Philips HDI 4000 User manual

U l t r a s o u n d S y s t e m

Reference Manual

4703-0037-02 Rev A

October 2002

P h i l i p s U l t r a s o u n d P . O . B o x 3 0 0 3 B o t h e l l , W A 9 8 0 4 1 - 3 0 0 3 U S A

Copyright © 2002 by Philips Ultrasound All rights reserved Printed in USA

Distributed by Philips Ultrasound

22100 Bothell-Everett Highway

Bothell, WA 98021-8431, USA

Telephone [phone] or [phone] Fax [phone]

Internet www.ultrasound.philips.com

EU Representative

Sonoace Deutschland GmbH

Elbestrasse 10

D-45768 Marl, Deutschland

Telephone [phone]

Fax [phone]

CAUTION United States federal law restricts this device to sale by or on the order of a physician.

”Chroma”, “Color Power Angio”, “HDI”, and “High Q” are registered trademarks of Philips Ultrasound.

“High Definition” is a trademark of Philips Ultrasound.

Non-Philips Ultrasound product names may be trademarks or registered trademarks of their respective owners.

Philips Ultrasound products may be manufactured under or operate in accordance with one or more of the following United States patents and corresponding patents in other countries: U.S. Patent Numbers 4,581,636; 4,607,642; 4,543,960; 4,644,795; 4,887,306; 5,016,641; 5,123,415; 5,197,477; 5,255,682; 5,050,610; 5,226,422; 5,275,167; 5,207,225; 5,287,753; 5,215,094; 5,381,795; 5,386,830; 5,402,793; 5,390,674; 5,438,994; 5,471,989; 5,482,045; 5,476,097; 5,471,990; 5,456,257; 5,485,842; 5,482,047; 5,479,930; Re 35,148; 5,555,887; 5,617,863; 5,669,385; 5,645,066; D369,307; 5,634,465; 5,603,323; 5,706,819; 5,715,823; 5,718,229; 5,720,291; 5,879,303, 5,951,478; Re 36,564; 5,980,457; 5,961,462; 5,940,123; 5,908,389; 5,891,035; 5,860,924; 5,795,297; 5,846,200; 5,833,613; 6,036,643; 6,117,084. Other patent applications are pending in various countries.

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Contents

Read This First . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

About Your System User Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

Conventions Used in the User Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

System Conventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4

System Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5

Video Monitor Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7

Control Module. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8

Keyboard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9

Storage Devices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

Peripherals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11

Scanhead Connections and Cable Management . . . . . . . . . . . . . . . . . . . . . . . . . . .12

Footswitch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13

Power Switch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

Rear Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

Wheel Locks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16

System Upgrades and User Information Updates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16

Customer Comments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16

Ordering Supplies and Accessories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17

If You Need Assistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17

In the United States . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17

Outside the United States . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18

Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25

Electrical Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25

Mechanical Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27

System Wheel Locks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27

Moving the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27

Equipment Protection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28

Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29

Biological Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31

ALARA Education Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31

Applying ALARA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32

Direct Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33

Indirect Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33

Receiver Controls. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34

An Example of Applying ALARA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34

Additional Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35

Output Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35

Mechanical Index (MI) Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36

Thermal Index (TI) Displays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37

Mechanical and Thermal Indices Display Precision and Accuracy . . . . . . . . . . .37

Control Effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39

Controls Affecting the Indices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39

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POWER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39

2D Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39

Color and Power Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40

M-Mode and Doppler Controls. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41

Related Guidance Documents. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41

Acoustic Output and Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42

In Situ, Derated, and Water Value Intensities . . . . . . . . . . . . . . . . . . . . . . . . . . .42

Conclusions Regarding Tissue Models and Equipment Survey . . . . . . . . . . . . .44

Acoustic Output Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45

Acoustic Measurement Precision and Uncertainty . . . . . . . . . . . . . . . . . . . . . . . . . .45

Scanheads . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49

Scanhead Selection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49

Applications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .50

Scanhead Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51

Acoustic Artifacts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51

Transesophageal Scanheads . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .57

