VisualSonics Vevo 770 High-Resolution Imaging System. Operator Manual

Transcription

1 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual

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3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual January 2006 PN Revision 1.3 V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual i

4 VisualSonics Inc. VisualSonics North America 3080 Yonge Street, Suite 6100 Box 66 Toronto, Ontario Canada M4N 3N1 Tel: +1 (416) Toll-Free: (North America) Fax: +1 (416) VisualSonics Europe VisualSonics Europe Kruislaan 406 Matrix V Suite SM Amsterdam The Netherlands Tel: +31 (0) Fax: +31 (0) Copyright by VisualSonics Inc. All Rights Reserved Printed in Canada VisualSonics, Vevo and Vevo 770 are registered trademarks of VisualSonics Inc. The VisualSonics logo, EKV and RMV are trademarks of VisualSonics Inc. VisualSonics RMV technology is protected by U.S. and international patents. U.S. Patents that may apply: US 6,511,430, US 6,851,392, AU , AU , AU , AU , AU , DE , ES , GB , GB , GB , SE Other U.S. and Foreign Patents pending, including published applications that may apply: US 2004/ , US 2004/ , US 2004/ , US 2005/ , US 2005/ , US 2005/ , WO 2004/034694, WO 2004/032725, WO 2004/099814, WO 2005/099345, WO 2005/ Windows and Windows XP are registered trademarks of Microsoft Corporation. Intel is a registered trademark of Intel Corporation. Nero and Nero Express are registered trademarks of Ahead Software AG. All other trademarks are the property of their respective owners. This manual documents the Vevo 770 High-resolution Imaging System and the Vevo 770 Software version ii VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

5 Product Safety and Electrical Testing VisualSonics Product Tested to the Following Standards Vevo 770 High-Resolution Imaging System CISPR 11:1997/EN 55011:1998, CLASS A, GROUP 1 - Limits and methods of measurements of radio disturbance characteristics of industrial, scientific and medical (ISM) radio-frequency equipment. EN 61326: A1: A2:2001 (IEC 61326:2002) - Electrical equipment for measurement, control and laboratory use - electromagnetic compatibility. IEC , Ed 1:90 + A1:92 and A2:95; CAN/CSA C22.2 No :92; B:97; UL :93 Test Laboratories Ultratech Engineering Labs Inc Bristol Circle Oakville, Ontario, Canada, L6H 6G4 Entela, Inc. 81 Kelfield Street, Unit 7 Toronto, Ontario, Canada, M9W 5A3 Please Send Any Questions to Product Safety and Testing Quality Assurance and Regulatory Affairs VisualSonics Inc Yonge Street, Suite 6100, Box 66 Toronto, Ontario, Canada, M4N 3N1 Tel: +1 (416) Toll-Free: (North America) Fax: +1 (416) productsafety@visualsonics.com Authorized Representative Europe Atlantic Bridge Limited Zenith House 11 the Street Chirton Devizes Wiltshire SN10 3QS Tel: +44(0) Contact: Mr. David Baker david.baker@atlanticbridge.co.uk V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual iii

6 Declaration of Conformity iv VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

7 Safety Please read the safety information before using the Vevo 770 High- Resolution Imaging System (Vevo 770). The following information applies to the Vevo 770 and supporting equipment. The use of this equipment is intended for qualified research scientists. Read all warnings and cautionary notes carefully before use. Warnings are necessary to prevent injury to, or loss of life for, the operator, and other persons. Cautions are precautions necessary to protect the equipment. WARNINGS Warning: THIS EQUIPMENT IS NOT APPROVED FOR USE ON HUMANS. The Vevo 770 has been designed and tested for use on laboratory research animals. This equipment must not be used on any living human being. Warning: Where available, always use the lowest power settings necessary to obtain diagnostically acceptable images. High levels of transmitted ultrasound energy can damage tissue. Never tamper with or alter the Vevo 770 in any way such that the acoustic power level is increased. Warning: Use ONLY VisualSonics RMV scanheads and transducers with the Vevo 770. The use of other scanheads or transducers may affect safety and system performance. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual v

8 Warning: Discontinue use upon erratic behavior. If the system exhibits erratic or abnormal behavior, discontinue use and contact a VisualSonics Technical Support Representative (support@visualsonics.com). Electric Shock Hazards Warning: Do not remove any panels from the Vevo 770. Do not remove the outer RMV scanhead housing. Service to the system is to be performed by qualified personnel only, with the exception of servicing the air filters and replacing RMV nosepieces. No operatorserviceable parts are located inside the system. Any internal adjustments, replacements or modifications to the Vevo 770 electronics or to the RMV scanheads should be made only by qualified VisualSonics Technical Support Representatives. Warning: If the system is not properly grounded or earthed, it becomes a possible electrical shock hazard. Protection against electrical shock has been provided through an isolation transformer and chassis grounding via a plug to an appropriate power source. DO NOT remove the ground wires from any part of the Vevo 770 for any reason. Warning: Ensure that all power sources, whether a UPC or a wall outlet, are properly grounded or earthed. Warning: Disconnect the system from the power source before cleaning the system or performing any maintenance operations. Warning: Verify that the specified voltage on the Vevo 770 label matches the power source voltage. An inappropriate power source voltage could result in an electrical hazard, and could cause serious damage to the equipment. Warning: Connection of devices not authorized by VisualSonics to the Vevo 770 isolation transformer could result in an electrical hazard. vi VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

9 Warning: If any part of the Vevo 770 is in contact with hazardous chemicals or biological materials, appropriate precautions must be taken by all who come into contact with the Vevo 770 until the device is declared completely free of harmful contamination. Warning: The Vevo 770 is both delicate and heavy. Careless moving and rough handling can damage the system and cause injury to others (e.g., rolling over feet, colliding with people or walls). Never use the system if there is damage to the cart, cables or accessories. Warning: Do not immerse the RMV scanhead in coupling medium beyond the fill port screw. The housing of the RMV is not watertight. If the RMV scanhead is immersed beyond the fill port screw, the electrical safety features may be compromised. Warning: DO NOT spray or drip any liquid into the system or onto the keyboard, as this could affect reliable operation and electrical safety. Electromagnetic Interference Warning: The Vevo 770 should never be used where patient safety could be affected by the malfunction of medical devices. The Vevo 770 is designed for use in preclinical laboratories and is not cleared for use with or in the vicinity of active medical devices. High levels of electromagnetic energy may interfere with the operation of the Vevo 770. Furthermore, the Vevo 770 could affect the safe operation of sensitive medical devices. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual vii

10 CAUTIONARY NOTES Physical Hazards Caution: Watch out for strained and twisted cables. Some of the optional accessories have long cables. Take care when working around the cables. Caution: VisualSonics recommends that the Vevo 770 be pushed by one person from behind and guided by another person in front, using the grab bars. Please use caution when going up or down ramps. Keep the system upright during transport. Ensure that the castors are locked when the Vevo 770 is not being transported. Never lift the system using the grab bars. Caution: Allow for adequate air circulation around the system. Do not to obstruct airflow in the vicinity of the system filters at the bottom of the cart, or the vents at the top of the cart. Caution: Never touch the transducer element. The active element of the transducer can be easily scratched and/or damaged. Scratches may lead to degraded system performance. Always store the RMV scanhead with the nosepiece attached to protect the transducer. Chemical and Biological Hazards Caution: Do not aggressively press the RMV scanhead into the animal. This may cause the acoustic membrane to deform, may damage the transducer and may injure the animal. The acoustic membrane on the RMV scanhead is soft and extremely pliable. Caution: Fill the nosepiece with de-ionized water only. Use of other materials within the nosepiece will cause damage to the RMV scanhead. This damage is not covered by the warranty or the service contract. viii VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

11 Caution: Keep both the RMV scanhead as well as all working surfaces clean. DO NOT use an autoclave or any other heat sterilization methods on the RMV scanhead as this may result in permanent damage. See Maintenance on page 219 for information about cleaning the Vevo 770 and the RMV scanhead. Magnetic Field Sensitivity Labelling and Verification Caution: DO NOT station the Vevo 770 close to large clinical magnets as the magnetic fields may affect the performance of the Vevo system and cause distortion in the acquired image. This device complies with Part 15 of the FCC Rules. Operation is subject to the following two conditions: 1. This device may not cause harmful interference; and 2. This device must accept any interference received, including interference that may cause undesired operation. This equipment has been tested and found to comply with the limits for a Class A digital device, pursuant to Part 15 of the FCC Rules. These limits are designed to provide reasonable protection against harmful interference when the equipment is operated in a commercial environment. This equipment generates, uses, and can radiate radio frequency energy and, if not installed and used in accordance with the instruction manual, may cause harmful interference to radio communications. Operation of this equipment in a residential area is likely to cause harmful interference in which case the operator will be required to correct the interference at his own expense. Warning: Changes or modifications not expressly approved by VisualSonics could void the operator s authority to operate the equipment. How to Read this Manual Content in this manual has been grouped according to function. Some content may be repeated within the manual because it applies to several different functions. Use the Table of Contents and the Index to locate the subject required. Use the glossary for definitions of standard terms. The steps written for a task will give instructions to press, click or select items to accomplish a function. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual ix

12 Click Item > Sub Item - This refers to selecting an item from the menu and then selecting the sub item from the list presented. For example: Click File > Save As. Click Item - This refers to using the trackball cursor to select an onscreen control labeled Item, in the application. Press <Item> - This requires the operator to press a key, labeled Item, on the keyboard or keypad. Click, double-click or right-click - Like a computer mouse, the trackball has a left, center and right button. Use the left button when asked to click or double-click. Use the right button when asked to right-click. Press ITEM - This refers to the rocker switches on the keyboard. Press the top of the rocker switch to increase the value; press the bottom of the rocker switch to decrease the value. x VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

13 Contents Introduction Welcome...1 Product Description...1 Available Configurations...3 Main Components...3 Optional Components...8 System Installation...8 Chapter 1: Introduction to High-Resolution Micro-Ultrasound Imaging RMV Scanhead and Transducer...9 Imaging Modes...10 Chapter 2: Getting Started RMV Scanhead Preparation...17 Connecting the RMV Scanhead...18 Imaging with the Vevo Integrated Rail System III...19 Setting Up the 3D Motor Stage (Optional)...20 RMV Imaging Tips...23 Starting the Vevo Starting the Vevo Software...26 Exiting the Vevo Software...27 Shutting Down the Vevo Disconnecting the RMV Scanhead...27 Storing the RMV Scanhead...28 Physiological Data Support...29 Chapter 3: Software Basics Scanhead Selection...31 Study Browser...34 Mode Window...36 Scan/Freeze...40 V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual xi

14 Associating Data with a Study...40 Operator Preferences...42 System Hot Keys...45 Chapter 4: Study Management Typical Study Session...47 Operators...49 Study Browser...51 Viewing Study Information...61 Closing a Study...61 Recovering a Study...61 Hot Keys...62 Chapter 5: B-Mode Imaging Fundamentals...65 Setting Up B-Mode...66 Typical B-Mode Image Acquisition...69 EKV Reconstruction...71 Needle Guide Overlay...73 Cine Loop...76 Time-Gain Compensation (TGC)...78 Chapter 6: 3D-Mode Imaging Theory of Operation...81 Setting Up the 3D Motor Stage...82 Typical 3D-Mode Image Acquisition...85 Respiration Gating for 3D Acquisition...86 Viewing 3D Image Data...87 Manipulating 3D Image Data...90 Creating Volumetric Measurements...94 Saving a 3D Image...98 Recording a 3D-Mode Session...99 Changing the 3D-Mode Display Parameters Chapter 7: PW Doppler Mode Imaging Defining the PW Doppler Sample Volume Defining the PW Doppler Angle V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual xii

15 PW Doppler Acquisition Window Time-Gain Compensation (TGC) Multiple Sample Volumes PW Doppler Cine Loop Typical PW Doppler Mode Image Acquisition Technical Overview of PW Doppler Chapter 8: Tissue Doppler Mode Imaging Fundamentals Setting Up Tissue Doppler Mode Typical Tissue Doppler Mode Image Acquisition Working With Tissue Doppler Acquisition Data Chapter 9: M-Mode Imaging Defining the M-Mode Sample Volume M-Mode Acquisition Window Time-Gain Compensation (TGC) M-Mode Cine Loop Typical M-Mode Image Acquisition AM-Mode Chapter 10: Power Doppler Mode Typical Power Doppler Image Acquisition Setting Up Power Doppler Mode Measuring Vascularity Power 3D Mode Chapter 11: Data Management Data Browser Browse By View Column Headings Selections File Types Study Details Thumbnail Preview Hot Keys Identifying Viewed Images V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual xiii

16 Chapter 12: Measurements Measurement Packages Displaying Measurements Measurements Tool B-Mode Measurements D-Mode Measurements PW Doppler Mode Measurements M-Mode Measurements Tissue Doppler Mode Measurements Pressure-Volume Loop Measurements Exporting Measurements and Calculations Batch Export Export Table Chapter 13: Text Annotations Placing Annotations Displaying Annotations Configuring Annotations Predefined Annotations Editing Annotations Chapter 14: Data Archiving Options for Transferring Studies from the Vevo Copying Data Using Nero Software Recommended Media Chapter 15: Troubleshooting Troubleshooting Table Error Reports Chapter 16: Maintenance and Service Maintenance Service Provided by VisualSonics Owner Responsibilities xiv VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

17 Appendix A: Specifications Environmental Specifications System Dimensions Electrical Specifications Appendix B: Accessories Optional Components Accessories Power Plug Appendix C: Blood Pressure Calibration Connecting the Blood Pressure Equipment Setting the Signal Level Input Impedance Calibrating the Pressure Scale Importing Calibration Data Appendix D: Measurement Report Using Standard Measurement Package Report Format Report File Layout Appendix E: Measurement Report Using the Abdominal, Cardiac or Embryology Measurements Packages Report Format Report File Layout Appendix F: Advanced Vevo 770 Keyboard Advanced Vevo 770 Keyboard Features Appendix G: Shifting to the Advanced Keyboard Hot Key Label Changes Hot keys assigned to rocker switches Glossary V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual xv

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19 Introduction Introduction Welcome Thank you for choosing the Vevo 770 High-Resolution Imaging System, VisualSonics high-resolution in vivo micro imaging system. Product Description The Vevo 770 High-Resolution Imaging System (Vevo 770) enables in vivo visualization, assessment, and measurement of anatomical structures and hemodynamic function in longitudinal imaging studies for small animal phenotyping. The following diagrams show the system components: Front View of the Vevo inch monitor Air vent (x2) Built-in speakers (with power switch and volume control) DVD drive Custom keyboard/ trackball RMV Scanhead or gel holders RMV Scanhead or gel holders Front grab bar Two RMV scanhead connectors RMV cable holder Physiological monitoring system connector Castor brake (x4) Replaceable air filter Castor (x4) V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 1

20 Introduction Rear View of the Vevo inch monitor Four BNC connectors Ethernet network connector Speaker cable 3D motor connector Power cable Main power switch External pointing device connector Two USB 2.0 connectors Parallel connector DVI connector Grab bar SVGA connector (remote) S-Video connector External keypad (optional) connector Castor (x4) Air filter 2 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

21 Introduction Available Configurations Several configurations of the Vevo 770 are available from VisualSonics. For a complete list of accessories and optional components, see Accessories on page 225. Standard Configuration Vevo 770 High-Resolution Imaging System Vevo 770 Software, including: a. Analytic software package for B-Mode (2D) image capture and analysis b. Cine loop image capture, display, and review c. Software analytics for Advanced Measurements and Annotations d. Physiological Data on-screen trace Three-pedal foot switch Flow Analysis Option PW Doppler Mode (for rapid flow applications) and Power Doppler (for slow blood flow applications) 3D Analysis Option 3D acquisition and visualization Digital RF Mode Option RF Mode for capturing and presenting RF Mode data in digital format. Includes associated RF electronics and software for digital RF capture and presentation Cardiac Analysis Option M-Mode EKV (ECG-gated image acquisition) Advanced Cardiology Option Tissue Doppler Imaging (TDI) for assessing diastolic dysfunction and myocardial strain Automated LV Analysis for semi-automated analysis and quantification of LV function Integrated Blood Pressure with Pressure-Volume Analysis Anatomical M-Mode for M-Mode analysis in the anatomically correct plane Advanced Cardiovascular Measurements Capability Accessories Vevo Compact Anesthesia System (mobile and table top models) Vevo Integrated Rail System III Vevo Micro Injection System RMV Scanheads 10 application-specific models Main Components The Cart The main components of the Vevo 770 are installed on every system. The cart houses the Vevo 770. The monitor is located on top of the cart. The cart is constructed of steel and stands on four lockable castors. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 3

22 Introduction Front Panel The front panel of the cart contains connectors for two RMV scanheads, and one connector for a physiological monitoring system cable input. It also contains an RMV cable holder. Physiological monitoring system connector Cable holder Two RMV scanhead connectors Rear Panel The rear panel contains the main power switch, the power cable, and connectors for an Ethernet network cable, a 3D motor (optional) cable, a speaker cable, two USB connectors, plus a parallel printer port, an SVGA connector, two PS/2 connectors, and four BNC connectors (RF Out, RF Frame Trig, RF Frame Start). Ethernet network connector Speaker cable Four BNC connectors External pointing device connector Two USB 2.0 connectors Parallel connector Main power switch DVI connector Power cable SVGA connector (remote) S-Video connector 3D motor connector (optional) External keyboard (optional) connector With the exception of the Ethernet network cable, cables being connected to the rear panel of the Vevo 770 cart must be 3 m (9' 10") in length, or shorter. 4 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

23 Introduction Grab Bars RMV Scanhead and Gel Holder The front and back grab bars should be used when transporting the system. The grab bars are not to be used for lifting the system as they are unable to bear the weight of the system. The RMV scanhead or gel holders located on the left and right sides of the cart and are used for storing RMV scanheads and gel bottles. Gel bottles can be stored upright or upside down. The RMV scanheads in the RMV scanhead holder. Castors Castors allow the Vevo 770 to be moved easily. The four castors can be locked using a lever located above each castor. The castors are locked when their levers are down. Castor brake, in the up (unlocked) position Filters (Front/Rear) Vents Data Storage Devices The cart includes two air filters. One is located at the base of the lower front frame of the cart. The second is located at the base of the rear frame of the cart. The cart includes two air vents located toward the rear of the left and right panels of the cart. The Vevo 770 includes a DVD+-RW drive and two hard drives. One hard drive contains the Microsoft Windows XP operating system and the Vevo software and the other hard drive is used for data storage. The DVD V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 5

24 Introduction drive is located on the left side of the Vevo 770 cart, and may be used to read or write data to and from CDs and DVDs. Network Connection Computer Peripherals The computer unit includes a 10/100 Mbps Ethernet network connection. The custom keyboard with integrated trackball and the three-pedal foot switch are used for operator input. Keyboard Three-Pedal Foot Switch Note: Press the left foot pedal for Frame Store. Display Monitor Speakers The 17-inch monitor features adjustable brightness and contrast controls. Integrated speakers are used to provide an audio representation of the blood flow acquired in PW Doppler Mode to complement the image on the PW Doppler spectral display. 6 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

25 Introduction 700-Series RMV Scanhead VisualSonics developed its 700-Series RMV (real-time microvisualization) scanheads for optimizing high-frequency ultrasound imaging for small animal research. The 700-series features a light, ergonomic design, with maximum frame rates up to 200 frames per second (depending on which RMV scanhead is being used and the Field of View or Sector Size set for image acquisition). The 700-series RMV also provides greater sensitivity, greater depth of penetration and higher resolution for small animal imaging. The 700-series RMV scanhead allows real-time visualization of the hemodynamic or anatomical target. The RMV scanhead is designed to be used as a hand-held probe for rapid screening procedures or to be attached to the Integrated Rail System III. For more information on connecting to the Vevo Integrated Rail System III, see Connecting the RMV Scanhead on page 18. RMV cable Strain relief for RMV cable Registration ridge Acoustic window Acoustic membrane Nosepiece pressure fit groove Fill port screw Nosepiece RMV housing Transducer Transducer arm Acoustic window The acoustic window is a disposable item due to the fragile nature of the acoustic membrane. Replacement acoustic windows can be ordered from VisualSonics. Isolation Transformer The monitor, the computer, the RF processing and motor control units, and the ventilation fans are attached to an isolation transformer through a strip of IEC power connectors. The isolation transformer serves to protect the equipment and the operator against electrical shock and power surges. The isolation transformer is located inside the Vevo 770 cart. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 7

26 Introduction The Vevo 770 has been designed to operate according to the electrical specifications of the region to which the system has been shipped. The nameplate on the back of the system indicates the electrical requirements. The Vevo 770 uses a combination power switch/circuit breaker for protection in case of electrical overload. If the circuit breaker is tripped, the switch is toggled to a position that is in between the on and off position. If the switch is in this position, unplug the machine immediately and contact a Technical Support Representative (support@visualsonics.com). Plug All units are equipped with an appropriate plug for the wall outlet. Please see Power Plug on page 227 to ensure that the plug installed on the Vevo 770 is most suitable for the configuration of a wall outlet. For optimal system performance, use a dedicated, interference-free grounded wall outlet. The power cable is securely connected to the Vevo 770 cart with a cable retainer. If it is necessary to remove the power cable from the cart, loosen the screw at the top of the cable retainer. Warning: Do not modify the attachment plug or use an adapter. Doing so may cause an electrical hazard. If a different plug is required to use the Vevo 770, please contact a Technical Support representative (support@visualsonics.com). Caution: Plug the system directly into the wall outlet. Use of an extension cord or a power bar is discouraged. Optional Components Remote Keypad Optional components can be purchased for use with the Vevo 770. A custom keypad provides remote access to the key system functions. The keypad may be situated closer to the work area for easy access to system controls. Labeled keypad System Installation The Vevo 770 must be installed by VisualSonics authorized representatives. 8 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

27 Chapter 1: Introduction to High-Resolution Micro-Ultrasound Imaging: RMV Scanhead and Transducer Chapter 1: Introduction to High-Resolution Micro-Ultrasound Imaging The Vevo 770 was designed to examine small animals in vivo and noninvasively. The high-frequency ultrasound imaging capability of the Vevo 770 facilitates visualization and measurement of anatomy and the quantification of physiology in adult, neo-natal and (in utero) embryonic small animals. B-Mode, M-Mode and PW Doppler Mode imaging are available at real-time frame rates for applications such as cancer biology, neurobiology, developmental biology and cardiovasular research. The Vevo 770 operates in the very high frequency range (center frequencies of MHz). The system s resolution and depth of penetration is dependent on the type of RMV scanhead used. RMV Scanhead and Transducer The transducer within the RMV scanhead is used to transmit an ultrasound pulse into the animal through a coupling medium such as water or ultrasound gel. The transducer detects the backscatter signal or ultrasound echo returned from the animal. The echo is used to create a single line of the digital ultrasound image. Selecting the proper RMV scanhead for a particular application, in addition to optimizing the system settings, is essential for obtaining the best images. Transducer Ultrasound pulse Ultrasound backscatter/echo Ultrasound scatter The transducer is the component from within the RMV scanhead that emits an ultrasound pulse that scatters off an object. Some of the ultrasound signal is scattered towards the transducer (echo) and this backscattered signal is acquired and used to make a single ultrasound line. As the transducer moves over the object, multiple ultrasound lines are acquired and combined into a B-Mode image. With PW Doppler and M-Mode images, the transducer emits multiple pulses and acquires the corresponding ultrasound lines. Refer to 700-Series RMV Scanhead on page 7 for the location of the transducer inside the RMV scanhead. The focal zone represents the region of the transducer beam which typically generates the best, focused image of the structure of interest. The depth of field is the size of the focal zone. The focal length is the distance from the active surface of the transducer to the middle of the focal zone. The aperture describes the diameter of the transducer s active surface. In the following diagram the depth of field, focal length and aperture are all displayed. The focal zone is the area inside the depth of field. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 9

28 Chapter 1: Introduction to High-Resolution Micro-Ultrasound Imaging: Imaging Modes Bottom view of transducer head Aperture Transducer Lateral resolution Depth of field Focal length Focused ultrasound beam The returning ultrasound echoes are not of uniform intensity. In general, the further the travel distance for the backscattered signal, the greater the signal attenuation or reduction in signal amplitude and intensity. Ultrasound signals returning from shallow structures are stronger than echoes from deeper structures. The RMV scanhead has a fixed-focused transducer, which also affects the intensity of the backscattered signal. Objects located within the focal zone of the transducer produce stronger echoes than those located outside the focal zone. Imaging Modes The Vevo 770 supports seven ultrasound imaging modes: B-Mode imaging 3D-Mode imaging PW Doppler Mode imaging Tissue Doppler Mode imaging M-Mode imaging Power Doppler Mode imaging Digital RF-Mode B-Mode Imaging To create a B-Mode image, the transducer acquires multiple lines while scanning the imaging field. The acquired lines are processed and combined to form the two-dimensional B-Mode image. Mechanical displacement of the transducer in a sector scan allows data collection of the reflected signals from a preset field of view. Proper positioning of the RMV scanhead is vital for obtaining good images. The RMV scanhead should be placed perpendicularly to the surface of the structure of interest for optimal penetration. 10 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

29 Chapter 1: Introduction to High-Resolution Micro-Ultrasound Imaging: Imaging Modes B-Mode image showing a heart valve of a mouse 3D-Mode Imaging 3D-Mode provides operators with tools to produce and manipulate threedimensional renderings and generate volumetric measurements of target objects viewed with high-resolution ultrasound. 3D-Mode image showing an object contoured within the 3D image and displayed in the context of the x, y, and z planes V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 11

30 Chapter 1: Introduction to High-Resolution Micro-Ultrasound Imaging: Imaging Modes Based on operator defined parameters, the 3D motor stage (affixing the RMV scanhead to the 3D motor stage on the Vevo Integrated Rail System III) travels a set distance as a series of steps in a direction perpendicular to the movement of the RMV scanhead. At each step, the RMV scanhead takes a two-dimensional B- Mode image. motor stage direction RMV scan plane Each two-dimensional B-Mode image slice is stacked and assembled with the other slices of acquired data and rendered by the Vevo software into a threedimensional data set. Operators can then: View and render objects of interest, such as target tumors, in 3D. Segment objects on any plane or across planes. Measure object lengths, widths, areas and volumes. PW Doppler Mode Imaging PW Doppler Mode allows operators to examine the velocity of flow (for example, blood flow) within a region of interest. The PW Doppler signal is presented as an audio output in addition to being rendered within the PW Doppler spectral display. The PW Doppler effect in ultrasound is a perceived shift in the frequency of the backscattered ultrasound signal reflected from the moving target. The amount of frequency shift depends on the flow velocity, the directional flow vector relative to the transducer position, the transmitted frequency and the speed of sound of the material that the ultrasound signal is travelling through. 12 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

31 Chapter 1: Introduction to High-Resolution Micro-Ultrasound Imaging: Imaging Modes Doppler Mode, the transducer alternately transmits and receives signals. The PW Doppler spectrum from a mouse Backscattered signals returning from different depths are received at different times. By processing only the signals that are received after precise time intervals, PW Doppler Mode acquires and quantifies data from a Sample Volume at a specific depth. Tissue Doppler Mode Imaging Tissue Doppler Mode Imaging (TDI) provides tools to assess the health of the myocardial wall of the left ventricle. TDI uses PW Doppler to detect moving myocardial tissue and display it as a PW Doppler Spectrum. This mode is useful for performing quantitative myocardial analysis, and for performing regional myocardial strain rate analysis by quantifying the distance and velocity relationship between two TDI spectrums. Tissue Doppler acquisition data is rendered in yellow to distinguish it from PW Doppler data. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 13

32 Chapter 1: Introduction to High-Resolution Micro-Ultrasound Imaging: Imaging Modes M-Mode Imaging M-Mode imaging displays the motion of tissue detected by one line of the B-Mode image over time. M-Mode is commonly used in echocardiography (ultrasound imaging of the heart). An M-Mode image is constructed by the backscatter data that is acquired by rapidly pulsing the transducer at a single point. Because the transducer can be pulsed much faster than it can be moved, M-Mode images are able to capture fast motion with better time fidelity than B-Mode images. M-Mode overlay Right ventricle wall Septum Left ventricle chamber Diastole Systole 2D image of the left ventricle Posterior wall M-Mode image M-Mode images can be used to evaluate cardiovascular function, studying the differences between normal and transgenic or diseased hearts. M-Mode images of the heart are used to determine the chamber dimensions at various time points throughout the cardiac cycle. The M-Mode image of wall motion in the heart of a mouse. 14 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

33 Chapter 1: Introduction to High-Resolution Micro-Ultrasound Imaging: Imaging Modes Power Doppler Mode Imaging Power Doppler mode visualizes and measures a relative flow volume when the flow volume is slow. This mode is useful for applications such as: Detecting microvascularity in and around orthotopic and subcutaneous tumors, and producing a relative quantification Determining percentage flow and flow volume to monitor tumor burden longitudinally A Power Doppler Mode image is constructed by collecting a series of PW Doppler signals within the region of interest and then applying a color map to the detected flow signal. A Power Doppler Mode image of the cross-section of a melanoma tumor in a mouse. Power Doppler Mode can be coupled with 3D acquisition to provide a 3D Percent Volume image and index for blood flow quantification. Digital RF-Mode Digital RF-Mode provides the operator with the ability to acquire, digitize and export the raw RF data for spectral analysis. For more information about this mode, refer to the Vevo 770 Digital RF Option Operator Manual. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 15

34 Chapter 1: Introduction to High-Resolution Micro-Ultrasound Imaging: Imaging Modes This page intentionally left blank. 16 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

35 Chapter 2: Getting Started: RMV Scanhead Preparation Chapter 2: Getting Started RMV Scanhead Preparation Required Tools and Materials The RMV scanhead is the most delicate component of the Vevo 770. Proper handling is required to maintain a high quality of performance and extend its working life. The following tools and materials are required to prepare the RMV scanhead for imaging: Bottle filled with de-ionized water Syringe to fill the nosepiece 1/4" slot screwdriver Replacement acoustic windows and fill port screws Attaching the Acoustic Window To attach the acoustic window to the nosepiece: 1. Remove the fill port screw with the 1/4" slot screwdriver. Caution: Failure to remove the fill port screw will cause damage to the RMV scanhead. This damage is not covered by the warranty or the service contract. 2. Place the acoustic window onto a clean flat surface with the outer face down. 3. Fill the acoustic window half-full with de-ionized water. 4. Gently press one of the short ends of the nosepiece into the matching groove in the acoustic window. 5. Gently press down and roll the RMV scanhead toward the other end of the acoustic window until a complete seal is obtained. Caution: Never touch the acoustic membrane as this will cause damage and may reduce image quality. Replacing the Acoustic Window The acoustic window is a disposable item due to the fragile nature of the acoustic membrane. It should be replaced under any of the following circumstances: An unexpected decrease in image intensity is detected. Any visible damage to the acoustic membrane, such as scratches is detected. An uneven surface or excessive wrinkles in the acoustic membrane is detected. Leakage of the de-ionized water from the nosepiece is detected. To prevent contamination between imaging sessions. Replacement acoustic windows can be ordered from VisualSonics (see Accessories on page 225). V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 17

36 Chapter 2: Getting Started: Connecting the RMV Scanhead Filling the Nosepiece To fill the nosepiece: 1. Ensure that the acoustic window is securely attached and that the fill port screw is removed. 2. Position the RMV scanhead with the fill port pointing upward. 3. Fill the nosepiece with de-ionized water using the supplied water bottle until the nosepiece is almost full. 4. Using the thumb, cover the fill port and tap the scanhead several times to dislodge any air bubbles in the nosepiece. 5. Check to ensure that the face of the transducer does not contain bubbles. If bubbles appear, tilt the RMV scanhead to dislodge them. 6. Orient the nosepiece so that the remaining air bubbles are placed under the fill port, and finish filling the nosepiece with the syringe. There is a vent hole that allows water and air to escape as the syringe is pressed. With the remaining air bubble oriented as close as possible to the fill port, slowly inject water with the syringe. 7. After removing all the air from the nosepiece, insert and tighten the fill port screw with a 1/4" slot screwdriver. Be careful to align the fill port screw properly with the threaded hole in the nosepiece. Failure to do so may damage the nosepiece. Do not over-tighten the fill port screw. Caution: Fill the nosepiece with de-ionized water only. Using other materials within the nosepiece will cause damage to the RMV scanhead. This damage is not covered by the warranty or the service contract. Caution: Before begin scanning, it is critical to completely fill the nosepiece so that no bubbles are present. If excessive bubbles are created during filling, the movement of the transducer arm, especially during high frame rate scanning, may cause foaming inside the nosepiece which will result in image quality degradation. Connecting the RMV Scanhead To connect the RMV scanhead to the Vevo 770: Two RMV scanheads can be connected to the Vevo 770 cart. RMV scanheads can be changed without having to turn off the Vevo 770 or the Vevo software. 1. If the system is off, go directly to Step When the system is already on, select Setup > Scanhead Selection or press <Select Scanhead>. 18 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

37 Chapter 2: Getting Started: Imaging with the Vevo Integrated Rail System III 3. Line up the two red dots on the cable cuff and RMV scanhead connector. RMV scanhead connector Cable cuff 4. Push the cable cuff into the RMV scanhead connector until it clicks. 5. If required, attach a second RMV scanhead to the connector on the front of the system. Note: If only one RMV scanhead is connected, another RMV scanhead can be connected in the future to the unused connector, even during image acquisition. Caution: Ensure that the RMV scanhead cable does not get caught under the system castors. Use the cable holder beneath the keyboard shelf to secure cables. Imaging with the Vevo Integrated Rail System III While using the Vevo Integrated Rail System III for imaging, the RMV scanhead must be secured within the RMV clamp. The clamp must then be attached to the stationary mount on the Vevo Integrated Rail System III. To secure the RMV scanhead with the RMV clamp: 1. Lift the latch to open the moving arm of the clamp. 2. Align the registration ridge of the RMV scanhead with either the hinge groove or the side groove. Quick Release post Latch Side groove Hinge groove Moving arm 3. Close the moving arm of the clamp while holding up the latch. 4. While holding the arm of the RMV clamp against the RMV scanhead, push the latch down until it locks into place. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 19

38 Chapter 2: Getting Started: Setting Up the 3D Motor Stage (Optional) To attach the RMV clamp to a stationary mount on the Vevo Integrated Rail System III: 1. Gently insert the RMV clamp Quick Release post onto the Quick Release mount so that the pins on the mount fit into the holes on the Quick Release post. RMV clamp Quick Release assembly Quick Release mount on the Vevo Integrated Rail System III Knob Quick Release post The four insertion points on the top of the Quick Release post align with the four insertion pins on the Quick Release mount. 2. Screw the knob onto the Quick Release post until finger tight. Setting Up the 3D Motor Stage (Optional) VisualSonics provides a 3D motor stage for customers who need to perform 3D volumetric measurements. The 3D motor stage connects to the Vevo Integrated Rail System III. The procedure for setting up the 3D motor stage is similar to setting up the RMV clamp. The 3D motor stage features a Quick Release post on the top to connect to the Vevo Integrated Rail System III, and a Quick Release mount on the bottom to affix the RMV clamp. 20 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

39 Chapter 2: Getting Started: Setting Up the 3D Motor Stage (Optional) Connecting the 3D motor stage to the Vevo Integrated Rail System III 1. Insert the Quick Release post (located on the top of the 3D motor stage unit) into the Quick Release mount located on the Rail System arm. Carefully line up the holes on the post with the pins on the Quick Release mount. Quick Release post 2. Tighten the knob on the Quick Release mount until finger tight. Quick Release mount 3. Connect the 3D motor cable to the DB-15 connector (labeled 3D Motor) on the rear panel of the Vevo 770 cart. 3D motor DB-15 connector Orienting the RMV scanhead As illustrated below, the long axis of the 3D motor stage must be aligned in the direction that the RMV scanhead travels during data acquisition. To adjust the orientation of the 3D motor stage: 1. Loosen the ball joint and rotate the 3D motor stage to adjust the 3D scan direction as necessary. Ball joint adjustment knob 3D motor stage Note: During 3D data acquisition, the RMV scanhead is physically moved. Ensure that the animal under the RMV scanhead is flat in relation to the 3D scan direction to prevent unintended contact with the animal as the RMV scanhead moves. 2. Connect the RMV clamp to the 3D motor stage. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 21

40 Chapter 2: Getting Started: Setting Up the 3D Motor Stage (Optional) Connecting the 700-series RMV scanhead to the 3D motor stage 1. Insert the Quick Release post on the RMV clamp into the Quick Release mount on the 3D motor stage unit. Rail mount RMV clamp RMV scanhead 3D motor stage 2. Tighten the Quick Release mount until it is finger tight. 3. Open the RMV clamp and secure the RMV scanhead by aligning the orientation ridge of the RMV scanhead with the hinge groove of the RMV clamp, as shown in the following illustration. 3D Motor Stage RMV scanhead orientation ridge Transducer (within the RMV scanhead). The direction of travel of the RMV scanhead along the 3D motor stage is perpendicular to the direction of the transducer (within the 22 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

