GE Vivid E9 User manual

GE Healthcare
Vivid*E9
Quick reference cards
imagination at work
ULTC-0258-05.12-EN-US
DOC1030607
©2012 General Electric Company – All rights reserved.
General Electric Company reserves the right to make changes
in specifications and features shown herein, or discontinue the
product described at any time without notice or obligation.
GE, GE Monogram and Vivid are trademarks
of General Electric Company.
GE Medical Systems Ultrasound & Primary Care Diagnostics, LLC,
a General Electric company, doing business as GE Healthcare.
*Trademark of General Electric Company.

nGetting started
n DVR
n 2D Auto EF
n AFI
n Tri-plane AFI/
TEE AFI
n IMT
n 4D LV Volume
Acquisition
n Color Acquisition
n 4D Views
n 4D Auto LVQ
Vivid E9 Quick Cards Index
n 4D LV Mass
n 4D Strain
n 4D Stress Echo
n Scan Assist Pro
n 4D Manual Crop Tool
n RV Volume
Acquisition
n Configuration
of Footswitch
and 6VT-D Probe
n MV TomTec Analysis
n 4D Workflow Tools

Getting started with Vivid E9
1. Circuit breaker
Assure switch is in the on position on rear of system
2. Power on/off
On top left corner of control panel
3. Control panel
Outer button: Press and hold this brake release for floating control panel
DO NOT transport system with control panel in free position
Inner button: Press top portion of the button to move control panel up
Press bottom portion of the button to move control
panel down
4. Alpha-numeric keyboard
Push corners of black keyboard under control panel to lock/unlock
the keyboard
5. Probe ports
Only use far right port for 4D imaging
transducer
6. Wheels and brakes
Left pedal: swivel lock
Right pedal: brake
Middle pedal: brake release
7. Monitor lock (on adjustable arm)
• Turn release counter clockwise to unlock
• Turn release clockwise to lock
• Grab top of monitor to adjust
angle for viewing
• DO NOT transport system with LCD
in free position
8. Start a new exam
• Press Patient on control panel
• Enter patient information
• Select Create Patient
9. Probe selection
Press Probe key on left side of control panel
to select transducer and application
10. Touch panel
Intuitive ‘‘one touch’’ user interface for
modes and measurements
11. End exam
• Press Patient on control panel
• Select End Exam
Getting started
(Getting started with Vivid E9 – cont.)

DVR
Recording Icons
DVR Disk status displays used/free space on DVD media
This icon changes according to current operational mode,
displays recording (title) number and time counter
Ejected
Stopped
Busy
Recording
Record pause
Burning to DVD media
Playback
Playback pause
Fast forward
Rewind
Searching
Shuttle search
(DVR – cont.)
DVR Quick Steps Recording
1. To start recording, insert a DVD +R/W media
(no other media types supported) in the lower
CD/DVD tray. The system will prepare the
media for up to 60 seconds, at which time
the ”Ejected” symbol is shown.
2. A patient name/ID must be entered prior
to recording.
3. When the “Stopped” symbol in the title bar is
shown, press the Record button on the keyboard
or touch panel under the Config—Utility tab
DVR
Record button on touch panel
Record on Vivid E9

(DVR – cont.)
4. The Record button will toggle between record and record pause. When
recording, the blinking red dot will appear in the title bar. When pausing,
the two vertical bar “Pause” symbol will appear.
5. The Record button is green when recording, yellow in pause
6. Two options for stopping the recording
— end the exam or start a new exam (preferred method)
— press the Stop recording button on the touch panel under Config—
Utility (this will finalize the media, so don’t do this until you are ready
to eject it).
7. Press Eject DVR when ready. Disk will be ejected immediately if Stop
Recording has been performed.
DVR
(DVR – cont.)
Clearing the DVD media—overwriting used disks
1. The DVD + R/W media is a rewritable
disk that allows clearing/overwriting.
2. To clear, press the Clear DVR button
on touch panel, under the Config—
Utility tab
3. A dialog pops up where you must
confirm that you want to erase the
content of the disk. Note that all
data on the disk will be erased.

(DVR – cont.)
DVR Quick Steps—Review on Vivid E9
1. Insert the DVD disk in the upper
CD/DVD tray. Enter Config—Utility on
the touch panel. Push the Playback
button which will appear after an hour
glass is extinguished, after the media
is recognized as a DVR recording type
of media.
2. Playback starts automatically. A Video
menu will appear on the touch panel.
DVR
3. Press Go-To/Search and use the drop
down menu to select the title (patient)
you wish to review
4. After having selected the patient, you
can quickly jump to the next “chapter”
(next recording after a pause)
5. Use the trackball to control speed, rewind,
fast forward etc.
(DVR – cont.)

