Mindray MX7 MX7T Vaus7 ZeusME7 Anesus ME7 Anesus ME7T MX8 MX8T Vaus8 ME8
Mindray MX7 MX7T Vaus7 ZeusME7 Anesus ME7 Anesus ME7T MX8 MX8T Vaus8 ME8
ME7/Anesus ME7T/MX8/MX8T/Vaus8/
ME8
Diagnostic Ultrasound System
Operator’s Manual
[Basic Volume]
    ©2021 Shenzhen Mindray Bio-Medical Electronics Co., Ltd. All Rights Reserved.
    For this Operator’s Manual, the issue date is 2021-01.
    NOTE:
    This equipment must be operated by skilled/trained clinical professionals.
        WARNING
    It is important for the hospital or organization that employs this equipment to
    carry out a reasonable service/maintenance plan. Neglect of this may result in
    machine breakdown or personal injury.
                                                 I
Warranty
      THIS WARRANTY IS EXCLUSIVE AND IS IN LIEU OF ALL OTHER WARRANTIES,
      EXPRESSED OR IMPLIED, INCLUDING WARRANTIES OF MERCHANTABILITY OR
      FITNESS FOR ANY PARTICULAR PURPOSE.
Exemptions
      Mindray's obligation or liability under this warranty does not include any transportation or other
      charges or liability for direct, indirect or consequential damages or delay resulting from the
      improper use or application of the product or the use of parts or accessories not approved by
      Mindray or repairs by people other than Mindray authorized personnel.
      This warranty shall not extend to:
      •      Malfunction or damage caused by improper use or man-made failure.
      •      Malfunction or damage caused by unstable or out-of-range power input.
      •      Malfunction or damage caused by force majeure such as fire and earthquake.
      •      Malfunction or damage caused by improper operation or repair by unqualified or unauthorized
             service people.
      •      Malfunction of the instrument or part whose serial number is not legible enough.
      •      Others not caused by instrument or part itself.
Important Information
      •      It is the customer’s responsibility to maintain and manage the system after delivery.
      •      The warranty does not cover the following items, even during the warranty period:
                                                    II
          –    Damage or loss due to misuse or abuse.
          –    Damage or loss caused by Acts of God such as fires, earthquakes, floods, lightning, etc.
          –    Damage or loss caused by failure to meet the specified conditions for this system, such as
               inadequate power supply, improper installation or environmental conditions.
          –    Damage or loss due to use of the system outside the region where the system was
               originally sold.
          –    Damage or loss involving the system purchased from a source other than Mindray or its
               authorized agents.
      •   This system shall not be used by persons other than fully qualified and certified medical
          personnel.
      •   DO NOT make changes or modifications to the software or hardware of this system.
      •   In no event shall Mindray be liable for problems, damage, or loss caused by relocation,
          modification, or repair performed by personnel other than those designated by Mindray.
      •   The purpose of this system is to provide physicians with data for clinical diagnosis. The
          physician is responsible for the results of diagnostic procedures. Mindray shall not be liable for
          the results of diagnostic procedures.
      •   Important data must be backed up on external memory media.
      •   Mindray shall not be liable for loss of data stored in the memory of this system caused by
          operator error or accidents.
      •   This manual contains warnings regarding foreseeable potential dangers, but you shall also be
          continuously alert to dangers other than those indicated. Mindray shall not be liable for
          damage or loss resulting from negligence or ignorance of the precautions and operating
          instructions described in this operator’s manual.
      •   If a new manager takes over this system, be sure to hand over this operator’s manual to the new
          manager.
                                                 III
              Signal word                                         Meaning
       TIP                         Important information that helps you to use the system more effectively.
Hardcopy 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 [Advanced Volume]
      •      Operator’s Manual [Acoustic Power Data and Surface Temperature Data]
             Contains data tables of acoustic output for transducers.
      •      Quick Reference Guide
             Contains a quick reference guide for basic system operations.
      NOTE:
      The accompanying manuals may vary depending on the specific system you purchased. Please refer
      to the packing list.
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.
Operator’s Manuals
      You may receive multi-language manuals on compact disc or paper. Please refer to the English
      manual for the latest information and registration information.
      The content of the operator manual, such as screens, menus or descriptions, may be different from
      what you see in your system. The content varies depending on the software version, options and
      configuration of the system.
                                                   IV
Contents
Operator’s Manual                                                                                                                                               i
Contents
ii                                                                                                                                  Operator’s Manual
                                                                                                                                                   Contents
iv                                                                                                                              Operator’s Manual
                                                                                                                                                   Contents
            7 Smart 3D ..............................................................................................................7 - 1
                    7.1 Overview ........................................................................................................................ 7 - 1
                         7.1.1 Terms ................................................................................................................... 7 - 1
                         7.1.2 ROI and VOI ....................................................................................................... 7 - 2
                         7.1.3 Render Mode ....................................................................................................... 7 - 3
                         7.1.4 MPR .................................................................................................................... 7 - 3
                         7.1.5 Wire cage ............................................................................................................. 7 - 4
                    7.2 Note before Use ............................................................................................................. 7 - 4
                         7.2.1 Smart 3D Image Acquisition ............................................................................... 7 - 6
                         7.2.2 Smart 3D Image Viewing .................................................................................... 7 - 7
Operator’s Manual                                                                                                                                            v
Contents
vi                                                                                                                                 Operator’s Manual
                                                                                                                                                      Contents
Operator’s Manual                                                                                                                                          ix
Contents
x                                                                                                              Operator’s Manual
1                   Safety Precautions
                    Symbol                                      Description
                                 Type-BF applied part
                                 The ultrasound probes connected to this system are type-BF applied parts.
                                 The ECG leads within this system is type-BF applied part.
                                 Caution!
                    CAUTION
            U.S.A. Federal Law restricts this device to sale by or on the order of a
            physician.
                    DANGER
            Do not operate this system and probes in an atmosphere containing flammable
            gases or liquids such as anesthetic gases, hydrogen, and ethanol, because
            there is danger of explosion.
                WARNING
            •    Do not connect the three-wire cable of the system with a two-wire plug
                 without protective grounding; otherwise, electric shock may result.
            •    Do connect the power plug of this system to wall receptacles that meet the
                 ratings indicated on the rating nameplate. If adapters or multi-functional
                 receptacles are used, it may cause the leakage current to exceed the
                 safety requirement.
            •    In the environment that patient is 1.5 meters around, connect peripherals to
                 the auxiliary power outlet, or power the peripherals by auxiliary output
                 cable or isolation transformer complied with IEC60601-1 or the power input
                 of the same safety level.
            •    DO NOT use power supply of different phases to power peripherals, like
                 power supply of air-conditioning.
            •    When using peripherals not powered by the auxiliary output of the
                 ultrasound system, or using peripherals other than permitted by Mindray,
                 make sure the overall leakage current of peripherals and the ultrasound
                 system meets the requirement of the local medical device electrical
                 regulation (like enclosure leakage current should be no more than 500 uA
                 of IEC60601-1), and the responsibility is held by the user.
            •    Connect the grounding conductor before turning ON the system.
                 Disconnect the grounding cable after turning OFF the system. Otherwise,
                 electric shock may result.
            •    For the connection of power and grounding, follow the appropriate
                 procedures described in this operator's manual. Otherwise, there is risk of
                 electric shock. Do not connect the grounding cable to a gas pipe or water
                 pipe; otherwise, improper grounding may result or a gas explosion may
                 occur.
            •    Before cleaning the system, disconnect the power cord from the outlet.
                 System failure and electric shock may result.
            •    This system is not water-proof designed. Do Not use this system in any
                 place where water or any liquid leakage may occur. If any water is sprayed
                 on or into the system, electric shock may result or the system may be
                 damaged. If water is accidentally sprayed on or into the system, contact
                 Mindray Customer Service Department or sales representative.
            •    DO NOT use a probe that has a damaged, scratched surface, or exposed
                 wiring of any kind. Immediately stop using the probe and contact Mindray
                 Customer Service Department or sales representative. There is risk of
                 electric shock if using a damaged or scratched transducer.
            •    Do not allow the patient to contact the live parts of the ultrasound system or
                 other devices, e.g. signal I/O ports. Electric shock may occur.
            •    Do not use an aftermarket probe other than those specified by Mindray.
                 The probes may damage the system causing a profound failure, e.g. a fire
                 in the worst case.
                 CAUTION
            •    Precautions concerning clinical examination techniques:
                 – This system must be used only by qualified medical professionals.
                 – This operator’s manual does not describe clinical examination
                      techniques. The clinician should select the proper examination
                      techniques based on specialized training and clinical experience.
            •    Malfunctions due to radio wave:
                 – If a radio wave emitting device is used in the proximity of this system, it
                      may interfere with operations. Do not use or take any devices
                      transmitting RF signals (such as cellular phones, transceivers and radio
                      controlled products) in the room placing the system.
                 – If a person brings a device that generates radio waves near the
                      system, ask him/her to immediately turn OFF the device.
            •    Precautions concerning movement of the system:
                 – When you place the system on the mobile trolley and move them
                      together, you must secure all objects on the mobile trolley to prevent
                      them from falling. Otherwise you should separate the system from the
                      mobile trolley and move them individually.
                      When you have to move the system with the mobile trolley upward or
                      downward the stairs, you must separate them first and then move them
                      individually.
                 – Object placed on the monitor may fall and injure an individual when
                      moving.
                 – Confirm that there is no peripheral device connected to the system
                      before moving the system. Otherwise, peripheral device may fall and
                      injure an individual.
            •    If the circuit protector is tripped, it indicates that the system or a peripheral
                 device was improperly shut down and the system is unstable. You cannot
                 repair the system under this circumstance and must call the Mindray
                 Customer Service Department or sales representative.
            •    There is no risk of high-temperature burns during normal ultrasound
                 examinations. It is possible for the surface temperature of the transducer to
                 exceed the body temperature of a patient due to environmental
                 temperature and exam type combinations. Do not apply the transducer to
                 the same region on the patient for a long time. Apply the transducer only for
                 a period of time required for the purpose of diagnosis.
            •    Do not use the system to examine a fetus for a long period of time.
            •    Except accessories that have been stated as sterile, the system and its
                 accessories are not disinfected or sterilized prior to delivery. The operator
                 is responsible for the cleaning and disinfection of probes and sterilization of
                 biopsy brackets according to the manuals, prior to the use. All items must
                 be thoroughly processed to completely remove harmful residual chemicals,
                    which will not only harmful to the human body, but also damage the
                    accessory.
            •       It is necessary to end the current scan that is in progress and clear the
                    current Patient Information field. Otherwise, new patient data may be
                    combined with the previous patient data.
            •       Do not connect or disconnect the system’s power cord or its accessories
                    (e.g., a printer or a recorder) without turning OFF the system power first.
                    This may damage the system and its accessories or cause electric shock.
            •       If the system is powered off improperly during operation, it may result in
                    data damage of the system’s hard disk or system failure.
            •       Do not use a USB memory device (e.g., a USB flash drive, removable hard
                    disk) which has unsafe data. Otherwise, system damage may result.
            •       It is recommended to only use the video devices specified in this manual.
            •       Do not use gel, disinfectant, probes, probe sheath or needle-guided
                    brackets that are not compatible with the system.
            •       The applied contrast agency should be compliant with the relevant local
                    regulations.
            •       Read the Acoustic Output Principle in the operation manual carefully before
                    operating this system on clinical examination.
            •       The cover contains natural rubber that can cause allergic reactions in some
                    individuals.
            •       Please use the ultrasound gel compliant with the relevant local regulations.
            •       DO NOT expose the system to excessive vibration through transportation.
                    Mechanical damage may result.
            •       Always keep the system dry. Avoid transporting this system quickly from a
                    cold place to a warm place; otherwise condensation or water droplets may
                    form allowing a short circuit and possible electric shock.
            NOTE:
            •       DO NOT use the system in the vicinity of strong electromagnetic field (such as a transformer),
                    which may affect the performance of the system.
            •       Do not use the system in the vicinity of high-frequency radiation source (e.g. cellular phones),
                    which may affect the performance of the system or even lead to failure.
            •       When using or placing the system, keep the system horizontal to avoid imbalance.
            •       To avoid damaging the system, do not use it in following environment:
                    –   Locations exposed to direct sunlight.
                    –   Locations subject to sudden changes in environmental temperature.
                    –   Dusty locations.
                    –   Locations subject to vibration.
                    –   Locations near heat generators.
                    –   Locations with high humidity.
            •       Turn ON the system only after the power has been turned OFF for a while. If the system is
                    turned ON immediately after being turned OFF, the system may not be rebooted properly and
                    could malfunction.
            •    Use the Freeze key to freeze an image or turn off the power of the system before connecting or
                 disconnecting a probe.
            •    Remove the ultrasound gel from the face of the transducer when the examination is completed.
                 Water in the gel may enter the acoustic lens and adversely affect the performance and safety of
                 the transducer.
            •    You should properly back up the system to a secure external storage media, including system
                 configuration, settings and patient data. Data stored to the system’s hard drive may be lost due
                 to system failure, improper operation or accident.
            •    Do not apply external force to the control panel. Otherwise, the system may be damaged.
            •    If the system is used in a small room, the room temperature may rise. Please provide proper
                 ventilation and free air exchange.
            •    To dispose of the system or any part, contact Mindray Customer Service Department or sales
                 representative. Mindray is not responsible for any system content or accessories that have been
                 discarded improperly.
            •    Electrical and mechanical performance may be degraded due to long usage (such as current
                 leakage or distortion and abrasion); the image sensitivity and precision may become worse too.
                 To ensure optimal system operations, it is recommended that you maintain the system under a
                 Mindray service agreement.
            •    Refer replacing job to Mindray service engineers or engineers authorized by Mindray only.
            •    Do not turn OFF the power supply of the system during printing, file storage or invoking other
                 system operations. An interrupted process may not be completed, and can become lost or
                 corrupted.
            •    Ensure that the current exam date and time are the same as the system date and time.
            •    Use detachable power supply cord as mains power breaking device. DO NOT set equipment in
                 place where difficult for disconnection of detachable power supply cord.
            Please read the following precautions carefully to ensure the safety of the patient and the operator
            when using the probes.
                WARNING
            •    The ultrasound probe is only for use with the specified ultrasound
                 diagnostic system.
            •    The ultrasound probe must be used only by qualified professionals.
            •    Confirm that the transducer and probe cable are normal before and after
                 each examination. A defective probe may cause electric shock to the
                 patient.
            •    Do not subject the probe to shock. A defective probe may cause electric
                 shock to the patient.
            •    Do not disassemble the probe to avoid the possibility of electric shock.
            •    Never immerse the probe connector into liquids such as water or
                 disinfectant because the connector is not waterproof. Immersion may
                 cause electric shock or malfunction.
            •    A transducer sheath must be installed over the transducer before
                 performing examination.
            •       When using a probe, pay attention to the status of the ultrasound image.
                    Do not use the probe to perform image acquisition when the image is
                    frozen.
                    CAUTION
            •       When using the probe, wear sterile gloves to prevent infection.
            •       Be sure to use sterile ultrasound gel. Please use the ultrasound gel com-
                    pliant with the relevant local regulations. And manage the ultrasound gel
                    properly to ensure that it does not become a source of infection.
            •       In normal diagnostic ultrasound mode, there is no danger of a normal-
                    temperature burn; however, keeping the probe on the same region of the
                    patient for a long time may cause such a burn.
            •       Do not use the carrying case for storing the transducer. If the carrying case
                    is used for storage, it may become a source of infection.
            •       It is required to practice ALARA when operating ultrasound system.
                    Minimize the acoustic power without compromising the quality of images.
            •       The probe and accessories supplied with it are not delivered disinfected or
                    sterilized. Sterilization (or high-level disinfect) before use is required.
            •       Disposable components should be packaged sterile and for single-use
                    only. Do not use if integrity of packaging violated or if expiration date has
                    passed. Please use the disposable components compliant with the relevant
                    local regulations.
            •       Please use the disinfection or sterilization solution recommended in this
                    operator's manual; otherwise Mindray will not be liable for damage caused
                    by other solutions. If you have any questions, please contact Mindray
                    Customer Service Department or sales representative.
            •       Do not use pre-lubricated condoms as a sheath. Lubricant may not be
                    compatible with the probe material and damage may result.
            •       The damage of the transducer may be caused by the contact of improper
                    gel or cleaner:
                    – DO NOT dip the transducer in the strong polar solution of ethanol,
                         chloride of lime, ammonium chloride, acetone and formaldehyde.
                    – DO NOT contact the transducer with solution or ultrasound gel
                         containing oily medium such as mineral oil or lanoline.
            NOTE:
            •       Read the following precautions to prevent the probe from malfunction:
                    –   Before connecting or disconnecting the probe, freeze or turn off the diagnostic ultrasound
                        system.
                    –   Clean and disinfect the probe before and after each examination.
                    –   After the examination, wipe off the ultrasound gel thoroughly. Otherwise, the ultrasound
                        gel may solidify and the image quality would be degraded.
            •    Repeated disinfection will eventually damage the probe, please check the probe performance
                 periodically.
                WARNING
            Allergic reactions in patients sensitive to latex (natural rubber) may range from
            mild skin reactions (irritation) to fatal anaphylactic shock, and may include
            difficulty breathing (wheezing), dizziness, shock, swelling of the face, hives,
            sneezing, or itching of the eyes (FDA Medical Alert on latex products, “Allergic
            Reactions to Latex-containing Medical Devices”, issued on March 29, 1991).
2.2         Contraindication
            For FDA region: None.
            For Canada region: Ophthalmic use is only permitted by probes with an ophthalmic indication.
           B Mode               B
           M Mode               M
           C Mode               Color
                                Power (DirPower)
           D Mode               PW/CW
           Special imaging      iScape View
                                Free Xros M
                                Free Xros CM
                                Tissue Doppler Imaging
                                TDI QA
                                Contrast Imaging
                                Contrast Imaging QA
                                LVO
                                Low MI Contrast
                                Strain Elastography
                                Stress Echo
                                Tissue Tracking QA
                                Smart 3D
                    WARNING
            Do not use this system in conditions other than those specified.
            NOTE:
            •       Histogram - measures and counts the gray distribution of ultrasonic echo signals within a
                    closed region.
            •       Profile - measures the gray distribution of ultrasonic echo signals on a line.
            •       Color Vel - measures the velocity of blood flow on the Color Mode image.
            •       Double-Dist - measures the lengths of line segments A and B perpendicular to each other.
            •       Spline length - measures the length of a curve on the image.
            •       Parallel line - measures the distance between every two line segments of five parallel line
                    segments, namely, four distances in total.
            •       Only MX7, MX7T, ME7, MX8 and ME8 are available in Canada.
2.6.3 Options
                               Item                                  Remarks
           Mobile Trolley                        Power supply, retractable cable
                                                 Power supply, without retractable cable
                                                 Without power supply, without retractable cable
           ECG module                            /
           Multilingual controls overlay         /
           Dust-proof cover                      /
           WiFi module                           /
           ECG cables                            ECG module should be configured
           DC-IN cable                           ECG module should be configured
           U-Bank (2 Batteries or 4 Batteries)   /
           Ultrasound gel                        /
           Magnetizer                            /
                             Item                                        Remarks
             Special imaging iScape View             /
                             Free Xros M             /
                             Free Xros CM            /
                             Tissue Doppler Imaging Cardiology Package should be configured.
                             TDI QA                  TDI should be configured.
                             CW                      /
                             Contrast imaging        /
                             Contrast Imaging QA     Contrast Imaging should be configured.
                             LVO                     Cardiology Package should be configured.
                             Low MI Contrast         Cardiology Package should be configured.
                             Strain Elastography     /
                             Stress Echo             Cardiology Package should be configured.
                             Tissue Tracking QA      Cardiology Package should be configured.
                             Smart 3D                /
             DICOM           DICOM Basic             DICOM Basic, including:
                                                     • Verify (SCU and SCP)
                                                     • Task management
                                                     • DICOM Storage
                                                     • DICOM Print
                                                     • DICOM Storage Commitment
                                                     • DICOM Media Storage (including DICOM DIR)
                             DICOM Worklist          DICOM Basic should be configured.
                             DICOM MPPS
                             DICOM Query/Retrieve
                             DICOM OB/GYN SR
                             DICOM Vascular SR
                             DICOM Cardiac SR
                             DICOM Breast SR
                             DICOM Abdomen SR
                              Item                                         Remarks
           Application       Abdomen/General           /
           packages          Package
                             Obstetrics Package        /
                             Smart OB                  Obstetrics package should be configured.
                             Smart NT                  Obstetrics package should be configured.
                             Gynecology Package        /
                             Cardiology Package        /
                             Small Parts Package       /
                             Urology Package           /
                             Vascular Package          /
                             Pediatrics Package        /
                             Nerve Package             /
                             Emergency&Critical        /
                             Package
                             RIMT                      Vascular Package should be configured.
                             AutoEF                    Cardiology Package should be configured.
                             R-VQS                     Vascular Package should be configured.
                             Smart B-line              /
                             Smart VTI                 Cardiology Package should be configured.
                             Smart IVC                 /
           Others            iWorks                    /
                             iNeedle                   /
                             eSpacial Navi             /
                             iVocal                    /
                             McAfee                    /
                             DVR Module                /
                          Item                                          Model
           Black/ white video printer           MITSUBISHI P95DW-N
           (digital)
           Black/ white video printer           SONY UP-X898MD
           (analog)
           Digital color video printer         SONY UP-D25MD
           iVocal                               SAMSON XPD1 Headset
                                                SAMSON XPD1 Presentation
                                                PYLE PUSBMIC43
                              Item                                 Model
             External DVD R/W drive         DVDRW HP GP60NB60
             Barcode reader                 DS4308
                                            LS2208
                                            JADAK HS-1M
                                            JADAK HS-1R
             Footswitch                     971-SWNOM (2-pedals)
                                            971-SWNOM (3-pedals)
                                            FS-81-SP-2 (1-pedal)
                    WARNING
            This system complies with IEC60601-1-2: 2014, and its RF emissions meet the
            requirements of CISPR11 Class B. In a domestic environment, the customer or
            user should ensure the system is connected to Class B peripheral devices,
            otherwise RF interference may occur, and the customer or user must take
            adequate measures accordingly.
                                    2
                                    3
                                    4
                                    5
                                    6
                                    7
                                    8
10
11
                                   12
                                   13
1 2 3 4 5 6
L1 L2 L3 L4 L5
2 - 10                                                                                           Operator’s Manual
                                                                                                   2 System Overview
                                                       NOTE:
                                                          When the U-Bank is charging or when you are pressing
                                                          the power button, the indicator blinks in orange for 5s,
                                                          and other indicators remain off. It indicates that the U-
                                                          Bank may have malfunction. Please stop using the U-
                                                          Bank and contact the Mindray service engineers or
                                                          your sales representative.
             6.          Power button                  Used for checking the U-Bank power status.
             7.          Detach levers                 Used for detaching the U-Bank from the system.
                                                       One is located at front side, and the other is located at the
                                                       bottom.
                                                       NOTE:
                                                          Press the two levers at the same time to detach the U-
                                                          Bank from the system. When the U-Bank is placed on a
                                                          flat platform, just use the front lever to detach.
             8.          Lock/Release tabs             Used for fixing the U-Bank to the system.
                                                       Release the U-Bank from the system by using the detach
                                                       lever(s).
Operator’s Manual                                                                                               2 - 11
 2 System Overview
           3.    Push the system in the arrow direction as shown in the figure above until the system is locked
                 in place.
           TIP:
           To remove the U-Bank from the system, press the detach lever of U-Bank and lift up slightly the
           system by holding the system’s handle.
2 - 12                                                                                         Operator’s Manual
                                                                                                  2 System Overview
1 2 3 4 5 6 7 8 9 10 11 12
                                                                                                               13
             24
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             23
             22                                                                                                15
             21
             20                                                                                                16
                                                19          18                17
1 2 3 4 5 6 7 8 9 10 11 12
                                                                                                                13
              24
                                                                                                                14
              23
              22                                                                                                15
              21
              20                                                                                                16
                                                 19             18            17
Operator’s Manual                                                                                             2 - 13
 2 System Overview
            13.      iTouch/Gain Gain and iTouch         Adjust the gain of the image in various modes.
                                 knob                    • Press to enter iTouch mode.
                                                         • Long press to exit iTouch mode.
                     Gain         Gain knob              Adjust the gain of the image in various modes.
            14.      Depth        Depth adjustment       Adjust the depth parameter when the indicator is
                                  button and             on.
                                  functional interface
            15.                   Save static image      Save images in a preset way.
                                  button
2 - 14                                                                                         Operator’s Manual
                                                                                          2 System Overview
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1 2 3 4 5 6 7
10 9 8
2 - 16                                                                                           Operator’s Manual
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                                                               9
                    1
                    4
                    5
                    6                                                                                      7
Operator’s Manual                                                                                              2 - 17
 2 System Overview
                 CAUTION
           If the exam mode is changed during a measurement, all measurement calipers
           on the image will be cleared. The data of general measurements will be lost,
           but the data of application measurements will be stored in the reports.
           Connect proper probes to the system, and tap [Probe] on the touch screen, the touch screen displays
           the following dialog box.
2 - 18                                                                                            Operator’s Manual
                                                                                               2 System Overview
5 4 3
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                  1
                  2                                                                                        14
                  3
                  4
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                                                                                                           12
                                                                                                           11
                  5                                                                                        10
                                                                                                           9
                                                                                                           8
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                                                                                                2 System Overview
                    Function                                          Operations
             Adding a control      Tap     to select a button to add and tap [Confirm].
             Add a user-defined In comment and body mark editing status, tap       and then tap [Custom] to
             control            bring out the dialog box for adding user-defined controls. Enter the control
                                name and tap [Confirm].
             Delete a control      Tap     of the target control and tap [Confirm] to delete.
             Change the control Tap and drag the control to the desired position.
             position
1 2 3
Operator’s Manual                                                                                           2 - 21
 2 System Overview
                 No.                                          Description
            1.            Click to speak to the microphone (the system recognizes the vocal order). The
                          system conducts the operations after recognizing the voice.
            2.            Click to stop the voice Recognition.
            3.            Click to open the help information.
            2.         The following labels are        1. Do not place the system with the mobile trolley
                       available when the system works    on a sloped surface. Otherwise the system may
                       with the mobile trolley.           slide, resulting in personal injury or the system
                                                          malfunction. Two persons are required to move
                          1                               the system over a sloped surface.
                                                           2. DO NOT sit on the trolley.
                                                           3. When the casters are locked, DO NOT push the
                           2             3                    trolley.
3. Non-ionizing radiation
2 - 22                                                                                          Operator’s Manual
                                                                                                2 System Overview
2.15 Symbols
            This system uses the symbols listed in the following table. Their meanings are explained as follows:
                                Symbol                                            Description
                                                              Type-BF applied part
Caution!
Standby
Transducer sockets
Network port
HDMI port
USB port
AC (Alternating current)
Standby indicator
Harddisk indicator
Battery indicator
Unlock position
Lock position
Dust-proof mesh
Equipotentiality
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 2 System Overview
                     Symbol                     Description
                              Manufacture date
Manufacturer
Power consumption
2 - 24                                                          Operator’s Manual
3                   System Preparation
                    CAUTION
            Maintain a generous, free air flowing space around the back and both sides of the
            system. Not doing so may result in failure due to the increased rise in the system's
            operating temperature.
            NOTE:
            •       You must use the specified power adapter.
            •       Do not use this power adapter in the conditions other than those specified.
                WARNING
           •    The battery is inside the machine. Only Mindray technical professionals or
                engineers authorized by Mindray following training can perform battery
                installation and uninstallation.
           •    If you need to change the battery or buy a new one, contact your sales
                representative.
           •    The replacement of lithium batteries by inadequately trained personnel
                could result in a HAZARD (such as excessive temperatures, fire or
                explosion).
Battery Performance
           Under power off or standby status, charging time of the battery from capacity 0 to 100% takes less
           than 4 hours.
           NOTE:
           Power off the system if it will not be used for a long period of time (including storage/transportation
           condition). Do not leave the system in standby status, otherwise the batteries will be discharged and
           permanently damaged.
Battery specification
           •    Voltage: 14.4 V
           •    Capacity: 6600 mAh (single battery)
            •       There is no condensation.
            •       There is no distortion, damage or dirt on the system and peripheral devices.
                    If any dirt is found, cleaning shall be performed, see “18 System Maintenance”.
            •       There are no loose screws on the monitor, control panel or the trolley.