Description. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .57

Scanhead Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .58

Physical Dimensions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .58

Transesophageal Scanhead Icon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59

Articulating Device Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59

Scan Plane Orientation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63

Image Orientation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .64

Thermal Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .64

Operating Instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .65

Inspection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .65

Scanning the Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .66

To scan the patient with the MPT7-4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .66

Maintenance and Storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .67

Probe Covers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .71

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .71

FDA Medical Alert, March 29, 1991, Allergic Reactions to Latex-Containing

Medical Devices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .71

Installing the Probe Cover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73

To install the cover. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73

Biopsy Guides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .77

Attaching and Removing a Biopsy Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .77

Using the Biopsy Guideline Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .78

To show or hide the biopsy guideline. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .78

Verifying the Biopsy Guide Alignment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .79

To verify alignment of the biopsy guide for the C5-2, C7-4, C8-5, L7-4, L12-5 38

mm, L 12-5 50 mm, P4-2, P5-3, P7-4, 3D5-3, and the 3D7-4 scanheads . . . . . .80

To verify alignment of the biopsy guide for the C9-5 ICT, C8-4v, and the 3D8-5v

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scanheads . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .81 Biopsy Procedure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .82 To perform a biopsy procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .82 Biopsy Guide Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .83

Peripherals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .87

Printing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .87 Adjusting Print Quality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .87 Image Printers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .88 Black-and-White Printer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .88 To print with the black-and-white printer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .88 Color Printer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .88 To print with the color printer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .88 Report Printer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .88 To use the report printer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .88

Recording. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .88 VCR Record. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .89 To use the VCR to record . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .89 VCR Playback . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .89 To view VCR playback on the system monitor. . . . . . . . . . . . . . . . . . . . . . . . . . .89

External Color Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90

Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .93

Ultrasound System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .93 Circuit Protection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .93 To exchange the fuses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .93 Cleaning. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .94 Scanheads . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .95 Printers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .95 Care of the Printer Cabinet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .95

Troubleshooting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .99

Troubleshooting Table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .99 Error Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .99

Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .103

Physical Dimensions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .103 Gray Shades . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .103 Channels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .103 CPU . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .103 Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .103 Input Signals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .103 Output Signals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .103 Maximum Measurable Doppler Velocities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .103 Peripherals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .105 Modality Interface. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .106 Electrical Parameters. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .106 Languages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .106

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Contents

Pressure Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .106

Humidity Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .106

Temperature Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .106

Safety Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .106

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .111

Cardiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .111

General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .115

Body Surface Area (BSA) in Square Meters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .115

Gynecology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .115

Hip Angle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .115

Obstetrics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .115

Amniotic Fluid Index (AFI) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .115

Biophysical Profile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .115

Gestational Age (G.A.). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .115

Abdominal Circumference (AC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .115

Antero-Posterior Diameter (APD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .116

Antero-Posterior Thorax Diameter (APTD) . . . . . . . . . . . . . . . . . . . . . . . . . . . .116

Biparietal Diameter (BPD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .116

Cerebellum (CEREB). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .116

Clavicle Length (CLAV) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .117

Crown-Rump Length (CRL) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .117

Femur Length (FL) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .117

Gestational Sac (GS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .118

Head Circumference (HC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .118

Humerus Length (HUM). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .118

Occipito-Frontal Diameter (OFD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .119

Outer Ocular Distance (OOD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .119

Tibia Length (TL) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .119

Transverse Abdominal Diameter (TAD). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .119

Transverse Thorax Diameter (TTD). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .119

Ulna Length . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .119

Fetal Growth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .119

Abdominal Circumference (AC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .119

Biparietal Diameter (BPD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .120

Cerebellum (CER) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .120

Clavicle Length (CLAV) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .120

Femur Length (FL) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .120

Fetal Trunk Area (FTA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .121

Head Circumference (HC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .121

Humerus Length (HUM). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .121

Radius Length (RAD). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .122

Tibia Length (TL) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .122

Ulna Length (ULNA). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .122

Estimated Fetal Weight (EFW) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .122

Abdominal Circumference (AC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .122

