerequisite
To be able to insert structured diagnostic statements and create
a conclusion in a patient record, the report template used must
have assigned fields for the structured findings, the codes and
the conclusion.
NOTE: Factory templates have Findings and Conclusion fields.
To create the assigned fields in a user-defined report template:
1. Select Report.
2. Press Template and select the desired report template.
3. Press Designer.
The Report designer screen is displayed.
4. Select the location in the report template where to insert the
Structured findings fields.
5. Select Insert and Archive Information.
The Archive information box is displayed (Figure 9-3).
6. Double-click on Select All under all three parameter fields
in the Archive information box to deselect all parameters.
7. Select Structured findings, Findings conclusion
Indication codes and Billing codes in the Exam
Information field (Figure 9-3).
8. Select OK.
9. Save the Report template and exit the Report designer.

9 -8
 Figure 9-3. The Archive information box

Starting Structured Findings

Structured Findings can be started from within the Report
function or during Image Analysis.
1. Press Report.
Make sure the current template has a Structured Findings
field and a Conclusion field defined or select another
template if necessary.
2. Press Findings or select the header of the Findings box in
the report.
The Structured Findings window is displayed (Figure 9-6).
NOTE: If the workstation has a dual screen, the Report screen and
the Structured Findings window are displayed. From the
Image Analysis screen the Structured Findings window is
displayed side by side with the images. A preview of the
report is also displayed if the workstation has a dual screen.

Structured Findings structure

The diagnostic statements are organized in tab folders (see

Figure 9-4). Each tab folder may contain:
• Underlying tab folders that contain Tab sheets.
• Tab sheets that contain diagnostic statements.

9 -9
1. Tab folder with underlying tab sheets
2. Tab sheet

Figure 9-4. Structured findings structure

There are three types of diagnostic statements (see Figure 9-5):

• Check box statement: when selected the statement is
included in the report.
• Combo box statement: create a statement by selecting one
alternative text among several choices.
• Statement group: create several statements by selecting
multiple check box statements.

1. Check box statement

2. Combo box statement
3. Statement group

Figure 9-5. Diagnostic statement types

Using Structured Findings

1. Start Structured Findings (see page 9-9). 9-10
 2. Browse to the tab sheet containing the statements of
interest.
3. To insert a statement in the report (Findings field):
• Check box statement: select the statement.
• Combo box statement: select an alternative text in the
combo box next to the statement.
• Statement group: select the statements of interest within
the group.
A preview of the selected statement(s) is displayed in the
Findings preview field (see Figure 9-6). The statement text
in the preview field can be edited. This will apply only for the
current report.
Once a statement is selected an asterisk is displayed on the
tab of the current sheet and folder.
NOTE: Select Normal to select only normal statements from the
current tab sheet (see page 9-17 for more information on
how to define normal statements).
NOTE: Select Clear to deselect all statements from the current tab
sheet.
To insert a conclusion statement in the report:
• Press the Conclusion button in front of the statement of
interest.
NOTE: Pressing the Conclusion button in front of a statement
that was not previously selected results in
simultaneously inserting the finding statement and
create the conclusion.
A preview of the selected conclusion statement is displayed
in the Conclusion preview field (see Figure 9-6). Conclusion
statements are displayed in a numbered list.
The list can be reordered: triple-click on the conclusion
statement to move in the Conclusion preview field and use
the Arrow up or Arrow down key to move the statement up
or down.
The conclusion text in the preview field can be edited. This
will apply only for the current report.
To display the changes in the report, select Refresh report.
4. Press Close.
The report for the current patient is displayed with the
selected findings, conclusion statement(s) and associated
codes (if any).
NOTE: Some diagnostic statements have measurements values in 9-11
the body text referred by a tag (e.g the {EF} tag refers to EF
 measurement). These statements require that the actual
measurement is done to display correctly in the report.

1. Statement inserted in the Conclusion and Findings field.

2. Statement inserted in the Findings field only.
3. Findings preview field
4. Conclusion preview field
5. Remove all selections.
6. Insert normal findings for the current tab sheet.
7. Create and add a statement. The statement will be available only for the current examination.

Figure 9-6. Structured Findings window

Global selection of normal statements

It is possible to select all normal statements from all tab sheets

belonging to the current top tab sheet.
1. Place the cursor in the Statement field, press the Right
mouse button and select Normal.
9-12
 All statements defined as normal are selected from all the
tab sheets. An asterisk is displayed on the tab of all the tab
sheets that contain normal statements.
NOTE: This operation will remove any other “non-normal”
previously selected statements.
2. To remove all statements at once, place the cursor in the
Statement field, press the Right mouse button and select
Clear.

Structured Findings configuration

Structured Findings configuration is used to:
• Create, edit or delete finding statements, conclusion
statements and codes.
• Organize the diagnostic statements in the Structured
Findings screen.
• Define the normal diagnostic statements.

Accessing the Structured Findings configuration screen

1. Press Config (F2) and select the Report category.

2. Select the Structured Findings tab.
The Structured Findings configuration screen is displayed
(Figure 9-7).
Or from within Structured Findings:
1. Place the cursor in the Statement field, press the Right
mouse button and select Config.

9-13
1. Structured Findings structure tree:
• Tab folder
• Tab sheet
• Check box statement
• Combo box statement
• Statement group
2. Tab or statement label
3. Findings text
4. Conclusion text
5. Codes for the selected statement
6. Create, move, copy or delete statement
7. Create folder, Combo box or statement groups
8. Enter a variable in statement or conclusion text
9. Hide selected tab or statement from the Structured Finding window
10. Set the selected statement as normal
11. Reset factory default findings
12. Export/import findings.

Figure 9-7. Structured Findings configuration screen

9-14
Creation of a tab folder

The following procedure describes how to create a new top level

tab folder.

1. Configuration window
2. Structured findings window

Figure 9-8. New tab folder

1. In the Structured Findings configuration window

(Figure 9-7), select the Structured Findings tab folder.
2. Select Add.
A new entry is created in the Structured Findings tab folder.
The new entry is by default a tab sheet ( ).
3. Select Enable one more tab level to change the new entry
to a tab folder ( ).
4. With the new entry selected, follow the following steps:
• Enter a name in the Label field (tab name).
• Enter a description in the Findings text field. The
description will be displayed in the report as a heading
when selecting a statement from the underlying tab
sheets. The system is always using the Findings text
from the highest item in the structure as a heading for
the selected underlying statements.
• Enter the appropriate codes.
NOTE: To enter several codes separate each code by a space.
5. Press Up or Down to move the tab in the structure tree (or 9-15
do drag and drop).
Creation of a tab sheet

The following procedure describes how to create a tab sheet in a

tab folder.

1. Configuration window
2. Structured findings window

Figure 9-9. New tab sheet

1. Make sure that the tab folder is selected and press Add.
A new entry is created in the tab folder. The new entry is by
default a tab sheet ( ).
2. With the new entry selected, follow the following steps:
• Enter a name in the Label field (tab name).
• Enter a description in the Findings text field.
If required:
• Enter the appropriate codes.
NOTE: To enter several codes separate each code by a space.

9-16
Adding statements in the tab sheet

Check box statement

The following procedure describes how to create a check box
statement.

1. Configuration window
2. Structured findings window

Figure 9-10. New check box statement

1. Make sure that the tab sheet is selected and press Add.
A new entry is created in the tab sheet. The new entry is by
default a check box statement ( ).
2. With the new entry selected, follow the following steps:
• Enter a name in the Label field (statement name).
• Enter the full statement in the Findings text field.
• Enter a conclusion in the Conclusion text field (optional).
NOTE: If the Conclusion text field is left empty, the statement
text will be used as conclusion when selected.
If required:
9-17
• Enter the appropriate codes.
 NOTE: To enter several codes separate each code by a space.
• Check Include findings in normal report to define the
statement as normal.
All statements within the selected tab sheet that have
this option checked will be included in the report when
Normal is selected in the Structured Findings window
(see ‘Using Structured Findings’ on page 9-10).

Combo box statement

The following procedure describes how to create a combo box
statement.

1. Configuration window
2. Structured findings window

Figure 9-11. New combo box statement

1. Create a new statement as described above. A check box

statement is created by default. 9-18
2. With the new statement selected, press Add.
 A new underlying entry is created and the parent statement
is changed to a Combo box statement ( ).
3. With the new underlying entry selected, follow the following
steps:
• Enter a name in the Label field.
• Enter a text in the Findings text field.
• Enter a conclusion in the Conclusion text field (optional).
4. Repeat the procedure from step 2 to create as many
underlying statements as necessary. Each underlying
statement will be a selectable entry in the combo box.

Statement group
Statement groups are created by changing a combo statement
to a statement group.
1. Create a combo box statement as described above.
2. Make sure the combo box statement is selected and
deselect the option Enable pull-downs.
The combo box statement is changed to a statement group
( ). Each underlaying entries are changed to check box
statements.

Editing a statement

Tab label, statements and statement alternative texts can be

edited.
1. In the Structured Findings configuration window
(Figure 9-7), select the item to edit.
2. Make the required changes.

9-19
Inserting variable parameters in a statement

Variable parameters such as patient name, institution name,

measurement values...etc can be inserted in a statement as
tagged information.
To insert variable parameters in a statement:
1. Place the cursor at the required position in the Findings text
field (or Conclusion text field).
2. Press Insert parameter.
The Insert parameter window is displayed (see Figure 9-12).

Figure 9-12. Insert parameter window

3. Browse and select the actual parameter to insert.

NOTE: For measurement values, select first the scanning mode.
4. Press OK.
NOTE: To display correctly in the report, the actual parameter value
must exist, e.g. if a measurement value is included in a
statement as a variable parameter, a measurement value
must exist for the current patient, otherwise the parameter
name is displayed. 9-20
 5. If the selected parameter can be measured/calculated by
different methods, the user is asked to select the preferred
parameter to insert (Figure 9-13). Move the preferred
parameter as first item in the list displayed and select OK.
The selected parameter is inserted in the statement as a tag
(e.g the {EF} tag refers to EF measurement)

Figure 9-13. The parameter list

Copy of a statement

Tab folders, tab sheets and statements can be copied from one
location to another. The word “Copied” is added to the copied
item name.
1. In the Structured Findings configuration window
(Figure 9-7), select the item to copy.
2. Select Copy.
3. Select the item to contain the copy.
4. Select Paste.
NOTE: If the item to copy cannot be copied in the selected location,
the operation is ignored.
NOTE: Copy can be done by drag-and-drop, while holding Ctrl
depressed.

9-21
Deletion of a statement

Tab folders, tab sheets and statements can be deleted.

CAUTION Deletion cannot be undone.

1. In the Structured Findings configuration window

(Figure 9-7), select the item to delete.
2. Select Delete.
The selected item is deleted.

Factory reset

All statements can be reset back to the factory default.

CAUTION Factory reset cannot be undone.

1. Select Reset.
The Reset statements window is displayed.
2. Select:
• Yes to reset all statement to the factory default (No
undo).
• No to cancel the operation.

9-22
Exporting/Importing statements

Diagnostic statements can be exported from one system and

imported on another system.

Exporting statements
1. In the Structured Findings configuration window
(Figure 9-7), select Export.
A browsing window is displayed.
2. Browse to a destination and select Save.

Importing statements
1. In the Structured Findings configuration window
(Figure 9-7), select Import.
A browsing window is displayed.
2. Browse to a destination and select Open.
3. Select one of the following options:
• Insert: the statements are imported in a new top tab
sheet, keeping the current statements in place.
• Replace: the imported statements replace the existing
ones.
• Cancel: cancel the import.

9-23
 Report designer

Introduction
The Report designer software package enables the user to
create report templates that best suit its needs.
Designing a report template consists of choosing the information
to display in the report (e.g. header, footer, logo, patient
information, images, measurements...etc.) and arrange it in the
report viewer.
The Report designer function is based on the information
container concept: each type of information is included within a
container with parameters that can be configured (size, color,
font properties, information to display...etc.).

Accessing the Report designer

1. Press Report.
The Report screen is displayed.
2. Press Designer.
The Report designer screen is displayed with the selected
template in the Report template design area (see
Figure 9-14).

9-24
Report designer overview

The Report designer screen

1. Menu bar
2. Report template design area

Figure 9-14. The Report designer screen

9-25
The menu bar

Menu Description
File • New: start working on an new template.
• Save: save the template using the same name. Factory report
templates cannot be overwritten.
• Save as: save the template using a new name.
• Page setup: define printing orientation and header/footer for the
printed report.
• Print Preview: display a print preview of the report template.
• Exit: exit the Report designer and returns to the report function. The
user can choose whether to save the updates or restore the original
template.

Menu Description
Edit • Delete: remove the selected object from the report template.
• Undo: restore the previous state of the report template.

Menu Description
Insert • Page Break: insert a new page in the report template.
• Table: configure and insert a table in the report template.
• Logo: select and insert a logo to the report template.
• Archive info: select and insert data from the following categories:
Patient information
Exam information
Site information
• Anatomical graphics: select and insert an anatomical graphic
(cardiac, vascular or TEE).
• Image: create a container for the display of ultrasound images.
• Wall motion analysis: insert a container for the display of Stress
Echo analysis results (cut planes Bull’s eye and scoring table).
• OB/GYN: insert OB graph.
• Measurements: insert a container for the display of measurements
and calculations. When creating a measurement container, the user
is prompted through a configuration procedure enabling the selection
of mode specific measurements and/or calculations.
• Text field: insert a container where the user can write in the report.
• Fixed text: insert a container with static text. The text typed during
the creation of the container will be displayed in the report.

Menu Description
Preferences • Page Color: sets the default background color for the template page.

9-26
Designing a report template

Starting template designing

1. Start the Report designer (see page 9-24).

2. Press File and select New to display a blank page or use
the current report template as basis template.

Setting the layout preferences

Adjusting the report page color background

1. Press Preferences and select Page Color.
The Color selection window is displayed.
2. Select the desired color.
3. Press OK.

Header and footer in the printed report

This function is described on page 9-38.

Inserting an information container in the report template body

The different types of information to be included in a report are

grouped in information containers. Designing a report template
consists in inserting and configuring the different information
containers in the template page in an ordered manner.
Information containers can be inserted either:
• Directly into the report template body: this procedure does
not allow side-by-side insertion, the information container
will normally cover the width of the report template page.
• Within a table: this procedure allows side-by-side insertion
of several information containers.

9-27
Inserting a table

1. Place the cursor at the desired insertion point in the Report

template design area.
2. Press Insert and select Table.
The Container properties window is displayed (see
Figure 9-15).
3. Adjust the parameters as desired.
4. Press OK.
The table is displayed in the template.
NOTE: To modify an inserted table, double-click in an empty area in
the table. A selection menu is displayed where the user can
add, delete a row or a column or open the Table properties
window.

Figure 9-15. The Table properties window

9-28
Inserting a logo

1. Provide the hospital logo in JPEG or Bitmap format onto a

removable media.
2. Select the location where to insert the logo (a table cell or
directly in the report template).
3. Select Insert and Logo.
The Logo box is displayed.

Figure 9-16. The logo box

4. Select a logo, or if not available, select Import logo.

Browse and select the logo and select OK.
5. Specify the appearance.
6. Select OK.

9-29
Inserting fixed text

Fixed text is an entry that cannot be changed in the report (e.g.

hospital information).
1. Select the location where to insert the fixed text (a table cell
or directly in the report template).
2. Select Insert and Fixed text.
The Fixed text box is displayed.

Figure 9-17. The Fixed text box

3. Enter the text and specify the appearance.

4. Select OK.

9-30
Inserting archive information

Archive information contains all the objects of the different

information menus (Patient, Exam, Study and Site Information).
You may display the archive information over two columns using
a table container as described below.
1. Insert a table for the archive information to the desired
location (a table cell or directly in the report template).
2. Select the first table cell.
3. Select Insert and Archive information.
The Archive information box is displayed.

Figure 9-18. The Archive information box

4. If desired, enter a heading and select a heading link from

the pull-down menu.
5. Select the Information parameters to be displayed in the first
cell.
Select Box properties to change the font, alignment,
appearance, etc.
6. Select OK.
7. Select the next table cell and repeat steps 3 to 6 to enter the
remaining archive information.

9-31
Inserting an Image container

• Select the location where to insert the fixed text (a table cell
or directly in the report template).
• Select Insert and Image.
The Ultrasound image box is displayed.

Figure 9-19. The Ultrasound image box

• If desired, enter a heading, set the container size and

specify the text appearance.
• Select OK.

9-32
Inserting a measurement container

You may display the measurements over several columns using

a table container as described below.
1. Insert a table for the measurements to the desired location.
2. Select the first table cell.
3. Select Insert and Measurements.
The Measurements box is displayed.

Figure 9-20. The Measurements box

4. Enter a heading (e.g. 2D).

5. Using the Filter criteria, define the type of measurements to
be displayed (e.g. Cardiac, 2D, measured and calculated).
Select Show normal value to display user-defined Normal
value next to the measurements in the Report (see ‘Normal
values’ on page 5-103 for more information).
NOTE: References for the normal values can be displayed in the
report by checking Normal value references from Insert ->
Archive Info (see page 9-31).
The Measurement list on the left side is updated.
6. From the measurement list, select the measurement to
insert and press Add. Both single measurements or a folder 9-33
may be added.
 7. The list of the inserted measurements is displayed in the
Selected measurement list on the right side.
8. Press OK.
9. Select the next table cell and repeat steps 3 to 8 to insert
several measurements.

Inserting Text fields

Text fields are:

• Containers for Referral reasons, Comments and Diagnosis
information.
• Containers for free text, where the user can type information
in the report.
1. Select the location where to insert the text field container (a
table cell or directly in the report template).
2. Select Insert and Text field.
The Text field box is displayed.

Figure 9-21. The Text field box 9-34

3. Enter a heading.
4. From the Display field, select between:
• Referral reasons: displays the information entered in
the Patient info and exam window.
• Comments: displays the information entered in the
Patient info and exam window.
• Diagnosis: displays the information entered in the
Patient info and exam window.
• Free text 1-8: creates an empty free text container.
5. If desired, adjust the font settings for the header and data.

9-35
Inserting Wall motion scoring analysis containers

Two different containers must be inserted for the Wall motion

scoring analysis:
• A Wall motion scoring diagrams container (Cut planes or
Bull’s eyes)
• A Wall motion scoring table

Inserting Wall motion scoring diagrams container

1. Select the location where to insert the free text container (a
table cell or directly in the report template).
2. Select Insert, Wall motion analysis and select between
Cut planes and Bull’s eye.
The corresponding Wall motion scoring box is displayed.

Figure 9-22. The Wall motion scoring box (Cut planes)

3. Adjust the parameters and select OK:

The scoring diagrams are inserted in the report template

Inserting Wall motion scoring table container

1. Place the cursor right below the Wall motion scoring
diagrams container.
2. Select Insert, Wall motion analysis and select Score table
box.
The Score table box is displayed.

9-36
 Figure 9-23. The Score table box

3. Adjust the layout parameters in the Score table box and

select OK.
The Score table is inserted in the report template.

Editing the information container

Resizing the information container

1. Move the cursor over the border of the container to resize.
The mouse cursor is changed to a cross .
2. Press Select.
The container is displayed with anchor squares on the sides
and at the corners.
3. Resize the container by dragging from the anchor points.

Editing the information container properties

1. Double-click in the container to edit and select Properties.
The Properties window is displayed.
2. Adjust the parameters specific to the selected container.
NOTE: Some information containers have additional parameters
that may be adjusted by selecting Box properties.

Inserting a new page

1. Place the cursor at the desired insertion point in the Report

template design area.
2. Press Insert and select Page Break.

9-37
Inserting header and footer

Header and footer may be defined to be displayed in the printed

report. The header and footer are not visible in the on screen
report.
To insert header and footer in the printed report:
1. Select File and Page setup.
The Page setup box is displayed.

Figure 9-24. The Page setup box

2. Adjust the printing orientation.

3. Define the header and footer for the printed report, by typing
text and entering the required variables listed in the table
below.
Check Different on first page and create a specific header/
footer for the first page.
4. Select OK.
To check the display of the header and footer, select File
and Print preview.

Variable Description

{pid} Patient ID 9-38

{pnm} Patient name
 Variable Description

{pdb} Patient date of birth

{exd} Examination date

{prd} Current date (printing date)

{prt} Current time (printing time)

{cp} Current page

{tp} Page count

{c} Subsequent entries are centered

{r} Subsequent entries are right aligned

9-39
Report templates management

This section describes:

• Configuration of the Template selection menu.
• Deletion of user-defined report templates.
• Export/import of user-defined report templates.
The report templates management is done from the Report
templates sheet in the system configuration package.
To access to the Report templates sheet:
1. Press Config (F2) and select the Report category.
The Report category sheet is displayed.

9-40
 Figure 9-25. The Report templates sheet

Configuration of the Template selection menu

The Template selection menu displays the application specific
report templates that can be selected when creating a report.
The Template selection menu can be configured to display only
the templates of interest.

Inserting a template in the Template selection menu

1. Press Config (F2) and select Report.

The Report templates sheet is displayed (Figure 9-25)
2. In the Available templates field (left field), select the
template to insert in the Template selection menu.
3. Next to Section, select the appropriate application.
4. Press the Right arrow button .
The selected template is inserted in the Template selection
menu.
NOTE: Double-clicking on a template in the Available template field
will also insert the template in the Template menu.

Removing a template from the Template selection menu

1. In the Report template menu field (right field), select the

template to remove.
2. Press the Left arrow button .
The selected template is removed from the Template
selection menu.
NOTE: Double-clicking on a template in the Report template menu
field will also remove the template from the Template menu.

Sorting the templates in the Template selection menu

1. In the Report template menu field, select the template to

move.
2. Press the Up or Down arrow buttons .
The selected template is moved accordingly in the Template
selection menu.

9-41
Deleting a report template from the system

Only user-defined report templates can be deleted from the

system.
1. In the Available templates field (left field), select the report to
delete (Figure 9-25).
2. Press Delete.
A Confirmation window is displayed.
3. Select Yes to delete the report template.

Export/Import of Report templates

User-defined report templates can be exported to a removable
media and imported from the removable media into another
system.

Export of Report templates

1. Insert a removable media in the drive.

2. Press Config (F2) and select Report.
The Report templates sheet is displayed (Figure 9-25 on
page 9-41).
3. Select Export Templates.
The available user-defined templates are displayed in the
Export templates window.

Figure 9-26. The Export templates window

4. Select the template(s) to export. Multiple selection can be

done using the Shift or Ctrl key. 9-42
 5. Select the desired removable media under Select target
device.
NOTE: To export to a shared folder on a network, a remote path
must be defined (see ‘Default remote path setting’ on
page 3-64).
6. Press OK.
A Confirmation window is displayed.
7. Press OK.
The selected template(s) are exported to the removable
media.
8. Press Alt + E and select the media to eject.

Import of Report templates

1. Insert the removable media with the report template(s) to

import.
2. Press Config (F2) and select Report.
The Report templates sheet is displayed (Figure 9-25 on
page 9-41).
3. Select Import Templates.
The Import templates window is displayed.

Figure 9-27. The Import template window

4. Select the source device from the pull-down menu.

5. Press OK.
A Confirmation window is displayed.
6. Press OK.
The templates are imported into the system.
7. Press Alt + E and select the media to eject.

9-43
 Chapter 10

2D Strain

‘Introduction’ on page 10-2

‘Acquisition’ on page 10-3

‘Starting 2D Strain’ on page 10-4

‘2D Strain processing’ on page 10-12

‘2D Strain quantitative analysis’ on page 10-15

‘Data management’ on page 10-28

‘2D Strain – Frequently asked questions’ on page 10-31

10-1
 Introduction

2D Strain is an option on EchoPAC Software Only allowing

global and regional quantitative evaluation of the myocardial
function. 2D Strain enables calculation of myocardial tissue
velocity and deformation parameters based on tissue tracking
from 2D grey scale and/or 2D tissue Doppler (TVI) images.

10-2
 Acquisition

CAUTION 2D Strain is only recommended for adult cardiac images

acquired with the following probes: M5Sc-D, 6Tc, 4V-D or
6VT-D. The layer strain component of 2D Strain is only
recommended for adult cardiac images acquired with the
M5Sc-D probe. The measurement accuracies of the strain
values reported in the Reference manual are verified with these
probes.

2D Strain can be applied to 2D grey scale or TVI acquisitions. In

both cases, the 2D grey scale frame rate should be between 40
and 80 frames per second.
NOTE: In TVI images the system reports TVI frame rate. It is the 2D
grey scale frame rate that must be between 40 and 80 frames
per second. A higher frame rate is recommended for high heart
rate.
Use only images of good quality where the entire myocardium is
visible.
1. Select a TVI or 2D acquisition.
The image quality should be reasonably good, all
myocardial segments to be analyzed should be clearly
visible on each frame.
2. If the acquisition has more than one heart cycle, select
Cineloop and select a single heart cycle (see also
page 4-16).
The scanner should be configured to store heart cycles with
100 milliseconds before and after the R-wave (in Config/
Global).

10-3
 Starting 2D Strain

1. In the Advanced control panel, select Q Analysis.

The Quantitative analysis screen is displayed.
2. Select 2D Strain to start the application.
The Choose view window is displayed.

Figure 10-1. The Choose view window

3. Select the correct view type.

It is recommended to start with the APLAX view. This will
allow the user to adjust the Aortic Valve Closure (AVC) to
define end of systole. The AVC setting will then be used in
the other views.

Defining a ROI
Once the view type has been selected, a Region of Interest
(ROI) must be created. The ROI is created either by manual
outlining of the endocardial border or by placing three points at
the endocardial corners: two basal points and one apical point
(Auto ROI, only for full apical views, not for short axis views and
single wall). When using manual outlining, the user may trace
the entire myocardial or a single wall.
The system automatically displays a frame at end-systole and
the mouse arrow cursor is changed to a pencil cursor . 10-4
 1. If required, adjust Ref. Frame to display another frame at
end-systole.

Manual outlining

1. Place the cursor at the starting point (as indicated next to

the pointer) and press the Left mouse button.
2. Move the cursor following the endocardial border and press
the Left mouse button to place a new point. By creating
several points the outlining trace can be bent to follow the
endocardial border (see ‘Guidelines for the ROI definition’
on page 10-6 for additional information).
The Yo-yo runs back and forth display around the reference
frame. This may help finding the endocardial border.
3. When placing the last point, double-click the Left mouse
button to end the trace.
A ROI following the endocardial border is displayed.
Data processing is started automatically if the cursor is not
moved for a few seconds.
NOTE: The auto processing function is configurable (from Config/
Meas-Text/Advanced/AFI auto processing.)

Figure 10-2. Tracing the Region of Interest (ROI)

10-5
NOTE: In a SAX view the trace should be closed.
Auto ROI

1. Place the cursor at the first basal point (as indicated next to
the pointer) and press the Left mouse button.
2. Place the cursor at the Apex and press the Left mouse
button.
3. Place the cursor at the other basal point and double-click on
the Left mouse button.
A ROI following the endocardial border is displayed.
Data processing is started automatically if the cursor is not
moved for a few seconds.
NOTE: The auto processing function is configurable (from Config/
Meas-Text/Advanced/AFI auto processing.)

Figure 10-3. Auto ROI creation

Guidelines for the ROI definition

• When tracing the myocardial border, the first and last point
should be placed at the connection between the mitral ring
and the wall (“hinge point”), except in the long axis view
where the anteroseptal end point should be set at the border
between the anteroseptal wall and the outflow tract.
• The ROI should be defined as a smooth curve, avoid to
warped curves. Make sure the pericardium is not inside the
ROI. Some amount of blood area within the ROI may be OK.
10-6
The following examples illustrate typical errors that should be
avoided when defining the ROI.
Wrong Correct Comment
1. The ROI is too wide and
extends beyond the
epicardial borders
2. Correct ROI definition

1. The ROI is too narrow, and

does not contain enough
information for tracking.
2. Correct ROI definition

1. The ROI should not follow

the bulging, as this results in
the ROI central line not being
in the direction of myocardial
contraction.
2. Correct ROI definition

10-7
Wrong Correct Comment
1. The apical point is too high,
extending beyond the
epicardium.
2. Correct ROI definition

1. The right border of the ROI is

way too much into the
chamber cavity.
2. Correct ROI definition

1. The ROI should not extend

into the aortic cavity.
2. Correct ROI definition

10-8
 Wrong Correct Comment
1. The ROI should not be traced
through the papillary
muscles.
2. Correct ROI definition

Figure 10-4. ROI definition guidelines

Adjusting a ROI

The following adjustments can be done to modify the ROI:

• Each point on the inner trace can be moved to modify the
ROI shape keeping the ROI width unchanged.
• The width of the ROI can be adjusted globally using the ROI
width control.
• Each point on the outer trace can be moved along a
perpendicular line to adjust the ROI width locally.
To adjust the ROI
1. Press Recalc.
ROI shape adjustment
1. Place the mouse cursor over a point to move in the inner
trace. The point is highlighted.
2. Press the Left mouse button and move the point.

Figure 10-5. Highlighted point on the inner trace

10-9
 3. Press the Left mouse button to place the point in the new
location.
The shape of the ROI is updated accordingly. The width of
the ROI is kept unchanged.
4. Data processing is started automatically if the cursor is not
moved for a few seconds.
NOTE: The auto processing function is configurable (from Config/
Meas-Text/Advanced/AFI auto processing.)
ROI width adjustment
1. Use the control ROI width to adjust the width of the entire
ROI. Make sure the ROI covers the region to be analyzed.
NOTE: In order to optimize the tracking try to avoid too wide or too
narrow ROI in comparison with the analyzed myocardial
wall.
Local ROI width adjustment:
1. Place the mouse cursor over a point to move in the outer
trace. The point is highlighted.
2. Press the Left mouse button and move the point along the
perpendicular yellow line to change the ROI width locally.

Figure 10-6. Highlighted point on the outer trace

3. Press the Left mouse button to place the point in the new
location.
The width of the ROI is updated accordingly.
4. Data processing is started automatically if the cursor is not
moved for a few seconds.

Single wall ROI adjustment

When tracing a ROI for a single wall, the generated ROI may
have to be adjusted relatively to the myocardial border.
1. Press ROI side to move the ROI to the correct side of the
myocardial border (Figure 10-7).

10-10
1. Generated ROI on the wrong side of the myocardial border
2. Adjusted ROI

Figure 10-7. Single wall ROI adjustment

10-11
 2D Strain processing

2D Strain processing divides the ROI into segments and

evaluates the tracking quality for each segment. The user has to
review and validate the tracking evaluation for each segment.
1. The Processing screen is displayed showing the ROI
divided into segments. The tracking quality for each
segment is automatically evaluated and summarized in the
Tracking table (see Figure 10-8).

1. The ROI divided in segment

2. The Tracking table
• V: valid tracking
• X: not acceptable tracking
3. Segmental labels

Figure 10-8. The Processing screen

NOTE: Post-scan gain adjustment does not affect the 2D Strain

processing. Live gain adjustment during acquisition will affect 10-12
 the 2D Strain processing, and should be adjusted for optimal
imaging of the myocardium.

Tracking validation
The tracking for each segment must be visually controlled and
validated.
1. Inspect each segment and make sure that the center line is
moving together with the underlying 2D image. To get a
better visualization you may adjust the control Bullets to
add or remove bullets.
The tracking quality is automatically evaluated for each
segment and displayed in the Scoring table. The user may
override the tracking quality evaluation done by the system
by clicking on the evaluation result in the Tracking table.
If the tracking quality needs to be improved, select Recalc,
re-adjust the ROI as described on page 10-9.
2. Once the tracking quality has been controlled for all
segments, press Approve in the Tracking table.
If running 2D Strain on an APLAX view, you may adjust the
AVC timing as described below.
If running 2D Strain on another view than the APLAX view,
the Trace analysis screen is displayed (see page 10-15).

Timing
Timing information may be crucial for accurate diagnosis. The
most important timing is the aortic valve closure (AVC), since it
is part of the definition of important parameters such as peak
systolic strain or peak systolic strain rate.
Determination of the AVC timing by the system is as follow,
depending on the situation:
• If AVC timing has been measured by the operator (through
an event timing measurement) the system is using this data.
• If event timing is not available, an automatic AVC estimate is
used, determined by the temporal contraction of all LV
segments (Strain curves).
• From the APLAX view, the user can adjust the estimated
AVC timing. The adjusted AVC timing will then be used in
the other apical views. This option is only available from the
APLAX view.
10-13
AVC timing adjustment

The following procedure is available in the APLAX view.

1. After validation of the tracking quality. the frame for the
current AVC setting (automatic or event timing
measurement) is displayed and highlighted on the ECG.
2. To keep the current AVC setting, press the Left mouse
button. To change the AVC setting, use the mouse to display
another frame and press the Left mouse button.
If the AVC setting was changed, a Confirmation window is
displayed. Select one of the following options:
• Manual to accept the manual AVC setting.
• Event timing to discard the manual AVC setting (if for
example the AVC setting was not possible to assess
from the APLAX view). The AVC event timing
measurement will then be used.
• Auto to discard the manual AVC setting and use the
automatic AVC timing.
NOTE: In non-APLAX view the AVC adjustment is possible after
processing by dragging the AVC green bar on the ECG.

10-14
2D Strain quantitative analysis

2D Strain quantitative analysis enables full data analysis in both

numerical, parametric color coding and graphical forms for any
point within the ROI in any frame in the cineloop.
The 2D Strain quantitative analysis is available through:
• The Trace analysis screen: provides a local graphical
display of various selectable parameters as a function of
time (curves) and color coded parametric display in the 2D
and M-Mode windows (page 10-17).
• The Single analysis screen: provides a display of various
selectable parameters as a color coded large size 2D
cineloop (page 10-19).
• The Quad analysis screen: provides a segmental graphical
display of various selectable parameters as a function of
time (curves) and color coded parametric display in the 2D
and M-Mode windows (page 10-20).
• The Layers screen: provides color-coded still images,
segmental traces and color M-Mode for both endocardial,
mid and epicardial Strain results (page 10-20).
• The Result analysis screen: provides both numerical and
graphical display of the results (page 10-24).
• The Bull’s eye screen and Bull’s eye with traces screen:
provide parametric imaging (both numerical and graphical)
of entire LV of the various selectable parameters. These
screens are available only when APLAX, 4-chamber and
2-chamber views have been processed (page 10-21).
• The Bull’s eye with layers screen: provides endocardial, mid
and epicardial parametric imaging (both numerical and
graphical) of entire LV of Strain parameter. This screen is
available only when APLAX, 4-chamber and 2-chamber
views have been processed (page 10-21).
• The Torsion screen: provides a graphical display of the
global apical and basal rotations and Torsion. From this
screen, the user may also display global apical and basal
rotation rates and torsion rate. This screen is available only
when apical short axis (SAX-AP) and mitral valve short axis
(SAX-MV) views have been processed (page 10-25). 10-15
 These screens are available only when all segment tracking
scores have been approved (see page 10-13).

About the results

Be aware of the following:
• Assessments should be made based on both color and
segmental Peak systolic strain values.
• The Save As function should not be used as the only
method to archive diagnostic data.
• Any strain drifting is linearly compensated throughout the
cycle. If the drift compensation in a given segment is too
high, the tracking quality is automatically set to Not
acceptable (X).

10-16
Trace analysis
To start the Trace analysis:
1. The Trace analysis screen is automatically displayed after
validating the tracking.
The Trace analysis screen displays the traces for the
selected parameter for the marked point at the center of
each segment and color coded parametric overlay in the 2D
and M-Mode windows.

1. 2D Cineloop with parametric color coding

2. M-mode with parametric color coding
3. Trace display for the selected parameter
4. Display adjustment controls
5. Screen selection controls
6. Processing parameters
7. Export controls and time caliper
8. Parameter selection panel
9. On line Help

Figure 10-9. The Trace analysis screen

2. In the control panel, select a parameter to display the

corresponding traces for all segments (see also
page 10-18).
3. The following adjustments may be done:
• Move the mouse cursor to any point in the ROI in the 2D
or M-Mode window to display numerical parameter 10-17
value and temporal trace for the highlighted point.
 • Adjust the Scale in the Trace window.
• Adjust the Opacity of the color coded parametric
display in the 2D and M-Mode window.
To perform a time measurement on the trace:
1. Press Time Caliper on the Control panel.
2. Place the cursor on the starting point of the measurement
and press the left mouse button.
3. Move the cursor to the end point of the measurement and
press the left mouse button.
The measurement result is displayed on screen.
NOTE: Repeat the operation to make multiple measurements.
4. Make a screen snapshot (see page 10-29) to store the
measurement(s).
5. To remove the time measurement(s), press Remove
calipers on the Control panel.

Parameters

The following calculation parameters are available:

Apical parameters • V: Velocity

• SR: Strain rate
• S: Strain
• D: Displacement
• IBS: Integrated back scatter
• RotR: Rotation rate (short axis only)
• Rot: Rotation (short axis only)
• ENDO/MID/EPI: display either endocardial, mid or epicardial Strain
information.
The parameters in the Doppler section are based on Doppler only
(available only if TVI data is present).

Short axis parameters

10-18
Note regarding ENDO, MID and EPI parameters
Speckle tracking is performed for the entire myocardial wall
thickness outlined by the tracked ROI borders. The MID (center
line) of the ROI represents the average values for the full wall
thickness (see Figure 10-10 on page 10-19).
The exact thickness of the endocardial and the epicardial layers
are not measured and used for the analysis. The measurement
presented for the endocardial layer (ENDO) and epicardial layer
(EPI) are the values at the inner and outer tracked ROI lines
(see Figure 10-10 on page 10-19).

1. Heart wall 5. ENDO: inner tracked ROI line (endocardial

2. Epicardial layer measurement)
3. Endocardial layer 6. MID: full heart wall thickness average (mid
4. Myocardium myocardial measurement)
7. EPI: Outer tracked ROI line (epicardial
measurement)

Figure 10-10. Schematic representation of myocardial layers, ROI, and position of the
calculated ENDO, MID and EPI measurements

Display options

Single screen
1. Select Single.
The cineloop is displayed in a single screen with color
coded parametric information.
2. Use the Display adjustment controls (see Figure 10-9) to
optimize image quality. 10-19
Quad screen
1. Select Quad.
A Quad screen is displayed showing the cine loop in the
upper left quadrant, color coded parametric still image in the
bottom left quadrant, color M-Mode window in bottom right
quadrant and segmental traces in the upper right quadrant.
2. To display a color coded parametric image for another
parameter, select the heading of the color coded parametric
image and choose another parameter.

Figure 10-11. The Quad screen

Layers screen
1. Select Layers.
The color-coded still images, segmental traces and color
M-Mode for both endocardial, mid and epicardial Strain
results are displayed. See ‘Note regarding ENDO, MID and
EPI parameters’ on page 10-19 for more information.

10-20
 Figure 10-12. The Layer screen

Bull’s eye, Bull’s eye with traces and Bull’s eye with layers screens
1. When APLAX, 4-chamber and 2-chamber views have been
processed, the Bull’s eye buttons become active.
Select BE Only.
A Bull's Eye screen is displayed showing the color-coded
parametric image in Bull's Eye schematic form.
2. To display a color-coded parametric image for another
parameter, select the heading of the color coded parametric
image and choose another parameter.

10-21
 Figure 10-13. The Bull’s eye screen

3. To display segmental traces and Bull’s eye, select

BE+Traces.

Figure 10-14. The Bull’s eye with traces screen

The user may to reject (or approve) traces previously

10-22
approved from the BE+Traces screen. This can be done by
 right-clicking a segment in the bull's eye. A popup menu will
appear allowing a segment to be approved or rejected.
4. To display Bull’s eyes for endocardial, mid and epicardial
Strain results, select BE+Layers.

Figure 10-15. The Bull’s eye with layers screen

10-23
Result analysis
The Result quantitative analysis screen displays the average
traces for a selected parameter for each segment (averaged on
all points in the segment) and corresponding peak values (Peak
S, Peak E and Peak A). The peak positions in the curves must
be assessed and approved.
All approved peak values and time positions will be exported
into the Excel Report.

Peak adjustment

1. Press Result.
The Result analysis screen is displayed.

1. 2D image with segmented ROI 5. Peak marker

2. M-mode with parametric color coding 6. Peak value
3. Trace display for the selected parameter 7. Select a parameter
4. Peak result table • Green V: approved parameter result
• Red X: not approved parameter result
Yellow: selected parameter

Figure 10-16. The Result analysis screen

2. Select a Peak marker (white square point) on one of the

traces.
The corresponding peak value is highlighted in the Peak 10-24
result table.
 OR
Select a Peak value in the Peak result table.
The corresponding Peak marker is selected.
3. Move the Peak marker to the correct position.
4. Press the Left mouse button.
The corresponding Peak value is updated in the Peak result
table.
5. Repeat the procedure for all Peak markers in all segments
for the selected parameter.

Peak validation

Once all peak positions in all segments for the selected

parameter are controlled, the results can be approved.
1. Select Approve in the Peak result table next to the selected
parameter.
A window is displayed prompting the user to save a
snapshot.
You may enter a text to be added to the file name in the text
field.

Figure 10-17. The store window

2. Select Save.
A snapshot of the screen is saved to the local hard disk.
To retrieve snapshots, see page 10-28.
3. Select the next parameter in the Peak result table and
repeat the Peak adjustment and validation procedures.

Torsion analysis
The Torsion screen displays the global apical rotation, global
basal rotation and global Torsion traces. The Torsion parameter
is calculated as the difference between the apical and basal
rotations. 10-25
 The Torsion screen is available only when apical short axis
(SAX-AP) and mitral valve short axis (SAX-MV) views have
been processed.
From this screen, the user can also display the global apical
rate, basal rotation rate and torsion rate traces.

1. Display global apical and basal rotations and global Torsion.

2. Display global apical and basal rotation rates and global Torsion rate.

Figure 10-18. The Torsion screen

When processing the SAX-AP and SAX-MV views, make sure

that:
• The acquisitions should have only one heart cycle.
• Both acquisitions should have similar heart rate and frame
rate.
• The cineloop markers should be placed in the same position
in both acquisitions.
To display the Torsion screen:
1. Process the SAX-AP and SAX-MV views. The Torsion
button is displayed.
2. Press Torsion.
The Torsion screen is displayed (see Figure 10-18) showing
the global apical and basal rotation curves and global 10-26
Torsion curve.
3. Press RotR to display the global apical and basal rotation
rate curves and global Torsion rate curve.
4. Press Snapshot to save a screen shot of the curves.

10-27
 Data management

The 2D Strain result file

2D Strain generates a single result file (spreadsheet) for each
day, regardless of how many examinations that have been
performed that day. The file can be exported to a removable
media or a shared network folder as described in ‘File
management’ on page 10-29.

Description of the 2D Strain result file

The 2D Strain result file is a spreadsheet consisting of:

• A worksheet for the global values (one row per view and per
patient, see Figure 10-19)
• A worksheet for segmental values
• A worksheet for segmental timings.
NOTE: The parameters listed in the worksheets are described in the
Reference manual.

Figure 10-19. 2D Strain result file (example)

10-28
Other files
The user may store:
• Snapshot (JPEG format) of the Trace analysis screen or
Result analysis screen (Snapshot button).
• AVI file with running cineloop in the Trace analysis screen or
Result analysis screen (Store AVI button).
• Trace data for the current screen (Store trace button).
• Trace data at all nodal points along the ROI, available from
the Result analysis screen (Store full button).
To store data:
1. Select one of the storing options.
The Store window is displayed.
The location, name and type of the stored file are shown in
upper, mid and bottom strings in the Store window. You may
enter a text to be added to the file name in the text field.

Figure 10-20. The Store window

2. Select Save.
A file is saved to the local hard disk.

File management
The 2D Strain result file and other stored files can be exported
from the local hard drive to a removable media or a shared
network folder.
If a shared network folder is used, the path (of type:
\\SERVER-NAME\SHARED-FOLDER) and login information to
the shared network folder must be entered in the TCP/IP sheet
in Config (F2)/Connectivity.
1. In the Trace analysis screen or in the Result analysis
screen, select Files.
The File management window is displayed showing the 10-29
available files in the Available items field.
 Figure 10-21. The File management window

2. Check the desired selection criteria and select one or

several files in the Available items field.
3. Select the Down arrow button to move them over to the
Selected items field (right side).
4. Under Choose action, select:
• Copy to CD/USB Flash card
• Copy to Net
5. Select Run.
6. The selected files are copied to the selected device.
7. The copied files can be opened from a regular PC.

10-30
2D Strain – Frequently asked
questions

1. Q: What system settings should be used for acquiring best

data for 2D Strain analysis?
A: The 2D grey scale frame rate should be between 40 and
80 frames per second. Use only images of good quality
where the entire myocardium is visible (not only the
endocardial border). Slightly more than one cardiac cycle
should be stored to allow adjustment of the QRS markers:
configure the scanner such that when you save the loop,
margins of 100 msec are saved at both ends of the heart
cycle.
2. Q: Are there different criteria for TVI images than for 2D
images?
A: The same criteria apply (see Question 1). Note that the
TVI and 2D grey scale images may have different frame
rates. It is the 2D grey scale frame rate that should be
between 40 and 80 frames per second.
3. Q: Is the peak of the R wave the starting point for the loop
used for 2D strain analysis?
A: Yes, the reference for the strain measurements is the
end-diastolic state.
4. Q: How do I define the start and end points of the heart
cycle?
A: In most cases, when the ECG signal is good, you do not
have to do anything, the software will do it automatically for
you by analyzing the QRS complex. Sometimes the ECG
signal is poor. In order to be able to handle these situations
we recommend to manually shift the markers that define the
heart cycle either prior to entering 2D Strain or within the
2D Strain package.
5. Q: Is “Right Twist” shown by red color and clockwise?
A: Yes, clockwise rotation is measured as negative degrees
and is colored red.
10-31
6. Q: How is the combination of greyscale and TVI information
performed?
 A: If the data set contains TVI, the velocities within the ROI
are first angle corrected to the actual motion direction found
by 2D Strain processing. Next, the quality of the TVI and the
2D Strain data is estimated for each point within the ROI
from the spatial variation around the point. The data type
with the lowest variance is used for further processing.
7. Q: How is the result affected if the ROI covers both
myocardium and blood?
A: The processing uses a special filtering which ensures
that the blood samples have minimal effect on the estimated
strain values.
8. Q: How do we calculate rotation (twist)?
A: The rotation (twist) is calculated as an angular
displacement of each point of myocardium around the
“center of gravity”. The start angle is zero at the beginning of
heart cycle. The rotation rate is the temporal derivative of
the rotation. The Global Rotation is the averaged rotation
along the ROI.
9. Q: What are the “global” values, and how are they found?
A: The global values are calculated from the whole ROI as a
single segment. Note that this is similar, but not necessarily
identical, to averaging the values of all the segments.
10. Q: How is the Time to peak strain parametric image derived,
and what do the quantitative values represent?
A: The Time to peak strain parametric image color codes
the time from start systole to the peak negative longitudinal
strain. The quantitative values are in milliseconds.
11. Q: What are the start and end search times for the Time to
peak strain parametric image, and can the user control
these times?
A: The start search time is start systole (start QRS), and can
be controlled by adjusting the AVC marker. The end search
time is the QRS of the next beat, and is not adjustable. It is
possible to adjust Peak marker position manually (using
Drag-and-drop) in the Result analysis screen.
12. Q: What are the consequences if the warnings for low frame
rate etc. are ignored and analysis is performed anyway?
A: Up to a certain limit, probably none. For images with a
good image quality the tracking is good even for frames
rates as low as 30 fps. The message will appear for frame
rates below 40 fps.
13. Q: How can I use another heart beat than the second in a
loop?
10-32
A: The desired beat should be selected prior to entering the
2D Strain application.
14. Q: I am assuming that 90 fps is acceptable? With the higher
frame rate acquisition this would give us a better temporal
resolution when performing the 2D strain analysis.
A: A too high frame rate tends to come in the expense of a
reduced line density. This has a detrimental effect on
tracking quality.
15. Q: Horizontal timing intervals are set at 15 msec. Can these
be smaller?
A: Timing interval is given by the acquisition frame rate.
16. Q: What is the strain length at longitudinal and transverse
strain?
A: We do not measure distances between selected points,
rather we calculate strain based on interpolated positions of
all points inside the ROI.
17. Q: What is the difference between Lagrangian strain and
natural strain?
A: There are several definitions for one-dimensional strain.
One of them is the so-called Lagrangian strain, a.k.a.
engineering strain, which is defined as epsilon = (L-L0)/L0.
Another is the natural strain, a.k.a. logarithmic strain, which
is defined as epsilon_n = ln(L/L0), where ln means the
natural logarithm. (The name “natural strain” comes from
the use of the natural logarithm.) There is a direct
mathematical relation between these two strain measures:
epsilon_n = ln(epsilon + 1) or correspondingly
epsilon = exp(epsilon_n) - 1, where “exp” is the exponential
function. Using two different measures for the same
property can be compared to presenting a temperature
either in Fahrenheit or in Celsius. If you know the natural
strain, you can easily convert it to the Lagrangian/
engineering strain and vice versa.

10-33
 Chapter 11

Appendix

‘Short-cuts’ on page 11-2

‘System self-test’ on page 11-6

11-1
 Short-cuts

Keyboard short-cuts

Short-cut Description

In Freeze, displays previous and next frame.

Displays previous state (window).

Performs Alt. store 1.

Performs Alt. store 2.

Starts Annotation application.

Ejects removable media

Starts Structured findings application.

Store screen image to clipboard.

11-2
 Short-cut Description

Print

Run/stop cineloops.

OR

DICOM spooler

Starts Q Analysis.

Image store

• Shift + F1: In the Analysis screen, select previous image.

• Shift + F2: In the Analysis screen, select the next image.

In duplex mode, scrolls through a cineloop.

Help: starts the On line user manual.

F1

Starts EchoPAC Software Only configuration package.

11-3
 Short-cut Description

• Adjusts Cine speed when the selected cineloop is running

(F3 = decrease,F4 = increase).
• Enables Frame scrolling when the selected cineloop is frozen
(F3 = backward, F4 = forward).

Adjusts the Baseline when a Doppler window is selected (F3 = up,

F4 = down).

Adjust the Horizontal sweep speed when a Doppler or M-Mode window is

selected (F5 = decrease, F6 = increase).

• F8 or Arrow Up: zoom in

• F7 or Arrow Down: zoom out

OR

Panning tool when in Zoom mode

Shift

Adjust Compression (F9 = decrease, F10 = increase).

Adjust Reject (F11 = decrease, F12 = increase).

Mouse short-cuts

Short-cut Description

Zoom: scroll the mouse wheel to zoom in/out.

11-4
Short-cut Description

Panning tool in Zoom mode: press and hold down the mouse wheel,
select any point in the image and drag around to display the different
parts of the image.

Color modes: select any point in the color bar and drag vertically to
change the Baseline position.

Select the Start or End cineloop marker and drag horizontally to

adjust the position.

In freeze: select the frame marker on the ECG and drag horizontally, or
select any point on the ECG to display another frame.

Doppler: select the Baseline and drag vertically to change its position.

Doppler: select any point in the Doppler spectrum (except for the
baseline) and drag horizontally to adjust the Horizontal sweep.

Anatomical M-Mode: select the AMM cursor and drag vertically to

change the position.

Anatomical M-Mode: select the AMM angle cursor arrow head and
drag horizontally to change the angle.

Tissue Tracking/Strain: select the Start or End marker and drag

horizontally to change its position.

11-5
 System self-test

EchoPAC Software Only is designed for reliable operation and

consistent, high-quality performance. Automatic self-testing
facilities are provided to monitor operation and to detect
malfunction as soon as possible, thereby eliminating
unnecessary downtime.

System malfunction
In the event of error or system malfunction the user may save
locally or export a log file to a removable media as described
below and contact authorized service personnel.
In addition, system malfunctions can be bookmarked, enabling
creation of a log file specific to that event.

Bookmarking a system malfunction

1. If a system malfunction is observed, press Alt - B.
A bookmark will be created when creating a log file.

Generating a log file

1. Press Alt - D on the alphanumeric keyboard.
The Problem description dialogue window is displayed (see
Figure 11-1).
2. Type in a description of the problem. If applicable, try to
describe the button or key pushing sequence that
immediately preceded the problem.
Check the mention System lockup if applicable.
3. Select the destination where to save or export the log file.
If Store locally is selected, the log file is saved to the local
hard disk.
If a removable media is selected, the current and previously
saved log files are exported to the selected media.
NOTE: To export to a shared folder on a network, a remote path
11-6
must be defined (see ‘Default remote path setting’ on
page 3-64).
 4. Press Save and Export.
A Zip file (named “logfile_<date>_<time>.zip”) is created.

Figure 11-1. The Problem description dialogue window

Advanced log options

Extensive Log

Extensive Log enables the creation of a log file containing

additional information for the selected functionality.

Options

Options enables creation of a log file based on a selected

bookmark or for a user configurable time frame. Different type of
information can be selected to be part of the log file.

11-7
 Index

Numerics E
2D Strain, 10-1 EchoPAC
4D Overview, 2-3
Cropping, 4-24 Export
Stereo vision, 4-25 Patient records, 3-24
4D MV-Assessment, 5-68
4D Stress Echo H
Analysis, 6-10
4D LV-function, 5-67 HDF, 4-32

A I
Accessories Image optimization, 4-6
Ordering, 1-6 Screen overview, 4-6
Requesting a catalog, 1-6 Images
Archive Review, 4-3
Configuration, 3-53 Information
AutoEF, 5-40 Requesting, 1-6
Automated 4D left ventricular volume measurements, Intima-Media Thickness, 5-75
5-47
Automated Functional Imaging, 5-19 J
AVI, 4-32
JPEG, 4-32
B M
Backup, 3-38
Measurements, 5-1
C Assign and measure, 5-7
Configuration, 5-85
cineloop, 4-16 Event timing, 5-12
Comments, 3-7 Measure and assign, 5-9
Connectivity User-defined formulas, 5-89
Buttons, 3-67 MPEG, 4-32
Dataflow, 3-57 MPEGVue, 4-34
Contacts Multi-plane Stress Echo
Clinical questions, 1-6 Analysis, 6-8
Internet, 1-6 Multi-Slice, 4-28
Service questions, 1-6
O
D
On/Off, 2-2
Delete
Image, 4-5 P
Diagnosis code, 3-8
Diagnosis information, 3-7 Patient record
Creating a new record, 3-10 1 -1
DICOM spooler, 4-38
Editing demographic data, 3-10
DICOM SR, 3-61
Disk space management, 3-31 Searching, 3-3
Q XYZ
Quantitative Analysis, 7-1 Zoom, 4-15
Anatomical M-Mode, 7-25
Deletion of a trace, 7-10
Frame disabling, 7-11
Manual tracking, 7-9
Optimizing, 7-12
Sample area, 7-8
Strain cursor, 7-9
To generate a trace, 7-8
Trace smoothing, 7-16
Wash-in curve fitting, 7-18
Wash-out curve fitting, 7-22

R
Referral reasons, 3-7
Removable, 3-16
Removable media, 3-16
Ejecting, 3-22
Formatting, 3-20
Report, 9-1
Configuration, 9-41
Deleting, 9-7
Export/Import templates, 9-42
Save, 9-5
Report designer, 9-24
Designing a template, 9-27
Restore data, 3-38

S
Searching
Patient record, 3-3
Service
Requesting, 1-6
Short-cuts, 11-2
Stress Echo, 6-1
Analysis, 6-6
Configuring levels, 6-27
Editing template, 6-24
Loop synchronization, 6-5
Quantitative TVI Stress analysis, 6-14
Scoring, 6-7
Tissue Tracking, 6-19

T
TCP/IP, 3-55
TSI measurements, 5-13

U
Unlock patient record, 3-70

W 1 -2
Worksheet, 8-1
Technical Publications
Vivid™ E80 / Vivid™ E90 / Vivid™ E95
EchoPAC™ Software Only / EchoPAC™ Plug-in
Version 201

0123
Reference Manual
GC092334
Rev. 05

Operating Documentation
Copyright 2014, 2015 By General Electric Co.
Regulatory requirement

This product complies with regulatory requirements of the following European

Directive 93/42/EEC concerning medical devices.

0123
This manual is a reference for the Vivid E80, Vivid E90 and Vivid E95 ultrasound
systems (Hereafter listed as Vivid E80/90/95), EchoPAC Software Only, and
EchoPAC Plug-in. It applies to all versions of the 201 software for the Vivid E80/90/
95 ultrasound system, EchoPAC Software Only, and EchoPAC Plug-in. All
information provided in this manual is relevant for all these products unless
otherwise specified.

Manufacturer:
GE VINGMED ULTRASOUND A/S
Strandpromenaden 45
N-3191 Horten, Norway
Tel.: (+47) 3302 1100 Fax: (+47) 3302 1350
Revision History
Reason for change

DATE
REV (YYYY-MM-DD) REASON FOR CHANGE

Rev. 01 2014-08-27 Initial release

Rev. 02 2014-10-06 FDR2a release

Rev. 03 2014-12-12 FDR2b release

Rev. 04 2015-02-19 M3 release

Rev. 05 2015-11-27 M4 release / IEC 62359 Ed.2 updates

List of effective pages

PAGE NUMBER REVISION NUMBER

All pages Rev. 05

Please verify that you are using the latest revision of this document. Information
pertaining to this document is maintained on ePDM (GE electronic Product Data
Management). If you need to know the latest revision, contact your distributor, local GE
Sales Representative or in the USA call the GE Ultrasound Clinical Answer Center at
1 800 682 5327 or 1 262 524 5698.

i -1
 Table of Contents

Table of Contents
Chapter 1 — Measurements
Measurement overview
Cardiac measurements - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-2
4D Automated Left Ventricular Quantification tool- - - - - - - - - - - - - - - - 1-14
2D Strain measurements - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-17
AFI measurements - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-24
Aorta Annulus tool- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-26
Measurement formulas
Formulas–Generic- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-27
Formulas–Cardiac- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-29
Formulas–Vascular - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-66
Formulas–OB - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-68
Measurement accuracy
General - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-75
Sources of error - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-75
Optimizing Measurement Accuracy- - - - - - - - - - - - - - - - - - - - - - - - - - 1-77
Measurement Uncertainties - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-77
DICOM SR Measurements
Supported parameters - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-82
Supported methods - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-90
Content of Vascular SR object - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1-92
Chapter 2 — OB Tables
OB Tables
ASUM - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-2
Berkowitz - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-4
Brenner - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-4
Campbell - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-5
Eriksen- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-5
Goldstein - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-6
Hadlock - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-7
Hansmann - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-13
Hellman - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-21
Hill - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-21
Hohler - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-22
Jeanty - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-22
JSUM- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-32
Kurtz - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-36 i -3
Mayden - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-36
 Mercer - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-38
Merz - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-39
Moore - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-49
Nelson - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-49
Osaka - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-50
Paris - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-54
Rempen - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-57
Robinson - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-62
Tokyo- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-62
Tokyo Shinozuka - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-66
Williams - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-72
Yarkoni - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 2-72
Chapter 3 — Acoustic information
The real-time display of acoustic output indices
Thermal Index- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-2
Mechanical Index - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-4
Track 3 ALARA Educational Program
Default Settings and Output Levels
Controls Affecting Acoustic Output
Track 3 Summary Table- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-9
Probe surface temperature safety mechanisms
Acoustic Parameters as Measured in Water
Definitions, symbols and abbreviations - - - - - - - - - - - - - - - - - - - - - - - 3-11
Multiple focal-zones- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-12
Operating Conditions- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-12
Acoustic Output Reporting Tables for IEC 62359 Ed.2
Transducer Model: M5Sc-D - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-14
Transducer Model: 6S-D - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-20
Transducer Model: 12S-D - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-26
Transducer Model: 4V-D - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-32
Transducer Model: 9L-D - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-38
Transducer Model: 11L-D - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-43
Transducer Model: L8-18i-D- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-48
Transducer Model: C1-6-D- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-53
Transducer Model: IC5-9-D - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-58
Transducer Model: C2-9-D- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-63
Transducer Model: 8C - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-68
Transducer Model: 6VT-D - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-73
Transducer Model: 6Tc / 6Tc-RS - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-79
Transducer Model: 9T / 9T-RS - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-84
Transducer Model: P2D - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-89
Transducer Model: P6D - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-90
Appendices
Statements on the safety of ultrasound - - - - - - - - - - - - - - - - - - - - - - - - 1-1
AIUM Statement on Mammalian in Vivo Ultrasonic Biological Effects - - - 1-1
i -4
 Chapter 1

Measurements

This chapter describes:

‘Measurement overview’ on page 1-2

‘Measurement formulas’ on page 1-27

‘Measurement accuracy’ on page 1-75

‘DICOM SR Measurements’ on page 1-81

1 -1
 Measurement overview

The following table shows the cardiac measurements available

on the Vivid E80/90/95 ultrasound unit.

