manual Advanced Volume

MX7/MX7T/Vaus7/Zeus/ME7/Anesus
ME7/Anesus ME7T/MX7P/MX7W/MX8/
MX8T/Vaus8/ME8
Diagnostic Ultrasound System
Operator’s Manual
[Advanced Volume]
© 2022 Shenzhen Mindray Bio-medical Electronics Co., Ltd. All Rights Reserved.
The issue date of this Operator’s Manual is 2022-12.
Intellectual Property Statement

SHENZHEN MINDRAY BIO-MEDICAL ELECTRONICS CO., LTD. (hereinafter referred to as
Mindray) owns the intellectual property rights to this Mindray product and this manual. This
manual may refer to information protected by copyright or patents and does not convey any license
under the patent rights or copyright of Mindray or of others.
Mindray intends to maintain the contents of this manual as confidential information. Disclosure of
the information in this manual in any manner whatsoever without the written permission of
Mindray is strictly forbidden.
Release, amendment, reproduction, distribution, rental, adaptation, translation or any other
derivative work of this manual in any manner whatsoever without the written permission of
Mindray is strictly forbidden.
IMPORTANT
• No part of this manual may be copied or reprinted, in whole or in part, without written
permission.
• The contents of this manual are subject to change without prior notice and without our legal
obligation.
About This Manual

This operator’s manual describes the operating procedures for this diagnostic ultrasound system. To
ensure safe and correct operation, carefully read and understand the manual before operating the
system.
When operating the system, refer to the following manuals:
• Operator’s Manual [Basic Volume]
Describes the basic functions and operations of the system, safety precautions, exam modes,
imaging modes, preset, maintenance and acoustic output, etc.
• Operator’s Manual [Acoustic Power Data and Surface Temperature Data]
Contains data tables of acoustic output for transducers.
Software Interfaces in this Manual

Depending on the software version, preset settings and optional configuration, the actual interfaces
may be different from those in this manual.
NOTE:
The functions described in this manual are not provided for all systems sold in all regions. The
functions available depend on the specific system purchased.
All the menus and screens in this manual take the system in full configuration as an example.
Meaning of Signal Words

In this manual, the signal words DANGER, WARNING, CAUTION, NOTE
and TIP are used regarding safety and other important instructions. The signal words and their
I
meanings are defined as follows. Please understand their meanings clearly before reading this
manual.
Signal word Meaning

Indicates an imminently hazardous situation that, if not avoided, will
DANGER
result in death or serious injury.
Indicates a potentially hazardous situation that, if not avoided, could
WARNING
result in death or serious injury.
Indicates a potentially hazardous situation that, if not avoided, may
CAUTION
result in minor or moderate injury.
NOTE Indicates a potentially hazardous situation that, if not avoided, may
result in prop-erty damage.
TIP Important information that helps you to use the system more effectively.
Conventions
In this manual, the following conventions are used to describe the buttons on the control panel,
items in the menus, buttons in the dialog boxes and some basic operations:
• <Buttons>: angular brackets indicate buttons, knobs and other controls on the control panel or
on the keyboard.
• [Items in menu or buttons in dialog box]: square brackets indicate items in menus, on the soft
menu or buttons in dialog boxes.
• Click [Items or Buttons]: move the cursor to the item or button and press <Set> or use the soft
key corresponding to the soft menu.
• [Items in menu] > [Items in submenu]: select a submenu item following the path.
Meaning of Safety Symbols
Symbol Description
General warning, caution, risk of danger.
II
Contents
Intellectual Property Statement ................................................................................................ I

IMPORTANT ........................................................................................................................... I
About This Manual ................................................................................................................... I
Software Interfaces in this Manual .................................................................................... I
Meaning of Signal Words ......................................................................................................... I
Conventions ...................................................................................................................... II
Meaning of Safety Symbols .................................................................................................... II
1 Overview of Measurements ................................................................................1 - 1
1.1 Measurement Preset ....................................................................................................... 1 - 2
1.2 Basic Operations and Buttons ........................................................................................ 1 - 2
1.3 Measurement Menu ........................................................................................................ 1 - 2
1.4 Measurement, Calculation and Study ............................................................................. 1 - 4
1.5 Measurement Caliper ..................................................................................................... 1 - 5
1.6 Results Window ............................................................................................................. 1 - 5
1.6.1 Results Display .................................................................................................... 1 - 5
1.6.2 Moving the Results Window ............................................................................... 1 - 5
1.6.3 Results Window Assignment ............................................................................... 1 - 6
1.7 Cross-window Measurement .......................................................................................... 1 - 7
2 General Measurement .........................................................................................2 - 1
2.1 2D General Measurements ............................................................................................. 2 - 1
2.1.1 Depth .................................................................................................................... 2 - 1
2.1.2 Distance ............................................................................................................... 2 - 1
2.1.3 Distance P-L ........................................................................................................ 2 - 1
2.1.4 Angle .................................................................................................................... 2 - 2
2.1.5 Area & Circumference ......................................................................................... 2 - 2
2.1.6 Smart Trace .......................................................................................................... 2 - 4
2.1.7 Volume ................................................................................................................ 2 - 4
2.1.8 Double Dist. ......................................................................................................... 2 - 5
2.1.9 Parallel ................................................................................................................. 2 - 6
2.1.10 Curve Length ..................................................................................................... 2 - 6
2.1.11 Ratio (D) ............................................................................................................ 2 - 7
2.1.12 Ratio (A) ............................................................................................................ 2 - 7
2.1.13 B-Profile ............................................................................................................ 2 - 7
2.1.14 B-Hist. ................................................................................................................ 2 - 8
2.1.15 Color Vel. .......................................................................................................... 2 - 8
2.1.16 Volume Flow ..................................................................................................... 2 - 9
2.1.17 IMT .................................................................................................................... 2 - 9
2.1.18 Strain .................................................................................................................. 2 - 9
2.1.19 Strain Ratio ...................................................................................................... 2 - 10
2.1.20 Strain Hist. ....................................................................................................... 2 - 10
2.1.21 Color Pixel Percentage ..................................................................................... 2 - 11
2.2 M General Measurements ............................................................................................ 2 - 12
Operator’s Manual i
Contents
2.2.1 Distance ..............................................................................................................2 - 12

2.2.2 Time ...................................................................................................................2 - 12
2.2.3 Slope ...................................................................................................................2 - 12
2.2.4 Velocity ..............................................................................................................2 - 12
2.2.5 HR ......................................................................................................................2 - 13
2.2.6 HR (R-R) ............................................................................................................2 - 13
2.3 Doppler General Measurements ...................................................................................2 - 14
2.3.1 Time ...................................................................................................................2 - 14
2.3.2 HR ......................................................................................................................2 - 14
2.3.3 HR (R-R) ............................................................................................................2 - 14
2.3.4 D Velocity ..........................................................................................................2 - 14
2.3.5 Acceleration .......................................................................................................2 - 14
2.3.6 D Trace ...............................................................................................................2 - 15
2.3.7 PS/ED .................................................................................................................2 - 18
2.3.8 Volume Flow ......................................................................................................2 - 18
2.3.9 Velocity Ratio ....................................................................................................2 - 19
2.3.10 VTI Ratio .........................................................................................................2 - 19
2.4 References .....................................................................................................................2 - 20
3 Abdomen .............................................................................................................. 3 - 1
3.1 Basic Measurement Procedures ......................................................................................3 - 1
3.2 Abdomen Measurement Tools ........................................................................................3 - 1
3.2.1 2D Mode ...............................................................................................................3 - 1
3.2.2 Doppler Mode ......................................................................................................3 - 4
4 Obstetrics ............................................................................................................. 4 - 1
4.2 Obstetric Measurement Tools .........................................................................................4 - 1
4.2.1 2D Mode ...............................................................................................................4 - 1
4.2.2 M Mode ................................................................................................................4 - 7
4.2.3 Doppler Mode ......................................................................................................4 - 7
4.3 Auto OB Measurement (Smart OB) ...............................................................................4 - 8
4.4 Auto NT Measurement (Smart NT) ................................................................................4 - 8
4.5 Multi-Fetus Exam ...........................................................................................................4 - 8
4.6 GA ...................................................................................................................................4 - 9
4.6.1 Clinical GA ..........................................................................................................4 - 9
4.6.2 Ultrasound GA .....................................................................................................4 - 9
4.7 Obstetric Formula .........................................................................................................4 - 11
4.7.1 GA and FG Formulae .........................................................................................4 - 11
4.7.2 Fetal Weight Formulae .......................................................................................4 - 14
4.7.3 Weight Percentile for Age ..................................................................................4 - 15
4.8 References .....................................................................................................................4 - 16
5 Cardiology ........................................................................................................... 5 - 1
5.2 Measurement Tools ........................................................................................................5 - 2
5.2.1 2D Mode ...............................................................................................................5 - 2
5.2.2 M Mode ................................................................................................................5 - 5
5.2.3 Doppler Mode ......................................................................................................5 - 7
5.2.4 TDI Cardiac Measurements Tools .....................................................................5 - 11
ii Operator’s Manual
Contents
5.3 Measurement Tool Operations ..................................................................................... 5 - 12

5.3.1 MV ALL ............................................................................................................ 5 - 12
5.4 Study Tool Operations .................................................................................................. 5 - 13
5.4.1 Left Ventricular Function .................................................................................. 5 - 13
5.4.2 Left Ventricular Mass (LV Mass) ...................................................................... 5 - 24
5.4.3 Mitral Valve Area (MVA) ................................................................................. 5 - 26
5.4.4 AVA (VTI) ........................................................................................................ 5 - 26
5.4.5 LA Vol ............................................................................................................... 5 - 27
5.4.6 LV Tei Index ...................................................................................................... 5 - 28
5.4.7 RVSP (Right Ventricular Systolic Pressure) ..................................................... 5 - 28
5.4.8 PAEDP (Pulmonary Artery End Diastolic Pressure) ......................................... 5 - 29
5.4.9 RVIMP (RV Tei Index) ..................................................................................... 5 - 29
5.4.10 Qp/Qs ............................................................................................................... 5 - 30
5.4.11 PISA ................................................................................................................. 5 - 31
5.4.12 TDI Mode ........................................................................................................ 5 - 34
5.5 References .................................................................................................................... 5 - 36
6 Vascular ................................................................................................................6 - 1
6.1 Basic Measurement Procedures ...................................................................................... 6 - 1
6.2 Measurement Tools ........................................................................................................ 6 - 1
6.2.1 2D Mode .............................................................................................................. 6 - 1
6.2.2 Doppler Mode ...................................................................................................... 6 - 2
6.3 Study Tool Operations .................................................................................................... 6 - 5
6.3.1 IMT ...................................................................................................................... 6 - 5
6.3.2 ABI ...................................................................................................................... 6 - 6
6.4 References ...................................................................................................................... 6 - 7
7 Urology .................................................................................................................7 - 1
7.2 Urology Measurement Tools .......................................................................................... 7 - 1
7.2.1 2D Mode .............................................................................................................. 7 - 1
7.2.2 Doppler Mode ...................................................................................................... 7 - 4
7.3 References ...................................................................................................................... 7 - 4
8 Gynecology ...........................................................................................................8 - 1
8.2 Gynecology Measurement Tools .................................................................................... 8 - 1
8.3 References ...................................................................................................................... 8 - 5
9 Small Parts ...........................................................................................................9 - 1

9.2 Small Parts Measurement Tools ..................................................................................... 9 - 1
9.2.1 2D Mode .............................................................................................................. 9 - 1
9.2.2 Doppler Mode ...................................................................................................... 9 - 3
9.3 References ...................................................................................................................... 9 - 3
10 Pediatrics ..........................................................................................................10 - 1
10.1 Basic Measurement Procedures .................................................................................. 10 - 1
10.2 Pediatrics Measurement Tools ................................................................................... 10 - 1
10.2.1 HIP ................................................................................................................... 10 - 1
Operator’s Manual iii

Contents
10.2.2 HIP-Graf ...........................................................................................................10 - 3

10.2.3 d/D ....................................................................................................................10 - 3
10.3 References ...................................................................................................................10 - 3
11 Emergency&Critical ....................................................................................... 11 - 1
11.1 Basic Measurement Procedures ..................................................................................11 - 1
11.2 EM Measurement Tools .............................................................................................11 - 1
12 Nerve ................................................................................................................ 12 - 1
12.1 Basic Measurement Procedures ..................................................................................12 - 1
12.2 Nerve Measurement Tools ..........................................................................................12 - 1
13 Report ............................................................................................................... 13 - 1
13.1 Viewing Reports .........................................................................................................13 - 1
13.1.1 To View Current Reports .................................................................................13 - 1
13.1.2 To View History Reports .................................................................................13 - 4
13.2 Obstetric Exam Report ...............................................................................................13 - 4
13.2.1 Fetal Biophysical Profile ..................................................................................13 - 4
13.2.2 Comparison Bar ...............................................................................................13 - 5
13.2.3 Z-Score .............................................................................................................13 - 5
13.2.4 Fetal Growth Curve ..........................................................................................13 - 6
13.2.5 Fetus Compare .................................................................................................13 - 6
13.3 Report Setting .............................................................................................................13 - 7
13.4 Printing Reports ..........................................................................................................13 - 8
13.5 Save/Load Report .......................................................................................................13 - 8
13.5.1 Save report .......................................................................................................13 - 8
13.5.2 Export report ....................................................................................................13 - 8
13.5.3 Load Report ......................................................................................................13 - 9
iv Operator’s Manual
1 Overview of Measurements
There are two kinds of measurement tools.

• General tools: basic measurement tools in General Measurement, such as the “distance” and
“Area.”
• Application tools: the measurement tools in Application Measurement. These items are
classified and combined in clinical application packages such as Abdomen, Obstetric, etc. For
example, HC (head circumference) in the Obstetric measurements is one of the application
tools.
TIP:
• Most application tools use the general measurement method while measuring, e.g., an “Area”
tool is used when measuring the HC. Only the application measurement results are recorded in
the report.
• The measurement tools listed in this manual are configured in the system. The application
measurement packages provided in this system are generally different combinations of
measurement tools.
Please observe the following precautions to ensure patient and operator safety when using this
system.
CAUTION
• Select the proper patient image and measurement tools. Only qualified
professionals can decide the appropriate measurements and results.
• Confine measurement calipers to the actual Region of Interest (ROI).
Measurements that extend beyond the ROI will be incorrect.
• Before examining a new patient, it is necessary to end the current scan and
delete the patient information and data. Failure to do so will result in new
patient data being combined with the previous patient’s data.
• When the system is turned OFF or end the exam, all unsaved data are lost.
• Pressing the <Clear> key will clear the measurement caliper and all data in
the result window, such as comments and body marks.
• In dual-B imaging mode, the measurement results of the merged image
can be inaccurate. Therefore, the results are provided for reference only,
not for confirming diagnoses.
• The quality of the extended image constructed in iScape (panoramic
imaging) is dependent on the skill of the operator. Extra attention should be
paid during the iScape measurement since the results could be inaccurate.
• Ensure that measurement data correctly corresponds to the fetus during
the Obstetric Measurement.
Operator’s Manual 1-1

• Fully understand the functionality of this system by referring to the

Operator’s Manual - Basic Volume.
• When the result of auto trace does not match the image exactly, perform
the measurement manually.
1.1 Measurement Preset

Before measuring, preset the following parameters:
• Measurement Parameters Preset
• Obstetric Preset
• General Measurement Preset
• Application Measurement Preset
• Report Preset
For detailed information about Measurement Preset, see Basic Manual.
1.2 Basic Operations and Buttons

The following descriptions for buttons and keys are used during performing measurements:
Keys Basic Operations

Measure To enter/exit the application measurement.
Caliper To enter/exit the general measurement.
Left/right Set key Press <Set> to confirm and end the current operation during
measurement.
Update To switch between the fixed end and active end of the caliper during a
measurement.
In iWorks status, press to enter a measurement according to the prompt.
Clear Short press: to return to the previous measurement step or delete the
caliper backwards.
Long press: to clear all measurement calipers on the screen and data in
the results window.
Report To enter/exit the report page.
Cursor To show/hide the cursor.
Trackball/Trackpad To move the cursor.
NOTE:
You can also tap the trackpad to confirm and end the current
operation during measurement.
For detailed information about button functions, see Basic Volume.
1.3 Measurement Menu

Press <Caliper>/ <Measure> to enter the general/application measurement.
1-2 Operator’s Manual

Take application measurement menu as example, measurement menu on the touch screen is shown
as Figure 1-1.
Figure 1-1 Touch screen display for measurement
10
1
3
9
4
8
5
6
7
1 Measurement mode
2 Measurement tools
3 Measurement loction
4 Measurement tools (Submenu)
5 Method selecting
6 Frame selection
7 Exit measurement
8 Edit Measurement
9 Display/Hide measurement results
10 Measurement Library
TIP:
• The order of the measurement items can be preset.
• A measurement tool can be activated by tapping the item on the touch screen. It is described as
“Select ... in the measurement menu” in the following procedures.
Measurement Location
The location buttons are used to select the measurement locations.
• Side (Left/Right): belongs to items (e.g., kidney) that contain measurements of left/right side
parameters respectively.
• Location (Prox./Mid./Dist.): belongs to items (e.g., vascular) that contain measurements of
Proximal, Middle or Distal parameters.
• Location (Far/near): belongs to items (e.g., carotid) that contain measurements of anterior or
posterior parameters.
• Pole (U/M/L): belongs to items (e.g., some abdomen vessels) that contain measurements of
upper, middle or lower parameters.

Measurement Tool
Tap the item on the touch screen to select the tool.
TIP:
A performed application item/tool is marked with a “√.” (If one or some items in a submenu
(extended menu) of a study are already performed, this study will be marked as measured.)
Measurement Mode
Tap the mode tab to switch to other measurement menus available for other modes.
Measurement Library Switching

During application measurement, tap the library drop-down list to select from the available
measurement libraries under the current probe of the current exam mode.
Measurement Method
Some measurement tools have multiple methods to select.
Tap “ ” on the right side of the item to select the method.
Adjust Frame
Tap [Adjust Frame], use the trackball/trackpad to select an appropriate frame to perform
measurements.
Edit Measurement Caliper

Tap [Edit]. Select the measurement caliper by using the trackball/trackpad and <Set> button. Move
the pointer of the measurement caliper. The measurement is updated in the result window.
1.4 Measurement, Calculation and Study

There are three kinds of measurement items.
Measurement
Results of measurements are directly obtained via the measurement tools, which are indicated by
“ ” in the preset screen.
For example, “Distance” in the 2D general measurement or “HC” in the OB measurement.
On the touch screen, measurement tools are displayed using square button.
Calculation
Results of calculations are automatically derived by the system using other measured or calculated
values as parameters, they are indicated by “ ” in the preset screen.
For example, EFW (Estimated Fetal Weight) in the OB measurement.
If all measurements related to a calculation tool are completed, the system will automatically
calculate the result. If some measurement tools are performed again, the system will automatically
update the calculation result using the latest measurement results.
On the touch screen, calculation tools are displayed using square button.
Study
A group of measurements and/or calculations for a specific clinical application, which are indicated
by “ ” in the preset screen.
For example, AFI in the OB measurement.

Fold/unfold the study to hide/show the measurement or calculation items included.

On the touch screen, study items are displayed with an arrow indicating the tools to be selected.
1.5 Measurement Caliper

A measurement caliper is a graphic consisting of several points and a straight line or curve drawn
on the ultrasound image.
Fixed/Active End
The ends of calipers can be active or fixed. The active end is called a Cursor.
Caliper Color
An active caliper appears green, while a fixed one appears white in the system default preset.
Caliper End Symbols

8 symbols are used as caliper ends, as shown in the figure below.
TIP:
The cursor type can be preset between Symbol and Number.
1.6 Results Window

The measurement window displays the conducted measurement’s result and the engaging
measurement in real time.
1.6.1 Results Display

Select [Hide] on the touch screen and the latest results display in the results window in time
sequence.
• When viewing the results: If the results window is full, the oldest value will be replaced
according to the “first in, first out” rule.
A maximum of 16 results can display in the results window and a maximum of two graphical
results windows can display in the screen.
• To identify the measurement results, symbols or numbers are used in the numerical results
window (B-histogram, B-profile) while “No:1” or “No:2” is used in the graphical results
window.
• The result displays as digits when the value obtained is within the clinical range. If the value
display is abnormal, perform the measurement again.
1.6.2 Moving the Results Window

To move the results window:
1. Place the cursor on the results window title and press <Set>.
2. Move the cursor to place the results window in the desired position.
3. Press <Set> to fix the results window

1.6.3 Results Window Assignment

An application measurement result can be assigned to a general measurement item from the results
window. The application item can be an existing item in the system or a new user-defined one.
NOTE:
Re-assignment for the assigned general result is not available.
Assigning an Existing Application Item

Perform the following procedure:
1. Move the cursor to a general measurement value in the results window. Press <Set> button and
the matching list appears as shown below.
Application items that meet the following requirements are displayed:

– Contained in the current application package.
– The item to be assigned and the assigner should use the same general measurement tool
for the result.
Application items in the current measurements that use the “Distance” method are listed as
shown above.
2. Select an application item from the list, then press <Set>.
3. The assigned value displays in the results window and is saved in the exam report.
Assigning a New Application Item

When no (desired) item displays in the matching list, you can create a new application item.
1. Select [new] at the bottom of the matching list.
2. The following dialog box appears, type in the new name.

3. Click [Confirm] to assign the general result to the new item.
Exiting Result Assignment

Click other area or select [Cancel] in the matching list to exit.
Auto-Spectrum Calculation Assignment

Like a general measurement result, you can assign the auto-spectrum calculation results to an
application item, using the same steps as described above.
NOTE:
The application item to assign should be an item using D trace in the current application package.
1.7 Cross-window Measurement

For linear probing, cross-window measurement is available in dual-B mode when the left and right
windows are imaging with the same probe, depth and invert mode.
Under Free Xros M mode (option), you can perform cross-window measurement of time and HR.

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2 General Measurement
There are 2D (B/Color/Power), M and Doppler (PW/CW) basic measurement tools.
2.1 2D General Measurements

2.1.1 Depth
Sectoral surface probe: the depth is the distance from the center of the sector to the cursor.
Convex array or linear array probe: the depth is the distance from the transducer surface to the
measuring cursor in the direction of the ultrasonic wave.
TIP:
The real-time depth displays in the results window only before the <Set> key is pressed to fix the
starting point. The history value of the depth is not displayed in the results window.

1. Select [Depth] in the measurement menu.
The cursor appears on the screen.
2. Move the cursor to the desired point.
3. Press <Set> to set the measurement point and the result displays in the results window.
2.1.2 Distance
Measures the distance between two points on the image.
1. Select [Distance] in the measurement menu.
2. Move the cursor to the starting point.
3. Press <Set> to set the starting point.
4. Move the cursor to the end point.
– Press <Clear> to cancel setting the starting point.
– Press <Update> to switch between the fixed end and the active end of the caliper.
5. Press <Set> to set the end point and the result displays in the results window.
2.1.3 Distance P-L

Measures the distance between two parallel line segments.
1. Select [Distance P-L] in the measurement menu.

2. Move the cursor to the starting point.

3. Press <Set> to set the starting point.
4. Move the cursor to the end point.
– Press <Update> to switch between the fixed end and the active end of the caliper.
5. Press <Set> to set the end point and the result displays in the results window.
2.1.4 Angle
Measures the angle of two crossing planes on the image and the range is: 0° to 180°.
1. Select [Angle(2L)] / [Angle(3P)] in the measurement menu.
2. Set two line segments as described in section 2.1.2.
The angle appears in the results window after setting the line segments.
2.1.5 Area & Circumference

Measures the area and circumference of a closed region on the image. Four measurement methods
are available:
• Ellipse: fix an ellipse region by two equal-cut perpendicular axes.
• Trace: fix a closed region by free tracing.
• Spline: fix a spline curve by a series of points (12 points at most).
• Cross: fix a closed region with two axes perpendicular to each other. The starting point and the
end point of the axes can both be fixed freely.
These four methods are also applicable to other measurement items and will not be repeated when
mentioned below.
Ellipse
1. Select [Ellipse] in the measurement menu.
2. Move the cursor to an area of interest.
3. Press <Set> to set the starting point of the first axis of the ellipse.
4. Move the cursor to position the end point of the first axis of the ellipse.
– Press <Update> to switch between the fixed end and the active end of the first axis.
– Press <Clear> to cancel the start point of the first axis.
5. Press <Set> to set the end point of the first axis of the ellipse.
The second axis appears on the screen.
6. Moving the cursor will increase or decrease the ellipse from the fixed axis. Move the cursor to
trace the area of interest as closely as possible.
Or, press the <Update> or <Clear> key to return to the step before setting the first axis.
7. Press <Set> to anchor the ellipse region.
The measurement result will be displayed in the results window.

Trace
1. Select [Trace] in the measurement menu.
3. Press <Set> to fix the starting point.
4. Move the cursor along the target to trace the outline of the target.
To modify the trace line, rotate the <Angle> knob:
– Anticlockwise: to cancel a series of points.
– Clockwise: to resume a series of points. You may also resume the points by moving the
cursor back.
5. Press <Set> and the trace line will be closed with a straight line connecting the start and end
points.
The trace will also be closed when the cursor is very near to the starting point.
Spline
1. Select [Spline] in the measurement menu.
3. Press <Set> to set the first reference point of the spline.
4. Move the cursor along the area of interest and press <Set> to anchor the second reference
point.
5. Move the cursor again and a spline defined by three points of the first and second reference
points and the active cursor appears on the screen.
6. Move the cursor along the edge of the target and set more reference points (12 at most) to make
the spline approach the target region as closely as possible.
To correct a previous point, press <Clear>.
7. Press <Set> twice to anchor the last reference point.
The spline is fixed and the results display in the results window.
Cross
1. Select [Cross] in the measurement menu.
3. Press <Set> to fix the starting point of the first axis.
4. Move the cursor to position the end point of the first axis and then press <Set>.
– Press <Update> to switch between the start point and the end point of the first axis.
– Press <Clear> to cancel setting the starting point of the first axis.
5. Press <Set> to set the end point of the first axis. The second axis (perpendicular to the first
axis) of the cross appears on the screen.
6. Move the cursor and press <Set> to fix the starting point of the second axis.