(DVR – cont.)
DVR Quick Steps—Review on a PC
1. Insert the DVD into the PC
2. The DVD contains a built-in media player that should launch
automatically if the PC is configured for auto launch
3. If you move the mouse, a title bar will appear on the top and
at the bottom. The buttons at the bottom are self explanatory
4. Use the |< or >| button to jump to the previous/next chapter
(next recording before/after a pause)
DVR
(DVR – cont.)
DVR Quick Steps—Review on a DVD player
1. Insert the DVD into the player
2. The DVD contains a built-in media player. It will launch automatically
after the DVD loading period is over
3. Click the Menu (or Display) button on the player/remote control
4. You will now see a screen with a title list and chapter list, and can
quickly jump from title (patient) to title
5. Use your remote control to play/pause, stop, rewind, fast forward, etc.
Note: Some TVs/monitors will cut off the top and bottom of the screen, just
like they do for video tapes (underscan/overscan issue)

Auto EF
1. Select 4C or 2C view on stored image
2. Select measure, Auto EF folder
3. Define view chosen (4C-2C) (choose)
4. Define ROI by following guide text on cursor with set
5. Adjust individual points with trackball and set, if user deems necessary
to correct minor tracking adjustments
6. Select process on soft key or set to Auto process in config
Note: if cell image has
EF in right corner, Auto EF
has been performed and
approved on this image and
process will display results
2D Auto EF
(Auto EF – cont.)
1. Select approve under image if agree with tracking
2. If results are not suitable select one of the following:
– recalc to edit again
– Select EF dual to edit simultaneously in ESV/EDV
– ES frame/ ED frame to adjust frame by frame
3. If results are edited manually on EDS/ESV, an “*” will appear on EF and
Volume results indicating edit was performed
4. Select the red Approve, approve will now turn green
Note: both 4Ch and 2Ch views must be used to obtain Bi-plane results

(Auto EF – cont.)
5. Select Worksheet for full results (EF, SV, Volumes, length, HR, CO, etc.)
6. You will be prompted to store loop, answer “yes” if storing loop
Note: please refer to User manual for full details on Auto EF
2D Auto EF
(Auto EF – cont.)
Auto EF Pitfalls
1. Frame Rates must be 40-80 fps
2. Heart rate limitations depending on Frame
Rate (120bpm)
3. If heart rate is too fast, tracking may not be accurate
4. Recommend to select 2 or more heart cycles or expand time before
and after heart cycle (100ms recommended)
5. Select 3 cycles on soft menu before storing or set in config when
transferring to DICOM server to avoid jumping

AFI
Acquire
1. Acquire APLAX, A4Ch and A2Ch and store
(acquiring all views at the same time helps
to ensure similar heart rate)
Note: At least 100 ms buffer around each beat
should be acquired (Can be set up as default in
Config-Imaging-Global-time before and after
heart cycle), to help promote good ECG
AFI
(AFI – cont.)
Measurement
1. Load APLAX view, press Measure and
select AFI folder, define APLAX view
2. Define ROI by following guide text on
cursor with 3 points indicated

(AFI – cont.)
3. Assess tracking, press Approve
4. Press Select to set AVC to automatic or
scroll to set AVC manually
5. Repeat defining and assessing for A4Ch
and A2Ch views from clipboard images
acquired (see Acquire)
AFI
(AFI – cont.)
Analysis
1. Default screen is bull’s eye and traces
2. Other choices on touch panel for display are:
– BE only
– Quad displays PSS regionally bottom left, curves top right, curved AMM
bottom right, global strain top left
– Single displays A2Ch loop with GS
3. Cine Stop/Play available in single and quad screen
4. Recalc button corrects ROI by moving endocardial points
5. Select Approve to confirm new edit changes

Please refer to User Manual for full details on AFI
Please refer to User Manual for full details on AFI
(AFI – cont.)
Store
1. To store quad and bull’s eye traces screen, press Image store (screen
shot only, not raw data)
2. To store the bull’s eye, press Exit, prompts to store bull’s eye, press Yes
(this is stored in raw data), this transfers the measurement to the worksheet
3. Exit AFI folder
(AFI - cont.)
New color map
1. Once AFI is performed, bull’s eye is displayed on the screen
2. Press BE maps
3. Select the BE maps and choose the map
you want to be displayed on the screen
AFI

Tri-plane AFI
Tri-plane AFI
Note:
Doppler acquisition is recommended for defining AVC
prior to going into tri-plane AFI
1. Acquire AoV Doppler image
2. Select Measure
3. Select event timing folder
4. Mark AoV Closure
(Tri-plane AFI – cont.)
Acquisition
1. Select 4D probe
2. Press Multi D button
3. Select Tri-plane on touch panel
4. Press Image Store
Tips: Set as default in Config-Imaging-Global-time before and after heart
cycle should be 100 ms
Ensure a full good ECG signal cycle during acquisition or in application tab,
set default to 3 cycles
Ensure all 3 views are aligned before storing the loops

