Tips and Tricks – Vivid™ T8

JB20918XX
Table of Contents
1. Image Quality 4. Miscellaneous
2. Measurements a. How to Set Home on Annotations
a. How to Define New M & A b. Log Files
b. How to Configure Calculations c. Stress
c. M&A Configuration
d. Precision M&A
e. Autosequence of Measurements
f. Turn Off Autocalculations
g. AVA Calculation
h. A’ Measurement
i. Mean Pressure Gradient
j. Manual LV Volume Calculations
k. LA Ellipsoid LV
l. Auto EF Calculation
m. AFI Calculation
n. Intima Media Thickness Calculation
o. Volume Calculation Pelvic Exam
3. Connectivity
a. Export – AVI or JPEG
b. Export DICOM* CD/DVD
c. Quad Save As
d. MPEGvue Export Note: Links work best with Adobe Reader 10.1.10
e. Understanding DICOM Spooler With some other versions they will be one page off.
Image Quality

• 2D IQ Basic Optimization
• 2D IQ Advanced Optimization
• Color Flow Settings
• Doppler Settings Optimization
Basic 2D Image Quality (IQ) Optimization

1. Use 2D GAIN for overall 2D brightness. Increasing it will brighten 2D image while decreasing it
will darken the image
2. Adjust the active mode’s gain by the Active Mode rotary. Can select the active mode by
pushing
3. Use DEPTH to set the maximum (far field) distance that will be imaged
4. The 6 TGC (Time Gain Compensation) sliders adjust the gain related to depth from near to far
field
5. Use FOCUS POSITION to change the location of the focal point - a triangular focus marker
indicates the depth of the focal point
6. Use DUAL FOCUS to activate dual focus mode – activate FOCUS to adjust the location of the
dual focus
7. Use WIDTH to control the size or angular width of the 2D image sector – a smaller angle
usually produces an image with a higher frame rate
Basic 2D Image Quality (IQ) Optimization

8. Use TILT to enable the axis of the 2D image to be tilted to the left or right – by using this
control in combination with angle control the image can be “aligned” to the direction of
interest and frame rates be optimized
9. Use FREQUENCY to change the transmit frequency of the probe. Lower frequencies will
provide better penetration with less spatial resolution, while higher frequencies will do the
opposite (less penetration but higher spatial resolution)
10. Use POWER to control the amount of acoustic power in all modes
11. Use ATO to let the system optimize 2D image quality automatically – it gives more contrast to
the image

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Advanced 2D Image Quality (IQ) Optimization
All the 2D image quality parameters can be found on the Touch Panel (Page 1 and 2 of 2D tab)

1. Use DYNAMIC RANGE to control the contrast of an image (ratio between black and white
pixels). Increasing DR will give more gray scale detail, image appears more smooth while
decreasing DR will give less gray scale, image appears more contrasty
2. Use COMPRESS to adjust the contrast, increasing it makes the image appear softer while
decreasing it makes the image appear more just black and white
3. Use REJECT to reduce noise in the image
4. Use COLOR MAP to select a gray map for the presentation of the 2D image
5. Use FRAME RATE to control spatial and temporal resolution. Increasing FR gives more
temporal resolution but lower spatial resolution. Decreasing FR works the opposite
Hint: In some cases a too slow display frame rate can be fixed by lowering the acquisition
frame rate
6. Use DDP to reduce noise without smoothening moving structures
7. EDGE ENHANCE – emphasizes the image borders
8. UD CLARITY (Ultra Definition) smoothens the image while sharpening the edges of the tissue
Advanced 2D Image Quality (IQ) Optimization
9. SPECKLE REDUCE – to reduce the unwanted effect of the speckles that appear as grainy
texture in otherwise uniform areas of tissue
10. DIFF High/Low – to remove reverberation artifacts. Diff High provides higher frame rates (but
shows more artifact) than Diff Low mode (lower FR but reduced artifact)