7. Move the cursor to the end point of the second axis.

8. Press <Set> to set the end point of the second axis and fix the region.
The results appear in the result window.
2.1.6 Smart Trace

Helps the operator to trace the contour of the target by automatically recognizing the margin of the
target and measures the lengths of major axis and minor axis, area and circumference of the closed
region.
TIP:
Smart Trace should be performed on frozen images.

1. After the image is frozen, tap [Smart Trace] in the measurement menu.
During tracing, you can move the cursor backwards to delete latest tracing. Or, you can press
<Set> to fix the traced contour.
The faster the cursor moving speed, the bigger the cursor, and the lager the recognized area.
5. Press <Set> twice and the trace line will be closed with a straight line connecting the start and
end points.
The trace will also be closed when the cursor is very near to the starting point.
2.1.7 Volume
Measures the volume of the target object.
Volume (3 Dist.)
For calculating the object’s volume with 3 axes of two images scanned in the plane perpendicular to
each other in B Mode. The calculation formula is as follows:
Where D1, D2 and D3 are the length of three axes of the target object.
1. Select [Volume] in the measurement menu.
2. Here D1, D2 and D3 are the lengths of three axes of the target object.
For detailed procedures, see “2.1.2 Distance”.
Generally D1, D2 and D3 should belong to different scanning planes.

Volume (Ellipse)
To calculate the object’s volume by its horizontal section area. The calculation formula is as
follows:
Where is the length of the major axis of the ellipse while the minor.
1. Select [Volume (Ellipse)] in the measurement menu.
2. The procedure is similar to that of Ellipse in the area measurement.
3. For details, see “2.1.5 Area & Circumference”.
Volume (Ellipse Dist.)

To calculate the object’s volume by its horizontal and vertical section area. The calculation formula
is as follows:
Here a, b and m indicate the length of the major, minor and the third axis of the ellipse respectively.
1. Select [Volume (E+ Dist.)] in the measurement menu.
2. Use the Ellipse method to measure the vertical section area.
The procedure is similar to that of Ellipse in the Area measurement, see “2.1.5 Area &
Circumference” for details.
3. Unfreeze the image. Rescan the area of interest perpendicular to the previous image.
4. Measure the length of the third axis with the Distance measurement method, see
“2.1.2 Distance” for detailed procedures.
2.1.8 Double Dist.

Measures the lengths of line segments A and B perpendicular to each other.
1. Select [Double Dist.] in the measurement menu.
2. Move the cursor to the measurement starting point.
3. Press <Set> to set the starting point of the first line segment.
4. Move the cursor to position the end point of the first axis and then press <Set>.
5. Press <Set> to set the starting point of the first line segment. The second line segment
perpendicular to the fixed line segment appears on the screen.
6. Move the cursor to the starting point of the second line segment.

7. Press <Set> to set the starting point of the second line segment. Or, press <Update> or <Clear>
to return to the last step.
8. Move the cursor to the end point of the second line segment. Then
– Press <Update> to switch between the starting point and the end point of the second axis.
– Press <Clear> to cancel setting the starting point of the second axis.
9. Press <Set> to confirm the end point of the second line segment.
2.1.9 Parallel
Measures the distance between every two line segments of five parallel line segments, namely, four
distances in total.
1. Select [Parallel] in the measurement menu.
Two lines perpendicular to each other appear on the screen. The intersection is the starting
point of the line segment.
2. Rotate the <Angle> knob to change the angle of the lines and press <Set> to confirm.
3. Move the cursor to the starting point of the line segment.
4. Press <Set> to confirm the starting point and the first line.
5. Move the cursor and press <Set> to confirm the other four parallel lines when the last parallel
line is set and the end point of the line that is perpendicular to the five parallel lines is
confirmed.
During the measurement, press <Set> twice to set the last parallel line and complete the
measurement.
2.1.10 Curve Length

Measures the length of a curve on the image. Measurement methods available include Trace and
Spline.
Trace
1. Select [Trace Len] in the measurement menu.
To modify the trace line, rotate the <Angle> knob:
– Anticlockwise: to cancel a series of points.
– Clockwise: to resume a series of points. You may also resume the points by moving the
cursor back.
5. Press <Set> to anchor the end point of the trace line.
Spline
1. Select [Trace Len (Spline)] in the measurement menu.


4. Move the cursor along the target and press <Set> to anchor the second, third, fourth, etc.,
points.
A maximum of 12 points can be anchored.
To correct a previous point, press <Clear>.
5. Press <Set> twice to set the end point of the spline.
2.1.11 Ratio (D)

Measures the lengths of two line segments and then calculates their ratio.
1. Select [Ratio (D)] in the measurement menu. The cursor appears on the screen.
2. Measure the length of the two line segments, see “2.1.2 Distance” for detailed procedures.
The results display in the results window after the measurement of the second line is
completed.
2.1.12 Ratio (A)

Measures the area of two closed regions and then calculates their ratio. The methods are Ellipse,
Trace, Cross and Spline.
1. Select [Ratio (A)] in the measurement menu.
2. Measure the area of the two closed regions; you may select different measurement methods for
each region, see “2.1.5 Area & Circumference” for details.
Under elastography imaging mode, in B+E dual display mode, click [Sync] on the touch
screen to On. Measurements on either of the two windows will be displayed in the other
window.
2.1.13 B-Profile
Measures the gray distribution of ultrasonic echo signals on a line.
TIP:
The following operations are performed on Freeze images by default.

1. Select [B-Profile] in the measurement menu.
2. Set a line segment, see “2.1.2 Distance” for detailed procedures.
The result is shown in the figure below:
Where

– No: The number of the graph. Value: 1 or 2. The last two results will be displayed on the
screen.
– Gmax: The maximum gray.
– Gmin: The minimum gray.
– Gmean: The average gray.
– Gsd: The variance of gray.
2.1.14 B-Hist.
Function: measures and counts the gray distribution of ultrasonic echo signals within a closed
region. The methods to set a closed region are Ellipse, Trace, Spline and Rect. (Rectangle).
TIP:
The following operations are performed on Freeze images by default.
B-Hist. (Rectangle)
Rect. sets a rectangle with two points on the cross.
1. Select [B-Hist. (Rectangle)] in the measurement menu.
2. Move the cursor to the first vertex of the rectangle, press <Set>.
3. Move the cursor to the second vertex of the rectangle, press <Set>. The result is shown in the
following figure:
Where
– Horizontal axis: The gray of the image
– The vertical axis: The gray distribution percentage.
– No: The number of the graph. The last two results will be displayed on the screen.
– N: The total pixel number in the area to be measured.
– M: M = ∑Di / N;
– MAX: MAX = the pixel number in the maximum gray/N×100%
– SD: Standard deviation. SD = (∑Di2/N-(∑Di/N)2)1/2
Di: the gray at each pixel point
∑Di: the total grays of all pixels.
B-Hist. (Ellipse/Trace/Spline)
For detailed procedures, see “2.1.5 Area & Circumference”.
2.1.15 Color Vel.

TIP:
• This measurement item is meant for a general estimation, not for accurate measurement.

• The following operations are performed on Freeze images by default.
Measures the velocity of blood flow on the Color Mode image.

1. Select [Color Vel.] in the measurement menu.
2. Move the cursor to the point to be measured for blood flow velocity.
3. Press <Set> to fix the point, a floating line is displayed in the direction parallel to the
ultrasonic wave beam at that point.
The compensation angle is currently 0°. You can change the angle (0°-80°) by rotating the
<Angle> knob to align the floating line in the same direction as the blood flow at the point to
be measured.
4. Press <Set> to set the direction of the blood flow.
The result displays in the results window.
2.1.16 Volume Flow

Measures blood flow through a vascular cross section per unit time.
For details, see “2.3.8 Volume Flow”.
2.1.17 IMT
IMT (Intima-Media Thickness) measures the distance between LI (Lumen-Intima) and MA
(Media-Adventia).
TIP:
The IMT should be performed on frozen images.
2.1.18 Strain
Support making measurement and calculation of the strain in a region.
TIP:
Only elastography imaging supports this function. For details, see Basic Volume.

1. Under Strain Elasto Mode, acquire the image and freeze. Select [Strain] in the measurement
menu.
2. Adjust the circle size by rotating <Angle> after select [Strain (Circle)]. Set the shell thickness
and select whether to turn on the shadow function.
– In B+E dual display Mode, tap [Sync] on the touch screen to On. Measurements on either
of the two windows will be displayed in the other window.
– Use [Shell Thick] to set the mass shell size.
After the strain is measured, select the [Shell Thick] to be more than 0 mm. The system
extends from lesion A automatically according to the shell thick value.
3. Perform measurements.

You may select different measurement methods for each region. For details, see “2.1.12 Ratio
(A)”.
2.1.19 Strain Ratio

Measures the strain ratio in the image, strain ratio = strain (normal tissue)/strain (lesion).
TIP:
• The Strain Ratio should be performed on frozen images.
• Only elastography imaging supports this function. For details, see Basic Volume.
In the image, the region selected from lesions is defined as A, and the region selected from normal
tissue is defined as B, where A' is the region extended from lesions and shell thick. Refers to the
thickness of the mass shell.
Tissue strain is related to forces on the probe and tissue depth. It is recommended to use regions of
the same depth and same area for comparison.
1. Under elastography imaging mode, acquire the image and freeze. Select [Strain Ratio] in the
measurement menu.
2. Adjust the circle size by rotating <Angle> after select [Strain Ratio (Circle)].
3. Set the shell thickness and select whether to turn on the shadow function.
– In B+E dual display Mode, tap [Sync] on the touch screen to On. Measurements on either
You may select different measurement methods for each region. For details, see “2.1.12 Ratio
(A)”.
After the strain ratio is measured, select the [Shell Thick] to be more than 0 mm. The system
extends from lesion A automatically according to the shell thick value. The results window
will display the results: B/A’, B/Shell, A/Shell.
2.1.20 Strain Hist.

TIP:
The Strain-Hist. should be performed on frozen images.
Displays the strain ratio using the histogram, strain ratio = strain (normal tissue)/strain (lesion).
1. Under elastography imaging mode, acquire the image and freeze. Select [Strain-Hist (Ellipse)]
or [Strain-Hist. (Trace)] in the measurement menu.
2. Set the shell thickness and select whether to turn on the shadow function.
– In B+E dual display mode, tap [Sync] on the touch screen to On. Measurements on either
You can select between ellipse or trace method. For details, see “2.1.14 B-Hist.”.
2 - 10 Operator’s Manual
After the Strain-Hist. is measured, select the [Shell Thick] to be more than 0 mm. The
histogram will display data for A as well as A’.Elas.
2.1.21 Color Pixel Percentage

TIP:
• This feature should be performed on frozen images.
• It is not suggested to perform CPP measurement on color mixing area.
Function: measures the pixel proportion of blood flow signal in the region of interest under Color or
Power mode.
The feature is not supported under TDI mode.
CPP(Ellipse)
1. Select [CPP(Ellipse)] in the measurement menu. The ellipse appears on the screen.
2. Rotate the knob under [CPP ROI] to adjust the ellipse of the ROI, and use the trackball to
move the ellipse to the desired position.
If [Manual] is selected, you can draw the ellipse. For details on procedure of drawing ellipse,
see “2.1.5 Area & Circumference”.
The ellipse should be in the color ROI.
3. Press <Set> key to fix the ellipse.
CPP(Rect)
1. Select [CPP(Rect)] in the measurement menu. The rectangle appears on the screen.
2. Rotate the knob under [CPP ROI] to adjust the ellipse of the ROI, and use the trackball to
move the rectangle to the desired position.
If [Manual] is selected, you can draw the rectangle. For details on procedure of drawing
rectangle, see “2.1.5 Area & Circumference”.
The rectangle should be in the color ROI.
3. Press <Set> key to fix the rectangle.
CPP(Trace)
1. Select [CPP(Trace)] in the measurement menu.
2. For details on procedure see “2.1.5 Area & Circumference”.
CPP(Recall)
Select [CPP(Recall)] in the measurement menu to repeat the last CPP measurement.
If CPP measurement has not been performed since the ultrasound system is powered on, the
measurement result is based on the default size and position of an ellipse.
Operator’s Manual 2 - 11
2.2 M General Measurements

2.2.1 Distance
Measures the distance between two points on the M Mode image.
1. Select [Distance] in the measurement menu.
Two dotted lines perpendicular to each other appear on the screen.
2. Move the crossing point of the dotted lines to the measurement starting point and press <Set>.
3. Move the crossing point to the end point. The crossing point can then only be moved in a
vertical direction.
– Press <Update> to switch between the fixed end and active end of the caliper.
4. Press <Set> to set the end point.
2.2.2 Time
Measures the time interval between two points on the M Mode image.
1. Select [Time] in the measurement menu.
3. Move the crossing point to the measurement end point.
The crossing point can only be moved in a horizontal direction.
2.2.3 Slope
Measures the distance and time between two points on the M Mode image and calculates the slope
between the two points.
1. Select [Slope] in the measurement menu. Two dotted lines perpendicular to each other appear
on the screen.
3. Move the crossing point to the measurement end point.
The crossing point is connected to the starting point by a dashed line.
2.2.4 Velocity
Measures the distance and time between two points on the M Mode image and then calculates the
average velocity between the two points.

1. Select [Velocity] in the measurement menu.
3. Move the crossing point to the end point. The crossing point can then only be moved in a
vertical direction.
2.2.5 HR
Measures the time interval of n (n≤8) cardiac cycles on the M Mode image and calculates the heart
rate.
The number of cardiac cycles “n” can be preset, see Basic Volume for details.
CAUTION
During the measurement, the number of cardiac cycles between the
measurement start and end points must be exactly the same as preset.
Otherwise, misdiagnosis may occur.

1. Select [HR] in the measurement menu.
2. Select n cardiac cycles.
The HR result in the results window displays the measured heart rate value and the preset
number of cardiac cycles, as shown in the figure below.
A
B
A Number of Cardiac Cycles

B Heart Rate
2.2.6 HR (R-R)
Measures the time interval between the R peaks of n (n≤8) cardiac cycles on the ECG image and
calculates the heart rate.
The number of cardiac cycles “n” can be preset, see Basic Volume for details.
CAUTION
During the measurement, the number of cardiac cycles between the
measurement start and end points must be exactly the same as preset.
Otherwise, misdiagnosis may occur.

1. Select [HR (R-R)] in the measurement menu.
2. Move the cursor onto the starting R peak point and press <Set>.
3. Move the cursor onto the end R peak point and press <Set>.
2.3 Doppler General Measurements

2.3.1 Time
Measures the time interval between two points on the Doppler image.
The operations are similar to the Time measurement in M Mode, see “2.2.2 Time” for details.
2.3.2 HR
Function: measures the time interval between n (n≤8) cardiac cycles on the Doppler Mode image
and calculates the number of heart beats per minute (BPM).
The operations are similar to the Heart Rate measurement in M Mode, see “2.2.5 HR” for details.
2.3.3 HR (R-R)
Measures the time interval between R peaks of n (n≤8) cardiac cycles on the ECG image and
calculates the number of heart beats per minute (BPM).
The operations are similar to the Heart Rate (R-R) measurement in M Mode, see “2.2.6 HR (R-R)”
for details.
2.3.4 D Velocity
Measures the velocity, pressure gradient and correction angle of a certain point on the Doppler
spectrum.
TIP:
The real-time velocity displays in the results window only before the <Set> key is pressed to fix the
starting point. The history value of the velocity is not displayed in the results window.

1. Select [Vel.] in the measurement menu.
2. Move the cursor to the point to be measured for velocity.
3. Press <Set> and the result displays in the results window.
2.3.5 Acceleration
Measures the velocities of two points and their time interval on the Doppler image, and calculates
the acceleration, pressure gradient, velocity difference and correction angle.
1. Select [Acceleration] in the measurement menu.
2. Move the cursor to the first point to be measured for velocity.

3. Press <Set> to fix the first point.
4. Move the cursor to the second point to be measured for velocity.
5. Press <Set> to fix the second point. The results display in the results window.
2.3.6 D Trace
Measures clinical indices using spectral Doppler tracing. Measurement methods available are
Trace, Auto, Spline, Vel. (Velocity) and 2 PT (Two Points).
A sketch of a Doppler spectrum is shown below:
NOTE:
When doing D trace, please set systolic starting time as the starting point and diastolic ending time
as end point. That is, by tracing the Doppler spectrum from systolic to diastolic to calculate indices.

1. Select [D Trace] in the measurement menu.
2. Move the cursor to the starting point to be measured and press the [Set] key to fix the point.
3. Move the cursor around the object.
– Move the cursor right: draw a trace line overlapping the spectrum as much as possible.
– Move the cursor left to correct the trace line already drawn.
4. Trace the end point to be measured and press <Set> to fix the point.
Result parameters
The results obtained from D trace are:
Parameters Descriptions
PS Peak Systolic Velocity The highest velocity of the red blood cells crossing the
sample volume.
ED End-Diastolic Velocity Measures the blood velocity at the end of the cardiac
cycle.
MD Min-Diastolic Velocity Minimum absolute Velocity in the diastolic cycle.
Vel. Velocity Flow velocity
Average / The average flow velocity in the whole traced Doppler
velocity spectrum.
TAMAX (Time Averaged Maximum Velocity):
Where V(t) is the maximum velocity

TAMEAN (Time Averaged Mean Velocity): Obtained
by auto-spectrum calculation.
Where V(t) is the mean velocity.

PPG Peak Pressure Gradient The corresponding pressure gradient of the peak
systolic velocity. PPG (mmHg) = 4 × PS (m/s)2
Average / The average pressure gradient in the whole traced
Pressure Doppler spectrum.
Gradient MPG: Maximum Pressure Gradient.
Where V(t) is the peak systolic velocity.

MMPG: Mean velocity Mean Pressure Gradient.
(Obtained during auto-spectrum calculation.)
Where V(t) is the mean systolic velocity.

VTI Velocity-Time Integral Velocity-time integral. The integral of the product of
Doppler instantaneous velocity and the total time
interval.
AT Acceleration Time The time of the blood velocity accelerating from the
end of diastole to the systolic peak. This is usually the
time interval between the end of the first cardiac cycle
and the peak of the next cardiac cycle. Choose the first
peak when two peaks exist in the systolic cycle.
DT Deceleration Time Deceleration Time.
HR Heart Rate Calculates the heart rate per minute by measuring the
time interval of one cardiac cycle.
S/D / PS/ED
S/D (No unit) = PS (m/s) / ED (m/s)
D/S / ED/PS.
D/S (No unit) = ED (m/s) / PS (m/s)
PI Pulsative Index Pulsatility index.
PI (No unit) = |(PS (m/s) - ED (m/s)) / TAMAX (m/s)|
RI Resistive Index Resistance index.RI (No unit) = |(PS (m/s) - ED (m/s))
/ PS (m/s)|
θ / The correction angle is the spectrum angle during
measurement, which is a result obtained from a non D
trace measurement tool and is usually displayed
together with the spectral measurement results.
PV Peak Velocity The peak velocity in systolic or diastolic cycles (with
no difference), which is the highest velocity of the red
blood cells that cross the sample volume. It can be
used to examine the venous vessel.
NOTE:
• In the formulae above, T means time, the unit is s; V means the velocity at each point during
T, the unit is cm/s; a is the traced starting point, while b is the traced end point.
• The above parameters are all the information obtained in D trace, while in application the
system only displays part of them according to the operation and preset.
The measurement method varies according to the result selected.
Velocity
Measures the velocity, pressure gradient and correction angle of a certain point on the Doppler
spectrum.
The operations are similar to the Time measurement in Doppler Mode, see “2.3.4 D Velocity” for
details.
2 PT
Measures the velocity, pressure gradient and correction angle between two points on the Doppler
spectrum.
1. Select items using the [2 PT] method in the measurement menu, the cursor displays as a large
“+.”
2. Move the cursor to the starting point to be measured and press <Set> to fix the point.
3. Move the cursor to the end point to be measured and press <Set> to fix the point.
Spline
1. Select items using the [Spline] method from the measurement menu.
2. Move the cursor to the starting point to be measured and press <Set> to fix the point.
3. Move the cursor along the edge of the desired region. Continue to fix the second, third, etc.,
point (50 points at most) of the spectrum.
4. Press <Set> twice to anchor the last reference point. Or the measurement ends automatically
when there are 50 reference points.
Trace
1. Select items using the [Manual] method from the measurement menu.
2. Move the cursor to the starting point to be measured, and press <Set> to fix the starting point.
3. Move the cursor around the object to draw a trace line overlapping the spectrum as much as
possible
4. Press <Set> to anchor the end point of the trace line.
Auto
1. Select items using the [Auto] method from the measurement menu.
2. Move the cursor to the starting point to be measured, and press <Set> to fix the starting point.
3. Move the cursor to anchor the end point of the trace line, and press <Set>.
The system will draw a trace line overlapping the spectrum automatically, and recognize a
complete cardiac cycle to calculate.
Auto-Spectrum Calculation
You can also acquire the above results by auto calculation, which calculates the recent cardiac
cycles.
1. Tap [Auto Calc.] in the PW image menu to activate it.
The system traces automatically and displays the results on the screen.
2. Tap [Auto Calc. Param.] in the PW image menu. You can select the parameters to be
calculated.
3. Tap [Auto Cardiac Cycle] in the PW image menu. You can select the cycle number to be
calculated.
4. If necessary, you can edit the LOVT spectrum manually:
a. Press <Freeze> to freeze the image.
b. Press the <Cursor> key to activate the cursor.
c. Move the cursor to the spectrum tracing line and press the <Set> key.
d. Move the cursor to trace a line, the calculation results display in real time.
2.3.7 PS/ED
Measures the Peak Systolic (PS) velocity and End Diastolic (ED) velocity on the Doppler spectrum,
and calculates their resistance index (RI), S/D and correction angle.
1. Select [PS/ED] in the measurement menu.
2. Move the cursor to the Systolic Peak and press <Set> to fix the point.
3. Move the cursor to the Diastolic End and press <Set> to fix the point.
2.3.8 Volume Flow

Measures blood flow through a vascular cross section per unit time.
1. Select [Volume Flow] in the measurement menu. The submenu displays.
– Tap [Vas. Area] to select the method for calculating the area: dist. or trace.
– Tap [PW Scope] to select the scope to be traced.

