Aplio iXXX TUS-AIxxx series Operation Manual Measurements Volume Rev D Nov 2016

Trademarks Windows® is a registered trademark of Microsoft Corporation in the United States and other countries. Aplio is a trademark of Toshiba Medical Systems Corporation. This manual may include trademarks or registered trademarks of other companies. Note that the trademark symbol "TM“ and the registered trademark symbol "®" may or may not be used in this manual.

IMPORTANT! 1. No part of this manual may be copied or reprinted, in whole or in part, without prior written permission. 2. The contents of this manual are subject to change without prior notice and without legal obligation. 3. The contents of this manual are correct to the best of our knowledge. Please inform us of any ambiguous or erroneous descriptions, missing information, etc.

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CONTENTS Page

1.

Outline of Measurement Functions ... 7 1.1 Switches Used for Measurement ... 8 1.2 Setting the Measurement...10 1.3 Modifying a Measurement...11 1.4 Deleting a Measurement ...14 1.5 Starting Next Measurement After Current Measurement ...14 1.5.1 During basic measurements...14 1.5.2 During application measurements ...14 1.6 Measurement Result Display Area ...15 1.6.1 Display type ...15 1.6.2 Customization of the Measurement Result Display Area ...15 1.6.3 Change of the format ...17 1.7 Worksheet Screen...18 1.8 Setting Measurement Preset ...20

2.

2D-Mode Measurements...21 2.1 Distance Measurement (Distance) ...23 2.2 Curved Line Distance Measurement (Trace Length) ...23 2.2.1 Continuous Trace...24 2.2.2 Spline Trace ...25 2.3 Angle Measurement (Angle)...26 2.4 Area/Circumference Measurement (Area) ...27 2.4.1 Continuous Trace...27 2.4.2 Spline Trace ...27 2.4.3 Ellipse ...28 2.4.4 Cross ...29 2.5 Volume Measurement (Volume)...32 2.6 Joint Measurement...33 2.7 MeanIMT Measurement...34 2.8 %Stenosis (Diam) Measurement ...36

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CONTENTS

Page

2.9

%Stenosis (Area) Measurement ...37

3.

M-Mode Measurements ...39 3.1 M-Mode Distance Measurement (Distance) ...41 3.2 Slope Measurement (Slope) ...42 3.3 Time Measurement (Time) ...43 3.4 Heart Rate Measurement (HR)...44

4.

Doppler-Mode Measurements...45 4.1 Velocity Measurement (Velocity)...47 4.2 Acceleration Measurement (Accel) ...48 4.3 Time Measurement (Time) ...49 4.4 Heart Rate Measurement (HR)...49 4.5 Velocity Trace Measurement (Vel Trace) ...49 4.5.1 Continuous Trace...50 4.5.2 Spline Trace ...52 4.5.3 Line Trace...53 4.5.4 Range ...54 4.5.5 Auto Range ...57 4.6 PI Measurement (PI Trace) ...58 4.7 RI Measurement ...59 4.8 S/D Measurement...60 4.9 Flow Volume Trace Measurement (Flow Volume) ...61

5.

Application Measurement (Cardiac)...65 5.1 Introduction ...66 5.1.1 Starting the application measurement menu...66 5.1.2 Heart rate acquisition methods (Cardiac) ...66 5.2 2D-Mode Measurements (Cardiac)...68 5.2.1 LV measurement (MOD Simpson method) ...68 5.2.2 LV measurement (Teichholz method) ...75 5.2.3 LV measurement (Cube method) ...80 5.2.4 LV measurement (Gibson method) ...80 5.2.5 LV measurement (Single-plane (aka Area-Length) method)...81 5.2.6 5.2.7 5.2.8 5.2.9

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LV measurement (Biplane method)...83 LV measurement (Bullet method) ...85 LA measurement (MOD Simpson method)...87 LA measurement (3-Axis method) ...89 2B771-174EN*D