Cardiac measurements

Abbreviation Definition Unit

%FS LV Fractional Shortening, 2D %

%FS LV Fractional Shortening, M-mode %

%IVS Thck IVS Fractional Shortening, 2D %

%IVS Thck IVS Fractional Shortening, M-mode %

%LVPW Thck LV Posterior Wall Fractional Shortening, 2D %

%LVPW Thck LV Posterior Wall Fractional Shortening, M-mode %

Ao Arch Diam Aortic Arch Diameter cm

Ao asc Ascending Aortic Diameter cm

Ao Desc Diam Descending Aortic Diameter cm

Ao Isthmus Aortic Isthmus cm

Ao Root Diam Aortic Root Diameter cm

Ao Root Diam Aortic Root Diameter, M-mode cm

AR ERO PISA: Regurgitant Orifice Area cm2

AR Flow PISA: Regurgitant Flow ml/s

AR PHT AV Insuf. Pressure Half Time ms

AR Rad PISA: Radius of Aliased Point cm

AR RF Regurgitant fraction over the Aortic Valve %

AR RV PISA: Regurgitant Volume Flow ml

AR Vel PISA: Aliased Velocity m/s

AR Vmax Aortic Insuf. Peak Velocity m/s

AR VTI Aortic Insuf. Velocity Time Integral cm 1 -2

 Abbreviation Definition Unit

ARed max PG Aortic Insuf. End-Diastole Pressure Gradient mm Hg

ARed Vmax Aortic Insuf. End-Diastolic Velocity m/s

AV Acc Slope Aortic Valve Flow Acceleration m/s2

AV Acc Time Aortic Valve Acceleration Time ms

AV AccT/ET AV Acceleration to Ejection Time Ratio

AV EOA I (VTI) Aortic Valve Effective Orifice Area Index by Continuity cm2/m2
Equation VTI

AV EOA I Vmax Aortic Valve Effective Orifice Area Index by Continuity cm2/m2
Equation Peak V

AV CO Cardiac Output by Aortic Flow l/min

AV Cusp Aortic Valve Cusp Separation, 2D cm

AV Cusp Aortic Valve Cusp Separation, M-mode cm

AV Dec Time Aortic Valve Deceleration Time ms

AV Diam Aortic Diameter, 2D cm

AV max PG Aortic Valve Peak Pressure Gradient mm Hg

AV mean PG Aortic Valve Mean Pressure Gradient mm Hg

AV SV Stroke Volume by Aortic Flow ml

AV Vmax Aortic Valve Peak Velocity m/s

AV Vmean AV Mean Velocity m/s

AV VTI Aortic Valve Velocity Time Integral cm

AVA (Vmax) AV Area by Continuity Equation by Peak V cm2

AVA (VTI) AV Area by Continuity Equation VTI cm2

AVA Planimetry Aortic Valve Area cm2

AVET Aortic Valve Ejection Time ms

AVET Aortic Valve Ejection Time, M-mode ms

CO (A-L A2C) CO 2CH, Single Plane, Area-Length l/min

CO (A-L A4C) CO 4CH, Single Plane, Area-Length l/min

CO (Biplane CO, Bi-Plane, MOD l/min

CO (bullet) CO, Bi-Plane, Bullet l/min

CO (MOD A2C) CO 2CH, Single Plane, MOD (Simpson) l/min

CO (MOD A4C) CO 4CH, Single Plane, 4CH, MOD (Simpson) l/min

1 -3
 Abbreviation Definition Unit

CO(Cube) Cardiac Output, 2D, Cubic l/min

CO(Cube) Cardiac Output, M-mode, Cubic l/min

CO(Teich) Cardiac Output, 2D, Teicholtz l/min

CO(Teich) Cardiac Output, M-mode, Teicholtz l/min

D-E Excursion MV Anterior Leaflet Excursion cm

D-E Excursion Mitral Valve D-E Slope cm

E’ Early diastolic mitral valve annular velocity m/s

E/E’ Mitral inflow E velocity to E’ ratio

E’ Avg Averaged early diastolic mitral valve annular velocity m/s

E/E’ Avg Mitral inflow E velocity to E’ Avg ratio

EDV (bullet) LV Volume, Diastolic, Bi-Plane, Bullet ml

EDV(Cube) Left Ventricle Volume, Diastolic, 2D, Cubic ml

EDV(Cube) Left Ventricle Volume, Diastolic, M-mode, Cubic ml

EDV(Teich) Left Ventricle Volume, Diastolic, 2D, Teicholtz ml

EDV(Teich) Left Ventricle Volume, Diastolic, M-mode, Teicholtz ml

EF (A-L A2C) Ejection Fraction 2CH, Single Plane, Area-Length %

EF (A-L A4C) Ejection Fraction 4CH, Single Plane, Area-Length %

EF (Biplane) Ejection Fraction, Bi-Plane, MOD %

EF (bullet) Ejection Fraction 2CH, Bi-Plane, Bullet %

EF (MOD A2C) Ejection Fraction 2CH, Single Plane, MOD (Simpson) %

EF (MOD A4C) Ejection Fraction 4CH, Single Plane, 4CH, MOD (Simpson) %

E-F Slope Mitral Valve E-F Slope m/s

EF(Cube) Ejection Fraction, 2D, Cubic %

EF(Cube) Ejection Fraction, M-mode, Cubic %

EF(Teich) Ejection Fraction, 2D, Teicholtz %

EF(Teich) Ejection Fraction, M-mode, Teicholtz %

E’ Lat Early diastolic mitral valve lateral annular velocity m/s

E/E’ Lat Mitral inflow E velocity to E’ Lat ratio

EPSS E-Point-to-Septum Separation, M-mode cm

EPSS 2D E-Point-to-Septum Separation, 2D cm

1 -4
ERO Effective Regurgitant Orifice cm 2
 Abbreviation Definition Unit

E’ Sept Early diastolic mitral valve septal annular velocity m/s

E/E’ Sept Mitral inflow E velocity to E’ Sept ratio

ESV (bullet) LV Volume, Systolic, Bi-Plane, Bullet ml

ESV(Cube) Left Ventricle Volume, Systolic, 2D, Cubic ml

ESV(Cube) Left Ventricle Volume, Systolic, M-mode, Cubic ml

ESV(Teich) Left Ventricle Volume, Systolic, 2D, Teicholtz ml

ESV(Teich) Left Ventricle Volume, Systolic, M-mode, Teicholtz ml

HR AV Heart Rate, Dop BPM

HR Heart Rate, 2D, Teicholtz bpm

HR Heart Rate for 2CH study bpm

HR Heart Rate for 4CH study bpm

HR Heart Rate for 2CH AL study bpm

HR Heart Rate for 2CH MOD study bpm

HR Heart Rate for 4CH AL study bpm

HR Heart Rate for 4CH MOD study bpm

HR Heart Rate for Bullet study bpm

HR Heart Rate for BiPlane MOD study bpm

HR LV Heart Rate, Dop bpm

HR Heart Rate, M-mode, Teicholtz bpm

HR Heart Rate bpm

IVC Inferior Vena Cava cm

IVCT Isovolumic Contraction Time ms

IVRT Isovolumic Relaxation Time ms

IVSd Interventricular Septum Thickness, Diastolic, 2D cm

IVSd IVS Thickness, Diastolic, M-mode cm

IVSs Interventricular Septum Thickness, Systolic, 2D cm

IVSs IVS Thickness, Systolic, M-mode cm

LA Diam Left Atrium Diameter, 2D cm

LA Diam Left Atrium Diameter, M-mode cm

LA Diam Right Atrium Diameter, 2D cm

1 -5
LA Major Left Atrium Major cm
 Abbreviation Definition Unit

LA Minor Left Atrium Minor cm

LA/Ao LA Diameter to AoRoot Diameter Ratio, 2D

LA/Ao LA Diameter to AoRoot Diameter Ratio, M-mode

LAEDV(A-L) LA End Diastolic Volume, Area-Length ml

LAEDV Index(A-L) LA End Diastolic Volume Index, Area-Length ml/m2

LVEDV (MOD BP) LV Volume, Diastolic, Bi-Plane, MOD ml

LAESV(A-L) LA End Systolic Volume, Area-Length ml

LAESV Index(A-L) LA End Systolic Volume Index, Area-Length ml/m2

LAEDV (MOD A4C) LA Volume, Single Plane, MOD ml

LAESV (MOD A4C) LA Volume, Systolic, Single Plane, MOD ml

LVESV (MOD BP) LV Volume, Systolic, Bi-Plane, MOD ml

LIMP Left Index of Myocardial Performance

LVA (s) Left Ventricular Area, Systolic, 2CH cm2

LVAd (A2C) Left Ventricular Area, Diastolic, 2CH cm2

LVAd (A4C) Left Ventricular Area, Diastolic, 4CH cm2

LVAd(sax) LV area, SAX, Diastolic cm2

LVAend (d) LV Endocardial Area, SAX cm2

LVAepi (d) LV Epicardial Area, SAX cm2

LVAs (A4C) Left Ventricular Area, Systolic, 4CH cm2

LVAs(sax) LV area, SAX, Systolic cm2

LVd Mass LV Mass, Diastolic, 2D g

LVd Mass LV Mass, Diastolic, M-mode g

LVd Mass Index LV Mass Index, Diastolic, 2D g/m2

LVd Mass Index LV Mass Index, Diastolic, M-mode g/m2

LVEDV (A-L A2C) LV Volume, Diastolic, 2CH, Area-Length ml

LVEDV (A-L A4C) LV Volume, Diastolic, 4CH, Area-Length ml

LVEDV (MOD A2C) LV Volume, Diastolic, Single Plane, 2CH, MOD ml

LVEDV (MOD A4C) LV Volume, Diastolic, Single Plane, 4CH, MOD ml

LVEDV (MOD BP) LV Volume, Diastolic, Bi-Plane, MOD ml 1 -6

 Abbreviation Definition Unit

LVESV (A-L A2C) LV Volume, Systolic, 2CH, Area-Length ml

LVESV (A-L A4C) LV Volume, Systolic, 4CH, Area-Length ml

LVESV (MOD A2C) LV Volume, Systolic, Single Plane, 2CH, MOD ml

LVESV (MOD A4C) LV Volume, Systolic, Single Plane, 4CH, MOD ml

LVESV (MOD BP) LV Volume, Systolic, Bi-Plane, MOD ml

LVESV (MOD LAX) LV Volume, Diastolic, Apical View, LAX, MOD ml

LVESV (MOD LAX) LV Volume, Systolic, Apical View, LAX, MOD ml

LVET Left Ventricle Ejection Time ms

LVIDd LV Internal Dimension, Diastolic, 2D cm

LVIDd LV Internal Dimension, Diastolic, M-mode cm

LVIDs LV Internal Dimension, Systolic, 2D cm

LVIDs LV Internal Dimension, Systolic, M-mode cm

LVLd (apical) Left Ventricular Length, Diastolic, 2D cm

LVLs (apical) Left Ventricular Length, Systolic, 2D cm

LVOT Area Left Ventricle Outflow Tract Area cm2

LVOT CO Cardiac Output by Aortic Flow l/min

LVOT Diam Left Ventricular Outflow Tract Diameter cm

LVOT max PG LVOT Peak Pressure Gradient mm Hg

LVOT mean PG LVOT Mean Pressure Gradient mm Hg

LVOT SI Stroke Volume Index by Aortic Flow ml/m2

LVOT SV Stroke Volume by Aortic Flow ml

LVOT Vmax LVOT Peak Velocity m/s

LVOT Vmean LVOT Mean Velocity m/s

LVOT VTI LVOT Velocity Time Integral cm

LVPWd Left Ventricular Posterior Wall Thickness, Diastolic, 2D cm

LVPWd Left Ventricular Posterior Wall Thickness, Diastolic, M-mode cm

LVPWs Left Ventricular Posterior Wall Thickness, Systolic, 2D cm

LVPWs Left Ventricular Posterior Wall Thickness, Systolic, M-mode cm

LVs Mass LV Mass, Systolic, 2D g

LVs Mass LV Mass, Systolic, M-mode g 1 -7

 Abbreviation Definition Unit

LVs Mass Index LV Mass Index, Systolic, 2D g/m2

LVs Mass Index LV Mass Index, Systolic, M-mode g/m2

LAAd (A2C) Left Atrium Area, Apical 2C cm2

LAAd (A4C) Left Atrium Area, Apical 4C cm2

MCO Mitral Valve closure to Opening ms

MP Area Mitral Valve Prosthesis cm2

MR Acc Time MV Regurg. Flow Acceleration s

MR ERO PISA: Regurgitant Orifice Area cm2

MR Flow PISA: Regurgitant Flow ml/s

MR max PG Mitral Regurg. Peak Pressure Gradient mm Hg

MR Rad PISA: Radius of Aliased Point cm

MR RF Regurgitant fraction over the Mitral Valve %

MR RV PISA: Regurgitant Volume Flow ml

MR Vel PISA: Aliased Velocity m/s

MR Vmax Mitral Regurg. Peak Velocity m/s

MR Vmax PISA: CW Peak Velocity m/s

MR Vmean Mitral Regurg. Mean Velocity m/s

MR VTI Mitral Regurg. Velocity Time Integral cm

MR VTI PISA: CW Velocity Time Integral cm

MV A Dur Mitral Valve A-Wave Duration ms

MV A Velocity MV Velocity Peak A m/s

MV Acc Slope Mitral Valve Flow Acceleration m/s2

MV Acc Time Mitral Valve Acceleration Time ms

MV Acc/Dec Time MV: Acc.Time/Decel.Time Ratio

MV an diam Mitral Valve Annulus Diameter, 2D cm

MV CO Cardiac Output by Mitral Flow l/min

MV Dec Slope Mitral Valve Flow Deceleration m/s2

MV Dec Time Mitral Valve Deceleration Time ms

MV E Velocity MV Velocity Peak E m/s

1 -8
MV E/A Ratio Mitral Valve E-Peak to A-Peak Ratio
 Abbreviation Definition Unit

MV max PG Mitral Valve Peak Pressure Gradient mm Hg

MV mean PG Mitral Valve Mean Pressure Gradient mm Hg

MV PHT Mitral Valve Pressure Half Time ms

MV Reg Frac Mitral Valve Regurgitant Fraction %

MV SI Stroke Volume Index by Mitral Flow ml/m2

MV SV Stroke Volume by Mitral Flow ml

MV Time to Peak Mitral Valve Time to Peak ms

MV Vmax Mitral Valve Peak Velocity m/s

MV Vmean MV Mean Velocity m/s

MV VTI Mitral Valve Velocity Time Integral cm

MVA Mitral Valve Area cm2

MVA By PHT Mitral Valve Area according to PHT cm2

MVA by plan Mitral Valve Area, 2D cm2

MVET Mitral Valve Ejection Time ms

P Vein A Pulmonary Vein Velocity Peak A (reverse) m/s

P Vein A Dur Pulmonary Vein A-Wave Duration ms

P Vein D Pulmonary Vein End-Diastolic Peak Velocity m/s

P Vein S Pulmonary Vein Systolic Peak Velocity m/s

PAEDP Pulmonary Artery Diastolic Pressure mm Hg

PE(d) Pericard Effusion, M-mode cm

PEs Pericard Effusion, 2D cm

PR max PG Pulmonic Insuf. Peak Pressure Gradient mm Hg

PR mean PG Pulmonic Insuf. Mean Pressure Gradient mm Hg

PR PHT Pulmonic Insuf. Pressure Half Time ms

PR Vmax Pulmonic Insuf. Peak Velocity m/s

PR VTI Pulmonic Insuf. Velocity Time Integral cm

PRend max PG Pulmonic Insuf. End-Diastole Pressure Gradient mm Hg

PRend Vmax Pulmonic Insuf. End-Diastolic Velocity m/s

Pulmonic Diam Pulmonary Artery Diameter, 2D cm

PV Acc Slope Pulmonic Valve Flow Acceleration m/s2

1 -9
 Abbreviation Definition Unit

PV Acc Time Pulmonic Valve Acceleration Time ms

PV Acc Time/ET Ratio PV Acceleration to Ejection Time Ratio

PV an diam Pulmonic Valve Annulus Diameter, 2D cm

PV Ann Area Pulmonic Valve Area cm2

PV CO Cardiac Output by Pulmonic Flow l/min

PV CO Cardiac Output by Pulmonic Flow l/min

PV max PG Pulmonic Valve Peak Pressure Gradient mm Hg

PV mean PG Pulmonic Valve Mean Pressure Gradient mm Hg

PV SV Stroke Volume by Pulmonic Flow ml

PV Vmax Pulmonary Artery Peak Velocity m/s

PV Vmax Pulmonic Valve Peak Velocity m/s

PV Vmean PV Mean Velocity m/s

PV VTI Pulmonic Valve Velocity Time Integral cm

PVA (VTI) Pulmonary Artery Velocity Time Integral cm2

PVein S/D Ratio Pulmonary Vein SD Ratio

PVET Pulmonic Valve Ejection Time ms

PVPEP Pulmonic Valve Pre-Ejection Period ms

PVPEP/ET Ratio PV Pre-Ejection to Ejection Time Ratio

Qp/Qs Pulmonic-to-Systemic Flow Ratio

RA Major Right Atrium Major, 2D cm

RA Minor Right Atrium Minor, 2D cm

RAA (d) Right Atrium Area, 2D, Diastole cm2

RAA (s) Right Atrium Area, 2D, Systole cm2

RAEDV A2C Right Atrium End Diastolic Volume, Apical 2 chamber cm3

RAEDV A-L RA End Diastolic Volume (A-L) ml

RAEDV MOD RA Volume Diastolic, Single Plan, MOD ml

RAEDV MOD RA End Diastolic Volume (MOD) ml

RAESV A-L RA End Systole Volume (A-L) ml

RAESV MOD RA Volume, Systolic, Single Plane, MOD ml

RAESV MOD RA End Systole Volume (MOD) ml

1-10
 Abbreviation Definition Unit

RALd Right Atrium Length, Diastole cm

RALs RA Length, systole cm

RIMP Right Index of Myocardial Performance

RJA (A4C) Regurgitant jet area cm2

RJA/LAA Regurgitant jet area ratio RJA/LAA

RV Major Right Ventricle Major cm

RV Minor Right Ventricle Minor cm

RV S’ Tricuspid annulus systolic excursion velocity m/s

RVAWd Right Ventricle Wall Thickness, Diastolic, 2D cm

RVAWs Right Ventricle Wall Thickness, Systolic, 2D cm

RVET Right Ventricle Ejection Time s

RVIDd Right Ventricle Diameter, Diastolic, 2D cm

RVIDd Right Ventricle Diameter, Diastolic, M-mode cm

RVIDs Right Ventricle Diameter, Systolic, 2D cm

RVIDs Right Ventricle Diameter, Systolic, M-mode cm

RVOT Area Right Ventricle Outflow Tract Area cm2

RVOT Diam RV Output Tract Diameter, 2D cm

RVOT Diam RV Output Tract Diameter, M-Mode cm

RVOT max PG RVOT Peak Pressure Gradient mm Hg

RVOT meanPG RVOT Mean Pressure Gradient mm Hg

RVOT SI LV Stroke Volume Index by Pulmonic Flow ml/m2

RVOT SV Stroke Volume by Pulmonic Flow ml

RVOT Vmax RVOT Peak Velocity m/s

RVOT Vmean RVOT Mean Velocity m/s

RVOT VTI RVOT Velocity Time Integral cm

RVSP Right Ventricle Systolic Pressure mm Hg

RVWd Right Ventricle Wall Thickness, Diastolic, M-mode cm

RVWs Right Ventricle Wall Thickness, Systolic, M-mode cm

SI (A-L A2C) LV Stroke Index, Single Plane, 2CH, Area-Length ml/m2

SI (A-L A4C) LV Stroke Index, Single Plane, 4CH, Area-Length ml/m2

1-11
 Abbreviation Definition Unit

SI (Biplane) LV Stroke Index, Bi-Plane, MOD ml/m2

SI (bullet) LV Stroke Index, Bi-Plane, Bullet ml/m2

SI (MOD A2C LV Stroke Index, Single Plane, 2CH, MOD ml/m2

SI (MOD A4C LV Stroke Index, Single Plane, 4CH, MOD ml/m2

SI (Teich) LV Stroke Index, Teicholtz, 2D ml/m2

SI (Teich) LV Stroke Index, Teicholtz, M-mode ml/m2

SV (A-L A2C) LV Stroke Volume, Single Plane, 2CH, Area-Length ml

SV (A-L A4C) LV Stroke Volume, Single Plane, 4CH, Area-Length ml

SV (Biplane) LV Stroke Volume, Bi-Plane, MOD ml

SV (bullet) LV Stroke Volume, Bi-Plane, Bullet ml

SV (MOD A2C) LV Stroke Volume, Single Plane, 2CH, MOD (Simpson) ml

SV (MOD A4C) LV Stroke Volume, Single Plane, 4CH, MOD (Simpson) ml

SV(Cube) LV Stroke Volume, 2D, Cubic ml

SV(Cube) LV Stroke Volume, M-mode, Cubic ml

SV(Teich) LV Stroke Volume, 2D, Teicholtz ml

SV(Teich) LV Stroke Volume, M-mode, Teicholtz ml

Systemic Diam Systemic Vein Diameter, 2D cm

Systemic Vmax Systemic Vein Peak Velocity m/s

Systemic VTI Systemic Vein Velocity Time Integral cm

TAPSE Tricuspid annular plane systolic excursion cm

TCO Tricuspid Valve Closure to Opening ms

TR max PG Tricuspid Regurg. Peak Pressure Gradient mm Hg

TR mean PG Tricuspid Regurg. Mean Pressure Gradient mm Hg

TR Vmax Tricuspid Regurg. Peak Velocity m/s

TR Vmean Tricuspid Regurg. Mean Velocity m/s

TR VTI Tricuspid Regurgitation Velocity Time Integral cm

TV A dur Tricuspid Valve A-Wave Duration ms

TV A Velocity Tricuspid Valve A Velocity m/s

TV Acc Time Tricuspid Valve Time to Peak ms

1-12
TV Ann Area Tricuspid Valve Area cm2
 Abbreviation Definition Unit

TV ann diam Tricuspid Valve Annulus Diameter, 2D cm

TV Area Tricuspid Valve Area, 2D cm2

TV CO Cardiac Output by Tricuspid Flow l/min

TV Dec Slope Tricuspid Valve Flow Deceleration m/s2

TV E Velocity Tricuspid Valve E Velocity m/s

TV E/A Ratio Tricuspid Valve E-Peak to A-Peak Ratio

TV max PG Tricuspid Valve Peak Pressure Gradient mm Hg

TV mean PG Tricuspid Valve Mean Pressure Gradient mm Hg

TV mean PG Tricuspid Valve Mean Pressure Gradient mm Hg

TV PHT Tricuspid Valve Pressure Half Time ms

TV SV Stroke Volume by Tricuspid Flow ml

TV Vmean TV Mean Velocity m/s

TV VTI Tricuspid Valve Velocity Time Integral cm

VSD max PG VSD Peak Pressure Gradient mm Hg

VSD Vmax VSD Peak Velocity m/s

1-13
4D Automated Left Ventricular Quantification tool

Volume measurements

Triangular meshes are automatically constructed by the border

detection algorithm. The mesh volumes are then calculated by
use of the Divergence Theorem1.

Abbreviation Definition Unit

EF Ejection fraction, EF(4D) %

Formula: ({LVEDV(4D)}-{LVESV(4D)})/{LVEDV(4D)}

SV Stroke Volume ml
Formula: ({LVEDV(4D)}-{LVESV(4D)})

CO Cardiac Output l/min

Formula: HR*{SV(4D)}

EDMass LV mass at end-diastole gram

Formula: EDMass = 1.05 * (LVEDV_epi - LVEDV_endo)

SpI Sphericity Index

Formula: SpI = EDV/(4/3* *(D/2)3) where D is the LV
end-diastolic long axis as determined by the alignment result.

1
Goldman. Area of Planar Polygons and Volume of Polyhedra.
In: Graphics Gems II, 1991.

4D Strain measurements

This section describes the parameters displayed when running

4D Strain in the 4D Auto LVQ tool.
4D Strain segmental parameters

Abbreviation Definition Unit

SL Longitudinal Strain %
SL = 100*(L-L0)/L0, where L is the instantaneous longitudinal
length of the segment and L0 is the initial length at start
systole (QRS). The length is measured as the average
midwall longitudinal length of the segment.

SC Circumferential Strain %
SC = 100*(L-L0)/L0, where L is the instantaneous
circumferential length of the segment and L0 is the initial
length at start systole (QRS). The length is measured as the
average midwall circumferential length of the segment. 1-14
 Abbreviation Definition Unit

SR Radial Strain (VolC) %

SR = 100*(R-R0)/R0, where R = V/A based on area strain (V
is segment volume). Volume conservation is assumed.

SA Area Strain %
SA = 100*(A-A0)/A0, where A is the instantaneous midwall
area of the segment and A0 is the initial area at start systole
(QRS).

4D Strain global parameters

Abbreviation Definition Unit

GSL Global Longitudinal Strain %

GSL is a weighted average of the segmental longitudinal
strain (SL) values. The initial segmental areas (A0) are used
as weights. The measurement is not available if more than
three segments are rejected.

GPSL Global Peak Longitudinal Strain %

GPSL is the peak negative global longitudinal strain (GSL)
value over the whole cardiac cycle. The measurement is not
available if more than three segments are rejected.

GSC Global Circumferential Strain %

GSC is a weighted average of the segmental circumferential
strain (SC) values. The initial segmental areas (A0) are used
as weights. The measurement is not available if more than
three segments are rejected.

GSR Global Radial Strain (VolC) %

GSR is a weighted average of the segmental radial strain
(VolC) (SR) values. The initial segmental areas (A0) are used
as weights. The measurement is not available if more than
three segments are rejected.

GSA Global Area Strain %

GSA is a weighted average of the segmental area strain (SA)
values. The initial segmental areas (A0) are used as weights.
The measurement is not available if more than three
segments are rejected.

4D Strain mesh export

When exporting 4D Strain results in HDF format (.h5), the file

includes a mid-myocardial mesh in the form of a structured
quadrilateral mesh consisting of a single mesh table of size
[3, Nl, Nc, Nf], where the first dimension is the X, Y, Z
coordinates of each node. The second and third dimensions are
the longitudinal and circumferential positions respectively in a
coordinate system relative to the left ventricle. The mesh is 1-15
periodic in the circumferential direction, and closed at apex. The
final dimension is the frame number. Several scientific
engineering software applications have support for loading of
the content of HDF5 files to facilitate more advanced analysis
and visualization of the meshes. Scripts to simplify loading into
these applications can be found on http://hdfutil.sourceforge.net/
(HdfUtil - Collection of utilities for simple exchange of HDF5 files
with C++, Matlab and Python).

1-16
2D Strain measurements

2D Strain shown parameters

The 2D Strain shown parameters are shown only on screen.

Apical view

Full name Definition Unit

Time to peak longitudinal Time from QRS to peak strain ms

strain Shown in Quad and Bull’s Eye screens

Wall motion rank (based on Combination of peak systolic strain and post-systolic index,
longitudinal strain) dual color map presentation: peak systolic strain less than
-5% shown in red shades if PSI is less than 20%, and PSS is
shown in green shades if PSI exceeds 20%. Reduced PSS
(>-5%) are shown in blue shades.
Shown in Quad and Bull’s Eye screens

Time to peak longitudinal Time from QRS to peak negative strain rate ms
strain rate Shown in Quad screen

Post Systolic Index (based Relative amount of total shortening that occurs after AVC. %
on longitudinal strain) Shown in Quad and Bull’s Eye screens
Formula: PSI = 100*(PS - ESS)/PS where ESS = strain at
AVC and PS = peak strain over whole cardiac cycle.

Pre-stretch Index (based Amount of early systolic stretching relative to the total %
on longitudinal strain) combined shortening, defined as the sum of the systolic
stretching and shortening.
Shown in Quad and Bull’s Eye screens
Formula: Pre-stretch = 100*Smaxpos/(Smaxpos - Sminsyst)
where Smaxpos is the peak positive strain in early systole
and Sminsyst is the peak negative strain in the systole.

IBS Integrated Backscatter

The average brightness of the image in the local ROI region.

Sax view

Full name Definition Unit

Time to peak Time from QRS to peak strain ms

circumferential strain Shown in Quad screen

Time to peak radial strain Time from QRS to peak strain ms

Shown in Quad screen

Wall motion rank (based on Combination of peak systolic strain and post-systolic index,
circumferential strain) dual color map presentation: peak systolic strain less than
-5% shown in red shades if PSI is less than 20%, and PSS is
shown in green shades if PSI exceeds 20%. Reduced PSS
(>-5%) are shown in blue shades. 1-17
Shown in Quad screen
 Full name Definition Unit

Time to peak Time from QRS to peak negative strain rate ms

circumferential strain rate Shown in Quad screen

Post Systolic Index (based Relative amount of total shortening that occurs after AVC. %
on circumferential strain) Shown in Quad screen
Formula: PSI = 100*(PS - ESS)/PS where ESS = strain at
AVC and PS = peak strain over whole cardiac cycle.

Post Systolic Index (based Shown in Quad screen %

on radial strain) Percentage of post-systolic wall thickening
Formula: PSI = 100*(PS - ESS)/PS where ESS = strain at
AVC and PS = peak strain over whole cardiac cycle.

Pre-stretch Index (based Amount of early systolic stretching relative to the total %
on circumferential strain) combined shortening, defined as the sum of the systolic
stretching and shortening.
Shown in Quad
Formula: Pre-stretch = 100*Smaxpos/(Smaxpos - Sminsyst)
where Smaxpos is the peak positive strain in early systole
and Sminsyst is the peak negative strain in the systole.

IBS Integrated Backscatter

The average brightness of the image in the local ROI region.

Global Rotation Average LV rotation deg

Rotation is calculated around the “center of mass”, the
position of which is calculated in each frame.

Global Rotation Rate Average LV rotation rate deg/s

Rotation is calculated around the “center of mass”, the
position of which is calculated in each frame.

Global Torsion Difference in global LV rotation between apical and basal deg
levels.

Global Torsion Rate Difference in global LV rotation rates between apical and deg/s
basal levels.

Bull’s eye view

Full name Definition Unit

GLPS_LAX Global longitudinal strain in apical long axis view. Peak %

contraction of the entire myocardial view wall. Only
calculated if at least 5 segments have acceptable TQ.
Formula: (MinWallLength-MaxWallLength)/ MaxWallLength

GLPS_A4C Global longitudinal strain in t chamber view. Peak %

contraction of the entire myocardial view wall. Only
calculated if at least 5 segments have acceptable TQ.
Formula: (MinWallLength-MaxWallLength)/ MaxWallLength

GLPS_A2C Global longitudinal strain in 2 chamber view. Peak %

contraction of the entire myocardial view wall. Only
calculated if at least 5 segments have acceptable TQ. 1-18
Formula: (MinWallLength-MaxWallLength)/ MaxWallLength
 Full name Definition Unit

GLPS_Avg Average global longitudinal strain. Averaged between %

3 views. Only calculated if global strains from all three views
are available.
Formula (GLPS_LAX + GLPS_A4C + GLPS_A2C)/3

AVC_MEAS Aortic valve closure time selected by user during 2D strain msec
work flow. Time interval between QRS (start systole) and
Aortic Valve Closure

HR_ApLAX Heart Rate in apical long axis view. bpm

FR_min Minimum frame rate from all three views fps

PSD Standard deviation of time to peak longitudinal strain for all msec
segments. Only calculated if GLPS_Avg is calculated.
Segments with time to peak longitudinal strain less than
50msec are not considered.
Formula: sqrt(1/(N-1)*sum(TTPSL_seg - TTPSL_avg)^2)
where N is the number of segments used in the calculation,
TTPSL_seg is the time to peak longitudinal strain for each
segment (the sum is taken over N values of TTPSL_seg) and
TTPSL_avg is the average time to peak longitudinal strain for
the N segments.

2D Strain global parameters

2D Strain global parameters are exported to the Excel report

("GlobalView_LAX" and/or "GlobalView_SAX" sheets).

Abbreviation Definition Unit

AVC (ms) Aortic Valve Closure ms

Time interval between QRS (start systole) and Aortic valve
closure. When automatic AVC is used, it is calculated as a
weighted average of the time to peak strain in each segment.

GSmid Global Strain %

Peak contraction of entire myocardial wall.
Formula:
GSmid = 100*(MinWallLength_mid-MaxWallLength_mid) /
MaxWallLength_mid

GSRa Global Strain Rate, diastolic peak A 1/s

Contraction rate of entire myocardial wall, diastolic peak A.

GSRe Global Strain Rate, diastolic peak E 1/s

Contraction rate of entire myocardial wall, diastolic peak E.

GSRs Global Strain Rate, systolic peak 1/s

Contraction rate of entire myocardial wall, systolic peak.

HR Heart Rate BPM

Heart rated based on the time between left and right QRS 1-19
markers in 2D Strain.
Formula: HR = 60/Cycle time
 Abbreviation Definition Unit

VAbasL Left basal longitudinal velocity, peak A cm/s

Velocity of the left basal ROI point along the myocardial wall.
Diastolic peak A.

VAbasR Right basal longitudinal velocity, peak A cm/s

Velocity of the right basal ROI point along the myocardial
wall. Diastolic peak A

VEbasL Left basal longitudinal velocity, peak E cm/s

Velocity of the left basal ROI point along the myocardial wall.
Diastolic peak E

VEbasR Right basal longitudinal velocity, peak E cm/s

Velocity of the right basal ROI point along the myocardial
wall. Diastolic peak E

GSendo Global endocardial Strain %

Peak contraction of entire myocardial wall using endocardial
length.
Formula:
GSendo = 100*(MinWallLength_endo-MaxWallLength_endo)
/MaxWallLength_endo

GSepi Global epicardial Strain %

Peak contraction of entire myocardial wall using epicardial
length.
Formula:
GSepi = 100*(MinWallLength-MaxWallLength) /
MaxWallLength

2D Strain segmental parameters

2D Strain segmental parameters are exported to the Excel

report. Segmental peak values are listed in the "SegmVal_LAX"
and/or "SegmVal_SAX" sheets and the segmental time to peak
values are listed in the "SegmTime_LAX" and/or
"SegmTime_SAX" sheets.

Abbreviation Definition Unit

DL (ES) Longitudinal displacement. End systolic value mm

For any point in the ROI, DL is defined as the change in
distance (L) along the tracked center line of the ROI from the
ROI apex to the point plus the displacement of the apical
point along the same center line.
For apical views only
Formula: DL = L - L0 + disp_apex

DL Peak G Longitudinal displacement. Peak value mm

See DL (ES) for definition of DL.
For apical views only
1-20
 Abbreviation Definition Unit

DT/DR (ES) Transverse or radial displacement. End systolic value mm

For any point on the internal ROI border, DT and DR are both
defined as the sum of the displacement components in the
direction perpendicular to the ROI center line in each frame
from start systole to the chosen time.

DT/DR Peak G Transverse or radial displacement. Peak value. mm

Rot (ES) LV rotation. End systolic value deg

Rotation around the “center of mass”, position of which is
calculated in each frame
For SAX views only

Rot Peak G LV rotation. Peak value deg

RotR Peak A LV rotation rate. Diastolic peak A. deg/s

RotR Peak E LV rotation rate. Diastolic peak E. deg/s

RotR Peak S LV rotation rate. Peak systolic value deg/s

S(tvi) Peak S Tissue Doppler Strain. Peak systolic value %

Calculated from angle-corrected strain rate Sr(tvi). First,
natural strain is calculated as the temporal integral of Sr(tvi).
Next the value is converted to Lagrangian strain as
S = exp(Sn) - 1, where Sn is the natural strain and exp is the
exponential function.

SL/SC (ES) Longitudinal or circumferential strain. End systolic value %

End systolic longitudinal or circumferential strain value
Formula: S = (L-L0)/L0, where L is the instantaneous length
of the segment and L0 is the initial length at start systole
(QRS). The length is measured along the ROI center line.

SL/SC Peak G Longitudinal or circumferential strain. Global peak value %

Most negative peak longitudinal or circumferential strain
along the entire heart cycle.

SL/SC Peak P Longitudinal or circumferential strain. Positive systolic peak %

value
Positive peak longitudinal or circumferential strain during
systole

SL/SC Peak S Longitudinal or circumferential strain. Systolic peak value. %

Most negative peak longitudinal or circumferential strain
during systole

Sr(tvi) Peak A Doppler strain rate. Diastolic peak A 1/s

Angle-corrected tissue Doppler strain rate, calculated as the
spatial derivative along ROI center line of angle corrected
tissue Doppler velocities.

Sr(tvi) Peak E Doppler strain rate. Diastolic peak E 1/s

Angle-corrected tissue Doppler strain rate, calculated as the
spatial derivative along ROI center line of angle corrected
tissue Doppler velocities.
1-21
 Abbreviation Definition Unit

Sr(tvi) Peak S Doppler strain rate. Peak systolic value 1/s

Angle-corrected tissue Doppler strain rate, calculated as the
spatial derivative along ROI center line of angle corrected
tissue Doppler velocities.

SrL/SrC Peak A Longitudinal or circumferential strain rate. Diastolic peak A 1/s

Strain rate is calculated as the temporal derivative of the
natural strain. The latter is found as ln(S-1), where S is the
strain and ln is the natural logarithm.

SrL/SrC Peak E Longitudinal or circumferential strain rate. Diastolic peak E 1/s

Strain rate is calculated as the temporal derivative of the
natural strain. The latter is found as ln(S-1), where S is the
strain and ln is the natural logarithm.

SrL/SrC Peak S Longitudinal or circumferential strain rate. Peak systolic 1/s

value
Strain rate is calculated as the temporal derivative of the
natural strain. The latter is found as ln(S-1), where S is the
strain and ln is the natural logarithm.

SrR Peak A Radial strain rate. Diastolic peak A 1/s

Strain rate is found as the spatial gradient of the velocity in
the radial direction.

SrR Peak E Radial strain rate. Diastolic peak E. 1/s

Strain rate is found as the spatial gradient of the velocity in
the radial direction.

SrR Peak S Radial strain rate. Peak systolic value 1/s

Strain rate is found as the spatial gradient of the velocity in
the radial direction.

ST/SR (ES) Transverse or radial strain. End systolic value %

End systolic transverse or radial strain value. Natural
transverse or radial strain is calculated as the temporal
integral of the transverse or radial strain rate. Next the value
is converted to Lagrangian strain as S = exp(Sn) - 1, where
Sn is the natural strain and exp is the exponential function.

ST/SR Peak G Transverse or radial strain. Global peak value %

Most positive peak transverse or radial strain along entire
heart cycle

TQ Tracking Quality
Internal estimation of segmental tracking quality

V(tvi) Peak A Doppler velocity. Diastolic peak A cm/s

Angle corrected tissue Doppler velocities, calculated as the
velocity along the ROI center line that corresponds to a
velocity component in the ultrasound beam direction equal to
the TVI velocity.

1-22
 Abbreviation Definition Unit

V(tvi) Peak E Doppler velocity. Diastolic peak E cm/s

Angle corrected tissue Doppler velocities, calculated as the
velocity along the ROI center line that corresponds to a
velocity component in the ultrasound beam direction equal to
the TVI velocity.

V(tvi) Peak S Doppler velocity. Peak systolic value cm/s

Angle corrected tissue Doppler velocities, calculated as the
velocity along the ROI center line that corresponds to a
velocity component in the ultrasound beam direction equal to
the TVI velocity.

VL Peak A Longitudinal velocity. Diastolic peak A cm/s

For apical views only

VL Peak E Longitudinal velocity. Diastolic peak E cm/s

For apical views only

VL Peak S Longitudinal velocity. Peak systolic value cm/s

Velocity component along the ROI direction
For apical views only

SLepi/SCepi (ES) Longitudinal or circumferential epicardial strain. End systolic %

value.
End systolic longitudinal or circumferential strain value
Formula: S = (L-L0)/L0
Where L is the instantaneous epicardial length of the
segment and L0 is the initial epicardial length at start systole
(QRS). The length is measured along the outer border of the
ROI.

SLepi/SCepi Peak G Longitudinal or circumferential epicardial strain. Global peak %

value.
Most negative peak longitudinal or circumferential strain
along the entire heart cycle.

SLepi/SCepi Peak S Longitudinal or circumferential epicardial strain. Systolic %

peak value.
Most negative peak longitudinal or circumferential strain
during systole

SLepi/SCepi Peak P Longitudinal or circumferential epicardial strain. Positive %

systolic peak value
Positive peak longitudinal or circumferential strain during
Systole.

SLepi/SCendo (ES) Longitudinal or circumferential endocardial strain. End %

systolic value.
End systolic longitudinal or circumferential strain value
Formula: S = (L-L0)/L0
Where L is the instantaneous endocardial length of the
segment and L0 is the initial endocardial length at start
systole (QRS). The length is measured along the inner
border of the ROI.

1-23
 Abbreviation Definition Unit

SLendo/SCendo Peak G Longitudinal or circumferential endocardial strain. Global %

peak value
Most negative peak longitudinal or circumferential strain
along the entire heart cycle.

SLendo/SCendo Peak S Longitudinal or circumferential endocardial strain. Systolic %

peak value.
Most negative peak longitudinal or circumferential strain
during systole

SLendo/SCendo Peak P Longitudinal or circumferential endocardial strain. Positive %

systolic peak value
Positive peak longitudinal or circumferential strain during
Systole.

AFI measurements

AFI shown parameters

The AFI shown parameters are shown only on screen.

Abbreviation Definition Unit

PSS Peak Systolic Longitudinal Strain %

Segmental most negative peak longitudinal strain during
systole. Replaced with a positive systolic peak if positive
peak exceeds 3/4*abs(negative).
Formula: S = (L-L0)/L0, where L is the instantaneous length
of the segment and L0 is the initial length at start systole
(QRS). The length is measured along the ROI center line.

PSI Post Systolic Index (based on longitudinal strain) %

Segmental, percentage of post-systolic contraction
Formula: PSI = 100*(PS - ESS)/PS where ESS = strain at
AVC and PS = peak strain over whole cardiac cycle.

HR Heart Rate BPM

Heart rated based on the time between left and right QRS
markers in 2D Strain.
Formula: HR = 60/Cycle time

1-24
AFI parameters exported to the Worksheet

Abbreviation Definition Unit

AVC Aortic Valve Closure ms

Time interval between QRS (start systole) and Aortic valve
closure.

A4C Apical 4 chamber view

BS peak sys SL Peak Systolic Longitudinal Strain - Basal Septum 1) %

MS peak sys SL Peak Systolic Longitudinal Strain - Mid Septum 1) %

AS peak sys SL Peak Systolic Longitudinal Strain - Apical Septum 1) %

BL peak sys SL Peak Systolic Longitudinal Strain - Basal Lateral segment 1) %

ML peak sys SL Peak Systolic Longitudinal Strain - Mid Lateral segment 1) %

AL peak sys SL Peak Systolic Longitudinal Strain - Apical Lateral segment 1) %

A2C: Apical 2 chamber view

BI peak sys SL Peak Systolic Longitudinal Strain - Basal Inferior segment 1) %

MI peak sys SL Peak Systolic Longitudinal Strain - Mid Inferior segment 1) %

AI peak sys SL Peak Systolic Longitudinal Strain - Apical Inferior segment 1) %

BA peak sys SL Peak Systolic Longitudinal Strain - Basal Anterior segment 1) %

MA peak sys SL Peak Systolic Longitudinal Strain - Mid Anterior segment 1) %

AA peak sys SL Peak Systolic Longitudinal Strain - Apical Anterior segment 1) %

APLAX: Apical long axis view

BP peak sys SL Peak Systolic Longitudinal Strain - Basal Posterior %

segment 1)

MP peak sys SL Peak Systolic Longitudinal Strain - Mid Posterior segment 1) %

AP peak sys SL Peak Systolic Longitudinal Strain - Apical Posterior %

segment 1)

BAS peak sys SL Peak Systolic Longitudinal Strain - Basal Antero-septal %

segment 1)

MAS peak sys SL Peak Systolic Longitudinal Strain - Mid Antero-septal %

segment 1)

AAS peak sys SL Peak Systolic Longitudinal Strain - Apical Antero-septal %

segment 1)
1) 1-25
Segmental most negative peak longitudinal strain during systole. Replaced with a
positive systolic peak if positive peak exceeds 3/4*abs(negative).
 Abbreviation Definition Unit

GLPS_LAX Global longitudinal strain in apical long axis view %

Peak contraction of the entire myocardial view wall. Only
calculated if at least 5 segments have acceptable TQ.
Formula: (MinWallLength-MaxWallLength) / MaxWallLength

GLPS_A4C Global longitudinal strain in 4 chamber view %

Peak contraction of entire myocardial view wall. Only
calculated if at least 5 segments have acceptable TQ.
Formula: (MinWallLength-MaxWallLength) / MaxWallLength

GLPS_A2C Global longitudinal strain in 2 chamber view %

Peak contraction of entire myocardial view wall. Only
calculated if at least 5 segments have acceptable TQ.
Formula: (MinWallLength-MaxWallLength) / MaxWallLength

GLPS_Avg Average global longitudinal strain %

Averaged between 3 views.
Formula: (GLPS_LAX+GLPS_A4C+GLPS_A2C)/3
1)Segmental most negative peak longitudinal strain during systole. Replaced with a
positive systolic peak if positive peak exceeds 3/4*abs(negative).

Aorta Annulus tool

Abbreviation Definition Unit

AA diameter Aortic annulus average diameter mm

Formula:
• maxRadius = AA max diameter/2
• minRadius = AA min diameter/2
• AA diameter = 3*( maxRadius + minRadius) - sqrt((3*
maxRadius+ minRadius)*( maxRadius+3* minRadius))

AA max diameter Aortic annulus major diameter mm

AA min diameter Aortic annulus minor diameter mm

AA circumference Aortic annulus circumference mm

Formula: AA circumference = PI* AA diameter

AA area Aortic annulus area cm2

Formula:
• maxRadius = AA max diameter/2
• minRadius = AA min diameter/2
• AA area = PI* maxRadius* minRadius

1-26
 Measurement formulas

Formulas–Generic

Calc Input Measurements

Mnemonic Calc Name Formula

BSA Body Surface Area Patient weight (kg) and height (cm)

BSA (m2)=0.007184 x Weight0.425 x Height0.725

BSA Body Surface Area Patient weight (kg)

BSA=0.1 x Weight0.667

MaxPG Maximum Pressure Gradient two Doppler blood flow peak velocities

MaxPG[mmHg]=4x(v1^2-v2^2)

MeanPG Mean Pressure Gradient flow velocities from one time marker to another time
marker in a Doppler display

MeanPG[mmHg]=n4x (Vi^2)/n i=1

% Stenosis Stenosis Ratio two areas (by ellipse, trace, circle or distance)

% Stenosis= [1-(Aresidual/ Alumen)]x100

PI Pulsatility Index two Doppler blood flow peak velocities and TAMAX

PI=(Vmax-Vdiastole)/TAMAXa

RI Resistivity Index two Doppler blood flow peak velocities

RI=(Vmax-Vdiastole)/Vmaxa

HR Heart Rate (beats/minute) one 2 beat time interval

HR[BPM]=120[sec]/2beat time [sec]

A/B Ratio Velocities Ratio two Doppler blood flow peak velocities

A/B=V1/V2

a) Vdiastole = Vmin or Vend-diastole (depends on preset selection)

1-27
 Calc Input Measurements
Mnemonic Calc Name Formula

TAMAX Time Averaged Maximum two time marks in a Doppler display

Velocity (Trace Method is
Peak or manual)

TAMAX=sum{Vt} from t1 to t2/(t2-t1) [cm/s or m/s]

TAMIN Time Averaged Minimum two time marks in a Doppler display

Velocity (Trace method is
Floor)

TAMIN=sum{Vt} from t1 to t2/(t2-t1) [cm/s or m/s]

TAMEAN Time Averaged Mean two time marks in a Doppler display

Velocity (Trace method is
Mean)

TAMEAN=sum{Vt} from t1 to t2/(t2-t1) [cm/s or m/s]

Calc Name Input Measurements Formula

Volume (spherical) one distance Vol[ml]=(p/6)xd^3

Volume (prolate spheroidal) two distances, d1>d2 Vol[ml]= (p/6)xd1xd2^2

Volume (prolate spheroidal) one ellipse, d1 major axis, d2 Vol[ml]= (p/6)xd1xd2^2

minor axis

Volume (spheroidal) three distances Vol[ml]= (p/6)xd1xd2xd3

Volume (spheroidal) one distance d1, one ellipse, d2 Vol[ml]= (p/6)xd1xd2xd3

major axis, d3 minor axis

1-28
Formulas–Cardiac
The following table lists the cardiac calculations. The folders
where to find the calculations and related measurements are
indicated in brackets “[ ]“.
The system provides calculations and charts based on
published scientific literature. The selection of the appropriate
chart and clinical interpretation of calculations and charts are the
sole responsibility of the user. The user must consider
contraindications for the use of a calculation or chart as
described in the scientific literature. The diagnosis, decision for
further examinations and medical treatment must be performed
by qualified personnel following good clinical practice.

%FS [Dimension, Cube/Teicholtz]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: (({LVIDd}-{LVIDs})/{LVIDd})
Needs measurement: LVIDd [Dimension, Cube/Teicholtz], LVIDs [Dimension, Cube/Teicholtz]
Measured by: LVs [2DLV], LVIDs [2DCALIPER], EF(Cube) [AUTOCALC]

%FS [Generic, Dimension]

Mode: MM:CM:AMM:CAMM:VRMM
Formula: (({LVIDd}-{LVIDs})/{LVIDd})
Needs measurement: LVIDd [Generic, Dimension], LVIDs [Generic, Dimension]
Measured by: LV Study [MMLV], LVIDs [MMDISCALIPER]
Belenkie, Israel, et al., “Assessment of Left Ventricular Dimensions and Function by Echocardiography,”
American Journal of Cardiology, June 1973, Vol. 31.

%IVS Thck [Dimension]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: (({IVSs}-{IVSd})/{IVSd})
Needs measurement: IVSs [Dimension], IVSd [Dimension]
Measured by: LVs [2DLV], IVSs [2DCALIPER]
Roelandt, Joseph, Practical Echocardiology, Ultrasound in medicine Series, Vol. 1, Denis White, ed.,
Research Studies Press, 1977, p. 130.Schiller, N. B., et al., “Recommendations for Quantification of the LV
by Two-Dimensional Echocardiography,” J Am Soc Echo, Sept-Oct 1989, Vol. 2, No. 5, p.364.

%IVS Thck [Dimension]

Mode: MM:CM:AMM:CAMM:VRMM
Formula: (({IVSs}-{IVSd})/{IVSd})
Needs measurement: IVSs [Dimension], IVSd [Dimension]
Measured by: IVSs [MMDISCALIPER]

%LVPW Thck [Dimension]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: (({LVPWs}-{LVPWd})/{LVPWd})
Needs measurement: LVPWs [Dimension], LVPWd [Dimension]
Measured by: LVs [2DLV], LVPWs [2DCALIPER]
Belenkie, Israel, et al., “Assessment of Left Ventricular Dimensions and Function by Echocardiography,”
American Journal of Cardiology, June 1973, Vol. 31. Roelandt, Joseph, Practical Echocardiology,
Ultrasound in Medicine Series, Vol. 1, Denis White, ed., Research Studies Press, 1977, p. 129.

1-29
%LVPW Thck [Dimension]
Mode: MM:CM:AMM:CAMM:VRMM
Formula: (({LVPWs}-{LVPWd})/{LVPWd})
Needs measurement: LVPWs [Dimension], LVPWd [Dimension]
Measured by: LVPWs [MMDISCALIPER]

Ao st junct/Ao [Dimension]
Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: {Ao st junct}/{Ao Diam}
Needs measurement: Ao st junct [Dimension], Ao Diam [Dimension]
Measured by: Ao st junct [2DCALIPER]

Ao/LA [Generic, Dimension]

Mode: MM:CM:AMM:CAMM:VRMM
Formula: {Ao Diam}/{LA Diam}
Needs measurement: Ao Diam [Generic, Dimension], LA Diam [Generic, Dimension]
Measured by: LA/Ao [MMLAAO]

AP Area [Aortic]
Mode: CW:PW:VRCW:VRPW
Formula: {LVOT Diam}^2*0.785*({LVOT VTI}/{AP VTI})
Needs measurement: LVOT Diam [Aortic], LVOT VTI [Aortic], AP VTI [Aortic]
Measured by: AP Area [SDMANTRACE]

AR RF [PISA]
Mode:CF:CW:PW:VRCW:VRPW
Formula: {AR RV}/{AV SV}
Needs measurement: AV Diam [Dimension], AV Trace [Aortic], AR Flow [PISA], AR Trace [PISA]
Measured by: AR RF [AUTOCALC]

AR ERO [PISA]
Mode: CF:CW:PW:VRCW:VRPW
Formula: {AR Flow}/{AR Vmax}
Needs measurement: AR Flow [PISA], AR Vmax [PISA]
Measured by: AR Trace [AUTOCALC]

AR RV [PISA]
Mode: CF:CW:PW:VRCW:VRPW
Formula: {AR Flow}/{AR Vmax}*{AR VTI}
Needs measurement: AR Flow [PISA], AR Vmax [PISA], AR VTI [PISA]
Measured by: AR Trace [AUTOCALC]

AV Acc Time/ET Ratio [Aortic]

Mode: CW:PW:VRCW:VRPW
Formula: {AV AccT}/{AVET}
Needs measurement: AV AccT [Aortic], AVET [Aortic]
Measured by: AVET [SDTIMECALIPER]

AV Area [Dimension]
Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: 3.14/4*{AV Diam}^2
Needs measurement: AV Diam [Dimension]
Measured by: AV Diam [2DCALIPER]

AV CI [Aortic]
Mode: CW:PW:VRCW:VRPW
Formula: (({AV Diam}^2*0.785*{AV VTI})*{HR}/60)/{BSA}
Needs measurement: AV Diam [Aortic], AV VTI [Aortic], HR [Aortic]
1-30
Measured by: AV Trace [SDMANTRACE]
AV CO [Aortic]
Mode: CW:PW:VRCW:VRPW
Formula: ({AV Diam}^2*0.785*{AV VTI})*{HR}/60
Needs measurement: AV Diam [Aortic], AV VTI [Aortic], HR [Aortic]
Measured by: AV Trace [SDMANTRACE]

AV EOA I (VTI) [Aortic]

Mode: 2D:CW:PW:VRCW:VRPW
Formula: {AVA (VTI)}/{BSA}
Needs measurement: LVOT Diam [Aortic], LVOT Trace [Aortic], AV Trace [Aortic]
Measured by: AVA (VTI) [AUTOCALC]

AV EOA I Vmax [Aortic]

Mode: 2D:CW:PW:VRCW:VRPW
Formula: {AVA Vmax}/{BSA}
Needs measurement: LVOT Diam [Aortic], LVOT Trace [Aortic], AV Trace [Aortic]
Measured by: AVA Vmax [AUTOCALC]

AV EOA I Vmax [Aortic]

Mode: 2D:CW:PW:VRCW:VRPW
Formula: {AVA Vmax}/{BSA}
Needs measurement: LVOT Diam [Aortic], LVOT Trace [Aortic], AV Vmax [Aortic]
Measured by: AVA Vmax [AUTOCALC]

AV EOA I Vmax, Pt [Aortic]

Mode: 2D:CW:PW:VRCW:VRPW
Formula: {AVA Vmax}/{BSA}
Needs measurement: LVOT Diam [Aortic], LVOT Vmax [Aortic], AV Trace [Aortic]
Measured by: AVA Vmax, Pt [AUTOCALC]

AV EOA I Vmax, Pt [Aortic]

Mode: 2D:CW:PW:VRCW:VRPW
Formula: {AVA Vmax}/{BSA}
Needs measurement: LVOT Diam [Aortic], LVOT Vmax [Aortic], AV Vmax [Aortic]
Measured by: AVA Vmax, Pt [AUTOCALC]

AV SI [Aortic]
Mode: CW:PW:VRCW:VRPW
Formula: ({AV Diam}^2*0.785*{AV VTI})/{BSA}
Needs measurement: AV Diam [Aortic], AV VTI [Aortic]
Measured by: AV Trace [SDMANTRACE]

AV SV [Aortic]
Mode: CW:PW:VRCW:VRPW
Formula: {AV Diam}^2*0.785*{AV VTI}
Needs measurement: AV Diam [Aortic], AV VTI [Aortic]
Measured by: AV Trace [SDMANTRACE]

AVA (VTI) [Aortic]

Mode: 2D:CW:PW:VRCW:VRPW
Formula: 3.14/4*{LVOT Diam}^2*{LVOT VTI}/{AV VTI}
Needs measurement: LVOT Diam [Aortic], LVOT VTI [Aortic], AV VTI [Aortic]
Measured by: AV Trace [AUTOCALC]

AVA Vmax [Aortic]

Mode: 2D:CW:PW:VRCW:VRPW
Formula: 3.14/4*{LVOT Diam}^2*abs({LVOT Vmax}/{AV Vmax})
Needs measurement: LVOT Diam [Aortic], LVOT Vmax [Aortic], AV Vmax [Aortic]
1-31
Measured by: AV Vmax [AUTOCALC]
AVA Vmax [Aortic]
Mode: 2D:CW:PW:VRCW:VRPW
Formula: 3.14/4*{LVOT Diam}^2*abs({LVOT Vmax}/{AV Vmax})
Needs measurement: LVOT Diam [Aortic], LVOT Vmax [Aortic], AV Vmax [Aortic]
Measured by: AV Trace [AUTOCALC]

AVA Vmax, Pt [Aortic]

Mode: 2D:CW:PW:VRCW:VRPW
Formula: 3.14/4*{LVOT Diam}^2*abs({LVOT Vmax}/{AV Vmax})
Needs measurement: LVOT Diam [Aortic], LVOT Vmax [Aortic], AV Vmax [Aortic]
Measured by: AV Vmax [AUTOCALC]

AVA Vmax, Pt [Aortic]

Mode: 2D:CW:PW:VRCW:VRPW
Formula: 3.14/4*{LVOT Diam}^2*abs({LVOT Vmax}/{AV Vmax})
Needs measurement: LVOT Diam [Aortic], LVOT Vmax [Aortic], AV Vmax [Aortic]
Measured by: AV Trace [AUTOCALC]

CI A-L A2C [Single Plane A2C, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D:Trace
Formula: (({LVEDV A-L A2C}-{LVESV A-L A2C})*{HR}/60)/{BSA}
Needs measurement: LVEDV A-L A2C [Single Plane A2C, AutoBiplane], LVESV A-L A2C [Single Plane
A2C, AutoBiplane], HR [Single Plane A2C, AutoBiplane]
Measured by: R-R [2DCALIPER], A2C [2DAUTOVOLUME]

CI A-L A2C [Single Plane A2C]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: (({LVEDV A-L A2C}-{LVESV A-L A2C})*{HR}/60/Auto)/{BSA}
Needs measurement: LVEDV A-L A2C [Single Plane A2C], LVESV A-L A2C [Single Plane A2C], HR [Single
Plane A2C]
Measured by: LVESV A2C [2DVOLUMETRACE]

CI A-L A4C [Single Plane A4C, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D:Trace
Formula: (({LVEDV A-L A4C}-{LVESV A-L A4C})*{HR}/60)/{BSA}
Needs measurement: LVEDV A-L A4C [Single Plane A4C, AutoBiplane], LVESV A-L A4C [Single Plane
A4C, AutoBiplane], HR [Single Plane A4C, AutoBiplane]
Measured by: R-R [2DCALIPER], A4C [2DAUTOVOLUME]

CI A-L A4C [Single Plane A4C]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: (({LVEDV A-L A4C}-{LVESV A-L A4C})*{HR}/60)/{BSA}
Needs measurement: LVEDV A-L A4C [Single Plane A4C], LVESV A-L A4C [Single Plane A4C], HR [Single
Plane A4C]
Measured by: LVESV A4C [2DVOLUMETRACE]

CI A-L LAX [Single Plane LAX, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D:Trace
Formula: (({LVEDV A-L LAX}-{LVESV A-L LAX})*{HR}/60)/{BSA}
Needs measurement: LVEDV A-L LAX [Single Plane LAX, AutoBiplane], LVESV A-L LAX [Single Plane
LAX, AutoBiplane], HR [Single Plane LAX, AutoBiplane]
Measured by: R-R [2DCALIPER], AutoVolume [2DAUTOVOLUME]

CI Biplane [Biplane]
Mode: 2D:CF:TT:SI:SRI:VR2D:Trace
Formula: d = biplane({LVLd A4C},{LVDisks},{LVLd A2C},{LVDisks})
Needs measurement: LVLd A4C [Biplane], LVLd A2C [Biplane], LVLs A4C [Biplane], LVLs A2C [Biplane], 1-32
HR [Biplane]
Measured by: R-R [2DCALIPER]
CI bp el [Biplane Ellipse]
Mode: 2D:CF:TT:SI:SRI:VR2D:Trace
Formula: ((d-s)*{ECG/HeartRate}/60)/{BSA} where:
s = (8/(3*3.14159))*{LVAs(A4C)}*{LVAs(sax MV)}/{2D/LVIDs}
d = (8/(3*3.14159))*{LVAd A4C}*{LVAd (sax MV)}/{LVIDd}
Needs measurement: LVAd A4C [Biplane Ellipse], LVAd (sax MV) [Biplane Ellipse], LVIDd [Biplane Ellipse],
LVAs A4C [Biplane Ellipse], LVAs sax MV [Biplane Ellipse], LVIDs [Biplane Ellipse], HR [Biplane Ellipse]
Measured by: R-R [2DCALIPER]

