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GE Vivid E9 Quick Reference Cards
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GE Vivid E9 Quick Reference Cards

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Summary of Contents for GE Vivid E9

  • Page 1 GE Healthcare Vivid Quick reference cards...
  • Page 2 Vivid E9 Quick Cards Index Getting started n 4D LV Volume Acquisition 2D Auto EF Color Acquisition 4D Views Tri-plane AFI/ TEE AFI 4D Auto LVQ 4D LV Mass Configuration of Footswitch 4D Strain and 6VT-D Probe 4D Stress Echo...
  • Page 3 4. Alpha-numeric keyboard Push corners of black keyboard under control panel to lock/unlock the keyboard (Getting started with Vivid E9 – cont.) 5. Probe ports 8. Start a new exam • Press Patient on control panel Only use far right port for 4D imaging transducer •...
  • Page 4 Record button on touch panel 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 Record on Vivid E9...
  • Page 5 (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.
  • Page 6 (DVR – cont.) DVR Quick Steps—Review on Vivid E9 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.
  • Page 7 (DVR – cont.) DVR Quick Steps—Review on a PC Insert the DVD into the PC The DVD contains a built-in media player that should launch automatically if the PC is configured for auto launch If you move the mouse, a title bar will appear on the top and at the bottom.
  • Page 8 Auto EF Note: if cell image has EF in right corner, Auto EF has been performed and 1. Select 4C or 2C view on stored image approved on this image and 2. Select measure, Auto EF folder process will display results 3.
  • Page 9 (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 (Auto EF –...
  • Page 10 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 –...
  • Page 11 (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 – cont.) Analysis 1.
  • Page 12 (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.
  • Page 13 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.
  • Page 14 (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.
  • Page 15 (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 –...
  • Page 16 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 – cont.) 5.
  • Page 17 (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 – cont.) 10. Place first caliper at start point within vessel above intima if measuring Posterior or below intima for Anterior 11.
  • Page 18 (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.
  • Page 19 (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 •...
  • Page 20 (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).
  • Page 21 4D LV Volume Acquisition – Multi beat 1. Press Multi beat to help ensure structure is contained in multi beat volume size when built Tips: Use Angle button – Number of cycles and frame rate can be adjusted on the fly SAX volume view allows “centering”...
  • Page 22 (Flexi Zoom – cont.) Workflow 2: 1. Scan in regular 2D mode 2. Press Multi-Dimensional on the keyboard 3. Press 4D Zoom Prepare on touch panel A biplane image appears on the screen The biplane image with the Zoom of interest is displayed (Flexi Zoom –...

  • Page 23: Temporal Resolution

    (Flexi Zoom – cont.) 3. Use Set button to change between Position and Size to optimize 4. To further adjust in elevation plane, press Trackball button 5. Adjust Width and Position in the elevation plane 6. Finally, when ready with adjustments then press 4D button or MV button on the touch panel to start 4D Zoom acquisition Note: FlexiZoom also works with 3V-D, 4V-D and...
  • Page 24 Color Acquisition – Single beat 4D 1. Select 3V, 4V-D, or 6VT-D probe, press 2D and press Color 2. Press 4D 3. Press Small, Medium, or Large for Color ROI Size (Color Acquisition – Single beat 4D – cont.) 4. Position the ROI with the trackball 5.
  • Page 25 (Color Acquisition – Single beat 4D – cont.) 6. Press Image Store or Freeze 7. Press 6 Slice after recalling a stored 4D color image to see 6 parallel – 2D slices at any angle Color Acquisition – Multi beat 4D 1.
  • Page 26 (Color Acquisition – Multi beat 4D – cont.) 6. Press Acquire Volume and watch volume build over number of cycles selected 7. Press Image Store or Freeze Tip: If ‘‘preview on’’ – Use rotary knob for Cycle Select to pick desired loop. If Freeze is pressed then press Cine to review loop options.
