Siemens ACUSON Cypress User manual

Operator’s Manual
ACUSON Cypress™ System
MANUFACTURER’S NAME: Siemens Medical Solutions USA, Inc.
MANUFACTURER’S ADDRESS:1230 Shorebird Way
Mountain View, CA 94043
Phone: [phone]
[phone]
EUROPEAN REPRESENTATIVE: Siemens Aktiengesellschaft
Medical Engineering Group
Henkestraße 127,
D-91052 Erlangen, Germany
Phone: [phone]
Document No. 10034330
Rev. 01
Language: English

ii
Copyright © 2006 by Siemens Medical Solutions USA, Inc.
All rights reserved. No part of this publication may be reproduced, transmitted,
transcribed, stored in retrieval systems, or translated into any language or com-
puter language, in any form or by any means, electronic, mechanical, mag-
netic, optical, chemical, manual, or otherwise, without the prior written
permission of Siemens Medical Solutions USA, Inc.
Siemens Medical Solutions USA, Inc. reserves the right to change its products
and services at any time. In addition, this manual is subject to change without
notice. Siemens Medical Solutions USA, Inc. welcomes customer input on cor-
rections and suggestions for improvements to this manual.
Although Siemens Medical Solutions USA, Inc. has attempted to ensure accu-
racy throughout this manual, Siemens Medical Solutions USA, Inc. assumes
no liability for any errors or omissions, nor for any damages resulting from the
application or use of this information.
ACR-NEMA v3 TCP/IP/Ethernet Interface Source Code licensed from
DeJarnette Research Systems, Inc.
Portions of JPEG compression software licensed from Pegasus Imaging
Corporation.
Printer drivers licensed from Epson, Inc. and Canon, Inc.
All product names are trademarks of their respective companies.
United States Federal Law restricts this device to use by or on the order of a
physician.
COPYRIGHT
TRADEMARKS
CAUTION!

iii
All computer programs copyright 2000–2006 by Siemens Medical Solutions
USA, Inc. OR ITS SUPPLIERS. Such programs are licensed under the follow-
ing software license agreement:
Siemens or its suppliers retain(s) ownership of and title to any computer pro-
gram supplied with the equipment and to the trade secrets embodied in such
computer programs. Subject to the Buyer’s acceptance and fulfillment of the
obligations in this paragraph. Siemens grants the Buyer a personal, non-trans-
ferable, perpetual, non-exclusive license to use any computer program sup-
plied with the Equipment that is necessary to operate the Equipment solely on
the medium in which such program is delivered for the purpose of operating
the equipment in accordance with the instructions set forth in the operator’s
manuals supplied with the Equipment and for no other purpose whatsoever.
Buyer may not reverse-assemble, reverse-compile or otherwise reverse-engi-
neer such computer programs nor may Buyer make a copy of such program or
apply any techniques to derive the trade secrets embodied therein. In the event
of a failure by Buyer to comply with the terms of this license, the license
granted by this paragraph shall terminate. Further, because unauthorized use of
such computer programs will leave Siemens without an adequate remedy at
law, Buyer agrees that injunctive or other equitable relief will be appropriate to
restrain such use, threatened or actual. Buyer further agrees that (i) any of Sie-
mens suppliers of software is a direct and intended beneficiary of this end-user
sublicense and may enforce it directly against Buyer with respect to software
supplied by such supplier, and (ii) NO SUPPLIER OF SIEMENS SHALL BE
LIABLE TO BUYER FOR ANY GENERAL, SPECIAL, DIRECT, INDI-
RECT, CONSEQUENTIAL, INCIDENTAL OR OTHER DAMAGES ARIS-
ING OUT OF THE SUBLICENSE OF THE COMPUTER PROGRAMS
SUPPLIED WITH THE EQUIPMENT.
LICENSE AGREEMENT

iv
WARNINGS
ELECTRICAL SHOCK HAZARD
Grounding reliability can only be achieved when equipment is
connected to an equivalent receptacle marked “HOSPITAL
GRADE.” Do not remove system covers. There are no operator
servicable parts inside. Refer servicing to qualified personnel.
DANGER
Possible explosion hazard if used in the presence of flammable
anesthetics.
WARNING
Risk of fire. Replace fuse as marked.
WARNING
The Cypress System is not intended for use as an ECG monitor
or for diagnostic ECG.
CAUTION
Total system chassis leakage current should not exceed 100µA.
ATTENTION
Before using the system, carefully read the “Safety, Technical
Description, and Accuracy” section.
IMPORTANT
Read this manual carefully before you begin using the system.