            •       There is no cable damage (e.g., power cord). Maintain secure connections to the system at all
                    times.
            •       The probes and probe cables are free from damage or stains.
                    For details of probe cleaning and disinfection, see “16.1.5 Probes Cleaning and Disinfection”.
            •       No miscellaneous odds and ends are attached or affixed to the control panel.
            •       Ensure that all connections are free from damage and remain clear of foreign object blockages.
                    There are no obstacles around the system and its air vent.
            •       Probe cleaning and disinfection.
            •       The entire scanning environment and field must be clean.
            •       The locking mechanism of the casters (if there is a trolley) works normally.
To change users
            Perform the following procedure:
            1.      To log out the current user and change to another user, click    in the bottom-right corner of
                    the screen to bring up the following dialog box
To modify password
            General operators and administrators can modify the password.
            Perform the following procedure:
           1.   Click     in the bottom-right corner to bring up the Session Manage dialog box where you can
                see the current user’s information.
           2.   If you want to modify the current password, click [Change Password] to bring up the Change
                Password dialog box.
           3.   Enter both the previous and new passwords, and confirm the new password in the dialog box.
           4.   Click [OK] to exit.
                WARNING
           •    If you use a probe giving off excessive heat, it may burn the patient.
           •    If you find anything not functioning properly, this may indicate that the
                system is defective. In this case, shut down the system immediately and
                contact Mindray Customer Service Department or sales representative.
           NOTE:
           When you start the system or switch between transducers, you will hear clicking sounds – this is
           expected behavior.
            NOTE:
            •       Press and hold the power button for a long time and the system will power off without
                    displaying the “Shutdown Confirm” screen. However, shutting down the system this way may
                    destroy the data.
            •       DO NOT rush direct shutdown of the system. It may damage the data.
            •       After the system is upgraded, use [Shutdown] to power the system off to make the upgraded
                    data effective.
3.3.5 Standby
            NOTE:
            •       Power off the system if you will not use the system for a long period of time (including
                    storage/ transportation condition), and you should not allow the system in standby status,
                    otherwise the batteries will be out of power and permanently damaged.
            •       If the system will not be used for a long period of time, you should disconnect the power
                    adapter, disconnect the mains power, and turn off the power to all peripherals connected to the
                    system.
To enter standby
            •       Fully fold the LCD display and wait for 30 seconds, then the system enters the standby status.
            •       Set the time for screen saver and standby, see “4.1.2 General”. If the system is not carrying out
                    an operation, the screensaver appears after the screensaver delay period. If there is still no
                    operation, the system enters standby after the standby delay period.
            •       Press the power button and select “Standby”.
To exit standby
            •       Unfold the LCD display.
            •       Press the power button.
            NOTE:
            On the monitor, the brightness adjustment comes before contrast. After readjusting the monitor’s
            contrast and brightness, adjust all preset and peripheral settings.
           NOTE:
           Before inserting the connector into the probe port, inspect the connector pin. If the pin is bent, do
           not use the probe until it has been inspected/repaired/replaced.
            •       When connecting a USB memory device to the ultrasound system via a USB port, a sound is
                    heard if it is connected successfully and the symbol appears in the bottom-right corner of
                    the screen.
            •       To remove the USB device: click      to open the [Remove USB Device] screen. Select the
                    device to be removed and click [OK]. A sound is heard when removing the USB memory
                    device.
            •       The system supports option of external DVD R/W drive. The DVD R/W drive is connected to
                    the ultrasound system via USB port.
            NOTE:
            •       When connecting an external DVD R/W drive, connect the two cables of the drive to the
                    ultrasound system if the drive provides 2 USB power cables. In this way, the DVD R/W drive
                    can work more normally.
            •       If the USB disk cannot be recognized by the system, please try disconnecting and then
                    connecting again several times, or try another USB disk. If the problem still exists, please
                    contact Mindray service engineer.
The function of the foot switch can be preset. For details, see “4.1.7 Key Configuration”.
                                                                             2
                                                 1
            2.      Connect the power cord of the printer to a receptacle. Connect the USB port of the system to
                    the USB port of the printer with USB cable.
            3.      Load a paper roll and turn on the system and printer.
            4.      Add a print service:
                    a.   Open [Setup] > [Print] screen.
                    b.   Click [Add Service] to enter the page.
                    c.   Select the service type and enter the service name manually.
                    d.   Click [OK] to return to the page.
                    e.   Select the target printer from the drop-down list in the “Property” box and set other
                         printing properties.
                    f.   Click [OK] to complete.
            The Setup function is designed to set the configuration parameters of operating the system and
            maintaining user workflow setup data. The setup data of the user and system are stored to the hard
            drive, and should be backed up to CD/DVD or USB memory device.
                    CAUTION
            When the preset data is changed, be sure to save the preset data according to
            the methods described in this chapter. Mindray is not responsible for the loss of
            preset data.
            •       To enter Setup:
                    Tap [Setup] on the exam main screen of the touch screen.
            •       To exit Setup:
                    –   Select [OK] in the Setup menu. The parameter settings are saved.
                    –   Select [Cancel] in the Setup menu to close the Setup menu.
                    When you change the system language and click [OK] in the Setup menu, the system
                    automatically shuts down to make the modification effective.
            •       Basic operations
                    The commonly-used setting types are:
                    –   Text box: position the cursor over the corresponding field box. Enter the desired value
                        using the soft keyboard on the soft menu.
                    –   Radio button: click the button to select an item.
                    –   Check box: click the checkbox to select one or more options.
                    –   Drop-down list: click the arrow beside the list to select an item.
                    Item                                            Description
          Hospital Information        To set the hospital-relevant information such as name, address,
                                      telephone, and so on.
          Language                    To select a language (input) for the system.
          Load Logo                   Import image for logo loading.
                                      NOTE:
                                         For a better display effect, please try to use an BMP image with
                                         400*400 pixels and 8/24/32 bitdepth.
          Time Zone                   To select the time zone.
          Time Format                 To select the time format.
          Date Format                 To set the date format.
          System Date                 To set the date for the system.
          System Time                 Move the cursor over the corresponding field and enter the time
                                      manually using the keyboard, or, move the cursor over the time segment
                                      and press <Set>, then increase or decrease the required value by
                                      clicking the icons on the right side.
          Time Synch                  To assign a time server and make the time of the ultrasound machine
                                      consistent with the server.
4.1.2 General
          Set patient information, exam setup, patient management, storage, system dormancy, auxiliary
          output setting and so on.
4.1.4 Application
          Set the measurement ruler, measurement setting, follicle method, left ventricular setting, comment
          setting and so on.
Measure Ruler
            Controls are as follows:
                      Item                                            Description
             Cursor Type               Type of cursor displayed on the measurement caliper and results
                                       window. Value options:
                                       • Number: the cursor always displays as “+” while different
                                          measurements are marked with numbers.
                                       • Symbol: the cursor displays sequentially in 8 symbols to identify
                                          different measurements.
             Cursor Size               The size of the cursor.
             Heart Beat                The number of cardiac cycles in the heart rate calculation. (In heart rate
                                       measurement, the number of cardiac cycles should match the preset
                                       number.)
             Cursor Line Display       If unselected, the connecting line between the measuring ends will be
                                       hidden after measurement.
             Ellipse Cross Line        If unselected, the measuring axis within the ellipse area will be hidden
             Display                   after measurement.
             Clear results while       Uncheck. The image is unfrozen or the image mode is changed after the
             deleting caliper          measurement is completed. The measurement results are saved if the
                                       caliper is cleared.
             Unit Setting              To set the measurement unit.
LV Cube/Teichholz/Gibsom
            Set the tools used in the Cube/Teichholz/Gibson study.
Follicle
            Set the method for calculating the follicle.
PW Measure
            PW measure velocity displays absolute value.
            All measurement results in PW mode are absolute values based on the unit of velocity after
            checking this item.
Comment
            Set whether to clear comments and bodymark:
                             Item                                           Description
             Clear comments while unfreezing          To set whether to clear comments while unfreezing image
             image or changing probe/exam             or changing probe/exam.
             Clear Bodymark upon unfreeze             To set whether to clear bodymark whiling unfreezing
                                                      image.
             Press comment/bodymark key enter         To set enter comment mode after pressing comment/
             comment mode                             bodymark key.
Intelligent Input
            Set to enable the Input Method Association.
4.1.5 OB
          Set the relevant information regarding the fetal gestational age, fetal growth formula and fetal
          weight.
          TIP:
          Only imported user-defined tables can be exported.
                    NOTE:
                        •    Fill in the table according to the actual clinical values, except for those cells with bold
                             text.
                        •    Value of standard deviation. Select from one of the following: None, ±1SD, ±2SD,
                             3%~97%, 5%~95%, 10%~90%.
                        •    Unit of the measurement value: according to the table to import, select from mm, cm, g,
                             kg, cm² or mm².
                        •    Row number (N) of the table: the maximum row number N in the column “No.”
                        •    The third row is empty.
                        •    GA value, Minimum value, Measurement value, Maximum value: enter the number of
                             days without the unit.
                    –       GA table
                    NOTE:
                        •    Fill in the table according to the actual clinical values, except for those cells with bold
                             text.
                        •    Value of standard deviation. Select from one of the following: None, ±1SD, ±2SD,
                             3%~97%, 5%~95%, 10%~90%.
                        •    Unit of the measurement value: according to the table to import, select from mm, cm, g,
                             kg, cm² or mm².
                        •    Row number (N) of the table: the maximum row number N in the column “No.”
User-defined OB Items
          NOTE:
          The calculation results of the user-defined OB formulae are used for reference rather than clinical
          diagnosis.
          You can add user-defined formulae for items (obstetric tools) that are not included in the GA and
          FG table.
          1.   Select [More OB Items] on the Fetal Gestational Age or Fetal Growth page.
          2.   Select an item and click [OK].
          3.   The new item appears in the left column and the system asks if to add a formula.
          4.   Click [OK] to select the *.csv file (formula file) for the item. Or add a formula for the new item
               by clicking [Import].
Measure Result
          EDD display: the EDD is displayed in the result window after checking.
                      Item                                          Description
          K1                         To set the function of K1 button.
          K2                         To set the function of K2 button.
          K3                         To set the function of K3 button.
          Enable Key Probe Key       After it is ticked, the key function of Key probe is enabled.
          Function
            2.      Click to select a function in the Function area. You can see the available functions selected on
                    the right side.
            3.      Click [OK] to complete the function setting.
Trackball Speed
            Set the speed of the trackball when using the trackball.
Key Volume
            Set the key volume level.
Key Brightness
            Set the brightness for the keys.
Trackball Light
            Set the light color for the trackball.
Touchscreen Volume
            Set button volume level on the touch screen.
           TIP:
           Repeat step 3 will continue adding auxiliary functions; you can add 6 functions at most.
4.1.8 Gesture
           The gesture setting is the same with the settings of other keys, see “4.1.7 Key Configuration”.
4.1.9 Output
           Set the output format, the range and the resolution for the image.
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                                                                                                           4 Setup
                    The operator can only access the function modules with assigned privileges. The operator can
                    only view exam information saved in the system and operated by him or herself, such as
                    patient information, images and reports, etc.
Deleting a User
            Turn on the access control function and log in to the system as Administrator before you delete the
            user.
            Select the user to be deleted in the User List. Click [Delete] to delete the selected user.
Editing Privilege
            Turn on the access control function and log in to the system as Administrator before you edit
            privileges.
            1.      Select a user, click [Edit Privilege] to enter the “Edit user privilege” dialog box.
            2.      Select or deselect the check box from the privilege list.
            3.      Click [OK] to confirm the editing and exit the dialog box.
                    The edited privileges will appear in the User List.
Modify Passwords
            The system administrator can modify all user passwords. The administrator password is empty by
            factory default. You can set this password.
            An operator can only modify his/her own password.
            1.      Select the user name to be modified in User List.
            2.      Click [Change Password] to open the dialog box.
            3.      Enter current password, new password and confirm new password, then click [OK].
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 4 Setup
                       Item                                          Description
           Service Address              Enter the server address in the field box after accessing the network
           Test LDAP Server             To test whether the LDAP server is accessible. If the LDAP is
                                        accessible, the system prompts the following message “Server test
                                        succeeded.”
           Root DN                      It is automatically displayed after the server is successfully tested.
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                                                                                                            4 Setup
                       Item                                           Description
             Default Domain              The default domain is the DC name in the Root DN. For example, if
                                         DC=security1, then input "security1" in the field box of the "Default
                                         Domain"
             Days to keep cached         Set days to keep the cached passwords in the local system.
             password                    Users can log in to the server even without accessing the network
                                         within the setting days.
                                         • Empty: the passwords are kept in the local system permanently.
                                         • 0: no passwords are kept in the local system.
                                         • ≥1: for example, if it is set to 5, the passwords are kept in the local
                                            system for 5 days.
             Member of filter/Privilege • Enter the member name, and select or deselect privileges from the
                                          drop-down list of “Privilege”.
                                        • Click [Add], and the new members and privileges will appear in
                                          the Member of filter list.
                                        • Select a member to be deleted, and click [Delete].
                                        • Select a member to be modified, modify the member name, and
                                          select or deselect privileges from the drop-down list of
                                          “Privilege”. Click [Modify], and the modified member name and
                                          privileges will appear in the Member of filter list.
             Logon Test                  1. Enter the User name and password in the field boxes of the
                                            Authentication test area.
                                         2. Click [Logon Test] to test whether the user is authenticated.
             User field name             Select [Use user field name] to customize the user field name. After
                                         that, the members and privileges cannot be edited.
                                         Enter the user field name in the field box of the “User field name”
                                         (the user field names are configured in the LDAP server. For details,
                                         please refer to the LDAP server manual).
                                         The user field name corresponding to privileges are as follows:
                                         • iStation Access: 1
                                         • Save Exam: 2
                                         • Export Exam: 4
                                         • Network Settings: 8
                                         • Maintenance Menus: 16
                                         • System Settings: 32
                                         • Workflow Settings: 64
                                         • Worklist Access: 128
                                         NOTE:
                                            The privilege items can be combined randomly. For example, if
                                            user A is assigned with all the above 8 privileges, the user field
                                            name for user A is 1+2+4+8+16+32+64+128=255.
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 4 Setup
                b.   Position the cursor on the target scene and press <Set> to switch.
           4.   Configure scenes:
                a.   In non-preset screen, press <Cursor> to show the cursor and move the cursor to the
                     bottom-right corner of the screen. Click    icon to see the scene management list.
                b.   Click [Configure] to see the following dialog box.
                c.   Add scenes: click [Add] and enter the scene name in the Add Scene dialog box and then
                     click [OK].
                d.   Click to select the target scene name in the Scene Name list on the left side.
                e.   Click to select a desired preset service on the right to open the screen.
                f.   Set necessary parameters and click [Save] to exit.
                g.   Click [Exit] to exit configuration.
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                                                                                                        4 Setup
                    Item                                        Description
             Scan Item          After scanning 1D bar code, the regular expression is matched in the priority
                                order: “Patient ID > Other ID > First name > Last name > Middle name >
                                Accession# > Operator > Diagnostician”. If the regular expression is
                                matched successfully, the data of 1D bar code will be displayed in this item
                                in Patient page automatically.
                                Example: The data of the bar code is 123 after scanning 1D bar code. The
                                regular expression is matched in the priority order: “Patient ID > Other ID >
                                First name > Last name > Middle name > Accession# > Operator >
                                Diagnostician”. If the regular expression of “Other ID” is matched
                                successfully, “123” will be displayed in “Other ID” item in Patient page
                                automatically.
             Regular            Set the regular expression according to the bar code format.
             Expression
             Append Options     The information of operator or diagnostician can be appended after selecting
                                the check box.
                                For example, after scanning a 1D barcode of an operator or diagnostician, the
                                obtained data is A, and A will be displayed in “Operator” or “Diagnostician”
                                item in Patient page automatically.
                                After scanning a 1D barcode of an operator or diagnostician for a second
                                time, the obtained data is B, and A will be appended by B in “Operator” or
                                “Diagnostician” item in Patient page automatically.
             Default Item       If the default item is set to “No”, and both the 2D and 1D barcodes fail to be
                                matched, the obtained data of the barcode is input as a string of characters.
                                After selecting a default item from the drop down list of “Default Item”, the
                                obtained data of the scanned barcode will be displayed in the corresponding
                                selected default item.
                                For example, if the default item is set to “Patient ID”, and both the 2D and
                                1D barcodes fail to be matched, the obtained data is displayed in the “Patient
                                ID” item in Patient page automatically.
             Move Up/Down       Move up or Move down a selected item.
             Add/Delete         Add or delete a selected item. (Only the default item can be added or
                                deleted.)
             Load default       Restore the parameter value to the default value.
             Worklist Options   • Select “Worklist server” from the drop-down list, and the system searches
                                  the Worklist server according to the scanned data.
                                • Select “No” from the drop-down list, and the system creates a new exam
                                  in the Patient page according to the scanned data.
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 4 Setup
                  Item                                         Description
           Worklist Default    • Select a default item for searching the Worklist server.
                                 For example, users select “Patient ID” from the drop down list of
                                 “Worklist Default”, and the system searches Patient ID in the Worklist
                                 server.
                               • Select “No”, and the system searches the Worklist server in the priority
                                 order: “Patient ID” > “Last name” > “Accession #”.
                               NOTE:
                                  The matching priority order is 2D item, 1D item, and Default Item, after
                                  the 1D/2D and default items are configured.
           Import/Export       Import and export configuration files to preset the barcode. For details,
                               please contact the Mindray service engineer.
                      Item                                        Description
           Scan Barcode Example     Input a barcode example, barcode example is separated by separators
                                    (the separator is used to set the start and end position of each item), and
                                    the barcode data is displayed in the following items in turn.
           Parameters               • Input a barcode example, and you can change the information of
                                      Patient ID, Other ID, First Name, Last Name, Middle Name, Birth
                                      (Day), Birth (Month), Birth (Year), Age, Gender and etc. in the
                                      “Content” list.
                                      Note: Ignore item is used to add one line below the selected item to
                                      hide unimportant patient information.
                                    • Set the start and end position of each item via separators. After
                                       inputting a barcode example, you can select item separators from the
                                       drop-down list of the Separator. (Only separators that are input in the
                                       field box of the Scan Barcode Example can be displayed in the drop-
                                       down list of the Separator.)
                                    Note: You can customize the age unit of Birth (Day), Birth (Month),
                                    Birth (Year) in the Content column. If the DOB provided by the patient
                                    contains only digit, the system displayed an auto-generated age.
           Age Unit                 Select an age unit from the drop-down list of the “Age Unit”: Year,
                                    Month, or Day.
           Male/Female              Input the customized gender symbol besides the Male and Female field
                                    box, such as Male (M) or Female (F).
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                                                                                                            4 Setup
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.
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                                                                                                            4 Setup
                         Item                                           Description
             Item Name & Result           Results obtained from D trace are listed. The selected items will be
                                          displayed in the results window after measurement.
                                          • If PV is selected, other results become deselected (except the
                                             temporary result “velocity”).
                                          • Some results, such as PS and ED, can be derived via a simple
                                             method (e.g., Velocity), but others, such as TAMAX, can only be
                                             derived via complicated methods such as Manual, Spline, Auto, etc.
                                          • Only Vel. is available in [Method] if only PS or ED is selected.
                                          • Methods for obtaining PS and TAMAX simultaneously (trace, spline
                                             and auto) should be chosen if both PS and TAMAX are selected
                                             (TAMEAN should use auto method).
             Unit                         Select the measurement unit.
                                          Click “Unit” column of each item to select.
             CalcMethod                   Select the measurement method for the tool.
                                          Click “CalcMethod” column of each item to select.
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 4 Setup
           •    Deleting Packages: Select a package from the [Available Items] list, click [Delete]. To delete
                an item from [Selected Items], you need to move it to the [Available Items] first.
           •    Setting Default Packages: Select a package from the [Selected Items] list, then click [Default].
                The default package is marked with a √.
                The default package displays when entering the [Measure] page.
                The measurement menu of the default package (corresponding to the exam mode) displays
                when entering the measuring status.
           •    Adjusting Package Positions: Select a package from the [Selected Items] and click [Move Up]/
                [Move Down] to adjust the sequence that the packages in the menu are arranged in.
User-defined Measurement/Calculation/Study
           NOTE:
           •    Please ensure the correctness and validity of the defined formula, otherwise Mindray will not
                be liable for damage caused by improper definition of the formula.
           •    Trigonometric functions are in degrees, not radians.
           •    PI is accurate to 7 digits.
           •    Adding B-Hist or B-Profile to the study is not supported.
           •    Click [Export Custom] in the measurement preset window to export the user-defined
                measurement.
           User-defined calculations are derived from arithmetic operations in which the parameters are
           measurement, calculation or study results obtained in measurement items which exist in the system
           or are user-defined.
           Perform the following procedure:
           1.   Select the [Measure] tab page.
           2.   Click [New].
                The “Measurement Custom Wizard” dialog box appears, as shown in the following figure.
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                                                                                                             4 Setup
            3.      Enter the Name in the “Measurement Custom Wizard” dialog box, then click [Next].
            4.      Set the user-defined attributes in the dialog box.
            5.      Click [Complete] to finish setting. The user-defined item is listed in the “Selected Items” menu
                    and in the “User-defined” category of “Available Items.” An asterisk appears after the user-
                    defined item for identification.
                    In the meantime, the user-defined item will be added automatically to the “Selected Items” in
                    the Report template. If the item is completed in an exam, the results will be displayed in the
                    report.
Add a Study
            You can add or remove user-defined study items in the [Selected Items] column.
            Perform the following procedure:
            1.      Select the [Measure] tab page.
            2.      Click [Add Study] on the right.
            3.      Enter the study name in the dialog box that appears.
            4.      Click [OK] and the item will be added to the “Selected Items.”
            5.      Select a measurement/calculation item from the “Available Items” and click [>] to add the item
                    to the user-defined study.
            6.      Repeat the step 5 to add more items if necessary.
            7.      Move the cursor to click on the study and click [Property] on the right to edit the measure
                    sequence.
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           TIP:
           You can only delete the user-defined items rather than the items in the system library. After a user-
           defined item is deleted, it will not be available.
           TIP:
           You can only delete the user-defined items rather than the items in the system library. After a user-
           defined item is deleted, it will not be available.
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                                                                                                              4 Setup
                        Item                                            Description
             Protocol Name          Enter the protocol name.
             Trigger                Set the trigger type.
             WMS model              Set the chamber segment division method.
             Loop usage             Displays the acquired loop number as well as the total usable loop number.
             View                   Set the views for each stage.
             Standard Views         Set the standard view.
             Load                   Import a protocol.
             Export                 Export a protocol.
             New Protocol           Create a new protocol.
             Copy Protocol          Create a new protocol with an existing one.
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                     Item                                          Description
           Delete Protocol        Delete the protocol.
           New stage              Create a stage for the current protocol.
4.6.2 Maintenance
                       Item                                            Description
           Acquire mode                 Set the type of ROI: manual ROI or full-screen.
           Overlay                      Select the items to be labeled on each loop.
           WMS score type               Set the chamber segment division method.
           QT-Time table                To customize the length of systolic duration acquired for a specific heart
                                        rate, it will store the clip duration. You can add and remove entries in
                                        this table. You can also load the factory defaults.
           Heart rate                   Enter the heart rate.
           Syst. duration               Enter the systolic duration.
           Load factory                 To reset the QT time table.
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                                                                                                                4 Setup
4.7         DICOM/HL7
4.7.1 DICOM Local Preset
            TIP:
            •       AE Title should be the same with the SCU AE Title preset in the server (PACS/RIS/HIS), for
                    example, if the AE Title of the server preset in the storage server is Storage, and the AE Title of
                    the accepted SCU is preset as Machine, then in the figure above, the AE Title of Local should
                    be Machine, and the AE Title of storage server should be Storage.
            •       The device name is random. If the server name is same with that in the DICOM server list, the
                    information “the server added already exits”, click [OK] to retype the name.
            •       IP address should be the address of the remote server.
                                 Item                                            Description
             Local Host          AE Title                 Application Entity title.
             DICOM
                                 Port                     Communication port, DICOM communication port.
             service
             property            PDU                      Maximum PDU data package size (not need to change),
                                                          ranging from 16384 to 65536; if the value is less than
                                                          16384 or greater than 65536, the system automatically
                                                          sets it to the value 32768.
                                 DICOM output             Select an character set for DICOM output according to
                                 charasets                the local PACS workstation.
                                 Transcoding elements Set what DICOM element(s) will be transcoded.
                                 TLS Port                 Set the TLS port.
                                 TLS Server Setting       Import the encryption key/certificate.
                                 TLS Client Setting       •   After importing TLS certificates, and selecting Verify
                                                              Certificate check box, the system verifies the
                                                              effectiveness of the TLS function in the DICOM
                                                              storage, print, and worklist services.
                                                          •   Import trusted certificates, or delete certificates.
             Server Setting      Device                   Name of the device supporting DICOM services.
                                 IP Address               IP address of the server.
                                 Ping                     You can ping the other machines after you entered the
                                                          correct IP address.
                                                          Besides, you can select a server in the Device list to ping
                                                          it.
                                 Device List              Displays the added device.
                                 Set DICOM Service        Provides server settings of DICOM service, for details,
                                                          please refer to the following chapters.
                                 Set DICOM Strategy       Click to enter the configure the strategy screen.
                                 Log Level                For engineer use only.
                                 Capture
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Add a Server
           Perform the following procedure:
           1.   Enter the server device name and IP address.
           2.   Click [Ping] to check the connection.
           3.   Click [Add] to add the server to the device list, and its name and address are displayed in the
                list.
Delete a Server
           Select a server in the device list, and then click [Delete].
           TIP:
           •    The DICOM strategy must be configured by qualified personnel with good knowledge of
                DICOM standards.
           •    The qualified personnel must ensure the validity of the DICOM strategy.
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                                                                                                               4 Setup
            TIP:
            Not all SCPs can support verification. See the SCP properties to confirm whether the SCP can
            support this service. If not, the verification will not be successful.
                        Item                                            Description
             Device                   After you set the server (s) in DICOM Preset screen, the name (s) will
                                      appear in the drop-down list, select the name of the storage server.
             Service Name             Default is xxx-Storage, user-changeable.
             AE Title                 Application Entity title, here, it should be consistent with that of the storage
                                      server.
             Port                     DICOM communication port, 104 is default. Here, the port should be
                                      consistent with that of the storage server port.
             Maximum Retries          Set the maximum retries (0-9). The default value is 3. If the DICOM task
                                      sending to the server fails, the retry times should be 3.
             Interval Time(s)         Interval time.
             Timeout                  Refers to the amount of time after which the system will stop trying to
                                      establish a connection to the service.
             TLS                      Transport Layer Security. Select whether to encrypt the data during network
                                      transportation.
             Cine Zoom Mode           Select the cine zoom mode during image file storage.
             Compression Mode Select the compression mode: original data (uncompressed), RLE (the
                              image not compressed), JPEG, and JPEG2000.
             Compression Ratio Select the JPEG compression ratio: lossless, low, medium, and high.
                               The compression ratio is inversely proportional to the image quality
                               (reserved function).
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                   Item                                           Description
           Color Mode            Select the color mode.
                                 If you choose the mix or the grey, RLE/JPEG is unavailable.
                                 The image uses 24 bit when sending the image from the ultrasound device to
                                 the server; it depends on the image when choosing the mix. The image use 8
                                 bit if the image is captured in color mode or the image has the tint. All
                                 images use 8 bit when choosing the grey.
           Allow Multiframe      If SCP supports this function, then select it.
           Max Frame Rate        Set the frame range of transferring cin file into DCM multi-frame file. It is
                                 editable to the user.
           3D/4D                 Set the 3D/4D image transfer mode.
                                 Set the transfer mode for the 3D/4D cine sending.
                                 • Normal: use the way that 2D image adopts to send;
                                 • Volume: use Enhanced US Volume Storage IOD to send;
                                 • Data source: used to obtain 3D/4D image for 4D Viewer.
           SR Storage Option     To enable or disenable structured reporting sending.
           Encapsulated PDF      Select if to encapsulate PDF format report in DICOM standard.
                                 It becomes available if SCP supports the function.
           Doppler audio         Set to save the audio of PW mode.
           Storage mode          Set the storage mode for image and cine file:
                                 • Parallel file: save the current file, and is ready for the storage of the next
                                    file.
                                 • Parallel frame: send the current frame, and is ready for sending the next
                                    frame.