  • Page 27 (Color Acquisition – Multi beat 4D – cont.) 8. Press 6 Slice after recalling a stored 4D color image to see 6 parallel – 2D slices at any angle. 4D Color Rendering – Single beat and Multi beat 4D 1. Recall a 4D color dataset 2.
  • Page 28 4D Color Rendering – Single beat and Multi beat 4D – cont.) 4. Use Tissue Transparency rotary knob to see through tissue obscuring color flow 5. Use Flow Transparency rotary knob to see through color flow obscuring tissue 6. Press Image Store or Freeze Tips: If Freeze is pressed then press Cine to review loop options Pressing the rotary knob toggles its function...
  • Page 29 (4D Views – cont.) 3. Tilt or translate laterally using the rotary knobs or the trackball until the left ventricle is centered with respect to the vertical lines. (4D Views – cont.) 4. Translate the short axis view to the mitral valve by click-and-drag of the horizontal line in one of the apical views or by using the rotary knob.
  • Page 30 1. Recall any mid-esophageal (ME) 4D TEE data set 2. Press 4D views button on the touch panel Vivid E9 EchoPAC — Select 4D Views from the Menu bar Note: 4D TEE dataset needs to be manually aligned unlike in 4D TTE dataset can be aligned automatically or manually too.
  • Page 31 Grab the blue lines and move it to the MV annulus (4D Views TEE – cont.) or use the rotary knobs from the scanner assigned respectively for control of the data 5. Once alignment is done press Approve button Vivid E9 EchoPAC 4D Views...
  • Page 32 (4D Views TEE – cont.) 6. Press one of Vivid E9 EchoPAC the LV views to get rendered image of the LV from the standard projections (4D Views TEE – cont.) Vivid E9 EchoPAC 7. To get a quick view of LV...
  • Page 33 (4D Views TEE – cont.) Vivid E9 EchoPAC (4D Views TEE – cont.) If you need to view the MV from the LV press Flip crop Vivid E9 EchoPAC 4D Views...
  • Page 34 (4D Views TEE – cont.) Same workflow as like the Mitral valve can be used to get a different view from Aortic valve (from LVOT or AO) and for Aortic valve Septum the Septum (view from LV or RV) 4D Auto LVQ for TTE (3V-D or 4V-D probe) and TEE (6VT-D probe) 1.
  • Page 35 (4D Auto LVQ – cont.) 4. If needed, align the center of the left ventricle to the Center axis Center axis vertical lines in the apical views with the rotary knobs or using the trackball 2-ch APLAX Center axis 4-ch (4D Auto LVQ –...
  • Page 36 (4D Auto LVQ – cont.) 6. Edit border contour if needed 7. Select ESV (end-systolic volume) 8. Repeat the process of placing three points at the endocardial border, two at the mitral annulus and one at the apex 9. Press Volume Waveform 10.
  • Page 37 (4D Auto LVQ – cont.) How to edit Contour Adjustment: To edit, place the cursor on the location to edit. Press Select key To delete an adjustment, double click on the point Tips: Use an image with a volume rate higher than 12fps Example of good waveform Waveform with frame rate too low...
  • Page 38 (4D LV Mass – cont.) 5. To edit, Select Epi, Endo, or Endo + Epi on touch panel to determine which needs to be edited 6. To complete, Select Approve & Exit or to continue to 4D strain: Note: Epi is default, therefore focus should be on this edit. Endo border was originated from EDV stage, therefore should already be edited by user 4D Strain Note: 25 FPS is recommended lower limit for 4D Strain or results...
  • Page 39 (4D Strain – cont.) 5. Press 4D Strain Results 6. You can view 4 Parameters of Strain: • Longitudinal Strain • Circumferential Strain • Area Strain • Radial Strain Note: to view strain values, select”Go To ES” on rotary or 2D freeze and values will appear on Bulls Eye.

  • Page 40: Stress Echo

    4D Stress Echo Exercise/Treadmill 1. Select 4D probe, Exercise application 2. Press Protocol 3. Select Stress on touch panel 4. Select Template – Exercise 2 X 5 2D/4D 5. Press Begin/Cont to start the procedure 6. Press Store to capture baseline images acquired 7.
  • Page 41 (4D Stress Echo – cont.) 7. Press Store to capture 4D acquisition 8. Continue steps 7 & 8 for each additional level 9. You will be prompted “Do you want to start protocol analysis now?” Answer yes Note: Use rotary knob to review images from page to page 10.
  • Page 42 (4D Stress Echo – cont.) To analyze from EchoPAC 1. Select Patient from Patient Archive 2. Select Exam 3. Press Protocol 4. Press Analyze Tips: To view next group click on Review page upper right corner or use > < Use Rotate/Translate for fine adjustments Click CC images in protocol screen to select continous captured images (4D Stress Echo –...
  • Page 43 (4D Stress Echo – cont.) • Tick for CC (continuous capture) • Tick for Preview store – to review image before storing. • Tick for Show reference image – either Baseline level or Previous level • Tick for Smart Stress – to remember your Depth, Gain, Frequency, Focus position number of MB cycles in 4D Template Editor: Defining Analysis Groups To update...
  • Page 44 (4D Stress Echo – cont.) Template storage options New template – initiate screen with blank template Save as template – save template with a new name Save template – save changes to template Delete template – delete selected template (cannot delete factory templates) Scan Assist Pro Using Scan Assist Pro 1.
  • Page 45 (Scan Assist Pro – cont.) 6. Continue until all steps are completed. Tip: To stop or pause protocol, press protocol button on keyboard or press buttons on touch panel under Scan Assist Pro tab. To skip a step or move to a certain step, use the up/down arrow keys or the trackball and pointer.
  • Page 46 (Scan Assist Pro – cont.) 7. Continue to add additional steps by using icons located on left of steps. Tip: new steps added will need to be edited in all fields: Imaging, comments, measurements, etc. 8. Once all steps are completed, Select Save As on top menu 9.
  • Page 47 (Scan Assist Pro – cont.) Editing a current Protocol 1. Once in a protocol, to edit steps enter config from Scan Assist Pro tab 2. Select Edit from middle of menus 3. Scan Assist Editor will open 4. Select step you would like to edit 5.
  • Page 48 (Scan Assist Pro – cont.) 6. Once step is selected you may double click to edit name of step 7. Change step name under general tab 8. Include instructions and what to advance on to go to next step Tip: we recommend to use Freeze as trigger or Image store to advance on 9.
  • Page 49 4D Manual Crop Tool 1. Open a 4D image loop to crop There are many automatically cropped views in 4D Views that may be used to avoid manual cropping, or which can be used as a starting image and then continued in manual crop.
  • Page 50 (4D Manual Crop Tool – cont.) Touch Panel 3. Press Crop plane color/number 4D Crop Tool on touch panel for a crop plane to become active in the workspace areas Green 1 & 2 are parallel crop planes which are parallel to the green reference box-plane-sides Yellow 1 &...
  • Page 51 (4D Manual Crop Tool – cont.) Rotation of the volume is possible so depending on the volume’s rotation Green 1 may be on top and Green 2 may be on bottom or any side if volume has been rotated (4D Manual Crop Tool – cont.) Amber planes designate active crop plane in reference images, dark blue on Touch panel...
  • Page 52 (4D Manual Crop Tool – cont.) 4. Press Parallel Crop 5. Turn rotary knob to translate; press and turn to change thickness (4D Manual Crop Tool – cont.) 6. Press Rotate Crop Rotate Crop changes the function of the trackball to rotate the crop plane(s).
  • Page 53 (4D Manual Crop Tool – cont.) 4D Crop Tool Flip & En Face 8. Press Flip or En Face View to quickly align view Flip changes the viewing crop plane and direction 180 degrees En Face squares the viewing plane to a perpendicular view to the crop plane (4D Manual Crop Tool –...