ACUSON Cypress™ Operator’s Manual v
CHAPTER 1 System Overview
Overview of the Cypress System 1-2
Turning the Cypress System On and Off 1-3
Turning the Cypress System ON 1-3
Turning the Cypress System OFF 1-4
Logging On and Off of the Cypress System 1-5
Logging On 1-5
Logging Off 1-6
Setting Up User Accounts 1-7
Adding Users 1-7
Editing or Removing Users 1-8
Connecting and Using Transducers 1-9
Magneto Optical (MO) Disk Drive 1-10
External Devices and Connections 1-11
Transporting the System 1-12
Proper Viewing Angle 1-13
System Security 1-14
Location of Fan and Vents 1-15
Contents

Contents
vi ACUSON Cypress™ Operator’s Manual
CHAPTER 2 Keyboard & General Controls
Keyboard Overview 2-2
Keyboard Controls 2-3
Mode Keys 2-3
Trackball and <ENTER> Keys 2-5
Main Knob 2-5
Time/Gain Compensation (TGC) 2-5
Main Knob Functions 2-6
How to Set the Playback Speed using the Play Function 2-6
Soft Window Knobs 2-7
Function Keys 2-10
Alphanumeric Keys 2-12
Special Marks 2-13
CHAPTER 3 Basic Setup
The Setup Menu 3-2
Navigating the Setup Menu 3-3
How to Specify a Setup Option 3-3
About User Accounts 3-3
Explanation of Setup Menu Fields 3-4
The Presets Menu 3-12
Storing a User-Defined Preset 3-13
Recalling a Saved Preset 3-13
Recalling a Saved Preset on the New Patient Screen 3-14
Renaming a User-Defined Preset 3-14
Removing a User-Defined Preset 3-14
Making Changes to the Current User-Defined Preset 3-15
Reload Preset with New Patient 3-15
The System Menu 3-16
How to Specify a System Option 3-16
Explanation of System Menu Fields 3-16
The Calculations Menu 3-18
The DICOM Menu 3-20
The Network Identification Menu 3-22
CHAPTER 4 Patients
The Patient Menu 4-2
Icons used in the Patient Directory 4-4

ACUSON Cypress™ Operator’s Manual vii
Contents
Explanation of Patient Menu Buttons 4-6
Study Formats 4-8
Expanding Patient Folders 4-8
Adding and Editing Patients and Studies 4-9
Adding a New Patient 4-9
Registering a New Patient Using the Worklist 4-12
Caching of Modality Worklist Results 4-14
Starting a New Study 4-15
Editing Patient and Study Information 4-16
Completing a Study with No Patient Name 4-18
Using Existing Studies 4-18
Adding Data to an Existing Study 4-18
Viewing Existing Patient Studies 4-19
How to Change the Display Format 4-19
Removing a Study or Patient from the System 4-20
Batch Removal 4-21
Patient Reports 4-22
Adding a Text Comment to a Patient Report 4-23
CHAPTER 5 Scanning
Overview of the Scanning Process 5-2
General Information 5-2
Basic Steps to Complete a Scanning Session 5-2
Using Soft Windows 5-3
Using Tools 5-4
Saving Image Data 5-5
Viewing Saved Loops 5-6
Flagging Images 5-7
When to Use the Flag Function 5-8
Cypress System Data 5-9
Trigger Modes 5-13
Keeping Track of Saved Loops 5-14
Adding Text to an Image 5-15
Text 5-15
Hiding the Factory-Defined List 5-17
Quick Text 5-18
Adding an Arrow when Quick Text is Enabled 5-19
Adding an Arrow when Quick Text is Not Enabled 5-19
Removing an Arrow 5-19
Zoom 5-20