CI bullet [Bullet]
Mode: 2D:CF:TT:SI:SRI:VR2D:Trace
Formula: ((d-s)*{ECG/HeartRate}/60)/{BSA} where:
s =5/6*{LVAs(sax)}*{LVLs(apical)}
d = 5/6*{LVAd sax)}*{LVLd apical}
Needs measurement: LVAd sax) [Bullet], LVLd apical [Bullet], LVAs sax) [Bullet], LVLs apical [Bullet], HR
[Bullet]
Measured by: R-R [2DCALIPER]

CI MOD A2C [Single Plane A2C, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D:Trace
Formula: (({LVEDV MOD A2C}-{LVESV MOD A2C})*{HR}/60)/{BSA}
Needs measurement: LVEDV MOD A2C [Single Plane A2C, AutoBiplane], LVESV MOD A2C [Single Plane
A2C, AutoBiplane], HR [Single Plane A2C, AutoBiplane]
Measured by: R-R [2DCALIPER], A2C [2DAUTOVOLUME]

CI MOD A2C [Single Plane A2C]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: (({LVEDV MOD A2C}-{LVESV MOD A2C})*{HR}/60)/{BSA}
Needs measurement: LVEDV MOD A2C [Single Plane A2C], LVESV MOD A2C [Single Plane A2C], HR
[Single Plane A2C]
Measured by: LVESV A2C [2DVOLUMETRACE]

CI MOD A4C [Single Plane A4C, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D:Trace
Formula: (({LVEDV MOD A4C}-{LVESV MOD A4C})*{HR}/60)/{BSA}
Needs measurement: LVEDV MOD A4C [Single Plane A4C, AutoBiplane], LVESV MOD A4C [Single Plane
A4C, AutoBiplane], HR [Single Plane A4C, AutoBiplane]
Measured by: R-R [2DCALIPER], A4C [2DAUTOVOLUME]

CI MOD A4C [Single Plane A4C]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: (({LVEDV MOD A4C}-{LVESV MOD A4C})*{HR}/60)/{BSA}
Needs measurement: LVEDV MOD A4C [Single Plane A4C], LVESV MOD A4C [Single Plane A4C], HR
[Single Plane A4C]
Measured by: LVESV A4C [2DVOLUMETRACE]

CI MOD LAX [Single Plane LAX, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D:Trace
Formula: (({LVEDV MOD LAX}-{LVESV MOD LAX})*{HR}/60)/{BSA}
Needs measurement: LVEDV MOD LAX [Single Plane LAX, AutoBiplane], LVESV MOD LAX [Single Plane
LAX, AutoBiplane], HR [Single Plane LAX, AutoBiplane]
Measured by: R-R [2DCALIPER], AutoVolume [2DAUTOVOLUME]

1-33
CI mod sim [Modified Simpson]
Mode: 2D:CF:TT:SI:SRI:VR2D:Trace
Formula: ((d-s)*{ECG/HeartRate}/60)/{BSA} where: s = ({LVLs(apical)}/9)*((4*{LVAs(sax
MV)})+(2*{LVAs(sax PM)})+ sqrt({LVAs(sax MV)}*{LVAs(sax PM)})) d = ({LVLd apical}/
9)*((4*{LVAd (sax MV)})+(2*{LVAd sax PM})+ sqrt({LVAd (sax MV)}*{LVAd sax PM}))
Needs measurement: LVLd apical [Modified Simpson], LVAd (sax MV) [Modified Simpson], LVAd sax PM
[Modified Simpson], LVLs apical [Modified Simpson], LVAs sax MV [Modified Simpson], LVAs sax PM
[Modified Simpson], HR [Modified Simpson]
Measured by: R-R [2DCALIPER]

CI(Cube) [Dimension, Cube/Teicholtz]

Mode: 2D:CF:TT:SI:SRI:VR2D:Trace
Formula: ((d-s)*{ECG/HeartRate}/60)/{BSA} where:
s = {2D/LVIDs}^3 d = {LVIDd}^3
Needs measurement: LVIDd [Dimension, Cube/Teicholtz], LVIDs [Dimension, Cube/Teicholtz], HR
[Dimension, Cube/Teicholtz]
Measured by: R-R [2DCALIPER]

CI(Cube) [Generic, Dimension]

Mode: MM:CM:AMM:CAMM:VRMM
Formula: ((dv-sv)*{MM/HeartRate}/60)/{BSA} where:
sv = {MM/LVIDs}^3 dv = {LVIDd}^3
Needs measurement: LVIDd [Generic, Dimension], LVIDs [Generic, Dimension], HR [Generic, Dimension]
Measured by: Heartrate [MMTIMECALIPER]

CI(Teich) [Dimension, Cube/Teicholtz]

Mode: 2D:CF:TT:SI:SRI:VR2D:Trace
Formula: ((d-s)*{ECG/HeartRate}/60)/{BSA} where:
s = 7/(2.4+{2D/LVIDs})*{2D/LVIDs}^3 d = 7/(2.4+{LVIDd})*{LVIDd}^3
Needs measurement: LVIDd [Dimension, Cube/Teicholtz], LVIDs [Dimension, Cube/Teicholtz], HR
[Dimension, Cube/Teicholtz]
Measured by: R-R [2DCALIPER]

CI(Teich) [Generic, Dimension]

Mode: MM:CM:AMM:CAMM:VRMM
Formula: ((dv-sv)*{MM/HeartRate}/60)/{BSA} where:
sv = 7/(2.4+{MM/LVIDs})*{MM/LVIDs}^3 dv = 7/(2.4+{LVIDd})*{LVIDd}^3
Needs measurement: LVIDd [Generic, Dimension], LVIDs [Generic, Dimension], HR [Generic, Dimension]
Measured by: Heartrate [MMTIMECALIPER]

CO A-L A2C [Single Plane A2C, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D:Trace
Formula: ({LVEDV A-L A2C}-{LVESV A-L A2C})*{HR}/60
Needs measurement: LVEDV A-L A2C [Single Plane A2C, AutoBiplane], LVESV A-L A2C [Single Plane
A2C, AutoBiplane], HR [Single Plane A2C, AutoBiplane]
Measured by: R-R [2DCALIPER], A2C [2DAUTOVOLUME]

CO A-L A2C [Single Plane A2C]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: ({LVEDV A-L A2C}-{LVESV A-L A2C})*{HR}/60
Needs measurement: LVEDV A-L A2C [Single Plane A2C], LVESV A-L A2C [Single Plane A2C], HR [Single
Plane A2C]
Measured by: LVESV A2C [2DVOLUMETRACE]

1-34
CO A-L A4C [Single Plane A4C, AutoBiplane]
Mode: 2D:CF:TT:SI:SRI:VR2D:Trace
Formula: ({LVEDV A-L A4C}-{LVESV A-L A4C})*{HR}/60
Needs measurement: LVEDV A-L A4C [Single Plane A4C, AutoBiplane], LVESV A-L A4C [Single Plane
A4C, AutoBiplane], HR [Single Plane A4C, AutoBiplane]
Measured by: R-R [2DCALIPER], A4C [2DAUTOVOLUME]

CO A-L A4C [Single Plane A4C]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: ({LVEDV A-L A4C}-{LVESV A-L A4C})*{HR}/60
Needs measurement: LVEDV A-L A4C [Single Plane A4C], LVESV A-L A4C [Single Plane A4C], HR [Single
Plane A4C]
Measured by: LVESV A4C [2DVOLUMETRACE]

CO A-L LAX [Single Plane LAX, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D:Trace
Formula: ({LVEDV A-L LAX}-{LVESV A-L LAX})*{HR}/60
Needs measurement: LVEDV A-L LAX [Single Plane LAX, AutoBiplane], LVESV A-L LAX [Single Plane
LAX, AutoBiplane], HR [Single Plane LAX, AutoBiplane]
Measured by: R-R [2DCALIPER], AutoVolume [2DAUTOVOLUME]

CO A-L LAX [Single Plane LAX]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: ({LVEDV A-L LAX}-{LVESV A-L LAX})*{HR}/60
Needs measurement: LVEDV A-L LAX [Single Plane LAX], LVESV A-L LAX [Single Plane LAX], HR [Single
Plane LAX]
Measured by: LVESV LAX [2DVOLUMETRACE]

CO Biplane [Biplane]
Mode: 2D:CF:TT:SI:SRI:VR2D:Trace
Formula: d = biplane({LVLd A4C},{LVDisks},{LVLd A2C},{LVDisks})
Needs measurement: LVLd A4C [Biplane], LVLd A2C [Biplane], LVLs A4C [Biplane], LVLs A2C [Biplane],
HR [Biplane]
Measured by: R-R [2DCALIPER]

CO bp el [Biplane Ellipse]
Mode: 2D:CF:TT:SI:SRI:VR2D:Trace
Formula: (d-s)*{ECG/HeartRate}/60 where:
s = (8/(3*3.14159))*{LVAs(A4C)}*{LVAs(sax MV)}/{2D/LVIDs}
d = (8/(3*3.14159))*{LVAd A4C}*{LVAd (sax MV)}/{LVIDd}
Needs measurement: LVAd A4C [Biplane Ellipse], LVAd (sax MV) [Biplane Ellipse], LVIDd [Biplane Ellipse],
LVAs A4C [Biplane Ellipse], LVAs sax MV [Biplane Ellipse], LVIDs [Biplane Ellipse], HR [Biplane Ellipse]
Measured by: R-R [2DCALIPER]

CO bullet [Bullet]
Mode: 2D:CF:TT:SI:SRI:VR2D:Trace
Formula: (d-s)*{ECG/HeartRate}/60 where:
s =5/6*{LVAs(sax)}*{LVLs(apical)}
d = 5/6*{LVAd sax)}*{LVLd apical}
Needs measurement: LVAd sax) [Bullet], LVLd apical [Bullet], LVLs apical [Bullet], HR [Bullet]
Measured by: R-R [2DCALIPER]

CO MOD A2C [Single Plane A2C, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D:Trace
Formula: ({LVEDV MOD A2C}-{LVESV MOD A2C})*{HR}/60
Needs measurement: LVEDV MOD A2C [Single Plane A2C, AutoBiplane], LVESV MOD A2C [Single Plane
A2C, AutoBiplane], HR [Single Plane A2C, AutoBiplane] 1-35
Measured by: R-R [2DCALIPER], A2C [2DAUTOVOLUME]
CO MOD A2C [Single Plane A2C]
Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: ({LVEDV MOD A2C}-{LVESV MOD A2C})*{HR}/60
Needs measurement: LVEDV MOD A2C [Single Plane A2C], LVESV MOD A2C [Single Plane A2C], HR
[Single Plane A2C]
Measured by: LVESV A2C [2DVOLUMETRACE]

CO MOD A4C [Single Plane A4C, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D:Trace
Formula: ({LVEDV MOD A4C}-{LVESV MOD A4C})*{HR}/60
Needs measurement: LVEDV MOD A4C [Single Plane A4C, AutoBiplane], LVESV MOD A4C [Single Plane
A4C, AutoBiplane], HR [Single Plane A4C, AutoBiplane]
Measured by: R-R [2DCALIPER], A4C [2DAUTOVOLUME]

CO MOD A4C [Single Plane A4C]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: ({LVEDV MOD A4C}-{LVESV MOD A4C})*{HR}/60
Needs measurement: LVEDV MOD A4C [Single Plane A4C], LVESV MOD A4C [Single Plane A4C], HR
[Single Plane A4C]
Measured by: LVESV A4C [2DVOLUMETRACE]

CO MOD LAX [Single Plane LAX, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D:Trace
Formula: ({LVEDV MOD LAX}-{LVESV MOD LAX})*{HR}/60
Needs measurement: LVEDV MOD LAX [Single Plane LAX, AutoBiplane], LVESV MOD LAX [Single Plane
LAX, AutoBiplane], HR [Single Plane LAX, AutoBiplane]
Measured by: R-R [2DCALIPER], AutoVolume [2DAUTOVOLUME]

CO MOD LAX [Single Plane LAX]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: ({LVEDV MOD LAX}-{LVESV MOD LAX})*{HR}/60
Needs measurement: LVEDV MOD LAX [Single Plane LAX], LVESV MOD LAX [Single Plane LAX], HR
[Single Plane LAX]
Measured by: LVESV LAX [2DVOLUMETRACE]

CO mod sim [Modified Simpson]

Mode: 2D:CF:TT:SI:SRI:VR2D:Trace
Formula: (d-s)*{ECG/HeartRate}/60 where: s = ({LVLs(apical)}/9)*((4*{LVAs(sax MV)})+(2*{LVAs(sax
d = ({LVLd apical}/9)*((4*{LVAd (sax MV)})+(2*{LVAd sax PM}) + sqrt({LVAd (sax MV)}*{LVAd sax PM}))
Needs measurement: LVLd apical [Modified Simpson], LVAd (sax MV) [Modified Simpson], LVAd sax PM
[Modified Simpson], LVLs apical [Modified Simpson], LVAs sax MV [Modified Simpson], LVAs sax PM
[Modified Simpson], HR [Modified Simpson]
Measured by: R-R [2DCALIPER]

CO(A-L) [Generic]
Mode: 2D:CF:TT:SI:SRI:Trace
Formula: ({EDV(A-L)}-{ESV(A-L)})*{HR}/60
Needs measurement: ESV(A-L) [Generic], HR [Generic]
Measured by: R-R [2DCALIPER]

CO(Cube) [Dimension, Cube/Teicholtz]

Mode: 2D:CF:TT:SI:SRI:VR2D:Trace
Formula: (d-s)*{ECG/HeartRate}/60 where:
s = {2D/LVIDs}^3
d = {LVIDd}^3
Needs measurement: LVIDd [Dimension, Cube/Teicholtz], LVIDs [Dimension, Cube/Teicholtz], HR
[Dimension, Cube/Teicholtz] 1-36
Measured by: R-R [2DCALIPER]
CO(Cube) [Generic, Dimension]
Mode: MM:CM:AMM:CAMM:VRMM
Formula: (dv-sv)*{MM/HeartRate}/60 where:
sv = {MM/LVIDs}^3
dv = {LVIDd}^3
Needs measurement: LVIDd [Generic, Dimension], LVIDs [Generic, Dimension], HR [Generic, Dimension]
Measured by: Heartrate [MMTIMECALIPER]

CO(Teich) [Dimension, Cube/Teicholtz]

Mode: 2D:CF:TT:SI:SRI:VR2D:Trace
Formula: (d-s)*{ECG/HeartRate}/60 where:
s = 7/(2.4+{2D/LVIDs})*{2D/LVIDs}^3
d = 7/(2.4+{LVIDd})*{LVIDd}^3
Needs measurement: LVIDd [Dimension, Cube/Teicholtz], LVIDs [Dimension, Cube/Teicholtz], HR
[Dimension, Cube/Teicholtz]
Measured by: R-R [2DCALIPER]

CO(Teich) [Generic, Dimension]

Mode: MM:CM:AMM:CAMM:VRMM
Formula: (dv-sv)*{MM/HeartRate}/60 where:
sv = 7/(2.4+{MM/LVIDs})*{MM/LVIDs}^3
dv = 7/(2.4+{LVIDd})*{LVIDd}^3
Needs measurement: LVIDd [Generic, Dimension], LVIDs [Generic, Dimension], HR [Generic, Dimension]
Measured by: Heartrate [MMTIMECALIPER]

EDV bp el [Biplane Ellipse]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: (8/(3*3.14159))*{LVAd A4C}*{LVAd (sax MV)}/{LVIDd}
Needs measurement: LVAd A4C [Biplane Ellipse], LVAd (sax MV) [Biplane Ellipse], LVIDd [Biplane Ellipse]
Measured by: LVEF BP-EL [AUTOCALC]

EDV bullet [Bullet]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: 5/6*{LVAd sax)}*{LVLd apical}
Needs measurement: LVAd sax) [Bullet], LVLd apical [Bullet]
Measured by: LVEF Bullet [AUTOCALC]

EDV mod sim [Modified Simpson]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: ({LVLd apical}/9)*((4*{LVAd (sax MV)})+(2*{LVAd sax PM})+ sqrt({LVAd (sax MV)}*{LVAd sax PM}))
Needs measurement: LVLd apical [Modified Simpson], LVAd (sax MV) [Modified Simpson], LVAd sax PM
[Modified Simpson]
Measured by: EF mod sim [AUTOCALC]

EDV(Cube) [Dimension, Cube/Teicholtz]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: {LVIDd}^3
Needs measurement: LVIDd [Dimension, Cube/Teicholtz]
Measured by: LVd [2DLV], LVIDd [2DCALIPER], EF(Cube) [AUTOCALC]

EDV(Cube) [Generic, Dimension]

Mode: MM:CM:AMM:CAMM:VRMM
Formula: {LVIDd}^3
Needs measurement: LVIDd [Generic, Dimension]
Measured by: LV Study [MMLV], LVIDd [MMDISCALIPER]

1-37
EDV(Teich) [Dimension, Cube/Teicholtz]
Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: 7/(2.4+{LVIDd})*{LVIDd}^3
Needs measurement: LVIDd [Dimension, Cube/Teicholtz]
Measured by: LVd [2DLV], LVIDd [2DCALIPER], EF(Cube) [AUTOCALC]

EDV(Teich) [Generic, Dimension]

Mode: MM:CM:AMM:CAMM:VRMM
Formula: 7/(2.4+{LVIDd})*{LVIDd}^3
Needs measurement: LVIDd [Generic, Dimension]
Measured by: LV Study [MMLV], LVIDd [MMDISCALIPER]

E/E’ [Mitral Valve]

Mode:CW:PW:VRCW:VRPW
Formula: {MV E Vel}/{E’
Needs measurement: MV E/A Velocity [Mitral Valve], E’ [Mitral Valve]
Measured by: E/E’ [AUTOCALC]
Nagueh, Sherif F. et al. “Recommendations for the Evaluation of Left Ventricular Diastolic Function by
Echocardiography”, I Am Soc Echo, Feb 2009, Vol. 22, No. 2, p. 107

E/E’ Sept [Mitral Valve]

Mode:CW:PW:VRCW:VRPW
Formula: {MV E Vel}/{E’ Sept
Needs measurement: MV E/A Velocity [Mitral Valve], E’ Sept [Mitral Valve]
Measured by: E/E’ Sept [AUTOCALC]
Nagueh, Sherif F. et al. “Recommendations for the Evaluation of Left Ventricular Diastolic Function by
Echocardiography”, I Am Soc Echo, Feb 2009, Vol. 22, No. 2, p. 107

E/E’ Lat [Mitral Valve]

Mode:CW:PW:VRCW:VRPW
Formula: {MV E Vel}/{E’ Lat
Needs measurement: MV E/A Velocity [Mitral Valve], E’ Lat [Mitral Valve]
Measured by: E/E’ Lat [AUTOCALC]
Nagueh, Sherif F. et al. “Recommendations for the Evaluation of Left Ventricular Diastolic Function by
Echocardiography”, I Am Soc Echo, Feb 2009, Vol. 22, No. 2, p. 107

E’ Avg [Mitral Valve]

Mode:CW:PW:VRCW:VRPW
Formula: ({E’ Sept}+{E’ Lat})/2
Needs measurement: E’ Sept [Mitral Valve], E’ Lat [Mitral Valve]
Measured by: E/E’ Avg [AUTOCALC]
Nagueh, Sherif F. et al. “Recommendations for the Evaluation of Left Ventricular Diastolic Function by
Echocardiography”, I Am Soc Echo, Feb 2009, Vol. 22, No. 2, p. 107

E/E’ Avg [Mitral Valve]

Mode:CW:PW:VRCW:VRPW
Formula: {MV E Vel}/(({E’ Sept}+{E’ Lat})/2)
Needs measurement: MV E/A Velocity [Mitral Valve], E’ Sept [Mitral Valve], E’ Lat [Mitral Valve]
Measured by: E/E’ Avg [AUTOCALC]
Nagueh, Sherif F. et al. “Recommendations for the Evaluation of Left Ventricular Diastolic Function by
Echocardiography”, I Am Soc Echo, Feb 2009, Vol. 22, No. 2, p. 107

EF A-L A2C [Biplane, Single Plane A2C, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: ({LVEDV A-L A2C}-{LVESV A-L A2C})/{LVEDV A-L A2C}
Needs measurement: LVEDV A-L A2C [Biplane, Single Plane A2C, AutoBiplane], LVESV A-L A2C [Biplane,
Single Plane A2C, AutoBiplane] 1-38
Measured by: EF SP A2C [AUTOCALC], LVESV A2C [2DVOLUMETRACE], A2C [2DAUTOVOLUME]
EF A-L A4C [Biplane, Single Plane A4C, AutoBiplane]
Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: ({LVEDV A-L A4C}-{LVESV A-L A4C})/{LVEDV A-L A4C}
Needs measurement: LVEDV A-L A4C [Biplane, Single Plane A4C, AutoBiplane], LVESV A-L A4C [Biplane,
Single Plane A4C, AutoBiplane]
Measured by: EF SP A4C [AUTOCALC], LVESV A4C [2DVOLUMETRACE], A4C [2DAUTOVOLUME]

EF A-L LAX [Single Plane LAX, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: ({LVEDV A-L LAX}-{LVESV A-L LAX})/{LVEDV A-L LAX}
Needs measurement: LVEDV A-L LAX [Single Plane LAX, AutoBiplane], LVESV A-L LAX [Single Plane
LAX, AutoBiplane]
Measured by: LVESV LAX [2DVOLUMETRACE], EF SP LAX [AUTOCALC], AutoVolume
[2DAUTOVOLUME]

EF Biplane [Biplane, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: d = biplane({LVLd A4C},{LVDisks},{LVLd A2C},{LVDisks})
Needs measurement: LVLd A4C [Biplane, AutoBiplane], LVLd A2C [Biplane, AutoBiplane], LVLs A4C
[Biplane, AutoBiplane], LVLs A2C [Biplane, AutoBiplane]
Measured by: EF Biplane [AUTOCALC]

EF mod sim [Modified Simpson]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: ({LVLd apical}/9)*((4*{LVAd (sax MV)})+(2*{LVAd sax PM})+ sqrt({LVAd (sax MV)}*{LVAd sax PM}))
Needs measurement: LVLd apical [Modified Simpson], LVAd (sax MV) [Modified Simpson], LVAd sax PM
[Modified Simpson], LVLs apical [Modified Simpson], LVAs sax MV [Modified Simpson], LVAs sax PM
[Modified Simpson]
Measured by: EF mod sim [AUTOCALC]

EF(A-L) [Generic]
Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: ({EDV(A-L)}-{ESV(A-L)})/{EDV(A-L)}
Needs measurement: ESV(A-L) [Generic], EDV(A-L) [Generic]
Measured by: EF Volume [AUTOCALC]

EF(Cube) [Dimension, Cube/Teicholtz]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: (d-s)/d where: s = {2D/LVIDs}^3 d = {LVIDd}^3
Needs measurement: LVIDd [Dimension, Cube/Teicholtz], LVIDs [Dimension, Cube/Teicholtz]
Measured by: LVs [2DLV], LVIDs [2DCALIPER], EF(Cube) [AUTOCALC]

EF(Cube) [Generic, Dimension]

Mode: MM:CM:AMM:CAMM:VRMM
Formula: (dv-sv)/dv where:
sv = {MM/LVIDs}^3
dv = {LVIDd}^3
Needs measurement: LVIDd [Generic, Dimension], LVIDs [Generic, Dimension]
Measured by: LV Study [MMLV], LVIDs [MMDISCALIPER]

EF(MOD) [Generic]
Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: ({EDV(MOD)}-{ESV(MOD)})/{EDV(MOD)}
Needs measurement: EDV(MOD) [Generic], ESV(MOD) [Generic]
Measured by: EF Volume [AUTOCALC]

1-39
EF(Teich) [Dimension, Cube/Teicholtz]
Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: (d-s)/d where:
s = 7/(2.4+{2D/LVIDs})*{2D/LVIDs}^3
d = 7/(2.4+{LVIDd})*{LVIDd}^3
Needs measurement: LVIDd [Dimension, Cube/Teicholtz], LVIDs [Dimension, Cube/Teicholtz]
Measured by: LVs [2DLV], LVIDs [2DCALIPER], EF(Cube) [AUTOCALC]

EF(Teich) [Generic, Dimension]

Mode: MM:CM:AMM:CAMM:VRMM
Formula: (dv-sv)/dv where:
sv = 7/(2.4+{MM/LVIDs})*{MM/LVIDs}^3
dv = 7/(2.4+{LVIDd})*{LVIDd}^3
Needs measurement: LVIDd [Generic, Dimension], LVIDs [Generic, Dimension]
Measured by: LV Study [MMLV], LVIDs [MMDISCALIPER]

ESV bp el [Biplane Ellipse]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: (8/(3*3.14159))*{LVAs A4C}*{LVAs sax MV}/{LVIDs}
Needs measurement: LVAs A4C [Biplane Ellipse], LVAs sax MV [Biplane Ellipse], LVIDs [Biplane Ellipse]
Measured by: LVEF BP-EL [AUTOCALC]

ESV bullet [Bullet]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: 5/6*{LVAs sax)}*{LVLs apical}
Needs measurement: LVAs sax) [Bullet], LVLs apical [Bullet]
Measured by: LVEF Bullet [AUTOCALC]

ESV mod sim [Modified Simpson]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: ({LVLs apical}/9)*((4*{LVAs sax MV})+(2*{LVAs sax PM})+ sqrt({LVAs sax MV}*{LVAs sax PM}))
Needs measurement: LVLs apical [Modified Simpson], LVAs sax MV [Modified Simpson], LVAs sax PM
[Modified Simpson]
Measured by: EF mod sim [AUTOCALC]

ESV(Cube) [Dimension, Cube/Teicholtz]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: {LVIDs}^3
Needs measurement: LVIDs [Dimension, Cube/Teicholtz]
Measured by: LVs [2DLV], LVIDs [2DCALIPER], EF(Cube) [AUTOCALC]

ESV(Cube) [Generic, Dimension]

Mode: MM:CM:AMM:CAMM:VRMM
Formula: {LVIDs}^3
Needs measurement: LVIDs [Generic, Dimension]
Measured by: LV Study [MMLV], LVIDs [MMDISCALIPER]

ESV(Teich) [Dimension, Cube/Teicholtz]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: 7/(2.4+{LVIDs})*{LVIDs}^3
Needs measurement: LVIDs [Dimension, Cube/Teicholtz]
Measured by: LVs [2DLV], LVIDs [2DCALIPER], EF(Cube) [AUTOCALC]

ESV(Teich) [Generic, Dimension]

Mode: MM:CM:AMM:CAMM:VRMM
Formula: 7/(2.4+{LVIDs})*{LVIDs}^3
Needs measurement: LVIDs [Generic, Dimension] 1-40
Measured by: LV Study [MMLV], LVIDs [MMDISCALIPER]
HR (Generic, Dimension, Biplane, Modified Simpson, Cube/Teicholtz, Single Plane A4C, Single Plane A2C,
Single Plane LAX, Bullet, Biplane Ellipse)
Mode: 2D:CF:TT:SI:SRI:Trace:VR2D
Formula: 60/{R-R}
Needs measurement: R-R [Generic, Dimension, Biplane, Modified Simpson, Cube/Teicholtz, Single Plane
A4C, Single Plane A2C, Single Plane LAX, Bullet, Biplane Ellipse]
Measured by: R-R [2DCALIPER] Used to calculate: CO(A-L),CO(Teich),CI(Teich),CO(Cube),CI(Cube),CO
Biplane,CI Biplane,CO mod sim,CI mod sim,CI A-L A4C,CO MOD A4C,CI MOD A4C,CI A-L A2C,CO A-L
A2C,CI A-L A2C,CO MOD A2C,CI MOD A2C,CO A-L LAX,CI A-L LAX,CO MOD LAX,CI MOD LAX,CO
bullet,CI bullet,CO bp el,CI bp el

HR [Generic, Dimension]
Mode: MM:CM:AMM:CAMM:VRMM
Formula: 60/{Time}
Needs measurement: Time [Generic, Dimension]
Measured by: Heartrate [MMTIMECALIPER]Used to calculate: CO(Cube),CO(Teich),CI(Teich),CI(Cube)
Dorland’s Illustrated Medical Dictionary, ed. 27, W. B. Sanders Co., Philadelphia, 1988, p. 1425.

HR [Generic]
Mode: CW:PW:VRCW:VRPW
Formula: 60/{Time}
Needs measurement: Time [Generic]
Measured by: Heartrate [SDTIMECALIPER]

IVSd/LVPWd [Dimension]
Mode: MM:CM:AMM:CAMM:VRMM
Formula: {IVSd}/{LVPWd}
Needs measurement: IVSd [Dimension], LVPWd [Dimension]
Measured by: LVPWd [MMDISCALIPER]
Roelandt, Joseph, Practical Echocardiology, Ultrasound in Medicine Series, Vol. 1, Denis White, ed.,
Research Studies Press, 1977, p. 270.

LA/Ao [Generic, Dimension]

Mode: MM:CM:AMM:CAMM:VRMM
Formula: {LA Diam}/{Ao Diam}
Needs measurement: LA Diam [Generic, Dimension], Ao Diam [Generic, Dimension]
Measured by: LA/Ao [MMLAAO]
Roelandt, Joseph, Practical Echocardiology, Ultrasound in Medicine Series, Vol. 1, Denis White, ed.,
Research Studies Press,1977, p. 270.
Schiller, N.B., et al., “Recommendations for Quantification of the LV by Two-Dimensional
Echocardiography,” J Am Soc Echo, Sept-Oct 1989, Vol. 2, No. 5, p. 364.

LIMP [Mitral Valve, Aortic]

Mode: CW:PW:VRCW:VRPW
Formula: ({MCO}-{AVET})/{AVET}
Needs measurement: MCO [Mitral Valve, Aortic], AVET [Mitral Valve, Aortic]
Measured by: LIMP [AUTOCALC]
Nishimura RA et.al. Doppler Echocardiography: theory, instrumentation, technique and application. Mayo
Clinic Proc 1985; 60:321-343
Yoganathan AP, et al. Review of hydrodynamic principles for the cardiologist: Application to the study of
blood flow and jets by imaging techniques. J Am Coll Cardio 1988; 12:1344-1353

LAEDV(A-L) [LA Volume]

Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: (8/(3*3.14159))*{LAAd(A4C)}*{LAAd(A2C)}/(minvalue({LALd(A4C)},{LALd(A2C)}))
Needs measurement: LAEDV A4C [LA Volume], LAEDV A2C [LA Volume]
Measured by: LAEDV(A-L) [AUTOCALC] 1-41
LAEDV Index(A-L) [LA Volume]
Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: (8/(3*3.14159))*{LAAd(A4C)}*{LAAd(A2C)}/(minvalue({LALd(A4C)},{LALd(A2C)}))/{BSA}
Needs measurement: LAEDV A4C [LA Volume], LAEDV A2C [LA Volume]
Measured by: LAEDV(A-L) [AUTOCALC]

LAEDV(MOD BP) [LA Volume]

Mode: 2D:3D:AP:CF:3DCF:APCF:TT:SI:SRI:TSI:VR2D
Formula: biplane({LALd(A4C)},{LADisksD(A4C)},{LALd(A2C)},{LADisksD(A2C)})
Needs measurement: LALd A4C [LA Volume], LADisks [LA Volume], LALd A2C [LA Volume], LADisks [LA
Volume]
Measured by: LA(Biplane) [AUTOCALC]
Schiller et.al: “Recommendations for quantitiation of the left ventricle by two-dimensional echocardiography.
ASE Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardograms.” J Am
Soc Echocardiogr 1989;2:358-367.

LAESV(A-L) [LA Volume]

Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: (8/(3*3.14159))*{LAAs(A4C)}*{LAAs(A2C)}/(minvalue({LALs(A4C)},{LALs(A2C)}))
Needs measurement: LAESV A4C [LA Volume], LAESV A2C [LA Volume]
Measured by: LAESV(A-L) [AUTOCALC]

LAESV Index(A-L) [LA Volume]

Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: (8/(3*3.14159))*{LAAs(A4C)}*{LAAs(A2C)}/(minvalue({LALs(A4C)},{LALs(A2C)}))/{BSA}
Needs measurement: LAESV A4C [LA Volume], LAESV A2C [LA Volume]
Measured by: LAESV(A-L) [AUTOCALC]

LAESV(MOD BP) [LA Volume]

Mode: 2D:3D:AP:CF:3DCF:APCF:TT:SI:SRI:TSI:VR2D
Formula: biplane({LALs(A4C)},{LADisksS(A4C)},{LALs(A2C)},{LADisksS(A2C)})
Needs measurement: LALs A4C [LA Volume], ?LADisks [LA Volume], LALs A2C [LA Volume], ?LADisks [LA
Volume]
Measured by: LA(Biplane) [AUTOCALC]
Schiller et.al: “Recommendations for quantitiation of the left ventricle by two-dimensional echocardiography.
ASE Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardograms.” J Am
Soc Echocardiogr 1989;2:358-367.

LVCI Dopp [Aortic]

Mode: PW:VRPW
Formula: ({LVOT Diam}^2*0.785*{LVOT VTI}*{HR}/60)/{BSA}
Needs measurement: LVOT Diam [Aortic], LVOT VTI [Aortic], HR [Aortic],
Measured by: LVOT Trace [SDMANTRACE]

LVCO Dopp [Aortic]

Mode: PW:VRPW
Formula: {LVOT Diam}^2*0.785*{LVOT VTI}*{HR}/60
Needs measurement: LVOT Diam [Aortic], LVOT VTI [Aortic], HR [Aortic]
Measured by: LVOT Trace [SDMANTRACE]

LVd Mass (ASE) [Generic]

Mode: MM:CM:AMM:CAMM:VRMM
Formula: ((1.04*(({IVSd}+{LVIDd}+{LVPWd})^3-({LVIDd})^3))*0.8+0.6)/1000
Needs measurement: IVSd [Generic], LVIDd [Generic], LVPWd [Generic]
Measured by: LV Study [MMLV]

1-42
LVd Mass [Dimension]
Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: ((1.04*(({IVSd}+{LVIDd}+{LVPWd})^3-({LVIDd})^3))-13.6)/1000
Needs measurement: IVSd [Dimension], LVIDd [Dimension], LVPWd [Dimension], LVIDd [Dimension]
Measured by: LVPWd [2DCALIPER]

LVd Mass [Generic, Dimension]

Mode: MM:CM:AMM:CAMM:VRMM
Formula: ((1.04*(({IVSd}+{LVIDd}+{LVPWd})^3-({LVIDd})^3))-13.6)/1000
Needs measurement: IVSd [Generic, Dimension], LVPWd [Generic, Dimension], LVIDd [Generic,
Dimension]
Measured by: LV Study [MMLV], LVPWs [MMDISCALIPER]

LVd Mass A-L [Mass]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: 1.05*5/6*({LVAd(sax epi)}*({LVLd(apical)}+t)-{LVAd(sax PM)}*{LVLd(apical)})/1000 where:
t = sqrt({LVAd sax EPI}/3.14159)-sqrt({LVAd sax PM}/3.14159)
Needs measurement: LVAd sax EPI [Mass], LVAd sax PM [Mass], LVLd apical [Mass]
Measured by: LVMass(d) [AUTOCALC]

LVd Mass I A-L [Mass]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: m/{BSA} where:
m = 1.05*5/6*({LVAd(sax epi)}*({LVLd(apical)}+t)-{LVAd(sax PM)}*{LVLd(apical)})/1000
t = sqrt({LVAd sax EPI}/3.14159)-sqrt({LVAd sax PM}/3.14159)
Needs measurement: LVAd sax EPI [Mass], LVAd sax PM [Mass], LVLd apical [Mass]
Measured by: LVMass(d) [AUTOCALC]

LVd Mass Ind (ASE) [Generic]

Mode: MM:CM:AMM:CAMM:VRMM
Formula: (((1.04*(({IVSd}+{LVIDd}+{LVPWd})^3-({LVIDd})^3))*0.8+0.6)/1000)/{BSA}
Needs measurement: IVSd [Generic], LVIDd [Generic], LVPWd [Generic]
Measured by: LV Study [MMLV]

LVd Mass Index [Dimension]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: m/{BSA} where m = ((1.04*(({IVSd}+{LVIDd}+{LVPWd})^3-({LVIDd})^3))-13.6)/1000
Needs measurement: IVSd [Dimension], LVIDd [Dimension], LVPWd [Dimension], LVIDd [Dimension]
Measured by: LVPWd [2DCALIPER]

LVd Mass Index [Generic, Dimension]

Mode: MM:CM:AMM:CAMM:VRMM
Formula: (((1.04*(({IVSd}+{LVIDd}+{LVPWd})^3-({LVIDd})^3))-13.6)/1000)/{BSA}
Needs measurement: IVSd [Generic, Dimension], LVIDd [Generic, Dimension], LVPWd [Generic,
Dimension]
Measured by: LV Study [MMLV], LVPWs [MMDISCALIPER]

LVd Mass TE [Mass]

Mode: 2D
Formula: 1.05*3.14159*((b+t)^2*(2/3*(a+t)+d-d^3/(3*(a+t)^2))-b^2*(2/3*a+d-d^3/(3*a^2)))/1000 where:
b = sqrt({LVAd(sax PM)}*10000/3.14159)
t = sqrt({LVAd(sax epi)}*10000/3.14159)-b
a = {TEa(d)}*100
d = {TEd(d)}*100
Needs measurement: LVAd sax EPI [Mass] LVAd sax PM [Mass] TEa(d) [Mass] TEd(d) [Mass]

1-43
LVd Mass Index TE [Mass]
Mode: 2D
Formula: m/{BSA} where:
m = 1.05*3.14159*((b+t)^2*(2/3*(a+t)+d-d^3/(3*(a+t)^2))-b^2*(2/3*a+d-d^3/(3*a^2)))/1000 where:
b = sqrt({LVAd(sax PM)}*10000/3.14159)
t = sqrt({LVAd(sax epi)}*10000/3.14159)-b
a = {TEa(d)}*100
d = {TEd(d)}*100
Needs measurement: LVAd sax EPI [Mass] LVAd sax PM [Mass] TEa(d) [Mass] TEd(d) [Mass]

LVEDV MOD BP [Biplane, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: biplane({LVLd A4C},{LVDisks},{LVLd A2C},{LVDisks})
Needs measurement: LVLd A4C [Biplane, AutoBiplane], LVLd A2C [Biplane, AutoBiplane]
Measured by: EF Biplane [AUTOCALC]
Schiller, N.B., et al., “Recommendations for Quantification of the LV by Two-Dimensional Echocardiography,
“J Am Soc Echo, Sept-Oct 1989, Vol. 2, No. 5. p. 364.

LVEF BP-EL [Biplane Ellipse]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: (d-s)/d where:
s = (8/(3*3.14159))*{LVAs(A4C)}*{LVAs(sax MV)}/{2D/LVIDs}
d = (8/(3*3.14159))*{LVAd A4C}*{LVAd (sax MV)}/{LVIDd}
Needs measurement: LVAd A4C [Biplane Ellipse], LVAd (sax MV) [Biplane Ellipse], LVIDd [Biplane Ellipse],
LVAs A4C [Biplane Ellipse], LVAs sax MV [Biplane Ellipse], LVIDs [Biplane Ellipse]
Measured by: LVEF BP-EL [AUTOCALC]

LVEF Bullet [Bullet]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: (d-s)/d where:
s =5/6*{LVAs(sax)}*{LVLs(apical)}
d = 5/6*{LVAd sax)}*{LVLd apical}
Needs measurement: LVAd sax) [Bullet], LVLd apical [Bullet], LVLs apical [Bullet]
Measured by: LVEF Bullet [AUTOCALC]

LVEF MOD A2C [Biplane, Single Plane A2C, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: ({LVEDV MOD A2C}-{LVESV MOD A2C})/{LVEDV MOD A2C}
Needs measurement: LVEDV MOD A2C [Biplane, Single Plane A2C, AutoBiplane], LVESV MOD A2C
[Biplane, Single Plane A2C, AutoBiplane]
Measured by: EF SP A2C [AUTOCALC], LVESV A2C [2DVOLUMETRACE], A2C [2DAUTOVOLUME]

LVEF MOD A4C [Biplane, Single Plane A4C, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: ({LVEDV MOD A4C}-{LVESV MOD A4C})/{LVEDV MOD A4C}
Needs measurement: LVEDV MOD A4C [Biplane, Single Plane A4C, AutoBiplane], LVESV MOD A4C
[Biplane, Single Plane A4C, AutoBiplane]
Measured by: EF SP A4C [AUTOCALC], LVESV A4C [2DVOLUMETRACE], A4C [2DAUTOVOLUME]

LVEF MOD LAX [Single Plane LAX, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: ({LVEDV MOD LAX}-{LVESV MOD LAX})/{LVEDV MOD LAX}
Needs measurement: LVEDV MOD LAX [Single Plane LAX, AutoBiplane], LVESV MOD LAX [Single Plane
LAX, AutoBiplane]
Measured by: LVESV LAX [2DVOLUMETRACE], EF SP LAX [AUTOCALC], AutoVolume
[2DAUTOVOLUME]
1-44
LVESV MOD BP [Biplane, AutoBiplane]
Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: biplane({LVLs A4C},{LVDisks},{LVLs A2C},{LVDisks})
Needs measurement: LVLs A4C [Biplane, AutoBiplane], LVLs A2C [Biplane, AutoBiplane]
Measured by: EF Biplane [AUTOCALC]

LVIDd Index [Dimension]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: {LVIDd}/{BSA}
Needs measurement: LVIDd [Dimension],
Measured by: LVIDd [2DCALIPER]

LVIDd Index [Dimension]

Mode: MM:CM:AMM:CAMM:VRMM
Formula: {LVIDd}/{BSA}
Needs measurement: LVIDd [Dimension]
Measured by: LVIDd [MMDISCALIPER]

LVIDs Index [Dimension]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: {LVIDs}/{BSA}
Needs measurement: LVIDs [Dimension]
Measured by: LVIDs [2DCALIPER]

LVIDs Index [Dimension]

Mode: MM:CM:AMM:CAMM:VRMM
Formula: {LVIDs}/{BSA}
Needs measurement: LVIDs [Dimension]
Measured by: LVIDs [MMDISCALIPER]

LVOT Area [Dimension]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: 3.14/4*{LVOT Diam}^2
Needs measurement: LVOT Diam [Dimension]
Measured by: LVOT Diam [2DCALIPER]

LVOT Diam [Aortic]

Mode: CW:PW:VRCW:VRPW
Formula: {LVOT Diam}
Needs measurement: LVOT Diam [Aortic]
Measured by: AP Area [SDMANTRACE] Used to calculate: AP Area

LVOT Diam [Mitral Valve]

Mode: CW:PW:VRCW:VRPW
Formula: {LVOT Diam}
Needs measurement: LVOT Diam [Mitral Valve]
Measured by: MP Area [SDMANTRACE] Used to calculate: MP Area

LVOT VTI [Aortic]

Mode: CW:PW:VRCW:VRPW
Formula: {LVOT VTI}
Needs measurement: LVOT VTI [Aortic]
Measured by: AP Area [SDMANTRACE] Used to calculate: AP Area

LVOT VTI [Mitral Valve]

Mode: CW:PW:VRCW:VRPW
Formula: {LVOT VTI}
Needs measurement: LVOT VTI [Mitral Valve]
1-45
Measured by: MP Area [SDMANTRACE] Used to calculate: MP Area
LVPEP/ET [Aortic]
Mode: CW:PW:VRCW:VRPW
Formula: {LVPEP}/{LVET}
Needs measurement: LVPEP [Aortic], LVET [Aortic]
Measured by: LVET [SDTIMECALIPER]

LVPEP/ET [Time]
Mode: MM:CM:AMM:CAMM:VRMM
Formula: {LVPEP}/{LVET}
Needs measurement: LVPEP [Time], LVET [Time]
Measured by: LVET [MMTIMECALIPER]

LVs Mass (ASE) [Generic]

Mode: MM:CM:AMM:CAMM:VRMM
Formula: ((1.04*(({IVSs}+{LVIDs}+{LVPWs})^3-({LVIDs})^3))*0.8+0.6)/1000
Needs measurement: IVSs [Generic], LVIDs [Generic], LVPWs [Generic]
Measured by: LV Study [MMLV]

LVs Mass [Dimension]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: ((1.04*(({IVSs}+{LVIDs}+{LVPWs})^3-({LVIDs})^3))-13.6)/1000
Needs measurement: IVSs [Dimension], LVIDs [Dimension], LVPWs [Dimension]
Measured by: LVPWs [2DCALIPER]

LVs Mass [Generic, Dimension]

Mode: MM:CM:AMM:CAMM:VRMM
Formula: ((1.04*(({IVSs}+{LVIDs}+{LVPWs})^3-({LVIDs})^3))-13.6)/1000
Needs measurement: IVSs [Generic, Dimension], LVIDs [Generic, Dimension], LVPWs [Generic,
Dimension]
Measured by: LV Study [MMLV], LVPWs [MMDISCALIPER]

LVs Mass A-L [Mass]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: 1.05*5/6*({LVAs(sax epi)}*({LVLs(apical)}+t)-{LVAs(sax PM)}*{LVLs(apical)})/1000 where:
t = sqrt({LVAs sax EPI}/3.14159)-sqrt({LVAs sax PM}/3.14159)
Needs measurement: LVAs sax EPI [Mass], LVAs sax PM [Mass], LVLs apical [Mass]
Measured by: LVMass(s) [AUTOCALC]

LVs Mass Ind (ASE) [Generic]

Mode: MM:CM:AMM:CAMM:VRMM
Formula: (((1.04*(({IVSs}+{LVIDs}+{LVPWs})^3-({LVIDs})^3))*0.8+0.6)/1000)/{BSA}
Needs measurement: IVSs [Generic], LVIDs [Generic], LVPWs [Generic]
Measured by: LV Study [MMLV]

LVs Mass Ind A-L [Mass]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: m/{BSA} where:
m = 1.05*5/6*({LVAs(sax epi)}*({LVLs(apical)}+t)-{LVAs(sax PM)}*{LVLs(apical)})/1000
t = sqrt({LVAs sax EPI}/3.14159)-sqrt({LVAs sax PM}/3.14159)
Needs measurement: LVAs sax EPI [Mass], LVAs sax PM [Mass], LVLs apical [Mass]
Measured by: LVMass(s) [AUTOCALC]

LVs Mass Index [Dimension]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: m/{BSA} where:
m = ((1.04*(({IVSs}+{LVIDs}+{LVPWs})^3-({LVIDs})^3))-13.6)/1000
Needs measurement: IVSs [Dimension], LVIDs [Dimension], LVPWs [Dimension] 1-46
Measured by: LVPWs [2DCALIPER]
LVs Mass Index [Generic, Dimension]
Mode: MM:CM:AMM:CAMM:VRMM
Formula: (((1.04*(({IVSs}+{LVIDs}+{LVPWs})^3-({LVIDs})^3))-13.6)/1000)/{BSA}
Needs measurement: IVSs [Generic, Dimension], LVIDs [Generic, Dimension], LVPWs [Generic,
Dimension]
Measured by: LV Study [MMLV], LVPWs [MMDISCALIPER]

LVs Mass(TE) [Mass]

Mode: 2D
Formula: 1.05*3.14159*((b+t)^2*(2/3*(a+t)+d-d^3/(3*(a+t)^2))-b^2*(2/3*a+d-d^3/(3*a^2)))/1000 where:
b = sqrt({LVAs(sax PM)}*10000/3.14159)
t = sqrt({LVAs(sax epi)}*10000/3.14159)-b
a = {TEa(s)}*100
d = {TEd(s)}*100’
Needs measurement: LVAs sax EPI [Mass] LVAs sax PM [Mass] TEa(s) [Mass] TEd(s) [Mass]

LVs Mass Index(TE) [Mass]

Mode: 2D
Formula: m/{BSA} where:
m = 1.05*3.14159*((b+t)^2*(2/3*(a+t)+d-d^3/(3*(a+t)^2))-b^2*(2/3*a+d-d^3/(3*a^2)))/1000 where:
b = sqrt({LVAs(sax PM)}*10000/3.14159)
t = sqrt({LVAs(sax epi)}*10000/3.14159)-b
a = {TEa(s)}*100
d = {TEd(s)}*100
Needs measurement: LVAs sax EPI [Mass] LVAs sax PM [Mass] TEa(s) [Mass] TEd(s) [Mass]

LVSI Dopp [Aortic]

Mode: PW:VRPW
Formula: {LVOT Diam}^2*0.785*{LVOT VTI}/{BSA}
Needs measurement: LVOT Diam [Aortic], LVOT VTI [Aortic],
Measured by: LVOT Trace [SDMANTRACE]

LVSV Dopp [Aortic]

Mode: PW:VRPW
Formula: {LVOT Diam}^2*0.785*{LVOT VTI}
Needs measurement: LVOT Diam [Aortic], LVOT VTI [Aortic]
Measured by: LVOT Trace [SDMANTRACE]

MeanAoDiaphragm [ZScores]
Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: ((2.1*{BSA})+(0.371*{BSA}^3)-(1.411*{BSA}^2)-0.922)
Measured by: AoDiaphragm [2DCALIPER]
Used to calculate: zAoDiaphragm
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

MeanAoIsthmus [ZScores]
Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: ((2.539*{BSA})+(0.368*{BSA}^3)-(1.627*{BSA}^2)-1.072)
Measured by: AoIsthmus [2DCALIPER]
Used to calculate: zAoIsth
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

1-47
MeanAo st junct [ZScores]
Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: ((2.643*{BSA})+(0.442*{BSA}^3)-(1.797*{BSA}^2)-0.759)
Measured by: Ao st junct [2DCALIPER]
Used to calculate: zAoStJunct
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

MeanAVAnn [ZScores]
Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: ((2.708*{BSA})+(0.452*{BSA}^3)-(1.841*{BSA}^2)-0.874)
Measured by: AV Annulus Diam [2DCALIPER]
Used to calculate: zAVAnn
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

MeanDistalAoArc [ZScores]
Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: ((2.469*{BSA})+(0.445*{BSA}^3)-(1.746*{BSA}^2)-0.976)
Measured by: DistalAoArch [2DCALIPER]
Used to calculate: zDistalAoArch
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

MeanIVSd [ZScores]
Mode: MM:CM:AMM:CAMM:VRMM
Formula: ((1.272*{BSA})+(0.208*{BSA}^3)-(0.762*{BSA}^2)-1.242)
Measured by: IVSd [MMDISCALIPER]
Used to calculate: zIVSd
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

MeanIVSs [ZScores]
Mode: MM:CM:AMM:CAMM:VRMM
Formula: ((1.751*{BSA})+(0.318*{BSA}^3)-(1.177*{BSA}^2)-1.048)
Measured by: IVSs [MMDISCALIPER]
Used to calculate: zIVSs
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

MeanLADiam [ZScores]
Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: ((2.164*{BSA})+(0.429*{BSA}^3)-(1.597*{BSA}^2)-0.208)
Measured by: LA [2DCALIPER]
Used to calculate: zLADiam
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

1-48
MeanLPA [ZScores]
Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: ((2.884*{BSA})+(0.466*{BSA}^3)-(1.954*{BSA}^2)-1.348)
Measured by: LPA [2DCALIPER]
Used to calculate: zLPA
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

MeanLVIDd [ZScores]
Mode: MM:CM:AMM:CAMM:VRMM
Formula: ((2.859*{BSA})+(0.552*{BSA}^3)-(2.119*{BSA}^2)-0.105)/100
Measured by: LVIDd [MMDISCALIPER]
Used to calculate: zLVIDd
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

MeanLVIDs [ZScores]
Mode: MM:CM:AMM:CAMM:VRMM
Formula: ((2.833*{BSA})+(0.538*{BSA}^3)-(2.081*{BSA}^2)-0.371)
Measured by: LVIDs [MMDISCALIPER]
Used to calculate: zLVIDs
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

MeanLVPWd [ZScores]
Mode: MM:CM:AMM:CAMM:VRMM
Formula: ((1.849*{BSA})+(0.313*{BSA}^3)-(1.188*{BSA}^2)-1.586)
Measured by: LVPWd [MMDISCALIPER]
Used to calculate: zLVPWd
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

MeanLVPWs [ZScores]
Mode: MM:CM:AMM:CAMM:VRMM
Formula: ((1.907*{BSA})+(0.330*{BSA}^3)-(1.259*{BSA}^2)-0.947)
Measured by: LVPWs [MMDISCALIPER]
Used to calculate: zLVPWs
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

MeanMPA [ZScores]
Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: ((2.746*{BSA})+(0.424*{BSA}^3)-(1.807*{BSA}^2)-0.707)
Measured by: MPA [2DCALIPER]
Used to calculate: zMPA
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

1-49
MeanMVAnn [ZScores]
Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: ((2.446*{BSA})+(0.425*{BSA}^3)-(1.700*{BSA}^2)-0.271)
Measured by: MV Ann Diam [2DCALIPER]
Used to calculate: zMVAnn
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

MeanPVAnn [ZScores]
Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: ((2.774*{BSA})+(0.436*{BSA}^3)-(1.808*{BSA}^2)-0.761)
Measured by: PV Ann Diam [2DCALIPER]
Used to calculate: zPVAnn
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

MeanRPA [ZScores]
Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: ((3.394*{BSA})+(0.660*{BSA}^3)-(2.508*{BSA}^2)-1.360)
Measured by: RPA [2DCALIPER]
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

MeanRVIDd [ZScores]
Mode: MM:CM:AMM:CAMM:VRMM
Formula: ((1.85*{BSA})-(1.274*({BSA}^2))+(0.335*({BSA}^3))-0.317)
Measured by: RVIDd [MMDISCALIPER]
Used to calculate: zRVIDd
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

MeanSoV [ZScores]
Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: ((2.537*{BSA})+(0.42*{BSA}^3)-(1.707*{BSA}^2)-0.5)
Measured by: Sinuses of Valsalva [2DCALIPER]
Used to calculate: zSinusesValsalva
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

MeanTransAoArch [ZScores]
Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: ((3.02*{BSA})+(0.712*{BSA}^3)-(2.484*{BSA}^2)-0.79)
Measured by: TransAoArch [2DCALIPER]
Used to calculate: zTransAoArch
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

1-50
MeanTVAnn [ZScores]
Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: ((2.341*{BSA})+(0.387*{BSA}^3)-(1.596*{BSA}^2)-0.164)
Measured by: TV Ann Diam [2DCALIPER]
Used to calculate: zTVAnn
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

MP Area [Mitral Valve]

Mode: CW:PW:VRCW:VRPW
Formula: {LVOT Diam}^2*0.785*({LVOT VTI}/{MP VTI})
Needs measurement: LVOT Diam [Mitral Valve], LVOT VTI [Mitral Valve], MP VTI [Mitral Valve]
Measured by: MP Area [SDMANTRACE]

MR ERO [PISA]
Mode: CF:CW:PW:VRCW:VRPW
Formula: {MR Flow}/{MR Vmax}
Needs measurement: MR Flow [PISA], MR Vmax [PISA]
Measured by: MR Trace [AUTOCALC]

MR RF [PISA]
Mode:CF:CW:PW:VRCW:VRPW
Formula: {MR RV}/{MV SV}
Needs measurement: MV Ann Diam [Dimension], MV Trace [Mitral Valve], MR Flow [PISA], MR Trace
[PISA]
Measured by: MR RF [AUTOCALC]

MR RV [PISA]
Mode: CF:CW:PW:VRCW:VRPW
Formula: {MR Flow}/{MR Vmax}*{MR VTI}
Needs measurement: MR Flow [PISA], MR Vmax [PISA], MR VTI [PISA]
Measured by: MR Trace [AUTOCALC]

MV AccT/DecT [Mitral Valve]

Mode: CW:PW:VRCW:VRPW
Formula: {MV AccT}/{MV DecT}
Needs measurement: MV AccT [Mitral Valve], MV DecT [Mitral Valve]
Measured by: MV AccT [SDCALIPER]

MV Area [Dimension]
Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: 3.14/4*{MV Ann Diam}^2
Needs measurement: MV Ann Diam [Dimension]
Measured by: MV Ann Diam [2DCALIPER]

MV CI [Mitral Valve]
Mode: CW:PW:VRCW:VRPW
Formula: {MV Ann Diam}^2*0.785*{MV VTI}*{HR}/60/{BSA}
Needs measurement: MV Ann Diam [Mitral Valve], MV VTI [Mitral Valve], HR [Mitral Valve]
Measured by: MV Trace [SDMANTRACE]

MV CO [Mitral Valve]
Mode: CW:PW:VRCW:VRPW
Formula: {MV Ann Diam}^2*0.785*{MV VTI}*{HR}/60
Needs measurement: MV Ann Diam [Mitral Valve], MV VTI [Mitral Valve], HR [Mitral Valve]
Measured by: MV Trace [SDMANTRACE] 1-51
MV E/A Ratio [Mitral Valve]
Mode: CW:PW:VRCW:VRPW
Formula: {MV E Vel}/{MV A Vel}
Needs measurement: MV E Vel [Mitral Valve], MV A Vel [Mitral Valve]
Measured by: MV A Vel [SDPTCALIPER], MV A Vel [AUTOCALC]

MV Reg Frac [Mitral Valve]

Mode: CW:PW:VRCW:VRPW
Formula: ({MV SV} - {LVSV Dopp})/{MV SV}
Needs measurement: MV Trace [Mitral Valve], MV Ann Diam [Dimension], LVOT Trace [Aortic], LVOT Diam
[Dimension]
Measured by: MV Reg Frac [AUTOCALC]

MV SI [Mitral Valve]
Mode: CW:PW:VRCW:VRPW
Formula: {MV Ann Diam}^2*0.785*{MV VTI}/{BSA}
Needs measurement: MV Ann Diam [Mitral Valve], MV VTI [Mitral Valve],
Measured by: MV Trace [SDMANTRACE]

MV SV [Mitral Valve]
Mode: CW:PW:VRCW:VRPW
Formula: {MV Ann Diam}^2*0.785*{MV VTI}
Needs measurement: MV Ann Diam [Mitral Valve], MV VTI [Mitral Valve]
Measured by: MV Trace [SDMANTRACE]

MVA (VTI) [Mitral Valve]

Mode: 2D:CW:PW:VRCW:VRPW
Formula: 3.14/4*{LVOT Diam}^2*{LVOT VTI}/{MV VTI}
Needs measurement: LVOT Diam [Mitral Valve], LVOT VTI [Mitral Valve], MV VTI [Mitral Valve]
Measured by: MV Trace [AUTOCALC]

MVA By PHT [Mitral Valve]

Mode: CW:PW:VRCW:VRPW
Formula: 22/({MV PHT})
Needs measurement: MV PHT [Mitral Valve]
Measured by: MV E/A Velocity [SDEA3], MV PHT [SDCALIPER]
Hatle, L. et al, “Non-invasive Assessment of Atrioventricular Pressure Halftime by Doppler Ultrasound,”
Circulation, Vol. 60, 1979, pp 1096-1104.

P Vein S/D Ratio [Pulmonary Vein]

Mode: PW:VRPW
Formula: {P Vein S}/{P Vein D}
Needs measurement: P Vein S [Pulmonary Vein], P Vein D [Pulmonary Vein]
Measured by: P Vein D [SDPTCALIPER]

PAEDP [Pulmonic]
Mode: CW:PW:VRCW:VRPW
Formula: {PRend PG}+{RAP}
Needs measurement: PRend PG [Pulmonic], RAP [Pulmonic]
Measured by: PRend Vmax [AUTOCALC]

PR ERO [PISA]
Mode: CF:CW:PW:VRCW:VRPW
Formula: {PR Flow}/{PR Vmax}
Needs measurement: PR Flow [PISA], PR Vmax [PISA]
Measured by: PR Trace [AUTOCALC]
1-52
PR RV [PISA]
Mode: CF:CW:PW:VRCW:VRPW
Formula: {PR Flow}/{PR Vmax}*{PR VTI}
Needs measurement: PR Flow [PISA], PR Vmax [PISA], PR VTI [PISA]
Measured by: PR Trace [AUTOCALC]

Pulmonic CO [Shunts, Congenital Heart]

Mode: CW:PW:VRCW:VRPW
Formula: {Pulmonic SV}*{Pulmonic HR}/60
Needs measurement: Pulmonic SV [Shunts, Congenital Heart], Pulmonic HR [Shunts, Congenital Heart]
Measured by: Pulmonic VTI [SDMANTRACE]

Pulmonic SV [Shunts, Congenital Heart]

Mode: CW:PW:VRCW:VRPW
Formula: 3.14159/4*{Pulmonic Diam}^2*{Pulmonic VTI}
Needs measurement: Pulmonic Diam [Shunts, Congenital Heart], Pulmonic VTI [Shunts, Congenital Heart]
Measured by: Pulmonic VTI [SDMANTRACE], Pulmonic VTI [SDMANTRACE] Used to calculate: Pulmonic
CO
Hatle, Liv, Angelsen, Bjorn., Doppler Ultrasound in Cardiology: Physical Principles and Clinical Applications,
ed. 2, Lea and Febiger, Philadelphia, Pennsylvania, 1985, p. 306.

