GE Vivid E95 Assembly instructions

4D TOE
Tips & Tricks
Kylie Hollitt
CVUS Applications Specialist GE healthcare
Australia

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Welcome to your 4D probe
Pages
Title
Description
3
Setting Up
System configuration
4
Getting to know you
6VT TOE probe configuration
5-6
Angle + Multi D
Biplane –Rotating and Tilting,
7-8
Angle + Multi D
Biplane - V Planes, Triplane
9-10
Acquiring 4D Workflows
Acquiring Larger 4D volumes
11-13
Acquiring 4D Workflows
4D Flexi Zoom
14
Acquiring 4D Workflows
FlexiViews
15
4D Tools –Live and Post
Processing
2 Click Crop
16-18
4D Tools –Live and Post
Processing
Flexi- Slice
19
4D Colour
Obtaining 4D Colour images, Optimisation Tips
20
4D Optimisation Controls
Knobology
Appendix
Quantification Tools
For more tips, webinars and resources visit the Vivid Echo Club
www.vividechoclub.net

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Setting Up/ Before You Start
Plug your TOE probe into the system and Press the “PROBE” icon on the touchscreen to activate your
6vt TOE probe. The available presets will be listed under this probe –the machine will automatically
default to the probe at the top of the list.
You will see the 6vt Probe steering angle appear on the screen confirming that a TOE probe has been
activated.
If your system is setup to provide a preview loop prior to store –your cardiologist may wish for this
feature to be turned off for the Transosephageal Echocardiogram.
To access this you will want to go to the Utility button on your touchscreen (if it’s not a shortcut press
on “MORE”) and into the Configuration menu –The Global/ Imaging screen should come up
automatically - if not go to the Global/Imaging tab to view the following screen and turn of preview
prior to store –Note you must turn this back on again after if it is required for transthoracic scanning

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Getting to know your TOE probe
TOE probe default set up
1. Button 1 (closest to the probe tip):
Counterclockwise scan plane rotation or rotate right
(takes the angle) from zero degrees forward)
2. Button 2: Image Store
3. Button 3: Clockwise scan plane rotation or rotate
left (takes the angle back towards zero degrees)
To customize these settings go to the Utility button
on your touchscreen. Press Config go to the
Imaging tab and press the TEE probe subtab
Cleaning the TOE probe
The TOE probe should be
processed immediately –do not
allow body fluids to dry on the
probe.
Products that are approved for use
on GE TOE probes are listed on the
following website link. Using non
approved products may void your probe warranty.
http://www3.gehealthcare.com/en/Products/Categories/Ultrasound/Ultrasound_Probes
Approved products should be used according to manufacturers guidelines however cleaning agents
must not come into contact with the probe system connector plate (7).If you have any other questions
regarding cleaning agents or the cleaning procedure contact your GE representative or refer to the TEE
User Manual for technical guidance.

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Single Plane imaging - Angle and Rotate
The Angle button is available on both the console and the touchscreen (Quick
Rotate). Pressing either will steer the angle of the probe internally at 30 degree
intervals. Pressing “Clear” on the console will take the angle straight back to zero.
Use the “Rotate” rotary knob to change the angle of the scan
plane 1 degree at a time.
Multi D –Biplane mode
•Select the “Multi D” button, a Biplane image will appear.
•Scan Plane (1) is the image in relation to the position and
orientation of the TOE probe –this image is highlighted by ayellow box –Thecurrent
angle of Scan Plane 1 is represented by ayellow line onthe onscreen navigator (3). Adjustments to the “Rotate”
knob will adjust the angle of this view.
•Scan Plane (2) defaults at an angle that is 90 degrees to Scan Plane 1. This image can be independently
tilted and rotated. If selected this image is bordered by a white box. Scan Plane 2’s angle is displayed as a white
line on the navigator (3) and may be adjusted independently using the “Angle 1” rotary knob.
1. Scan Plane 1 (yellow reference line) default scan plane
2. Scan Plane 2 (white reference line)
3. Navigator displays the position of both scan plane as seen from the probe.
4. Trackball functions.

