ZIEHM - Vision - R MANUAL

Table of Contents
About this Manual 1

System Overview 2
Safety Instructions 3
Putting the System into Service 4
Mechanical Handling 5
Ziehm Vision
Controls 6
Switching the System On 7
Ziehm Vision FD Standard Fluoroscopic Operations 8
Adjusting Live Images 9
Data Management 10
User Manual
DICOM Functions 11
Cine Loops 12
Subtraction Modes 13
Post-Processing Images 14
Measurements 15
Displayed Texts and Text Functions 16
Image Documentation 17
Laser Positioning Device 18
Direct Radiography 19
System Configuration 20
C-Arm Power Assist (U.S. Option) 21
Appendix
Index
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Safety instructions This manual does not constitute a complete catalog of all safety measures necessary for
the operation of the respective medical equipment, since special operating conditions may
require further measures. However, it does contain instructions which must be observed in
order to ensure the personal safety of operating staff and patients as well as to avoid
damage to property.
Intended use The medical equipment is intended for fluoroscopies in the field of surgery, e.g. in
traumatology, orthopedics, neurology, urology, cardiology. Third-party devices and
components used in combination with this system must comply with the safety
requirements according to IEC 60601-1 and/or IEC 60601-1-1 or furnish proof of an
equivalent degree of safety.
To ensure CE conformity, these components must have a CE approval in accordance with
Council Directive 93/42/EEC. In addition, a declaration in compliance with Article 12 of the
said directive must be provided.
For components without CE approval, a conformity assessment procedure is obligatory.
Proper and safe operation of the system requires adequate transportation, storage,
assembly and installation as well as appropriate use and maintenance.
The limiting values indicated in this user manual must not be exceeded; this applies also
when putting the system into service.
Operation (U.S.A.) In the U.S.A., Federal law restricts use of this device to trained personnel on the order of a
physician.
Authorized personnel Only authorized personnel are allowed to assemble and/or repair the medical equipment
described in this manual. Authorized personnel are persons who have attended an
appropriate training course provided by the manufacturer.
Exclusion of liability The manufacturer accepts responsibility for the safety, reliability and performance of the
system only if
• any installation, modification or repair work is carried out exclusively by persons
authorized by the manufacturer;
• the electrical installation of the site where the system is operated complies with the
requirements of VDE 0107 or the corresponding national regulations of the country of
installation;
• the system is used in accordance with the user manual.
The warranty becomes invalid in case that any repair, modification or installation work is
carried out by unauthorized personnel. No consequential damages will be accepted either.
The equipment conforms to Class IIb according to the Council Directive 93/42/EEC.
This user manual has been written and reviewed originally in German and translated.
Copyright Quality Standards

Copyright © 2005 Ziehm Imaging GmbH This manual was produced in compliance with the quality principles of
All rights reserved. ISO 9001. The information provided in this manual may be updated at
Transmission or reproduction of this manual, exploitation and regular intervals and is subject to change without prior notice.
disclosure of its contents to third persons is not permitted without
express written consent of the manufacturer. Infringements shall Manufactured by: In the U.S.A.:
entitle to damage claims. Ziehm Imaging GmbH Ziehm Imaging, Inc.
Donaustr. 31 4181 Latham Street
Registered Trademarks D-90451 Nuremberg (Germany) Riverside, CA 92501
This manual may contain the names of registered trademarks or e-mail: info@ziehm-eu.com e-mail: info@ziehm.com
brands, the use of which by third persons for their purposes may http://www.ziehm.com
infringe the rights of their respective owners.
Rev. 07/2005
Ziehm Vision
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Table of Contents
Table of Contents I
1 About this Manual 1-1
2 System Overview 2-1

2.1 Fields of application.......................................................................................... 2-1
2.2 Features ........................................................................................................... 2-1
2.3 Options ............................................................................................................. 2-4
2.4 Options (U.S.A.) ............................................................................................... 2-5
2.5 Optional accessories ........................................................................................ 2-6
2.6 Optional accessories (U.S.A.) .......................................................................... 2-6
2.7 Parts of the system........................................................................................... 2-7
2.7.1 C-arm stand ...................................................................................... 2-7
2.7.2 Monitor cart ....................................................................................... 2-9
2.7.2.1 Monitor cart with 18.1" flat-screen monitors....................... 2-9
2.7.2.2 Monitor cart with CRT monitors ......................................... 2-10
2.7.3 Twin monitors.................................................................................... 2-11
2.7.4 Monitor settings on a Ziehm Vision with flat-screen monitors ........... 2-12
2.7.4.1 Integrated button panel...................................................... 2-12
2.7.4.2 Setting the brightness, contrast and backlight brightness . 2-12
2.7.4.3 Setting the menu language................................................ 2-14
2.7.4.4 Restoring the factory settings ............................................ 2-15
2.7.5 Video output ...................................................................................... 2-16
3 Safety Instructions 3-1

3.1 General safety instructions............................................................................... 3-1
3.2 X-rays ............................................................................................................... 3-2
3.3 Electromagnetic compatibility........................................................................... 3-3
3.4 Protective grounding ........................................................................................ 3-4
3.5 Equipotential grounding.................................................................................... 3-4
3.6 Laser radiation.................................................................................................. 3-5
3.7 Environmental compatibility.............................................................................. 3-6
4 Putting the System into Service 4-1

4.1 Unpacking the system ...................................................................................... 4-1
4.2 Accessories ...................................................................................................... 4-2
4.3 Cable connections............................................................................................ 4-3
4.4 First power-up of the system ............................................................................ 4-3
4.5 Setting up the system....................................................................................... 4-4
5 Mechanical Handling 5-1

5.1 Transport position............................................................................................. 5-1
5.1.1 C-arm stand transport position.......................................................... 5-1
5.1.2 Monitor cart transport position........................................................... 5-2
5.2 Braking and steering the monitor cart .............................................................. 5-4
5.3 Braking and steering the C-arm stand.............................................................. 5-5
5.4 C-arm movements............................................................................................ 5-6
5.4.1 Orbital rotation .................................................................................. 5-7
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5.4.2 Angulation ......................................................................................... 5-8

5.4.3 Swiveling (panning) ........................................................................... 5-9
5.4.4 Horizontal movement ........................................................................ 5-10
5.4.5 Vertical movement............................................................................. 5-11
6 Controls 6-1
6.1 Vision Center control panel .............................................................................. 6-1
6.1.1 Elements of the control panel............................................................ 6-1
6.1.2 Controls in the Fluoroscopy and Subtraction operating modes......... 6-2
6.2 Switches on the unit ......................................................................................... 6-9
6.3 Hand switch and foot switch ............................................................................. 6-10
7 Switching the System On 7-1

7.1 Preparing the system........................................................................................ 7-1
7.2 Switching the system on................................................................................... 7-2
7.3 EMERGENCY STOP button............................................................................. 7-3
7.4 Key switch ........................................................................................................ 7-4
8 Standard Fluoroscopic Operations 8-1

