超聲儀器如何操作（How to operate the ultrasonic instrument）

超聲儀器如何操作（Howtooperatetheultrasonicinstrument）凍凍結(jié)鍵我激活M型線調(diào)出M型或彩色取樣線連續(xù)激活連續(xù)多譜勒功能（僅在心臟探頭）B二維顯示或在多譜勒/米模式下轉(zhuǎn)回二維模式。CFM彩色功能鍵激活或退出。PW激活脈沖多譜勒功能，連續(xù)觸發(fā)可進(jìn)行二維/多譜勒頻譜實(shí)時(shí)轉(zhuǎn)換。變焦局部放大鍵，連續(xù)觸發(fā)可進(jìn)行局部放大或轉(zhuǎn)回正常二維狀態(tài)。多雙幅/四幅拼圖功能鍵，單激后再觸發(fā)B鍵，可實(shí)現(xiàn)雙幅拼圖。電力按此鍵后左右移動(dòng)下面的調(diào)節(jié)輪，可調(diào)節(jié)超聲功率大小體積按此鍵后左右移動(dòng)下面的調(diào)節(jié)輪，可調(diào)節(jié)多普勒音量大小心電圖按此鍵后左右移動(dòng)下面的調(diào)節(jié)輪，可調(diào)節(jié)心電信號(hào)幅度大小速度用于調(diào)整米/PW/CW的刷新速度調(diào)節(jié)取樣容積大小SV大小引導(dǎo)用于調(diào)整線陣探頭彩色取樣框或取樣線偏轉(zhuǎn)角度后對(duì)二維/彩色/能量圖進(jìn)行后處理調(diào)整預(yù)對(duì)二維彩色進(jìn)行前處理色度偽彩選擇角調(diào)整多譜勒取樣角度bsline調(diào)整PW/CW的基線PRF調(diào)整彩色脈沖重復(fù)頻率即彩色量程范圍過(guò)濾濾波鍵部門凸陣及相控陣探頭扇掃角度調(diào)整深度深度反圖象左右/頻譜上下翻轉(zhuǎn)重點(diǎn)凍結(jié)焦點(diǎn)移動(dòng)或在彩色模式下作為彩色取樣框和聚焦點(diǎn)的激活轉(zhuǎn)換TX；B/CFMROI彩色取樣框/局部放大框大小的調(diào)整測(cè)量測(cè)量菜單鍵報(bào)告報(bào)告鍵ESC清除鍵進(jìn)入確認(rèn)鍵/軟體功能激活鍵鍵盤區(qū)：不能文本輸入鍵明確文本清除鍵我病人基本信息及檢查條件選擇鍵探頭探頭選擇鍵錄像機(jī)放像鍵阿爾奇REW存儲(chǔ)圖象調(diào)出鍵菜單系統(tǒng)菜單鍵（此鍵用戶慎用）測(cè)量功能介紹二維下的距離、面積測(cè)量：在二維下凍結(jié)圖象，如需要測(cè)量距離可直接按的…進(jìn)行距離測(cè)量，按鍵進(jìn)行面積測(cè)量。其他參數(shù)測(cè)量如要進(jìn)行其他測(cè)量，則在凍結(jié)圖像后直接按措施鍵，出現(xiàn)右圖，用軌跡球選擇所需要項(xiàng)目，如面積、體積、角度：1。凍結(jié)圖像，觸發(fā)措施后，2。此時(shí)可根據(jù)需要用軌跡球選擇您的測(cè)量選項(xiàng)，并用進(jìn)入鍵確認(rèn)。區(qū)域（e）橢圓面積法面積（P）手動(dòng)描繪測(cè)面積法量（E）橢圓體積法體積（A/D）面積乘直徑測(cè)體積法音量（BI）三條直徑測(cè)體積法角度角度測(cè)量我型測(cè)量：在M下凍結(jié)圖像，如需要測(cè)量速度可直接按進(jìn)行徑線測(cè)量。其他參數(shù)測(cè)量如要進(jìn)行其他測(cè)量，則在凍結(jié)圖像后直接按措施鍵，出現(xiàn)右圖，用軌跡球選擇所需要項(xiàng)目，如時(shí)間時(shí)間、心率心率、坡斜率等等，并用進(jìn)入鍵確認(rèn)多普勒測(cè)量：（如圖2）在PW/CW下凍結(jié)圖像，進(jìn)行每點(diǎn)對(duì)應(yīng)的速度測(cè)量如需要測(cè)量速度可直接按的。其他參數(shù)測(cè)量如要進(jìn)行其他測(cè)量，則在凍結(jié)圖像后直接按措施鍵，出現(xiàn)右圖，用軌跡球選擇所需要項(xiàng)目，如RI阻力指數(shù)、FVI流速積分、比速度比值、心率心率，并用進(jìn)入鍵確認(rèn)1。RI阻力指數(shù)FVI流速積分：從收縮期起始點(diǎn)到舒張期末期的頻譜進(jìn)行包羅（手動(dòng)）后，進(jìn)入鍵確認(rèn)，Themachineautomaticallyaddsintegralvalues,averageflowvelocity,peakflowvelocity,enddiastolicflowvelocity,pulsatilityindex,andresistanceindextothedataregion.RATIOspeedratio(measuredtwopointsspeed)HEARTRATEheartrate(putthecursoratthestartingpointoftheheartcycle,pressthe"ENTER"key,andthenmovethecursortotheendofthecardiaccycle,pressthe"ENTER"key.TwodimensionalimageconditioningThequalityofanultrasoundimageiscloselyrelatedtotheimagingparametersandthepatient'sconditionanddoctor'sexperience.TheseparametersincludefrequencyFREQ,preprocessPRE,postprocessPOSTandafterglowPERSIST.Thesefourparametersareshownatthemonitor'slocation(Figure3,figure4).Hereisadetaileddescriptionoftheeffectofthefourparametersonthetwo-dimensionalimageandhowitisadjusted.ThefrequencyofFREQ:effectofZontheimagefrequency:thehigherthefrequency,thebetterverticalresolutionimage,theimagelooksmorefine,figure3andpenetrationworse,rearattenuationisobvious;onthecontrary,thelowerthefrequency,theverticalresolutionofimagesispoor,imagecoarseparticles,andbetterpenetration.Allprobesofthismachinearebroadbandfrequencyprobe,thecenterfrequencyistwo:CA421probeis3.5/5.0MHz,LA523probeis7.5/10MHz,PA220Eprobeis2.5/3.5MHz.Frequencyregulation:(seeFigure5)withtheCA421probeasanexample,inthecaseofreal-timescanning,clicktheENTERbutton,thebuttonbelowthescreenwillhavesoftwareactivationwithatrackballselectiontoFREQ,atthistimewillautomaticallypopuponthepull-downmenuinFigure4youcanuseeither(withatrackballorthecorrespondingthedigital(highfrequencyprobenokey)correspondingtothefrequencyordifferentharmonicfunction(TEI(P)highpenetrationtype,TEI(R)highresolutiontype)Harmonicfunction).Colourfrequencychanges,ditto.FREpre-processing:Theinfluenceofpre-processingonimages:pre-processingistheparameterthatregulatesthebrightness(contrast)ofthewholeimage.Itisdividedinto16levels.Thehighertheprogression,thebrightertheimageandthestrongerthecontrast.Instead,thesoftertheimage.Therefore,fortheexaminationoforganizationaldetails(suchastheabdomen,smallorgans),thisvalueisgenerallysetat2-5,andfortheexaminationwhichrequiresonlytissuecontrast(suchastheheartandbloodvessel),thisvaluecanbesetto5-7.ConditioningofZpretreatment(seeFigure6),Figure6Inreal-timescanning,clickthePREbuttontoadjusttheENCODERknobbelow,youcanaccordingtotheneedsChoosearbitrarily(withtrackballorcorrespondingnumerickey)atdifferentlevelsPOSTpostprocessingTheinfluenceofZpostprocessingonimage:Postprocessingistheparameterthatregulatesthegraylevelofthewholeimage,mainlytochangetherelationbetweenechointensityandgrayscale.Itisdividedinto4grades,Inthe1-3stage,thehighertheseries,thegreaterthegraylevel.Thesettingofthisvalueismorearbitrary,entirelybasedonpersonalpreferencesDecide.ConditioningofZpostprocessing:TheadjustmentkeyPOSTpositionofthisvalue,asshownabove,canbeadjustedupanddown.Thespecificvalueisdisplayedontheupperleftofthescreen(seeFigure3)PERSISTafterglowTheeffectofZafterglowonimages:persistencecontrolstheretentiontimeofeachpixelonthescreen.Dividedinto8levels,thehigherthelevel,thelongereachpixelstaysonthescreen,thesmallertheimage,butforthelargermovementorgans,the"tailing"phenomenonismoreobvious.Ontheotherhand,theshortertheretentiontimeofeachpixelonthescreen,thethickertheimageandbetterfollow-upfortheorganswithlargermotionrange.Socheckforrelativelystaticorgans(suchastheabdomen,smallorgans)issetto5-7,andcheckforobviouspulsatileorgans(suchasheart,neckartery)thisvalueissettoolow,usually2-4.RegulationofZafterglow(seeFigure4)Inthecaseofreal-timescanning,clicktheENTERbuttontoactivatethesoftwarebuttonbelowthescreenwithatrackball,choosetoPERSIST,atthistimewillautomaticallypopuponthepull-downmenu,youcanchooseaccordingtoneed(withatrackballorthecorrespondingnumberkey)ofdifferentlevel.Theabovefourparametersdeterminethestyleoftheimage,Theydifferandinfluenceeachother,sowhenyoucanfullygraspthemeaningandadjustmentoftheaboveparameters,youwillgetasatisfactorytwo-dimensionalmapHereareoursuggestedparametervalues:Frequencypretreatment,post-treatment,afterglowAbdominal5MHz425/6Vascular10MHz41,4/5Smallorgan10MHz426CardiacRES(R)1012/3ColorDopplerregulationThehigherthefrequency,thebetterthecolorsensitivity,buttheweakerthepenetrationrate,thebetterforlowvelocitybloodflow;otherwise,thedeepandhighvelocitybloodflowshowbetter;Theadjustmentofcolorfrequencywiththeregulationoftwodimensionalfrequency.Themainparametersofcolorflowchartincludecolorfrequency,FREQandcolorgainC/D,GAIN,andpulserepetitionfrequencyPRF.DisplaybitsforthreesetsofdataFREQfrequency:Itsmainadjustmentistherangeofcolorcodingrange,theprincipleofregulationishighspeedbloodflowwithhigherPRF,andviceversawithlowerPRF.Thestandardofadjustmentisthatthecolorbloodflowisfullandatthesametimethereisnoobvious8spillover.PRFandtheactualbloodflowvelocity,bloodflowisnotgood,suchastheactualhightolowPRFwillappearcoloraliasing,spottedlikebloodflowsignal,thePRFcanbeincreased;ontheotherhand,theactualflowisrelativelylow,andtothehighPRFwillappearcolorfillingdefectphenomenon,asifintravascularbloodflowornotmistakenlybelievethattherewillbeappropriatetoreducethrombosis,thisPRFbloodflowwillgraduallyfill.Theadjustmentkeyofthepulserepetitionfrequencyislocatedinthecontrolareaofthekeyboard.C/DGAINcolorgain:Theadjustmentofthegainislocatedinthefunctionalareaofthekeyboard.Thecolorgainshouldbeadjustedtotheoutsideofthevessel,justasthenoiselesssignalisthebest.PRFpulserepetitionfrequency:PulseandcontinuousDopplermodulationTheadjustmentofpulseandcontinuousDopplerscanisrelativelysimple,mainlysamplingline/windowLINEandsamplingwindowangleTherangeofANGLE,BSLINE,FILTERfilter,baselinesamplingwindowsizeofsSIZEandDopplerspectrumRangePRF.ThespecificdisplaypositionoftheaboveparametersisshowninFigure9andfigure10.Samplingline/windowadjustment:clicktheLINEkeyandadjustwithtrackball.Adjustmentofsamplingwindowangle:adjusttheANGLEkeyofkeyboardcontrolareaupanddown.Baselineadjustment:upanddowntheBSLINEkeyforthekeyboardcontrolarea.Filter:adjusttheFILTERkeyofkeyboardcontrolareaupanddown.Samplingwindowadjustment:ClickENTER,activatetheS.SIZEkeyinthesoftwarekey,andselectbytrackballornumerickey.BodypositionsignThefunctionalkeysbelowthemonitorscreenarecalledsoftkeys.