           TransducerTracking Files of images that are saved in DCM format through DICOM or
                              DICOMDIR contain transducer serial number information.
           Strategy Name         Set the DICOM strategy.
           TIP:
           •   If the server software supports the compression algorithm, select JPEG, RLE, JPEG2000.
               Otherwise, original data should be used (RLE is the default method).
           •   RLE, JPEG and JPEG2000 are not supported by all SCPs. Refer to the SCP’s DICOM
               CONFORMANCE STATEMENT electronic file to check whether SCP supports it or not. Do
               not select these compression modes if the storage server does not support them.
           •   Images of PW/M/TVM/TVD mode (B image is not frozen) and images other than PW/M/
               TVM/TVD mode: if “Max Frame rate” is not “Full” and the actual frame rate is larger than the
               set value, the system will save the image files in a frame rate of the set value, and transfer in a
               frame rate of B mode.
           •   Images of PW/M/TVM/TVD mode (B image is frozen), the system will save/transfer the
               images files in frame rate of 6.
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                         Item                                      Description
             Device                  After you set the server (s) in DICOM Preset screen, the name (s) will
                                     appear in the drop-down list, select the name of the print server.
             Service Name            Default is xxx-Print, user-changeable.
             AE Title                Application Entity title, here, it should be consistent with that of the
                                     print server.
             Port                    DICOM communication port, 104 is default. Here, the port should be
                                     consistent with that of the print server port.
             Maximum Retries         It starts retrying if it fails to send DICOM task to the server. The retry
                                     entry times should be this value.
             Interval Time (s)       Reserved time.
             Timeout                 Refers to the amount of time after which the system will stop trying to
                                     establish a connection to the service.
             TLS                     Transport Layer Security. Select whether to encrypt the data during
                                     network transportation.
             Copies                  Refer to copies of printed files. You can select among 1 through 5, or
                                     directly enter the numeral.
             Settings                The system supports RGB (color printing) and MONOCHROME2
                                     (black and white printing). Please select the type the printer supports.
             Film Orientation        Select between LANDSCAPE and PORTRAIT.
             Priority                Specify printing task priority among HIGH, MED and LOW.
             Film Size               Select film size among the selections listed in the drop-down list.
             Display Format          Specify quantity of printed files, e.g. STANDARD\2, 3 indicates 6
                                     images are printed for each page.
             Medium Type             Specify print medium: Paper, Clear Film, Blue Film; select Blue Film
                                     or Clear Film for black and white printing; select Paper for color
                                     printing.
             Trim                    Specify whether you want a trim box to be printed around each image
                                     on the film: Yes or No.
             Configuration Info      Enter configuration information in the field.
             Min Density             Enter the minimum density of the film.
             Max Density             Enter the maximum density of the film.
             Destination             Specify where the file is exposed: MAGAZINE (stored in the
                                     magazine), or, PROCESSOR (exposed in the processor).
             Magnification Type      Select how the printer magnifies an image to fit the film.
                                     • Replicate: interpolated pixels belong to duplicate of adjacent pixels);
                                     • Bilinear: interpolated pixels are generated from bilinear
                                        interpolations between adjacent pixels;
                                     • Cubic: interpolated pixels are generated from cubic interpolations
                                        between adjacent pixels;
                                     • None: without interpolation.
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                      Item                                          Description
           Strategy Name             Set the DICOM strategy.
Worklist Setting
           DICOM service setting for Worklist is described as follows:
                      Item                                          Description
           Device Name               After you set the server (s) in DICOM Server Setting screen, the name
                                     (s) will appear in the drop-down list, select the name of the Worklist
                                     server.
           Service Name              Default is server-Worklist, and it can be modified.
           AE Title                  Application Entity title. It is consistent with that of the Worklist server.
           Port                      DICOM communication port, 104 by default. The port should be
                                     consistent with that of the Worklist server port.
           Maximum Retries           Reserved feature.
           Interval Time(s)          Reserved feature.
           Timeout                   Refers to time after which the system will stop trying to establish a
                                     connection to the service.
           TLS                       Transport Layer Security. Select whether to encrypt the data during
                                     network transportation.
           Strategy Name             Set the DICOM strategy.
           Remove Attributes(0)      Set what DICOM element(s) that will not be used in worklist query.
MPPS Preset
           MPPS setting items are described as follows:
                      Item                                          Description
           Device Name               After you set the server (s) in DICOM Server Setting, the name (s) will
                                     appear in the drop-down list, select the name of the MPPS server.
           Service Name              Default is server-MPPS, and it can be modified.
           AE Title                  Application Entity title. It should be consistent with that of the MPPS
                                     server.
           Port                      DICOM communication port, 104 by default. The port should be
                                     consistent with that of the MPPS server.
           Maximum Retries           It starts retrying if it fails to send DICOM task to the server. The retry
                                     entry times should be this value.
           Interval Time(s)          Reserved feature.
           Timeout                   Refers to the amount of time after which the system will stop trying to
                                     establish a connection to the service.
           TLS                       Transport Layer Security. Select whether to encrypt the data during
                                     network transportation.
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            TIP:
            Set the MPPS service as the default when using the MPPS.
                        Name                                            NOTE
             Device Name              After you set the server (s) in DICOM Server Setting, the name (s) will
                                      appear in the drop-down list, select the name of the storage commitment
                                      server.
             DICOM Service Name       Default is server-SC, and it can be modified.
             AE Title                 Application Entity title. Here, it should be consistent with that of the
                                      storage commitment server.
             Port                     DICOM communication port, 104 by default. Here, the port should be
                                      consistent with that of the storage commitment server port.
             Maximum Retries          Reserved feature.
             Interval Time(s)         Reserved feature.
             Timeout                  Refers to the amount of time after which the system will stop trying to
                                      establish a connection to the service.
             Associated Storage       The associated storage server is preset before storage commitment, only
             Service                  after the exam is sent out, can storage commitment be created.
             TLS                      Transport Layer Security. Select whether to encrypt the data during
                                      network transportation.
Query/Retrieve
            DICOM query/retrieve setting items are described as follows:
                        Item                                        Description
             Device Name              Select the name of a device that can be added (including the local).
             Service Name             Default is server-queryRetrieve, and it can be modified.
             AE Title                 Application Entity title.Here, it should be consistent with that of the
                                      storage commitment server.
             Port                     DICOM communication port, 104 by default.Here, the port should be
                                      consistent with that of the storage commitment server port.
             Maximum Retries          Reserved feature.
             Interval Time(s)         Reserved feature.
             Timeout                  Refers to the amount of time after which the system will stop trying to
                                      establish a connection to the service.
             TLS                      Transport Layer Security. Select whether to encrypt the data during
                                      network transportation.
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                      Item                                          Description
           Device Name                After you set the server (s) in DICOM Server Setting screen, the name
                                      (s) will appear in the drop-down list, select the name of the Worklist
                                      server.
           Service Name               Default is server-HL7Query, and it can be modified.
           AE Title                   Application Entity title.here, it should be consistent with that of the
                                      HL7 server.
           Port                       DICOM communication port, 104 by default.Here, the port should be
                                      consistent with that of the HL7 server port.
           Maximum Retries            Reserved feature.
           Interval Time(s)           Reserved feature.
           Timeout                    Refers to the amount of time after which the system will stop trying to
                                      establish a connection to the service.
           Listen mode                This function enables the ultrasound system to use the listen port for
                                      data receiving.
           Listen port                Port for ultrasound system to receive data after the listen mode function
                                      is activated. Here, the port should be consistent with that of the HL7
                                      server port.
                                      For details of listen port setting, refer to settings in the server.
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                                                                                                          4 Setup
                         Item                                         Description
             Status                      • No driver: click [SetupDriver] to enter the “TAP-Windows 9.21.2
                                           Setup” interface, and do as instructed.
                                         • Ready: the VPN is ready for use.
                                         • Advance: VPN Advance Configuration
                                         • Connected: VPN is successfully connected.
                                         • Disconnected: VPN is disconnected.
                                         • Error: error connection.
             Server IP                   /
             Group                       /
             User Name                   /
             Password                    /
             Hide characters             The password is displayed as *.
             Connect/ Disconnect         Connect or disconnect VPN.
             Advance                     Enters the “VPN Advance Config” interface.
                                         • Reset: if the system does not respond after you click [Config], click
                                            [Reset].
                                         • Config: enters the “OpenConnect-GUI VPN client” interface. For
                                            details about the settings, please refer to the TAP manual.
                                         NOTE:
                                             After exiting the “VPN Advance Config” interface, you need to
                                             reboot the system; otherwise, you cannot connect VPN normally.
             Close                       Close the “VPN Advance Config” interface.
                         Item                                         Description
             Service Name                The name of the iStorage service.
             IP Address                  IP address of the iStorage service device.
             Port                        Port for transmitting.
             Charset                     Set the character set.
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                         Item                                            Description
             Advanced                     Sets the sub URLs of “QView full” and “QView lite”.
                                          The sub URL is set by default. Users can modify the sub URL and click
                                          [Apply] to exit the “QView sub URL setting” window.
             Enable Direct Report         Sets whether to open the Q-Path server through the [Report] key.
             Worksheet Only               Sets whether to directly enter the Worksheet interface after opening the
                                          Q-Path server.
             Password On Worksheet Sets whether to display the Signature field box in a worksheet.
                                   Tap [Report] > [WorkSheet] or tap [Review] > [Report] > [WorkSheet],
                                   enter the worksheet password in the field box, and click [OK].
                                   Users can query the corresponding worksheet by searching the
                                   worksheet password in the Q-Path server.
             Password On End Exam Sets whether to input the worksheet password after ending an exam.
             Password Visible             Sets whether the password is visible.
             Import                       Imports a user-defined worksheet template from the USB storage
                                          (downloaded from the Q-Path server).
             Backup                       Backs up worksheets to the USB storage.
             Restore                      Restores the backup worksheet template from the USB storage to the
                                          ultrasound system.
             Delete                       Deletes a worksheet template.
             Restore Factory              Restores the worksheet template to the default state.
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eGateway Query
                      Item                                              Description
           Service Name                 The name of the eGateway service.
           IP Address                   Input the ADT Source IP address in the eGateway Server configuration
                                        interface.
           Port                         Input the MAQ Server Port in the eGateway Server configuration
                                        interface.
           Clear                        Click to cancel the parameter setting.
           Add                          Click to add the Network service to the service list.
           Update                       Select an item in the service list, change the parameters in the above
                                        area, and click [Update] to update the item in the service list.
           Delete                       Click to delete the selected service in the service list
           Default                      Set the eGateway server as the default.
                                        Select an item in the service list, click [Default] and you can see “Y” in
                                        the Default column.
           Connect                      Click to verify whether the connection is normal.
eGateway Store
           Before using the eGateway storage, ensure the Send Mode is set to “MDM with Reference” in the
           eGateway Server configuration interface.
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                                                                                                                  4 Setup
                          Item                                              Desciption
             Add Service                     Click to begin adding print services.
             Remove Service                  Click to delete the selected print service.
             Rename Service                  Click to rename the selected print service.
             Property                        Preset print service properties.
4.10 Maintenance
            In the Setup menu, select [Maintenance] to enter the screen.
            The [Maintenance] function is designed for you to import or export user data, restore factory setting
            and export log. You may also execute self-test and option installation/trial through the maintenance
            menu. Furthermore, you can set the factory preset, export the register data, and etc.
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 4 Setup
           If you require other maintenance functions, please contact Mindray Customer Service Department
           or sales representative.
4.10.1 Option
           The system enters the Option page after entering the Maintenance screen. In the Option list, the
           system lists all the system-supported options and their installation status (not installed or installed).
           To install and uninstall:
           •    Click [Install] to begin installing a disabled option.
           •    Click [Uninstall] to begin uninstalling a previously-installed option.
           Please contact the Mindray Customer Service Department or a sales representative for details.
                           Item                                           Description
           Load Factory                          Local factory default settings.
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                                                                                                              4 Setup
                              Item                                            Description
             Setup        Export Log                Export the log.
                          Self Test                 Perform system self-test and restart the machine.
                          Recover                   To recover the system.
                          Enter Windows             For password, please contact your service engineer.
                          Prepay Installment        Display the prepay installment information.
                          Start/Stop WinProxy       Cursor debug interface.
                          Touch Screen              To calibrate the touch screen.
                          Calibration
                          Needles List Replace      Update the list of needles that support eSpacial Navi function.
                                                    NOTE:
                                                        The list of needles must be release version provided by
                                                        Mindray.
                          Needles List Recover      Restore the list of needles that support eSpacial Navi function
                                                    to the last version.
                          Needles List Factory      Restore the list of needles that support eSpacial Navi function
                                                    to the factory version.
                          Enable Tracking           Enable the transducer and patient tracking function:
                                                    • Find transducers used with a patient by patient ID.
                                                    • Find patients who used a transducer by transducer SN.
                                                    After enabling the tracking function, you can set the maximum
                                                    number of days the data can be retained.
                          Fast Startup              To speed up the startup process.
                                                    NOTE:
                                                         If McAfee has been installed, please disable this function
                                                        to avoid McAfee failure.
If you have any questions, please contact the service engineer or your sales representative.
4.11 Security
4.11.1 Drive Encryption/Secure Data Wipe
            Encrypt the patient data stored in the hard disk. The system provides two encryption methods:
            Factory Default and User Define.
            •       Factory Default: the system is in factory state by default.
            •       User Define: add a user-defined password.
            Perform the following procedure:
            1.      Select [User Define].
            2.      If no patient data are stored in the hard disk, click [Confirm], input the password and click
                    [Confirm] to finish the password setting
                    If the patient data are already stored in the hard disk, the system will pop-up prompts, follow
                    the steps below:
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 4 Setup
               a.   Click [OK].
               b.   Click [Wipe] and operate according to the screen prompts to clear patient data.
               c.   Select [User Define] again, and click [Confirm].
               d.   Input the password and click [Confirm] to finish the password setting.
           NOTE:
           •   If you want to switch to Factory Default, perform steps above again. The password is the same
               as that of the User Define.
           •   When you set password, multi-language and Chinese characters are not supported.
4.11.2 Anti-Virus
           The system provides two anti-virus software: Windows Defender and McAfee. They can
           effectively prevent the ultrasound system from being attacked by virus, spyware, or other malware.
           •   Windows Defender is already installed on the system.
           •   The McAfee software is an option. If you want to buy McAfee, contact the service engineer or
               your sales representative.
           NOTE:
           McAfee cannot be uninstalled after successful installation.
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5                   Exam Preparation
            To start a new patient exam, it is better to type the detailed patient information. The system will set
            up a unique information database for each patient based on the patient information entered, so that
            the information of one patient will not be confused with that of another patient.
            1.      Tap [Info] on the touch screen to enter the patient information page.
                    Place the cursor onto the targeted box. The field box is highlighted and a flashing cursor
                    appears. Information can be entered or selected from the options
                    NOTE:
                        •     Patient ID is generated automatically by the system after starting a new patient, and can
                              be modified manually.The characters “\”, “\”, “*”, “?” are not permitted.
                        •     You can either enter the patient’s date of birth manually, or click    to select the date,
                              and click [Confirm] to finish.
                        •     The age unit can be “Years”, “Months” or “Days.” If the age is less than one year, the
                              system will automatically calculate the age in months or days.
            2.      Exam Type
                    –       Select the exam type tab to enter exam-specific information.
                    –       Input general information/operating Information
            3.      Functional keys
                    –       [New Patient]: click to clear the current patient information in the patient information
                            screen in order to input new patient information.
                –    [New Exam]: click to clear the current exam information in order to create a new exam for
                     the current patient.
                –    [Pause Exam]: to pause the current exam due to some special causes or system power off.
                –    [Cancel Exam]: to cancel the current exam.
                     The cancelled exam can’t be restored.
                –    [Quick Register]: to save the patient information quickly and return to the main screen.
                –    [OK]: click to save the patient data entered and exit the screen.
                –    [Cancel]: click to cancel the patient data entered and exit the screen.
WorkList/HL7 Enquiry
            TIP:
            Worklist is an optional function. Configure DICOM Basic and DICOM WorkList first.
            When the DICOM basic package is configured and the Worklist server has been set, click
            [Worklist] in the “Patient Info” screen to query or import the patient data. For details, see
            “15.3 Worklist”.
            NOTE:
            •       The system can automatically load the patient information and exam data to continue the
                    exam.
            •       If you want to continue an exam which data lies in an external memory database, you have to
                    first allow the system to load the patient data to the system’s patient database.
            •       For an only one re-activated exam, you can modify patient ID.
                    WARNING
            •       The images displayed in this system are only reference for diagnosis.
                    Mindray is not responsible for the correctness of diagnostic results.
            •       In Dual-B imaging mode, the measurement results of the merged image
                    may be inaccurate. Therefore, the results are provided for reference only,
                    not for confirming a diagnosis.
            TIP:
            Operations for switching between different image modes and optimizing images, see “2.13 Basic
            Operations”.
6.1         B Mode
            B mode is the basic imaging mode that displays real-time views of anatomical tissues and organs.
Gain
            To adjust the gain of the whole receiving information in B mode. The real-time gain value is
            displayed in the image parameter area.
Depth
            This function is used to adjust the display depth of sampling, the real-time value of which is
            displayed in the image parameter area.
TGC
           The system compensates the signals from deeper tissue by segments to optimize the image.
           There are 8-segment TGC sliders corresponding to the areas in the image.
           Adjust the signal gain for the certain image area to get a balanced image.
Acoustic power
           Refers to the power of ultrasonic wave transmitted by the probe, the real-time value of which is
           displayed in the upper left corner of the screen.
           TIP:
           You should perform exams according to actual situation and follow the ALARA Principle.
           TIP:
           •    The FOV position/range is available only for the convex and phased probes.
           •    When the scan range is adjusted to the widest, the FOV position cannot be changed.
Steer
           To steer the beam the probe transmits.
           TIP:
           Steer is available only for linear probes.
Line Density
           The function determines the quality and information of the image.
           The higher the line density is, the higher the resolution becomes.
Dynamic Range
           Adjusts contrast resolution of an image, compresses or expands gray display range.
           The real-time dynamic range value is displayed on the image parameter area.
           The more the dynamic range, the more specified the information, and the lower the contrast with
           more noise.
Smooth
           This feature is used to reject the noise and smooth the image.
iClear
           The function is used to enhance the image profile so as to distinguish the image boundary for
           optimization.
Persistence
           Used to superimpose and average adjacent B images, so as to optimize the image and remove
           noises.
Rotation/Flip
            This function provides a better observation for image display.
            The “M” mark indicates the orientation of the image; the M mark is located on the top of the
            imaging area by default.
iBeam
            This function is used to superimpose and average images of different steer angles to obtain image
            optimization.
            TIP:
            The phased probe does not support iBeam. iBeam is unavailable when ExFov is enabled.
Auto Merge
            In the Dual-split mode, when the images of the two windows have the same probe type, depth,
            invert status, rotation status and magnification factor, the system will merge the two images so as to
            extend the field of vision.
            TIP:
            Only for linear probes.
Gray Map
            Adjusting grayscale contras to optimize the image.
Tint Map
            This function provides an imaging process based on color difference rather than gray distinction.
TSI
            The TSI function is used to optimize the image by selecting acoustic speed according to tissue
            characteristics.
HD Scope
            The image inside the ROI is clearer than these outside when the function is enabled.
            The function is disabled in frozen state.
            The optimize speed is ended when saving the image in real-time.
iTouch
            To optimize image parameters as per the current tissue characteristics for a better image effect.
            It is available for all real-time imaging in B mode.
H Scale
            Display or hide the width scale (horizontal scale).
            The scale of the horizontal scale is the same as that of vertical scale (depth), they change together in
            zoom mode, or when the number of the image window changes.The H Scale will be inverted when
            image is turned upwards/downwards.
Dual Live
            Display different image effects of one probe for a better observation.
           Two pages of adjustable parameters are displayed on the touch screen as well; where, shared
           parameters and left window parameters are displayed in the B (L) page, while right window
           parameters are displayed in the B(R) page.
           In the image parameter area, parameters of the both windows are displayed.
           It supports the magnification of the image.
LGC
           Adjust the gain along the scan line to improve the lateral resolution of the image.
           TIP:
           The system provides several preset parameters for imaging.
Echo Boost
           The contrast is increased and the noise is decreased with the clear boundary after generating the
           function.
           TIP:
           Use phased probe to activate the function in cardiac mode.
           TIP:
           In Color Mode, acoustic power is synchronous with that of B Mode. Adjustment of the depth or
           zoom to the B Mode image will lead to corresponding changes in Color Mode image.
Image Quality
            Refers to the transmitting frequency in Doppler mode of the probe, the real-time value of which is
            displayed in the image parameter area.
B/C Align
            To set and constrain the maximum width of the B mode image to that of the Color ROI.
Dual Live
            This function is used to display B image and Color image synchronously.
Steer
            The feature is used to adjust the ROI of color flow with different angles with immobility of the
            probe.
            This function is used to adjust the scan angle of linear probes, so as to change the angle between the
            transmitting beam and flow direction.
            TIP:
            Steer is available only for linear probes.
Line Density
            The function determines the quality and information of the image.
            The higher the line density is, the higher the resolution becomes.
Packet Size
            This function is an indication of the ability to detect flow, which is used to adjust the accuracy of
            color flow.
            The higher the sensitivity is, the more sensitive indication for low-velocity flow becomes.
Flow State
            Refers to optimizing the various flow states.
Persistence
            This function is to adjust the temporal smooth to optimize the image.
Smooth
            This feature is used to reject the noise and smooth the image.
Scale
            This function is used to adjust the speed range of color flow, which is adjusted through PRF in the
            system. The real-time PRF value is displayed in the image parameter area.
            Aliasing may occur if low velocity scale is used and high velocities are encountered.
            Low velocities may not be identified when a high velocity scale is used.
Baseline
            Refers to the area where the velocity is zero in the scale. Adjust according to the actual situation so
            as to get an optimum flow display.
Invert
            To set the display mode of the color flow, the color scale will be inverted when the function is
            activated.
           TIP:
           It is available only for linear probes.
Color Map
           This function is a combination of several image parameters, which indicates the display effect of
           color image.
WF (Wall Filter)
           It filters out low-velocity signals to provide effective information, and this function is used to adjust
           the filtered frequency. The real-time value (WF) is displayed in the image parameter area.
Smart Track
           To optimize image parameters as per the current tissue characteristics for a better image effect. The
           angle and the position of the ROI are adjusted after the function is enabled. The area is tracked
           without being affected by the dynamic moves.
           TIP:
           The linear probes for Upper Ext Artery, Upper Ext Vein, Lower Ext Artery, Lower Ext Vein,
           carotid, EM Vascular exam supports the smart track.
Priority
           This function is used to set levels of the flow display, to display the grayscale signal or color signal.
           The color image is preferred with higher value; while grayscale signals are displayed with the lower
           value.
Velocity Tag
           This function is used to mark the specified velocity range in flow to check the flow function or
           specific flow velocity value.
           Enable this function, the green mark appears on the color scale. Use trackball/trackpad and <Set> to
           set the marking range and marking position.
iTouch
           To optimize image parameters as per the current tissue characteristics for a better image effect.
           TIP:
           In Power mode, the acoustic power is synchronous with that of B mode. Adjustment of the depth to
           the B mode image will lead to corresponding changes in Power mode image.
            1.      Select a premium image during B mode or B+ Color scan, and adjust to place the area of
                    interest in the center of the image.
            2.      Press <P> to enter B+Power mode.
            3.      Use the trackball/trackpad and <Set> to change position and size of the Region of Interest
                    (ROI).
            4.      Adjust the image parameters during scan to obtain optimized images.
Power Gain
            Refers to the overall sensitivity to flow signals, and this function is used to adjust the gain in Power
            mode. The real-time gain value is displayed in the image parameter area.
Color Map
            This feature indicates the display effect of power image. The maps in Power mode image are
            grouped into two categories: Power maps and Directional Power maps.
            •       The Power maps provide information of blood flow, which are highly sensitive to the low-
                    velocity flows.
            •       The Directional Power maps provide information of flow direction.
Dynamic Range
            This function is to adjust the transformation of echo intensity into color signal.
            Increasing dynamic range will lead to higher sensitivity to low-power signals, thus enhances the
            range of signals to display.
6.4         M Mode
6.4.1 M Mode Image Scanning
            Perform the following procedure:
            1.      Select a premium image during B mode or B+ Color scan, and adjust to place the area of
                    interest in the center of the image.
            2.      Press <M> on the control panel, and use the trackball/trackpad to adjust the sampling line.
            3.      Press <M> on the control panel again or <Update> to enter M mode, and then you can observe
                    the tissue motion along with anatomical images of B mode. During the scanning process, you
                    can also adjust the sampling line accordingly when necessary.
            4.      Adjust the image parameters to obtain optimized images.
Display Format
           To set the display format of B mode image and M mode image.
           Adjust according to the actual situation and obtain a desired analysis through comparison.
Speed
           This function is used to set the scan speed of M mode imaging, and the real-time speed value is
           displayed in the image parameter area.
Tint Map
           This function provides an imaging process based on color difference rather than gray distinction.
Gray Map
           Adjusting grayscale contrast to optimize the image.
Edge Enhance
           This function is used to increase image profile, so as to distinguish the image boundary.
           Larger edge enhance may lead to noise increase.
Dynamic Range
           Adjusts contrast resolution of an image, compresses or expands gray display range. The real-time
           dynamic range value will be displayed on the image parameter area on the top of the screen.
M Soften
           This feature is used to process the scan lines of M images to reject noise, making the image details
           to be clearer.
           TIP:
           Linear probe does not support Color M mode.
                    CAUTION
            Anatomical M Mode and Color Anatomical M mode images are provided for
            reference only, not for confirming diagnoses. Compare the image with those of
            other machines, or make diagnoses using non-ultrasound methods.
            TIP:
            Free Xros M imaging and Free Xros CM imaging are options.
                 CAUTION
            Curved anatomical M image in the operator’s manual that it is provided for
            reference, not for confirming a diagnosis. Generally it should be compared with
            other device or make a diagnosis by non-ultrasonic methods.
            TIP:
            Only phased probe supports Free Xros CM.
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            PW mode provides a function to examine flow at one specific site for its velocity, direction and
            features; while CW mode proves to be much more sensitive to high velocity flow display. Thus, a
            combination of both modes will contribute to a much more accurate analysis.
            CW module is optional.
PW Sampling Gate
            Adjusts the SV position and size of sampling in PW mode, the real-time value of SV and SVD are
            displayed in the image parameter area, in which SV represents the size of the sampling gate, and
            SVD represents the sampling depth.
CW Focus Position
            To adjust the focus position of CW mode. The real-time focus position value is displayed on the
            image parameter area in SVD.
Image Quality
            Refers to the transmitting frequency in Doppler mode of the probe, the real-time value of which is
            displayed in the image parameter area.
Scale
            This function is used to adjust the speed range of color flow, which is adjusted through PRF in the
            system. The real-time PRF value is displayed in the image parameter area.
            To provide a much clearer color flow image.
            Use low PRF to observe low-velocity flows, and use high PRF to observe high-velocity flows.
iTouch
            To optimize image parameters as per the current tissue characteristics for a better image effect.
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Auto Calculation
            This function is used to trace the spectrum and calculate the PW/CW mode image parameters. The
            results are displayed in the results window.
            In real-time scanning, the results displayed are derived from the calculation of the latest cardiac
            cycle.
            In the freeze and cine status, the results displayed are calculated from the current selected area.
            •    Auto Calculation Parameter: To set the calculation results to display.
            •    Auto Calculation Cycle: To set the heart cycle number for auto-calculation.
            •    Trace Area: To set the trace area of the Doppler wave in the spectrum map, applicable for auto
                 calculation, V Max and V Mean display.
            •    Trace Smooth: To set the smooth level when tracing.
            •    Trace Sensitivity: This function is used to set the sensitivity of tracing in the spectrum.
Invert
            This function is used to set the display manner of spectrum.
            TIP:
            It is available only for linear probes.
Speed
            This function is used to set the scan speed of PW mode imaging.
T/F Res
            Adjusts for a balance between time resolution and spatial resolution.
WF (Wall Filter)
            To display the image accurately, it adjusts the cut-off used in the wall filter, and filters out the flow
            noise which is produced by vessel wall vibration. The real-time value is displayed in the image
            parameter area.
Tint Map
            This function provides an imaging process based on color difference rather than gray distinction.
Gray Map
            Selects among post processing map curves to optimize grayscale images.
Display Format
            Sets the display proportion of PW mode image and B mode image.