8.1 Overview........................................................................................................... 8-1
8.2 Fluoroscopy modes .......................................................................................... 8-2
8.2.1 Continuous pulse fluoroscopy ........................................................... 8-2
8.2.2 Digital radiography (snapshot) .......................................................... 8-4
8.3 Manual exposure rate setting ........................................................................... 8-5
8.4 Fluoroscopy programs...................................................................................... 8-7
8.4.1 Anatomical programs ........................................................................ 8-7
8.4.2 Metal artifact correction function ....................................................... 8-8
8.4.3 Reposition function............................................................................ 8-8
8.4.4 High quality function .......................................................................... 8-8
8.4.5 Large patient function........................................................................ 8-9
8.5 Screen display during radiation ........................................................................ 8-9
8.6 Dose area product ............................................................................................ 8-10
8.7 Saving............................................................................................................... 8-10
8.8 Printing the live monitor image ......................................................................... 8-12
8.9 Warning signals and faults ............................................................................... 8-13
8.9.1 Permanent warning during radiation ................................................. 8-13
8.9.2 Interval warning during radiation ....................................................... 8-13
8.9.3 Temperature monitoring .................................................................... 8-14
8.9.4 Error and alert messages .................................................................. 8-14
9 Adjusting Live Images 9-1

9.1 Overview........................................................................................................... 9-1
9.2 Contrast and brightness settings for the CRT monitors.................................... 9-2
9.3 Contrast and brightness adjustment of individual images (windowing) ............ 9-4
9.4 Filters................................................................................................................ 9-7
9.4.1 Recursive filter................................................................................... 9-7
9.4.2 Edge filter .......................................................................................... 9-8
9.4.3 Stack filter ......................................................................................... 9-9
9.5 Electronic image magnification......................................................................... 9-10
9.6 Digital image zooming ...................................................................................... 9-11
9.7 Grayscale inversion .......................................................................................... 9-13
9.8 Collimation........................................................................................................ 9-13
9.8.1 Iris collimator ..................................................................................... 9-13
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9.8.2 Slot collimator ................................................................................... 9-14

9.8.3 Virtual collimator................................................................................ 9-15
9.9 Image swapping ............................................................................................... 9-15
9.10 Image reversal and image rotation................................................................... 9-16
9.10.1 Horizontal and vertical image reversal .............................................. 9-16
9.10.2 Image rotation ................................................................................... 9-17
10 Data Management 10-1

10.1 Organization of patient and image data ........................................................... 10-1
10.1.1 Patient folders ................................................................................... 10-1
10.1.2 Generated patient folders ................................................................. 10-2
10.2 Managing patient data...................................................................................... 10-2
10.2.1 Creating a new patient folder on the Ziehm Vision ........................... 10-3
10.2.1.1 Entering patient data manually .......................................... 10-4
10.2.2 Modifying patient data ....................................................................... 10-5
10.3 Image data management ................................................................................. 10-7
10.3.1 Processing patient folders................................................................. 10-8
10.3.2 Finding and displaying a patient folder.............................................. 10-15
10.3.3 Activating a patient folder.................................................................. 10-17
10.3.4 Browsing through the active patient folder ........................................ 10-20
10.3.5 Processing and outputting images in a patient folder ....................... 10-20
10.3.6 Comparing saved images ................................................................. 10-29
10.3.7 Making backup copies of patient folders ........................................... 10-30
10.3.7.1 Backup to USB storage device .......................................... 10-31
10.3.7.2 Backup to CD or DVD....................................................... 10-34
11 DICOM Functions 11-1

11.1 Prerequisites .................................................................................................... 11-1
11.2 Downloading patient data from a DICOM server.............................................. 11-1
11.2.1 Query ................................................................................................ 11-1
11.2.2 Downloading a Worklist..................................................................... 11-2
11.2.2.1 Downloading a Worklist for a specific time span .............. 11-3
11.2.2.2 Downloading a patient-specific Worklist ........................... 11-4
11.2.2.3 Downloading a Worklist for a procedure step ................... 11-6
11.3 Saving images from one or several patient folders .......................................... 11-8
11.3.1 Saving and printing images and cine loops....................................... 11-9
11.4 Saving or printing single cine loop images ....................................................... 11-11
11.5 Importing images and cine loops from a DICOM server .................................. 11-12
12 Cine Loops 12-1

12.1 Overview .......................................................................................................... 12-1
12.2 Generating a cine loop ..................................................................................... 12-1
12.3 Opening a saved cine loop............................................................................... 12-4
12.4 Controlling and editing a cine loop during playback ......................................... 12-6
12.5 Processing and outputting saved cine loops .................................................... 12-8
12.6 Processing and outputting single cine loop images ......................................... 12-15
13 Subtraction Modes 13-1

13.1 Overview .......................................................................................................... 13-1
13.2 Acquiring a DSA cine loop................................................................................ 13-2
13.3 Acquiring an MSA image.................................................................................. 13-4
13.4 Acquiring an RSA image .................................................................................. 13-5
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13.5 Generating MSA and RSA images from a saved DSA cine loop ..................... 13-7
13.5.1 Opening and postprocessing a DSA cine loop in an active patient
folder ................................................................................................. 13-7
13.5.2 Opening and postprocessing any DSA cine loop .............................. 13-8
13.6 Editing a DSA cine loop.................................................................................... 13-11
13.7 Pixel shift .......................................................................................................... 13-13
13.8 Landmarking..................................................................................................... 13-14
14 Post-Processing Images 14-1

14.1 Overview........................................................................................................... 14-1
14.2 Activating the post-processing functions .......................................................... 14-3
14.3 Contrast and brightness settings for the CRT monitors.................................... 14-4
14.4 Contrast and brightness adjustment of individual images (windowing) ............ 14-5
14.5 Edge filter ......................................................................................................... 14-8
14.6 Digital image zooming ...................................................................................... 14-9
14.7 Grayscale inversion .......................................................................................... 14-11
14.8 Image rotation................................................................................................... 14-11
14.9 Horizontal and vertical image reversal ............................................................. 14-11
14.10 Digital collimation (image crop) ........................................................................ 14-12
14.11 Marking and deleting images............................................................................ 14-12
14.12 Outputting images ............................................................................................ 14-15
15 Measurements 15-1
15.1 Measuring functions ......................................................................................... 15-1
15.2 Calibrating ........................................................................................................ 15-3
15.3 Measuring a length or distance ........................................................................ 15-5
15.4 3-point measurement........................................................................................ 15-8
15.5 4-point measurement........................................................................................ 15-11
15.6 4-point ratio measurement................................................................................ 15-15
16 Displayed Texts and Text Functions 16-1

16.1 Overview........................................................................................................... 16-1
16.2 Image information on the monitor..................................................................... 16-1
16.2.1 Upper left corner of the monitor......................................................... 16-1
16.2.2 Upper right corner of the monitor ...................................................... 16-1
16.2.3 Lower left corner of the monitor......................................................... 16-2
16.2.4 Lower right corner of the monitor ...................................................... 16-3
16.3 Entering and editing text................................................................................... 16-4
17 Image Documentation 17-1

17.1 Overview........................................................................................................... 17-1
17.2 Output to video printer ...................................................................................... 17-1
17.3 Record and playback on video cassette recorder ............................................ 17-2
18 Laser Positioning Device 18-1

18.1 Applications ...................................................................................................... 18-1
19 Direct Radiography 19-1

19.1 Overview........................................................................................................... 19-1
19.2 Fitting the film cassette holder.......................................................................... 19-1
19.3 Making a direct radiographic exposure............................................................. 19-2
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20 System Configuration 20-1