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Page

5.2.10 LV Mass measurement ...91 5.3 M-Mode Measurement (Cardiac) ...93 5.3.1 LV measurement (Teichholz method) ...93 5.3.2 LV measurement (Cube method) ...97 5.3.3 LV measurement (Gibson method) ...97 5.3.4 Aortic valve measurement ...98 5.3.5 Mitral valve measurement... 100 5.3.6 Tricuspid valve measurement ... 102 5.4 Doppler-Mode Measurement (Cardiac)... 103 5.4.1 Aortic valve measurement ... 103 5.4.2 Mitral valve measurement... 111 5.4.3 Pulmonary valve measurement... 119 5.4.4 Tricuspid valve measurement ... 125 5.4.5 Pulmonary vein blood flow measurement... 130 5.4.6 PISA... 132 5.4.7 Coronary ... 134 6.

Application Measurement (Vascular) ... 137 6.1 Starting the Application Measurement Menu ... 138 6.1.1 2D-mode measurement... 138 6.1.2 Doppler-mode measurement... 140 6.1.3 Measurement value display on the Worksheet screen... 142 6.2 Auto-IMT Measurement... 142 6.2.1 Touch panel menu ... 142 6.2.2 Measurement method... 145 6.2.3 Worksheet screen... 147

7.

Measurements on a Stored Image... 149 7.1 Measurements on ER Images... 152 7.2 Measurements on ER Images for Which Manual Calibration Is Required... 153 7.3 Manual Calibration Required Before the Start of Each Measurement ... 158 7.4 Worksheet Display... 159 7.5 Accuracy of Measurement When Manual Calibration Is Used... 160

8.

Measurement Data Storage and Review Function ... 161 8.1 Storing Measurement Data in the DICOM SR Format... 162

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8.1.1 Automatic data storage at the time of termination of exam ... 162 8.1.2 Data storage using the Worksheet screen ... 163 8.2 Reviewing Measurement Data in the DICOM SR Format... 165 8.3 Reproduction of Caliper on the Stored Image ... 166 9.

Presetting... 167 9.1 Setting Presets ... 169 9.2 Details of Each Preset... 171 9.2.1 Common Preset ... 171 9.2.2 Labeled Preset ... 175 9.2.3 Basic Preset ... 193 9.2.4 Labeled (Details of registration functions in Measure Setup)... 194 9.2.5 Import/Export function ... 204 9.2.6 Initial Setting function ... 208 9.2.7 Copy function... 209 9.3 Confirmation of the automatic measurement start item ... 210 9.3.1 Measurement to be started in basic measurement mode ... 210 9.3.2 Measurement to be started in application measurement mode... 212

10.

6

Registration of User-Programmed Measurements ... 215

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1. Outline of Measurement Functions

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1. Outline of Measurement Functions

1Outline of Measurement Functions

1.1

Switches Used for Measurement

No.

Switch

Function

<1>

Moves the marker.

<2>

Sets the start and end point.

<3>

Starts a measurement (the type of measurement that is started differs according to the examination type and the number of times the switch is pressed).

• Radiology: Press once to start a basic measurement, twice to start an application measurement. • Obstetrics: Press once to start an application measurement, twice to start a basic measurement. • Cardiac: Press once to start an application measurement, twice to start a basic measurement. • Vascular: Press once to start an application measurement, twice to start a basic measurement.

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<4>

Rotates the line marker to adjust the angle.

<5>

Modifies trace lines. Deletes the selected measurement.

<6>

Freezes the image.

<7>

Turns ON/OFF the cursor display. Used to customize the measurement result display area.

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1. Outline of Measurement Functions

1. The measurements that start when the corresponding switch is pressed and the methods for setting the measurement data differ depending on the preset. The data used for calculation and the display of calculation results also differ depending on the preset. Refer to the section "Presetting" and register the desired presets before using the above switches. 2. The default basic measurement can be changed as needed. Contact your Toshiba service representative for details.