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Abdominal Circumference, Biparietal Diameter (AC, BPD) . . . . . . . . . . . . . . . .122 Abdominal Circumference, Femur Length (AC, FL) Hadlock1. . . . . . . . . . . . . .123 Abdominal Circumference, Biparietal Diameter, Femur Length (AC, BPD, FL) Hadlock2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .123 Abdominal Circumference, Femur Length, Head Circumference (AC, FL, HC) Hadlock3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .123 Abdominal Circumference, Biparietal Diameter, Femur Length, Head Circumference (AC, BPD, FL, HC) Hadlock4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .123 Antero-Posterior Thorax Diameter, Biparietal Diameter, Transverse Thorax Diameter (APTD, BPD, TTD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .123 Antero-Posterior Thorax Diameter, Biparietal Diameter, Femur Length, Transverse Thorax Diameter (APTD, BPD, FL, TTD). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .123 Biparietal Diameter, Femur Length, Fetal Trunk Area (BPD, FL, FTA) . . . . . . .123 Biparietal Diameter, Transverse Thorax Diameter (BPD, TTD) . . . . . . . . . . . . .123 Estimated Fetal Weight Growth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .124

Fetal Ratios . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .124 Cephalic Index (CI) (BPD/OFD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .124 FL/AC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .124 FL/BPD. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .124 HC/AC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .124

Vascular . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .124

Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .127 Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .175

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About Your System User Information

The ultrasound system user information is for the reader who is familiar with ultrasound techniques. Sonography training and clinical procedures are not included here. The user information for the ultrasound system is organized as follows:

•Reference Manual: Contains information about maintenance, troubleshooting, safety, scanheads, biopsy guides, peripherals, specifications, medical references, and a glossary. The glossary contains descriptions of all controls and display elements.

•Help: The Help is on the ulrasound system hard disk. The Help contains the instructions for use of the system. Press ? to display the Help viewer.

•Compact Disc: Includes a copy of the Help and electronic copies of the Reference Manual, Using Disinfectants and Gels, Acoustic Output Tables, and Medical Ultrasound Safety.

•Using Disinfectants and Gels: Contains information about compatible gels and disinfectants and disinfecting Philips products.

•Acoustic Output Tables: Contains information about mechanical and thermal index precision and accuracy, the acoustic output default tables, and the acoustic output tables.

•Medical Ultrasound Safety: Contains information about bioeffects and biophysics, prudent use, and implementing ALARA (as low as reasonably achievable).

•Operating Notes: Contains information that clarifies certain system responses that might be misunderstood or cause user difficulty.

Conventions Used in the User Information

The user information uses the following conventions:

•All procedures are numbered. You must complete steps in the sequence they are presented to ensure a result.

•Bulleted lists indicate general information about a particular function or procedure. They do not imply a sequential procedure.

•Control names and menu items or titles are spelled as they are on the system, and they appear in bold text.

•Symbols appear as they appear on the system.

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•The left side of the system is to your left as you stand in front of the system, facing the system.

•Scanheads and pencil probes both are referred to as scanheads, unless the distinction is important to the meaning of the text.

System Conventions

These conventions are used in the system:

•“Click” means to move a cursor to, or highlight, an object and press SET.

•The menu controls are used to adjust the system parameters listed in the menus on the left side of the screen. Those menus are related to the imaging mode or system condition. Use MENU and SELECT to change the values of the parameters or menu items.

•The trackball controls include the trackball, SET, CHG., and EXIT. Those controls are used to enable display elements, move cursors, alternate control of cursor or display functions, and exit system modes or conditions.

•To enter text into a text field, use the keyboard.

•To use the scroll bar to scroll through a list, move the cursor to the scroll bar, press SET, and move the trackball up or down. You can also move the cursor to the arrows at either end of the scroll bar and press SET to move the scroll bar up or down.

•The blue menu keys appear across the bottom of the display. They assume different values based on the system mode. They provide quick access to those functions. The blue menu keys correspond to the controls labeled 1 through 6 across the top of the control panel. Press the corresponding button to initiate the blue menu key function.