PV A/MV A Dur [Pulmonary Vein]

Mode: PW:VRPW
Formula: {P Vein A Dur}/{MV A Dur}
Needs measurement: P Vein A Dur [Pulmonary Vein], MV A Dur [Pulmonary Vein]
Measured by: P Vein A Dur [SDTIMECALIPER]

PV A/MV VTI [Pulmonary Vein]

Mode: PW:VRPW
Formula: {P Vein A Dur}/{MV VTI}
Needs measurement: P Vein A Dur [Pulmonary Vein], MV VTI [Pulmonary Vein]
Measured by: P Vein A Dur [SDTIMECALIPER]

PV AccT/ET [Pulmonic]
Mode: CW:PW:VRCW:VRPW
Formula: {PV AccT}/{PVET}
Needs measurement: PV AccT [Pulmonic], PVET [Pulmonic]
Measured by: PVET [SDTIMECALIPER]

PV A-MV A Dur [Pulmonary Vein]

Mode: PW:VRPW
Formula: {P Vein A Dur}-{MV A Dur}
Needs measurement: P Vein A Dur [Pulmonary Vein], MV A Dur [Pulmonary Vein]
Measured by: P Vein A Dur [SDTIMECALIPER]

PV Area [Dimension]
Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: 3.14/4*{PV Ann Diam}^2
Needs measurement: PV Ann Diam [Dimension]
Measured by: PV Ann Diam [2DCALIPER]

PV CI [Pulmonic, Valvular PS]

Mode: CW:PW:VRCW:VRPW
Formula: (({PV Ann Diam}^2*0.785*{PV VTI})*{HR}/60)/{BSA}
Needs measurement: PV Ann Diam [Pulmonic, Valvular PS], PV VTI [Pulmonic, Valvular PS], HR
[Pulmonic, Valvular PS]
Measured by: PV Trace [SDMANTRACE] 1-53
PV CO [Pulmonic, Valvular PS]
Mode: CW:PW:VRCW:VRPW
Formula: ({PV Ann Diam}^2*0.785*{PV VTI})*{HR}/60
Needs measurement: PV Ann Diam [Pulmonic, Valvular PS], PV VTI [Pulmonic, Valvular PS], HR
[Pulmonic, Valvular PS]
Measured by: PV Trace [SDMANTRACE]

PV SI [Pulmonic, Valvular PS]

Mode: CW:PW:VRCW:VRPW
Formula: ({PV Ann Diam}^2*0.785*{PV VTI})/{BSA}
Needs measurement: PV Ann Diam [Pulmonic, Valvular PS], PV VTI [Pulmonic, Valvular PS]
Measured by: PV Trace [SDMANTRACE]
Gorge, G., et al., “High Resolution Two-dimensional Echocardiography Improves Quantification of Left
Ventricular Function, “J Am Soc Echo, 1992, Vol. 5, pp. 125-134.

PV SV [Pulmonic, Valvular PS]

Mode: CW:PW:VRCW:VRPW
Formula: {PV Ann Diam}^2*0.785*{PV VTI}
Needs measurement: PV Ann Diam [Pulmonic, Valvular PS], PV VTI [Pulmonic, Valvular PS]
Measured by: PV Trace [SDMANTRACE]

PVA (Vmax) [Pulmonic]

Mode: 2D:CW:PW:VRCW:VRPW
Formula: 3.14/4*{RVOT Diam}^2*{RVOT Vmax}/{PV Vmax}
Needs measurement: RVOT Diam [Pulmonic], RVOT Vmax [Pulmonic], PV Vmax [Pulmonic]
Measured by: PV Vmax [AUTOCALC]

PVA (Vmax) [Pulmonic]

Mode: 2D:CW:PW:VRCW:VRPW
Formula: 3.14/4*{RVOT Diam}^2*{RVOT Vmax}/{PV Vmax}
Needs measurement: RVOT Diam [Pulmonic], RVOT Vmax [Pulmonic], PV Vmax [Pulmonic]
Measured by: PV Trace [AUTOCALC]

PVA (VTI) [Pulmonic]

Mode: 2D:CW:PW:VRCW:VRPW
Formula: 3.14/4*{RVOT Diam}^2*{RVOT VTI}/{PV VTI}
Needs measurement: RVOT Diam [Pulmonic], RVOT VTI [Pulmonic], PV VTI [Pulmonic]
Measured by: PV Trace [AUTOCALC]

Qp/Qs [Shunts, Congenital Heart]

Mode: CW:PW:VRCW:VRPW
Formula: 3.14159/4*{Pulmonic Diam}^2*{Pulmonic VTI}/(3.14159/4*{Systemic Diam}^2*{Systemic VTI})
Needs measurement: Pulmonic Diam [Shunts, Congenital Heart], Pulmonic VTI [Shunts, Congenital Heart],
Systemic Diam [Shunts, Congenital Heart], Systemic VTI [Shunts, Congenital Heart]
Measured by: Qp/Qs [AUTOCALC]

RIMP [Pulmonic, Tricuspid Valve]

Mode: CW:PW:VRCW:VRPW
Formula: ({TCO}-{PVET})/{PVET}
Needs measurement: TCO [Pulmonic, Tricuspid Valve], PVET [Pulmonic, Tricuspid Valve], PVET [Pulmonic,
Tricuspid Valve]
Measured by: RIMP [AUTOCALC]

RVOT Area [Dimension]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: 3.14/4*{RVOT Diam}^2
Needs measurement: RVOT Diam [Dimension] 1-54
Measured by: RVOT Diam [2DCALIPER]
RVOT CI [Pulmonic, Valvular PS]
Mode: PW:VRPW
Formula: (({RVOT Diam}^2*0.785*{RVOT VTI})*{HR}/60)/{BSA}
Needs measurement: RVOT Diam [Pulmonic, Valvular PS], RVOT VTI [Pulmonic, Valvular PS], HR
[Pulmonic, Valvular PS],
Measured by: RVOT Trace [SDMANTRACE]

RVOT CO [Pulmonic, Valvular PS]

Mode: PW:VRPW
Formula: ({RVOT Diam}^2*0.785*{RVOT VTI})*{HR}/60
Needs measurement: RVOT Diam [Pulmonic, Valvular PS], RVOT VTI [Pulmonic, Valvular PS], HR
[Pulmonic, Valvular PS]
Measured by: RVOT Trace [SDMANTRACE]

RVOT SI [Pulmonic, Valvular PS]

Mode: PW:VRPW
Formula: ({RVOT Diam}^2*0.785*{RVOT VTI})/{BSA}
Needs measurement: RVOT Diam [Pulmonic, Valvular PS], RVOT VTI [Pulmonic, Valvular PS],
Measured by: RVOT Trace [SDMANTRACE]

RVOT SV [Pulmonic, Valvular PS]

Mode: PW:VRPW
Formula: {RVOT Diam}^2*0.785*{RVOT VTI}
Needs measurement: RVOT Diam [Pulmonic, Valvular PS], RVOT VTI [Pulmonic, Valvular PS]
Measured by: RVOT Trace [SDMANTRACE]

RVPEP/ET [Pulmonic]
Mode: CW:PW:VRCW:VRPW
Formula: {RVPEP}/{RVET}
Needs measurement: RVPEP [Pulmonic], RVET [Pulmonic]
Measured by: RVET [SDTIMECALIPER]

RVPEP/ET [Time]
Mode: MM:CM:AMM:CAMM:VRMM
Formula: {RVPEP}/{RVET}
Needs measurement: RVPEP [Time], RVET [Time]
Measured by: RVET [MMTIMECALIPER]

RVSP [Tricuspid Valve]

Mode: CW:PW:VRCW:VRPW
Formula: {TR maxPG}+{RAP}
Needs measurement: TR maxPG [Tricuspid Valve], RAP [Tricuspid Valve]
Measured by: TR Vmax [AUTOCALC]

SI A-L A2C [Biplane, Single Plane A2C, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: ({LVEDV A-L A2C}-{LVESV A-L A2C})/{BSA}
Needs measurement: LVEDV A-L A2C [Biplane, Single Plane A2C, AutoBiplane], LVESV A-L A2C [Biplane,
Single Plane A2C, AutoBiplane]
Measured by: EF SP A2C [AUTOCALC], LVESV A2C [2DVOLUMETRACE], A2C [2DAUTOVOLUME]

SI A-L A4C [Biplane, Single Plane A4C, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: ({LVEDV A-L A4C}-{LVESV A-L A4C})/{BSA}
Needs measurement: LVEDV A-L A4C [Biplane, Single Plane A4C, AutoBiplane], LVESV A-L A4C [Biplane,
Single Plane A4C, AutoBiplane]
Measured by: EF SP A4C [AUTOCALC], LVESV A4C [2DVOLUMETRACE], A4C [2DAUTOVOLUME] 1-55
SI A-L LAX [Single Plane LAX, AutoBiplane]
Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: ({LVEDV A-L LAX}-{LVESV A-L LAX})/{BSA}
Needs measurement: LVEDV A-L LAX [Single Plane LAX, AutoBiplane], LVESV A-L LAX [Single Plane
LAX, AutoBiplane]
Measured by: LVESV LAX [2DVOLUMETRACE], EF SP LAX [AUTOCALC], AutoVolume
[2DAUTOVOLUME]

SI Biplane [Biplane, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: d = biplane({LVLd A4C},{LVDisks},{LVLd A2C},{LVDisks})
Needs measurement: LVLd A4C [Biplane, AutoBiplane], LVLd A2C [Biplane, AutoBiplane], LVLs A4C
[Biplane, AutoBiplane], LVLs A2C [Biplane, AutoBiplane]
Measured by: EF Biplane [AUTOCALC]

SI bp el [Biplane Ellipse]
Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: (d-s)/{BSA} where:
s = (8/(3*3.14159))*{LVAs(A4C)}*{LVAs(sax MV)}/{2D/LVIDs}
d = (8/(3*3.14159))*{LVAd A4C}*{LVAd (sax MV)}/{LVIDd}
Needs measurement: LVAd A4C [Biplane Ellipse], LVAd (sax MV) [Biplane Ellipse], LVIDd [Biplane Ellipse],
LVAs A4C [Biplane Ellipse], LVAs sax MV [Biplane Ellipse], LVIDs [Biplane Ellipse]
Measured by: LVEF BP-EL [AUTOCALC]

SI bullet [Bullet]
Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: (d-s)/{BSA} where:
s =5/6*{LVAs(sax)}*{LVLs(apical)}
d = 5/6*{LVAd sax)}*{LVLd apical}
Needs measurement: LVAd sax) [Bullet], LVLd apical [Bullet], LVLs apical [Bullet],
Measured by: LVEF Bullet [AUTOCALC]

SI MOD A2C [Biplane, Single Plane A2C, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: ({LVEDV MOD A2C}-{LVESV MOD A2C})/{BSA}
Needs measurement: LVEDV MOD A2C [Biplane, Single Plane A2C, AutoBiplane], LVESV MOD A2C
[Biplane, Single Plane A2C, AutoBiplane]
Measured by: EF SP A2C [AUTOCALC], LVESV A2C [2DVOLUMETRACE], A2C [2DAUTOVOLUME]

SI MOD A4C [Biplane, Single Plane A4C, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: ({LVEDV MOD A4C}-{LVESV MOD A4C})/{BSA}
Needs measurement: LVEDV MOD A4C [Biplane, Single Plane A4C, AutoBiplane], LVESV MOD A4C
[Biplane, Single Plane A4C, AutoBiplane]
Measured by: EF SP A4C [AUTOCALC], LVESV A4C [2DVOLUMETRACE], A4C [2DAUTOVOLUME]

SI MOD LAX [Single Plane LAX, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: ({LVEDV MOD LAX}-{LVESV MOD LAX})/{BSA}
Needs measurement: LVEDV MOD LAX [Single Plane LAX, AutoBiplane], LVESV MOD LAX [Single Plane
LAX, AutoBiplane]
Measured by: LVESV LAX [2DVOLUMETRACE], EF SP LAX [AUTOCALC], AutoVolume
[2DAUTOVOLUME]

1-56
SI mod sim [Modified Simpson]
Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: d-s/{BSA} where:
s = ({LVLs(apical)}/9)*((4*{LVAs(sax MV)})+(2*{LVAs(sax PM)})+ sqrt({LVAs(sax MV)}*{LVAs(sax PM)}))
d = ({LVLd apical}/9)*((4*{LVAd (sax MV)})+(2*{LVAd sax PM})+ sqrt({LVAd (sax MV)}*{LVAd sax PM}))
Needs measurement: LVLd apical [Modified Simpson], LVAd (sax MV) [Modified Simpson], LVAd sax PM
[Modified Simpson], LVLs apical [Modified Simpson], LVAs sax MV [Modified Simpson], LVAs sax PM
[Modified Simpson]
Measured by: EF mod sim [AUTOCALC]
Gorge, G., et al., “High Resolution Two-dimensional Echocardiography Improves Quantification of Left
Ventricular Function, “J Am Soc Echo, 1992, Vol. 5, pp. 125-134.

SI(A-L) [Generic]
Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: ({EDV(A-L)}-{ESV(A-L)})/{BSA}
Needs measurement: ESV(A-L) [Generic]
Measured by: EF Volume [AUTOCALC]

SI(Cube) [Dimension, Cube/Teicholtz]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: (d-s)/{BSA} where: s = {2D/LVIDs}^3 d = {LVIDd}^3
Needs measurement: LVIDd [Dimension, Cube/Teicholtz], LVIDs [Dimension, Cube/Teicholtz]
Measured by: LVs [2DLV], LVIDs [2DCALIPER], EF(Cube) [AUTOCALC]

SI(Cube) [Generic]
Mode: MM:CM:AMM:CAMM:VRMM
Formula: (dv-sv)/{BSA} where: sv = {MM/LVIDs}^3 dv = {LVIDd}^3
Needs measurement: LVIDd [Generic], LVIDs [Generic],
Measured by: LV Study [MMLV]

SI(MOD) [Generic]
Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: ({EDV(MOD)}-{ESV(MOD)})/{BSA}
Needs measurement: EDV(MOD) [Generic], ESV(MOD) [Generic]
Measured by: EF Volume [AUTOCALC]

SI(Teich) [Dimension, Cube/Teicholtz]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: (d-s)/{BSA} s = 7/(2.4+{2D/LVIDs})*{2D/LVIDs}^3 d = 7/(2.4+{LVIDd})*{LVIDd}^3
Needs measurement: LVIDd [Dimension, Cube/Teicholtz], LVIDs [Dimension, Cube/Teicholtz]
Measured by: LVs [2DLV], LVIDs [2DCALIPER], EF(Cube) [AUTOCALC]

SI(Teich) [Generic]
Mode: MM:CM:AMM:CAMM:VRMM
Formula: (dv-sv)/{BSA} where:
sv = 7/(2.4+{MM/LVIDs})*{MM/LVIDs}^3 dv = 7/(2.4+{LVIDd})*{LVIDd}^3
Needs measurement: LVIDd [Generic], LVIDd [Generic], LVIDs [Generic]
Measured by: LV Study [MMLV]

SV A-L A2C [Biplane, Single Plane A2C, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: {LVEDV A-L A2C}-{LVESV A-L A2C}
Needs measurement: LVEDV A-L A2C [Biplane, Single Plane A2C, AutoBiplane], LVESV A-L A2C [Biplane,
Single Plane A2C, AutoBiplane]
Measured by: EF SP A2C [AUTOCALC], LVESV A2C [2DVOLUMETRACE], A2C [2DAUTOVOLUME]

1-57
SV A-L A4C [Biplane, Single Plane A4C, AutoBiplane]
Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: {LVEDV A-L A4C}-{LVESV A-L A4C}
Needs measurement: LVEDV A-L A4C [Biplane, Single Plane A4C, AutoBiplane], LVESV A-L A4C [Biplane,
Single Plane A4C, AutoBiplane]
Measured by: EF SP A4C [AUTOCALC], LVESV A4C [2DVOLUMETRACE], A4C [2DAUTOVOLUME]

SV A-L LAX [Single Plane LAX, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: {LVEDV A-L LAX}-{LVESV A-L LAX}
Needs measurement: LVEDV A-L LAX [Single Plane LAX, AutoBiplane], LVESV A-L LAX [Single Plane
LAX, AutoBiplane]
Measured by: LVESV LAX [2DVOLUMETRACE], EF SP LAX [AUTOCALC], AutoVolume
[2DAUTOVOLUME]

SV Biplane [Biplane, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: d = biplane({LVLd A4C},{LVDisks},{LVLd A2C},{LVDisks})
Needs measurement: LVLd A4C [Biplane, AutoBiplane], LVLd A2C [Biplane, AutoBiplane], LVLs A4C
[Biplane, AutoBiplane], LVLs A2C [Biplane, AutoBiplane]
Measured by: EF Biplane [AUTOCALC]

SV bp el [Biplane Ellipse]
Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: d = (8/(3*3.14159))*{LVAd A4C}*{LVAd (sax MV)}/{LVIDd}
Needs measurement: LVAd A4C [Biplane Ellipse], LVAd (sax MV) [Biplane Ellipse], LVIDd [Biplane Ellipse],
LVAs A4C [Biplane Ellipse], LVAs sax MV [Biplane Ellipse], LVIDs [Biplane Ellipse]
Measured by: LVEF BP-EL [AUTOCALC]

SV bullet [Bullet]
Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: d-s where:
s = 5/6*{LVAs(sax)}*{LVLs(apical)}
d = 5/6*{LVAd sax)}*{LVLd apical}
Needs measurement: LVAd sax) [Bullet], LVLd apical [Bullet], LVLs apical [Bullet]
Measured by: LVEF Bullet [AUTOCALC]

SV MOD A2C [Biplane, Single Plane A2C, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: {LVEDV MOD A2C}-{LVESV MOD A2C}
Needs measurement: LVEDV MOD A2C [Biplane, Single Plane A2C, AutoBiplane], LVESV MOD A2C
[Biplane, Single Plane A2C, AutoBiplane]
Measured by: EF SP A2C [AUTOCALC], LVESV A2C [2DVOLUMETRACE], A2C [2DAUTOVOLUME]

SV MOD A4C [Biplane, Single Plane A4C, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: {LVEDV MOD A4C}-{LVESV MOD A4C}
Needs measurement: LVEDV MOD A4C [Biplane, Single Plane A4C, AutoBiplane], LVESV MOD A4C
[Biplane, Single Plane A4C, AutoBiplane]
Measured by: EF SP A4C [AUTOCALC], LVESV A4C [2DVOLUMETRACE], A4C [2DAUTOVOLUME]

SV MOD LAX [Single Plane LAX, AutoBiplane]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: {LVEDV MOD LAX}-{LVESV MOD LAX}
Needs measurement: LVEDV MOD LAX [Single Plane LAX, AutoBiplane], LVESV MOD LAX [Single Plane
LAX, AutoBiplane]
Measured by: LVESV LAX [2DVOLUMETRACE], EF SP LAX [AUTOCALC], AutoVolume 1-58
[2DAUTOVOLUME]
SV mod sim [Modified Simpson]
Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: ({LVLd apical}/9)*((4*{LVAd (sax MV)})+(2*{LVAd sax PM})+sqrt({LVAd (sax MV)}*{LVAd sax PM}))
Needs measurement: LVLd apical [Modified Simpson], LVAd (sax MV) [Modified Simpson], LVAd sax PM
[Modified Simpson], LVLs apical [Modified Simpson], LVAs sax MV [Modified Simpson], LVAs sax PM
[Modified Simpson]
Measured by: EF mod sim [AUTOCALC]
Pombo, J.F., “Left Ventricular Volumes and Ejection by Echocardiography,” Circulation 1971, Vol 43, pp.
480-490

SV(A-L) [Generic]
Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: {EDV(A-L)}-{ESV(A-L)}
Needs measurement: ESV(A-L) [Generic]
Measured by: EF Volume [AUTOCALC]

SV(Cube) [Dimension, Cube/Teicholtz]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: d-s where: s = {2D/LVIDs}^3 d = {LVIDd}^3
Needs measurement: LVIDd [Dimension, Cube/Teicholtz], LVIDs [Dimension, Cube/Teicholtz]
Measured by: LVs [2DLV], LVIDs [2DCALIPER], EF(Cube) [AUTOCALC]

SV(Cube) [Generic, Dimension]

Mode: MM:CM:AMM:CAMM:VRMM
Formula: dv-sv where: sv = {MM/LVIDs}^3 dv = {LVIDd}^3
Needs measurement: LVIDd [Generic, Dimension], LVIDs [Generic, Dimension]
Measured by: LV Study [MMLV], LVIDs [MMDISCALIPER]

SV(MOD) [Generic]
Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: {EDV(MOD)}-{ESV(MOD)}
Needs measurement: EDV(MOD) [Generic], ESV(MOD) [Generic]
Measured by: EF Volume [AUTOCALC]

SV(Teich) [Dimension, Cube/Teicholtz]

Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: d-s where:
s = 7/(2.4+{2D/LVIDs})*{2D/LVIDs}^3
d = 7/(2.4+{LVIDd})*{LVIDd}^3
Needs measurement: LVIDd [Dimension, Cube/Teicholtz], LVIDs [Dimension, Cube/Teicholtz]
Measured by: LVs [2DLV], LVIDs [2DCALIPER], EF(Cube) [AUTOCALC]

SV(Teich) [Generic, Dimension]

Mode: MM:CM:AMM:CAMM:VRMM
Formula: dv-sv where:
sv = 7/(2.4+{MM/LVIDs})*{MM/LVIDs}^3
dv = 7/(2.4+{LVIDd})*{LVIDd}^3
Needs measurement: LVIDd [Generic, Dimension], LVIDs [Generic, Dimension]
Measured by: LV Study [MMLV], LVIDs [MMDISCALIPER]

Systemic CO [Shunts, Congenital Heart]

Mode: CW:PW:VRCW:VRPW
Formula: {Systemic SV}*{Systemic HR}/60
Needs measurement: Systemic SV [Shunts, Congenital Heart], Systemic HR [Shunts, Congenital Heart]
Measured by: Systemic VTI [SDMANTRACE]

1-59
Systemic SV [Shunts, Congenital Heart]
Mode: CW:PW:VRCW:VRPW
Formula: 3.14159/4*{Systemic Diam}^2*{Systemic VTI}
Needs measurement: Systemic Diam [Shunts, Congenital Heart], Systemic VTI [Shunts, Congenital Heart]
Measured by: Systemic VTI [SDMANTRACE], Systemic VTI [SDMANTRACE] Used to calculate: Systemic
CO
Calafiore P, MBBS, Stewart WJ, Doppler Echocardiographic Quantitation of Volumetric Flow Rate,
Cardiology Clinics, vol. 8, No. 2, 1990

TR ERO [PISA]
Mode: CF:CW:PW:VRCW:VRPW
Formula: {TR Flow}/{TR Vmax}
Needs measurement: TR Flow [PISA], TR Vmax [PISA]
Measured by: TR Trace [AUTOCALC]

TR RV [PISA]
Mode: CF:CW:PW:VRCW:VRPW
Formula: {TR Flow}/{TR Vmax}*{TR VTI}
Needs measurement: TR Flow [PISA], TR Vmax [PISA], TR VTI [PISA]
Measured by: TR Trace [AUTOCALC]

TV AccT/DecT [Tricuspid Valve]

Mode: CW:PW:VRCW:VRPW
Formula: {TV AccT}/{TV Dec Time}
Needs measurement: TV AccT [Tricuspid Valve], TV Dec Time [Tricuspid Valve]
Measured by: TV AccT [SDCALIPER]

TV Area [Dimension]
Mode: 2D:CF:TT:SI:SRI:VR2D
Formula: 3.14/4*{TV Ann Diam}^2
Needs measurement: TV Ann Diam [Dimension]
Measured by: TV Ann Diam [2DCALIPER]

TV CI [Tricuspid Valve]
Mode: CW:PW:VRCW:VRPW
Formula: (({TV Ann Diam}^2*0.785*{TV VTI})*{HR}/60)/{BSA}
Needs measurement: TV Ann Diam [Tricuspid Valve], TV VTI [Tricuspid Valve], HR [Tricuspid Valve]
Measured by: TV Trace [SDMANTRACE]
The Merc Manual of Diagnosis and Therapy, ed. 15, Robert Berkon, ed., Merck and Co., Rahway, NJ, 1987,
p. 387
Schiller, N.B., et al., “Recommendations for Quantification of the LV by Two-Dimensional Echocardiography,
“J Am Soc Echo, Sept-Oct 1989, Vol. 2, No. 5. p. 364.

TV CO [Tricuspid Valve]
Mode: CW:PW:VRCW:VRPW
Formula: ({TV Ann Diam}^2*0.785*{TV VTI})*{HR}/60
Needs measurement: TV Ann Diam [Tricuspid Valve], TV VTI [Tricuspid Valve], HR [Tricuspid Valve]
Measured by: TV Trace [SDMANTRACE]
Calafiore, P., Stewart, W.J., “Doppler Echocardiographic Quantitation of Volumetric Flow Rate, “Cardiology
Clinics, May 1990, Vol. 8, No. 2, pp. 191-202.

TV E/A Ratio [Tricuspid Valve]

Mode: CW:PW:VRCW:VRPW
Formula: {TV E Vel}/{TV A Vel}
Needs measurement: TV E Vel [Tricuspid Valve], TV A Vel [Tricuspid Valve]
Measured by: TV A Vel [SDPTCALIPER]
1-60
TV SI [Tricuspid Valve]
Mode: CW:PW:VRCW:VRPWFormula: ({TV Ann Diam}^2*0.785*{TV VTI})/{BSA}
Needs measurement: TV Ann Diam [Tricuspid Valve], TV VTI [Tricuspid Valve]
Measured by: TV Trace [SDMANTRACE]

TV SV [Tricuspid Valve]
Mode: CW:PW:VRCW:VRPW
Formula: {TV Ann Diam}^2*0.785*{TV VTI}
Needs measurement: TV Ann Diam [Tricuspid Valve], TV VTI [Tricuspid Valve]
Measured by: TV Trace [SDMANTRACE]

TVA (Vmax) [Tricuspid Valve]

Mode: 2D:CW:PW:VRCW:VRPW
Formula: 3.14/4*{RVOT Diam}^2*{RVOT Vmax}/{TV Vmax}
Needs measurement: RVOT Diam [Tricuspid Valve], RVOT Vmax [Tricuspid Valve], TV Vmax [Tricuspid
Valve]
Measured by: TV Vmax [AUTOCALC]

TVA (Vmax) [Tricuspid Valve]

Mode: 2D:CW:PW:VRCW:VRPW
Formula: 3.14/4*{RVOT Diam}^2*{RVOT Vmax}/{TV Vmax}
Needs measurement: RVOT Diam [Tricuspid Valve], RVOT Vmax [Tricuspid Valve], TV Vmax [Tricuspid
Valve]
Measured by: TV Trace [AUTOCALC]

TVA (VTI) [Tricuspid Valve]

Mode: 2D:CW:PW:VRCW:VRPW
Formula: 3.14/4*{RVOT Diam}^2*{RVOT VTI}/{TV VTI}
Needs measurement: RVOT Diam [Tricuspid Valve], RVOT VTI [Tricuspid Valve], TV VTI [Tricuspid Valve]
Measured by: TV Trace [AUTOCALC]

Vcf mean [Dimension]

Mode: MM:CM:AMM:CAMM:VRMM
Formula: ({LVIDd}-{LVIDs})/({LVIDd}*{LVET})
Needs measurement: LVIDd [Dimension], LVIDs [Dimension], LVET [Dimension]
Measured by: Vcf [MMTIMECALIPER]

Vcf mn (corr) [Dimension]

Mode: MM:CM:AMM:CAMM:VRMM
Formula: ({LVIDd}-{LVIDs})/({LVIDd}*({LVET}/sqrt({Time})))
Needs measurement: LVIDd [Dimension], LVIDs [Dimension], LVET [Dimension], Time [Dimension]
Measured by: Vcf [MMTIMECALIPER]

zAoDiaphragm [ZScores]
Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: (ln({2D/AoDiaphragm}*100)-{2D/MeanAoDiaphragm})/(0.1342)
Needs measurement: Ao at Diaphragm [ZScores], MeanAoDiaphragm [ZScores]
Measured by: AoDiaphragm [2DCALIPER]
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

1-61
zAoIsth [ZScores]
Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: (ln({2D/Ao Isthmus}*100)-{2D/MeanAoIsthmus})/(0.1643)
Needs measurement: Ao Isthmus [ZScores], MeanAoIsthmus [ZScores]
Measured by: AoIsthmus [2DCALIPER]
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

zAoStJunct [ZScores]
Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: (ln({2D/Ao st junct}*100)-{2D/MeanAoStJunct})/(0.1342)
Needs measurement: Ao st junct [ZScores], MeanAo st junct [ZScores]
Measured by: Ao st junct [2DCALIPER]
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

zAVAnn [ZScores]
Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: (ln({2D/AV Annulus Diam}*100)-{2D/MeanAVAnn})/(0.1)
Needs measurement: AV Annulus Diam [ZScores], MeanAVAnn [ZScores]
Measured by: AV Annulus Diam [2DCALIPER]
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

zDistalAoArch [ZScores]
Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: (ln({2D/DistalAoArch}*100)-{2D/MeanDistalAoArc})/(0.1612)
Needs measurement: Distal Ao Arch [ZScores], MeanDistalAoArc [ZScores]
Measured by: DistalAoArch [2DCALIPER]
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

zIVSd [ZScores]
Mode: MM:CM:AMM:CAMM:VRMM
Formula: (ln({MM/IVSd}*100)-{MM/MeanIVSd})/0.2145
Needs measurement: IVSd [ZScores], MeanIVSd [ZScores]
Measured by: IVSd [MMDISCALIPER]
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

zIVSs [ZScores]
Mode: MM:CM:AMM:CAMM:VRMM
Formula: (ln({MM/IVSs}*100)-{MM/MeanIVSs})/0.1844
Needs measurement: IVSs [ZScores], MeanIVSs [ZScores]
Measured by: IVSs [MMDISCALIPER]
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

1-62
zLADiam [ZScores]
Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: (ln({2D/LA}*100)-{2D/MeanLADiam})/(0.1414)
Needs measurement: LA Diam [ZScores], MeanLADiam [ZScores]
Measured by: LA [2DCALIPER]
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

zLPA [ZScores]
Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: (ln({2D/LPA}*100)-{2D/MeanLPA})/(0.1673)
Needs measurement: LPA [ZScores], MeanLPA [ZScores]
Measured by: LPA [2DCALIPER]
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

zLVIDd [ZScores]
Mode: MM:CM:AMM:CAMM:VRMM
Formula: (ln({MM/LVIDd}*100)-{MM/MeanLVIDd})/(0.1)
Needs measurement: LVIDd [ZScores], MeanLVIDd [ZScores]
Measured by: LVIDd [MMDISCALIPER]
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

zLVIDs [ZScores]
Mode: MM:CM:AMM:CAMM:VRMM
Formula: (ln({MM/LVIDs}*100)-{MM/MeanLVIDs})/(0.1265)
Needs measurement: LVIDs [ZScores], MeanLVIDs [ZScores]
Measured by: LVIDs [MMDISCALIPER]
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

zLVPWd [ZScores]
Mode: MM:CM:AMM:CAMM:VRMM
Formula: (ln({MM/LVPWd}*100)-{MM/MeanLVPWd})/0.1924
Needs measurement: LVPWd [ZScores], MeanLVPWd [ZScores]
Measured by: LVPWd [MMDISCALIPER]
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

zLVPWs [ZScores]
Mode: MM:CM:AMM:CAMM:VRMM
Formula: (ln({MM/LVPWs}*100)-{MM/MeanLVPWs})/(0.1517)
Needs measurement: LVPWs [ZScores], MeanLVPWs [ZScores]
Measured by: LVPWs [MMDISCALIPER]
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

1-63
zMPA [ZScores]
Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: (ln({2D/MPA}*100)-{2D/MeanMPA})/(0.1549)
Needs measurement: MPA [ZScores], MeanMPA [ZScores]
Measured by: MPA [2DCALIPER] , RPA [2DCALIPER]
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

zMVAnn [ZScores]
Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: (ln({2D/MV Annulus Diam}*100)-{2D/MeanMVAnn})/(0.1483)
Needs measurement: MV Ann Diam [ZScores], MeanMVAnn [ZScores]
Measured by: MV Ann Diam [2DCALIPER]
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

zPVAnn [ZScores]
Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: (ln({2D/PV Annulus Diam}*100)-{2D/MeanPVAnn})/(0.1517)
Needs measurement: PV Ann Diam [ZScores], MeanPVAnn [ZScores]
Measured by: PV Ann Diam [2DCALIPER]
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

zRVIDd [ZScores]
Mode: MM:CM:AMM:CAMM:VRMM
Formula: ((ln({MM/RVIDd}*100))-{MM/MeanRVIDd})/(0.2408)
Needs measurement: RVIDd [ZScores], MeanRVIDd [ZScores]
Measured by: RVIDd [MMDISCALIPER]
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

zSinusesValsalva [ZScores]
Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: (ln({2D/SinusesOfValsalva}*100)- {2D/MeanSinusesValsalva})/(0.1095)
Needs measurement: Sinuses of Valsalva [ZScores], MeanSoV [ZScores]
Measured by: Sinuses of Valsalva [2DCALIPER]
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

zTransAoArch [ZScores]
Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: (ln({2D/TransAoArch}*100)-{2D/MeanTransAoArch})/(0.1517)
Needs measurement: Transverse Aortic Arch [ZScores], MeanTransAoArch [ZScores]
Measured by: TransAoArch [2DCALIPER]
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

1-64
zTVAnn [ZScores]
Mode: 2D:3D:CF:3DCF:TT:SI:SRI:TSI:VR2D
Formula: (ln({2D/TV Annulus Diam}*100)-{2D/MeanTVAnn})/(0.1897)
Needs measurement: TV Ann Diam [ZScores], MeanTVAnn [ZScores]
Measured by: TV Ann Diam [2DCALIPER]
Pettersen et al. "Regression Equations for Calculation of Z Scores of Cardiac Structures in a Large Cohort
of Healthy Infants, Children, and Adolescents: An Echocardiographic Study" Journal of the American
Society of Echocardiography, Aug 2008, Vol. 21 No. 8, p. 922.

1-65
Formulas–Vascular

Vascular Calculation Formulas

Calc Input Measurements

Mnemonic Calc Name Formula

RT ECA Right External Carotid Artery one Doppler blood flow peak velocity
Velocity

RT ECA=v1[cm/s or m/s]

RT CCA Right Common Carotid Artery one Doppler blood flow peak velocity
Velocity

RT CCA=v1[cm/s or m/s]

RT BIFURC Right Carotid Bifurcation one Doppler blood flow peak velocity
Velocity

RT BIFURC=v1[cm/s or m/s]

RT ICA Right Internal Carotid Artery one Doppler blood flow peak velocity
Velocity

RT ICA=v1[cm/s or m/s]

RT ICA/CCA Right Internal Carotid Artery two Doppler blood flow peak velocities
Velocity/Common Carotid
Artery Velocity Ratio

RT ICA/CCA=VICA/VCCA

LT ECA, LT Same as above, for Left Carotid Same as above

CCA, LT Artery
BIFURC, LT
ICA, LT ICA/
CCA

A/B Ratio Velocities Ratio two Doppler blood flow peak velocities

A/B=V1/V2

% Stenosis Stenosis Ratio two areas (by ellipse, trace, circle or distance)

% Stenosis=[1-(Aresidual/ Alumen)]x100

S/D Ratio Systolic Velocity/Diastolic two Doppler blood flow peak velocities
Velocities Ratio

S/D=Vsystole/Vdiastolea

PI Pulsatility Index two Doppler blood flow peak velocities and TAMAX

PI=(Vmax-Vdiastole)/TAMAXa

RI Resistivity Index two Doppler blood flow peak velocities 1-66

 Calc Input Measurements
Mnemonic Calc Name Formula

RI=(Vmax-Vdiastole)/ Vmaxa

HR Heart Rate (beats/minute) one 2 beat time interval (measured manually or

automatically)

HR[BPM]=120[sec]/2 beat time[sec]

a
) Vdiastole = Vmin or Vend-diastole (depends on preset selection)

1-67
Formulas–OB

OB Calculation Formulas

Calc Input Measurements Author

Mnemonic Calc Name Formula Reference

AC Abdominal circumference by trace, ellipse, circle or two Hadlock et al,

Circumference distances Radiology,
152:497-501,
AC=13.3+1.61 (GA) -0.00998 (GA)2 1984

BPD Biparietal one distance

Diameter

BPD = -3.08+0.41 (GA) - 0.000061 (GA)3

CRL Crown Rump one distance

Length

CRL=1.684969+ 0.315646xd1+ 0.049306xd1^2+

0.004057xd1^3+ 0.000120456xd1^4

FL Femur Length one distance

FL = -3.91 + 0.427 (GA) - 0.0034 (GA)2

GS Gestational Sac three distances

GS [wk] = 1.42450142 * (d1+d2+d3)/3+ 3.6225

HC Head circumference by trace, ellipse, circle or two

Circumference distances

HC=-11.48 + 1.56 (GA) - 0.0002548 (GA)3

Calc Input Measurements Author

Mnemonic Calc Name Formula Reference

HC Head one ellipse Hansmann,

Circumference Ultrasound
Diagnosis in
Obstetrics and
Gynecology
438-9, 1985

HC [mm] = 2.325 * (BPD [mm]^2 + OFD

[mm]^2)^0.5

EF Ejection two distances on M-Mode (End-diastolic dimension n/a

Fraction and End-systolic dimension on M-Mode)

EF = (1 - Ds^3 / Dd^3)

1-68
CUA Hadlock Formulas

Calc
Mnemonic Calc Name Formula

CUAa Composite 1. CUA (BPD) = 9.54 + 1.482 * BPD + 0.1676 * BPD2

Ultrasound
2. CUA (HC) = 8.96 + 0.540 * HC + 0.0003 * HC3
Age
3. CUA (AC) = 8.14 + 0.753 * AC + 0.0036 * AC2
4. CUA (FL) = 10.35 + 2.460 * FL + 0.170 * FL2
5. CUA (BPD, HC) = 10.32 + 0.009 * HC2 + 1.3200 * BPD + 0.00012 *
HC3
6. CUA (BPD, AC) = 9.57 + 0.524 * AC + 0.1220 * BPD2
7. CUA (BPD, FL) = 10.50 + 0.197 * BPD * FL + 0.9500 * FL + 0.7300 *
BPD
8. CUA (HC, AC) = 10.31 + 0.012 * HC2 + 0.3850 * AC
9. CUA (HC, FL) = 11.19 + 0.070 * HC * FL + 0.2630 * HC
10. CUA (AC, FL) = 10.47 + 0.442 *AC + 0.3140 * FL2 -0.0121 * FL3
11. CUA (BPD, HC, AC) = 10.58 + 0.005 * HC2 + 0.3635 * AC + 0.02864
* BPD * AC
12. CUA (BPD, HC, FL) = 11.38 = 0.070 * HC * FL + 0.9800 * BPD
13. CUA (BPD, AC, FL) = 10.61 + 0.175 * BPD * FL + 0.2970 * AC +
0.7100 * FL
14. CUA (HC, AC, FL) = 10.33 + 0.031 * HC * FL + 0.3610 * HC + 0.0298
* AC * FL
15. CUA (BPD, HC, AC, FL) = 10.85 + 0.060 * HC * FL + 0.6700 * BPD +
0.1680 * AC

Author Reference: Hadlock, Radiology, 1984 152:497-501

a
) Formulas are used only if Hadlock HC, FL, AC and BPD are used and CUA is selected as the preset in the
CUA/AUA for Hadlock preset in the System M&A Preset Menu. If other authors are used, CUA automatically
changes to AUA and an average value is displayed.

1-69
EFW Calculation Formulas

Calc Input Measurements Author

Mnemonic Calc Name Formula Reference

EFW Estimated Fetal AC and HC Hadlock,

Weight Radiology,
150:535, 1984

EFW [kg] = 10^ (1.182+(0.0273*HC

[cm])+(0.07057*AC [cm] - (0.00063*AC
[cm]^2)-(0.0002184*AC [cm] * HC [cm]))

EFW Estimated Fetal BPD, AC, and FL Hadlock,

Weight AJOG,
151:333, 1985

EFW [g]=10^(1.335-(0.0034*AC [cm] * FL [cm]) +

(0.0316 * BPD [cm]) + (0.0457 * AC [cm]) + (0.1623
* FL [cm]

EFW Estimated Fetal AC, HC, and FL Hadlock,

Weight AJOG,
151:333, 1985

EFW [g]=10^(1.326-(0.00326 * AC [cm] * FL [cm]) +

(0.0107 * HC [cm]) + (0.0438 * AC [cm]) + (0.158 *
FL [cm]))

EFW Estimated Fetal AC, HC, BPD, FL Hadlock,

Weight AJOG,
151:333, 1985

EFW [g] = 10^(1.3596- (0.00386 * AC [cm] * FL

[cm]) + (0.0064 * HC [cm]) + (0.00061 * BPD [cm] *
AC [cm]) + (0.0424 * AC [cm]) + (0.174 * FL [cm]))

Calc Input Measurements Author

Mnemonic Calc Name Formula Reference

EFW Estimated Fetal AC and FL Hadlock,

Weight Radiology,
150:535, 1984

EFW [g] = 10^(1.304 + 0.05281 * AC [cm] + 0.1938

* FL [cm] - 0.004 * AC [cm] * FL [cm])

EFW Estimated Fetal EFW [g] = -3200.40479 + 157.07186 * AC [cm] + Merz

Weight 15.90391 * BPD [cm]^2

EFW Estimated Fetal EFW [g] = 0.515263 -0.105775 * BPD [mm] + German
Weight (0.000930707 * BPD [mm]^2 + 0.0649145 * TAD
[mm] - 0.00020562 * TAD [mm]^2

EFW Estimated Fetal AC and BPD Shepard,

Weight AJOG,
142:47, 1982 1-70
 Calc Input Measurements Author
Mnemonic Calc Name Formula Reference

EFW [kg] = 10^(-1.7492 + 0.166 * BPD [cm] + 0.046

* AC [cm] - 2.646 * AC [cm] * BPD [cm]/1000)

EFW Estimated Fetal BPD [cm] and AC [cm] Shepard/

Weight Warsoff

EFW [g] = 10^(1.7288+0.09184 * BPD [cm] +

0.02581 * AC [cm] + 0.00011 * BPD [cm] * AC [cm])

EFW Estimated Fetal BPD [cm] and AC [cm] Richards/

Weight Berkowitz

EFW [g] =10^(3-1.7492 + (0.166 * BPD [cm]) +

(0.04 * A [cm]) - (0.002646 * AC [cm] * BPD [cm]))

EFW Estimated Fetal EFW [g] = 1.07 * BPD [cm]^3 + 3.42 * APTD [cm] * Tokyo
Weight TTD [cm] * FL [cm] University

Calc Input Measurements Author

Mnemonic Calc Name Formula Reference

EFW Estimated Fetal BPD, AxT, FL [cm] Tokyo

Weight Shinozuka

EFW1 [g] =1.07 * BPD [cm]^3 + 3.42 * AxT [cm2] *

FL [cm]

EFW Estimated Fetal BPD, AC, FL [cm] Tokyo

Weight Shinozuka

EFW2 [g] = 1.07 * BPD [cm]^3 + 0.30 * AC [cm]^2 *

FL [cm]

EFW Estimated Fetal BPD, AxT, LV [cm] Tokyo

Weight Shinozuka

EFW3 [g] = 1.07 * BPD [cm] ^3 + 2.91 * AxT [cm2] *

LV [cm]

1-71
Amniotic Fluid Index (AFI)

The normal values are considered to be:

• 36-40 weeks Sagittal

• 0-5 cm = very low
• 5.1-8.0 cm = low
• 8.1-18.0 cm = normal
• >18.0 = high

Dr. Rutherford/Dr. Phelan, Obstetrics and Gynecology, Volume 70, No. 3, Part 1, p.353-6, Sept. 1987.

• 28-40 weeks Transverse

• 15.0 cm = average
• >20.0 - 24.0 = hydramnios
• <5.0-6.0 = Oligohydramnios

Dr. C.C. Smith, The Female Patient, Volume 15, p.85-97, March 1990.

1-72
Formulas–GYN

GYN Calculation Formulas

Calc Input
Mnemonic Calc Name Measurements Formula

UT-L Uterine Length one distance Ut-L[cm or mm]=d1

UT-H Uterine Height one distance Ut-H[cm or mm]=d1

UT-W Uterine Width one distance Ut-W[cm or mm]=d1

UT-Volume Uterine Volume

UtPFD Uterus Portio-Fundus

Distance

UtAP Anterior-Posterior Uterus

Diameter

UtQ Transverse Uterus

Diameter

Endo Endometrium Thickness one distance Endo[cm or mm]=d1

Lt. Ov-L Left Ovarian Length one distance Lt. Ov-L[cm or mm]=d1

Lt. Ov-H Left Ovarian Height one distance Lt. Ov-H[cm or mm]=d1

Lt. Ov-W Left Ovarian Width one distance Lt. Ov-W[cm or mm]=d1

Lt. Ov-Volume Left Ovarian Volume

Rt. Ov-L Right Ovarian Length one distance Rt. Ov-L[cm or mm]=d1

Rt. Ov-H Right Ovarian Height one distance Rt. Ov-H[cm or mm]=d1

Rt. Ov-W Right Ovarian Width one distance Rt. Ov-W[cm or mm]=d1

Rt. Ov-Volume Right Ovarian Volume

Lt. Ov-RI Left Ovarian Vessel two Doppler blood Lt. Ov-RI= (Vmax-Vdiastole)/
Resistive Index flow peak velocities Vmaxa

Ut-RI Uterine Vessel Resistive two Doppler blood Ut-RI= (Vmax-Vdiastole)/Vmaxa

Index flow peak velocities

Rt. Ov-RI Right Ovarian Vessel two Doppler blood Rt. Ov-RI= (Vmax-Vdiastole)/
Resistive Index flow peak velocities Vmaxa

1-73
 Calc Input
Mnemonic Calc Name Measurements Formula

LtOvFo[ml] Left Ovary Follicles One distanceb D1[cm]3 x p/6

Two distancesb D1[cm]2 x D2x[cm] p/6

: (D1<D2)

D1[cm] x D2[cm] 2x p/6

: (D2<D1)

Three distances D1[cm] x D2[cm]x D3[cm] x p/6

RtOvFo[ml] Right Ovary Follicles One distanceb D1[cm]3 x p/6

Two distancesb D1[cm]2 x D2[cm] x p/6

: (D1 <D2)

D1[cm] x D2[cm]2 x p/6

: (D2 <D1)

Three distances D1[cm] x D2[cm] x D3[cm] x p/6

Lt. Ov-PI Left Ovarian Vessel

Pulsatility Index

Rt. Ov-PI Right Ovarian Vessel

Pulsatility Index

a
) Vdiastole = Vmin or Vend-diastole (depends on preset selection)
b
) To calculate LtOvFo or RtOvFo with one (or two distances), press the Clear key after the first (or second
distance) measurement(s).

1-74
 Measurement accuracy

General
When using the Measurement and Analysis (M&A) package, it is
important to keep in mind the different aspects that affect the
accuracy of the measurements. These include acoustical
properties, patient echogenicity, measurement tools and
algorithms, scanner setup (especially Field-of-view or Range
settings), probe type used, and operator inputs.

Sources of error

Image Quality

The accuracy of each measurement is highly dependent on

image quality. Image quality is highly dependent on system
design, operator variability, and patient echogenicity. The
operator variability and patient echogenicity are independent of
the ultrasound system.

Operator variability

One of the largest potential sources of error is operator

variability. A skilled operator can reduce this by optimizing the
image quality for each type of measurement. Clear identification
of structures, good probe alignment and correct cursor
placement is important. Because of pixel resolution, the
accuracy of a measurement decreases with decreasing distance
on screen. Therefore it is important when scaling the object on
the screen to avoid measuring objects that are too small.
NOTE: See also ‘Optimizing Measurement Accuracy’ on page 1-77 for
recommended techniques.

Image measurement

The accuracy in lateral direction is limited by the beam width and 1-75
the beam positioning. The radial accuracy is mainly limited by
the acoustic pulse length.
Doppler alignment

Errors in velocity measurements increase with the cosine of the

angle between the measured flow and the ultrasound beam. For
example, an alignment error of 20 degrees, will give a 6%
under-estimation of the velocities, while an error of 40 degrees
will cause the under-estimation to be 24%.Optimize transducer
position to align the beam with the flow direction.
NOTE: If alignment is not possible, you may use the Angle Correction
control to compensate if the flow direction is known.

Screen pixel resolution

The display screen is composed of an array of square picture

elements (pixels). The smallest resolvable unit is +/- 1pixel. This
pixel error is only significant when measuring short distances on
the screen. By observing good scanning practices, the settings
of the field of view should be such that the measured distance
covers a relatively large portion of the screen. When such
scaling is impossible, the pixel error may come into play. The
pixel error is +/- 0.2% of the full ultrasound area in the User
Screen.

Algorithms

Some formulae used in clinical calculations are based on

assumptions or approximations. For example the volume
calculations from 2D or M mode assume a certain, ‘ideal’ shape
of the heart chamber, while the actual shape can vary quite
much between individuals. Also, formulae taking several “raw”
measurements as inputs are prone to increased errors,
depending on the combination of input variable accuracies. For
example, the Cardiac Output formula from Doppler is sensitive
to errors in the entered Diameter, since this will be squared in
the formula.

Speed of Sound in Tissue

The average value 1540 meters / second is used for all

calculations. Depending on the tissue structures, this
generalization may give errors from 2% (typical) to 5% (much
fatty tissue layers present).

1-76
Optimizing Measurement Accuracy

Probe selection

Select a transducer appropriate for the application, and optimize

the transducer frequencies used. Higher imaging frequencies
give better resolution, but less penetration than lower
frequencies. Lower Doppler frequencies can measure higher
max velocities, and at greater depths, but with less velocity
resolution than higher Doppler frequencies.

Field of View

All display modes should be adjusted so that the area of interest

covers as large portion of the display as possible. Use Depth,
Angle, Zoom, Horizontal Sweep and Velocity controls to
optimize the different modes.

Cursor Placement

All measurements are dependent on the accuracy of their “input”

data. Consistency and precision in placing cursors and drawing
traces correctly on the images are important.
NOTE: Avoid placement of the cursor near the array edges when using
convex or linear probes.

Measurement Uncertainties
The accuracy percentages reported below are based on data
taken with optimum control settings, using calibrated phantoms
and test equipment. The table below only includes errors related
to the system with probes.
The calibration was done for the basic measurable parameters:
Distance, Time and Velocity.
Independent sources of uncertainty contribute to a total
uncertainty by a RMS (Root Mean Square) combination of the
sources. Refer to the discussions above regarding
measurement accuracy and sources of error when reading the
table below.

1-77
 Measurement Range Accuracy Comments

2D Calipers

Depth 20 - 105 mm max (5.0%, 1.0 mm)

Vertical distance 0.25 - 110 mm max (5.0%, 1.0 mm)

Horizontal distance 10 - 110 mm max (5.0%, 1.0 mm)

Area 0.5 – 150 cm2 10%

Circumference 5 - 30 cm 10%

M-mode Calipers

Depth 20 - 105 mm max (5.0%, 1.0 mm)

dt 10 - 10000 ms max (5.0%, 1 ms) With optimal sweep

speed setting

Biplane Calipers

Depth 30 - 105 mm max (5.0%, 1.0 mm)

Vertical distance 10 - 110 mm max (5.0%, 1.0 mm)

Horizontal distance 10 - 110 mm max (5.0%, 1.0 mm)

4D Slice Image Calipers

Depth 30 - 105 mm max (5.0%, 1.0 mm)

Vertical distance 10 - 110 mm max (5.0%, 1.0 mm)

Horizontal distance 10 - 110 mm max (5.0%, 1.0 mm)

4D Rendering Image Calipers

Distance 10 - 60 mm max (5.0%, 1.0 mm)

Area 5 - 110 cm2 10%

Circumference 5 - 30 cm 10%

Spectrum Calipers

Velocity 0.2 – 6.0 m/s 10%

dt 10 - 1000ms max (5.0%, 5 ms) With optimal sweep

speed setting
1000 - 10000ms 1.5%

Spectrum Doppler AutoCalc

Velocity 5 - 110 cm/s 10%

dt 10 - 200 ms max (2%, 4 ms)

Acceleration 250 - 1300 cm/s2 12%

1-78
Volume Flow 60 - 1600 ml/min 20%
 Measurement Range Accuracy Comments

Heart Rate 55 - 115 bpm 10%

TSI Caliper

dt 65 - 420 ms max (2 frames, 25 ms)

Velocity 2.6 - 7.5 cm/s +/-10%

ECG Caliper/Heart Rate

dt 10 - 10000 ms max (5.0%, 1 ms)

Heart Rate 40 - 250 bpm 5% The heart rate

displayed on screen
while scanning,
estimated based on
the eight last heart
beats acquired by
ECG.

Event timing

Time 130 - 650 ms max (5.0%, 1 ms)

Triplane Volume

Volume (triplane) 65 - 210 ml 15 ml

Volume (4D data) 65 - 210 ml 15 ml

Q Analysis

Velocity from TVI data 1 - 45 cm/s 3 cm/s

Strain rate from TVI data -6 - +2 s-1 max (2 s-1, 20%)

Strain from TVI data -45 - +65% +/-7 percentage points

Displacement from TVI data 3 - +15 mm 2 mm

Grayscale intensity difference 12 dB +/-10%

from 2D data

Velocity from color flow data 25 - 75 cm/s 7 cm/s

dt 10 -10000 ms max (2 frames, 25 ms)

2D Auto EF

EF (single view) 15 – 65% +/-15 percentage points

ESV (single view) 15 – 300 ml +/-40 ml

EDV (single view) 30 – 400 ml +/-40 ml

Ls and Ld 5 – 13 cm +/-2 cm

EF_BiP 15 –60% +/-15 percentage points

1-79
ESV_BiP 15 – 300 ml +/-20 ml
 Measurement Range Accuracy Comments

EDV_BiP 30 – 400 ml +/-20 ml

AFI/Triplane AFI/2D Strain

Global Longitudinal Strain -5 – -20% +/-3 percentage points Accuracy +/- 5

percentage points for
TEE probes

Regional Longitudinal Strain -5 – -20% +/-9 percentage points

2D Strain Regional -2 – -34% +/-9 percentage points

Circumferential Strain

2D Strain Regional Radial -10 – +55% +/-9 percentage points

2D Strain Longitudinal -2 – -25% +/-9 percentage points

Endocardial strain

2D Strain Longitudinal Epicardial -2 – -10% +/-9 percentage points

strain

2D Strain Circumferential -19 – -40% +/-9 percentage points

Endocardial strain

2D Strain Circumferential -5 – -19% +/-9 percentage points

Epicardial strain

4D Auto LVQ

Volumes (EDV, ESV) 65 – 210 ml +/-15 ml The tool should not

be used on
collapsing ventricles

ED Mass 80 – 130 g +/-20 g

ES Mass 80 – 130 g +/-20 g

Sphericity Index 0.79 – 0.98 +/-0.2

4D Strain Segmental strain -35 – +45% +/-9 percentage points

(Longitudinal, Circumferential,
Area, Radial)

Rotation 2.1 – 12.4° +/-5 °

4D Auto AVQ (Aortic Annulus)

Area 3.3 - 5.2 cm2 +/-10%

Diameter 2.1 - 2.7 cm +/-10%

IMT

Distance 0.35 – 1.2 mm 0.20 mm

1-80
DICOM SR Measurements

DICOM Structured Reporting (SR) is a standardized format for

medical results. Vivid E80/90/95, EchoPAC Software Only, and
EchoPAC Plug-in support the specialized form for Adult Echo
Ultrasound (“TID 5200 Echocardiography Procedure Report”)
and Vascular Ultrasound (“TID 5100 Vascular Ultrasound
Procedure Report”) for M&A results.
“TID 5200 Echocardiography Procedure Report” and “TID 5100
Vascular Ultrasound Procedure Report” do not support all M&A
results from Vivid E80/90/95, EchoPAC Software Only, and
EchoPAC Plug-in. They are limited to the following:
• No unassigned measurement.
• The following modes: 2D, M-mode, Color Flow, PW Doppler,
CW Doppler, 3D and TDI.
• Not Modified Simpson method or Bullet methods.
• Basic derivations (Average, Last, Min and Max), no
references between the derived measurements and the
ones they were made from.
• Wall Motion Scoring: individual segment scores only
according to 16-segment model, no graded Hypokinesis
(only Hypokinesis is used).