41 Chapter 2: Getting Started: RMV Imaging Tips RMV scanhead) during image acquisition, as shown in the following illustration. 3D motor stage Direction of travel RMV scanhead Image slice Direction of travel transducer (within the RMV scanhead) 4. Close the clamp and push the latch down until it locks into place. RMV Imaging Tips Caution: Do not aggressively press the RMV scanhead into the animal. This may cause the acoustic membrane to deform, may damage the transducer, and may injure the animal. The acoustic membrane on the RMV scanhead is soft and extremely pliable. Positioning the imaging target at the focal depth may require movement of the RMV scanhead in the vertical direction. Maintain a mound of ultrasound gel at all times between the acoustic window and the animal being imaged to facilitate height adjustment. Acoustic Coupling Medium For proper acoustic transmission, use a layer of water-based ultrasound gel between the RMV scanhead and the animal. Do not use mineral oil or any oil-based coupling material because they may damage the RMV scanhead. To check the suitability of a particular coupling material for use with the RMV scanhead and for a specific application, please contact a VisualSonics Applications Specialist (support@visualsonics.com). V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 23

42 Chapter 2: Getting Started: Starting the Vevo 770 Caution: Do not immerse the RMV scanhead in acoustic medium beyond the fill port screw. The housing is watertight, but it is not waterproof. If the RMV scanhead is immersed beyond the fill port screw, the electrical safety features may be compromised. Do not immerse the RMV scanhead any further than just below the fill port screw. The boundary region is represented by the blue line in this illustration. Starting the Vevo 770 To turn on and start the Vevo 770: 1. Attach the RMV scanhead that will be used during the imaging session to the Vevo Turn on the computer using the computer standby switch. 3. Turn on the monitor. 4. Wait for the Windows XP operating system to start up. The system is configured by VisualSonics to automatically log in. If changes have been made to the user accounts, logging in to the system may be required. 5. The Vevo software should automatically launch. If not, double-click on the Vevo desktop icon or select: Start > All Programs > VSI > Vevo 770 > Vevo 770 V2.0.0 Note: If the system is not connected to a network, an error message may be displayed that indicates the connection is not found. This error message may be ignored without affecting system performance. This error occurs only when network drives have been mapped to logical drives on the Vevo 770. Main Power Switch The main power switch is located on the upper left corner of the system s rear panel. The system is ON when the switch is toggled to its upper position and OFF when the switch is toggled to its lower position. The end of the power cord is located beside the power switch. Note: VisualSonics recommends leaving the main power turned on. 24 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

43 Chapter 2: Getting Started: Starting the Vevo 770 Main power switch Note: For protection in case of electrical overload, this instrument uses a combination power switch/circuit breaker. If the circuit breaker has tripped (neither ON nor OFF), unplug the machine immediately and contact a Technical Support representative (support@visualsonics.com). Warning: Before connecting the main power cable, ensure that there is no damage to the cable, ensure that the cable has the correct connectors for the country in which it will be used, and ensure that the voltage setting matches the supply voltage. Failure to heed this warning could cause electric shock. Computer Standby Switch The Vevo 770 operates on an Intel -based computer that must be powered up after the main Vevo power switch has been activated. To power up the computer and the system electronics, toggle the computer standby switch once. Computer standby switch V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 25

44 Chapter 2: Getting Started: Starting the Vevo Software Note: Avoid toggling the computer standby switch during an imaging session with the Vevo 770. Close the current study before toggling the computer standby switch. Make sure the monitor is turned on. The monitor power switch is at the bottom right corner on the front of the monitor. Starting the Vevo Software To start the Vevo software: 1. In the Scanhead Selection dialog: a. In the Measurement Definition list, select the appropriate package, based on the package of measurement protocols you intend to use for the session. The list includes the following options: VisualSonics Abdominal Measurements VisualSonics Cardiac Measurements VisualSonics Embryology Measurements VisualSonics Standard Measurements (For more information, see Measurement Packages on page 153.) b. In the scanhead selection list, select the appropriate RMV scanhead. To view the properties of the selected RMV scanhead, click View Properties. (For more information, see Scanhead Selection on page 31). c. Click Initialize. To exit the software start-up process, click Cancel or press <Esc>. 2. If the Vevo software had not closed down properly during the previous session, the system attempts to recover the interrupted study. For further discussion on recovering an interrupted study, see Recovering a Study on page VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

45 Chapter 2: Getting Started: Exiting the Vevo Software 3. The Study Browser (see Study Browser on page 51) is displayed for selecting a study for analysis or for opening a new study for data acquisition. Exiting the Vevo Software To shut down the Vevo software: 1. Close the Data Browser, click Close Study or select Study > Close Study or press <Close>. Commit or discard the study as desired. 2. The Study Browser appears. Click Exit to exit the software. Shutting Down the Vevo 770 To turn off the Vevo 770: 1. After closing an open study, press the computer standby switch (located next to the DVD drive). The Windows Turn off computer dialog is displayed. 2. Click Turn Off. Windows begins the shut down process. Note: VisualSonics recommends shutting down the Vevo 770 computer at the end of each day. Note: If the standby switch was pressed inadvertently, click the Cancel button, or press the Esc key to return to the Vevo software. Disconnecting the RMV Scanhead To disconnect the RMV scanhead from the Vevo 770: Two RMV scanheads can be connected to the Vevo 770 at any one time. An RMV scanhead can be disconnected and changed without having to turn off the Vevo 770 system or shutting down the Vevo software. Note: When disconnecting the RMV, take care to pull on the cable cuff. Do not pull on the cable as this may damage the cable. To remove the RMV clamp from the mount on the Vevo Integrated Rail System III: Unscrew the knob on the Quick Release mount from the RMV clamp Quick Release post and gently remove the RMV clamp from the stationery mount. Removing the Acoustic Window To remove the acoustic window and empty the de-ionized water: 1. Disconnect the RMV scanhead from the Vevo 770 system. 2. Clean the acoustic window. The acoustic window may be reused as long as the acoustic membrane remains undamaged. 3. Place a dish under the RMV scanhead to collect the de-ionized water. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 27

46 Chapter 2: Getting Started: Storing the RMV Scanhead 4. Remove the fill port screw with the 1/4" slot screwdriver. Caution: Failure to remove the fill port screw will cause damage to the RMV scanhead. This damage is not covered by the warranty or the service contract. 5. Gently pry off the acoustic window with your thumbnail from either of the two overhanging corners. Do not attempt to pry off the acoustic window from another point along the edge, as this may cause damage. 6. Empty the de-ionized water from the nosepiece. 7. Let the nosepiece dry. Acoustic window Corner for prying off the acoustic window Nosepiece Note: Always empty the de-ionized water from the nosepiece when the imaging session is complete. Storing the RMV Scanhead The RMV scanhead may be stored in the RMV scanhead and gel holder attached to the side of the Vevo 770 cart. Place the RMV scanhead into the RMV scanhead and gel holder with the nose pointing downwards and with the cable directed toward the front of the cart. Use the spring-loaded cable holder to ensure that the cable does not get twisted when storing the RMV scanhead. RMV scanhead and gel holder Spring-loaded cable holder 28 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

47 Chapter 2: Getting Started: Physiological Data Support Always use the provided case to transport the RMV scanhead from one site to another. Follow these guidelines when storing the RMV scanhead in its case: Always store the RMV scanhead with the nosepiece cover attached. Always empty the de-ionized water from the nosepiece before storing. Make sure that the RMV scanhead is clean and dry before placing it in the case. Place the RMV scanhead in the case carefully to prevent kinking of the cable. Avoid storing the RMV scanhead in areas of extreme temperatures or in direct sunlight. Store the RMV scanhead separately from other instruments to avoid inadvertent damage. Physiological Data Support The animal's heart rate, temperature, respiration rate and blood pressure (optional with third-party blood pressure device) is tracked by the Physiological Controller Unit. The data from this system can also be monitored in the on-screen physiological monitoring display under the B-Mode, M-Mode, PW Doppler, Power Doppler, and Tissue Doppler windows within the Vevo software. The animal's ECG signal is captured through the electrode pads on the Animal Platform. The animal's temperature is monitored through the rectal probe connected to the Physiological Controller Unit. The animal's respiration rate is monitored through the electrode pads on the Animal Platform and is derived from the ECG signal. The animal's blood pressure can be monitored by a third-party blood pressure monitoring system such as a catheter pressure transducer or a tail cuff monitor. The signal is sent through the Physiological Controller Unit to the Vevo system and the pressure trace viewed on screen within the Vevo software. Note: Physiological data can be exported with the study data and integrated with the measurements and calculations. Animal Preparation Table Preparation Getting an ECG Signal Refer to the Vevo Integrated Rail System II Operator Manual. Refer to the Vevo Integrated Rail System II Operator Manual. The pads transmit the animal s ECG to a controller box. Connect the ECG cable to the controller box, and connect the keyed end of the cable to the front panel of the Vevo cart. Calibrating Blood Pressure Refer to Blood Pressure Calibration on page 229. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 29

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49 Chapter 3: Software Basics: Scanhead Selection Chapter 3: Software Basics This chapter describes the following fundamental concepts of the Vevo 770 software: Scanhead Selection (page 31) Study Browser (page 34) Mode Window (page 36) Scan/Freeze (page 40) Associating Data with a Study (page 40) Operator Preferences (page 42) System Hot Keys (page 45) Scanhead Selection The Scanhead Selection dialog is used to configure the measurements package and the RMV scanhead for the current session. It is displayed during the software start-up sequence (see Starting the Vevo Software on page 26). Measurements Definition Package List Measurements are grouped according to the following application packages: Abdominal imaging Cardiac imaging Embryology imaging Standard imaging V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 31

50 Chapter 3: Software Basics: Scanhead Selection Each package consists of specific study protocols. The protocol contains a set of predefined measurements related to the specific analysis, as described in the following table: Application Package Abdominal Measurements Package Included Protocols Liver Abdominal Aorta and IVC Spleen Gallbladder Kidney Adrenal Glands Pancreas Female Reproductive Mammary Glands Male Reproductive Generic Cardiac Measurements Package B-Mode M-Mode Aortic Valve Mitral Valve Tricuspid Valve Pulmonary Valve Tissue Doppler Vascular Generic Embryology Measurements Package Uterine Horn Placenta Generic 32 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

51 Chapter 3: Software Basics: Scanhead Selection Application Package Standard Measurements Package Included Protocols Simpson s LV Mass Epicardial Endocardial Insufficiency Parasternal Short Axis Parasternal Long Axis Apical, 2 Chamber Apical, 3 Chamber Apical, 4 Chamber Apical, 5 Chamber Embryonic Kidney Liver Fetal/Maternal Blood Flow Generic The Measurements Tool window for each imaging mode includes online help that describes the measurements and calculations for each protocol. (For more information, see Measurement Packages on page 153.) Scanhead List The scanhead list provides information about the installed RMV scanhead files. The following parameters describe the function of the RMV scanhead selected in the scanhead drop-down list: Notes Frequency F-Number Focal Length This area contains any notes that are particular to the RMV scanhead. A descriptive note of the RMV scanhead is provided. The center frequency of the transducer The ratio of focal length to aperture of the transducer The focal length of the transducer Select the RMV scanhead required from the drop-down list and click Initialize. This loads the parameter settings that are specific to the selected RMV scanhead. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 33

52 Chapter 3: Software Basics: Study Browser Study Browser The Vevo 770 opens by loading the Study Browser, which contains a list of the studies on the system. Menu Operator selection Study Browser selections Study information Storage Capacity The Study Browser contains a list of studies that have been acquired and/or analyzed by one or more operators. Study Browser Menu The Study Browser includes the following menus: Edit Click Operator Preferences to set study parameters. See Operator Preferences on page 42. Click Configure Text Annotations to edit or add text labels. See Text Annotations on page VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

53 Chapter 3: Software Basics: Study Browser View Select Message Log to toggle the display of the message log window. See Message Log on page 215. The study browser displays the list of saved studies which can be sorted by study name, acquisition operator, study owner, study date, animal ID or notes. The Study ID is a unique identifier for a study. Select Group By > Study ID to group all copies of the same study together under the same heading. Select Measurements to display or hide the measurements placed on the images and loops stored on the system. Select Annotations to display or hide the annotations placed on the images and loops stored on the system. Select View ECG to display or hide the ECG trace. Select View Respiration to display or hide the respiration trace. Select Invert Respiration to flip the standard respiration trace. Select View Blood Pressure to display or hide the blood pressure trace. Select View Blood Pressure Derivative to display or hide the blood pressure derivative trace. Select View Physiology to display or hide the physiological data display. Setup Choose Select Scanhead or press <Select Scanhead> to open the Scanhead Selection dialog. Use this option to view the scanhead properties or to change the RMV scanhead in use. Help Select About VisualSonics Vevo 770 to display a message box with information about the system and software version. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 35

54 Chapter 3: Software Basics: Mode Window Select Quick Start Guide or press <Help> to review general study acquisition instructions. Select Available Calculations or press <Shift+Help> to review a list of available measurements and calculations. Additional Features See Study Browser on page 51, for information on study management features. See Data Browser on page 143, for information on data management features. Mode Window The mode window displays data for a selected study. It can be accessed in one of two ways from the Study Browser: Select a study name and click Open from the Study Browser selections to open the Data Browser. Select a specific item within the study and click Load. Select a study name and double-click a thumbnail image to review a specific image or loop in the study. Menu RMV scanhead Orientation Marker Image area Frame header Mode display The mode window in B-Mode Mode Window Menu The mode window includes the following menus: 36 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

55 Chapter 3: Software Basics: Mode Window Study Click Close Study or press <Close> to close the study and commit or discard the study data. Click Browse Study or press <Browse> to view the Data Browser. Click View Study Information to open the study information dialog. See New Study on page 52 for more information. Export features allow operators to save files in the selected file format to a specified location. Refer to Export on page 145 for more details. Click Export Report to save a copy of the measurements and calculations for the study to a comma-separated values (CSV) file. Click Export Image or press <Export> to save a copy of the full screen or image only portion of the screen to a BMP or TIFF file. Click Export Cine Loop to export the current loop as an AVI (video) or WAV (audio) file. Note: Images and cine loops can be exported as RDB (raw image data) files. For more information, contact a Technical Support Representative (support@visualsonics.com). Storage features allow operators to store images or cine loops during the study. Images are not saved unless the entire study is committed. See Associating Data with a Study on page 40 for more details. Frame Store adds the current frame to the study, or re-saves a frame that has already been stored. Cine Store adds the current loop to the study, or re-saves a loop that has already been stored. Mode To start and stop data acquisition, select Mode > Freeze. For more information, see Scan/Freeze on page 40 more details. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 37

56 Chapter 3: Software Basics: Mode Window Select the mode (B-Mode, Doppler Mode, M-Mode, 3D-Mode, Power Doppler Mode, Tissue Doppler Mode, or Digital RF-Mode). The system dims the current mode label and adds a check mark. Edit Select Operator Preferences to set study parameters. For more information, see Operator Preferences on page 42. Select Configure Text Annotations to edit or add text labels. For more information, see Text Annotations on page 197. Select Image Label to apply a text label to the current image. Tools Menu Select Measurements to toggle the display of the measurements tool. For more information, see Measurements on page 153. View Select Message Log to toggle the display of the message log window. See Message Log on page 215. Select Measurements to display or hide the measurements placed on the images and loops stored on the system. Select Annotations to display or hide the annotations placed on the images and loops stored on the system. Select Cine Loop Range to toggle the range control on and off in B-Mode. 38 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

57 Chapter 3: Software Basics: Mode Window Select Caliper Options and then select one of three available caliper types from the submenu. Select View ECG to display or hide the ECG trace. Select View Respiration to display or hide the respiration trace. Select Invert Respiration to flip the standard respiration trace. Select View Blood Pressure to display or hide the blood pressure trace. Select View Blood Pressure Derivative to display or hide the blood pressure derivative trace. Select View Physiology to display or hide the physiological data display. Overlay The Overlay menu is available in B-Mode and Power Doppler Mode. It allows the operator to select from the available wire-frame overlays. Sample Volume wire-frames are used to locate an appropriate sampling region for the PW Doppler, Tissue Doppler, and M-Mode ultrasound images. The Needle Guide wire-frame is used to visualize the alignment of a needle with an injection target for image-guided injection procedures. The Power Box Wire-Frame is used to locate the appropriate sampling region for the Power Doppler Mode image acquisition. Setup The Setup menu accesses: a. The current mode s editable setup fields. b. The Scanhead Selection dialog. Help The About VisualSonics Vevo 770 selection displays information about the system and the software version. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 39

58 Chapter 3: Software Basics: Scan/Freeze Select Quick Start Guide or press <Help> to review instructions regarding general study acquisition. Select Available Calculations or press <Shift+Help> to review a list of measurements and calculations used by the Vevo 770. Note: Press <Alt> to access the menu using quick keys. Quick keys are also available in many of the software dialogs. Access frequently used software functions via the keyboard hot keys. Refer to Hot Keys on page 239 for a list of these functions. Mode Window Header The mode window header is divided into four sections to provide information about the study and the current system state. The mode window header A B C D VisualSonics logo Institution (operator-defined) Operator (operator-defined) Study Name Animal ID Image label System mode Frame status Loop status Acquisition date Acquisition time Study state Mode Display The mode display area of the mode window displays the data image, system parameters, the physiological data and the controls for the selected imaging mode. Refer to the figure The mode window in B- Mode on page 36. Scan/Freeze The Scan/Freeze function (select Mode > Freeze or press <Scan/Freeze>) starts and stops image acquisition. This function can be toggled to quickly control the acquisition of data with the Vevo 770. When the system is inactive (no data is being acquired), a check mark appears beside the Freeze option in the Mode menu and System Paused is displayed in the mode window header (see The mode window header on page 40). When the system is actively acquiring data, System Active is displayed as the study state to indicate that image data is being acquired. Modes can be changed (for example, from B-Mode to M-Mode) without pausing data acquisition. If the Auto UNFREEZE on Mode Entry parameter is enabled in the Operator Preferences dialog, data acquisition begins automatically once the mode change is complete. Associating Data with a Study Frame Store To store a frame: Select Study > Frame Store or press <Frame Store>. The current screen contents are stored with the study as a single image frame. If the current frame has already been stored, it is re-saved. 40 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

59 Chapter 3: Software Basics: Associating Data with a Study Cine Store To store a cine loop: Select Study > Cine Store or press <Cine Store>. The loop that is displayed is stored with the study. If the current cine loop has already been stored, the system saves it again. If the data is not stored, it is lost when the next acquisition is made or when another cine loop or image is loaded for analysis from the Data Browser. If Cine Store is activated while the system is acquiring data: Data acquisition stops The cine loop is stored to the study. The data buffer is cleared and data acquisition resumes. To save a 3D image to the Study Browser: Press <Frame Store> or select Study > Image Store. If the current image has already been stored, the system resaves it. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 41

60 Chapter 3: Software Basics: Operator Preferences Operator Preferences The Operator Preferences dialog (select Edit > Operator Preferences) is used to define study parameters. Preferences can be saved as parameter files for specific operators or study types. 42 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

61 Chapter 3: Software Basics: Operator Preferences Operator Information The following parameters are applied to every study session for any operator or settings selected: Institution Default Save Directory The Institution is displayed beneath the VisualSonics logo in the main window. If this parameter is left blank, nothing is displayed. The folder into which files are saved by default. Click Browse to select a new default directory. The Default Save Directory is used when exporting data from the software. Default Cine Loop Size (in frames) Sets the maximum size that can be used during a B-Mode or PW Doppler Mode imaging session. The default setting for both modes is 300 frames. To ensure that the system will select the longest available cine loop size, check the Max box. Parameter Settings It is possible to save and recall a parameter file. VisualSonics recommends that parameter settings be saved for each type of application that the Vevo 770 is used for. By using application-specific parameter files, settings are consistent for every study. To save parameter settings: 1. Specify the settings required in the applicable modes. 2. Click Save Custom or press <Save> when the Operator Preferences dialog is not displayed. 3. A dialog appears. Choose the file name and location where the parameter file should be saved. 4. Click Save to save the parameters. Note: All parameter settings are saved, including the Measurement Property settings. To restore previously saved parameter settings: 1. Click Recall Custom, or press <Ctrl+P> or press <Load> when the Operator Preferences dialog is not open. 2. A dialog appears. Select the file from which parameters are loaded. 3. Click Open to recall the selected parameters. To restore the parameter settings to their start-up values: Click Reset Defaults, or press <Ctrl+Shift+P> when the Operator Preferences dialog is not open. The system parameters are reset to their default values based on the active RMV scanhead. Store the current data to the study before loading system parameters via Recall Custom or Reset Defaults to ensure that no data is lost. When system parameters are loaded, the current acquisition mode clears the V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 43

62 Chapter 3: Software Basics: Operator Preferences previously acquired data from the buffer and restores the current mode to its start-up state. Mode Options The following mode options are available. Auto UNFREEZE on mode entry When this box is checked, the system automatically begins data acquisition immediately after switching to a new mode. This box is checked by default. Note: This parameter applies to all imaging modes except 3D-Mode. Auto SAVE on Image Label By default, this box is cleared. When selected, the system will automatically save an image when a label is applied. To save the label with the current frame, instead of with the full cine loop: 1. Select Auto SAVE on Image Label. 2. In the Image To Auto SAVE list, select Current Frame. Auto SAVE Pre-Triggered Cine Loop By default, this box is cleared. When selected, the system automatically saves a cine loop that is acquired by pre-triggering. Measurements and Calculations Measurement Display Options This parameter indicates the name and version of the active measurements and calculations file. This file contains the measurements and calculations that are available in all modes. Use the options in the tree control to select the values to be displayed when placing generic measurements on an image. When analyzing the study by placing generic measurements on an image, only the selected options are displayed. Use the Show View Name check box and the Show Embryo Index check box to specify whether to include view and embryo information in measurement labels for predefined and generic measurements. Physiological Data Available Set the physiological data values that are available for acquisition and display. The following physiological data are available: ECG Respiration Temperature Blood Pressure Note: If a blood pressure source is not connected, ensure that the Blood Pressure check box is cleared. If the option is selected, the system will record noise on the channel. Further, if any of the physiological data signals are not available, ensure that the corresponding check box is cleared. 44 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

63 Chapter 3: Software Basics: System Hot Keys System Hot Keys Hot keys are mapped to the keyboard, the three-switch foot pedal and the remote keypad (optional). The layouts are shown in the following diagrams. Keyboard Layout Pre Trig Select Scanhead Mode Setup EKV TM 3D B-Mode M-Mode PW Power STUDY MANAGEMENT SETTINGS Esc Help New Browse Close Delete Export Save Load Image Label F10 F11 F12 PRTSC PAUSE BREAK PAN SECTOR X SECTOR Y WINDOW ANGLE # $ % ^ & * ( ) _ = BACKSPACE HOME Overlay TAB Q W E R T Y U I O P { [ } ] \ PG UP FREQ FOV SV BASELINE Toggle Scout CAPS A S D F G H J K L : ; ENTER PG DN GAIN VELOCITY Measure Annotate SHIFT Z X C V B N M <, >.? O+ Shift / END Frame Store Cine Store CTRL ALT ~` FN INS DEL O- Scan/ Freeze Foot Pedal Layout Frame Store Scan Freeze Toggle Scout Auxiliary Keypad Layout B-Mode PW Doppler M-Mode Power Doppler Velocity Baseline Angle SV Velocity Baseline Angle SV Overlay FOV Cine Store Browse Study Toggle Scout FOV Frame Store Scan Freeze For a complete description of all hot key functions, see Appendix F: Hot Keys on page 239. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 45

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65 Chapter 4: Study Management: Typical Study Session Chapter 4: Study Management The Vevo software provides the flexibility to both acquire image data and analyze the data in post-imaging analysis. Data that is acquired with the Vevo 770 is organized into studies. Each study is a collection of image data and its associated measurements, calculations, annotations, and physiological parameters. The Vevo software provides the ability to: 1. Organize measurements, annotations and calculations, and parameters. 2. Organize the studies that have been stored on the system. 3. Browse and analyze study data that has been previously acquired. 4. Export data for presentation, publication, statistical analysis, etc. 5. Capture, associate and save physiological data. Two types of study sessions are available: Acquisition and review (or analysis) as described in the following table: Acquisition Review Data is acquired and analyzed for a study. Existing data in a study is opened for further analysis or measurement. New data for the study cannot be acquired. Typical Study Session Typical Acquisition Session When a new study is created, the software is in acquisition mode for acquiring and analyzing data. If an existing study is opened, the software is in a review session allowing analysis and measurement of the data stored in the study. A typical acquisition session would be performed as follows: 1. Prepare the animal for imaging. Contact a VisualSonics Applications Specialist if help is required when preparing an animal (support@visualsonics.com). 2. Prepare the RMV scanhead: a. Attach an RMV clamp to a stationary mount and connect the RMV scanhead to the clamp, or prepare for freehand scanning b. Connect the RMV scanhead to the Vevo 770 (see RMV Scanhead Preparation on page 17) 3. Turn on the Vevo 770 (see Starting the Vevo 770 on page 24) and start the Vevo software (see Starting the Vevo Software on page 26). 4. Select the appropriate scanhead and click Initialize. 5. Select an operator from the drop-down list or create a new operator. 6. Select the study type from the Study Browser: V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 47

66 Chapter 4: Study Management: Typical Study Session Click New to create a new study. Enter the study information in the New Study dialog. Click Study Again to create a new study using information from a selected study. Click Quick Study to start acquiring images with default study information. 7. Start imaging and acquiring data in the desired mode (B-Mode, PW Doppler Mode, M-Mode, 3D-Mode, Power Doppler Mode): To acquire B-Mode data, see B-Mode Imaging on page 65. To acquire 3D-Mode data, see 3D-Mode Imaging on page 81. To acquire PW Doppler Mode data, see PW Doppler Mode Imaging on page 101. To acquire M-Mode data, see M-Mode Imaging on page 125. To acquire Power Doppler Mode data, see Power Doppler Mode on page 135. To acquire Tissue Doppler, see Tissue Doppler Mode Imaging on page Store the desired data: To store a cine loop, select Study > Cine Store or press <Cine Store>. To store a frame, select Study > Frame Store or press <Frame Store>. To store a 3D image, select Study > Image Store or press <Frame Store>. 9. Analyze the data: To make measurements, see Measurements on page 153. To annotate the images, see Text Annotations on page Review the data: To review measurements and calculations, see Data Browser on page 143. To export stored or acquired data, see Export on page Save the study: To close the study, select Study > Close Study, press <Close> or click Close Study from the Data Browser, and click Commit Session Data. To copy the study to a storage location, from the study browser click Copy To and select a target drive or storage device. 12. Click Exit to close the application. 13. Clean the RMV scanhead. 14. Return the animal to its cage and monitor it until it regains consciousness. 48 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

67 Chapter 4: Study Management: Operators Note: VisualSonics recommends powering down the Vevo 770 using the computer standby switch at the end of each day. Typical Review Session A typical review session would be performed as follows: 1. Turn on the Vevo 770 (see Starting the Vevo 770 on page 24) and start the Vevo software (see Starting the Vevo Software on page 26). 2. From the Study Browser, select a study to review. Select an operator, then click Open to open the study and analyze the acquired data. 3. Select which data item to view using the Data Browser. 4. Add measurements and calculations: To add measurements to the study data, see Measurements on page 153. To add annotations to the study data, see Text Annotations on page 197. Note: When attempting to make changes to a study that is not owned by the current operator, the operator is prompted to open a copy of the study. Changes are applied to that copy of the study. 5. To review calculations that are based on measurements, refer to Data Browser on page To export the data, see Export on page To save the study select Study > Close Study, press <Close> or click Close Study from the Data Browser, and click Commit Session Data. 8. To copy the study to a storage location, click Copy To and select a target drive or storage device. 9. Click Exit to close the application. Note: VisualSonics recommends powering down the Vevo 770 using the computer standby switch at the end of each day. Operators Only one operator can own a particular copy of a given study. An operator can add information to a study by acquiring data and making new measurements and annotations to that data, or by analyzing previously acquired data and making measurements and annotations. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 49

68 Chapter 4: Study Management: Operators Opening a Study Owned by Another Operator To open a study owned by another operator: 1. From the Study Browser, double-click the study. The system displays the following Identify Study Owner dialog. 2. Select the appropriate ownership option. If you want to review the study or if you want to add to, or modify the other operator s existing measurements, select the first option: Continue to review this study? If you intend to review the study and make your own measurements in the study, select the second option: Create your own copy of this study and open it? The system creates a copy of the study in your name, with the same date as the original, and deletes all measurements made by the original operator. Closing a Study Owned by Another Operator If you have not modified the study in any way, the system closes the study immediately, with no prompts. To close a study that you have opened for review and modified: 1. From the mode view, click Study > Close Study. The system displays the following Identify Study Owner dialog. 2. Select the appropriate ownership option. If you have modified the study in any way, and want to store the changes you have made, select the first option: Create your own copy of the study? The system creates a copy of the study in your name, with the same date as the original, and stores all measurements made by you and by the original operator. If you do not want to store any changes, select the second option: Discard session and exit? The system closes the study and stores only the measurements made by the original owner. 50 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

69 Chapter 4: Study Management: Study Browser To view and make changes to the list of available system operators: 1. Click Add Operator from the Study Browser. 2. To add a new operator, click New. 3. Enter the name of the new operator in the Name field. 4. Click OK to add the name to the list. To edit an operator name, select an operator from the list and click Edit. Make changes in the Name field and click OK to update the list. If the operator edits the name of the current operator, the change is reflected within the open study. To delete an operator, select an operator from the list and click Delete. The operator is asked to confirm the action. Note: You cannot delete the owner of the current study from the list. Study Browser The Study Browser allows the operator to view a list of the studies that are stored on the system. The Study Browser is automatically displayed when the software starts and when a study is closed. From this dialog, the operator can: Make changes to the operator list. Create a new study. Open a pre-existing study for analysis. Copy a study from the Vevo 770 to another storage location. Copy a study from another storage location to the Vevo 770. Export a measurement report. Delete a study from the system. Exit the Vevo software. See Software Basics on page 31 for a review of the screen sections. Study List The study information section of this window contains a list of the acquired studies. The list can be sorted by study name, acquisition V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 51

70 Chapter 4: Study Management: Study Browser operator, study owner, study date, animal ID or notes by clicking the column heading. Study list sorted by Owner. Clicking the Study Name column heading sorts the list by study name. The list of studies can also be grouped using the Study ID. The Study ID is a unique identifier assigned to every study. Select View > Group By > Study ID to group studies and copies of studies by their Study IDs. Thumbnail Images When a study is selected in the study list, thumbnail images of the study data are displayed in the right side of the window. Use the scroll bar on the right side of this window to scroll through the thumbnails of the entire study. Quick Study The Quick Study button starts a study without requiring study information to be defined first. Study information can be modified any time during the study session by selecting View Study Information from the Study menu, or by selecting Study Info in the Data Browser. If no operator has been selected for the study, the study cannot be committed. The Operator and the Study Name can be changed during the acquisition in the Study Information dialog (see Viewing Study Information on page 61). A new acquisition session always starts in B-Mode. New Study Click New or press <New> to open the New Study window. The Current Operator and Study Name are mandatory fields in this window. Three tabbed pages: Animal, General and Custom, can be used to provide additional information or notes about the study. New Study window 52 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

71 Chapter 4: Study Management: Study Browser Animal Information This page contains fields used to identify the animal being studied, such as animal weight, age, sex, pregnancy state, etc. Animal Information page General Information This page can be used to describe the anesthetic type, protocol and injection details. General Information page V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 53

72 Chapter 4: Study Management: Study Browser Custom Information This page provides six custom fields. The field values can be used for any type of custom study identifier, for example, the name of the assisting operator. Custom Information page Study Notes The New Study window also contains a large text field (Study Notes) that can be used to enter comments and observations about the study. Fill in the Granting Institution field to identify the organization funding the study. This study information can also be edited during a study by using the Study Information window. See Viewing Study Information on page 61. A new acquisition session always starts in B-Mode. Open Study Again The Open button starts a review session to analyze previously acquired data. During a review session, no new data can be acquired but measurements and annotations can be added to the study by the owner of that study. The Study Again button starts a new study using some of the study information from the selected study. The New Study window is displayed with study information from the original study already filled in. Enter a new Study Name and specify the Current Operator. A new acquisition session always starts in B-Mode. 54 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

73 Chapter 4: Study Management: Study Browser Copy To You may copy a study to another Vevo 770 or to another storage location. Copy to window. To copy a single study to another location: 1. Select the study to be copied, and select Copy To in the Study Browser. 2. In the dialog that opens: a. Select the destination directory for the copy operation. b. Specify a name for the study, or use the default name in the Save As field. c. Click OK. The study is copied to a sub-directory beneath the selected destination directory, with the specified name. Note: It is possible to create new destination folders from the Copy to dialog if necessary. To copy several studies to another location: 1. Select the studies to be copied, and select Copy To in the Study Browser. 2. A dialog opens. Select the destination directory for the copy operation, and click OK. Each study is copied to its own subdirectory, beneath the selected destination directory. When copying multiple studies, the system automatically creates a folder name for each study, using the Study Name, Animal ID, Study Date, and Operator Name of the owner of that copy of the study. When copying single or multiple studies: If the copy operation could overwrite studies that already exist in the destination directory, an Overwrite existing files check box appears. If V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 55

74 Chapter 4: Study Management: Study Browser this check box is checked, all selected studies are copied, and studies that exist in the destination directory are overwritten during the copy operation. If the check box is not checked, only those studies that will not overwrite existing studies are copied. The operator is notified if the copy operation cannot be performed (for example, due to space limitations at the destination location). Following the completion of a copy operation, a message is displayed to confirm the studies that were successfully copied and identify any that were not. The operator has the option of deleting studies from the Study Browser as they are successfully copied to another destination. To choose this option, select the Automatically delete unlocked studies after copying check box. If the operator chooses this option, it is applied only to studies that are not locked. Copy From Use this command to copy studies acquired on another Vevo 770 or from another storage location. To copy a study from another location: 1. Click Copy From. A dialog opens in which the operator may browse local drives, removable media, and network locations for studies. If a folder contains a study, a check box is displayed. 2. Click the check boxes next to studies to be copied and click OK. If the copy operation would overwrite studies that already exist in the Study Browser, the system displays an Overwrite existing files check box. If this check box is checked, only those studies that are unlocked are overwritten during the copy operation. If the check box is not checked, only those studies that will not overwrite existing studies are copied. The operator is notified if the copy operation cannot be performed (for example, due to space limitations at the destination location). If any Vevo 660 studies are included in the set of copied files, the system displays the Vevo 660 Studies Found dialog. Click OK. The system converts the Vevo 660 files to Vevo 770 format. Following the completion of a copy operation, a message is displayed to confirm that the studies that were successfully copied and identifying any that were not. The imported studies will appear in the study list. If the operator who owns the imported study is not already on the operator s list, the 56 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

75 Chapter 4: Study Management: Study Browser system adds the operator to the operator s list and adds the label (imported) to the operator s name. 3. Select VSI Individual Report File as the report type. Exporting Reports The operator can create report files that list all measurements and calculations created in the study, and the physiological data that is associated with the images in the study. These reports are generated as comma-separated values (CSV) files, which can be loaded into thirdparty analysis tools. To export reports as individual files: 1. Select the studies for which reports are to be created. 2. Click Export Report. 3. Select VSI Individual Report File the report type. 4. Select a destination directory and click OK. A separate CSV report file is created for each study that was selected. A file name is created automatically for each, using the Study Name, Animal ID, Study Date, and Operator name. The report file contains the measurements that were made on images in the study, and their resulting calculations. The instance number of each measurement is displayed at the top of the measurement columns for convenient referencing to the original measurement Average value and standard deviation of each named measurement If the operator selects to export a report for a single study from the Study Browser, the operator can specify a file name for the report file. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 57

76 Chapter 4: Study Management: Study Browser Exporting a Report From Multiple Studies To export a report from multiple studies to a combined file: 1. From the Study Browser, select the reports to export, and click Export Report. To select multiple studies, press Ctrl and select an item in the list. 2. In the Export Reports To window: a. In the directory explorer, select the directory destination for the report. b. In the Save As field, type the name of the report. c. If it is important to include the measurement instances in addition to the average value and standard deviation of each instance of a named measurement, which is included by default, select the Export measurement instances check box. d. In the Report Type field, select the appropriate report type. To export multiple studies as a single file, select VSI Combined Report File (*.csv). This is only available if all selected studies use the same protocol based measurement package. e. Click OK. The system displays a progress bar as it creates and stores the report. 58 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

77 Chapter 4: Study Management: Study Browser To review the combined report, open the CSV file in a spreadsheet or database application. Data in a combined report is organized by protocol. Locking and Deleting Studies Locking studies When a study is locked, it cannot be deleted until it is unlocked. If only locked studies are selected, the Delete button is not enabled. If multiple studies are selected, and some of them are unlocked, only unlocked studies are deleted when the operator performs a Delete operation. To lock a study, select the studies to be locked and click Lock. Each locked study is displayed in the Study Browser with an asterisk next to it. Click Unlock to unlock selected studies. Deleting studies The Delete command permanently removes a study from the system. Note: A deleted study cannot be recovered. To delete one or more studies, select the studies to be deleted, and click Delete. A confirmation dialog is displayed, containing a warning that the information is permanently inaccessible when the study is deleted. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 59

