This user manual describes the 4D and Multi-plane Imaging
applications for the Vivid 7 Dimension and
EchoPACPCDimension.
The 2D matrix probe 3V enables real time volume rendering,
simultaneous bi-plane or tri-plane data acquisition (multi-plane
acquisition).
Introduction
1.Real time Volume acquisition (4D imaging)
2.Real time Bi-plane acquisition
3.Real time Tri-plane acquisition
4D imaging
4D imaging enables real time acquisition and rendering of
volume ultrasound data. Free rotation of the 3-dimensional
image combined with the zoom function and 4D image
optimization controls enhance spatial understanding of the
anatomical structure and function of the heart.
4D imaging is available in combination with B-Mode only.
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Introduction
Multi-plane Imaging
Multi-plane imaging displays two (Bi-plane) or three (Tri-plane)
rotated scan planes acquired simultaneously. Free rotation,
tilting (in Bi-plane) of the scan planes and zoom enable the
investigation of anatomical structures from different angles.
Multi-plane imaging is available from B-Mode, Color flow mode
and TVI related modes.
If not otherwise specified, the term multi-plane means either
Bi-plane or Tri-plane.
Measurement and analysis
All cardiac measurements available in B mode are also
available in 4D and Multi-plane.
The 4D and Multi-plane modes enable the creation of a left
ventricular volume reconstruction based on contours drawn
from three cross sections at both end-systole and end-diastole
with calculation of end-systolic and end-diastolic volumes and
ejection fraction.
Multi-plane stress echo
Combined with specially designed Stress echo protocols,
Multi-plane mode enables faster stress tests as several views
can be acquired simultaneously.
Remark concerning the 3V probe
The 3V probe temperature will increase during extensive use,
due to heating from the probe electronics. If the probe reaches
its temperature limit, this will be detected by the system and
scanning will stop. Currently, this limit is set to 42.3 degrees
Celsius, which complies with regulatory instructions relating to
patient comfort and safety. This is reported with a dialog box
and the user has to wait until the temperature is below
acceptable limits before scanning can continue. This does not
in any way indicate probe malfunction. The user has to
unfreeze to start scanning again.
In order to reduce the chance for full freeze due to heating, the
system will reduce power slightly in a temperature interval just
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Important
Introduction
below the full freeze limit. Changes to the power level are
reported in the status bar as Setting power level down and
Setting power level up.
The recommended use of this probe for live 4D and full volume
4D scanning is to enter full freeze whenever the probe is not
used for imaging. For other modalities no special actions are
required.
Read and understand all instructions in the Vivid 7 and
EchoPAC PC User manuals before attempting to use the
devices.
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Introduction
Conventions used in this manual
Keys and button, on the control panel or alphanumeric
keyboard are indicated by over and underlined text (ex.
refers to the 2D mode key)
Bold type, describes button names on the screen.
Italic type: describes program windows, screens and dialogue
boxes.
Icons, highlight safety issues as follow:
Indicates that a specific hazard exists that, given inappropriate
conditions or actions, will cause:
DANGER
WARNING
• Severe or fatal personal injury
• Substantial property damage
Indicates that a specific hazard exists that, given inappropriate
conditions or actions, will cause:
• Severe personal injury
• Substantial property damage
2D
CAUTION
Indicates that a potential hazard may exist that, given
inappropriate conditions or actions, can cause:
• Starting the 4D LV Volume application — EchoPAC PC ........... 41
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Introduction
The 3V probe enables real time acquisition of volume
ultrasound data. Free rotation of the three-dimensional image
combined with zooming and 4D image optimization controls
enhance spatial understanding of the anatomical structure and
function of the heart.
Two display modes are available, Volume rendering mode for
three dimensional scanning and Slice mode for measurements
and volume reconstruction purpose.
4D imaging is available from B mode only.
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4D mode overview - Vivid 7
Volume rendering mode screen
The Volume rendering mode displays a volume rendering and
2D images from two perpendicular cut-planes.
4D Imaging
1. Volume rendering display from cut-plane 1 (yellow). The volume rendering may be adjusted by
rotating and translating the cut-plane 1.
2. Cut-plane 2 (white): 2D image in the azimuth plane.
3. Cut-plane 3 (green): 2D image in the elevation plane.
4. Orientation window: displays a three-dimensional model with cut-planes position and orientation.
5. Color coded cut-plane markers indicate the other cut-planes position relative to the displayed
cut-plane.