1-81
Supported parameters

Left ventricle

2D/%FS 2D/%IVS Thck 2D/%LVPW Thck

2D/CI(Cube) 2D/CI(Teich) 2D/CO(Cube)

2D/CO(Teich) 2D/EDV(A-L) 2D/EDV(Cube)

2D/EDV(MOD) 2D/EDV(Teich) 2D/EF(A-L)

2D/EF(Cube) 2D/EF(MOD) 2D/EF(Teich)

2D/ESV(A-L) 2D/ESV(Cube) 2D/ESV(MOD)

2D/ESV(Teich) 2D/IVSd 2D/IVSs

2D/LVA diastole 2D/LVA systole 2D/LVd Mass

2D/LVd Mass/ASE 2D/LVIDd 2D/LVIDs

2D/LVIDs Index 2D/LV Major 2D/LV Minor

2D/LVOT Area 2D/LVOT Diam 2D/LVPWd

2D/LVPWs 2D/LVs Mass 2D/LVs Mass/ASE

2D/SAX/LVA diastole 2D/SAX/LVA systole 2D/SAX/LVAend diastole

2D/SAX/LVAend systole 2D/SAX/LVAepi diastole 2D/SAX/LVAepi systole

2D/SI(A-L) 2D/SI(Cube) 2D/SI(MOD)

2D/SI(Teich) 2D/SV(A-L) 2D/SV(Cube)

2D/SV(MOD) 2D/SV(Teich) 3DStrain/AI PeakSysSL

3DStrain/AL PeakSysSL 3DStrain/AS PeakSysSL 3DStrain/BA PeakSysSL

3DStrain/BAS PeakSysSL 3DStrain/BI PeakSysSL 3DStrain/BL PeakSysSL

3DStrain/BP PeakSysSL 3DStrain/BS PeakSysSL 3DStrain/MA PeakSysSL

3DStrain/MAS PeakSysSL 3DStrain/MI PeakSysSL 3DStrain/ML PeakSysSL

3DStrain/MP PeakSysSL 3DStrain/MS PeakSysSL AP/LVOT Diam

AP/LVOT VTI Auto2DEF/HR_2Ch_Q Auto2DEF/HR_4Ch_Q

Auto2DEF/LVCO_2Ch_Q Auto2DEF/LVCO_4Ch_Q Auto2DEF/LVCO_BiP_Q

Auto2DEF/LVEF_2Ch_Q Auto2DEF/LVEF_4Ch_Q Auto2DEF/LVEF_BiP_Q

Auto2DEF/LVLd_2Ch_Q Auto2DEF/LVLd_4Ch_Q Auto2DEF/LVLs_2Ch_Q

Auto2DEF/LVLs_4Ch_Q Auto2DEF/LVSV_2Ch_Q Auto2DEF/LVSV_4Ch_Q

Auto2DEF/LVSV_BiP_Q Auto2DEF/LVVED_2Ch_Q Auto2DEF/LVVED_4Ch_Q

1-82
Auto2DEF/LVVED_BiP_Q Auto2DEF/LVVES_2Ch_Q Auto2DEF/LVVES_4Ch_Q
Auto2DEF/LVVES_BiP_Q AWMA/AA PeakSysSL AWMA/AAS PeakSysSL

AWMA/AI PeakSysSL AWMA/AL PeakSysSL AWMA/AP PeakSysSL

AWMA/AS PeakSysSL AWMA/AVC AWMA/BA PeakSysSL

AWMA/BAS PeakSysSL AWMA/BI PeakSysSL AWMA/BL PeakSysSL

AWMA/BP PeakSysSL AWMA/BS PeakSysSL AWMA/GPeakSysSL(A2C)

AWMA/GPeakSysSL(A4C) AWMA/GPeakSysSL(APLAX) AWMA/GPeakSysSL(Avg)

AWMA/MA PeakSysSL AWMA/MAS PeakSysSL AWMA/MI PeakSysSL

AWMA/ML PeakSysSL AWMA/MP PeakSysSL AWMA/MS PeakSysSL

CI(A-L A2C) CI(A-L A2C)/AutoHR CI(A-L A4C)

CI(A-L A4C)/AutoHR CI(A-L LAX) CI(A-L LAX)/AutoHR

CI(Biplane) CI(Biplane)_03 CI(bp el)

CI(bullet) CI(MOD A2C) CI(MOD A2C)/AutoHR

CI(MOD A4C) CI(MOD A4C)/AutoHR CI(MOD LAX)

CI(MOD LAX)/AutoHR CI(mod sim) CO(4D)

CO(A-L A2C) CO(A-L A2C)/AutoHR CO(A-L A4C)

CO(A-L A4C)/AutoHR CO(A-L LAX) CO(A-L LAX)/AutoHR

CO(A-L) CO(Biplane) CO(Biplane)_03

CO(bp el) CO(bullet) CO(Geom)

CO(MOD A2C) CO(MOD A2C)/AutoHR CO(MOD A4C)

CO(MOD A4C)/AutoHR CO(MOD LAX) CO(MOD LAX)/AutoHR

CO(mod sim) ECG/HeartRate ECG/HeartRate/Auto

EDV(bp el) EDV(bullet) EDV(mod sim)

EF(4D) EF(A-L A2C) EF(A-L A4C)

EF(A-L LAX) EF(Biplane) EF(Biplane)_03

EF(bp el) EF(bullet) EF(Geom)

EF(MOD A2C) EF(MOD A4C) EF(MOD LAX)

EF(mod sim) ESV(bp el) ESV(bullet)

ESV(mod sim) GPSL(4D) IVCT

IVRT LIMP LVAd(A2C)

LVAd(A4C) LVAd(LAX) LVAd(sax epi)

LVAd(sax MV)LVAd(sax MV) LVAd(sax PM) LVAs(A2C)

1-83
LVAs(A4C) LVAs(LAX) LVAs(sax epi)
LVAs(sax MV) LVAs(sax PM) LVAs(sax)

LVd Mass(4D) LVd Mass(A-L) LVd Mass Index(A-L)

LVd Mass(TE) LVd Mass Index(TE) LVEDV(4D)

LVEDV(A-L A2C) LVEDV(A-L A4C) LVEDV(A-L LAX)

LVEDV(Geom) LVEDV(MOD A2C) LVEDV(MOD A4C)

LVEDV(MOD BP) LVEDV(MOD BP)_03 LVEDV(MOD LAX)

LVESV(4D) LVESV(A-L A2C) LVESV(A-L A4C)

LVESV(A-L LAX) LVESV(Geom) LVESV(MOD A2C)

LVESV(MOD A4C) LVESV(MOD BP) LVESV(MOD BP)_03

LVESV(MOD LAX) LVLad(apical) LVLd(A2C)

LVLd(A4C) LVLd(apical) LVLd(avg)

LVLdd(apical) LVLs(A2C) LVLs(A4C)

LVLs(apical) LVLs(avg) LVOT CI

LVOT CO LVOT HR LVOT maxPG

LVOT meanPG LVOT SI LVOT SV

LVOT Vmax LVOT Vmax P LVOT Vmean

LVOT VTI LVs Mass(4D) LVs Mass(A-L)

LVs Mass(TE) MM/%FS MM/%LVPW Thck

MM/CI(Cube) MM/CI(Teich) MM/CO(Cube)

MM/CO(Teich) MM/EDV(Cube) MM/EDV(Teich)

MM/EF(Cube) MM/EF(Teich) MM/ESV(Cube)

MM/ESV(Teich) MM/HeartRate MM/IVSd

MM/IVSd/LVPWd MM/IVSs MM/LVd Mass

MM/LVd Mass/ASE MM/LVIDd MM/LVIDs

MM/LVPWd MM/LVPWs MM/LVs Mass

MM/LVs Mass/ASE MM/SI(Cube) MM/SI(Teich)

MM/SV(Cube) MM/SV(Teich) MP/LVOT Diam

MP/LVOT VTI SD/HeartRate SD/HeartRate/Calc

SI(A-L A2C) SI(A-L A4C) SI(A-L LAX)

SI(Biplane) SI(Biplane)_03 SI(bp el)

SI(bullet) SI(MOD A2C) SI(MOD A4C)

1-84
SI(MOD LAX) SI(mod sim) SV(4D)
SV(A-L A2C) SV(A-L A4C) SV(A-L LAX)

SV(Biplane) SV(Biplane)_03 SV(bp el)

SV(bullet) SV(Geom) SV(MOD A2C)

SV(MOD A4C) SV(MOD LAX) SV(mod sim)

TomTec/LVFunction/EDV TomTec/LVFunction/EF TomTec/LVFunction/ESV

TomTec/LVFunction/SDI16 TomTec/LVFunction/SV TSI/All segments max delay

TSI/All segments stdev TSI/BA PeakVel TSI/BA TimeToPeak

TSI/BAS PeakVel TSI/BAS TimeToPeak TSI/Basal max delay

TSI/Basal stdev TSI/BI PeakVel TSI/BI TimeToPeak

TSI/BL minus BS TSI/BL PeakVel TSI/BL TimeToPeak

TSI/BP minus BAS TSI/BP PeakVel TSI/BP TimeToPeak

TSI/BS PeakVel TSI/BS TimeToPeak TSI/MA PeakVel

TSI/MA TimeToPeak TSI/MAS PeakVel TSI/MAS TimeToPeak

TSI/MI PeakVel TSI/MI TimeToPeak TSI/ML PeakVel

TSI/ML TimeToPeak TSI/MP PeakVel TSI/MP TimeToPeak

TSI/MS PeakVelTSI/MS PeakVel TSI/MS TimeToPeak

1-85
Right ventricle

2D/RVAWd 2D/RVAWs 2D/RVD Major

2D/RVD Minor 2D/RVIDd 2D/RVIDs

2D/RVOT Area 2D/RVOT Diam Est RVSP

MM/RVAWd MM/RVAWs MM/RVIDd

MM/RVIDs MM/RVOT RIMP

RV S’ RVAd(A4C) RVAs(A4C)

RVEDV(A-L A4C) RVEDV(MOD A4C) RVESV(A-L A4C)

RVESV(MOD A4C) RVLd(A4C) RVLs(A4C)

RVOT CI RVOT CO RVOT HR

RVOT maxPG RVOT meanPG RVOT SI

RVOT SV RVOT Vmax RVOT Vmax P

RVOT Vmean RVOT VTI TomTec/RVFunction/EDV

TomTec/RVFunction/EF TomTec/RVFunction/ESV

Left atrium

2D/Ao/LA 2D/LA 2D/LA Area

2D/LA Major 2D/LA Minor 2D/LA/Ao

2D/LAEDV(A-L) 2D/LAEDV(A-L) 2D/LAEDVI(A-L)

2D/LAESV(A-L) LAAd(A4C) LAAs(A4C)

LAEDV(A-L A2C) LAEDV(A-L A4C) LAEDV(MOD A2C)

LAEDV(MOD A4C) LAEDV(MOD BP) LAESV(A-L A2C)

LAESV(A-L A4C) LAESV(MOD A2C) LAESV(MOD A4C)

LAESV(MOD BP) LALd(A4C) LALs(A4C)

MM/Ao/LA MM/LA MM/LA/Ao

MM/LAAo/Ao/LA MM/LAAo/LA/Ao

Right atrium

2D/RA RAAs(A4C) 2D/RAD Major

2D/RAD Minor RAP

1-86
Aortic valve

2D/AV Area 2D/AV Cusp 2D/AV Diam

2D/AVA Planimetry 2D/AVA/AV Diam 2D/LAX/Trans AVA diastole

2D/LAX/Trans AVA systole 2D/SAX/Trans AVA diastole 2D/SAX/Trans AVA systole

AR Dec Slope AR Dec Time AR maxPG

AR meanPG AR PHT AR Vmax

AR Vmean AR VTI ARend maxPG

ARend Vmax AV Acc Slope AV Acc Time

AV Acc Time/ET Ratio AV CI AV CO

AV Dec Slope AV Dec Time AV HR

AV maxPG AV meanPG AV SI

AV SV AV Vmax AV Vmax P

AV Vmean AV VTI AVA (Vmax)

AVA (Vmax)2 AVA (Vmax)P AVA (Vmax)P2

AVA (VTI) AVET MM/AV Cusp

MM/AV Diam PISA/AR/ERO PISA/AR/Flow

PISA/AR/Radius PISA/AR/RF PISA/AR/RV

PISA/AR/Velocity PISA/AR/Vmax PISA/AR/VTI

Mitral valve

2D/MV Annulus Diam 2D/MV Area 2D/MVA Planimetry

2D/SAX/MVA E’ Sept E/E’ Sept

E’ Lat E/E’ Lat E’ Avg

E/E’ Avg MCO MM/EPSS

MM/MV E/A Ratio MM/MV E-F Slope MR Acc Slope

MR dp/dt MR maxPG MR meanPG

MR Vmax MR Vmean MR VTI

MV A Dur MV A Velocity MV A VTI

MV Acc Slope MV Acc Time MV Acc Time/MV Dec Time

MV CI MV CO MV Dec Slope
1-87
MV Dec Time MV E Velocity MV E VTI
 MV E/A Ratio MV E/Eprime Ratio/Calc MV Eprime Velocity

MV HR MV maxPG MV meanPG

MV PHT MV Reg Frac MV SI

MV SV MV Vmax MV Vmean

MV VTI MVA (PHT) MVA (VTI)

PISA/MR/ERO PISA/MR/Flow PISA/MR/Radius

PISA/MR/RF PISA/MR/RV PISA/MR/Velocity

PISA/MR/Vmax PISA/MR/VTI

Pulmonic valve

2D/PV Annulus Diam 2D/PV Area MM/Q-to-PV close

PISA/PR/ERO PISA/PR/Flow PISA/PR/Radius

PISA/PR/RV PISA/PR/Velocity PISA/PR/Vmax

PISA/PR/VTI PR Dec Slope PR Dec Time

PR maxPG PR meanPG PR PHT

PR Vmax PR Vmean PR VTI

PRend maxPG PRend Vmax PV Acc Slope

PV Acc Time PV Acc Time/ET Ratio PV HR

PV maxPG PV meanPG PV Vmax

PV Vmax P PV Vmean PV VTI

PVA (Vmax) PVA (Vmax)P PVA (VTI)

PVET SD/Q-to-PV close

1-88
Tricuspid valve

2D/TV Annulus Diam 2D/TV Area 2D/TVA Planimetry

MM/Q-to-TV open PISA/TR/ERO PISA/TR/Flow

PISA/TR/Radius PISA/TR/RV PISA/TR/Velocity

PISA/TR/Vmax PISA/TR/VTI SD/Q-to-TV open

TAPSE TCO TR maxPG

TR meanPG TR Vmax TR Vmean

TR VTI TV A Velocity TV Acc Slope

TV Acc Time TV Dec Slope TV Dec Time

TV E Velocity TV E/A Ratio TV HR

TV maxPG TV meanPG TV PHT

TV Vmax TV Vmax P TV Vmean

TV VTI TVA TVA (Vmax)

TVA (Vmax)P TVA (VTI)

Aorta

2D/Ao Arch Diam 2D/Ao Asc Diam 2D/Ao Desc Diam

2D/Ao Isthmus 2D/Ao Root Diam Asc Ao maxPG

Asc Ao Vmax Dsc Ao maxPG Dsc Ao Vmax

MM/Ao Root Diam MM/LAAo/Ao Root Diam

Pulmonary artery

2D/LPA 2D/MPA 2D/RPA

LPA maxPG LPA Vmax MPA Vmax

RPA maxPG RPA Vmax

Section Pulmonary Venous Structure

P_Vein A P_Vein A Dur P_Vein D

P_Vein D VTI P_Vein S P_Vein S VTI

P_Vein S/D Ratio 1-89

Vena cava

2D/IVC 2D/IVC Diam Exp 2D/IVC Diam Ins

Pulmonic VTI Systemic VTI

Cardiac shunt study

Pulmonic VTI Qp/Qs Systemic VTI

Congenital anomaly of cardiovascular system

2D/ASD Diam 2D/VSD Diam ASD maxPG

ASD Vmax VSD maxPG VSD Vmax

Pericardial cavity

2D/PEd 2D/PEs MM/PEd

Supported methods

2D Auto EF

4D Auto LVQ

4D LV Volume

4D RV Volume

AFI

Area-length, biplane

Area-length, single plane

Biplane Ellipse

Continuity Equation by Peak Velocity

Continuity Equation by Velocity Time Integral

Cube

Left Ventricle Mass by M-mode

Left Ventricle Mass Truncated Ellipse

Method of Disks, biplane 1-90

Method of Disks, single plane
PISA

Planimetry

Pressure Half-Time

Teichholz

Triplane

TSI

1-91
Content of Vascular SR object

Usage and Extension of TID 5100 Vascular Ultrasound Report

Relation
with Concept Req Value Set
NL Parent Value Type Name VM Type Cond. Constraint

1 CONTAINER DT (121070, 1 M
DCM,
"Findings")

> HAS CODE EV (G-C0E3, See ‘GEU

CONCEPT SRT, "Finding Applications and
MOD Site") Extensions’ on
page 1-95, Section
scope.

> HAS CODE EV (G-C171, See ‘GE

CONCEPT SRT, Ultrasound
MOD "Laterality") Sidedness and
Vessel Location’
on page 1-105.

> HAS CODE EV (G-0373, See ‘GE

CONCEPT SRT, "Image Ultrasound Modes’
MOD Mode") on page 1-105.

> CONTAINS INCLUDE DTID (5104) See ‘TID 5104

Vascular Vascular
Measurement Ultrasound
Group Measurement
Group’ on
page 1-95.

CONTAINS INCLUDE DTID (300) Measurement =

Measurement AnatomyRatio

TID 5101 Vascular Patient Characteristics

Relation
with Concept Req Value Set
NL Parent Value Type Name VM Type Cond. Constraint

1 CONTAINER EV (1251118, 1 M
DCM,
"Patient
Characteristic
s")

> CONTAINS NUM EV (121033, 1 U Units = DCID

DCM, (7456) Units of
"Subject Measure for Age 1-92
Age")
 Relation
with Concept Req Value Set
NL Parent Value Type Name VM Type Cond. Constraint

> CONTAINS CODE EV (121032, 1 U

DCM,
"Subject
Sex")

> CONTAINS NUM EV (8867-4, 1 U

LN, "Heart
Rate")

> CONTAINS NUM EV (F-008EC, 1 M

SRT, "Systolic
Blood
Pressure")

CONTAINS NUM EV (F-008ED, 1 M

SRT,
"Diastolic
Blood
Pressure")

1-93
TID 5102 Vascular Procedure Summary Section

Relation
N with Concept V Req Value Set
L Parent Value Type Name M Type Cond. Constraint

1 CONTAINER DT (121111, 1 M
DCM,
"Summary")

> CONTAINS TEXT EV (121106, 1 M

DCM,
"Comment")

TID 5103 Vascular Ultrasound Section (extended)

Relation
N with Concept V Req Value Set
L Parent Value Type Name M Type Cond. Constraint

1 CONTAINER DT (121070, 1 M
DCM,
"Findings")

> HAS CODE EV (G-C0E3, 1 M See ‘GEU

CONCEPT SRT, "Finding Applications and
MOD Site") Extensions’ on
page 1-95,
$Section scope

> HAS CODE EV (G-C171, 1 U See ‘GE Ultrasound

CONCEPT SRT, Sidedness and
MOD "Laterality") Vessel Location’ on
page 1-105.

> HAS CODE EV (G-0373, 1 M See ‘GE Ultrasound

CONCEPT SRT, "Image Modes’ on
MOD Mode") page 1-105.

> CONTAINS INCLUDE DTID (5104) 1 M See ‘TID 5104

Vascular Vascular
Measurement Ultrasound
Group Measurement
Group’ on
page 1-95.

> CONTAINS INCLUDE DTID (300) 1 U $Measurement =

Measurement $AnatomyRatio

1-94
TID 5104 Vascular Ultrasound Measurement Group

Relation
with Concept Req Value Set
NL Parent Value Type Name VM Type Cond. Constraint

1 CONTAINER $Anatomy 1 M See ‘GEU

GEU Applications and
Parameters Extensions’ on
page 1-95,
Anatomy GEU
Parameter

> HAS CODE EV (G-A1F8, 1 U See ‘GE

CONCEPT SRT, Ultrasound
MOD "Topographic Sidedness and
al Modifier") Vessel Location’
on page 1-105.

> CONTAINS INCLUDE DTID (300) 1-n U $Measurement =

Measurement See ‘SR Mapping
Table for Vascular
Base
Measurement
Concept’ on
page 1-107.
$Derivation =
DCID (3626)
Measurement
Type

GEU Applications and Extensions

GEU Parameters
Section Section Anatomy BASE MEASUREMENT CONCEPT
Scope Laterality Anatomy Ratio NAME

DT (121070, EV
DCM, (G-C171,
"Findings") SRT,
"Laterality")

1-95
 GEU Parameters
Section Section Anatomy BASE MEASUREMENT CONCEPT
Scope Laterality Anatomy Ratio NAME

(T-40501, (G-A101, DCID Anatomy GEU Code and Description

SRT, "Blood SRT, "Left") 12105 parameter
Vessel of for Left, Intracranial
Head") (G-A100, Cerebral ICA (T-45300, SRT, "Internal
SRT, Vessels Carotid Artery")
"Right") for Or
Right. DCID MCA G (T-45600, SRT,
"Middle Cerebral Artery")
or 12106
(G-A103, Intracranial ACA (T-45540, SRT, "Anterior
SRT, Cerebral
Cerebral Artery")
"Unilateral") Vessels
(Unilateral) PCA (T-45900, SRT,
"Posterior Cerebral
Artery")

PComA (T-45320, SRT,

"Posterior
Communicating Artery")

AComA (T-45530, SRT, "Anterior

Communicating Artery")

VERT (T-45700, SRT,

"Vertebral Artery")

BA (T-45800, SRT, "Basilar

Artery")

TABLE 15.6.1 TCD Study Folder Code

Maps

(T-45005, (G-A101, DCID DCID 12123 Anatomy GEU Code and Description
SRT, "Artery SRT, "Left") 12104 Carotid parameter
of neck”) for Left, Extracrania Ratios
or l Arteries
(G-A100,
SRT,
"Right") for
Right.

1-96
 GEU Parameters
Section Section Anatomy BASE MEASUREMENT CONCEPT
Scope Laterality Anatomy Ratio NAME

VERT (T-45700, SRT,

"Vertebral Artery")

CCA (T-45100, SRT,

"Common Carotid
Artery")

ICA (T-45300, SRT, "Internal

Carotid Artery")

BULB (T-45170, SRT, "Carotid

Bulb")

ECA (T-45200, SRT, "External

Carotid Artery")

SUBC (T-46100, SRT,

"Subclavian Artery")

BIF (SRT, T-45160, "Carotid

Bifurcation")

TABLE 15.6.2 Carotid Study Folder Code

Maps

1-97
 GEU Parameters
Section Section Anatomy BASE MEASUREMENT CONCEPT
Scope Laterality Anatomy Ratio NAME

(T-47040, (G-A101, DCID Anatomy GEU Code and Description

SRT, "Artery SRT, "Left") 12109 parameter
of Lower for Left, Lower
Extremity") or Extremity ComIliac (T-46710, SRT,
(G-A100, Arteries "Common Iliac Artery")
SRT, or
"Right") for DCID ExtIliac(EIA) (T-46910, SRT, "External
Iliac Artery")
Right. 12112
Or Abdominal ComFemoral (T-47400, SRT,
(G-A103, Arteries
(CFA) "Common Femoral
SRT, (unilateral)
Artery")
"Unilateral")
SupFemoral (T-47403, SRT,
(SFA) "Superficial Femoral
Artery")

Popliteal (Pop (T-47500, SRT,

A) "Popliteal Artery")

AntTibial (ATA) (T-47700, SRT, "Anterior

Tibial Artery")

PostTibial T-47600, SRT, "Posterior

(PTA) Tibial Artery")

Peroneal (T-47630, SRT,

(Peron A) "Peroneal Artery")

DorsPedis (T-47741, SRT, "Dorsalis

(DPA) Pedis Artery")

DeepFemoral (T-47440, SRT,

(DFA) "Profunda Femoris
Artery")

Profunda(Pro) (T-47440, SRT,

"Profunda Femoris
Artery")

Aorta (T-4200, SRT, "Aorta")

TABLE 15.6.3 LEA Study Folder Code

Maps

1-98
 GEU Parameters
Section Section Anatomy BASE MEASUREMENT CONCEPT
Scope Laterality Anatomy Ratio NAME

(T-49403, (G-A101, DCID Anatomy GEU Code and Description

SRT, "Vein of SRT, "Left") 12110 parameter
Lower for Left, Lower
Extremity") or Extremity Popliteal (T-49640, SRT,
(G-A100, of Veins "Popliteal Vein")
SRT, or
"Right") for DCID LSaphenous (T-49550, SRT, "Lesser
Saphenous Vein")
Right. 12114
Or Abdominal AntTibial (T-49630, SRT, "Anterior
(G-A103, Veins
Tibial Vein")
SRT, (unilateral)
"Unilateral") PostTibial (T-49620, SRT,
"Posterior Tibial Vein")

Peroneal (T-49650, SRT,

"Peroneal Vein")

Profunda (T-49660, SRT,

"Profunda Femoris
Vein")

ExtIliac (T-48930, SRT, "External

Iliac Vein")

ComFemoral (G-035B, SRT,

"Common Femoral
Vein")

ComIliac (T-48920, SRT,

"Common Iliac Vein")

Great (T-49530, SRT, "Great

saphenous Saphenous Vein")

Femoral (G-035B, SRT, "Femoral

Vein")

IVC (T-48710, SRT, "Inferior

Vena Cava")

DeepFemoral (T-49660, SRT,

"Profunda Femoris
Vein")

TABLE 15.6.4 LEV Study Folder Code

Maps

1-99
 GEU Parameters
Section Section Anatomy BASE MEASUREMENT CONCEPT
Scope Laterality Anatomy Ratio NAME

(T-47020, (G-A101, DCID Anatomy GEU Code and Description

SRT, "Artery SRT, "Left") (12107) parameter
of Upper for Left Upper
Extremity") or Extremity SUBC (T-46100, SRT,
(G-A100, Arteries "Subclavian artery")
SRT,
"Right") for Axill (T-47100, SRT, "Axillary
artery")
Right.
BrachialA (T-47160, SRT, "Brachial
artery")

RadialA (T-47300, SRT, "Radial

artery")

UlnarA (T-47200, SRT, "Ulnar

artery")

Palmar (T-47340, SRT, "Deep

Palmar Arch of Radial
Artery")

Innominate (T-46010, SRT,

"Innominate Artery")

TABLE 15.6.5 UEA Study Folder Code

Maps

1-100
 GEU Parameters
Section Section Anatomy BASE MEASUREMENT CONCEPT
Scope Laterality Anatomy Ratio NAME

(T-49103, (G-A101, DCID Anatomy GEU Code and Description

SRT, "Vein of SRT, "Left") 12108 parameter
Upper for Left, Upper
Extremity") or Extremity JugularV (T-48170, SRT, "Internal
(G-A100, Veins Jugular vein")
SRT,
"Right") for InnoV (T-48620, SRT,
"Innominate vein")
Right.
SUBCV (T-48330, SRT,
"Subclavian vein")

AxillV (T-49110, SRT, "Axillary

vein")

CephV (T-49240, SRT,

"Cephalic vein")

BasilV (T-48052, SRT, "Basilic

vein")

BracV (T-49350, SRT, "Brachial

vein")

McubV (T-49250, SRT, "Median

Cubital vein")

RadialV (T-49340, SRT, "Radial

vein")

UlnarV (T-49330, SRT, "Ulnar

vein")

TABLE 15.6.6 UEV Study Folder Code

Maps

1-101
 GEU Parameters
Section Section Anatomy BASE MEASUREMENT CONCEPT
Scope Laterality Anatomy Ratio NAME

(T-71019, (G-A101, DCID DCID 12124 Anatomy GEU Code and Description
SRT, SRT, "Left") 12115 Renal parameter
"Vascular for Left, Renal Ratios
Structure of or Vessels MRenalA (T-46600, SRT, "Renal
Kidney") (G-A100, Artery")
SRT,
"Right") for RenalV (T-48740, SRT, "Renal
Vein")
Right.
SegmentalA (T-46659, SRT,
"Segmental Artery")

InterlobarA (T-4667D, SRT,

"Interlobar Artery of
Kidney")

ArcurateA (T-4668A, SRT, "Arcuate

Artery of the Kidney")

Aorta (T-4200, SRT, "Aorta")

TABLE 15.6.7 Renal Study Folder Code

Maps

1-102
 GEU Parameters
Section Section Anatomy BASE MEASUREMENT CONCEPT
Scope Laterality Anatomy Ratio NAME

(T-46002, (G-A101, DCID Anatomy GEU Code and Description

SRT, "Artery SRT, "Left") 12111 or parameter
of Abdomen") for Left, 12112
(G-A100, Abdominal Aorta (T-42000, SRT, "Aorta")
SRT, Arteries
"Right") for Celiac (T-46400, SRT, "Celiac
(lateral or
Right. unilateral). Axis")
Or DCID
CHA (T-46421, SRT,
(G-A103, 12113 or "Common Hepatic
SRT, 12114
Artery")
"Unilateral") Abdominal
Veins Splenic A (T-46460, SRT, "Splenic
(lateral or Artery")
unilateral)
or SMA (T-46510, SRT, "Superior
DCID Mesenteric Artery")
12115
Renal IMA (T-46520, SRT, "Inferior
Vessels Mesenteric Artery")

MRenalA (T-46600, SRT, "Renal

Artery")

RenalV (T-48740, SRT, "Renal

Vein")

SegmentalA (T-46659, SRT,

"Segmental Artery")

InterlobarA (T-4667D, SRT,

"Interlobar Artery of
Kidney")

ArcurateA (T-4668A, SRT, "Arcuate

Artery of the Kidney")

CIA (T-46710, SRT,

"Common Iliac Artery")

PrHepatic (T-46422, SRT, "Proper

Hepatic Artery")

GDA (T-46440, SRT,

Gastroduodenal Artery)

IVC (T-48710, SRT, "Inferior

Vena Cava")

Splenic V (T-48890, SRT, Splenic

Vein")

Hepatic V (T-48720, SRT, Hepatic

Vein")
1-103
 GEU Parameters
Section Section Anatomy BASE MEASUREMENT CONCEPT
Scope Laterality Anatomy Ratio NAME

MHV (T-48726, SRT, Middle

Hepatic Vein")

MPV (GEU-1004-65,
99GEMS, "Main Branch
of Portal Vein")

Portal V (T-48810, SRT, "Portal

Vein")

SMV (T-48840, SRT, "Superior

Mesenteric Vein")

TIPS (G-036C, SRT,

"Transjugular
Intrahepatic
Portosystemic Shunt")

CIV (T-48920, SRT,

"Common Iliac Vein")

TABLE 15.6.8 Abdomen Study Folder Code

Maps

1-104
TID 300 Measurement

Relation
with Concept Req Value Set
NL Parent Value Type Name VM Type Cond. Constraint

1 NUM $Measurement 1 M Units = $Units

4 > HAS CODE EV(G-A1F8, 1 U See ‘GE

CONCEPT SRT, Ultrasound
MOD "Topographical Sidedness and
modifier") Vessel Location’
on page 1-105.

5 > HAS CODE EV(121401, 1 U See ‘Derivation

CONCEPT DCM, and Selection’ on
MOD "Derivation") page 1-108.

6 > HAS CODE EV(121404, 1 U See ‘Derivation

CONCEPT DCM, and Selection’ on
MOD "Selection page 1-108.
Status")

GE Ultrasound Modes

GE Ultrasound Modes Code Value

2D (G-03A2, SRT, "2D mode")

CF (R-409E2, SRT, "Doppler Color Flow")

PW (R-409E4, SRT, "Doppler Pulsed")

MM (G-0394, SRT, "M mode")

CW (R-409E3, SRT, "Doppler Continuous Wave")

GE Ultrasound Sidedness and Vessel Location

Side Code Value

Rt (G-A100, SRT, "Right")

Lt (G-A101, SRT, "Left")

Vessel Location Code Value

Prox (G-A118, SRT, "Proximal")

Mid (G-A188, SRT, "Mid-longitudinal")

Dist (G-A119, SRT, "Distal") 1-105

NOTE: When there is no Sidedness or Locations, the SR nodes are not
populated.

1-106
SR Mapping Table for Vascular Base Measurement Concept

PWD-Mode Measurements

GEU Measurement Parameter Standard Measurement Concept Name

PS (11726-7, LN, "Peak Systolic Velocity")

ED (11653-3, LN, "End Diastolic Velocity")

MD (11665-7, LN, "Minimum Diastolic Velocity")

Tamax (11692-1, LN, "Time averaged peak velocity")

PI (12008-9, LN, "Pulsatility Index")

RI (12023-8, LN, "Resistivity Index")

PV (11726-7, LN, Peak Velocity)

SD Ratio (12144-2, LN, "Systolic to Diastolic Velocity Ratio")

DS Ratio (122218, DCM, “Diastolic/Systolic Velocity Ratio”)

Accel (20167-3, LN, "Acceleration Index")

AT (20168-1, LN, "Acceleration Time")

TAMEAN (20352-1, LN, "Time averaged mean velocity")

VOLFLOW (33878-0, LN, "Volume flow")

ICACCA Ratio (PS) (33868-1, LN, "ICA/CCA velocity")

HR (Heart Rate) (8867-4, LN, Heart Rate)

AC (GEU-1004-9, 99GEMS, "Angular Correction")

RAR (33869-9, LN, "Renal Artery/Aorta velocity ratio")

Vascular B-Mode Measurements

GEU Measurement Parameter Standard Measurement Concept Name

DiamStenD1/D2 (G-0364 , SRT, " Vessel Lumen Diameter")

AreaStenA1/A2 (G-0366, SRT, "Vessel Lumen Cross-Sectional Area")

StenosisD (R-101BB, SRT, " Lumen Diameter Stenosis")

StenosisA (R-101BA, SRT, "Lumen Area Stenosis")

IMT Ant Avg (GEU-1005-20, 99GEMS, "IMT Anterior Average")

IMT Ant Max (GEU-1005-21, 99GEMS, "IMT Anterior Max")

IMT Ant Min (GEU-1005-22, 99GEMS, "IMT Anterior Min")

1-107
IMT Ant SD (GEU-1005-23, 99GEMS, "IMT Anterior SD")
 GEU Measurement Parameter Standard Measurement Concept Name

IMT Ant nMeas (GEU-1005-24, 99GEMS, "IMT Anterior nMeas")

IMT Post Avg (GEU-1005-26, 99GEMS, "IMT Posterior Average")

IMT Post Max (GEU-1005-27, 99GEMS, "IMT Posterior Max")

IMT Post Min (GEU-1005-28, 99GEMS, "IMT Posterior Min")

IMT Post SD (GEU-1005-29, 99GEMS, "IMT Posterior SD")

IMT Post nMeas (GEU-1005-30, 99GEMS, "IMT Posterior nMeas")

Derivation and Selection

GEU Name Derivation Selection

Av Mean User chosen value

Mx Maximum User chosen value

Mn Minimum User chosen value

Lt Most recent value chosen User chosen value

* (decided by another parameter) Best Value User chosen value

1-108
 Chapter 2

OB Tables

Reference for Obstetric Measurement Tables.

2 -1
 OB Tables

ASUM
Table 2-1: AC: ASUM, Deler (Fetal Age)Unit: AC (mm); Age (Days); 2SD (Days)

AC Age 2SD AC Age 2SD AC Age 2SD AC Age 2SD

<35 n/a —— 126 126 10 228 189 14 331 252 18

35 70 8 137 133 10 240 196 14 342 259 18
46 77 8 149 140 10 251 203 14 354 266 20
57 84 8 160 147 10 263 210 14 365 273 20
69 91 8 171 154 10 274 217 14 377 280 20
80 98 9 183 161 10 285 224 16 >377 n/a ——
92 105 9 194 168 12 297 231 16
103 112 9 206 175 12 308 238 18
114 119 9 217 182 12 320 245 18

Table 2-2: BPD: ASUM, Aust NZ, Obstet Gynaecol 1989: 29:26 (Fetal Age)Unit: BPD
(mm); Age (Week); 2SD (Week - * signifies No Data)

BPD Age 2SD BPD Age 2SD BPD Age 2SD BPD Age 2SD

<20 n/a —— 40 123 8 61 171 13 82 225 18

20 84 4 41 126 9 62 173 13 83 228 18
21 86 4 42 128 9 63 176 14 84 231 19
22 88 4 43 130 9 64 178 14 85 234 0
23 90 4 44 132 9 65 181 14 86 237 0
24 92 5 45 134 9 66 183 14 87 240 0
25 94 5 46 136 10 67 186 15 88 244 0
26 95 5 47 139 10 68 188 15 89 247 0
27 97 5 48 141 10 69 191 15 90 251 0
28 99 5 49 143 10 70 193 15 91 255 0
29 101 6 50 145 11 71 196 16 92 259 0
30 103 6 51 147 11 72 199 16 93 264 0
31 105 6 52 149 11 73 201 16 94 270 0
32 107 6 53 152 11 74 204 16 95 276 0
33 109 7 54 154 12 75 206 17 96 284 0
34 111 7 55 157 12 76 209 17 97 292 0
35 113 7 56 159 12 77 212 17 98 301 0
36 115 7 57 161 12 78 214 17 >98 n/a ——
37 117 8 58 164 13 79 217 17
38 119 8 59 166 13 80 220 18
39 121 8 60 169 13 81 222 18
2 -2
Table 2-3: CRL: ASUM, Silva et al 1991.6 (Fetal Age)Unit: CRL (mm); Age (Days);
2SD (* No Data available)

CRL Age 2SD CRL Age 2SD CRL Age 2SD CRL Age 2SD

<2 n/a —— 16 56 * 34 71 * 58 86 *
2 42 * 17 57 * 36 72 * 60 87 *
3 43 * 18 58 * 37 73 * 62 88 *
4 44 * 19 59 * 38 74 * 64 89 *
5 45 * 20 60 * 40 75 * 66 90 *
6 46 * 22 61 * 41 76 * 68 91 *
7 47 * 23 62 * 43 77 * 70 92 *
8 48 * 24 63 * 45 78 * 72 93 *
9 49 * 25 64 * 46 79 * 74 94 *
10 50 * 26 65 * 48 80 * 76 95 *
11 51 * 27 66 * 50 81 * 78 96 *
12 52 * 29 67 * 51 82 * 80 97 *
13 53 * 30 68 * 53 83 * 82 98 *
14 54 * 31 69 * 55 84 * >82 n/a ——
15 55 * 33 70 * 57 85 *

2 -3
Berkowitz
Table 2-4: BD: Berkowitz (Fetal Age)Unit: BD (mm); Age (Day); SD (mm)

BD Age SD BD Age SD BD Age SD BD Age SD

<13 n/a —— 25 112 0 38 155 0 51 217 0

13 81 0 26 116 0 39 159 0 52 223 0
14 82 0 27 120 0 40 162 0 53 230 0
15 84 0 28 124 0 41 166 0 54 237 0
16 86 0 29 128 0 42 169 0 55 244 0
17 88 0 30 130 0 43 173 0 56 251 0
18 91 0 31 132 0 44 179 0 57 258 0
19 95 0 32 135 0 45 185 0 58 266 0
20 98 0 33 138 0 46 191 0 59 275 0
21 102 0 34 142 0 47 197 0 >59 n/a ——
22 105 0 35 145 0 48 202 0
23 109 0 36 149 0 49 207 0
24 110 0 37 152 0 50 212 0

Brenner
Table 2-5: EFW: Brenner (Fetal Growth)GP, Table/Graph Range = 10%: 90%Age
(Weeks); Mini/Mean/Max (grams)

Age Min Mean Max Age Min Mean Max

21.0 280 410 860 33.0 1480 2010 2690

22.0 320 480 920 34.0 1670 2220 2880
23.0 370 550 990 35.0 1870 2430 3090
24.0 420 640 1080 36.0 2190 2650 3290
25.0 490 740 1180 37.0 2310 2870 3470
26.0 570 860 1320 38.0 2510 3030 3610
27.0 660 990 1470 39.0 2680 3170 3750
28.0 770 1150 1660 40.0 2750 3280 3870
29.0 890 1310 1890 41.0 2800 3360 3980
30.0 1030 1460 2100 42.0 2830 3410 4060
31.0 1180 1630 2290 43.0 2840 3420 4100
32.0 1310 1810 2500 44.0 2790 3390 4110

2 -4
Campbell
Table 2-6: HC/AC Ratio: Campbell, Br J Obstet Gynaecol 1977, 84:165-174 (Fetal
Growth)Unit: GA (Weeks); Min/Max (Index)

GA Min Max GA Min Max GA Min Max

<13 n/a —— 23 1.05 1.21 35 0.93 1.11

13 1.14 1.31 25 1.04 1.22 37 0.92 1.05
15 1.05 1.39 27 1.05 1.22 39 0.87 1.06
17 1.07 1.29 29 0.99 1.21 41 0.93 1.00
19 1.09 1.26 31 0.96 1.17 >42 n/a n/a
21 1.06 1.25 33 0.96 1.11

Eriksen
Table 2-7: TAD: Eriksen (Fetal Age)Unit: TAD (mm); Age (Day); SD (mm)

TAD Age SD TAD Age SD TAD Age SD TAD Age SD

<23 n/a —— 45 134 0 68 182 0 91 232 0

23 91 0 46 136 0 69 184 0 92 234 0
24 93 0 47 138 0 70 186 0 93 236 0
25 95 0 48 140 0 71 188 0 94 239 0
26 97 0 49 142 0 72 190 0 95 241 0
27 99 0 50 144 0 73 192 0 96 243 0
28 101 0 51 146 0 74 195 0 97 245 0
29 103 0 52 148 0 75 197 0 98 247 0
30 105 0 53 150 0 76 199 0 99 250 0
31 107 0 54 152 0 77 201 0 100 252 0
32 109 0 55 154 0 78 203 0 101 254 0
33 111 0 56 156 0 79 206 0 102 256 0
34 113 0 57 158 0 80 208 0 103 259 0
35 115 0 58 161 0 81 210 0 104 261 0
36 117 0 59 163 0 82 212 0 105 263 0
37 119 0 60 165 0 83 214 0 106 266 0
38 120 0 61 167 0 84 217 0 107 268 0
39 122 0 62 169 0 85 219 0 108 270 0
40 124 0 63 171 0 86 221 0 109 273 0
41 126 0 64 173 0 87 223 0 110 275 0
42 128 0 65 175 0 88 225 0 111 277 0
43 130 0 66 177 0 89 228 0 112 280 0
44 132 0 67 179 0 90 230 0 >112 n/a ——

2 -5
Goldstein
Table 2-8: TCD: Goldstein et a, Am J OB/GYN, May 1987 (Fetal Growth)Unit: TCD
(Weeks); Age/Quat1/Mean/Quat3/Max (mm)

Age Min Quat1 Mean Quat3 Max

15 10 12 14 15 16
16 14 16 16 16 17
17 16 17 17 18 18
18 17 18 18 19 19
19 18 18 19 19 22
20 18 19 20 20 22
21 19 20 22 23 24
22 21 23 23 24 24
23 22 23 24 25 26
24 22 24 25 27 28
25 23 21.5 28 28 29
26 25 28 29 30 32
27 26 28.5 30 31 32
28 27 30 31 32 34
29 29 32 34 36 38
30 31 32 35 37 40
31 32 35 38 39 43
32 33 36 38 40 42
33 32 36 40 43 44
34 33 38 40 41 44
35 31 37 40.5 43 47
36 36 29 43 52 55
37 37 37 45 52 55
38 40 40 48.5 52 55
39 52 52 52 55 55

2 -6
Hadlock
Table 2-9: AC: Hadlock, Radiology 1984, Vol. 152:497 (Fetal Age)Unit: AC (mm); Age
(Week); 2SD (Week)

AC Age 2SD AC Age 2SD AC Age 2SD AC Age 2SD

<50 n/a —— 135 19.0 ± 2.1 225 26.9 ± 2.2 315 35.4 ± 3.0
50 12.0 ± 1.7 140 19.4 ± 2.1 230 27.4 ± 2.2 320 35.9 ± 3.0
55 12.4 ± 1.7 145 19.8 ± 2.1 235 27.8 ± 2.2 321 36.0 ± 3.1
60 12.8 ± 1.7 150 20.2 ± 2.1 240 28.3 ± 2.2 325 36.4 ± 3.1
65 13.2 ± 1.7 155 20.7 ± 2.1 245 28.7 ± 2.2 330 36.9 ± 3.1
70 13.6 ± 1.7 160 21.1 ± 2.1 250 29.2 ± 2.2 335 37.4 ± 3.1
75 14.0 ± 1.7 165 21.5 ± 2.1 255 29.7 ± 2.2 340 37.9 ± 3.1
80 14.4 ± 1.7 170 22.0 ± 2.1 258 30.0 ± 2.2 345 38.4 ± 3.1
85 14.8 ± 1.7 175 22.4 ± 2.1 259 30.1 ± 3.0 350 38.9 ± 3.1
90 15.2 ± 1.7 180 22.9 ± 2.1 260 30.2 ± 3.0 355 39.4 ± 3.1
95 15.6 ± 1.7 185 23.3 ± 2.1 265 30.6 ± 3.0 360 39.9 ± 3.1
100 16.0 ± 1.7 190 23.7 ± 2.1 270 31.1 ± 3.0 365 40.4 ± 3.1
105 16.4 ± 1.7 192 23.9 ± 2.1 275 31.6 ± 3.0 370 40.9 ± 3.1
110 16.9 ± 1.7 193 24.0 ± 2.2 280 32.0 ± 3.0 375 41.4 ± 3.1
115 17.3 ± 1.7 195 24.2 ± 2.2 285 32.5 ± 3.0 380 42.0 ± 3.1
120 17.7 ± 1.7 200 24.6 ± 2.2 290 33.0 ± 3.0 385 42.5 ± 3.1
123 17.9 ± 1.7 205 25.1 ± 2.2 295 33.5 ± 3.0 >385 n/a ——
124 18.0 ± 2.1 210 25.5 ± 2.2 300 34.0 ± 3.0
125 18.1 ± 2.1 215 26.0 ± 2.2 305 34.5 ± 3.0
130 18.5 ± 2.1 220 26.4 ± 2.2 310 34.9 ± 3.0

Table 2-10: AC: Hadlock, AJR; 139: 367-370; 1982 (Fetal Age)Unit: AC (mm); Age
(Days); SD (Days)

AC Age SD AC Age SD AC Age SD AC Age SD

<47 n/a —— 138 133 14 230 189 15 305 241 21

47 84 13 144 136 14 235 192 15 310 245 21
53 87 13 151 140 14 241 196 15 314 248 21
60 91 13 157 143 14 246 199 15 319 252 21
67 94 13 163 147 14 251 203 15 323 255 18
74 98 13 174 154 14 256 206 15 328 259 18
80 101 13 180 157 14 261 210 15 332 262 18
87 105 13 186 161 14 266 213 21 337 266 18
93 106 13 192 164 14 271 217 21 341 269 18
100 112 13 197 168 14 276 220 21 344 273 18
106 115 13 203 171 15 281 224 21 349 276 18
113 119 13 208 175 15 286 227 21 353 280 18
119 122 13 214 178 15 291 231 21 >353 n/a ——
126 126 13 219 182 15 296 234 21
132 129 14 225 185 15 300 238 21

2 -7
 Table 2-11: BPD: Hadlock, Radiology 1984, Vol. 152:497 (Fetal Age) aUnit: BPD
(mm); Age (Week); 2SD (Week)

BPD Age 2SD BPD Age 2SD BPD Age 2SD BPD Age 2SD

<14 n/a —— 36 17.0 ± 1.2 59 24.1 ± 2.2 82 33.0 ± 3.1

14 11.9 ± 1.2 37 17.3 ± 1.2 60 24.5 ± 2.2 83 33.4 ± 3.1
15 12.1 ± 1.2 38 17.6 ± 1.2 61 24.8 ± 2.2 84 33.8 ± 3.1
16 12.3 ± 1.2 39 17.9 ± 1.2 62 25.2 ± 2.2 85 34.2 ± 3.1
17 12.5 ± 1.2 40 18.1 ± 1.7 63 25.5 ± 2.2 86 34.7 ± 3.1
18 12.8 ± 1.2 41 18.4 ± 1.7 64 25.9 ± 2.2 87 35.1 ± 3.1
19 13.0 ± 1.2 42 18.7 ± 1.7 65 26.3 ± 2.2 88 35.6 ± 3.1
20 13.2 ± 1.2 43 19.0 ± 1.7 66 26.6 ± 2.2 89 36.0 ± 3.2
21 13.4 ± 1.2 44 19.3 ± 1.7 67 27.0 ± 2.2 90 36.5 ± 3.2
22 13.6 ± 1.2 45 19.6 ± 1.7 68 27.4 ± 2.2 91 36.9 ± 3.2
23 13.8 ± 1.2 46 19.9 ± 1.7 69 27.7 ± 2.2 92 37.4 ± 3.2
24 14.1 ± 1.2 47 20.2 ± 1.7 70 28.1 ± 2.2 93 37.8 ± 3.2
25 14.3 ± 1.2 48 20.5 ± 1.7 71 28.5 ± 2.2 94 38.3 ± 3.2
26 14.5 ± 1.2 49 20.8 ± 1.7 72 28.9 ± 2.2 95 38.7 ± 3.2
27 14.8 ± 1.2 50 21.1 ± 1.7 73 29.3 ± 2.2 96 39.2 ± 3.2
28 15.0 ± 1.2 51 21.5 ± 1.7 74 29.7 ± 2.2 97 39.7 ± 3.2
29 15.2 ± 1.2 52 21.8 ± 1.7 75 30.1 ± 3.1 98 40.2 ± 3.2
30 15.5 ± 1.2 53 22.1 ± 1.7 76 30.5 ± 3.1 99 40.6 ± 3.2
31 15.7 ± 1.2 54 22.4 ± 1.7 77 30.9 ± 3.1 100 41.1 ± 3.2
32 16.0 ± 1.2 55 22.8 ± 1.7 78 31.3 ± 3.1 101 41.6 ± 3.2
33 16.3 ± 1.2 56 23.1 ± 1.7 79 31.7 ± 3.1 102 42.1 ± 3.2
34 16.5 ± 1.2 57 23.4 ± 1.7 80 32.1 ± 3.1 103 42.6 ± 3.2
35 16.8 ± 1.2 58 23.8 ± 1.7 81 32.5 ± 3.1 >103 n/a ——

a.Variability of GA estimate by BPD at term is ± 2 SD (6 weeks)

Table 2-12: BPD: Hadlock, J Ultrasound Med 1:97-104, April 1982 (Fetal Age)Unit:
BPD (mm); Age (Days ); SD (Days)

BPD Age 2SD BPD Age 2SD BPD Age 2SD BPD Age 2SD

<20 n/a —— 40 126 10 61 175 9 82 233 14

20 85 6 41 128 10 62 177 9 83 237 14
21 88 6 42 130 10 63 180 9 84 239 14
22 90 6 43 132 10 64 183 9 85 243 14
23 92 6 44 134 10 65 185 9 86 246 14
24 93 6 45 137 10 66 188 9 87 249 14
25 95 6 46 139 10 67 190 9 88 253 25
26 97 6 47 141 10 68 193 9 89 256 25
27 99 6 48 144 10 69 196 9 90 259 25
28 102 6 49 146 10 70 198 9 91 263 25
29 103 6 50 148 10 71 201 9 92 266 25
30 105 6 51 151 10 72 204 9 93 270 25
31 107 6 52 153 10 73 207 9 94 272 25
32 109 6 53 155 10 74 209 9 95 276 25
33 111 6 54 158 10 75 213 14 96 279 25
34 113 6 55 160 10 76 216 14 97 284 25
35 116 6 56 162 10 77 218 14 98 287 25
36 118 6 57 163 10 78 221 14 99 291 25
37 120 6 58 167 10 79 224 14 100 294 25
38 122 6 59 169
2 -8
9 80 228 14 >100 n/a ——
39 124 6 60 172 9 81 230 14
 Table 2-13: CI: Hadlock, AJR, 137: 83, 1981 (Fetal Growth)

Min (Index) Max (Index)

70 86

Table 2-14: CRL: Hadlock, Radiology 1992, Vol. 182:501 (Fetal Age)Unit: CRL (mm);
Age (Week); SD (Week)

CRL Age SD CRL Age SD CRL Age SD CRL Age SD

<2 n/a —— 32 10.1 ± 0.5 63 12.7 ± 0.6 94 15.3 ± 0.7

2 5.7 ± 0.3 33 10.2 ± 0.5 64 12.8 ± 0.6 95 15.3 ± 0.7
3 5.9 ± 0.3 34 10.3 ± 0.5 65 12.8 ± 0.6 96 15.4 ± 0.7
4 6.1 ± 0.3 35 10.4 ± 0.5 66 12.9 ± 0.6 97 15.5 ± 0.7
5 6.2 ± 0.3 36 10.5 ± 0.5 67 13.0 ± 0.6 98 15.6 ± 0.7
6 6.4 ± 0.3 37 10.6 ± 0.5 68 13.1 ± 0.6 99 15.7 ± 0.7
7 6.6 ± 0.3 38 10.7 ± 0.5 69 13.1 ± 0.6 100 15.9 ± 0.7
8 6.7 ± 0.3 39 10.8 ± 0.5 70 13.2 ± 0.6 101 16.0 ± 0.7
9 6.9 ± 0.3 40 10.9 ± 0.5 71 13.3 ± 0.6 102 16.1 ± 0.7
10 7.1 ± 0.3 41 11.0 ± 0.5 72 13.4 ± 0.6 103 16.2 ± 0.7
11 7.2 ± 0.3 42 11.1 ± 0.5 73 13.4 ± 0.6 104 16.3 ± 0.7
12 7.4 ± 0.3 43 11.2 ± 0.5 74 13.5 ± 0.6 105 16.4 ± 0.7
13 7.5 ± 0.3 44 11.2 ± 0.5 75 13.6 ± 0.6 106 16.5 ± 0.7
14 7.7 ± 0.3 45 11.3 ± 0.5 76 13.7 ± 0.6 107 16.6 ± 0.7
15 7.9 ± 0.4 46 11.4 ± 0.5 77 13.8 ± 0.6 108 16.7 ± 0.7
16 8.0 ± 0.4 47 11.5 ± 0.5 78 13.8 ± 0.6 109 16.8 ± 0.7
17 8.1 ± 0.4 48 11.6 ± 0.5 79 13.9 ± 0.6 110 16.9 ± 0.8
18 8.3 ± 0.4 49 11.7 ± 0.5 80 14.0 ± 0.6 111 17.0 ± 0.8
19 8.4 ± 0.4 50 11.7 ± 0.5 81 14.1 ± 0.6 112 17.1 ± 0.8
20 8.6 ± 0.4 51 11.8 ± 0.5 82 14.2 ± 0.6 113 17.2 ± 0.8
21 8.7 ± 0.4 52 11.9 ± 0.5 83 14.2 ± 0.6 114 17.3 ± 0.8
22 8.9 ± 0.4 53 12.0 ± 0.5 84 14.3 ± 0.6 115 17.4 ± 0.8
23 9.0 ± 0.4 54 12.0 ± 0.5 85 14.4 ± 0.6 116 17.5 ± 0.8
24 9.1 ± 0.4 55 12.1 ± 0.5 86 14.5 ± 0.6 117 17.6 ± 0.8
25 9.2 ± 0.4 56 12.2 ± 0.5 87 14.6 ± 0.6 118 17.7 ± 0.8
26 9.4 ± 0.4 57 12.3 ± 0.5 88 14.7 ± 0.7 119 17.8 ± 0.8
27 9.5 ± 0.4 58 12.3 ± 0.5 89 14.8 ± 0.7 120 17.9 ± 0.8
28 9.6 ± 0.4 59 12.4 ± 0.6 90 14.9 ± 0.7 121 18.0 ± 0.8
29 9.7 ± 0.4 60 12.5 ± 0.6 91 15.0 ± 0.7 >121 n/a ——
30 9.9 ± 0.4 61 12.6 ± 0.6 92 15.1 ± 0.7
31 10.0 ± 0.4 62 12.6 ± 0.6 93 15.2 ± 0.7

2 -9
Table 2-15: EFW: Hadlock (Fetal Age)Unit: EFW (grams); Mean (Weeks); SD (grams)

EFW Mean 2SD EFW Mean 2SD EFW Mean 2SD

<35 n/a —— 399 21 51 2162 33 275

35 10 4 478 22 61 2377 34 302
45 11 6 568 23 72 2595 35 330
58 12 7 670 24 85 2813 36 357
73 13 9 785 25 101 3028 37 385
93 14 12 913 26 116 3236 38 411
117 15 15 1055 27 134 3435 39 436
146 16 19 1210 28 154 3619 40 460
181 17 23 1379 29 175 3787 41 481
223 18 28 1559 30 198 >3787 n/a ——
273 19 35 1751 31 222
331 20 42 1953 32 248

Table 2-16: FL: Hadlock, Radiology 1984, Vol. 152:497 (Fetal Age)Unit: FL (mm); Age
(Week); 2SD (Week)

FL Age 2SD FL Age 2SD FL Age 2SD FL Age 2SD

<6 n/a —— 25 17.6 ± 1.4 45 24.9 ± 2.1 65 33.5 ± 3.0

6 11.9 ± 1.4 26 17.9 ± 1.4 46 25.3 ± 2.1 66 34.0 ± 3.0
7 12.2 ± 1.4 27 18.2 ± 1.8 47 25.7 ± 2.1 67 34.5 ± 3.0
8 12.4 ± 1.4 28 18.6 ± 1.8 48 26.1 ± 2.1 68 34.9 ± 3.0
9 12.7 ± 1.4 29 18.9 ± 1.8 49 26.5 ± 2.1 69 35.4 ± 3.0
10 13.0 ± 1.4 30 19.3 ± 1.8 50 26.9 ± 2.1 70 35.9 ± 3.0
11 13.3 ± 1.4 31 19.6 ± 1.8 51 27.3 ± 2.1 71 36.4 ± 3.1
12 13.5 ± 1.4 32 20.0 ± 1.8 52 27.7 ± 2.1 72 36.9 ± 3.1
13 13.8 ± 1.4 33 20.3 ± 1.8 53 28.2 ± 2.1 73 37.4 ± 3.1
14 14.1 ± 1.4 34 20.7 ± 1.8 54 28.6 ± 2.1 74 37.9 ± 3.1
15 14.4 ± 1.4 35 21.0 ± 1.8 55 29.0 ± 2.1 75 38.4 ± 3.1
16 14.7 ± 1.4 36 21.4 ± 1.8 56 29.5 ± 2.1 76 38.9 ± 3.1
17 15.0 ± 1.4 37 21.8 ± 1.8 57 29.9 ± 2.1 77 39.4 ± 3.1
18 15.3 ± 1.4 38 22.2 ± 1.8 58 30.3 ± 3.0 78 39.9 ± 3.1
19 15.6 ± 1.4 39 22.5 ± 1.8 59 30.8 ± 3.0 79 40.4 ± 3.1
20 16.0 ± 1.4 40 22.9 ± 1.8 60 31.2 ± 3.0 80 40.9 ± 3.1
21 16.3 ± 1.4 41 23.3 ± 1.8 61 31.7 ± 3.0 81 41.4 ± 3.1
22 16.6 ± 1.4 42 23.7 ± 1.8 62 32.1 ± 3.0 82 42.0 ± 3.1
23 16.9 ± 1.4 43 24.1 ± 2.1 63 32.6 ± 3.0 83 42.5 ± 3.1
24 17.2 ± 1.4 44 24.5 ± 2.1 64 33.1 ± 3.0 >83 n/a ——

2-10
Table 2-17: FL: Hadlock, AJR 138: 875-878, May 1982 (Fetal Age)Unit: FL (mm); Age
(Days); 2SD (Days)

FL Age SD FL Age SD FL Age SD FL Age SD

<10 n/a —— 27 125 6 45 171 10 63 226 10

10 90 6 28 127 6 46 174 10 64 230 10
11 92 6 29 130 6 47 177 10 65 233 10
12 94 6 30 132 6 48 180 10 66 237 10
13 95 6 31 134 6 49 183 10 67 239 10
14 97 6 32 137 6 50 185 10 68 243 10
15 99 6 33 139 6 51 189 10 69 246 10
16 101 6 34 142 6 52 192 10 70 250 10
17 104 6 35 145 6 53 195 10 71 253 11
18 106 6 36 147 6 54 197 10 72 257 11
19 108 6 37 150 6 55 201 10 73 260 11
20 110 6 38 153 6 56 204 10 74 264 11
21 112 6 39 155 6 57 207 10 75 268 11
22 114 6 40 157 6 58 210 10 76 272 11
23 116 6 41 160 6 59 213 10 77 275 11
24 118 6 42 163 6 60 216 10 78 279 11
25 120 6 43 166 6 61 220 10 79 283 11
26 123 6 44 169 10 62 223 10 >79 n/a ——

Table 2-18: HC: Hadlock, Radiology 1984, Vol. 152:497 (Fetal Age)Unit: HC (mm);
Age (Week); 2SD (Week)

HC Age 2SD HC Age 2SD HC Age 2SD HC Age 2SD

<55 n/a —— 135 17.0 ± 1.2 215 23.6 ± 1.5 290 31.9 ± 3.0
55 12.0 ± 1.2 140 17.3 ± 1.2 219 23.9 ± 1.5 295 32.6 ± 3.0
60 12.3 ± 1.2 145 17.7 ± 1.2 220 24.0 ± 2.1 300 33.3 ± 3.0
65 12.6 ± 1.2 149 18.0 ± 1.2 225 24.5 ± 2.1 305 33.9 ± 3.0
70 12.8 ± 1.2 150 18.1 ± 1.5 230 25.0 ± 2.1 310 34.6 ± 3.0
75 13.1 ± 1.2 155 18.4 ± 1.5 235 25.5 ± 2.1 315 35.3 ± 3.0
80 13.4 ± 1.2 160 18.8 ± 1.5 240 26.1 ± 2.1 319 35.9 ± 3.0
85 13.7 ± 1.2 165 19.2 ± 1.5 245 26.6 ± 2.1 320 36.1 ± 2.7
90 14.0 ± 1.2 170 19.6 ± 1.5 250 27.1 ± 2.1 325 36.8 ± 2.7
95 14.3 ± 1.2 175 20.0 ± 1.5 255 27.7 ± 2.1 330 37.6 ± 2.7
100 14.7 ± 1.2 180 20.4 ± 1.5 260 28.3 ± 2.1 335 38.3 ± 2.7
105 15.0 ± 1.2 185 20.8 ± 1.5 265 28.9 ± 2.1 340 39.1 ± 2.7
110 15.3 ± 1.2 190 21.3 ± 1.5 270 29.4 ± 2.1 345 39.9 ± 2.7
115 15.6 ± 1.2 195 21.7 ± 1.5 274 29.9 ± 2.1 350 40.7 ± 2.7
120 16.0 ± 1.2 200 22.2 ± 1.5 275 30.0 ± 3.0 355 41.6 ± 2.7
125 16.3 ± 1.2 205 22.6 ± 1.5 280 30.7 ± 3.0 360 42.4 ± 2.7
130 16.6 ± 1.2 210 23.1 ± 1.5 285 31.3 ± 3.0 >360 n/a ——

2-11
Table 2-19: HC: Hadlock, AJR 138: 649-653, 1982 (Fetal Age)Unit: HC (mm); Age
(Days); 2SD (Days)

HC Age SD HC Age SD HC Age SD HC Age SD

<69 n/a —— 169 136 11 260 196 16 322 252 19

69 84 9 175 140 11 264 199 16 325 255 24
75 87 9 181 143 11 269 203 16 328 259 24
81 91 9 187 147 11 273 206 16 331 262 24
88 94 9 193 150 11 278 210 16 334 266 24
96 98 9 198 154 11 282 213 19 337 269 24
103 101 9 204 157 11 286 217 19 340 273 24
110 105 9 209 161 11 291 220 19 343 276 24
117 108 9 215 164 11 294 224 19 345 280 24
124 112 9 220 168 11 298 227 19 348 286 24
131 115 9 225 171 16 302 231 19 351 287 24
137 119 9 230 175 16 306 234 19 353 290 24
144 122 9 240 182 16 309 238 19 354 294 24
150 126 9 245 185 16 312 241 19 >354 n/a ——
157 129 11 250 189 16 316 245 19
163 133 11 255 192 16 319 248 19

Table 2-20: FL/HC Ratio: Hadlock, J Ultrasound Med 1984, 3: 439-442 (Fetal
Growth)Unit: GA (Weeks)

GA Min Max GA Min Max GA Min Max

<15 n/a —— 24 18.7 20.9 34 19.4 21.8

15 15.3 17.1 25 18.7 20.3 35 20.1 22.3
16 13.3 16.5 26 18.6 20.4 36 20.1 22.1
17 14.6 17.6 27 18.6 20.4 37 20.8 22.6
18 15.8 18.0 28 18.8 20.6 38 20.9 22.7
19 16.1 18.3 29 19.6 20.8 39 20.6 23.4
20 16.8 19.8 30 19.2 21.4 40 20.7 22.5
21 15.9 20.3 31 19.3 21.3 41 21.6 23.2
22 18.4 20.2 32 19.1 21.3 42 20.1 23.9
23 19.2 20.8 33 19.9 21.5 >42 n/a n/a

Table 2-21: FL/AC Ratio: Hadlock (Fetal Growth)Unit: Age (Weeks)

Age Min (Index) Max (Index)

21 20 24
42 20 24

2-12
Hansmann
Table 2-22: AC: Hansmann (Fetal Age) (Hansmann:M & Al:Geburtsh, u, Frauenheilk
39:656, 1979) Unit: AC (mm); Age (Weeks/Days); SD (mm)