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Rotating and Tilting –Biplane Mode
•The “Rotate” knob rotates all images together.
•Scan Plane 1 and 2 can be rotated independent of each other and Scan Plane 2 can also be tilted.
•The “Angle 1” rotary knob adjust’s the angle increment of Scan Plane 2.
•To tilt Scan Plane 2 press the “Select” mouse key until “Pos” is highlighted – Use the trackball to tilt the
second scan plane. Pressing the “Clear” button resets Scan Plane 2 back to a non-tilted position. Note: Tilt
and rotate can only occur in biplane mode.
Note example below : Scan Plane 1 is at 56 degrees (yellow) and Scan Plane 2 has defaulted to 146 degrees
(white) the operator has tilted the second scan plane to 12 degrees to better view a catheter as it is placed
through a perivalvular leak. To rotate Scan Plane 2 further use the “Angle 1” toggle. Moving Scan Plane 1 is
achieved by utilizing the "Rotate” toggle.
Clinical Suggestion –Utilise Biplane with tilt and rotate in Interventional settings to visualize the
Intra-atrial septum in two views during atrial septal puncture or to guide catheter placement.

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Multi–D - Biplane Mode
V Planes
Image a situation where you might normally need
to move the TOE probe to get a particular view I.e.
moving Trans-gastric to get a short axis. V-Planes
tilt the scan plane down reducing the need to
move the probe.
To begin enter Bi-Plane.
Select V -Planes and the scan plane 2 will
automatically rotate so that it is the same angle as
scan plane 1.
Ensure that Pos is highlighted as the current
trackball function.
Scan plane 2 can now be
tilted using the trackball
(up and down). To reset
the V- Planes press the
Clear button on the
console.
Note the navigator angle
on this image - both scan plane angles have defaulted to zero however scan plane 2 has been
tilted up 20 degrees using the trackball function.

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Multi D - Triplane Features
•Change to Triplane on the touch screen (default is to Biplane)
•Move probe as needed so that you can clearly see all three views.
•In Tri-Plane the third scan plane (A2 or Angle 2) is represented by a green line - to change the angle of
the third image press the “Angle 1” rotary knob so that “Angle 2” is highlighted – turning this knob will
rotate the third image individually.
Want to learn more, go to www.vividechoclub.net for online tutorials, webinars and product information.

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Obtaining larger 4D volumes
Enter your 4D image by either pushing 4D on the console or pressing Medium or Large on the touch
screen (selection dependant on volume size required). You may like to consider a reduction in
Frequency to assist with improving the Penetration for your larger volume.
To acquire a 4D
dataset of the
valves, left atrial
appendage or IAS
consider using
Flexi Views or 4D
Flexi Zoom (see
relevant sections
below for more
information).
Once you are in your 4d screen you can make further adjustments to the size using the Volume
size/shape toggle.
Frame Rate and
Multi Beat options
are also available
on this touch
screen. Note
adjustments to
Frame Rate will
affect the spatial
resolution.

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4D Zoom
Hit 4D Zoom Prepare on the touchscreen and you will be taken to a biplane image as per below
Adjusting Zoom region of interest -The
trackball will default to Position adjustment inthe
Azimuth plane (The left box). Pressing the
trackball Set key changes the ROI box between
the position and region size adjustment.
Optimise until satisfied.
To adjust the view in the elevation plane (Image
to the right) press your Trackball button or Ref
plane on your touchscreen. As per the Azimuth
plane use the trackball Set button to switch
between position and size adjustment.
When you are ready to view
your 4D image press the 4D Button on the console (note pressing 4D Zoom turns
off the 4D zoom feature) to be taken to the 4D rendered image. The default 4D
rendered image displayed will be dependant on the saved default position of your
Translate line. Move the Translate line position by adjusting the rotary knob or
adjust the angle of this line using the Angle button on your console. To alter the
displayed Layout press the Layout button on your console.
Now that you have your 4D dataset refer to the optimization section of this tips book to see which post
processing features can assist you further.