Duplex/Triplex
            This function is used to set if B image or B+Color image (Power) is scanned synchronously.
HPRF
            HPRF mode is used when detected velocities exceed the processing capabilities of the currently
            selected PW Doppler scale or when the selected anatomical site is too deep for the selective PW
            Doppler scale.
Baseline
            Refers to the area where the velocity in zero in the spectrum. The map changes after being edited.
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Angle
            This function is used to adjust the angle between Doppler vector and flow to make the velocity
            more accurate.
            The real-time adjusting angle value is displayed in the image parameter area.
Quick Angle
            Adjusts the angle faster in increments of 60°, and the real-time value of which is displayed in the
            image parameter area.
Dynamic Range
            The dynamic range conveys the information that being transformed from echo intensity to gray
            scale.
Audio
            Adjusts the output audio in spectrum Doppler.
Steer
            Adjusts the scan angle in PW mode, so as to change the angle between the transmitting beam and
            flow direction.
            Obtain more information with immobility of the probe.
            Values of steer angles vary with the probe.
            TIP:
            Steer is available only for linear probes.
6.8         TDI
            TDI mode is intended to provide information of low-velocity and high-amplitude tissue motion,
            specifically for cardiac movement.
            There are 4 types of TDI mode available:
            •       Tissue Velocity Imaging (TVI): This imaging mode is used to detect tissue movement with
                    direction and speed information. Generally the warm color indicates the movement towards
                    the transducer, while the cool color indicates the movement away from the transducer.
            •       Tissue Energy Imaging (TEI): This imaging mode reflects the status of cardiac movement by
                    providing the energy information, the larger the energy is, the brighter the color becomes.
            •       Tissue Velocity Doppler Mode (TVD): This imaging mode provides direction and speed
                    information of the tissue.
            •       Tissue Velocity M Mode (TVM): This function assists to observe the cardiac motion through a
                    direct angle.
            TIP:
            TDI is optional.
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                 –     In B or B+Color mode: to enter TVI Mode, parameters of TVI mode will be displayed on
                       the touch screen.
                 –     In Power mode: to enter TEI Mode, parameters of TEI mode will be displayed on the
                       touch screen.
                 –     PW mode: Press <TDI> or the user-defined key and then press <PW> or <Update> to
                       enter TVD. The parameters of TCD are displayed on the touch screen.
                 –     M mode: Press <TDI> or the user-defined key and then press <M> or <Update> to enter
                       TVM. The parameters of TVM are displayed on the touch screen.
            2.   Adjust the image parameters to obtain optimized images.
            3.   Press <TDI> or the user-defined key to exit from TDI mode and enter general imaging modes.
                 Or, press <B> on the control panel to return to B mode.
Tissue State
            This function is used for fast image optimization.
            NOTE:
            To perform the strain and strain curve, the ECG curve is in need in case of the deviation in curve.
            TIP:
            •    TDI quantitative analysis is an option.
            •    The current image (in frozen state) and the saved image can be used in the quantitative
                 analysis.
            •    Only after the user chooses the image review, the quantitative analysis is available.If the user
                 chooses the static image (only one frame), the quantitative analysis is not available.
            It is about analyzing the data of TVI imaging and measuring the velocity of the myocardium with
            the cardiac cycle.
            Here are three types of curves to perform the quantitative analysis:
            •    Velocity-time curve
            •    Strain-time curve
            •    Strain rate-time curve
                 –     Strain: Deformation and displacement of the tissue within the specified time.
                 –     Strain rate: speed of the deformation, as myocardial variability will result in velocity
                       gradient, strain rate is used commonly to evaluate how fast the tissue is deforming.
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Figure 6-1 Quantitative analysis display (taking velocity-time curve as the example)
             1       TDI review                 Sampling area: indicates the sampling position of the curve. The
                                                sampling lines are marked with color numbers. It can mark 8
                                                ROIs at most.
             2       2D grey image review       • Use the trackball/trackpad; the images in TDI review
                                                  window and 2D review window are reviewed synchronously,
                                                  since the two images are frozen at the same time.
                                                • ROI movement is linked between the TDI (Tissue Doppler
                                                  Imaging) review window and the 2D imaging reviewing
                                                  window.
             3       Display analysis curve     • Y-axis represents the velocity (unit: cm/s) [in strain-time
                                                  curve, Y-axis represents the strain (%); in strain-time curve,
                                                  Y-axis represents the strain (unit: 1/s)].
                                                • X-axis represents time (s);
                                                • Frame mark: a white straight line perpendicular to the X-
                                                  axis, and can be moved left and right by using the trackball/
                                                  trackpad.
                                                • Click the check box in front of the ROI to display or hide the
                                                  analysis curve.
                                                • You can get the current X/Y axis value by moving the cursor
                                                  onto one point on the curve; and if you press <Set> at this
                                                  time, the frame marker will move to the spot.
             4       ECG display area           /
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 6 Image Acquisition
                 NOTE:
                       •     The current image (in frozen state) and the saved image can be used in the quantitative
                             analysis.
                       •     Only after the user chooses the image review, the quantitative analysis is available. If
                             the user chooses the static image (only one frame), the quantitative analysis is not
                             available.
            2.   Tap [TDI QA] or press the user-defined key for “TDI QA” to enable the function.
            3.   Mark the interested myocardium area.
                 One image can save 8 ROIs at most, and draw the corresponding curve in image area. Each
                 ROI has different color; the corresponding curve is painted with each color.
                 ROI settings:
                 a.        Tap [Standard ROI]/[Ellipse ROI] to select a ROI method.
                           The cursor moves into the review area (TDI review window or 2D grey review window.
                 b.        Review to the desired frame.
                 c.        Move the cursor to one cine review window.
                 d.        Add a ROI.
                           When selecting “Standard ROI”: Add ROI automatically after capturing the area. ROI
                           size is decided by “Standard Height/Width/Angle”.
                           When selecting “Ellipse ROI”: Press <Set> to confirm the start point, and use the
                           trackball/trackpad and press <Set> to confirm the next point; then use the trackball/
                           trackpad to adjust the size and press <Set> to complete the drawing.
                           You can press <Clear> to remove the last ROI.
            4.   Select the curve: Tap [Speed], [Strain] or [Strain Rate].
                 For [Strain] or [Strain Rate], tap [Strain Dist.] on the touch screen to select the corresponding
                 value for Strain – Time curve or Strain Rate – Time curve.
                 If needed, tap [ROI Tracking] to enable the function. This function provides a motion
                 compensated ROI as precise time-intensity information can be acquired using active tracking.
                 It can enhance the calculation accuracy as reducing the impact of probe or patient respiratory
                 movement.
                 NOTE:
                     Elliptical ROIs can be positioned in any manner that keeps their center within the image
                     boundaries. In the case that part of the ROI is outside the image boundary, only data from
                     within the image boundary is used for calculating the mean intensity value.
            5.   Adjust the curve display:
                 –         X Scale: Choose different value, so that the X scale display manner will be changed. This
                           function can be used to track detailed tissue information.
                 –         Smooth: Adjust the smooth feature of the curves.
            6.   Save the curves, and export the curve data, parameter data.
                 a.        Tap [Export] on the touch screen.
                           The dialog box appears.
                 b.        Select the storage path and type the file name.
                           E drive is default; and the file type is .CSV.
                 c.        Click [OK] to complete the export.
                 After being exported successfully, a BMP. file shows on the thumbnail area.
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6.9         iScape
            The iScape panoramic imaging feature extends your field of view by piecing together multiple B
            images into a single, extended B image. Use this feature, for example, to view a complete hand or
            thyroid.
            When scanning, move the probe linearly and acquire a series of B images. The system pieces these
            images together into a single, extended B image in real time. The system also supports out-and-
            back image piecing.
            After obtaining the extended image, you can rotate it, move it linearly, magnify it, add comments or
            body marks, or perform measurements on the extended image.
            The system provides a color iScape function, so you can get more information from extended
            images.
                    CAUTION
            •       It is provided for reference, not for confirming a diagnosis.
            •       iScape panoramic imaging constructs an extended image from individual
                    image frames. The quality of the resulting image is user-dependent and
                    requires operator skill and additional practice to become fully proficient.
                    Therefore, the measurement results can be inaccurate. Exercise caution
                    when you perform measurements in iScape mode. A smooth and even
                    speed will help produce optimal image results.
            NOTE:
            •       Guidance and precautions for even movement:
                    –    Make sure there is enough coupling gel along the scan path.
                    –    Always move the probe slowly and steadily.
                    –    Continuous contact is required throughout the length of the extended image. Do not lift
                         the probe from the skin's surface.
                    –    Always keep the probe perpendicular to the skin's surface. Do not rock, rotate or tilt the
                         probe during the scan.
                    –    The system accommodates a reasonable range of motion velocity. Do not make abrupt
                         changes in motion speed.
            •       Deeper scans generally require reduced acquisition speed.
            NOTE:
            •       iScape is an option.
            •       Needle mark cannot be displayed in iScape imaging mode.
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            NOTE:
            •       iScape panoramic imaging is intended for use by well-trained ultrasound operators or
                    physicians. The operator must recognize image items that will produce a sub-optimal or
                    unreliable image.
            •       If the image quality cannot satisfy the following criteria, you shall remove the image and
                    capture it again.
                    –   The Image must be continuous (no part of an image moves suddenly or disappears.)
                    –   No shadow or absent signal along the scan plane.
                    –   Clear profile of anatomy through the entire scan plane without distortion.
                    –   Skin line is continuous.
                    –   The images are captured from the same plane.
                    –   There are no large black areas in the image.
6.10 R-VQS
            R-VQS (RF-data based quantification on arterial stiffness) tracks movements of the upper and
            lower vessel walls and measures vessel diameter, displacement, coefficient of hardness and PWV
            (dimensionless pulse wave velocity).
            Hardness coefficient: Arterial stiffness is changed with the blood pressure changing. The bigger the
            value the higher the stiffness.
            PWV (dimensionless pulse wave velocity) represents the transmit speed of pulse wave. The bigger
            the stiffness parameter the higher the PWV.
            NOTE:
            •       Vascular Package should be configured.
            •       R-VQS is an option.
            •       Only linear probe under Carotid exam mode supports this feature.
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 6 Image Acquisition
            1.   Select a probe and carotid exam mode. Perform B real-time imaging and search for carotid
                 vessel. Try to place the vessel on the image horizontally.
            2.   Tap [R-VQS] and use the trackball/trackpad to locate the ROI box on the target area.
                 Dotted line of the ROI lies in the middle of the vessel and divides the vessel upper wall and
                 lower wall. Use <Set> key and trackball/trackpad to change ROI size and position.
                 Note that ROI should include the upper and lower wall of the vessel.
            3.   Tap [Start Calc] to start tracking. Upper wall and lower wall are marked by the line in the ROI
                 box.
                 Motion curve of vessel walls display under the image in real time. 6 cardiac cycles are
                 calculated in total with each results display in the result window on the left synchronously.
                 Where,
                 Dist = [maximum diameter within 1 s] – [minimum diameter within 1 s]
                 Diam: Vessel diameter refers to maximum diameter within 1 s.
                 6 R-VQS (RF-data based quantification on arterial stiffness) values (6 cardiac cycles are
                 calculated in total), standard deviation SD and ROI length will be displayed in the result
                 window on the left.
            4.   Adjust parameters.
                 –     Speed: Adjust refresh speed of vessel wall motion curve.
                 –     Position: Adjust the location of the motion curve upwards and downwards.
                 –     Curve Disp (Min)/Curve Disp (Max): Adjust amplitude of vessel wall motion curve.
            5.   Tap [Stop Calc] or press <Freeze> to freeze the image and stop updating motion curve and
                 result data.
            6.   Use the trackball/trackpad to review the cine file and select desired frame.
                 –     Tap [Accept Result] to update the result window data to the report.
                       Save the single-frame and multi-frame image if necessary.
                 –     Tap [Cancel Result] to recalculate and perform step 3-5 if necessary.
            7.   Tap [Report] to check report.
                 Only the last result data will be saved.
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                    If pressure is entered in the patient information page or the report page, Hardness coefficient
                    and PWV result will be displayed on the report.
                    For details about report operation, refer to Advanced Volume.
            TIP:
            •       Smart B-line is only available in Single B imaging mode.
            •       It supports single-frame and multi-frame image file detection in B mode.
            •       Smart B-line is an option.
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                 –     B Lines: indicates the number of B lines of the current frame. The number can be 1, 2, 3,
                       4, or ≥5. When the number is equal to or greater than 5, the system does not display a
                       specific number.
                 –     Percent: indicates the percent of the B lines area against the total sampling area.
                 –     Score: the score is among 0 to 3.
                       Normal: when there are a lung sliding sign and A line, or isolated B lines (<3), it is
                       marked as N in the brackets and the score is 0.
                       Moderate: when there are multiple clearly-distributed B lines, it is marked as B1 in the
                       brackets and the score is 1.
                       Severe: when there are intensively fused B lines, it is marked as B2 in the brackets and the
                       score is 2.
                       Lung consolidation: when the lung has a symptom that is similar to the liver lesion
                       structure and air bronchogram, it is marked as C in the brackets and the score is 3. When
                       the lung consolidation and pleural effusion occur at the same time, it is marked as C/P in
                       the brackets and the score is 3.
                 –     Dist n (B Line distance): indicates the distance between the 2 neighboring lines and is
                       measured in the pleura line area, among which, n corresponds to the number between the
                       2 B lines.
                 –     Avg Dist (B Line average distance): indicates the average distance of all B lines.
                 According to the quantitative index calculated by the system, you can add image and diagnosis
                 information. Tap the check box under the [Image] or [Diagnosis] tab to select items:
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            6.      Press the <Save> key to save the single-frame image and B line calculation results.
                    If necessary, press the <Freeze> key again to unfreeze the image. Repeat steps 4-6 to finish
                    calculating other points.
            7.      Tap [Report], and select “Fluid Management” from the drop list box of [Report Type] to check
                    report.
                    For details about report operation, refer to Advanced Volume.
6.11.2 Overview
            After capturing images, tap [Overview] to enter the Overview screen. The Smart B-line supports
            displaying two types of lung overviews in the main screen. You can switch the two lung overviews
            using the corresponding buttons on the touch screen.
            •       Image Map: Displays the ultrasound images of all zones, so as to check the overall lung
                    condition. Ever lung zone displays the ultrasound image with the highest percent of the B line
                    area by default.
                    If a zone saves multiple ultrasound images, tap the point corresponds to this zone, and tap [Pre
                    Item] and [Next Item] to switch the image.
            •       Color Map: Displays the color map of the lung and ultrasound image of a zone. The color map
                    uses different colors to mark the ultrasound image analysis result of every lung zone. This
                    analysis result is calculated from the ultrasound image with the highest percent of B line area.
                    Tap a point on the touch screen to check the calculation result of the zone related to this point.
            TIP:
            •       The cardiac package should be configured in advance.
            •       Smart VTI is an option.
            •       Smart VTI supports B mode image calculation in real time.
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            2.   Move the probe to capture an appropriate image of the long axis view of the left ventricular
                 near the sternum.
            3.   Press the <Measure> key to enter the application measurement. Select the “LVOT Diam” item
                 and the measurement cursor is displayed on the main screen.
                 a.    Move the cursor to the starting point and press <Set> to confirm.
                 b.    Move the cursor to the end point.
                       Press <Clear> to cancel setting the starting point for measurement and <Update> to
                       switch the active end and fixed end of the caliper.
                 c.    Press <Set> to set the end point.
                 For more information about measurement, see Advanced Volume.
            4.   Press the <Freeze> key to unfreeze the image. Move the probe to capture an appropriate image
                 of the apical five chamber view.
            5.   Tap [Smart VTI] on the touch screen or the user-defined key to enter the Smart VTI mode.
                 The system will:
                 –     Automatically trace the color VOI, and PW sampling line and sampling volume.
                 –     Automatically recognize the cardiac cycle: when there are ECG inputs, the ECG signals
                       are preferred; when there are no ECG signals, the system automatically starts calculation.
                 –     Trace the LVOT spectrum in a cardiac cycle in real time to gain the VTI, HR, and CO
                       results of the LVOT.
            6.   If necessary, adjust the color VOI, and PW sampling line and sampling volume:
                 –     Use the trackball/trackpad and <Set> keys to adjust the color VOI position and size, and
                       the PW sampling line position.
                 –     Tap the PW tab to enter the PW mode, and adjust the PW sampling volume.
                 After adjustment, the LVOT spectrum tracing and calculation results display in real time.
            7.   Press the <Freeze> key to freeze the image, and check the Smart VTI calculation results.
                 If necessary, you can edit the LOVT spectrum manually:
                 a.    Tap [Edit VTI] on the touch screen.
                 b.    Press the <Cursor> key to activate the cursor.
                 c.    Move the cursor to the spectrum tracing line and press the <Set> key.
                 d.    Use the trackball/trackpad to trace a line.
                       After tracing, the calculation results display in real time.
            8.   Tap [Save VTI] to save the Smart VTI calculation results of the current cardiac cycle to the
                 report.
            9.   Tap [Graph] to check the quantitative index trend curve.
                 VTI, SV, and CO have different trend curves and are differentiated by colors. A maximum of 6
                 sets of Smart VTI results can be saved and displayed.
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                                                                                                   6 Image Acquisition
            10. Tap [Report], and select “Fluid Management” from the drop list box of [Report Type] to check
                report.
                    For details about report operation, refer to Advanced Volume.
            TIP:
            •       Smart IVC is an option.
            •       Smart IVC supports calculation in both real time and freeze modes.
                    –    Enable Smart IVC in real time. The calculation starts from the current frame and ends
                         after the image is frozen.
                    –    Enable Smart IVC in freeze mode or from the cine file. The calculation starts from the
                         current frame and ends at the last frame. If the cine length is no longer than 10 seconds, it
                         is allowed to calculate in retrospective from the current frame after the cine length reaches
                         10 seconds.
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 6 Image Acquisition
                 b.    Use [Angle] on the touch screen to adjust the sampling line angle, and use the trackball/
                       trackpad to adjust the sampling line position.
                 c.    Press the <Update> key to start calculating IVC again.
            5.   Press the <Freeze> key to freeze the image and finish calculating IVC.
                 The calculation results and quantitative trend curve are displayed on the main screen. Tap the
                 diagnostic Information item on the touch screen to add diagnostic information to the image
                 quickly.
                                                                                                               6
                 1
                 2
                                                                                          Volume
                                                                                      responsiveness           5
             1       B Mode Image          /
             2       IVC CI                Corresponds to the selected breath type:
                     (Collapsibility       • Spontaneous Breath: displays the IVC CI curve.
                     Index), DI            • Mechanical Vent: displays the IVC DI curve and IVCV curve.
                     (Distensibility
                     Index), IVCV trend
                     curve
             3       IVC Sampling Line     /
             4       IVC Trending Line     The horizontal axis represents the time, which is displayed in the
                                           below Free Xros M image, and is traced along the IVC vessel wall.
             5       Diagnostic            Displays the added diagnostic information.
                     Information
             6       Calculation Results   Displays the calculation results within the current calculation range.
                     Window                • Dmax: indicates the maximum IVC inner diameter within a
                                              respiratory cycle.
                                           • Dmin: indicates the minimum IVC inner diameter within a
                                              respiratory cycle.
                                           • IVC CI = (Dmax-Dmin)/Dmax
                                           • IVC DI = (Dmax-Dmin)/Dmin
                                           • IVCV = (Dmax-Dmin)/[(Dmax+Dmin)/2]
            6.   Tap [Save Data] to save the calculating IVC results to the report.
            7.   Tap [Report], and select “Fluid Management” from the drop list box of [Report Type] to check
                 report.
                 For details about report operation, refer to Advanced Volume.
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                                                                                                  6 Image Acquisition
            TIP:
            •       RIMT is an option.
            •       It is merely available to enter RIMT imaging mode in B single window and dual window when
                    adopting linear probe for carotid exam.
            •       Do not press the probe after entering RIMT imaging mode when scanning the image in real
                    time.
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 6 Image Acquisition
            Apart from TDI imaging function, the system also provides tissue tracking QA function for
            myocardial movement evaluation.
            By tissue tracking QA function, the ultrasound system will scan each pixel position by frame within
            the cardiac cycle, and then use region matching method and auto-correlation searching method to
            trace each spot and calculate the movement, so as to determine myocardial motion in a more
            quantitative way.
            Tissue tracking quantitative analysis is an option.
            NOTE:
            Only use the probes that support stress echo function under the cardiac mode to start Tissue
            Tracking QA function.
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                                                                                               6 Image Acquisition
1 6
3 5
3    Display curve: Velocity/                 Each curve on the image is matched with a certain segment in the
     Displacement/Strain/Strain Rate.         cardiac segmentation model (6), identified by different colors.
                                              • Velocity curve: X-axis represents time (s); Y-axis represents
                                                 velocity (cm/s).
                                              • Displacement curve: X-axis represents time (s); Y-axis
                                                 represents displacement (mm).
                                              • Strain curve: X-axis represents time (s); Y-axis represents
                                                 deformation of the tissue (%).
                                              • Strain-rate curve: X-axis represents time (s); Y-axis represents
                                                 strain by time (s-1).
4    Displays ECG trace                       /
5    Displays cardiac segmentation            • In the figure,   marks the peak position of the curve.
     model, and each segment name is          • Under tracking status, click on a segment in the cardiac
     illustrated beneath the model.             segmentation model. The segment has “X” mark and its
                                                corresponding calculating is eliminated.
                                              • Tap certain segment in the cardiac segmentation model, the
                                                segment will turns grey and its corresponding curve no longer
                                                displays.
                                              • You can get the current X/Y axis value by moving the cursor
                                                onto one point on the curve; and if you press <Set> at this time,
                                                the frame marker will move to the spot.
                                              The segment boundary color indicates the tracking quality.
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    6 Image Acquisition
6        Displays measurement and               •  EDV: Maximum value of the end diastolic volume during the
         calculation results                       trace.
                                                • EDA: Maximum value of the end diastolic area (Left
                                                   Ventricular) during the trace.
                                                • ESV: Maximum value of the end systolic volume (Left
                                                   Ventricular) during the trace.
                                                • ESA: Maximum value of the end systolic area (Left
                                                   Ventricular) during the trace.
                                                • FAC (for short axis section): Fractional Area Change= (EDA —
                                                   ESA)/EDA
                                                • EF (for long axis section): Ejection fraction
                                                • HR: Heart rate
                                                • Global strain of all segments.
                                                • Displays when strain rate curve is acquired.
                                                • Global strain rate of all segments.
                                                • Displays when strain rate curve rate is acquired.
                                                Also on Bull’s Eye figure, the system displays TPSD value:
                                                Time to Peak Standard Deviation (TPSD):
                                                Where, standardized value of time to peak data: TPi | i  1 , N  .
                                                (N is the number of time to peak data) Average value of
                                                standardized value of time to peak data: TP , and the standard
                                                deviation is
                                                               TP  TP 
                                                               N
                                                                              2
                                                                     i
                                                    TPSD      1
                                                                     N
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                                                                                                  6 Image Acquisition
1 3
Retracing
            If current trace is not satisfactory, tap [Reload] on the touch screen to clear the trace and to start
            another tracing.
            During the tracing drawing, press <Clear> to clear already traced drawing.
            TIP:
            Under tracking status, tap [Edit] on the touch screen to enter the status.
View Selection
            Before tracing, touch the corresponding keys to select for the view.
            •       [A4C]: apical four chamber.
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Parameter Adjustment
            •    [Thickness]: adjusts the tracing thickness, i.e., the distance between the endocardium wall and
                 the tracking points on the epicardium.
            •    [Tracking Points]: adjusts the number of points within the segment.
            •    [Cycle]: select the next cycle.
            •    [Display Effect]: turns on/off the arrow vector graphical display of the myocardial movement.
            •    [Velocity Scale]: adjust the scale length of the velocity.
            •    [Display Style]: display the endometrial, the epicardium, the myocardial or all.
            •    [Tracking Cycles]: select the cycles to be tracked.
            •    [Average Cycles]: obtain the average parameter curves of the tissue.
            •    [Cycle Select]: select among different cycles.
Time Mark
            According to the status of the current section, tap the corresponding key on the touch screen to
            check the matching time.
            •    [AVO]: displays aortic valve open time.
            •    [AVC]: displays aortic valve closure time.
            •    [MVO]: displays mitral valve open time.
            •    [MVC]: displays mitral valve closure time.
Curve Display
            Select [Parameter], the system provides different curves of different segments for observation.
            •    General
                 –     Speed curve: The X-axis represents time (s); the Y-axis represents velocity (cm/s).
                 –     Displacement curve: The X-axis represents time (s); the Y-axis represents displacement
                       (cm).
            •    Long axis section
                 –     Volume: The X-axis represents time(s); the Y-axis represents volume (ml).
                 –     Strain curve (Longitudinal, Transversal): The X-axis represents time (s); the Y-axis
                       represents strain deformation of the tissue (%).
                 –     Strain-rate curve (Longitudinal, Transversal): The X-axis represents time (s); the Y-axis
                       represents strain by time (s-1).
            •    Short axis section
                 –     Area curve: The X-axis represents time(s); the Y-axis represents area (cm2).
                 –     Strain curve (Radial, Circumferential): The X-axis represents time (s); the Y-axis
                       represents strain deformation of the tissue (%).
                 –     Strain-rate curve (Radial, Circumferential): The X-axis represents time (s); the Y-axis
                       represents strain by time (s-1).
                 –     Circumferential Rotation curve: The X-axis represents time (s); the Y-axis represents
                       rotation of the tissue (Deg).
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                    –   Circumferential Rotation Rate curve: The X-axis represents time (s); the Y-axis represents
                        rotation by time (Deg/s).
6.15.6 Bulleye
            After tracking, the system can display Bull’s Eye graph, so as to judge reverse movement or scope
            of myocardium.
            1.      Tap [Bull’s Eye] on the touch screen to turn on the function:
                    You can acquire:
                    –   Time to peak value and peak value of the 17 segments (similar to 16 segments);
                    –   Display measurement result EDV/ESV/EF/TPSD.
            2.      Use [Parameter] on the touch screen to see different parameter bull’s eye graph.
                    “-” will display in the table to indicate those segments that are not well tracked.
6.15.7 Measurement/Comment
            Under tissue tracking QA mode, only Time measurement is available. For details, please refer to
            Operator’s Manual Advanced Volume.
            Comments and Body Mark operations are the same as in other modes.
            TIP:
            •       The system provides different protocol events based on the different application regions.
            •       iWorks is an option.
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 6 Image Acquisition
            2.   Tap [iWorks] on the touch screen or press the user-defined key for “iWorks” to enter the
                 protocol selection screen, and tap the corresponding protocol button to enter the status.
                 After the system enters the iWorks screen, the available protocol is displayed on the right of
                 the screen.
            3.   Perform the scanning and saving according to the screen prompt.
            4.   Perform measurements or add comments/body marks to the image according to the screen
                 prompt.
            5.   After a view scanning is complete, press the user-defined save key to switch to the next view
                 according to the screen prompt.
            6.   Repeat steps 3 to 5 to acquire all the necessary images.
                 –     If a pathology is discovered, tap [Insert] to select a protocol outside of the normal routine
                       to start scanning.
                 –     Tap [Repeat] to add a copy of the selected view to work on if necessary.
                 –     Tap [Next] or [Previous] to skip to a particular view you are interested in.
                 –     Tap [Replace] to delete images and operations for the selected view and restart operations
                       on that view.
                 –     Tap [Delete] to delete the currently activated view.
                 –     Tap [Suspend] to start a manual scan when an unusual or atypical workflow is required,
                       and tap [Resume iWorks] to restart the iWorks procedure.
            7.   After all views are finished, the system will prompt you to exit iWorks. Tap [Yes] to exit.
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Touchscreen Display
            The touchscreen displays the following screen:
View Selection
            Tap [Prev]/[Next] to select the view to be scanned. The current view is surrounded by a solid frame.
View Operation
            In the current active view, you can perform image scanning, measurements, and adding comments
            and body marks, etc. Operations are the same as those for manual operation. See the relevant
            chapters for details.
Repeat View
            If necessary, tap [Repeat] to insert another template of the current view. You can then perform an
            extra examination.
View Replacement
            The previous image will be deleted and replaced by the new image.
Delete View
            Tap [Prev]/[Next] to select the view to be deleted. Tap [Delete] to delete the selected view.
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 6 Image Acquisition
            •    Return to iWorks: tap [Resume iWorks] to return to automated status. You can continue the
                 previous iWorks scan.