AC Age SD AC Age SD AC Age SD AC Age SD

<53 n/a —— 99 15w2d 0 146 20w2d 0 193 25w2d 0

53 11w1d 0 100 15w3d 0 147 20w2d 0 194 25w3d 0
54 11w2d 0 101 15w4d 0 148 20w3d 0 195 25w4d 0
55 11w2d 0 102 15w5d 0 149 20w3d 0 196 25w4d 0
56 11w3d 0 103 15w5d 0 150 20w4d 0 197 25w5d 0
57 11w3d 0 104 15w6d 0 151 20w4d 0 198 25w5d 0
58 11w4d 0 105 16w0d 0 152 20w5d 0 199 25w6d 0
59 11w4d 0 106 16w0d 0 153 20w6d 0 200 26w0d 0
60 11w5d 0 107 16w1d 0 154 21w0d 0 201 26w0d 0
61 11w6d 0 108 16w2d 0 155 21w1d 0 202 26w1d 0
62 12w0d 0 109 16w3d 0 156 21w2d 0 203 26w2d 0
63 12w1d 0 110 16w3d 0 157 21w2d 0 204 26w3d 0
64 12w2d 0 111 16w4d 0 158 21w3d 0 205 26w3d 0
65 12w2d 0 112 16w5d 0 159 21w3d 0 206 26w4d 0
66 12w3d 0 113 16w6d 0 160 21w4d 0 207 26w5d 0
67 12w3d 0 114 16w6d 0 161 21w4d 0 208 26w6d 0
68 12w4d 0 115 17w0d 0 162 21w5d 0 209 26w6d 0
69 12w5d 0 116 17w1d 0 163 21w6d 0 210 27w0d 0
70 12w5d 0 117 17w2d 0 164 22w0d 0 211 27w1d 0
71 12w6d 0 118 17w2d 0 165 22w1d 0 212 27w2d 0
72 12w6d 0 119 17w3d 0 166 22w2d 0 213 27w2d 0
73 13w0d 0 120 17w3d 0 167 22w3d 0 214 27w3d 0
74 13w0d 0 121 17w4d 0 168 22w4d 0 215 27w4d 0
75 13w1d 0 122 17w4d 0 169 22w5d 0 216 27w4d 0
76 13w2d 0 123 17w5d 0 170 22w5d 0 217 27w5d 0
77 13w2d 0 124 17w6d 0 171 22w6d 0 218 27w5d 0
78 13w3d 0 125 18w0d 0 172 23w0d 0 219 27w6d 0
79 13w3d 0 126 18w1d 0 173 23w1d 0 220 28w0d 0
80 13w4d 0 127 18w2d 0 174 23w2d 0 221 28w0d 0
81 13w4d 0 128 18w3d 0 175 23w2d 0 222 28w1d 0
82 13w5d 0 129 18w3d 0 176 23w3d 0 223 28w2d 0
83 13w6d 0 130 18w4d 0 177 23w3d 0 224 28w3d 0
84 14w0d 0 131 18w5d 0 178 23w4d 0 225 28w4d 0
85 14w1d 0 132 18w6d 0 179 23w4d 0 226 28w5d 0
86 14w2d 0 133 18w6d 0 180 23w5d 0 227 28w5d 0
87 14w2d 0 134 19w0d 0 181 23w6d 0 228 28w6d 0
88 14w3d 0 135 19w1d 0 182 24w0d 0 229 29w0d 0
89 14w3d 0 136 19w2d 0 183 24w1d 0 230 29w1d 0
90 14w4d 0 137 19w2d 0 184 24w2d 0 231 29w2d 0
91 14w5d 0 138 19w3d 0 185 24w3d 0 232 29w2d 0
92 14w5d 0 139 19w3d 0 186 24w4d 0 233 29w3d 0
93 14w6d 0 140 19w4d 0 187 24w5d 0 234 29w3d 0
94 14w6d 0 141 19w4d 0 188 24w5d 0 235 29w4d 0
95 15w0d 0 142 19w5d 0 189 24w6d 0 236 29w4d 0
96 15w0d 0 143 19w6d 0 190 25w0d 0 237 29w5d 0
97 15w1d 0 144 20w0d 0 191 25w1d 0 238 29w6d 0
98 15w2d 0 145 20w1d 0 192 25w2d 0 239 30w0d 0

2-13
Table 2-22: AC: Hansmann (Fetal Age) (Hansmann:M & Al:Geburtsh, u, Frauenheilk
39:656, 1979) Unit: AC (mm); Age (Weeks/Days); SD (mm)

AC Age SD AC Age SD AC Age SD AC Age SD

240 30w1d 0 261 32w3d 0 282 34w4d 0 303 36w5d 0

241 30w2d 0 262 32w3d 0 283 34w4d 0 304 36w6d 0
242 30w3d 0 263 32w4d 0 284 34w5d 0 305 37w0d 0
243 30w3d 0 264 32w4d 0 285 34w6d 0 306 37w1d 0
244 30w4d 0 265 32w5d 0 286 35w0d 0 307 37w2d 0
245 30w5d 0 266 32w6d 0 287 35w1d 0 308 37w3d 0
246 30w6d 0 267 33w0d 0 288 35w2d 0 309 37w3d 0
247 30w6d 0 268 33w1d 0 289 35w3d 0 310 37w4d 0
248 31w0d 0 269 33w2d 0 290 35w3d 0 311 37w5d 0
249 31w1d 0 270 33w3d 0 291 35w4d 0 312 37w6d 0
250 31w2d 0 271 33w3d 0 292 35w5d 0 313 37w6d 0
251 31w3d 0 272 33w4d 0 293 35w6d 0 314 38w0d 0
252 31w3d 0 273 33w5d 0 294 35w6d 0 315 38w1d 0
253 31w4d 0 274 33w6d 0 295 36w0d 0 316 38w2d 0
254 31w5d 0 275 33w6d 0 296 36w1d 0 317 38w4d 0
255 31w6d 0 276 34w0d 0 297 36w2d 0 318 38w5d 0
256 31w6d 0 277 34w1d 0 298 36w2d 0 319 39w0d 0
257 32w0d 0 278 34w2d 0 299 36w3d 0 320 39w1d 0
258 32w1d 0 279 34w2d 0 300 36w3d 0 >320 n/a ——
259 32w2d 0 280 34w3d 0 301 36w4d 0
260 32w2d 0 281 34w3d 0 302 36w4d 0

2-14
 Table 2-23: BPD: Hansmann (Fetal Age)Ultrasound Diagnosis in Obstetrics &
Gynecology, 438-439, 1985Known LMP (left)—Unknown LMP (right)Unit: BPD (mm);
Age (Weeks/Days); 2SD (mm [Known LMP] or day [Unknown LMP])

BPD Age 2SD BPD Age 2SD BPD Age 2SD BPD Age 2SD

<14 n/a —— 60 22w6d 5 <14 n/a —— 60 23w2d 10

14 10w0d 0 61 23w1d 5 14 9w1d 7 61 23w4d 10
15 10w1d 0 62 23w4d 5 15 9w3d 7 62 24w0d 10
16 10w2d 0 63 23w6d 5 16 9w5d 7 63 24w2d 10
17 10w5d 0 64 24w1d 6 17 10w0d 7 64 24w4d 10
18 10w6d 0 65 24w4d 6 18 10w2d 7 65 24w6d 10
19 11w1d 0 66 24w6d 6 19 10w4d 7 66 25w1d 11
20 11w3d 0 67 25w1d 6 20 10w6d 7 67 25w3d 12
21 11w5d 0 68 25w3d 6 21 11w1d 7 68 25w6d 10
22 12w0d 0 69 25w5d 6 22 11w3d 7 69 26w1d 10
23 12w2d 0 70 26w1d 6 23 11w5d 7 70 26w3d 10
24 12w4d 5 71 26w3d 6 24 12w0d 7 71 26w5d 12
25 12w6d 5 72 26w6d 6 25 12w2d 7 72 27w1d 11
26 13w1d 5 73 27w1d 6 26 12w4d 7 73 27w3d 13
27 13w2d 5 74 27w3d 6 27 12w6d 7 74 27w6d 12
28 13w4d 4 75 27w6d 6 28 13w1d 7 75 28w1d 12
29 13w6d 4 76 28w1d 6 29 13w3d 8 76 28w4d 13
30 14w1d 4 77 28w4d 6 30 13w5d 7 77 28w6d 13
31 14w3d 4 78 28w6d 6 31 14w0d 8 78 29w2d 15
32 14w4d 4 79 29w2d 6 32 14w2d 8 79 29w5d 16
33 14w6d 4 80 29w5d 6 33 14w4d 9 80 30w0d 15
34 15w2d 4 81 30w0d 6 34 15w0d 9 81 30w3d 15
35 15w4d 4 82 30w3d 6 35 15w2d 8 82 31w0d 15
36 15w6d 4 83 30w5d 6 36 15w4d 9 83 31w2d 16
37 16w1d 4 84 31w2d 6 37 16w0d 8 84 31w6d 17
38 16w3d 4 85 31w5d 6 38 16w2d 9 85 32w2d 17
39 16w5d 4 86 32w1d 6 39 16w4d 9 86 32w5d 18
40 17w0d 4 87 32w4d 6 40 17w0d 9 87 33w2d 20
41 17w2d 4 88 33w0d 7 41 17w2d 9 88 33w5d 19
42 17w4d 4 89 33w3d 7 42 17w4d 9 89 34w2d 19
43 17w6d 4 90 33w6d 7 43 17w6d 9 90 34w5d 19
44 18w1d 4 91 34w3d 7 44 18w1d 9 91 35w1d 25
45 18w3d 4 92 34w6d 7 45 18w4d 9 92 35w6d 24
46 18w5d 4 93 35w3d 7 46 18w6d 9 93 36w5d 21
47 19w0d 4 94 36w0d 7 47 19w1d 10 94 37w3d 19
48 19w2d 5 95 36w3d 7 48 19w3d 10 95 38w3d 22
49 19w4d 5 96 37w1d 7 49 19w5d 10 96 38w6d 25
50 19w6d 5 97 37w6d 7 50 20w0d 10 97 39w0d 22
51 20w1d 5 98 38w4d 7 51 20w3d 10 98 39w2d 20
52 20w3d 5 99 39w3d 7 52 20w5d 10 99 39w3d 22
53 20w6d 5 100 40w3d 7 53 21w0d 11 100 39w4d 20
54 21w1d 5 101 41w3d 7 54 21w3d 10 101 39w5d 20
55 21w2d 5 >101 n/a —— 55 21w5d 10 102 39w6d 19
56 21w4d 5 56 22w0d 9 103 40w0d 19
57 21w6d 5 57 22w2d 9 104 40w1d 19
58 22w2d 5 58 22w5d 9 105 40w2d 17
59 22w4d 5 59 23w0d 10 >105 n/a ——

2-15
 Table 2-24: CRL: Hansmann (Fetal Age) Ultrasound Diagnosis in Obstetrics &
Gynecology, 438-439, 1985Unit: CRL (mm); Age (Weeks/Days); 2SD (mm [Known LMP]
or day [Unknown LMP])

CRL Age 2SD CRL Age 2SD CRL Age 2SD CRL Age 2SD

Known LMP

<13 n/a —— 54 12w0d 15 96 15w3d 11 138 19w2d 15

13 7w4d 0 55 12w1d 16 97 15w3d 11 139 19w3d 15
14 7w5d 0 56 12w1d 16 98 15w4d 11 140 19w4d 15
15 8w0d 0 57 12w2d 16 99 15w4d 11 141 19w4d 16
16 8w1d 0 58 12w2d 16 100 15w5d 11 142 19w5d 16
17 8w2d 0 59 12w3d 16 101 15w5d 10 143 19w5d 16
18 8w3d 0 60 12w3d 16 102 15w6d 10 144 19w6d 16
19 8w4d 7 61 12w4d 15 103 15w6d 10 145 20w0d 16
20 8w5d 7 62 12w4d 15 104 16w0d 10 146 20w1d 17
21 8w6d 8 63 12w5d 15 105 16w1d 10 147 20w2d 17
22 9w0d 8 64 12w5d 15 106 16w2d 10 148 20w2d 17
23 9w1d 10 65 12w6d 15 107 16w2d 10 149 20w3d 17
24 9w2d 10 66 12w6d 15 108 16w3d 10 150 20w4d 17
25 9w3d 11 67 13w0d 15 109 16w3d 10 151 20w4d 0
26 9w4d 11 68 13w1d 15 110 16w4d 10 152 20w5d 0
27 9w4d 11 69 13w1d 15 111 16w4d 11 153 20w5d 0
28 9w5d 11 70 13w2d 15 112 16w5d 11 154 20w6d 0
29 9w6d 11 71 13w3d 15 113 16w5d 11 155 21w0d 0
30 10w0d 12 72 13w3d 15 114 16w6d 11 156 21w0d 0
31 10w0d 12 73 13w4d 15 115 17w0d 11 157 21w1d 0
32 10w1d 12 74 13w4d 15 116 17w1d 12 158 21w1d 0
33 10w2d 12 75 13w5d 15 117 17w2d 12 159 21w2d 0
34 10w3d 12 76 13w5d 15 118 17w2d 12 160 21w3d 0
35 10w3d 13 77 13w6d 15 119 17w3d 12 161 21w3d 0
36 10w4d 13 78 13w6d 15 120 17w3d 12 162 21w4d 0
37 10w5d 13 79 14w0d 15 121 17w4d 13 163 21w4d 0
38 10w5d 13 80 14w0d 15 122 17w5d 13 164 21w5d 0
39 10w6d 13 81 14w1d 13 123 17w5d 13 165 21w6d 0
40 10w6d 13 82 14w1d 13 124 17w6d 13 166 21w6d 0
41 11w0d 14 83 14w2d 13 125 18w0d 13 167 22w0d 0
42 11w1d 14 84 14w2d 13 126 18w1d 14 168 22w0d 0
43 11w1d 14 85 14w3d 13 127 18w1d 14 169 22w1d 0
44 11w2d 14 86 14w3d 13 128 18w2d 14 170 22w1d 0
45 11w2d 14 87 14w4d 13 129 18w2d 14 171 22w2d 0
46 11w3d 14 88 14w4d 13 130 18w3d 15 172 22w2d 0
47 11w3d 15 89 14w5d 13 131 18w4d 15 173 22w3d 0
48 11w4d 15 90 14w6d 13 132 18w4d 15 174 22w3d 0
49 11w4d 15 91 14w6d 12 133 18w5d 15 175 22w4d 0
50 11w5d 15 92 15w0d 12 134 18w6d 15 >175 n/a ——
51 11w5d 15 93 15w0d 12 135 19w0d 15
52 11w6d 15 94 15w1d 12 136 19w1d 15
53 11w6d 15 95 15w2d 12 137 19w1d 15

Unknown LMP

2-16
 Table 2-24: CRL: Hansmann (Fetal Age) Ultrasound Diagnosis in Obstetrics &
Gynecology, 438-439, 1985Unit: CRL (mm); Age (Weeks/Days); 2SD (mm [Known LMP]
or day [Unknown LMP])

CRL Age 2SD CRL Age 2SD CRL Age 2SD CRL Age 2SD

<6 n/a —— 22 9w1d 7 54 12w3d 9 106 16w2d 13

6 6w1d 7 23 9w2d 7 56 12w4d 9 110 16w4d 14
7 6w2d 7 24 9w3d 7 58 12w5d 9 113 17w0d 14
8 6w4d 7 26 9w5d 7 60 12w6d 9 116 17w2d 14
9 6w6d 7 28 10w0d 8 63 13w0d 10 120 17w4d 14
10 7w0d 7 30 10w2d 8 66 13w2d 10 123 18w0d 14
11 7w2d 7 32 10w3d 8 70 13w3d 10 126 18w2d 14
12 7w3d 7 34 10w5d 8 73 13w5d 11 130 18w6d 14
13 7w4d 7 36 10w6d 8 76 13w6d 11 133 19w1d 15
14 7w6d 7 38 11w1d 8 80 14w1d 11 136 19w4d 16
15 8w0d 7 40 11w2d 8 83 14w2d 12 140 20w0d 16
16 8w2d 7 42 11w3d 8 86 14w4d 12 143 20w3d 16
17 8w3d 7 44 11w4d 9 90 14w6d 12 146 20w6d 16
18 8w4d 7 46 11w6d 9 93 15w1d 12 150 21w3d 16
19 8w5d 7 48 12w0d 9 96 15w3d 12 >150 n/a ——
20 8w6d 7 50 12w1d 9 100 15w5d 12
21 9w0d 7 52 12w2d 9 103 16w0d 13

Table 2-25: FL: Hansmann (Fetal Age)Ultrasound Diagnosis in Obstetrics and

Gynecology, 438-439, 1985Known/Unknown LMP; Unit: FL (mm); Age (Weeks/Days);
2SD (Week)

FL Age 2SD FL Age 2SD FL Age 2SD FL Age 2SD

<12 n/a —— 28 18w4d 4 45 24w6d 5 62 32w1d 5

12 13w4d 0 29 18w6d 4 46 25w2d 5 63 32w5d 5
13 13w6d 0 30 19w2d 4 47 25w4d 5 64 33w1d 6
14 14w1d 0 31 19w4d 4 48 26w0d 5 65 33w5d 6
15 14w3d 0 32 20w0d 4 49 26w3d 5 66 34w1d 6
16 14w5d 5 33 20w3d 4 50 26w6d 5 67 34w5d 6
17 15w1d 5 34 20w5d 4 51 27w3d 5 68 35w1d 6
18 15w2d 4 35 21w1d 5 52 27w5d 5 69 35w5d 6
19 15w5d 4 36 21w3d 5 53 28w1d 5 70 36w1d 6
20 16w0d 4 37 21w6d 5 54 28w4d 5 71 36w5d 6
21 16w2d 4 38 22w1d 5 55 29w0d 5 72 37w2d 6
22 16w4d 4 39 22w4d 5 56 29w3d 6 73 37w6d 6
23 16w6d 4 40 22w6d 5 57 29w6d 6 74 38w3d 7
24 17w2d 4 41 23w2d 5 58 30w2d 6 75 39w0d 7
25 17w4d 4 42 23w5d 5 59 30w5d 5 >75 n/a ——
26 17w6d 4 43 24w0d 5 60 31w2d 5
27 18w2d 4 44 24w3d 5 61 31w5d 5

2-17
Table 2-26: GS: Hansmann (Fetal Age)Hansmann: M and Al: Geburtsh, u, Frauenheilk
39: 656, 1979Unit: GS (mm); Age (Days); SD (mm)

GS Age SD GS Age SD GS Age SD GS Age SD

<10 n/a —— 24 47 5 39 61 5 54 76 5
10 33 5 25 48 5 40 62 5 55 77 5
11 34 5 26 49 5 41 63 5 56 78 5
12 35 5 27 50 5 42 64 5 57 79 5
13 36 5 28 51 5 43 65 5 58 80 5
14 37 5 29 52 5 44 66 5 59 81 5
15 38 5 30 53 5 45 67 5 60 82 5
16 39 5 31 54 5 46 68 5 61 83 5
17 40 5 32 55 5 47 69 5 62 84 5
18 41 5 33 56 5 48 70 5 63 85 5
19 42 5 34 57 5 49 71 5 64 86 5
20 43 5 35 58 5 50 72 5 65 87 5
21 44 5 36 58 5 51 73 5 >65 n/a ——
22 45 5 37 59 5 52 74 5
23 46 5 38 60 5 53 75 5

Table 2-27: HC: Hansmann (Fetal Age)Ultrasound Diagnosis in Obstetrics and

Gynecology, 438-439, 1985Known/Unknown LMP; Unit: HC (mm); Age (Weeks/Days);
2SD (mm)

HC Age 2SD HC Age 2SD HC Age 2SD HC Age 2SD

<105 n/a —— 165 18w4d 16 230 23w5d 18 295 29w5d 19

105 13w3d 0 170 19w0d 16 235 24w1d 18 300 30w2d 19
110 14w0d 0 175 19w3d 16 240 24w4d 18 305 30w5d 19
115 14w3d 14 180 19w5d 16 245 25w0d 18 310 31w2d 19
120 14w6d 14 185 20w1d 17 250 25w3d 18 315 32w1d 20
125 15w3d 14 190 20w4d 17 255 25w6d 18 320 32w5d 20
130 15w5d 14 195 21w0d 17 260 26w2d 18 325 33w3d 20
135 16w1d 14 200 21w2d 17 265 26w5d 18 330 34w2d 20
140 16w4d 14 205 21w5d 17 270 27w1d 18 335 35w1d 20
145 17w0d 15 210 22w1d 17 275 27w4d 19 340 36w2d 20
150 17w3d 15 215 22w4d 17 280 28w1d 19 345 37w6d 20
155 17w6d 16 220 23w0d 17 285 28w5d 19 >345 n/a ——
160 18w1d 16 225 23w3d 17 290 29w1d 19

2-18
 Table 2-28: OFD: Hansmann (Fetal Age)Ultrasound Diagnosis in Obstetrics and
Gynecology, 438-439, 1985Known/Unknown LMP; Unit: OFD (mm); Age (Weeks/Days);
2SD (mm)

OFD Age 2SD OFD Age 2SD OFD Age 2SD OFD Age 2SD

<34 n/a —— 54 18w4d 5 75 23w2d 7 96 29w0d 8

34 13w3d 0 55 18w6d 5 76 23w4d 7 97 29w3d 8
35 13w5d 0 56 19w0d 6 77 23w6d 7 98 29w5d 8
36 14w0d 0 57 19w2d 6 78 24w1d 7 99 30w0d 8
37 14w2d 5 58 19w3d 6 79 24w2d 7 100 30w3d 8
38 14w4d 5 59 19w5d 6 80 24w4d 7 101 30w5d 8
39 14w6d 5 60 20w0d 6 81 24w6d 7 102 31w1d 8
40 15w1d 5 61 20w1d 6 82 25w1d 7 103 31w4d 8
41 15w3d 5 62 20w2d 6 83 25w2d 7 104 32w0d 8
42 15w5d 5 63 20w4d 6 84 25w4d 7 105 32w3d 8
43 16w0d 5 64 20w6d 6 85 25w6d 7 106 32w6d 8
44 16w1d 5 65 21w0d 6 86 26w1d 7 107 33w3d 8
45 16w3d 5 66 21w2d 6 87 26w3d 7 108 33w6d 8
46 16w4d 5 67 21w4d 6 88 26w5d 7 109 34w3d 8
47 16w6d 5 68 21w5d 6 89 27w0d 7 110 35w0d 8
48 17w1d 5 69 22w0d 6 90 27w2d 7 111 35w4d 8
49 17w3d 5 70 22w1d 7 91 27w4d 8 112 36w2d 8
50 17w4d 5 71 22w3d 7 92 27w6d 8 113 37w0d 8
51 17w6d 5 72 22w4d 7 93 28w1d 8 114 38w0d 8
52 18w1d 5 73 22w6d 7 94 28w3d 8 115 39w0d 8
53 18w2d 5 74 23w1d 7 95 28w5d 8 >115 n/a ——

Table 2-29: TAD: Hansmann (Fetal Age)Hansmann: M and Al: Geburtsh, u,

Frauenheilk 39: 656, 1979Unit: TAD (mm); Age (Days); SD (mm)

TAD Age SD TAD Age SD TAD Age SD TAD Age SD

<20 n/a —— 41 130 4 63 179 4 85 232 5

20 87 4 42 132 4 64 182 4 86 235 5
21 89 4 43 135 4 65 184 4 87 237 5
22 91 4 44 137 4 66 186 4 88 240 5
23 93 4 45 139 4 67 188 4 89 242 5
24 95 4 46 141 4 68 191 5 90 245 5
25 97 4 47 143 4 69 193 5 91 247 5
26 99 4 48 146 4 70 195 5 92 250 5
27 101 4 49 148 4 71 198 5 93 252 5
28 103 4 50 150 4 72 200 5 94 255 5
29 105 4 51 152 4 73 203 5 95 258 5
30 107 4 52 155 4 74 205 5 96 261 5
31 109 4 53 157 4 75 208 5 97 264 5
32 111 4 54 159 4 76 210 5 98 267 5
33 113 4 55 161 4 77 212 5 99 270 5
34 115 4 56 164 4 78 215 5 100 273 5
35 117 4 57 166 4 79 217 5 101 276 5
36 119 4 58 168 4 80 220 5 102 279 5
37 122 4 59 170 4 81 222 5 103 282 5
38 124 4 60 173 4 82 225 5 >103 n/a ——
39 126 4 61 175 4 83 227 5
40 128 4 62 177 4 84 230 5 2-19
 Table 2-30: ThD: Hansmann (Fetal Age)Ultrasound Diagnosis in Obstetrics and
Gynecology, 438-439, 1985Known/Unknown LMP; Unit: ThD (mm); Age (Weeks/Days);
2SD (mm)

ThD Age 2SD ThD Age 2SD ThD Age 2SD ThD Age 2SD

<20 n/a —— 41 18w5d 5 63 25w5d 7 85 33w1d 9

20 12w4d 0 42 19w0d 5 64 26w1d 7 86 33w4d 9
21 12w6d 0 43 19w3d 5 65 26w3d 7 87 33w6d 9
22 13w1d 0 44 19w5d 5 66 26w5d 7 88 34w2d 9
23 13w3d 0 45 19w6d 5 67 27w0d 7 89 34w4d 9
24 13w4d 4 46 20w2d 5 68 27w3d 8 90 35w0d 9
25 13w6d 4 47 20w4d 6 69 27w5d 8 91 35w3d 10
26 14w1d 4 48 20w6d 6 70 28w0d 8 92 35w5d 10
27 14w3d 4 49 21w2d 6 71 28w3d 8 93 36w1d 10
28 14w6d 4 50 21w4d 6 72 28w5d 8 94 36w3d 10
29 15w1d 4 51 21w6d 6 73 29w1d 8 95 36w6d 10
30 15w2d 4 52 22w1d 6 74 29w3d 8 96 37w1d 10
31 15w4d 4 53 22w4d 6 75 29w5d 8 97 37w4d 10
32 15w6d 4 54 22w6d 6 76 30w1d 8 98 38w1d 11
33 16w2d 4 55 23w1d 6 77 30w3d 8 99 38w4d 11
34 16w4d 4 56 23w3d 6 78 30w5d 8 100 38w6d 11
35 16w6d 4 57 23w6d 7 79 31w1d 8 101 39w3d 12
36 17w1d 5 58 24w1d 7 80 31w3d 8 102 39w6d 14
37 17w3d 5 59 24w3d 7 81 31w5d 8 103 40w2d 14
38 17w5d 5 60 24w6d 7 82 32w1d 9 104 40w5d 14
39 18w1d 5 61 25w1d 7 83 32w4d 9 105 41w2d 14
40 18w3d 5 62 25w3d 7 84 32w6d 9 >105 n/a ——

2-20
Hellman
Table 2-31: GS: Hellman (Fetal Age)A/OG 103: 789, 1969Unit: GS (mm); Age (Week);
SD (Week)

GS Age SD GS Age SD GS Age SD GS Age SD

<10 n/a —— 23 6.9 ± 1.0 37 8.9 ± 1.0 51 10.9 ± 1.0

10 5.0 ± 1.0 24 7.0 ± 1.0 38 9.0 ± 1.0 52 11.0 ± 1.0
11 5.2 ± 1.0 25 7.2 ± 1.0 39 9.2 ± 1.0 53 11.2 ± 1.0
12 5.3 ± 1.0 26 7.3 ± 1.0 40 9.3 ± 1.0 54 11.3 ± 1.0
13 5.5 ± 1.0 27 7.5 ± 1.0 41 9.5 ± 1.0 55 11.5 ± 1.0
14 5.6 ± 1.0 28 7.6 ± 1.0 42 9.6 ± 1.0 56 11.6 ± 1.0
15 5.8 ± 1.0 29 7.8 ± 1.0 43 9.7 ± 1.0 57 11.7 ± 1.0
16 5.9 ± 1.0 30 7.9 ± 1.0 44 9.9 ± 1.0 58 11.9 ± 1.0
17 6.0 ± 1.0 31 8.0 ± 1.0 45 10.0 ± 1.0 59 12.0 ± 1.0
18 6.2 ± 1.0 32 8.2 ± 1.0 46 10.2 ± 1.0 60 12.2 ± 1.0
19 6.3 ± 1.0 33 8.3 ± 1.0 47 10.3 ± 1.0 >60 n/a ——
20 6.5 ± 1.0 34 8.5 ± 1.0 48 10.5 ± 1.0
21 6.6 ± 1.0 35 8.6 ± 1.0 49 10.6 ± 1.0
22 6.8 ± 1.0 36 8.8 ± 1.0 50 10.7 ± 1.0

Hill
Table 2-32: TCD: Hill (Fetal Age)Obstet Gyn, 75: 981-984, 1990Unit: TCD (mm); Age
(Weeks); SD (Week)

TCD Age SD TCD Age SD TCD Age SD

<14 n/a —— 28 24.9 ± 1.01 43 33.9 ± 1.2

14 15.2 ± 0.5 29 25.5 ± 1.01 44 34.4 ± 1.2
15 15.8 ± 0.5 30 26.2 ± 1.01 45 34.8 ± 1.2
16 16.5 ± 0.5 31 26.9 ± 1.01 46 35.3 ± 1.2
17 17.2 ± 0.5 32 27.5 ± 1.01 47 35.7 ± 1.2
18 17.9 ± 0.5 33 28.1 ± 1.01 48 36.1 ± 1.6
19 18.6 ± 0.9 34 28.8 ± 1.01 49 36.5 ± 1.6
20 19.3 ± 0.9 35 29.4 ± 1.01 50 36.8 ± 1.6
21 20.0 ± 0.9 36 30.0 ± 1.2 51 37.2 ± 1.6
22 20.7 ± 0.9 37 30.6 ± 1.2 52 37.5 ± 1.6
23 21.4 ± 0.9 38 31.2 ± 1.2 54 38.0 ± 1.6
24 22.1 ± 0.9 39 31.8 ± 1.2 55 38.3 ± 1.6
25 22.8 ± 0.9 40 32.3 ± 1.2 56 38.5 ± 1.6
26 23.5 ± 0.9 41 32.8 ± 1.2 >56 n/a ——
27 24.2 ± 1.01 42 33.4 ± 1.2

2-21
Hohler
Table 2-33: FL: Hohler (Fetal Growth)Communications in Brief, 143: 479-481, 1982

Age (Weeks) Min (Index) Max (Index)

23 71 87
40 71 87

Jeanty
Table 2-34: AC: Jeanty (Fetal Age)Jeanty, Radiology 143: 513, 1982Unit: AC (mm);
Age (Day); SD (mm)

AC Age 2SD AC Age 2SD AC Age 2SD AC Age 2SD

<50 n/a —— 115 122 22 185 169 22 255 218 22

50 79 22 120 125 22 190 172 22 260 222 22
55 82 22 125 129 22 195 176 22 265 226 22
60 85 22 130 132 22 200 179 22 270 230 22
65 89 22 135 135 22 205 182 22 275 234 22
70 92 22 140 139 22 210 186 22 280 239 22
75 95 22 145 142 22 215 189 22 285 244 22
80 99 22 150 146 22 220 192 22 290 249 22
85 102 22 155 149 22 225 196 22 295 254 22
90 105 22 160 152 22 230 199 22 300 259 22
95 109 22 165 156 22 235 203 22 305 265 22
100 112 22 170 159 22 240 206 22 310 272 22
105 115 22 175 162 22 245 210 22 315 279 22
110 119 22 180 166 22 250 214 22 >315 n/a ——

Table 2-35: BD: Jeanty (Fetal Age)Jeanty: Radiology 143: 513, 1982Unit: BD (mm);
Age (Days); SD (mm)

BD Age SD BD Age SD BD Age SD BD Age SD

<15 n/a —— 28 127 0 42 185 0 56 243 0

15 73 0 29 131 0 43 189 0 57 247 0
16 77 0 30 135 0 44 193 0 58 251 0
17 81 0 31 139 0 45 197 0 59 256 0
18 85 0 32 143 0 46 201 0 60 260 0
19 89 0 33 147 0 47 206 0 61 264 0
20 93 0 34 152 0 48 210 0 62 268 0
21 97 0 35 156 0 49 214 0 63 272 0
22 102 0 36 160 0 50 218 0 64 276 0
23 106 0 37 164 0 51 222 0 65 281 0
24 110 0 38 168 0 52 226 0 >65 n/a ——
25 114 0 39 172 0 53 231 0
26 118 0 40 177 0 54 235 0
27 122 0 41 181 0 55 239 0

2-22
 Table 2-36: BPD: Jeanty (Fetal Age)Jeanty: Radiology 143: 513, 1982Unit: Meas
(mm); Min/Mean/Max (Weeks/Days); Table/Graph Range: 5%:95%

Meas Min Mean Max Meas Min Mean Max

<10 n/a n/a n/a 53 18w4d 21w1d 23w6d

10 6w4d 9w1d 11w6d 54 18w6d 21w4d 24w1d
11 6w6d 9w4d 12w1d 55 19w1d 21w6d 24w4d
12 7w0d 9w5d 12w3d 56 19w4d 22w1d 24w6d
13 7w2d 10w0d 12w5d 57 19w6d 22w4d 25w1d
14 7w4d 10w2d 12w6d 58 20w1d 22w6d 25w4d
15 7w6d 10w4d 13w1d 59 20w4d 23w1d 25w6d
16 8w1d 10w6d 13w3d 60 20w6d 23w4d 26w1d
17 8w3d 11w1d 13w5d 61 21w1d 23w6d 26w4d
18 8w4d 11w2d 14w0d 62 21w4d 24w1d 26w6d
19 8w6d 11w4d 14w1d 63 21w6d 24w4d 27w1d
20 9w1d 11w6d 14w4d 64 22w1d 24w6d 27w4d
21 9w3d 12w1d 14w6d 65 22w4d 25w2d 27w6d
22 9w5d 12w3d 15w0d 66 22w6d 25w4d 28w2d
23 9w6d 12w4d 15w2d 67 23w2d 26w0d 28w4d
24 10w1d 12w6d 15w4d 68 23w5d 26w3d 29w0d
25 10w4d 13w1d 15w6d 69 24w0d 26w5d 29w3d
26 10w5d 13w3d 16w1d 70 24w3d 27w1d 29w6d
27 11w0d 13w5d 16w3d 71 24w6d 27w4d 30w1d
28 11w2d 14w0d 16w4d 72 25w1d 27w6d 30w4d
29 11w4d 14w1d 16w6d 73 25w4d 28w2d 30w6d
30 11w6d 14w4d 17w1d 74 26w0d 28w5d 31w2d
31 12w1d 14w6d 17w3d 75 26w3d 29w1d 31w5d
32 12w2d 15w1d 17w5d 76 26w6d 29w4d 32w1d
33 12w4d 15w2d 18w0d 77 27w1d 29w6d 32w4d
34 12w6d 15w4d 18w2d 78 27w4d 30w2d 33w0d
35 13w1d 15w6d 18w4d 79 28w0d 30w5d 33w3d
36 13w4d 16w1d 18w6d 80 28w4d 31w1d 33w6d
37 13w5d 16w3d 19w1d 81 28w6d 31w4d 34w2d
38 14w0d 16w5d 19w3d 82 29w2d 32w0d 34w5d
39 14w2d 17w0d 19w5d 83 29w6d 32w4d 35w1d
40 14w4d 17w2d 19w6d 84 30w1d 32w6d 35w4d
41 14w6d 17w4d 20w1d 85 30w5d 33w3d 36w0d
42 15w1d 17w6d 20w4d 86 31w1d 33w6d 36w4d
43 15w3d 18w1d 20w6d 87 31w4d 34w2d 37w0d
44 15w5d 18w3d 21w1d 88 32w1d 34w6d 37w3d
45 16w0d 18w5d 21w3d 89 32w4d 35w2d 37w6d
46 16w2d 19w0d 21w5d 90 33w0d 35w5d 38w3d
47 16w4d 19w2d 22w0d 91 33w4d 36w1d 38w6d
48 16w6d 19w4d 22w2d 92 34w0d 36w5d 39w3d
49 17w1d 19w6d 22w4d 93 34w4d 37w1d 39w6d
50 17w4d 20w2d 22w6d 94 35w0d 37w5d 40w3d
51 17w6d 20w4d 23w1d 95 35w4d 38w2d 40w6d
52 18w1d 20w6d 23w4d >95 n/a n/a n/a

2-23
 Table 2-37: BPD: Jeanty (Fetal Growth)Jeanty: Radiology 143: 513, 1982Unit: Age
(Weeks/Days); Min/Mean/Max (mm); Table/Graph Range: 5%:95%

Age Min Mean Max Age Min Mean Max

10.0+0 9 14 18 26.0+0 62 67 71
11.0+0 13 17 22 27.0+0 65 70 74
12.0+0 16 21 25 28.0+0 68 72 77
13.0+0 20 24 29 29.0+0 70 75 79
14.0+0 23 28 32 30.0+0 73 77 82
15.0+0 27 31 36 31.0+0 75 79 84
16.0+0 30 35 39 32.0+0 77 82 86
17.0+0 34 38 43 33.0+0 79 84 88
18.0+0 37 42 46 34.0+0 81 86 90
19.0+0 40 45 49 35.0+0 83 87 92
20.0+0 44 48 53 36.0+0 84 89 93
21.0+0 47 51 56 37.0+0 86 90 95
22.0+0 50 55 59 38.0+0 87 91 96
23.0+0 53 58 62 39.0+0 88 93 97
24.0+0 56 61 65 40.0+0 89 93 98
25.0+0 59 64 68

Table 2-38: CRL: Jeanty (Fetal Age)Jeanty: Radiology 143: 513, 1982Unit: CRL (mm);
Age (Days); SD (mm)

CRL Age SD CRL Age SD CRL Age SD CRL Age SD

<5 n/a —— 17 58 5 30 69 7 43 77 7
5 44 4 18 59 5 31 70 7 44 78 7
6 45 4 19 60 5 32 70 7 45 79 7
7 46 4 20 61 5 33 71 7 46 79 7
8 48 4 21 62 6 34 72 7 47 80 7
9 50 4 22 63 6 35 73 7 48 81 7
10 51 4 23 64 6 36 73 7 49 81 7
11 52 4 24 65 6 37 74 7 50 82 7
12 53 4 25 66 6 38 75 7 51 83 7
13 54 4 26 67 7 39 76 7 52 83 7
14 55 4 27 67 7 40 76 7 53 84 7
15 56 5 28 67 7 41 76 7 54 85 7
16 57 5 29 68 7 42 77 7 >54 n/a ——

2-24
Table 2-39: FIB: Jeanty (Fetal Growth)Fetal Limb Bimetry (Letter), Radiology 147:602,
1983Unit: Age (Weeks); Min/Mean/Max (mm); Table/Graph Range: 5%:95%

Age Min Mean Max Age Min Mean Max

11 2 2 2 26 32 39 43
12 5 5 5 27 35 41 47
13 8 8 8 28 36 43 47
14 6 11 10 29 40 45 50
15 10 14 18 30 38 47 52
16 6 17 22 31 40 48 57
17 7 19 31 32 40 50 56
18 10 22 28 33 43 51 59
19 18 24 30 34 46 52 56
20 18 27 30 35 51 54 57
21 24 29 34 36 51 55 56
22 21 31 37 37 55 56 58
23 23 33 44 38 54 57 59
24 26 35 41 39 55 58 62
25 33 37 42 40 54 59 62

2-25
Table 2-40: FL: Jeanty (Fetal Age)Jeanty: Radiology 143: 513, 1982Unit: Meas (mm);
Min/Mean/Max (Weeks/Days); Table/Graph Range: 5%:95%

Meas Min Mean Max Meas Min Mean Max

<14 n/a n/a n/a 48 24w0d 26w1d 28w3d

14 11w5d 13w6d 16w1d 49 24w3d 26w4d 28w6d
15 12w0d 14w1d 16w3d 50 24w6d 27w0d 29w1d
16 12w3d 14w4d 16w6d 51 25w1d 27w3d 29w4d
17 12w5d 14w6d 17w1d 52 25w4d 27w6d 30w0d
18 13w0d 15w1d 17w3d 53 26w0d 28w1d 30w3d
19 13w3d 15w4d 17w6d 54 26w3d 28w4d 30w6d
20 13w5d 15w6d 18w1d 55 26w6d 29w1d 31w2d
21 14w1d 16w2d 18w4d 56 27w2d 29w4d 31w5d
22 14w3d 16w4d 18w6d 57 27w5d 29w6d 32w1d
23 14w5d 16w6d 19w1d 58 28w1d 30w2d 32w4d
24 15w1d 17w2d 19w4d 59 28w4d 30w5d 32w6d
25 15w3d 17w4d 19w6d 60 28w6d 31w1d 33w2d
26 15w6d 18w0d 20w1d 61 29w3d 31w4d 33w6d
27 16w1d 18w2d 20w4d 62 29w6d 32w0d 34w1d
28 16w4d 18w5d 20w6d 63 30w1d 32w3d 34w4d
29 16w6d 19w0d 21w1d 64 30w5d 32w6d 35w1d
30 17w1d 19w3d 21w4d 65 31w1d 33w2d 35w4d
31 17w4d 19w6d 22w0d 66 31w4d 33w5d 35w6d
32 17w6d 20w1d 22w2d 67 32w0d 34w1d 36w3d
33 18w2d 20w4d 22w5d 68 32w3d 34w4d 36w6d
34 18w5d 20w6d 23w1d 69 32w6d 35w0d 37w1d
35 19w0d 21w1d 23w3d 70 33w2d 35w4d 37w5d
36 19w3d 21w4d 23w6d 71 33w5d 35w6d 38w1d
37 19w6d 22w0d 24w1d 72 34w1d 36w3d 38w4d
38 20w1d 22w3d 24w4d 73 34w4d 36w6d 39w0d
39 20w4d 22w5d 24w6d 74 35w1d 37w2d 39w4d
40 20w6d 23w1d 25w2d 75 35w4d 37w5d 39w6d
41 21w2d 23w4d 25w5d 76 36w0d 38w1d 40w3d
42 21w5d 23w6d 26w1d 77 36w3d 38w4d 40w6d
43 22w1d 24w2d 26w4d 78 36w6d 39w1d 41w2d
44 22w4d 24w5d 26w6d 79 37w2d 39w4d 41w5d
45 22w6d 25w0d 27w1d 80 37w6d 40w0d 42w1d
46 23w1d 25w3d 27w4d >80 n/a n/a n/a
47 23w4d 25w6d 28w0d

2-26
 Table 2-41: FL: Jeanty (Fetal Growth)Jeanty: Radiology 143: 513, 1982Unit: Age
(Weeks/Days); Min/Mean/Max (mm); Table/Graph Range: 5%:95%

Age Min Mean Max Age Min Mean Max

12.0+0 4 8 13 27.0+0 45 49 54
13.0+0 6 11 16 28.0+0 47 52 56
14.0+0 9 14 18 29.0+0 50 54 59
15.0+0 12 17 21 30.0+0 52 56 61
16.0+0 15 20 24 31.0+0 54 59 63
17.0+0 18 23 27 32.0+0 56 61 65
18.0+0 21 25 30 33.0+0 58 63 67
19.0+0 24 28 33 34.0+0 60 65 69
20.0+0 26 31 36 35.0+0 62 67 71
21.0+0 29 34 38 36.0+0 64 68 73
22.0+0 32 36 41 37.0+0 65 70 74
23.0+0 35 39 44 38.0+0 67 71 76
24.0+0 37 42 46 39.0+0 68 73 77
25.0+0 40 44 49 40.0+0 70 74 79
26.0+0 42 47 51

Table 2-42: HC: Jeanty (Fetal Age)Jeanty: Radiology 143: 513, 1982Unit: Meas (mm);
Min/Mean/Max (Weeks/Days); Table/Graph Range: 5%:95%

Meas Min Mean Max Meas Min Mean Max

<80 n/a n/a n/a 225 22w3d 24w3d 26w2d

80 11w3d 13w2d 15w2d 230 22w6d 24w6d 26w6d
85 11w5d 13w5d 15w4d 235 23w3d 25w3d 27w2d
90 11w7d 13w7d 15w6d 240 23w6d 25w6d 27w6d
95 12w2d 14w2d 16w2d 245 24w3d 26w3d 28w2d
100 12w4d 14w4d 16w4d 250 24w7d 26w6d 28w6d
105 12w7d 14w6d 16w6d 255 25w4d 27w3d 29w3d
110 13w2d 15w2d 17w1d 260 26w0d 28w0d 29w7d
115 13w4d 15w4d 17w4d 265 26w4d 28w4d 30w4d
120 13w6d 15w6d 17w6d 270 27w1d 29w1d 31w1d
125 14w2d 16w2d 18w1d 275 27w6d 29w5d 31w5d
130 14w4d 16w4d 18w4d 280 28w3d 30w2d 32w2d
135 14w7d 16w6d 18w6d 285 28w7d 30w7d 32w6d
140 15w2d 17w2d 19w2d 290 29w4d 31w4d 33w4d
145 15w5d 17w4d 19w4d 295 30w2d 32w1d 34w1d
150 16w0d 17w7d 19w7d 300 30w6d 32w6d 34w6d
155 16w3d 18w3d 20w2d 305 31w4d 33w4d 35w3d
160 16w6d 18w5d 20w5d 310 32w2d 34w1d 36w1d
165 17w1d 19w1d 21w1d 315 32w6d 34w6d 36w6d
170 17w4d 19w4d 21w3d 320 33w4d 35w4d 37w4d
175 17w7d 19w6d 21w6d 325 34w2d 36w2d 38w2d
180 18w3d 20w2d 22w2d 330 35w0d 37w0d 38w7d
185 18w6d 20w5d 22w5d 335 35w6d 37w5d 39w5d
190 19w1d 21w1d 23w1d 340 36w4d 38w4d 40w3d
195 19w4d 21w4d 23w4d 345 37w2d 39w2d 41w2d
200 20w1d 22w0d 23w7d 350 38w1d 40w0d 42w0d
205 20w4d 22w3d 24w3d 355 38w6d 40w6d 42w6d
210 20w7d 22w7d 24w6d 360 39w5d 41w5d 43w4d
215 21w3d 23w3d 25w3d >360 n/a n/a n/a 2-27
220 21w6d 23w6d 25w6d
 Table 2-43: HC: Jeanty (Fetal Growth)Jeanty: Radiology 143: 513, 1982Unit: Age
(Weeks/Days); Min/Mean/Max (mm); Table/Graph Range: 5%:95%

Age Min Mean Max Age Min Mean Max

12.0+0 51 75 100 27.0+0 228 252 277

13.0+0 64 88 112 28.0+0 238 262 286
14.0+0 76 101 125 29.0+0 247 271 296
15.0+0 89 113 138 30.0+0 256 281 305
16.0+0 101 126 150 31.0+0 265 289 313
17.0+0 114 138 163 32.0+0 273 297 322
18.0+0 126 151 175 33.0+0 281 305 329
19.0+0 138 163 187 34.0+0 288 312 336
20.0+0 150 175 199 35.0+0 294 319 343
21.0+0 162 187 211 36.0+0 300 325 349
22.0+0 174 198 223 37.0+0 306 330 355
23.0+0 185 210 234 38.0+0 311 335 359
24.0+0 196 221 245 39.0+0 315 339 364
25.0+0 207 232 256 40.0+0 319 343 367
26.0+0 218 242 266

Table 2-44: HL: Jeanty (Fetal Age)Obstetrical Ultrasound, Table 13.9, 1984Unit: Meas
(mm); Min/Mean/Max (Weeks/Days); Table/Graph Range: 5%:95%

Meas Min Mean Max Meas Min Mean Max

<10 n/a n/a n/a 40 21w4d 24w2d 27w1d

10 9w6d 12w4d 15w2d 41 22w0d 24w6d 27w4d
11 10w1d 12w6d 15w4d 42 22w4d 25w2d 28w0d
12 10w3d 13w1d 15w6d 43 23w0d 25w5d 28w4d
13 10w6d 13w4d 16w1d 44 23w4d 26w1d 29w0d
14 11w1d 13w6d 16w4d 45 24w0d 26w5d 29w4d
15 11w3d 14w1d 16w6d 46 24w4d 27w1d 30w0d
16 11w6d 14w4d 17w2d 47 25w0d 27w5d 30w4d
17 21w1d 14w6d 17w4d 48 25w4d 28w1d 31w0d
18 12w4d 15w1d 18w0d 49 26w0d 28w6d 31w4d
19 12w6d 15w4d 18w2d 50 26w4d 29w2d 32w0d
20 13w1d 15w6d 18w5d 51 27w1d 29w6d 32w4d
21 13w4d 16w2d 19w1d 52 27w4d 30w2d 33w1d
22 13w6d 16w5d 19w3d 53 28w1d 30w6d 33w4d
23 14w2d 17w1d 19w6d 54 28w5d 31w3d 34w1d
24 14w5d 17w3d 20w1d 55 29w1d 32w0d 34w5d
25 15w1d 17w6d 20w4d 56 29w6d 32w4d 35w2d
26 15w4d 18w1d 21w0d 57 30w2d 33w1d 35w6d
27 15w6d 18w4d 21w3d 58 30w6d 33w4d 36w3d
28 16w2d 19w0d 21w6d 59 31w3d 34w1d 36w6d
29 16w5d 19w3d 22w1d 60 32w0d 34w6d 37w4d
30 17w1d 19w6d 22w4d 61 32w4d 35w2d 38w1d
31 17w4d 20w2d 23w0d 62 33w1d 35w6d 38w5d
32 18w0d 20w5d 23w4d 63 33w6d 36w4d 39w2d
33 18w3d 21w1d 23w6d 64 34w3d 37w1d 39w6d
34 18w6d 21w4d 24w2d 65 35w0d 37w5d 40w4d
35 19w2d 22w0d 24w6d 66 35w4d 38w2d 41w1d
36 19w5d 22w4d 25w1d 67 36w1d 38w6d 41w5d
37 20w1d 22w6d 25w5d 68 36w6d 39w4d 42w2d 2-28
38 20w4d 23w3d 26w1d 69 37w3d 40w1d 42w6d
39 21w1d 23w6d 26w4d >69 n/a n/a n/a
 Table 2-45: Radius: Jeanty (Fetal Growth)Fetal Limb Bimetry (Letter), Radiology
147:602, 1983Unit: Age (weeks); Min/Mean/Max (mm); Table/Graph Range: 5%:95%

Age Min Mean Max Age Min Mean Max

<11 n/a n/a n/a 26 30 37 41

11 5 5 5 27 33 39 45
12 7 7 7 28 33 40 45
13 10 10 10 29 36 42 47
14 8 13 12 30 34 43 49
15 12 15 19 31 34 44 53
16 9 18 21 32 37 45 51
17 11 20 29 33 41 46 51
18 14 22 26 34 39 47 53
19 20 24 29 35 38 48 57
20 21 27 28 36 41 48 54
21 25 29 32 37 45 49 53
22 24 31 34 38 45 49 53
23 26 32 39 39 46 50 54
24 27 34 38 40 46 50 54
25 31 36 40 >40 n/a n/a n/a

2-29
Table 2-46: TIB: Jeanty (Fetal Age)Obstetrical Ultrasound, Table 13.9, 1984Unit: Meas
(mm); Min/Mean/Max (Weeks/Days); Table/Graph Range: 5%:95%

Meas Min Mean Max Meas Min Mean Max

<10 n/a n/a n/a 40 22w3d 25w2d 28w1d

10 10w4d 13w3d 16w2d 41 22w6d 25w5d 28w4d
11 10w6d 13w5d 16w4d 42 23w2d 26w1d 29w1d
12 11w1d 14w1d 17w0d 43 23w5d 26w4d 29w4d
13 11w4d 14w3d 17w2d 44 24w1d 27w1d 30w0d
14 11w6d 14w6d 17w5d 45 24w4d 27w4d 30w4d
15 12w1d 15w1d 18w0d 46 25w1d 28w0d 30w6d
16 12w4d 15w4d 18w3d 47 25w4d 28w4d 31w3d
17 13w0d 15w6d 18w6d 48 26w1d 29w0d 31w6d
18 13w2d 16w1d 19w1d 49 26w4d 29w3d 32w2d
19 13w5d 16w4d 19w4d 50 27w0d 29w6d 32w6d
20 14w1d 17w0d 19w6d 51 27w4d 30w3d 33w2d
21 14w4d 17w3d 20w2d 52 28w0d 30w6d 33w6d
22 14w6d 17w6d 20w5d 53 28w4d 31w3d 34w2d
23 15w1d 18w1d 21w1d 54 29w0d 31w6d 34w6d
24 15w4d 18w4d 21w3d 55 29w4d 32w3d 35w2d
25 16w0d 18w6d 21w6d 56 30w0d 32w6d 35w6d
26 16w3d 19w2d 22w1d 57 30w4d 33w3d 36w2d
27 16w6d 19w5d 22w4d 58 31w0d 33w6d 36w6d
28 17w1d 20w1d 23w0d 59 31w4d 34w3d 37w2d
29 17w4d 20w4d 23w4d 60 32w0d 34w6d 37w6d
30 18w1d 21w0d 23w6d 61 32w4d 35w3d 38w2d
31 18w4d 21w3d 24w2d 62 33w0d 35w6d 38w6d
32 18w6d 21w6d 24w5d 63 33w4d 36w4d 39w3d
33 19w2d 22w1d 25w1d 64 34w1d 37w0d 39w6d
34 19w5d 22w4d 25w4d 65 34w4d 37w4d 40w3d
35 20w1d 23w1d 26w0d 66 35w1d 38w0d 41w0d
36 20w4d 23w4d 26w3d 67 35w5d 38w4d 41w4d
37 21w0d 23w6d 26w6d 68 36w1d 39w1d 42w0d
38 21w4d 24w3d 27w2d 69 36w6d 39w5d 42w4d
39 21w6d 24w6d 27w5d >69 n/a n/a n/a

2-30
Table 2-47: ULNA: Jeanty (Fetal Age)Obstetrical Ultrasound, Table 13.9, 1984Unit:
Meas (mm); Min/Mean/Max (Weeks/Days); Table/Graph Range: 5%:95%

Meas Min Mean Max Meas Min Mean Max

<10 n/a n/a n/a 38 22w1d 25w1d 28w1d

10 10w1d 13w1d 16w1d 39 22w4d 25w4d 28w5d
11 10w4d 13w4d 16w4d 40 23w1d 26w1d 29w1d
12 10w6d 13w6d 16w6d 41 23w4d 26w5d 29w5d
13 11w1d 14w1d 17w2d 42 24w1d 27w1d 30w2d
14 11w4d 14w4d 17w5d 43 24w5d 27w5d 30w6d
15 11w6d 15w0d 18w0d 44 25w1d 28w2d 31w2d
16 12w2d 15w3d 18w3d 45 25w6d 28w6d 31w6d
17 12w5d 15w5d 18w6d 46 26w2d 29w3d 32w3d
18 13w1d 16w1d 19w1d 47 26w6d 29w6d 33w0d
19 13w4d 16w4d 19w4d 48 27w3d 30w4d 33w4d
20 13w6d 16w6d 20w0d 49 28w0d 31w1d 34w1d
21 14w2d 17w2d 20w3d 50 28w4d 31w4d 34w5d
22 14w5d 17w5d 20w6d 51 29w1d 32w1d 35w2d
23 15w1d 18w1d 21w1d 52 29w5d 32w6d 35w6d
24 15w4d 18w4d 21w4d 53 30w2d 33w3d 36w3d
25 16w0d 19w0d 22w1d 54 30w6d 34w0d 37w0d
26 16w3d 19w3d 22w4d 55 31w4d 34w4d 37w5d
27 16w6d 19w6d 22w6d 56 32w1d 35w1d 38w2d
28 17w2d 20w2d 23w3d 57 32w6d 35w6d 38w6d
29 17w5d 20w6d 23w6d 58 33w3d 36w3d 39w4d
30 18w1d 21w1d 24w2d 59 34w0d 37w1d 40w1d
31 18w4d 21w5d 24w6d 60 34w4d 37w5d 40w6d
32 19w1d 22w1d 25w1d 61 35w2d 38w2d 41w3d
33 19w4d 22w5d 25w5d 62 35w6d 39w0d 42w0d
34 20w1d 23w1d 26w1d 63 36w4d 39w4d 42w5d
35 20w4d 23w4d 26w5d 64 37w1d 40w2d 43w2d
36 21w1d 24w1d 27w1d >64 n/a n/a n/a
37 21w4d 24w4d 27w5d

2-31
JSUM
Table 2-48: AC, JSUM, J Med Ultrasound Vol.28 No.5 (2001)Unit: AC (cm); Age (w+d);
SD (cm)

Age AC Age 1SD Age AC Age 1SD

16 10.4 16+0 0.57 30 24.2 30+0 1.24

17 11.4 17+0 0.62 31 25.1 31+0 1.29
18 12.5 18+0 0.67 32 25.9 32+0 1.33
19 13.5 19+0 0.71 33 26.8 33+0 1.38
20 14.5 20+0 0.76 34 27.6 34+0 1.43
21 15.5 21+0 0.81 35 28.4 35+0 1.48
22 16.5 22+0 0.86 36 29.2 36+0 1.52
23 17.5 23+0 0.90 37 29.9 37+0 1.57
24 18.5 24+0 0.95 38 30.6 38+0 1.62
25 19.5 25+0 1.00 39 31.3 39+0 1.67
26 20.5 26+0 1.05 40 31.9 40+0 1.71
27 21.4 27+0 1.10 41 32.5 41+0 1.76
28 22.4 28+0 1.14 42 33.1 42+0 1.81
29 23.3 29+0 1.19

Table 2-49: BPD, JSUM, J Med Ultrasound Vol.28 No.5 (2001)Unit: BPD (mm); Age
(w+d); SD (mm)

Age BPD Age 1SD Age BPD Age 1SD

10 12.6 10+0 2.29 27 67.4 27+0 3.23

11 15.9 11+0 2.34 28 70.1 28+0 3.29
12 19.3 12+0 2.40 29 72.6 29+0 3.35
13 22.7 13+0 2.45 30 75.1 30+0 3.40
14 26.1 14+0 2.51 31 77.4 31+0 3.46
15 29.5 15+0 2.57 32 79.6 32+0 3.51
16 32.9 16+0 2.62 33 81.7 33+0 3.57
17 36.3 17+0 2.68 34 83.6 34+0 3.62
18 39.6 18+0 2.73 35 85.3 35+0 3.68
19 43.0 19+0 2.79 36 86.9 36+0 3.74
20 46.2 20+0 2.84 37 88.3 37+0 3.79
21 49.5 21+0 2.90 38 89.6 38+0 3.85
22 52.6 22+0 2.96 39 90.6 39+0 3.90
23 55.7 23+0 3.01 40 91.5 40+0 3.96
24 58.8 24+0 3.07 41 92.2 41+0 4.01
25 61.7 25+0 3.12 42 92.6 42+0 4.07
26 64.6 26+0 3.18

2-32
Table 2-50: CRL, JSUM, J Med Ultrasound Vol.28 No.5 (2001)Unit: GA (week+day);
CRL (mm)

CRL

GA 5% 10% 50% 90% 95%

7W+0 5.7 6.8 10.1 16.0 17.2

7W+2 6.0 7.3 10.5 15.7 16.4
7W+4 6.5 8.1 11.3 16.0 16.6
7W+6 7.2 9.0 12.5 17.0 17.5
8W+1 8.1 10.2 14.0 18.4 19.1
8W+3 9.1 11.6 15.8 20.4 21.3
8W+5 10.3 13.1 17.8 22.7 24.0
9W+0 11.7 14.9 20.0 25.4 27.0
9W+2 13.3 16.7 22.5 28.3 30.3
9W+4 15.1 18.7 25.0 31.4 33.7
9W+6 17.1 20.9 27.6 34.6 37.3
10W+1 19.2 23.1 30.3 37.8 40.7
10W+3 21.5 25.4 33.1 41.0 44.1
10W+5 24.1 27.9 35.8 44.1 47.1
11W+0 26.7 30.4 38.4 47.0 49.8
11W+2 29.6 32.9 40.9 49.6 52.1
11W+4 32.7 35.5 43.3 51.9 53.8

Table 2-51: EFW, JSUM, J Med Ultrasound Vol.28 No.5 (2001)Unit: EFW (g); Age
(w+d); 1SD (g)

Age EFW Age 1SD Age EFW Age 1SD

18 187 18+0 30.13 30 1,470 30+0 185.98

19 247 19+0 40.47 31 1,635 31+0 202.09
20 313 20+0 51.30 32 1,805 32+0 218.68
21 387 21+0 62.61 33 1,980 33+0 235.75
22 469 22+0 74.39 34 2,156 34+0 253.30
23 560 23+0 86.66 35 2,333 35+0 271.33
24 660 24+0 99.41 36 2,507 36+0 289.84
25 771 25+0 112.64 37 2,676 37+0 308.83
26 892 26+0 126.35 38 2,838 38+0 328.30
27 1,023 27+0 140.53 39 2,989 39+0 348.25
28 1,163 28+0 155.20 40 3,125 40+0 368.68
29 1,313 29+0 170.35 41 3,244 41+0 389.59

2-33
Table 2-52: FL, JSUM, J Med Ultrasound Vol.28 No.5 (2001)Unit: FL (mm); Age (w+d);
SD (mm)