78 Chapter 4: Study Management: Study Browser The Vevo 770 is able to keep track of which studies have been copied to another location. When deleting studies, if the Vevo determines that the study to be deleted has not yet been copied, the operator can select the Delete uncopied studies check box to include that study in the delete operation. VisualSonics recommends deleting studies that have been copied to an external storage location, to help create more storage space for future studies. Exit Current Operator Select Exit to close the Vevo 770 software. The Study Browser includes a list of defined operators and a button to add new operators to the list. An operator does not have to be selected before a study can be created or opened, but an operator must be selected if the acquired data is to be saved or measurements and annotations are to be added to an open study. See Operators on page 49 for details on how to add an operator to the operator list or edit an operator name in the list. Study Storage Capacity The Storage Capacity indicator in the Study Browser indicates the amount of storage space that is available on the system. VisualSonics recommends that the operator regularly copy studies to the network, to removable media, or to another workstation to maintain sufficient storage space on the Vevo 770. After studies are copied to another location, they may be deleted from the Vevo 770 to free space for future studies. Sufficient storage capacity for a study is meant to be a guideline of the typical amount of data that is stored within a given study. The amount of space required by a study depends on the amount of data stored in the study. Currently, no maximum size for a study exists. A typical study is estimated to require 3 GB of storage capacity. Such capacity could store a study that contains: 10 typical B-Mode cine loops (120 Megabytes is typical but this can range from 10 to 500 MB depending on sector size) 10 full PW Doppler cine loops (30 seconds each; 5 Megabytes) 10 full M-Mode cine loops (30 seconds each; 65 Megabytes) 10 full 3D-Mode images (500 slices each; 12 Megabytes) 5 typical Power Doppler Mode cine loops (300 frames each; 120 Megabytes) 5 full Tissue Doppler Mode cine loops (30 seconds each; 5 Megabytes) 60 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

79 Chapter 4: Study Management: Viewing Study Information 500 measurements and annotations 200 B-Mode frames (2.5 Megabytes) Before a new study is created or an existing study opened, the system checks for sufficient storage space for the study. The operator is notified if there is insufficient space to proceed with the selected operation. Viewing Study Information The Study Information window displays the operator-specified general information about the study (select Study > View Study Information). This window contains the same fields found in the New Study window. The fields may have been filled in during a new study setup or they may be blank if Quick Study was used to start the study (see New Study on page 52). Closing a Study Close the study to store all the information gathered (data, measurements, annotations) during the study session. To close a study, click Close Study or press <Close>. A message box appears with three options: Commit Session Discard Session Cancel (Keep Session Open) This option saves and stores the acquired data, measurements, calculations and annotations from the session. This option permanently discards all information (data acquired during the session and/or any measurement and annotations made on the data) associated with the current session. This operation must be confirmed in a separate confirmation message. This option returns to the study. Pressing <Esc> also returns to the study. Note: The system dims the Commit Session command if an operator was not selected. The study cannot be saved if no operator has been selected. Recovering a Study During system initialization, the software checks for any interrupted studies. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 61

80 Chapter 4: Study Management: Hot Keys If an interrupted study is detected, three options are presented: Commit Session Data Discard Session Data Continue Session This option commits data from the interrupted session and close the study. This option is recommended if the interrupted study session was started by a different operator. This option discards data from the interrupted session and close the study. This option continues the interrupted study session. If the interrupted study session was an acquisition session, data acquisition can be continued. If the interrupted study session was a review session, the session opens for continued data analysis. Note: If Continue Session is selected, the original operator is reinstated. If the software detects an interrupted study that it is unable to recover, the study can be continued in its last known state. To restore previously saved parameter settings: 1. From any window, press <Ctrl+P> or <Load>. 2. In the Recall Parameters dialog, browse to the appropriate saved VSI parameter file. 3. Click Open. To reset the parameter settings to their default system values: Press <Ctrl+Shift+P>. The system parameters are reset to their default values. Hot Keys Various elements of study management may be accessed via hot keys on the keyboard and the optional keypad. The following chart details the hot key functions during acquisition: Function Toggle scanning on/off Store image frame Store cine loop Change to B-Mode Change to PW Doppler Mode Change to M-Mode Change to 3D-Mode Change to Power Doppler Mode Hot Key Scan/Freeze Frame Store Cine Store B-Mode PW M-Mode 3D Power 62 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

81 Chapter 4: Study Management: Hot Keys Function Change to EKV acquisition on/off (from B-Mode) Change to Tissue Doppler Mode Toggle the Study Browser on/off Toggle Mode Setup on/off Close the study Hot Key EKV Tissue Browse Mode Setup Close V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 63

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83 Chapter 5: B-Mode Imaging: Fundamentals Chapter 5: B-Mode Imaging B-Mode imaging allows the acquisition of two-dimensional images and cine loops. This mode is often used to determine the location of areas of interest for measurements in M-Mode and PW Doppler Mode. The following illustration describes the features of the mode window in B-Mode. The line in this icon corresponds to the orientation ridge on the RMV scanhead and indicates the orientation of the RMV scanhead relative to the image. B-Mode ultrasound image window. To toggle between the basic and detailed display parameters views, click Details or press <Ctrl+D>. The grayscale bar indicates the dynamic range of the display. Cine loop playback controls. See Playback Controls on page 76. Physiological Data trace. The cine loop range control slider defines a subset of the cine loop to be played back or saved. See Cine Loop Range on page 77. The time-gain compensation (TGC) sliders specify the receive gain to be used for acquiring different sections of a B-Mode image. See Time- Gain Compensation (TGC) on page 78. The depth ruler indicates the depth from the transducer face. The triangular arrow indicates the focal length of the transducer. Fundamentals To enter B-Mode: Select Mode > B-Mode or press <B-Mode>. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 65

84 Chapter 5: B-Mode Imaging: Setting Up B-Mode Setting Up B-Mode To set the parameters for B-Mode: 1. Select Setup > B-Mode Setup or press <Mode Setup>. 2. The B-Mode Setup fields are displayed to the left of the image window. Set the values for the desired parameters. The B-Mode Setup fields may be kept on the screen while the system is acquiring data to dynamically change the parameter settings. The parameters that cannot be modified during data acquisition are grayed out. Some parameters cannot be modified when data acquisition is paused. B-Mode Setup Parameters Note: Acquisition-specific parameters cannot be changed in a review session. Transmit settings Power Set the power of the transmit signal by selecting a value between 3% and 100%. Step Attenuation (db) Power (%) Note: Power includes sixteen available values between 3% and 100%. Each step represents a single db decrement of attenuation, which is inversely related to the power. 66 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

85 Chapter 5: B-Mode Imaging: Setting Up B-Mode RF Cycles The number of cycles output by the transmitter. The default setting is 1 cycle. Acquisition Settings Depth Sector Size The distance between the top of the image and the transducer face. The depth is set by default to vertically center the transducer focal length on the image. The size of the acquired image. Sector size can be adjusted in either the X or the Y axis of the image. Note: The frame rate increases when the sector size in the X-axis is decreased. Field of View The field of view is related to the sector size and indicates the size of the widest sector. If the field of view is set to a smaller size than the widest sector, the sector size is changed accordingly. Note: The frame rate increases with a small field of view or a smaller sector size in the X-axis. Frame Rate Frame rate is the target rate at which the images are acquired in real-time. A relative frame rate can be set from Min to Max. The acquisition frame rate is determined by the relative frame rate setting, the RMV scanhead, the field of view, and sector size. The rate is displayed in the B-Mode Setup dialog. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 67

86 Chapter 5: B-Mode Imaging: Setting Up B-Mode Display Settings Contrast Brightness Adjusts the contrast of the grayscale. Adjusts the brightness of the grayscale. 3D Settings Range Step size Defines the distance, in millimeters, that the 3D motor moves over the target area during acquisition. Defines how far the 3D motor stage is to move between each B-Mode slide acquired. (Step sizes can be a minimum of 0.01 mm.) Note: The smaller the step size, the more B-Mode slices are acquired, creating a more accurate, detailed 3D image. Each 3D acquisition is limited to a maximum of 500 slices. EKV (ECG-based kilohertz visualization see EKV Reconstruction on page 71) Settings Quality Sets the level of the EKV acquisition quality. Note: Higher quality corresponds to a higher resolution. This level takes longer to acquire. Hot Keys If the operator presses a hot key when the system is acquiring data, the software, where necessary, automatically freezes the acquisition, updates the appropriate parameters, and then resumes acquisition. If the value of the parameter is at the upper or lower limit when the associated hot key is pressed, the system does not change the parameter value, with the exception of the <FREQ> hot key, which continues to cycle through available values. The following table provides the step sizes for the hot key functions: Parameter Hot Key Step Size Gain (Coarse) GAIN 5 db (this can be seen by the movement of the TGC sliders) Gain (Fine) Shift + GAIN 1.0 db (this can be seen by the movement of the TGC sliders) 68 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

87 Chapter 5: B-Mode Imaging: Typical B-Mode Image Acquisition Parameter Hot Key Step Size Field of View FOV 1x1, 2x2, 4x4, 6x6, 8x8, 10x10, 12x12, 16x16, 20x20, largest available (may be constrained at the upper or lower end of the range, depending on the RMV scanhead being used) Sector Size X-axis SECTOR X 1mm (Change sector in the X-axis) Sector Size Y-axis SECTOR Y 1mm (Change sector in the Y-axis) Depth (Coarse) PAN 1 mm Depth (Fine) Shift + PAN 0.1 mm Sample Volume Size (M-Mode, small adjustment) Sample Volume Size (M-Mode, large adjustment) Sample Volume Size (PW Doppler Mode, small adjustment) Sample Volume Size (PW Doppler Mode, small adjustment) Adjust Transit Frequency SV Shift + SV SV Shift + SV FREQ 50 microns 500 microns 20 microns (may be adjusted to ensure integral number of cycles) 100 microns (may be adjusted to ensure integral number of cycles) Adjusts up or down to available transmit frequencies (depends on active RMV scanhead) Typical B-Mode Image Acquisition This procedure assumes that the animal is prepared for imaging and an acquisition session is open (see Typical Acquisition Session on page 47). 1. Select B-Mode (click Mode > B-Mode or press <B-Mode>). 2. Position the RMV scanhead over the animal and begin imaging. Ensure that there is ultrasound gel or water between the scanhead and the animal. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 69

88 Chapter 5: B-Mode Imaging: Typical B-Mode Image Acquisition 3. If desired, click the image orientation icon to reverse the image view. The icon is situated in the upper-left corner of the image area and indicates the position of the orientation ridge of the RMV scanhead in relation to the image. 4. If data acquisition does not begin, select Mode > Freeze or press <Scan/Freeze> to begin acquiring data. 5. Position the RMV scanhead and locate the region of interest. 6. To adjust the imaging parameters as necessary to obtain the desired images, select Setup > B-Mode Setup or press <Mode Setup>. 7. Select Mode > Freeze or press <Scan/Freeze> to stop data acquisition. 8. Scroll through the acquired frames of the cine loop using the playback controls under the image. 9. Store the desired data: To store a cine loop, select Study > Cine Store or press <Cine Store>. To store a frame, select Study > Frame Store or press <Frame Store>. 10. Analyze the data: To make measurements, see Measurements on page 153. To annotate the images, see Text Annotations on page Review the data: To review measurement and calculations, see Data Browser on page 143. To export the acquired data to file, see Export on page 145. Note: To export a file to removable media, see Copying Data on page Save the study: Select Study > Close Study to close the study and click Commit Session Data to save the data. To copy the study to a storage location, click Copy To. Note: To copy a study to removable media, see Copying Data on page Click Exit to close the application. 70 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

89 Chapter 5: B-Mode Imaging: EKV Reconstruction Signal Integration of Physiological Data One of either the ECG, Respiration, or Blood Pressure traces can be displayed below the high-resolution ultrasound image in B-Mode, M- Mode, PW Doppler Mode, Power Doppler Mode, and Tissue Doppler Mode. All available physiological data values are displayed to the right of the trace window. Right-click the ECG trace to increase the signal amplification. Leftclick to decrease. The ECG trace waveform is displayed in a window below the B-Mode image. The trace is synchronized with the ultrasound image so that the image marker in the trace window corresponds to the point in the ECG trace where the frame is acquired. To toggle the ECG trace display on or off, select View > View ECG. Note: In B-Mode, the Vevo 770 outputs up to two seconds of the animal's electrocardiogram when the operator scans an animal that is connected to an ECG monitor. Exporting Physiological Data The enabled physiological data trace and values are saved in exported cine loop and frames along with the image data. This data is displayed when the operator views a saved cine loop or frame. This data is also stored with an associated measurement file. EKV Reconstruction EKV (ECG-based Kilohertz Visualization) Reconstruction is a technique that synthesizes B-Mode images from a series of heart rhythm cycles from an animal and reconstructs one representative heart cycle that is spatially precise and synchronized to the animal's ECG. EKV functions within B-Mode during an acquisition session. The EKV data can be analyzed, measured and annotated and then saved as a cine loop. Acquiring an EKV Loop The Vevo 770 compiles an EKV acquisition by acquiring sufficient ECGgated scan line data in B-Mode in order to reconstruct a 1000 Hz EKV loop that spans one full heart cycle interval. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 71

90 Chapter 5: B-Mode Imaging: EKV Reconstruction To acquire an EKV loop: 1. Ensure that the paws of the animal are properly secured to the ECG electrodes of the animal platform on the Vevo Integrated Rail System III. 2. Check the ECG monitor to ensure that the system is producing a consistent, strong ECG signal. Note: Successful EKV image acquisition requires a strong and consistent ECG signal. 3. Mount the RMV scanhead to the Vevo Integrated Rail System III. See Imaging with the Vevo Integrated Rail System III on page Acquire a B-Mode image. (See Typical B-Mode Image Acquisition on page 69.) 5. In the parameter settings area, under EKV Settings, from the Quality list select the level of EKV quality to acquire. Different EKV Quality Settings dictate different acquisition times. For example, Presentation quality EKV loops require up to 7 minutes of acquisition, whereas Preview quality EKV loops require 45 seconds of acquisition time. The Quality level parameters are described below: Quality level Preview Low Medium Presentation EKV Acquisition Time 90 seconds or less 160 seconds or less 320 seconds or less 420 seconds or less Note: The acquisition time depends on the RMV and the image sector size. 6. Click Start EKV or press <EKV>. The progress bar beneath the image area tracks the EKV acquisition. When the acquisition ends, the EKV loop has been acquired. 72 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

91 Chapter 5: B-Mode Imaging: Needle Guide Overlay Studying an EKV Image When the EKV data is acquired, the operator can study it in the same way as any B-Mode data: Action Replay an EKV loop Procedure Use the standard B-Mode cine loop playback controls. For more information, see Playback Controls on page 76. The B-Mode cine loop frame indicator indicates the point in the ECG trace from which the data for that frame was acquired. Save an EKV loop Press <Cine Store> or click Study > Cine Store. Save an EKV image Press <Frame Store> or click Study > Frame Store. Make measurements and add annotations Make B-Mode measurements using the B- Mode Measurement Tool (see B-Mode Measurements on page 161). Add annotations to an EKV loop or frame as required (see Placing Annotations on page 197). Return to B-Mode imaging Press <Scan/Freeze> or click Mode > Freeze to acquire B-Mode data. Needle Guide Overlay The needle guide overlay is a software tool that is used specifically to assist in image-guided needle injection procedures. The needle guide overlay is used during the image-guided injection procedure to help visualize the alignment of the needle with the injection target. To place the needle guide overlay in B-Mode: 1. Select Overlay > Needle Guide Wire-frame or press <Overlay> until the needle guide is displayed. The focal depth of the RMV scanhead is indicated by a dotted red line across the image. A text message appears on the B-Mode image with instructions to place the needle guide. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 73

92 Chapter 5: B-Mode Imaging: Needle Guide Overlay Image orientation icon RMV scanhead focal depth B-Mode image with RMV scanhead focal depth displayed 2. If required, click the image orientation icon ( ) to change the orientation of the data. Note: The image orientation icon is situated in the upper-left corner of the image. 3. Click to specify the first of two caliper positions for the needle guide line segment. The first caliper is displayed as a green diamond. A dotted line is displayed to join the initial caliper and the current trackball cursor position. Right-click to view the line segment extended beyond the two defining calipers. 4. Left-click to place the second caliper point. Two green points appear on the image window. If they are positioned incorrectly, left-click to place the two points again. 5. When both needle guide points are in place, right-click to toggle the focal depth line and the green needle guide line on and off. 74 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

93 Chapter 5: B-Mode Imaging: Needle Guide Overlay Caliper Needle Guide line Focal depth B-Mode image showing needle guide overlay and calipers A typical image-guided needle injection procedure is performed as follows: 1. With the injection target below focus or out of the plane, physically bring the needle into the image, towards the expected target location, using the Integrated Injection and Rail System III. Bring the needle tip as close to the focal depth as possible. Note: The needle must be submersed in water (for externalized targets) or within the anatomy of the animal to be visible on the Vevo. 2. Select Overlay > Needle Guide Wire-frame. 3. Place the first caliper of the needle guide on the tip of the needle (where it appears on the screen) and place the second caliper where the needle enters the edge of the image window. 4. Physically retract the needle using the Rail System III. Ensure that the needle moves along the line specified by the needle guide. 5. Bring the target into the image plane and line up the target with the needle guide caliper indicating the needle tip. 6. Physically bring the needle into the image plane. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 75

94 Chapter 5: B-Mode Imaging: Cine Loop 7. Advance the needle tip to the tissue target and begin the guided injection. 8. Once the needle tip is within the target area inject the sample. 9. Select Study > Cine Store or press <Cine Store> to store image data of the injection. 10. Physically retract the needle using the Rail System III. Cine Loop The Vevo 770 can display B-Mode images as single frames or as cine loops. A cine loop is an animated compilation of B-Mode frames viewed in sequence. When image acquisition is paused or a cine loop has been stored, the operator is able to scroll through the cine loop to view the frames or play back the images in a loop at a desired frame rate. Four controls at the bottom of the B-Mode display define the functionality of the cine loop: Frame counter Playback controls Frame rate control Cine loop range Frame Counter The frame counter indicates the location of the current frame. The counter indicates the frame number and the total number of frames located within the buffer. To view another frame in the cine loop, click on the triangular frame indicator and drag it to the desired frame. The trackball cursor changes to a hand icon when it is placed over the frame indicator. Cine loop frame counter Playback Controls The playback controls allow forward and backward playback of the cine loop at the selected frame rate and allow the operator to step through the cine loop or to jump to either end of the cine loop range. When a play button is enabled (the cine loop is in playback mode), it becomes a Stop button. play backward play forward jump to start of range step backward step forward jump to end of range 76 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

95 Chapter 5: B-Mode Imaging: Cine Loop Frame Rate Control Use this option to control the playback rate of the cine loop. To change the frame rate, click on the triangle and drag it. The playback frame rate is initially set to the frame rate at which the cine loop was acquired. The actual frame rate of the playback is indicated during playback. Cine Loop Range An operator can define a subset of the cine loop to be played back or saved. Default cine loop range The default number of frames for saving/pre-triggering a B-Mode or Power Doppler Mode cine loop is 300. To define a default cine loop range: 1. Click Edit > Operator Preferences. 2. Under Default Cine Loop Size (in frames): a. In the B-Mode or Power Doppler field, type a value between 2 and 10,000. This sets the maximum size that can be used during a session. The default setting for both modes is 300 frames. Optimal estimated sizes are 1000 frames of B-Mode images at the full field of view, and 500 frames of Power Doppler Mode images at the full field of view. To ensure the maximum available cine loop size based on the system s internal calculation of maximum performance, check the Max box. b. Click Set. To override a specified cine loop range: 1. Select View > Cine Loop Range or press <Ctrl+R>. This command toggle the display of the range indicator underneath the frame counter. 2. To define the range, click on either end of the range indicator and drag it to the desired frame. The cine loop range indicator is displayed by default. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 77

96 Chapter 5: B-Mode Imaging: Time-Gain Compensation (TGC) The cine loop range has been defined between image 33 and image 191 within the Cine loop. Cine loops that are stored as shorter loops take up much less computing memory. Cine Loop Pre-trigger During data acquisition, press <Pre Trig>. This starts the acquisition of a new loop, which stops automatically when the specified number of frames has been acquired. Store and Export The cine loop may be stored to the study for further analysis, or exported to a file. If a cine loop range has been defined, only the images within the defined range are stored and exported. To store the entire cine loop to the study: Select Study > Cine Store or press <Cine Store>. To store the current frame to the study: Select Study > Frame Store or press <Frame Store>. To view a stored cine loop: Select Study > Browse Study or press <Browse> to open the Data Browser. To export the cine loop: Select Study > Export Cine Loop. To export the current frame: Select Study > Export Image. Note: For information on the exported files see File Types on page 149. Time-Gain Compensation (TGC) The time-gain compensation (TGC) controls in B-Mode are used to specify the receive gain to be used at different depths within a B-Mode image. The Vevo 770 software features eight TGC sliders for modifying TGC values. Each slider is associated with the physical depth position as indicated by the B-Mode depth scale. The B-Mode image is divided into eight horizontal bands. One TGC slider controls each band. Default TGC positions are dependent on the RMV scanhead in use. TGC positions can only be adjusted during B-Mode acquisition. After acquiring or loading a B-Mode image, its TGC slider positions cannot be adjusted. Adjusting the TGC Value To adjust the TGC: 1. Begin acquiring B-Mode data. 2. Drag a TGC slider to the left or right to decrease or increase the receive gain for the 'band' of the B-Mode image associated with that slider. 78 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

97 Chapter 5: B-Mode Imaging: Time-Gain Compensation (TGC) Use the GAIN rocker switch to adjust the positions of all the TGC sliders simultaneously. GAIN adjusts the slider positions to represent a gain increase or decrease of 5dB. Press <Shift> while pressing GAIN to adjust the slider positions to represent a gain change of 1.0 db. Time-gain compensation (TGC) sliders Smooth tool. To create a smooth, curved effect centered on the selected slider, click this tool and then drag any slider. Reset tool. To reset the sliders to their default positions, click this tool. Lock tool. To lock all sliders together so the operator can drag them simultaneously, click this tool and then drag any slider. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 79

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99 Chapter 6: 3D-Mode Imaging: Theory of Operation Chapter 6: 3D-Mode Imaging 3D-Mode imaging provides operators with tools to create and manipulate three-dimensional renderings and make volumetric measurements of objects viewed with high-resolution ultrasound. Theory of Operation 3D-Mode acquires a series of B-Mode slices and assembles them into a 3D data set. The 3D data set can then be visualized and manipulated. Targets (for example, tumor growth) can be segmented and volumetric measurements made. 3D imaging can be used in either B-Mode or Power Doppler Mode imaging procedures. Hardware Setup The RMV scanhead is mounted on a Vevo Integrated Rail System III equipped with a 3D motor stage. The RMV scanhead connects to a clamp connected to the bottom of the 3D motor stage. The 3D motor stage connects to the stationary mount on the Vevo Integrated Rail System III. RMV scanhead mounted to a clamp and connected to the 3D motor stage Image Acquisition Based on operator-defined parameters, the 3D motor stage travels a set distance across the target object in a series of minute steps. The motor, with the attached RMV scanhead travels in a direction perpendicular to the movement of the transducer within the RMV scanhead. At each step, the RMV scanhead takes a two-dimensional B-Mode or Power Doppler image, or slice. motor stage direction RMV scan plane Each two-dimensional B-Mode or Power Doppler image slice is assembled with the other slices of acquired data and rendered by the Vevo software into a three-dimensional data set. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 81

100 Chapter 6: 3D-Mode Imaging: Setting Up the 3D Motor Stage 3D Image Study Operators can use the 3D analysis tools to: View and render objects of interest, such as target tumors, in 3D. Segment objects on any plane or across planes. Measure lengths, areas and volumes. When starting the 3D acquisition from Power Doppler mode (Power 3D Mode), the RMV scanhead acquires each slice twice. The first is a two-dimensional B-Mode image; the second is a two-dimensional Power Doppler Mode image. Setting Up the 3D Motor Stage The procedure for setting up the 3D motor stage is similar to that for setting up the RMV scanhead. The 3D motor stage features a Quick Release post on the top which connects to the Vevo Integrated Rail System III, and a Quick Release mount on the bottom to affix the RMV clamp. Connecting the 3D motor stage to the Vevo Integrated Rail System III 1. Insert the Quick Release post (located on the top of the 3D motor stage unit) into the Quick Release mount located on the Rail System arm. Quick Release post Carefully line up the holes on the post with the pins on the Quick Release mount. 2. Tighten the knob on the Quick Release mount until finger tight. Quick Release mount 3. Connect the 3D motor cable to the DB-15 connector (labeled 3D Motor) on the rear panel of the Vevo 770 cart. 3D motor DB-15 connector Orienting the RMV scanhead As shown in the following illustration, the long axis of the 3D motor stage must be aligned in the direction that the RMV scanhead travels during data acquisition. 82 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

101 Chapter 6: 3D-Mode Imaging: Setting Up the 3D Motor Stage To adjust the orientation of the 3D motor stage: 1. Loosen the ball joint and rotate the 3D motor stage to adjust the 3D scan direction as necessary. Ball joint adjustment knob 3D motor stage Note: During 3D data acquisition, the RMV scanhead is physically moved. Ensure that the animal under the RMV scanhead is flat in relation to the 3D scan direction to prevent unintended contact with the animal as the RMV scanhead moves. 2. Connect the RMV clamp to the 3D motor stage. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 83

102 Chapter 6: 3D-Mode Imaging: Setting Up the 3D Motor Stage Connecting the 700-series RMV scanhead to the 3D motor stage 1. Insert the Quick Release post on the RMV clamp into the Quick Release mount on the 3D motor stage unit. Rail mount RMV clamp RMV scanhead 3D motor stage 2. Tighten the Quick Release mount until it is finger tight. 3. Open the RMV clamp and secure the RMV scanhead by aligning the orientation ridge of the RMV scanhead with the hinge groove of the RMV clamp, as illustrated below. 3D Motor Stage RMV scanhead orientation ridge RMV clamp Transducer (within the RMV scanhead). 84 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

103 Chapter 6: 3D-Mode Imaging: Typical 3D-Mode Image Acquisition The direction of travel of the RMV scanhead along the 3D motor stage is perpendicular to the direction of the transducer (within the RMV scanhead) during image acquisition, as illustrated below: 3D motor stage Direction of travel RMV scanhead Image slice Direction of travel transducer (within the RMV scanhead) 4. Close the clamp and push the latch down until it locks into place. Typical 3D-Mode Image Acquisition Setting the Parameters of the Target Scan Area To acquire a 3D-Mode image, complete the following procedures: 1. Prepare the animal and move it into position for imaging. 2. From B-Mode, access 3D-Mode. Use either one of the following methods: Click Init 3D. Click Mode > 3D-Mode and then click Mode > Initialize. The Initialize 3D Motor Stage box alerts the operator that the motor stage is about to move. 3. Select Yes. The 3D motor stage moves once through its maximum range. After the 3D motor stage has travelled its full range, the system then positions the RMV scanhead at the center of its range. Note: The 3D motor stage needs to be initialized before 3D-Mode image scanning can begin. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 85

104 Chapter 6: 3D-Mode Imaging: Respiration Gating for 3D Acquisition Note: If acquiring Power 3D Mode data, start the 3D acquisition from Power Doppler mode rather than from B-Mode. 4. From the Mode Setup dialog, enter the Range value and Step Size value. Range sets the distance (in millimeters) that the 3D motor stage will travel. The minimum Range distance is 0.03 mm. Step Size sets the distance that the 3D motor stage will travel between each B-Mode slice. Step sizes can range between 0.03 and 0.5 mm. Using smaller step sizes results in a greater number of slices being acquired over the range. More slices produce a more detailed 3D image. Starting 3D-Mode To start 3D-Mode 1. From B-Mode select Mode > Freeze or press <Scan/Freeze> to acquire a B-Mode image. 2. Locate the object of interest and center it as closely as possible relative to the RMV scanhead using the platform controls on the Vevo Integrated Rail System III. Note: The RMV scanhead should not be positioned against the animal at this point. The movement of the 3D motor stage could injure the animal and damage the RMV scanhead. 3. Image the target area. From B-Mode, click Start 3D. Refer to the Vevo Integrated Rail System II Operator Manual to find detailed procedures on how to secure an animal to the platform and adjust the platform controls. From 3D-Mode, click Mode > Freeze, or press <Scan/Freeze>. The 3D motor stage begins stepping along the acquisition route. The RMV scanhead completes a B-Mode scan at each step. When the acquisition is complete, the B-Mode slices are automatically assembled into a 3D image data set and can be viewed as a 3D volume. 4. Click Mode > Freeze at any time during the acquisition to cancel the acquisition. The 3D motor stage returns to its center position. Respiration Gating for 3D Acquisition Respiration gating during 3D acquisition acquires 3D data during the rest period of a respiration cycle. This removes image artifact caused by excessive movement during respiration. Using respiration gating ensures a 3D volume with less artifact caused by breathing. 86 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

105 Chapter 6: 3D-Mode Imaging: Viewing 3D Image Data Viewing 3D Image Data Select a 3D View 3D-Mode includes software analysis tools that provide the operator with different ways to view the acquired data. To select a view: 1. In the image area, click the desired pane. 2. On the button bar, click the appropriate View button, as shown below. Cube view Cross view Transverse view Sagittal view Coronal view Surface view The following additional View buttons are available in Power 3D Mode imaging: Grayscale Display Power Display In 3D-Mode, the following views are available: View Cube view Description Three-dimensional view of the acquired data, constructed from the full set of B-Mode image slices. The cube displays a blue wire-frame by default. As the operator passes the trackball cursor over a plane on the cube, the plane becomes active and the wire-frame for that plane is displayed in green. Cross view Three single, slidable image slice views presented on the x, y, and z planes. Each plane presents its own color outline: Blue = x-y plane on the z axis Green = y-z plane on the x axis Red = x-z plane on the y axis V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 87

106 Chapter 6: 3D-Mode Imaging: Viewing 3D Image Data View Transverse view Description Straight-on perspective of the x-y plane image slice, displayed on the Cross view as the plane outlined in blue. Sagittal view Straight-on perspective of the y-z plane image slice, displayed on the Cross view as the plane outlined in green. Coronal view Straight-on perspective of the x-z plane image slice, displayed on the Cross view as the plane outlined in red. Surface view A compilation view that uses the Cross view to map operator-generated volumes to the acquired data. Viewing options for Power 3D Mode Grayscale Display Toggles the display of the B-Mode portion of the acquired Power 3D Mode data. Power Display Toggles the display of the Power Doppler portion of the acquired Power 3D Mode data. Select a Viewing Pane Layout You can view the 3D image in one of three viewing layouts: single pane, dual pane, or quad pane. 88 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

107 Chapter 6: 3D-Mode Imaging: Viewing 3D Image Data To select a pane layout (on the button bar) select the appropriate layout, as shown below: Single pane Dual pane Quad pane A single pane layout provides a larger and more detailed view of the image. Multiple pane layouts provide the option of placing different views simultaneously within different panes. Pane menus Each pane includes a menu situated in the upper left corner. Each menu displays the options that are available to the active view. The following commands are available for the Cube view: Command Wire-frame Orientation Restore Function Turns the image outline on/off. Turns the orientation marker points on/off. Resets the original view of the 3D image including size, orientation, brightness and zoom values. From the Cube view in the active pane, right-click the cube to generate a menu that provides the following command options: Command Align Plane to Screen Delete Plane Annotate Function Rotates the cube to display a head-on view of the active plane. Removes a manually created plane. Provides a text box in which to type an annotation. Orient an Image View an image slice by slice Each view includes two buttons in the lower right corner that the operator can use to step through the slices of the 3D image. Note: These buttons are only displayed in the active pane. The > button steps forward through the slices; the < button steps back through the slices. These buttons can be used to step through the image one slice at a time, five at a time, or ten at a time, as detailed below: V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 89

108 Chapter 6: 3D-Mode Imaging: Manipulating 3D Image Data Command Step size > 1 slice Shift + > Ctrl + > 5 slices 10 slices Note: During rotational segmentation, these rotate through the volume, rather than moving slice by slice. Zoom in/out Click the appropriate Zoom button to zoom in and out of a pane. Zoom in Zoom out Rotate an image In Cube view, Cross view and Surface view: 1. Position the trackball cursor outside the image, and then left-click. 2. Drag in any direction. 3. Left-click to stop the rotation. Pan an image 1. Position the trackball cursor in the image pane. 2. While pressing the Shift key, left-click and drag in any direction. 3. Left-click to stop the panning. Manipulating 3D Image Data The Cube view includes a Render tool and a Sculpting tool to better define and visualize specific areas in the 3D image. After selecting either tool, functions for the tool appear in the area below the tools list. Render a 3D Image Use the Render tool to display the full 3D image. To render an image: 1. In the tools area, click Render. 2. Select from the available modes. The Render tool includes four modes as described below: 90 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

109 Chapter 6: 3D-Mode Imaging: Manipulating 3D Image Data Mode Texture Mapping Function and procedure Texture Mapping mode displays the surface texture of the 3D image. Texture mapping mode is the default rendering mode for 3D acquisition. To apply texture mapping to a 3D image: Under Mode, click Texture Mapping. The Cube view displays data on the surface of each plane of the 3D image. Render Render mode displays the full 3D image in the Cube view. To render a 3D image: Under Mode, click Render. The Cube view traces each line of the data, perpendicular to the display for the full image. MIP (Max) MIP (Maximum Intensity Projection) enhances the contrast of an image by maximizing the brightest pixels in the image. Use this mode to better distinguish organs from their surrounding area when the organ objects are brighter than their surrounding structures. To apply MIP (Max) to a 3D image: Under Mode, click MIP (Max). MIP (Min) MIP (Min) (Minimum Intensity Projection) enhances the contrast of an image by minimizing the brightest pixels in the image. Use this mode to better distinguish organs from their surrounding area when the organ objects are darker than their surrounding structures. To apply MIP (Min) to a 3D image: Under Mode, click MIP (Min). Adjust opacity and luminance 1. Left-click and drag a point along the curves and then left-click to lock the point to a new setting. 2. Click Reset to return both curves to their default settings. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 91

110 Chapter 6: 3D-Mode Imaging: Manipulating 3D Image Data Sculpt an Image Use the Sculpting tool to cut away superfluous image data to view volumes of interest more easily. To sculpt an image: 1. In the tools area, click Sculpting. 2. Select from the available modes. The Sculpting tool includes three modes: Shave mode Shave provides fine control over the amount of data the operator wants to cut away. This mode functions like an eraser: set the depth that the tool can shave the target, and then use the tool on the image in Cube view. To shave a 3D image dataset: 1. Under Mode, click Shave. 2. Under Depth, set the slider to the depth of shave required. Depth slider values are proportional. The Max setting represents the full distance through the image. This means that if the operator sets the slider to Max, the system shaves a hole completely through the image. 3. Step through the image slices to find the plane from which shaving should start. 4. Position the trackball cursor in the target area. 5. Left-click, and hold down the trackball button, and move the trackball cursor. 6. Release the trackball button to complete the shaving procedure. Scalpel (Inside) mode Scalpel (Inside) mode functions like a cookie cutter. Select a depth, then outline an area within which to remove data. To scalpel inside a 3D image: 1. Under Mode, click Scalpel (Inside). 2. Under Depth, set the slider to the required depth. 3. Position the trackball cursor over the image. 4. Left-click, hold down the trackball button and drag the trackball cursor to create the outline of the area to be scalpeled. 92 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

111 Chapter 6: 3D-Mode Imaging: Manipulating 3D Image Data 5. Release the trackball button. The outlined area is removed from the image. Image before scalpeling Image after scalpeling (inside) Scalpel (Outside) mode Scalpel (Outside) mode functions like a cookie cutter, much the same way as Scalpel (Inside). Select a depth, then outline an area outside of which to remove data. To scalpel outside a 3D image: 1. Under Mode, click Scalpel (Outside). 2. Under Depth, set the slider to the required depth. 3. Position the trackball cursor over the image. 4. Left-click, hold down the trackball button and drag the trackball cursor to create the outline of the area to be scalpeled. 5. Release the trackball button. Data outside the outlined area is removed from the image. Image before scalpeling Image after scalpeling (outside) V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 93

112 Chapter 6: 3D-Mode Imaging: Creating Volumetric Measurements Creating Volumetric Measurements Area Volume In Cube view, the 3D-Mode Volume tool accurately measures object volumes within an image. Volumes are created by segmenting a series of contours and calculating the volume within the contoured region. 3D volumes can be created in 3D-Mode or Power 3D Mode using Parallel or Rotational Segmentation. Typically, rotational segmentation should be used when the volume resembles a spherical shape. Otherwise, parallel segmentation should be used. For either method of segmentation, the system can perform a manual or semi-automated segmentation of the volume. When the manual segmentation procedure is followed, the operator draws each contour of the volume. When the semi-automated segmentation procedure is followed, the system draws two or more contours automatically. Parallel Segmentation To create a volume using parallel segmentation: 1. In the tools area, click Volume. 2. Ensure that the 3D data is displayed in the Cube View. 3. In the Volume area: a. Select Parallel. b. Assign a color to the contours of the volume. Click Color, select the appropriate color from the Color dialog, and then click OK. Note: This step is optional. c. Click Start. 4. To create the first contour, start in the Cube view and then complete the following procedures: a. Left-click to create a point on the circumference of a contour. b. Position the cursor to a second point along the intended contour, and then left-click to set the second point. c. Continue creating points, and then right-click the last point, or left-click near the first point to complete the contour. The contour is displayed in the Contour List as Volume if this is the first contour of the first volume measurement on the image. The contour color changes from blue to the specified color. Note: If the position of the trackball cursor is within five pixels of the previous caliper when the right-click occurs, the previously placed caliper is considered to 94 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