6. View direction marker.
7. Soft menu controls (see page 16)
8. Trackball functions (see page 17)
Figure 1-1: The 4D screen (Volume rendering)
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Slice mode screen
The Slice mode displays three cut-planes. The cut-planes can
be rotated and translated independently of each other. This
mode is use to perform measurements and volume
reconstruction based on contour traces done on several
cut-planes.
1. Cut-plane 1 (yellow)
2. Cut-plane 2 (white)
3. Cut-plane 3 (green)
4. Color coded cut-plane markers indicate the position of the other cut-planes relative to the displayed
cut-plane.
5. Orientation window: displays a three-dimensional model with cut-planes position.
6. View direction marker.
7. Trackball functions (see page 17)
Figure 1-2: The 4D screen (Slice mode)
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4D mode controls
Alt.Alt.Alt.Alt.
4D Imaging
3
4
Width
Update /
ck
ll
a
a
Tr
B
Menu
1. 4D key
2. Multiplane key (see page 65)
3. Assigned 4D rotaries: see next page.
4. Assigned 4D keys: see next page.
5. Zoom/HR Zoom (see page 20)
6. Layout (see page 19): toggles the display
between:
• Multi screen with volume/slice
• Single screen volume/slice
7. Soft menu
8. Trackball (see page 17)
• Rotate/translate volume rendering or selected
cut-plane (Slice mode)
• Scroll through the cineloop
9. Clear: resets the orientation to default
positions.
10. Angle: predefined orientations optimized for
volume rendering.
11. 4D Gain
12. 2D Gain
Figure 1-3: The 4D controls on the control panel
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Assigned rotaries and keys
Volume rendering assigned controls
1. Assigned rotaries
• Width
• Frequency
• Focus position
• Volume size
MORE menu
• Translate R
Slice mode assigned controls
1. Assigned rotaries
• Width
• Rotate R
• Translate (in Freeze only) R
• Focus position
• Volume size
MORE menu
• Frequency
Controls marked with R are also available in cine replay.
Figure 1-4: Volume rendering and Slice mode assigned controls
2. Assigned keys
• Slice R
• Front/Back
• Crop (in Freeze only) R
• Box (in Freeze only) R
• Cineloop (in Freeze only) R
• Full volume
• 4D Colorize R
• 9 Slice (in Full volume Freeze only) R
MORE menu
• Up/Down R
• Flip R
• Orientation window R
• Cine rotate (in Freeze only) R
2. Assigned keys
• Slice exit R
• Reference plane R
• Cineloop (in Freeze only) R
MORE menu
• Up/Down R
• Orientation window R
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4D mode assigned controls
This section describes only the 4D mode controls. The
scanning mode controls are described in the system User
manual.
Width
(Volume rendering and Slice mode, Live)
Controls both elevation and azimuth widths, an increase of the
elevation width results in a decrease of the azimuth width.
Volume size
(Volume rendering and Slice mode, Live)
Controls the size of the volume. Adjusting the volume size may
affect the volume rate.
Rotate
(Slice mode, Live and Replay)
1. Rotate control
Rotate the selected cut-plane around the z-axis (see
Figure 1-5).
Figure 1-5: Cut-plane rotation around the z-axis
Slice/Slice exit
(Volume rendering and Slice mode, Live and Replay)
Toggles the display between Volume rendering (Figure 1-1)
and Slice mode (Figure 1-2).
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Front/Back
(Volume rendering, Live and Replay)
Tilts the volume in the elevation direction and rotates the view
position in one operation.
rendering display from different angles (Figure 1-6).
FRONT/BACK enables volume
1. Front/Back: Volume tilt and View position rotation
A. Volume tilted to the left, view position looking towards the anterior wall.
B. Volume tilted to the right, view position looking towards the inferior wall.
Figure 1-6: Front/Back control on a PLAX volume
Reference plane
(Slice mode, Live and Replay)
Toggles the cut-plane selection between cut-plane 1, 2 or 3.
Crop (Free cropping)
(Volume rendering, Freeze and Replay)
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4D Imaging
Removes all data up front of the active cut-plane. Cropping can
be applied on several parts of the volume by rotating/translating
the active cut-plane (see page 26).
Box (Box cropping)
(Volume rendering, Freeze and Replay)
Removes all data around a user-adjustable box (see page 27).