Age FL Age 1SD Age FL Age 1SD

16 20.1 16+0 2.64 30 53.8 30+0 3.11

17 22.7 17+0 2.67 31 55.8 31+0 3.15
18 25.3 18+0 2.71 32 57.8 32+0 3.18
19 27.8 19+0 2.74 33 59.6 33+0 3.21
20 30.4 20+0 2.77 34 61.4 34+0 3.25
21 32.9 21+0 2.81 35 63.0 35+0 3.28
22 35.4 22+0 2.84 36 64.6 36+0 3.31
23 37.9 23+0 2.88 37 66.0 37+0 3.35
24 40.3 24+0 2.91 38 67.4 38+0 3.38
25 42.7 25+0 2.94 39 68.6 39+0 3.42
26 45.0 26+0 2.98 40 69.6 40+0 3.45
27 47.3 27+0 3.01 41 70.6 41+0 3.48
28 49.6 28+0 3.04 42 71.4 42+0 3.52
29 51.7 29+0 3.08

Table 2-53: MCA PI values with advance in gestationJSUM, J Med Ultrasound Vol.28
No.5 (2001)Unit: Age (Weeks)

Age 5% 10% 50% 90% 95% Age 5% 10% 50% 90% 95%

20 1.271 1.270 1.440 1.880 1.990 31 1.446 1.515 1.933 2.436 2.489
21 1.318 1.329 1.537 1.986 2.091 32 1.425 1.493 1.915 2.420 2.468
22 1.359 1.381 1.623 2.080 2.182 33 1.397 1.464 1.887 2.394 2.435
23 1.393 1.426 1.699 2.164 2.261 34 1.363 1.427 1.849 2.356 2.390
24 1.421 1.463 1.765 2.236 2.328 35 1.324 1.383 1.800 2.308 2.335
25 1.444 1.493 1.820 2.298 2.385 36 1.277 1.331 1.741 2.248 2.268
26 1.459 1.515 1.865 2.348 2.430 37 1.225 1.272 1.671 2.178 2.191
27 1.469 1.530 1.899 2.388 2.465 38 1.167 1.205 1.591 2.096 2.102
28 1.473 1.537 1.923 2.416 2.488 39 1.102 1.131 1.501 2.004 2.001
29 1.470 1.537 1.937 2.434 2.499 40 1.031 1.050 1.400 1.900 1.890
30 1.461 1.530 1.940 2.440 2.500 41 0.954 0.961 1.289 1.786 1.767

Table 2-54: MCA RI values with advance in gestationJSUM, J Med Ultrasound Vol.28
No.5 (2001)Unit: Age (Weeks)

Age 5% 10% 50% 90% 95% Age 5% 10% 50% 90% 95%

20 0.717 0.718 0.775 0.842 0.871 31 0.769 0.789 0.865 0.922 0.928
21 0.731 0.735 0.793 0.857 0.883 32 0.762 0.783 0.862 0.920 0.925
22 0.742 0.749 0.808 0.871 0.894 33 0.755 0.775 0.857 0.916 0.920
23 0.753 0.761 0.821 0.883 0.903 34 0.745 0.766 0.851 0.911 0.914
24 0.761 0.772 0.833 0.894 0.911 35 0.733 0.754 0.843 0.904 0.907
25 0.767 0.780 0.743 0.903 0.918 36 0.720 0.740 0.833 0.895 0.898
26 0.772 0.787 0.851 0.910 0.923 37 0.705 0.725 0.821 0.885 0.888
27 0.775 0.791 0.857 0.916 0.927 38 0.688 0.707 0.808 0.873 0.876
28 0.776 0.793 0.862 0.920 0.929 39 0.669 0.688 0.793 0.859 0.863
29 0.775 0.794 0.865 0.922 0.930 40 0.649 0.666 0.775 0.844 0.849
30 0.773 0.792 0.865 0.923 0.930 41 0.627 0.643 0.757 0.827 0.833

2-34
Table 2-55: UMA PI values with advance in gestationJSUM, J Med Ultrasound Vol.28
No.5 (2001)Unit: Age (Weeks)

Age 5% 10% 50% 90% 95% Age 5% 10% 50% 90% 95%

20 1.118 1.144 1.390 1.620 1.688 31 0.766 0.821 0.986 1.161 1.285
21 1.075 1.106 1.340 1.565 1.641 32 0.747 0.802 0.965 1.135 1.261
22 1.034 1.069 1.293 1.513 1.597 33 0.731 0.785 0.947 1.112 1.238
23 0.996 1.034 1.249 1.464 1.554 34 0.716 0.770 0.931 1.091 1.218
24 0.959 1.001 1.207 1.417 1.514 35 0.704 0.757 0.918 1.073 1.199
25 0.925 0.970 1.168 1.373 1.475 36 0.694 0.746 0.907 1.057 1.182
26 0.893 0.941 1.131 1.331 1.438 37 0.686 0.736 0.899 1.044 1.168
27 0.863 0.913 1.097 1.292 1.404 38 0.681 0.728 0.893 1.033 1.155
28 0.836 0.887 1.065 1.255 1.371 39 0.677 0.722 0.890 1.025 1.145
29 0.810 0.863 1.036 1.221 1.341 40 0.676 0.718 0.890 1.020 1.136
30 0.787 0.841 1.010 1.190 1.312 41 0.677 0.716 0.892 1.017 1.129

Table 2-56: UMA RI values with advance in gestationJSUM, J Med Ultrasound Vol.28
No.5 (2001)Unit: Age (Weeks)

Age 5% 10% 50% 90% 95% Age 5% 10% 50% 90% 95%

20 0.698 0.722 0.778 0.820 0.846 31 0.535 0.589 0.648 0.700 0.746
21 0.680 0.707 0.763 0.808 0.836 32 0.524 0.580 0.640 0.690 0.738
22 0.663 0.692 0.749 0.796 0.826 33 0.513 0.573 0.632 0.681 0.730
23 0.646 0.679 0.735 0.785 0.816 34 0.503 0.565 0.625 0.672 0.723
24 0.630 0.665 0.722 0.774 0.807 35 0.494 0.559 0.619 0.663 0.716
25 0.615 0.653 0.710 0.763 0.798 36 0.485 0.552 0.613 0.654 0.708
26 0.600 0.640 0.698 0.752 0.788 37 0.477 0.547 0.608 0.645 0.702
27 0.586 0.629 0.687 0.741 0.780 38 0.469 0.542 0.603 0.636 0.695
28 0.572 0.618 0.676 0.730 0.771 39 0.462 0.538 0.599 0.628 0.688
29 0.559 0.608 0.666 0.720 0.762 40 0.456 0.534 0.596 0.620 0.682
30 0.547 0.598 0.657 0.710 0.754 41 0.450 0.531 0.593 0.612 0.676

2-35
Kurtz
Table 2-57: BPD: Kurtz (Fetal Age)Journal of Clinical Ultrasound, 8: 319-326,
1980Unit: BPD (mm); Age (Days); SD (mm)

BPD Age SD BPD Age SD BPD Age SD BPD Age SD

<21 n/a —— 40 125 4 60 168 5 80 222 5

21 84 4 41 127 4 61 170 5 81 225 5
22 87 4 42 129 4 62 173 5 82 229 5
23 91 4 43 131 4 63 175 5 83 232 5
24 93 4 44 133 4 64 178 5 84 235 5
25 95 4 45 135 4 65 181 5 85 238 5
26 97 4 46 137 4 66 183 5 86 241 5
27 99 4 47 139 4 67 186 5 87 244 5
28 101 4 48 141 4 68 188 5 88 248 5
29 103 4 49 143 4 69 191 5 89 252 5
30 105 4 50 145 4 70 194 5 90 257 5
31 107 4 51 147 4 71 196 5 91 262 5
32 109 4 52 149 4 72 199 5 92 267 5
33 111 4 53 151 4 73 201 5 93 272 5
34 113 4 54 153 4 74 204 5 94 276 5
35 115 4 55 155 5 75 207 5 95 280 5
36 117 4 56 157 5 76 210 5 96 284 5
37 119 4 57 160 5 77 213 5 97 288 5
38 121 4 58 162 5 78 216 5 98 293 5
39 123 4 59 165 5 79 219 5 >98 n/a ——

Mayden
Table 2-58: IOD: Mayden (Fetal Age)Am J Obstet Gynecol 144:289, 1982Unit: Meas
(mm); Mean (Weeks)

Meas Mean Meas Mean Meas Mean Meas Mean

5 11.6 11 17.9 16 24.3 19 32.5

5 11.6 12 18.4 16 24.7 19 33.0
6 12.1 12 18.9 16 25.2 19 33.5
6 12.6 12 19.4 16 25.2 19 34.0
6 12.6 13 19.4 17 25.7 19 34.4
7 13.1 13 19.9 17 26.2 19 35.0
7 13.6 13 20.4 17 26.2 19 35.4
7 13.6 13 20.4 17 26.7 19 35.9
8 14.1 14 20.9 17 27.2 19 36.4
8 14.6 14 21.3 17 27.6 19 36.9
8 14.6 14 21.3 17 28.1 19 37.3
9 15.0 14 21.8 18 28.6 19 37.8
9 15.5 14 22.3 18 29.1 19 38.3
9 15.5 15 22.3 18 29.6 19 38.3
10 16.0 15 22.8 18 30.0 19 39.3
10 16.5 15 23.3 18 30.6 19 39.8
10 16.5 15 23.3 18 31.0
10 17.0 15 23.8 18 31.5 2-36
11 17.5 16 24.3 18 32.0
Table 2-59: OOD: Mayden (Fetal Age)Am J Obstet Gynecol 144:289, 1982Unit: Meas
(mm); Mean (Weeks)

Meas Mean Meas Mean Meas Mean Meas Mean

13 11.6 28 17.9 42 24.3 52 32.5

14 11.6 30 18.4 43 24.7 53 33.0
15 12.1 31 18.9 43 25.2 54 33.5
16 12.6 32 19.4 44 25.2 54 34.0
17 12.6 32 19.4 44 25.7 54 34.4
17 13.1 33 19.9 45 26.2 55 35.0
18 13.6 34 20.4 45 26.2 55 35.4
19 13.6 34 20.4 46 26.7 56 35.9
20 14.1 35 20.9 46 27.2 56 36.4
21 14.6 36 21.3 47 27.6 57 36.9
21 14.6 36 21.3 47 28.1 57 37.3
22 15.0 37 21.8 48 28.6 58 37.8
23 15.5 38 22.3 48 29.1 58 38.3
24 15.5 38 22.3 49 29.6 58 38.3
25 16.0 39 22.8 50 30.0 59 39.3
25 16.5 40 23.3 50 30.6 59 39.8
26 16.5 40 23.3 51 31.0
27 17.0 41 23.8 51 31.5
27 17.5 41 24.3 52 32.0

2-37
Mercer
Table 2-60: Ft: Mercer (Fetal Age)Am J Obstet Gynecol, 156: 350-355, 1987Unit:
Meas (mm); Min/Mean/Max (Weeks); Table/Graph Range: 2SD

Meas Min Mean Max Meas Min Mean Max

<10 n/a n/a n/a 50 24.3 26.4 28.4

10 11.5 12.5 13.5 52 24.9 27.1 29.3
12 12.1 13.1 14.2 54 25.7 27.9 30.1
14 12.7 13.8 14.9 56 26.4 28.4 30.9
16 13.3 14.4 15.5 58 27.1 29.4 31.8
18 13.9 15.1 16.3 60 27.8 30.2 32.6
20 14.5 15.7 17.0 62 28.5 31.0 33.5
22 15.1 16.4 17.7 64 29.3 31.8 34.3
24 15.7 17.1 18.4 66 30.0 32.6 35.2
26 16.3 17.7 19.1 68 30.7 33.4 36.1
28 16.9 18.4 19.9 70 31.5 34.2 36.9
30 17.6 19.1 20.6 72 32.2 35.0 37.8
32 18.2 19.8 21.4 74 33.0 35.9 38.7
34 18.9 20.5 22.1 76 33.8 36.8 39.6
36 19.5 21.2 22.9 78 34.5 37.5 40.5
38 20.2 21.9 23.7 80 35.3 38.4 41.4
40 20.8 22.7 24.5 82 36.1 39.2 42.4
42 21.5 23.4 25.2 84 36.9 40.1 43.3
44 22.2 24.1 26.0 86 37.7 41.0 44.2
46 22.9 24.9 26.8 >86 n/a n/a n/a
48 23.6 25.6 27.6

2-38
Merz
Table 2-61: AC: Merz (Fetal Age) Habilitationsschrift, Mainz University Women’s
Hospital, 1988, Unit: Meas (mm); Min/Mean/Max (Weeks); Table/Graph Range: 5%:95%

Meas Min Mean Max Meas Min Mean Max

<56 n/a n/a n/a 148 19w2d 20w6d 22w3d

56 10w6d 12w1d 13w2d 150 19w4d 21w1d 22w4d
58 11w1d 12w2d 13w4d 152 19w5d 21w1d 22w6d
60 11w2d 12w4d 13w5d 154 19w6d 21w3d 23w0d
62 11w4d 12w5d 13w6d 156 20w1d 21w4d 23w1d
64 11w5d 12w6d 14w1d 158 20w1d 21w6d 23w3d
66 11w6d 13w1d 14w2d 160 20w3d 22w0d 23w4d
68 12w0d 13w2d 14w4d 162 20w4d 22w1d 23w6d
70 12w1d 13w4d 14w5d 164 20w6d 22w3d 24w0d
72 12w3d 13w4d 14w6d 166 21w0d 22w4d 24w1d
74 12w4d 13w6d 15w1d 168 21w1d 22w6d 24w3d
76 12w6d 14w0d 15w2d 170 21w2d 23w0d 24w4d
78 12w6d 14w1d 15w4d 172 21w4d 23w1d 24w6d
80 13w1d 14w3d 15w5d 174 21w5d 23w2d 25w0d
82 13w2d 14w4d 15w6d 176 21w6d 23w4d 25w1d
84 13w4d 14w6d 16w1d 178 22w1d 23w5d 25w3d
86 13w5d 15w0d 16w2d 180 22w1d 23w6d 25w4d
88 13w6d 15w1d 16w4d 182 22w3d 24w1d 25w6d
90 14w0d 15w3d 16w5d 184 22w4d 24w2d 26w0d
92 14w1d 15w4d 16w6d 186 22w6d 24w4d 26w1d
94 14w3d 15w5d 17w1d 188 23w0d 24w5d 26w3d
96 14w4d 15w6d 17w2d 190 23w1d 24w6d 26w4d
98 14w6d 16w1d 17w4d 192 23w2d 25w0d 26w6d
100 14w6d 16w2d 17w5d 194 23w4d 25w1d 27w0d
102 15w1d 16w4d 17w6d 196 23w5d 25w3d 27w1d
104 15w2d 16w5d 18w1d 198 23w6d 25w4d 27w3d
106 15w4d 16w6d 18w2d 200 24w1d 25w6d 27w4d
108 15w5d 17w1d 18w3d 202 24w2d 26w0d 27w6d
110 15w6d 17w2d 18w4d 204 24w3d 26w1d 27w6d
112 16w0d 17w3d 18w6d 206 24w4d 26w3d 28w1d
114 16w1d 17w4d 19w0d 208 24w6d 26w4d 28w2d
116 16w3d 17w6d 19w1d 210 25w0d 26w6d 28w4d
118 16w4d 18w0d 19w3d 212 25w1d 27w0d 28w5d
120 16w6d 18w1d 19w4d 214 25w2d 27w1d 28w6d
122 17w0d 18w3d 19w6d 216 25w4d 27w2d 29w1d
124 17w1d 18w4d 20w0d 218 25w5d 27w4d 29w2d
126 17w2d 18w6d 20w1d 220 25w6d 27w5d 29w4d
128 17w4d 19w0d 20w3d 222 26w1d 27w6d 29w5d
130 17w5d 19w1d 20w4d 224 26w2d 28w1d 29w6d
132 17w6d 19w2d 20w6d 226 26w3d 28w2d 30w1d
134 18w0d 19w4d 21w0d 228 26w4d 28w4d 30w2d
136 18w1d 19w5d 21w1d 230 26w6d 28w5d 30w4d
138 18w3d 19w6d 21w3d 232 27w0d 28w6d 30w5d
140 18w4d 20w1d 21w4d 234 27w1d 29w0d 30w6d
142 18w6d 20w2d 21w6d 236 27w3d 29w1d 31w1d
144 19w0d 20w4d 22w0d 238 27w4d 29w3d 31w2d
146 19w1d 20w5d 22w1d 240 27w5d 29w4d 31w4d

2-39
 Table 2-61: AC: Merz (Fetal Age) Habilitationsschrift, Mainz University Women’s
Hospital, 1988, Unit: Meas (mm); Min/Mean/Max (Weeks); Table/Graph Range: 5%:95%

Meas Min Mean Max Meas Min Mean Max

242 27w6d 29w6d 31w5d 298 33w0d 35w1d 37w1d

244 28w1d 30w0d 31w6d 300 33w1d 35w2d 37w3d
246 28w2d 30w1d 32w1d 302 33w3d 35w4d 37w4d
248 28w3d 30w3d 32w2d 304 33w4d 35w5d 37w6d
250 28w4d 30w4d 32w4d 306 33w5d 35w6d 38w0d
252 28w6d 30w6d 32w5d 308 33w6d 36w1d 38w1d
254 29w0d 30w6d 32w6d 310 34w1d 36w2d 38w3d
256 29w1d 31w1d 33w1d 312 34w2d 36w4d 38w4d
258 29w3d 31w2d 33w2d 314 34w4d 36w4d 38w6d
260 29w4d 31w4d 33w4d 316 34w4d 36w6d 39w0d
262 29w5d 31w5d 33w5d 318 34w6d 37w0d 39w1d
264 29w6d 31w6d 33w6d 320 35w0d 37w1d 39w3d
266 30w1d 32w1d 34w1d 322 35w1d 37w3d 39w4d
268 30w2d 32w2d 34w2d 324 35w3d 37w4d 39w6d
270 30w4d 32w4d 34w4d 326 35w4d 37w6d 40w0d
272 30w4d 32w5d 34w5d 328 35w5d 38w0d 40w1d
274 30w6d 32w6d 34w6d 330 35w6d 38w1d 40w3d
276 31w0d 33w0d 35w1d 332 36w1d 38w3d 40w4d
278 31w1d 33w1d 35w2d 334 36w2d 38w4d 40w6d
280 31w3d 33w3d 35w4d 336 36w4d 38w5d 41w0d
282 31w4d 33w4d 35w5d 338 36w5d 38w6d 41w1d
284 31w5d 33w6d 35w6d 340 36w6d 39w1d 41w3d
286 31w6d 34w0d 36w1d 342 37w0d 39w2d 41w4d
288 32w1d 34w1d 36w2d 344 37w1d 39w4d 41w6d
290 32w2d 34w3d 36w4d 346 37w3d 39w5d 42w0d
292 32w4d 34w4d 36w5d 348 37w4d 39w6d 42w1d
294 32w4d 34w5d 36w6d >348 n/a n/a n/a
296 32w6d 34w6d 37w1d

2-40
Table 2-62: AC: Merz (Fetal Growth) Habilitationsschrift, Mainz University Women’s
Hospital, 1988Unit: Age (Weeks); Min/Mean/Max (mm); Table/Graph Range 5%:95%)

Age Min Mean Max Age Min Mean Max

12.5 50 62 74 27.5 202 222 242

13.0 55 67 80 28.0 207 227 247
13.5 60 73 85 28.5 212 232 252
14.0 65 78 91 29.0 217 237 257
14.5 71 83 96 29.5 221 242 263
15.0 76 89 102 30.0 226 247 268
15.5 81 94 108 30.5 231 252 273
16.0 86 100 114 31.0 235 257 278
16.5 91 105 119 31.5 240 262 283
17.0 96 111 125 32.0 244 266 288
17.5 102 116 131 32.5 249 271 293
18.0 107 122 136 33.0 253 276 298
18.5 112 127 142 33.5 258 280 303
19.0 117 132 148 34.0 262 285 308
19.5 122 138 153 34.5 266 289 313
20.0 127 143 159 35.0 270 294 317
20.5 133 149 165 35.5 275 298 322
21.0 138 154 170 36.0 279 303 327
21.5 143 159 176 36.5 283 307 331
22.0 148 165 181 37.0 287 311 336
22.5 153 170 187 37.5 290 315 340
23.0 158 175 193 38.0 294 319 344
23.5 163 181 198 38.5 298 323 348
24.0 168 186 204 39.0 301 327 352
24.5 173 191 209 39.5 305 331 356
25.0 178 196 215 40.0 308 334 360
25.5 183 202 220 40.5 311 338 364
26.0 188 207 226 41.0 314 341 367
26.5 193 212 231 41.5 317 343 370
27.0 198 217 236

2-41
 Table 2-63: BPD: Merz (Fetal Age)Habilitationsschrift, Mainz University Women’s
Hospital, 1988Unit: BPD (mm); % Age (Weeks/Days)

Meas Min Mean Max Meas Min Mean Max

<21 n/a n/a n/a 62 22w1d 24w1d 26w1d

21 10w5d 12w1d 13w5d 63 22w4d 24w4d 26w4d
22 10w6d 12w3d 13w6d 64 22w6d 24w6d 26w6d
23 11w1d 12w5d 14w1d 65 23w1d 25w1d 27w1d
24 11w4d 13w0d 14w4d 66 23w4d 25w4d 27w4d
25 11w5d 13w1d 14w5d 67 23w6d 25w6d 27w6d
26 12w0d 13w4d 15w0d 68 24w1d 26w1d 28w2d
27 12w1d 13w6d 15w3d 69 24w3d 26w4d 28w4d
28 12w4d 14w1d 15w5d 70 24w5d 26w6d 28w6d
29 12w5d 14w2d 15w6d 71 25w1d 27w1d 29w2d
30 13w0d 14w4d 16w1d 72 25w4d 27w4d 29w5d
31 13w2d 14w6d 16w4d 73 25w6d 27w6d 30w0d
32 13w4d 15w1d 16w6d 74 26w1d 28w2d 30w3d
33 13w6d 15w3d 17w0d 75 26w4d 28w4d 30w5d
34 14w0d 15w5d 17w3d 76 26w6d 29w0d 31w1d
35 14w2d 16w0d 17w5d 77 27w1d 29w3d 31w4d
36 14w4d 16w2d 18w0d 78 27w4d 29w6d 32w0d
37 14w6d 16w4d 18w1d 79 27w6d 30w1d 32w2d
38 15w1d 16w6d 18w4d 80 28w2d 30w4d 32w5d
39 15w3d 17w1d 18w6d 81 28w5d 30w6d 33w1d
40 15w5d 17w3d 19w1d 82 29w1d 31w2d 33w4d
41 15w6d 17w5d 19w4d 83 29w4d 31w5d 33w6d
42 16w1d 18w0d 19w6d 84 29w6d 32w1d 34w2d
43 16w4d 18w2d 20w1d 85 30w2d 32w4d 34w6d
44 16w6d 18w4d 20w3d 86 30w5d 32w6d 35w1d
45 17w1d 18w6d 20w5d 87 31w0d 33w2d 35w4d
46 17w3d 19w1d 21w0d 88 31w4d 33w6d 36w1d
47 17w4d 19w3d 21w1d 89 31w6d 34w1d 36w4d
48 17w6d 19w5d 21w4d 90 32w2d 34w4d 36w6d
49 18w1d 20w0d 21w6d 91 32w6d 35w1d 37w3d
50 18w4d 20w3d 22w1d 92 33w1d 35w4d 37w6d
51 18w6d 20w5d 22w4d 93 33w4d 35w6d 38w1d
52 19w1d 21w0d 22w6d 94 34w0d 36w3d 38w6d
53 19w3d 21w2d 23w1d 95 34w4d 36w6d 39w2d
54 19w5d 21w4d 23w4d 96 34w6d 37w2d 39w5d
55 20w0d 21w6d 23w6d 97 35w3d 37w6d 40w1d
56 20w2d 22w1d 24w1d 98 35w6d 38w2d 40w5d
57 20w4d 22w4d 24w3d 99 36w3d 38w6d 41w1d
58 20w6d 22w6d 24w5d 100 36w6d 39w2d 41w6d
59 21w1d 23w1d 25w1d 101 37w2d 39w6d 42w2d
60 21w4d 23w4d 25w4d 102 37w6d 40w2d 42w6d
61 21w6d 23w6d 25w6d >102 n/a n/a n/a

2-42
Table 2-64: BPD: Merz (Fetal Growth)Habilitationsschrift, Mainz University Women’s
Hospital, 1988Unit: Age (Weeks); Min/Mean/Max (mm); Table/Graph Range 5%:95%)

Age Min Mean Max Age Min Mean Max

12.5 21 25 29 27.5 68 73 78
13.0 23 26 30 28.0 69 74 79
13.5 24 28 31 28.5 71 76 81
14.0 25 29 33 29.0 72 77 82
14.5 27 31 35 29.5 73 78 84
15.0 28 32 36 30.0 74 80 85
15.5 30 34 38 30.5 76 81 86
16.0 31 35 39 31.0 77 82 88
16.5 33 37 41 31.5 78 83 89
17.0 35 39 43 32.0 79 85 90
17.5 36 40 45 32.5 80 86 91
18.0 38 42 46 33.0 81 87 92
18.5 40 44 48 33.5 82 88 93
19.0 41 46 50 34.0 83 89 95
19.5 43 47 52 34.5 84 90 96
20.0 45 49 53 35.0 85 91 97
20.5 46 51 55 35.5 86 92 97
21.0 48 52 57 36.0 87 92 98
21.5 49 54 59 36.5 87 93 99
22.0 51 56 60 37.0 88 94 100
22.5 53 57 62 37.5 89 95 101
23.0 54 59 64 38.0 89 95 101
23.5 56 61 65 38.5 90 96 102
24.0 57 62 67 39.0 90 96 103
24.5 59 64 69 39.5 91 97 103
25.0 61 65 70 40.0 91 97 103
25.5 62 67 72 40.5 91 97 104
26.0 64 68 73 41.0 91 98 104
26.5 65 70 75 41.5 92 98 104
27.0 66 71 77

2-43
 Table 2-65: FL: Merz (Fetal Age)Habilitationsschrift, Mainz University Women’s
Hospital, 1988Unit: FL (mm); % Age (Weeks/Days)

Meas Min Mean Max Meas Min Mean Max

<10 n/a n/a n/a 46 23w4d 25w3d 27w1d

10 11w1d 12w2d 13w4d 47 24w0d 25w6d 27w4d
11 11w4d 12w5d 13w6d 48 24w3d 26w1d 28w0d
12 11w6d 13w0d 14w1d 49 24w5d 26w4d 28w2d
13 12w1d 13w2d 14w4d 50 25w1d 26w6d 28w5d
14 12w3d 13w5d 15w0d 51 25w4d 27w2d 29w1d
15 12w5d 14w0d 15w2d 52 25w6d 27w5d 29w4d
16 13w1d 14w3d 15w5d 53 26w1d 28w1d 30w0d
17 13w3d 14w5d 16w0d 54 26w4d 28w4d 30w4d
18 13w6d 15w1d 16w3d 55 27w0d 29w0d 31w0d
19 14w1d 15w3d 16w5d 56 27w3d 29w3d 31w3d
20 14w4d 15w6d 17w1d 57 27w6d 29w6d 31w6d
21 14w6d 16w1d 17w3d 58 28w1d 30w1d 32w1d
22 15w1d 16w4d 17w6d 59 28w4d 30w4d 32w4d
23 15w3d 16w6d 18w1d 60 29w0d 31w0d 33w0d
24 15w6d 17w1d 18w4d 61 29w4d 31w4d 33w4d
25 16w1d 17w4d 19w1d 62 29w6d 31w6d 33w6d
26 16w3d 17w6d 19w3d 63 30w2d 32w2d 34w2d
27 16w6d 18w2d 19w6d 64 30w6d 32w6d 34w6d
28 17w1d 18w4d 20w1d 65 31w1d 33w1d 35w1d
29 17w4d 19w0d 20w4d 66 31w4d 33w4d 35w4d
30 17w6d 19w3d 20w6d 67 32w0d 34w1d 36w1d
31 18w1d 19w5d 21w1d 68 32w3d 34w4d 36w4d
32 18w4d 20w1d 21w4d 69 32w6d 35w0d 37w1d
33 18w6d 20w4d 22w1d 70 33w2d 35w3d 37w4d
34 19w1d 20w6d 22w3d 71 33w6d 35w6d 38w0d
35 19w4d 21w1d 22w6d 72 34w1d 36w2d 38w3d
36 20w0d 21w4d 23w1d 73 34w4d 36w6d 39w0d
37 20w2d 21w6d 23w4d 74 35w1d 37w2d 39w4d
38 20w5d 22w2d 23w6d 75 35w4d 37w5d 39w6d
39 21w0d 22w5d 24w3d 76 36w0d 38w1d 40w3d
40 21w3d 23w1d 24w6d 77 36w4d 38w5d 40w6d
41 21w5d 23w3d 25w1d 78 37w0d 39w1d 41w3d
42 22w1d 23w6d 25w4d 79 37w3d 39w4d 41w6d
43 22w4d 24w1d 25w6d 80 37w6d 40w1d 42w2d
44 22w6d 24w4d 26w3d >80 n/a n/a n/a
45 23w1d 25w0d 26w6d

2-44
Table 2-66: FL: Merz (Fetal Growth)Habilitationsschrift, Mainz University Women’s
Hospital, 1988Unit: Age (Weeks); Min/Mean/Max (mm); Table/Graph Range 5%:95%)

Age Min Mean Max Age Min Mean Max

12.5 6 9 12 27.5 48 52 57
13.0 8 11 14 28.0 49 53 58
13.5 10 13 16 28.5 50 55 59
14.0 11 15 18 29.0 51 56 60
14.5 13 16 20 29.5 52 57 61
15.0 15 18 21 30.0 53 58 62
15.5 16 20 23 30.5 54 59 63
16.0 18 21 25 31.0 55 60 64
16.5 19 23 26 31.5 56 61 66
17.0 21 24 28 32.0 57 62 67
17.5 22 26 29 32.5 58 63 68
18.0 24 27 31 33.0 59 64 69
18.5 25 29 32 33.5 60 65 70
19.0 27 30 34 34.0 61 66 71
19.5 28 32 35 34.5 62 67 72
20.0 29 33 37 35.0 63 68 73
20.5 31 35 38 35.5 64 69 74
21.0 32 36 40 36.0 65 70 74
21.5 33 37 41 36.5 66 70 75
22.0 35 39 42 37.0 66 71 76
22.5 36 40 44 37.5 67 72 77
23.0 37 41 45 38.0 68 73 78
23.5 39 43 46 38.5 69 74 79
24.0 40 44 48 39.0 69 74 79
24.5 41 45 49 39.5 70 75 80
25.0 42 46 50 40.0 71 76 81
25.5 43 48 52 40.5 71 76 81
26.0 45 49 53 41.0 72 77 82
26.5 46 50 54 41.5 72 77 83
27.0 47 51 55

2-45
 Table 2-67: HC: Merz (Fetal Age) Habilitationsschrift, Mainz University Women’s
Hospital, 1988Unit: HC (mm); % Age (Weeks/Days)

Meas Min Mean Max Meas Min Mean Max

>72 n/a n/a n/a 172 17w6d 19w2d 20w6d

72 11w0d 12w1d 13w1d 174 17w6d 19w3d 20w6d
74 11w1d 12w2d 13w4d 176 18w0d 19w4d 21w1d
76 11w1d 12w3d 13w4d 178 18w1d 19w6d 21w3d
78 11w2d 12w4d 13w5d 180 18w2d 19w6d 21w4d
80 11w4d 12w5d 13w6d 182 18w4d 20w1d 21w5d
82 11w4d 12w6d 14w0d 184 18w4d 20w1d 21w6d
84 11w5d 12w6d 14w1d 186 18w6d 20w3d 22w0d
86 11w6d 13w1d 14w2d 188 19w0d 20w4d 22w1d
88 12w0d 13w1d 14w3d 190 19w1d 20w5d 22w2d
90 12w1d 13w2d 14w4d 192 19w2d 20w6d 22w4d
92 12w2d 13w4d 14w5d 194 19w4d 21w1d 22w5d
94 12w3d 13w4d 14w6d 196 19w4d 21w1d 22w6d
96 12w4d 13w5d 14w6d 198 19w5d 21w3d 23w0d
98 12w5d 13w6d 15w1d 200 19w6d 21w4d 23w2d
100 12w6d 14w0d 15w1d 202 20w0d 21w5d 23w3d
102 12w6d 14w1d 15w4d 204 20w1d 21w6d 23w4d
104 13w0d 14w2d 15w4d 206 20w3d 22w1d 23w6d
106 13w1d 14w3d 15w5d 208 20w4d 22w1d 23w6d
108 13w2d 14w4d 15w6d 210 20w5d 22w3d 24w1d
110 13w3d 14w5d 16w0d 212 20w6d 22w4d 24w2d
112 13w4d 14w6d 16w1d 214 21w0d 22w5d 24w3d
114 13w5d 15w0d 16w2d 216 21w1d 22w6d 24w4d
116 13w6d 15w1d 16w3d 218 21w3d 23w1d 24w6d
118 14w0d 15w2d 16w4d 220 21w4d 23w2d 25w0d
120 14w1d 15w3d 16w5d 222 21w6d 23w4d 25w1d
122 14w1d 15w4d 17w0d 224 21w6d 23w4d 25w2d
124 14w2d 15w5d 17w1d 226 22w1d 23w6d 25w4d
126 14w3d 15w6d 17w1d 228 22w1d 24w0d 25w6d
128 14w4d 16w0d 17w3d 230 22w3d 24w1d 26w0d
130 14w5d 16w1d 17w4d 232 22w4d 24w3d 26w1d
132 14w6d 16w2d 17w5d 234 22w5d 24w4d 26w2d
134 15w0d 16w3d 17w6d 236 22w6d 24w5d 26w4d
136 15w1d 16w4d 18w0d 238 23w1d 24w6d 26w5d
138 15w2d 16w5d 18w1d 240 23w2d 25w1d 26w6d
140 15w4d 16w6d 18w2d 242 23w4d 25w2d 27w1d
142 15w4d 17w0d 18w3d 244 23w5d 25w4d 27w2d
144 15w6d 17w1d 18w4d 246 23w6d 25w5d 27w4d
146 15w6d 17w2d 18w5d 248 24w1d 25w6d 27w5d
148 16w0d 17w4d 19w0d 250 24w1d 26w0d 27w6d
150 16w1d 17w4d 19w1d 252 24w3d 26w1d 28w0d
152 16w2d 17w6d 19w2d 254 24w4d 26w3d 28w1d
154 16w3d 17w6d 19w3d 256 24w6d 26w4d 28w3d
156 16w4d 18w1d 19w4d 258 25w0d 26w6d 28w4d
158 16w5d 18w1d 19w5d 260 25w1d 27w0d 28w6d
160 16w6d 18w3d 19w6d 262 25w3d 27w1d 29w0d
162 17w0d 18w4d 20w0d 264 25w4d 27w3d 29w1d
164 17w1d 18w5d 20w1d 266 25w6d 27w4d 29w3d
166 17w2d 18w6d 20w2d 268 26w0d 27w6d 29w4d
168 17w4d 19w0d 20w4d 270 26w1d 28w1d 30w0d
170 17w4d 19w1d 20w4d 272 26w3d 28w2d 30w1d 2-46
 Table 2-67: HC: Merz (Fetal Age) Habilitationsschrift, Mainz University Women’s
Hospital, 1988Unit: HC (mm); % Age (Weeks/Days)

Meas Min Mean Max Meas Min Mean Max

274 26w4d 28w4d 30w3d 322 32w0d 34w1d 36w1d

276 26w6d 28w5d 30w4d 324 32w2d 34w3d 36w4d
278 27w0d 28w6d 30w6d 326 32w4d 34w5d 36w6d
280 27w1d 29w1d 31w0d 328 32w6d 34w6d 37w0d
282 27w3d 29w2d 31w1d 330 33w1d 35w1d 37w2d
284 27w5d 29w4d 31w4d 332 33w2d 35w4d 37w5d
286 27w6d 29w6d 31w5d 334 33w4d 35w6d 38w0d
288 28w1d 30w0d 31w6d 336 33w6d 36w1d 38w2d
290 28w2d 30w1d 32w1d 338 34w1d 36w3d 38w4d
292 28w4d 30w4d 32w3d 340 34w3d 36w4d 38w6d
294 28w6d 30w5d 32w4d 342 34w5d 36w6d 39w1d
296 29w0d 30w6d 32w6d 344 35w0d 37w1d 39w3d
298 29w1d 31w1d 33w0d 346 35w2d 37w4d 39w5d
300 29w3d 31w3d 33w3d 348 35w4d 37w6d 40w1d
302 29w4d 31w4d 33w4d 350 35w6d 38w1d 40w4d
304 29w6d 31w6d 33w6d 352 36w1d 38w4d 40w6d
306 30w1d 32w1d 34w1d 354 36w4d 38w6d 41w1d
308 30w2d 32w2d 34w2d 356 36w6d 39w1d 41w3d
310 30w4d 32w4d 34w4d 358 37w1d 39w4d 41w6d
312 30w6d 32w6d 34w6d 360 37w4d 39w6d 42w1d
314 31w1d 33w1d 35w1d 362 37w6d 40w1d 42w3d
316 31w3d 33w3d 35w3d 364 38w1d 40w4d 42w6d
318 31w4d 33w4d 35w4d >364 n/a n/a n/a
320 31w6d 33w6d 36w0d

2-47
Table 2-68: HC: Merz (Fetal Growth) Habilitationsschrift, Mainz University Women’s
Hospital, 1988Unit: Age (Weeks); Min/Mean/Max (mm); Table/Graph Range 5%:95%)

Age Min Mean Max Age Min Mean Max

12.5 80 92 104 27.5 253 268 284

13.0 84 96 108 28.0 258 273 289
13.5 89 101 113 28.5 263 278 294
14.0 94 106 119 29.0 268 283 299
14.5 100 112 124 29.5 272 288 303
15.0 105 118 130 30.0 277 292 308
15.5 111 124 137 30.5 281 297 313
16.0 117 130 143 31.0 285 301 317
16.5 123 136 149 31.5 289 305 321
17.0 130 143 156 32.0 293 309 325
17.5 136 149 162 32.5 297 313 329
18.0 142 155 168 33.0 300 316 333
18.5 148 162 175 33.5 303 320 336
19.0 155 168 181 34.0 307 323 340
19.5 161 174 188 34.5 310 326 343
20.0 167 181 194 35.0 313 329 346
20.5 173 187 201 35.5 315 332 349
21.0 180 193 207 36.0 318 335 352
21.5 186 200 214 36.5 320 337 354
22.0 192 206 220 37.0 322 339 356
22.5 198 212 226 37.5 324 341 359
23.0 204 218 232 38.0 326 343 361
23.5 210 224 238 38.5 327 345 362
24.0 216 230 244 39.0 329 346 364
24.5 221 236 250 39.5 330 348 365
25.0 227 241 256 40.0 331 349 366
25.5 232 247 262 40.5 332 349 367
26.0 238 253 267 41.0 332 350 368
26.5 243 258 273 41.5 332 350 369
27.0 248 263 278

2-48
Moore
Table 2-69: AFI: Moore Unit: Age (Days); Min/Max (mm); Table/Graph Range (2.5%:
97.5%)

Age Min Max CRL Age SD CRL Age SD

16 73 201 25 89 240 34 72 278

17 77 211 26 89 242 35 70 279
18 80 220 27 85 245 36 68 279
19 83 225 28 86 249 37 66 275
20 86 230 29 84 254 38 65 269
21 88 233 30 82 258 39 64 255
22 89 235 31 79 263 40 63 240
23 90 237 32 77 269 41 63 216
24 90 238 33 74 274 42 63 192

Nelson
Table 2-70: CRL: Nelson (Fetal Age) Journal of Clinical Ultrasound, 9: 67-70,
1981Unit: CRL (mm); GA (Days)

CRL GA CRL GA CRL GA CRL GA CRL GA

14 59 34 71 54 83 74 95 94 107
15 60 35 72 55 84 75 96 95 108
16 61 36 73 56 85 76 97 96 109
17 61 37 73 57 85 77 97 97 109
18 62 38 74 58 86 78 98 98 110
19 62 39 74 59 86 79 98 99 110
20 63 40 75 60 87 80 99 100 111
21 64 41 76 61 88 81 100 101 112
22 64 42 76 62 88 82 100 102 112
23 65 43 77 63 89 83 101 103 113
24 65 44 77 64 89 84 101 104 113
25 66 45 78 65 90 85 102 105 114
26 67 46 79 66 91 86 103 106 115
27 67 47 79 67 91 87 103 107 115
28 68 48 80 68 92 88 104 108 116
29 68 49 80 69 92 89 104 109 116
30 69 50 81 70 93 90 105 110 117
31 70 51 82 71 94 91 106 111 118
32 70 52 82 72 94 92 106
33 71 53 83 73 95 93 107

2-49
Osaka
Table 2-71: BPD: Osaka (Fetal Age), Osaka University Method 1989, 3 by Univ.
Osaka, Unit: BPD (mm); Age (Days); SD (mm)

BPD Age SD BPD Age SD BPD Age SD BPD Age SD

<13 n/a —— 33 107 2.4 54 152 3.0 75 203 3.5

13 70 1.9 34 109 2.5 55 154 3.0 76 206 3.5
14 71 1.9 35 112 2.5 56 157 3.0 77 209 3.5
15 73 1.9 36 114 2.5 57 159 3.1 78 212 3.5
16 75 1.9 37 116 2.5 58 161 3.1 79 214 3.6
17 77 2.0 38 118 2.6 59 164 3.1 80 217 3.6
18 78 2.0 39 120 2.6 60 166 3.1 81 220 3.6
19 80 2.0 40 122 2.6 61 168 3.2 82 224 3.6
20 82 2.1 41 124 2.7 62 171 3.2 83 227 3.6
21 84 2.1 42 126 2.7 63 173 3.2 84 230 3.7
22 86 2.1 43 128 2.7 64 175 3.2 85 234 3.7
23 88 2.1 44 130 2.7 65 178 3.3 86 237 3.7
24 90 2.2 45 132 2.8 66 180 3.3 87 238 3.7
25 92 2.2 46 135 2.8 67 182 3.3 88 245 3.7
26 94 2.2 47 137 2.8 68 185 3.3 89 249 3.8
27 96 2.3 48 139 2.8 69 187 3.3 90 254 3.8
28 98 2.3 49 141 2.9 70 190 3.4 91 259 3.8
29 99 2.3 50 143 2.9 71 193 3.4 92 265 3.8
30 101 2.3 51 145 2.9 72 195 3.4 93 273 3.9
31 103 2.4 52 148 2.9 73 198 3.4 94 280 3.9
32 105 2.4 53 150 3.0 74 200 3.5 >94 n/a ——

Table 2-72: CRL: Osaka (Fetal Age), Osaka University Method 1989, 3 by Univ. Osaka,
Unit: CRL (mm); Age (Days); SD (mm)

CRL Age SD CRL Age SD CRL Age SD CRL Age SD

<9 n/a —— 23 65 4.0 38 75 5.5 53 84 6.9

9 50 1.7 24 66 4.1 39 76 5.7 54 85 7.0
10 52 2.0 25 66 4.1 40 76 5.7 55 85 7.0
11 53 2.2 26 67 4.3 41 77 5.8 56 86 7.2
12 55 2.5 27 68 4.5 42 77 5.8 57 86 7.2
13 56 2.6 28 69 4.6 43 78 6.0 58 87 7.3
14 57 2.8 29 69 4.6 44 79 6.1 59 87 7.3
15 58 2.9 30 70 4.8 45 79 6.1 60 88 7.5
16 59 3.1 31 71 4.9 46 80 6.3 61 89 7.6
17 60 3.2 32 71 4.9 47 80 6.3 62 89 7.6
18 61 3.4 33 72 5.1 48 81 6.4 63 90 7.8
19 62 3.5 34 73 5.2 49 82 6.6 >63 n/a ——
20 63 3.7 35 73 5.2 50 83 6.7
21 63 3.7 36 74 5.4 51 83 6.7
22 64 3.8 37 74 5.4 52 83 6.7

2-50
 Table 2-73: EFW: Osaka (Fetal Age), Osaka University Method 1989, 3 by Univ.
Osaka, Unit: EFW (grams); Age (Days); SD (grams)

EFW Age SD EFW Age SD EFW Age SD EFW Age SD

<137 n/a —— 590 160 81 1420 203 171 2360 242 268
137 112 29 600 160 81 1440 204 174 2380 243 271
140 113 29 610 161 83 1460 205 176 2400 244 274
150 115 29 620 162 85 1480 206 178 2420 245 276
160 116 30 630 162 85 1500 207 181 2440 245 276
170 118 30 640 163 87 1520 208 183 2460 246 279
180 120 31 650 164 89 1540 209 185 2480 247 282
190 121 32 660 164 89 1560 210 188 2500 248 285
200 123 33 670 165 91 1580 210 188 2520 249 288
210 124 34 680 165 91 1600 211 190 2540 249 288
220 126 35 690 166 92 1620 212 192 2560 250 290
230 127 36 700 167 94 1640 213 195 2580 251 293
240 128 37 720 168 96 1660 214 197 2600 252 296
250 130 39 740 169 98 1680 215 200 2620 253 299
260 131 40 760 170 100 1700 216 202 2640 254 302
270 132 41 780 171 102 1720 216 202 2660 254 302
280 133 42 800 173 106 1740 217 204 2680 255 305
290 134 43 820 174 108 1760 218 207 2700 256 308
300 135 44 840 175 110 1780 219 209 2720 257 311
310 136 45 860 176 112 1800 220 212 2740 258 314
320 137 46 880 177 114 1820 220 212 2760 259 317
330 138 48 900 178 116 1840 221 214 2780 259 317
340 139 49 920 179 118 1860 222 217 2800 260 320
350 140 50 940 180 120 1880 223 219 2820 261 323
360 141 51 960 181 123 1900 224 222 2840 262 326
370 142 53 980 182 125 1920 224 222 2860 263 329
380 143 54 1000 183 127 1940 225 224 2880 264 332
390 144 56 1020 185 131 1960 226 227 2900 265 335
400 145 57 1040 186 133 1980 227 229 2920 266 339
410 146 58 1060 187 135 2000 228 232 2940 266 339
420 147 60 1080 188 138 2020 229 234 2960 267 342
430 148 61 1100 189 140 2040 229 234 2980 268 345
440 149 63 1120 190 142 2060 230 237 3000 269 348
450 149 63 1140 191 144 2080 231 239 3020 270 352
460 150 65 1160 192 146 2100 232 242 3040 271 355
470 151 66 1180 193 149 2120 233 244 3060 272 358
480 152 68 1200 194 151 2140 233 244 3080 273 362
490 153 69 1220 195 153 2160 234 247 3100 274 365
500 153 69 1240 195 153 2180 235 250 3120 275 369
510 154 71 1260 196 155 2200 236 252 3140 276 372
520 155 73 1280 197 158 2220 236 252 3160 277 376
530 155 73 1300 198 160 2240 237 255 3180 278 379
540 156 74 1320 199 162 2260 238 257 3200 279 383
550 157 76 1340 200 164 2280 239 260 3220 280 387
560 157 76 1360 201 167 2300 240 263 >3220 n/a ——
570 158 78 1380 202 169 2320 241 265
580 159 80 1400 203 171 2340 241 265

2-51
Table 2-74: FL: Osaka (Fetal Age), Osaka University Method 1989, 3 by Univ. Osaka,
Unit: FL (mm); Age (Days); SD (mm)

FL Age SD FL Age SD FL Age SD FL Age SD

<9 n/a —— 25 127 2.3 42 172 2.6 59 227 2.9

9 91 2.1 26 130 2.3 43 175 2.6 60 230 2.9
10 93 2.1 27 132 2.3 44 178 2.6 61 235 2.9
11 95 2.1 28 135 2.4 45 181 2.6 62 239 2.9
12 97 2.2 29 137 2.4 46 184 2.6 63 242 3.0
13 99 2.2 30 140 2.4 47 186 2.6 64 247 3.0
14 102 2.2 31 142 2.4 48 190 2.7 65 250 3.0
15 104 2.2 32 145 2.4 49 193 2.7 66 255 3.0
16 106 2.2 33 147 2.4 50 196 2.7 67 258 3.0
17 108 2.2 34 150 2.4 51 199 2.7 68 260 3.1
18 110 2.2 35 152 2.5 52 202 2.6 69 269 3.1
19 113 2.2 36 155 2.5 53 205 2.8 70 274 3.1
20 115 2.3 37 158 2.5 54 209 2.8 71 279 3.2
21 118 2.3 38 162 2.5 55 212 2.8 >71 n/a ——
22 120 2.3 39 163 2.5 56 216 2.8
23 122 2.3 40 166 2.5 57 220 2.8
24 125 2.3 41 169 2.6 58 223 2.9

Table 2-75: FTA: Osaka (Fetal Age), Osaka University Method 1989, 3 by Univ. Osaka,
Unit: FTA (mm2); Age (Days); SD (mm2)

FTA Age SD FTA Age SD FTA Age SD FTA Age SD

<560 n/a —— 2600 159 330 4800 205 560 7000 246 800
560 98 120 2700 162 340 4900 207 570 7100 248 820
600 100 120 2800 164 350 5000 209 580 7200 250 830
700 103 130 2900 166 360 5100 211 590 7300 252 840
800 108 150 3000 168 370 5200 213 600 7400 254 860
900 113 160 3100 170 380 5300 215 610 7500 256 870
1000 115 170 3200 173 390 5400 216 620 7600 258 880
1100 117 170 3300 175 400 5500 218 630 7700 260 900
1200 122 190 3400 177 410 5600 220 640 7800 262 910
1300 125 200 3500 179 420 5700 222 650 7900 264 930
1400 128 210 3600 181 430 5800 224 670 8000 265 930
1500 130 220 3700 183 440 5900 226 680 8100 268 960
1600 134 230 3800 185 450 6000 227 680 8200 270 970
1700 137 240 3900 187 460 6100 229 700 8300 273 990
1800 139 250 4000 189 470 6200 231 710 8400 274 1000
1900 142 260 4100 191 480 6300 233 720 8500 276 1010
2000 145 270 4200 193 490 6400 235 730 8600 279 1040
2100 147 280 4300 195 500 6500 237 750 8660 280 1040
2200 150 290 4400 197 510 6600 238 750 >8660 n/a ——
2300 152 300 4500 199 520 6700 240 760
2400 155 310 4600 201 530 6800 242 780
2500 157 330 4700 203 540 6900 244 790

2-52
Table 2-76: HL: Osaka (Fetal Age), Osaka University Method 1989, 3 by Univ. Osaka,
Unit: HL (mm); Age (Days); SD (mm)

HL Age SD HL Age SD HL Age SD HL Age SD

<10 n/a —— 23 123 2.2 37 164 2.4 51 217 2.6

10 91 2.0 24 126 2.2 38 167 2.4 52 222 2.6
11 93 2.0 25 129 2.2 39 170 2.4 53 227 2.7
12 96 2.0 26 132 2.2 40 174 2.4 54 232 2.7
13 98 2.1 27 134 2.2 41 178 2.4 55 237 2.7
14 100 2.1 28 137 2.2 42 182 2.5 56 242 2.7
15 103 2.1 29 140 2.3 43 185 2.5 57 248 2.8
16 105 2.1 30 143 2.3 44 188 2.5 58 254 2.8
17 108 2.1 31 145 2.3 45 192 2.5 59 260 2.8
18 110 2.1 32 149 2.3 46 196 2.5 60 267 2.9
19 113 2.1 33 151 2.3 47 200 2.5 61 275 2.9
20 115 2.1 34 155 2.3 48 204 2.6 62 280 2.9
21 117 2.1 35 158 2.3 49 208 2.6 >62 n/a ——
22 121 2.2 36 161 2.4 50 213 2.6

2-53
Paris
Table 2-77: BPD: Paris (Fetal Age), Unit: BPD (mm); Age (Days); SD (mm)

BPD Age SD BPD Age SD BPD Age SD BPD Age SD

<13 n/a —— 33 110 3 54 158 4 75 210 5

13 77 3 34 113 3 55 161 4 76 213 5
14 78 3 35 115 3 56 163 4 77 217 5
15 79 3 36 117 3 57 165 4 78 220 5
16 80 3 37 119 3 58 168 4 79 224 5
17 81 3 38 121 3 59 170 4 80 227 5
18 82 3 39 123 3 60 172 4 81 231 5
19 83 3 40 126 4 61 175 4 82 234 5
20 84 3 41 128 4 62 177 4 83 238 5
21 85 3 42 130 4 63 179 4 84 242 5
22 87 3 43 133 4 64 182 4 85 247 5
23 89 3 44 135 4 65 184 4 86 252 5
24 91 3 45 137 4 66 187 4 87 256 5
25 93 3 46 140 4 67 189 4 88 261 5
26 95 3 47 142 4 68 192 4 89 266 5
27 97 3 48 144 4 69 194 4 90 287 5
28 100 3 49 147 4 70 197 4 >90 n/a ——
29 102 3 50 149 4 71 199 4
30 104 3 51 151 4 72 202 4
31 106 3 52 154 4 73 204 4
32 108 3 53 156 4 74 207 4

Table 2-78: CRL: Paris (Fetal Age), Unit: CRL (mm); Age (Days); SD (mm)

CRL Age SD CRL Age SD CRL Age SD CRL Age SD

<5 n/a —— 25 64 7 46 78 7 67 90 7
5 42 4 26 65 7 47 79 7 68 90 7
6 43 4 27 66 7 48 79 7 69 91 7
7 44 4 28 66 7 49 80 7 70 91 7
8 46 4 29 67 7 50 80 7 71 91 7
9 47 4 30 68 7 51 81 7 72 92 7
10 49 4 31 69 7 52 82 7 73 92 7
11 50 4 32 70 7 53 82 7 74 93 7
12 51 4 33 70 7 54 83 7 75 93 7
13 52 4 34 71 7 55 84 7 76 94 7
14 53 4 35 71 7 56 84 7 77 94 7
15 54 4 36 72 7 57 85 7 78 94 7
16 55 5 37 73 7 58 85 7 79 95 7
17 56 5 38 73 7 59 86 7 80 95 7
18 57 5 39 74 7 60 86 7 81 96 7
19 58 6 40 74 7 61 87 7 82 96 7
20 59 6 41 75 7 62 87 7 83 97 7
21 60 6 42 76 7 63 88 7 84 97 7
22 61 6 43 76 7 64 88 7 85 98 7
23 63 6 44 77 7 65 89 7 >85 n/a ——
24 63 7 45 77 7 66 89 7

2-54
 Table 2-79: FL: Paris (Fetal Age), Unit: FL (mm); Age (Days); SD (mm)

FL Age SD FL Age SD FL Age SD FL Age SD

<15 n/a —— 31 137 5 48 183 5 65 238 5

15 98 4 32 139 5 49 186 5 66 241 5
16 100 4 33 142 5 50 189 5 67 245 5
17 102 4 34 145 5 51 192 5 68 248 5
18 105 4 35 148 5 52 194 5 69 252 5
19 107 4 36 150 5 53 197 5 70 255 5
20 109 4 37 153 5 54 200 5 71 259 5
21 112 4 38 156 5 55 203 5 72 262 5
22 114 4 39 159 5 56 206 5 73 266 5
23 116 4 40 161 5 57 210 5 74 271 5
24 119 4 41 164 5 58 213 5 75 276 5
25 121 4 42 167 5 59 217 5 76 281 5
26 123 4 43 170 5 60 219 5 77 287 5
27 126 5 44 172 5 61 221 5 >77 n/a ——
28 128 5 45 175 5 62 224 5
29 131 5 46 178 5 63 231 5
30 134 5 47 181 5 64 234 5

Table 2-80: Ft: Paris (Fetal Age), Unit: Ft (mm); Age (Days); SD (mm)

Ft Age SD Ft Age SD Ft Age SD Ft Age SD

<13 n/a —— 29 133 4 46 173 4 63 221 4

13 91 2 30 135 4 47 175 4 64 224 4
14 94 2 31 137 4 48 178 4 65 227 4
15 97 2 32 140 4 49 180 4 66 231 5
16 100 2 33 142 4 50 183 4 67 234 5
17 103 3 34 144 4 51 185 4 68 238 5
18 106 3 35 147 4 52 188 4 69 242 5
19 109 3 36 149 4 53 190 4 70 246 5
20 112 4 37 151 4 54 193 4 71 250 5
21 114 4 38 154 4 55 196 4 72 254 5
22 116 4 39 156 4 56 199 4 73 258 5
23 119 4 40 158 4 57 202 4 74 262 5
24 121 4 41 161 4 58 205 4 75 266 6
25 123 4 42 163 4 59 208 4 >75 n/a ——
26 126 4 43 165 4 60 211 4
27 128 4 44 168 4 61 215 4
28 130 4 45 170 4 62 218 4

2-55
 Table 2-81: TAD: Paris (Fetal Age), Unit: TAD (mm); Age (Days); SD (mm)

TAD Age SD TAD Age SD TAD Age SD TAD Age SD

<10 n/a —— 32 116 0 55 171 0 78 229 0

10 84 0 33 118 0 56 174 0 79 232 0
11 84 0 34 120 0 57 176 0 80 234 0
12 85 0 35 122 0 58 179 0 81 237 0
13 86 0 36 124 0 59 181 0 82 239 0
14 87 0 37 126 0 60 184 0 83 242 0
15 87 0 38 128 0 61 186 0 84 245 0
16 88 0 39 131 0 62 189 0 85 248 0
17 89 0 40 133 0 63 191 0 86 252 0
18 90 0 41 136 0 64 194 0 87 255 0
19 91 0 42 138 0 65 196 0 88 259 0
20 92 0 43 141 0 66 199 0 89 262 0
21 94 0 44 143 0 67 201 0 90 266 0
22 96 0 45 146 0 68 204 0 91 269 0
23 98 0 46 148 0 69 207 0 92 273 0
24 100 0 47 151 0 70 209 0 93 276 0
25 102 0 48 153 0 71 212 0 94 280 0
26 104 0 49 156 0 72 214 0 95 283 0
27 106 0 50 158 0 73 217 0 96 287 0
28 108 0 51 161 0 74 219 0 >96 n/a ——
29 110 0 52 163 0 75 222 0
30 112 0 53 166 0 76 224 0
31 114 0 54 169 0 77 227 0

2-56
Rempen
Table 2-82: BPD: Rempen (Fetal Age), Der Frauenarzt 32, 4 (1991) 425-30’ Known
LMP (left)—Unknown LMP (right), Unit: BPD (mm); Age (Weeks/Days); 2SD (mm
[Known LMP] or day [Unknown LMP])

BPD Age 2SD BPD Age 2SD BPD Age 2SD BPD Age 2SD

<2 n/a —— 15 10w2d 4 <3 n/a —— 16 10w4d 8

2 6w2d 4 16 10w5d 4 3 6w6d 8 17 10w6d 8
3 6w4d 4 17 11w0d 4 4 7w1d 8 18 11w1d 8
4 6w6d 4 18 11w2d 4 5 7w3d 8 19 11w3d 8
5 7w1d 4 19 11w5d 4 6 7w5d 8 20 11w5d 8
6 7w4d 4 20 12w0d 4 7 8w0d 8 21 12w0d 8
7 7w6d 4 21 12w2d 4 8 8w2d 8 22 12w2d 8
8 8w1d 4 22 12w4d 4 9 8w4d 8 23 12w4d 8
9 8w3d 4 23 13w0d 4 10 8w6d 8 24 12w6d 8
10 8w5d 4 24 13w2d 4 11 9w1d 8 25 13w1d 8
11 9w1d 4 >24 n/a —— 12 9w3d 8 26 13w3d 8
12 9w3d 4 13 9w5d 8 27 13w5d 8
13 9w5d 4 14 10w0d 8 >27 n/a ——
14 10w0d 4 15 10w2d 8

Table 2-83: BPD: Rempen (Fetal Growth), Der Frauenarzt 32, 4 (1991) 425-30, Unit:
Age (Weeks/Days); Mean (mm); 2SD (mm); Table/Graph Range (5%:95%)

Age Mean SD Age Mean SD Age Mean SD

6w2d 2.0 3.7 8w5d 9.8 3.7 11w1d 17.4 3.7

6w3d 2.5 3.7 8w6d 10.3 3.7 11w2d 17.9 3.7
6w4d 3.0 3.7 9w0d 10.7 3.7 11w3d 18.3 3.7
6w5d 3.4 3.7 9w1d 11.2 3.7 11w4d 18.7 3.7
6w6d 3.9 3.7 9w2d 11.6 3.7 11w5d 19.2 3.7
7w0d 4.3 3.7 9w3d 12.1 3.7 11w6d 19.6 3.7
7w1d 4.8 3.7 9w4d 12.5 3.7 12w0d 20.0 3.7
7w2d 5.3 3.7 9w5d 13.0 3.7 12w1d 20.5 3.7
7w3d 5.7 3.7 9w6d 13.4 3.7 12w2d 20.9 3.7
7w4d 6.2 3.7 10w0d 13.9 3.7 12w3d 21.3 3.7
7w5d 6.7 3.7 10w1d 14.3 3.7 12w4d 21.8 3.7
7w6d 7.1 3.7 10w2d 14.8 3.7 12w5d 22.2 3.7
8w0d 7.6 3.7 10w3d 15.2 3.7 12w6d 22.6 3.7
8w1d 8.0 3.7 10w4d 15.7 3.7 13w0d 23.1 3.7
8w2d 8.5 3.7 10w5d 16.1 3.7 13w1d 23.5 3.7
8w3d 8.9 3.7 10w6d 16.5 3.7 13w2d 23.9 3.7
8w4d 9.4 3.7 11w0d 17.0 3.7