Tri-plane AFI
(Tri-plane AFI – cont.)
Process
1. Select tri-plane image, press Measure
2. Select AFI folder
3. Define ROI by placing 3 points following on screen prompts
Note: click for tips is available for more detailed instruction
(Tri-plane AFI – cont.)
4. Assess tracking, press Approve if ok
5. Press Select button to set AVC to event timing (already defined in
doppler) or automatic (if event timing is not defined) or scroll to set AVC
manually
Tip: Select “Next View” on touch panel
6. Repeat steps 3 and 4 to finish all 3 views

Tri-plane AFI
(Tri-plane AFI – cont.)
To Store
1. Quad screen and bull’s eye traces screen, press Image store (screen shot
only, not raw data)
2. The bull’s eye, press Exit, message will show “Do you want to store Bull’s
Eye?” press Yes (stored as raw data) and measurements are transferred
to the worksheet
Note: Further details for Triplane AFI, please refer to User’s Manual
(Tri-plane AFI – cont.)
Analysis
1. Default screen is BE + traces
2. Other choices on touch panel for display are:
– Single displays Apical 2Ch loop with GS
– Quad displays Apical 2 Ch loop with GS, regional PSS, tracing and
curved AMM
– BE Only – Bull’s eye display
– BE+Review – displays triplane apical views and BE

Carotid IMT
1. Select linear probe
2. Select Carotid preset
3. Connect patient to ECG leads
(Optional: Used for better accuracy
and follows ASE guidelines)
4. Optimize IQ settings
Tip: Make sure intima is visible with
proper gain settings
Carotid IMT
(Carotid IMT – cont.)
5. Press Image Store
Tip: Use trackball to scroll to desired frame
(Optional: Select R Wave frame for best accuracy and ASE Standard)
Image Store

(Carotid IMT – cont.)
6. Select Measure
7. Select specific Vessel IMT from the menu
8. Select RT or LT
9. Select Vessel IMT Post
or Vessel IMT Ant
Measure
Carotid IMT
(Carotid IMT – cont.)
10. Place first caliper at start point within vessel
above intima if measuring
Posterior or below intima for Anterior
11. Place second caliper a minimum of 50 pts
from start point and set caliper. IMT values
will automatically calculate and will be
displayed in results window on the screen
Tip: If IMT trace is not correct, double
click on end point arrow and shorten
distance. Trace fit can also
re-optimize the auto trace tool

(Carotid IMT – cont.)
12. Select Transfer to
place in worksheet
13. Press Image Store
to store image to
patient study
Image Store
4D LV Volume Acquisition – Single beat
1. Select 3V, 4V-D, or 6VT-D probe, press 4D
2. Press desired volume size on touch panel:
Small, Medium or Large
Tip: Volume size displayed is the angle of sector in
both azimuth and elevation. Lowest is 25, highest is 90
3. Ensure structure is contained in single beat volume size
Tips: Front/Back steers volume towards structure
Use Angle button – SAX volume view allows centering of the LV in the capturing
of LV volumes, use Angle to help visualize entirety of target structures
4D LV Volume Acquisition – Single beat

(4D LV Volume Acquisition – Single beat – cont.)
4. Optimize frame rate
How to decide between Single beat
or Multi beat?
• Always set volume size in single beat mode,
volume size does not change when entering MB
• If more frame rate is needed, go to Multi beat.
Going down on frame rate helps improve spatial
resolution
• If a higher frame rate is needed, going to Multi
beat is a good option.
4D LV Volume Acquisition – Single beat
(4D LV Volume Acquisition – Single beat – cont.)
5. Optimize image controls
Step 1: Start by adjusting 2D gain in 2D mode. Use the TGC’s to help make
sure that the image is uniform from apex to base in brightness
as well as in azimuth and elevation planes
Step 2: Enter 4D to help ensure that 2D gain is correct by looking at cut planes
Step 3: If necessary, adjust 4D gain. Turn 4D gain up if there is a lot of noise
in the left ventricular cavity that obscures the back wall. Turn 4D
gain down if there are black holes in the wall. Choose best color
depth render map

(4D LV Volume Acquisition – Single beat – cont.)
Step 4: If necessary, adjust the volume optimize and/or transparency
(page 2 on touch panel). Increasing these may help you see
through any cavity noise
Step 5: It is recommended to be conservative with both smoothing and
shading (page 2 on touch panel). Smoothness can smooth the
image but also slightly blur. Shading up can increase crispness,
recommended at 25
4D LV Volume Acquisition – Single beat
(4D LV Volume Acquisition – Single beat – cont.)
6. Press Image Store or Freeze
Tips: There may be an image quality boost upon storing. This is UD Clarity
giving its final image processing boost to the image quality prior to storing.
This can be adjusted upwards in preview mode to help increase crispness
If ‘‘preview on’’ – Use rotary knob for Cycle Select to pick desired loop. If
Freeze is pressed then press Cine to review loop options. When desired cycle
loop is playing – Press Image Store again to store