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Color Flow (CFM) Settings
1. Scale – to adjust the color Doppler signal to the blood flow velocities shown. It is used to control
aliasing
2. Baseline – to adjust the color map to emphasize either the flow towards the probe (positive) or
away from the probe (negative). Available in Live and Freeze mode
3. Invert – to invert the color scheme (positive vs. negative velocities) . Available in Live and Freeze
mode
4. Variance – helps visualizing turbulent flow. Can be turned On/Off. Available in Live and Freeze
mode
5. Tissue priority – emphasizes either the color mode or the grey scale image. Available in Live and
Freeze mode
6. Sample Volume – balances between flow resolution (lower) and sensitivity (higher). Available in Live
mode
7. LVR (Low Velocity Reject) - also known as Wall motion filter – adjusts removal of low velocities
(usually wall movement). Available in live mode
8. Frequency – controls sensitivity vs. penetration. Higher settings -> resolution, lower settings ->
penetration. Available in live mode
Color Flow (CFM) Settings
9. Lateral averaging – smoothens the image by averaging data collected along the horizontal line.
Increase will reduce lateral resolution
10. Radial averaging- smoothens the image by averaging data collected along the radial line.
Increase will reduce radial resolution
Hint: If Color noise over the tissue is visible with Adult probes (especially in presets without variance),
DECREASE Low Velocity Reject to remove this noise

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Spectral Doppler Settings for PW/CW
All the Spectral Doppler image quality parameters can be found on the Touch Panel (Page 1 and 2 of
PW/CW tab)

1. Horizontal Sweep – controls the time (seconds) of the Doppler spectrum displayed. Available in
live and Freeze mode
2. Scale – adjusts the velocity scale to the blood flow velocities shown. The velocity range directly
controls the Nyquist limit
3. Baseline – sets the vertical position of the Doppler baseline to display the relevant part of the
spectrum (negative/positive velocities). Available in Live and Freeze mode
4. LVR (Low Velocity Reject) - also known as wall motion filter – adjusts removal of low velocities
(usually wall movement). Available in Live mode
5. LPRF (Low Pulse Repetition Frequency) – it limits the maximum velocities of a PW signal that can
be displayed but improves resolution of spectrum
6. Compress – controls the contrast of the spectral Doppler display. Available in Live and Freeze
mode
7. Reject – enables to remove undesired background noise from spectral Doppler display resulting
in cleaner and darker background. Available in Live and freeze mode
Spectral Doppler Settings for PW/CW
8. ASO – automatically adjusts Gain, Baseline, PRF and Sweep Speed
• Baseline needs to be in the middle position
• Adjusted to the spectrum displayed by:

• Press “Auto” the first time: spectrum display is optimized considering both directions
(positive and negative) of the flow displayed
• Press “Auto” a second time: only the spectrum signal above the baseline is considered and
optimized
• Press “Auto” a third time: only the spectrum signal below the baseline is considered and
optimized

Hint: With difficult to scan patients, if the maximum Doppler velocity scale is not enough for the
received signal, decrease transmit frequency (parameter located in the 4-way rocker control)
Spectral Doppler Settings for PW/CW
Pages 1 and 2 of PW tab on the Touch Panel

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Measurements
How to define new M&A - Measurement
• Go to Utility tab on the Touch Panel and press
“Config” button - select “Meas/Text” tab
• Select the folder for your new measurement

• Press “Add measurement” – “Blank” – “Ok”

How to define new M&A - Measurement
• Enter name for new measurement and select
measurement tool from the Tool bar

• All related parameters will be displayed – only those of interest for the user need to be
selected and be given a name and will be displayed later on the screen
How to define new M&A - Formula
• Select the measurement where you want to add the new formula
• Click in the window and a new line will appear

• Type in a name, click on the to insert the formula

• A new window will appear
How to define new M&A - Formula
• Formula written only in one line
• Basic functions: Operators (+, -, *, …) – Advanced calculations: Functions (sin, cos…)
 How to define new M&A - Formula
• Parameters can be chosen from the list –
they appear next to the folder where they are placed
to avoid misunderstandings

• At the end you can make a “Check” of the formula and type in your unit (result will be
displayed in SI units by default if you do not insert a unit)
Note: If your parameter is completely new, you need to act multiplication factors to
convert to SI units

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How to Configure calculations
• Go to Config (F2) and select Meas/Text
• Open «Measurement menu» tab
• Select the mode for your calculations (2D, MM, Dop.)

• Select the M&A category where your measurement is located (Cardiac, Vascular, Gynecology,
etc.)
• Select the measurement study folder (Area, Volume). Check “V” on studies that you would like
to be calculated
How to Configure calculations
• In each measurement study, click all the parameters you would like to be calculated

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How to configure your M&A
• To configure your measurements, go to Config and select Meas/Text
How to configure your M&A
• Click the mode you want to modify

• Add/remove folders by clicking into the white box

How to configure your M&A
• Click a folder to open it
• Modify measurements in a folder by removing / adding checkmarks
How to configure your M&A - Order
• In the measurements menu on the right side of the screen, select measurements studies
(folders) or measurements
• Change the order of measurements (or folders) by clicking twice on the specific measurement
/file and then moving it up / down using keyboard arrows or by pressing the arrows in the
picture below
How to configure your M&A - Units
• Select the measurement from the list on the right or double click on a measurement in the
central screen
• Click on the unit and select the desired unit from the popup list