(seeFigure11)includingbodymarkingsBODY,MARK,displaymode,DISPLAY,aswellasfrequencyconversion,pre-processing,postprocessing,afterglow,samplingwindowsize,etc.,introducedbefore.Activationofsoftwarekeys:clicktheENTERkey.BODYMARKbodymarkings:(Figure12)Figure11Option,atthispoint,thepop-upmenucontains3options:AfterselectingtheBODYMARKentry,usethetrackballtodirectlyselectthedesiredbodysurfacemarkeratthenextlevelmenu.Atthispoint,theprobeindicatesthatthearrowisblue.Adjustthebitmap12withthetrackball,andusetheSTEERkeytorotatethearrowangle.Finally,confirmwithENTER.(arrowschangefrombluetoblack)ClicktheENTERkey,1ON/SELECTopenandselect:selectthis2VECTORreadjustprobemark3CLEARclearanceofbodymarkings.Note:thebodymarkingsaredifferentindifferentexaminationconditions.MovieplaybackThismachineoffersavarietyofmovieplayback,includingsingle/double/fourmanualandautomaticfilmplayback.Thissectiondescribesonlysinglemanualandautomaticfilmplayback.Followingtheimagefreeze,thefollowingselectionappearsontherightsideofthemonitor:(seeFigure13)One全全程電影回放2。通過(guò)循環(huán)循環(huán)電影回放三.序列截取式電影回放4。16幀16幅電影回放當(dāng)您要進(jìn)行手動(dòng)電影回放時(shí)，只需左右移動(dòng)軌跡球即可。（單擊當(dāng)您要進(jìn)行自動(dòng)電影回放時(shí)，選擇全即可。鍵盤區(qū)的1鍵）圖13四幅顯示一）按“多格式”鍵，進(jìn)入2幅狀態(tài)，按”進(jìn)入“鍵，移動(dòng)軌跡球選中”顯示“菜單，選擇”4quad”；B）做好一幅圖象后，依次按“2D”鍵，做好4幅圖象后，按凍結(jié)鍵；C）移動(dòng)軌跡球，依次手動(dòng)回放各幅圖象；D）自動(dòng)回放：凍結(jié)后按”進(jìn)入“鍵，選擇“電影”菜單，選擇”1full”；E）用軌跡球選擇各幅圖象后依次分別按空格鍵（4次），4幅自動(dòng)回放。F）按“ESC”退出。產(chǎn)科報(bào)告的應(yīng)用產(chǎn)科報(bào)告僅在產(chǎn)科條件下才能應(yīng)用。在進(jìn)入產(chǎn)科條件后，監(jiān)視器出現(xiàn)如圖14的對(duì)話框，讓你輸入孕婦的末次月經(jīng)，輸入完畢后移動(dòng)軌跡球機(jī)器自動(dòng)添加孕周及預(yù)產(chǎn)期此時(shí)單擊進(jìn)入鍵即可進(jìn)行檢查。同時(shí)機(jī)器自動(dòng)將上述三個(gè)數(shù)據(jù)（末次月經(jīng)、預(yù)產(chǎn)期、孕周）添加至報(bào)告。如果您在此對(duì)話框中不輸入任何數(shù)據(jù)，直接單擊進(jìn)入鍵，也可進(jìn)行下一步的檢查，但機(jī)器將無(wú)法評(píng)估胎兒的生長(zhǎng)發(fā)育情況。報(bào)告內(nèi)容包括：孕周、預(yù)產(chǎn)期、胎兒體重、FL/AC、HC/交流、FL/桶、BPD、CRL、FL、交流、HC、等見(jiàn)下圖GS。mage062.jpg（0字節(jié)）下載次數(shù)：02006-1-916:07具體操作：（以BPD為例）1。凍結(jié)圖像2。單擊報(bào)告鍵，出現(xiàn)上圖，用軌跡球選至BPD項(xiàng)，單擊措施鍵確認(rèn)三.固定起始光標(biāo)，進(jìn)入鍵確認(rèn)，再固定終止光標(biāo)，單擊進(jìn)入鍵確認(rèn)。此時(shí)測(cè)量數(shù)據(jù)已自動(dòng)顯示在屏幕并存儲(chǔ)到報(bào)告中。對(duì)于其余各項(xiàng)的測(cè)量重復(fù)以上步驟即可。如果要測(cè)胎兒重量，則需要測(cè)出BPD和交流腹圍。觀察報(bào)告：?jiǎn)螕魣?bào)告鍵即可。