  • Page 54 (4D Manual Crop Tool – cont.) Additional Crop Planes 10. Translate & Rotate active cropping plane Steps: Press Rotate crop on the touch panel to change the trackball function from rotating the volume to rotating the crop plane. Use rotary knob or press Select for trackball function to change to translate.
  • Page 55 (4D Manual Crop Tool – cont.) 11. Rotate Volume Tip: Alternatively, View-crop may be used to view the volume from the cropping plane, instead of rotating the volume around a fixed view point. Must exit crop tool to apply view-crop 12.
  • Page 56 (4D Manual Crop Tool – cont.) 15. Press Image Store or Freeze 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 Can re-store this cropped 4D image and not increase file size;...
  • Page 57 (4D Manual Crop Tool – cont.) Yellow Viewing Arrow Rotate Volume 20 degrees Looking at inferior septum Verification: Arrow has moved to the left on Yellow reference image and is short Arrow has become shorter on White ref image. Arrow has moved around towards the septum Green ref image (4D Manual Crop Tool –...
  • Page 58 (4D Manual Crop Tool – cont.) Yellow Viewing Arrow Rotate Volume 100 degrees Looking at RV and IVS, good approach for VSD Verification: Yellow arrow is now slightly anterior to 4Ch plane, seen by dimmed arrow in yellow reference plane; also slightly shorter yellow ref image dimming corner (4D Manual Crop Tool –...
  • Page 59 RV Volume Acquisition 1. Select 3V probe, press 4D Tip: Bi-plane can be used to line up the Sub-optimal RV centering correct probe position prior to entering and size 4D mode 2. Center the RV in the sector Tip: Larger RV sizes may require moving the probe laterally and tilting anteriorly towards the RVOT and/or up an inter- Optimal RV...
  • Page 60 (RV Volume Acquisition – cont.) 4. Adjust gains and volume optimize Step 1: Start by adjusting 2D gain in 2D mode. Use the TGC’s to 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 and ensure that 2D gain is correct by looking at cut planes Step 3: If necessary adjust 4D gain.
  • Page 61 (RV Volume Acquisition – cont.) 5. Determine best volume size Tips: Most RV Volumes will require at least large volume sizes. Ensure critical RV structures of RV free wall, and RV outflow tract are contained in the dataset with the correct volume size setting Volume size may need to be adjusted to larger than ‘‘Large’’...
  • Page 62 (RV Volume Acquisition – cont.) 7. Press Multi beat* Tips: Adjust frame rate knob for optimal balance between endocardial border visualization (spatial resolution) and endocardial motion (temporal resolution) Use Angle button on control panel – SAX volume view – allows “centering” of the RV in the capturing volume See 4D Acquisition quickcard for more Multi beat 4D acquisition steps &...
  • Page 63 Configuration of Footswitch 1. Select Config 2. Select Utility tab on the touch panel 3. While on Config go to Imaging 4. Select Application tab Footswitch Functions that can be selected Footswitch has three • No function • Rotate 90 • 2D • Print pedals that can be • Select • P revious cycle • Color...
  • Page 64 Configuration of the 6VT-D probe 1. Select Utility on the touch panel 2. Select Config button 3. While on Config go to Imaging 4. Select TEE probe tab The 6VT–D probe has three buttons that can be configured 6VT-D probe Functions that can be selected • No function • Rotate Right • Next cycle...
  • Page 65 MV TomTec analysis for 4D TEE Image Acquisition 1. Only images acquired with 6VT-D probe can be analyzed 2. During acquisition, MV and MV annulus should be complete as well as part of the AV 3. For dynamic measurement frame rate should not be too low 4.
  • Page 66 (MV assessment – cont.) Set MV Annulus Landmarks Position the green bar in the middle of the systolic range Set MV annulus with two points in Azimuth plane and two points in Elevation plane Set LVOT Landmark From the three SAX views check out the one where LVOT is seen best and set the landmark in the middle of the LVOT Set Aortic Annulus (if required) Click the set Aortic annulus button...