20.1 Overview .......................................................................................................... 20-1
20.2 Operation settings ............................................................................................ 20-2
20.2.1 Autotransfer ...................................................................................... 20-2
20.2.2 Autostore........................................................................................... 20-3
20.2.3 Displaying a crosshair ....................................................................... 20-4
20.2.4 Defining the start screen ................................................................... 20-5
20.2.5 Cine loop settings ............................................................................. 20-6
20.2.6 Showing or hiding the native image .................................................. 20-7
20.2.7 Discarding the operation settings...................................................... 20-7
20.3 Basic settings ................................................................................................... 20-8
20.3.1 Setting the system date and the system time ................................... 20-8
20.3.2 Determining the live monitor ............................................................. 20-9
20.3.3 Entering the hospital data ................................................................. 20-10
20.3.4 Discarding the basic settings ............................................................ 20-11
20.4 Monitor / Dose .................................................................................................. 20-11
20.5 Storage media .................................................................................................. 20-13
20.5.1 Floppy disk storage format................................................................ 20-14
20.5.2 Defining the USB device storage format ........................................... 20-14
20.5.3 Defining the CD / DVD storage format .............................................. 20-15
20.5.4 Deleting data from storage media ..................................................... 20-16
21 C-Arm Power Assist (U.S. Option) 21-1

21.1 Function............................................................................................................ 21-1
21.2 Operating instructions ...................................................................................... 21-1
21.3 Using the C-arm Power Assist ......................................................................... 21-2
Appendix A-1
A.1 Regular checks................................................................................................. A-1
A.1.1 Routine checks to be performed by the user .................................... A-1
A.1.2 Consistency test according to national regulations ........................... A-2
A.1.3 Checking the exposure rate control .................................................. A-2
A.1.4 Dose meter check (optional feature) ................................................. A-2
A.1.5 Checking the useful beam ................................................................ A-4
A.1.6 Leakage in the cooling system.......................................................... A-5
A.1.7 Gettering the image intensifier tube (n/a for Ziehm Vision FD) ......... A-5
A.1.8 Gain adjustment and pixel correction (Ziehm Vision FD).................. A-5
A.2 Cleaning, disinfection, sterilization ................................................................... A-6
A.2.1 Cleaning ............................................................................................ A-6
A.2.2 Disinfection ....................................................................................... A-6
A.2.3 Sterilization ....................................................................................... A-7
A.3 Faults................................................................................................................ A-7
A.3.1 Types of faults................................................................................... A-7
A.3.1.1 Alerts during power-up....................................................... A-7
A.3.1.2 Errors during power-up ...................................................... A-7
A.3.1.3 Alerts during operation....................................................... A-8
A.3.1.4 Errors during operation ...................................................... A-8
A.3.2 List of errors and alerts ..................................................................... A-8
A.4 Labels on the Ziehm Vision .............................................................................. A-16
A.5 Focal spot position ........................................................................................... A-26
A.5.1 Ziehm Vision ..................................................................................... A-26
A.5.2 Ziehm Vision FD................................................................................ A-27
A.6 Heat capacity.................................................................................................... A-28
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A.7 Scattered radiation in the significant zone of occupancy.................................. A-29

A.7.1 Ziehm Vision ..................................................................................... A-29
A.7.2 Ziehm Vision FD................................................................................ A-30
A.8 Dimensions....................................................................................................... A-31
A.9 Technical data .................................................................................................. A-35
A.9.1 Ziehm Vision ..................................................................................... A-35
A.9.2 Laser positioning device.................................................................... A-39
A.9.3 Dose measurement chamber ............................................................ A-39
A.10 Labels on the Ziehm Vision (U.S.A.) ................................................................ A-40
A.11 Technical data Ziehm Vision (U.S.A.)............................................................... A-48
A.12 Technical data Ziehm Vision (Japan) ............................................................... A-51
Index i
VI Ziehm Vision
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About this Manual 1
This manual is designed to enable owners and operators of a Ziehm Purpose of this
Vision or Ziehm Vision FD to operate the systems described herein safely manual
and efficiently.
Ziehm Vision and Ziehm Vision FD, software version 4. Scope of validity of
this manual
For several system options, separate operating instructions are Separate operating
available. They are supplied with the system, provided that the system instructions
configuration includes the respective option. You will find a
corresponding reference in the relevant sections of the manual.
Typographical conventions
In this manual, the following notations and formats will be used to

highlight certain elements of the Vision Center control panel or the
documentation itself:
Element Format Example

Vision Center Bold Post Process
elements (buttons,
symbols and
boxes), operating
modes, functions
Cross-references Italic, preceded by → Ch. 20, p. 20-1
an arrow
Steps of a Preceded by a • Press the OK button.
procedure •
Table 1-1 Notations and formats used in this manual
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1 About this Manual
Hints and warnings The manual contains some information which must be observed in order
to ensure the personal safety of operating staff and patients as well as to
avoid damage to property. All such information is highlighted as follows:
WARNING
This is the highest level of risk. Personal injury or damage to property
may occur if the operator does not observe the instructions provided
here.
CAUTION
This means that a situation exists which may require a decision or action
on the part of the user for optimum equipment performance or to avoid
a minor hazard.
Note
Notes are merely informative. Additional useful information and hints are
provided for the operator here.
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System Overview 2
2.1 Fields of application
The Ziehm Vision is a mobile C-arm X-ray image intensifier which is Applications
suitable for all surgical applications in traumatology, orthopedics,
neurology, urology and cardiology, for use in gastroenterology and for all
vascular applications.
The Ziehm Vision FD is suitable for more demanding vascular Ziehm Vision FD
interventions requiring a high level of precision, e.g. in the field of
neurology.
2.2 Features
With its compact design and combined steering & braking system, the Mobility
Ziehm Vision offers unrestricted mobility at the operating table, even if
space is scarce.
The easy adjustability of the ample C-arm and the perfect
counterbalancing of the C-arm stand make it possible to access even the
most difficult positions.
Computer-controlled anatomical programs ensure optimal exposure rate Anatomical

and image quality control as well as high operating comfort. A ‘Soft’ programs
program for soft tissue visualization during foreign body localization and
a ‘Metal’ program for suppressing image flare resulting from the use of
metal implants and surgical instruments complete the automatic
functions.
The superior penetration capabilities of the digital high-frequency Radiation dose

generator enable a significant reduction in the patient skin dose. reduction
Radiation-free collimation is provided by the system’s ‘Virtual Collimator’.
18" flat-screen monitors or optionally 1000 cd2 CRT monitors with anti- Image quality
reflection coating which are based on 150 Hz technology (U.S.A.: 90 Hz
non-interlaced) guarantee flicker-free images. The advanced Full Frame
Technology, which uses non-interlacing throughout the entire image
processing chain, generates noise-free images without motion artifacts,
even if the subject has moved.
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2 System Overview
Ziehm Vision FD The Ziehm Vision FD features a fully-digital image processing chain. The
digital flat-panel detector ensures distortion-free images.
Image adjustment Comprehensive real-time image processing functions (customizable

noise and area filtering, electronic contrast and brightness adjustment,
zooming, radiation-free horizontal and vertical image reversal, digital
image rotation) ensure perfect adaptation of the image quality and
orientation on the screen to the surgeon’s needs.
Further image processing functions are available for saved images
(post-processing).
Active Cooling The Active Cooling system allows for nearly unlimited fluoroscopy times,
being often indispensable e.g. in cardiac and vascular surgery.
Image management A patient-based image management system providing a 16-image