113 Chapter 6: 3D-Mode Imaging: Creating Volumetric Measurements be the last caliper for the measurement. This applies to 3D-Mode polygon measurements and for 3D-Mode volume contours. 5. Click Refine to initiate the edge detection algorithm. This function detects the edge of the vessel or volume wall and attempts to closely fit the line to the outside wall of the vessel or volume. The Refine function can be repeated to achieve the closest possible fit. Note: The Refine function achieves the best results when the contour is drawn just outside the boundary of the anatomical structure. Initial contour Refined contour 6. Subsequent contours can be drawn manually or semi-automatically. Select the preferred parallel segmentation parameters in the Segmentation area of the Volume tool. a. Set the Step Size. The default step size is the scan step size. b. Set the Direction of segmentation: Inward, Outward, or Both. c. To use manual segmentation set the Step Num to 1. To use semi-automatic segmentation, set the Step Num to a value of two or more. Note: When using semi-automatic segmentation, the contours are generated automatically. Each contour is refined before the next contour is drawn. d. To generate additional contours, click Proceed. If the manual segmentation procedure is being used, the next contour is drawn and refined. If semi-automatic segmentation is used, the set number of contours are created. The second contour is listed in the Contour List as Volume Repeat the previous step as necessary until the desired number of contours have been defined, and then click Finish. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 95

114 Chapter 6: 3D-Mode Imaging: Creating Volumetric Measurements The first calculated volume set for the image is now created. If a second volume is required, an additional set of contours can be measured. Rotational Segmentation To create a volume using rotational segmentation: Follow steps 1 to 5 in the Parallel Segmentation procedure, with the following exceptions: Step 3: In the Volume area, select Rotational. Step 4: Before the first contour is created, step to a slice that is not one of the outer slices of the cube. Select Start. The system prompts the operator to set a Rotational Axis. The axis of rotation can be set by clicking once at one end of the axis of rotation and then clicking at the other end. The axis of rotation should run through entire volume region, as illustrated below: To continue the Rotational Segmentation procedure after the first contour has been defined: 1. Select the preferred rotational segmentation parameters in the Segmentation section of the Volume tool. a. Set the desired Method of segmentation: Auto or Semi. b. Set the Angle of rotation. The angle represents the degrees separating each contour. The default value is 10 degrees. 96 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

115 Chapter 6: 3D-Mode Imaging: Creating Volumetric Measurements c. Set the Direction of rotation: Clockwise or Counterclockwise, relative to the axis of rotation. d. If Semi was selected as the method of segmentation, select the Step Num. This dictates the number of contours that are created. 2. Click Proceed to draw subsequent contours. If Semi was selected, the system creates the number of contours defined in the Step Num setting. Repeat the previous steps until the full volume has been segmented. Click Finish to complete the segmentation. The volume calculation is displayed in the lower left corner of the cube view. If Auto was selected the system creates a sufficient number of contours to complete a full rotation around the volume. This completes the segmentation procedure and the volume calculation is displayed in the lower left corner of the cube view. Fixing a volume After a volume has been created using either of the methods described, it is possible to edit one or more of the contours in the Volume. To modify a contour, select the contour in the Contour List, left-click a point, drag the point to a new position, and then left-click it to set the point. This can be done on one or more points. Click Refine to use the edge detection feature to fit the contour in line with the new point. To move a contour, select the contour between the points on the contour. To view the volume measurement as a 3D object: 1. On the button bar, click the Surface View icon. The system compiles a 3D representation of the volume in the Surface view, and then displays the measured volume as a mesh overlay on the three planes. 2. Use the rotate, pan and zoom tools to modify the view of the object. Segmentation in Power 3D Mode To segment a volume in Power 3D Mode, follow the same procedure that is used to segment a volume in 3D-Mode. In Power 3D Mode, a Percent Vascularity (PV) value is provided after the volume has been created. The PV value provides the percentage of the volume that contains flow or other movement detected from Power Doppler mode. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 97

116 Chapter 6: 3D-Mode Imaging: Saving a 3D Image If the volume has been modified, click PV Recalc in the Contour area of the Volume tool to re-calculate the PV value. Generic Measurements In the Cube view, use the 3D-Mode Measurements Tool to complete the following generic measurements: Linear distance (mm) Single point (x,y,z) Polygon ROI (mm 2 ) For complete 3D-Mode measurement procedures, see 3D-Mode Measurements on page 170. Note: 3D measurements can only be made on data displayed in the Cube view. Saving a 3D Image To save a new 3D image to the Study Browser: Press <Frame Store> or click Study > Image Store. These commands re-save a 3D image if it has already been saved. To export a 3D image from the 3D-Mode window: 1. From the 3D-Mode window click Study > Export Image 2. In the Export Data dialog: a. Browse to the destination drive or network location. 98 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

117 Chapter 6: 3D-Mode Imaging: Recording a 3D-Mode Session b. Name the file. The Save as type list provides options to save the image only, or the full 3D-Mode window as either a TIFF, BMP, or RDB (raw image data) file. c. Select the appropriate format and then click Save. To export 3D images from the Data Browser: Note: These instructions are applicable for exporting images acquired in any mode. 1. Select one or more images in the Image Browser and click the Export Image button. A dialog is presented in which the operator can select a destination folder, and the type of file to create. The operator can optionally specify a prefix to appear at the beginning of each exported file name. 2. Click OK. A separate file (note that two files are exported with raw image data) is created for each file. The file name includes the prefix (if specified), the Image Label (if defined), the Image Acquisition Time, and a unique number. If the operator selects a single image to export from the Image Browser, the operator can specify the file name for the exported image. The operator is notified if the export operation cannot be performed (for example, due to space limitations at the destination location). Recording a 3D-Mode Session The Record tool creates a real-time AVI file of actions performed on 3D image data in the active pane. To record a study session: 1. In the tools area, click Record and then click Start Recording. The Export Data dialog is displayed. 2. In the Export Data dialog: a. Locate the directory into which the file is to be saved. b. Under File name, type a filename. c. Under Save as type, select the appropriate AVI compression type. d. Click Save. The system begins recording the activity occurring in the selected view pane. Use the 3D tools as desired. 3. In the tools area, click Stop Recording when work is completed. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 99

118 Chapter 6: 3D-Mode Imaging: Changing the 3D-Mode Display Parameters Changing the 3D-Mode Display Parameters The system provides a Display Tool that operators can use to modify the display parameters for 3D-Mode and Power 3D Mode. In 3D-Mode and Power 3D Mode, the Brightness and Contrast levels of the grayscale data can be modified by moving the bar on the sliders from left to right. In Power 3D Mode, the following Power Doppler parameters can be changed: Range Min Range Max Priority After one or more of these values have been changed, click Regenerate to apply the changes to the Power 3D Mode image data. 100 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

119 Chapter 7: PW Doppler Mode Imaging: Defining the PW Doppler Sample Volume Chapter 7: PW Doppler Mode Imaging PW Doppler Mode uses pulsed-wave Doppler to examine the velocity of flow within a region of interest. The Vevo software presents the detected PW Doppler signal as both audio output and as a spectral image in the display window. Note: For best flow measurements, first locate the region of interest and target flow using B-Mode, and then switch to PW Doppler Mode. Defining the PW Doppler Sample Volume The Sample Volume is the region from which the PW Doppler signal is acquired. This can be set up in B-Mode, while acquiring data. To position the Sample Volume in B-Mode: 1. Press <Scan/Freeze> to begin acquiring B-Mode data. 2. Select Overlay > PW Doppler Sample Volume Wire-frame or press <Overlay> until the PW Doppler Sample Volume is displayed. A check mark is displayed beside this menu item. The guide indicates the direction of the RMV scanhead ultrasound beam (a vertical red line) and Sample Volume (represented by two short horizontal yellow lines connected by a vertical dashed line). The details about the PW Doppler Sample Volume are displayed in the parameters display. Note: The PW Doppler Sample Volume can only be repositioned or resized during acquisition. 3. Move the trackball cursor over the red vertical line. The trackball cursor is displayed as a crosshair when it is within a region that can be repositioned. 4. Left-click the position line. Use the trackball cursor to move the overlay. The system renders the Sample Volume in yellow when it is positioned within the RMV scanhead s focal zone. If the Sample Volume is positioned outside the focal zone it is rendered in red. For the best data acquisition, the Sample Volume should be positioned within the focal zone. 5. Left-click again to place the Sample Volume. The Sample Volume details are updated in the parameters display. To adjust the size of the Sample Volume: 1. Press <Scan/Freeze> to begin acquiring B-Mode data. 2. Move the trackball cursor over one edge of the Sample Volume. The trackball cursor is displayed as a double arrow when it is in the proper position. 3. Resize the Sample Volume, using either one of the two following procedures: V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 101

120 Chapter 7: PW Doppler Mode Imaging: Defining the PW Doppler Angle From the B-Mode window, left-click the Sample Volume marker, and move the trackball cursor up or down to adjust the Sample Volume size. When the Sample Volume is the desired size, left-click to set the size. The length of the Sample Volume is updated in the parameters display. Using the hot keys, press the SV rocker switch to adjust the size of the Sample Volume. <SV> increases or decreases the size of the Sample Volume by approximately 20 microns, or by 100 microns when the Shift key is held down. Defining the PW Doppler Angle The PW Doppler angle is used to calculate the velocity of the measured PW Doppler signal. For a more detailed overview on how PW Doppler measurements work refer to Technical Overview of PW Doppler on page 115. To set the PW Doppler angle: 1. Start acquiring B-Mode data. 2. Position the PW Doppler angle, using one of the following two procedures. From the B-Mode window, position the trackball cursor over the PW Doppler angle line (displayed as a dotted yellow or blue line). The trackball cursor changes to a crosshair. Right-click to activate editing of the PW Doppler angle line. The angle line follows the movement of the trackball cursor. When the angle is at the desired setting, right-click to set the angle. The angle value is updated in the parameters display. Turn the ANGLE dial to adjust the PW Doppler angle. Each click of the dial as it is turned clockwise or counterclockwise changes the PW Doppler angle setting value by 1. Note: The PW Doppler angle is displayed in red when the Sample Volume is outside the focal zone. The PW Doppler angle value is always displayed in the B-Mode image when the PW Doppler Sample Volume overlay is enabled. PW Doppler angles between 60 to 80 appear in blue. VisualSonics recommends a PW Doppler angle that is between 0 and 60 for the most accurate velocity estimate. The Vevo 770 prevents the system from setting PW Doppler angles between 80 and 90. This restriction is due to the inaccuracy of the flow velocity at PW Doppler angles close to VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

121 Chapter 7: PW Doppler Mode Imaging: PW Doppler Acquisition Window PW Doppler angle PW Doppler Sample Volume positioning line PW Doppler Sample Volume The following information about the Sample Volume is listed in the parameter display to the left of the B-Mode image. The Cycles parameter is shown only when the Details button is selected. Depth Length Cycles Angle The depth to the center of the Sample Volume from the transducer face. The length of the Sample Volume. The number of transmit cycles for the given Sample Volume length. The angle from the vertical red line to the dashed angle line. This angle always displays a positive value between 0 and 80, regardless of which side of the vertical line it is positioned on. Starting PW Doppler Mode To start PW Doppler Mode, click Mode > Doppler Mode or press <PW>. PW Doppler Acquisition Window During PW Doppler Mode acquisition, the RMV scanhead acquires data along a single line in the scout window, as represented by the red vertical positioning line in the following illustration. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 103

122 Chapter 7: PW Doppler Mode Imaging: PW Doppler Acquisition Window The PW Doppler angle is measured between the line of acquisition and the blood flow (represented by the PW Doppler angle line). The closer this angle is to zero, the more accurate the velocity measurement will be. Scout window The frequency scale indicates the frequency shift in the acquired PW Doppler signal. Angle measurement Sample Volume position The image area is a right-to-left scrolling display. The most recently acquired data appears on the right of the window. The velocity scale indicates the velocity of the measured PW Doppler signal. ECG trace The grayscale bar indicates the dynamic range of the display. Time scale in milliseconds. During scanning, press <Toggle Scout> to toggle between PW Doppler data acquisition and the continuous updating of the scout window. Setup To modify the PW Doppler parameters: 1. Select Setup > Doppler Mode Setup or press <Mode Setup>. 2. The PW Doppler Mode Setup dialog is displayed. Modify the desired parameters. 104 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

123 Chapter 7: PW Doppler Mode Imaging: PW Doppler Acquisition Window 3. Select Setup > Doppler Mode Setup or press <Mode Setup> to turn off the setup display and return to the parameters display. Transmit Settings PRF The pulse repetition frequency (PRF) of the transmitted PW Doppler signal determines the maximum observable PW Doppler frequency shift and flow velocity. Receive Settings Wall Filter Doppler Gain The Wall Filter is used to reduce the amount of motion artifact due to respiration and other slow movements in the signal. The Doppler Gain should be set to compensate for signal loss due to attenuation. Display Settings Baseline Threshold Contrast Brightness Baseline The lower limit (black) of the grayscale. Adjusts the contrast of the grayscale. Adjusts the brightness of the grayscale. The baseline of the spectrum may be adjusted vertically so that the entire signal may be seen within the window. Possible values range from -50% to 50%. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 105

124 Chapter 7: PW Doppler Mode Imaging: PW Doppler Acquisition Window Volume Display Window Invert Spectrum This controls the audio output of the PW Doppler signal. It can be adjusted in increments of 0.5 from 1.0 (min.) to 5.0 (max). The volume level data is used to set the audio output level when exporting to an AVI or WAV file, and its setting is saved with the cine loop. Shows the number of milliseconds of data displayed in the image area. The selected value also determines the speed at which data is scrolled during acquisition and playback. Inverting the PW Doppler spectrum adjusts the display so that what is drawn below the zero frequency line is drawn above and vice versa. Hot Keys The following table provides the step sizes for the hot key functions: Parameter Hot key Step Size Doppler Gain (Coarse) GAIN 5 db Doppler Gain (Fine) Shift +GAIN 1.0 db PRF VELOCITY 1.0, 2.0, 5.0, 10.0, 20.0, 30.0, 40.0, 50.0, 60.0, 70.0, 80.0, 90.0, 100.0, 110.0, khz Baseline BASELINE 5 percent higher or lower Sample Volume Size (small adjustment) Sample Volume Size (large adjustment) SV Shift + SV 20 microns (may be adjusted to ensure integral number of cycles) 100 microns (may be adjusted to ensure integral number of cycles) Adjust Display Window WINDOW 200, 400, 600, 800, 1000, 2000, 4000, VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

125 Chapter 7: PW Doppler Mode Imaging: PW Doppler Acquisition Window Parameter Hot key Step Size Adjust Transmit Frequency FREQ Adjusts up or down to available transmit frequencies (depends on active RMV scanhead) Doppler Angle ANGLE Rotates PW Doppler angle If the value of the parameter is at the upper or lower limit when the associated hot key is pressed, the system does not change the parameter value, with the exception of the WINDOW and FREQ rocker switches, and the ANGLE dial. Each of these adjusts up or down to the available values. Scout Window The Scout window (indicated in white, below) displays the position of the PW Doppler Sample Volume within the B-Mode image. PW Doppler Mode window with scout window. To update the Scout window: 1. Store the current PW Doppler loop to the study (select Study > Cine Store or press <Cine Store>). The current PW Doppler loop is lost if the data is not stored. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 107

126 Chapter 7: PW Doppler Mode Imaging: Time-Gain Compensation (TGC) 2. While acquiring PW Doppler data press <Toggle Scout>. The Scout window toggles to continuously update the Scout image. 3. Adjust the Sample Volume position, size, and PW Doppler angle if required using the same steps described in Defining the PW Doppler Sample Volume on page 101 and Defining the PW Doppler Angle on page Press <Toggle Scout>. The scout image freezes and PW Doppler data acquisition resumes. Time-Gain Compensation (TGC) TGC sliders appear next to the B-Mode Scout window, and are used to control the receive gain of the B-Mode image. When the Scout window is being continuously updated, use the TGC sliders to update the gain for the B-Mode image being acquired. Alternatively, press GAIN to adjust the position of all the TGC sliders simultaneously. For more information, see Adjusting the TGC Value on page 78. When the system is paused, or during acquisition of PW Doppler data, the TGC controls are disabled. Press GAIN to affect the Doppler Gain, rather than the B-Mode gain. Multiple Sample Volumes In PW Doppler Mode, the Vevo 770 uses a pulsed-wave method where the transducer alternately transmits and receives the ultrasound signal. While the transducer is transmitting the ultrasound signal, returning echoes cannot be received. This results in a blockout zone where the Sample Volume cannot be placed. Blockout zone The blockout zone is identified on the PW Doppler Sample Volume wire-frame overlay by a light blue line. 108 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

127 Chapter 7: PW Doppler Mode Imaging: Multiple Sample Volumes In general, the PRF setting in PW Doppler Mode limits the maximum depth at which the Sample Volume may be defined. The backscattered echo should be received before the transducer transmits the next pulse to prevent any ambiguity in resolving the acquired signal. The distance that the ultrasound pulse is able to travel from the transducer to the deepest Sample Volume and back to the transducer before the next pulse is sent is known as the sampling interval. Secondary echoes at distances beyond the sampling interval can be introduced into the acquired PW Doppler signal. These secondary echoes originate from secondary Sample Volumes spaced at distances equal to the sampling interval measured from the initial Sample Volume. When imaging with a transducer with a deep focal zone, the secondary Sample Volumes may be used to acquire PW Doppler signal from deep vessels using a high PRF. If a high PRF has been set in PW Doppler Mode, the software might display multiple Sample Volumes when the PW Doppler Sample Volume wire-frame is enabled. Each Sample Volume is numbered and the Sample Volume closest to the transducer face is labeled 1. Sample Volume 1 Sample Volume 2 Blockout zone A B-Mode image with the PW Doppler Sample Volume wire-frame overlay. Two Sample Volumes and one blockout zone may be seen. In this image, Sample Volume 1 is the active Sample Volume as it is located closest to the transducer focal zone. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 109

128 Chapter 7: PW Doppler Mode Imaging: PW Doppler Cine Loop The acquired PW Doppler signal may arise from any of the multiple Sample Volumes. This could result in signal ambiguity if vessels are located within multiple Sample Volumes. If the acquired PW Doppler signal is not as expected, a signal from another Sample Volume may be causing interference. Multiple Sample Volumes and PRF The positions of the blockout zones are dependent on the PRF setting in PW Doppler. Changes to the Sample Volume position may change the PRF. Positioning the Sample Volume Position the Sample Volume anywhere along the transducer beam indicator. If the Sample Volume is moved past a blockout zone, the Sample Volume number changes to indicate that the Sample Volume is within a different sampling interval. If the active Sample Volume is placed within a blockout zone, the PRF is adjusted such that the active Sample Volume is no longer within the blockout zone. Changes to the PRF When the PRF value is changed (using Setup > Doppler Mode Setup or Velocity hot keys), the Vevo software maintains the position of the active Sample Volume. If the selected PRF results in placement of the active Sample Volume within a blockout zone, the system automatically adjusts the PRF to the next available value. As the PRF changes, the active Sample Volume may change as the blockout zones change positions. Note: The system always attempts to maintain the position of the active Sample Volume (the Sample Volume closest to the focal zone). The other Sample Volumes may not maintain their positions. The active Sample Volume is always the Sample Volume that is located closest to the focal depth of the RMV scanhead. PW Doppler Cine Loop When PW Doppler data is acquired, the PW Doppler data may be analyzed by stepping through the cine loop. The playback function allows the operator to view the cine loop and listen to the acquired audio simultaneously. The maximum length of a stored PW Doppler loop is 30 seconds. Scrolling Through the Data Click and to step through the PW Doppler data to view, analyze and make measurements on the data. Audio Playback When PW Doppler data is paused, a play button ( ) appears with the standard playback controls, below the spectral image. This button plays through the PW Doppler loop with the audio data being sent to the 110 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

129 Chapter 7: PW Doppler Mode Imaging: PW Doppler Cine Loop system speakers. When the play button is enabled (i.e., when the PW Doppler cine loop is playing), the button becomes a stop button. play forward jump to start step forward jump to start Note: A PW Doppler cine loop cannot be played in reverse. Store and Export The cine loop can be stored for further analysis and can be exported. To store an image: Select Study > Frame Store or press <Frame Store>. The current screen contents are stored as a loop. Including annotations and measurements in stored frames Annotations are included in a stored frame if the majority of the annotation is visible on the image area when the frame is stored. Measurements are included if all points of a measurement are visible on the image area. This annotation will not be included. The majority of the typed entry is off-screen. This annotation will be included. The majority of the typed entry is visible. This time interval measurement will be included. All points on the measurement are visible, even though some of the measurement label is off-screen. This time interval measurement will not be included. Only one of its two calipers is visible. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 111

130 Chapter 7: PW Doppler Mode Imaging: Typical PW Doppler Mode Image Acquisition If Frame Store is activated while the system is acquiring data: Data acquisition stops. The system stores the displayed data. The system clears the data buffer and data acquisition resumes. To store a loop: Select Study > Cine Store or press <Cine Store>. The audio data is stored along with the spectral data. View a loop: To view stored cine loops: 1. Select Study > Browse Study or press <Browse> to open the Data Browser. 2. Select an image to view and click Load. To export only the audio component: To export the audio component of the cine loop (audio data), select Study > Export Cine Loop and select to save the file in Windows Audio.WAV format. To export an image: To export the currently displayed data, select Study > Export Image. To export the loop with the audio components: To export the image and audio components of the cine loop, select Study > Export Cine Loop. Select either of the available AVI formats. Refer to the table of File Types on page 149. Typical PW Doppler Mode Image Acquisition The following describes a typical PW Doppler acquisition session. The description assumes that the animal has already been prepared for imaging and that an acquisition session is open in the current study (see Typical Acquisition Session on page 47). 1. In B-Mode acquisition (see Typical B-Mode Image Acquisition on page 69), localize the target region for PW Doppler acquisition. 2. Select Overlay > Doppler Sample Volume Wire-frame or press <Overlay> until the PW Doppler Sample Volume is displayed. 3. Position and size the Sample Volume wire-frame at the desired location for PW Doppler signal acquisition on the B-Mode image. 4. Position the PW Doppler angle. 5. To switch to PW Doppler Mode from B-Mode select Mode > Doppler Mode or press <PW>. PW Doppler Mode opens and automatically start acquiring data. New PW Doppler lines enter the window from the right side and scroll across the window to the left in real-time. The audio representation of the acquired PW Doppler data can be heard 112 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

131 Chapter 7: PW Doppler Mode Imaging: Typical PW Doppler Mode Image Acquisition through the system speakers. Audio heard through the right-hand speaker represents movement towards the transducer. Audio heard through the left-hand speaker represents movement away from the transducer. Note: Toggle to the Scout image to verify the Sample Volume location throughout the imaging session. Press <Toggle Scout> or use the Toggle Scout foot pedal command to toggle continuous scanning in the Scout window. 6. Select Mode > Freeze or press <Scan/Freeze> to stop data acquisition. 7. Use the playback controls located below the image area to review the acquired data. 8. Adjust the imaging parameters by selecting Setup > Doppler Setup (or press <Mode Setup>). 9. To store data: For the cine loop, click Study > Cine Store or press <Cine Store>. For the visible frame, click Study > Frame Store or press <Frame Store>. 10. Analyze the data. To make measurements, see Measurements on page 153. To annotate the images, see Text Annotations on page Review the data. To review measurement and calculations, see Data Browser on page 143. To export the acquired data to a file, see Export on page Save the study. Select Study > Close Study or press <Close> to close the study and click Commit Session Data to save the data. To copy the study to a storage location, click Copy To. 13. Click Exit to close the application. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 113

132 Chapter 7: PW Doppler Mode Imaging: Typical PW Doppler Mode Image Acquisition Signal Integration of Physiological Data Any of the ECG, Respiration, and Blood Pressure traces can be displayed below the high-resolution ultrasound image. All available physiological data can be displayed to the right of the trace window. Right-click the ECG trace to increase the signal amplification. Left-click to decrease. The Physiological data trace waveform is displayed in a window below the image. The trace is synchronized with the ultrasound image. Storing Physiological Data Physiological data is included in exported cine loops and frames along with the PW Doppler Mode image data, and is displayed when viewing a saved cine loop or frame. The physiological data can also be saved with image measurement files. 114 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

133 Chapter 7: PW Doppler Mode Imaging: Technical Overview of PW Doppler Technical Overview of PW Doppler Obtaining the best PW Doppler data requires some technical knowledge on how the signal is obtained. The velocity of flow may be estimated using measurements of both the PW Doppler frequency shift and the PW Doppler angle. The transducer (the part of the RMV scanhead that generates the ultrasound beam) should be positioned as parallel to the direction of blood flow as possible to ensure accurate velocity estimation by the Vevo 770. For the best velocity estimate, VisualSonics recommends using a PW Doppler angle that is less than 60. An operator must rely on his/her knowledge of animal anatomy, on the PW Doppler audio signal, and on the maximum velocity displayed on the PW Doppler spectrum to achieve the optimum angle. For the best estimate of the flow velocities, the PW Doppler angle should be less than 60 and as close to 0 as possible. To measure high velocities (i.e., adult mouse blood flow), a high sampling rate is required. The maximum detectable velocity within the Sample Volume is limited by the PW Doppler Mode s sampling rate or Pulse Repetition Frequency (PRF). This PRF limitation is called the Nyquist limit and is equal to one-half the system s PRF. For deep Sample Volumes, lower PRFs are required to allow time for an ultrasound pulse to reach the target and return to the receiver. A lower PRF (i.e., slower sampling rate) lowers the Nyquist limit and directly limits the maximum velocity that can be measured. For Sample Volumes closer to the surface, higher PRFs may be used, allowing higher velocity flows to be measured. Velocities exceeding the Nyquist limit lead to aliasing. An aliased signal is observed in the spectral display as a folded-over, or wrapped around, PW Doppler signal. The maximum velocity peak above the baseline is cut off and displayed out-of-phase below the baseline. Due to the Nyquist limit of PW Doppler at deeper volumes, it may be impossible to determine high velocities accurately. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 115

134 Chapter 7: PW Doppler Mode Imaging: Technical Overview of PW Doppler A PW Doppler signal acquired with a PRF of 20 khz. Aliasing is characterized by the wrap around signal, in which the high frequency portions of the signal appear to wrap from the bottom to the top of the display. VTI Measurement The VTI (Velocity Time Integral) is measured through a manual trace or using a real-time frequency trace. The VTI measurement known as stroke distance is an indicator of the volumetric blood flow through a vessel with each ventricular contraction, represented by a distance. In the case of the aorta, most of the blood is moving at the same speed through the heart cycle (the velocity profile is flat or blunt) so this integral is equivalent to a physical length (velocity measured over a time in seconds ((m/s)*s)). In other vessels the fluid flow includes a range of speeds, fastest at the center and slowest on the outside. In these cases the integral is relevant to the volumetric flow but does not translate to a physical length. 116 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

135 Chapter 8: Tissue Doppler Mode Imaging: Fundamentals Chapter 8: Tissue Doppler Mode Imaging Tissue Doppler Mode Imaging (TDI) provides tools to assess the function of the heart muscle. TDI uses PW Doppler to detect and display moving myocardial tissue as a PW Doppler Spectrum. This mode is useful for the following applications: Performing quantitative myocardial analysis Performing regional myocardial strain rate analysis by quantifying the distance and velocity relationship between two TDI spectrums The following illustration highlights the features of Tissue Doppler Mode. Scout window Angle measurement Sample Volume position The frequency scale indicates the frequency shift in the acquired PW Doppler signal. Tissue Doppler acquisition data is rendered in yellow to distinguish it from standard PW Doppler data. The image area is a right-to-left scrolling display. The most recently acquired data appears on the right of the window. The velocity scale indicates the velocity of the measured PW Doppler signal. ECG trace The grayscale bar indicates the dynamic range of the display. Time scale in milliseconds. For a technical overview of the pulsed-wave technology that is used in the Tissue Doppler Mode, see Technical Overview of PW Doppler on page 115. Fundamentals To enter Tissue Doppler Mode: Select Mode > Tissue Doppler Mode or press <Tissue>. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 117

136 Chapter 8: Tissue Doppler Mode Imaging: Setting Up Tissue Doppler Mode Setting Up Tissue Doppler Mode To set the parameters for Tissue Doppler Mode: 1. Select Setup > Tissue Doppler Mode Setup or press <Mode Setup>. The system displays the Tissue Doppler Mode Setup dialog. 2. Set the parameters as described in the following tables. Transmit Settings PRF The pulse repetition frequency (PRF) of the transmitted PW Doppler signal determines the maximum observable PW Doppler frequency shift and flow velocity. The following PRF values are available: 1, 2, 3, 4, 5, 7, 10, 15 khz. The default PRF is 5 khz. Receive Settings Wall Filter Doppler Gain The Wall Filter reduces the amount of motion artifact due to respiration and other slow movements in the signal. The Doppler Gain should be set to compensate for signal loss due to attenuation. Display Settings Baseline Threshold Contrast Brightness Baseline The lower limit (black) of the grayscale. Adjusts the contrast of the grayscale. Adjusts the brightness of the grayscale. The baseline of the spectrum may be adjusted vertically so that the entire signal may be seen within the window. Possible values range from -50% to 50%. 118 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

137 Chapter 8: Tissue Doppler Mode Imaging: Setting Up Tissue Doppler Mode Volume Display Window Invert Spectrum This controls the audio output of the PW Doppler signal. It can be adjusted in increments of 0.5 from 1.0 (min.) to 5.0 (max). The volume level data is used to set the audio output level when exporting to an AVI or WAV file, and its setting is saved with the cine loop. Shows the number of milliseconds of data displayed in the image area. The selected value also determines the speed data is scrolled through during acquisition and playback. Inverting the Tissue Doppler spectrum adjusts the display so that what is drawn below the zero frequency line is drawn above and vice versa. 3. Select Setup > Tissue Doppler Mode Setup, or press <Mode Setup> to turn off the setup display and return to the parameters display. Hot Keys The following table provides the step sizes for the hot key functions: Parameter Hot key Step Size Doppler Gain (Coarse) GAIN 5 db Doppler Gain (Fine) Shift +GAIN 1.0 db PRF VELOCITY 1.0, 2.0, 3.0, 4.0, 5.0, 7.0, 10.0, 15.0 khz Baseline BASELINE 5 percent Sample Volume Size (small adjustment) Sample Volume Size (large adjustment) SV Shift + SV 20 microns (may be adjusted to ensure integral number of cycles) 100 microns (may be adjusted to ensure integral number of cycles) Adjust Display Window WINDOW 200, 400, 600, 800, 1000, 2000, 4000, 8000 V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 119

138 Chapter 8: Tissue Doppler Mode Imaging: Setting Up Tissue Doppler Mode Parameter Hot key Step Size Adjust Transmit Frequency Doppler Angle (increase) FREQ ANGLE Adjusts up or down to available transmit frequencies (depends on active RMV scanhead) Rotates the Tissue Doppler angle by 1 clockwise or counterclockwise. If the value of the parameter is at the upper or lower limit when the associated hot key is pressed, the system does not change the parameter value, with the exception of the WINDOW and FREQ hot keys, and the ANGLE dial. Each of these adjusts up or down to the available values. Scout Window The Scout window (circled in white, below) displays the position of the Tissue Doppler Sample Volume within the B-Mode image. Tissue Doppler Mode window with scout window. To update the Scout window: 1. Store the current Tissue Doppler loop to the study (select Study > Cine Store or press <Cine Store>). The current Tissue Doppler loop is lost if the data is not stored prior to acquiring another image. 2. While acquiring Tissue Doppler data press <Toggle Scout>. The Scout window toggles to continuously update the Scout image. 120 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

139 Chapter 8: Tissue Doppler Mode Imaging: Typical Tissue Doppler Mode Image Acquisition 3. Adjust the Sample Volume position, size, and Tissue Doppler angle if required using the same steps described in Defining the PW Doppler Sample Volume on page 101 and Defining the PW Doppler Angle on page Press <Toggle Scout>. The scout image freezes and Tissue Doppler data acquisition resumes. Typical Tissue Doppler Mode Image Acquisition The following procedure describes a typical Tissue Doppler acquisition session. The description assumes that the animal has already been prepared for imaging and that an acquisition session is open in the current study (see Typical Acquisition Session on page 47). 1. In B-Mode acquisition (see Typical B-Mode Image Acquisition on page 69), localize the target region for Tissue Doppler acquisition. 2. Select Overlay > Tissue Doppler Sample Volume Wire-frame or press <Overlay> until the Tissue Doppler Sample Volume is displayed. 3. Position and size the Sample Volume wire-frame at the desired location for Tissue Doppler signal acquisition on the B-Mode image. 4. Position the Tissue Doppler angle. 5. To switch to Tissue Doppler Mode from B-Mode select Mode > Tissue Doppler Mode or press <Tissue>. Tissue Doppler Mode opens and automatically starts acquiring data. New Tissue Doppler lines enter the window from the right side and scroll across the window to the left in real-time. The audio representation of the acquired Tissue Doppler data is output through the system speakers. Audio heard through the right-hand speaker represents movement towards the transducer. Audio heard through the left-hand speaker represents movement away from the transducer. Note: Toggle to the Scout image to verify the Sample Volume location throughout the imaging session. Press <Toggle Scout> or use the Toggle Scout foot pedal command to toggle continuous scanning in the Scout window. 6. Select Mode > Freeze or press <Scan/Freeze> to stop data acquisition. 7. Use the playback controls located below the image area to review the acquired data. 8. To adjust the imaging parameters, select Setup > Tissue Doppler Mode Setup (or press <Mode Setup>). 9. To store data: For the cine loop, click Study > Cine Store or press <Cine Store>. For the visible frame, click Study > Frame Store or press <Frame Store>. 10. Analyze the data. To make measurements, see Measurements on page 153. To annotate the images, see Text Annotations on page 197. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 121

140 Chapter 8: Tissue Doppler Mode Imaging: Working With Tissue Doppler Acquisition Data 11. Review the data. To review measurement and calculations, see Data Browser on page 143. To export the acquired data to a file, see Export on page Save the study. Select Study > Close Study or press <Close> to close the study and click Commit Session Data to save the data. To copy the study to a local or network storage location, click Copy To. Note: To copy a study to removeable media, see Copying Data on page Click Exit to close the application. Signal Integration of Physiological Data Any of the ECG, Respiration, and Blood Pressure traces can be displayed below the high-resolution ultrasound image. All available physiological data can be displayed to the right of the trace window. Right-click the ECG trace to increase the signal amplification. Left-click to decrease. The Physiological data trace waveform is displayed in a window below the image. The trace is synchronized with the ultrasound image. Storing Physiological Data Physiological data is included in exported cine loops and frames along with the Tissue Doppler Mode image data, and is displayed when viewing a saved cine loop or frame. The physiological data can also be saved with image measurement files. Working With Tissue Doppler Acquisition Data For strain rate measurement and calculation procedures, see Measuring and Calculating the Strain Rate on page 185. All other data acquisition tasks in Tissue Doppler Mode are completed in the same way as data acquisition tasks are completed in PW Doppler 122 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

141 Chapter 8: Tissue Doppler Mode Imaging: Working With Tissue Doppler Acquisition Data Mode. These tasks are documented in the chapter PW Doppler Mode Imaging. Refer to the following sections in PW Doppler Mode Imaging for complete information on the following data acquisition tasks: For Defining the PW Doppler Sample Volume see page 101 For Defining the PW Doppler Angle see page 102 For PW Doppler Acquisition Window see page 103 For Time-Gain Compensation (TGC) see page 108 For Multiple Sample Volumes see page 108 For PW Doppler Cine Loop see page 110 V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 123

142 Chapter 8: Tissue Doppler Mode Imaging: Working With Tissue Doppler Acquisition Data This page intentionally left blank. 124 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

143 Chapter 9: M-Mode Imaging: Defining the M-Mode Sample Volume Chapter 9: M-Mode Imaging M-Mode imaging produces quantifiable images to characterize moving anatomy such as a cardiac wall motion by selecting a line of the B-Mode image and observing it over time. Defining the M-Mode Sample Volume The Sample Volume is the region of interest from which the M-Mode signal is acquired. To position the Sample Volume in the Scout window: The guides indicating the position of the transducer image (a vertical red line) and volume (represented by two short horizontal yellow lines connected by a vertical dashed line) are shown on the B-Mode scout image on page Press <Scan/Freeze> to begin acquiring data. Note: The M-Mode Sample Volume can only be repositioned or resized during acquisition. 2. Position the trackball cursor over the red vertical line. The trackball cursor is displayed as a crosshair when it is within a region that can be repositioned. 3. Left-click to select the Sample Volume positioning line and use the trackball cursor to change the position of the Sample Volume. The Sample Volume appears yellow when it is positioned within the focal zone of the RMV scanhead. If the Sample Volume is positioned outside the focal zone, it appears red. For the best data acquisition, the Sample Volume should be positioned within the focal zone. 4. When the Sample Volume is in the desired position, left-click again. The position is displayed in the parameters area. To adjust the size of the Sample Volume: 1. Press <Scan/Freeze> to begin acquiring data. 2. Move the trackball cursor over one edge of the Sample Volume. The trackball cursor is displayed as a double arrow when it is in the proper position. 3. Resize the Sample Volume, using either one of the two following procedures: From the B-Mode window, left-click the Sample Volume marker, and move the trackball cursor up or down to adjust the Sample Volume size. When the Sample Volume is the desired size, left-click to set the size. The length of the Sample Volume is updated in the parameters area. Using the hot keys, press SV to adjust the size of the Sample Volume by approximately 50 microns, or by 500 microns when the Shift key is held down. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 125