Contents
viii ACUSON Cypress™ Operator’s Manual
2D Scanning 5-21
Activate the 2D Display 5-22
Time/Gain Compensation (TGC) Controls 5-22
Main Knob Controls Compress and Gain 5-22
2D Soft Windows 5-23
2D Tools 5-27
Color Flow Scanning 5-30
Activate the Color Flow Display 5-31
Main Knob Controls 2D and Color Gain 5-31
Color Flow Soft Windows 5-32
Color Flow Tools 5-35
Continuous Wave Doppler (CW) Scanning 5-38
Activate the CW Display 5-39
Main Knob Controls Volume and CW Gain 5-39
CW Soft Windows 5-40
CW Tools 5-41
Pulsed Wave Doppler (PW) Scanning 5-43
Activate the PW Display 5-44
Main Knob Controls PW Gain and Volume 5-44
PW Soft Windows 5-45
PW Tools 5-48
M-Mode Scanning 5-50
Activate the M-Mode Display 5-51
Main Knob Controls Gain and Compress 5-51
M-Mode Soft Windows 5-52
M-Mode Tools 5-53
CHAPTER 6 Cardiac Calculations
Overview of Cardiac Measurements 6-2
Types of General Cardiac Measurements 6-2
Types of Specific Cardiac Calculations 6-3
Cardiac Calculations Setup 6-4
Setting Parameters 6-4
About Construction Methods 6-4
How to Add or Change an Estimated Value Using Setup 6-4
How to Edit the Estimated Value While Performing a Calculation 6-5
Selecting a Report Format 6-5
Selecting a Report Background Color 6-5
Using the Averaging Function 6-5
Using the Cardiac Calculations Package 6-7

ACUSON Cypress™ Operator’s Manual ix
Contents
Performing General Measurements 6-7
Performing Specific Cardiac Calculations 6-9
Saving Calculations to the Patient Report 6-10
Entering A Heart Rate 6-11
Saving Frames Containing Measurement Graphics 6-12
Deleting a General Measurement 6-12
Deleting a Specific Measurement 6-12
Making Corrections to the Trace and Area Measurements 6-13
Stopping a Measurement Before Completion 6-13
Setting the Trace Resolution 6-13
Viewing the Patient Report 6-13
Changing the Position of a CALC Menu 6-14
Setting a Default Position for the CALC Menu 6-14
Cardiac Formulas and References 6-15
2D Formulas 6-15
M-Mode Formulas 6-18
Doppler Formulas 6-20
Cardiac Calculation References 6-24
CHAPTER 7 Vascular Calculations
Overview of Vascular Measurements 7-2
Types of General Vascular Measurements 7-2
Types of Specific Vascular Calculations 7-3
Vascular Calculations Setup 7-4
Setting Parameters 7-4
About Construction Methods 7-4
Selecting a Report Format 7-5
Selecting a Report Background 7-5
About Default Sites for Vascular 7-5
Adding Default Sites for Vascular 7-5
Editing Default Vascular Sites 7-6
Removing Default Vascular Sites 7-6
Restoring Factory Defaults to Vascular Sites 7-6
Changing the Position and Order of the Vascular Sites 7-6
Using the Vascular Calculations Package 7-7
Performing General Vascular Measurements 7-7
Performing Specific Vascular Calculations 7-9
Saving Calculations to the Patient Report 7-10
Saving Frames Containing Measurement Graphics 7-10
Deleting a General Measurement 7-11
Deleting a Specific Measurement 7-11