如果胎兒某項(xiàng)發(fā)育異常（如BPD），則在報(bào)告頁(yè)該項(xiàng)的測(cè)值后方出現(xiàn)>或<符號(hào)，表示該項(xiàng)發(fā)育過(guò)快或遲緩心功能測(cè)量報(bào)告中英文對(duì)照心臟測(cè)量報(bào)告僅在心臟條件下才能應(yīng)用，心臟報(bào)告的內(nèi)容非常豐富，在B、M、PW/CW下分別擁有不同內(nèi)容的報(bào)告頁(yè)，且每一個(gè)報(bào)告內(nèi)又有不同的子報(bào)告其具體測(cè)量菜單的中英文對(duì)照見(jiàn)下表：（具體如何測(cè)量見(jiàn)后面內(nèi)容）。心功能測(cè)量操作方法：如果您想將測(cè)量數(shù)據(jù)存儲(chǔ)到報(bào)告單內(nèi)，一般情況下則應(yīng)在測(cè)量之前先進(jìn)入報(bào)告頁(yè)（方法為單擊報(bào)告鍵），再選擇相應(yīng)的測(cè)量項(xiàng)目，選擇好相應(yīng)的測(cè)量項(xiàng)目后一定用措施鍵進(jìn)行確認(rèn)。二維圖像凍結(jié)后按報(bào)告（報(bào)告）鍵的報(bào)告頁(yè)面：二維心功能測(cè)量：您可根據(jù)需要去選擇一組測(cè)量數(shù)據(jù)的總項(xiàng)（如在M型下，您測(cè)量左室功能，可在報(bào)告單內(nèi)直接選擇LV項(xiàng)），也可選擇其中的小項(xiàng)（如您只想測(cè)量射血分?jǐn)?shù)，下的則可以直接選擇LV射血分?jǐn)?shù)項(xiàng)）比如選擇LV一項(xiàng)測(cè)量左室心功能：先做雙幅圖像，分別回放到舒張期和收縮期，再按措施，根據(jù)屏幕提示開(kāi)始測(cè)量；1）先測(cè)量舒張期左室瓣環(huán)周長(zhǎng)，再測(cè)量最大內(nèi)徑。2）測(cè)量收縮期左室瓣環(huán)周長(zhǎng)，再測(cè)量左室最大內(nèi)徑，EF等參數(shù)值自動(dòng)被計(jì)算出結(jié)果。3）如果要用辛普森法測(cè)量心功能，TochooseLVSIMPSON,thenpresstheMEASUREbutton,thenaccordingtothescreen,measuringrespectivelyfourchamberandtwochamberheartdiastolicandsystolicleftventricularareaanddiameter(8steps),finallyautomaticallycalculatevariousparameterssuchasejectionfractionEF.MtypereportpageafterpressingREPORT(report)buttonafterfreezing:MITRALmitralvalveE-Septum(mm)Epeak,diaphragmthicknessEFSlope(mm/sec)EFslopeTypeMcardiacfunctionmeasurement1)makeMtypeimages,freeze,presstheREPORTkey;2)selectLVandpresstheMEASUREkey;3)followtheRVDdbelowthescreenandplacethefirstpointatthebeginningoftherightatriumatthediastoleENTERkey.Movethetrackballagain.PlacethesecondpointattheendofdiastoleandpresstheENTERkey;4)taketheIVSD:samplingpoint,placetheleftventricularseptum,andpresstheENTERkey;5)measureLVDD(diastolicleftventriculardiameter):attheendoftherelaxationpointatthesamplingpoint,presstheENTERkey;6)measurePW(diastolicleftventricularposteriorwall):attheendofthesamplingpoint,attheendofthewall,presstheENTERkey;7)repeatthreesteps,butonlythesystolicphase:8)taketheIVS:samplingpoint,placetheleftventricularseptum,andpresstheENTERkey;9)measureLVDS(systolicleftventriculardiameter):attheendofthesamplingpoint,presstheENTERkeyattheendofsystole;10)measurePW(systolicleftventricularposteriorwall):thepointaftersampling,theendofthewall,presstheENTERkey;11)themeasurementisautomaticallyfinished,andtheparameterssuchasEFaredisplayedonthescreenAftertheDopplerimagefreezes,presstheREPORT(report)keyonthereportpage:Dopplerheartfunctionmeasurement:1)aftertheDOPPLERimageisfrozen,presstheREPORTkeyandselecttheFLOWVOLUMESpageNoodles;2)selectMITRIAL(mitralvalve)orother,andthenpresstheMEASUREkey;3)accordingtothelowerleftcornerofthescreenprompts,firstoftwokeysspect