144 Chapter 9: M-Mode Imaging: M-Mode Acquisition Window The Scout window displays a B-Mode image with the selected M-Mode Sample Volume. M-Mode Sample Volume M-Mode Sample Volume position parameters The grayscale bar indicates the dynamic range of the display. The depth ruler indicates the depth from the transducer face. The triangular arrow indicates the focal length. ECG trace Time scale in milliseconds. The image window scrolls right to left. The most recently acquired data appears on the right of the window. The following information about the Sample Volume is listed in the parameter display to the left of the Scout window: Depth Length The depth to the center of the Sample Volume from the transducer face. The length of the Sample Volume. The M-Mode Sample Volume may also be repositioned and resized from within B-Mode. M-Mode Acquisition Window Setup During M-Mode operation the transducer sends a pulsed signal along a single line, acquiring data about the motion of the tissue along that line. To modify the M-Mode parameters: 1. Select Setup > M-Mode Setup or press <Mode Setup>. 2. The M-Mode Setup dialog is displayed. Modify the desired parameter settings. 126 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

145 Chapter 9: M-Mode Imaging: M-Mode Acquisition Window 3. Select Setup > M-Mode Setup or press <Mode Setup> to turn off the setup display and return to the parameters display Transmit Settings Power RF Cycles Set the power of the transmit signal by selecting a value between 3% and 100%. The number of cycles output by the transmitter. The default setting is 1 cycle. Display Settings Contrast Brightness Display Window Adjusts the contrast of the grayscale. Adjusts the brightness of the grayscale. Shows the number of milliseconds of data displayed in the image area. The selected value also determines the speed that data is scrolled through during acquisition and playback. Hot Keys When the M-Mode parameters are adjusted using the system hot keys, the associated parameter displayed in the display parameters section shall be updated when the next image is acquired. The following table provides the step sizes for the hot key functions: Parameter Hot Key Step Size Gain (Coarse) GAIN 5 db (this can be seen by the movement of the TGC sliders) Gain (Fine) Shift + GAIN 1.0 db (this can be seen by the movement of the TGC sliders) Sample Volume Size (small adjustment) Sample Volume Size (large adjustment) SV Shift + SV 50 microns 500 microns V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 127

146 Chapter 9: M-Mode Imaging: M-Mode Acquisition Window Parameter Hot Key Step Size Adjust Display Window WINDOW 200, 400, 600, 800, 1000, 2000, 4000, 8000 Adjust Transmit Frequency FREQ Adjusts up or down to available transmit frequencies (depends on active RMV scanhead) If the value of the parameter is at the upper or lower limit when the associated hot key is pressed, the system does not change the parameter value, with the exception of WINDOW and FREQ. Each of these hot keys adjusts up or down to the available values. Use the hot keys to change any of the system parameters without freezing data acquisition. Scout Window The Scout window (indicated in white, below) displays the position of the M-Mode Sample Volume within the B-Mode image. Typical use of the Scout window includes two steps: 1) Reposition the Sample Volume in the Scout window. 2) Update the Scout window to verify that the M-Mode data being acquired is still valid. To update the Scout window: 1. Store the current M-Mode loop to the study (click Study > Cine Store or press <Cine Store>). The current M-Mode loop is lost if the data is not stored. 2. While acquiring M-Mode data, press <Toggle Scout>. The Scout window toggles to continuously update the B-Mode Scout window. 128 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

147 Chapter 9: M-Mode Imaging: Time-Gain Compensation (TGC) 3. Adjust the M-Mode Sample Volume and position if required using the same steps described in Defining the M-Mode Sample Volume on page Press <Toggle Scout>. The scout image freezes and M-Mode data acquisition resumes. Time-Gain Compensation (TGC) TGC sliders appear next to the B-Mode Scout window, and are used to control the receive gain of the B-Mode image. When acquiring M-Mode data, or when the Scout window is being continuously updated, use the TGC sliders to update the gain for the B-Mode image being acquired. This also updates the gain for the M-Mode image. Alternatively, press GAIN to adjust the position of the TGC sliders. For more information, see Adjusting the TGC Value on page 78. When the system is paused, the TGC controls and the GAIN hot keys are disabled. M-Mode Cine Loop When M-Mode data is acquired, the M-Mode cine loop may be reviewed and analyzed by stepping through the data. The M-Mode cine loop has a maximum length of 30 seconds. Full Playback When M-Mode data is paused, a play button ( ) appears with the standard playback controls, below the image window. This button plays through the cine loop. When the play button is enabled (the M-Mode cine loop is playing), the button becomes a stop button. play forward jump to start step forward jump to start Note: An M-Mode cine loop cannot be played in reverse. Scrolling Through the Data Click < > and < > to step through the M-Mode data to view, analyze and make measurements on the data. Store and Export The cine loop may be stored to the study for further analysis. Individual images may be exported to file. To store an image: Select Study > Frame Store or press <Frame Store>. The current screen contents are stored with the study as a loop. Including annotations and measurements in Frame Store An annotation is included in a stored frame if the majority of the annotation is visible on the image area. A measurement is included if all points of a measurement are visible on the image area. If Frame Store is activated while the system is acquiring data: V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 129

148 Chapter 9: M-Mode Imaging: Typical M-Mode Image Acquisition 1. Data acquisition stops. 2. The system stores the displayed data. 3. The system clears the data buffer and data acquisition resumes. To store a loop: To store the cine loop, select Study > Cine Store or press <Cine Store>. To view a loop: 1. To view a stored cine loop, select Study > Browse Study or press <Browse> to view the Data Browser. 2. Select an image to view and click Load. To export an image: To export the currently displayed data, select Study > Export Image. To export a cine loop: To export the current cine loop, select Study > Export Cine Loop. Typical M-Mode Image Acquisition The following describes a typical M-Mode image acquisition session. The description assumes that the animal has already been prepared for imaging and that an acquisition session is open in the current study (see Typical Acquisition Session on page 47). 1. Press <Toggle Scout> to toggle between M-Mode acquisition and continuously updating the Scout window. 2. In the scout window, localize the target region for M-Mode acquisition. 3. Position and size the Sample Volume wire-frame at the desired location. 4. Start acquiring M-Mode data. In the image window, the M-Mode display consists of data from a single ultrasound line displayed as a function of time. The brightness of the grayscale corresponds to the amplitude of the received ultrasound echo. The vertical axis of the M-Mode strip corresponds to depth, and the horizontal axis corresponds to time. 5. Select Mode > Freeze or press <Scan/Freeze> to stop data acquisition. 6. Use the playback controls located below the image window to review the acquired data. 7. To adjust the imaging parameters, select Setup > M-Mode Setup or press <Mode Setup>. 8. Refresh the Scout image to verify the Sample Volume location throughout the imaging session. Press <Toggle Scout> or use the Toggle Scout foot pedal command to toggle to continuous scanning in the Scout window. 9. To store data for further study: 130 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

149 Chapter 9: M-Mode Imaging: Typical M-Mode Image Acquisition For a data loop, click Study > Cine Store or press <Cine Store>. For the visible frame, click Study > Frame Store or press <Frame Store>. 10. Analyze the data. To make measurements, see Measurements on page 153. To annotate the images, see Text Annotations on page Review the data. To review measurements and calculations, see Data Browser on page 143. To export the acquired data, see Export on page Save the study. Select Study > Close Study to close the study and click Commit Session Data to save the data. To copy the study to a storage location, click Copy To. 13. Click Exit to close the application. Signal Integration of Physiological Data Any of the ECG, Respiration, and Blood Pressure traces can be displayed below the high-resolution ultrasound image. All available physiological data can be displayed to the right of the trace window. Right-click the ECG trace to increase the signal amplification. Left-click to decrease. The physiological data trace waveform is displayed in a window below the image. The trace is synchronized with the ultrasound image. Storing physiological data Physiological data output is included in exported cine loops and frames along with the M-Mode image data, and is displayed when viewing a saved cine loop or frame. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 131

150 Chapter 9: M-Mode Imaging: AM-Mode AM-Mode Anatomical M-Mode (AM-Mode) gives operators a tool to obtain anatomically correct LV measurements along any line through a B-Mode image. Unlike M-Mode data, which is acquired directly along a single acquisition line, AM-Mode data is constructed. The system generates an AM-Mode spectrum from the acquired B-Mode cine loop based on the Ultrasound grayscale information along the Sample Volume plane. The following illustration of an arbitrary sample volume plane highlights the features of AM-Mode. AM-Mode and M-Mode settings are the same. The yellow A denotes AM-Mode, to distinguish the sample volume in the Scout window from an M-Mode sample volume position. Sample Volume position. The Sample Volume can be positioned and rotated in any direction on the B-Mode cine loop. LVID trace measurements have been made on this AM-Mode data. AM-Mode data, regenerated from B-Mode cine loop data, is displayed in the mode window. AM-Mode and M-Mode share measurement, calculation and annotation functions. Typical AM-Mode Data Construction Because AM-Mode data is constructed, not acquired, it can be generated from existing B-Mode data or from real-time data acquisition. Constructing AM-Mode data To construct AM-Mode data from existing B-Mode data: 1. From the Data Browser, open the B-Mode image. 132 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

151 Chapter 9: M-Mode Imaging: AM-Mode Note: For best results, the B-Mode image should have been acquired at a minimum of 100 frames per second. 2. Click Overlay > M-Mode Sample Volume Wire-frame. 3. In the mode window, right-click the image area. The system activates modifications to the interface, as described in the following illustration: A yellow A identifies that the Sample Volume is in the AM-Mode state. Click and drag the Sample Volume positioning line as required. A yellow pointer is placed on the lower caliper of the Sample Volume positioning line. This point appears at the bottom of the sample volume, regardless of the final orientation of the Sample Volume position line. If you are working from acquired or stored B-Mode data, the AM-Mode button appears. Click AM-Mode to launch AM-Mode in review mode to load the current frame of the cine loop in the B-Mode scout window. Right-click the image area to toggle back to the M-Mode Sample Volume positioning line, and remove the AM-Mode button. 4. Set the sample volume. Note the following functions: The pointer becomes a cross-arrows cursor when the cursor is positioned over one of the calipers. Left-click the cross-arrow to start moving a caliper. Left-click again to commit the caliper position. While positioning a caliper, press any key to return the SV to its previous state. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 133

152 Chapter 9: M-Mode Imaging: AM-Mode The last position of the AM-Mode SV is maintained in both the acquisition session and the review mode. 5. Switch to AM-Mode to view the cine loop. If you are constructing AM-Mode data from stored B-Mode data: Click AM-Mode. The system launches AM-Mode in review mode and loads the current frame of the cine loop in the B-Mode scout window. If you are working with real-time data, click Mode > M-Mode. 6. Complete the measurements, calculations and annotations using the same functions that are available in M-Mode. 7. Save the image to the study. Note: The AM-Mode SV on a loaded or reloaded AM-Mode image cannot be modified. 134 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

153 Chapter 10: Power Doppler Mode: Typical Power Doppler Image Acquisition Chapter 10: Power Doppler Mode Power Doppler Mode provides tools to visualize and measure a flow volume in 2D and 3D. This mode is very useful for applications such as: Detecting microvascularity in and around orthotopic and subcutaneous tumors, and producing a measure of relative quantification Determining percentage flow and flow volume to monitor tumor burden longitudinally The following screen illustrates the features of Power Doppler Mode: Priority indicator. Gray-scale bar. Time-gain compensation (TGC) sliders. Power Doppler Acquisition Parameters Power Doppler Histogram. Typical Power Doppler Image Acquisition This procedure assumes that the animal is prepared for imaging and an acquisition session is open (see Typical Acquisition Session on page 47). V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 135

154 Chapter 10: Power Doppler Mode: Setting Up Power Doppler Mode To start Power Doppler Mode: 1. From B-Mode, set the power box overlay to the correct dimensions (i.e. so that it covers the entire area for which you would like to see Power Doppler). If the Power Box Wire-frame is not already on, it can be switched on by using the Overlay hot key and toggling through the various overlays or by selecting Power Box Wire-frame from the Overlay dropdown. 2. The Power Box Wire-frame dimensions can be changed by moving the trackball pointer over the edge of the wire-frame, and left clicking. This allows you to drag the wire-frame to the new position. Left clicking again sets the new position. 3. Select Mode > Power Doppler or press <Power Doppler>. Setting Up Power Doppler Mode When the Power Box Wire-frame is satisfactorily set to encapsulate the area for observing Power Doppler, configure the acquisition settings to create the optimal Power Doppler images. To configure the system for Power Doppler: 1. Select Mode > Power Doppler Setup or press <Mode Setup>. Power Doppler setup parameters 136 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

155 Chapter 10: Power Doppler Mode: Setting Up Power Doppler Mode 2. Configure the settings as described in the following table: Velocity Sets the Pulse Repetition Frequency (PRF) to use for Power Doppler. Options include: Slow - 2 khz. Medium - 5 khz. Fast - 10 khz. Max - 20 khz. Typically, the default value (Medium) for this setting is sufficient for most tumor imaging. Scan Speed Defines how quickly the transducer of the RMV sweeps across the area of interest. The Power Doppler Scan Speed can be set to between 0.5 and 15 mm/s; however, for most application one should not need to go beyond 6 mm/s. In some cases, if the box size is large and the Velocity combo box is set high, the minimum Scan Speed may be greater than 0.5 mm/s. To limit motion artifact as much as possible, the default scan speed should be used if possible. Scan speeds of 1.0 mm/s to 2.0 mm/s are usually sufficient for tumor imaging. Increasing the scan speed generates faster screen updates (frame rate) but might introduce motion artifact into the image. Wall Filter Filters out noise and motion artifact to improve image quality. This feature controls a high pass filter which is used to separate clutter from flow signal thus separating stationary and slow moving components from the image. This setting can be increased to remove clutter and noise and reduced to increase flow sensitivity. Typically, the Wall Filter should be set higher than the Scan Speed (at least 0.1 mm/s to 0.5 mm/s) to prevent the system from interpreting the motion of the transducer as flow. If the Auto Scan Speed option is enabled, the system automatically selects the Wall Filter value. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 137

156 Chapter 10: Power Doppler Mode: Setting Up Power Doppler Mode Contrast Minimum Establishes the lower threshold for the Power Doppler. Signal at or below this level appears as the darkest red on the Power Doppler histogram. The setting can be modified by typing values into the Contrast Minimum edit box. However, it is easier to use the contrast setting controls that are part of the Power Doppler histogram. To set the Contrast Minimum control: 1. Position the cursor on the bottom line of the control. 2. Drag the line up or down until it is slightly above the highest peak (extending to the right) in the histogram. The position of the minimum contrast control can be set by left clicking. Note: To move the Contrast Minimum and Contrast Maximum values together, left-click the vertical line that connects the two, position the cursor to the new desired position, and then left-click again to set the position. Contrast Maximum Establishes the upper threshold for the Power Doppler. Signal at or above this level appears as the brightest yellow on the Power Doppler histogram. The setting can be modified by typing values into the Contrast Maximum edit box. However, it is easier to use the contrast setting controls that are part of the Power Doppler histogram. To set the Contrast Maximum control: 1. Position the cursor on the top line of the control. 2. Drag the line up or down until it is in line with the highest signal level (in db) that is detected by the system. The position of the maximum contrast control can be set by left clicking. Note: To move the Contrast Minimum and Contrast Maximum values together, left-click the vertical line that connects the two, position the cursor to the new desired position, and then left-click again to set the position. 138 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

157 Chapter 10: Power Doppler Mode: Setting Up Power Doppler Mode Auto Histogram This box is checked by default, and automatically positions the minimum and maximum levels to filter out the system noise from the image. This spreads the power intensity levels on the color map to cover the widest possible range of values under the histogram curve. If the check box is cleared, the system does not filter out the system noise from the image. Priority Excludes selected shades of gray scale from the Power Doppler imaging. This is typically used to filter out a bright reflector (for example, a skin line) that might have slight motion and therefore appear to the system as flow. The setting can be modified by typing values into the Priority edit box. However, it is often easier to use the priority setting control located on the gray scale bar to the left of the image. To set the Priority control: 1. Position the cursor over the small red triangle and left-click. 2. Move the triangle up or down until the bright reflectors to be excluded from the Power Doppler are gone. 3. Left-click to set the position of the priority range control. Respiration Gating When the system is configured to receive a respiration signal, this setting gates the Power Doppler images so that they are refreshed at the same point in the respiration cycle. At the conclusion of a respiration cycle, the system gathers the next set of data required to update the image. The image should therefore remain relatively stationary since the data is captured at approximately the same point in the respiration cycle for each refresh. To activate Respiration Gating, select the check box situated to the left of Respiration Gating label. While this feature is designed to eliminate the respiration from the left side of the image (due to the start of a refresh at the conclusion of a respiration cycle), you might still see respiration artifact toward the right side of the image if the scan speed is lower than the respiration cycle. If this is a concern, increase the Scan Speed or activate the Auto Scan Speed setting. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 139

158 Chapter 10: Power Doppler Mode: Setting Up Power Doppler Mode Auto Scan Speed This setting is only available when the Respiration Gating is active. When Auto Scan Speed is active, the system attempts to calculate the scan speed required to ensure the image refresh is completed before the next respiration cycle begins. This should reduce the occurrence of respiration artifact in the image. Note: The scan speed is only calculated when the scan is started. If the respiration rate changes over time, it may be necessary to freeze/unfreeze the acquisition so that a more current respiration rate is used to calculate the required scan speed. Power Typically, the default value (100%) for this setting is sufficient. Lower the value if the signal displayed on the histogram (to the right of the image) is being clipped at the 70 db mark. RF Cycles Typically, the default value (2) for this setting is sufficient. This setting can be increased (maximum is 5) if more signal sensitivity is required. Note that there is a trade-off between number of cycles and resolution. The higher the number of cycles, the lower the resolution. Gain This setting (default value 20 db) is the Power Doppler gain used by the hardware. It could be increased (maximum value is 40) to enhance weak signals. Note that the gain sliders to the right of the image affect B-Mode receive gain, while this setting is a Power Doppler only gain. Note: The Contrast Minimum, Contrast Maximum and Priority display settings are dynamic. Any changes to these parameters during acquisition or review affects the display in real time. The Reset View button resets the B-Mode view parameters including FOV and Sector Size to the default settings. The Power Box is not modified unless it becomes larger than the B-Mode FOV. This can occur when the Power Box size is larger than the default B-Mode FOV when the reset is applied. Saving the Power Doppler Mode Settings Power Doppler Mode settings can be saved and recalled using the Parameter Settings feature in the Operator Preferences dialogue. Saved Power Doppler settings can be used to reproduce an imaging environment for longitudinal studies. For more information on how to save and recall settings, see Parameter Settings on page VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

159 Chapter 10: Power Doppler Mode: Measuring Vascularity Measuring Vascularity A 2D area measurement of a structure (for example, a tumor) can be completed in Power Doppler Mode, as in B-Mode imaging. When completing a 2D area measurement in Power Doppler, the system also calculates the Percentage of Vascularity (PV). This can be accessed through the Histogram feature. Note: The histogram in Power Doppler only includes colored pixels. Gray-scale data is excluded. To view a histogram, right-click on the ROI measurement, and click Histogram. A pop-up window is displayed containing a plot of the relative distribution of pixels across the gray scale shown on the horizontal axis. The blue indicator on the gray scale indicates the mean gray level. The green indicators on the gray scale indicate the standard deviation for the gray level. The operator can export an image of the histogram plot as either a BMP or TIFF file. To export an image of the histogram plot: 1. Click the Export button in the histogram pop-up. 2. In the dialog that appears, specify a destination location and name for the file to be exported. Power 3D Mode B-Mode vs. Power Doppler Data 3D-Mode supports the acquisition of both B-Mode data and Power Doppler data. This combined mode is called Power 3D Mode. Power 3D Mode reconstructs a volume with the color structure integrated with the B-Mode 3D volume. Power 3D Mode is initiated when a 3D volume is acquired from Power Doppler Mode, or when 3D-Mode is entered from Power Doppler Mode. The same functionality available in 3D-Mode is available in Power 3D Mode with the following additional functionality specific to Power 3D Mode: When viewing an acquired Power 3D volume, the system can be set to display only the B-Mode data, only the Power Doppler data, or the integrated B-Mode and Power Doppler data. To select the desired view option, click the Grayscale Display or the Power Display icon or both, depending on which display is required. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 141

160 Chapter 10: Power Doppler Mode: Power 3D Mode Percent Vascularity (PV) Display Settings A percent vascularity (PV) index is calculated when a volume has been created in Power 3D Mode using the 3D segmentation tool. If the volume is edited by changing the position or size of one or more of its contours, the PV can be recalculated by clicking the PV Recalc button in the Volume tool. In the Display tool there are options to change the Contrast Minimum, Contrast Maximum and Priority. To apply the changes in these parameters, click Regenerate. Note: This operation may take some time due to the size of a 3D volume and the reconstruction of each slice in the volume. Acquisition Settings When starting a 3D acquisition from 3D-Mode instead of starting from 2D Power Doppler mode, the following Power Doppler parameters can be changed: Velocity Wall Filter Scan Speed For more details on 3D image acquisition and display options, see 3D-Mode Imaging on page VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

161 Chapter 11: Data Management: Data Browser Chapter 11: Data Management The Vevo software data management functions allow the operator to: Manage image data. Manage the association between image data, measurements and studies. Export measurement and calculation data for post-imaging analysis. Export image data for viewing in other applications, for storage or for use in presentations and publications. Data Browser To open the Data Browser and view a list of images stored in a study, select the study of interest in the Study Browser and click Open. The Data Browser allows the operator to browse a list of images and cine loops that have been associated with a study as well as the measurements and calculations that have been made on the data, as shown in the following illustration. Study Browser commands List of measurements associated with this study Browse By view options Study Details Selected measurement Thumbnail of selected image V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 143

162 Chapter 11: Data Management: Browse By View Browse By View The type of data listed in the Data Browser window is selected from the options available in the Browse By section to the right of the list. Images 1. Under Browse by, to the right of the data list, select Images. This is the default setting for the Data Browser. 2. Click on any column heading to sort the list. Note: The list cannot be sorted by the M&A column. To review an image: 1. Select the image from the list. The area at the bottom right corner of the Data Browser displays a thumbnail of the image. 2. Click Load to open the image in the mode window or use Previous and Next to review other images in the study. Measurements 1. Under Browse by, to the right of the data list, select Measurements. A list of the measurements that have been made on the study data is shown. 2. Click on any column heading to sort the list. Note: The list cannot be sorted by the Value column. To review a measurement: 1. Select the measurement to be viewed. 2. Click Load to open the image displaying that measurement in the mode window. For more information on measurements, see Measurements on page 153. Calculations 1. Under Browse by, to the right of the data list, select Calculations. A list of the calculations that have been computed from the existing measurements is presented. 2. Click on any column heading to sort the list. Note: The list cannot be sorted by the Value column. 3. Select Show all calculations to view all possible calculations. Calculations with results that cannot be computed due to their component measurements not having been made are noted in the Value column with Could not find value(s) for:.... For a detailed description of all the calculations, refer to the Vevo 770 Measurements and Calculations document. Column Headings Image Label The column headings in the Data Browser are different in the Images view than they are in the Measurements or Calculations views. An image label can be applied to any image. This label is associated with the image and is seen in: The Study Browser, under the thumbnail of the image 144 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

163 Chapter 11: Data Management: Selections The Data Browser, as the heading of the first column in the list of image data The header of the mode window, under the Animal ID In the header of the exported image An image label can be applied from the mode window or from the Data Browser. Click Edit > Image Label or press <Image Label>. Note: A label assigned to a B-Mode cine loop is referenced in the label for any frame stored from that loop. To add or edit an image label: 1. Press <Image Label> or click Edit > Image Label for a selected image in the Data Browser, or when data is displayed in the mode window. 2. Type the desired label in the Image Label dialog. The label may have a maximum length of 40 characters. 3. Click OK. Mode Date/Time Length Indicates the mode in which an image or measurement was created. Indicates the date and time at which an image was created. Indicates the size of a stored image. For a B-Mode, Power Doppler Mode or EKV-Mode cine loop, the length is the number of frames in the loop. For a PW Doppler Mode, Tissue Doppler Mode or M-Mode cine loop, the length is the number of seconds of data. For a 3D-Mode or Power 3D Mode image, the length is the range of the 3D scan. M and A Annotation Value Embryo Name Protocol Description Indicates the number of measurements and annotations on the image. Indicates the label for the measurement. Indicates the value of a measurement or calculation. Indicates the uterine horn and embryo number for a measurement made on an embryo, or for a calculation whose measurements were made on an embryo. An abbreviation of the name of the calculation. Indicates the protocol within a measurement package from which measurements in a calculation were made. The full name of the calculation. Selections Export To export a cine loop: 1. In the Browse by Images view: V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 145

164 Chapter 11: Data Management: Selections a. Select one or more cine loops, and select Export Cine Loop. A dialog is presented in which the operator can select a destination folder, and the type of file to create (for example, an AVI file, or a WAV file). b. Select a destination directory for the export. If desired, specify a prefix (optional) to appear at the beginning of each file name. 2. Click OK. A separate file is created for each cine loop that was selected. A file name is created automatically for each file. The file name includes the prefix (if specified), the Image Label (if defined for the loop), the Image Acquisition Time, and a unique number. If the operator selects a single cine loop to export from the Image Browser, the operator can specify the file name for the exported cine loop. The operator is notified if the export operation cannot be performed (for example, due to space limitations at the destination location). File Types Files in any one of the following AVI file formats: AVI format AVI Uncompressed AVI Compressed - Microsoft Video 1 AVI Compressed - Cinepak WAV RDB Note Largest file size. Highest image quality. Available for exporting a B-Mode cine loop, an EKV-Mode loop, or a Power Doppler loop. Smaller file size, good quality. For export to Macintosh systems. Longest compression time but smallest in file size. On Windows, these files play on Microsoft Media Player version 10 or later and on Quicktime version or later. An uncompressed format that stores audio waveform data. On Windows systems, these files play on Microsoft Media Player version 10 or later. On Macintosh systems, the files play on Quicktime version or later. Raw image data. For more information, contact a Technical Support Representative (support@visualsonics.com). Note: To export a cine loop from the mode window, select Study > Export Cine Loop. AVI playback on an external PC Use the following procedure to play an exported B-Mode, PW Doppler Mode, Power Doppler Mode, AM-Mode, Power 3D Mode, Tissue 146 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

165 Chapter 11: Data Management: Selections Doppler Mode, 3D-Mode or M-Mode AVI file on a PC using Microsoft Windows Media Player: 1. From the Start menu, click Windows Media Player. Mode 2. If the player is in the Skin Mode, click the Mode toggle button. 3. If the menu is not displayed, click the Show/Hide toggle button. Show / Hide 4. From the menu selection drop-down, click Tools > Options. 5. In the Options dialog, click the Performance tab. Menu selection drop-down 6. Under Video acceleration, click Advanced. 7. Under Video acceleration: a. Clear the Use overlays check box. b. Clear the Drop frames to keep AV in sync check box, click OK. 8. Click Apply. 9. On the confirmation dialog, select Yes, and then click OK. 10. From the File menu, browse to a location that contains AVI files, and select an AVI file to open. The AVI file may automatically begin playing. If it does not, select Play > Play/Pause. Export Image Exporting images is similar to exporting cine loops. To export an image: 1. In the Browse by Images view: a. Select one or more images, and select Export Image or press Export. A dialog is presented in which the operator can select a destination folder, and the type of file to create (for example, a BMP file, or a TIF file). b. Select a destination directory for the export. c. If desired, specify a prefix (optional) to appear at the beginning of each file name. 2. Click OK. A separate file is created for each image that was selected. A file name is created automatically for each file, using the same naming convention as that used when exporting images. If a cine loop is amongst the images selected to be exported, the exported file displays the same data displayed when that loop is first loaded. Note: To export an image from the mode window, click Study > Export Image, or press <Export>. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 147

166 Chapter 11: Data Management: Selections Export Report Export a report containing the measurements and calculations in a format that can be imported into a database or spreadsheet. The exported file is in a Comma Separated Values (CSV) format. 1. Click Export Report. 2. Browse to the desired storage location. 3. Enter a file name and click Save. See Exporting Measurements and Calculations on page 192 for a discussion on the format of the measurements and calculations file. Note: Measurement reports can also be exported by selecting Study > Export Report from the mode window. Export Table Export a table containing the current view of the Data Browser list to a plain text file. 1. Click Export Table, and then browse to the desired storage location. 2. Enter a file name and then click Save. Strain Rate The Strain Rate button is enabled if the SR Vel 1 and SR Vel 2 strain rate measurements have been created on two Tissue Doppler cine loops (one measurement on each loop), and the two measurements are selected in the Measurement Browser. These measurements are available in the Cardiac Measurements Package. To obtain the strain rate: 1. Select two strain rate velocity measurements (SR Vel 1 and SR Vel 2). 2. From the Measurements Browser, click Strain Rate. The system displays the Strain Rate Analysis window. For more information, see Measuring and Calculating the Strain Rate on page 185. PV Loop The PV Loop button is enabled if LV area measurements have been made on B-Mode and M-Mode images that have blood pressure data. To create a PV Loop: 1. Select one or more LV area measurements made in B-Mode or M-Mode images. 2. From the Measurements Browser, click PV Loop. The system displays the Pressure-Volume Relationship window. For more information, see Pressure-Volume Loop Measurements on page VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

167 Chapter 11: Data Management: File Types File Types The available file types for saving each of the data items are: Data Type B-Mode cine loop EKV-Mode loop Power Doppler loop B-Mode image (with measurements and annotations) Available File Types AVI Uncompressed AVI Compressed Microsoft Video AVI Compressed Cinepack Raw Image Data Windows BMP Windows TIFF Raw Image Data EKV-Mode image (with measurements and annotations) Power Doppler Mode image (with measurements and annotations) B-Mode pressure-volume loop EKV-Mode pressure-volume loop PW Doppler cine loop (with measurements, annotations and audio) CSV Windows BMP Windows TIFF Compressed AVI Microsoft Video Compressed AVI Cinepack Raw Image Data Tissue Doppler cine loop (with measurements, annotations and audio) PW Doppler cine loop - audio only Windows Audio WAV Tissue Doppler cine loop - audio only PW Doppler image (with measurements and annotations) Windows BMP Windows TIFF Raw Image Data Tissue Doppler image (with measurements and annotations) Tissue Doppler strain rate graph CSV Windows BMP Windows TIFF V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 149

168 Chapter 11: Data Management: File Types Data Type M-Mode cine loop (with measurements and annotations) Available File Types Compressed AVI Microsoft Video Compressed AVI Cinepack Raw Image Data AM-Mode cine loop (with measurements and annotations) M-Mode frame (with measurements and annotations) Windows BMP Windows TIFF Raw Image Data AM-Mode frame (with measurements and annotations) M-Mode pressure-volume loop AM-Mode pressure-volume loop 3D-Mode manipulations Power 3D Mode manipulations 3D-Mode image Power 3D Mode image ROI histogram Table of images, measurements, calculations Measurements and calculations report for importing into database or spreadsheet CSV Windows BMP Windows TIFF Compressed AVI Microsoft Video Compressed AVI Cinepack Raw Image Data Windows BMP Windows TIFF Raw Image Data Windows BMP Windows TIFF TXT CSV Note: Images and cine loops can be saved as RDB (raw image data) files. For more information, contact a Technical Support Representative (support@visualsonics.com). Note: Recording AVI exports using Cinepak can take longer when recorded from the dual or single pane image layout in 3D-Mode. PW Doppler, M-Mode, Tissue Doppler, and AM-Mode cine loops can only be exported as compressed AVI files (MS Video 1 for Windows and Cinepak, a Quick Time compatible format). The AVI includes an uncompressed audio track for the PW Doppler Mode export. 150 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

169 Chapter 11: Data Management: File Types An exported image area includes the scale markings and measurements as well as the institution, study name, animal ID, acquisition date and image label. The Windows AVI files for B-Mode, EKV-Mode, and Power Doppler Mode cine loops may be saved as either compressed or uncompressed files. A compressed file occupies less storage space with a slight loss of image quality. No image quality is lost when saving uncompressed files. Typical file sizes of exported files: File Type Windows AVI Uncompressed (B-Mode, 300 frames) Windows AVI Compressed (B-Mode, 300 frames) Windows AVI Compressed (PW Doppler, 30 seconds) Windows AVI Compressed (M-Mode, 30 seconds) Windows Audio Wave (PW Doppler, 30 seconds) Windows BMP (full screen) Windows TIFF (full screen) File Size MB 50 MB 160 MB 150 MB 5.6 MB 3.0 MB 2.2 MB Note: Images and cine loops can be saved as RDB (raw image data) files. For more information, contact a Technical Support Representative (support@visualsonics.com). Delete Image To delete image data: 1. Select one or more images in the Image Browser. 2. Click Delete or press <Delete>. 3. On the Confirm Deletion dialog, click Yes to permanently delete the data from the study. Note: The system displays the Confirm Deletion dialog if an image that is selected for deletion contains the last instance of a predefined measurement. Study Info Close Study Cancel Click Study Info to view and edit information about the animal, the animal s preparation and general notes for the study. Refer to New Study on page 52 for more information about the study information dialog. When Close Study is selected and changes have been made to the study, the operator is prompted to commit or discard the study data. If no changes have been made, the study closes without displaying a message. Click Cancel to close the Data Browser and return to the mode window to continue acquisition or analysis. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 151

170 Chapter 11: Data Management: Study Details Study Details The Study Details section of the Data Browser displays the study name, acquisition operator, study owner and animal ID for the study. Thumbnail Preview The lower right side of the Data Browser contains a thumbnail of the selected image. Click Load to view the image in the mode window or click Previous and Next to step through the images in the study. Hot Keys Various elements of data management may be accessed via hot keys on the keyboard and the optional keypad. The following chart details the hot key functions for the Data Browser: Function Toggle the data browser. Restore previously saved parameter settings. Reset the parameter settings to their values at system start-up. Start scanning in the mode window that was previously open. Create or edit the image label. Select the RMV scanhead. Close the study. Delete the selected image(s). Hot Key Browse Ctrl+P Ctrl+Shift+P Scan/Freeze Image Label Select Scanhead Close Delete Identifying Viewed Images The Image Browser indicates any image that has been created or reloaded since opening or creating the study by displaying it in a non-bolded font. Similarly, the Measurement Browser indicates any image that has been created or reloaded since opening or creating the study by displaying it in a non-bolded font. 152 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

171 Chapter 12: Measurements: Measurement Packages Chapter 12: Measurements The Vevo software provides the operator with packages of tools to identify and label anatomic or physiological features on the image and to make measurements of these features. Different operators can review, analyze and re-measure copies of study data. Measurement Packages Measurements are grouped according to the following application packages: Abdominal imaging Cardiac imaging Embryology imaging Standard imaging Each package consists of specific study protocols that include the defined set of predefined measurements related to a specific analysis, as described in the following table: Application Package Abdominal Measurements Package Cardiac Measurements Package Embryology Measurements Package Included Protocols Liver Abdominal Aorta and IVC Spleen Gallbladder Kidney Adrenal Glands Pancreas Female Reproductive Mammary Glands Male Reproductive Generic B-Mode M-Mode Aortic Valve Mitral Valve Tricuspid Valve Pulmonary Valve Tissue Doppler Vascular Generic Uterine Horn Placenta Generic V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 153

172 Chapter 12: Measurements: Displaying Measurements Application Package Standard Measurements Package Included Protocols Simpson s LV Mass Epicardial Endocardial Parasternal Short Axis Parasternal Long Axis Insufficiency Apical, 2 Chamber Apical, 3 Chamber Apical, 4 Chamber Apical, 5 Chamber Embryonic Kidney Liver Fetal/Maternal Blood Flow Generic Displaying Measurements To view measurements in thumbnails, study images, and exported images of all studies: In any mode and in any browser, click View > Measurements. This view state is enabled by default. Measurements Tool The measurements tool is used to create measurements on image data: To activate the measurements tool, click Tools > Measurements or press <Measure>. To cancel placement of a measurement, click Cancel Measurement or press <Esc>. To close the measurements tool, click Close or press <Measure>. 154 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

173 Chapter 12: Measurements: Measurements Tool The measurements tool is customized for each imaging mode and includes eight areas of functionality, as shown in the following illustration: Generic measurement buttons Measurement package change button Active measurement package label Protocol help button Protocol selection list Predefined protocol measurements Embryo settings Image mode measurement parameters Measurements Tool (B-Mode) V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 155