2. Measure the vascular area.
3. Tap [TAMEAN] or [TAMAX] to calculate the volume flow.
Item Description Methods or formulae

Vas Area Dist. Obtain the area by measuring Vas. Area = π × Vas Diam (cm)2/ 4
the vascular diameter.
Trace Obtain the area using the trace Area in 2D General Measurements
method.
TAMEAN Vol Flow(Area) - TAMEAN Vol Flow(A) (ml/min) = |Vas
TAMEAN (cm/s)| × Vas. Area
(cm2) × 60 (s)
Vas. TAMEAN - Time Averaged
Mean Velocity, obtained from the
Vas. Trace measurement.
TAMAX Vol Flow(Area) - TAMAX Vol Flow(A) (ml/min) = |Vas
TAMAX (cm/s)| × Vas Area (cm2)
× 60 (s)
Vas. TAMAX - Time Averaged
Maximum Velocity, obtained from
the Vas. Trace measurement.
2.3.9 Velocity Ratio

Measures two D velocity values on one or two spectrums and calculate the ratio to analyze the flow
information.
1. Select [Ratio (Vel)] in the measurement menu.
2. Move the cursor and press <Set> to obtain two velocity values.
3. The system calculates the ratio automatically.
Where
2.3.10 VTI Ratio

Measures two VTI values on the spectrum and calculate the ratio.
1. Select [Ratio (VTI)] in the measurement menu.
2. Move the cursor to obtain VTI1 and VTI2 values using the D trace method.
3. The system calculates the ratio automatically.
Where
2.4 References
3 Dist. Volume
Emamian, S.A., et al., “Kidney Dimensions at Sonography: Correlation With Age, Sex, and
Habitus in 665 Adult Volunteers,” American Journal of Radiology, January, 1993, 160:83-86.
HR (M general measurement)
Dorland’s Illustrated Medical Dictionary, ed. 27, W. B. Sanders Co., Philadelphia,1988, p. 1425.
PG
Powis, R., Schwartz, R. Practical Doppler Ultrasound for the Clinician. Williams & Wilkins,
Baltimore, Maryland, 1991, p. 162.
Acceleration
Starvos, A.T.,et.al.“Segmental Stenosis of the Renal Artery Pattern Recognition of Tardus and
Parvus Abnormalities with Duplex Sonography.” Radiology, 184:487-492,1992.
Taylor,K.W.,Strandness,D.E.Duplex Doppler Ultrasound. Churchill-Livingstone, New York, 1990.
PPG
Yoganathan, Ajit P., et al., “Review of Hydrodynamic Principles for the Cardiologist:Applications
to the Study of Blood Flow and Jets by Imaging Techniques,” Journal of the American College of
Cardiology, 1988, Vol. 12, pp. 1344-1353
MPG
Yoganathan, Ajit P., et al., “Review of Hydrodynamic Principles for the Cardiologist: Applications
to the Study of Blood Flow and Jets by Imaging Techniques,” Journal of the American College of
Cardiology, 1988, Vol. 12, pp. 1344-1353
VTI
Degroff, C. G. Doppler Echocardiography. Third Edition. Lippincott-Raven, Philadelphia, 1999, p.
102-103
RI
Burns, P.N., “The Physical Principles of Doppler and Spectral Analysis,” Journal of Clinical
Ultrasound, November/December 1987, Vol. 15, No. 9, p. 586
PI
Burns, Peter N., “The Physical Principles of Doppler and Spectral Analysis,” Journal of Clinical
Ultrasound, November/December 1987, Vol. 15, No. 9, p. 585
S/D
Ameriso S, et al., “Pulseless Transcranial Doppler Finding in Takayasu’s Arteritis,” J Clin
Ultrasound, September 1990; 18:592-6
D/S
Ameriso S, et al., “Pulseless Transcranial Doppler Finding in Takayasu’s Arteritis,” J Clin
Ultrasound, September 1990; 18:592-6
Volume Flow(Diam)-TAMAX
Ultrasound, November/December 1987, 15(9):587.
Volume Flow(Area)-TAMAX
Ultrasound, November/December 1987, 15(9):587.
3 Abdomen
3.1 Basic Measurement Procedures

1. Tap [Info] on the touch screen and enter the patient information.
2. Perform the scanning to acquire the desired image.
3. Press <Measure> to enter the Application Measurement.
4. Select the measurement tool from the measurement menu to start the measurement.
– For measurement tools, see “3.2 Abdomen Measurement Tools”.
– For measurement methods, see “2 General Measurement”.
The system calculates and displays the results after the measurement tools have been
completed.
3.2 Abdomen Measurement Tools

3.2.1 2D Mode
Measurement
Tools Descriptions Methods or formulae

Liver / Distance in 2D General Measurements
Renal L Renal Length
Renal H Renal Height
Renal W Renal Width
Cortex Renal Cortical Thickness
Adrenal L Adrenal Length
Adrenal H Adrenal Height
Adrenal W Adrenal Width
CBD Common bile duct
Portal V Diam Portal Vein Diameter
CHD Common hepatic duct
GB L Gallbladder Length
GB H Gallbladder Height
GB wall th. Gallbladder wall thickness
Panc. duct Pancreatic duct
Panc. head Pancreatic head

3 Abdomen

Panc. body Pancreatic body Distance in 2D General Measurements
Panc. tail Pancreatic tail
Spleen L Spleen Length The system automatic calculates Spleen Vol.
value.
Spleen W Spleen Width
Skin-L.Capsule Dist. /
Spleen H Spleen Height
Spleen Area / Area in 2D General Measurements
Spleen V Diam Spleen vein Diam Distance in 2D General Measurements
Spleen A Diam Spleen artery Diam
Aorta Diam. H Aorta Diameter Height
Aorta Diam. W Aorta Diameter Width
Aorta Aneurysm H Aorta Aneurysm Height
Aorta Aneurysm W Aorta Aneurysm Width
Aorta Aneurysm L Aorta Aneurysm Length
Aorta Bif. Aorta Bifurcation
Iliac Diam. Iliac Diameter
Hepatic Lesion1-3, /
d1-3
Hepatic Cyst1-3, d1- /
3
Renal Cyst1-3, d1-3 /
Renal Lesion1-3, d1- /
3
Pre-BL L Pre-void Bladder Length
Pre-BL H Pre-void Bladder Height
Pre-BL W Pre-void Bladder Width
Post-BL L Post-void Bladder Length
Post-BL H Post-void Bladder Height
Post-BL W Post-void Bladder Width
Ureter /
Hepatic Lesion1~3 Hepatic Lesion1~3 Elastography in 2D General Measurements
Elas. Elastography
LSM Liver Stiffness
Measurement

3 Abdomen
Calculation

Aorta Sten D Aorta Stenosis Aorta Stenosis D (No unit) = (Normal Diam. (cm) -
Diameter Resid Diam. (cm)) / Normal Diam. (cm) × 100%
Stenosis D (No unit) = | (D1-D2) / MAX(D1,
D2)|*100%
Where D1 and D2 refer to the measured Aorta
diameter, and MAX (D1, D2) represents the larger
value of the two.
Aorta Sten A Aorta Stenosis Area Stenosis A (No unit) = | (A1-A2) / MAX (A1, A2)
|*100%
Where A1 and A2 refer to the measured Aorta area,
and MAX (A1, A2) represents the larger value of the
two.
Renal Vol. Renal Volume Renal L, Renal H and Renal W
NOTE:
The left and right sides respectively need to be
measured.
Pre-BL Vol. Pre-void Bladder Pre-BL L, Pre-BL H and Pre-BL W
Volume
NOTE:
The Mictur.Vol is displayed in the report if the
Post-BL Vol is measured.
Post-BL Vol. Post-void Bladder Post-BL L, Post-BL H and Post-BL W
Volume
NOTE:
The Mictur.Vol is displayed in the report if the Pre-
BL Vol is measured.
Mictur. Vol. Micturated Volume Pre-BL Vol. and Post-BL Vol.
NOTE:
The Post-BL Vol. and Mictur.Vol. are calculated
automatically, the Post-BL Vol. is displayed in the
report.
Study
Tools Methods or formulae

Spleen Spleen L, Spleen W, Spleen H, Spleen Area
Aorta Aneu-rysm Aorta Aneurysm H, Aorta Aneurysm W, Aorta Aneurysm L
Hepatic Lesion1-3 Hepatic Lesion1-3 d1-3
Hepatic Cyst1-3 Hepatic Cyst1-3 d1-3
Renal Cyst1-3 Renal Cyst1-3 d1-3
Renal Lesion1-3 Renal Lesion1-3 d1-3

3 Abdomen

Kidney Renal L, Renal H and Renal W
Adrenal Adrenal L, Adrenal H and Adrenal W
Bladder Pre-BL L, Pre-BL H, Pre-BL W, Post-BL L, Post-BL H and
Post-BL W
Hepatic Lesion1~3 ElasRatio Elastography ratio in 2D General Measurements
3.2.2 Doppler Mode

Measurements

Ren. A Org. Renal Artery Origin D trace in General D measurements
Arcuate A Arcuate Artery
Segment A Segmental Artery
Interlobar A Interlobar Artery
Renal A Renal Artery
M Renal A Main Renal Artery
Renal V Renal Vein
Aorta /
Celiac Axis /
SMA Superior Mesenteric Artery
IMA Inferior Mesenteric Artery D trace and PS/ED in 2D General
Measurements
C Hepatic A Common Hepatic Artery D trace in General D measurements
Hepatic A Hepatic Artery
Splenic A Splenic Artery
IVC Inferior Vena Cava
IVC Reflux Inferior Vena Cava Reflux Time in M General Measurements
Portal V Portal Vein D trace in General D measurements
M Portal V Main Portal Vein
Hepatic V Hepatic Vein
Lt Hepatic V Left Hepatic Vein
Rt Hepatic V Right Hepatic Vein
M Hepatic V Middle Hepatic Vein
Splenic V Splenic Vein
SMV Superior Mesenteric Vein
IMV Inferior Mesenteric Artery Distance in 2D General
Measurements

3 Abdomen
Calculation

RAR Ratio of Renal Artery PS the RAR (no unit) = |Renal A PS (cm/s)/
Abdominal Aorta PS Aorta PS (cm/s)|
SMA/Ao Ratio of Superior Mesenteric SMA/Ao (no unit) = |SMA PS (cm/s)/
Artery PS and Abdominal Aorta Aorta PS (cm/s)|
PS
CA/Ao Ratio of Celiac Axis PS and CA/Ao (no unit) = |Celiac Axis PS
Abdominal Aorta PS (cm/s)/ Aorta PS (cm/s)|

4 Obstetrics
Obstetric measurements are used to estimate the GA and EDD and calculate the growth indices,
including the EFW. The growth estimate is determined by the growth curve and fetal biophysical
profile.
CAUTION
Ensure the system date is correct, otherwise the GA and EDD calculated will
be wrong.

– For measurement tools, see “3.2 Abdomen Measurement Tools”.
completed.
4.2 Obstetric Measurement Tools

NOTE:
• The Smart NT must be used with convex-wide probe and good image quality. If an evident
inaccurate recognition exists, confirm the target profile manually and adjust the result.
• If the results of the calculation items of CI, FL/BPD, FL/AC, HC/AC and FL/HC exceed the
clinical range, the result value displays as “value*.”
4.2.1 2D Mode
Measurement

GS Gestational Sac Diameter Distance in 2D General
Measurements
YS Yolk Sac

4 Obstetrics

CRL Crown Rump Length Dist (same as Distance in 2D
General Measurements), Trace,
Spline
NT Nuchal Translucency Distance in 2D General
Measurements (Support Smart NT
method if the Smart NT function is
configured)*
BPD Biparietal Diameter Distance in 2D General
Measurements (Support Smart OB
OFD Occipital Frontal Diameter
method if the Smart OB function is
configured)
FL Femur Length The system automatic calculates
GA value.
HC Head Circumference Circumference in 2D General
configured)
NOTE:
Head Circumference: in the HC
measurement, if the
measurement cursor of BPD
appears on the screen, then the
measurement starting point will
be automatically positioned at
the measurement cursor starting
point of the last BPD. If you use
“Ellipse” to measure the HC, the
measurement cursor of the last
BPD will be the first axis of the
ellipse in the default status.
AC Abdominal Circumference Circumference in 2D General
configured).
IT Intracranial Translucency Distance in 2D General
Measurements
TAD Abdominal Transversal
Diameter
APAD Anteroposterior Abdominal
Diameter
TCD Cerebellum Diameter
Cist Magna Cist Magna
LVW Lateral Ventricle Width
HW Hemisphere Width
OOD Outer Orbital Diameter
NBL Nasal Bone Length

4 Obstetrics

IOD Inter Orbital Diameter Distance in 2D General
Measurements
HUM Humerus Length
Ulna Ulna Length
RAD Radius Length
Tibia Tibia Length
FIB Fibula Length
CLAV Clavicle Length
Vertebrae Length of Vertebrae
MP Middle Phalanx Length
Foot Foot Length The GA is calculated automatically
after foot measurements are
completed.
Ear Ear Length Distance in 2D General
Measurements
APTD Anteroposterior trunk diameter
TTD Transverse trunk diameter
FTA Fetal Trunk Cross-sectional Area in 2D General Measurements
Area
THD Thoracic Diameter Distance in 2D General
Measurements
HrtC Heart Circumference Area in 2D General Measurements
TC Thoracic circumference
Umb. VD Umbilical Vein Diameter Distance in 2D General
Measurements
F-kidney Fetal kidney Length
Mat. Kidney Matrix Kidney Length
Cervix L Cervical Length
AF Amniotic Fluid
NF Nuchal Fold
Orbit Orbit
PL Thickness Placental Thickness
Sac Diam1 Gestational Sac Diameter 1
AF1 Amniotic Fluid 1
LVIDd Left Ventricular Internal
Diameter at End-diastole

4 Obstetrics

LVIDs Left Ventricular Internal Distance in 2D General
Diameter at End-systole Measurements
LV Diam. Left Ventricular Diameter
LA Diam. Left Atrium Diameter
RVIDd Right Ventricular Internal
Diameter at End-diastole
RVIDs Right Ventricular Internal
Diameter at End-systole
RV Diam. Right Ventricular Diameter
RA Diam. Right Atrium Diameter
IVSd Interventricular Septal Distance in 2D General
Thickness at End-diastole Measurements
IVSs Interventricular Septal
Thickness at End-systole
IVS Interventricular Septal
Thickness
LV Area Left Ventricular Area
LA Area Left Atrium Area
RV Area Right Ventricular Area
RA Area Right Atrium Area
Ao. Diam. Aorta Diameter
MPA Diam. Main Pulmonary Artery
Diameter
LVOT Diam. Left Ventricular Outflow Tract
Diameter
RVOT Diam. Right Ventricular Outflow
Tract Diameter
Facial Angle Angle of the two lines: one Angle in 2D General Measurements
from fetus nasal base to
forehead and the other from
nasal base to ear base.
HrtA Heart area Area in 2D General Measurements

4 Obstetrics

MV Diam(Z-Score) Mitral Valve diameter Distance in 2D General
Measurements
PV Diam(Z-Score) Pulmonary Valve Diameter
Ao. Asc. Diam(Z-Score) Ascending Aorta Diameter
Ao. Desc. Diam(Z-Score) Descending Aorta Diameter
Duct. Art. Diam(Z-Score) Ductus Arteriosus Diameter
TV Diam(Z-Score) Tricuspid Valve Diameter
LPA Diam(Z-Score) Left Pulmonary Artery
Diameter
RPA Diam(Z-Score) Right Pulmonary Artery
Diameter
AV Diam(Z-Score) Aorta Valve Diameter
IVC Diam(Z-Score) Inferior Vena Cava Diameter
MPA Diam(Z-Score) /
RV Diam(Z-Score) /
LV Diam(Z-Score) /
RV Area(Z-Score) /
LV Area(Z-Score) /
RVIDd(Z-Score) /
lVIDd(Z-Score) /
UT L Uterine Length Distance, Trace and Spline in 2D
General Measurements
UT H Uterine Height Distance in 2D General
Measurements
UT W Uterine Width
Endo. Endometrium Thickness
AC (c) / Cross for area in 2D General
Measurements
AC(c) = π(TAD+APAD)/2
Calculation

Mean Sac Mean Gestational Sac Diameter The average value of three sac diameters
Diam
AFI / Measure the maximum AFs of the four
amniotic fluid pockets of pregnant
woman.
AFI = AF1+AF2+AF3+AF4

4 Obstetrics

EFW Estimated Fetal Weight 1 EFW is calculated by the default EFW
formula, based on multiple measured
EFW2 Estimated Fetal Weight 2
parameters. The formula can be
reselected in the OB report.
HC/AC / HC/AC
FL/AC / FL/AC×100
FL/BPD / FL/BPD ×100%
AXT / APTD × TTD
CI / BPD/OFD ×100%
FL/HC / FL/AC×100
HC(c) / HC(c) = 2.325×(BPD2 + OFD2)1/2
HrtC/TC / HrtC/TC
TCD/AC / TCD/AC
LVW/HW / LVW/HW × 100%
LVD/RVD / LV Diam/RV Diam
LAD/RAD / LA Diam/RA Diam
AoD/MPAD / Ao Diam/MPA Diam
LAD/AoD / LA Diam/Ao Diam
UT Vol. UT Volume UT L, UT H, UT W
Uterus Body / UT L,UT H, UT W
Uterus Body (cm) = UT L (cm) + UT H
(cm) + UT W (cm)
UT-L/ CX-L / UT L, Cervix L
UT-L/CX-L (No unit) = UT L (cm) /
Cervix L (cm)
Study

AFI AF1, AF2, AF3, AF4
AFI=AF1+AF2+AF3+AF4
Uterus UT L, UT H, UT W, Endo
NOTE:
If the Uterus and Cervix L has been measured, the system also calculates the
UT-L/CX-L.

4 Obstetrics
4.2.2 M Mode
Measurement

OB_FHR(M) Fetal Heart Rate Heart Rate in M General
Measurements
LVIDd Left ventricular short-axis diameter Distance in 2D General
at end diastole Measurements
LVIDs Left ventricular short-axis diameter
at end systole
RVIDd Right ventricular short-axis
diameter at end diastole
RVIDs Right ventricular short-axis
diameter at end systole
IVSd interventricular septal thickness at
end diastole
IVSs interventricular septal thickness at
end systole
RVIDd(Z-Score) /
LVIDd(Z-Score) /
4.2.3 Doppler Mode

Measurement

Umb A Umbilical Artery D trace in General D measurements
Placenta A Placenta Artery
MCA Middle Cerebral Artery
Fetal Ao. Fetal Aorta
Desc. Aorta Descending Aorta
Ut. A Uterine Artery
Ovarian A Ovarian Artery
Duct. Veno Ductus Veno D trace in General D measurements
Acquire Duct Veno D by 3-PT method to
measure peak value of ventricular systole
(S), peak value of early diastole (D) and
minimum value of atrial contraction (a).
OB_FHR(Doppler) Fetal Heart Rate HR in General D measurements

4 Obstetrics

Asc. Aorta Ascending Aorta D trace in General D measurements
RVOT Right Ventricle Outflow Tract
LVOT Left Ventricle Outflow Tract
4.3 Auto OB Measurement (Smart OB)

There is an auto measurement method for commonly-used OB measurement items (BPD, HC, AC,
FL, HUM, OFD and etc.).
1. Scan the proper image.
2. Select the OB measurement item from the menu and select the [Auto] method.
3. The measurement caliper is drawn on the image automatically.
If the result of the auto measurement does not match the image exactly, press <Update> and
use the trackball/trackpad to modify the caliper.
4. Press <Set> to confirm the measurement.
4.4 Auto NT Measurement (Smart NT)

There is an auto measurement method for NT measurement item.
1. Scan the proper image.
2. Select the NT measurement item from the menu and select the [Auto] method.
3. The measurement caliper is drawn on the image automatically.
You can move the cursor to modify the caliper if the result of the auto measurement does not
match the image exactly.
4. Press <Set> to confirm the measurement.
Or, press <Update>/<Clear> to modify the caliper for a more accurate result.
4.5 Multi-Fetus Exam

NOTE:
Ensure that the fetus displayed in the multi-fetus measurement menu is the one on which you intend
to perform the measurements.
The system allows multi-fetus examination (4 at most). In a similar way to the OB measurement:
1. Set the number of fetuses in [Gestations] via [Info] > [OB].
If [Gestations] is set to be more than 1, the [Fetus] widget displays in the OB measurement
menu, You can switch between [Fetus A], [Fetus B], [Fetus C] or [Fetus D] via the [Fetus]
button on the touch screen.
2. Carry out the measurement of the fetus respectively.

4 Obstetrics
The measurement results in the results window are marked with fetus label A, B or C.
3. In the Obstetric report, select [Fetus A], [Fetus B], [Fetus C] or [Fetus D] to switch between
the results for different fetuses.
4. Tap [Fetus Compare] on the touch screen to see a visualized comparison result.
5. In the [OB Graph] dialog box, select [A], [B], [C] or [D] to display the growth curves of the
different fetuses.
• Data of Fetus: different symbols are used on the growth curves to identify measurement
data of different fetuses.
• Historic/current data: symbol size is used to differentiate, with historic data appearing
in smaller symbols.
TIP:
You can select whether to print multi-fetus data in one report via [Report] > [Setting].
4.6 GA
4.6.1 Clinical GA
The GA (Gestational Age) and EDD (Estimated Delivery Date) are calculated according to clinical
parameters.
Tap [Info] on the touch screen and register the patient information in the [Patient Info] > [OB]
dialog box. The system automatically calculates the GA and EDD after entering the relative
information. The clinical GA is shown at the top of the obstetric report.
The calculation methods are listed as follows:
• LMP: enter the LMP, the system will calculate the GA and EDD.
• DOC: enter the DOC, the system will calculate the GA and EDD.
• IVF: after you enter IVF, the system will calculate the GA and EDD.
• PRV: enter the date and GA of the last exam, the system will calculate a new GA and EDD.
• BBT: after you enter BBT, the system will calculate the GA and EDD.
• EDD: enter the EDD, the system will calculate the GA and LMP.
TIP:
The latest EDD and GA calculation is considered as the final value if more than one EDD and GA
calculations are valid.
4.6.2 Ultrasound GA
The ultrasound GA and ultrasound EDD are calculated according to the parameters obtained in the
measurements.
• GA in OB Items
• AUA (Average Ultrasound Age)

4 Obstetrics
• CUA (Composite Ultrasound Age)
GA in OB Items
The GA in the OB items is calculated from the related GA tables/formulae. It is independent from
the clinical GA.
1. Preset the GA formulae and whether to display the EDD or not.
See Basic Volume for details.
2. The GA and other measurement values display in the results window after a measurement.
If the Diagnostic GA exceeds the threshold, an OOR (out of range) displays in the results
window and this result is not recorded in the report.
The GA of an OB item displays to the right of the item measurements.
3. For result values used to calculate GA (Gestational Age) and EDD (Estimated Date of
Delivery), the formula used in this calculation can be selected from [Formula].
AUA
AUA is the average of the valid GAs that are calculated according to the biparietal diameter (BPD),
head circumference (HC), abdomen circumference (AC), femur length (FL), Gestational Sac (GS),
crown rump length (CRL), etc.
All valid values of all the above items will be included in the AUA calculation in the system default
method.
Click the checkboxes to the right of the related items to select whether to include the item in the
AUA calculation or not. The AUA value varies according to the selection.
CUA
The CUA is calculated according to formulae based on certain measurement items (the items
involved include the biparietal diameter (BPD), head circumference (HC), abdomen circumference
(AC) and femur length (FL)). To calculate the CUA, all the GA formulae of the parameters
involved must be Hadlock, the unit of the parameters is cm and unit of CUA is week. The formulae
are listed as follows:
• CUA(BPD) = 9.54+1.482×BPD+0.1676×BPD2
• CUA(HC) = 8.96+0.540×HC+0.0003×HC3
• CUA(AC) = 8.14+0.753×AC+0.0036×AC2
• CUA(FL) = 10.35+2.460×FL+0.170×FL2
• CUA(BPD, HC) = 10.32+0.009×HC2+1.3200×BPD+0.00012×HC3
• CUA(BPD, AC) = 9.57+0.524×AC+0.1220×BPD2
• CUA(BPD, FL) = 10.50+0.197×BPD×FL+0.9500×FL+0.7300×BPD
• CUA(HC, AC) = 10.31+0.012×HC2+0.3850×AC
• CUA(HC, FL) = 11.19+0.070×HC×FL+0.2630×HC
• CUA(AC, FL) =10.47+0.442×AC+0.3140×FL2 - 0.0121×FL3
• CUA(BPD, HC, AC) = 10.58+0.005×HC2 +0.3635×AC+ 0.02864×BPD×AC
• CUA(BPD, HC, FL) = 11.38+0.070×HC×FL+0.9800×BPD
• CUA(BPD, AC, FL) = 10.61+0.175×BPD×FL+0.2970×AC+0.7100×FL
• CUA(HC, AC, FL) = 10.33+0.031×HC×FL+0.3610×HC+0.0298×AC×FL
• CUA(BPD, HC, AC, FL)=10.85+0.060×HC×FL+0.6700×BPD+0.1680×AC
4 Obstetrics
The default method of calculating the CUA is to use the formula that involves more measurement
items. You can also select the parameters by clicking the checkboxes to the right of the related
items.
OB Growth Percentile
The obstetric growth percentile is used to estimate the fetal growth. It calculates the difference
between the ultrasound measurement results and the measurement results corresponding to the
clinical GA in the FG table. The percentile will not be calculated when there is no clinical GA, or
no FG table, or the SD Type of the FG table is set to “None.”
The premise is: data in the FG table are (approximately) normally distributed and support “lower-
limit < average value < upper-limit.”
The system does not calculate the OB growth percentile if:
• An FG table is not normally distributed.
• There is no upper/lower deviation set in the FG table.
• The FG table has the upper/lower deviation set, but certain clinical GA values have no upper/
lower deviation or the deviation value is not plus. The fetal growth curve is not affected. E.g.
Jeanty FG table of RAD.
The OB growth percentile is displayed in the results window, the measurement report, the exported
PDF/RTF report and the OB structured report, and it supports print viewing and printing.
4.7 Obstetric Formula

The obstetric formulae are used in the GA, EFW calculations and Fetal Growth Curve.
4.7.1 GA and FG Formulae

GA will be automatically calculated after the corresponding measurements are completed. The
system will recalculate the GA after new measurements are completed.
The GA and FG formulae are shown in the table below:
NOTE:
“/” means no formula provided for the item.
Tools GA FG
EFW/EFW2 Tokyo Hadlock
Hadlock Hansmann
Tokyo
Brenner
William
CFEF_2014
Persson
GS Tokyo Tokyo
Rempen Hellman
Hansmann Rempen
China Hansmann
4 Obstetrics
Tools GA FG
CRL Tokyo Tokyo
Jeanty Hadlock
Hadlock Robinson
Nelson Rempen
Robinson Hansmann
Rempen ASUM
Hansmann Medvedev
China
ASUM
Daya
RobinsonBMUS
Daya
Verburg
BPD Tokyo Tokyo
Hadlock Hadlock
Jeanty Kurtz
Kurtz Jeanty
Hansmann Sabbagha
Merz Hansmann
Rempen Merz
ChittyOI Rempen
Osaka ChittyOI
China Osaka
Nicolaides Nicolaides
ASUM ASUM
CFEF CFEF_2000/2006
Verburg Medvedev
Verburg
AC Hadlock Hadlock
Jeanty Jeanty
Merz Merz
Nicolaides Nicolaides
ASUM ASUM
CFEF CFEF_2000/2006
Hansmann Hansman
Chitty Chitty
Medvedev
Verburg
4 Obstetrics
Tools GA FG
FL Hadlock Hadlock
Tokyo Tokyo
Jeanty Jeanty
Hohler Merz
Merz Hansmann
Hansmann O'Brien
Warda Warda
Chitty Chitty
Osaka Osaka
China Nicolaides
Nicolaides ASUM
ASUM CFEF_2000/2006
CFEF Medvedev
Verburg
OFD Hansmann Merz
Nicolaides Hansmann
ASUM Nicolaides
Jeanty ASUM
Jeanty
Medvedev
APAD / Merz
TAD CFEF Merz
FTA OSAKA OSAKA
THD Hansmann Hansmann
HUM Jeanty Jeanty
ASUM Merz
ASUM
Medvedev
Ulna Jeanty Merz
Jeanty
Medvedev
Tibia Jeanty Merz
Jeanty
Medvedev
RAD Jeanty Merz
FIB Jeanty Merz