Full volume
(Volume rendering, Live)
Activates the ECG triggered sub-volume acquisition. This
technique enables the acquisition of a larger volume without
compromising the resolution, by combining several
sub-volumes acquired over two to six heart cycles (see
Figure 1-7). When acquisition is done for the number of heart
cycles set, the process is repeated replacing the oldest
sub-volumes.
Adjusts the volume rendering color from a color map menu.
Depth encoded color maps
From this menu the user can also select a depth encoded color
map. These color maps use colors to improve the perception of
depth. Selecting the bronze/blue color map will display
structures that are close to the view plane with a bronze color.
Structures that are farther behind will be colored with a gray
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4D Imaging
color, while the structures that are farthest behind will be
colored in blue. Very bright colors are almost white,
independent of the depth.
Stereo vision
4D Stereo vision is a display technique that enhances the
perception of depth in 3D renderings. This is achieved by
mixing two different volume renderings with slightly separated
viewing angles and presenting them separately to the user’s
left and right eyes. This feature requires the use of anaglyph
stereo glasses (glasses with one red and one cyan lens).
Normally you should be able to see the stereoscopic effect
after a few seconds. The effect may gradually improve after a
while. If you are already wearing glasses or lenses you should
not take them off, since the stereo effect then may be greatly
reduced.
Note: Not all users may be able to perceive depth using
stereoscopic display techniques.
Additional 4D mode assigned controls
The following controls are available after pressing MORE.
Up/Down
(Volume rendering and Slice mode, Live and Replay)
Flips the volume 180 degrees.
Flip
(Volume rendering, Live and Replay)
Flips the view position (Figure 1-8).
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1. Flip control
A. View position looking downward
B. View position looking upward
Figure 1-8: Flip control
Orientation window
4D Imaging
(Volume rendering and Slice mode, Live and Replay)
Shows/hides the Orientation window.
Cine rotate
(Volume rendering, Replay)
Rotates back and forth the volume rendering.
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4D Imaging
Soft menu controls
Soft menu controls are related to image quality adjustment.
These controls are accessed using the 4-way rocker on the
control panel. Only the 4D controls are described in this
section, refer to the system user manual for general imaging
controls.
Smoothness
(Volume rendering, Live and Replay)
Affects continuity of structures and image noise. Too much
smoothness will blur the image, too little will leave too much
noise.
Shading
(Volume rendering, Live and Replay)
Adjusts the shading effect on the image. Shading may improve
three dimensional perception.
Tilt
(Volume rendering, Live)
Tilts the volume in the elevation direction.
1. Tilt control: volume tilting in the elevation direction
Figure 1-9: Tilt control
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Number of Cycles
(Volume rendering, Live, Full volume acquisition)
Controls the number of cycles the ECG triggered full volume
acquisition is based on. Select between two, three, four or six
cycles. Four cycles is default setting.
DDP (Data Dependent Processing)
(Volume rendering, Live)
Performs temporal processing which reduces random noise
without affecting the motion of significant tissue structures.
UD Clarity
(Volume rendering, Freeze and Replay)
Enables the user to create a personalized appearance of the
tissue rendering by reducing noise and enhancing boundaries
between different structures. Adjustment toward the left creates
a smoother image. Adjustment toward the right creates a
crisper image.
Volume optimize
(Volume rendering, Live and Replay)
Optimizes the volume rendering by adjusting several display
controls simultaneously (e.g Shading, Smoothness... etc.).
Gamma
Adjusts the brightness of midtone values. A higher gamma
value produces an overall darker image, a lower gamma value
a lighter image.
Trackball controls
The trackball has multiple functions. The trackball functions are
organized in several functional groups as shown in the table
below.
The function selected is displayed in the lower right corner of
the screen (Figure 1-10).
• Press
within the active functional group. Groups with several
SELECT to toggle between the trackball functions
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4D Imaging
functions are marked with a + symbol.
• Press
1. Trackball key: toggles between trackball functional groups.
2. Select key: toggles between the functions within the active group. Groups
with several functions are marked with a + symbol.
TRACKBALL to toggle between the functional groups.
Figure 1-10: The Trackball area
Orientation controls group
FunctionDescription
Press
SELECT to toggle between the controls.
RotateRotates the volume rendering (see page 25).
TranslateTranslates the volume rendering (see
page 25).
Cineloop control group
FunctionDescription
ScrollScrolls through a cineloop.
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4D Imaging
Display controls
Layout key on the front panel
Toggles the display between multi-screen and single-screen.