174 Chapter 12: Measurements: Measurements Tool Measurements Tool Functionality Elements Generic measurement icons Measurement package change button Active measurement package label Protocol help button Protocol selection list Predefined protocol measurements display area Embryo settings Image mode measurement parameters These buttons are used to create measurements on the image. The buttons and measurement types that are available based on the mode in which the measurement is being made. Launches the Operator Preferences window so the operator can change the active measurement package. Identifies the active measurement package. Launches an online help page that describes all measurements and calculations included in the selected protocol. Lists the available protocols in the selected measurement package. When a protocol is selected, the system displays the predefined measurements for that protocol in the predefined measurements display area. Displays the predefined measurements for the protocol selected in the Protocol selected list. The controls in this area allow enumeration of embryos by indicating uterine horn and embryo number. This section is enabled if the study information indicates that the animal is pregnant. A dynamic area that provides available measurement parameter controls related to the current image mode. In B-Mode review sessions, this area includes LV Analysis parameters. In PW Doppler Mode and Tissue Doppler Mode review sessions, this area includes frequency trace parameters. In M-Mode, AM-Mode, and 3D-Mode, no measurement parameter controls are available. Measurement Caliper A caliper indicates the placement points for the measurement. The system includes the following caliper option shapes: Small cross Bold cross 156 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

175 Chapter 12: Measurements: Measurements Tool Small point To change the shape of the caliper: Select the desired caliper shape from View > Caliper Options. A check mark is displayed beside the selected caliper shape. Note: When the Vevo 770 starts, the default caliper shape is the small cross. Creating a Measurement To create a measurement: 1. Activate the Measurements Tool (select Tools > Measurements or press <Measure>). 2. Select the generic or predefined measurement to be made on the data. 3. Place the measurement on the data by left-clicking at the desired location. The number of clicks required to complete the measurement is dependent on the type of measurement being made. For measurements that are defined by a variable number of points, right-click to place the final point of the measurement. 4. Placing a measurement automatically saves the current image to the study. Select Study > Browse Study to view this image or measurement in the Data Browser (see Data Browser on page 143). Deleting a Measurement Measurements can only be deleted by the owner of the study. Measurements made by other operators on that data can be modified. However, the changes cannot be committed to the study. To delete a measurement: Right-click a measurement, and select Delete. If the measurement being deleted is the last instance of a particular predefined measurement in the study, a confirmation dialog is displayed. Accept the confirmation prompt to delete the measurement Modify a Measurement Measurements can only be modified by the owner of the study. Measurements made by other operators on that data can be modified. However, the changes cannot be committed to the study. To reposition or resize a measurement made during the current study session: 1. Left-click a measurement, one of its calipers, or its label. 2. Reposition or resize the item and click again. The system updates the measurement values if the measurement was resized. To edit a measurement label made during the current study session: 1. Right-click on the measurement or its label. 2. Select Edit from the menu dialog. 3. Modify the label text. 4. Click the image or press <Enter> to complete the modification. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 157

176 Chapter 12: Measurements: Measurements Tool Note: Predefined measurements can be repositioned and resized but their labels cannot be edited. To reposition or resize a measurement made in an earlier study session: 1. Select a measurement, one of its calipers, or its label. A message appears, warning that the stored measurement will be changed. 2. Click Yes to continue to make the change. 3. Reposition or resize the item and click again. The system updates the measurement values if the measurement was resized. To edit the measurement label for a generic measurement made in an earlier study session: 1. Right-click on the measurement or its label. 2. Select Edit from the menu. 3. Click Yes to continue to make a change to the stored measurement. 4. Modify the label text. 5. Click the image or press <Enter> to complete the modification. Embryo Measurements A pregnant animal carries multiple embryos. The same measurement can be applied to each embryo in utero when performing developmental studies. The Vevo software assumes that these embryos are enumerated along the left and right uterine horns and that a maximum of 12 embryos are located on each side. When an embryonic measurement is made, the measurement label includes an embryo index that follows the view suffix. For example, a crown rump length measurement on the third embryo on the left uterine horn is labeled Crown Rump Length:Emb:LE3. Note: The embryo and View Suffix can be enabled/disabled in Measurement Display Options in Operator Preferences. To specify an embryonic measurement: 1. Ensure that the Study Information dialog (select Study > View Study Information) indicates that the animal is pregnant. 2. Select Tools > Measurements or press <Measure> to open the measurements dialog. 3. Enable the Embryo Measurement option. Note: Changes to the Embryo Measurement options do not affect measurements that have already been made. 4. Select the Uterine Horn from the drop-down list. 158 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

177 Chapter 12: Measurements: Measurements Tool 5. Specify the Embryo Number. Measurement Units The system includes the following measurement types and units: Measurement Type Length / Distance Unit millimeters (mm) Area square millimeters (mm 2 ) Velocity millimeters per second (mm/s) Acceleration millimeters per second per second (mm/s 2 ) Time Heart Rate Velocity Time Integral (VTI) milliseconds (ms) beats per minute (BPM) centimeters per second integrated over the time interval in seconds (cm) Volume millimeters cubed (mm 3 ) RR Interval Pressure Gradient Temperature milliseconds (ms) millimeters of Mercury (mmhg) degrees Celsius Selecting the Initial Measurement Package To select the initial measurement package: 1. Start the Vevo software (Start > All Programs > VSI > Vevo 770 > Vevo 770 V2.0.0). 2. In the Scanhead Selection dialog, in the Measurement Definition list, select the appropriate package, based on the package of measurement protocols you intend to use for the session. Changing the Measurement Package The measurement package can be changed in one of two ways: From the Operator Preferences window From the measurements tool When a new package is loaded, the system deletes all measurements that were created in the previously selected package. To change the measurement package from the Operator Preferences window: 1. From the Data Browser, open the Operator Preferences window (Edit > Operator Preferences). V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 159

178 Chapter 12: Measurements: Measurements Tool 2. In the Measurements and Calculations area under Active File, select the appropriate measurements package. The system displays the following dialog to inform the operator that the system will delete all measurements that have been created in the current package. 3. Click Yes. The system activates the selected package. 4. Click OK. The system returns to the Data Browser. To change the measurement package from the Measurements Tool: 1. From the mode window, open the Measurements Tool (Tools > Measurements). 2. Click Change. 3. The system opens the Operator Preferences window. 4. In the Measurements and Calculations area under Active File, select the appropriate measurements package. 160 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

179 Chapter 12: Measurements: B-Mode Measurements The system displays the following dialog to inform the operator that the system will delete all measurements that have been created in the current package. 5. Click Yes. The system activates the selected package. 6. Click OK. The system returns to the mode window. B-Mode Measurements Generic Measurements In B-Mode, the following generic measurements are available: Linear distance (mm) (See page 161) Traced distance (mm)(see page 162) Polygon ROI (mm 2 )(See page 162) Ellipse ROI (mm 2 ) (See page 163) Circle ROI (mm 2 ) (See page 164) Single point (x,y) (See page 166) LV Wall trace (See page 166) Generic measurements are labeled with a sequence number that increments with each measurement of that type made in the study (i.e Point 1, Point 2, Point 3...). The sequential numbering is not affected by deletion of measurements. If the last created measurement is Point1 and it is deleted, the next measurement is Point2. Linear Distance Measurement To place a linear distance measurement: 1. Click the linear distance measurement button. The button remains selected until the measurement is completed. 2. Click on the image to place the initial caliper. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 161

180 Chapter 12: Measurements: B-Mode Measurements 3. The measured distance between the initial caliper and the current trackball cursor position is updated as the cursor is moved on the image. 4. Click to place the second caliper. 5. The default measurement label is Linear#, where # is a sequential number. The label is editable after placing the second caliper. 6. Edit the label text and press <Enter> to accept the edit, or click the image area or press <Enter> to accept the default label. Note: The options enabled in the Measurement Display Options in the Operator Preferences dialog is displayed on the image and in the Data Browser. Traced Distance Measurement To place a traced distance measurement: 1. Click the traced distance measurement button. The button remains selected until the measurement is completed. 2. Click on the image to place the initial caliper. 3. Move the cursor along the contour to be traced. The system automatically plots trace points as the cursor moves, and updates the distance value for the contour as the cursor is moved over the image. 4. Right-click to place the last caliper and complete the measurement. 5. The default measurement label is Traced Distance#, where # is a sequential number. The label is editable after placing the last caliper. 6. Edit the label text and press <Enter> to accept the edit, or click the image area or press <Enter> to accept the default label. Note: The options enabled in Measurement Display Options in the Operator Preferences dialog are displayed on the image and in the Data Browser. Point measurement B-Mode image showing single point, linear and traced distance measurements. Linear distance measurement Traced distance measurement Polygon ROI Measurements To place a polygon ROI (region of interest) area measurement: 1. Click the polygon ROI area button. The button remains selected until the measurement is completed. 162 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

181 Chapter 12: Measurements: B-Mode Measurements 2. Click on the image to place the initial caliper. 3. Move the cursor along the contour to be traced. The system automatically plots trace points as the cursor moves, and updates the area value for the polygon as the cursor is moved over the image. 4. Right-click (or left-click near the first point) to place the last caliper. A line segment joins the last point in the polygon with the first point. Note: If the position of the trackball cursor is within five pixels of the previous caliper when the right-click occurs, the previously placed caliper is considered to be the last caliper for the measurement. This applies to B-Mode and 3D-Mode polygon measurements and for 3D-Mode volume contours. 5. The default measurement label is Polygon#, where # is a sequential number. The label is editable after placing the last caliper. 6. Edit the label text and press <Enter> to accept the edit, or click the image area or press <Enter> to accept the default label. Note: The options enabled in the Measurement Display Options in the Operator Preferences dialog are displayed on the image and in the Data Browser. Ellipse ROI Measurements To place an ellipse ROI area measurement: 1. Click the ellipse ROI area button. The button remains selected until the measurement is completed. 2. Click on the image to place the center point of the ellipse. 3. Click again to define the size of the ellipse. The ellipse is initially drawn as a circle with radius equal to the length of the axis indicator. As the size of the ellipse is being defined, the measurement value of the ellipse is updated as the trackball cursor is moved over the image. 4. The default measurement label is Ellipse#, where # is a sequential number. The label is editable after placing the last caliper. 5. Edit the label text and press <Enter> to accept the edit, or click the image area or press <Enter> to accept the default label. 6. Click on the ellipse circumference and drag the edge in or out to adjust the eccentricity. 7. Click to commit the new shape. 8. Click on the axis indicator, which is the line drawn from the center of the ellipse to the circumference, to rotate the orientation of the ellipse. To reposition an ellipse ROI measurement: 1. Click the center point of the ellipse ROI measurement. 2. Move the trackball cursor to reposition the measurement. 3. Click to commit the change. To resize an ellipse ROI measurement: 1. Click the edge of the ellipse. 2. Move the trackball cursor to resize the ellipse. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 163

182 Chapter 12: Measurements: B-Mode Measurements 3. Click to commit the change. Note: All options enabled in Measurement Display Options in the Operator Preferences dialog are displayed on the image and in the Data Browser. Circle ROI Measurements To place a circle ROI area measurement: 1. Click the circle ROI area button. The button remains selected until the measurement is completed. 2. Click on the image to place the center point of the circle. 3. Move the trackball cursor to define the circle s radius. As the size of the circle is being defined, the measurement value of the circle is updated as the trackball cursor is moved over the image. 4. Click to commit the circle radius. 5. The default measurement label is Circle#, where # is a sequential number. The label is editable after placing the last caliper. 6. Edit the label text and press <Enter> to accept the edit, or click the image area or press <Enter> to accept the default label. Note: All options enabled in Measurement Display Options in the Operator Preferences dialog are displayed on the image and in the Data Browser. To reposition a circle ROI measurement: 1. Click the center point of the circle ROI measurement. 2. Move the trackball cursor to reposition the measurement. 3. Click to commit the change. To resize a circle ROI measurement: 1. Click the edge of the circle. 2. Move the trackball cursor to resize the circle. 3. Click to commit the change. 164 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

183 Chapter 12: Measurements: B-Mode Measurements Circle measurement Ellipse measurement Polygon measurement B-Mode image showing polygon, circle and ellipse measurements. Mean and standard deviation of gray levels for ROI measurements The operator is able to measure the mean and standard deviation of gray levels for ROI measurements made in B-Mode. The operator can view a histogram of a selected B-Mode ROI measurement. To view a histogram, right-click on the ROI measurement, and click Histogram. A pop-up window is displayed containing a plot of the relative distribution of pixels across the gray scale shown on the horizontal axis. The blue indicator on the gray scale indicates the mean gray level. The green indicators on the gray scale indicate the standard deviation for the gray level. The operator can export an image of the histogram plot as either a BMP or TIFF file. To export an image of the histogram plot: V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 165

184 Chapter 12: Measurements: B-Mode Measurements 1. Click the Export button in the histogram pop-up. 2. In the dialog that appears, specify a destination location and name for the file to be exported. Single Point Measurement To place a single point measurement: 1. Click the point measurement button. The button remains selected until the measurement is completed. 2. The (x, y) coordinate of the current trackball cursor position is updated as it is moved over the image. 3. Click to place the caliper. 4. The default measurement label is Point#, where # is a sequential number. The label is editable after placing the point. 5. Edit the label text and press <Enter> to accept the edit, or click the image area or press <Enter> to accept the default label. Note: All options enabled in Measurement Display Options in the Operator Preferences dialog are displayed on the image and in the Data Browser. B-Mode LV Wall Trace Measurement LV wall trace measurement provides the operator with a tool to trace the endocardial wall through multiple cardiac cycles, semi-automatically or manually. Note: This is an optional function, and is available only if the Automated LV Analysis package is purchased. To place an LV wall trace measurement semi-automatically: 1. In the B-Mode Measurements Tool window: a. Click the wall trace measurement button. The button remains selected until the measurement is completed. b. In the LV Analysis area: In B-Mode, select the appropriate axis view and number of cardiac cycles. In EKV-Mode, select the appropriate axis view and number of frames. 166 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

185 Chapter 12: Measurements: B-Mode Measurements 2. Left-click the upper wall of the annulus and then the bottom wall of the annulus. The system places a straight line between these points to define the top of the LV precisely. Note: If the short axis view has been selected for analysis, the system does not insert an annulus line. 3. Left-click a point on the wall furthest from the annulus. This creates the basic curve. 4. Continuing with left-clicks, click along the wall to trace the area curve to the contour of the wall. In this example, six wall points have been added to the trace curve. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 167

186 Chapter 12: Measurements: B-Mode Measurements 5. Right-click anywhere to commit the trace. The system labels the measurement. You can accept or edit the label. 6. Right-click the trace and select Refine Forward or Refine Reverse. The system automatically traces the wall forward or backward through the frames. Frame 1: traced manually Remaining frames: traced automatically by the system To automatically refine the trace one frame forward, select Refine Next. To refine the trace one frame backward, select Refine Previous. The system does not enable Refine Forward and Refine Next when the last frame of the loop is displayed. The system does not enable Refine Reverse and Refine Previous when the first frame of the loop is displayed. 7. Modify the trace or points on the trace if required and then select Refine Forward again to complete the automatic wall trace. 8. Store the cine loop. When you replay the cine loop, the system displays the trace that represents the systolic LV in green, and the diastolic LV in red. Modifying Points on the Trace To move a point, left-click within five pixels of the point, drag the point to a new position, then left-click again to commit the point. To add a point, left-click the trace, move the cursor to a new position, then left-click again to commit the new point. To delete a point, right-click within five pixels of the point and select Delete Point. If more than one point is located within the five-pixel radius, the system deletes the point that is closest point to the cursor. 168 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

187 Chapter 12: Measurements: B-Mode Measurements Modifying the Trace To move the trace (that is, all the points as a group) left-click the center point of the trace, drag the trace to a new position, then leftclick again to commit the trace. Center point To resize the trace, press and hold Shift, select the trace, move the cursor inward or outward, then left-click to commit the trace. To delete the trace, right-click the curve and select Delete. In the Delete Measurement dialog, click Yes. The system deletes all frames of the LV measurement. Predefined Protocol Measurements Predefined protocol measurements can be made and stored with a B-Mode frame. To place a predefined protocol measurement: 1. From the protocol selection list, select the appropriate protocol. 2. In the list of predefined measurements for the selected protocol, select the desired measurement. 3. Place the calipers on the image using the procedure for the corresponding generic measurement type described earlier in this chapter. For complete descriptions of the measurements and calculations available in B-Mode, click Help. Automated Heart Rate Measurement for Calculations If the system is equipped to acquire an ECG trace concurrent with the ultrasound image, the system automatically records the heart rate as part of the measurement data. This value is available for use in calculated V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 169

188 Chapter 12: Measurements: 3D-Mode Measurements values such as Cardiac Output. For measurements that record the heart rate, the Heart Rate is displayed as the HR parameter. If the ECG signal is unavailable, the heart rate measurement from M-Mode or PW Doppler will continue to be used. Measurements that record the heart rate are included in the following measurement packages. Measurement Package Standard Cardiac Measurement Simpson 1 Length; d Simpson 2 Length; d Simpson 3 Length; d Epicardial Major; d Endocardial Major; d LV Major; d RV Major; d Stroke Distance LVOT 3D-Mode Measurements Use the 3D-Mode Measurements Tool to create the following generic measurements within the Cube view: Linear distance (mm) Single point (x,y,z) Polygon ROI (mm 2 ) Linear Distance Measurement To place a linear distance measurement: 1. Click the linear distance measurement button. The button remains selected until the measurement is completed. 2. Click on the image to place the initial caliper. 3. Click on the image to place the second caliper. 170 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

189 Chapter 12: Measurements: 3D-Mode Measurements 4. The default measurement label is Linear#, where # is a sequential number. The label is editable after placing the second caliper. 5. Edit the label text and press <Enter> to accept the edit, or click the image area or press <Enter> to accept the default label. Note: All options enabled in Measurement Display Options in the Operator Preferences dialog are displayed on the image and in the Data Browser. Single Point Measurement To place a single point measurement: 1. Click the point measurement button. The button remains selected until the measurement is completed. 2. The (x, y, z) coordinate of the current trackball cursor position is displayed. 3. Click on the image to place the caliper. 4. The default measurement label is Point#, where # is a sequential number. The label is editable after placing the point. 5. Edit the label text and press <Enter> to accept the edit, or click the image area or press <Enter> to accept the default label. Note: All options enabled in Measurement Display Options in the Operator Preferences dialog are displayed on the image and in the Data Browser. Polygon ROI Measurements To place a polygon ROI (region of interest) area measurement: 1. Click the polygon ROI area button. The button remains selected until the measurement is completed. 2. Click on the image to place the initial caliper. 3. Move the cursor along the contour to be traced. The system automatically plots trace points as the cursor moves, and updates the area value for the polygon as the cursor is moved over the image. 4. Right-click (or left-click near the first point) to place the last caliper. A line segment joins the last point in the polygon with the first point. Note: If the position of the trackball cursor is within five pixels of the previous caliper when the right-click occurs, the previously placed caliper is considered to be the last caliper for the measurement. This applies to B-Mode and 3D-Mode polygon measurements and for 3D-Mode volume contours. 5. The default measurement label is 3D Polygon#, where # is a sequential number. The label is editable after placing the last caliper. 6. Edit the label text and press <Enter> to accept the edit, or click the image area or press <Enter> to accept the default label. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 171

190 Chapter 12: Measurements: PW Doppler Mode Measurements Note: All options enabled in Measurement Display Options in the Operator Preferences dialog are displayed on the image and in the Data Browser. Linear distance measurement Single point measurement Polygon measurement 3D-Mode image displaying polygon, linear, and point measurements. PW Doppler Mode Measurements Generic Measurements In PW Doppler Mode, the following generic measurements are available: Acceleration/Deceleration (mm/s 2 )(See page 173) Time interval (ms)(see page 173) Velocity (mm/s)(see page 174) Single point (x,y1,y2) (See page 174) Heart Rate (BPM) (See page 175) VTI (cm) (See page 175) Generic measurements are labeled with a sequence number that increments with each measurement of that type in the study. The sequential numbering is not affected by the deletion of measurements. 172 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

191 Chapter 12: Measurements: PW Doppler Mode Measurements For example, if the last created measurement is Point1 and it is deleted, the next generated measurement is Point2. Acceleration Measurement To place an acceleration measurement: 1. Click the acceleration measurement button. The button remains selected until the measurement is completed. 2. Click on the image to place the initial caliper. Note: Press Ctrl+Click to place the caliper on the baseline at the desired time value. 3. The measurement value between the initial caliper and the current trackball cursor position is updated as the trackball cursor is moved over the image. 4. Click to place the second caliper. Note: Acceleration measurements are constrained to either the positive portion of the PW Doppler spectrum or the negative portion depending on the placement of the initial caliper. The measurement cannot straddle the baseline. 5. The default measurement label is Acceleration#, where # is a sequential number. The label is editable after placing the second caliper. 6. Edit the label text and press <Enter> to accept the edit, or click the image area or press <Enter> to accept the default label. Note: All options enabled in Measurement Display Options in the Operator Preferences dialog are displayed on the image and in the Data Browser. PW Doppler Mode image showing single point, time interval, acceleration and velocity measurements Time Interval Measurement To place a time interval measurement: 1. Click the time interval measurement button. The button remains selected until the measurement is completed. 2. Click on the image to place the initial caliper. The system places a yellow reference line in the physiological window so the operator can V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 173

192 Chapter 12: Measurements: PW Doppler Mode Measurements make the most accurate possible placement of the second caliper in relation to a point on the ECG, Respiration or Blood Pressure traces. Reference line 3. The default measurement label is Time#, where # is a sequential number. The label is editable after placing the second caliper. 4. Edit the label text and press <Enter> to accept the edit, or click the image area or press <Enter> to accept the default label. Velocity Measurement To place a velocity measurement: 1. Click the velocity measurement button. The button remains selected until the measurement is completed. 2. Click on the image to place the velocity marker at the trackball cursor position. Note: Press Ctrl+Click to place the velocity caliper on the baseline at the desired time value. 3. The default measurement label is Doppler Velocity#, where # is a sequential number. The label is editable after placing the caliper. 4. Edit the label text and press <Enter> to accept the edit, or click the image area or press <Enter> to accept the default label. Note: All options enabled in Measurement Display Options in the Operator Preferences dialog are displayed on the image and in the Data Browser. Single Point Measurement The single point measurement in PW Doppler is represented by three components, x (time in ms), y1, (velocity in mm/s) and y2 (frequency in Hz). To place a single point measurement: 1. Click the point measurement button. The button remains selected until the measurement is completed. 2. The (x, y1, y2) value of the current trackball cursor position is updated as the trackball cursor is moved over the image. 3. Click on the image to place the caliper. 4. The default measurement label is Point#, where # is a sequential number. The label is editable after placing the point. 174 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

193 Chapter 12: Measurements: PW Doppler Mode Measurements 5. Edit the label text and press <Enter> to accept the edit, or click the image area or press <Enter> to accept the default label. Note: All options enabled in Measurement Display Options in the Operator Preferences dialog are displayed on the image and in the Data Browser. Heart Rate Measurement To place a heart rate measurement: 1. Click the heart rate measurement button. The button remains selected until the measurement is completed. 2. Click on the image to place the initial caliper. 3. Click to place the next caliper in the sequence of heart beats. Note: The measured heart rate is the average heart rate (averaged over the number of beats measured) if this measurement value has been checked in the Operator s Preferences. See Measurement Display Options on page 44. Note: Each caliper should be placed at the same point in the cardiac cycle for each heart beat. 4. Right-click on the last heart beat of the sequence to end the measurement. 5. The default measurement label is Heart Rate#, where # is a sequential number. The label is editable after placing the last caliper. 6. Edit the label text and press <Enter> to accept the edit, or click the image area or press <Enter> to accept the default label. Note: All options enabled in Measurement Display Options in the Operator Preferences dialog are displayed on the image and in the Data Browser. Heart rate measurement VTI Measurement Without Real-Time Frequency Trace Enabled The VTI (Velocity Time Integral) is measured through a manual trace when no real-time traces are selected. To manually trace a VTI measurement: 1. Click the VTI button. The button remains selected until the measurement is completed. 2. None must be selected for the real-time frequency trace options. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 175

194 Chapter 12: Measurements: PW Doppler Mode Measurements 3. Click on the image to place the initial caliper. Note: Press Ctrl+Click to place a caliper on the baseline at the desired time value. 4. Click to place the next caliper to trace the PW Doppler spectrum. 5. Move the cursor to trace the PW Doppler spectrum. The system automatically plots trace points as the cursor moves, and updates the VTI measurement value as the cursor is moved over the image. The velocity time integral is calculated for the region between the baseline and the traced spectrum. 6. Right-click to place the last caliper and complete the measurement. 7. The default measurement label is VTI#, where # is a sequential number. The label is editable after placing the last caliper. 8. Edit the label text and press <Enter> to accept the edit, or click the image area or press <Enter> to accept the default label. Note: All options enabled in Measurement Display Options in the Operator Preferences dialog are displayed on the image and in the Data Browser. VTI measurement. Manually-traced VTI measurement Note: VTI measurements are constrained to either the positive portion of the PW Doppler spectrum or the negative portion, depending on the placement of the initial caliper. The measurement cannot straddle the baseline. VTI Measurement With Real-Time Frequency Trace The VTI measurement can be drawn automatically over a selected area when a real-time frequency trace has been selected. To auto-trace a VTI measurement: 1. Select a real-time frequency trace (Peak or Mean). 2. Click the VTI button. The button remains selected until the measurement is completed. 3. Click on the image to place the initial caliper. 4. Move the trackball cursor along the trace. A line follows the trackball cursor movement updating the VTI value. 176 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

195 Chapter 12: Measurements: PW Doppler Mode Measurements 5. Click to place the second caliper and define the range of the measurement. The software automatically traces the peaks. Automatically-traced VTI measurement (blue) - with positive Peak real-time frequency trace selected (green). Note: If the selected real-time frequency trace is Positive for either Peak or Mean, the auto VTI measurement is placed on a positive portion of the PW Doppler spectrum. The reverse is true for the Negative frequency traces. If Positive and Negative is selected, the VTI measurement is placed on the PW Doppler spectrum depending on the placement of the initial caliper. If Auto is selected, the VTI measurement traces the largest velocity value, positive or negative. Automatically-traced VTI measurements (blue) - with positive and negative Peak real-time measurements selected. Predefined Protocol Measurements Predefined protocol measurements can be made and stored with a PW Doppler image. To place a predefined protocol measurement: 1. From the protocol selection list, select the appropriate protocol. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 177

196 Chapter 12: Measurements: PW Doppler Mode Measurements 2. In the list of predefined measurements for the selected protocol, select the desired measurement. 3. Place the calipers on the image using the procedure for the corresponding generic measurement type described earlier in this chapter. For complete descriptions of the measurements and calculations available in PW Doppler Mode, click Help. Real-time Frequency Traces The real-time traces option traces the peak and mean frequencies of the PW Doppler signal in real-time as the data is being acquired or during playback. To enable a real-time frequency trace, open the Measurements Tool and select an option from the Peak drop-down menu and/or from the Mean drop-down menu. The frequencies are indicated by different colored lines: Peak Peak - Positive Peak - Negative Peak - Positive and Negative Mean - Positive Mean - Negative Trace Color Green Red Orange Cyan Fuchsia The following options are available: Auto Trace When the Auto Trace check box is selected, changes that are made to the display settings update the appearance of the PW Doppler image, and subsequently adjust the frequency trace to follow the adjusted PW Doppler signal. When the Auto Trace check box is not selected, changes that are made to the display settings update the appearance of the PW Doppler image without affecting the frequency trace. Retrace The Retrace feature is available when the Auto Trace check box is cleared. When Retrace is selected, the frequency traces are adjusted to follow the PW Doppler signal. 178 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

197 Chapter 12: Measurements: M-Mode Measurements M-Mode Measurements Generic Measurements In M-Mode, the following generic measurements are available: Velocity (mm/s) (See page 179) Time interval (ms) (See page 180) Depth interval (mm) (See page 179) Single point (x,y) (See page 181) Heart rate (BPM) (See page 181) LV wall trace (See page 181) Generic measurements are labeled with a sequence number that increments with each measurement of that type in the study. The sequential numbering is not be affected by the deletion of measurements. For example, if the last created measurement is Point1 and it is deleted, the next generated measurement is Point2. Velocity Measurement To place a velocity measurement: 1. Click the velocity measurement button. The button remains selected until the measurement is completed. 2. Click on the image to place the velocity caliper. 3. The measurement value between the initial caliper and the current trackball cursor position is updated as the trackball cursor is moved over the image. 4. Click to place the second caliper. 5. The default measurement label is M-Mode Velocity#, where # is a sequential number. The label is editable after placing the second caliper. 6. Edit the label text and press <Enter> to accept the edit, or click the image area or press <Enter> to accept the default label. Note: All options enabled in Measurement Display Options in the Operator Preferences dialog are displayed on the image and in the Data Browser. Depth Interval Measurement To place a depth measurement: 1. Click the depth measurement button. The button remains selected until the measurement is completed. 2. Click on the image to place the initial caliper. 3. Click on the image to place the second caliper. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 179

198 Chapter 12: Measurements: M-Mode Measurements 4. The default measurement label is Depth#, where # is a sequential number. The label is editable after placing the second caliper. 5. Edit the label text and press <Enter> to accept the edit, or click the image area or press <Enter> to accept the default label. Note: All options enabled in Measurement Display Options in the Operator Preferences dialog are displayed on the image and in the Data Browser. M-Mode image showing depth, point, time interval and velocity measurements Time Interval Measurement To place a time interval measurement: 1. Click the time interval measurement button. The button remains selected until the measurement is completed. 2. Click on the image to place the initial caliper. The system places a yellow reference line in the physiological window so the operator can make the most accurate possible placement of the second caliper in relation to a point on the ECG, Respiration or Blood Pressure traces. Reference line 3. The default measurement label is Time#, where # is a sequential number. The label is editable after placing the second caliper. 4. Edit the label text and press <Enter> to accept the edit, or click the image area or press <Enter> to accept the default label. Note: All options enabled in Measurement Display Options in the Operator Preferences dialog are displayed on the image and in the Data Browser. 180 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

199 Chapter 12: Measurements: M-Mode Measurements Single Point Measurement To place a single point measurement: 1. Click the point measurement button. The button remains selected until the measurement is completed. 2. The (x, y) coordinate of the current trackball cursor position is updated as the trackball cursor is moved over the image. 3. Click on the image to place the caliper. 4. The default measurement label is Point#, where # is a sequential number. The label is editable after placing the point. 5. Edit the label text and press <Enter> to accept the edit, or click the image area or press <Enter> to accept the default label. Note: All options enabled in Measurement Display Options in the Operator Preferences dialog are displayed on the image and in the Data Browser. Heart Rate Measurement To place a heart rate measurement: The procedure is the same as that described for PW Doppler Mode (see page 175). Refer to the M-Mode heart rate measurement in the following figure. Heart rate measurement M-Mode image showing heart rate measurement M-Mode LV Wall Trace Measurement LV wall trace measurement provides the operator with a tool to measures the inner area of the left ventricle by tracing the position of the upper and lower inner walls of the ventricle through a heart cycle. Note: This is an optional function, and is available only if the Automated LV Analysis package is purchased. To place an LV wall trace measurement: 1. Click the wall trace measurement button. The button remains selected until the measurement is completed. 2. Left-click a point on the upper wall, and move the cursor across at least one cardiac cycle to another point on the upper wall. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 181

200 Chapter 12: Measurements: M-Mode Measurements 3. Right-click. The system automatically plots points that trace the movement of the wall tissue. 4. Left-click the lower wall at a point that corresponds to either the furthest left point or furthest right point you selected on the upper wall. 5. Move the cursor across at least one cardiac cycle to another point on the upper wall, and then right-click. The system completes the following tasks: Data points are automatically plotted along the tissue wall. The calculated LV area is labeled. Corresponding systole and diastole points on the upper and lower wall are identified by green and red dotted lines respectively. 6. Edit the measurement title, if required, and then either left-click or press Enter to commit the label title. Features of the Initial Trace Either the upper wall trace or the lower wall trace can be drawn first, but they must be drawn in succession. That is, when you have completed the first right-click to complete the first trace, the system requires the operator to place the first left-click of the alternate wall trace procedure. The system adds a point for each left-click during the initial creation of the trace, but once a second point is added, additional points can only be added in the same direction (right to left, or left to right). No points can be added between points during the initial trace. The two traces do not need to be completely overlapped. However, the system only completes calculations on data in the overlapping region. If the final end point does not overlap with the end point of the alternate wall, right-click to automatically add a point that does overlap. 182 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

201 Chapter 12: Measurements: M-Mode Measurements Modifying the Trace Points can be modified after the initial upper and lower traces are complete. To move a point, left-click within five pixels of the point, drag the point to a new position, then left-click again to commit the point. To increase the number of points on a trace, right-click the trace and select Increase Points. The first time the Increase Points command is used, the system distributes additional points so that the interval between any two points is not greater than 25 ms. Each subsequent time the system doubles the number of points, to a maximum of four times the number of points plotted during the initial trace. To decrease the number of points on a trace, right-click the trace and select Decrease Points. The system removes half the points, to a maximum four-fold decrease. To delete an individual point, right-click within five pixels of the point and select Delete Point. If more than one point is located within the five-pixel radius, the system deletes the point that is closest point to the cursor. To extend a trace, select either end point, move the cursor outward to the new position, and then left-click to commit the point. To contract a trace, select either end point, move the cursor inward to the new position, and then left-click to commit the point. The system removes all points between the original end point position and the new end point position. If the end point is moved outward again before it is committed, the system does not remove points across that distance. Refining the Trace The system includes a Refine feature that automatically adds points along a tissue layer to define the layer more precisely, as shown in the following illustration. Wall trace before auto-refine Wall trace after auto-refine To apply the refine feature to one trace (upper or lower): 1. Create a trace with a minimum of two points. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 183

202 Chapter 12: Measurements: M-Mode Measurements 2. Right-click the trace and select Refine. The system automatically adds points along the tissue layer. Depending on the placement of the initial points, the Refine feature might produce less than optimal results. To return to the initial trace, right-click the trace and select Undo Change. Predefined Protocol Measurements Predefined measurements can be made on an M-Mode image. To place a predefined protocol measurement: 1. From the protocol selection list, select the appropriate protocol. 2. In the list of predefined measurements for the selected protocol, select the desired measurement. 3. Place the calipers on the image using the procedure for the corresponding generic measurement type described earlier in this chapter. For complete descriptions of the measurements and calculations available in M-Mode, click Help. Measurement Chains In M-Mode, the following sequenced measurements can be completed in automatic chains, as shown in the diagram below: Diastole: RVID --> IVS --> LVID --> LVPW Systole: IVS --> LVID --> LVPW. To complete a chained measurement: 184 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

203 Chapter 12: Measurements: Tissue Doppler Mode Measurements 1. In the protocol measurements list, click the first measurement in the chain. For example, click RVID;d. 2. Click the top point of the first measurement of the chain and move the cursor toward the bottom point. For example, click the top point of the RVID;d measurement. The system labels the measurement and displays the measurement value dynamically as the cursor is moved toward the bottom point. 3. Click the bottom point of the first measurement. The system commits the measurement value for the first measurement. This bottom point of the first measurement automatically becomes the top point of the second measurement in the chain, for example, the IVS;d measurement. 4. Click the bottom point of the second measurement. The system measures and labels the second measurement. 5. Click the remaining bottom points of the next measurements in the chain. The system measures and labels each measurement until the final measurement is completed. Tissue Doppler Mode Measurements Measuring and Calculating the Strain Rate All PW Doppler Mode measurements can also be made in Tissue Doppler Mode. For more information, see PW Doppler Mode Measurements on page 172. The strain rate measurement feature provides the operator with a tool to complete strain rate velocity measurements on two different Tissue Doppler loops. Strain Rate Overview The system generates averaged mean velocity curves over one virtual heart cycle (the shortest in the defined time interval). Then the system pairs the two measurements and plots both the velocity curves and the calculated strain rate curves in a graphic view for further analysis and export. Measuring and Calculating the Strain Rate Before beginning: In Operator Preferences under Active File, ensure that the VisualSonics Cardiac Measurements package is selected. Create at least two Tissue Doppler cine loops, using the same settings for each loop. Ensure that the ECG signal is being acquired. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 185

204 Chapter 12: Measurements: Tissue Doppler Mode Measurements To measure and calculate a strain rate: 1. From the Data Browser, load one Tissue Doppler cine loop. 2. In the Tissue Doppler Measurements tool: a. In the Protocol list, select Tissue Doppler. b. In the predefined measurements list, select SR Vel 1 (strain rate velocity 1). Note: If the ECG signal has not been acquired, the system dims the SR Vel measurement selections and the strain rate measurements cannot be made. 3. In the mode window, create a horizontal linear measurement across at least one cardiac cycle so the system can produce an average spectrum over one virtual cardiac cycle. 4. Load another Tissue Doppler loop and create a second strain rate velocity measurement (SR Vel 2). 5. In the Data Browser: a. Under Browse By, select Measurements. b. Select the SR Vel 1 and SR Vel 2 strain rate measurements. c. Click Strain Rate. 186 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