Jeanty
CLAV Yarkoni Yarkoni
TCD Hill Goldstein
Nicolaides Hill
Nicolaides
Verburg
4 Obstetrics
Tools GA FG
OOD Jeanty Jeanty
Cist Magna / Nicolaides
Mean Sac Diam Daya /
Hellman
MCA PI / JSUM
MCA RI / JSUM
Umb A PI / JSUM
Umb A RI / JSUM
Ut A PI / Merz
Ut A RI / Merz
AFI / Moore
FL/HC (Hadlock) / Hadlock
HC/AC (Campbell) / Campbell
AC(c) Hadlock Chitty
Hadlock
Ut A PI / Merz
Ut A RI / Merz
Duct Veno PIV / Baschat
Duct Veno PVIV / Baschat
Duct Veno PLI / Baschat
Duct Veno S/a / Baschat
Foot Mercer Mercer
NBL / Bunduki
Sonek
4.7.2 Fetal Weight Formulae

EFW is a calculation item. If all tools required for the EFW formula have been performed, EFW
will be obtained automatically. The system will recalculate the EFW after new measurements are
completed.
Formulae of EFW and EFW2 of GA/FG are different from those on the [Fetal Calc] page ([Setup] >
[System Preset] > [OB] page).
• EFW formulae of GA/FG are used to perform the GA calculation or the Fetal Growth Curve
based on EFW.
• EFW formulae on the [Fetal Growth] page are used in the EFW calculation based on certain
OB measurement results (e.g., AC).
4 Obstetrics
The Fetal Weight formulae are shown in the following table:
Formulae Descriptions Units

EFW Item
Hadlock (AC, EFW= 10^(1.304+ (0.05281×AC)+ (0.1938×FL)- g cm
FL) (0.004×AC×FL))
SD=0.154×EFW SD Type=±2SD g g
Hadlock (AC, EFW= 10^(1.335 -(0.0034×AC×FL) + (0.0316×BPD) + g cm
FL, BPD) (0.0457×AC) + (0.1623×FL))
Hadlock (AC, EFW= 10^(1.326-(0.00326×AC×FL)+ (0.0107×HC)+ g cm
FL, HC) (0.0438×AC)+ (0.158×FL))
Hadlock (AC, EFW= 10^(1.3596- (0.00386×AC×FL)+ (0.0064×HC)+ g cm
FL, HC, BPD) (0.00061×BPD×AC)+ (0.0424×AC)+ (0.174×FL))
Shepard (AC, EFW = 10^(-1.7492+ (0.166×BPD)+ (0.046×AC)- kg cm
BPD) (2.646×AC×BPD/1000))
Merz1 (AC, EFW=-3200.40479+(157.07186×AC)+(15.90391×(BPD^2)) g cm
BPD)
Merz2 (AC) EFW=0.1×(AC^3) g cm
Hansmann (BPD, EFW = (-1.05775×BPD)+ (0.0930707×(BPD^2))+ kg cm
THD) (0.649145×THD)- (0.020562×(THD^2))+ 0.515263
Tokyo (BPD, EFW=(1.07×(BPD^3))+(3.42×APTD×TTD×FL) g cm
APTD, TTD, FL)
Osaka (FL, BPD, EFW=(1.25674×(BPD^3))+(3.50665×FTA×FL)+6.3 g cm
FTA)
Campbell (AC) EFW = EXP (-4.564+(0.282×AC)-(0.00331× (AC^2))) kg cm
Schild(HC, AC, EFW = 5381.193 + 150.324×HC + 2.069×FL^3 + g cm
FL) 0.0232×AC^3 - 6235.478×log(HC)
Person(BPD, FL, EFW = (BPD×10)^0.972 × (MAD×10)^1.743× (FL×10)^0.367 g cm
MAD) ×10^(-2.646)
4.7.3 Weight Percentile for Age

The Clinical Percentile (CP) and Ultrasound Percentile (UP) is calculated and displayed in the
report in the following format according to the formula selected for EFW calculation.
• CP (Calc Method) (Formula) ××.××%: Where Calc Method may be LMP, PRV, IVF, BBT,
DOC and EDD.
• UP (Calc Method) (Formula) ××.××%: Where Calc Method may be AUA, CUA.
Clinical Percentile (CP)

Find the average value and calculate the threshold range in the formula (to calculate EFW) in the
FG table according to the clinical GA (obtained in patient information such as LMP, IVF).
4 Obstetrics
If the actual EFW value is in the following range, keep calculating. If not, the CP will not be
displayed.
average EFW x1.25 > EFW > average EFW x0.75
E.g. EFW-GP(LMP) is the EFW Clinical Percentile calculated from the LMP obtained from the
patient information.
Ultrasound Percentile (UP)

This has the same calculation method as CP except for using the ultrasound GA instead of clinical
GA.
E.g. EFW-GP(AUA) and EFW-GP(CUA) is the EFW Clinical Percentile calculated from the AUA
and CUA respectively.
4.8 References
GS
• Rempen A., 1991
Arztliche Fragen. Biometrie in der Fruhgraviditat (i.Trimenon): 425-430.
• Hansmann M, Hackelöer BJ, Staudach A
Ultraschalldiagnostik in Geburtshilfe und Gynäkologie 1985
• Hellman LM, Kobayashi M, Fillisti L, et al. Growth and development of the human fetus prior
to the 20th week of gestation. Am J Obstet Gynecol 1969; 103:784-800.
• Studies on Fetal Growth and Functional Developments, Takashi Okai, Department of
Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo
• China
Written by Zhou Yiongchang & Guo Wanxue
in Chapter 38 of “Ultrasound Medicine” (3rd edition) Science & Technology Literature Press,
1997
• Daya S, Wood S, Ward S, et al. Early pregnancy assessment with transvaginal ultrasound
scanning Can Med Assoc J, 1991;144(4);441-446
CRL
• Rempen A., 1991
• Hadlock FP, et al. Fetal Crown-Rump Length: Reevaluation of Relation to Menstrual
Age (5-18 weeks) with High-Resolution Real-time US. Radiology 182:501-505.
• Jeanty P, Romero R. “Obstetrical Sonography”, p. 56. New York, McGraw-Hill, 1984.
• Nelson L. Comparison of methods for determining crown-rump measurement by realtime
ultrasound. J Clin Ultrasound February 1981; 9:67-70.
• Robinson HP, Fleming JE. A critical evaluation of sonar crown rump length
measurements. Br J Obstetric and Gynaecologic September 1975; 82:702-710.
• Fetal Growth Chart Using the Ultrasonotomographic Technique
Keiichi Kurachi, Mineo Aoki
Department of Obstetrics and Gynecology, Osaka University Medical School
4 Obstetrics
Revision 3 (September 1983)

• Studies on Fetal Growth and Functional Developments
• Takashi Okai
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo
Pam Loughna1, Lyn Chitty, Tony Evans, Trish Chudleigh. Fetal size and dating: Fetal size and
dating: charts recommended for clinical obstetric practice. British Medical Ultrasound Society.
ULTRASOUND August 2009 Volume 17 Number 3
• China
1997
• Ultrasonic fetal Measurement Standards for an Australian Population, compiled by Susan
Campbell Westerway - Faculty of Health Sciences University of Sydney
http://www.asum.com.au/open.home.htm Date: December 2003
A.Yu. Blinov, M.V. Medvedev, O.I. Kozlova. Fundamentals of Ultrasonic fetometry (Основы
ультразвуковой фетометрии), ed. 3 exp., Real Time, Moscow, 2014
Daya S. Accuracy of gestational age estimation by means of fetal crown-rump length
measurement. Am J Obstet Gynecol 1993; 168: 903-908
BPD
• Merz E., Werner G. & Ilan E. T. “Ultrasound in Gynecology and Obstetrics” Textbook and
Atlas 312, 326-336. 1991 Georg Thieme Verlag, pp.326~327
• Rempen A., 1991
• Jeanty P, Romero R. “Obstetrical Ultrasound.” McGraw-Hill Book Company, 1984, pp. 57-61.
• Sabbagha RE, Hughey M. Standardization of sonar cephalometry and gestational age.
Obstetrics and Gynecology October 1978; 52:402-406.
• Kurtz AB, Wapner RJ, Kurtz RJ, et al. Analysis of bipariental diameter as an accurate indicator
of gestational age. J Clin Ultrasound 1980;8:319-326.
• Fetal Growth Chart Using the Ultrasonotomographic Technique, Keiichi Kurachi, Mineo
Aoki, Department of Obstetrics and Gynecology, Osaka University Medical School Revision 3
(September 1983)
• Studies on Fetal Growth and Functional Developments, Takashi Okai, Department of
Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo
• Chitty LS, Altman DG
British Journal of Obstetrics and Gynaecology January 1994, Vol.101 P29-135.
• China
1997
• Altmann D.G.; Chitty L.S. New charts for ultrasound dating of pregnancy Obstetrics and
Gynecology Vol. 10: 174-191, 1997
• Hadlock FP, et al. Estimating Fetal Age: Computer-Assisted Analysis of Multiple Fetal
Growth Parameters. Radiology 1984:152: 497-501
4 Obstetrics
• Hansmann, Hackeloer, Staudach, Wittmann. Ultrasound Diagnosis in Obstetrics and

Gynecology. Springer-Verlag, New York, 1985
• Jeanty P., Cousaert E., Hobbins J.C., Tack B., Bracken M., Cantraine F. A longitudinal Study
of fetal head biometry. American Journal of Perinatology; Volume1; Number 2; January 1984;
pages 118-128
• R. J. M. Snijders and K. H. Niicolaides. Fetal biometry at 14-40 weeks’gestation. Ultrasound
Obstet. Gynecol. 4 (1994) 34-48
• Norio Shinozuka, Takashi Okai, Masahiko Mizuno. Issued by Shindan & Tiryo Sya Tokyo
University, School of Medicine, OB/GYN dept. How to interpret OB/GYN ultrasound
measurement data. 80. Fetal Measurement Obstetrics & Gynecology Chapter 56 Separate
volume; 1989, Oct. 27th Publication
OFD
• Merz E., Werner G. & Ilan E. T., 1991
Ultrasound in Gynecology and Obstetrics Textbook and Atlas 312, 326-336.
Jeanty P., Cousaert E., Hobbins J.C., Tack B., Bracken M., Cantraine F “A longitudinal study
of fetal head biometry” American Journal of Perinatology; Volume 1; Number 2; January 1984
• Ultrasonic fetal Measurement Standards for an Australian Population. compiled by Susan
Campbell Westerway - Faculty of Health Sciences University of Sydney http://
www.asum.com.au/open.home.htm Date: December 2003
• Hansmann, Hackelöer, Staudach, (Wittmann). Ultrasound Diagnosis in Obstetrics and
Gynecology. Springer- Verlag, New York, 1986,p.433
• R. J. M. Snijders and K. H. Niicolaides. Fetal biometry at 14-40 weeks’gestation. Ultrasound
HC
Growth Parameters. Radiology 1984; 152 (No. 2):499.
• Jeanty P, Romero R. “Obstetrical Ultrasound.” McGraw-Hill Book Company, 1984.
British Journal of Obstetrics and Gynaecology January 1994, Vol.101
P29-135.
• Chitty L.S., Altman D.G., Hendesson A., Campell S., Charts of fetal size: 2 Head
measurements, Br J Obstetric Gynecology 1994, Vol 101, P 35-43.
Altmann D.G.; Chitty L.S. “New charts for ultrasound dating of pregnancy” Ultrasound in
Obstetrics and Gynecology Vol. 10: 174-191, 1997
Jeanty P., Cousaert E., Hobbins J.C., Tack B., Bracken M., Cantraine F “A longitudinal study
of fetal head biometry” American Journal of Perinatology; Volume 1; Number 2; January 1984
4 Obstetrics
• R. J. M. Snijders and K. H. Niicolaides. Fetal biometry at 14-40 weeks’ gestation. Ultrasound

AC
Ultrasound in Gynecology and Obstetrics Textbook and Atlas 312, Georg Thieme Verlag,326-
336.
Hadlock FP, et al. Estimating Fetal Age: Computer-Assisted Analysis of Multiple Fetal
• Jeanty P, Romero R. A longitudinal study of fetal abdominal growth, “Obstetrical Ultrasound.”
MacGraw-Hill Book Company, 1984.
Chitty LS, Altman DG
P29-135.
Ultrasound Diagnosis in Obstetrics and Gynecology
• Crequat,J., Duyme,M., Brodaty,G. Biometry 2000. Fetal growth charts by the French College
of fetal ultrasonography and the Inserm U 155. Gynecol.Obstet Fertil., Vol. 28 No. 2, 2000,
pages 435-455
• Chitty L.S. Altman D.G. Hendesson A. Campell S. Charts of fetal size: 3. Abdominal
measurements. Br J Obstetric Gynaecology 1994, Vol 101, pages 35-43.
Chitty,L.S., Altman,D.G., Henderson,A., Campbell,S. Charts of fetal size: 3. Abdominal
measurements Br.J.Obstet.Gynaecol. Vol. 101 No. 2, 1994, pages 125-131
Gynecology
Springer- Verlag, New York, 1986, p.431.
• Jeanty P., Cousaert E., Cantraine F. Normal Growth of the Abdominal Perimeter. American
Journal of Perinatology; Volume 1 Number 2; January 1984; pages 129-135
• R. J. M. Snijders and K. H. Niicolaides. Fetal biometry at 14-40 weeks' gestation. Ultrasound
FL
Ultrasound in Gynaecology and Obstetrics Textbook and Atlas 312, 326-336.
• Warda A. H., Deter R. L. & Rossavik, I. K., 1985.
Fetal femur length: a critical re-evaluation of the relationship to menstrual age. Obstetrics and
Gynaecology, 66,69-75.
• O'Brien GD, Queenan JT (1981)
Growth of the ultrasound femur length during normal pregnancy,
American Journal of Obstetrics and Gynecology 141:833-837.
4 Obstetrics
• Jeanty P, Rodesch F, Delbeke D, Dumont J. Estimation of gestational age from

measurements of fetal long bones. Journal of Ultrasound Medicine
February 1984; 3:75-79.
• Hohler C., Quetel T. Fetal femur length: equations for computer calculation of gestational age
from ultrasound measurements. American Journal of Obstetrics and Gynecology June 15,
1982; 143 (No. 4):479-481.
• Keiichi Kurachi, Mineo Aoki
• Studies on Fetal Growth and Functional Developments
Takashi Okai
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo
P29-135.
Jeanty P., Cousaert E., Cantraine F., Hobbins J.C., Tack B., Struyven J. “A longitudinal Study
of fetal limb growth” American Journal of Perinatology; Volume 1; Number 2; January
1984;136-144
• Jeanty P., Rodesch F., Delbeke D., Dumont J. “Estimation of Gestational Age from
Measurements of Fetal Long Bones” Journal of Ultrasound Medicine, 3: 75-79, February,
1984
• China
1997
• ASUM
Ultrasonic fetal Measurement Standards for an Australian Population, compiled by Susan
Campbell Westerway - Faculty of Health Sciences University of Sydney. http://
www.asum.com.au/open/home.htm Date: December 2003
• R. J. M. Snijders and K. H. Niicolaides; Fetal biometry at 14-40 weeks' gestation Ultrasound
TAD
Merz E., Werner G. & Ilan E. T., 1991
APAD
THD
Hansmann M, Hackelöer BJ, Staudach A
FTA
Fetal Growth Chart Using the Ultrasonotomographic Technique
4 Obstetrics
Keiichi Kurachi, Mineo Aoki

HUM
• Jeanty P, Rodesch F, Delbeke D, Dumont J. Estimation of gestational age from
measurements of fetal long bones. Journal of Ultrasound Medicine February 1984;
3:75-79.
Jeanty P., Cousaert E., Cantraine F., Hobbins J.C., Tack B., Struyven J. “A longitudinal Study
of fetal limb growth” American Journal of Perinatology; Volume 1; Number 2; January
1984;136-144
• Ultrasonic fetal Measurement Standards for an Australian Population, compiled by Susan
Campbell Westerway - Faculty of Health Sciences University of Sydney. http://
www.asum.com.au/open/home.htm Date: December 2003
CLAV
“Clavicular Measurement: A New Biometric Parameter for
Fetal Evaluation.” Journal of Ultrasound in Medicine 4:467-470, September 1985.
TCD
• Goldstein I, et al. Cerebellar measurements with ultrasonography in the evaluation of fetal
growth and development. Am J Obstet Gynecol 1987; 156:1065-1069.
• Hill LM, et al. Transverse cerebellar diameter in estimating gestational age in the large for
gestational age fetus, Obstet Gynecol 1990; 75:981-985.
• R. J. M. Snijders and K. H. Niicolaides; Fetal biometry at 14-40 weeks’ gestation Ultrasound
GS
Hellman LM, Kobayashi M, Fillisti L, et al. Growth and development of the human fetus prior to
the twentieth week of gestation. Am J Obstet Gynecol,1969;103(6):789-800
Ulna
Jeanty P., Rodesch F., Delbeke D., Dumont J., “Estimation of Gestational Age from Measurements
of Fetal Long Bones.” J Ultrasound Med 3:75-79, 1984
Jeanty P., Cousaert E., Cantraine F., Hobbins J.C., Tack B., Struyven J. “A longitudinal Study of
fetal limb growth” American Journal of Perinatology; Volume 1; Number 2; January 1984;136-144
Tibia
Jeanty P., Rodesch F., Delbeke D., Dumont J., “Estimation of Gestational Age from Measurements
of Fetal Long Bones.” J Ultrasound Med 3:75-79, 1984
Jeanty P., Cousaert E., Cantraine F., Hobbins J.C., Tack B., Struyven J. “A longitudinal Study of
fetal limb growth” American Journal of Perinatology; Volume 1; Number 2; January 1984;136-144
4 Obstetrics
RAD
• Fetal Limb Bimetry (Letter), Radiology 147:602, 1983
FIB
• Fetal Limb Bimetry (Letter), Radiology 147:602, 1983
OOD
Jeanty P., Cantraine R., Cousaert E., et al. The Binocular Distance: A New Way to Estimate Fetal
Age. J Ultrasound Med 1984; 3: 241-243.
Ultrasound GA
Hadlock,Radiology,1984 152:497-501
Cist Magna
R. J. M. Snijders and K. H. Niicolaides. Fetal biometry at 14-40 weeks’ gestation. Ultrasound
Estimated Fetal Weight (EFW)

• Merz E., Werner G. & Ilan E. T., Ultrasound in Gynaecology and Obstetrics. Textbook and
Atlas 1991 Georg Thieme Verlag, 308-338
• Hansmann M, Hackelöer BJ, Staudach A Ultraschalldiagnostik in Geburtshilfe und
Gynäkologie 1995
• Campbell S, Wilkin D. “Ultrasonic Measurement of Fetal Abdomen Circumference in the
Estimation of Fetal Weight.” Br J Obstetrics and Gynaecology September 1975; 82 (No.
9):689-697.
• Hadlock FP, Harrist R, et al. Estimation of fetal weight with the use of head, body, and femur
measurements - a prospective study. American Journal of Obstetrics and Gynecology February
1, 1985; 151 (No. 3):333-337.
• Shepard M, Richards V, Berkowitz R, Warsof S, Hobbins J. An Evaluation of Two Equations
for Predicting Fetal Weight by Ultrasound. American Journal of Obstetrics and Gynecology
January 1982; 142 (No. 1): 47-54.
• Fetal Growth Chart Using the Ultrasonotomographic Technique Keiichi Kurachi, Mineo Aoki
Department of Obstetrics and Gynecology, Osaka University Medical School Revision 3
(September 1983)
• Studies on Fetal Growth and Functional Developments Takashi Okai Department of Obstetrics
and Gynecology, Faculty of Medicine, University of Tokyo
• Brenner W.E., Edelman D.A., Hendricks C.H. A standard of fetal growth for the United States
of America. VOL. 91, NO. 6, JUNE 1998
• Hadlock F.P., Harrist R., Martinez-Poyer J. In utero analysis of fetal growth: A sonographic
standard. Radiology 1991;181:129-133
• Ronald Williams, Robert Creasy, George Cunningham, Warren Hawes, Rank Norris, Michiko
Tashiro. Fetal Growth and Perinatal Viability in California. Obstetric & Gynecology Vol. 59,
NO. 5, May 1982
4 Obstetrics

Gynecology. Springer-Verlag, New York, 1986
• Shinozuka N., Okai T., Kohzuma S., Mukubo M., Shih C.T., Maeda T., et al. Formulas for
Fetal Weight Estimation by Ultrasound Measurements based on Neonatal Specific Gravities
and Volumes. American Journal of Obstetrics and Gynecology 157: 1140-1145; 1987
Fetal Biophysical Profile

• Manning FA. Dynamic ultrasound-based fetal assessment: the fetal biophysical profile score.
Women's Hospital, Department of Obstetrics and Gynecology, Winnipeg, Manitoba, Canada.
• Dyanamic ultrasound-based fetal Assessment: The Fetal Biophysical Profile Score,Clinical
obstetrics and gynecology,Manning FA,38:26-44,1995a.
Weight Percentile for Age

Hadlock F.P., Harrist R., Martinez-Poyer J. In utero analysis of fetal growth: A sonographic
standard. Radiology 1991;181:129-133.
AFI
Thomas R,Moore MD, Jonathan E, Cayle MD. The amniotic fluid index in normal human
pregnancy. American journal of Obstetrics and Gynecology May 1990; 162: 1168-1173.
Z-Score
Schneider C. et. al., “Development of Z-scores for fetal cardiac dimensions from echocardio-
graphy”, Ultrasound Obstet Gynecol. Vol. 26, 2005: 599-605.
CI
Hadlock, F., Deter, R., Carpenter, R., Park, D. Estimating Fetal Age: effect of Head Shape on BPD.
American Journal of Roentgenology, 137: 83-85, July 1981
FL/AC
Hadlock F., Deter R., Harrist R., Roecker E., Park S. A Date-Independent Predictor of Intrauerine
Growth Retardation: Femur Length/Abdominal Circumference Ratio American Journal of
Roentgenology, 141:979-984, November 1983
FL/HC(Hadlock)
Hadlock,F.P.,Harrist,R.B.,Shah,Y.,Park,S.K. The femur length/head circumference relation in
obstetric sonography. J Ultrasound Med 1984, 3: 439-442 (Fetal Growth)
HC/AC(Campbell)
Campbell S. Ultrasound Measurement of Fetal Head and Abdomen Circumference Ratio in the
Assessment of Growth Retardation. Obstetrics and Gynaecology, Vol 84, 165- 174, March 1977
FL/BPD
Hohler C.W., Quetel, T:A: Comparison of Ultrasound Femur Length and Biparietal Diameter in
Late pregnancy. American Journal of Obstetrics and Gynecology, volume 14, No. 7: 759-762, 1-
Dec.-1981
Ut A RI/MCA RI
Kurmanavicius J, Florio I, Wisser J, Hebisch G, Zimmermann R, Muller R et al. Reference
resistance indices of the umbilical, fetal middle cerebral and uterine arteries at 24-42 weeks of
gestation. Ultrasound Obstet. Gynecol. 1997;10:112-20.
4 Obstetrics
Duct Veno
A. A. BASCHAT. Relationship between placental blood flow resistance and precordial venous
Doppler indices. Ultrasound Obstet Gynecol 2003; 22: 561–566
IT
Bunduki V, Ruano R, Miguelez J, Yoshizaki CT, Kahhale S, Zugaib M. Fetal nasal bone length:
reference range and clinical application in ultrasound screening for trisomy 21. Ultrasound Obstet
Gynecol 2003; 21: 156-160
Sonek JD, McKenna D, Webb D, Croom C, Nicolaides K. Nasal bone length throughout gestation:
normal ranges based on 3537 fetal ultrasound measurements. Ultrasound Obstet Gynecol 2003; 21:
152-155
CFEF
L. J. SALOMON, M. DUYME, J. CREQUAT, G. BRODATY, C. TALMANT, N. FRIES and M.
ALTHUSER. French fetal biometry: reference equations and comparison with other charts.
Ultrasound Obstet Gynecol 2006; 28: 193–198
M Massoud, M Duyme, M Fontanges D Combourieu. Chart for estimation of fetal weight 2014 by
the FrenchCollege of Fetal Sonography (CFEF). J Gynecol Obstet Biol Reprod (Paris) (2015).
Verburg
B.O. VERBURG, E. A. P. STEEGERS, M. DE RIDDER, R. J.M. SNIJDERS, E. SMITH, A.
HOFMAN, H. A. MOLL, V. W. V. JADDOE and J. C. M. WITTEMAN. New charts for ultrasound
dating of pregnancy and assessment of fetal growth: longitudinal data from a population-based
cohort study. Ultrasound Obstet Gynecol 2008; 31: 388–396 Published online 17 March 2008 in
Wiley InterScience (www.interscience.wiley.com). DOI:10.1002/uog.5225
5 Cardiology
NOTE:
• The heartbeat of the traced spectrum in VTI measurement should be equal to that preset,
otherwise the obtained HR (Heart Rate) will be incorrect, see Basic Volume for the relevant
preset.
• Some application items in the measurement preset library (and matching list in the results
assignment) are displayed different from those in the measurement menu and results window.
In the preset library (and matching list in the results assignment), the item is followed with the
word indicating the mode or location.

4. Select the study tool, and select measurement tool from the measurement menu to start the
measurement.
– For measurement tools, see “5.2 Measurement Tools”.
– For study tools, see “5.4 Study Tool Operations”.
completed.