Contents
xACUSON Cypress™ Operator’s Manual
Making Corrections to the Trace and Area Measurements 7-11
Stopping a Measurement Before Completion 7-12
Viewing the Patient Report 7-12
Changing the Position of a CALC Menu 7-12
Setting a Default Position for the CALC Menu 7-13
Vascular Formulas and References 7-14
2D Formulas 7-14
Doppler Formulas 7-15
Vascular Calculation References 7-16
IMT Options Package 7-17
IMT Setup Options 7-17
Types of IMT Calculations 7-17
Using the IMT Calculations Package 7-18
Turning the IMT Grid ON and OFF 7-19
Using the IMT On-screen Labels 7-19
IMT Formulas 7-20
IMT References 7-20
CHAPTER 8 Stress Echo
Connecting and Using ECG 8-2
Stress Echo ECG Cables and Connectors 8-3
ECG Signal Quality During Stress Echo Exam 8-6
Reducing ECG Artifacts 8-6
About the Stress Protocols 8-7
Important Stress Controls 8-9
Using the Protocol Soft Window Knob 8-10
Deleting Unlabeled Loops from a Study 8-11
Transferring Studies in a DICOM Format 8-11
Stress Echo TOOLS 8-12
Conducting a Stress Echo Protocol Exam 8-13
Step-By-Step Stress Echo Exam 8-13
Quad-Screen Soft Windows 8-19
Viewing Additional Loops in a Quad 8-19
Removing a Label 8-20
Changing the ROI Position 8-20
Deleting Loops 8-20
Changing a View or Stage Label 8-20
Labeling Views 8-21
Saving and Labeling Loops 8-21
Suspending the Protocol Labeling Function 8-21

ACUSON Cypress™ Operator’s Manual xi
Contents
Save the Loop and then Assign a Label 8-22
Viewing the Quad-Screen Display 8-23
Trimming Frames from a Loop 8-25
Save and Label Loops from Freeze Mode 8-25
Save and Label the Loop Simultaneously 8-26
CHAPTER 9 Transferring Studies
Exporting Images from the Cypress System 9-2
Overview 9-2
DICOM Format to MO Disk 9-2
Native Cypress System Format to MO Disk 9-3
Setting an IP Address 9-3
DICOM Format to a DICOM Server via a Network 9-4
Multimedia Format 9-5
Multimedia Format to a Computer Via a Network 9-5
Explanation of DICOM Menu Fields 9-6
Changing Server Information 9-8
DICOM Setup for Network Transfers 9-8
DICOM Storage Commitment 9-10
Setting the Network Speed 9-10
DICOM Setup For Modality Worklist 9-11
DICOM Setup For Storage Commitment 9-12
Connecting the Cypress System to a Network 9-13
Transferring Studies 9-14
Selecting Studies 9-14
Sending the Studies 9-17
Removing Patient Name and ID from Multimedia and DICOM Images 9-20
Troubleshooting a Network DICOM Transfer 9-21
Transferring Studies Using the MO Drive 9-22
MO Disk Drive Parts 9-22
Formatting Disks 9-23
Reading Native Cypress System Format Studies from the MO Disk 9-24
Copying Studies from an MO Disk to the Cypress System (Batch Restore) 9-25
Troubleshooting an MO Disk Transfer 9-26
CHAPTER 10 Safety, Technical Description, and Accuracy
Important Warnings and Notices 10-2
Electrical Shock Hazard 10-2
Explosion Hazard 10-2

Contents
xii ACUSON Cypress™ Operator’s Manual
Safety Information and Other Warnings 10-2
Display Monitor Radiation 10-2
Prescription Device Statement 10-2
Intended Use 10-3
Safety Overview of Intended Use 10-3
Intended Use of the Cypress System Ultrasound Imaging System 10-3
Cardiac Studies 10-4
Intraoperative Cardiac Studies 10-4
Pediatric Studies 10-5
Neonatal Cephalic Studies 10-5
Peripheral Vascular Studies 10-6
Fetal Studies 10-7
Abdominal Studies 10-8
ACUSON AcuNav Diagnostic Ultrasound Catheter 10-8
Patient Safety 10-9
Exposure to Ultrasound Energy — Acoustic Output 10-9
Reducing Acoustic Exposure on the Cypress System — Implementing
ALARA 10-10
Electrical Warnings 10-11
Infection Control 10-11
Sterilization 10-12
Infection Control Reference 10-13
Patient Contact Materials 10-13
U.S. Food and Drug Administration Medical Alert 10-14
Peripheral Device Connections 10-15
Ultrasound Contrast Agents 10-16
Operator Safety Issues 10-17
Electrical Safety 10-17
Explosion Hazards 10-17
Carpal Tunnel Syndrome 10-17
Glutaraldehyde Exposure 10-18
Infection Control 10-18
Transporting and Placing the System 10-19
Technical Description and Accuracy 10-20
Specifications 10-20
Electromagnetic Interference 10-22
Labeling Icons 10-23
Measurement Accuracies 10-25
Accuracy by Transducer Type 10-25
Potential Sources of Error During Scanning 10-28
Measurement Accuracy References 10-30