205 Chapter 12: Measurements: Tissue Doppler Mode Measurements The system displays the following dialog: If the acquisition settings for the two Tissue Doppler cine loops are not identical, the system cannot match the measurements and calculate the strain rate. If the ECG signal is not regular enough to determine the cardiac cycle length, the system cannot match the measurements and calculate the strain rate. If the settings match, the system calculates the strain rate and displays the rendered strain rate graph. The systole and diastole points can be manually positioned, as required. To view the velocity graph, select Velocity. Exporting Strain Rate Data To export the strain rate data: 1. On the Strain Rate Analysis window, click Export. 2. In the Export Strain Rate Values dialog, select the export directory, name the file, and select the file type. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 187

206 Chapter 12: Measurements: Pressure-Volume Loop Measurements The data can be saved as one of the following file types: CSV Comma separated values, for import into a database or spreadsheet. TIFF Vector based graphic. BMP Bitmap graphic. Pressure-Volume Loop Measurements Pressure-volume (PV) loop measurements provide a graphical method of identifying and evaluating LV pressure-volume relationship changes related to dynamic levels of cardiac stress. PV loops can be generated in the Vevo software from LV area measurements made on M-Mode and B-Mode images that include a continuous blood pressure trace. Note: Blood pressure traces are typically acquired from a blood pressure catheter. Creating PV Loops from M-Mode Data To create a PV loop in M-Mode: 1. In the Data Browser: a. In the Browse By area, select Images. b. Load an M-Mode cine loop that includes continuous blood pressure trace data. 2. In the mode window, create an LV area measurement, as described in M-Mode LV Wall Trace Measurement on page In the Data Browser: a. In the Browse By area, select Measurements. 188 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

207 Chapter 12: Measurements: Pressure-Volume Loop Measurements b. Select the LV area measurements for which you want to view the PV relationship trend. To select multiple measurements, press Ctrl and select an item in the list. c. Click PV Loop. The system renders the Pressure-Volume Relationship graph. Averaged pressure-volume loop from measurement 1. Averaged pressure-volume loop from measurement 2. For Pressure-Volume Relationship graph display options, see Pressure-Volume Relationship Graphs on page 190. Creating PV Loops from B-Mode Data To create a PV loop in B-Mode: 1. In the Data Browser: a. In the Browse By area, select Images. b. Load a B-Mode cine loop that includes continuous blood pressure trace data. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 189

208 Chapter 12: Measurements: Pressure-Volume Loop Measurements 2. In the mode window, create an LV area measurement, as described in B-Mode LV Wall Trace Measurement on page In the Data Browser: a. In the Browse By area, select Measurements. b. Select the LV area measurements for which you want to view the PV relationship trend. To select multiple measurements, press Ctrl and select an item in the list. c. Click PV Loop. The system renders the Pressure-Volume Relationship graph. Averaged pressure-volume loop from measurement 1. Averaged pressure-volume loop from measurement 2. For Pressure-Volume Relationship graph display options, see Pressure-Volume Relationship Graphs on page 190. Pressure-Volume Relationship Graphs The Vevo 770 software generates a pressure-volume graph from LV area measurements acquired from M-Mode or B-Mode images that include continuous blood pressure trace data. 190 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

209 Chapter 12: Measurements: Pressure-Volume Loop Measurements The Pressure-Volume Relationship graph provides five functionality options. ESPVR check box Check this box to display the end systolic PV points. If the graph displays a single loop, the system plots a green dot on the curve at the End Systolic point. If the graph displays multiple loops, the system plots a best-fit line through the End Systolic points. EDPVR check box Check this box to display the end diastolic points. If the graph displays a single loop, the system plots a red dot on the curve at the End Diastolic point. If the graph displays multiple loops, the system plots a best-fit line through the End Diastolic points. Average check box Check this box to display a loop that represents a virtual or averaged cardiac cycle, calculated from the aggregate cycles defined by each LV V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 191

210 Chapter 12: Measurements: Exporting Measurements and Calculations wall trace. Clear the check box to display all cardiac cycle instances. This check box is selected by default. When the Average option is selected, the graph displays a single smooth loop. When the Average option is cleared, the graph plots the cardiac cycle. Volume command Click this command to toggle the horizontal dimension between Volume and the basic dimension of the loops. For measurements made in M- Mode the dimension is Diameter in millimeters. For measurements made in B-Mode, the dimension is Area in square millimeters. Export command Click this command to export the pressure-volume relationship data as one of three file formats: CSV (comma separated value) file. A CSV file can be imported into a spreadsheet or database TIFF file. A TIFF file saves the graph data as a vector based image. BMP file. A BMP file saves the graph data as a bitmap image. Exporting Measurements and Calculations Exporting Measurements Measurements and calculations can be exported as a CSV (comma separated values) file. CSV files can be imported into a spreadsheet or a database. To export the list of measurements and calculations for a study: 1. Click Export Report when viewing the measurements list or calculations list in the Data Browser or select Study > Export Report. 2. Enter the desired filename and location for the report file. 3. Click Save. 192 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

211 Chapter 12: Measurements: Exporting Measurements and Calculations A CSV file is created that contains the measurements and calculations made in the study. The instance number of each measurement is displayed at the top of the measurement columns for convenient referencing to the original measurement Average value and standard deviation of each instance of a named measurement For more information about the format of the CSV file, see Measurement Report Using Standard Measurement Package on page 233. Note: Measurement reports can also be exported from the Study Browser. For more information, see Exporting Reports on page 57. Exporting Reports for Multiple Studies To export reports for multiple studies: 1. From the Study Browser, select the studies for which to export reports, and click Export Report. To select multiple studies, press Ctrl and select an item in the list. 2. In the Export Reports To window: a. In the directory explorer, select the directory destination for the report(s). b. In the Save As field, type the name of the report. c. If it is important to include the measurement instances in addition to the average value and standard deviation of each instance of a named measurement, which is included by default, select the Export measurement instances check box. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 193

212 Chapter 12: Measurements: Batch Export d. In the Report Type field, select the appropriate report type. To export multiple studies as a single file, select VSI Combined Report File (*.csv). This is only available if all studies used the same measurement package and the package is one other than the standard package. To export multiple studies as individual files, select VSI Individual Report File (*.csv). e. Click OK. The system displays a progress bar as it creates the report. To review the report, open the CSV file in a spreadsheet or database application. Data in a combined report is organized by protocol. Batch Export If multiple reports are exported from the Study Browser, and the Individual Report File report type is selected, multiple files are created in the Export folder location. Export Table To export a text file containing the contents of the Measurements Browser: 1. From the Measurements Browser, click Export Table. 2. Browse to the desired storage location. 3. Enter a file name. 4. Click Save. To export a text file containing the contents of the Calculations Browser: 1. From the Calculations Browser, click Export Table. 2. Browse to the desired storage location. 194 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

213 Chapter 12: Measurements: Export Table 3. Enter a file name. 4. Click Save. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 195

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215 Chapter 13: Text Annotations: Placing Annotations Chapter 13: Text Annotations Text annotations may be placed on any image in any of the imaging modes when acquisition is paused or when the study is in review. An annotation is a text label with an optional anchor line and is used to identify important features in the data. Anchor line Text label Predefined annotation Placing Annotations To place an annotation on an image: Note: Annotations may not be placed in B-Mode when an overlay is enabled. Note: Annotations may not be placed during acquisition or playback. 1. Right-click and hold on the point in the image to be annotated. 2. Drag the trackball cursor to the position where the annotation text is placed. An anchor line follows the trackball cursor movement. 3. Release the right button. The Annotation Context menu is displayed. 4. Select a predefined annotation to be displayed or select Free Text to enter an annotation into a text field. When Free Text is chosen, a text box appears on the screen. Text entered in an annotation automatically wraps on word boundaries after approximately 15 characters. The maximum length of an annotation is 80 characters. If the annotation has sub-items, an arrow is displayed to indicate a second drop-down menu. Placing an annotation on a B-Mode image V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 197

216 Chapter 13: Text Annotations: Displaying Annotations Alternatively, press <Annotate> to create an annotation. To use this hot key: 1. Acquire data in any mode. 2. Position the trackball cursor over the image. 3. Press <Annotate>. The system creates a text box centered at the trackball cursor's position, in which a Free Text annotation can be typed. 4. Type the annotation, and press <Enter> or move the trackball cursor to the next annotation position, and press <Annotate> again to commit the first annotation, and to begin to create a second one. Displaying Annotations To view annotations in all modes, thumbnails, study images, and exported images of all studies: In any mode or browser, click View > Annotations. Configuring Annotations Customized annotations can be added to the predefined annotation list. Existing annotations can be edited as well. Select Edit > Configure Text Annotations to access the Configure Text Annotation dialog containing the list of predefined annotations. Add Item Add Sub Item Edit Delete Item Add a top-level annotation. Annotations may be up to 80 characters in length. Add a sub-item to a top-level annotation. Edit the text of the selected annotation. Delete the selected annotation. Confirmation is required to delete the annotation from the list. Note: If a top-level item is deleted, all the sub-items associated with it are also deleted. 198 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

217 Chapter 13: Text Annotations: Predefined Annotations Move Up Move Down Move the selected annotation up the list to change the order of the annotation context menu and have it appear closer to the top of the list. Move the selected annotation down the list to change the order of the annotation context menu and have it appear lower in the list. If an annotation is edited or deleted from the list, annotations that have already been placed on an image are not affected. The change only applies to future annotations. Save and Load The File menu in the Configure Text Annotation dialog allows the operator to save the annotation list to a file or to load a previously saved annotation list from a file. 1. Select File > Save (to save the current list) or File > Load (to open another list). Note: Loading a list overwrites the current list, but does not affect annotations already made on images. 2. Navigate to the storage directory. 3. Specify a file name and click Save to save the current list or select a file and click Open to load the file. Predefined Annotations The following annotations are predefined in the Vevo software: Application Annotation Embryonic Placenta Umbilical Cord Embryo Neural Tube Heart Tube Heart Aorta Eye Lens Retina Liver Somite V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 199

218 Chapter 13: Text Annotations: Editing Annotations Application Cardiology Annotation Left Ventricle LV PW (Left Ventricle, Posterior Wall) Right Ventricle RV AW (Right Ventricle, Anterior Wall) Left Atrium Right Atrium Intra-Ventricular Septum Infarct Respiratory Motion Fetal/Maternal Blood Flow Umbilical Vein Umbilical Artery Vitelline Artery Vitelline Vein Placenta Kidney Cortex Medulla Hilum Renal Vein Renal Artery Liver Hepatic Artery Hepatic Vein Portal Vein Lobe Editing Annotations To move an annotation: 1. Click the unlabeled end of an anchor line to reposition that end of the anchor line, or click an annotation to reposition the annotation text. 2. Drag the selected item to the desired location. 3. Click to place the item at the new location. 200 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

219 Chapter 13: Text Annotations: Editing Annotations Edit text and properties of an annotation: Annotations can be edited, and can also be deleted from an image. 1. Right-click an existing annotation to display the Annotation context menu. 2. Select the desired menu option. The following table describes the function of each choice: Loop Annotation Frame Annotation (B-Mode only) Edit Delete Properties Convert to Frame Annotation This is a non-selectable label describing the annotation as being applied to the entire loop or to a specific frame range in the loop. This is a non-selectable label describing the annotation as being applied to the current frame only. Edit the text of the annotation. Note: If all the text of an annotation is removed during the edit, the annotation is deleted. Delete the annotation. Confirmation is required to delete the annotation. Display the Annotation Properties dialog. When a loop annotation is selected, it can be converted to a frame annotation so that it only appears on the current frame. This option is only available for an annotation on a B-Mode cine loop. To edit the annotation properties: 1. Right-click an annotation and select Properties from the Annotation context menu. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 201

220 Chapter 13: Text Annotations: Editing Annotations 2. If the properties apply to a B-Mode loop annotation, the annotation range is editable. Select the range of frames within the loop, to which the annotation is applied. The default range includes all frames in the loop. 3. Select Show Anchor Line to toggle the anchor line on and off. 4. Click Color to change the color of the annotation anchor line and text. Note: The default color is cyan and cannot be changed. 5. Click OK to apply the changes. When an image or cine loop is stored or exported, any annotations that are displayed as part of the image or cine loop are included in the stored or exported data. 202 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

221 Chapter 14: Data Archiving: Options for Transferring Studies from the Vevo 770 Chapter 14: Data Archiving The Vevo 770 allows the operator to collect significant amounts of data. This requires an effective data management and storage plan. This chapter describes the technology and procedures for managing and storing this data. Options for Transferring Studies from the Vevo 770 Studies saved by the Vevo 770 can be quite large. A typical study size is approximately 3GB. Because the total space of the Vevo 770 is 120GB, it is not intended to be a long-term storage device for images and studies. Operators should routinely off-load the studies from the Vevo 770 to an external storage location. Three possible options for external storage are: Network storage External USB hard drive CD and DVD Network Storage The Vevo 770 can be easily connected to a dedicated storage location on the institution's local area network (LAN). Note that the set-up of the Vevo 770 to the network should be performed during installation of the Vevo 770. The default user account VS-USER must run the Ultrasound application. It is configured to provide the optimal environment to run the application. The VS-USER user account requires administrator privileges. If the procedures for establishing these privileges are not known, contact Technical Support at VisualSonics (support@visualsonics.com). By default, the VS-USER account does not have a password. If one is required to access the local network, it can be configured by the institution's IT personnel. The Vevo 770 system runs on the Windows XP Professional operating system and can be networked on an Ethernet LAN. To manage studies on the Vevo 770, use the Copy To function and the Copy From function found in the application. After successfully saving a study on the LAN, VisualSonics recommends deleting it from the Vevo 770 system. External USB Hard Drive An external USB hard drive can be used to manually move studies on a regular basis from the Vevo 770 to the LAN or to other computers. To connect an external USB hard drive: 1. Exit the Vevo software. 2. Shut down the computer. 3. Connect the external USB hard drive to one of the two USB 2.0 connectors on the rear panel of the Vevo 770. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 203

222 Chapter 14: Data Archiving: Copying Data 4. Start the computer. 5. Launch the Vevo 770 software. 6. Copy studies to and from the external USB hard drive using the Copy To function and Copy From function of the Vevo application. 7. After successfully copying a study on the external USB hard drive, the study should be deleted from the Vevo 770 system only after it has been successfully transferred from the external USB hard drive to a long-term storage location. For any additional USB devices that need to be connected to the system, consult with Technical Support at VisualSonics (support@visualsonics.com). CD and DVD Studies can be archived by using the built-in CD or DVD writer on the Vevo 770. For CD storage, this only works when the study size is less than 700 MB. Studies that are written to DVD can be a maximum size of 4.7 GB. Note: Writing study files to CDs or DVDs can be a time-consuming process. Copying Data To copy data to a CD or DVD: 1. Copy data from the Vevo 770 to a temporary storage location on a local drive (for example, D:\Vevo770\Data). 2. Using the Nero software that is supplied with the Vevo 770, copy data from the temporary storage location. Using Nero Software To use Nero software for copying data to a CD or DVD: 1. From the desktop, double-click the Nero StartSmart shortcut. 2. Select the media that the data will be copied to. To copy to a CD, click the CD icon that is situated in the top, righthand corner of the Nero screen. 204 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

223 Chapter 14: Data Archiving: Using Nero Software To copy to a DVD, click the DVD icon in the top right-hand corner of the Nero screen. 3. Move the trackball cursor above the Data icon. 4. When Data options are displayed, click Make Data Disc. The Disc Content window is displayed. 5. Click Add. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 205

224 Chapter 14: Data Archiving: Using Nero Software 6. In the Select Files and Folders window: a. Select the files and/or folders that are to be written to the CD or DVD. b. Click Add. The Disc Content window refreshes to include the newly added files and/or folders. Note: The best practice is to select files only from local drives. It is not recommended to select files from a network location. 7. Click Finished when the desired files and folders have been added to the Disc Content window. The system closes the Select Files and Folders windows. 8. In the Disc Content window, click Next. 9. In the Final Burn Settings window: a. In the Current recorder list, select the F: drive. 206 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

225 Chapter 14: Data Archiving: Using Nero Software b. In the Disc name box, type a volume label for the CD or DVD. c. In the Writing speed list, select the slowest possible write speed. d. In the Number of copies list, select 1. e. Clear the Allow files to be added later (multisession disc) check box. 10. Click Burn. A progress window is displayed. While the system burns the data to disc, do not click Stop, even when the Process status bar indicates 100% completion. A completion message is displayed when the process is complete. 11. Click OK. 12. Click Next. 13. From the Nero Express window, click Exit to exit the Nero software. After exiting, the DVD drive door opens automatically. 14. If desired, delete any files or folders from the temporary storage location (from where they were copied to the CD or DVD). Verify that the CD or DVD contains the expected folders and files prior to deleting them from the temporary storage location. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 207

226 Chapter 14: Data Archiving: Recommended Media Recommended Media VisualSonics recommends the following media for storing data collected with the Vevo 770: Disc format CD-R DVD-R DVD+R DVD-RAM Brands recommended by the DVD drive manufacturer LG, Mitsubishi Kagaku Media, Verbatim, Taiyo Yuden, TDK or SKC discs Maxell, Mitsubishi Kagaku Media, Taiyo Yuden are recommended Mitsubishi Kagaku Media, Verbatim are recommended Maxell, Panasonic Disc format Brand Time to burn a 2GB study (at the slowest available write speed) CD-R Maxell N/A - Study exceeds CD storage capacity DVD-R Maxell 8 Minutes VisualSonics media 8 Minutes DVD+R Maxell 12 Minutes DVD-RAM Maxell 28 Minutes Note: When burning data on a DVD-RAM, the following message may be displayed: The disc in the drive is not empty. Writing to this disc erases any existing data on it. Do you want to proceed? If this message is displayed, select OK to continue. The files are burned to the DVD as expected. When burning data on a DVD-R or a DVD+R, the following message may be displayed: You are about to burn a multisession disc, and contains options to Burn Multisession anyway, and Burn Without Multisession. If this message is displayed, select Burn Without Multisession. 208 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

227 Chapter 15: Troubleshooting: Troubleshooting Table Chapter 15: Troubleshooting Troubleshooting Table If a problem is encountered when using the Vevo 770, try the solutions that are listed. If none of the solutions solves the problem, contact a VisualSonics Technical Support representative (support@visualsonics.com). System Controls System does not power up. Software does not run. Error RMV scanhead has been disabled. Please reinitialize scanhead. when starting software. Ensure that the main power cable for the system is properly connected to the Vevo 770. Ensure that the system is plugged into a grounded wall outlet. Turn the main power switch On. Turn the computer standby switch On. Ensure that the monitor power switch is On. Ensure that the desktop shortcut is pointing to the correct executable: (C:\Vevo770\Application\Version \VsiVevo.exe). Some functions in Study Browser are disabled (i.e. Quick Study, New, Study Again). This message is an indicator that the RMV scanhead is not connected or initialized. Press <Select Scanhead> and initialize a connected RMV scanhead. Ensure that the RMV scanhead is full with deionized water. Note: In the event that attempts to reinitialize the RMV scanhead fail following an unintended exit of the Vevo software, shut down the entire Vevo 770 system as follows: 1. Press the computer standby switch (next to the DVD drive). 2. From the Windows Turn off Computer dialog, select Turn Off. Windows shuts down. 3. After the computer has shut down, turn the main power switch Off. 4. Wait a few seconds, then turn the main power switch on. 5. Toggle the computer standby switch, and wait for the Scanhead Selection dialog to appear. If it is still not possible to initialize the RMV scanhead, contact Technical Support (support@visualsonics.com). V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 209

228 Chapter 15: Troubleshooting: Troubleshooting Table No audio. Ensure that the speaker power switch is On. Adjust the volume on the speakers. Ensure that the connection from the monitor speaker base to the rear panel is secure. Adjust any PW Doppler settings (such as the PW Doppler angle, the Doppler Gain, the Sample Volume Position) to increase the strength of the PW Doppler signal. Unable to acquire data in any of the imaging modes. Ensure that the RMV scanhead nosepiece has been filled with de-ionized water. Ensure that there is acoustic coupling medium between the RMV scanhead and the animal. Ensure that hair is removed from the animal and that no air has been trapped along the skin. Study Manager Unable to create new studies. Ensure that an RMV scanhead is connected to the front panel of the Vevo 770 cart, and ensure that it has been initialized. Unable to commit a study session. Ensure that an operator has been specified. B-Mode Lack of penetration or sensitivity. Bands in the image near-field. Ensure that the RMV scanhead nosepiece is free of air bubbles. There should be no air bubbles between the transducer face and the nosepiece. Ensure that there is adequate coupling medium (for example, ultrasound gel) between the RMV scanhead and the animal. Adjust the position of the TGC sliders. Increase the Power. Ensure the appropriate RMV scanhead is being used. Bands can be caused from the acoustic membrane as well as from the transducer transmit signal Replace the acoustic window. 210 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

229 Chapter 15: Troubleshooting: Troubleshooting Table PW Doppler Mode Aliasing in the PW Doppler acquisition. The PW Doppler signal is very small when the viewed flow is slow. PW Doppler signal appears to be low intensity. PW Doppler signal exhibits saturation. Low frequency noise level in PW Doppler acquisition is high. Increase the PRF. Decrease the PW Doppler angle. Adjust the Baseline. Decrease the PRF. Adjust the Doppler Gain setting. Lower the Doppler Gain. Increase the Wall Filter setting. Tissue Doppler Mode Tissue Doppler signal is very small when the viewed signal is low. Tissue Doppler signal appears to be low intensity. Low frequency noise level in Tissue Doppler acquisition is high. Noise appears in the image. Decrease the PRF. Adjust the Doppler Gain setting. Increase the Wall Filter setting. Adjust the Sample Volume size and position such that it includes tissue only. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 211

230 Chapter 15: Troubleshooting: Troubleshooting Table Power Doppler Mode Color bands in the image. Respiration artifacts in the image. Noise in the image. Lack of sensitivity. Enable Respiration Gating. Adjust Wall Filter setting. Adjust Scan Speed setting. Adjust the Contrast Max and Min settings. Enable Respiration Gating. Adjust Wall Filter setting. Adjust Scan Speed setting. Use Auto Histogram. Ensure the anatomy being studied is in the focal zone for the scanhead. M-Mode Lack of penetration or sensitivity. Ensure that the RMV scanhead nosepiece is free of air bubbles. There should be no air bubbles between the transducer face and the nosepiece. Increase the Power. Ensure that there is adequate coupling medium (for example, ultrasound gel) between the RMV scanhead and the animal. Adjust the position of the TGC sliders. Ensure the appropriate RMV scanhead is being used. 212 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

231 Chapter 15: Troubleshooting: Troubleshooting Table 3D-Mode Can t initialize the motor Expected data is not acquired Ensure that the cable for the 3D motor stage is connected to the rear panel. Ensure that the motor is positioned such that there are no objects obstructing the path of the RMV scanhead during initialization. Ensure the RMV scanhead is oriented correctly, with the transducer arm of the RMV scanhead moving perpendicular to the direction of travel of the 3D motor stage. Ensure that the Range and Step Size settings are adequate for acquiring the desired amount of data. If two RMV scanheads are connected, ensure that the active RMV scanhead is the one connected to the 3D motor stage. Ensure that the RMV scanhead is tightly connected to one of the ports on the front of the cart. Physiological Data No ECG signal is displayed ECG signal appears flatlined Ensure that the View ECG option (under the View menu) is turned on. Ensure the ECG cable is connected to the physiological monitoring and control system, and the keyed end of the cable is connected to the front panel of the Vevo cart. Ensure that the ECG monitor is producing a strong, consistent signal. ECG signal is poor Ensure that all of the animal s limbs are secured to the ECG pads on animal platform. Ensure that no gel has leaked onto any of the contacts on the animal platform. Ensure that there is no 50/60 Hz noise source near the animal platform (for example a lamp or a power cable). Blood pressure signal is not accurate Calibrate the blood pressure signal. Check hardware gain and blood pressure check box in Operator Preferences. Check positioning and operation of blood pressure catheter. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 213

232 Chapter 15: Troubleshooting: Troubleshooting Table EKV Expected data is not acquired Image quality is substandard Ensure the RMV scanhead is correctly positioned over the object of interest before beginning the EKV acquisition. Ensure the ECG cable is connected to the physiological monitoring and control system, and the keyed end is connected to the front panel of the Vevo 770 cart. Ensure that the ECG monitor is producing a strong, consistent signal. Ensure that heart rate fluctuation is minimal. Ensure the appropriate EKV Quality Setting has been selected. Measurements, Annotations and Calculations Measurements Tool is disabled. Some measurements are missing from the browser. A calculated value is not displayed in the Value column for calculations. PV Loop calculations are not available. Systole and diastole are placed incorrectly. Ensure that the system is not acquiring data or playing a cine loop. Ensure that all overlays have been disabled. Ensure that Measurements is selected under the View menu. Ensure that data is displayed in the mode window. In the Operator Preferences, ensure that the appropriate Measurement Display Options are selected. If a measurement parameter was disabled when a specific measurement was created, no entry is displayed for that value. Not all the measurements from which the calculation is derived have been made. Make the additional measurements so that the software may compute the calculation. The system might not have recorded a blood pressure signal. Ensure that a blood pressure source is connected to the animal. The system might be recording blood pressure noise because a blood pressure source is not connected, but the Operator Preferences is set to record blood pressure data. Ensure that the Blood Pressure check box in the Physiological Data Available area in the Operator Preferences window is cleared. 214 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

233 Chapter 15: Troubleshooting: Error Reports Error Reports Error Notification Message Log Record any error messages displayed by the system and relay them to a VisualSonics Technical Support Representative (support@visualsonics.com). When the software detects an error, a message box is displayed to notify the operator. The Message Log displays various notification messages that indicate the status of software events. When the message log exceeds 100MB, the system copies log data to an overflow log file and resets the log. The messages are given different priorities and an error message may display a separate message box while the Vevo 770 is in operation. If an error notification appears on the screen, exit the Vevo application, and contact Technical Support, who will provide direction about how to save the relevant files, to send to VisualSonics. To copy an archived Message Log to send to Technical Support: 1. Start the Vevo application. 2. Select View > Message Log to open the Message Log window. 3. From the Message Log, select File > Manage Archives. 4. From the Manage Archives window: a. Select the appropriate Exit archive or the Severe Error archive (as directed by Technical Support). b. Select Copy To. c. In the Browse for Folder dialog, browse to a location for copying the archive, and click OK. d. Close the Message Log and exit the Vevo 770 software. Note: Follow this same step to copy or delete Severe Error logs, Recovery logs, Exit logs, and Overflow logs. 5. Right-click the Windows Start menu, and select Explore. 6. In Windows Explorer: a. Browse to the location in which the archive was copied. b. Right-click the archived folder, and click Send To > Compressed (zipped) Folder. 7. the zipped file to support@visualsonics.com. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 215

234 Chapter 15: Troubleshooting: Error Reports Description The Message Log reports any system notifications generated by the Vevo software. File menu View menu Priority Filter menu Filters menu If an error has occurred, saving the log records the information for troubleshooting. The operator is also able to clear the message log. Toggles between Thread Activity and Message Log. When the Thread Activity is selected, all other menu options are grayed-out. The Priority Filter displays the messages according to their priority. The Custom Filter provides search fields to search messages of a particular type, or for messages that contain specific text. Message Log window Messages are classified according to the following priorities: All System Messages All Activity Messages Low Level Messages Describes information about the operation of the system. Describe actions performed by the operator. Provide general information about the operation of the system. 216 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

235 Chapter 15: Troubleshooting: Error Reports Medium Level Messages High Level Messages Warning Messages Errors Only Describe statistics regarding system operation. Describe major events in the system to indicate direction of program flow. Describe events that the system was able to recover from. Describe errors encountered by the software. Errors also generate a pop-up message to notify the operator that an error has occurred and to provide further instruction. Error messages are always displayed in the message log regardless of the Priority Filter settings. Allow Debug Messages This option displays additional diagnostic information used by VisualSonics for troubleshooting errors. To toggle the sort order in which messages are displayed, select Priority Filter/Reverse Time Order. This alternates the chronological list order from most recent, to oldest. Toggle the display of the Message Log window from the main window of the Vevo software (select View > Message Log). A check mark is shown beside the item to indicate whether or not it is displayed. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 217

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237 Chapter 16: Maintenance and Service: Maintenance Chapter 16: Maintenance and Service Maintenance Vevo 770 High-Resolution Imaging System The Vevo 770 requires proper care and cleaning. Improper system care voids the warranty or the service contract. Moving Move the system carefully. Be especially alert when moving the system along inclined passages. The following precautions should be observed when moving the system: Turn the system off and disconnect the power cord and any other cords. Secure loose cables using the cable holder beneath the keyboard shelf. Cable holder Disconnect the RMV scanheads and store them in the provided cases. Unlock the castors. Use the grab bars to move the system. Do not use the grab bars to lift the system. Do not allow the system to strike walls or door frames. Use care when moving the system off ramps or elevators. Lock the castors when the system is to remain stationary. Caution: Care should also be taken when handling heavy items, as it is easy to crush limbs when lifting or moving them. Cleaning To clean the Vevo 770: 1. Turn the system off and unplug it from the power outlet. 2. Clean the system cart, the integrated keyboard/trackball, and the monitor with a damp cloth soaked in mild soap and water. Caution: DO NOT spray or drip any liquid into the system or onto the keyboard. If the trackball feels rough, use the tip of a pen to turn the trackball housing ring, remove the ring, remove the ball, and then wipe it with a damp cloth. Replace the ball and the housing ring. If disinfection is required for the system, use Sporicidin wipes. RMV Scanhead The RMV scanhead houses the transducer, which is the most delicate component of the Vevo 770. Use care when handling the RMV scanhead. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 219

238 Chapter 16: Maintenance and Service: Maintenance Proper handling maintains the high quality performance of the transducer in addition to extending the working lifetime of the RMV scanhead and the transducer. Caution: Never touch the transducer. The active element can be easily scratched and/or damaged. Scratches may lead to degraded system performance. Always store the RMV scanhead with the nosepiece attached to protect the transducer. Cleaning After every imaging session, gently rinse the acoustic coupling gel from the RMV scanhead acoustic window using warm water in a wash bottle. Never touch the acoustic membrane as this can cause damage. The RMV scanhead housing and the nosepiece may be cleaned with a damp cloth soaked in mild soap and water. If disinfection is required, VisualSonics recommends cleaning the housing and the nosepiece with Sporicidin wipes. The parts of the RMV scanhead that are covered by the nosepiece (the transducer and transducer arm) do not require cleaning. Storing The RMV scanhead may be stored in the scanhead and gel holder attached to the sides of the Vevo 770 cart. Place the RMV scanhead into one of the scanhead and gel holders with the nose pointing downward. Always ensure that the cable is not twisted when storing the RMV scanhead. Always use the provided case to transport the RMV scanhead from one site to another. RMV scanheads in the scanhead/gel holders Follow these guidelines when storing the RMV scanhead in the provided case: Always store the RMV scanhead with the acoustic window attached and the fill port screw loosely attached. Always empty the de-ionized water from the nosepiece before storing. Make sure that the RMV scanhead is clean and dry before placing it in the case. Place the RMV scanhead in the case carefully to prevent kinking of the cable. Avoid storing the RMV scanhead in areas of extreme temperatures or in direct sunlight. Store the RMV scanhead separately from other instruments to avoid inadvertent damage. 220 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

239 Chapter 16: Maintenance and Service: Service Provided by VisualSonics Disposal The equipment owner is required to ensure that environmental and health and safety regulations are met when equipment is disposed of. Since the Vevo 770 includes components that may contain substances that could be harmful, particular care should be taken to meet the current regulations for the disposal of hazardous substances. The following substances within the Vevo 770 are potential health hazards: Substance Location in Vevo 770 Indication of Quantity Lead (Pb) Soldered joints Very small quantities Lithium Ion Back-up battery in computer Very small quantities Note: These substances are only capable of being released when the component or the whole assembly is being disposed of. Should there be any queries about any of the substances within the Vevo 770 system, please contact VisualSonics Service Provided by VisualSonics If problems arise with the Vevo 770 High-Resolution Imaging System, VisualSonics will ensure that the system remains operational, with minimal downtime. When such problems occur, please contact the VisualSonics Technical Support department so that a Technical Support representative can assess and resolve the problem. Reach us at: Phone: Fax: Toll-Free: (in North America) support@visualsonics.com For minor problems, the Technical Support representative can help to troubleshoot the situation by phone or by . For more complex problems, we may send a Technical Support representative to the location to evaluate the problem or we may request that the equipment be sent to the VisualSonics Service department. Owner Responsibilities Cleaning the Air Filters It is the responsibility of the equipment owner to ensure that Electrical Safety Testing is done in accordance with National Requirements. The equipment owner is required to periodically clean the air filters in the Vevo 770 system. There are two filters to be cleaned. One is situated at the front of the cart, the other at the rear. Complete the following instructions when cleaning either filter. No tools are required. To clean the air filter: 1. Loosen the thumbscrews securing the filter housing to the cart. 2. Slide the filter housing away from the cart to release it. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 221

240 Chapter 16: Maintenance and Service: Owner Responsibilities 3. Remove the four wing-nuts. 4. Remove the filter from the filter housing. Air filter 5. Wash the filter with water, or vacuum it to remove dust. To replace the air filter in the Vevo 770 cart: 1. Place the filter in the filter housing. 2. Secure the filter using four wing-nuts. 3. Slide the filter housing back into the cart. 4. Tighten the thumbscrews to secure the filter housing to the cart. Cleaning schedule VisualSonics recommends cleaning both air filters every three months. If an air filter has been torn, it should be replaced. Contact a VisualSonics Technical Support Representative (support@visualsonics.com). 222 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

241 Appendix A: Specifications Appendix A: Specifications Environmental Specifications The Vevo 770 operating environment should be free of fumes, dirt, and electrical interference. Temperature 10º to 40º C (50º to 104º F) Relative Humidity 15% to 80% non-condensing System Dimensions Height (without monitor) Height (with monitor) Width Depth Weight 107 cm (42 in.) 150 cm (59 in.) 71 cm (28 in.) 96 cm (38 in.) kg ( lb.) Please ensure that sufficient clearance is available around the system for adequate airflow and cooling. Do not block the air vents or air filters. Electrical Specifications VisualSonics manufactures systems that operate with AC line voltages of 100V, 120V, and 230V. The electrical configuration of the system is noted on the system nameplate. 100V systems require 4.5A service, 120V systems require 3.7A service and 230V systems require 2A service. The AC line voltage is rated for a frequency of 50/60Hz. For optimal system performance, use a dedicated, interference-free, isolated, grounded wall outlet. Warning: Before having the system installed, ensure that the electrical service in the facility is adequate. Do not modify the attachment plug or use an adapter. Doing so may cause an electrical hazard. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 223

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243 Appendix B: Accessories Appendix B: Accessories Optional Components The following components are available as options to the base configuration of the Vevo 770. Item 15 LCD color monitor (remote second monitor for the Vevo 770) Remote Keypad PW Doppler application for the Vevo software Power Doppler M-Mode application for the Vevo software 3D Acquisition EKV-Mode Tissue Doppler Digital RF-Mode Automated LV Analysis Advanced Cardiovascular Package Part Number SA SA VS VS VS VS VS VS VS VS VS Accessories The following accessories are available for use in conjunction with the Vevo 770 during an imaging session. Item Vevo Compact Anesthesia System (tabletop configuration) RMV 703 Scanhead (Mouse Abdominal) RMV 704 Scanhead (Mouse Vascular) RMV 706 Scanhead (Mouse Abdominal) RMV 707 Scanhead (Mouse Cardiac) RMV 707B High Frame Rate Scanhead (Mouse Cardiac) RMV 708 Scanhead (Mouse Epidural) RMV 710 Scanhead (Rat Cardiac) Part Number SA VS VS VS VS VS VS VS V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 225

244 Appendix B: Accessories Item RMV 710B High Frame Rate Scanhead (Rat Cardiac) RMV 711 Scanhead (Guided Injection Near) RMV 712 Scanhead (Guided Injection Far) 10-Pack Replacement Acoustic Windows (RMV-703) 10-Pack Replacement Acoustic Windows (RMV-704) 10-Pack Replacement Acoustic Windows (RMV-706) 10-Pack Replacement Acoustic Windows (RMV-707) 10-Pack Replacement Acoustic Windows (RMV-707B) 10-Pack Replacement Acoustic Windows (RMV-708) 10-Pack Replacement Acoustic Windows (RMV-710) 10-Pack Replacement Acoustic Windows (RMV-710B) 10-Pack Replacement Acoustic Windows (RMV-711) 10-Pack Replacement Acoustic Windows (RMV-712) Vevo Compact Anesthesia System (mobile configuration) Vevo Integrated Rail System III complete configuration Vevo Integrated Rail System III imaging configuration Imaging Starter Kit Thermasonic Gel Warmer Part Number VS VS VS VS VS VS VS VS VS VS VS VS VS SA SA SA SA V - SA V - SA Capillaries Petri Dish SA SA VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