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1. Outline of Measurement Functions

1.2

Setting the Measurement When the measurement is set on an image in the current examination, the color of the measurement markers is changed to cyan. When the measurement is set on an image stored for a previous examination, the color of the measurement markers is changed to white.

Be sure to perform measurement within the displayed images. If an area outside an image is included in a measurement, an incorrect result may be output.

1. The application measurement results are not displayed on the Worksheet screen if the measurement data has not been set. 2. In basic measurement mode, the measured data is lost when the system power is turned OFF or the exam data has been changed. 3. The results of basic measurements are not displayed on the Worksheet screen. 4. Only a part of the calculation results are displayed on the measurement result screen in application measurement mode. To check all the measurement results (calculation results), use the Worksheet screen. 5. It is possible to preset whether or not the line connecting the start point and end point is displayed before the measurement is set in distance measurement and area measurement.

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1. Outline of Measurement Functions

1.3

Modifying a Measurement A measurement data item may be modified even after the measurement data is set and the measured value is displayed. Press

to display an arrow. Then move the arrow near the point to be

modified, and press

to start modification.

<<Example of distance measurement>> Step 1: Start modification. <1> Press

Step 2: Move the start point.

<3> Change the position of . the start point using

↓

An arrow is displayed. <2> Move the arrow near the marker to be modified and then press

.

A

Step 3: Finish modification of the start point. <4> Press

A

↓ The newly measured data is set.

.

Step 4: Modify the end point. <5> After finishing modification of the start point, repeat steps <1> to <4> to modify the end point (select the end point in <2>).

.

Modification of the start point (initially set point) is possible in the figure above.

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1. Outline of Measurement Functions

<<Example of measurement using the Continuous Trace method>> Step 1: Start modification. <1> Press

Step 2: Undo the trace to the desired point. <3> Rotate

. ↓ An arrow is displayed. <2> Move the arrow near the marker to be modified and then press

to undo the trace to the desired point.

.

Step 3: Draw the trace again.

Step 4: Set the newly measured data.

<4> From that point, draw the trace again using

<6> After finishing modification of the start point, repeat steps <1> to<5> to modify the end point (select the end point in <2>)

.

↓ <5> Press

↓

↓

Modification of the start point (initially set point) is possible in the figure above.

The newly measured data is set.

.

* During velocity trace measurement in PW/CW mode, rotate counterclockwise to undo the trace.

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1. Outline of Measurement Functions

<<Example of measurement using the Spline Trace method>> Step 1: Step 2: Start modification. Select the marker to be modified. <1> Press . ↓

Step 3: Move the marker.

Step 4: Set the newly measured data.

<2> Move the <4> Move the <5> Press arrow near marker to the the marker to desired be modified. position ↓ using

An arrow is displayed.

.

.

The newly measured data is set.

↓ The color of the selected marker changes to red. ↓ <3> Press .

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1. Outline of Measurement Functions

1.4

Deleting a Measurement Perform the procedures below to delete the selected measurement result. Step 1: Start

<1> Press

Step 2: Select the measurement result to be deleted. .

↓ An arrow is displayed.

<2> Move the arrow near the marker for the measurement result to be deleted. A

B

Step 3: Delete the measurement result. <3> Press

. ↓

The measurement result associated with the selected marker is deleted.

↓ The color of the selected marker changes to red.

1.5 1.5.1

Starting Next Measurement After Current Measurement During basic measurements When

is moved after a measurement is determined A

by pressing

, the next marker is displayed to allow

the user to perform the same type of measurement again.

1.5.2

During application measurements When

is moved after the measurement data is fixed by pressing

,

the next measurement item in the application measurement menu is started. In application measurements, the measurement item to be started when

is

moved can be set. In addition, the details of the measurement item to be started when the image is frozen can be selected.

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1. Outline of Measurement Functions

1.6 1.6.1

Measurement Result Display Area Display type The display type can be set to "Current" or "Group" in the presets.