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How to Edit Precision of Measurements
• Start Config (F2) – select «Meas/Text» - open «Advanced» tab
• Enable the use of non-standard precision by selecting «off» in «Use standardized precision»
option
How to Edit Precision of Measurements
• Select Measurement category (Abdominal, Cardiac, Vascular, Pediatric Heart, etc.)
• Select your work mode (2D, MM, Dop.)
• Open the folder where your measurement is located – select your measurement
How to Edit Precision of Measurements
• On the measurement window, click on the Precision field
• Select the number of decimal digits you would like to use (0, 1, 2 or 3)
• Note: Increasing precision by displaying more decimal digits does not increase measurement accuracy and
therefore needs to be treated carefully

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Autosequence of Measurements
• If you want the system to go automatically to the next measurements, you need to configure
them to be in a sequence – when finishing a certain measurement, system will automatically
jump to the next one in the list, without the user selecting it
• Start Config (F2) – select «Meas/Text»
• Select your work mode (2D, MM, Dop.)
• If you want the folders in that mode to be in autosequence, just click «Autosequence»
without opening any folder
Autosequence of Measurements
• If you would like measurements inside a folder to be consecutive, open that folder and click
«Autosequence»

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How to Turn Off Automatic Calculations
-Vascular
• In PW mode, the system can provide automatically the pre-configured measurements and
calculations (either in Live or Freeze mode)
• Open your PW Doppler image
• Open «Measurement» menu
• If it does not appear automatically, select «Vascular» category
• Select the folder where your measurement is located (i.e. Carotid in this example)
How to Turn Off Automatic Calculations
-Vascular
• Open up your measurement
• Select «Auto» for automatic measurements to be
modified
 If no automatic calculations are wanted,
select «Off»
 For automatic calculations to be provided
during live scanning, select «Live»
 For automatic calculations to be provided
when freezing the image, select «Frozen»

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AVA Calculation
• Aortic Valve Area calculation is based on continuity equation. This calculation needs three
measurements:
1. Left Ventricular Outflow Tract (LVOT) dimension
2. LVOT flow
3. Aortic Valve (AV) flow

1. Acquire a 2D image where LVOT diameter can be measured, press «Freeze» and scroll
through the loop
Start «Measurement» - open «Dimensions» folder
- select «LVOT Diam»
AVA Calculation
2. Acquire an Apical 5 chamber view
Place PW cursor in the middle of LVOT - acquire a PW Doppler signal – «Freeze»
Open Measurement – «Aortic» folder – Select «LVOT Trace»
AVA Calculation
3. Acquire an Apical 5 chamber view
Place CW cursor in the aortic valve area - acquire a CW Doppler signal – «Freeze»
Open Measurement – «Aortic» folder – Select «AV Trace»
AVA Calculation
The result will be automatically displayed above the last measured parameters – and in the
Doppler section of the worksheet

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A’ Measurement
• To measure the A’ wave of the annulus, we need to create a new measurement
Go to Config (F2) – select Meas/Text – select Measurement menu - select Dop. mode
Open «Mitral Valve» folder (in «Cardiac» measurements)
A’ Measurement
• Press «Add measurement» – «Blank» - «Ok»

• Name the measurement «A’» and select «SD point caliper» Tool
A’ Measurement
• Name as «A’» the Velocity parameter and select the unit

• To get the A/A’ ratio, name the last parameter as «A/A’» and click on to create the
formula
Select the "MV A Vel" in the Dop. section
Select “/" in the Operator section
Select "A'" in the Doppler section

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Mean Pressure Gradients (PG)
• When measuring any Doppler flow, there are two ways to get Pressure Gradients (PG) (Note:
Measurements can always be chosen either from the Measurement menu or the Touch Panel)

1. Choosing Vmax – place caliper at peak of the wave – system gives maximum PG
(maxPG)
Mean Pressure Gradients (PG)
2. Choosing Trace – trace the envelope of the wave – system gives both maximum and
mean PG (maxPG and meanPG) plus VTI (Velocity-Time Integral) and Env. Ti (Envelope
Time duration)