6.16.4 Insert
            Insert is a specialized protocol event within iWorks and iWorks OB. It assists with the workflow for
            documenting and measuring common pathological (disease) states (i.e. Mass, Cyst, Stenosis,
            Thrombus) that occurs outside a routine, normal examination.
            Tap [Insert] on the touch screen to enter the status.
            Select the necessary protocol and the system adds the protocol events to the current protocol.
            Perform measurements or add comments/body marks to the image if necessary.
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7                   Smart 3D
            The operator moves the probe to change its position/angle when performing the scanning. After the
            scanning, the system carries out image reconstruction, and then displays a single frame of 3D
            image.
            NOTE:
            Smart 3D imaging is largely environment-dependent, so the images obtained are provided for
            reference only, not for confirming a diagnosis.
            TIP:
            Smart 3D is an option.
7.1         Overview
            The ordinary 2D imaging has the limitations on viewing the overall structure and different planes of
            the target. However, 3D imaging can obtain the reference information by overall observation.
7.1.1 Terms
                                                                 View
                                                                 视点          point
                                                             2           3
                                                         1           4
                                                                                     X
                                                                                         Y
                                                    6                                7
                                                5
                                                                                8
            •       Volume data: to obtain the data collection of three-dimensional object via the sequence
                    reconstruction to two-dimensional object.
            •       3D image Volume Rendering (VR): the 3D image on the screen.
            •       View point: the position for viewing volume data/3D image.
            •       MultiPlaner Rendering (MPR): a tangent plane of the 3D image that obtained by algorithm.Of
                    which, XY-paralleled plane is C-plane, XZ-paralleled plane is B-plane, and YZ-paralleled
                    plane is A-plane.YZ-paralleled plane is B-section. The probe is moved along the X-axis.
            •       ROI (Region of Interest): a volume box used to determine the height and width of scanning
                    volume.
             •     VOI (Volume of Interest): a volume box used to display 3D image (VR) by adjusting
                   interesting region in MPR.
                                           1   2D image
                                           2   ROI
                                           3   Cut plane
             NOTE:
             •     To define a ROI, please remove the useless data as to reduce the volume data and shorten the
                   time for image storing, processing and reconstruction.
             •     Set ROI on the 2D image with the largest section area of the fetal face.
             •     Set ROI a little larger than the fetal head.
            TIP:
            You may have to adjust the threshold to obtain a clear body boundary.
Max
            Set Max as 3D image rendering mode, displays the maximum echo intensity in the observation
            direction.
            This is helpful for viewing bony structures.
Min
            Set Min as 3D image rendering mode. Display the minimum echo intensity in the observation
            direction.
            This is helpful for viewing vessels and hollow structures.
X Ray
            Set X-ray as 3D image rendering mode. Display the average value of all gray values in the ROI.
            This is used for imaging tissues with different structure inside or tissues with tumor.
7.1.4 MPR
            MPR represents three different views of 3D image.
            In the quad display format view, the screen displays 3 MPRs (A, B and C) and the 3D image.
A B
A window B window
C 3D
             •   Section A: corresponds to the 2D image in B mode.Section A is the sagittal section in fetal face
                 up posture, as shown in the figure A above.
             •   Section B: it is the horizontal section in fetal face up posture, as shown in the figure B above.
             •   Section C: it is the coronal section in fetal face up posture, as shown in the figure C above.
             The upper part of the 3D image in the 3D window is corresponding to the orientation mark on the
             probe, if the fetal posture is head down (orientating the mother’s feet), and the orientation mark is
             orientating the mother’s head, then the fetus posture is head down in the 3D image, you can make
             the fetus head up by rotating the 3D image by taping [180°] on the touch screen.
                 CAUTION
             The ultrasound images are provided for reference only, not for confirming a
             diagnosis. Please use caution to avoid misdiagnosis.
             NOTE:
             •   In accordance with the ALARA (As Low As Reasonably Achievable) principle, please try to
                 short the sweeping time after a good 3D imaging is obtained.
            •       A region with qualified image in B mode may not be optimal for 3D imaging. E.g. adequate
                    AF isolation for one section plane of 2D image doesn’t mean the whole desired region is
                    isolated by AF for 3D imaging.
            •       More practices are needed for a high success of qualified 3D imaging.
            •       Even with good imaging condition, to acquire an approving 3D image may need more than one
                    scanning.
Fetal Condition
            •       Gestational age
                    Fetuses of 24~30 weeks old are the most appropriate to 3D imaging.
            •       Fetal body posture
                    Recommended: Cephalic face up (figure a) or face aside (figure b); NOT recommended:
                    Cephalic face down (figure c).
a b c
                  –   Linear scanning
                      Move the probe across the surface. See the following figure.
                  –   Rocked scanning
                      Rotate the probe once from the left to the right side (or from the right to the left) to include
                      the entire desired region. See the following figure.
MPR Viewing
            In actual display, different colors of the window box and the section line are used to identify the
            section A, B and C.
            •       The color of window A is blue, and the color of the lines (representing section A) displayed in
                    the other two windows is blue as well.
            •       The color of window B is yellow, and the color of the lines (representing section B) displayed
                    in the other two windows is yellow as well.
            •       The color of window C is orange, and the color of the lines (representing section C) displayed
                    in the other two windows is orange as well.
            Positions of the other two sectional planes are indicated in the selected plane. You can roll the track
            ball to change the position.
MPR Only
             Select [Display Format] > [MPR Only] on the touch screen to display section images. And the
             adjustable image parameters are changed into MPR parameters automatically.
             Only A, B and C section images are displayed, and 3D image is not displayed.
Asymmetric
             Select [Display Format] > [A4:1] on the touch screen to display section images and 3D image.
View Direction
             The Region of Interest (ROI) contains the section of the volume you want to render. You can adjust
             the view direction of the ROI.
             The system supports the observation of 3D image from 6 directions.
a. Up/Down b. Down/Up
c. Left/Right d. Right/Left
                                    e. Front/Back                 f. Back/Front
             Tap [Up/Down], [Left/Right] or [Front/Back] to select the direction of the figure a, c and e.
             Tap [Flip] on the first page to observe by the converse direction of the current direction, which is
             equivalent of the 180° rotation of current VOI, as shown in the figure b, d, e and f.
Adjust VOI
             Adjusting the VOI box size and position is to select the volume data needed to restructure the 3D
             image and improve the reconstruction effect.
             •   VOI On
                 3D image (VR) image displays VOI information.
                 a.   In image viewing status, tap [VOI] to be “On”.
                 b.   Select a desired section plane by tapping [Ref. Image] > [A], [B] or [C] or [VR].
                    c.   Use the trackball/trackpad to adjust VOI position, size and curved VOI, and press <Set>
                         to toggle among the adjusting status.
            •       VOI Off
                    3D image (VR) image displays ROI information.
                    Tap [VOI] to be Off, then the ROI image is displayed on the screen, use the trackball/trackpad
                    to observe section images.
Accept VOI
            This function is usually used for section image observation and to determine the relative position of
            the section image to the VR.
            1.      Tap [Accept VOI].
            2.      Select a desired MPR image by tapping [Ref. Image] > [A], [B] or [C].
            3.      Use the trackball/trackpad to view the current active section image, and the other section
                    images change correspondingly
            In Accept VOI status, when the 3D image is active or the section image which is perpendicular to
            the view direction is active, center point of the 3D image displays, and you can adjust the position
            by using the trackball/trackpad.
                         Item                                            Description
             Threshold                    Set the threshold for 3D image rendering. 3D image is rendered on the
                                          signal above thresholds by eliminating noise via the Threshold
                                          parameter. Lower threshold can eliminate lower range noises and echo,
                                          which will contribute to a clearer and smoother image.
                                          Available only in Surface rendering mode.
             Opacity                      Adjust the transparency value for 3D image rendering. It implies the
                                          transparency of the light. The higher the value is, the tougher the
                                          surface becomes.
                                          The lower the number is, the more transparent the gray scale
                                          information will be.
                                          Available only in Surface rendering mode.
             Smooth                       Set the smoothness of 3D image.
                                          NOTE:
                                             Insufficient smoothness can result in a fuzzy image; however, too
                                             much smoothness will lead to image distortion.
             Brightness                   Set the brightness of image.
                                          NOTE:
                                             The adjustment is for 3D (VR) and MPR.
                         Item                                          Description
              Contrast                   Set the contrast scale of the image.
                                         As long as the contrast becomes larger, the bright spot and dark spot on
                                         the image change as well.
                                         NOTE:
                                            The adjustment is for 3D (VR) and MPR.
              Tint                       Enable/disable tint map. The color of image change according the tint
                                         value.
              Quick Rotation             Rotate the 3D image quickly.
              iClear                     Use the 3D self-adapation filter to strengthen the space continuity of the
                                         tissue structure, and provide speckle suppression, and improve the
                                         image contrast effect, so as to optimize the image data.
                                         Adjust iClear to optimize MPR image.
              VR Refine                  Optimize the signal-noise ratio and the contrast of VR image.
              MagiClean                  Reduce the noise and keep the boundary of the image more clearly.
                                         NOTE:
                                            Available only in Surface rendering mode.
              Depth VR                   Superimpose the tint map basic on the VR image to improve the
                                         stereoscopic sensation and the contrast of the image.
              Thickness                  Adjust the render thickness of MPR.
Reset Curve
              Do one of the following to reset the curve:
                         Item                                          Description
              Ori                        To reset the volume rotation, shifting and zooming of 3D image to
                                         original status.
              All                        To reset the parameters, rendering rotation, VOI and image effect.
              Reset Curve                To reset the curve to be the original beeline.
Render Mode
              Set 3D image rendering mode.
              The rendering manners can be applied to inversion mode.
Inversion
              This function is to inverse the echo of the 3D image, so as to enhance observation for low-echo
              region, applicable for vessel, cyst and etc.
              When the Inversion is turned on, the rendering mode parameters change into the corresponding
              inversion parameters.
              Vessel shape is correct with the capture target. The vessel wall is smooth and clear.
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            NOTE:
            You can view the back of the VR by rotating it 180°. The back view image may not be as vivid as
            the front. (Here we call the initial view of the VR the “front”). It is recommended to re-capture
            rather than rotate the VR if a certain desired region is obscured in the VR.
            •       Axial rotation
                    Axial rotation is to rotate the 3D image around the X, Y or Z axis. Use [X Axis], [Y Axis] and
                    [Z Axis] buttons to rotate the image along the selected axis:
                    –    Tap the left part of the button, or rotate the multi-functional knob anticlockwise: the image
                         rotates left along the selected axis.
                    –    Tap the right part of the button or rotate the multi-functional knob clockwise: the image
                         rotates right along the selected axis.
            •       Auto Rotation
                    a.   In 3D viewing mode, tap [Tools] > [Auto Rot.] to enter into auto rotation preparation
                         state.
                    b.   Tap [Left/Right] or [Up/Down] to set the auto rotation direction
                    c.   Set Start position and End position:
                         Start position: Use the trackball/trackpad to view to a certain position, tap [Set Start].
                         End position: Use the trackball/trackpad to view to a certain position, tap [Set End]
                    d.   Set the auto rotation increment: rotate the knob under the [Increment].
                    e.   Tap [Off] to start auto rotation.
                         Use [Speed] to adjust the rotation speed
                         Tap [SE/SE] for single direction rotation; tap [SE/ES] for bidirectional rotation.
Surface Enhancement
            This function is to make the edge structure of the image and surface details clearer, so as to enhance
            the overall contrast.
            Tap [Surf. ENH] to adjust the enhancement level, the higher the level is, the clearer the edge
            structure of the image is.
            When the level is higher than 0 and [Move Light] is highlighted, image close to the light source is
            clearer, and image away from the light source is darker.
Sync
            This function is to switch the direction of the image to the direction that is perpendicular to the
            current active plane, so as to get a better observation.
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 7 Smart 3D
Image Editing
              Image cutting is a more elaborate function than VOI adjusting to optimize the 3D by clipping
              (removing) the part blocked the region of interests.
              TIP:
              •    In image cutting status, image parameter can not be edited. There displays a cutting cursor + or
                   an eraser cursor , and the system enters “Accept VOI” status.
              •    The editing function is only available on 3D image.
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                                                                                                         7 Smart 3D
            TIP:
            Capturing preparation does not support the measurement.
Image Saving
            •       Image saving
                    In the 3D Review mode, press <Save> key (with user-defined saving function) to save the
                    current image and volume data to the patient information management system in the set
                    format.
            •       Image review
                    Open an image file to enter the image review mode. In this mode, you can perform the same
                    operations as what you can in review mode.
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8                   Strain Elastography
                    CAUTION
            It is provided for reference, not for confirming a diagnosis.
            TIP:
            •       The strain elastography is an option.
            •       Select an appropriate probe before performing elastography imaging scan, see “16.1 Probes”.
            It is produced based on the slight manual-pressure or human respiration in 2D real-time mode. The
            tissue hardness of the mass can be determined by the image color and brightness. Besides, the
            relative tissue hardness is displayed in quantitative manners.
Opacity
            Adjust the opacity feature of the Elasto image.
Invert
            Invert the E color bar and therefore invert the colors of benign and malignant tissue.
Display Format
            Adjust the display format of ultrasound image and the Elasto image.
            Tap [H 1:1], [V 1:1], [Full] on the touch screen to adjust.
            The system provides 3 types of display format:
            •    H 1:1: Right and left display (the real-time ultrasound image appears on the left, and the elasto
                 image appears on the right);
            •    V 1:1: Up down display (the elasto image appears above, and the real-time ultrasound image
                 appears below).
            •    Full: The elasto image only displayed.
Map
            Select different maps for observation.
Strain mode
            Affect the display effect of adjusting dynamic range.
Dynamic Range
            Adjust contrast resolution of an image.
            The real-time dynamic range value is displayed on the image parameter area in the upper left corner
            of the screen.
E Sensitivity
            Increase the image palpability.
Strain Scale
            Adjust the bar height of the pressure hint curve to keep the average height of the hint bar on proper
            position.
Map Position
            Adjust the up/down position of the map.
            The contrast imaging is used in conjunction with ultrasound contrast agents to enhance imaging of
            blood flow and microcirculation. Injected contrast agents re-emit incident acoustic energy at a
            harmonic frequency much more efficient than the surrounding tissue. Blood containing the contrast
            agent stands out brightly against a dark background of normal tissue.
                    CAUTION
            •       Set MI index by instructions in the contrast agent accompanied manual.
            •       Read contrast agent accompanied manual carefully before using contrast
                    function.
            NOTE:
            •       Make sure to finish parameter setting before injecting the agent into the patient to avoid
                    affecting image consistency. This is because the acting time of the agent is limited.
            •       The applied contrast agency should be compliant with the relevant local regulations.
            TIP:
            •       Contrast imaging is an option.
            •       Select an appropriate probe for Contrast Imaging, see “16.1 Probes”.
                For every single contrast imaging procedure, use [Timer 2] for timing.
                If necessary, activate destruction function by tapping [Destruct] at “ON” to destruct the micro-
                bubbles left by the last contrast imaging; or to observe the reinfusion effect in a continuous
                agent injecting process.
           7.   Exit contrast imaging.
                Press <B> button to return to B mode.
           This feature enhances echo reflection by using contrast agent to perform myocardial analysis based
           on echocardiography technique.
           Perform the following procedure:
           1.   Acquire ECG signal.
           2.   Select an appropriate probe and cardiac exam mode.
           3.   Workflow of Low MI Contrast imaging is similar to abdomen contrast imaging, see “9.1 Basic
                Procedures for Contrast Imaging”.
Timer
           NOTE:
           The starting time displayed may be inconsistent with the actual one due to system error or some
           other man-made mistakes; please check the agent-injecting time.
            The two timers are used to record total time of contrast imaging and single time of one contrast
            exam.
            After the image is frozen, Timer 1 is still timing, and after unfreezing the image, the corresponding
            time can be seen.
            Timer 2 stops timing when one contrast exam is frozen, and after unfreezing the image, the Timer 2
            is off.
            Set [Timer 1] as “ON” to start the timing at the moment you inject the contrast agent. Here, the
            screen displays the times at the lower corner.
Micro-bubble Destruction
                    CAUTION
            Use the contrast imaging according to the residual level of the micro-bubbles,
            using contrast imaging continuously may result in human harm.
            Destruct the micro-bubbles left by the last contrast imaging; or to observe the reinfusion effect in a
            continuous agent injecting process.
            Tap [Destruct] on the touch screen to enable the micro-bubble destruction function:
            •       DestructAP: Adjust the destruct acoustic power via the touch screen.
            •       Destruct Time: Adjust the destruct time via the touch screen.
Dual Live
            In live mode or freeze mode, set touch screen item [Dual Live] as “ON” to enable dual live
            function. Both the contrast mode and tissue mode are displayed. The THI and B image are
            displayed on the screen if the [Dual Live] is enabled.
            TIP:
            •       In dual live mode, the screen displays the contrast image and tissue image
            •       In freeze mode, there displays only one cine review progress bar as the contrast image and
                    tissue image are reviewed synchronously.
Mix Map
            This function is to mix the contrast image with the tissue image, so that interested contrast regions
            can be located.
            Use [Mix] to select different mixing mode.
            •       When dual live function is on, you can see the mixed effect on the contrast image.
            •       When dual live function is off, you can see the mixed effect on the full screen image.
            Select the map through the [Mix Map] item.
iTouch
            On contrast status, you can also get a better image effect by using iTouch function.
            1.      Press <iTouch> on the control panel to turn on the function.
                    The symbol of iTouch will be displayed in the image parameter area once press <iTouch>.
            2.      Select different levels of iTouch effect through [iTouch] on the touch screen.
            3.      Long press <iTouch> to exit the function.
           TIP:
           •    MFE imaging is available only for real-time imaging or cine file of auto review mode. If a
                MFE cine is reviewed manually, MFE effect cannot be displayed.
           •    In MFE status, patient should lie down and hold breath, and transducer should be kept still.
           TIP:
           •    In case of inaccuracy of the data, do not adjust the depth and the pan-zoom when saving the
                cine.
           •    If the contrast signal inside the selected ROI does not meet the requirements of gamma fitting
                condition, that is the bulleting injection, curve fitting may not be available.
             1       Contrast cineloop     Sample area: indicates sampling position of the analysis curve. The
                     window                sample area is color-coded, 8 (maximum) sample areas can be
                                           indicated.
             2       B cineloop window     Sample areas are linked in the contrast cineloop window and B
                                           cineloop window.
             3       Time-intensity curve •    Y axis represents the intensity (unit: dB), while X axis represents
                                               the time (unit: s).
                                           •   Frame marker: a white line that is perpendicular to the X axis, can
                                               be moved horizontally left to right (right to left) by using the
                                               trackball/trackpad.
                                           •   Click the check box beside the ROI to set if to hide or to display the
                                               QA curve.
                                           •   You can get the current X/Y axis value by moving the cursor onto
                                               one point on the curve; and if you press <Set> at this time, the
                                               frame marker will move to the spot.
                a.   Use [ROI Type] to select the method for determining the shapes of the sample area: Trace
                     ROI and Ellipse ROI.
                     The cursor is evolved in the image review area.
                b.   Use the trackball/trackpad to position the caliper on the reference image at the start point.
                     Press <Set> to fix the start point.
                          Item                                          Description
            GOF (Goodness of Fit)             Calculate the fit degree of the curve; range: 0-1, where 1 means
                                              the fit curve fits the raw curve perfectly.
            BI (Base Intensity)               Basic intensity of no contrast agent perfusion status.
            AT (Arrival Time)                 Time point where contrast intensity appears, generally, the actual
                                              time value is 110% higher than the base intensity.
            TTP (Time To Peak)                Time when the contrast intensity reaches peak value.
                             Item                                            Description
             PI (Peak Intensity)                  Contrast peak intensity.
             AS (Ascending Slope)                 Ascending slope of contrast, the slope between the start point of
                                                  lesion perfusion to the peak.
             DT/2                                 Time when the intensity is half the value of the peak intensity.
             DS (Descending Slope)                Descending slope of the curve.
             AUC (Area Under Curve)               To calculate the area under the time-intensity curves during
                                                  contrast.
                    You can set range for the fit curve. After the range is set, the system displays fit curve within
                    the range only. Use the trackball/trackpad to the time-intensity curve to move the frame marker
                    position.
                    a.   Set starting point of the fit curve: Use the trackball/trackpad to select the starting time and
                         tap [Set Fit Start].
                    b.   Set end of the fit curve: Use the trackball/trackpad to select the end time and tap [Set Fit
                         End].
            7.      Use [X Scale] on the touch screen to choose different value, so that the X scale display manner
                    will be changed.
                    This function can be used to track detailed tissue information.
            8.      Save the curved image, export the data and do parameter analysis.
                    a.   Tap [Export] on the touch screen.
                    b.   Select the drive and enter the file name in the displayed window.
                    c.   Select [OK] to save the data and return to the QA Analysis screen.
                         All displayed ROI traces are saved in the exported file.
                         The parameters are included in the trace file if the user has fixed a ROI.
                         After the exporting is succeeded, a .BMP format image is displayed in the thumbnail area
                         of the screen.
                         Only data from the user selected image range is included in the exported trace file.
            9.      Tap [Exit] to exit Contrast QA.
            The physiological unit signal waveform is used for checking ultrasound image in ultrasound exam
            (cardiac exam mainly).
                    WARNING
            •       Do not use the physiological traces for diagnosis and monitoring.
            •       To avoid electric shock, the following checks shall be performed prior to an
                    operation:
                    – The ECG electrode cable must not be cracked, frayed or show any
                        signs of damage or strain.
                    – The ECG electrode cable must be correctly connected.
                    – You must use the ECG leads provided with the physiological unit
                        module. Failure to do so may result in electric shock.
            •       The ECG electrode cable must be connected to the system first. Only after
                    the cable is connected to the system, can the patient be connected to the
                    ECG electrodes. Failure to follow these instructions may subject the patient
                    to electric shock.
            •       Do not place the ECG electrodes directly in contact the patient’s heart;
                    otherwise it may lead to stop of the patient’s heartbeat.
            •       Do not use this system when any digital device such as a high-frequency
                    electrotome, high-frequency therapeutic device or defibrillator is applied
                    already.
            •       Conductive parts of electrodes and associated connectors for ECG should
                    not contact other conductive parts including earth/grounding.
            •       Frequent trampling or squeezing on the cables may result in cable break-
                    down or fracture.
            •       Display effect of respiratory curve depends on the patient breathing status.
                    While a very slow or smooth breathing may lead to an inapparent
                    respiratory curve, breathing in a large amplitude may cause an incomplete
                    display of the respiratory curve. Display effect is linked to the connected
                    parts of the body. Generally, signals by connecting to limbs are stronger
                    than by connecting to the chest.
10.1 ECG
            Perform the following procedure:
            1.      Connect the device and place ECG electrodes.
                    a.   Turn off the power supply of the system, and connect the ECG module to the system.
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 10 Physiological Unit Signal
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             2.   Tap [Physio] or press the user-defined key for “Physio” to enter physio operation interface.
             3.   Switch the imaging modes and display formats, adjusting the parameters to get an optimized
                  image.
             4.   Parameter adjusting:
                  Tap [ECG] on the touch screen to enable or disable ECG waveform curve. Adjust the [Speed],
                  [ECG Gain], [Position] and [Invert].
             5.   Trigger:
                  Select the trigger mode, or tap [Real & Trig] to set the trigger time, triggering delay time and
                  image display format.
             6.   Freeze the triggering image and the curve, and then review them.
             7.   Tap [Physio] or press the user-defined key for “Physio” to exit ECG mode, and remove ECG
                  electrodes from the patient.
ECG Triggering
             ECG triggering means that image scanning is activated at some time points of ECG signals, thus
             obtaining B images at these time points. The triggering image should be in 2D-mode.
             When ECG triggering occurs, some marks (frame triggering mark) appear on the ECG waveform
             (relative R wave, the time for delay set), indicating the time points when the 2D images are
             captured.
             TIP:
             •    The triggering mark is displayed in both freeze mode and live mode
             •    The marks in Dual trigger are in different colors.
             •    Triggering function is unavailable if the ECG trace is disappeared. Only the live 2D image can
                  be triggered.
             •    No delay time or time interval shall be less than the time required to scan a single image.
             •    If the delay time is longer than a heart cycle, then the heart cycle in the delay time is omitted,
                  that is to say no trigger is occurred when R waveform is detected in the duration.
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                                                                                          10 Physiological Unit Signal
Triggering Mode
            There are three triggering modes available: Single, Dual, and Timer.
            •       Single Trigger: When an R waveform is detected, an image will be triggered after delay time
                    T1. The time of T1 can be edited in single mode.
            •       Dual trigger: when an R waveform is detected, two images in two windows will be triggered
                    respectively after delay time T1 and T2. The time of T1 and T2 can be edited in dual mode.
            •       Timer Trigger: an image will be triggered after a time interval.The time interval can be edited
                    in triggering status.
            The image triggering operation is described as follows (Take single trigger as an example):
            1.      Select exam mode.
            2.      Tap [Trig Mode] on the touch screen to enable the trigger.
            3.      Select [Single].
            4.      Set the delay time (or use the T1 by default).
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 10 Physiological Unit Signal
                       Parameter                                     Description
              ECG Source               Select ECG source.
              Gain                     Set the amplitude of the trace.
              Position                 Set the vertical position of the both traces on the image display.
              Speed                    Change the speed of the physio trace.
              T1                       Set the delay time T1 in Single trigger or Dual trigger.
              T2                       Set the delay time T2.
              Interval                 Set the time interval for Timer.
              Invert                   Invert the display.
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11                  Stress Echo
            Stress Echo is an option, only the phased probes support stress echo function under the cardiac
            mode.
                    CAUTION
            Stress echo data are provided for reference only, not for confirming diagnoses.
            The Stress Echo feature allows you to capture and review cardiac loops for multiple-phase
            (multiple-stage) Stress Echo protocols.
            Stress Echo data consists of Stress Echo loops, wall motion scores, and all other information
            pertaining to the Stress Echo portion of a patient examination.
            A loop is a clip that displays the motion of an entire heart cycle, or from the beginning systole to the
            end systole, as indicated by the R-wave of the ECG trace and determined by the QT – Time Table.
            The loops in a given protocol are acquired by stages (phases), according to stage configuration
            (continuous (prospective) or retrospective (non-continuous)).
            •       Loops in non-continuous stages are limited to a specified loop-per-view maximum (such as
                    four). View labels can only be selected in the configured order. Acquisition is retrospective -
                    when you press <Save> on the control panel, the system saves the previously acquired images.
            •       Loops in continuous stages are limited by time rather than a maximum number of loops - the
                    system stops acquisition after two minutes. Acquisition is prospective - when you select the
                    stage label and then press <Save> on the control panel, the system starts saving newly acquired
                    images. In some protocols, the system will jump to Select Mode after retrospective saving.
            When images are saved, the system places a green checkmark to the right of the view or continuous
            stage and then shifts the red mark to the next view or next stage.
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 11 Stress Echo
                  When you confirm the ROI size by pressing <Update>, you cannot adjust the ROI size during
                  acquisition. You can only adjust the ROI position using the trackball/trackpad.
            4.    Press <Save> on the control panel to start acquisition.
                  The system displays the Protocol window on the screen, listing the phases for the selected
                  protocol along with the first phase views (phases are stages). The system selects the first view
                  for acquisition by default.
            5.    Proceed through each view in each stage according to the following instructions:
                  Non-continuous stages:
                  –   To save acquired images for the selected view, press <Save> on the control panel. The
                      system goes to the next view for acquisition by default, saved views are marked with a
                      green “√.”
                  –   Use [Stages XXX] or [Views XXX] to select the stage and view for image acquisition (or
                      reacquisition). Press <Save> to start acquisition.
                      Views can be re-acquired until you tap [End Acquisition].
                  If the protocol contains continuous stages (for alternative workflows), then proceed through
                  each continuous stage according to the following instructions:
                  –   To begin saving acquired images for the selected stage, press <Save> on the control panel.
                  –   The system displays a percentage marker below the selected stage indicating the progress
                      of the continuous capture.
                  –   To halt saving acquired images for the selected stage, tap [Pause] on the touch screen or
                      press <Freeze> directly. The percentage stops increasing.
                  –   Select [Continue] or press <Freeze> again to continue.
                  –   To end the current acquisition, press <Save> on the control panel.
                  –   To select another continuous stage, use [Stages XXX] on the touch screen.
                  –   Suspending is not allowed under continuous exam.