245 Appendix B: Accessories Item Mouse Handling Platform II Rat Handling Platform II Part Number SA SA Power Plug The following table shows the plugs that are available for installation on the Vevo 770. Country/ Region Mains AC Power Plug Country/ Region Mains AC Power Plug North America Australia/ New Zealand Hospital grade plug provided features a green dot Part #: VS Hospital grade plug provided Part #: VS Japan Israel Part #: VS Part #: VS Continental Europe Italy Part #: VS Part #: VS United Kingdom/ Ireland Switzerland Part #: VS Part #: VS V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 227

246 Appendix B: Accessories Country/ Region Mains AC Power Plug Country/ Region Mains AC Power Plug Denmark China Part #: VS Part #: VS Argentina India/ South Africa Part #: VS Part #: VS Supplier The supplier for all the items that are listed in this Appendix: VisualSonics Inc Yonge Street, Suite 6100, Box 66 Toronto, Ontario Canada, M4N 3N1 Tel: +1 (416) Toll Free: (North America) Fax: +1 (416) VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

247 Appendix C: Blood Pressure Calibration Appendix C: Blood Pressure Calibration A third-party blood pressure monitoring system can connect to the Vevo 770 system to allow blood pressure traces to be incorporated and displayed by the Vevo software. Connecting the Blood Pressure Equipment The Vevo 770 provides a 1/8" phono plug as part of its Physiology Controller Unit as shown in the following illustration. Blood Pressure connector on the THM 150 Due to the wide range of blood pressure monitoring systems available, VisualSonics does not provide adapter cables to connect to all systems. The most common connectors are BNC and ¼" stereo plugs. Setting the Signal Level The Vevo 770 blood pressure input can be adjusted to accept a wide range of voltages from different blood pressure systems. To adjust the input gain for the blood pressure data: 1. Click Edit > Operator Preferences. 2. In the Physiological Data Available area, select the appropriate value from the Hardware Gain list. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 229

248 Appendix C: Blood Pressure Calibration Note: Set the blood pressure output so that the maximum output signal of the blood pressure monitoring system will not be "clipped" by the Vevo 770's input amplifier stage. The usable voltage level for each gain setting is displayed in the table below. 3. Select the gain setting that provides a voltage range higher than the output level of the blood pressure monitoring system, as detailed in the following table. Hardware Gain Nominal Voltage Range Input Impedance (kohms) Note: The default value for the Hardware Gain is 4. This value is appropriate for blood pressure systems such as the Millar PCU2000. This device outputs 0 volts for 0 mmhg and 1 volt for 100mmHg. Input Impedance The input impedance of the Vevo 770 is a function of the input gain setting. The minimal value is approximately 1.4 kohms. The blood pressure system that is connected to the Vevo 770 must be capable of providing sufficient current to drive this impedance. If the current is insufficient, the pressure calibration might not be accurate. Note: If a T-connection is used to connect the Vevo 770 system in parallel with another blood pressure monitoring system, verify the accuracy of both systems to ensure that the blood pressure transducer can provide sufficient current to drive both systems. Calibrating the Pressure Scale Prior to starting blood pressure data acquisition, calibrate the Vevo 770 application for the blood pressure monitoring system in use. Note: This procedure assumes that the blood pressure monitoring system includes a built-in calibration function. It is not necessary to have a subject connected to the system for this adjustment. However, it can help to verify that the connections are operating. To acquire blood pressure data: 1. Start acquiring data in B-Mode. 2. Click View>Blood Pressure to display the blood presssure trace. 3. Click Mode > B-Mode Setup or press <B-Mode>. 4. In the Pressure Calibration parameters area: 230 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

249 Appendix C: Blood Pressure Calibration a. Adjust the blood pressure monitoring system so that the output is 0 mmhg. b. Click Calibrate. The blood pressure trace (red) should move to coincide with the 0 mark on the blood pressure scale. c. Adjust the blood pressure monitoring system to output a known level, and note the numeric value of this level. d. Type the numeric value of the output level into the At N mmhg field, where N is the output level value, then click Calibrate. The system adjusts the blood pressure trace to coincide with the calibration mark on the blood pressure scale. The system retains the calibration settings between imaging sessions. The calibration procedure only needs to be repeated if a different blood pressure monitoring system is connected or if a problem is suspected with the calibration accuracy. Importing Calibration Data If the blood pressure monitoring system does not provide a calibrated output, calibration files can be imported into the system. The data for some common monitoring systems is provided by VisualSonics Inc. To import calibration data: 1. From the B-Mode Setup window, click Import. 2. In the Import Pressure Calibration window, select the appropriate file for the blood pressure monitoring system in use. This sets the calibration values and adusts the hardware gain value. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 231

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251 Appendix D: Measurement Report Using Standard Measurement Package Appendix D: Measurement Report Using Standard Measurement Package Operators can export reports containing all measurements and calculations made in a study. Report Format An exported report is output as a CSV (comma-separated value) file, which can be read and analyzed with a text editor such as Notepad, a spreadsheet program such as Microsoft Excel, a database program such as Microsoft Access, and a number of other data analysis applications. When exporting a measurement report using the Standard Measurements Package, the report contains information from a single study. Report File Layout A measurement and calculation report is organized into the following sections: Report File Header Predefined Measurement Values Calculated Values Generic Measurement Values Report File Header Section The first section of a measurement and calculation report file is the Header section, which identifies the: Date on which the report was generated Name of the study Name of the owner operator and acquisition operator for the study Name of the institution (if defined) Date on which the study was created Name, description and version of the measurements definition file used to generate the report (i.e., the Standard Measurements definition file) Version and build number of the Vevo software from which the report was generated Predefined Measurement Values Section The Predefined Measurement Values section of a report lists all predefined measurements that were created in a study, and their values. Predefined measurements are grouped in the report by the mode in which they were made, and are subgrouped by the view within that mode. Within each view, each measurement is listed as follows, from left to right: V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 233

252 Appendix D: Measurement Report Using Standard Measurement Package Measurement the name of the measurement. It includes an embryo identifier if the measurement was made on an embryo. Parameter for a predefined measurement, the only parameter shown is the measurement's primary parameter. The exception to this is that the heart rate parameter will be displayed also if the measurement's heart rate parameter could be used in a calculation. Units identifies the unit for the measurement Value 1 the value for the first measured instance of the measurement Value 2 the value for the second measured instance of the measurement up to Value 10 the value for the 10th measured instance of the measurement Average the average value for all instances of the measurement STD the standard deviation for the values of the measurement Calculated Values section The Calculated Values section of a measurement and calculation report lists values for calculations for which all requisite measurements have been made. Calculations listed in the report are grouped by the protocol in which the requisite measurements were made. Within each view, each calculation is listed as follows, from left to right: Calculation the name of the calculation. This includes an embryo identifier if the requisite measurements were made on an embryo. Units identifies the unit for the calculated value (if applicable) Value the calculated value If multiple instances of the same measurement were created in the study, the maximum measured value is applied to the formula for the calculation. Generic Measurement Values Section The Generic Measurement Values section of a measurement and calculation report lists all generic measurements that were created in the study, and their values. Generic measurements in the report do not have any grouping. Each measurement is listed as follows, from left to right: Measurement the name of the measurement. This includes an embryo identifier if the measurement was made on an embryo. Parameter All possible measurement display options are listed for a generic measurement, regardless of what parameters were enabled in Operator Preferences when the measurement was made. Value the value for the measurement Units identifies the unit for the measurement If the same generic B-Mode, M-Mode, Power Doppler or AM-Mode measurement exists on multiple copies of the same image, it is only listed once in the measurement report. 234 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

253 Appendix D: Measurement Report Using Standard Measurement Package If the same generic PW Doppler Mode or Tissue Dopppler measurement exists on multiple copies of the same image, it is listed as many times as there are copies of the image, with the exception of instances of the same generic heart rate measurement, which is only listed once in the report. Export measurement instances option Reports exported using the Standard Measurements package will be the same whether or not the Export measurements instances option is enabled when the report is exported. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 235

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255 Appendix E: Measurement Report Using the Abdominal, Cardiac or Embryology Measurements Packages Appendix E: Measurement Report Using the Abdominal, Cardiac or Embryology Measurements Packages Operators can export reports containing all measurements and calculations made in a study. Report Format An exported report is output as a CSV (comma-separated value) file, which can be read and analyzed with a text editor such as Notepad, a spreadsheet program such as Microsoft Excel, a database program such as Microsoft Access, and a number of other data analysis applications. When exporting a measurement report using the Abdominal, Cardiac or Embryology Measurements Packages, the operator may choose from the following: A report that contains information from a single study or from multiple studies (the Individual report file) A report that contains information from a single study or from multiple studies (the Combined report file) Report File Layout A measurement and calculation report is organized into the following sections: Report File Header Measurement Values and Calculated Values Generic Measurement Values Report File Header Section The first section of a measurement and calculation report file is the Header section, which identifies the: Date on which the report was generated Name of each study in the report (for a combined report, the report will contain data for multiple studies ) Name of the owner operator for each study in the report Name of the acquisition operator for each study in the report Name of the institution (if defined) Date and time on which each study in the report was created Information about the animal being studied in each study Name, description and version of the measurements definition file used to generate the report Version and build number of the Vevo software from which the report was generated V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 237

256 Appendix E: Measurement Report Using the Abdominal, Cardiac or Embryology Measurements Packages Measurement Values and Calculated Values Section The Measurement Values and Calculated Values section of a report lists all predefined measurements that were created in a study (or studies, for a combined report), the resulting calculations, and their values. A combined report will list all measurements and the resulting calculations made in each study in the report. Predefined measurements and calculations are grouped in the report by the protocol in which they were made. Within each protocol, each measurement is listed as follows, from left to right: Measurement the name of the measurement. It includes an embryo identifier if the measurement was made on an embryo Parameter for a predefined measurement, the only parameter shown is the measurement's primary parameter Units identifies the unit for the measurement Instance number (appears only if the Export Measurement instances was checked during the export) a numbered heading that corresponds to measurements for which multiple instances were created Average value: For an individual report file, this is the average value for all instances of the measurement in the study For a combined report file, there will be several average values displayed, where each displays the average value for the measurement within the indicated study STD: For an individual report file, this is the standard deviation for the values of the measurement For a combined report file, there will be several STD values displayed, where each displays the standard deviation for the measurement within the indicated study Within each protocol, each calculation is listed as follows, from left to right: Calculation the name of the calculation. It includes an embryo identifier if the calculation was made on an embryo. Units identifies the unit for the measurement Calculated Value the value of the calculation is computed using the maximum value for the measurement. For a combined report file, the calculated value for each study in the report is listed separately. Generic Measurement Values Section The Generic Measurement Values section of a measurement and calculation report lists all generic measurements that were created in the study, and their values. Generic measurements in the report do not have any grouping. Each measurement is listed as follows, from left to right: 238 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

257 Appendix E: Measurement Report Using the Abdominal, Cardiac or Embryology Measurements Packages Measurement the name of the measurement. It includes an embryo identifier if the measurement was made on an embryo Parameter All possible measurement display options are listed for a generic measurement, regardless of what parameters were enabled in Operator Preferences when the measurement was made. Units identifies the unit for the measurement Value the value for the measurement V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 239

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259 Appendix F: Advanced Vevo 770 Keyboard Appendix F: Advanced Vevo 770 Keyboard This appendix introduces the advanced keyboard and integrated trackball system that is provided with Vevo 770 software system versions and and describes how it differs from the standard Vevo 770 keyboard. Advanced Vevo 770 Keyboard Features Keyboard Layout The advanced Vevo 770 keyboard: Replaces 2-key increase/decrease hot key sets with single rocker switch hot keys for easier and faster control Groups hot keys according to operator tasks to improve efficiency Provides a dial control for setting PW Doppler angles dynamically The layout of the advanced Vevo 770 keyboard is illustrated in the following diagram: Angle dial Pre Trig Select Scanhead Mode Setup EKV TM 3D B-Mode M-Mode PW Power STUDY MANAGEMENT SETTINGS Esc Help New Browse Close Delete Export Save Load Image Label F10 F11 F12 PRTSC PAUSE BREAK PAN SECTOR X SECTOR Y WINDOW ANGLE # $ % ^ & * ( ) _ = BACKSPACE HOME Overlay TAB Q W E R T Y U I O P { [ } ] \ PG UP FREQ FOV SV BASELINE Toggle Scout CAPS A S D F G H J K L : ; ENTER PG DN GAIN VELOCITY Measure Annotate SHIFT Z X C V B N M <, >.? O+ Shift / END Frame Store Cine Store CTRL ALT ~` FN INS DEL O- Scan/ Freeze Rocker switch hot keys Track ball Rocker Switch Hot Keys A rocker switch is a spring-return key that provides the operator with dynamic and incremental control of a parameter value. To increase the parameter value, press the switch forward; to decrease the value, press the switch backward. Rocker switches are provided for all parameters that can be configured by the operator, including Pan, Sector X and Y, Window, Frequency, V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 241

260 Appendix F: Advanced Vevo 770 Keyboard Field of View, Sample Volume, Baseline, Gain, and Velocity. This replaces the 2-hotkey sets that are provided on the standard keyboard for these parameters. (For more information, see Hot keys assigned to rocker switches on page 247.) Angle Dial Task Based Hot Key Groupings The Angle dial provides dynamic, intuitive control of the PW Doppler angle setting. Each click of the dial as it is turned clockwise or counterclockwise changes the PW Doppler angle setting value by 1. Hot keys are grouped according to tasks, as described in the following tables. Study Management Tasks Hot key Type Description New Key Opens a new study from the Study Browser. Browse Key Toggles between the Data Browser and the imaging window. Close Key Displays the Commit Session dialog for closing a study. Delete Key In the Study Browser or Data Browser, deletes the selected item(s). Export Key Opens the Export Image dialog from within any mode window, or from the Image Browser, for exporting data to other formats. Mode Tasks Hot key Type Description Mode Setup Key Toggles the mode setup parameters on and off for B-Mode, PW Doppler Mode, Tissue Doppler Mode, M-Mode, 3D-Mode, and Power Doppler. EKV Key From B-Mode, starts EKV acquisition if B-Mode is paused. Stops EKV acquisition if EKV data is being acquired. Pre Trig Key Starts the capture of the specified number of frames for a B-Mode or Power Doppler loop and then stops the acquisition. 3D Key Changes to 3D-Mode. 242 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

261 Appendix F: Advanced Vevo 770 Keyboard Hot key Type Description B-Mode Key Changes to B-Mode. M-Mode Key Changes to M-Mode. PW Key Changes to PW Doppler Mode. Power Key Changes to Power Doppler Mode. Tissue Key Changes to Tissue Doppler Mode. Image Management Tasks Hot key Type Description Image Label Key Opens the Image Label dialog while viewing the image in the mode window or when an image is selected in the Data Browser. A data label can contain a maximum of 40 characters. Overlay Key Cycles between PW Doppler Sample Volume wireframe, Tissue Doppler Sample Volume wireframe, M-Mode Sample Volume wireframe, Needle Guide wire-frame, Power Box wireframe, and no overlay in B-Mode and Power Doppler Mode. No function in PW Doppler Mode, Tissue Doppler Mode, M-Mode or 3D-Mode. Toggle Scout Key In PW Doppler Mode, Tissue Doppler Mode or M-Mode, toggles between data acquisition and the continuous updating of the Scout window. Measure Key Turns the measurement tool on and off in B- Mode, M-Mode, 3D-Mode, PW Doppler Mode, Power Doppler Mode, and Tissue Doppler Mode. Annotate Key Creates a free text annotation when the trackball cursor is positioned over an image. Frame Store Cine Store Scan/ Freeze Key Key Key Stores the current frame. Stores the current cine loop. Toggles scanning on/off. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 243

262 Appendix F: Advanced Vevo 770 Keyboard Parameter Value Tasks Hot key Type Description PAN Rocker switch Moves the image window up and down by 1mm to view signal closer to the transducer or farther away from it. Available in B-Mode, M-Mode, and Power Doppler Mode. SECTOR X Rocker switch Adjusts the Sector in the X-axis (1mm) for B-Mode and Power Doppler Mode. SECTOR Y Rocker switch Adjusts the Sector in the Y-axis (1mm) for B-Mode and Power Doppler Mode. WINDOW Rocker switch Adjusts available Display Window values in M-Mode, PW Doppler Mode, and Tissue Doppler Mode. ANGLE Dial Rotates the PW Doppler and Tissue Doppler angle by 1 clockwise or counterclockwise. FREQ Rocker switch Adjusts available Transmit Frequency values in B-Mode, M- Mode, PW Doppler Mode, Power Doppler Mode, and Tissue Doppler Mode. FOV Rocker switch Adjusts the Field of View (FOV) for B-Mode and Power Doppler Mode. SV Rocker switch Adjusts the M-Mode Sample Volume size by increments of 50 microns. Increases or decreases the PW Doppler Mode or Tissue Doppler Mode Sample Volume size by increments of 20 microns (may be adjusted to ensure integral number of cycles). BASELINE Rocker switch Adjusts the PW Doppler or Tissue Doppler baseline value by 5 percent. GAIN Rocker switch Adjusts the receive gain in B- Mode, PW Doppler Mode, Power Doppler Mode, Tissue Doppler Mode, and M-Mode by 5 db. 244 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

263 Appendix F: Advanced Vevo 770 Keyboard Hot key Type Description VELOCITY Rocker switch Adjusts to the next available PRF setting for PW Doppler Mode and Tissue Doppler Mode. Settings Tasks Hot key Type Description Save Key Saves custom parameter settings. Load Key Loads custom parameter settings. Select Scanhead Key Opens the Scanhead Selection dialog. o+ Key Press FN + o+ to increase keyboard backlighting. o- Key Press FN + o- backlighting. to decrease keyboard System Tasks Hot key Type Description Esc Key Cancels an operation or pop-up window. Help Key Opens the Quick Start Guide. Hot Key Combinations The following table describes the available hot key combinations that are available. Hot key combination Shift+GAIN Shift+PAN Shift+SV Description Adjusts the gain in B-Mode, PW Doppler Mode, Power Doppler Mode, Tissue Doppler Mode, and M-Mode by 1 db. Moves the image window up and down by 0.1mm to view signal closer to the transducer or farther away from it. Available in B-Mode, M-Mode, and Power Doppler Mode. Increases or decreases the M-Mode Sample Volume size by increments of 500 microns. Increases or decreases the PW Doppler Mode or Tissue Doppler Mode Sample Volume size by increments of 100 microns (may be adjusted to ensure integral number of cycles). V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 245

264 Appendix F: Advanced Vevo 770 Keyboard Hot key combination Ctrl+D Ctrl+Frame Store Ctrl+Cine Store Ctrl+Shift+P Ctrl+R Shift+Help Description Toggles between Basic and Details parameter view in the mode window. Saves a new copy of the current frame image. Saves a new copy of the current loop. Restores the parameter settings to their values at system start-up when the Operator Preferences dialog is not open. Toggles range control on/off in B-Mode and Power Doppler Mode. Opens the Available Calculations help file. 246 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

265 Appendix G: Shifting to the Advanced Keyboard Appendix G: Shifting to the Advanced Keyboard This appendix provides information that is useful if you are using the standard keyboard or are switching from the standard keyboard to the advanced keyboard. Hot Key Label Changes Some hot keys are labeled differently on the advanced Vevo 770 keyboard than on the standard Vevo 770 keyboard, as described in the following table. Standard Advanced Description New Study Browse Study Export Image Ctrl + P No hot key previously New (STUDY MANAGEMENT) Browse (STUDY MANAGEMENT) Export (STUDY MANAGEMENT) Load (SETTINGS) Save (SETTINGS) Begins a new study. Toggles the Data Browser for the study that is currently open (for reviewing images, measurements, calculations). Exports the current image or a group of selected images for export to either BMP, TIFF or Raw Data format. Allows loading of a custom parameter file without having to open the Operator Preferences facility. Allows saving of a customer parameter file without having to open the Operator Preferences facility. PW Doppler PW Change to PW Doppler Mode. Power Doppler Power Change to Power Doppler Mode. Ctrl + L Image Label Enter or edit a label for the current image or a selected image. Hot keys assigned to rocker switches The following table describes the functions that are controlled by keys on the standard Vevo 770 keyboard and by a rocker switch on the advanced Vevo 770 keyboard. Hot Key Rocker Switch Description Pan Pan PAN Increases or decreases the image depth in increments of 1 mm (or 0.1 mm when the Shift key is pressed). V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 247

266 Appendix G: Shifting to the Advanced Keyboard Hot Key Rocker Switch Description Sector Sector Ctrl + Sector Ctrl + Sector SECTOR X SECTOR Y Increases or decreases the sector width in increments of 1 mm (or 0.1 mm when the Shift key is pressed). Increases or decreases the sector height in increments of 1 mm (or 0.1 mm when the Shift key is pressed). Window WINDOW Increases or decreases the display window time to the next available value. Frequency FREQ Increases or decreases the transmit frequency to the next available value for the active RMV scanhead. FOV FOV SV SV Baseline Baseline Gain Gain Velocity Velocity FOV SV BASELINE GAIN VELOCITY Increases or decreases the field of view. In M-Mode, increases or decreases the sample volume size in increments of 50 microns (or 500 microns when the Shift key is pressed). In PW Doppler mode or Tissue Doppler Mode, increases or decreases the sample volume size in increments of 20 microns (or 100 microns when the Shift key is pressed). Increases or decreases the PW Doppler or Tissue Doppler baseline position in increments of 5%. Increases or decreases the receive gain in increments of 5 db (or 1.0 db when the Shift key is pressed). Note: When the receive gain setting is changed, the system changes the position of the TGC controls. Increases or decreases the PRF to the next available value, effectively changing the PW Doppler velocity range. 248 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

267 Glossary Glossary 3D-Mode Active Sample Volume Aliasing Anchor Angle dial Annotation Aperture Attenuation AVI Axial resolution B-Mode Backscatter Bandwidth Blockout zone BMP CD-R CD-ROM CD-RW Caliper Chassis A method of acquiring ultrasound data to create a 3D image. The Sample Volume that is located closest to the focal zone of the RMV scanhead. An artifact that occurs in PW Doppler Mode due to ambiguity in the measurement of flow that has a higher velocity than the maximum limit determined by the PRF. The line that connects the annotation text with the object that is being referenced. A manual dial control on the Vevo 770 Keyboard that provides dynamic, intuitive control of the PW Doppler angle setting. Each click of the dial as it is turned clockwise or counterclockwise changes the PW Doppler angle setting value by 1. A label used to identify a structure seen in the data. The diameter of the transducer s active surface. The reduction of signal strength. Audio Video Interleave (AVI) is a standard file format developed by Microsoft that includes both live video and sound. The ability to distinguish two separate but closely positioned structures on a line in the image plane parallel to the axis of the ultrasound beam. A method of acquiring ultrasound data to create a 2D image. The deflected ultrasound signal that returns to the transducer as an echo. The range of frequency in which the transducer can operate, measured as a percent of center frequency. A region along the ultrasound beam where the PW Doppler Sample Volume cannot be placed. BMP is a Bitmap file extension of a static image file format. Each bit of the saved BMP file represents a piece or pixel of the image. Recordable CD format. Read only CD format. Re-writeable CD format. An operator-defined point for a measurement. The framework to which the electronics of the system are attached. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 249

268 Glossary Cine loop Cine store CSV De-ionized water Depth of field Digital RF-Mode Dongle Doppler angle Doppler effect Doppler frequency DVD ECG Edit box EKV f-number FFT Field of view (FOV) Flow hood Focal length In B-Mode, the cine loop is a set of frames. In PW Doppler and M-Mode, the cine loop is the data acquired over time. The operator action which associates the current cine loop with the study. Comma Separated Values (CSV) is a file format used to represent database fields. Each entry of the file represents one field and is separated from the next field by a comma. Water from which trace ions and gas bubbles have been removed. The length of the focal zone. Provides the operator with the ability to acquire, digitize and export the raw RF data for spectral analysis. A hardware device that serves as copy protection for the software by rendering the software inoperable when the device is not plugged into a USB connector. The angle between the ultrasound pulse and the direction of blood flow. This angle is also known as the incident angle to flow or the angle of insonation. The perceived shift in the frequency of the backscattered ultrasound signal reflected from a moving target. The change in frequency between the transmitted ultrasound pulse and the received ultrasound echo. Digital Versatile Disc. Electrocardiogram is a electronic representation of a physiological measurement of the electrical potentials of heart tissue. The output is a trace of the heart rhythm. A dialog element used to display text parameters and allow the operator to edit the text. ECG Kilohertz Visualization (EKV) The ratio of focal length to aperture. Fast Fourier Transform. An algorithm for computing the Fourier transform of a set of discrete data values. Given a finite set of data points (for example, a periodic sampling taken from a real-world signal) the FFT expresses the data in terms of its component frequencies. It also solves the essentially identical inverse problem of reconstructing a signal from the frequency data. This B-Mode parameter indicates the size of the acquired image. A biosafety cabinet, a chemical fume hood or a laminar flow hood. The distance from the active surface of the transducer to the middle of the focal zone. 250 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

269 Glossary Focal zone Frame Rate The portion of a focused ultrasound beam which is the region of optimal resolution. The structure of interest is optimally focused when it is imaged within this region. The number of acquisition image updates per second in B-Mode. A higher acquisition frame rate is desirable when watching a moving structure such as the heart, or when moving the scanhead. Hot keys Any key on the keyboard or keypad that starts a function in the Vevo 770 software. I & Q Doppler signals Image plane Lateral resolution M-Mode MIP (Max) Message log MIP (Min) Multi-session CD Non-invasive Nosepiece Nyquist limit Operator The two quadrature signals from the PW Doppler acquisition. These signals are used to determine the direction of the detected flow. In B-Mode, the image plane is a cross-sectional 2-D image running parallel to the transducer beam with an area defined by the sweep distance of the transducer and the depth of the transducer beam. The ability to distinguish between two separate but closely positioned structures on a line in the image plane perpendicularly to the axis of the ultrasound beam. A method of acquiring ultrasound data to generate an image of a single ultrasound beam over time. Maximum Intensity Projection highlights the denser portions of the volume by bringing them forward in the image and making them brighter. This more clearly displays a small bright object in the middle of a dark ultrasound image. A system window that reports any notifications that are generated by the Vevo software. This information may be useful for troubleshooting when a system error occurs. Minimum Intensity Projection highlights the less dense portions of the volume by bringing them forward in the image and making them darker. This more clearly displays a small dark object in the middle of a bright ultrasound image. There are two types of copy sessions available when coping data to a CD using a CD-R or CD-RW. The first type, a single session, copies the data to the CD then label the session as closed. No more data can be written to that media. The second type of copy session, a multi-session, labels the session as open so more data can be added using the same session configuration. Not penetrating the body, as by incision or injection. The part of the RMV scanhead that encapsulates the transducer. The maximum frequency that may be detected by a given sample rate. This limit is equal to one-half the specified sampling rate. A specified operator of the system with whom study sessions may be associated. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 251

270 Glossary Oscilloscope Overlay Penetration depth An instrument in which the variations in a fluctuating electrical quantity appear temporarily as a visible wave form on the fluorescent screen of a cathode-ray tube. A graphical item that may be superimposed on the ultrasound image to define a Sample Volume or a guide. The maximum depth at which structures may be distinguished by the ultrasound beam. Power Doppler Mode Provides tools to visualize and measure a flow volume in 2D and 3D. Pressure-volume loop PRF limitation Pulse Repetition Frequency (PRF) PW Doppler Mode Radio frequency (RF) Real-time Microvisualization (RMV) scanhead Rocker Switch A graphical method of identifying and evaluating LV pressure-volume relationship changes related to dynamic levels of cardiac stress. Refers to the Nyquist limit. The rate at which the ultrasound transducer is being pulsed. The PRF is also equal to the sampling rate. A method of acquiring data for examination of flow velocity within a region of interest. PW Doppler Mode acquires data using pulsed-wave Doppler where the transducer alternately transmits and receives ultrasound signals. A frequency in the range within which radio waves may be transmitted, from about 3 khz to about 300,000 MHz. The hand-held probe developed by VisualSonics Inc. for high-frequency ultrasound imaging for small animal research. A rocker switch is a spring-return key that provides the operator with dynamic and incremental control of a parameter value. To increase the parameter value, press the switch forward; to decrease the value, press the switch backward. Sample Volume The region of interest being imaged during PW Doppler Mode or M- Mode acquisition. Sample Volume size is defined by the length of the pulse and the width of the ultrasound beam. Scanhead Scout window Sector scan Session Study The apparatus that houses the transducer and the electrical and mechanical components which move the transducer along the scan direction. A small B-Mode window that renders the region of interest for M-Mode or PW Doppler acquisition. A scan through which the transducer is moved in a arc-like fashion. A period of time that an operator spends adding information (acquiring data or making measurements and/or annotations on acquired data) to a study. A collection of acquired data and its associated measurements and annotations. 252 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

271 Glossary Thread activity TIFF Tissue Doppler Mode Transducer WAV A view in the Message Log that provides a list of the currently active software threads and their properties. This information may be useful for troubleshooting when a system error occurs. Tagged Image File Format (TIFF) is a standard still image file format that includes tagged fields with the image that can be read by the opening application. Provides tools to assess the function of the heart muscle using PW Doppler to detect and display moving myocardial tissue as a PW Doppler spectrum. The component of the Vevo 770 that produces the ultrasound pulses and receives the reflected ultrasound echoes. WAV is the file extension for a Waveform file format developed by Microsoft that includes sound. This file format is used exclusively in Windows. V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 253

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273 Index Index Numerics 3D-Mode, 81 3D motor stage, 82 3D settings, 68 area volume, 94 creating volumetric measurements, 94 display parameters, 100 generic measurements, 98 manipulating 3D image data, 90 measurements, 170 range, 86 recording a 3D-Mode session, 99 rendering a 3D image, 90 sculpting an image, 92 step size, 86 theory of operation, 81 viewing 3D image data, 87 A acceleration measurement, 173 accessories, 225 acquisition scan/freeze, 40 typical 3D-Mode, 85 typical B-Mode, 69 typical M-Mode, 130 typical Power Doppler, 135 typical PW Doppler, 112 typical study, 47 typical Tissue Doppler Mode, 121 adjust display window hot keys, 106, 119, 128 adjust transmit frequency hot keys, 107, 120, 128 AM-Mode typical data construction, 132 Animal, 53 animal preparation, 29 audio export, 112 playback, 110 audio output PW Doppler, 106, 119 auto histogram parameter, 139 auto scan speed parameter, 140 B baseline, 105, 118 hot keys, 106, 119 baseline threshold, 105, 118 blockout zone, 108 blood pressure, 29 B-Mode cine loop, 76 hot keys, 68 main window, 65, 117 measurements, 161 needle guide overlay, 73 setup, 66 theory, 10 typical acquisition, 69 brightness B-Mode setup, 68 M-Mode setup, 127 PW Doppler Mode setup, 105, 118 C calculations export, 192 viewing, 144 cautions, viii cine loop B-Mode, 76 export, 145 M-Mode, 129 PW Doppler Mode, 110 cine loop pre-trigger, 78 cine loop range, 77 commit study, 48, 61, 151 contrast B-Mode setup, 68 M-Mode setup, 127 PW Doppler Mode setup, 105, 118 copy copy to, 55 D Data Browser, 143 data label, 144 data management data browser, 143 delete, 151 export, 145 hot keys, 152 viewing, 144 depth, 67 depth measurement, 179 disk space. See storage capacity display window, 106, 119, 127 Doppler gain, 106, 119 hot keys, 106, 119 parameter, 105, 118 E ECG signal, 29 EKV acquiring an EKV loop, 71 B-Mode settings, 68 definition, 71 make measurements and add annotations, 73 quality level settings, 72 quality setting definition, 68 replay an EKV loop, 73 return to B-Mode imaging, 73 save an EKV image, 73 save an EKV loop, 73 studying an EKV loop, 73 export calculations, 192 data, 145 data browser, 145 file types, 146, 149 measurements, 192 F field of view, 67 parameter, 67 FOV hot keys, 69 frame counter, 76 frame rate, 67 frame rate control, 77 G gain hot keys, 68, 127 parameter, 140 General, 53 Group by, 35, 52 H Heart, 175, 181 heart rate M-Mode calculation, 181 PW Doppler mode calculation, 175 hot keys, 241 B-Mode, 68 data management, 152 Doppler Mode, 106 layout, 45 M-Mode, 127 PW Doppler Mode, 119 I image label, 144 invert spectrum, 106, 119 L label image, 144 M measurement packages changing, 159 selecting initial, 159 measurements 3D-Mode, 170 acceleration, 173 V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 255

274 Index B-Mode, 161 creating, 157 deleting, 157 depth, 179 displaying, 154 embryo, 158 export, 192 heart rate, 175, 181 measurement tool, 154 M-Mode, 179 M-Mode LV wall trace, 181 modifying, 157 packages, 153 point, 174 pressure-volume loop, 188 PW Doppler Mode, 172 real-time, 178 strain rate, 185 time interval, 173 Tissue Doppler Mode, 184 units, 159 velocity, 174, 179 viewing, 144 VTI with auto trace, 176 VTI without auto trace, 116, 175 measuring vascularity, 141 menu Edit, 34 Help, 35, 37, 38 mode window menu options, 40 Overlay, 39 Setup, 35, 39 Study, 37 Study Browser menu options, Study Frame menu options, 36 Tools, 38 View, 35, 38 message log description, 216 reporting, 215 M-Mode cine loop, 129 defining Sample Volume, 125 hot keys, 127 main window, 126 measurements, 179 scout window, 128 setup, 126 theory, 14 typical acquisition, 130 mode window, 36 N needle guide, 73 typical injection procedure, 75 Nyquist limit technical overview, 115 O operator add and edit, 51 preferences, 42 study ownership, 49 overlay menu items, 39 M-Mode Sample Volume, 125 needle guide, 73 PW Doppler Sample Volume, 101 P parallel segmentation, 94 parameters 3D-Mode, 90 B-Mode, 66 M-Mode, 126 Power Doppler Mode, 136 PW Doppler Mode, 104 Tissue Doppler Mode, 118 percent vascularity, 142 physiological data, 29 exporting data, 71 signal integration, 71 playback controls, 76 point measurement, 174 power parameter, 66, 127, 140 Power 3D Mode, 141 percent vascularity, 142 segmentation in, 97 Power Doppler Mode measuring vascularity, 141 setup, 136 theory, 15 typical acquisition, 135 pressure-volume loop measurement, 188 from B-Mode data, 189 from M-Mode data, 188 graphs, 190 PRF affect on multiple Sample Volumes, 110 hot keys, 106, 119 parameter, 105, 118 technical overview, 115 priority parameter, 139 Pulse Repetition Frequency, 115 PW Doppler angle hot keys, 107, 120 PW Doppler Mode aliasing, 115 cine loop, 110 defining the Sample Volume, 101 Doppler angle, 102 hot keys, 106, 119 main window, 103 measurements, 172 multiple Sample Volumes, 108 scout window, 107, 120 setup, 104 theory, 12 typical image acquisition, 112 PW Doppler Sample Volume, 101 R range 3D settings, 68 3D-Mode, 86 range maximum parameter, 138 range minimum parameter, 138 real-time measurements, 116, 175, 176, 178 respiration gating for 3D acquisition, 86 parameter, 139 respiration rate, 29 RF cycles, 67 parameter, 127, 140 RMV scanhead cleaning, 220 connecting to Vevo 770, 18 description, 7 selecting in software, 31 storing, 220 rotational segmentation, 96 S Sample Volume PW Doppler, 101 secondary, 108 Sample Volume size hot keys, 106, 119, 127 save study, 48, 61, 151 scan speed parameter, 137 scout window M-Mode, 128 PW Doppler Mode, 107, 120 sector size, 67 setting up the 3D motor stage, 82 setup menu items, 39 range, 86 step size, 86 signal integration, 71 step size, 86 3D settings, 68 strain rate, 185 Study, 34 study associating data, 40 close, 61 commit, 48, 61, 151 copy from, 56 copy to, 55 Data Browser, 143 exporting multiple, 193 ID, 35 menu items, 37 new study, 52 open, 54 ownership, 49 quick study, 52 recovery, 61 save, 48, 61, 151 storage capacity, 60 study again, 54 study browser, 51 study information, 52, 61 typical acquisition session, 47 V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 256

275 Index typical review session, 49 Study Browser, Study Frame, 40 Study Information, 52 T temperature, 29 text annotations configuring, 198 displaying, 198 editing, 200 placing, 197 time interval measurement, 173 time-gain compensation (TGC), 78 Tissue Doppler Mode fundamentals, 117 setup, 118 typical image acquisition, 121 transducer, 9 troubleshooting reporting errors, 215 table, 209 V velocity parameter, 137 velocity measurement, 174, 179 Vevo 770 accessories, 225 available configurations, 3 cleaning, 219 description, 1 main components, 3 moving, 219 optional components, 8 product safety, v shutting down, 27 specifications, 223 starting, 24 Vevo software shutting down, 27 starting, 26 volume, 106, 119 volumetric measurements, 94 fixing a volume, 97 parallel segmentation, 94 rotational segmentation, 96 segmentation in Power 3D Mode, 97 VTI with auto trace, 176 without auto trace, 116, 175 W wall filter parameter, 105, 118, 137 warnings, v wire-frame needle guide, 73 PW Doppler Sample Volume, 101 V1.3 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual 257

276 Index 258 VisualSonics Vevo 770 High-Resolution Imaging System Operator Manual V1.3

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