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How to perform manual LV (Left
ventricle) volume calculations
• To check the method used for LV volume calculation, please go to Utility tab on the touch
panel – go to Utility tab on Touch panel – press “Config” button – select “Meas/Text” tab –
select “Measurement menu” tab – select “2D” category and “Volume” folder
• Click to activate the desired calculation folder:
• “Single Plane A4C” to do the calculation of only the Apical 4Ch view
• “Single Plane A2C” to use only the Apical 2Ch view
• “Biplane” to calculate the volumes on both Apical 4Ch and Apical 2Ch views and get the
average volumes and EF
• Note: The method used for calculation is Simpson´s method
How to perform manual LV (Left
ventricle) volume calculations
• Select 3Sc probe and a cardiac preset
• Store the needed loops (Apical 4Ch view or/and Apical 2Ch view)
• Open your desired view – usually recommended to start with Apical 4Ch
• Scroll the loop until the ED frame
• Press “Measurement” - make sure “Cardiac” category is selected
• Select “Volume” folder – select either Biplane or Single Plane
• Select LVEDV A4C to perform the end-dyastolic measurement of the
LV volume in the Apical 4Ch view

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LA Ellipsoid Calculation
• To ensure “LA Ellipsoid” folder appears when pressing M&A, go to Utility tab on the touch
panel – press “Config” button – enter “Meas/Text” tab - select “Measurement menu” tab -
select “2D” mode – “Volume” folder – click on the white box to activate “LA Ellipsoid” if it is not
already selected
LA Ellipsoid Calculation
• Acquire an Apical 4Ch and an Apical 2Ch image where the LA is completely seen
• Open the Apical 4Ch image
• Start “Measurement” – open “Volume2 folder – select “LA Ellipsoid”
LA Ellipsoid Calculation
• Measure the two diameters (LA D1, LA D2) corresponding to the long and short axis of the LA
in this view (select the diameter on the Measurement menu or on the Touch Panel)
LA Ellipsoid Calculation
• Open the Apical 2Ch view – start “Measurement” – “Volume” folder – “LA ellipsoid” - select LA
D3 from the Measurement menu or on the Touch Panel directly
LA Ellipsoid Calculation
• The LA volume will appear above the last measurement performed (LA D3) and in the B mode
section of the Worksheet
• If you have introduced Weight and Height of the patient, the system will also calculate the LA
Volume Index: LA Volume Index = LA volume / BSA (Body Surface Index)

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Auto EF Calculations
• 2D FPS between 37 – 80 fps
• Store 4-Chamber or 2-Chamber cineloops (for monoplane EF) or both for Biplane EF
• Recall one of them
• Open Auto EF folder in Measurements

• Select 4Ch or 2Ch according to the image

Auto EF Calculations

• System will suggest three points according to guidelines and

user can allow processing with/without confirming these 3
points:

• 4Ch: Basal Septum – Basal Lateral wall – Apex

• 2Ch: Basal Inferior wall – Basal Anterior wall – Apex

• Automatic trace of endocardial border - > Contour verification

• If needed, adjust border manually or automatically
Auto EF Calculations
• Automatic adjustment: press “Recalc” button on the touch panel and then use “Edge shift
left” or “Edge shift right” on the Touch Panel to adjust the contour to the wall (settings will be
remembered by the system unless adjusted differently)
Auto EF Calculations
• Manual adjustment: move cursor on the green contour - click and drag any dot

Note: if you need any help during the tracing, click on

the tips section up right on the image
Auto EF Calculations
• After processing, display of loop with EF + Volumes – ED frame – ES frame

• Good tracking – all segments in green colors

• Bad tracking – corresponds to red segments
Auto EF Calculations
• Press “Recalc” button on the Touch Panel to
repeat the whole process if not satisfied with results

OR
• Press “EF dual” button on the Touch Panel to adjust the ES and/or the ED directly in the
according frames
Auto EF Calculations
• If user adjustments have been done, results get an *

• Click Approve bar if satisfied with results

Press “Layout” button on the Touch

Panel to get access to different
views of the results
Auto EF Calculations
• For every plane (4Ch or 2Ch), results calculated are:
• EF (Ejection Fraction)
• CO (Cardiac Output)
• ESV (End-systolic volume)
• EDV (End-diastolic volume)
• SV (Stroke Volume)
• Ls (systolic length of LV axis)
• Ld (diastolic length of LV axis)
• HR (estimated heart rate)

• If both 4Ch and 2Ch have been analyzed, system will provide Biplane calculations in addition
• At exit, click «Yes» to archive the loop if satisfied (system will remember the full process)