  • Page 67 (MV assessment – cont.) To Store Images Store images to clipboard Press Alt+P To Store AVI or bmp outside EchoPAC Use this icon on the upper left side, to store either loop or still frame im- ages to another media To Store a screenshot on your hard drive Use this icon to store a screenshot to your computer hard drive _\...
  • Page 68 Quick Rotate and Rotate Quick Rotate—The system can do the rotation inside the probe, while the user keeps the probe still at the same position, without any movement. Steps are always +/- 30° 1. Press from touch panel by clicking on the right (clockwise rotation) or left arrow (counter clockwise rotation) 2.
  • Page 69 Biplane Tilt and Rotate In biplane mode, by default planes are orthogonal to each other starting at 0°/90° Press Quick rotate, planes are still orthogonal in position but can be rotated to a different angle Default 0°/90°, 30°/120° Tilt With rotation of 30° clockwise V-Planes 1.
  • Page 70 Biplane Prepare The tool uses the 4D render image to orientate and obtain biplane images with high frame rate and high spatial resolution 1. While in 4D imaging, press Biplane prepare button on the touch panel 2. Adjust the position of the Laser lines either by using rotary knob or by trackball (Biplane Prepare –...
  • Page 71 This tool provides an enhanced correlation and the position between the 2D slice images and the rendered image From the Vivid E9—From the touch panel, go to page 2 and Press Laser Lines Select either Red or Color ( White and Yellow ) From EchoPAC—In the Menu bar, 3 selections...
  • Page 72 Color 2 Click Crop With this tool, the image will be cropped and the viewing Vivid E9 direction is getting adjusted to the position where the user wanted to look from 1. While in 4D imaging, from the touch panel (scanner) select 2 Click Crop.
  • Page 73 (2 Click Crop – cont.) 2. Press 2 Click Crop, set the 1st point on the position where you want to start 3. Adjust the cursor to visualize the structure you want to see 4. Move the cursor to the final position and set the 2nd point 1st Click 2nd Click Adjust...
  • Page 74 Layout overview—Laser lines are following color scheme as indicated by the colored corner. Designated solid frames indicates Vivid E9 EchoPAC the same view as the rendered image. 4D Workflow Tools...
  • Page 75 (FlexiSlice – cont.) Orange X, shows from which side of the plane the image is cropped Viewing direction (FlexiSlice – cont.) How to use FlexiSlice BEFORE to MOVE the cursor to middle part of the line until desired position Image and line to manipulate 2D slice belonging to the line AFTER Old and new position of the line...
  • Page 76 (FlexiSlice – cont.) to TILT end of the line BEFORE until desired position Image and line to 2D slice belonging to the line manipulate AFTER Old and new position of the line The NEW 2D slice belonging to the line (FlexiSlice –...
  • Page 77 (FlexiSlice – cont.) Rotation The NEW 2D Slices belonging to the lines AFTER Old and new position of the lines (FlexiSlice – cont.) to move the 2 lines together until you achieve desired image position 2D Slices belonging to the lines BEFORE Image and lines to manipulate 4D Workflow Tools...
  • Page 78 (FlexiSlice – cont.) The NEW 2D Slices belonging to the lines AFTER Old and new position of the lines (FlexiSlice – cont.) While manipulating the 2D slices the rendered image in the upper left corner will change and depending on the 2D slice where the frame is highlighted.
  • Page 79 Changing the reference plane To change the reference image plane, simply select the color that corresponds to the image To activate the YELLOW as reference plane Reference plane layout or select WHITE as the reference plane 4D Workflow Tools...
  • Page 80 1. Press Depth mode on the touch panel Example 1: Position the intersection EchoPAC of the Laser lines set on the tip of the Vivid E9 posterior MV leaflet (Render Depth Mode – cont.) Example: Position the intersection of the...