It may not be possible to display all measurement results in the Measurement Result Display area when the "Group" display type is selected and the number of checkmarks for the items to be displayed in the Measurement Display Area is increased. Contact your service representative for details.

1.6.2

Customization of the Measurement Result Display Area When the display type is set to "Current", the position of the measurement result display area and the font size used in this area can be changed. (1) The measurement result display area can be customized by moving the cursor to the lower left corner of the area using and then pressing

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on the main panel

.

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1. Outline of Measurement Functions

(2) The position of the measurement result display area can be moved using the trackball

.

(3) The font size used in the measurement result display area can be changed using

(five steps).

(4) Press

to register the changes made to the measurement result

display area.

Note that the measurement result display area can be moved to a position where the entire area is not visible. Be sure to move the measurement result display area back to a position where the entire area is visible when it is necessary to confirm the measurement results.

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1. Outline of Measurement Functions

1.6.3

Change of the format

: Switches the layout formats in the measurement result display area between Single, Wide and Hide.

The layout formats are the same for application measurement and basic measurement.Selection of Single or Wide is applied even if the system restarts. Wide is enabled only when "Group" is set for the MDA display type (MDA format). Selection of Hide is released after measurement (the previously selected layout format is displayed in the measurement result display area).

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1. Outline of Measurement Functions

1.7

Worksheet Screen After performing application measurement, press

to display the

worksheet screen. On this screen, the measurement and calculation results obtained in the application measurement are displayed.

1. If the measurement data displayed on the Worksheet screen is edited, the data that precedes editing is overwritten and lost. 2. If many items have been measured, it may take from tens of seconds to several minutes to display the Worksheet screen after

is pressed.

Do not operate the main panel or touch panel until the Worksheet screen is displayed. 3. The examination type for which the results are to be displayed can be selected from the pull-down menu on the Worksheet screen when more than one measurement has been performed using different examination types. If the number of examination types used is large, there may be a delay of several tens of seconds to several minutes before the results for the selected examination type are displayed. Do not operate the main panel or touch panel during this period.

1. The representative value and each measurement result are displayed on the Worksheet screen. Only the representative value is displayed when [Edit] is set to OFF in the worksheet 2. If two or more measurements have been performed for a single item, be sure to check each measurement result using the worksheet function. If an unexpected measurement value is obtained, it will affect the representative value. 3. If a result for a measurement item is deleted with "Last" selected, the result of the immediately preceding measurement is displayed.

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1. Outline of Measurement Functions

4. If a result for a measurement item is deleted in the worksheet edit window and no other results remain for the item, the measurement item, the representative value of the item, and the calculation results obtained using the measurement value (representative value) are all deleted automatically. To redisplay these values, the item must be measured again. Before deleting the contents of the worksheet edit window, confirm that required data will not be deleted. When entering or editing data for measurement items, be sure to enter the values and units correctly. 5. Measurement or calculation data cannot be saved unless a patient ID is registered for the patient. Be sure to register the patient ID before starting measurement. 6. Confirm that no unexpected values are displayed on the Worksheet screen before saving the data. 7. The measured value for some items displayed on the Worksheet screen can be edited, provided that the examination has not yet been completed. Once the measured data is saved, however, the data cannot be edited. Confirm the results on the worksheet before saving the data. 8. Do not turn ON the measurement switch while the Worksheet screen is displayed. 9. Only a part of the calculation results are displayed on the measurement result screen in application measurement mode. To check all the measurement results (calculation results), use the Worksheet screen. 10. The last page of the worksheet is the comment area (except for when OB is selected for the examination type).

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1. Outline of Measurement Functions

1.8

Setting Measurement Preset On the application measurement menu screen, press

(the following

is an example of the Cardiac application measurement screen).

The following screen is displayed. Select the desired examination type and measurement preset. (In the example shown below, "Cadiac" is selected as the examination type and "Cadiac" is selected as the measurement preset.)

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