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AFI
AFI Calculation
• AFI (Automated Function Imaging) is a decision support tool derived from 2D strain used to
compute local and global tissue deformations in the myocardium
• 2D FPS (frames per second) should be between 37 – 80 fps
• Store Apical LAX, Apical 4 Ch and Apical 2 Ch sequentially for similar HR
• Recommendation: Measure Aortic Valve Closure (AVC) from M-Mode or Doppler

JB22651XX
AFI Calculation
• Open APLAX view and Measure – select AFI folder

• Select view

Note: the process needs to be done in this order – APLAX view, 4-ch view, 2-ch view

• To detect region of interest (ROI), the system uses the 3 points method, where system will
suggest three points (two at the endocardial border at each side of the annulus base and one
at the LV apex) and user needs to confirm/reposition these points using the trackball before
process begins.
AFI Calculation
After ROI is drawn, user can modify region by pressing “ROI width” or by click and drag in any
dot.
When satisfied, press “Process” to begin on the Touch Panel (automatic process will begin if
trackball is not moved – by default after 4 seconds if not defined differently)

Three suggested points

AFI Calculation
• Check ROI tracking quality
• User can manually change the
assessment (good vs. bad – green vs red
colour)
• User can recalculate to achieve better
fitting

• Approve scoring table (user can click in any

red segment to manually approve it )
AFI Calculation
• Set AVC: System proposes AVC from Event Timing (if measured as recommended) or Default
AVC by system – Adjust from APLAX image – Confirm
• Parametric systolic strain from APLAX displayed (single plane format – press “Single” on the
soft keys to display parametric image of a single plane only)
AFI Calculation
• Press Quad Screen on the Touch Panel to see
more details
AFI Calculation
• Repeat the same process for 4Ch and 2Ch views
• System will automatically show Bull´s eye and three apical views in 2D
AFI Calculation
• User can then display the curves from the three views
and the Bull´s eye (press “BE traces”)
AFI Calculation
• Press “BE Only” to see only Bull´s eye
• User can choose between two Bull´s eye Color maps:

Red-Blue Green-Yellow-Red

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Intima Media Thickness (IMT)
Measurement
• Acquire a 2D Carotid image at desired level where the Intima Media is visible – usually easier
to see in the Posterior Wall of the artery
Intima Media Thickness (IMT)
Measurement
• Open «Measurement» - «Vascular» package – «Carotid»
• Select artery: CCA (Common Carotid Artery) – ICA (Internal Carotid Artery) – BIF (Bifurcation)
• Select side: Rt (Right) – Lt (Left)
• Select wall: Post (Posterior) – Ant (Anterior)
Intima Media Thickness (IMT)
Measurement
• Perform the measurement in the desired region of interest of the carotid wall
• The system will provide: Maximum value (Max), Minimum value (Min), Average value (Avg),
Standard Deviation value (SD) and number of points used for the measurement (Pts)
Intima Media Thickness (IMT)
Measurement
• For the measurements to be archived into the Patient´s worksheet, click “Transfer” on the
Measurement menu

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How to Perform Volume Calculations in
Pelvic Exams
• Select Convex probe and pelvic preset
• Image the bladder in longitudinal plane in 2D mode – Press «Measurement» - make sure
«Abdominal» category is selected
• Select «Volume» calculation under «Generic» or «Abdominal» folder – Figure 1
• A cursor will appear – press «Set» to start and measure the first diameter and press
«Set» to finish (parameter will be displayed as «d1»)
• A second cursor will appear – press «Set» to measure the second diameter (parameter
will be displayed as «d2»)
• Image the bladder in transversal plane in 2D mode – Press «Measurement»
• Select «Volume» calculation in the same folder as before – Figure 2
• A cursor will appear – press «Set» to measure the transverse diameter (parameter will be
displayed as «d3») – the Vol calculation will automatically appear on screen

Available in Live and Freeze mode

How to Perform Volume Calculations in
Pelvic Exams

Figure 1: Longitudinal plane – Figure 2: Transverse plane –

d1 and d2 measurements d3 measurement and Vol calculation

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Connectivity
Export AVI or JPEG files
• It is possible to export static images or loops to a removable media (CD/DVD – USB)
individually
 Open the image / loop to be exported
 Press «Update/Menu» button (right upper button above trackball)
 Select «Save as» in the menu that appears
 The following window will open:
Export AVI or JPEG files
• Select destination device («USB HD/Memstick» - «CD/DVD Writable»)
Export AVI or JPEG files
• Select file format: «avi» or «wmv» for loops and «jpeg» for static images
• Select a «File name»
• Select «Compression» – usually «Jpeg» - and «Quality» of compression (95 by default,
compression values < 90 provide bad image quality)
Export AVI or JPEG files
• Select what to store:
 «Image only» to save only the US image
 «Secondary capture» for a complete screenshot
 «Quad View» for saving either two or four images simultaneously on the same screen
Export AVI or JPEG files
• Examples of different store configurations:

Image only Secondary capture

Quad view
Export AVI or JPEG files
• Finally click «Save»
• To eject the media, select «Eject» button or press «Alt» + «E» on the alphanumeric keyboard
• Select the device to be ejected – USB or CD/DVD

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Export to DICOM CD/DVD
• First go to «Archive» screen – select patient to be exported
• Select «Export» – following window will appear
• Select To: «DICOM CD/DVD» – click «Ok»
Export to DICOM CD/DVD
• If the media is not yet formatted, following screen will appear:

• Write a name for the media – click «Ok» or «Eject» if you want to use another media
Export to DICOM CD/DVD
 Select patient from the list (if more than one patient, use Ctrl or Shift buttons for multiple
selections, or click “Select all” to export all patients in Archive list) – click «Copy» -
process begins – when finished, select «Done»
 Note: on the right side, you can see free space on destination device («FreeDisk»)
and the size of the patient data to be exported («Selection»)
Export to DICOM CD/DVD
• To eject the media, select «Eject» button or press «Alt» + «E» on the alphanumeric keyboard
• Select the device to be ejected – CD/DVD

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Quad View – Export
• It is possible to export up to four static images or loops simultaneously on the same image.
There are two ways:

1. Press 1/2/4 button twice

 Select an empty place – the window frame will be highlighted in yellow
 Double click on the desired image – the image will be placed in the previously selected
empty cell
 Proceed accordingly for the other three images

2. Store at least 4 images/loops – two ways of getting a quad screen

 Press Review button – click once on the first three images to be selected (they
will be highlighted with a yellow frame) – double click on the fourth image
 Select images from Image Browser – double click on the fourth image

The quad screen with all four images/loops

will appear
Quad View – Export
 Press «Update/Menu» button (right upper button above trackball) and choose “Save as”
from the menu
 The following window will open:
Quad View – Export
• Select destination device («USB HD/Memstick» - «CD/DVD Writable» - «Remote path» -
«MOD »)
• Select a «File name»
• Select «Compression» type (usually «jpeg») and Quality
Quad View – Export
• Select store configuration:
 «Quad View» for saving up to 4 images simultaneously on the same screen
 Save as type: select “jpeg” for static images and “avi” for loops
Quad View – Export
• Finally click «Save»
• To eject the media, select «Eject» button or press «Alt» + «E» on the alphanumeric keyboard
• Select the device to be ejected – USB or CD/DVD

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MPEGvue Export
• When exporting in MPEGvue format, first you need to configure the destination device (USB
or CD/DVD) – you need to log in as ADM (administrator)
 Enter «Config» (F2) – select «Connectivity» - enter «Dataflow»
 Select «Misc Export» – click on «MPEGvue» in Outputs section – select «Properties»
MPEGvue Export
 Following window will open
 Select «Destination» device (usually USB HD/Memstick or CD/DVD) – or «Remote Path» if
you would like to export the study via network
 Select «Add Microsoft Media Player Components» if you would like to export a viewer
along with the images
 Click «Include Report» to export the patient Report along with the images
MPEGvue Export
 Open «Archive» screen – Select patient to be exported
 Use “Local Archive – Int. HD” as Dataflow
 Select «Export» - To: «To MPEGvue» - click «Ok»
MPEGvue Export
 Select patient from the list (if more than one patient, use Ctrl or Shift buttons for multiple
selections, or click “Select all” to export all patients in Archive list) – click «Copy» -
process begins – when finished, select «Done»
 Note: on the right side, you can see free space on destination device («FreeDisk»)
and the size of the patient data to be exported («Selection»)
MPEGvue Export
• To eject the media, select «Eject» button or press «Alt» + «E» on the alphanumeric keyboard
• Select the device to be ejected – USB or CD/DVD

• When opening the exams in a PC, you need to have Administration rights, since the MPEG
viewer will automatically be installed in that computer

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Understanding DICOM Spooler
• There are three possibilities when sending images to a DICOM server:
1. Store single images via «Alt Storage»:
Start Config (F2) – select «Connectivity» - «Additional Outputs»
Select desired button «P1» or «P2»
Add «Dicom storage» as Output, using button

* Note: if there is a video printer connected,

a button should be reserved for controlling it
Understanding DICOM Spooler
2. Full exam is sent via «Export» function»
Open «Archive» screen – use Dataflow “Local Archive – Int. HD” - select «Export»
Select «DICOM Server» as destination