mosaic view and menu-controlled user guidance guarantees efficient
image data handling.
Documentation and For documentation purposes, a video printer and a video cassette
output recorder are available.
For filmless archiving, the following devices are available:
− Floppy disk drive
− CD writer or DVD writer
− USB port
Images can be stored in the following formats:
− PC-compatible BMP format (floppy disk)
− PC-compatible TIF format
− PC-compatible JPEG format with reduced resolution and reduced
color depth
− DICOM format
− DICOM format with reduced resolution and reduced color depth
− Multimedia format: Video CD format (CD) or MPEG2 format (DVD).
The system documents not only patient-related data, but also image-
related data (e.g. the fluoroscopy parameters).
In addition, all systems have a video output.
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2 System Overview
The optional DICOM 3.0 interface (Ziehm NetPort) enables integration Networkability
into any network supporting DICOM, e.g. PACS. Thanks to ‘Primary
Capture’ support, the original fluoroscopic images can be archived
without the changes which may have been applied to them later. The
following DICOM Classes are available: Print, Storage (including
multiframe capability), Media, Worklist, Query/Retrieve and Verification.
It is possible to connect and configure several DICOM servers for each
DICOM Class.
For more information on DICOM, please refer to our DICOM
Conformance Statement included in the “Technical Manual”.
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2 System Overview
2.3 Options
This manual describes a system with maximum configuration. The

system configuration chosen by you may not contain all options and
functions described here.
The following options can be integrated into the system upon request:
− DICOM 3.0 interface Ziehm NetPort (Primary Capture)
Depending on the chosen system configuration, the following DICOM
Classes are supported:
− Print Class
− Storage Class including multiframe capability
− Media Class
− Worklist Class
− Query/Retrieve Class
− Verification Class
− Dose measurement chamber for measuring the dose area product
− Laser positioning device on the generator and/or image intensifier or
digital flat-panel detector
− Key switch
− EMERGENCY STOP button
− Connection for external separate radiation warning lamp (including
software)
− Codonics laser printer (EP 1660)
− Codonics laser printer (NP 1660 MD)
− S-VHS video cassette recorder with automatic recording control
(Sony® SVO-9500MDP)
− Video printer Sony® UP-895 or UP-960 (for printout on paper) or
UP-980 (for printout on paper or transparent film)
− CRT monitors
− USB port
− CD writer or DVD writer
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2 System Overview
2.4 Options (U.S.A.)
This manual describes a system with maximum configuration. The

system configuration chosen by you may not contain all options and
functions described here.
The following options can be integrated into the system upon request:
Hardware options:
− CD writer
− Video printer Sony® UP-895 or UP-960 (for printout on paper) or
UP-980 (for printout on paper or transparent film)
− Codonics laser printer (EP 1660)
− Laser positioning device on the generator and/or image intensifier
− Dose measurement chamber for measuring the dose area product
− Vision Center located in the monitor cart
Optional functions:
− Measurements
− DSA
− CINE with 5/10/15/30 frames per second (30 frames per second only
with DSA option)
− Additional image storage: 5,000/10,000/20,000/50,000 images
(50,000 images only with DSA option)
− DICOM 3.0 interface Ziehm NetPort (Primary Capture)
Depending on the chosen system configuration, the following DICOM
Classes are supported:
− Print Class
− Storage Class including multiframe capability
− Media Class
− Worklist Class
− Query/Retrieve Class (patient level)
− Query/Retrieve Class (study level)
− Query/Retrieve Class (series level)
− Query/Retrieve Class (image level)
− Verification Class
− Dose area product display
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2 System Overview
2.5 Optional accessories
The following accessories are optionally available for the Ziehm Vision:
− Sterile disposable covers for all sizes
− Hand surgery table (n/a for Ziehm Vision FD)
− Universal film cassette holder (n/a for Ziehm Vision FD)
− Foot switch cover
2.6 Optional accessories (U.S.A.)
− Hand surgery table

− Universal film cassette holder
− C-arm power assist (→ Ch. 21, p. 21-1)
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2 System Overview
2.7 Parts of the system
2.7.1 C-arm stand
C-arm Image intensifier with

Ziehm Vision
integrated CCD camera
Vision Center
control panel
C-arm
handle
Horizontal
carriage
Lifting
column Cassette holder
Swivel arm
Steering &
braking lever
X-ray generator
Handle
Hand switch
Coupling cable
connection
Cable guards
Fig. 2-1 Mobile C-arm stand of Ziehm Vision
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2 System Overview
Ziehm Vision FD C-arm Digital flat-panel detector
Vision Center
control panel C-arm
handle
Horizontal
carriage
Lifting Swivel arm

column
Steering &
braking lever
X-ray generator
Handle
Hand switch
Coupling cable
connection
Cable guards
Fig. 2-2 Mobile C-arm stand of Ziehm Vision (Ziehm Vision FD)
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2 System Overview
2.7.2 Monitor cart
2.7.2.1 Monitor cart with 18.1" flat-screen monitors
Front view
Radiation
warning lamp
Flat-screen
monitors
Button panels for Button panels for

monitor settings monitor settings
Floppy disk Control

drive panel
CD writer or
DVD writer
Video printer
USB port
Foot lever for Foot lever for

braking and braking and
direction locking direction locking
Fig. 2-3 Monitor cart with 18.1" flat-screen monitors, front view
Rear view
DICOM port
(optional)
Coupling
cable support
VIDEO OUT
Power cable
support DICOM port
(optional)
TX/RX Coupling cable

connection connection
Power supply Equipotential
connection grounding
Spare earth
ground connection
Fig. 2-4 Monitor cart with 18.1" flat-screen monitors, rear view
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2 System Overview
On the rear side of each flat-screen monitor, there is an ON/OFF switch.

ON OFF
CAUTION
Always set the ON/OFF switches on the flat-screen monitors to ON in
order to ensure that the monitors are switched on automatically during
power-up of the system.
Movement of the The flat-screen monitors are mounted on a pivot and can be swiveled by
flat-screen approx. 15° to the right or to the left.
monitors
2.7.2.2 Monitor cart with CRT monitors
Front view
Radiation
warning lamp
Twin
monitors
Control
Floppy disk panel
drive
CD writer or
DVD writer
USB port
Video printer
Foot lever for Foot lever for

braking and braking and
direction locking
direction locking
Fig. 2-5 Monitor cart with CRT monitors, front view
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2 System Overview
Rear view
DICOM port
(optional)
Coupling
cable support
VIDEO OUT
Power cable
support DICOM port
(optional)
TX/RX Coupling cable

connection connection
Power supply Equipotential
connection grounding
Spare earth ground

connection
Fig. 2-6 Monitor cart with CRT monitors, rear view
2.7.3 Twin monitors
On the Ziehm Vision, the left monitor has been factory-set as the live Monitor
monitor and the right monitor as the reference monitor. assignment
During operation, the following images will be displayed on the screens:
− Live monitor: Live images and saved images, both as full-screen
image
− Reference monitor: Thumbnail mosaic, reference images at full-
screen size
Note
To avoid confusion, the neutral terms ‘live monitor’ and ‘reference
monitor’ are used throughout this manual, regardless of your custom
setting.
You can change the monitor assignment in the Configuration operating Changing the
mode under Basic Settings (→ Ch. 20.3.2, p. 20-9). monitor settings
You can customize the contrast and brightness settings of the 18.1" flat-
screen monitors (→ Ch. 2.7.4, p. 2-12) and of the CRT monitors
(→ Ch. 9.2, p. 9-2 or → Ch. 14.3, p. 14-4).
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2.7.4 Monitor settings on a Ziehm Vision with flat-screen monitors
Monitor settings You can change the following monitor settings yourself:
− Brightness
− Contrast
− Backlight brightness
− Menu language for monitor settings
In addition, you can restore the factory settings.
The factory-set menu language is English.
The following monitor settings cannot be changed by the user:
− Video input (Inputs)
− Gamma
− Picture settings (Picture), e.g. vertical position/horizontal position,
sharpness, scaling
− Menu setup (Setup), e.g. menu lock (exception: language setting)
If you want to change one or more of these monitor settings, please
contact your service engineer.
2.7.4.1 Integrated button panel
Each flat-screen monitor (→ Fig. 2-3, p. 2-9) has an integrated button

panel with six buttons, which are used for accessing the monitor setting
menus.
Fig. 2-7 Integrated button panel of the flat-screen monitor
2.7.4.2 Setting the brightness, contrast and backlight brightness
Brightness To set the brightness of the monitor, do the following:

• Press the Brightness/Contrast button.
The Brightness menu appears on the screen.
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2 System Overview
• Press the + or – arrow button to increase or decrease the screen

brightness.
The settings become immediately valid on the monitor. After a few
seconds, the Brightness menu disappears automatically.
To set the contrast of the monitor, do the following: Contrast

• Press the Brightness/Contrast button twice.
The Contrast menu appears on the screen.
• Press the + or – arrow button to increase or decrease the contrast.

seconds, the Contrast menu disappears automatically.
To set the backlight brightness of the monitor, do the following: Backlight

brightness
• Press the Brightness/Contrast button three times.
The Backlight Brightness menu appears on the screen.
• Press the + or – arrow button to increase or decrease the backlight

brightness.
seconds, the Backlight Brightness menu disappears automatically.
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2 System Overview
Note
Lowering the backlight level will increase the backlight lifetime.
2.7.4.3 Setting the menu language
The factory-set menu language is English. You can choose one of the
following languages as menu language:
− German
− French
− Italian
− Spanish
− Dutch
− Swedish
To define the menu language, do the following:

• Press the Menu button.
The menu selection window appears on the screen.
• Select the Setup menu with the help of the + or – arrow buttons.
• Move to the Language menu item with the help of the Scroll button.
• Press the + arrow button until the desired language is displayed.

All menus and menu items are displayed immediately in the chosen
language.
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2 System Overview

The menu selection window disappears.
2.7.4.4 Restoring the factory settings
After having changed the monitor settings, you may restore the factory-
set values at any time.
To restore the factory settings, do the following:

The menu selection window opens.
• Select the Defaults menu with the help of the + or – arrow buttons.
• Press the Scroll button.

The Factory Defaults menu item is selected.
• Press the + arrow button.

The menu selection window disappears. All settings are reset to the
factory values.
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2 System Overview
2.7.5 Video output
BNC socket A BNC socket which is used for video connection (VIDEO OUT) is
located on the rear of the monitor cart.
VIDEO OUT The VIDEO OUT socket supplies a CCIR video signal of the live monitor
image. The fluoroscopic image (live or stored) is available there for
further processing by a video cassette recorder, an external monitor, a
video printer, etc.
WARNING
Supplementary equipment used in combination with the Ziehm Vision
must comply with the safety requirements according to IEC 60601-1
and/or IEC 60601-1-1 or furnish proof of an equivalent degree of safety.
To ensure CE conformity, these components must have a CE approval
in accordance with Council Directive 93/42/EEC. In addition, a
declaration in compliance with Article 12 of the said directive must be
provided.
For components without CE approval, a conformity assessment
procedure is obligatory.
If you combine the Ziehm Vision with equipment which does not comply
with these requirements, the safety of the whole system is no longer
given and the warranty will become invalid.
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Safety Instructions 3
3.1 General safety instructions
WARNING
You must be familiar with the contents of this user manual in order to be
able to operate the system as intended. Study this user manual
thoroughly before operating the system.
It is important to observe all directions, safety instructions and warnings!
WARNING
Supplementary equipment used in combination with the Ziehm Vision
must comply with the safety requirements according to IEC 60601-1
and/or IEC 60601-1-1 or furnish proof of an equivalent degree of safety.
To ensure CE conformity, these components must have a CE approval
in accordance with Council Directive 93/42/EEC. In addition, a
declaration in compliance with Article 12 of the said directive must be
provided.
For components without CE approval, a conformity assessment
procedure is obligatory.
If you combine the Ziehm Vision with equipment which does not comply
with these requirements, the safety of the whole system is no longer
given and the warranty will become invalid.
Only properly trained personnel are allowed to operate the system. Operation
The system may only be operated by properly trained personnel under Operation (U.S.A.)
the direction of a physician.
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3 Safety Instructions
Assembly and Only authorized personnel are allowed to assemble the system and to
service provide technical service. The necessary qualifications can only be
obtained by attending a training course provided by the manufacturer.
CAUTION
Always observe the relevant regulations of the country of installation for
putting the system into service, training of personnel and maintenance.
WARNING
Never use the system if you suspect any electrical or radiation-
generating components to be defective!
WARNING
Never pull at the power cable or coupling cable of the monitor cart in
order to move the cart to another position. Otherwise severe equipment
damage may result.
3.2 X-rays
General The system produces X-rays. If you do not observe the safety measures
and precautions required by your local radiation protection regulatory
body, these X-rays can be hazardous both to operating staff and other
persons within the radiation zone of occupancy.
WARNING
The system may only be operated by personnel who has undergone
radiological training.
WARNING (U.S.A.)
The system may only be operated by properly trained personnel under
the direction of a physician.
CAUTION
The relevant safety regulations of the country of installation must be
observed.
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Staff members who stay within the radiation controlled area must wear X- Protection of staff
ray protective clothing.
The radiation controlled area depends upon the size of the image
intensifier installed and has the following radius:
− 23 cm i.i.: 4 m
− 31 cm i.i.: 4 m
(→ Fig. A-12, p. A-29)
− Digital flat-panel detector: 4 m
(→ Fig. A-13, p. A-30)
WARNING
In order to avoid unintentional radiation, the foot switch must be hung up
on the foot switch support when the system is switched on, but not in
use.
To minimize the radiation burden of the patient, you must keep the focus- Protection of the
skin distance as large as possible. The generator design guarantees a patient
minimum focus-skin distance of 20 cm.
WARNING
In order to avoid unintentional radiation, the foot switch must be hung up
on the foot switch support when the system is switched on, but not in
use.
WARNING
When you initiate radiation and no live image is displayed, although all
necessary settings have definitely been made, please contact your
after-sales service center!
3.3 Electromagnetic compatibility
Medical electrical equipment requires special precautionary measures

with respect to EMC and must be installed and put into service in
accordance with the EMC guidelines contained in the accompanying
documents.
Portable and mobile RF communications equipment may interfere with
medical electrical equipment.
All operating modes of the system have been considered in the EMC
tests. There are no exceptions to the rules.
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Only conductors, connecting cables and accessories that are specified

by the manufacturer may be used.
WARNING
Using components other than those specified may result in increased
electromagnetic emissions or reduced electromagnetic immunity.
Please observe also the attached document Manufacturer’s Declaration

regarding Electromagnetic Compatibility according to IEC 60601-1-2!
3.4 Protective grounding
The system must be connected only to power systems having a separate