ACUSON Cypress™ Operator’s Manual xiii
Contents
CHAPTER 11 Maintenance, Care, and Service
Cleaning the System 11-2
Cleaning the MO Disk Drive 11-3
Maintenance 11-4
Preventive Maintenance 11-4
Transducer Maintenance 11-4
MO Disk Drive Maintenance 11-5
Hard Drive Maintenance 11-5
Frequency of Maintenance 11-6
Electrostatic Discharge Protection 11-6
Troubleshooting 11-7
No Power 11-7
LCD Screen 11-7
Fuse Replacement 11-8
Trackball Maintenance 11-9
Cleaning the Cypress Trackball 11-9
APPENDIX A Connecting External Devices
Connecting a Video Printer A-3
Connecting a SVHS VCR A-5
Connecting a VCR and Video Printer A-7
Connecting an External Monitor A-9
Connecting an External Keyboard A-10
APPENDIX B Printing Reports
Connecting an Ink-Jet Printer B-2
Printing Patient Reports B-3
Printing the Active Study B-5
Printing Reports from Calculations B-6
Index

xiv ACUSON Cypress™ Operator’s Manual
Styles Used in this Manual
The following conventions are used in this manual:
MODE KEYS Mode keys are in bold, capital letters.
FUNCTION KEYS Function keys are in bold, capital letters.
SOFT WINDOW KNOBS The names of the Soft Window knobs are in capital
letters.
Options Options on menus and screens are in bold italics.
Tabs Tab names are in bold italics
[BUTTON] Buttons that appear on the screen are in capital let-
ters and enclosed in [ ] (square) brackets.
<KEY> Keys are in capital letters and enclosed in < >
(angle) brackets.
system output System output (e.g., messages) are in courier font.
Click In this manual, “click” means:
nMove the cursor to the desired location using the
Trackball,
nand then press oneof the <ENTER> keys located
next to the Trackball.
Double-click Double-click means to quickly press the <ENTER>
key twice. The rate is set on the Setup menu. For
more information see Table 4, “Setup Menu Fields”.

ACUSON Cypress™ Operator’s Manual 1-1
CHAPTER 1 System Overview
1
This chapter presents an overview of the ACUSON Cypress™ ultrasound
system. It includes the following information:
Overview drawings of the system
How to turn the power ON and OFF
How to log on and off of the system
How to connect transducers
Using removable media in the optical disk drive
Connections to external devices
How to transport the Cypress system
System security

System Overview
1-2 ACUSON Cypress™ Operator’s Manual
Overview of the Cypress System
FIGURE 1. Overview of the Cypress System
KEYBOARD
TRANSDUCER
CONNECTOR
TILT
MONITOR
KEYBOARD
TILT
MECHANISM
ON/OFF
SWITCH
(ON BACK)
ECG
CONNECTOR
(ON BACK)
MAGNETO
OPTICAL
DRIVE
EXTERNAL
CONNECTORS