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System Description

The HDI 4000 Ultrasound System is a high-resolution system (Figure 1-1). You can use it for 2D, 3D, Live 3D, M-mode, Doppler, Color, and Color Power Angio (CPA) imaging. You can also perform duplex and triple-mode imaging. A range of scanheads are available: curved, phased, linear, compact linear, 3D, multiplane transesophageal, and continuous-wave Doppler. Applications for specific scanheads are listed in Table 3-1.

Figure 1-1 HDI 4000 Ultrasound System

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Several measurement tools are included: distance, area, and volume. In calculations, there are application-specific tools including: manual trace, limited trace, auto trace, velocity, stenosis area and diameter percentage, and vessel area and diameter. After you perform the measurements, the system makes the pertinent calculations and organizes the measurements, calculations, and patient information into a patient report.

You can store and review single images and Cine sequences. Images and Cine sequences can be stored on a compact disc (CD), magneto-optical (MO) disc, or sent over a network to a server or printer.

The control panel provides imaging controls and and access to a variety of functions. A retractable keyboard allows data entry. A footswitch is also provided with the system.

Peripheral devices are available: You can connect a VCR, and black-and-white, color, and report printers to the system.

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Video Monitor Controls

The video monitor has three controls on the front: MENU, + and - (Figure 1-2). MENU displays a CONTRAST slider; use the + and - controls to set the monitor contrast. Press the MENU control again to display a BRIGHTNESS slider; use the + and - controls to set the monitor brightness. Recommended settings are 65 for contrast and 73 for brightness. Press the + or - control to display a DEGAUSS display. To degauss the monitor, press the MENU control. To remove the DEGAUSS display without degaussing the video monitor, press + or -.

Figure 1-2 Video Monitor Controls

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Control Module

The control module contains the imaging controls, TGC slide controls, blue menu keys, and programmable USER controls, and provides access to scanhead selection, review, calculations, setup, and annotation functions (Figure 1-3). The knobs are multipurpose controls: For example, when you press the M control, M-mode imaging begins; when you turn the M control, the 2D/M-mode gain changes; in 3D imaging, when you turn the M control, the magnification changes. The blue menu keys appear across the bottom of the screen. The controls related to the blue menu keys are located along the top of the control panel and assume different functions, depending on the system operating mode. Press the control corresponding to the blue menu key to perform the blue menu key function.

Figure 1-3 Control Module

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Keyboard

Beneath and in front of the control panel is a retractable keyboard (Figure 1-4). Directly above the keyboard is a light. The light switch is above the keyboard to the right of the control panel.

Figure 1-4 Keyboard

Light switch

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Storage Devices

An MO drive and a CD-RW disc drive are above the control panel (Figure 1-5). The system hard disk is located inside the system and can be accessed from the rear panel of the system (Figure 1-10).

Figure 1-5 Locations of the MO and CD-RW Drives

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Peripherals

There is room in the peripheral bay in the front of the system for a black-and-white printer and a color printer (Figure 1-6). The VCR can be installed in the peripheral bay on the sides of the system for convenient access from either the right or left side of the system (Figure 1-9).

Figure 1-6 Peripheral Bay (Front View)

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Scanhead Connections and Cable Management

Three active scanhead receptacles, a pencil-probe receptacle, and an inactive scanhead receptacle are on the front of the system (Figure 1-7). Four scanhead holders are in back of the control panel, and two cable management brackets are underneath the control panel.

Figure 1-7 Scanhead Connections

Scanhead holders

Cable management bracket

Inactive scanhead receptacle

Pencil probe receptacle

Scanhead

receptacles

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Footswitch

The footswitch receptacle is on the bottom front of the system (Figure 1-8).

Figure 1-8 Footswitch Connection

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Power Switch

The power switch is on the right side of the system, above the VCR peripheral bay (Figure 1-9).

ECG

The ECG receptacle and the ECG gain control are on the right side of the system, near the power switch, above the VCR peripheral bay (Figure 1-9).