2-57
 Table 2-84: CRL: Rempen (Fetal Age), Der Frauenarzt 32, 4 (1991) 425-30, Known
LMP (left)—Unknown LMP (right), Unit: CRL (mm); Age (Weeks/Days); 2SD (mm [Known
LMP] or day [Unknown LMP])

CRL Age 2SD CRL Age 2SD CRL Age 2SD CRL Age 2SD

<1 n/a —— 40 10w5d 8 <2 n/a —— 41 10w5d 7

1 5w5d 8 41 10w6d 8 2 6w0d 6 42 10w6d 6
2 5w6d 8 42 11w0d 8 3 6w1d 6 43 11w0d 7
3 6w0d 8 43 11w0d 8 4 6w2d 6 44 11w0d 7
4 6w1d 8 44 11w1d 8 5 6w3d 6 45 11w1d 6
5 6w2d 8 45 11w2d 8 6 6w4d 6 46 11w2d 7
6 6w3d 8 46 11w2d 8 7 6w5d 6 47 11w2d 7
7 6w4d 8 47 11w3d 8 8 6w6d 6 48 11w3d 6
8 6w6d 8 48 11w4d 8 9 7w0d 6 49 11w4d 7
9 6w6d 8 49 11w4d 8 10 7w1d 6 50 11w4d 6
10 7w0d 8 50 11w5d 8 11 7w2d 6 51 11w5d 6
11 7w2d 8 51 11w6d 8 12 7w3d 6 52 11w5d 7
12 7w2d 8 52 12w0d 8 13 7w4d 7 53 11w6d 6
13 7w4d 8 53 12w0d 8 14 7w5d 7 54 12w0d 7
14 7w4d 8 54 12w1d 8 15 7w6d 7 55 12w0d 7
15 7w5d 8 55 12w2d 8 16 7w6d 7 56 12w1d 6
16 7w6d 8 56 12w2d 8 17 8w0d 7 57 12w1d 7
17 8w0d 8 57 12w3d 8 18 8w1d 6 58 12w2d 6
18 8w1d 8 58 12w3d 8 19 8w2d 6 59 12w3d 7
19 8w2d 8 59 12w4d 8 20 8w3d 6 60 12w3d 6
20 8w3d 8 60 12w5d 8 21 8w4d 7 61 12w4d 7
21 8w4d 8 61 12w5d 8 22 8w5d 7 62 12w4d 6
22 8w5d 8 62 12w6d 8 23 8w5d 7 63 12w5d 7
23 8w6d 8 63 13w0d 8 24 8w6d 7 64 12w5d 7
24 8w6d 8 64 13w0d 8 25 9w0d 6 65 12w6d 6
25 9w0d 8 65 13w1d 8 26 9w1d 6 66 12w6d 7
26 9w1d 8 66 13w2d 8 27 9w2d 7 67 13w0d 6
27 9w2d 8 >66 n/a —— 28 9w3d 7 68 13w0d 7
28 9w3d 8 29 9w3d 7 69 13w1d 6
29 9w4d 8 30 9w4d 7 70 13w1d 7
30 9w4d 8 31 9w5d 7 71 13w2d 7
31 9w5d 8 32 9w6d 7 72 13w2d 6
32 9w6d 8 33 9w6d 7 73 13w3d 7
33 10w0d 8 34 10w0d 6 74 13w3d 6
34 10w1d 8 35 10w1d 6 75 13w4d 7
35 10w1d 8 36 10w2d 7 76 13w4d 6
36 10w2d 8 37 10w2d 7 77 13w4d 7
37 10w3d 8 38 10w3d 6 78 13w5d 6
38 10w4d 8 39 10w4d 6 >78 n/a ——
39 10w4d 8 40 10w5d 7

2-58
Table 2-85: CRL: Rempen (Fetal Growth), Der Frauenarzt 32, 4 (1991) 425-30, Unit:
Age (Weeks/Days); Mean (mm); 2SD (mm); Table/Graph Range (5%:95%)

Age Mean SD Age Mean SD Age Mean SD

5w5d 1.2 7.8 8w2d 18.9 7.8 10w6d 41.3 7.8

5w6d 2.1 7.8 8w3d 20.0 7.8 11w0d 42.6 7.8
6w0d 3.0 7.8 8w4d 21.1 7.8 11w1d 44.0 7.8
6w1d 3.8 7.8 8w5d 22.3 7.8 11w2d 45.4 7.8
6w2d 4.7 7.8 8w6d 23.5 7.8 11w3d 46.9 7.8
6w3d 5.7 7.8 9w0d 24.6 7.8 11w4d 48.3 7.8
6w4d 6.6 7.8 9w1d 25.8 7.8 11w5d 49.8 7.8
6w5d 7.5 7.8 9w2d 27.0 7.8 11w6d 51.2 7.8
6w6d 8.5 7.8 9w3d 28.3 7.8 12w0d 52.7 7.8
7w0d 9.5 7.8 9w4d 29.5 7.8 12w1d 54.2 7.8
7w1d 10.5 7.8 9w5d 30.7 7.8 12w2d 55.7 7.8
7w2d 11.5 7.8 9w6d 32.0 7.8 12w3d 57.3 7.8
7w3d 12.5 7.8 10w0d 33.3 7.8 12w4d 58.8 7.8
7w4d 13.5 7.8 10w1d 34.6 7.8 12w5d 60.3 7.8
7w5d 14.6 7.8 10w2d 35.9 7.8 12w6d 61.9 7.8
7w6d 15.6 7.8 10w3d 37.2 7.8 13w0d 63.5 7.8
8w0d 16.7 7.8 10w4d 38.5 7.8 13w1d 65.1 7.8
8w1d 17.8 7.8 10w5d 39.9 7.8 13w2d 66.7 7.8

2-59
Table 2-86: GS: Rempen (Fetal Age), Der Frauenarzt 32, 4 (1991) 425-30, Known LMP
(left)—Unknown LMP (right), Unit: GS (mm); Age (Weeks/Days); 2SD (mm [Known LMP]
or day [Unknown LMP])

GS Age 2SD GS Age 2SD GS Age 2SD GS Age 2SD

<1 n/a —— 38 9w1d 11 <1 n/a —— 38 9w1d 10

1 4w4d 11 39 9w2d 11 1 4w5d 10 39 9w2d 10
2 4w5d 11 40 9w4d 11 2 4w6d 10 40 9w3d 10
3 4w6d 11 41 9w5d 11 3 5w0d 10 41 9w4d 10
4 5w0d 11 42 9w6d 11 4 5w1d 10 42 9w5d 10
5 5w0d 11 43 10w0d 11 5 5w2d 10 43 9w6d 10
6 5w1d 11 44 10w1d 11 6 5w2d 10 44 9w6d 10
7 5w2d 11 45 10w2d 11 7 5w3d 10 45 10w0d 10
8 5w3d 11 46 10w3d 11 8 5w4d 10 46 10w1d 10
9 5w3d 11 47 10w4d 11 9 5w5d 10 47 10w2d 10
10 5w4d 11 48 10w6d 11 10 5w5d 10 48 10w3d 10
11 5w5d 11 49 11w0d 11 11 5w6d 10 49 10w4d 10
12 5w6d 11 50 11w1d 11 12 6w0d 10 50 10w5d 10
13 6w0d 11 51 11w2d 11 13 6w1d 10 51 10w6d 10
14 6w0d 11 52 11w4d 11 14 6w2d 10 52 11w0d 10
15 6w1d 11 53 11w5d 11 15 6w2d 10 53 11w1d 10
16 6w2d 11 54 12w0d 11 16 6w3d 10 54 11w2d 10
17 6w3d 11 55 12w1d 11 17 6w4d 10 55 11w3d 10
18 6w4d 11 56 12w2d 11 18 6w5d 10 56 11w4d 10
19 6w5d 11 57 12w4d 11 19 6w6d 10 57 11w5d 10
20 6w6d 11 58 12w5d 11 20 6w6d 10 58 11w6d 10
21 6w6d 11 59 13w0d 11 21 7w0d 10 59 12w0d 10
22 7w0d 11 60 13w1d 11 22 7w1d 10 60 12w1d 10
23 7w1d 11 >60 n/a —— 23 7w2d 10 61 12w2d 10
24 7w2d 11 24 7w3d 10 62 12w3d 10
25 7w3d 11 25 7w4d 10 63 12w4d 10
26 7w4d 11 26 7w4d 10 64 12w5d 10
27 7w5d 11 27 7w5d 10 65 12w6d 10
28 7w6d 11 28 7w6d 10 66 13w0d 10
29 8w0d 11 29 8w0d 10 67 13w1d 10
30 8w0d 11 30 8w1d 10 68 13w2d 10
31 8w1d 11 31 8w2d 10 69 13w3d 10
32 8w2d 11 32 8w3d 10 70 13w4d 10
33 8w3d 11 33 8w3d 10 71 13w5d 10
34 8w4d 11 34 8w4d 10 72 14w0d 10
35 8w5d 11 35 8w5d 10 73 14w1d 10
36 8w6d 11 36 8w6d 10 >73 n/a ——
37 9w0d 11 37 9w0d 10

2-60
Table 2-87: GS: Rempen (Fetal Growth), Der Frauenarzt 32, 4 (1991) 425-30, Unit:
Age (Weeks/Days); Mean (mm); 2SD (mm); Table/Graph Range (5%:95%)

Age Mean SD Age Mean SD Age Mean SD

4w4d 0.5 10.5 7w4d 26.2 10.5 10w4d 46.6 10.5

4w5d 1.8 10.5 7w5d 27.3 10.5 10w5d 47.4 10.5
4w6d 3.2 10.5 7w6d 28.4 10.5 10w6d 48.2 10.5
5w0d 4.5 10.5 8w0d 29.5 10.5 11w0d 49.0 10.5
5w1d 5.8 10.5 8w1d 30.5 10.5 11w1d 49.8 10.5
5w2d 7.1 10.5 8w2d 31.6 10.5 11w2d 50.6 10.5
5w3d 8.4 10.5 8w3d 32.6 10.5 11w3d 51.4 10.5
5w4d 9.7 10.5 8w4d 33.6 10.5 11w4d 52.1 10.5
5w5d 10.9 10.5 8w5d 34.6 10.5 11w5d 52.9 10.5
5w6d 12.2 10.5 8w6d 35.6 10.5 11w6d 53.6 10.5
6w0d 13.4 10.5 9w0d 36.6 10.5 12w0d 54.3 10.5
6w1d 14.6 10.5 9w1d 37.6 10.5 12w1d 55.1 10.5
6w2d 15.9 10.5 9w2d 38.5 10.5 12w2d 55.8 10.5
6w3d 17.1 10.5 9w3d 39.5 10.5 12w3d 56.4 10.5
6w4d 18.3 10.5 9w4d 40.4 10.5 12w4d 57.1 10.5
6w5d 19.4 10.5 9w5d 41.3 10.5 12w5d 57.8 10.5
6w6d 20.6 10.5 9w6d 42.2 10.5 12w6d 58.4 10.5
7w0d 21.7 10.5 10w0d 43.1 10.5 13w0d 59.1 10.5
7w1d 22.9 10.5 10w1d 44.0 10.5 13w1d 59.7 10.5
7w2d 24.0 10.5 10w2d 44.9 10.5 13w2d 60.3 10.5
7w3d 25.1 10.5 10w3d 45.7 10.5

2-61
Robinson
Table 2-88: CRL: Robinson (Fetal Age), Br J Gynecol, 82: 702, 1975, Unit: CRL (mm);
Age (Days); SD (mm)

CRL Age SD CRL Age SD CRL Age SD CRL Age SD

<7 n/a —— 26 64 5 46 78 7 66 90 7
7 45 4 27 65 5 47 79 7 67 90 7
8 46 4 28 66 6 48 79 7 68 91 7
9 47 4 29 67 6 49 80 7 69 91 7
10 48 4 30 68 6 50 81 7 70 91 7
11 50 4 31 69 7 51 82 7 71 92 7
12 52 4 32 69 7 52 83 7 72 92 7
13 53 4 33 70 7 53 83 7 73 93 7
14 54 4 34 70 7 54 83 7 74 93 7
15 55 4 35 71 7 55 84 7 75 93 7
16 56 4 36 72 7 56 84 7 76 94 7
17 57 4 37 72 7 57 84 7 77 94 7
18 58 4 38 73 7 58 85 7 78 95 7
19 59 4 39 74 7 59 85 7 79 95 7
20 60 4 40 74 7 60 86 7 80 96 7
21 60 4 41 75 7 61 86 7 81 97 7
22 61 4 42 75 7 62 87 7 82 98 7
23 62 4 43 76 7 63 88 7 >82 n/a ——
24 63 5 44 77 7 64 89 7
25 64 5 45 77 7 65 90 7

Tokyo
Table 2-89: APTDxTTD: Tokyo (Fetal Age), Tokyo University Method 1986, 6 by
University Tokyo, Unit: Meas (cm2); Age (Weeks/Days); SD (Days)

Meas Age SD Meas Age SD Meas Age SD

<10 n/a —— 38 25w6d ± 10d 68 33w3d ± 15d

10 16w1d ± 8d 40 26w3d ± 11d 70 33w6d ± 16d
12 17w0d ± 8d 42 27w0d ± 11d 72 34w2d ± 16d
14 17w6d ± 8d 44 27w3d ± 11d 74 34w6d ± 17d
16 18w4d ± 8d 46 28w0d ± 12d 76 35w3d ± 17d
18 19w3d ± 8d 48 28w4d ± 12d 78 35w6d ± 17d
20 20w1d ± 8d 50 29w0d ± 12d 80 36w3d ± 18d
22 20w6d ± 9d 52 29w3d ± 13d 82 37w0d ± 18d
24 21w4d ± 9d 54 30w0d ± 13d 84 37w4d ± 18d
26 22w2d ± 9d 56 30w3d ± 13d 86 38w1d ± 18d
28 22w6d ± 9d 58 31w0d ± 14d 88 38w5d ± 19d
30 23w4d ± 9d 60 31w3d ± 14d 90 39w2d ± 19d
32 24w1d ± 10d 62 31w6d ± 14d >90 n/a ——
34 24w5d ± 10d 64 32w3d ± 15d
36 25w2d ± 10d 66 32w6d ± 15d

2-62
Table 2-90: APTDxTTD by Gestational Age: Tokyo, Tokyo University Method 1986, 6
by University Tokyo

Weeks -1.64 SD -1.5 SD -1.28 SD Mean +1.28 SD +1.5 SD +1.64 SD

16.0 7.0 7.4 7.9 11.2 14.6 15.1 15.5

17.0 8.7 9.0 9.7 13.3 17.0 17.6 18.0
18.0 10.5 10.9 11.6 15.6 19.6 20.3 20.7
19.0 12.5 13.0 13.7 18.1 22.4 23.2 23.6
20.0 14.7 15.2 16.1 20.8 25.5 26.3 26.8
21.0 17.1 17.6 18.5 23.6 28.8 29.6 30.2
22.0 19.6 20.2 21.2 26.7 32.2 33.2 33.8
23.0 22.2 22.9 23.9 29.9 35.9 36.9 37.5
24.0 25.0 25.7 26.8 33.2 39.7 40.8 41.5
25.0 27.9 28.6 29.8 36.7 43.6 44.8 45.6
26.0 30.9 31.7 33.0 40.3 47.7 49.0 49.8
27.0 33.9 34.8 36.2 44.1 52.0 53.3 54.2
28.0 37.1 38.0 39.4 47.9 56.3 57.8 58.7
29.0 40.3 41.3 42.8 51.8 60.8 62.3 63.3
30.0 43.5 44.5 46.2 55.7 65.3 66.9 68.0
31.0 46.8 47.9 49.6 59.7 69.9 71.6 72.7
32.0 50.0 51.2 53.0 63.8 74.5 76.4 77.6
33.0 53.3 54.5 56.5 67.8 79.2 81.2 82.4
34.0 56.5 57.8 59.9 71.9 83.9 86.0 87.3
35.0 59.7 61.1 63.3 75.9 88.6 90.8 92.2
36.0 62.8 64.3 66.6 79.9 93.3 95.6 97.0
37.0 65.9 67.4 69.8 83.9 97.9 100.3 101.9
38.0 68.8 70.4 72.9 87.7 102.5 105.0 106.7
39.0 71.6 73.3 76.0 91.5 107.0 109.7 111.4
40.0 74.3 76.1 78.9 95.1 111.4 114.2 116.0
41.0 76.8 78.6 81.6 98.6 115.7 118.6 120.5
42.0 79.1 81.1 84.1 102.0 119.8 122.9 124.8

Table 2-91: BPD: Tokyo (Fetal Age), Tokyo University Method 1986, 6 by University
Tokyo, Unit: BPD (mm); Age (Days); SD (Days)

BPD Age SD BPD Age SD BPD Age SD BPD Age SD

<20 n/a —— 38 123 ±5 57 164 ±6 76 213 ±8

20 85 ±6 39 125 ±5 58 167 ±6 77 216 ±8
21 87 ±6 40 127 ±5 59 169 ±6 78 218 ±8
22 89 ±6 41 129 ±5 60 171 ±6 79 221 ±8
23 92 ±6 42 131 ±5 61 174 ±7 80 225 ±8
24 94 ±6 43 133 ±5 62 176 ±7 81 228 ±8
25 96 ±6 44 135 ±5 63 179 ±7 82 231 ±8
26 98 ±6 45 138 ±6 64 181 ±7 83 234 ±9
27 100 ±6 46 140 ±6 65 183 ±7 84 238 ±9
28 102 ±6 47 142 ±6 66 186 ±7 85 241 ±9
29 102 ±6 48 144 ±6 67 188 ±7 86 245 ±9
30 106 ±5 49 146 ±6 68 191 ±7 87 249 ±9
31 108 ±5 50 148 ±6 69 194 ±7 88 253 ±9
32 110 ±5 51 151 ±6 70 196 ±7 89 258 ±9
33 112 ±5 52 153 ±6 71 199 ±8 90 262 ±9
34 114 ±5 53 154 ±6 72 201 ±8 >90 n/a ——
35 116 ±5 54 157 ±6 73 204 ±8 2-63
36 118 ±5 55 160 ±6 74 207 ±8
37 120 ±5 56 162 ±6 75 210 ±8
Table 2-92: CRL: Tokyo (Fetal Age), Tokyo University Method 1986, 6 by University
Tokyo, Unit: CRL (mm); Age (Days); SD (Days)

CRL Age SD CRL Age SD CRL Age SD CRL Age SD

<13 n/a —— 22 64 ±7 32 73 ±7 42 81 ±7
13 55 ±8 23 65 ±7 33 74 ±7 43 81 ±7
14 56 ±9 24 66 ±7 34 74 ±7 44 82 ±7
15 57 ± 10 25 67 ±7 35 75 ±7 45 83 ±7
16 58 ±8 26 68 ±7 36 76 ±7 46 84 ±7
17 59 ±9 27 68 ±7 37 77 ±7 47 84 ±7
18 60 ± 10 28 69 ±7 38 78 ±7 48 85 ±7
19 61 ±8 29 70 ±7 39 78 ±7 49 86 ±7
20 62 ±9 30 71 ±7 40 79 ±7 50 86 ±7
21 63 ±7 31 72 ±7 41 80 ±7 >50 n/a ——

Table 2-93: FL: Tokyo (Fetal Age), Tokyo University Method 1986, 6 by University
Tokyo, Unit: FL (mm); Age (Days); SD (mm)

FL Age SD FL Age SD FL Age SD FL Age SD

<33 n/a ——± 43 175 ±6 54 210 ±7 65 251 ±8

33 143 6 44 178 ±6 55 214 ±7 66 256 ±8
34 146 ±6 45 181 ±6 56 217 ±7 67 260 ±8
35 149 ±6 46 185 ±7 57 220 ±7 68 266 ±7
36 153 ±6 47 188 ±7 58 224 ±7 69 271 ±7
37 156 ±6 48 191 ±7 59 228 ±8 70 278 ±7
38 159 ±6 49 194 ±7 60 231 ±8 71 286 ±6
39 162 ±6 50 197 ±7 61 235 ±8 >71 n/a ——
40 166 ±6 51 200 ±7 62 239 ±8
41 169 ±6 52 204 ±7 63 243 ±8
42 172 ±6 53 207 ±7 64 247 ±8

Table 2-94: GS: Tokyo (Fetal Age), Tokyo University Method 1986, 6 by University
Tokyo, Unit: GS (mm); Age (Days); SD (Days)

GS Age SD GS Age SD GS Age SD GS Age SD

<12 n/a —— 22 43 ±7 33 56 ±0 44 66 ±0
12 31 ±7 23 44 ±7 34 57 ±0 45 67 ±0
13 32 ±7 24 46 ±7 35 58 ±0 46 68 ±0
14 33 ±7 25 47 ±7 36 59 ±0 47 69 ±0
15 34 ±7 26 48 ±8 37 60 ±0 48 70 ±0
16 36 ±7 27 49 ±9 38 61 ±0 49 71 ±0
17 37 ±7 28 50 ± 10 39 62 ±0 50 72 ±0
18 38 ±7 29 51 ±0 40 63 ±0 >50 n/a ——
19 40 ±7 30 52 ±0 41 64 ±0
20 41 ±7 31 53 ±0 42 65 ±0
21 42 ±7 32 55 ±0 43 65 ±0

2-64
 Table 2-95: LV: Tokyo (Fetal Age), Tokyo University Method 1986, 6 by University
Tokyo, Unit: LV (mm); Age (Days); SD (Days)

LV Age SD LV Age SD LV Age SD LV Age SD

<44 n/a —— 55 181 ±7 67 217 ± 10 79 260 ± 10

44 154 ±5 56 183 ±8 68 220 ± 10 80 264 ± 10
45 157 ±5 57 186 ±8 69 224 ± 10 81 267 ± 10
46 159 ±5 58 189 ±8 70 227 ± 11 82 271 ± 10
47 161 ±5 59 192 ±8 71 231 ± 11 83 275 ± 10
48 163 ±5 60 195 ±9 72 234 ± 11 84 278 ± 10
49 166 ±6 61 198 ±9 73 238 ± 11 85 282 ± 10
50 168 ±6 62 201 ±9 74 241 ± 11 86 285 ± 10
51 171 ±6 63 204 ±9 75 245 ± 11 >86 n/a ——
52 173 ±6 64 207 ± 10 76 249 ± 11
53 176 ±7 65 210 ± 10 77 252 ± 11
54 178 ±7 66 213 ± 10 78 256 ± 11

2-65
Tokyo Shinozuka
Table 2-96: AC: Tokyo Shinozuka (Fetal Age), Shinozuka Jpn J Med Ultrasonics vol 23:
12 1996, Unit: AC (cm); Age (Weeks/Days); SD (cm)

AC Age 1SD AC Age 1SD AC Age 1SD

<10 n/a —— 18 23w3d 0.9 27 33w1d 1.4

10 15w3d 0.5 19 24w3d 1.0 28 34w2d 1.4
11 16w4d 0.6 20 25w3d 1.0 29 35w4d 1.5
12 17w4d 0.6 21 26w3d 1.1 30 37w0d 1.6
13 18w4d 0.7 22 27w3d 1.1 31 38w2d 1.6
14 19w4d 0.7 23 28w4d 1.2 32 39w6d 1.7
15 20w3d 0.8 24 29w4d 1.2 33 41w2d 1.8
16 21w3d 0.8 25 30w5d 1.3 >33 n/a ——
17 22w3d 0.9 26 31w6d 1.3

Table 2-97: AC: Tokyo Shinozuka (Fetal Growth), Shinozuka Jpn J Med Ultrasonics vol
23: 12 1996, Unit: Age (Weeks/Days); Min/Mean/Max (cm); Table/Graph Range: 1.64SD

Age Min Mean Max Age Min Mean Max

16 9.3 10.9 12.5 30 22.0 24.7 27.3

17 10.3 12.0 13.6 31 22.8 25.6 28.3
18 11.2 13.0 14.7 32 23.5 26.5 29.2
19 12.2 14.0 15.8 33 24.3 27.3 30.1
20 13.1 15.1 16.9 34 25.0 28.1 31.0
21 14.0 16.1 18.0 35 25.7 28.9 31.9
22 15.0 17.1 19.1 36 26.4 29.7 32.7
23 15.9 18.1 20.2 37 27.0 30.4 33.5
24 16.8 19.1 21.2 38 27.6 31.1 34.3
25 17.7 20.1 22.3 39 28.2 31.8 35.0
26 18.6 21.0 23.3 40 28.8 32.4 35.7
27 19.5 22.0 24.4 41 29.3 33.0 36.4
28 20.3 22.9 25.4 42 29.7 33.6 37.0
29 21.1 23.8 26.4

2-66
 Table 2-98: AxT (APTDxTTD): Tokyo Shinozuka (Fetal Age), Shinozuka Jpn J Med
Ultrasonics vol 23: 12 1996, Unit: AxT (mm); Age (Weeks/Days); SD (cm2)

AxT Age 1SD AxT Age 1SD AxT Age 1SD

<10 n/a —— 38 25w6d 5.5 68 33w3d 8.8

10 16w1d 2.5 40 26w3d 5.7 70 33w6d 9.1
12 17w0d 2.7 42 27w0d 6.0 72 34w2d 9.3
14 17w6d 2.9 44 27w3d 6.1 74 34w6d 9.6
16 18w4d 3.1 46 28w0d 6.4 76 35w3d 9.9
18 19w3d 3.4 48 28w4d 6.6 78 35w6d 10.1
20 20w1d 3.6 50 29w0d 6.8 80 36w3d 10.2
22 20w6d 3.8 52 29w3d 7.0 82 37w0d 10.7
24 21w4d 4.0 54 30w0d 7.2 84 37w4d 11.0
26 22w2d 4.3 56 30w3d 7.4 86 38w1d 11.3
28 22w6d 4.4 58 31w0d 7.7 88 38w5d 11.7
30 23w4d 4.7 60 31w3d 7.9 90 39w2d 12.0
32 24w1d 4.9 62 31w6d 8.1 >90 n/a ——
34 24w5d 5.1 64 32w3d 8.4
36 25w2d 5.3 66 32w6d 8.6

Table 2-99: AxT (APTDxTTD): Tokyo Shinozuka (Fetal Growth), Shinozuka Jpn J Med
Ultrasonics vol 23: 12 1996, Unit: Age (Weeks); Min/Mean/Max (cm2); Table/Graph
Range: 1.64SD

Age Min Mean Max Age Min Mean Max

16 7.0 11.2 15.5 30 43.5 55.7 68.0

17 8.7 13.3 18.0 31 46.8 59.7 72.7
18 10.5 15.6 20.7 32 50.0 63.8 77.6
19 12.5 18.1 23.6 33 53.3 67.8 82.4
20 14.7 20.8 26.8 34 56.5 71.9 87.3
21 17.1 23.6 30.2 35 59.7 75.9 92.2
22 19.6 26.7 33.8 36 62.8 79.9 97.0
23 22.2 29.9 37.5 37 65.9 83.9 101.9
24 25.0 33.2 41.5 38 68.8 87.7 106.7
25 27.9 36.7 45.6 39 71.6 91.5 111.4
26 30.9 40.3 49.8 40 74.3 95.1 116.0
27 33.9 44.1 54.2 41 76.8 98.6 120.5
28 37.1 47.9 58.7 42 79.1 102.0 124.8
29 40.3 51.8 63.3

2-67
Table 2-100: BPD: Tokyo Shinozuka (Fetal Age), Shinozuka Jpn J Med Ultrasonics vol
23: 12 1996, Unit: BPD (mm); Age (Weeks/Days); SD (mm)

BPD Age 1SD BPD Age 1SD BPD Age 1SD

<13 n/a —— 39 17w6d 2.7 66 26w3d 3.2

13 10w1d 2.3 40 18w1d 2.7 67 26w6d 3.2
14 10w3d 2.3 41 18w3d 2.8 68 27w2d 3.3
15 10w5d 2.3 42 18w5d 2.8 69 27w4d 3.3
16 11w0d 2.3 43 19w0d 2.8 70 28w0d 3.3
17 11w2d 2.4 44 19w2d 2.8 71 28w3d 3.3
18 11w4d 2.4 45 19w4d 2.8 72 28w5d 3.3
19 11w6d 2.4 46 20w0d 2.8 73 29w1d 3.4
20 12w1d 2.4 47 20w2d 2.9 74 29w4d 3.4
21 12w3d 2.4 48 20w4d 2.9 75 30w0d 3.4
22 12w6d 2.4 49 20w6d 2.9 76 30w3d 3.4
23 13w1d 2.5 50 21w1d 2.9 77 30w6d 3.4
24 13w3d 2.5 51 21w3d 2.9 78 31w2d 3.5
25 13w5d 2.5 52 21w6d 2.9 79 31w5d 3.5
26 14w0d 2.5 53 22w1d 3.0 80 32w1d 3.5
27 14w2d 2.5 54 22w3d 3.0 81 32w5d 3.6
28 14w4d 2.5 55 22w5d 3.0 82 33w1d 3.6
29 14w6d 2.6 56 23w1d 3.0 83 33w5d 3.6
30 15w1d 2.6 57 23w3d 3.0 84 34w2d 3.6
31 15w3d 2.6 58 23w5d 3.1 85 34w6d 3.7
32 15w5d 2.6 59 24w1d 3.1 86 35w3d 3.7
33 16w0d 2.6 60 24w3d 3.1 87 36w0d 3.7
34 16w2d 2.6 61 24w5d 3.1 88 36w5d 3.8
35 16w4d 2.7 62 25w1d 3.1 89 37w4d 3.8
36 16w6d 2.7 63 25w3d 3.1 90 38w3d 3.9
37 17w1d 2.7 64 25w5d 3.2 >90 n/a ——
38 17w4d 2.7 65 26w1d 3.2

Table 2-101: BPD: Tokyo Shinozuka (Fetal Growth), Shinozuka Jpn J Med Ultrasonics
vol 23: 12 1996, Unit: Age (Weeks); Min/Mean/Max (mm); Table/Graph Range: 1.64SD

Age Min Mean Max Age Min Mean Max

10 10.5 14.3 18.1 27 63.4 68.7 74.1

11 13.7 17.6 21.5 28 65.9 71.4 76.8
12 17.0 21.0 25.0 29 68.3 73.9 79.4
13 20.4 24.4 28.5 30 70.6 76.3 81.9
14 23.7 27.8 32.0 31 72.8 78.5 84.2
15 27.0 31.2 35.5 32 74.8 80.6 86.5
16 30.3 34.6 39.0 33 76.7 82.6 88.5
17 33.5 38.0 42.4 34 78.5 84.5 90.4
18 36.8 41.3 45.8 35 80.1 86.1 92.2
19 40.0 44.6 49.2 36 81.5 87.6 93.8
20 43.2 47.9 52.6 37 82.7 89.0 95.2
21 46.3 51.1 55.9 38 83.8 90.1 96.5
22 49.3 54.2 59.1 39 84.6 91.1 97.5
23 52.3 57.3 62.3 40 85.3 91.8 98.4
24 55.2 60.3 65.3 41 85.8 92.4 99.0
25 58.0 63.2 68.4 42 86.0 92.8 99.5
26 60.8 66.0 71.3 2-68
Table 2-102: CRL: Tokyo Shinozuka (Fetal Age), Shinozuka Jpn J Med Ultrasonics vol
23: 12 1996, Unit: CRL (mm); Age (Weeks/Days); SD (mm)

CRL Age 1SD CRL Age 1SD CRL Age 1SD

<5 n/a —— 20 8w6d 3.7 36 10w6d 5.9

5 6w3d 1.1 21 9w0d 3.9 37 11w0d 6.0
6 6w4d 1.3 22 9w1d 4.0 38 11w0d 6.0
7 6w6d 1.6 23 9w2d 4.2 39 11w1d 6.2
8 7w0d 1.7 24 9w3d 4.3 40 11w2d 6.3
9 7w1d 1.9 25 9w4d 4.5 41 11w3d 6.5
10 7w2d 2.0 26 9w4d 4.5 42 11w3d 6.5
11 7w3d 2.2 27 9w5d 4.6 43 11w4d 6.6
12 7w4d 2.3 28 9w6d 4.8 44 11w5d 6.8
13 7w5d 2.5 29 10w0d 4.9 45 11w6d 6.9
14 7w6d 2.6 30 10w1d 5.1 46 11w6d 6.9
15 8w1d 2.9 31 10w2d 5.2 47 12w0d 7.1
16 8w2d 3.1 32 10w3d 5.4 48 12w1d 7.2
17 8w3d 3.3 33 10w4d 5.5 49 12w1d 7.2
18 8w4d 3.4 34 10w5d 5.7 50 12w2d 7.4
19 8w5d 3.6 35 10w6d 5.9 >50 n/a ——

Table 2-103: CRL: Tokyo Shinozuka (Fetal Growth), Shinozuka Jpn J Med Ultrasonics
vol 23: 12 1996, Unit: Age (Weeks/Days); Mean (mm); SD (mm); Table/Graph Range:
1.64SD

Age Mean SD Age Mean SD Age Mean SD

7w0d 7.9 1.7 9w1d 21.2 4.0 11w2d 40.0 6.3

7w1d 8.6 1.9 9w2d 22.3 4.2 11w3d 41.4 6.5
7w2d 9.3 2.0 9w3d 23.4 4.3 11w4d 42.9 6.6
7w3d 10.1 2.2 9w4d 24.5 4.5 11w5d 44.4 6.8
7w4d 10.9 2.3 9w5d 25.7 4.6 11w6d 45.9 6.9
7w5d 11.7 2.5 9w6d 26.8 4.8 12w0d 47.4 7.1
7w6d 12.5 2.6 10w0d 28.0 4.9 12w1d 49.0 7.2
8w0d 13.4 2.8 10w1d 29.3 5.1 12w2d 50.6 7.4
8w1d 14.3 2.9 10w2d 30.5 5.2 12w3d 52.2 7.5
8w2d 15.2 3.1 10w3d 31.8 5.4 12w4d 53.9 7.7
8w3d 16.1 3.3 10w4d 33.1 5.5 12w5d 55.5 7.8
8w4d 17.1 3.4 10w5d 34.4 5.7 12w6d 57.2 8.0
8w5d 18.1 3.6 10w6d 35.8 5.9 13w0d 58.9 8.2
8w6d 19.1 3.7 11w0d 37.1 6.0
9w0d 20.1 3.9 11w1d 38.5 6.2

2-69
Table 2-104: EFW: Tokyo Shinozuka (Fetal Age), Shinozuka Jpn J Med Ultrasonics vol
23: 12 1996, Unit: EFW (grams); Age (Weeks/Days); SD (grams)

EFW Age 1SD EFW Age 1SD EFW Age 1SD

<250 n/a —— 1200 28w3d 162 2200 34w2d 258

250 19w3d 45 1250 28w5d 166 2250 34w4d 264
300 20w0d 51 1300 29w1d 173 2300 34w6d 269
350 20w4d 58 1350 29w3d 177 2350 35w1d 274
400 21w2d 66 1400 29w5d 181 2400 35w3d 279
450 21w5d 71 1450 30w0d 186 2450 35w5d 284
500 22w2d 78 1500 30w2d 191 2500 35w7d 290
550 22w6d 85 1550 30w5d 197 2550 36w2d 295
600 23w2d 90 1600 30w7d 202 2600 36w4d 301
650 23w6d 98 1650 31w2d 207 2650 36w6d 306
700 24w2d 103 1700 31w4d 211 2700 37w2d 314
750 24w5d 109 1750 31w6d 216 2750 37w4d 320
800 25w2d 116 1800 32w1d 221 2800 37w6d 325
850 25w5d 122 1850 32w3d 226 2850 38w1d 331
900 26w1d 128 1900 32w5d 231 2900 38w4d 340
950 26w4d 134 1950 32w7d 236 2950 38w6d 345
1000 26w6d 138 2000 33w1d 238 3000 39w2d 354
1050 27w2d 145 2050 33w3d 243 >3000 n/a ——
1100 27w5d 151 2100 33w5d 248
1150 28w0d 155 2150 34w0d 253

Table 2-105: EFW: Tokyo Shinozuka (Fetal Growth), Shinozuka Jpn J Med Ultrasonics
vol 23: 12 1996, Unit: Age (Weeks); Min/Mean/Max (grams); Table/Graph Range: 1.64SD

Age Min Mean Max Age Min Mean Max

18 158 216 274 30 1234 1552 1870

19 204 279 355 31 1375 1720 2064
20 256 349 442 32 1520 1892 2265
21 314 427 539 33 1667 2068 2469
22 381 513 645 34 1814 2244 2675
23 456 609 761 35 1960 2420 2880
24 541 714 888 36 2102 2592 3083
25 634 830 1026 37 2236 2758 3280
26 737 956 1175 38 2360 2915 3469
27 849 1092 1334 39 2471 3059 3647
28 970 1237 1504 40 2565 3187 3809
29 1099 1391 1683 41 2639 3296 3952

2-70
Table 2-106: FL: Tokyo Shinozuka (Fetal Age), Shinozuka Jpn J Med Ultrasonics vol
23: 12 1996, Unit: FL (mm); Age (Weeks/Days); SD (mm)

FL Age 1SD FL Age 1SD FL Age 1SD

<20 n/a —— 37 22w2d 2.9 55 30w5d 3.1

20 16w1d 2.6 38 22w5d 2.9 56 31w2d 3.2
21 16w3d 2.7 39 23w1d 2.9 57 31w6d 3.2
22 16w6d 2.7 40 23w4d 2.9 58 32w3d 3.2
23 17w1d 2.7 41 24w0d 2.9 59 33w0d 3.2
24 17w3d 2.7 42 24w3d 2.9 60 33w3d 3.2
25 17w6d 2.7 43 24w6d 2.9 61 34w0d 3.2
26 18w1d 2.7 44 25w3d 3.0 62 34w4d 3.3
27 18w3d 2.7 45 25w6d 3.0 63 35w1d 3.3
28 18w6d 2.7 46 26w2d 3.0 64 35w5d 3.3
29 19w1d 2.7 47 26w5d 3.0 65 36w2d 3.3
30 19w4d 2.8 48 27w2d 3.0 66 37w0d 3.3
31 20w0d 2.8 49 27w5d 3.0 67 37w4d 3.4
32 20w2d 2.8 50 28w2d 3.1 68 38w1d 3.4
33 20w5d 2.8 51 28w5d 3.1 69 38w5d 3.4
34 21w1d 2.8 52 29w2d 3.1 70 39w3d 3.4
35 21w3d 2.8 53 29w5d 3.1 >70 n/a ——
36 21w6d 2.8 54 30w2d 3.1

Table 2-107: FL: Tokyo Shinozuka (Fetal Growth), Shinozuka Jpn J Med Ultrasonics
vol 23: 12 1996, Unit: Age (Weeks); Min/Mean/Max (mm); Table/Graph Range: 1.64SD

Age Min Mean Max Age Min Mean Max

16 17.1 21.4 25.8 30 49.7 54.8 60.0

17 19.6 24.0 28.4 31 51.6 56.8 62.0
18 22.1 26.5 31.0 32 53.5 58.7 64.0
19 24.6 29.1 33.6 33 55.2 60.5 65.8
20 27.1 31.6 36.2 34 56.9 62.2 67.6
21 29.5 34.1 38.8 35 58.4 63.8 69.2
22 31.9 36.6 41.3 36 59.9 65.3 70.8
23 34.3 39.1 43.8 37 61.2 66.7 72.2
24 36.7 41.5 46.3 38 62.4 68.0 73.6
25 39.0 43.9 48.7 39 63.5 69.1 74.7
26 41.3 46.2 51.1 40 64.4 70.1 75.8
27 43.5 48.4 53.4 41 65.3 71.0 76.7
28 45.6 50.6 55.7 42 65.9 71.7 77.5
29 47.7 52.8 57.9

2-71
Williams
Table 2-108: EFW: Williams (Fetal Growth), Unit: Age (Weeks); Min/Mean/Max
(grams)

Age Min Mean Max Age Min Mean Max

22.0 320 513 746 34.0 1728 2394 3132

23.0 365 589 861 35.0 1974 2628 3333
24.0 417 675 989 36.0 2224 2849 3521
25.0 477 773 1132 37.0 2455 3052 3706
26.0 546 882 1289 38.0 2642 3227 3867
27.0 627 1005 1463 39.0 2790 3364 3994
28.0 720 1143 1653 40.0 2881 3462 4080
29.0 829 1298 1859 41.0 2946 3524 4127
30.0 955 1484 2136 42.0 3011 3589 4185
31.0 1100 1695 2402 43.0 3044 3626 4221
32.0 1284 1920 2673 44.0 3043 3633 4233
33.0 1499 2155 2910

Yarkoni
Table 2-109: CLA:Yarkoni S, Journal of Ultrasound in Medicine, 4:467-470, 1985
(Fetal Age), Unit: Meas (mm); Min/Mean/Max (Weeks/Days)

Meas Min Mean Max Meas Min Mean Max

11 8w3d 13w6d 17w2d 29 23w2d 28w5d 32w1d

12 9w1d 14w4d 18w1d 30 24w0d 29w4d 34w0d
13 10w0d 14w3d 19w6d 31 25w6d 29w2d 34w6d
14 11w6d 15w2d 20w5d 32 26w5d 30w1d 35w4d
15 12w5d 16w1d 21w4d 33 27w4d 31w0d 35w3d
16 12w3d 18w0d 21w3d 34 27w3d 32w6d 36w2d
17 13w2d 18w5d 22w2d 35 28w1d 33w5d 37w1d
18 14w1d 19w4d 23w0d 36 29w0d 33w3d 39w0d
19 16w0d 19w3d 24w6d 37 30w6d 34w2d 39w5d
20 16w6d 20w2d 25w5d 38 31w5d 35w1d 40w4d
21 17w4d 21w1d 26w4d 39 32w4d 37w0d 40w3d
22 17w3d 22w6d 26w2d 40 32w2d 37w6d 41w2d
23 18w2d 23w5d 27w1d 41 33w1d 38w4d 42w0d
24 19w1d 24w4d 28w0d 42 35w0d 38w3d 43w6d
25 21w0d 24w3d 29w6d 43 35w6d 39w2d 44w5d
26 21w5d 25w1d 30w5d 44 36w5d 40w1d 45w4d
27 22w4d 26w0d 30w3d 45 36w3d 41w6d 45w3d
28 22w3d 27w6d 31w2d

2-72
 Chapter 3

Acoustic information

This chapter describes:

‘The real-time display of acoustic output indices’ on

page 3-2

‘Track 3 ALARA Educational Program’ on page 3-6

‘Default Settings and Output Levels’ on page 3-7

‘Controls Affecting Acoustic Output’ on page 3-8

‘Probe surface temperature safety mechanisms’ on

page 3-10

‘Acoustic Parameters as Measured in Water’ on

page 3-11

‘Acoustic Output Reporting Tables for IEC 62359 Ed.2’

on page 3-13

3 -1
 The real-time display of acoustic
output indices

The Vivid E80/90/95 and EchoPAC software have real-time

display features according IEC62359 Ed.2. They displays both a
thermal (TI) and a mechanical (MI) index in all operating modes
according to the required standard. These two indices are
intended to estimate the potential for thermal and mechanical
bioeffects induced by ultrasound. Both TI and MI are displayed
with increments of 0.1. The displayed (estimated) TI and MI are
nominal values.

Thermal Index
TI is defined as:
where: W0 is the time-averaged acoustic power and Wdeg is the
estimated power necessary to raise the target tissue one
degree C.
The displayed TI is an estimate of temperature increase of soft
tissue or bone, presented to make it easier for the operator to
implement the ALARA (As Low As Reasonably Achievable)
principle. There are three thermal index categories:
• TIS: Soft tissue thermal index. The main TI category. Used
for applications that do not image bone.
• TIB: Bone thermal index (bone located in a focal region).
Used for fetal application.
• TIC: Cranial bone thermal index (bone located close to the
surface). Used for transcranial application.
The correct category is based on display standard, mode of
operation and chosen application, and presents the relevent TI
category to the operator. It is therefore important that the
operator chooses the right application. The system also
provides the ability to select the display of any of the TI
categories regardless of the current application.
3 -2
Vivid E80/90/95 and EchoPAC have an internal limit of 3.0 on TI
for the chosen index category.
 The British Medical Ultrasound Society has suggested some
maximum scanning times relative to displayed TI as follows:

Obstetric scanning

TI time Note

0.0–0.7 Unlimited Monitor TIS up to 10 weeks post LMP, TIB thereafter

0.7–1.0 < 60 min

1.0–1.5 < 30 min

1.5–2.0 < 15 min

2.0–2.5 < 4 min

2.5–3.0 < 1 min

Neonatal trans-cranial & spinal scanning

TI time Note

0.0–0.7 Unlimited Monitor TIC. MI>0.7 should be used with caution in the presence of
contrast agents.
0.7–1.0 < 60 min

1.0–1.5 < 30 min

1.5–2.0 < 15 min

2.0–2.5 < 4 min

2.5–3.0 < 1 min

Neonatal general and cardiac scanning

TI time Note

0.0–1.0 Unlimited Monitor TIB. MI>0.7 should be used with caution in the presence of
contrast agents.
1.0–1.5 < 120 min

1.5–2.0 < 60 min

2.0–2.5 < 15 min

2.5–3.0 < 4 min

3 -3
 Adult trans-cranial scanning

TI time Note

0.0–1.0 Unlimited Monitor TIC. MI>0.7 should be used with caution in the presence of
contrast agents.
1.0–1.5 < 30 min

1.5–2.0 < 15 min

2.0–2.5 < 4 min

2.5–3.0 < 1 min

General Abdominal, Peripheral Vascular and other scanning (excluding the eye)

TI time Note

0.0–1.0 Unlimited Monitor TIB or TIC if bone closer than 1 cm, TIS if no bone is in the
image. MI>0.7 should be used with caution in the presence of
1.0–1.5 < 120 min contrast agents.

1.5–2.0 < 60 min

2.0–2.5 < 15 min

2.5–3.0 < 4 min

NOTE: The does not monitor the thermal exposure time.

References
• The British Medical Ultrasound Society. Guidelines for the
safe use of diagnostic ultrasound equipment.
• American Institute of Ultrasound in Medicine Consensus
Report on Potential Bioeffects of Diagnostic Ultrasound.

Mechanical Index
MI is the estimated likelihood of tissue damage due to cavitation.
MI is defined as:

equivalent to Track3 MI when the depth ZMI=Zsp.

The MI will not exceed a value of 1.9 according to Track 3 in the
FDA 510(k) guidance of September 9, 2008.
The depth for is not limited by the Break-Point Depth.
The MI according to IEC62359 Ed2 will not exceed 1.9.
3 -4
Display Accuracy and Acoustic Measurement Uncertainties

The display accuracy and measurement precision of the output

display are summarized in the table below. Accuracy of the
output display (TI, MI) parameters depends on the
measurement system uncertainty, the acoustic model used to
calculate the parameters, and variation in the acoustic output of
probes and systems. The overall measurement uncertainty has
been assessed by determining Type A and Type B uncertainties
following ISO GUM at a 95% confidence level for MI and TI from
and above the 0.4 limit given by EN60601-2-37 Ed2, Amd1.

Parameter Estimated accuracya Measurement uncertainty

M/Color/PW/CW 2D/CFM mode

Pressure, MI ±25% ±15%

Power, TI ±50% ±30% ±40%

Frequencyb ±1% ±1%

a. Accuracy = (Measured value - displayed value)/displayed

value * 100%. b. For the measurement system.

3 -5
Track 3 ALARA Educational
Program

The user should be familiar with the enclosed document

“Medical Ultrasound Safety”, published by AIUM (American
Institute of Ultrasound in Medicine). This document is
acceptable to FDA as meeting the content of the ALARA
educational program. ALARA is an acronym for the principle of
prudent use of diagnostic ultrasound by obtaining the diagnostic
information at an output that is As Low As Reasonably
Achievable. In addition to the AIUM document, the sections ‘The
real-time display of acoustic output indices’ on page 3-2 and
‘Controls Affecting Acoustic Output’ on page 3-8 should be
studied carefully in order to implement ALARA.

3 -6
Default Settings and Output Levels

The default nominal acoustic output level will not exceed a

thermal index (TI) of 3.0 or a mechanical index (MI) of 1.5.
The default nominal maximum TI is 50% of the maximum
possible TI (6.0) and the maximum default MI is 80% of the
maximum possible MI (1.9).
The output level will not exceed the default level until the user
intentionally increases the power level by adjusting the power
control on the system.
The output level will return to default each time
• a new probe is chosen
• a new application is chosen
• a new patient is chosen.

3 -7
Controls Affecting Acoustic Output

The initial means by which the user can affect acoustic output
are by 1) selecting a probe, 2) selecting an application (exam
category) and then 3) selecting the imaging mode or particular
imaging characteristics. After these selections are made, the
only user control that can affect the output is the acoustic output
control. This is achieved through an acoustic output control
scheme in which all parameters that directly or indirectly affect
acoustic output are fed to the control algorithm. The algorithm
estimates all relevant parameters and compares them to the
FDA limits.
Output levels remain below the limits with a 95% confidence
margin. The absolute maximum allowable output for all
applications is:
• ISPTA less than or equal to 720 mW/cm2
• MI less than or equal to 1.9
• TI less than or equal to 6

3 -8

Figure 3-1. The Acoustic Output Control Scheme

 The following table summarizes the mode/probe combinations
for which the global maximum displayed MI or TI may be greater
than 1.0. For each probe/mode combination checked, a Track 3
acoustic output table exists.
Not all probes listed may be supported worldwide. Please refer
to your local language User Manual for an overview of the
probes that are supported in your country.

Track 3 Summary Table

Operating Mode Transducer Model

L8-18i-D
M5Sc-D

C1-6-D
12S-D

11L-D
6S-D

4V-D

9L-D

B-Mode (2D) Yes Yes Yes Yes Yes Yes Yes Yes

M-Mode Yes Yes Yes Yes Yes Yes Yes Yes

Pulsed Doppler (PW) Yes Yes Yes Yes Yes Yes Yes Yes

CW Doppler (CW) Yes Yes Yes Yes - - - -

Color Flow Yes Yes Yes Yes Yes Yes Yes Yes

Color M-Mode Yes Yes Yes Yes Yes Yes Yes Yes

Operating Mode Transducer Model

IC5-9-D

6Tc-RS
C2-9-D

9T-RS

6VT-D

P2D

P6D
6Tc/

9T/
8C

B-Mode (2D) Yes Yes Yes Yes Yes Yes - -

M-Mode Yes Yes Yes Yes Yes Yes - -

Pulsed Doppler (PW) Yes Yes Yes Yes Yes Yes - -

CW Doppler (CW) - - - Yes Yes Yes Yes Yes

Color Flow Yes Yes Yes Yes Yes Yes - -

Color M-Mode Yes Yes Yes Yes Yes Yes - -

3 -9
Probe surface temperature safety
mechanisms

The system has an Probe Surface Temperature Control

Algorithm to ensure that each probe is set up and run within
temperature limits given by the harmonized safety standard
IEC60601-2-37. The Control Algorithm is implemented in the
software and calibrated by laboratory measurements of surface
temperature on each probe type. A Control Algorithm Input
Parameter check is performed during setup of each new scan,
and any detected error in the input, and/or malfunction are
protected by software error handling that aborts setup and
prevents start of scanning. The system has monitoring of
voltage and power used by the ultrasound transmits circuitry and
probe. If transmit voltage or power exceeds expected values,
the transmit voltage will be set to zero and scanning will stop.
This mechanism will protect against illegal setup and/or probe
defects.
These safety mechanisms are designed to ensure that the
surface temperature for each probe supported by the system, is
kept within values listed in the table “Maximum Probe
Temperature” in Chapter “Probes” of the system’s user manual.
No particular user actions are required for the proper functioning
of the described safety mechanisms.

3-10
Acoustic Parameters as Measured in
Water

Definitions, symbols and abbreviations

The following definitions, symbols and abbreviations are used in
the acoustic output reporting tables in this chapter:

IEC Meaning—IEC 62359 Ed.2

MI Mechanical Index

TIS Soft Tissue Thermal Index

TISas Soft Tissue Index at-surface, scanning or non-scanning

TISbs Soft Tissue Index below-surface, scanning or non-scanning

TIB Bone Thermal Index

TIBas Bone Thermal Index at surface, scanning or non-scanning

TIBbs Bone Thermal Index below-surface, scanning or non-scanning

TIC Cranial-bone Thermal Index

pr,α Attenuated peak-rare-factional acoustic pressure

CMI Normalizing Coefficient 1MPa*MHz-1/2

P Output power

P1x1 Bounded square output power

zs Depth for TIS below surface

zb Depth for TIB below surface

zMI Depth for MI

Zpii, α Depth for Ipa, ,α and Ispta, ,α

fawf Acoustic working frequency

3-11
prr Pulse repetition rate
 IEC Meaning—IEC 62359 Ed.2

srr Scan repetition rate

npps Number of pulses per scan line

Ipa, ,α Attenuated pulse average intensity

Ispta, ,α Attenuated speatial-peak temporal-average intensity

Ispta Spatial-peak temporal-average intensity

pr Peak-rare-factional acoustic pressure

Multiple focal-zones
When using multiple focal-zones on, the time in one frame is
divided between the different focal-zones. When measuring this,
the MI is found as the maximum MI of all zones:

while the TI and W0 is found as the time-weighted sum of all

zones:

tzone is the time fraction used per zone in a frame.

Some of the parameters in the acoustic output report tables will
have one value per zone. In this case, the range of the
parameter values is reported. The number of zones and which
zone has the greater MI is also given in the tables.

Operating Conditions
All table entries are with the operating conditions specified at the
end of the table.

Explanation of Footnote
The mechanical and thermal indices may be replaced by the
footnote ‘#’ inditating that this probe is not intended for
transcranial or neonatal cephalic uses.

3-12
Acoustic Output Reporting Tables for
IEC 62359 Ed.2

Not all probes listed may be supported worldwide. Please refer

to your local language User Manual for an overview of the
probes that are supported in your country.
NOTE: These acoustic output reporting tables are produced according
to IEC 62359 Ed.2 and as such should not be consulted by
users in China. For acoustic output reporting tables according to
IEC 62359 Ed.1 or NEMA UD2/UD3 to be used in China, please
consult separate Chinese Technical Reference Manual.

3-13
Transducer Model: M5Sc-D
Operating Mode: 2D

See ‘Explanation of Footnote’ on page 3-12 3-14

Transducer Model: M5Sc-D

Operating Mode: M-Mode

See ‘Explanation of Footnote’ on page 3-12 3-15

Transducer Model: M5Sc-D

Operating Mode: M+CM

See ‘Explanation of Footnote’ on page 3-12 3-16

Transducer Model: M5Sc-D

Operating Mode: 2D+CF

3-17
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: M5Sc-D

Operating Mode: PW

3-18
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: M5Sc-D

Operating Mode: CW

3-19
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 6S-D
Operating Mode: 2D

See ‘Explanation of Footnote’ on page 3-12 3-20

Transducer Model: 6S-D

Operating Mode: M-Mode

3-21
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 6S-D

Operating Mode: M+CM

3-22
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 6S-D

Operating Mode: 2D+CF

3-23
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 6S-D

Operating Mode: PW

3-24
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 6S-D

Operating Mode: CW

3-25
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 12S-D
Operating Mode: 2D

3-26
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 12S-D

Operating Mode: M-Mode

3-27
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 12S-D

Operating Mode: M+CM

3-28
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 12S-D

Operating Mode: 2D+CF

3-29
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 12S-D

Operating Mode: PW

3-30
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 12S-D

Operating Mode: CW

3-31
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 4V-D
Operating Mode: 2D

See ‘Explanation of Footnote’ on page 3-12 3-32

Transducer Model: 4V-D

Operating Mode: M-Mode

3-33
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 4V-D

Operating Mode: M+CM

3-34
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 4V-D

Operating Mode: 2D+CF

3-35
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 4V-D

Operating Mode: PW

3-36
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 4V-D

Operating Mode: CW

3-37
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 9L-D
Operating Mode: 2D

See ‘Explanation of Footnote’ on page 3-12 3-38

Transducer Model: 9L-D

Operating Mode: M-Mode

3-39
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 9L-D

Operating Mode: M+CM

3-40
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 9L-D

Operating Mode: 2D+CF

3-41
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 9L-D

Operating Mode: PW

3-42
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 11L-D
Operating Mode: 2D

See ‘Explanation of Footnote’ on page 3-12 3-43

Transducer Model: 11L-D

Operating Mode: M-Mode

3-44
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 11L-D

Operating Mode: M+CM

3-45
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 11L-D

Operating Mode: 2D+CF

3-46
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 11L-D

Operating Mode: PW

3-47
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: L8-18i-D
Operating Mode: 2D

3-48
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: L8-18i-D

Operating Mode: M-Mode

3-49
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: L8-18i-D

Operating Mode: M+CM

3-50
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: L8-18i-D

Operating Mode: 2D+CF

3-51
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: L8-18i-D

Operating Mode: PW

3-52
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: C1-6-D
Operating Mode: 2D

3-53
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: C1-6-D

Operating Mode: M-Mode

3-54
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: C1-6-D

Operating Mode: M+CM

See ‘Explanation of Footnote’ on page 3-12

3-55
Transducer Model: C1-6-D

Operating Mode: 2D+CF

3-56
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: C1-6-D

Operating Mode: PW

3-57
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: IC5-9-D
Operating Mode: 2D

3-58
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: IC5-9-D

Operating Mode: M-Mode

3-59
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: IC5-9-D

Operating Mode: M+CM

3-60
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: IC5-9-D

Operating Mode: 2D+CF

3-61
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: IC5-9-D

Operating Mode: PW

3-62
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: C2-9-D
Operating Mode: 2D

3-63
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: C2-9-D

Operating Mode: M-Mode

3-64
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: C2-9-D

Operating Mode: M+CM

See ‘Explanation of Footnote’ on page 3-12 3-65

Transducer Model: C2-9-D

Operating Mode: 2D+CF

3-66
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: C2-9-D

Operating Mode: PW

3-67
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 8C
Operating Mode: 2D

3-68
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 8C

Operating Mode: M-Mode

3-69
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 8C

Operating Mode: M+CM

3-70
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 8C

Operating Mode: 2D+CF

3-71
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 8C

Operating Mode: PW

3-72
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 6VT-D
Operating Mode: 2D

See ‘Explanation of Footnote’ on page 3-12 3-73

Transducer Model: 6VT-D

Operating Mode: M-Mode

3-74
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 6VT-D

Operating Mode: M+CM

3-75
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 6VT-D

Operating Mode: 2D+CF

3-76
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 6VT-D

Operating Mode: PW

3-77
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 6VT-D

Operating Mode: CW

3-78
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 6Tc / 6Tc-RS
Operating Mode: 2D

3-79
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 6Tc / 6Tc-RS

Operating Mode: M-Mode

3-80
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 6Tc / 6Tc-RS

Operating Mode: M+CM

3-81
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 6Tc / 6Tc-RS

Operating Mode: 2D+CF

3-82
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 6Tc / 6Tc-RS

Operating Mode: PW

3-83
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 6Tc / 6Tc-RS

Operating Mode: CW

3-84
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 9T / 9T-RS
Operating Mode: 2D

3-85
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 9T / 9T-RS

Operating Mode: M-Mode

3-86
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 9T / 9T-RS

Operating Mode: M+CM

3-87
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 9T / 9T-RS

Operating Mode: 2D+CF

3-88
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 9T / 9T-RS

Operating Mode: PW

3-89
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: 9T / 9T-RS

Operating Mode: CW

3-90
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: P2D
Operating Mode: CW

3-91
See ‘Explanation of Footnote’ on page 3-12
Transducer Model: P6D
Operating Mode: CW

3-92
See ‘Explanation of Footnote’ on page 3-12
 Appendices

Statements on the safety of ultrasound

October 1982, revised March 1983 and October 1983
Diagnostic ultrasound has been in use for over 35 years. Given
its known benefits and recognized efficacy for medical
diagnosis, including use during human pregnancy, the American
Institute of Ultrasound In Medicine herein addresses the clinical
safety of such use:
No confirmed biological effects on patients or instrument
operators caused by exposure at intensities typical of present
diagnostic ultrasound instruments have ever been reported.
Although the possibility exists that such biological effects may
be identified in the future, current data indicate that the benefits
to patients of the prudent use of diagnostic ultrasound outweigh
the risks, if any, that may be present.

AIUM Statement on Mammalian in Vivo Ultrasonic Biological Effects

August 1976, revised October 1978, reaffirmed October 1982
and October 1983
In the low megahertz frequency range there have been (as of
this date) no independently confirmed significant biological
effects in mammalian tissues exposed to intensities ”a” below
100 mW/cm2. For ultrasound exposure times “b” less than
500 seconds and greater than 1 second, such effects have not
been demonstrated even at higher intensities when the product
of intensity “a” and exposure time “b” is less than 50 Joules/cm2.
• Spatial peak, temporal average as measured in a free field
in water.
• Total time, this includes off-time as well as on-time for a
repeated pulse regime.

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