ground connection.
3.5 Equipotential grounding
Heart and brain If you use the system in combination with other equipment for
examinations examinations of the heart or brain or the surrounding anatomical regions,
equipotential grounding is required for patient and operating staff safety
(IEC 60601-1-1:1992/A1:1995).
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3.6 Laser radiation
As an option, the system may be equipped with a laser positioning device Laser positioning
at the image intensifier and/or generator. device
The laser positioning device uses diode laser modules which emit laser
radiation. Do not under any circumstances look directly at the laser
beam or any scattered laser radiation – either with the naked eye or with
optical instruments.
The laser positioning device is a Class 2M laser product according to IEC
60825-1:2001-11. Make sure to comply with all operating safety
precautions when using the laser positioning device.
The maximum output of continuous laser radiation, measured at the
beam exit, is <1 mW. The wavelength of the emitted radiation is 635 nm.
WARNING
LASER RADIATION – DO NOT LOOK INTO THE BEAM!
Do not look directly with optical instruments into the laser beam
apertures, since doing so can be hazardous to your eyes!
Please observe the provisions of IEC 60825-1:2001, Section 3, “User’s
Guide” for operation of the laser positioning device.
The laser positioning device is maintenance-free. Any adjustment or Maintenance

repair which might become necessary must be carried out by the
manufacturer or a person who has been authorized to do so by the
manufacturer.
Laser beam apertures
Fig. 3-1 Laser beam apertures on the image intensifier (left) and on
the generator (right) (Ziehm Vision)
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Laser beam aperture
Laser beam aperture
Fig. 3-2 Laser beam apertures on the digital flat-panel detector (left)
and on the generator (right) (Ziehm Vision FD)
3.7 Environmental compatibility
The system does not produce any waste during operation.

When the system has reached the end of its useful service life, the
relevant waste disposal regulations must be observed.
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Putting the System into Service 4
4.1 Unpacking the system
Detailed instructions of how to unpack and assemble the system are Detailed
supplied with the system. information
WARNING
Only authorized personnel (→ p. 1-2) are allowed to unpack and
assemble the system.
During assembly, the system may be handled only by trained personnel
who have studied the contents of Ch. 4, Putting the System into Service
and Ch. 5, Mechanical Handling.
In case of major differences in temperature, all parts of the system must Room temperature
have reached room temperature before the system is put into service in
order to avoid damage to the system as a result of condensation.
WARNING
The cooling tank may have been emptied before shipping for transport
temperatures below 0°C. In this case, you must refill the cooling tank
with water with the help of the filler and vent hoses before putting the
system into service.
WARNING
Do not operate the system until the equipment has reached a safe
operating temperature of +15°C to +35°C with no condensation present.
Otherwise severe equipment damage may result.
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4 Putting the System into Service
4.2 Accessories
Depending on the integrated options, the following accessories are

included in the scope of delivery:
Accessory item Qty.

User Manual 2
Technical Manual 1
Specifications and Certificates 1
(n/a for the U.S.A.)
All systems
Coupling cable (7.5 m) 1

Equipotential grounding cable (6 m) 1
Active Cooling
Filler and vent hose (1.5 m) 2
Instructions for “Filling of Cooling Agent into 1
Ziehm Vision”
Video printer
Operating instructions for video printer 1
Printer paper 1 roll
Printer transparent film 1 roll
(only Sony® UP-980)
Video cassette recorder
Operating instructions for video cassette 1
recorder
Video cassette S-VHS (240 min.) 1
Options
CD writer
CD (640 MB) 1
DVD writer
DVD (4.7 GB) 1
USB port
USB storage device 1
DICOM
RJ45 interface with Cat.5 patch cable 1
(10 m)
Fiber-optic connection (FOC): 1
ST coupling, 10base-FL or 100base-FX
Table 4-1 Accessories
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4.3 Cable connections
Before switching on the system for the first time, or after each transport, General
you must establish different cable connections.
To connect the various parts of the system, do the following:
• Unwind the coupling cable from the upper cable support on the back
of the monitor cart (→ Fig. 2-6, p. 2-11 or → Fig. 2-4, p. 2-9).
• Plug the coupling cable connector into the socket located at the side
of the C-arm stand and lock the connector (→ Fig. 2-1, p. 2-7).
• Make sure that a suitable supply voltage is available and that the
socket-outlet is properly grounded and fused.
• Check the power plug on the monitor cart power cable (→ Fig. 2-6,
p. 2-11 or → Fig. 2-4, p. 2-9) and the socket-outlet for compatibility.
• Connect the system to the power supply.
WARNING
Never connect the monitor cart and C-arm stand when the monitor cart
is already connected to the power supply or switched on.
Damage to the electronics of the system cannot be excluded if this
warning is ignored!
4.4 First power-up of the system
• Make sure that the inclination of the system does not exceed 5° from Preparation
the level in operating position.
• Ensure that all electrical connections are properly established

(→ Ch. 4.3, p. 4-3).
• Put on suitable protective clothing.

• Switch on the system.
The buttons for switching the system on and off are located on the
monitor cart behind the control panel on the left and on the left side of
the C-arm stand next to the handle. Each of the two buttons switches
on or off both system components simultaneously.
The default settings after power-up vary from system to system,
according to the customer-specific setup.
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CAUTION
Ziehm Vision with USB port: Do not plug the USB storage device into
the USB interface until the system has fully completed its power-up
sequence.
Note
Due to background radiation, the Dose Area Product display (if
enabled) may indicate some small value after power-up of the system.
Note
As part of the power-up sequence, the radiation warning lamp may light
up. This is a system test and does not mean that radiation is released.
4.5 Setting up the system
Configuration You have the possibility to adjust various basic and operation settings so
as to meet your special working requirements. If these settings have not
already been made at the factory, you can make them yourself in the
Configuration operating mode (→ Ch. 20, p. 20-1).
Entering the In order to avoid having to enter the invariable hospital data (i.e., name
hospital data of the hospital, department and doctor) again and again for each new
patient, you can record this data once in the Configuration operating
mode under Basic Settings (→ Ch. 20.3.3, p. 20-10). Each time you
create a new patient folder (→ Ch. 10.2.1, p. 10-3), the hospital data
which has been entered there will appear automatically in the
corresponding fields.
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Mechanical Handling 5
5.1 Transport position
For safety reasons, you must return both the C-arm stand and the General
monitor cart to their respective transport position before transporting
them.
5.1.1 C-arm stand transport position
To return the C-arm stand to its transport position, do the following: How to proceed
• Wind the foot switch cable onto the foot switch support and hang up
the foot switch there.
• Rotate the C-arm orbitally until the image intensifier is positioned

directly above the generator and secure it with the relevant brake
(→ Fig. 5-1, p. 5-2 and → Fig. 5-5, p. 5-7).
• Put the swivel arm of the C-arm into an upright position and secure it
with the relevant brake (→ Fig. 5-1, p. 5-2 and → Fig. 5-7, p. 5-8).
• Swivel the horizontal carriage into a central position and secure it with
the relevant brake (→ Fig. 5-1, p. 5-2 and → Fig. 5-7, p. 5-8).
• Retract the horizontal carriage completely and secure it with the

relevant brake (→ Fig. 5-1, p. 5-2 and → Fig. 5-11, p. 5-10).
• Lower the lifting column completely (→ Fig. 5-1, p. 5-2 and → Fig. 5-
13, p. 5-12) using the UP/DOWN buttons.
• Switch off the system and disconnect the power cable from the power
supply.
• Unlock the coupling cable connector on the C-arm stand and unplug
the connector.
• Release the parking brake by lifting the steering & braking lever
(→ Fig. 5-1, p. 5-2).
• If you want to move the C-arm stand over very soft or uneven floors
(e.g. doorways), raise the cable guards on the wheels.
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5 Mechanical Handling
C-arm + brake
Swivel arm + brake
Horizontal carriage + brake
Swivel brake
Lifting column
Steering & braking