Figure 1-9 Power Switch, ECG Controls, and VCR

Power switch		ECG receptacle

ECG gain control

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Rear Panel

The rear panel of the system contains the receptacles for the peripheral devices, network devices, and power cords. Also located on the rear panel is access to the hard disk and the system fuses (Figure 1-10).

Figure 1-10 Rear Panel

Hard disk

Peripheral

receptacles

Fuses

Power cord

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Wheel Locks

The front wheels can be locked (Figure 1-11).

Figure 1-11 Wheel Locks

	Unlocked caster		Locked caster

System Upgrades and User Information Updates

Philips Ultrasound is committed to innovation and continued improvement. Upgrades may be announced that consist of hardware or software improvements. Updated user information will accompany those system upgrades.

Customer Comments

If you have questions about the user information, or you discover an error, please call us at [phone]; or if you are outside the USA, call our nearest office, listed later in this section. You can also send e-mail to the following address:

[e-mail]

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Ordering Supplies and Accessories

You can order probe covers, biopsy guides, and other supplies and accessories from CIVCO Medical Instruments:

CIVCO Medical Instruments

102 First St. South

Kalona, IA 52247-9589

Telephone [phone], Ext. 1 for Customer Service (USA) [phone] (International)

Fax [phone] (USA)

[phone] (International) E-mail [e-mail] Internet ultrasoundsupplies.com

If You Need Assistance

Customer service representatives are available worldwide to answer questions and to provide maintenance and service.

In the United States

For assistance within the USA, contact the Philips Ultrasound corporate headquarters:

Philips Ultrasound P.O. Box 3003

Bothell, WA 98041-3003 [phone]

For specific questions, use the following directory:

Customer Service

[phone]

•Customer representative

•Upgrade information

•Sales information

•Pricing and ordering information

•Delivery information

•Clinical and marketing materials

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Learning Center

[phone] or [phone]

•Applications courses and referrals

•Educational materials

•Consultation for educational needs

Accounts Receivable

[phone] or [phone]

•Payments

•Account balance

Outside the United States

For assistance outside the USA, contact the nearest office:

African Countries, see European Headquarters (except South Africa, see below)

Algeria, see France

Argentina
Philips Argentina	Telephone: [phone]
Vedia 3892	Fax: [phone]
1430 Buenos Aires
Asian Countries Not Listed, see Hong Kong
Australia
Philips Medical Systems Australia	Telephone: [phone]
Locked Bag 30	or 1800 251 400
North Ryde NSW 1670	Fax: [phone]
Austria
Philips Austria Ges. m.b.H.	Telephone: [phone]
Carlbergergasse 38/13	Fax: [phone]
A-1230 Wien (Vienna)
Belgium
Philips Medical Systems - Division	Telephone: [phone]
Ultrasound	Fax: [phone]
Tweestations Straat 80
B-1070 Brussels

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	Brazil
	Philips Medical Systems Ltda.	Telephone: [phone]
	Rua Ceara #58	Fax: [phone]
	06465-120 - São Paulo - SP
	Cambodia, see Singapore
	Canada
	Philips Medical Systems Canada Ltd.	Telephone: [phone]
	281 Hillmount Rd.	or [phone]
	Markham, Ontario L6C 2S3	Telephone, Quebec: [phone]
		Fax: [phone]
	Caribbean, see Latin American Headquarters
	China
	Philips China - Beijing	Telephone: [phone]
	Rm. 1702, 17/F	Fax: [phone]
	China Resources Building
	No. 8 Jianguomenbei Ave.
	Beijing 100005
	Colombia
	Philips de Colombia S.A.	Telephone: [phone]
	Calle 15 #104-33	Fax: [phone]
	Santa Fe de Bogotá
	European Countries Not Listed, see European Headquarters
	European Headquarters
	Philips Ultrasound Munich
	Edisonstrasse 6	Telephone: [phone]
	D-85716 Unterschleissheim	Fax: [phone]
	Munich
	France
	Philips France S.A.R.L.	Telephone: [phone]
	ZA de Courtaboeuf	Fax: [phone]
	19, Ave de Norvege, BP 320
	F-91958 Courtaboeuf Cédex
	Germany
	Philips (Deutschland) GmbH	Telephone: [phone]
	Norbertstrasse 8	Fax: [phone]
	D-42655 Solingen