• Multi-screen:
• In Volume rendering: displays a volume rendering and
2D images from two perpendicular cut-planes.
• In Slice mode: displays 2D images from three cut-planes
with the selected cut-plane in the main window.
• Single-screen:
• In Volume rendering: displays the volume rendering.
• In Slice mode: display the 2D image of the selected
cut-plane.
1. Display options for Volume rendering
2. Display options for Slice mode
Figure 1-11: 4D mode display options
4D Gain (Active Gain rotary)
Affects the image “depth” or transparency. Too much 4D Gain
applied will take away structures, too little will leave opaque
“Gray clouds” in the ventricle.
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4D Imaging
Zoom
Display zoom
Activated and adjusted by rotating the
rectangular shape of the zoomed area is displayed in the
Orientation window.
High Resolution (HR) zoom
HR zoom concentrates the image processing to a magnified,
user selectable area in the image, resulting in a higher volume
rate in the selected image area.
To be able to use the HR zoom in 4D imaging the HR zoom
function must be activated in B mode before
imaging mode.
ZOOM rotary (). The
entering the 4D
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Using 4D mode - Vivid 7
1.Select the 3V probe and cardiac application.
2.Create an examination.
Parasternal view acquisition
1.In 2D mode, acquire a PLAX view and optimize the image
quality, using
2.Press
4D.
3.Move the probe up or down so that the anterior wall is just
inside the image in the lower left window in the 4D screen
(Figure 1-12).
DEPTH, GAIN, TGC...etc.
4D Imaging
Note: In this position the volume is tilted to the left and the view position is looking
towards the anterior wall.
Figure 1-12: PLAX volume rendering
4.Adjust 4D Gain to optimize the depth impression of the
back wall.
5.To display a volume looking towards the inferior wall, press
FRONT/BACK.
The volume is tilted to the right and the view position is
rotated 180 degrees.
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4D Imaging
6.Press FREEZE, 2D FREEZE and rotate the volume to check
the result.
7.Press
IMG. STORE.
Apical view acquisition
1.In 2D mode, acquire a Apical view and optimize the image
quality, using
2.Press
4D and follow the same procedure as for the PLAX
view (see page 21).
Make sure to assess the image quality in the reference
views and the volume rendering. Use
display the volume correctly.
3.Press
FREEZE, 2D FREEZE and rotate the volume to check
the result.
4.Press
IMG. STORE.
DEPTH, GAIN, TGC...etc.
FRONT/BACK to
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Full volume acquisition
Full volume acquisition is based on ECG triggering acquisition
of sub-volumes. This technique enables the acquisition of a
larger volume without compromising the resolution, by
combining several sub-volumes acquired over two, three, four
or six heart cycles (see Figure 1-7, page 13). When acquisition
is done for the number of heart cycles set, the process is
repeated replacing the oldest sub-volumes.
ECG triggering acquisition may by nature contain artifacts.
CAUTION
Artifacts may be caused by:
• Movements of the probe caused by the operator during
acquisition.
• Movements of the patient during acquisition.
• Irregular heart rate during acquisition.
To validate the acquisition, perform a visual inspection in both
the volume rendering and the elevation plane. Stitching artifacts
are shown as visible transitions between the sub-volumes
(Figure 1-13)
To avoid spatial artifacts, make sure that the probe and the
patient are not moving during the acquisition. The patient
should, if possible hold his/her breath. The ECG trace should
be stable.
1.Connect the ECG device and make sure to obtain a stable
ECG trace.
2.In 2D mode, acquire an Apical view and optimize the image
quality, using
3.Press
4.Press
4D.
FULL VOLUME.
DEPTH, GAIN, TGC...etc.
The Full volume acquisition is started.
5.You may adjust
ANGLE to get different view. The default
top/down view is best for stitching quality assessment.
6.Ask the patient to hold her/his breath at end expiration.
Keep the probe steady and look for stitching artifacts in both
the volume rendering and the elevation plane in the lower
left window of the screen (Figure 1-13).
Attention should be brought on stitching quality during
acquisition rather than volume rendering quality.
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A: Acquisition with stitching artifacts
1. Elevation plane
2. Volume rendering
B: Acquisition without stitching artifacts
1. Elevation plane
2. Volume rendering
Figure 1-13: Stitching quality assessment
When no artifacts are seen over a few heart cycles, press
FREEZE.
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