5 Cardiology
5.2 Measurement Tools

5.2.1 2D Mode
Measurement

LA Diam Left Atrium Diameter Distance in 2D General Measurements
LA Major Left Atrium Major Diameter
LA Minor Left Atrium Minor Diameter
RA Major Right Atrium Major Diameter
RA Minor Right Atrium Minor Diameter
LV Major Left Ventricular Major Diameter
LV Minor Left Ventricular Minor Diameter
RV Major Right Ventricular Major Diameter
RV Minor Right Ventricular Minor Diameter
LA Area Left Atrium Area Area in 2D General Measurements
RA Area Right Atrium area
LV Area(d) Left Ventricular area at end- The system automatic calculates FAC
diastole value.
LV Area(s) Left Ventricular area at end-systole FAC=((LV Area(d)- LV Area(s))/ LV
Area(d))×100%
RV Area(d) Right Ventricular area at end- The system automatic calculates RV FAC
diastole value.
RV Area(s) Right Ventricular area at end- RV FAC=((RV Area(d)- RV Area(s))/ RV
systole Area(d))×100%
LVAd sax MV Left Ventricular Area at Mitral Area in 2D General Measurements

Valve level at End-diastole in
Short-axis view
LVAs sax MV Left Ventricular Area at Mitral
Valve level at End-systole in Short-
axis view
LVAd apical Left Ventricular Long-axis Area at
End-diastole in apical view
LVAs apical Left Ventricular Long-axis Area at
end-systole in apical view
LVAd sax Epi Left Ventricular Epicardial Area at
Papillary Muscle level at end-
diastole in Short-axis view
LVAd sax Endo Left Ventricular Endocardial Area
at Papillary Muscle level at end-
diastole in Short-axis view

5 Cardiology

LVIDd Left Ventricular Internal Diameter The system automatic calculates RWT
at end-diastole value.
LVPWd Left Ventricular Posterior wall RWT=(LVPWd(cm)×2)/LVIDd(cm)
thickness at end-diastole
LVIDs Left Ventricular Internal Diameter Distance in 2D General Measurements
at end-systole
RVDd Right Ventricular Diameter at end-
diastole
RVDs Right Ventricular Diameter at end-
systole
LVPWs Left Ventricular Posterior wall
thickness at end-systole
RVAWd Right Ventricular Anterior wall
RVAWs Right Ventricular Anterior wall
IVSd Interventricular Septal Thickness at
end-diastole
IVSs Interventricular Septal Thickness at
end-systole
LVLd apical Left Ventricular Long-axis Length
at End-diastole in apical view
LVLs apical Left Ventricular Long-axis Length
at End-systole in apical view
Ao Diam Aorta Diameter
Ao Arch Diam Aorta Arch Diameter
Ao Asc Diam Ascending Aorta Diameter
Ao Desc Diam Descending Aorta Diameter
Ao Isthmus Aorta Isthmus Diameter
Ao st junct Aorta ST Junction Diameter
Ao Sinus Diam Aorta Sinus Diameter
Duct Art Diam Ductus Arteriosus Diameter
Pre Ductal Previous Ductal Diameter
Post Ductal Posterior Ductal Diameter
ACS Aortic Valve Cusp Separation
LVOT Diam Left Ventricular Outflow Tract
Diameter
AV Diam Aorta Valve Diameter
AVA Aortic Valve Area Area in 2D General Measurements

5 Cardiology

PV Diam Pulmonary Valve Diameter Distance in 2D General Measurements
LPA Diam Left Pulmonary Artery Diameter
RPA Diam Right Pulmonary Artery Diameter
MPA Diam Main Pulmonary Artery Diameter
RVOT Diam Right Ventricular Outflow Tract
Diameter
MV Diam Mitral Valve diameter
MVA Mitral Valve Area Area in 2D General Measurements
MCS Mitral Valve Cusp Separation Distance in 2D General Measurements
MV EPSS Distance between point E and
Interventricular Septum when
mitral valve is fully open
TV Diam Tricuspid Valve Diameter
TVA Tricuspid Valve Area Area in 2D General Measurements
IVC Inferior Vena Cava Inspiration The system automatically calculates IVC
Diam(Insp) Diameter Depth(Expir), IVC Depth(Insp), IVC
Diam(Expir), IVC Diam(Insp), SVC
IVC Inferior Vena Cava Expiration
Depth(Insp), SVC Diam(Insp), SVC
Diam(Expir) Diameter
Depth(Expir), SVC Diam(Expir), IVC-CI,
SVC Superior Vena Cava Inspiration IVC-DI, SVC-CI, SVC-DI value.
Diam(Insp) Diameter IVC-CI = |IVC Diam(Expir) - IVC
SVC Superior Vena Cava Expiration Diam(Insp)| / Max (IVC Diam(Expir), IVC
Diam(Expir) Diameter Diam(Insp))
• IVC-DI = |IVC Diam(Expir) - IVC
Diam(Insp)| / Min (IVC Diam(Expir),
IVC Diam(Insp))
• SVC-CI = |SVC Diam(Expir) - SVC
Diam(Insp)| / Max (SVC Diam(Expir),
SVC Diam(Insp))
• SVC-DI = |SVC Diam(Expir) - SVC
Diam(Insp)| / Min (SVC Diam(Expir),
SVC Diam(Insp))
LCA Diam Left Coronary Artery Distance in 2D General Measurements
RCA Diam Right Coronary Artery
VSD Diam Ventricular Septal Defect Diameter
ASD Diam Atrial Septal Defect Diameter
PDA Diam Patent Ductus Arteriosus Diameter
PFO Diam Patent Oval Foramen Diameter
PEd Pericardial Effusion at diastole
PEs Pericardial Effusion at systole
HR Heart Rate Heart Rate in M General Measurements

5 Cardiology

Diastole End-diastolic Left Ventricular FoldLine in 2D mode
Measurement
Systole End-systolic Left Ventricular
Measurement
RA Vol(A4C) Right Atrium Volume (4-chamber) see “5.4.1 Left Ventricular Function”
AutoEF Automatic measuring of the see Basic Volume
diastolic and systolic sectional
planes
RAP Right Atrium Pressure Select from the pop-up dialog box or enter
a value manually, see “5.4.7 RVSP (Right
Ventricular Systolic Pressure)”
Calculation

LA/Ao Left Atrium Diameter/ LA Diam (cm) / Ao Diam (cm)
Aorta Diameter
Study
For details, see “5.4 Study Tool Operations”.
5.2.2 M Mode
Measurement

LA Diam. Left Atrium Diameter Distance in M General
Measurements
LVIDd Left Ventricular Internal Diameter at The system automatic calculates
end-diastole RWT value.
LVPWd Left Ventricular Posterior wall RWT=(LVPWd(cm)×2)/
thickness at end-diastole LVIDd(cm)

5 Cardiology

LVIDs Left Ventricular Internal Diameter at Distance in M General
end-systole Measurements
RVDd Right Ventricular Diameter at end-
diastole
RVDs Right Ventricular Diameter at end-
systole
LVPWs Left Ventricular Posterior wall
RVAWd Right Ventricular Anterior wall
RVAWs Right Ventricular Anterior wall
IVSd Interventricular Septal Thickness at
end-diastole
IVSs Interventricular Septal Thickness at
end-systole
Ao. Diam. Aorta Diameter
Ao. Arch Di-am. Aorta Arch Diameter
Ao. Asc. Di-am. Ascending Aorta Diameter
Ao. Desc. Diam. Descending Aorta Diameter
Ao. Isthmus Aorta Isthmus Diameter
Ao. ST Junct. Aorta ST Junction Diameter
Ao. Sinus Diam. Aorta Sinus Diameter
LVOT Diam. Left Ventricular Outflow Tract
Diameter
ACS Aortic Valve Cusp Separation
LPA Diam. Left Pulmonary Artery Diam-eter
RPA Diam. Right Pulmonary Artery Diameter
MPA Diam. Main Pulmonary Artery Diameter
RVOT Diam. Right Ventricular Outflow Tract
Diameter
MV E Amp. Amplitude of the Mitral Valve E wave
MV A Amp. Amplitude of the Mitral Valve A wave
MV E-F Slope Mitral Valve E-F slope Slope in M General Measurements
MV D-E Slope Mitral Valve D-E slope

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MV D-E Amp Amplitude of the Mitral Valve DE wave Distance in M General
Measurements
MCS Mitral Valve Cusp Separation
MV EPSS Distance between point E and the
interventricular septum
PEd Pericardial Effusion at dias-tole
PEs Pericardial Effusion at systole
LVPEP Left Ventricular pre-ejection period Time in M General Measurements
LVET Left Ventricular Ejection Time
RVPEP Right Ventricular Pre-Ejection Period
RVET Right Ventricular Ejection Time
HR Heart Rate Heart Rate in M General
measurements
Diastole End-diastolic Left Ventricular Parallel method in M mode
Measurement
Measurement
MAPSE Mitral Annular Plane Systolic Time in M General Measurements
Excursion
TAPSE Tricuspid Annular Plane Systolic Distance in M General
Excursion Measurements
MV ALL M wave measurement of mitral valve see “5.3.1 MV ALL”
anterior leaflet
Calculation

LA/Ao Left Atrium Diameter/ LA Diam (cm) / Ao Diam (cm)
Aorta Diameter
Study
5.2.3 Doppler Mode

Measurement

MV Vmax Mitral Valve Maximum Velocity D Vel. in Doppler General
Measurements
MV E Vel. Mitral Valve E-wave Velocity
MV A Vel. Mitral Valve A-wave Velocity

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MV E VTI Mitral Valve E-wave Velocity-Time D Trace in Doppler General
Integral Measurements
MV A VTI Mitral Valve A-wave Velocity-Time
Integral
MV VTI Mitral Valve Velocity-Time Integral
MV AccT Mitral Valve Acceleration Time Acceleration in Doppler General
Measurements
MV DecT Mitral Valve Deceleration Time
IVRT Mitral Valve Isovolumic Relaxation Time in Doppler General
Time Measurements
IVCT Mitral Valve Isovolumic Con-traction
Time
MV E Dur. Mitral Valve E-wave Duration
MV A Dur. Mitral Valve A-wave Duration
LVOT Vmax Left Ventricular Outflow Tract D Vel. in Doppler General
Maximum Velocity Measurements
LVOT VTI Left Ventricular Outflow Tract Velocity- D Trace in Doppler General
Time Integral measurements
LVOT AccT Left Ventricular Outflow Tract Acceleration in Doppler General
Acceleration Time Measurements
AAo Vmax Ascending Aorta Maximum Velocity D Vel. in Doppler General
Measurements
DAo Vmax Descending Aorta Maximum Velocity
AV Vmax Aorta Valve Maximum Velocity
AV VTI Aorta Valve Velocity-Time Integral D Trace in Doppler General
measurements
LVPEP(Doppler) Left Ventricular Pre-Ejection Period Time in Doppler General
Measurements
LVET(Doppler) Left Ventricular Ejection Time
AV AccT Aorta Valve Acceleration Time
AV DecT Aorta Valve Deceleration Time
RVET(Doppler) Right Ventricular Ejection Time Time in Doppler General
Measurements
RVPEP(Doppler) Right Ventricular Pre-Ejection Period
TV Vmax Tricuspid Valve Maximum Velocity D Vel. in Doppler General
Measurements
TV E Vel. Tricuspid Valve E-wave Flow Velocity
TV A Vel. Tricuspid Valve A-wave Flow Velocity
TV VTI Tricuspid Valve Velocity-Time Integral D Trace in Doppler General
measurements
TV AccT Tricuspid Valve Acceleration Time Acceleration in Doppler General
Measurements
TV DecT Tricuspid Valve Deceleration Time
TV A Dur. Tricuspid Valve A-wave Duration Time in Doppler General
Measurements

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RVOT Vmax Right Ventricular Outflow Tract D Vel. in Doppler General
RVOT VTI Right Ventricular Outflow Tract D Trace in Doppler General
Velocity-Time Integral measurements
PV Vmax Pulmonary Valve Maximum Velocity D Vel. in Doppler General
Measurements
PV VTI Pulmonary Valve Velocity-Time Integral D Trace in Doppler General
measurements
PV AccT Pulmonary Valve Acceleration Time Acceleration in Doppler General
Measurements
PR DecT Pulmonary Artery Regurgatation Acceleration in Doppler General
Deceleration Time Measurements
MPA Vmax Main Pulmonary Artery Maximum D Vel. in Doppler General
Velocity Measurements
RPA Vmax Right Pulmonary Artery Maximum
Velocity
LPA Vmax Left Pulmonary Artery Maximum
Velocity
PVein S Vel. Pulmonary Vein S-wave Flow Velocity D Vel. in Doppler General
Measurements
PVein D Vel. Pulmonary Vein D-wave Flow Velocity
PVein A Vel. Pulmonary Vein A-wave Flow Velocity
PVein A Dur. Pulmonary Vein A-wave Duration Time in Doppler General
Measurements
PVein S VTI Pulmonary Vein S-wave Velocity-time D Trace in Doppler General
Integral measurements
PVein D VTI Pulmonary Vein D-wave Velocity-time
Integral
PVein DecT Pulmonary Vein Deceleration Time Time in Doppler General
Measurements
IVC Vel. (Insp.) Inferior Vena Cava Inspiration D Vel. in Doppler General
IVC Vel. (Expir.) Inferior Vena Cava Expiration
Maximum Velocity
SVC Vel. (Insp.) Superior Vena Cava Inspiration
Maximum Velocity
SVC Vel. (Expir.) Superior Vena Cava Expiration
Maximum Velocity
MR Vmax Mitral Valve Regurgitation Maximum
Velocity
MR VTI Mitral Valve Regurgitation Velocity- D Trace in Doppler General
MS Vmax Mitral Valve Stenosis Maximum D Vel. in Doppler General

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dP/dt Rate of Pressure change dP/dt Measurement
AR Vmax Aortic Valve Regurgitation Maximum D Vel. in Doppler General
AR VTI Aortic Valve Regurgitation Velocity- D Trace in Doppler General
AR DecT Aortic Valve Regurgitation Deceleration Acceleration in Doppler General
Time Measurements
AR PHT Aortic Valve Regurgitation Pressure Doppler Measurement
Half Time
AR Ved Aortic Valve Regurgitation Velocity at D Vel. in Doppler General
end-Diastole Measurements
TR Vmax Tricuspid Valve Regurgitation
Maximum Velocity
TR VTI Tricuspid Valve Regurgitation Velocity- D Trace in Doppler General
PR Vmax Pulmonary Valve Regurgitation D Vel. in Doppler General
PR VTI Pulmonary Valve Regurgitation D Trace in Doppler General
Velocity-Time Integral measurements
PR PHT Pulmonary Valve Regurgitation Pressure Doppler Measurement
Half Time
PR Ved Pulmonary Valve Regurgitation Velocity D Vel. in Doppler General
at end-Diastole Measurements
VSD Vmax Ventricular Septal Defect Maximum
Velocity
ASD Vmax Atrial Septal Defect Maximum Velocity
PDA Vel(d) Patent Ductus Arteriosus Velocity at
End-diastole
PDA Vel(s) Patent Ductus Arteriosus Velocity at
End-systole
Coarc. Pre-Duct. Coarctation of Pre-Ductus
Coarc. Post-Duct. Coarctation of Post-Ductus
AV/TV/MV/PV Heart Rate HR in Doppler General
HR Measurements
RAP Right Atrium Pressure Select from the pop-up dialog box
or enter a value manually. For
RAP measurements, see
“5.4.7 RVSP (Right Ventricular
Systolic Pressure)”
Hepatic V S Vel. Hepatic Vein Systolic Peak Velocity D Vel. in Doppler General
Measurements
Hepatic V D Vel. Hepatic Vein Diastolic Peak Velocity
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Calculation

MV E/A Mitral Valve E-Vel./A-Vel. MV E Vel. (cm/s)/MV A Vel. (cm/s)
MVA(PHT) Mitral Valve Orifice Area (PHT) MVA(PHT) (cm2) = 220 / MV PHT (ms)
TV E/A Tricuspid Valve E-Vel./A-Vel. TV E/A=TV E Vel(cm/s)/TV A Vel(cm/s)
TVA(PHT) Tricuspid Valve Orifice Area (PHT) TVA(PHT)=220/TV PHT(cm2)
Study
5.2.4 TDI Cardiac Measurements Tools

Measurement
The following measurement items are performed in TDI mode.

MV Aa(medial) Mitral Valve medial Late diastolic motion D Vel. in Doppler General
measurements
MV Sa(medial) Mitral Valve medial Systolic motion
D Vel. in Doppler General
MV Aa(lateral) Mitral Valve lateral Late diastolic motion measurements
MV Sa(lateral) Mitral Valve lateral Systolic motion
MV ARa(medial) Mitral Valve medial AcceleRation Rate Acceleration in Doppler General
Measurements
MV DRa(medial) Mitral Valve medial DeceleRation Rate
MV ARa(lateral) Mitral Valve lateral AcceleRation Rate
MV DRa(lateral) Mitral Valve lateral DeceleRation Rate
MV Ea(lateral) Mitral Valve lateral Early diastolic motion Measure MV E Vel item to get E/
Ea result.
measurements
*1
MV Ea(medial) Mitral Valve medial Early diastolic motion Measure MV E Vel item to get E/
Ea result.
measurements
*2
*1 means:
*2 means:
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Study
5.3 Measurement Tool Operations

5.3.1 MV ALL
Measure M wave of mitral valve anterior leaflet.
Measure items:
Item Description
MV D Point End of systolic, immediately before the opening of the Mitral Valve.
MV E Point The anterior leaflet of the mitral valve opens, it peaks at E.
MV F Point Lowest point of the initial diastolic closing.
MV A Point In atria systole, blood is propelled through the mitral orifice and the
mitral leaflets reopen. The peak of this phase of mitral valve motion is
indicated as A.
MV C Point Complete closure occurs after the onset of the ventricular systole.
Measurement Result:
Item Description Method

MV E Amp Amplitude of the Mitral Valve E wave to C point Distance in M General
Measurements
MV D-E Amp Distance between the onset of the opening of the Distance in M General
mitral valve at D and the maximum opening of the Measurements
anterior mitral valve leaflet at E.
MV D-E Slope The rate of change that exists between two point Slope in M General
(D, E). Measurements
MV E-F Slope The rate of change that exists between two point Slope in M General
(E, F). Measurements
MV A Amp Amplitude of the Mitral Valve A wave to C point Distance in M General
Measurements
MV A-C The time interval between the A point and the C Time in M General
Interval point. Measurements

1. Select the [MV ALL] in the measurement menu.
2. Move the cursor, press <Set> to fix points D, E, F, A and C in turn. Corresponding character
symbol will display at the right side of the point.
3. After D point and E point are fixed, MV D-E Amp and MV D-E Slope values are acquired.
4. MV E-F Slope value is acquired by fixing F point.
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5. MV E Amp, MV A Amp and MV A-C Interval values are acquired by fixing A point and C
point.
6. You can end measurement in advance by pressing <Set> twice on point E, F, A or C.
5.4 Study Tool Operations

5.4.1 Left Ventricular Function
This group of studies estimates the Left Ventricular (LV) diastolic and systolic capabilities using a
series of clinical indices measured on the B or M image. As well as calculating the left ventricular
volume and end diastole and end systole, they may calculate the following indices (not all indices
are calculated in every study, see the Study Results table for each study for reference).
Result Description Formulae

SV Stroke Volume SV(ml) = EDV(ml)-ESV(ml)
CO Cardiac Output CO(l/min) = SV(ml)×HR(bpm)/1000
EF Ejection Fraction EF(No unit) = SV(ml)/EDV(ml)
SI SV Index SI(No unit) = SV(ml)/ Body Surface Area (m2)
CI Cardiac output in-dex CI(No unit) = CO(l/min)/Body Surface Area (m2)
FS Fractional Short-ening FS (No unit) = (LVIDd (cm) - LVIDs [cm]) / LVIDd (cm)
MVCF Mean Velocity of MVCF = (LVIDd(cm) - LVIDs(cm)) / (LVIDd (cm) × ET
Circumferential Fiber (s))
Shortening
NOTE:
The HR value entered manually should be within the range 1~999.
S-P Ellipse
Study Items:
Tools Descriptions Operations

LVLd apical Left Ventricular Long-axis Length at Distance in 2D General measurements
End-diastole in apical view
LVAd apical Left Ventricular Long-axis Area at End- Area in 2D General Measurements
diastole in apical view
LVLs apical Left Ventricular Long-axis Length at Distance in 2D General measurements
End-systole in apical view
LVAs apical Left Ventricular Long-axis Area at end- Area in 2D General Measurements
systole in apical view
HR Heart Rate Obtained by ECG, HR(R-R)
measurement or entered di-rectly
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Study Results:
Tools Descriptions Formulae

EDV(SP Ellipse) End-diastolic Left
Ventricular Volume
ESV(SP Ellipse) End-systolic Left

Ventricular Volume
EDV Index(SP End-diastolic Left EDV Index=EDV/BSA

Ellipse) Ventricular Volume
Index
ESV Index(SP End-systolic Left ESV Index=ESV/BSA
Ellipse) Ventricular Volume
Index
SV(SP Ellipse) Stroke Volume see “5.4.1 Left Ventricular Function”
CO(SP Ellipse) Cardiac Output
EF(SP Ellipse) Ejection Fraction
SI(SP Ellipse) SV Index
CI(SP Ellipse) CO Index

1. Select [S-P Ellipse] in the measurement menu.
2. In apical long-axis view at end-diastole, measure the following parameters:
– LVLd apical
– LVAd apical
The EDV value is then calculated.
3. In apical long-axis view at end-systole, measure the following parameters:
– LVLs apical
– LVAs apical
The ESV value is then calculated.
The system calculates the SV and EF.
If the height and weight have already been entered, the SI, EDV Index and ESV Index are
calculated.
4. Select the HR source: HR(R-R) measurement, ECG or entered.
The CO and CI are calculated automatically using the entered height and weight values.
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B-P Ellipse
Study Items:

LVIDd Left Ventricular Internal Diameter at End-diastole Distance in 2D General
Measurements
LVIDs Left Ventricular Internal Diameter at End-systole
LVAd sax Left Ventricular Area at Mitral Valve level at End- Area in 2D General
MV diastole in Short-axis view measurements
LVAs sax Left Ventricular Area at Mitral Valve level at End-
MV systole in Short-axis view
LVAd Left Ventricular Long-axis Area at End-diastole in
apical apical view
LVAs Left Ventricular Long-axis Area at end-systole in apical
apical view
HR Heart Rate Obtained by ECG, HR(R-
R) measurement or entered
directly
Study Results:

EDV(BP Ellipse) End-diastolic Left Ventricular *1
Volume
ESV(BP Ellipse) End-systolic Left Ventricular Volume *2
EDV Index(BP End-diastolic Left Ventricular EDV Index=EDV/BSA
Ellipse) Volume Index
ESV Index(BP End-systolic Left Ventricular Volume ESV Index=ESV/BSA
Ellipse) Index
SV(BP Ellipse) Stroke Volume see “5.4.1 Left Ventricular
Function”
CO(BP Ellipse) Cardiac Output
EF(BP Ellipse) Ejection Fraction
SI(BP Ellipse) SV Index
CI(BP Ellipse) CO Index
*1 means:
*2 means:

1. Select [B-P Ellipse] in the measurement menu.
2. In left ventricular short-axis view, measure the following parameters:
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– At end diastole: LVIDd

– At end systole: LVIDs
3. In short-axis view at mitral valve level, measure the following parameters:
– At end diastole: LVAd sax MV
– At end systole: LVAs sax MV
4. In apical long-axis view, measure the following parameters:
– LVAd apical, the EDV is calculated
– LVAs apical, the ESV is calculated
The system calculates the SV and EF after the LVAs apical has been measured.
calculated.
5. Use the menu to select the HR source: ECG, HR(R-R) measurement or entered.
Bullet
Study Items:

LVLd apical Left Ventricular Long-axis Length at End- Distance in 2D General
diastole in apical view Measurements
LVLs apical Left Ventricular Long-axis Length at End-
LVAd sax MV Left Ventricular Area at Mitral Valve level Area in 2D General measurements
at End-diastole in Short-axis view
LVAs sax MV Left Ventricular Area at Mitral Valve level
at End-systole in Short-axis view
measurement or entered directly
Study Results:

EDV(Bullet) End-diastolic Left Ventricular Volume EDV(ml) = 5/6×LVLd
apical(cm)×LVAd sax MV(cm2)
ESV(Bullet) End-systolic Left Ventricular Volume ESV(ml) = 5/6×LVLs
apical(cm)×LVAs sax MV(cm2)
EDV End-diastolic Left Ventricular Volume EDV Index=EDV/BSA
Index(Bullet) Index
ESV End-systolic Left Ventricular Volume ESV Index=ESV/BSA
Index(Bullet) Index
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SV(Bullet) Stroke Volume see “5.4.1 Left Ventricular
Function”
CO(Bullet) Cardiac Output
EF(Bullet) Ejection Fraction
SI(Bullet) SV Index
CI(Bullet) CO Index

1. Select [Bullet] in the measurement menu.
In apical long-axis view, measure the following parameters:
– At end diastole: LVLd apical
– At end systole: LVLs apical.
– At end diastole: LVAd sax MV, the EDV is calculated
– At end systole: LVAs sax MV, the ESV is calculated
calculated.
Mod.Simpson
Study Items:

LVLd apical Left Ventricular Long-axis Length at End- Distance in 2D General
diastole in apical view Measurements
LVLs apical Left Ventricular Long-axis Length at End-
LVAd sax Left Ventricular Area at Mitral Valve level at Area in 2D General measurements
MV End-diastole in Short-axis view
LVAs sax Left Ventricular Area at Mitral Valve level at
MV End-systole in Short-axis view
LVAd sax Left Ventricular Area at Papillary Muscle
PM level at end-diastole in short axis view
LVAs sax Left Ventricular Area at Papillary Muscle
PM level at end-systole in short axis view
measurement or entered directly
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Study Results:

EDV(Mod.Simpson) End-diastolic Left Ventricular Volume *1
ESV(Mod.Simpson) End-systolic Left Ventricular Volume *2
EDV In- End-diastolic Left Ventricular Volume EDV Index=EDV/BSA
dex(Mod.Simpson) Index
ESV In- End-systolic Left Ventricular Volume ESV Index=ESV/BSA
dex(Mod.Simpson) Index
SV(Mod.Simpson) Stroke Volume see “5.4.1 Left Ventricular
Function”
CO(Mod.Simpson) Cardiac Output
EF(Mod.Simpson) Ejection Fraction
SI(Mod.Simpson) SV Index
CI(Mod.Simpson) CO Index
*1 means:
*2 means:

1. Select [Mod.Simpson] in the measurement menu.
2. In apical long-axis view, measure the following parameters:
– At end diastole: LVLd apical
– At end systole: LVLs apical
– At end diastole: LVAd sax MV
– At end systole: LVAs sax MV
4. In short-axis view at papillary muscle level, measure the following parameters:
– At end diastole: LVAd sax PM, the EDV is calculated
– At end systole: LVAs sax PM, the ESV is calculated
calculated.
Simpson
You may select to measure single plane (A2C or A4C) only or both planes (A2C and A4C) to study.
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Study Items:

A2Cd Left ventricular long-axis length at end diastole Simpson measurement (Trace/
in A2C view Spline/Auto)
A2Cs Left ventricular long-axis length at end systole
in A2C view
A4Cd Left ventricular long-axis length at end diastole
in A4C view
A4Cs Left ventricular long-axis length at end systole
in A4C view
measurements or entered directly
Study Results:

EDV(A2C/ End-diastolic Left Ventricular
A4C) Volume (A2C/A4C)
LVLd apical: Left Ventricular Long-axis Length at
End-diastole in apical view, i.e. the long-axis length
obtained in measurement.
: Radii obtained from diastolic measurement
EDV (BP) End-diastolic Left Ventricular *1
Volume (BP)
ESV(A2C/ End-systolic Left Ventricular
A4C) Volume (A2C/A4C)
LVLs apical: Left Ventricular Long-axis Length at
End-systole in apical view, i.e. the long-axis length
obtained in measurement.
: Radii obtained from systolic measurement
ESV (BP) End-systolic Left Ventricular *2
Volume (BP)
EDV Index End-diastolic Left Ventricular EDV Index=EDV/BSA
(A2C/A4C/ Volume Index (A2C/A4C/BP)
BP)
ESV Index End-systolic Left Ventricular ESV Index=ESV/BSA
(A2C/A4C/ Volume Index (A2C/A4C/BP)
BP)
SV Stroke Volume see “5.4.1 Left Ventricular Function”
CO Cardiac Output
EF Ejection Fraction
SI SV Index
CI CO Index
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*1 means:
*2 means:
Calculate the LV volume on the apical 2-chamber view image:
Calculate the LV volume on the apical 4-chamber view image:
Where
– Left ventricular long-axis length at end diastole at apical two-chamber view, which is the
long-axis length obtained by EDV (A2C) measurement
– Left ventricular long-axis length at end diastole at apical four-chamber view, which is the
long-axis length obtained by EDV (A4C) measurement
– Left ventricular long-axis length at end systole at apical two-chamber view, which is the
long-axis length obtained by ESV (A2C) measurement
–Left ventricular long-axis length at end systole at apical four-chamber view, which is the
long-axis length obtained by ESV (A4C) measurement
– Radii obtained by EDV (A2C) or ESV (A2C) at apical two-chamber view
– Radii obtained by EDV (A4C) or ESV (A4C) at apical four-chamber view
Simpson: Simpson single plane measurement (measure apical A2C or A4C only)
1. Select [Simpson] in the measurement menu.
2. Measure the endocardium.
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The endocardium can be measured using trace, spline or auto, click items on the menu to select
the method.
Methods Operations
Trace Trace the endocardium along the edge of the target area using a method
similar to Trace method in 2D Area measurements, then set the long
axis.
Spline Set reference points (up to 12) along the edge of the endocardium using
a method similar to Spline method in 2D Area measurements, then set
the long axis.
Auto Follow the steps below:
1. Set points A and B using the trackball/trackpad and <Set> key,
where
A: Left ventricular interventricular septal and mitral valve junction;
B: Left ventricular wall and mitral valve junction;
2. After setting A and B, the cursor will be automatically displayed at
point D (where is considered as the apical part by system detecting).
After point D is set, the long axis (line segment CD) and the line that
traces the endocardium are displayed. Where
C: Midpoint of A and B.
D: Apical part of left ventricle.
3. You can do the following operations:

Adjust the long axis: Move the cursor on the long axis (which turns
yellow), then press <Set>; Move the cursor to adjust point D (with
point C unchanged) after the cursor changes to .
Adjust the trace line: Move the cursor to position the cursor on the
trace line (which turns yellow), and then press <Set>; Move the
cursor along the endocardium edge to adjust the line after the cursor
changes to .
4. Press <Set> outside the line to confirm the adjustment.
– Measure the left ventricular endocardium at end-diastolic and set the long axis, the EDV
is obtained.
– Measure the left ventricular endocardium at end-systolic and set the long axis, the ESV is
obtained.
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calculated.
3. Use the menu to select the HR source: ECG, HR (R-R) measurement or entered.
Simpson: Simpson Bi-plane measurement
CAUTION
When using Simpson to measure LV function, be sure to keep the apical four-
chamber view and apical two-chamber view perpendicular. Otherwise the
measurement result will be incorrect.

1. Select [Simpson] in the measurement menu.
2. In apical two-chamber view, measure the following parameters:
– Left ventricular endocardium at end-diastolic and set the long axis, the EDV(A2C) is
obtained
– Left ventricular endocardium at end-systolic and set the long axis, the ESV(A2C) is
obtained
3. In apical four-chamber view, measure the following parameters:
– Left ventricular endocardium at end-diastolic and set the long axis, the EDV(A4C) is
obtained
– Left ventricular endocardium at end-systolic and set the long axis, the ESV(A4C) is
obtained
If the height and weight have already been entered, the SV, EF, SI, EDV Index and ESV Index
are calculated.
4. Use the touch screen to select the HR source: ECG, HR(R-R) measurement or entered.
LV (2D)
Study Items:

Diastole End-diastolic Left Ventricular FoldLine in 2D mode
Measurement Parallel method in M mode
Measurement
LVIDd Left Ventricular Internal Distance in 2D/M General
Diameter at End-diastole measurements
LVIDs Left Ventricular Internal
Diameter at End-systole
measurements or entered directly
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Study Results:

IVSd Interventricular Septal Thickness at End- Distance in 2D/M General
diastole Measurements
LVPWd Left Ventricular Posterior Wall Thickness at
End-diastole
IVSs Interventricular Septal Thickness at End-
systole
LVPWs Left Ventricular Posterior Wall Thickness at
End-systole
EDV End-diastolic Left Ventricular Volume EDV(ml)= LVIDd(cm)3
ESV End-systolic Left Ventricular Volume ESV(ml)= LVIDs(cm)3
EDV Index End-diastolic Left Ventricular Volume EDV Index=EDV/BSA
ESV Index End-systolic Left Ventricular Volume ESV Index=ESV/BSA
SV Stroke Volume see “5.4.1 Left Ventricular Function”
CO Cardiac Output
EF Ejection Fraction
FS Fractional Shortening
MVCF Mean Velocity of Circumferential Fiber
Shortening
SI SV Index
CI CO Index
TIP:
• In the [Setup] > [System] > [Application] screen, you can set the method for the Cube/
Teichholz/HR study.
• Click [Property] in [Setup] > [Measure] to select formula for LV measurement by selecting
result items: Cube, Teichholz or Gibson.
Taking the method using LVIDd, LVIDs, HR as an example.

1. Select [LV (2D)] in the measurement menu.
2. Measure LVIDd in 2D or M mode.
The LVIDd and EDV are obtained.
3. Measure the LVIDs in 2D or M mode.
– The LVIDs and ESV are obtained.
– The system calculates the SV, EF and FS.
4. Using the menu to select the HR source: ECG, HR(R-R) measurement or entered.
If the height and weight have already been entered, the SI, CO, CI, EDV Index and ESV Index
are calculated.
The MVCF is calculated if the LVET is measured.
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5.4.2 Left Ventricular Mass (LV Mass)

Estimates the Index of Left Ventricular Mass (LV Mass-I) by calculating the LV Mass.
LV MASS-I (No unit) = LV Mass (g) / Body Surface Area (m2)
LV Mass (Cube)
Study Items:

IVSd Interventricular Septal Thickness at End-diastole Distance in 2D/M
General
LVIDd Left Ventricular Internal Diameter at End-diastole
Measurements
LVPWd Left Ventricular Posterior Wall Thickness at End-diastole
Study Results:

LV Mass (Cube) Left Ventricular Mass LV Mass (g) = 1.04 × ((LVPWd(cm) +
IVSd(cm) + LVIDd(cm))3 - LVIDd(cm)3) -
13.6
LV MASS-I Index of Left Ventricular LV MASS-I (No unit) = LV Mass(g) / Body
(Cube) Mass Surface Area(m2)

1. Select [LV Mass (Cube)] in the measurement menu.
2. At end diastole, measure the following parameters:
– IVSd
– LVIDd
– LVPWd
The LV Mass (Cube) is calculated.
If the height and weight have already been entered, the LV Mass-I(Cube) is calculated.
LV Mass (A-L)
Study Items:

LVAd sax Epi Left Ventricular Epicardial Area at Papillary Muscle Area in 2D General
level at end-diastole in Short-axis view Measurements
LVAd sax Left Ventricular Endocardial Area at Papillary Muscle
Endo level at end-diastole in Short-axis view
LVLd apical Left Ventricular Long-axis Length at End-diastole in Distance in 2D General
apical view Measurements
Study Results:

LV Mass (A-L) Left Ventricular Mass *1
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LV MASS-I (A- Index of Left Ventric-ular LV MASS-I (No unit) = LV Mass(g) / Body
L) Mass Surface Area(m2)
*1 means:
Where

1. Select [LV Mass (A-L)] in the measurement menu.
2. In long-axis view at end diastole, measure the LVLd apical.
3. In short-axis view at papillary muscle level at end diastole, measure the following parameters:
– Endocardium area: LVAd sax Endo
– Epicardium area: LVAd sax Epi
The LV Mass (A-L) is calculated.
If the height and weight have already been entered, the LV Mass-I(A-L) is calculated.
LV Mass (T-E)
Study Items:

LVAd sax Epi Left Ventricular Epicardial Area at Papillary Muscle Area in 2D General
level at end-diastole in Short-axis view measurements
LVAd sax Left Ventricular Endocardial Area at Papillary Muscle
Endo level at end-diastole in Short-axis view
a Semi-major axis from widest minor axis radius to apex Distance in 2D General
Measurements
d Truncated semi-major axis from widest minor axis
radius to mitral annulus plane
Except for the values in the upper table, the following results can be obtained in this study:

LV Mass (T-E) Left Ventricular Mass *1
LV MASS-I (T-E) Index of Left Ventric-ular LV MASS-I (No unit) = LV Mass(g) / Body
Mass Surface Area(m2)
*1 means:
Where units of a, b, d, t are cm.
5 Cardiology
• a: Semi-major axis from widest minor axis radius to apex

• d: Truncated semi-major axis from widest minor axis radius to mitral annulus plane
• t: Thickness of the myocardium
• b: Short axis radius, usually measured where the radius is largest.

1. Select [LV Mass (T-E)] in the measurement menu.
2. In short-axis view at papillary muscle level at end diastole, measure the following parameters:
– Endocardium area: LVAd sax Endo
– Epicardium area LVAd sax Epi
3. Measure a and d.
The LV Mass (T-E) is calculated.
If the height and weight have already been entered, the LV Mass-I(T-E) is calculated.
5.4.3 Mitral Valve Area (MVA)

The Mitral Valve Area (MVA) can be calculated using two methods: pressure half time (PHT) or
velocity-time integral (VTI).
The MVA Calculation by PHT method should be performed in CW mode.
MVA (PHT) (cm2) = 220 / MV PHT (ms)
Study Items:

LVOT Left Ventricular Outflow Tract Diameter Distance in 2D General
Diam. Measurements
LVOT VTI Left Ventricular Outflow Tract Velocity-Time D trace in General D measurements
Integral
MV VTI Mitral Valve Velocity-Time Integral

MVA(VTI) Mitral Valve Area
See the table above for methods and formulae for the measurement items.
5.4.4 AVA (VTI)

The Aortic Valve Area (AVA) can be calculated by velocity-time integral (VTI). The
measurements should be performed on 2D and Doppler images
5 Cardiology
Study Items:

LVOT Diam. Left Ventricular Outflow Tract Diameter Distance in 2D General
Measurements
LVOT VTI Left Ventricular Outflow Tract Velocity-Time D trace in General D
Integral measurements
AV VTI Aortic Valve Velocity-Time Integral

AVA(VTI) Aortic Valve Area
5.4.5 LA Vol
LA Vol. (Left Atrium Volume) used to estimate the size of the left atrium.
LA Vol(A-L)
Estimates the Left Atrium Volume using area and length.
Study Items:

LA apical Left Atrium Diameter Distance in 2D General
Measurements
LAA(A2C) Left Atrium Area at apical 2-chamber view Area in 2D General Measurements
LAA(A4C) Left Atrium Area at apical 4-chamber view

LA Left Atrium
Vol(A-L) Area
LA Vol Left Atrium LA Vol Index= LA Vol/ BSA

Index (A- Area
L)
LA Vol (Simp)
Estimates the left atrium volume using the Simpson method. Performed at apical two-chamber view
and apical four-chamber view.
5 Cardiology
Study Items and Results:

LA Vol.(A2C) Left Atrium Volume at apical 2-chamber Same as the Simpson SP
view measurement
LA Vol.(A4C) Left Atrium Volume at apical 4-chamber
view
LA Vol. Index Left Atrium Volume Index LA Vol. Index = LA Vol./BSA
(A2C/A4C)
5.4.6 LV Tei Index

The LVIMP (Left Ventricular Index of Myocardial Performance) is used to analyze the integrative
ventricular diastolic and systolic capabilities.
Study Items:

MV C-O Dur. Mitral Valve Close-Open Duration Time in M/Doppler General
Measurements
LVET Left Ventricular Ejection Time

LV Tei Index Left Ventricular Index of
Myocardial Performance
5.4.7 RVSP (Right Ventricular Systolic Pressure)

The RVSP measures the right ventricular systolic pressure.
Study Items:

TR Vmax Tricuspid Valve Regurgitation Maximum D Vel. in Doppler General
RAP Right Atrium Pressure See below

TR PGmax Tricuspid Valve TR PGmax (mmHg) = 4 × TR Vmax (m/s)2
Regurgitation Pressure
Gradient
RVSP Right Ventricular Systolic
Pressure
5 Cardiology
1. Select [RVSP] in the measurement menu.

2. Measure the TR Vmax in Doppler mode.
The TR PGmax is calculated.
3. Select [RAP] in the [RVSP] sub-menu and select (or enter) the pressure in the dialog box
which appears, as shown in the figure below:
The range of input values is [0, 50.0 mmHg].
4. Click [OK] after selecting (or entering) the pressure. The RAP is obtained.
RVSP is calculated.
5.4.8 PAEDP (Pulmonary Artery End Diastolic Pressure)

The PAEDP measures the pulmonary artery end diastolic pressure.
Study Items

PR Ved Pulmonary Valve Regurgitation Velocity D Vel. in Doppler General
at end-Diastole Measurements
RAP Right Atrium Pressure See RAP measurement in 5.4.7

PR PGed Pulmonary Valve /
Regurgitation Pressure
Gradient at end-Diastole
PAEDP Pulmonary Pressure at end-
Diastole
5.4.9 RVIMP (RV Tei Index)

The measurement of RVIMP (Right Ventricular Index of Myocardial Performance) is similar to
that of LVIMP.
Study Items:

TV C-O Dur. Tricuspid Valve Close-Open Duration Time in Doppler General Measurements
RVET Right Ventricular Ejection Time

RV Tei Index Right Ventricular
Index of Myocardial
Performance
5 Cardiology
5.4.10 Qp/Qs
Flow ratio of pulmonary circulation and systemic circulation.
Study Items:

RVOT Right Ventricular Outflow Tract Diameter Distance in 2D General
Diam. measurements
LVOT Left Ventricular Outflow Tract Diameter
Diam.
RVOT VTI Right Ventricular Outflow Tract Velocity-Time D Trace in Doppler General
LVOT VTI Left Ventricular Outflow Tract Velocity-Time
Integral
Item Description Operations

RVOT SV Right Ventricular Outflow Tract Stroke Volume Obtained from the RVOT
VTI measurement
RVOT CO Right Ventricular Outflow Tract Cardiac Output
RVOT SI Right Ventricular Outflow Tract SV Index
RVOT CI Right Ventricular Output Tract CO Index
RVOT Vmax Right Ventricular Outflow Tract Maximum Velocity
RVOT Vmean Right Ventricular Outflow Tract Minimum Average
Velocity
RVOT Right Ventricular Outflow Tract Maximum Pressure
PGmax Gradient
RVOT Right Ventricular Outflow Tract Average Pressure
PGmean Gradient
LVOT SV Left Ventricular Outflow Tract Stroke Volume Obtained from the LVOT
VTI measurement
LVOT SI Left Ventricular Outflow Tract SV Index
LVOT CO Left Ventricular Outflow Tract Cardiac Output
LVOT CI Left Ventricular Output Tract CO Index
LVOT Vmax Left Ventricular Outflow Tract Maximum Velocity
LVOT PGmax Left Ventricular Outflow Tract Maximum Pressure
Gradient
LVOT Vmean Left Ventricular Outflow Tract Average Velocity
LVOT Left Ventricular Outflow Tract Minimum Pressure
PGmean Gradient
Qp/Qs Flow ratio of Pulmonary circulation and Systemic *1
circulation
Qp-Qs Flow difference of Pulmonary circulation and
Systemic circulation
5 Cardiology
*1:
5.4.11 PISA
The PISA (Proximal Isovelocity Surface Area) is used in the quantitative analysis of the mitral
valve regurgitation (PISA MR), aortic valve regurgitation (PISA AR), tricuspid valve regurgitation
(PISA TR) and pulmonary valve regurgitation (PISA PR) in color mode.
The PISA measurement procedure is as follows:
1. Start PISA and move the semicircular caliper by using the trackball/trackpad.
2. Fix the center of the semicircular caliper by pressing <Set>.
3. Adjust the radius length orientation of the semicircular caliper by using the trackball/trackpad.
4. Press <Set> to fix the caliper.
PISA MR
Mitral valve regurgitation (PISA MR) needs to be measured in Color and Doppler modes.
Study Items:

MR Rad Mitral Valve Stenosis Radius PISA measurement
MR VTI Mitral Valve Regurgitation Velocity-Time D Trace in Doppler General
MR Mitral Valve Regurgitation Aliasing You can choose to use the top aliasing
Als.Vel. Maximum Velocity velocity or bottom aliasing velocity,
or enter the value directly.
Study Results:

MR Vmax Mitral Obtained from the MR VTI measurement
Regurgitation
Maximum Velocity
MR Flow Mitral
Regurgitation Flow
MR Flow Mitral
Rate Regurgitation Flow
Rate
5 Cardiology

MR Mitral Valve
Fraction Regurgitation
Fraction
MR Mitral Valve
EROA Effective
Regurgitant Orifice
Area

1. Enter color mode and adjust the color map until the aliasing appears.
2. Select [PISA MR] in the measurement menu.
3. Measure MR Rad using the PISA caliper.
Input MR Als.Vel.
4. Measure the MR spectrum using D trace to obtain:
– MR Vmax
– MR VTI
The MR Flow, MR Flow Rate and MR EROA are calculated automatically.
If the MV SV is measured, the MR Fraction will be calculated automatically.
PISA AR
Aortic valve regurgitation (PISA AR) needs to be measured in Color and Doppler modes.
Study Items:

AR Rad. Aortic Valve Stenosis Radius PISA measurement
AR VTI Aortic Valve Regurgitation Velocity- D Trace in Doppler General
Time Integral Measurements
AR Aortic Valve Regurgitation Aliasing You can choose to use the top aliasing
Als.Vel. Maximum Velocity velocity or bottom aliasing velocity, or
enter the value directly.
Study Results:

AR Vmax Aortic Obtained from the AR VTI measurement
Regurgitation
Maximum Velocity
AR Flow Aortic
Regurgitation Flow
AR Flow Aortic
Rate
5 Cardiology

AR Aortic Valve
Fraction Regurgitation
Fraction
AR EROA Aortic Valve
Effective
Regurgitant Orifice
Area
Operating procedures is the same as the PISA MR measurement.
PISA TR
Tricuspid valve regurgitation (PISA TR) needs to be measured in Color and Doppler modes.
Study Items:

TR Rad. Tricuspid Valve Stenosis Radius PISA measurement
TR VTI Tricuspid Valve Regurgitation Velocity- D Trace in Doppler General
TR Als.Vel. Tricuspid Valve Regurgitation Aliasing You can choose to use the top aliasing
Maximum Velocity velocity or bottom aliasing velocity, or
Study Results:

TR Vmax Tricuspid Obtained from TR VTI measurement
Regurgitation
Maximum Velocity
TR Flow Tricuspid
Regurgitation Flow
TR Flow Tricuspid
Rate
TR Fraction Tricuspid Valve
Regurgitation
Fraction
TR EROA Tricuspid Valve
Effective
Regurgitant Orifice
Area
Operating procedures are the same as the PISA MR measurement.
PISA PR
Pulmonary valve regurgitation (PISA PR) needs to be measured in Color and Doppler modes.
5 Cardiology
Study Items:

PR Rad. Pulmonary Valve Stenosis Radius PISA measurement
PR VTI Pulmonary Valve Regurgitation Velocity- D Trace in Doppler General
PR Pulmonary Valve Regurgitation Aliasing You can choose to use the top aliasing
Als.Vel. Maximum Velocity velocity or bottom aliasing velocity, or
Study Results:

PR Vmax Pulmonary Obtained from PR VTI measurement
Regurgitation
Maximum Velocity
PR Flow Pulmonary
Regurgitation Flow
PR Flow Pulmonary
Rate
PR Fraction Pulmonary Valve
Regurgitation
Fraction
PR EROA Pulmonary Valve
Effective
Regurgitant Orifice
Area
Operating procedures are the same as the PISA MR measurement.
5.4.12 TDI Mode

Study Items:

MV Sa(medial) Mitral Valve medial Systolic motion D Vel. in Doppler General
Measurements
MV Ea(medial) Mitral Valve medial Early diastolic
motion
MV Aa(medial) Mitral Valve medial Late diastolic
motion
MV Mitral Valve medial Acceleration Rate Acceleration in Doppler General
ARa(medial) Measurements
MV Mitral Valve medial Deceleration Rate
DRa(medial)
5 Cardiology

MV Sa(lateral) Mitral Valve lateral Systolic motion D Vel. in Doppler General
Measurements
MV Ea(lateral) Mitral Valve lateral Early diastolic
motion
MV Aa(lateral) Mitral Valve lateral Late diastolic motion
MV ARa(lateral) Mitral Valve lateral Acceleration Rate Acceleration in Doppler General
Measurements
MV DRa(lateral) Mitral Valve lateral Deceleration Rate
Study Results:

MV Ea/Aa(medial) MV medial E-Vel./A-Vel.
ATa(medial) MV medial E-wave Obtained from the ARa(medial)

Acceleration Time measurement
DTa(medial) MV medial E-wave Obtained from the DRa(medial)
Deceleration Time measurement
MV Ea/Aa(lateral) MV lateral E-Vel./A-Vel.
MV E/Ea(medial) Used to estimate the diastolic Calculate after measuring MV E Vel and MV
function of left ventricular Ea(medial):
MV E/Ea(lateral) Calculate after measuring MV E Vel and MV

Ea(lateral):
MV E/ Calculate after measuring MV E Vel, MV

Ea(medial+lateral) Ea(medial) and MV Ea(lateral)
ATa(lateral) MV lateral E-wave Obtained from the ARa(lateral) measurement

Acceleration Time
DTa(lateral) MV lateral E-wave Obtained from the DRa(lateral) measurement
Deceleration Time
5 Cardiology
5.5 References
Body Surface Are (BSA)
DuBois, D., DuBois, E.F., “A Formula to Estimate the Approximate Surface Area if Height and
Weight Be Known,” Nutrition, Sept-Oct 1989, Vol. 5, No. 5, pp. 303-313.
EDV(S-P Ellipse)
Folland, E.D., et al., “Assessment of Left Ventricular Ejection Fraction and Volumes by Real-
Time, Two-Dimensional Echocardiography,” Circulation, October 1979, Vol. 60, No.4, pp. 760-
766
ESV(S-P Ellipse)
766.
Stroke Volume (SV)

Gorge, G., et al., “High Resolution Two-dimensional Echocardiography Improves the
Quantification of Left Ventricular Function”, Journal of the American Society of
Echocardiography, 1992, 5: 125-34.
Roelandt, Joseph, Practical Echocardiology, vol. 1 of Ultrasound in Medicine Series, ed. Denis
White, Research Studies Press, 1977, p. 124.
Ejection Fraction (EF)

Pombo, J.F., “Left Ventricular Volumes and Ejection by Echocardiography,” Circulation, 1971,
Vol. 43, pp. 480-490.
Stroke Volume Index (SI)

Gorge, G., et al., “High Resolution Two-dimensional Echocardiography Improves the
Quantification of Left Ventricular Function”, Journal of the American Society of
Echocardiography, 1992, 5: 125-34.
Roelandt, Joseph, Practical Echocardiology, vol. 1 of Ultrasound in Medicine Series, ed. Denis
White, Research Studies Press, 1977, p. 124.
Cardiac Output (CO)

Belenkie, Israel, et al., “Assessment of Left Ventricular Dimensions and Function by
Echocardiography,” American Journal of Cardiology, June 1973, Vol. 31
Cardiac output Index (CI)