3. Define a new Dataflow that includes «Dicom export»

Understanding DICOM Spooler
• To check the transmission progress, you can open «DICOM Spooler» with Alt + S
Understanding DICOM Spooler
• There are several fields in this window:
 Last Name and Patient ID: corresponding to the patient being sent
 Destination: It will display the name of the destination (i.e. name of the DICOM server
or DICOM printer)
Understanding DICOM Spooler
 Type:
 «Storage» for images sent to a Dicom server
 «Print» if sent to a DICOM printer
 «SRStorage» for Structured Reporting (SR) or Storage Commitment
 «MPPS» to send information (typically to a HIS) that a scheduled exam
has been started, performed or interrupted
Understanding DICOM Spooler
 Contents: number of images to be sent sent
 Sent: number of images already sent successfully
 Status: progress of the sending process - «Active» for images being sent –
«Pending» when there is a connection problem during transmission – «Done» for
transmission ended successfully – «Failed» for unsuccessful sending due to
connection problems – «Error»: connection is working but transmission of the
particular file is not successful
 Information: additional explanation on the failed sending
Understanding DICOM Spooler
• Below the main window, you can find the following buttons:

 Refresh: to refresh the screen (progress status)

 Delete: to cancel any of the pending process
 Resend: to send again any of the images/patients that failed before
 Send to: to create a new transmission to another Dicom device
 Hold: stop momentaneously the sending of the selected image/patient
 Hide: close the DICOM Spooler window
 Select all: choose all images/patients

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Miscellaneous
How to Set Home on Annotations
• Press «Text»
• Select the category of your exam (Cardiac, Abdominal, Small Parts…)
• See the assignable rotary on the Touch Panel (TP) – Arrow Rotate/Set Home: press on the
rotary to activate the “Set Home” option and select the initial location for the Annotations

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How to Export Log Files
(for record of system problems)
• When any kind of system error occurs (including system lockup), press “Alt” + “D”
• The following screen will appear:
How to Export Log Files
(for record of system problems)
• Write a short description of the problem in the box named “Description of issue”
• Click the box “System lockup” if the system shut down by itself

• Select destination to store log file (usually

USB memstick)
• Press “Save and Export” button
How to Export Log Files
(for record of system problems)
• To eject the media, select «Eject» button or press «Alt» + «E» on the alphanumeric keyboard
• Select the device to be ejected – USB or CD/DVD

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Tips and Tricks
Stress Echo Optimization

a. Template Creation
b. How to do Pharmacological or Bicycle
Stress Echo
c. How to do Treadmill/Exercise
Stress Echo (with continuous capture)
d. How to Analyze a Stress Echo
TEMPLATE CREATION
You can delete edited or newly created templates, but you cannot DELETE factory default templates

1. Press PROTOCOL hard key on the control panel

2. Press TEMPLATE and scroll down to TEMPLATE EDITOR

3. Select a factory template

Note: You create a new template by EDITING a factory default
template and storing it under a new name
4. Type in the desired number of LEVELS and VIEWS
5. It is possible to edit the LEVELS’ factory default names
It can be named e.g. as Baseline, Mid dose, Peak dose, 5 mcg, Recovery…

6. Select the VIEWS from the drop menu lists

7. Select the number of cycles to store

8. Add a CHECK MARK to activate Continuous capture (CC) during your acquisition
for Exercise or Treadmill Stress Echo.
9. Add CHECKMARKS if you prefer to preview the loop before and/or to
show your reference image (Baseline level or Previous level)
during acquisition

10. You may also add CHECKMARKS to other options like T1 (timer 1),
T2 (timer 2), Auto start analysis , Show systole only during
analysis or to Smart stress
SMART STRESS- the system remembers several image settings (maps, depth, gain, width…) done
during acquisition of the baseline level and will apply them to all levels of the same view
T1 :
Starts when the stress echo protocol is started. Shows how long the Stress Echo procedure lasted.
T2:
A second timer can be started at any time during the stress echo acquisition, e.g. when the last
image in baseline is stored and the exercise starts, or as timer during Dobutamine injections.
Auto start analysis:
When the last image is stored to the template, the system will automatically start the analysis by
opening the first group of loops
11. To automatically analyse the cells in groups, create Groups or select a factory group
12. To modify a group, select the CELLS you want to assign to the group and the group name, and
then click UPDATE GROUP
13. To ADD a new group, select the CELLS, click NEW GROUP and type in the new name like 4CH,
2CH, SAX, Peak, Recovery etc.
14. To SAVE the new template select SAVE AS TEMPLATE