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Hong Kong (Asia Pacific
Headquarters)	Telephone: [phone]
Philips Medical Systems	Fax: [phone]
Asia Pacific Regional Office
28/Floor, Hopewell Centre
17 Kennedy Road, Wanchai
Hong Kong
India
Philips Medical Systems India Ltd.	Telephone: [phone]
3, Haddows Road	Fax: [phone]
Chennai 600 006
Italy
Philips/ATL S.p.A.	Telephone: [phone]
Via Casati 23	Fax: [phone]
1-20052 Monza (MI)
Korea
Philips Medical Systems Korea	Telephone: [phone]
Eunsung Building, 4th Floor	Fax: [phone]
53-8 chungdam-dong
Kangnam-Ku, Seoul
Laos, see Singapore
Latin American Headquarters
1550 Sawgrass Corporate Parkway	Telephone: [phone]
Suite 300	Fax: [phone]
Sunrise, FL 33323
USA
Luxembourg, see Belgium
Malaysia
Electronic Systems (M) Sdn Bhd	Telephone: [phone]
No. 76 Jalan Universiti	Fax: [phone]
46200 Petaling Jaya
Selangor Dahrul Ehsan
Mexico
Philips Sistemas Medicos S.A. de C.V.	Telephone: [phone]
Norte 45, #669	Fax: [phone]
02300 México, D.F., México

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Middle East, see European Headquarters

The Netherlands
Philips Netherlands B.V.	Telephone: [phone]
Polaanerbaan 13H	Fax: [phone]
NL-3447 GN Woerden
New Zealand, see Australia
Pacific Islands, see Australia
Paraguay, see Argentina
Peru
Philips Peruana, S.A. Medical Systems	Telephone: [phone]
Ave. Comandante Espinar #719	Fax: [phone]
Miraflores
Lima 19, Perú
Poland
Philips Polska Sp. z.o.o. PMS	Telephone: [phone]
Al. Jerozolimskie 195B	Fax: [phone]
Warsaw 02-222
Portugal
Philips Portuguesa, S.A.	Telephone: [phone]
Divisão de Sistemas Medicos	Fax: [phone]
Rua Dr. Antonio Loureiro Borges, 5
Aquiparque, Miraflores, 1495-131
Algés
Romania
Philips Romania S.R.L.	Telephone: [phone]
Medical Systems Division	Fax: [phone]
Str. Pictor Ion. Negulici 40, Sektor 1
Singapore
Philips Medical Systems	Telephone: [phone]
620A Lorong 1 Toa Payoh	Fax: [phone]
Singapore 319762
South Africa
PMS South Africa and ESAS Ltd.	Telephone: [phone]
P.O. Box 58088	Fax: [phone]
Newville 2114, South Africa

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Spain
Philips Sistemas Medicos, SA	Telephone: [phone]
Calle Martinez Villergas 49	Fax: [phone]
28027 Madrid
Sweden
Div. Medicinska System Philips AB	Telephone: [phone]
Kottbygatan 7	Fax: [phone]
S-164 58 Stockholm
Switzerland
Philips Medical Systems	Telephone: [phone]
Allmendstrasse 140, Postfach 670	Fax: [phone]
CH-8027 Zurich
Thailand
Philips Electrical (Thailand) Ltd.	Telephone: [phone]
209/2 Sanpavut Road	Fax: [phone]
Bangna, Bangkok 10260, Thailand
United Kingdom
Philips/ATL UK Ltd.	Telephone: [phone]
Arden Press House, Pixmore Avenue	Fax: [phone]
Letchworth, Hertfordshire
England SG6 1LH
Uruguay
Philips/ATL Uruguay	Telephone: [phone]
Industrias Philips del Uruguay	Fax: [phone]
Boulevard Gral. Artigas 420
Montevideo 11300

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