The Merck Manual of Diagnosis and Therapy, ed. 15, Robert Berkon, ed., Merck and Co., Rahway,
NJ, 1987, p. 378.
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.
EDV(B-P Ellipse)
766
5 Cardiology
ESV(B-P Ellipse)
766
EDV (Bullet)
766
ESV (Bullet)
766
EDV (Simpson)
Weyman, Arthur E., Cross-Sectional Echocardiography, Lea & Febiger, 1985, p. 295.Folland, E.D.,
et al., “Assessment of Left Ventricular Ejection Fraction and Volumes by Real-Time, Two-
Dimensional Echocardiography,” Circulation, October 1979, Vol. 60, No.4, pp. 760-766
ESV (Simpson)
Weyman, Arthur E., Cross-Sectional Echocardiography, Lea & Febiger, 1985, p. 295.Folland, E.D.,
et al., “Assessment of Left Ventricular Ejection Fraction and Volumes by Real-Time, Two-
Dimensional Echocardiography,” Circulation, October 1979, Vol. 60, No.4, pp. 760-766
EDV (Simpson SP)

Echocardiography,” Journal of the American Society of Echocardiography, Sept-Oct 1989, Vol.2,
No. 5, p. 364
ESV (Simpson SP)

No. 5, p. 364
EDV (Simpson BP)

No. 5, p. 364
ESV (Simpson BP)

No. 5, p. 364
EDV (Cube)
Dodge, H.T., Sandler, D.W., et al., “The Use of Biplane Angiography for the Measurement of Left
Ventricular Volume in Man,” American Heart Journal, 1960, Vol. 60, pp. 762-776.
Echocardiography,” American Journal of Cardiology, June 1973, pg. 31.
5 Cardiology
ESV (Cube)
Dodge, H.T., Sandler, D.W., et al., “The Use of Biplane Angiography for the Measurement of Left
Ventricular Volume in Man,” American Heart Journal, 1960, Vol. 60, pp. 762-776.
Echocardiography,” American Journal of Cardiology, June 1973, pg. 31.
Fractional Shortening (FS)

Echocardiography,” American Journal of Cardiology, June 1973, Vol. 31.
MVCF
Colan, S.D., Borow, K.M., Neumann, A., “Left Ventricular End-Systolic Wall Stress-Velocity of
Fiber Shortening Relation: A Load-Independent Index of Myocardial Contractility,” J Amer Coll
Cardiol, October, 1984, Vol. 4, No. 4,pp. 715-724.
Snider, A.R., Serwer, G.A., Echocardiography in Pediatric Heart Disease, Year Book Medical
Publishers, Inc., Littleton, MA, 1990, p. 83.
Teichholz
Teichholz, L.E., et al., “Problems in Echocardiographic Volume Determinations:
Echocardiographic-Angiographic Correlations in the Presence or Absence of Asynergy,” American
Journal of Cardiology, January 1976, Vol. 37, pp. 7-11
LVMW
John H. Phillips, “Practical Quantitative Doppler Echocardiography”, CRC Press, 1991, Page 96.
LV MASS-I
John H. Phillips, “Practical Quantitative Doppler Echocardiography”, CRC Press, 1991, Page 96.
LA/Ao
Roelandt, Joseph, Practical Echocardiology, Ultrasound in Medicine Series, Vol. 1,Denis White,
ed., Research Studies Press, 1977, p. 270.
Echocardiography,” J Am Soc Echo, Sept-Oct, 1989, Vol. 2, No. 5,p. 364.
MV CA/CE
Maron, Barry J., et al., Noninvasive Assessment of Left Ventricular Diastolic Function by Pulsed
Doppler Echocardiography in Patients with Hypertrophic
Cardiomyopathy, J Am Coll Cardio, 1987, Vol. 10, pp. 733-742.
MV E/A
Maron, Barry J., et al., “Noninvasive Assessment of Left Ventricular Diastolic Function by Pulsed
Doppler Echocardiography in Patients with Hypertrophic Cardiomyopathy,” Journal of the
American College of Cardiology, 1987, Vol. 10, pp. 733-742.
Pressure Half Time (PHT)

Oh, J.K., Seward, J.B., Tajik, A.J. The Echo Manual. Boston: Little, Brown and Company, 1994,
p.59-60
Mitral valve area

Goldberg, Barry B., Kurtz, Alfred B., Atlas of Ultrasound Measurements, Year Book Medical
Publishers, Inc., 1990, p. 65.
5 Cardiology
Stamm, R. Brad, et al., “Quantification of Pressure Gradients Across Stenotic Valves by Doppler
Ultrasound,” J Am Coll Cardiol, 1983, Vol. 2, No. 4,pp. 707-718.
Right Ventricular Systolic Pressure

Stevenson, J.G., “Comparison of Several Noninvasive Methods for Estimation of Pulmonary
Artery Pressure,” Journal of the American Society of Echocardiography, June 1989, Vol. 2, pp.
157-171.
Yock, Paul G. and Popp, Richard L., “Noninvasive Estimation of Right Ventricular Systolic
Pressure by Doppler Ultrasound in Patients with Tricuspid Regurgitation,” Circulation, 1984, Vol.
70, No. 4, pp. 657-662.
E/Ea
Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography
2009 Published by Elsevier Inc. on behalf of the American Society of Echocardiography.
LVIDd/LVPWd
“Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An
Update from the American Society of Echocardiography and the European Association of
Cardiovascular Imaging” J Am Soc Echocardiogr 2015;28:1-39.
Cantinotti M;Scalese M; Murzi B;Assanta N;Spadoni I;Festa P;De Lucia V; Crocetti M;Marotta
M;Molinaro S;Lopez L;Iervasi G. Echocardiographic nomograms for ventricular, valvular and
arterial dimensions in caucasian children with a special focus on neonates, infants and toddlers. J
Am Soc Echocardiogr 2014; 27: 179-191 (e2).
Cantinotti M, Scalese M, Murzi B, Assanta N, Spadoni I, et al. Echocardiographic Nomograms for
Chamber Diameters and Areas in Caucasian Children. J Am Soc Echocardiogr 2014; 27: 1279-
1292 (e2).
6 Vascular
Vascular measurements are mainly used for carotid, cerebral, upper and lower extremity vessels.
The system supports the following 2D and Doppler vascular measurements.

– For measurement tools, see “6.2 Measurement Tools”.
completed.
6.2 Measurement Tools

6.2.1 2D Mode
Measurement

CCA IMT Common Carotid Artery IMT ROI measurement in IMT
Bulb IMT Bulbillate IMT
ICA IMT Internal Carotid Artery IMT
ECA IMT External Carotid Artery IMT
Calculation

Stenosis D Stenosis Diameter Stenosis D (No unit) = (Normal Diam. (cm) – Resid
Diam. (cm)) / Normal Diam. (cm) × 100%
Stenosis D (No unit) = | (D1-D2) / MAX (D1,
D2)|*100%
Where D1 and D2 refer to the measured vascular
diameter, and MAX (D1, D2) represents the larger
value of the two.

6 Vascular

Stenosis A Stenosis Area Stenosis A (No unit) = | (A1-A2) / MAX (A1, A2)
|*100%
Where A1 and A2 refer to the measured vascular area,
and MAX (A1, A2) represents the larger value of the
two.
Study

IMT Intima-Media see “6.3.1 IMT”
Thickness
Stenosis A / Stenosis (No unit) = |(A1-A2)/ MAX(A1,A2)|*100%
Where A1 and A2 refer to the measured vascular area, and
MAX (A1, A2) represents the larger value of the two.
You may select different method for the two area
measurement.
6.2.2 Doppler Mode

Measurement

CCA Common Carotid Artery D trace in General D
measurements
Bulb Bulbillate
ICA Internal Carotid Artery
ECA External Carotid Artery
Vert. A Vertebral Artery
Innom. A Innominate Artery
Subclav. A Subclavian Artery
Axill. A Axillary Artery D trace in General D
measurements
Brachial A Brachial Artery
Ulnar A Ulnar Artery
Radial A Radial Artery
Subclav. A Subclavian Artery
Axill. V Axillary Vein

6 Vascular

Cephalic V Cephalic Vein D trace in General D
measurements
Basilic V Basilic Vein
Ulnar V Ulnar Vein
Radial V Radial Vein
C.Iliac A Common Iliac Artery
Ex.Iliac A External Iliac Artery
CFA Common Femoral Artery
SFA Superficial Femoral Artery
Pop. A Popliteal Artery
TP Trunk A Tibial Peroneal Trunk Artery
Peroneal A Peroneal Artery
P.Tib. A Posterior Tibial Artery
A.Tib. A Anterior Tibial Artery
Dors.Ped. A Dorsalis Pedis Artery
C.Iliac V Common Iliac Vein
Ex.Iliac V External Iliac Vein
Femoral V Femoral Vein
Saph. V Great Saphenous Vein
Pop. V Popliteal Vein
TP Trunk V Tibial Peroneal Trunk Vein
Sural V Sural Vein
Soleal V Soleal Vein
Peroneal V Peroneal Vein
P.Tib. V Posterior Tibial Vein
A.Tib. V Anterior Tibial Vein
ACA Anterior Cerebral Artery
MCA Middle Cerebral Artery
PCA Posterior Cerebral Artery
AComA Ant.communicating br.
PComA Post.communicating br.
BA Basilar Artery

6 Vascular

IIA Internal Iliac Artery D trace in General D
measurements
DFA Deep Femoral Artery
Ba V Basilar Vein
Brachial V Brachial Vein
IIV Internal Iliac Vein
CFV Common Femoral Vein
SFV Superficial Femoral Vein
DFV Deep Femoral Vein
SSV Small Saphenous Vein
C.Iliac V Reflux Common Iliac Vein Reflux Time in General D
measurements
Ex.Iliac V Reflux External Iliac Vein Reflux
Femoral V Reflux Femoral Vein Reflux
Saph. V Reflux Great Saphenous Vein Reflux
Pop. V Reflux Popliteal Vein Reflux
TP Trunk V Reflux Tibial Peroneal Trunk Vein Reflux
Sural V Reflux Sural Vein Reflux
Soleal V Reflux Soleal Vein Reflux
Peroneal V Reflux Peroneal Vein Reflux
P.Tib. V Reflux Posterior Tibial Vein Reflux
A.Tib. V Reflux Anterior Tibial Vein Reflux
IIV Reflux Internal Iliac Vein Reflux
CFV Reflux Common Femoral Vein Reflux
SFV Reflux Superficial Femoral Vein Reflux
DFV Reflux Deep Femoral Vein Reflux
SSV Reflux Small Saphenous Vein Reflux
ASP Ankle Systolic Pressure Type in
BSP Brachial Systolic Pressure

6 Vascular
Calculation
Tool Method or formulae

ICA/CCA(PS) Measure the flow velocity ratio between ICA and CCA
to calculate the stenosis.
1. Select [ICA/CCA (PS)] in the measurement menu.
2. Measure the PS value of the ICA and CCA using the
2 PT method in D trace, and the system calculates the
stenosis.
Where, the ICA value adopts the maximum PS value
of proximal, middle and distal and the CCA adopts
the latest measured value after changing the Prox./
Mid./Dist. attribute (the default CCA adopts the distal
PS value).
Study
Tool Methods or formulae

ABI see “6.3.2 ABI”
6.3 Study Tool Operations

6.3.1 IMT
NOTE:
• The IMT function is unavailable on the product not configured with IMT.
• The IMT measurement is available on frozen (or history) linear array images only.
TIP:
• Make sure that you select the correct vessel wall (Near/Far) before the IMT measurement.
Otherwise the intima may be recognized incorrectly due to different algorithms that are applied
in near/far wall recognition.
• To achieve a good trace result, try to place the ROI box parallel with the vessel and adjust the
box size to reduce unwanted interference.
IMT (Intima-Media Thickness) measures the distance between LI (Lumen-Intima) and MA

(Media-Adventia).
The IMT values at 4 positions: CCA (Common Carotid Artery), ICA (Internal Carotid Artery),
ECA (External Carotid Artery) and Bulb (Bulbillate) need to be measured here.
1. Enter the IMT exam mode, scan and freeze the image (or review a historic image).
2. Select [IMT] in the measurement menu and enter the IMT measurement.
3. Select the side (Left/Right), angle and vessel wall (Near/Far).

6 Vascular
4. Select an item such as [ICC, IMT], and the ROI box displays on the screen.
– It appears as when Near is selected
– It appears as when Far is selected
5. Move the ROI box to the desired position, then press <Set>. Two auto trace lines appear in the
box.
While the ROI box is green, you can:
– Adjust the size of the ROI box.
– Trace manually
Move the cursor to a trace line. The trace line turns yellow. Press <Set>.
Move the cursor along the interface of the vessel. Press <Set> to confirm the trace after
re-adjusting.
– Erase the trace lines inside the box by pressing <Clear>. (Long press <Clear> to clear all
measurement calipers on the screen.)
6. Press <Set> outside the box to confirm the adjustment result after the manual trace is
complete. The results are recorded in the IMT report.
The system calculates:
– IMT Max.
– IMT Min.
– IMT Mean
– IMT SD
– IMT ROI Length
– IMT Measure Length
– IMT Quality Index
The Quality Index indicates the reliability of one measurement. Manual trace or re-scan of an
image with clear endocardium edges is recommended if the Quality Index value is small.
For multiple measurements on the same side, vessel and angle, the system calculates the
following parameters in the report:
– Average Mean IMT
– Average Max IMT
– Standard deviation
It also provides the Composite Mean IMT, which is an overall mean value of all IMT mean
values derived from the measured items.
6.3.2 ABI
Calculate the Ankle Brachial Index (ABI) by measuring the Ankle Systolic Pressure (ASP) and the
Brachial Systolic Pressure (BSP) on a Doppler image.
ABI = ASP/BSP
TIP:
The left and right sides respectively need to be measured.

1. Select [ABI] in the measurement menu.
2. Click [ASP] from the [ABI] menu and enter the value.

6 Vascular
3. Click [BSP] from the [ABI] menu and enter the value.
4. The ABI is calculated by the system automatically.
6.4 References
Stenosis D
Honda, Nobuo, et al., “Echo-Doppler Velocimeter in the Diagnosis of Hypertensive Patients: The
Renal Artery Doppler Technique,” Ultrasound in Medicine and Biology, 1986, Vol. 12(12), pp.
945-952.
Stenosis A
Jacobs, Norman M., et al., “Duplex Carotid Sonography: Criteria for Stenosis,Accuracy,and
Pitfalls,” Radiology, 1985, 154:385-391.

7 Urology

– For measurement tools, see “7.2 Urology Measurement Tools”.
The system calculates and displays the results after the measurement tools have been completed.
7.2 Urology Measurement Tools

7.2.1 2D Mode
Measurement

Renal L Renal Length Distance in 2D General measurements
Renal H Renal Height
Renal W Renal Width
Cortex Renal Cortical Thickness
Adrenal L Adrenal Length
Adrenal H Adrenal Height
Adrenal W Adrenal Width
Prostate L Prostate Length
Prostate H Prostate Height
Prostate W Prostate Width
Seminal L Seminal Vesicle Length
Seminal H Seminal Vesicle Height
Seminal W Seminal Vesicle Width
Testis L Testicular Length
Testis H Testicular Height
Testis W Testicular Width

7 Urology

Ureter / Distance in 2D General measurements
Pre-BL L Pre-void Bladder Length
Pre-BL H Pre-void Bladder Height
Pre-BL W Pre-void Bladder Width
Post-BL L Post-void Bladder Length
Post-BL H Post-void Bladder Height
Post-BL W Post-void Bladder Width
Renal Cyst1-3 d1-3 /
Renal Lesion1-3 d1- /
3
Prostate Mass1 d1-3 /
Testis Mass1 d1-3 /
Testis Mass2 d1-3 /
Testis Mass3 d1-3 /
Epididymis L Epididymis Length
Epididymis W Epididymis Width
Epididymis H Epididymis Height
Scrotal Wall /
Thickness
Calculation

Renal Vol. Renal Volume Renal L, Renal H, Renal W
NOTE:
Needs to be measured on the left and right sides
respectively.
Prostate Vol. Prostate Volume Prostate L, Prostate H and Prostate W
If [Serum PSA] in [Patient Info] > [URO] has been
entered, PSAD (Prostate Special Antigen Density) will also
be calculated.
• PPSA (ng/ml) = PPSA Coefficient (ng/ml2) × Prostate
Vol (ml)
• PSAD (ng/ml2) = Serum PSA (ng/ml) / Prostate Vol.
(ml)
Here, the PPSA Coefficient and Serum PSA are entered in
the [Patient Info] > [URO] dialog box. The default value of
the PPSA Coefficient is 0.12.

7 Urology

Testicular Vol. Testicular Testis L, Testis H, Testis W
Volume
NOTE:
respectively.
Pre-BL Vol. Pre-void Bladder Pre-BL L, Pre-BL H, Pre-BL W
Volume The Mictur.Vol is displayed in the report if the Post-BL Vol
is measured.
Post-BL Vol. Post-void Post-BL L, Post-BL H, Post-BL W
Bladder Volume The Mictur.Vol is displayed in the report if the Pre-BL Vol
is measured.
Mictur. Vol. Micturated Pre-BL Vol, Post-BL Vol
Volume The Post-BL Vol. and Mictur.Vol. are calculated
automatically, the Post-BL Vol. is displayed in the report.
Study

Kidney Renal L, Renal H, Renal W
NOTE:
Needs to be measured on the left and right sides respectively.
Adrenal Adrenal L, Adrenal H, Adrenal W
NOTE:
Prostate Prostate L, Prostate H, Prostate W
If [Serum PSA] in [Patient Info] > [URO] has been entered, PSAD
(Prostate Special Antigen Density) will also be calculated.
• PPSA (ng/ml) = PPSA Coefficient (ng/ml2) × Prostate Vol (ml)
• PSAD (ng/ml2) = Serum PSA (ng/ml) / Prostate Vol. (ml)
Here, the PPSA Coefficient and Serum PSA are entered in the
[Patient Info] > [URO] dialog box. The default value of the PPSA
Coefficient is 0.12.
The PSAD displays in the report if the PSA value is entered.
Seminal Vesicle Seminal L, Seminal H, Seminal W
NOTE:
Testis Testis L, Testis H, Testis W
NOTE:
Bladder Pre-BL L, Pre-BL H, Pre-BL W; Post-BL L, Post-BL H, Post-BL W

7 Urology

Mass1-10 Distance in 2D General measurements
Prostate mass 1-3
Testis mass 1-3
Epididymis Epididymis L, Epididymis H, Epididymis W
NOTE:
Renal Cyst1-3 d1-3 Distance in 2D General measurements
Renal Lesion1-3 d1-3
7.2.2 Doppler Mode

Measurement

Testicular A Testicular Aorta Distance in 2D General measurements
Testicular V Testicular Vein
Epididymis A Epididymis Aorta
Epididymis V Epididymis Vein
7.3 References
PPSA
Peter J. Littrup M.D., Fed LeE. M.D., Curtis Mettin. P.D. Prostate Cancer Screening: Current
Trends and Future Implications. CA-A CANCER JOURNAL FOR CLINICIANS, Jul/Aug 1992,
Vol.42, No.4
PSAD
MITCHELL C. BENSON, IHN SEONG, CARL A. OLSSON, J., McMahon, WILLIAM
H.COONER. The Use of Prostate Specific Antigen Density to Enhance the Predictive Value of the
Intermediate Levels of Serum Prostate Specific Antigen. THE JOURNAL OF UROLOGY, 1992,
Vol.147, p817-821

8 Gynecology

– For measurement tools, see “8.2 Gynecology Measurement Tools”.
completed.
8.2 Gynecology Measurement Tools

Measurement

UT H Uterine Height Distance in 2D General measurements
UT W Uterine Width
UT L Uterine Length Distance, Trace and Spline in 2D
General Measurements
Cervix L Uterine Cervix Length
Cervix H Uterine Cervix Height Distance in 2D General measurements
Cervix W Uterine Cervix Width
Endo Endometrium Thickness
Ovary L Ovary Length
Ovary H Ovary Height
Ovary W Ovary Width
Follicle1~16 L Follicle 1~16 Length
Follicle1~16 W Follicle 1~16 Width
Follicle1~16 H Follicle1~16 Height
Fibroid1-3 d1-3 /
GYN Lesion1-3 d1-3 /
Ovarian Cyst1-3 d1-3 /
DWT Detrusor Wall Thickness

8 Gynecology

Intus. Depth Intussusceptions Depth Distance in 2D General measurements
BSD (R) Bladder Neck-Symphysis Parallel in 2D General Measurements
Distance (Rest)
BSD (Va) Bladder Neck-Symphysis
Distance (Valsalva)
Cx-SP Dist. (R) Cervix - Symphysis Publis
Distance (Rest)
Cx-SP Dist. (Va) Cervix - Symphysis Publis
Distance (Valsalva)
RA-SP Dist. (R) Rectal Ampulla - Symphysis
Publis Distance (Rest)
RA-SP Dist. (Va) Rectal Ampulla - Symphysis
Publis Distance (Valsalva)
Rectocele Depth /
Shuttle (R) Bladder Neck-Symphyseal The system automatically calculates
Distance (Rest) BSD, BPW-SP Dist., Cx-SP Dist. and
RA-SP Dist. values.
Shuttle (S) Bladder Neck-Symphyseal
Distance (Stress) The measurement of reference line
distance: measure the distance from
BN, front point, middle point, back
point of pelvis floor to the reference
line of the symphysis pubis.
1. Move the bigger cursor to a certain
point.
2. Rotate <Angle> to adjust the
orientation of the reference line.
3. Press <Set> to fix the reference line.
4. Press <Set> to fix BN position.
Measure the distance from this point
to the reference line (BN distance).
Then, measure BPW-SP Dist., Cx-
SP Dist. and RA-SP Dist..
Press <Clear> to remove the last
measurement result. Double-click
<Set> to complete the measurement
in advance. Press <Update> to start
a new measurement.

8 Gynecology

RVA (R) Retrovesical Angle (Rest) Angle in 2D General measurements
RVA (S) Retrovesical Angle (Stress)
UTA (R) Urethral Tilt Angle (Rest)
UTA (S) Urethral Tilt Angle (Stress)
URA Urethral Rotation Angle
PVA (R) Pubovesical Angle (Rest)
PVA (S) Pubovesical Angle (Stress)
PUA (R) Pubourethral Angle (Rest)
PUA (S) Pubourethral Angle (Stress)
ARA (R) Anorectal Angle (Rest)
ARA (S) Anorectal Angle (Stress)
ARA (C) Anorectal Angle (Contraction)
LH AP Diam (R) Levator Hiatal Anteroposterior Distance in 2D General Measurements
Diameter (Rest)
LH AP Diam (S) Levator Hiatus
Anteroposterior Diameter
(Stress)
LH AP Diam (C) Levator Hiatus
Anteroposterior Diameter
(Contraction)
LH Lateral Diam (R) Levator Hiatus Lateral
Diameter (Rest)
LH Lateral Diam (S) Levator Hiatus Lateral
Diameter (Stress)
LH Lateral Diam (C) Levator Hiatus Lateral
Diameter (Contraction)
LA Thickness (R) Levator Ani Thickness (Rest)
LA Thickness (S) Levator Ani Thickness (Stress)
LA Thickness (C) Levator Ani Thickness
(Contraction)
LH Area (R) Levator Hiatus Area (Rest) Area in 2D General measurements
LH Area (S) Levator Hiatus Area (Stress)
LH Area (C) Levator Hiatus Area
(Contraction)
LA Angle (R) Levator Ani Angle (Rest) Angle in 2D General measurements
LA Angle (S) Levator Ani Angle (Stress)
LA Angle (C) Levator Ani Angle
(Contraction)

8 Gynecology

LUG (R) Levator Urethra Gap (Rest) Distance in 2D General Measurements
LUG (S) Levator Urethra Gap (Stress)
LUG (C) Levator Urethra Gap
(Contraction)
BPW-SP Dist. (S) Bladder Post Wall - Symphysis Parallel in 2D General Measurements
Publis Distance (Stress)
BPW-SP Dist. (Va) Bladder Post Wall - Symphysis
Publis Distance (Valsalva)
GYN Lesion1~3 Strain / Strain in 2D General measurements
Calculation

Ovary Vol. Ovary Volume Ovary L, Ovary H, Ovary W
NOTE:
respectively.
UT Vol. UT Volume UT L, UT H, UT W
Uterus Body / UT L, UT H, UT W
Uterus Body (cm) = UT L (cm) + UT H (cm) + UT W (cm)
UT-L/ CX-L / UT L, Cervix L
UT-L/CX-L (No unit) = UT L (cm) / Cervix L (cm)
Follicle 1-16 / Length, height and width of follicle 1~16
Mean DWT Mean Detrusor Wall Distance in 2D General Measurements
Thickness Mean DWT = (DWT1 + DWT2 + DWT3) /3
IAS Damage / Damage ratio= the length of sphincter muscle of anus
damage / the length of sphincter muscle of anus
EAS /
Damage
Study

Uterus / Length, height and width of uterus,
endometrium thickness
Uterine Cervix / Length, height and width of uterine cervix
Ovary / Length, height and width of ovary
Follicle 1~16 / Length, height and width of follicle 1~16

8 Gynecology

Fibroid1-3 d1-3 / Distance in 2D General Measurements
GYN Lesion1-3 d1-3 /
Ovarian Cyst1-3 d1-3 /
BL Height Bladder Height The system automatic calculates Residual
Urine value.
BL Depth Bladder Depth
• Dietz formula: Residual Urine (ml) = BL
Height (cm) × BL Depth (cm)× 5.6, or
• Haylen formula: Residual Urine (ml) = BL
Height (cm)× BL Depth (cm) ×5.9 - 14.6,
or
• Dicuio formula: Residual Urine (ml) = BL
Height (cm) × BL Depth (cm) × BL
Transverse Diameter (cm)× 0.52
GYN Lesion1~3 Strain Ratio in 2D General Measurements
StrRatio
Where, the methods and formulae for follicle volume are as follows:
• Average Diameter
– 2-distance
– 3-distance
• Follicle Volume
– 1-distance
– 2-distance
– 3-distance
8.3 References
Uterus Body
Feng Kui, Sun Yanling, Li Hezhou. Ultrasonic diagnosis of adenomyosis. Journal of Henan
Medical University, 1995; 30 (2).