Type in the Template name and click OK

15. To apply changes only to current patient, press OK

HOW TO DO PHARMACOLOGICAL/BICYCLE
STRESS ECHO
1. Press PATIENT button from keyboard and enter patient information

Note: Sometimes a routine echo is requested prior to Stress Echo exam, so when you finish the
regular echo, just select ADD EXAM to proceed to a full stress echo study
2. Press PROTOCOL and select the desired TEMPLATE (Pharmacological, Bicycle or your customized
template)
3. Select PHYSIO on the Touch Panel to check the ECG
(gain, position and horizontal sweep)
4. Press Begin/Cont

5. Press 2D button and scan the correct view according to the protocol. Press IMAGE STORE to
acquire a cine loop (you need to press IMAGE STORE twice if you have configured the preview
before store option; if you do not want to store the image, simply press FREEZE)
The system will jump automatically to the next template cell
6. Follow step 5, to fill in the protocol cells

Note:

A GREEN BOX marks the next available cell in the stress template
You can move the active cell marker (by the arrow buttons on the
keyboard) to skip cells or overwrite already filled cells. The box then
turns RED

7. When you are finished with all image acquisitions, select END EXAM and
SAVE
Note: You can also pause the protocol to store additional images or finish the protocol at any time
To store images outside of the protocol, press button “Protocol Pause” button on the Touch Panel –
store desired images and re-enter the protocol by pressing “Protocol Pause” again
To get completely out of a protocol, press “Protocol” button twice
HOW TO DO EXERCISE/TREADMILL STRESS
ECHO
1. Press PATIENT button from keyboard and enter patient information

2. Press PROTOCOL and select EXERCISE TEMPLATE or your new customized template.
3. Select PHYSIO on the Touch Panel to check the ECG (gain, position and horizontal sweep)
4. Press Begin/Cont on the Touch Panel

5. Press 2D button and scan the correct view according to the protocol. Press IMAGE STORE to
acquire a cine loop (you need to press IMAGE STORE twice if you have configured the preview
before store option; if you do not want to store the image, simply press FREEZE)
The system will jump automatically to the next template cell
 Baseline
6. Follow step 5, to fill in the Baseline stage
7. Press STORE or 2D FREEZE button (beside FREEZE button) to
start acquisition of the continuous capture

“Capture” is displayed in buffer bar and percentage

increases
8. Press STORE or 2D FREEZE again to stop capture (e.g. to
change probe position or view location)
“Pause” is displayed in buffer bar
9. Press FREEZE to finish acquiring continuous capture
See message also from the menu bar

Note: the preset cannot be changed in the middle of the CC

The right preset for CC must be selected before the buffer starts running
10. Press “Select cycles” – the CC screen will
appear (it appears automatically if buffer is
filled up)
11. Select your images for analysis by scrolling
through the pages, clicking on an image and
selecting the view you want to assign it (a
checkmark will appear next to the selected
view)
Finally select any of these options:
• Press Delete to discard the capture
OR
• Press Select later if you want to keep any
loops for later assignment (open the capture
again by pressing “Select cycles” from the
Protocol screen)
OR
• Press Store all to keep the entire capture for
later assignment

12. Finish the loop assignments by

selecting END EXAM and SAVE
HOW TO SELECT LOOPS FROM CC

1. Double click this icon

2. You will see this window to assign

a loop to a specific label
YELLOW checkmark means you
have already a loop assigned to
that label
Highlighted window means it is the selected loop
3. After selecting and assigning the images to their specific labels, a question will prompt:

Select YES if you want to delete remaining CC images from the buffer
Select NO if you want to keep all the images
 HOW TO DO STRESS ECHO ANALYSIS
1. Press “Analyse” button on the Touch Panel

2. Select the Group or Cells to analyse

3. A quad screen view will appear

4. Highlighted window corresponds
to highlighted window for wall motion
scoring or analysis
5. In Wall Motion analysis, 2 views are available
(toggling between them is done by pressing the
small icon on the top right corner)

Bull’s eye Cut planes

6. Wall motion coloured numbers representation

Select a segment (either in Bull´s eye or Cut
planes view) and use the trackball to select
the correct wall motion scoring

7. To finish, click END EXAM and SAVE

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GE, GE Monogram, and Vivid are trademarks of General Electric company or one of its subsidiaries.
*DICOM is a trademark of the National Electrical Manufacturers Association for its standards
publications relating to digital communications of medical information.