ACUSON Cypress™ Operator’s Manual 1-3
Turning the Cypress System On and Off
Turning the Cypress System On and Off
Before turning the Cypress system power ON, make sure that:
The supplied power cord is securely inserted into the receptacle at the back
of the unit.
The power cord is securely plugged into a properly grounded wall outlet. See
the WARNINGS on page 10-2.
Turning the Cypress System ON
To turn the system ON:
1. Press the switch located above the powercord receptacle. Press the “–” side
of the rocker switch.
The system goes through its boot-up sequence. If User Accounts are enabled,
the Login window opens (see “Logging On and Off of the Cypress System” on
page 1-5 and “Setting Up User Accounts” on page 1-7 for more information). If
User Accounts are not enabled the 2D screen appears and the system is ready
for use.
WARNING Never turn the system OFF when it is in the process of booting-
up, as this may cause a fatal error. Always wait until the 2D
screen appears before turning the system OFF.
FIGURE 2. Cypress System Power Switch
– o
POWER
SWITCH
POWER
CORD
FUSE BOX
ECG
CONNECTION

System Overview
1-4 ACUSON Cypress™ Operator’s Manual
Turning the Cypress System OFF
To turn the system OFF:
1. Press the PATIENT or SETUP function key.
2. Select the Shutdown tab.
3. If User Accounts are enabled, click the [LOGOFF] button.
4. Click the [SHUTDOWN] button. The system displays the Shutdown in
Progress message: Please wait while the system writes
unsaved data to the disk. Wait until the system displays this mes-
sage: It is now safe to turn off your computer.
NOTE: Using Shutdown insures that any open Patient Studies or images are
properly saved. Failure to use the Shutdown command can result in
boot-up delays the next time the system is turned on.
5. Switch the power OFF. Press the “o” side of the rocker switch.
FIGURE 3. The Shutdown Menu Screen
. . . THEN CLICK
THE SHUTDOWN
BUTTON
ShutdownReportsSetupPatient
Logoff Shutdown Utilities
PRESS THE SETUP KEY AND CLICK THE SHUTDOWN TAB . . .
Job Patient Name Study Date Location Action Status

ACUSON Cypress™ Operator’s Manual 1-5
Logging On and Off of the Cypress System
Logging On and Off of the Cypress System
The Cypress system can be set so that all users must have a valid logon User
name and Password. This helps to ensure Cypress system privacy and security.
(See “Setting Up User Accounts” on page 1-7 for information about enabling the
logon feature and creating User names and Passwords).
When the system is set up to require User Accounts and the system is booted,
the following things happen:
On the Shutdown screen, the [RESTART] button is replaced by the [LOGOFF]
button.
Every user must have a valid User Name and Password.
The logon screen opens when the system is started:
Logging On
To logon to the system, follow these steps:
1. Type your User name.
2. Type your Password.
3. Click [OK].
OK Shutdown
User
Password

System Overview
1-6 ACUSON Cypress™ Operator’s Manual
Logging Off
There are two log off methods:
Manual — each user logs themselves off of the system when they are ready.
Auto-Logoff — users are automatically logged off when there is no activity
on the system for a specified time. The system Administrator sets the time in
the Setup menu.
In both cases once the logoff occurs the Cypress system will not respond until a
valid User name and Password are entered and [OK] is selected.
Manual Logoff
To manually log off the system, follow these steps:
1. Press the SETUP function key.
2. Select the Shutdown tab.
3. Click the [LOG OFF] button. The Logon dialog box will open and the system
will not respond until a valid user name and password are entered.
Automatic Logoff
An automatic logoff occurs when the system Administrator has Enabled the
Automatic Logoff option and there is no system activity (i.e., nothing on the key-
board is pressed or touched) for the specified time.
The time choices for automatic logoff are 15, 30, 45, and 60 minutes. If the
imaging system is active, and there is no activity in the specified time (e.g., 60
minutes) the Cypress freezes and the logon screen will be displayed — no sys-
tem activity will be allowed until a user successfully logs on.
To set an automatic logoff, follow these steps:
1. Press the SETUP key.
2. Doubleclick the User Accounts option.
3. On the right side of the screen click the Enabled box.
4. Use the pull-down menu to select the number of minutes that the system
should wait before freezing.