                  When acquisition is complete for each stage, the system advances to the next stage. If the stage
                  is non-continuous, the system displays the stage views. When image acquisition is completed
                  for all views and continuous stages, the system switch to Select Mode.
            6.    To start or restart the timer, tap [Stage Timer]/[Exam Timer] to turn it on.
                  The Stage time is displayed to the right side of each stage in the protocol list, while the Exam
                  time is displayed in the left side of the screen.
                  Each saved image will be marked with two times T1 and T2. T1 refers to the total time of the
                  whole acquisition, while T2 indicates the time the acquisition lasted for a certain stage.
            7.    To review loops before ending acquisition, select [Review/WMS]. You can redisplay the real-
                  time imaging screen to continue acquisition by selecting [Acquire].
            8.    To end the acquisition and review the acquired images, tap [End Acquisition].
                  When the acquisition is ended, no stress echo image acquisition can be performed for the same
                  exam.
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                                                                                                         11 Stress Echo
                        Selection                                          Description
             Stages XXX                    To select a stage.
             Views XXX                     To select a view.
             Acquire/Select/ Review/ To switch the mode status.
             WMS
             1. Clip/2. Clip/3. Clip/4. For selecting views in the selected stage.
             Clip
             Next                          Next four Clips.
             Previous                      Previous four Clips.
             First                         Go to “first” Clips.
             Last                          Go to “last” Clips.
             Play                          Click to play/stop cine play.
             Prev frame                    See previous frame of the cine file.
             Next frame                    See next frame of the cine file.
             First frame                   See first frame of the cine file.
             Last frame                    See last frame of the cine file.
             Speed decrease/Speed          Decreases or increases playback speed.
             increase
             Text                          Function that turns the screen graphic text “On” or “Off”. Information
                                           includes: name of level, name of view, heart rate, time stamp
                                           acquisition, timers, frame slider, loop ID, clip control. For the cine
                                           without distributed view, the name of level and name of view are
                                           displayed in “--”.
             Apply edit all                Clip edit applied to all clips taken.
             Clip Length                   Specify the clip segments: systole, diastole, full cycle or user-defined.
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 11 Stress Echo
                    Selection                                           Description
             Bookmark                    For continuous acquisition, when the bookmark is set to “On”, only the
                                         selected loops for the current view can be displayed.
             Delete Unselected           Delete clips that are not selected. If selected, the system will delete all
                                         clips that are not selected after the exam is ended.
             Suspend exam                Pauses the stress echo exam but does not end the stress echo exam.
                                         When a stress echo exam is suspended, the user can perform image
                                         acquisition of all other imaging modes, or perform operations such as
                                         measurement.
             End SE exam                 End the stress echo exam.
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                                                                                                         11 Stress Echo
                    Description of review/WMS mode keys (keys with the same function as in select mode are not
                    described below):
                         Item                                            Description
             Review/WMS                    Perform side-by-side comparison of the same views at different stages
                                           (PLAX, PSAX, A4C, A2C at “Rest” compared to PLAX, PSAX, A4C,
                                           A2C “Post-Exercise”). Clips are synchronized.
                                           • Under [Text] “Off” status, when you select one stage, all view loops
                                               are displayed on the screen; when you select one view, all loops of
                                               the same view in different stages will be displayed on the screen.
                                           • Set [Text] to “On”, the system will select loops of first two views of
                                               the first two stages to display automatically. If you choose
                                               [Previous], then loops of the next two views of the first stages will
                                               be displayed. If you choose [Next], loops of the first two views in
                                               the 3rd and 4th stage will be displayed.
                                           In the meantime, if you choose one stage, loops of all views under this
                                           stage will be displayed on the screen (4 at most), and choosing one
                                           view will lead to loops of this view in different stages be displayed (4 at
                                           most).
             Display Selected              Displays loops of all the stages and views selected.
            2.      Use the trackball/trackpad to select the value and then click the target segments, then the
                    segment is assigned with a value.
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 11 Stress Echo
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12                  Display & Cine Review
Dual-split
            Press <Dual> on the control panel to enter the dual-split mode, and use <Dual> / <Update> key to
            switch between the two images; press <B> to exit.
Quad-split
            Press the user-defined key for “Quad” to enter the quad-split mode, and use the user-defined key to
            switch among four images; press <B> to exit.
            Modes support quad-split display: B mode, Color mode and Power mode.
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 12 Display & Cine Review
                 CAUTION
            •    The cine memory must be cleared at the end of the current patient and the
                 onset of the next new patient by tapping [End].
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                                                                                            12 Display & Cine Review
            •       Cine files stored in the system’s hard drive shall contain patient information,
                    to avoid the selection of an incorrect image file and potential misdiagnosis.
1 2 3 4 5
                                           1    Start mark
                                           2    Playback mark
                                           3    End mark
                                           4    Current frame
                                           5    Total frames
                                           6    Auto Review Region
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 12 Display & Cine Review
            TIP:
            You can perform cine review on each image window in the dual/quad splitting mode, and set auto
            review region for each window.
1 2 3 4 5
                                        1     Start mark
                                        2     Playback mark
                                        3     End mark
                                        4     Time played
                                        5     Total time
                                        6     Auto Review Region
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                                                                                            12 Display & Cine Review
            TIP:
            There is no audio when the spectrum is reviewed in manual status but audio synchronization can be
            realized in auto review status with speed of ×1.
            The frame synchronization mark on the time mark of M/PW image indicates the corresponding 2D
            image and M/PW image. In statuses other than dual live status, you can only review images in the
            currently active window.
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 12 Display & Cine Review
                 There is “Display” column you can filter the images by selecting “All Items”, “Selected”,
                 “Unselected”.
                 Click [Clear Selected] to clear all selected images.
            4.   Click [OK] to enter image comparison.
            5.   Switch the multi-frame cine among the windows to review (single-frame image cannot be
                 reviewed).
                 –   Press <Dual> to toggle between the two images.
                 –   Press the user-defined key for “Quad” to switch among 3-4 images.
                 The window with the highlighted “M” mark is the current activated window.
                 You can select the image to be reviewed at synchronous time when the multi-frame image is
                 reviewed by using [Sync Play].
            6.   Save the image if necessary.
            7.   Click [Return] on the screen or press <Freeze> to exit image compare.
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                                                                                           12 Display & Cine Review
            TIP:
            •       Press the save key again or <Freeze> to stop saving.
            •       When a saving is completed, a thumbnail is showed in the Thumbnail area.
            TIP:
            It is only available to save the cine retrospectively in the frozen status.
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13           Measurement, Comments and
            Body Mark
13.1 Measurement
            There are general measurements and application measurement. You can perform measurements on
            a zoomed image, cine reviewing image, real-time image, or frozen image. For measurement details,
            please refer to the Advanced Volume.
                    WARNING
            •       Be sure to measure areas of interest from the most optimal image plane to
                    avoid misdiagnosis from inaccurate measurement values.
            •       To obtain accurate Doppler flow measurement values, make sure the
                    transmitting beam is not perpendicular to the flow, otherwise false readings
                    and potential misdiagnosis may result.
                    CAUTION
            •       If an image is unfrozen or the mode is changed during a measurement, the
                    calipers and measurement data will be cleared from the screen, but the
                    measurement data will be stored in the report.
            •       If the system is turned off or [End] is selected during a measurement, the
                    data not saved will be lost.
            •       In Dual-B imaging mode, the measurement results of the merged image
                    may be inaccurate. Therefore, the results are provided for reference only,
                    not for confirming a diagnosis.
Measurement Accuracy
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 13 Measurement, Comments and Body Mark
           Table 13-3
                         Function                 Measurement item                      Error
            Smart IVC                      Dmax                            Within ±10%
                                           Dmin                            Within ±10%
                                           CI                              Within ±10%
                                           DI                              Within ±10%
                                           IVCV                            Within ±10%
            Smart VTI                      LVOT Vmax                       Within ±10%
                                           LVOT VTI                        Within ±10%
                                           LVOT HR                         Within ±10%
                                           LVOT SV                         Within ±10%
                                           LVOT CO                         Within ±10%
            Smart B-line                   Percent                         Within ±10%
                                           Dist                            Within ±10%
                                           Avg Dist                        Within ±10%
                                           B lines                         0
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                                                                             13 Measurement, Comments and Body Mark
NOTE:
            Within the selected field range, the measurement accuracy is ensured within the range mentioned
            above. The accuracy specifications are performance in the worst conditions, or based on the real
            test for the system, regardless of acoustic speed error.
13.2 Comments
            Comments can be added to an ultrasound image to bring attention, notate or communicate
            information observed during the examination. You can add comments to: zoomed image, cine
            review image, real-time image, frozen image. You can type the character as comments; insert the
            pre-defined comments from the comment library; insert arrow markers or add the trace.
            For products equipped with the trackpad, set user-defined keys for comments (text, arrow and trace)
            first, see “4.1.7 Key Configuration”.
                    WARNING
            You must ensure that the entered comments are correct. Incorrect comments
            may lead to misdiagnosis.
Adding an Arrow
            You can add an arrow to a location where you want to pay attention.
            Perform the following procedure:
            1.      Select <ABC> button > [Comments] > Arrow button or press the user-defined key for
                    “Arrow” to enter the arrow status.
            2.      Adjust the position and orientation of the arrow:
                    –   Use the trackball/trackpad to move the arrow to the desired position.
                    –   Rotate the <Angle> knob to change the arrow’s orientation.
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 13 Measurement, Comments and Body Mark
                If needed, tap [Advanced Settings] to enter comment property screen to set the arrow style/
                size.
           3.   Press <Set> to anchor the arrow position.
                Repeat steps above to add more arrows if necessary.
           4.   Press <ABC> or the user-defined key for “Arrow” to exit the arrow comment status.
Trace
           In comment status, tap [Advanced Settings] > [Trace] on the touch screen to activate trace function,
           and the current image is also displayed on the touch screen.
           Using the control panel:
           1.   Use the trackball/trackpad to move the cursor to a desired position, and press <Set> to confirm
                the start point.
           2.   Use the trackball/trackpad to move the cursor along the edge of the desired region and trace the
                outline of the region.
                –    Rotate the <Angle> knob counter-clockwise to cancel 1 pixel of trace.
                –    Rotate the <Angle> knob clockwise to restore 1 pixel of trace.
                –    Short press <Clear> to clear last trace. Long press <Clear> to delete all tracing.
           3.   Press <Set> to finish the tracing.
           Using the touch screen:
           1.   Trace around the ROI by taping the touch screen image using your finger.
           2.   Remove your finger to finish the tracing.
                –    [Clear]: tap to delete the trace in reverse order one by one.
                –    [Clear All]: tap to delete all traces.
           3.   Tap [Exit] to exit the tracing.
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                    Or, double press <Set> to enter comment editing status, and use the direction-control keys to
                    move the cursor to the desired location to insert/delete characters; you can either type
                    characters by pressing the corresponding keys or select the new comment text from the menu.
            2.      Press <Del> to delete the comment character or text on the right side of the cursor; press
                    <Back> to delete the comment character or text on the left side of the cursor.
            3.      Press <Set> key, or move the cursor to confirm the added comments text and exit the edit
                    status.
            If there are already comments on the screen, press the space bar to enter editing status.
Modifying Arrows
            Perform the following procedure:
            1.      Move the cursor on the arrow that needs to be modified. After the cursor becomes , press
                    <Set>. There is a frame around the arrow, indicating the arrow can be edited. Move the cursor
                    to change the arrow position.
            2.      Rotate the <Angle> knob to modify the arrow’s direction.
            3.      Press <Set> key to complete the operation.
            NOTE:
            •       When no item is selected, press <Clear> will clear all comments and all measurements
                    calipers.
            •       After powering off, the system will clear all comments on the image.
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           1.   Select <ABC> > [Comments] or press the user-defined key for “Annotation” to enter the
                comment status.
           2.   Move the cursor to the target position, then press <Set Home> to set the start position of the
                comment.
                Tap <Home> on the touch screen; the cursor returns to the start position.
           The Body Mark feature is used for indicating the exam position of the patient and transducer
           position and orientation.
           You can preset the system configured general body marks for each exam mode. The system
           supports the import of user-defined body marks.
           For products equipped with the trackpad, set user-defined keys for bodymark first, see “4.1.7 Key
           Configuration”.
           NOTE:
           In Dual B Mode, a Body Mark cannot be moved between the separate image windows.
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14                  Patient Data Management
            NOTE:
            •       DO NOT use the internal hard drive for long-term image storage. Daily backup is
                    recommended. External storage media is recommended for archiving images.
            •       The system patient database space is limited, please back up or clear patient data in time.
            •       Mindray is not responsible for lost data if you DO NOT follow suggested backup procedures.
System-relevant formats
            •       Single-frame image file (FRM)
                    Refers to single-frame static image files not to be compressed; you can perform measurements
                    and comments adding on this type of files.
            •       Cine file (CIN)
                    System-defined multi-frame file format; you can perform manual or auto cine review, and
                    perform measurements or add comments for the reviewed images. After you open a stored CIN
                    file, the system automatically enters cine review status.
PC-compatible formats
            •       Screen file (BMP)
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                 Single-frame file format, used to save the current screen, non-compressed format;
            •    JPG: Single frame export format.
            •    TIFF: Single frame export format
            •    Multi-medium files
                 Multi-frame export format.
            •    DICOM files
                 DICOM standard files format, single-frame or multi-frame format, used to record patient
                 information and images; you can only open DCM files to view rather than to edit.
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14.1.8 Thumbnails
            The stored images or cineloops are displayed in the form of thumbnails on the screen:
            •       During image scanning, thumbnails of the current exam display in the Clip board/Thumbnails
                    Area of the screen.
            •       In the iStation screen, the thumbnails of the current selected patient display at the bottom of the
                    screen. When you move the cursor onto a thumbnail, its name and format will display.
            •       On the [Review] page, the thumbnails refer to the images stored in the same exam. When you
                    move the cursor onto a thumbnail, its name and format will display.
            •       On the Review page, open images to enter the image analyzing status, all the thumbnails
                    belong to the exam are displayed.
To review images
            You can review all images stored in an exam, and send, delete or analyze the stored images.
            •       During image scan, saved image thumbnails will display on the right of the screen. Move the
                    cursor onto a thumbnail, and press <Set> twice to open the image; if the stored image is a cine
                    file, double-click the thumbnail to enter the auto cine review.
            •       To enter image review:
                    –   Tap [Review] to enter review page. Images of the current exam and the current patient are
                        displayed.
                    –   Select an exam of a patient in the iStation screen, and click <Review> or double-click the
                        exam to enter the Review screen to review the images of the patient.
Analysis
            In the image analysis status, you can view, zoom, perform post processing and measurements, add
            comments and perform cine review for a stored image (FRM or CIN format). The operation steps
            are the same as those for real-time scanning; please refer to relevant sections for details.
            1.      To enter image analysis:
                    –   In the image scanning or freeze status, double-click a thumbnail stored in this exam to
                        enter the image analysis status; or
                    –   In the image review status, double-click the selected thumbnail to open the image.
                    You can perform cine review operations in image analysis status.
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                           Item                                           Description
             USB/iStorage                     For external memory devices (e.g. USB memory devices, DVD
                                              recorder) or network storage server, you can set:
                                              • PC format transfer.
                                              • DCM format transfer
                                              • Cine Zoom Mode.
                                              • Export the report or the report format.
                                              • Hide patient information.
             DICOM/Print/eGateway             Select the DICOM Storage, Print server or eGateway server.
             MedTouch/MedSight                Send the image to MedTouch/MedSight as necessary.
                                              NOTE:
                                                  The file sent to MedTouch/MedSight is transferred into PNG
                                                  format, and the cine file is transferred into AVI format.
                 NOTE:
                     If the transferred AVI file cannot be played normally on PC, please try to transfer the multi-
                     frame cine file in MP4 format and try Send To function again, or use a VLC media player.
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 14 Patient Data Management
            3.   Enter the key word. The matching patient information is displayed in the patient list.
            4.   When you select a patient in the patient list, the images of this patient will be displayed at the
                 bottom of the screen.
                  Item                                            Description
             Review an        Select an exam of a patient, click [Review Image] to enter Review screen.
             image
             Patient          Select an exam of a patient, click [Patient Info] to check the patient information
             Information      of this exam.
             Review Report After you select an exam of a patient, click [Review Report] to view the report of
                           this exam for this patient.
             Delete Exam      • Select the patient record. Click [Delete Exam] to delete the exam. However,
                                you cannot delete patient data being printed, exported or sent, or delete the
                                current exam.
                              • To delete an image, select the image and click     on the right side.
             Backup Exam      You can back up the selected patient data to the system-supported media in order
                              to view it on PC, or restore the patient data to the system from an external media.
                              The exam after being backed up can be restored to the system for another review.
                              Click to back up the selected patient data to the system-supported media.
                              • Original format: to back up the data in original format.
                              • DICOM format: you can change the cine compression mode, and JPEG
                                  compression mode.
                              • You can select whether to remove images or the whole exam record from the
                                  system.
             Restore Exam     Click to import the patient data from an external media.
             Send Exam        You can use this function to export the exam data to external devices (in PC data
                              or DICOMDIR data format) and then import to PC or restore to the ultrasound
                              system to review the data.
                              1. Select the patient record, click [Send Exam] in the menu to send exam data or
                                 images of the selected record.
                              2. Select from the destination, and set related settings.
             Activate an      After you select an exam, which has been performed within 24 hours, click
             Exam             [Activate Exam] to activate the exam and load the basic patient information and
                              measurement data to continue the exam.
                              If you want to select a patient data in an external memory database to start a new
                              exam or recover the exam, you have to first allow the system to load the patient
                              data to the system’s patient database.
             Continue an      Select an exam that is paused within 24 hours, click [Continue Exam] to activate
             Exam             the exam and load the basic patient information and measurement data to
                              continue the exam.
                              If you want to select a patient data in an external memory database, you have to
                              first allow the system to load the patient data to the system’s patient database.
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                        Item                                         Description
             Annotation an        Select an exam and click [Annotation Exam] to add annotation.
             exam                 In the popped-up screen, you can also review the history annotations for the
                                  selected exam.
            NOTE:
            If the capacity of the recycle bin exceeds 200. The system reminds the user to clean. Follow the
            procedures below to clean the recycle bin.
To set maximum number of days or deleted data to be kept in the recycle bin
            NOTE:
            The patient exams which exceed the preset maximum will be deleted and unrecoverable, it is
            recommended to perform patient data backup before enabling this function to avoid data loss.
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14.5 iStorage
            TIP:
            To use iStorage function, you need UltraAssist software in 2.0 version (with V1.0 network
            protocol); consult Mindray service engineer for details.
            Network storage is used to save image files and measurement reports to the remote PC server.
            For network storage setting, see “4.8.2 iStorage Preset”.
            1.   Enter iStation, select one (or more than one) patient data or image in the local data source.
            2.   Click [Send Exam].
            3.   Select [iStorage] in the Send To dialog box, and select the PC server of the right side.
            4.   Select PC transfer format and check whether to send report.
            5.   Click [OK] to start sending.
14.6 Print
            For printer connection, see “3.8 Installing a Printer”.
            For user-defined key for printing and video output settings, see “4.1 System Preset”.
            TIP:
            •    Writing data using “Send To” supports the PC format transfer function, while CD/DVD
                 writing using “Back Up” supports only system-relevant formats.
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            •       The     symbol indicates that the input CD/DVD is damaged or contains data in an incorrect
                    format.
            The system supports writing data to CD/DVD using the DVD-RW/DVD+RW drive and reading
            data from CD/DVD on the PC.
            Perform the following procedure:
            1.      Put a CD/DVD in the tray.
            2.      Select the data to be backed up. Select [Send Exam] or [Back up Exam] in the menu which
                    appears. Select the target drive in the Send To or Back Up Patient Record dialog box.
            3.      Click [OK] or [Back up] to begin writing when the        symbol displays.
            4.      After the writing process is complete, click     to bring up the Disc Option dialog box, and
                    select [Eject] to eject the CD/DVD.
Storage Task
            Displays the DICOM storage task.
Print Task
            Displays image or report printing tasks.
            In the Task Management dialog box, the patient ID, name, destination, progress, type, contents and
            task created time are displayed.
            You can perform the following operations:
            •       Click [Delete] to delete the task.
            •       Click [Retry] to retry the failed task.
            •       Click [Select All] to select all the tasks.
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Task Status
            When there are tasks underway, the task management icon displays as        . Click the icon to check
            the process.
            When tasks have failed, the task management icon displays as       . Click the icon to check the
            reason for the failure.
            When the task management icon displays as        , it means no task is underway or has failed.
Troubleshooting
            If a serious error occurs, such as network disconnection or operation timeout, the system can try to
            reconnect the network. The interval time and maximum retries can be set as desired. For details, see
            “4.7.2 DICOM Service Preset”.
14.9 V-Access
            The ultrasound system can be used to log on to a remote server to check or modify patient data on
            the server.
            Perform the following procedure:
            1.   Press the user-defined key for “V Access” to use the function.
                 The system brings up a dialog box for entering the IP address of the remote server.
            2.   Enter the IP address and click [OK].
            3.   Log on with the server account and password.
            4.   Check the data transferred and carry out operations as necessary.
                 After logging in to the remote server, you can switch from the Ultrasound System and the
                 remote server as follows:
                 a.   Click [Minimize] to exit the remote server and enter the Doppler interface.
                 b.   Press the user-defined key for “V-Access” to enter the remote server again.
14.10 Q-Path
            You can use the ultrasound system to check data on browser directly. After you have ordered
            storage service of a network website service, you can check data using the website, authorized
            account and password (provided by the service vendor). You can open the browser to review
            previously sent DICOM data. For Q-Path settings, see “4.8.5 Q-Path Preset”.
            Perform the following procedure:
            1.   Send stored images or worksheet reports from iStation/Review/thumbnail area to the Q-Path
                 server.
            2.   Press the user-defined key for “Q-Path” to enable the function.
            3.   Log in to the Q-Path server through the Q-View browser to check the stored images and
                 worksheet reports.
            4.   Click [Esc] to exit the Q-View browser.
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15                  DICOM/HL7
            NOTE:
            Before using DICOM, please read the electronic file DICOM CONFORMANCE STATEMENT
            along with the device.
            TIP:
            The DICOM package is optional, so the description here is only applicable for the system
            configured with the DICOM package.
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         2.     Click    in the top-right part or [Send To] to bring up the Send To dialog box.
         3.     Click to select “DICOM” in the Target box on the left side, then select the DICOM storage
                server in the Storage Server box on the right side, and click [OK].
         TIP:
         To define the shortcut key, for details see “4.1.7 Key Configuration”.
         Start the ultrasound exam scan. Press the user-defined key to send the image or the cine to DICOM
         storage.
         Start the ultrasound exam scan. Tap [End] to send the image or the cine to DICOM storage
         automatically.
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                    –   Tap [iStation] on the exam main screen to enter the iStation page. Click to select a patient
                        or an exam record in the list. Thumbnails are displayed in the thumbnail area in the lower
                        part of the screen, and then click to select a thumbnail. Or, select an exam or exams from
                        the patient list (there should be images for this exam).
                    –   Tap [Review] on the exam main screen to enter the Review screen. Click to select a
                        thumbnail.
                    –   On the main screen, select a thumbnail or the cine.
            2.      Click      in the top-right part or [Send To].
            3.      Click to select “DICOM” in the Target box on the left side, then select the DICOM print server
                    on the right side, and click [OK].
            Start the scan and obtain the image. Each time [End Exam] is tapped, the system will send the
            image to the default DICOM print server for printing.
15.3 Worklist
            When the DICOM basic package is configured and the Worklist server has been set, click
            [Worklist] in the “Patient Info” screen to query or import the patient data.
            The system supports: DICOM, HL7 and eGateway.
            Perform the following procedure:
            1.      Tap [Info] on the touch screen to enter the patient information page.
            2.      Click [Worklist] to enter the Worklist page.
            3.      Guarantee the data source: after select the service type, select the worklist server from the
                    corresponding server.
            4.      Input the searching condition:
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                –    DICOM server: Search via patient ID, accession #, key words, AE title, worklist server or
                     exam date.
                –    Select HL7 server: Search via patient ID, patient name.
                –    eGateway server: Search via patient ID, patient name, exam date, and so on.
         5.     Click [Query]. The scheduled patients, which meet the criteria, are displayed in the lower part
                of the screen.
                –    After the first query, you can perform the second query based on the preview results.The
                     scheduled patients in the list will update in real time.
                –    Enter patient ID, patient name, accession # and exam date, the system affords the result in
                     real-time.
                –    Select the keyword type, enter the keywords and then click [Query] to search.
                To reset the criteria, click [Clear] button.
         6.     Select the desired patient from the list.
                –    Click [Start Exam], the patient information is imported into the system and then an exam
                     is started.
                –    Click [Transfer], the patient information is imported into the “Patient Info” screen and it is
                     opened. After you edit the patient information in the “Patient Info” screen, click [OK] to
                     start a new exam.
                –    Click [Show Detail] to see details of patient data.
         7.     Click [Exit] to exit the Worklist.
15.4 MPPS
         MPPS is used to send exam state information to the configured server. This facilitates the other
         systems in obtaining the exam progress in time.
         After you preset the Worklist server and MPPS server, if the system obtains the patient information
         from Worklist server to begin the exam, it will send exam status information to MPPS server of
         when the exam is undergoing or ended. If the sending fails, the system resends automatically.
         NOTE:
         Multi-frame storage is not allowed if “Allow Multiframe” is not selected (About “Allow
         Multiframe” setting, see “4.7.2 DICOM Service Preset”). Even if there is a multi-frame file in the
         exam to be sent, only single-frame image storage will be performed. After the storage is complete,
         there is no “√” marked in the list of the iStation screen.
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            Start the scan and obtain the image. Tap [End] each time; the system will send the image to the
            default DICOM storage server for storage and send storage commitment to the storage commitment
            server.
            Storage commitment is confined to the whole exam. Not each image sending can be indicated.
15.6 Query/Retrieve
            The query/retrieve function is used to query and retrieve patient exam records in a designated
            server.
            After setting the DICOM query/retrieve server, you can perform the query/retrieve function in the
            iStation screen.
            1.      Tap [iStation] to enter iStation screen.
            2.      Click [Query/Retrieve] to open Query/Retrieve screen.
            3.      Select the server in the “Server and Service” area (both the source and the destination) and
                    query level.
            4.      Enter the query information, such as Patient ID, Patient Name, Accession #, Exam Date or key
                    words.
                    Click [Clear] to empty the entered query information.
            5.      Click [Query]. The system performs the query and lists the results in the patient (source) list.
                    You can perform further queries based on the results by entering new query information.
            6.      Select one or more patient records according to the actual situation.
                    –   Click [Select All] to select all the patient records in the list.
                    –   Click [Deselect All] to deselect all the patient records in the list.
            7.      Click [Retrieve] to retrieve the patient records in the DICOM query/retrieve server to the local
                    machine.
            8.      Click [Exit]. The retrieved patient records are listed in the iStation screen.
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         DICOM media storage and DICOMDUR review should meet the following conditions:
         •      There is a DVD disk in the ultrasound device, and it works well.
         •      File system format of CD/ DVD optical file should be ISO9660, and the optical disk should not
                be damaged.
         •      File system format of DVD optical file should be UDF, and the optical disk should not be
                damaged.
         •      Normally read/write data from the USB ports on the ultrasound system.
         •      File system format of removable device (USB flash drive) is FAT32 and the media should not
                be damaged.
         TIP:
         There must be no DICOMDIR/DCMIMG/IHE_PDI files on the external storage media of the same
         name as the one being backed up. Otherwise, the backup cannot proceed. Ensure there is enough
         storage space, or the backup may fail due to shortage of space.
         After the DICOM format data are saved to external media, restore the data to the ultrasound system.
         Connect the external media containing DCM files to the system.
         1.     In iStation, review the data stored on the external media.
         2.     Select the data to be restored in iStation.
         3.     Click [Restore Exam] on the iStation screen.
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            NOTE:
            Only the PACS system from the Medstreaming company (http://www.medstreaming.com/
            default.aspx) supports sending self-defined measurements by DICOM SR.
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16                  Probes and Biopsy
16.1 Probes
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            TIP:
             Abdominal use of C5-1s and SC5-1Ns includes gynecology application region.
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                                                  1     Orientation mark
                                                  2     Mark
            This section describes general procedures for operating the probe. The proper clinical technique to be
            used for operating the probe should be selected on the basis of specialized training and clinical
            experience.
