GE Vivid E95 Instructions de montage

4D TOE

Tips & Tricks

Kylie Hollitt

CVUS Applications Specialist GE healthcare

Australia

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Welcome to your 4D probe

Pages

Title

Description

Setting Up

System configuration

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

Acquiring 4D Workflows

FlexiViews

4D Tools –Live and Post

Processing

2 Click Crop

16-18

4D Tools –Live and Post

Processing

Flexi- Slice

4D Colour

Obtaining 4D Colour images, Optimisation Tips

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.

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