8 Gynecology
UT-L/ CX-L
Ji Jindi, et al. Ultrasonographic study of the intersex problems and the internal genitalia
abnormalities. Journal of China medical ultrasound. 1996, Volume 12, No8 P40.
Residual Urine
• Dietz HP, et al. Determination of postvoid residual by translabial ultrasound. Int Urogynecol J
2012; 23: 1749-1752.
• Haylen BT. Verification of the accuracy and range of transvaginal ultrasound in measuring
bladder volumes in women. Br J Urol 1989;64:350-352.
• Cassadó, J., Espu?a-Pons, M., Díaz-Cuervo, H., Rebollo, P. and on behalf of the GISPEM
Group (2015), How can we measure bladder volumes in women with advanced pelvic organ
prolapse?. Ultrasound Obstet Gynecol, 46: 233–238. doi:10.1002/uog.14678
Levator Hiatus Diam, Area, Thickness and LA Angle

• 3-Dimensional transvaginal ultrasonography evaluation of femal pelvic floor structure and
function.
• Dan V. Valsky, MD, Simcha Yagel, MD. Three-Dimensional Transperineal Ultrasonography of
he Pelvic Floor. J Ultrasound Med 2007; 26:1373–1387.
LUG (Levator Urethra Gap)

H. P. DIETZ, A. ABBU and K. L. SHEK. The levator–urethra gap measurement: a more
objectivemeans of determining levator avulsion? Ultrasound Obstet Gynecol 2008; 32: 941–945.
Smart Pelvic
• Svabik K, Shek KL, Dietz HP. How much does the levator hiatus have to stretch during
childbirth? BJOG 2009;116:1657–62
• Abdool Z, Shek KL, Dietz HP. The effect of levator avulsion on hiatal dimensions and
function. Am J Obstet Gynecol 2009;201(1). 89.e1–5.
• Dietz, H., Hoyte, L., Steensma, A. (2008). Atlas of Pelvic Floor Ultrasound. United Kingdom:
Springer-Verlag London Ltd.
• Dietz H, De Leon J, Shek K. Ballooning of the levator hiatus. Ultrasound Obstet Gynecol
2008; 31: 676–680.
• Eisenberg VH, Chantarasorn V, Shek KL, Dietz HP. Does levator ani injury affect cystocele
type? Ultrasound Obstet Gynecol 2010; 36: 618–623.
• Oerno A, Dietz H. Levator co-activation is a significant confounder of pelvic organ descent on
Valsalva maneuver.Ultrasound Obstet Gynecol 2007; 30: 346–350.
• Dietz H, Lanzarone V. Levator trauma after vaginal delivery.Obstet Gynecol 2005;106: 707–
712.
• Dietz HP, Abbu A, Shek KL. The levator–urethra gap measurement:a more objective means of
determining levator avulsion? Ultrasound Obstet Gynecol 2008; 32: 941–945.
• Dietz HP, Schierlitz L. Pelvic floor trauma in labour—myth or reality? Aust N Z J Obstet
Gynaecol 2005;45:3–11.
• Dietz H, Abbu A, Shek K (2008) The levator urethral gap measurement: a more objective
means of determining levator avulsion? Ultrasound Obstet Gynecol 32:941–945
• Valsky DV, Yagel S. Three-dimensional transperineal ultrasonography of the pelvic floor:
improving visualization for new clinical applications and better functional assessment. J
Ultrasound Med 2007; 26: 1373–1387
• Dietz HP. Pelvic floor ultrasound: a review. Am J Obstet Gynecol 2010; 202: 321–334

9 Small Parts

– For measurement tools, see “9.2 Small Parts Measurement Tools”.
completed.
9.2 Small Parts Measurement Tools

9.2.1 2D Mode
Measurement

Thyroid L Thyroid Length Distance in 2D General
measurements
Thyroid H Thyroid Height
Thyroid W Thyroid Width
Isthmus H Isthmus height
Testis L Testicular Length
Testis H Testicular Height
Testis W Testicular Width
Epididymis L Epididymis Length
Epididymis W Epididymis Width
Epididymis H Epididymis Height
Scrotal Wall Thickness /
Breast Mass1~10 L Mass Length
Breast Mass1~10 W Mass Width
Breast Mass1~10 H Mass Height
Nip.-Mass 1~10 Dist. Distance between nipple and mass
Skin-Mass 1~10 Dist. Distance between skin and mass

9 Small Parts

Thyroid Mass 1-3 d1-3 Thyroid mass Distance in 2D General
measurements
Thyroid Nodule 1-3 d1-3 / Distance in 2D General
measurements
Thyroid Cyst 1-3 d1-3 /
Testicular Mass 1-3 d1-3 Testicular mass
THY Mass1~3 Strain Thyroid Mass Strain Strain in 2D General
measurements
THY Nodule1~3 Strain Thyroid Nodule Strain
Breast Mass1~10 Strain /
THY Mass1~3 Elas. Thyroid Mass Elastography Elastography in 2D General
Measurements
THY Nodule1~3 Elas. Thyroid Nodule Elastography
Breast Mass1~10 Elas. Breast Mass Elastography
Calculation

Thyroid Vol. Thyroid Volume Thyroid Vol. (cm3) = k × Thyroid L (cm) ×
Thyroid H (cm) × Thyroid W (cm)
Where k= 0.479 or 0.523
Testicular Vol. Testicular Volume Testis L, Testis H, Testis W
NOTE:
Needs to be measured on the left and
right sides respectively.
Study

Thyroid / Same formulae as in the Thyroid Vol.
calculation
Testis / Testis L, Testis H and Testis W, calculates
the Testis Vol.
Epididymis / Epididymis L, Epididymis H and
Epididymis W
Breast Mass1~10 / Volume (3 Dist.) in 2D General
Measurements
Thyroid Mass1~10 /
Testicular Mass1~10 /

9 Small Parts

THY Mass1~3 Strain Thyroid Mass Strain Ratio Strain Ratio in 2D General measurements
Ratio
THY Nodule1~3 Thyroid Nodule Strain Ratio
Strain Ratio
Breast Mass1~10 /
Strain Ratio
THY Mass1~3 Elas. Thyroid Mass Elastography Elastography Ratio in 2D General
Ratio Ratio Measurements
THY Nodule1~3 Thyroid Nodule Elastography
Elas. Ratio Ratio
Breast Mass1~10 Breast Mass Elastography
Elas. Ratio Ratio
9.2.2 Doppler Mode

Measurement

STA Superior Thyroid Artery D trace in General D measurements
ITA Inferior Thyroid Artery
Testicular A Testicular Aorta
Testicular V Testicular Vein
Epididymis A Epididymis Aorta
Epididymis V Epididymis Vein
9.3 References
Thyroid Vol (k= 0.479)
Volumetrie der Schilddruesenlappn mittels Realtime-Sonographie; J Brunn, U. Block, G. Ruf, et al.;
Dtsch.med. Wschr.106 (1981), 1338-1340.
Thyroid Vol (k=0.523)

Gomez JM, Gomea N, et al. Determinants of thyroid volume as measured by ultrasonography in
healthy adults randomly selected. Clin Endocrinol(Oxf), 2000;53:629-634

10 Pediatrics
The HIP (Hip Joint Angle) measurement is used in pediatric Pediatrics. Such measurement
provides early diagnosis for infant hip joint dislocation.

– For measurement tools, see “10.2 Pediatrics Measurement Tools”.
completed.
10.2 Pediatrics Measurement Tools

10.2.1 HIP
The HIP calculation assists in assessing the development of the infant hip. In this calculation, three
straight lines are superimposed on the image and aligned with the anatomical features. The two
angles are calculated and displayed.
3
β
1
α
Line 1 The baseline (BL), connecting the osseous acetabular convexity to

the point where the joint capsule and the perichondrium unite with
the ilium.
2 The roof line (RL), connecting the lower edge of the ilium to the
osseous acetabular convexity.
3 The inclination line (IL), connecting the osseous acetabular
convexity to the acetabular labrum.
Angle α (Alpha) The angle between BL and RL.
β (Beta) The angle between BL and IL
10 Pediatrics
Dislocation type can be determined using the Graf method, as described in the following table.
Tpye α Bony roof Superior β Cartilaginous roof Age

bony rim (Weeks)
I Ia ≥60° good angular/slightly ≤55° covers the femoral head any age
rounded
(“blunt”)
Ib ≥60° good angular/slightly >55° covers the femoral head any age
rounded
(“blunt”)
II IIa [50°,60°) adequate rounded any angle covers the femoral head [0,6]
(satisfactory)
IIa(+) [55°,60°) adequate rounded any angle covers the femoral head (6,12]
(satisfactory)
IIa(-) [50°,55°) deficient rounded any angle covers the femoral head (6,12]
IIb [50°,60°) deficient rounded any angle covers the femoral head >12
IIc [43°,50°) severely rounded to ≤77° covers the femoral head any age
deficient flattened
D [43°,50°) severely rounded to >77° pressed shift any age
deficient flattened
III IIIa ≤42° poor flattened no pressed upwards-without any age
measure structural alteration
(devoid of echoes)
proximal perichondrium
goes up to the contour of
the iliac wall
IIIb ≤42° poor flattened no pressed upwards-with any age
measure structural alteration (they
are echogenic) proximal
perichondrium goes up to
the contour of the iliac
wall
IV ≤42° poor flattened no pressed downwards any age
measure (horizontal or mulded
proximal perichondrium

1. In B mode, select [HIP] from the measurement menu.
A line appears, and there is a fulcrum on the line.
2. Use the trackball/trackpad to move the line to the position of the hip joint. Then rotate the
<Angle> knob to fix the baseline.
3. Press <Set> to confirm and the second line displays.
4. Use the method for adjusting the first line to anchor the RL and press <Set> to fix the RL.
5. Use the same method to fix the third line IL. The angles of α and β come out.
If the patient's age is entered, the dislocation type is also displayed.
Measure the angles of α and β separately: click [HIP (α)] or [HIP (β)] to measure.
10 Pediatrics
10.2.2 HIP-Graf
The measurement items, results and procedures, see “10.2.1 HIP”.
10.2.3 d/D
Measures the distance between the baseline and bottom line of the osseous acetabular and the
maximum width of the hip to estimate the hip osseous acetabular coverage.
1
D

1. Select [d/D] in the measurement menu.
2. Use the Distance tool in the 2D General Measurement to measure the maximum width of the
hip (D), and the distance between the osseous acetabular roof and bottom (d).
The system calculates the d/D.
10.3 References
Graf R., “Sonographic diagnosis of hip dysplasia. Principles, sources of error and consequences”
Ultraschall Med. 1987 Feb;8(1):2-8
Schuler P., “Principles of sonographic examination of the hip” Ultraschall Med. 1987 Feb;8(1):9-1
Graf, R. “Fundamentals of Sonographic Diagnosis of Infant Hop Dysplasia.” Journal Pediatric
Orthopedics, Vol. 4, No. 6:735-740,1984.
Graf, R. Guide to Sonography of the Infant Hip. Georg Thieme Verlag, Stuttgart and New York,
1987.
Morin, C., Harcke, H., MacEwen, G. “The Infant Hip: Real-Time US Assessment of Acetabular
Development.” Radiology, 177:673-677, December 1985.
R. Graf. “Hip Sonography Diagnosis and Management of Infant Hip Dysplasia” With the
collaboration of S. Scott, K. Lercher, F. Baumgartner, A. Benaroya
11 Emergency&Critical

– For measurement tools, see “11.2 EM Measurement Tools”.
completed.
11.2 EM Measurement Tools

The following optional emergency exam modes are available in the current system:
• EM ABD
• EM FAST
• EM OB
• EM Vascular
• EM Superficial
The commonly used measurement tools are contained in the EM package corresponding to each
EM exam mode.
NOTE:
• Measurement tools in each EM package depend on the specific measurement data preset for
each ultrasound system.
• For detailed descriptions of the measurement items, see the corresponding application chapter.
• For more information about package preset, see Basic Volume.
12 Nerve

– For measurement tools, see “12.2 Nerve Measurement Tools”.
completed.
12.2 Nerve Measurement Tools

There are no specific tools for Nerve by default, however, you can preset measurement tools for
Nerve using tools from other packages. For details, see Basic Volume.
NOTE:
Measurement tools in each application package depend on the specific measurement data preset for
each ultrasound system.
13 Report
The report records measurement results, which are automatically saved by the system after each
measurement.
13.1 Viewing Reports

13.1.1 To View Current Reports
Tap [Report] on the touch screen to enter the report dialog box. The default report of the current
exam appears.
• Each measurement contains the three latest values and a final value.
• The report only displays results of tools that are displayed in the report template by default and
are completed, as shown in the figure above.
• Select [Previous] or [Next] to switch between pages if the report has more than one page.
• When using Obstetric template, if LMP has already been entered, tap [OB Graph] to view
Fetal Growth Curve after measurement.
• After viewing, press <Freeze>, or select [Cancel] or [Save] to exit the report page.
Editing Measurement Data
CAUTION
Input appropriate data when editing the measurement values, otherwise
misdiagnosis may occur.
13 Report
NOTE:
• Only measurement values are editable while calculation values are not.
• After a measurement value is modified, the average value of the tool and the corresponding
calculation value will be updated automatically.
The measurement values in the text boxes are editable. Move the cursor to the text box and press
<Set>.
The modified value(s) is/are underlined.
The final value displays in the [Value] column. Select an option ([Last], [Avg], [Max] or [Min])
from [Method] to determine the method in which the final value is calculated.
For result values used to calculate GA (Gestational Age) and SD (Standard Deviation), the formula
used in this calculation can be selected from [Formula]. The GA and SD values update with the
formula change.
Entering Ultrasound Remarks

In the [Comments] box, enter the corresponding information.
You can also save or load the comments.
• Save comment: enter information in the Comments box and then tap [Save Comment] on the
touch screen to save current information in the report comment database.
• Load comment: tap [Load Comment] on the touch screen to open the dialog box to check
history saved comment information. You can select related information to add to current report
comment or select the location of the comments.
Selecting Images
Images saved for the current exam can be added to the report.
1. Click [Add Picture] on the report page to bring up the following dialog box.
– Left Column: Images saved for the current exam.
– Right Column: Images selected to add to the report.
2. Select the image.
– Add/Remove the image by using [>], [>>], [<] and [<<].
– Select an image in the right column and click [Move Up] or [Move Down] to adjust the
sequence in which the images are arranged in the report.
3. Click [OK] to confirm.
Adding Anatomical Picture

You may add anatomical graphics for illustration. OB, EM OB, IVF, Stress Echo and LV analysis
reports do not support this function.
1. Tap [Anatomical Graphic] on the touch screen.
The dialog box appears.
13 Report
– Available items: the graphic saved in the current exam can be added to the report.
– Selected items: the selected graphic will be added to the report.
2. Select the graphic
– Adding/ Removing the image with [ ], [ ], [ ], [ ].
– Select a graphic from the selected items. Click [Move Left] or [Move Right] to adjust the
graphic sequence in the list.
The sequence of the graphic in the bottom column is that of the graphics in the report.
You may customize the anatomical graphic and import it to the report. Display effect of
480*640 works best.
3. Tap Right/Left or Prox/Mid/Dist/None. Select the measurement to be added to the anatomical
curve (see the figure below).
4. When measuring the results of the anatomical curve, the measurements appear on the curve.
5. Select the painter color, and draw on the anatomical area manually.
6. Click [Save] to add anatomical picture.
Analyzing Report Data

You can preset and edit anatomy information in the report.
13 Report

1. Tap [Analyze].
2. Select or enter anatomy descriptions.
Descriptions of [Fetus Score] can only be selected from the drop-down list.
Use the [Previous]/[Next] buttons to switch between pages.
3. Click [Save] to confirm. Analysis information displays after the measurement values in the
report.
Adding a Signature
Fill in the signature after completing the report.
1. Tap [Signature]. Draw the signature information on the touch screen. Tap [OK] to save the
information.
2. Click [Save].
3. Print or preview the report to view the signature information.
13.1.2 To View History Reports

NOTE:
History reports can be viewed, but cannot be edited.
If more than one exam is performed for a patient, an [Exam] drop-down list appears in the top-right
part on the report.
1. Select previous exams from the [Exam] drop-down list.
2. According to the exam mode, select a proper template from the [Report Type].
Make sure the template matches the exam mode, otherwise the measurement result will not
display correctly. E.g. An abdomen measurement result will not display in an OB report
template preset without any abdomen measurement items.
3. View the history report.
13.2 Obstetric Exam Report

13.2.1 Fetal Biophysical Profile
Fetal Biophysical Profile means to first obtain a few indices related to fetal growth through
experiment or measurement and then evaluate the hazardous situation that the fetus is facing by
grading these indices respectively.
Under OB report status, tap [Analyze] on the touch screen, the fetus Score is listed after the fetal
analysis.
13 Report
The scoring criteria the system provides are based on the Vintzileos formula, as shown in the table
below.
Fetal Score 0 Score 2 Observa-tion

growth time
index
FHR <2, or Reactive FHR ≤15 Reactive FHR ≥ 15 bpm, duration 30 minutes
bpm ≥ 15 s, ≥ 2 times
FM ≥ 2 fetal movements FM ≥ 3 times (continuous 30 minutes
movement is deemed as 1 time)
FBM No FBM or duration ≤ 30 s FBM ≥ 1 times; duration ≥ 30 s 30 minutes
FT Limbs stretch, no bend, Limbs and spine stretch/bend ≥ 1 /
fingers loose times
AF No AF, or AF volume < 2 One or more AF volumes > 2 × 2 /
× 2 cm cm
The score(s) can be manually entered into the system. The scores of each index as well as the total
score will be appended to the report.
Fetal scoring results criteria:
Total scores Growth condition

8-10 Normal, chronic asphyxia risk low
4-6 Chronic asphyxia risk suspicious
0-2 Chronic asphyxia risk high
13.2.2 Comparison Bar

This function compares the clinical GA, the ultrasound GA obtained from OB measurements and
the AUA (CUA).
Select the [Print] checkbox to determine whether to include the bar in the printed report or not.
13.2.3 Z-Score
NOTE:
The Z-Score study is effective for fetuses aged 15~40 weeks.
As the FL, BPD and GA are most relevant to the fetus cardiac structure and the Z-Score regression
equation is related to the natural logarithm value of the FL, BPD and GA variables, the Z-Score of
cardiac structures can be obtained by looking at the Z-Score table, which is important in fetus
cardiac growth evaluation and intrauterine interventional therapy.
In (predicted cardiac dimension) = m×In(FL, GA or BPD)+c
Z-Score = (In(actual) - In(predicted cardiac dimension))/root MSE
Where the unit of FL and BPD is cm, GA is week, m is multiplier, c is intercept and root MSE is
root-mean-square error, which can be obtained from the table.
1. Enter the patient information and obstetric information in the [Patient Info] > [OB] dialog box.
2. Measure the BPD and FL.
13 Report
3. Select Z-Score parameters (with Z-Score tag in the name) from the measurement menu.
4. Open the report to check the Z-Score result.
13.2.4 Fetal Growth Curve

TIP:
If the patient ID is blank, the clinical GA is not calculated or the measurement value is not valid, the
measurement values will not be displayed on the curve.
The fetus growth curve compares the measured data of the fetus with the normal growth curve to
judge whether the fetus is in normal growth state. The growth curve data is sourced from the Fetal
Growth Table.
1. Enter the patient information and obstetric information in the [Patient Info] > [OB] dialog box.
2. Perform one or more fetal growth parameter tools.
3. Tap [OB Graph] on the report touch screen to display the Obstetric Growth Curve dialog box.
The dialog box displays the growth curve and the position of the measurement value.
– Two drop-down lists above the curve display the measurement item/tool and the formula
of the curve, which can be changed.
– Different symbols are used on the growth curves to identify measurement data of different
fetuses.
– Current and historic data of a fetus are displayed in the same symbols, with the historic
data appearing in smaller symbols.
– Click the [Print] checkbox to determine whether to include the growth curve in the printed
report or not.
– The green dotted line indicates the clinical GA on the X-axis.
– Select the number and layout of the curves from [Display Layout].
1*1: one curve displays in the screen.
2*1: two curves (up/down) display in the screen.
2*2: four curves display in the screen.
– Click [Previous]/[Next] to turn the growth curve pages.
4. Click [Save] to confirm the setting and exit the page.
13.2.5 Fetus Compare

TIP:
You can select whether to print multi-fetus data in one report via [Report] > [Setting].
In the Obstetric report, select [Fetus A], [Fetus B], [Fetus C] or [Fetus D] to switch between the
results for different fetuses.
1. Tap [Fetus Compare] on the touch screen to see a visualized comparison result.
2. In the [OB Graph] dialog box, select [A], [B], [C] or [D] to display the growth curves of the
different fetuses.
– Data of Fetus: different symbols are used on the growth curves to identify measurement
data of different fetuses.
13 Report
– Historic/current data: symbol size is used to differentiate, with historic data appearing in
smaller symbols.
13.3 Report Setting

Tap [Setting] on the touch screen to generally change the report display.
Type Description
Print Choose the item (s) to be displayed on the report: ultrasound image, anatomical
information and graphic, analysis and comments.
layout Set the layout for ultrasound image and anatomical graphic for printing.
Ultrasound Image Select the ultrasound image to be printed.
Then, set the image layout for printing.
If checking “Ink-Saving Mode”, the ultrasound image is
printed in white background.
Anatomical Graphic Select the anatomical graphic to be printed.
Then, set the graphic layout for printing.
Analyze Select to print the added analysis.
Comments Select to print the comment column.
Print colored After checking it, WMS score mode of stress echo is
displayed in color.
If not checking it, WMS score mode is displayed in
numeric.
Measurement Show all Display all measurement results of each item for
measurement results printing.
Show all fetus data in After clicking it, the report chooses and prints the multi-
one report fetus data simultaneously.
Fetus compare Select the fetus comparison to be printed.
13 Report
Type Description
Fetal Growth Fetal growth Select to print fetal growth result.
Then set the layout in the report.
Fetal growth Select the result of fetal growth comparison to be
compare printed.
13.4 Printing Reports

Click [Print] to print the report.
Or click [Preview] to preview the report. On the preview page, you can:
• Click [Print].
• Select [Prev. Page] or [Next] to view the previous or next page.
• Select a zoom ratio from the drop-down list.
• Click [Close] to exit preview.
13.5 Save/Load Report

After the report template is edited, the history report archived in the system will change at the same
time. The user may print or export the current report to make a copy in advance.
TIP:
• The function is disenabled for anonymous patient.
• For report sending and backup, see Basic Volume.
13.5.1 Save report

1. Under report status, tap [Save Report] to bring up the following dialog box.
2. Select “Local” and click [Save] to save the information of the current report.
You can click [Load Report] to view or print the report.
13.5.2 Export report

Reports can be exported as RTF or PDF documents, which can be viewed and edited on a PC.
1. Under report status, tap [Save Report] to bring up the following dialog box.
13 Report
2. Select “Other Medium” and click [Save] to see the following dialog box, you can export the
report directly.
Reports can be exported as RTF or PDF documents, which can be viewed and edited on a PC.
3. Select the drive and directory.

4. Enter the filename for the report to export and select the file type.
5. Select the file type.
6. Click [OK] to confirm.
13.5.3 Load Report

Click [Load Report] to bring up the history report dialog box, click to select a report to export or
print.
P/N: 046-018840-00 (4.0)

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MX7/MX7T/Vaus7/Zeus/ME7/Anesus

Intellectual Property Statement

About This Manual

Software Interfaces in this Manual

Meaning of Signal Words

Signal word Meaning

Meaning of Safety Symbols

Intellectual Property Statement ................................................................................................ I

2.2.1 Distance ..............................................................................................................2 - 12

5.3 Measurement Tool Operations ..................................................................................... 5 - 12

9 Small Parts ...........................................................................................................9 - 1

Operator’s Manual iii

10.2.2 HIP-Graf ...........................................................................................................10 - 3

There are two kinds of measurement tools.

Operator’s Manual 1-1

• Fully understand the functionality of this system by referring to the

1.1 Measurement Preset

1.2 Basic Operations and Buttons

Keys Basic Operations

For detailed information about button functions, see Basic Volume.

1.3 Measurement Menu

1-2 Operator’s Manual

Figure 1-1 Touch screen display for measurement

Operator’s Manual 1-3

Measurement Library Switching

Edit Measurement Caliper

1.4 Measurement, Calculation and Study

1-4 Operator’s Manual

Fold/unfold the study to hide/show the measurement or calculation items included.

1.5 Measurement Caliper

Caliper End Symbols

1.6 Results Window

1.6.1 Results Display

1.6.2 Moving the Results Window

Operator’s Manual 1-5

1.6.3 Results Window Assignment

Assigning an Existing Application Item

Application items that meet the following requirements are displayed:

Assigning a New Application Item

2. The following dialog box appears, type in the new name.

1-6 Operator’s Manual

3. Click [Confirm] to assign the general result to the new item.

Exiting Result Assignment

Auto-Spectrum Calculation Assignment

1.7 Cross-window Measurement

Operator’s Manual 1-7

There are 2D (B/Color/Power), M and Doppler (PW/CW) basic measurement tools.

2.1 2D General Measurements

Perform the following procedure:

2.1.3 Distance P-L

Operator’s Manual 2-1

2. Move the cursor to the starting point.

2.1.5 Area & Circumference

2-2 Operator’s Manual

Operator’s Manual 2-3

7. Move the cursor to the end point of the second axis.

2.1.6 Smart Trace

Perform the following procedure:

2-4 Operator’s Manual

Volume (Ellipse Dist.)