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                             Examinations
                                                          Biopsy procedure
                   Disconnection to the system
                                                   Thoroughly cleaning the needle-
                                                           guided bracket
                   Wiping off the ultrasound gel
                                                               Storage
                         Disinfecting the probe
Storage
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Examinations
Storage
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            A legally marketed probe sheath must be installed over the probe before performing intra-cavitary
            and intra-operative examination. Protective barriers may be required to minimize disease
            transmission. Probe sheaths are available for use with all clinical situations where infection is a
            concern.
            To order probe sheath, contact:
            CIVCO Medical Instruments Co.
            102 First Street South, Kalona, IA 52247-9589 USA
            Tel: 1-319-656-4447
            E-mail: [email protected]
            http://www.civco.com
            Refer to the following dimension table of all probes to choose the necessary probe sheath type. You
            can select the probe sheath according to the actual application situation.
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            2.      Insert the probe into the sheath; make sure to use proper sterile technique. Pull cover tightly
                    over probe acoustic lens to remove wrinkles and air bubbles, and taking care to avoid
                    puncturing the sheath.
                    WARNING
            Never immerse the probe connector into liquid such as water or disinfectant.
            Immersion may cause electrical shock or malfunction.
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                 CAUTION
            •    No cleaning and disinfecting may result in the probe becoming a source of
                 infection.
            •    Please follow the disinfectant manufacturer’s manual for performing
                 cleaning and disinfection, including preparing sterile water and cleaning
                 and disinfection time.
            NOTE:
            •    After the examination, wipe off the ultrasound gel thoroughly. Otherwise, the ultrasound gel
                 may solidify and degrade the image quality of the probe.
            •    DO NOT make the probe to become overheated (more than 55 °C) during cleaning and
                 disinfections. High temperature may cause the probe to become deformed or damaged.
            •    Observe the graph here carefully to immerse the probe. Only soak parts of the probe below the
                 strain relief.
            •    Repeated disinfection will eventually damage the probe, please check the probe performance
                 periodically.
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Cleaning
            Please refer to the instructions in the manual and follow your hospital policy and procedures for
            cleaning.
            Perform the following procedure:
            1.      Wear a pair of gloves to prevent infection.
            2.      Disconnect the probe from the system. If the sheath is used, take off the sheath and discard it.
            3.      Wipe off the ultrasound gel or other visible dirt on the surface of the probe by using a damp
                    piece of disposable lint-free soft cloth or tissue.
            4.      Choose an appropriate cleaning agent including mild detergents, enzymatic cleaners and
                    specially designed enzymatic sponges.
            5.      Immerse the probe fully in the cleaning fluid for at least 1 minute or according to
                    manufacturer’s instructions. Lightly mechanical clean the probe with a piece of lint-free soft
                    cloth or soft sponge until no dirt is visible. When necessary, clean the seams or biopsy guide
                    features by using disposable cotton swabs. Avoid using a brush to wash the lens because it may
                    damage the probe.
            6.      Rinse the probe thoroughly by using a large amount of clean water (about 7.5 L/2 gallons) at
                    room temperature for about 30 s to remove the residual dirt and cleaning solvent. Repeat the
                    rinsing operation twice.
            7.      Dry the probe by wiping with a piece of disposable lint-free soft cloth or tissue.
                    Do not dry the probe by heating.
            8.      Inspect the probe. If visible dirt still exists, repeat the preceding steps to wash the probe until it
                    is all clean.
            9.      Check whether the probe has defects such as peeling, rifts, bumps, cracks, or liquid spill. If
                    such defects exist, the probe has reached the end of its service life. In this case, stop using it
                    and contact the Mindray service department.
                    CAUTION
            Use protective eyewear when disinfecting using sprays.
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                                                                 Connector
                                                               Strain relief
            4.     Wipe away the residual disinfectant on the probe by using a piece of lint-free soft cloth soaked
                   with clean water. Wipe three times. Or rinse the probe thoroughly by using a large amount of
                   clean water (about 7.5 L/2 gallons) at room temperature.
            5.     Dry the probe by wiping with a piece of disposable lint-free soft cloth. Do not dry the probe by
                   heating.
            6.     Check whether the probe has defects such as peeling, rifts, bumps, cracks, or liquid spill. If
                   such defects exist, the probe has reached the end of its service life. In this case, stop using it
                   and contact the Mindray service department.
            7.     Store the probe in a cool, clean and dry environment. And repeat the cleaning and disinfection
                   process before the next use.
Strain relief
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                    –    Wiping: Use a market disinfection wipe product or sterile disposable lint-free soft cloth
                         wetted with disinfection spray and wipe all surfaces of the probe for a duration according
                         to the manufacturer instructions.
            4.      Rinse the probe thoroughly by using a large amount of clean water (about 7.5 L/2 gallons) at
                    room temperature for about 30 s to remove the residual disinfectant. Repeat the operation
                    twice. Or follow the disinfectant manufacturer’s instructions regarding rinsing.
            5.      Dry the probe by wiping with a piece of clean disposable lint-free soft cloth. Do not dry the
                    probe by heating.
            6.      Check whether the probe has defects such as peeling, rifts, bumps, cracks, or liquid spill. If
                    such defects exist, the probe has reached the end of its service life. In this case, stop using it
                    and contact the Mindray service department.
            7.      Store the probe in a cool, clean and dry environment. And repeat the cleaning and disinfection
                    process before the next use.
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 16 Probes and Biopsy
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            •       When the probe is sent to MINDRAY Customer Service Department or sales representative for
                    repair, be sure to disinfect it and keep it in the carrying case to prevent infection.
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 16 Probes and Biopsy
                 reference. Always monitor the relative positions of the biopsy needle during
                 the procedures.
            •    Adjust the needle mark before the biopsy procedure is performed.
            •    When performing biopsy procedures, use only sterile ultrasound gel that is
                 certified to be safe. And manage the ultrasound gel properly to ensure that
                 it does not become a source of infection.
            •    When performing the operation concerning biopsy, wear sterile gloves.
            •    Image of the biopsy target and the actual position of the biopsy needle:
                 Diagnostic ultrasound systems produce tomographic plane images with
                 information of a certain thickness in the thickness direction of the probe.
                 (That is to say, the information shown in the images consist all the
                 information scanned in the thickness direction of the probe.) So, even
                 though the biopsy needle appears to have penetrated the target object in
                 the image, it may not actually have done so. When the target for biopsy is
                 small, dispersion of the ultrasound beam may lead to image deviate from
                 the actual position. Pay attention to this.
                 If the target object and the biopsy needle appear in the image as shown in
                 the figures below (For reference only):
                           The biopsy needle appears to reach the target object      Dispersion of the
                           in the image                                              ultrasound beam
Probe
Biopsy
Needle
                  Target                                                          Ultrasound
                                                                                  beam
                                                                                     Target
                 The biopsy needle may not have actually entered the target object even
                 though it appears to have done so in the image. To avoid this, note the
                 points below:
                 – Do not rely only on the needle tip in the image. Pay careful attention to
                     the fact that when the biopsy needle enters the target object or comes
                     into contact with it, the object should shift slightly.
                 – Before performing the biopsy, evaluate the size of the object and
                     confirm whether the biopsy can be carried out.
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 16 Probes and Biopsy
                                            1    Locating bulge
                                            2    Needle guide
                                            3    Locking nut
                                            4    Retaining clamp
                                            5    Probe
                                            6    Locating groove
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                    b.   Open the retaining clamp, align the needle-guided bracket with the probe to align the
                         locating bulge on the needle guide with the locating grooves on the probe, then turn the
                         retaining clamp to align it with the probe.
                    c.   When the retaining clamp is turned to the correct position, the locking nut will lock the
                         retaining clamp and the needle-guided bracket is then mounted in the correct position.
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 16 Probes and Biopsy
                 c.     Screw the pinch nut of the needle-guided bracket to ensure that the needle-guided bracket
                        is properly installed on the probe.
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                                                                                                 16 Probes and Biopsy
                    c.   Insert a biopsy needle with the same specification as that of the guiding block into the
                         guiding block hole.
                    a.   Screw the nut of the guiding block and remove the guiding block slightly along the
                         direction of the needle’s tail.
                    b.   Separate the residual part of the needle-guide bracket and the probe from the needle.
            5.      Remove the needle-guided bracket:
                    a.   Unscrew the Needle-guided bracket pinch nut, and remove the needle-guided bracket
                         from the probe.
                    b.   Separate the probe and the needle-guided bracket.
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 16 Probes and Biopsy
                 c.     Check manually to confirm that the needle-guided bracket is securely installed on the
                        probe.
            2.   Install the guiding block:
                 a.     Select a proper guiding block and push it into the groove above the angle block, and
                        clamp it tightly.
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                    b.   Insert a biopsy needle with the same specification as that of the guiding block into the
                         hole of the guiding block.
                    a.   Remove the guiding block slightly along the direction of the needle’s tail.
                    b.   Separate the residual part of the needle-guide bracket and the probe from the needle.
            4.      Remove the needle-guided bracket:
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 16 Probes and Biopsy
                                                                                        6
                                                                  7
                                                                              4
                                                                                            5
                                         2                       3
                                             1    Clamp
                                             2    Locating groove
                                             3    Grip knob
                                             4    Needle guide rack
                                             5    Needle guide hole
                                             6    Needle guide clamping knob
                                             7    Needle guide
                                             8    Locating pit
2 3 4 5 6 7 8 9 10 11
                                             1   Groove
                                             2   Clamp
                                             3   Needle type adjusting base
                                             4   Needle type dial scale
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                                                                                                  16 Probes and Biopsy
                    c.   Screw the pinch nut of the needle-guided bracket to confirm that the needle-guided
                         bracket is properly installed on the probe.
            2.      Adjust the needle angle to the proper shift as required:
                    a.   Loosen the angle pinch nut.
                    b.   Adjust the angle block to the desired level.
                    c.   Tighten the angle pinch nut.
            3.      Insert the biopsy needle:
                    a.   Adjust the dial scale to the required needle type shift, and then screw the needle fixing nut
                         to lock the dial scale. (To adjust the dial scale you have to loosen the needle fixing nut
                         first.)
                    b.   Pull the lock pin and close the V-shaped cover to fix the lock pin in the groove of the
                         needle type adjusting base, so as to install the needle into the guiding hole.
            4.      Release the needle from the bracket:
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 16 Probes and Biopsy
                 a.     Pull the lock pin and open up the V-shaped cover to expose the needle.
                 b.     Separate the bracket and the probe from the needle.
            5.   Remove the needle-guided bracket:
3 4
                                              1     Pinch nut
                                              2     Intra-cavity probe
                                              3     Lower clamp
                                              4     Location hole
                                              5     Front slot
                                              6     Front clamp
                                              7     Location clamp
                                              8     Upper clamp
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                    b.   Open the clamp. Insert the front clamp to the front groove, and align front clamp with
                         front groove.
                    c.   Push the biopsy forward (arrow’s direction) until the locating pole inserting into the
                         location hole. Turn the lower clamp against the intra-cavity probe. Tighten the nut to lock
                         the biopsy (arrow’s direction)
                    a.   Hold the prober in the left hand; unscrew the locking nut with the right hand to loose the
                         clamp (arrow’s direction).
                    b.   Lift the biopsy up (towards arrow’s direction). The locating pole, front clamp, the locating
                         hole and the front clamp become loose.
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 16 Probes and Biopsy
1 4
                                                           2
                                                                              3
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                    a.   Rotate the locking nut in the direction of the arrow shown on the figure to separate the
                         bracket from the probe.
                    b.   Hold the probe and take out the bracket.
8 7 6 5
                                         1     Right clamp
                                         2     Groove
                                         3     Guiding block fixing frame
                                         4     Locking nut of left and right clamps
                                         5     Guiding blocks
                                         6     Depth shift sign
                                         7     Depth pinch nut
                                         8     Left clamp
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 16 Probes and Biopsy
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                    b.   Insert a biopsy needle with the same specification as that of the guiding block into the
                         guiding block hole
                    c.   Rotate the clamping nuts of the needle guided-bracket. The needle guided-bracket is
                         separate from the probe. Hold the probe and take out the bracket.
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 16 Probes and Biopsy
                                                                                         5
                                                  4
                                           1     Needle exit
                                           2     Needle guide
                                           3     Needle entry
                                           4     Retaining clamp
                                           5     Locating bulges
                 b.     Align the needle-guided bracket with the probe to align the locating bulges on the needle
                        guide with the locating grooves on the probe, then turn the retaining clamp to the correct
                        position.
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c. Hold the probe, and insert the needle into Needle entry of the needle guide.
                    b.   Hold the probe and raise the needle-guided bracket to separate the locating bulge from the
                         locating grooves.
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 16 Probes and Biopsy
1 2 3 4
7 6 5
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            NOTE:
            You can perform guide line verification on a single live B/C image, and all biopsy-irrelevant
            operations are forbidden.
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 16 Probes and Biopsy
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            NOTE:
            Disposable components are packaged sterile and are single-use only. Do not use if integrity of
            packaging is violated or if expiration date has passed. Please use the disposable components
            compliant with the relevant local regulations.
Cleaning
            Perform the following procedure:
            1.      Wear a pair of gloves to prevent infection.
            2.      After use, immerse the needle-guided bracket in distilled water immediately to prevent dirt
                    from drying. Wipe the entire surface of the needle-guided bracket by using a piece of
                    disposable lint-free soft cloth to remove coarse dirt.
            3.      Prepare a cleaning solvent (enzymatic or neutral pH detergent, e.g., liquinox, MetriZyme) by
                    using distilled or softened water in accordance with the operator’s manual provided by the
                    manufacturer.
            4.      Detach all the detachable parts of the needle-guided bracket and immerse the needle-guided
                    bracket and all its parts fully in the cleaning solvent for at least 1 minute or a period specified
                    by the manufacturer.
            5.      Immerse the needle-guided bracket and all its parts fully in the cleaning solvent. Wipe and
                    wash the surface and connecting parts of the needle-guided bracket gently by using a soft
                    brush until no dirt is visible. Place the needle-guided bracket inside an ultrasonic cleaner and
                    perform ultrasonic cleaning for 3–5 minutes.
            6.      Rinse the needle-guided bracket thoroughly by using a large amount of distilled or softened
                    water (about 2 gallons) at room temperature for about 30 s to remove the residual dirt and
                    cleaning solvent. Repeat the operation twice.
            7.      Wipe away the water on the needle-guided bracket by using a piece of disposable lint-free soft
                    cloth.
            8.      Inspect the needle-guided bracket. If visible dirt still exists, repeat the preceding steps to wash
                    the bracket until it is all clean.
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 16 Probes and Biopsy
            4.   Immerse the needle-guided bracket fully in the sterilant and shake the bracket appropriately to
                 remove any bubbles on the surface. Use a syringe to draw an appropriate amount of sterilant
                 and inject the sterilant into the hole to remove the bubbles inside the hole if necessary.
                 For details about the immersion duration, see the operator’s manual provided by the
                 manufacturer.
            5.   After sterilization, wash the needle-guided bracket thoroughly by using a large amount of
                 sterile distilled water (about 2 gallons) at room temperature for about 30 s to remove the
                 residual sterilant. Repeat the operation twice.
            6.   Dry the needle-guided bracket by using a piece of sterile disposable lint-free soft cloth.
            7.   Store the needle-guided bracket in a cool, clean and dry environment.
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            •       If the needle-guided bracket is sent to your MINDRAY representative for repair, be sure to
                    disinfect or sterilize it and keep it in the carrying case to prevent infection.
            •       Sterilize the carrying case as necessary.
            •       Store or transport the needle-guided bracket under the following ambient conditions:
                    –    Ambient temperature: -20 °C to 55 °C
                    –    Relative humidity: 20% to 85% (no condensation)
16.2.7 Disposal
            Be sure to sterilize the needle-guided bracket before disposing of it.
            Contact your MINDRAY representative when disposing of this device.
            NOTE:
            This function in the ultrasound system is for lesion (stone) location and observation only. For
            details, please refer to lithotripsy machine accompanying manuals.
            Tap [Biopsy] > [Middle Line] or press the user-defined key for “Middle Line” to turn on the
            function.
            •       The middle line is a vertical dotted line located in the middle of the screen, the position and
                    direction of which cannot be changed.
            •       There is a mark icon of “×” located on the middle line which can be moved up and down along
                    the line by using the trackball/trackpad.
            •       To use the Middle Line function of the ultrasound system:
                    a.   Use the trackball/trackpad to change the mark position and by adjusting lithotripsy
                         machine tools or patient posture to locate the stone center at the mark.
                    b.   Read the depth of the mark by observing the depth caliper on the screen.
                    c.   After the stone is located, refer to lithotripsy machine manuals to perform the lithotripsy.
            •       The depth of the mark is displayed in the image parameter area of the screen.
                    WARNING
            •       Ultrasound images should be referenced during the whole process of
                    needle guidance.
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 16 Probes and Biopsy
            •    The magnetizer should be used with the needle cap. Disinfect the
                 magnetizer after use.
            •    The needle cap is a sterile, single use device. To maintain procedural
                 sterility, it is important that the needle cap is isolated from non-sterile
                 objects.
                 CAUTION
            •    Keep the magnetizer away from any device that is sensitive to magnetic
                 fields. Never place or hold the magnetizer within 1 m of the probe.
            •    The eSpacial Navi system supports only the needle types listed on the
                 needle list. For details, see “16.4.1 Interface”.
            •    Keep the L11-3VNs away from the source of disturbance, such as metal
                 objects and magnetized objects. Do not use or store L11-3VNs in the
                 vicinity of strong electric or magnetic fields.
            NOTE:
            •    When used under optimal operating conditions by an experienced medical professional, the
                 eSpacial Navi system can achieve precision as high as ±2.4 mm.
            •    Place the magnetizer in the proper position to prevent the magnetizer from falling off or
                 becoming damaged.
            •    DO NOT make the magnetizer overheated (more than 50 °C) during cleaning and
                 disinfections. High temperature may cause the magnetizer to become deformed or damaged.
16.4.1 Interface
In Plane Needle Guidance GUI
            2
                                                                                                             8
            3
                                                                                                             7
4 5
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                          2    Filed strength
                          3    Maximum depth at which the needle can be detected
                          4    Selected needle type
                          5    Scale of guideline (5 mm/scale)
                          6    Needle guidance trajectory
                          7    Needle tip position in the ultrasound plane
                          8    Needle position in the ultrasound plane
1 8
              2
                                                                                                             7
3 6
16.4.2 Preset
eSpacial Navi Needle Menu
            Select [eSpacial Navi] > [eS.Navi Needle] to enter the “eS.Navi Needle” menu.
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 16 Probes and Biopsy
                  b.    Introduce a needle into the cap, and ensure that the needle tip contacts the bottom of the
                        needle cap.
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                                                                                                   16 Probes and Biopsy
                         If the needle cap associated with the needle does not meet the requirements, you are
                         recommended to use BBraunSterican <35 mm needles cap or B&D Microlance <35 mm
                         needles cap.
c. Hold the needle for 1 or 2 seconds and then withdraw it quickly from the magnetizer.
16.4.4 Procedure
            NOTE:
            •       The Pan Zoom function is not supported on eSpacial Navi mode.
            •       Do not freeze the ultrasound image during the procedure. Otherwise, biopsy guidance
                    information will disappear.
            •       When the insertion angle of a needle relative to the skin surface exceeds 60°,        is displayed
                    on screen to notify users to adjust the angle. After the angle is smaller than 60°,     disappears.
                    CAUTION
            •       When performing cleaning and disinfection of the magnetizer to prevent
                    infection, wear sterile gloves.
            •       After disinfection, rinse the magnetizer thoroughly with sterile water to
                    remove all chemical residues.
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 16 Probes and Biopsy
            NOTE:
            •    Please refer to the instructions provided by the manufacturer of the disinfectant for details.
            •    The magnetizer can be disinfected using the compatible disinfectants at least 500 times.
Cleaning
            Perform the following procedure:
            1.   Wear sterile gloves to prevent infection.
            2.   Wash the magnetizer with clean water or soapy water to remove all the foreign matters, or,
                 wipe the magnetizer with a soft ethyl carbamate sponge.
                 Avoid using a brush, because it may damage the magnetizer.
            3.   Dry the magnetizer using a sterile cloth or gauze after rinsing. Do not dry the magnetizer by
                 heating it.
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                    CAUTION
            Use protective eyewear when disinfecting using sprays.
Disinfecting by Immersion
            Perform the following procedure:
            1.      Wear sterile gloves to prevent infection.
            2.      Clean the magnetizer before disinfecting it. MINDRAY recommends the compatible solutions
                    to disinfect the magnetizer.
                    –   Refer to the instructions provided by the chemical manufacturer concerning concentration
                        of the disinfectant solution, method of disinfection and dilution and cautions during use.
                    –   Soak the magnetizer into the disinfectant solution for the shortest time the manufacturer
                        recommends.
                    –   Follow local regulations when selecting and using the disinfectant.
            3.      Rinse the magnetizer with plenty of water (about 2 gallons) for at least 1 minute to remove all
                    chemical residues on it. Or, follow the rinsing method recommended by the disinfectant
                    manufacturer to rinse the magnetizer.
            4.      Wipe off the water on the magnetizer with sterile cloth or gauze after rinsing it. Do not dry the
                    magnetizer by heating.
16.4.7 Disposal
            Be sure to disinfect the magnetizer before disposing of it.
            Contact your MINDRAY representative when disposing of this device.
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17                  DVR Recording
            NOTE:
            •       Strictly observe the procedures described here to perform the recording and replaying
                    operations; otherwise it may result in data loss or system malfunction.
            •       Set the PAL or NTSC in the setup and this shall be consistent with that in the DVR.
            •       Accidental exposure to strong electromagnetic fields or mishandling of the video cassette may
                    result in image and data loss, so check if the recording is successful as soon as possible.
                    Mindray is not responsible for any data loss.
            The system provides built-in DVR recording function. You can use the DVR to record and replay
            videos and audios that can be stored in DVD disc or hard disc.
            The recorded video is AVI format; you can save it in the hard disk drive, burn to the DVD or export
            to the USB disk.
            When the built-in DVR is in normal status, the        displays at the lower right corner of the screen.
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 17 DVR Recording
17.3.1 Replay on PC
           Connect the USB disk or optical disk with the file to the PC, open the file directly.
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18                  System Maintenance
            Routine system maintenance shall be carried out by the user. System maintenance after the
            warranty has expired is the full responsibility of the owner/operator.
            The responsibility for maintenance and management of the product after delivery resides with the
            customer who has purchased the product.
            If you have any questions, please contact Mindray Customer Service Department or sales
            representative.
                    WARNING
            •       Only an authorized Mindray service engineer can perform maintenance not
                    specified in this operator’s manual.
            •       For the sake of the system performance and safety, you should perform
                    periodical checks for the system.
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 18 System Maintenance
                 CAUTION
            Do not spill water or other liquid into the system while you perform the cleaning.
            Otherwise it may result in malfunction or electric shock.
           NOTE:
            •    DO NOT use hydrocarbon glass cleaner or cleaner for OA (Office Automation) equipment to
                 clean the monitor. These substances may cause deterioration of the monitor.
            •    Please clean the control panel periodically, otherwise the button may be blocked by dirt and the
                 system will be buzzing while the button makes no response.
Cleaning probes
            Tools: mild soapy water, dry soft cloth, soft brush
            Method:
            1.   Wipe out the dust attached to surface of probe head, connector and cable.
            2.   Use soft brush to brush the dust inside probe connector gently.
            3.   Remained stain or dust attached to surface of cable or surface of connector should be washed
                 out by cloth with a little soapy water, and then air-dry.
           NOTE:
            Don’t use cloth with water to clean the probe connector.
Cleaning holders
            Tools: soft dry cloth, soapy water, soft brush.
            Remaining stains should be wiped away using a cloth with clean or soapy water and the surface left
            to air dry.
            Perform the following procedure:
            1.   Use a soft dry cloth to wipe away dust attached to the inside, outside and gaps in the probe
                 holder. Use a soft brush to brush away dust or stains from the small intra-cavity probe holder or
                 its gap.
            2.   Remaining stains on the inside and outside of the holder should be wiped away using a cloth
                 with a little soapy water and then air dried.
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                                                                                                 18 System Maintenance
                    If the control panel is difficult to clean, disassemble the key caps first and then clean it with
                    mild soapy water.
                    Rotate the trackball clamp ring anticlockwise. When the clamping ring lifts, remove the
                    clamping ring and trackball. You can draw out the ball with the help of adhesive tape.
            2.      Cleaning:
Dust excluder
Waterspout
                    Clean the lens slightly using the tissue until there is no foreign matter. Then clean the other
                    parts and the dust excluder. Make sure to exert force properly when clean the small ball,
                    otherwise, the small ball may drop down.
                    When liquid is spray onto the trackball area, most of the liquid can be discharged through the
                    waterspout, besides, you can dry the leaving water using the tissue or cloth.
            3.      Installing:
                    Put back the ball, align the buckle with gap of the front cover, press the clamp ring with both
                    hands and rotate it clockwise to click the buckle. At this moment, the clamp ring cannot be
                    moved any further, it indicates that the clamp ring clicks in position.
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 18 System Maintenance
                CAUTION
            Please clean all dust-proof covers of the system periodically (1 time per
            month); otherwise, system damage may result. Cleaning times can be
            increased when the system is used in the open air or somewhere dust is more.
                WARNING
            •   Use only Mindray approved disinfectants and methods listed in this section
                to disinfect the main unit. Warranty does not cover damage caused by
                unapproved substances or methods.
            •   Do not mix disinfectants, as hazardous gases may result.
            •   We make no claims regarding the efficacy of the listed chemicals or
                methods as a means for controlling infection. For the method to control
                infection, consult your hospital’s infection control officer or epidemiologist.
                CAUTION
            •   Never immerse any part of the main unit in liquids or allow liquid to enter
                the interior.
            •   Any contact of disinfectants with connectors or metal parts may cause
                corrosion.
            •   Do not pour or spray any liquid directly on the main unit or permit fluid to
                seep into connections or openings.
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                                                                                              18 System Maintenance
            •       If you spill liquid on the main unit, disconnect the power supply, dry the
                    main unit, and contact your service personnel.
            •       Never use abrasive materials (such as steel wool or silver polish), or
                    erosive cleaners (such as acetone or acetone-based cleaners).
            •       Dilute and use the disinfectants according to the manufacturer's
                    instructions.
            •       Check the system after disinfection. If there is any sign of damage, remove
                    it from use.
            •       Follow local regulations when selecting and using the disinfectant.
            •       Disinfectants listed in this section are used for disinfecting the housing of
                    the main unit and the monitor only, not for disinfecting the probes or the
                    trolley.
            •       During cleaning, wear medical gloves to prevent infection.
Compatible Disinfectants
            The following table lists compatible disinfectants.
Disinfection Procedures
            NOTE:
            The system has passed puncture test and leakage current test, and thus can be disinfected on power-
            on status: tap > bar in the left side of the touch screen to enter the Exam Main Menu screen and then
            select       to lock the system for 10 seconds to disinfect the system while the power is “On”.
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 18 System Maintenance
            3.   Remove any residue with a water-moistened soft cloth on the main unit.
            4.   Wipe off water on the main unit using sterile cloth or gauze. Do not dry the main unit by
                 heating.
                    Content                                          Description
            Color and B/W video        First wipe off dust or stain attached to the cover of printer with soft dry
            printer                    cloth, then clean the inside of printer. Be sure to do the cleaning
                                       maintenance according to the operation manual if necessary.
            Graph / text printer       First wipe off dust or stain attached to the cover of printer with soft dry
                                       cloth, then clean the inside of printer. Be sure to do the cleaning
                                       maintenance according to the operation manual if necessary.
            Footswitch                 Use soft dry cloth with a little mild soap water to wipe off the dust or
                                       stain attached to the pedals or cable of foot switch.
            Barcode reader             First use soft dry cloth to wipe off dust attached to glass panel of the
                                       reader, then the dust or strain attached to cable and bracket.
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                                                                                              18 System Maintenance
18.2 Troubleshooting
            If any persistent system malfunction is experienced, e.g., an onscreen error message, blank imaging
            screen, absent menus, see the table below. If the failure cannot be resolved, contact the Mindray
            Customer Service Department or a sales representative.
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A                   Barcode Reader
            The product supports two kinds of readers for logging data as patient ID: 1-D barcode reader
            (SYMBOL LS2208) and 2-D barcode reader (SYMBOL DS4308).
            The laser transmitted by SYMBOL LS2208 is Class 2 laser.
            SYMBOL DS4308 is classified as “EXEMPT RISK GROUP” according to IEC 62471:2006 and
            EN 62471:2008.
                    WARNING
            •       Class 2 laser adopts low power, visible LED. DO NOT stare into beam
                    because of unknown hazards of transient radiation provided by class 2
                    laser.
            •       DO NOT stare into beam emitted by SYMBOL DS4308 for more than 10 s.
                    CAUTION
            Ensure the information acquired by barcode reader is consistent with the actual
            information.
            TIP:
            The reader does not support decoding of Multi-language.
A.1.2 Setting
          The reader has factory settings; please refer to A.4 for details.
          The reader supports some user-defined functions as introduced below.
            For more details, please contact the SYMBOL reader agents or Mindray Customer Service
            Department.
Volume setting
            Scan the following barcode to set the volume parameter.
            •       Low Volume:
• Medium Volume:
• High Volume:
I 2 of 5 symbols setting:
          Select this option to decode only I 2 of 5 symbols containing a selected length. Select the length
          using the numeric barcodes below. For example, to decode only I 2 of 5 symbols with 8 characters,
          scan I 2 of 5 - One Discrete Length, then scan 0 followed by 8.
3. Upon successful decode, the reader beeps and the LED turns green.
                    Do not hold the reader directly over the barcode. Laser light reflecting directly back into the
                    reader from the barcode is known as specular reflection. This specular reflection can make
                    decoding difficult. You can tilt the reader up to 55° forward or back and achieve a successful
                    decode.
                                2     Flat areas
                                3     Stand base
                                4     Wingnut
               1       Two screw-mount holes            For Screw Mount, follow the steps below:
                                                        1. Position the assembled base on a flat surface.
                                                        2. Screw one #10 wood screw into each screw-mount
                                                           hole until the base of the stand is secure
               2       Double-side tap areas         For Tape Mount, follow the steps below:
                       (3 places, dimensions: 1”×2”) 1. Peel the paper liner off one side of each piece of
                                                        tape and place the sticky surface over each of the
                                                        three rectangular tape holders.
                                                        2. Peel the paper liner off the exposed sides of each
                                                           piece of tape and press the stand on a flat surface
                                                           until it is secure.
A.2.1 Overview
A.2.3 Setting
          The reader has factory settings, for details see “A.5 Parameter Defaults”.
          The reader supports some user-defined functions as introduced below.
          For more details, please contact the SYMBOL reader agents or Mindray Customer Service
          Department.
Volume setting
            Scan the following barcode to set the volume parameter.
            •       Low Volume
• Medium Volume
• High Volume
I 2 of 5 symbols setting
           Select this option to decode only I 2 of 5 symbols containing a selected length. Select the length
           using the numeric barcodes below. For example, to decode only I 2 of 5 symbols with 8 characters,
           scan I 2 of 5 - One Discrete Length, then scan 0 followed by 8.
A - 10                                                                                       Operator’s Manual
                                                                                                    A Barcode Reader
            3.      When the digital imager reader senses movement, in its default Auto Aim trigger mode, it
                    projects a red LED dot which allows positioning the barcode within the field of view.
                    If necessary, the digital imager reader turns on its red LEDs to illuminate the target barcode.
            4.      Center the symbol. Be sure the entire symbol is within the rectangular area formed by the
                    illumination LEDs.
            5.      Hold the trigger until the digital imager reader beeps, indicating the barcode is successfully
                    decoded.
                    Steps 2 - 4 above may be required to repeat on poor quality or difficult barcodes.
                    The aiming pattern is smaller when the digital imager reader is closer to the symbol and larger
                    when it is farther from the symbol. Scan symbols with smaller bars or elements (mil size)
                    closer to the digital imager reader, and those with larger bars or elements (mil size) farther
                    from the digital imager reader.
                    The digital imager reader can also read a barcode presented within the aiming dot not centered.
                    The top examples in show acceptable aiming options, while the bottom examples cannot be
                    decoded.
Operator’s Manual                                                                                              A - 11
 A Barcode Reader
           TIP:
           Users can customize the JADAK barcode reader based on specific requirements or contact the
           Mindray service engineers. This configuration guide is applicable for the Ultrasound System only.
A - 12                                                                                           Operator’s Manual
                                                                                                   A Barcode Reader
Operator’s Manual                                                                                             A - 13
 A Barcode Reader
A.4        Maintenance
           Cleaning the exit window is the only maintenance required. A dirty window can affect scanning
           accuracy.
           •    Do not allow any abrasive material to touch the window.
           •    Remove any dirt particles with a damp cloth.
           •    Wipe the window using a tissue moistened with ammonia/water.
           •    Do not spray water or other cleaning liquids directly into the window.
A - 14                                                                                             Operator’s Manual
                                                                                     A Barcode Reader
Operator’s Manual                                                                              A - 15
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B                   Trolley and Accessories
                    WARNING
            •       DO NOT connect the trolley to the outlets with the same circuit breakers
                    and fuses that control the current to devices such as life-support systems. If
                    the trolley or the system malfunctions and generates over-current, or when
                    there is an instantaneous current at power ON, the circuit breakers and
                    fuses of the building’s supply circuit may be tripped.
            •       When you connect another device to the trolley, you should use the
                    equipotential wire to connect each of equipotential terminals; otherwise
                    electric shock may result.
            •       Be sure to connect the equipotential wire before inserting the power plug
                    into the receptacle; be sure to remove the power plug from the receptacle
                    before disconnecting the equipotential wire; otherwise electric shock may
                    result.
            •       Connect the earth cable before powering ON. Disconnect the earth cable
                    after powering OFF. Otherwise, electric shock may result.
                    CAUTION
            •       Maximum output power of the outlet in the trolley is 240 VA.
            •       When moving the trolley with mounted system, please take care of the
                    connector of the power adapter in case of damage.
            •       DO NOT insert fingers into the gap next to the plug in case of injury.
B.1         Accessories
            TIP:
            The supplied accessories are depending on the actual purchased order.
MT3 Trolley
            •       Power cord
            •       Probe holder
            •       Cover grounding cable
            •       Probe extension module or Probe extend module panel
            •       Auxiliary output cable
            •       Printer bracket
MT2 Trolley
           •      Probe extension module
           •      Printer bracket
                                                          13                                          14
                                                          12
                  1
                                                          11                                          15
                  2
                                                          10                                          16
                  3
                                                          9
                                                          8
                                                          7
                                                          6
MT2 Trolley
                                          Figure B-2 Overview of the Trolley
                                                          11
                                                    1
                                                    2
3 10
                                                    4
                                                           9
                                                    5
            The following electrical safety tests are recommended as part of a comprehensive preventive
            maintenance program. They are a proven means of detecting abnormalities that, if undetected,
            could prove dangerous to either the patient or the operator. Additional tests may be required
            according to local regulations.
            All tests can be performed using commercially-available safety analyzer test equipment. These
            procedures assume the use of a 601PROXL International Safety Analyzer or equivalent safety
            analyzer. Other popular testers which comply with IEC 60601-1 and are used in Europe, such as
            Fluke, Metron or Gerb, may require modifications to the procedure. Follow the analyzer
            manufacturer's instructions.
            An electrical safety inspection should be periodically performed every two years. The safety
            analyzer is also an excellent troubleshooting tool for detecting abnormalities in line voltage and
            grounding, as well as total current loads.
            NOTE:
            Make sure the safety analyzer is authorized and complies with the requirements of IEC 61010-1.
            Follow the analyzer manufacturer's instructions.
LIMITS
            ALL COUNTRIES R = 0.2 Ω Maximum
LIMITS
            •       For ES 60601-1:
                    –   300 μA in Normal Condition.
                    –   1000 μA in Single Fault Condition.
            •       For IEC 60601-1:
                    –   500 μA in Normal Condition.
                    –   1000 μA in Single Fault Condition.
LIMITS
            •       For ES 60601-1
                    –   100 μA in Normal Condition.
                    –   300 μA in Single Fault Condition.
            •       For IEC 60601-1:
                    –   100 μA in Normal Condition.
                    –   500 μA in Single Fault Condition.
LIMITS
            For BF          applied parts:
            •       100 μA in Normal Condition.
            •       500 μA in Single Fault Condition.
LIMITS
            For BF         applied parts: 5000 μA.
LIMITS
            For BF         applied parts,
            •     100 μA in Normal Condition.
            •     500 μA in Single Fault Condition.
            The system provides wireless net adapter configuration, so as to assist information query and
            unlimited network service.
                    WARNING
            •       Use the wireless LAN function prudently in OR/ICU/CCU as it may interfere
                    with other devices.
            •       When the wireless LAN function is turned on, the ultrasound system may
                    suffer interference from other equipment, even if that other equipment
                    complies with CISPR EMISSION requirements.
            •       Keep at least 20 cm away from the ultrasound system when the wireless
                    LAN function is in use.
            NOTE:
            Disconnection may be caused if the devices connected excess the router capacity (please refer to
            settings of the router, generally it should be ≤5.)
            DO NOT connect devices other than specified into the LAN.
            Medical devices within the same LAN may interfere with each other, the operator should be
            cautious. (Do not connect devices that may cause strong interference. For example, life-supporting
            devices should not be connected in the same LAN.)
            Other non-medical devices in the same frequency band may cause interference, please be cautious.
            For a better wireless LAN transmission effect, please take the following settings:
            •       SSID > 80% with stable WLAN network.
            •       Wireless router and the server are in the same network segment.
            •       Router setting:
                    –   Wireless standard IEEE 802.11 ac/a/b/g/n.
                    –   Maximum transmission speed 300 Mbps.
                    –   Number of the devices connected to the same router ≤5.
            •       Target server setting:
                    –   Network is stable and not under overloading state (e.g. high CPU/memory usage, fast
                        HDD speed, limited HDD space).
                    –   Level other than the highest level of firewall is adopted.
                    –   Operating system is Windows 10 or higher versions and it supports a Gigabit Ethernet.
          1.     Press <Cursor> to show the cursor, click         in the bottom bar to open the wireless network
                 manager.
          2.     Move the cursor to the target network and press <Set> to select it, then click [Connect] to
                 connect to the network.
          3.     When connecting an encrypted network, enter the password in the box first. You can select to
                 hide password characters or not.
          4.     The system tries to connect and the wireless manager icon turns into         . The icon turns into
                      or      after successful connection.
          5.     Click [Refresh] to refresh the “Wireless Network Connection” list.
D.2       IP Configure
          NOTE:
          •      When the system background is processing network task (DICOM sending for example),
                 please do not enter network setting to change the IP, otherwise the background task may fail.
                 You can check if there are tasks undergoing in the task manager.
          •      If the IP address displays as 0.0.0.0, this means that the network is abnormal. The reason for
                 the failure may be disconnection or the system cannot obtain the IP address.
          IP config is used for setting local network parameters, which is also applied to DICOM connection.
          Perform the following procedure:
          1.     In Wireless network manager screen, click [IP Config] to open the configuration page.
                 –   If “DHCP” is selected, the IP address will be automatically obtained from the DNS server.
                 –   If “Static” is selected (using a static IP address), enter the IP address.
                 IP address of the system should be in the same network segment with the server.
          2.     Click [OK] to save current setting. Click [Cancel] to exit.
            By providing the referential information, such as, the ultrasonic image, the anatomic graphic,
            scanning pictures/other scanning tips or diagnosis comments, the system helps the doctors to
            operate the scanning by iScanHelper. Furthermore, it is a good platform for the self-learning and
            training of ultrasound scanning technique for doctors. The system also plays a role in the assistant
            software system in fulfilling training and education.
            NOTE:
            THIS “iScanHelper” IS FOR REFERENCE OR TUTORIAL PURPOSES ONLY, AND THE
            MANUFACTURER WILL NOT BE LIABLE FOR DAMAGES AND/OR OTHER
            UNDESIRABLE CONSEQUENCE IN ANY KIND THAT MAY OCCUR TO THE PATIENT OR
            THE USERS BY USING THE SOFTWARE.
            TIP:
            iScanHelper feature is available under abdominal, gynecological, urological, obstetrical, small parts
            and nerve block area.
2 5
                1   Section selecting box Move the cursor onto the target view and press <Set> to select
                                          a section.
                2   Anatomic graphic          Related anatomical tissue information are provided here.
                3   Scanning picture          Ordinary scanning tips can be observed here, including
                                              posture, probe mark, probe swing/sweep techniques.
                4   Scanning tips             You can read tissue related anatomical information and
                                              adjacent tissue information here.
                5   Ultrasonic image          It is used to compare with images scanned by the operator.
           Press <Cursor> to obtain the cursor. Move the cursor on the anatomic graphic, the ultrasound image
           or scanning tips.
           •    Double-click Anatomic graphic, Scanning picture or Ultrasonic image to go to the single
                window of each of them.
           •    Double-click single window again to return to quad-window display.
            The iVision function is used to demonstrate the stored images. Image files are played one by one
            according to file names (including system-relevant and PC-compatible format images).
            Perform the following procedure:
            1.      Press the user-defined key for “iVision” to enter the iVision screen.
            2.      Add the contents to be played and select demo mode.
            3.      Select an item in the list and click [Start] to begin the demonstration.
            4.      Click [Exit] to exit iVision status.
            The ultrasound system can automatically recognize some vocal commands. You can use a
            microphone device to input the vocal commands as shown in the following table. After the input
            command is recognized, the system automatically performs the corresponding operations.
            This section of the operator’s manual applies to the overall system including the main unit, probes,
            accessories and peripherals. This section contains important safety information for operators of the
            device, pertaining to acoustic output and how to control patient exposure through use of the
            ALARA (as low as reasonably achievable) principle. Also this section contains information
            regarding the acoustic output testing and the real-time output display.
            Read this information carefully before using the system.
           Additional information regarding the concept of ALARA and the possible bioeffects of Ultrasound is
           available in a document from the AIUM (American Institute of Ultrasound Medicine) title “Medical
           Ultrasound Safety”.
MI (Mechanical Index)
           The mechanical bioeffects are the result of compression and decompression of insonated tissues
           with the formation of micro bubbles that may be referred to as cavitations.
           MI is an index that shows the possibility of the cavitations generation based on acoustic pressure,
           and the value in which the peak-rarefactional acoustic pressure is divided by the square root of the
           frequency. Therefore MI value becomes smaller when the frequency is higher or the peak-
           rarefactional acoustic pressure is lower, it becomes difficult to generate the cavitations.
                                                                 P r, 
                                                 MI = ---------------------------------
                                                                                      -
                                                          f awf  C MI
TI (Thermal Index)
           TI is determined by the ratio of the total acoustic power to the acoustic power required to raise the
           tissue temperature by 1 degree C. In addition, because the temperature rises is greatly different
           according to tissue structures, TI is divided three kinds: TIS (Soft-tissue Thermal Index), TIB
           (Bone Thermal Index) and TIC (Cranial-bone Thermal Index).
           •    TIS: Thermal index related to soft tissues, such as abdominal and cardiac applications.
           •    TIB: Thermal index for applications, such as fetal (second and third trimester) or neonatal
                cephalic (through the fontanel), in which the ultrasound beam passes through soft tissue and a
                focal region is in the immediate vicinity of bone.
           •    TIC: Thermal index for applications, such as pediatric and adult cranial applications, in which
                the ultrasound beam passes through bone near the beam entrance into the body.
            Although the output power is automatically controlled for the selected applications, high TI values
            should be kept to a minimum or avoided in obstetric applications. WFUMB (World Federation for
            Ultrasound in Medicine and Biology) guidelines: state that temperature increase of 4 degree C for 5
            min or more should be considered as potentially hazardous to embryonic and fetal tissue.
            The smaller the MI/TI values, the lower the bioeffects.
            NOTE:
            If there is a value of MI or TI exceeds 1.0, you must be careful to practice the ALARA
            principle.
Adjusting range
                                               Initial power: 0.13% to 100%*
            Definition of 100%: The maximum acoustic power of a probe determined by the increase in probe
            surface temperature in the selected mode and the acoustic power restrictions specified by the FDA.
            Default settings of acoustic power value refer to the best image quality of the probe. The larger the
            acoustic power value, the better the image quality.
            In this product, to obtain optimum images for applications under the requirements of safety and
            ALARA principle, we set acoustic power default values in factory to be maximum 93.33% in all
            exam modes for a better image quality. The user can make adjustments according to the imaging
            effect in practical use.
           NOTE:
           This system automatically returns to the settings whenever changes are made to the values
           (when you turn on the power, switch between probes, end the exam, or select OK or Cancel in
           the Setup menu). In the factory default settings, the Acoustic Output is limited below 100%.
           Following the ALARA restriction, you are allowed to increase the acoustic power under FDA
           510 (k) Guidance-Track 3 limits and to set it in the image preset screen.
           The acoustic output of the system has been measured and calculated in accordance with IEC60601-
           2-37: 2015, FDA 510(K) GUIDANCE, IEC 62359: 2017, Ultrasonics-Field characterization-Test
           methods for the deter mination of thermal and mechanical indices related to medical diagnostic
           ultrasonic fields.
Direct controls
           It is possible to control, if necessary, the acoustic output with the “A.power” item. In this case, the
           maximum value of the acoustic output never exceeds an MI of 1.9 and an ISPTA.3 of 720 mW/cm2
           in any mode of operation.
Indirect controls
           The controls that indirectly affect output are the many imaging parameters. These are operating
           modes, frequency, focal point positions, overall depth, and PRF.
           The operating mode determines whether the ultrasound beam is scanning or non-scanning. Thermal
           bioeffect is closely connected to M mode, Doppler and Color mode. Acoustic attenuation of tissue
           is directly related to probe frequency. The focal point is related to active aperture of probe and beam
           width. For the higher PRF (pulse repetition frequency), the more output pulses occur over a period
           of time.
Receiver controls
           The receiver controls (for example, gain, dynamic range, and image post-processing, etc.) won’t
           affect output. These controls should be used, when possible, to improve the image quality before
           using controls that directly or indirectly affect output.
                                                                   – 0.3   10  f c  z 
                                     I atten = I water  10
            Where Iatten is the attenuated intensity, Iwater is the intensity measured in a water tank (at distance
            z), fc is the center frequency of the ultrasound wave (as measured in water), and z is the distance
            from the probe. The equation for attenuating pressure values is similar except that the attenuation
            coefficient is 0.15 dB/cm/MHz, or one-half the intensity coefficient. The intensity coefficient is
            double the pressure coefficient because intensity is proportional to the square of pressure.
            Although the attenuation coefficient chosen, 0.3 dB/cm/MHz, is significantly lower than any
            specific solid tissue in the body, this value was chosen to account for fetal examinations. In early
            trimester ultrasound fetal examinations, there may be a significant fluid path between the probe and
            the fetus, and the attenuation of fluid is very small. Therefore the attenuation coefficient was
            lowered to account for this case.
            The system complies with the EMC standard IEC 60601-1-2: 2014.
            Intended Environments: HOME HEALTHCARE ENVIRONMENT (except for near active HF
            SURGICAL EQUIPMENT and the RF shielded room of an ME SYSTEM for magnetic resonance
            imaging).
                    WARNING
            •       The use of unapproved accessories may diminish system performance.
            •       Use of components, accessories, probes, and cables other than those
                    specified may result in increased emission or decreased immunity of
                    system.
            •       Operation of system, in the case that the patient physiological signal is
                    lower than the minimum amplitude or value specified in the product
                    specifications, results may not be obtained (results can be obtained when
                    the HR is in the range of 30-250 bmp or when the QRS wave amplitude is
                    between 0.5-5 mV.)
            •       Use of this equipment adjacent to or stacked with other equipment should
                    be avoided because it could result in improper operation. If such use is
                    necessary, this equipment and the other equipment should be observed to
                    verify that they are operating normally.
            •       Use of accessories, transducers and cables other than those specified or
                    provided by the manufacturer of this equipment could result in increased
                    electromagnetic emissions or decreased electromagnetic immunity of this
                    equipment and result in improper operation.
            •       Portable RF communications equipment (including peripherals such as
                    antenna cables and external antennas) should be used no closer than 30
                    cm (12 inches) to any part of the system, including cables specified by the
                    manufacturer. Otherwise, degradation of the performance of this equipment
                    could result.
            •       Keep a distance of at least 20 cm away from the monitor when WiFi
                    function is in use.
            NOTE:
            This equipment has been tested and found to comply with the limits for a Class B digital device,
            pursuant to part 15 of the FCC Rules. These limits are designed to provide reasonable protection
            against harmful interference in a residential installation. This equipment generates, uses and can
            radiate radio frequency energy and, if not installed and used in accordance with the instructions,
            may cause harmful interference to radio communications. However, there is no guarantee that
             interference will not occur in a particular installation. If this equipment does cause harmful
             interference to radio or television reception, which can be determined by turning the equipment off
             and on, the user is encouraged to try to correct the interference by one or more of the following
             measures:
             •   Reorient or relocate the receiving antenna.
             •   Increase the separation between the equipment and receiver.
             •   Connect the equipment into an outlet on a circuit different from that to which the receiver is
                 connected.
             •   Consult the dealer or an experienced radio/TV technician for help.
             Any Changes or modifications not expressly approved by the party responsible for compliance
             could void the user's authority to operate the equipment.
             The device has been evaluated to meet general RF exposure requirement. The device can be used in
             portable exposure condition without restriction.
             NOTE:
             •   The system needs special precautions regarding EMC and needs to be installed and put into
                 service according to the EMC information provided below.
             •   Other devices may interfere with this system even though they meet the requirements of
                 CISPR.
             •   Preventing conducted RF immunity. Due to technological limitations, the conducted RF
                 immunity level are limited to 3 Vrms level, conducted RF interference above 3 Vrms may
                 cause wrong diagnosis and measurements. We suggest that you position system further from
                 sources of conducted RF noise.
             •   Portable and mobile RF communications equipment can affects system.
                 See Table I-1, Table I-2, Table I-3 and Table I-4 below.
             If the system is operated within the electromagnetic environment listed in Table I-2 and Table I-3,
             the system will remain safe and will provide the following basic performances:
             •   Imaging;
             •   Doppler acoustic spectral displaying;
             •   Taking measurements;
             •   Patient information;
             •   Date/time information.
Table I-1
            GUIDANCE AND MINDRAY DECLARATION-ELECTROMAGNETIC EMISSIONS
   The system is intended for use in the electromagnetic environment specified below. The
    customer or the user of system should assure that it is used in such an environment.
  EMISSIONS TEST               COMPLIANCE           ELECTROMAGNETIC ENVIROMENT - GUIDANCE
RF emissions                Group 1                 The system uses RF energy only for its internal function.
CISPR 11                                            Therefore, its RF emissions are very low and are not likely
                                                    to cause any interference in nearby electronic equipment.
Table I-1
            GUIDANCE AND MINDRAY DECLARATION-ELECTROMAGNETIC EMISSIONS
   The system is intended for use in the electromagnetic environment specified below. The
    customer or the user of system should assure that it is used in such an environment.
   EMISSIONS TEST               COMPLIANCE             ELECTROMAGNETIC ENVIROMENT - GUIDANCE
RF emissions                  Class B                  The system is suitable for use in all establishments
CISPR 11                                               including domestic establishments and those directly
                                                       connected to the public low-voltage power supply network
Harmonic Emissions            Class A                  that supplies buildings used for domestic purposes
IEC 61000-3-2
Voltage Fluctuations/         Compliance
Flicker Emissions
IEC 61000-3-3
Table I-2
            GUIDANCE AND MINDRAY DECLARATION-ELECTROMAGNETIC IMMUNITY
   The system is intended for use in the electromagnetic environment specified below. The
    customer or the user of system should assure that it is used in such an environment.
    IMMUNITY TEST                    IEC 60601              COMPLIANCE LEVEL ELECTROMAGNETIC
                                    TEST LEVEL                                 ENVIRONMENT-
                                                                                 GUIDANCE
Table I-2
             GUIDANCE AND MINDRAY DECLARATION-ELECTROMAGNETIC IMMUNITY
   The system is intended for use in the electromagnetic environment specified below. The
    customer or the user of system should assure that it is used in such an environment.
      IMMUNITY TEST                   IEC 60601             COMPLIANCE LEVEL ELECTROMAGNETIC
                                     TEST LEVEL                                ENVIRONMENT-
                                                                                 GUIDANCE
Table I-3
            GUIDANCE AND MINDRAY DECLARATION-ELECTROMAGNETIC IMMUNITY
   The system is intended for use in the electromagnetic environment specified below. The
    customer or the user of system should assure that it is used in such an environment.
    IMMUNITY          IEC 60601 TEST            COMPLIANCE                  ELECTROMAGNETIC
      TEST                LEVEL                   LEVEL                   ENVIRONMENT-GUIDANCE
Conduced RF IEC 3 Vrms                       3 Vrms                   Portable and mobile RF
61000-4-6       0,15 MHz – 80 MHz            0,15 MHz – 80 MHz        communications equipment should be
                6 Vrms in ISM and            6 Vrms in ISM and        used no closer to any part of system,
                amateur                      amateur                  including cables, than the recommended
                                                                      separation distance calculated from the
                radio bands between          radio bands between
                                                                      equation applicable to the frequency of
                0,15 MHz and 80              0,15 MHz and 80 MHz      the transmitter. Recommended
                MHz                                                   separation distance
Radiated RF IEC     10 V/m                   10 V/m                   d = 1.2 × P
61000-4-3           80MHz - 2.7GHz           80MHz - 2.7GHz
Proximity fields    27 V/m                   27 V/m                   d = 1.2 × P 80 MHz to 800 MHz
from RF             380–390 MHz                                       d = 2.3 × P 800 MHz to 2.7GHz
wireless                                                              Where, P is the maximum output power
                    28 V/m             28 V/m                         rating of the transmitter in watts (W)
communications
                    430–470 MHz, 800–                                 according to the transmitter
equipment           960 MHz, 1700–1990                                manufacturer and d is the recommended
IEC 61000-4-3       MHz, 2400–2570                                    separation distance in meters (m).
                    MHz                                               Field strengths from fixed RF
                    9 V/m              9 V/m                          transmitters, as determined by an
                    704–787 MHz, 5100–                                electromagnetic site survey, should be
                    5800 MHz                                          less than the compliance level in each
                                                                      frequency range.
                                                                      Interference may occur in the vicinity of
                                                                      equipment marked with the following
                                                                      symbol:
Note 1: At 80 MHz and 800 MHz, the higher frequency range applies.
Note 2: These guidelines may not apply in all situations. Electromagnetic propagation is affected by
absorption and reflection from structures, objects and people.
 a Field strengths from fixed transmitters, such as base stations for radio (cellular /cordless) telephones and
land mobile radios, amateur radio, AM and FM radio broadcast and TV broadcast cannot be predicted
theoretically with accuracy.
To assess the electromagnetic environment due to fixed RF transmitters, an electromagnetic site survey should
be considered. If the measured field strength in the location in which system is used exceeds the applicable RF
compliance level above, system should be observed to verify normal operation. If abnormal performance is
observed, additional measures may be necessary, such as reorienting or relocating the system.
b Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 3 V/m.
Table I-4
       RECOMMENDED SEPARATION DISTANCES BETWEEN PORTABLE AND MOBILE RF
                    COMMUNICATION DEVICE AND THE SYSTEM
    The system is intended for use in an electromagnetic environment in which radiated RF
       disturbance are controlled. The customer or the user of system can help prevent
    electromagnetic interference by maintaining a minimum distance between portable and
    mobile RF communication equipment (transmitters) and system as recommended below,
          according to the maximum output power of the communication equipment.
      Rated Maximum                Separation Distance According to Frequency of Transmitter
      Output power of
                                  150kHz -80MHz               80MHz-800MHz                 800MHz-2.7GHz
        Transmitter
                                    d = 1.2 P                  d = 0.35 P                    d = 0.7 P
            (W)
0.01                        0.12                        0.035                        0.07
0.1                         0.38                        0.11                         0.22
1                           1.2                         0.35                         0.7
10                          3.8                         1.11                         2.22
100                         12                          3.5                          7
For transmitters at a maximum output power not listed above, the recommended separation distanced in
meters (m) can be determined using the equation applicable to the frequency of the transmitter, where P is the
maximum output power rating of the transmitter in watts (W) according to the transmitter manufacturer.
If system image distortion occurs, it may be necessary to position system further from sources of conducted
RF noise or to install external power source filter to minimize RF noise to an acceptable level.
Note 1: At 80 MHz and 800 MHz, the separation distance for the higher frequency range applies.
Note 2: These guidelines may not apply in all situations. Electromagnetic propagation is affected by
absorption and reflection from structures, objects and people.