lever
Cable guards
Fig. 5-1 C-arm stand transport position (Ziehm Vision)
C-arm + brake
Swivel arm + brake
Horizontal carriage + brake
Swivel brake
Lifting column
Steering & braking

lever
Cable guards
Fig. 5-1 C-arm stand transport position (Ziehm Vision FD)
5.1.2 Monitor cart transport position
To return the monitor cart to its transport position, do the following:
• Wind the power cable onto the lower cable support on the back of the
monitor cart.
• Wind the coupling cable onto the upper cable support on the back of
the monitor cart.
• If applicable, disconnect the equipotential grounding cable from the

system ground.
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• Unlock the parking brake by pushing the foot levers on the front
wheels with your foot into the middle position.
Coupling
cable support
Power cable
support
Fig. 5-2 Monitor cart transport position
CAUTION
Do not move the system over floors with an inclination of more than 10°
from level during transport. This applies to both the C-arm stand and the
monitor cart.
Exercise extreme caution when moving the mobile C-arm stand and the
monitor cart over rough surfaces such as tile flooring, pavement, asphalt
or carpet. Take care that the cable guards do not drag and the wheels
do not catch or tilt causing damage to the equipment.
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5.2 Braking and steering the monitor cart
Brake On both front wheels of the monitor cart there is a foot lever which serves
for locking and releasing the brake.
Foot lever for locking the

wheel
Fig. 5-3 Monitor cart front wheel
You can push the foot lever with your foot into three different positions:
− Lever in middle position:
The wheels can move freely, the brake is released
− Lever in lower position:
The wheels are locked, the brake is locked as well
− Lever in upper position:
You can move the monitor cart forward and backward.
Steering To steer the monitor cart, use the two lateral handles.
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5.3 Braking and steering the C-arm stand
The C-arm stand has a combined steering & braking lever. It is located Steering & braking
at the rear end of the C-arm stand (→ Fig. 2-1, p. 2-7). lever
The C-arm stand parking brake operates as follows: Parking brake

− Steering & braking lever lowered:
Rear wheels are locked
− Steering & braking lever raised:
Rear wheels can move freely
To steer the C-arm stand, do the following: Steering
• Lift the steering & braking lever and turn it until reaching the desired
position. The lever can be turned freely; however, detents are placed
at 90° increments. The rear wheels will always stay parallel to one
another aligned exactly in parallel with the steering & braking lever.
− To maneuver the C-arm stand freely, ensure that the steering &
braking lever has engaged in its central position, pointing directly
backward from the unit (→ Fig. 5-4, p. 5-6, left).
− To move the C-arm stand in an exactly-defined direction, rotate the
steering & braking lever until it points toward the desired direction
(→ Fig. 5-4, p. 5-6, right).
• Push the C-arm stand in the desired or predefined direction using the
lateral handles, or use the hand rail around the image intensifier to
pull the C-arm stand.
CAUTION
Release the parking brake only to move or position the C-arm.
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Fig. 5-4 C-arm stand steering (schematic representation, view from

above)
5.4 C-arm movements
Mechanical brakes The C-arm can be moved in virtually any plane. For each movement, a
separate brake is available, allowing you to secure the C-arm in any
position.
To release the corresponding brake, turn it counter-clockwise.
The limit stop of the brake handles can be adjusted individually. To do so,
lift the spring-loaded brake handle, turn it until reaching the desired limit
stop position and release it to re-engage it at the new position.
CAUTION
Before moving the C-arm, make sure that there is nobody within its
range of movement.
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WARNING
Release the mechanical brakes only for positioning.
Take care to always seize the C-arm at its handle during any adjustment
in order to prevent the C-arm from hitting the respective limit stop at full
speed!
Take care not to place your hand in the C-arm guide rails when adjusting
the C-arm.
Make sure that all mechanical brakes are locked when transporting the
C-arm stand!
5.4.1 Orbital rotation
The C-arm can be rotated orbitally by 115° (optionally 135° for 23 cm i.i.):
–90° from vertical to horizontal position and +25° (optionally +45°)
forward. A scale with 5° divisions on the outside of the C-arm as well as
a mechanical detent at the ‘zero’ position are provided to facilitate precise
positioning.
Angulation brake
Orbital rotation
brake
Fig. 5-5 Orbital rotation of the C-arm (Ziehm Vision)
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Angulation brake
Orbital rotation
brake
Fig. 5-6 Orbital rotation of the C-arm (Ziehm Vision FD)
5.4.2 Angulation
The C-arm can be rotated by ± 225° in the vertical plane around the
horizontal axis (i.e., the horizontal carriage). A scale with 10° divisions is
provided at the pivot joint of the horizontal carriage (except on 31 cm i.i.
systems) to facilitate precise positioning.
Fig. 5-7 Angulation of the C-arm (Ziehm Vision)
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Fig. 5-8 Angulation of the C-arm (Ziehm Vision FD)
The angulation brake is located on the horizontal carriage (→ Fig. 5-5,

p. 5-7).
5.4.3 Swiveling (panning)
The C-arm can be swiveled 10° to the left or to the right around the
vertical axis of the lifting column.
Swivel brake
Fig. 5-9 Swiveling (panning) of the C-arm (Ziehm Vision, view from
above)
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Swivel brake
Fig. 5-10 Swiveling (panning) of the C-arm (Ziehm Vision FD, view
from above)
5.4.4 Horizontal movement
You can move the C-arm forward and backward by 22 cm in the

horizontal plane by means of the horizontal carriage. A scale with 1 cm
divisions is provided to facilitate precise positioning.
Horizontal movement
brake
Fig. 5-11 Horizontal movement of the C-arm (Ziehm Vision)
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Horizontal movement
brake
Fig. 5-12 Horizontal movement of the C-arm (Ziehm Vision FD)
5.4.5 Vertical movement
The C-arm can be moved up and down by 43 cm. This movement is

motorized. A scale with 1 cm divisions is provided on the lifting column to
facilitate precise positioning.
The UP/DOWN buttons are on the C-arm stand next to the lateral
handles. To move the C-arm up or down, you must press and hold down
the corresponding UP/DOWN button.
CAUTION
Before moving the C-arm up or down, make sure that it does not collide
with any persons or objects!
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UP/DOWN
buttons
Fig. 5-13 Vertical movement of the C-arm (Ziehm Vision)
UP/DOWN
buttons
Fig. 5-14 Vertical movement of the C-arm (Ziehm Vision FD)
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Controls 6
6.1 Vision Center control panel
The Vision Center control panel is designed as a touch screen. For

system operation, just press the desired button or option directly on the
screen. Depending on the selected function, other controls (buttons,
input boxes, displays, etc.) will appear on the screen.
Both the C-arm stand and the monitor cart have a control panel. The
screens on both control panels are identical, enabling you to use any of
them for system operation.
6.1.1 Elements of the control panel
Warning
symbols
Selected Title bar
operating
mode
Displays
Dynamic
control Buttons
area
Buttons
Tabs for
operating
mode
selection
Fig. 6-1 Elements of the control panel
There are three types of buttons:

− Buttons with a gray background: When you press one of these
buttons, an action is executed immediately on the monitor, or a mode
is activated. If a certain mode is active, the corresponding button is
highlighted in yellow.
− Buttons with a gray background and a purple bar at the top:
When you press one of these buttons, new controls appear in the
dynamic control area, allowing you to make further settings.
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6 Controls
− Buttons with a gray background and a green bar at the top: When
you press one of these buttons, another mode or sub-mode is
activated.
6.1.2 Controls in the Fluoroscopy and Subtraction operating modes
Fluoroscopy In the Fluoroscopy operating mode, you can make different settings for
operating mode fluoroscopies:
4$ 4% 5) 4^ 4& 4* 4( 5!
2& 3) 3#
2* 3! 3$
2( 3@ 3%
B E H 1# 1$ 1* 2! 2$
C F I 1) J 1% 1^ 1( 2@ 2^
D G 1! 1@ 1& 2) 2# 2%
3^ 3& 3* 3( 4) 4! 4@ 4#
Fig. 6-2 Control panel in the Fluoroscopy operating mode
Control Symbol(s) Meaning

no.
B Continuous Pulse Fluoroscopy
Activates the continuous pulse
fluoroscopy mode and displays the
pulse rate setting controls in the
dynamic control area.
C High Quality
Activates the high quality
supplementary function.
Caution: Reduce radiation time!
D Snapshot
Activates the snapshot mode.
Table 6-1 Controls in the Fluoro operating mode
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6 Controls

no.
E Manual Exposure Rate Setting
Enables manual setting of tube voltage
and tube current.
Caution: Use only in exceptional
cases!
F Large Patient
Activates the large patient
G Cine
Activates or deactivates the cine loop
mode.
H Image Swapping
Swaps the images between the live and
reference monitors.
I Rotate Image CW
Rotates the image in clockwise
direction.
Ziehm Vision FD: As soon as the image
is rotated, it assumes a circular shape.
J Rotate Image CCW
Rotates the image in counter-clockwise
direction.
Ziehm Vision FD: As soon as the image
is rotated, it assumes a circular shape.
1) Rotate Image to 0°
Resets the angle of rotation of the
image in one step to 0°.
1! Reverse Up/Down
Mirrors the image vertically around the
horizontal axis.
1@ Reverse Left/Right
Mirrors the image horizontally around
the vertical axis.
1# Close Iris Collimator
Closes the iris collimator.
1$ Open Iris Collimator Fully

Fully opens the iris collimator in one
step.
Table 6-1 Controls in the Fluoro operating mode (cont.)
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6 Controls

no.
1% Close Vertical Slot Collimator
Closes the slot collimator.
When you press the Close Vertical
Slot Collimator button, the buttons for
opening and rotating the collimator
appear on the control panel:
Open Vertical Slot Collimator
Opens the slot collimator.
Rotate Vertical Slot Collimator CW

Rotates the slot collimator in clockwise
direction.
Rotate Vertical Slot Collimator CCW
Rotates the slot collimator in counter-
clockwise direction.
1^ Open Vertical Slot Collimator Fully
Fully opens the vertical slot collimator in
one step.
1& Rotate Vertical Slot Collimator to 0°

Resets the vertical slot collimator in one
step to 0°.
1* Bones
Activates the anatomical program for
visualizing any part of the skeleton.
1( Heart
visualizing the heart and thorax region.
2) Abdomen
visualizing the abdominal region.
2! Metal
Activates the metal artifact correction
2@ Reposition
Activates the reposition
2# Soft
visualizing soft tissues.
2$ Up Arrow
Displays the image with the next higher
number in the active patient folder at
full-screen size.
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6 Controls

no.
2% Down Arrow
Displays the image with the next lower
number in the active patient folder at
full-screen size.
2^ Save
Saves the active image to the hard disk.
2& Laser
Activates or deactivates the laser
positioning device(s).
2* Filter
Shows or hides the controls for raw
image processing (recursive filter, edge
filter, stack filter) in the dynamic control
area.
2( VCR
Displays the controls for operating the
video cassette recorder in the dynamic
control area.
3) Magnify (n/a for Ziehm Vision FD)
Shows or hides the controls for setting
the image intensifier’s electronic
magnification in the dynamic control
area. The buttons always show the
current image magnification level.
3! Zoom
Shows or hides the controls for setting
the zoom function in the dynamic
control area.
3@ Contrast/Brightness
Shows or hides the monitor setting
controls and the contrast and
brightness (windowing) controls in the
3# Print Live Monitor Image
Prints the image displayed on the live
monitor on the video printer.
3$ Text
Activates the text mode.
3% Grayscale Inversion
Displays the active (positive) image
with a negative grayscale or vice versa.
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6 Controls

no.
3^ Fluoro
Activates the Fluoroscopy operating
mode, which is used for performing
standard fluoroscopies.
3& Subtraction
Activates the Subtraction operating
mode, which is used for generating
DSA, MSA and RSA images.
3* Radiography (n/a for Ziehm Vision FD)
Activates the Radiography operating
mode, which is used for making direct
radiographies.
3( Patient
Activates the Patient operating mode,
which is used for managing patient
data.
4) Post Proc.
Activates the Post Process operating
mode, which is used for post-
processing saved images.
4! Measure
Activates the Measurement operating
mode, which is used for measuring
distances and angles in saved images.
4@ Archive
Activates the Archive operating mode,
which is used for managing saved
images.
4# Config
Activates the Configuration operating
mode, which is used for adjusting the
operation settings and the basic
settings and for deleting data on
storage media.
4$ Voltage display
Shows the automatically determined or
manually set tube voltage in kV.
After fluoroscopy, the last kV value
remains stored.
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6 Controls

no.
4% Current display
Shows the automatically determined
tube current in mA.
After fluoroscopy, the last mA value
remains stored.
4^ Pulsewidth % display
Shows the current pulse width.
4& Pulses /s display

Shows the current pulse rate.
4* Dose Area Product display

Shows the dose area product for the
active patient folder in cGy × cm2, if the
system is equipped with a dose
measurement chamber.
4( Radiation Time display
Shows the accumulated radiation time
for fluoroscopies and direct
radiographies for the active patient
folder in minutes and seconds.
5) Temperature symbol
Shows the thermal conditions in the
generator.
5! X-ray symbol
Lights up yellow during X-ray exposure
(fluoroscopy and direct radiography).
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6 Controls
Subtraction The Subtraction operating mode screen is to a large extent identical to

operating mode the Fluoroscopy operating mode screen. Instead of the Soft and Metal
buttons, it shows the DSA button:
5@
Fig. 6-3 Control panel in the Subtraction operating mode

no.
5@ DSA
Displays the controls for the DSA
subtraction mode settings in the
Table 6-2 Additional controls in the Subtraction operating mode
Unavailable Controls which are not required in a certain operating situation (e.g.
controls playback of a saved cine loop) are automatically locked, i.e. they are not
available.
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6 Controls
In the Patient, Text, Archive Search, Archive Backup and Alphanumeric

Configuration operating modes, an alphanumeric keypad is displayed, keypad
allowing you to enter texts.
Fig. 6-4 Alphanumeric keypad displayed on the Vision Center

control panel
Note
It is not possible to press two keys on the keypad simultaneously. To
combine a key with the Shift key, first press and release the Shift key
and then the desired key.
To generate uppercase letters and special characters, first press and Uppercase letters
release the Shift key and then the corresponding key. and special
characters
The Shift key is valid for one subsequent letter or special character.
If you want to type several consecutive uppercase letters or special

characters, press the Caps Lock key before entering the letters or
characters. To deactivate the Caps Lock mode, press the Caps Lock key
once again.
To generate a blank space, press the Space key.
6.2 Switches on the unit
Both the C-arm stand and the monitor cart have buttons for switching the
system on or off (→ Fig. 7-1, p. 7-2).
On the C-arm stand, there are two buttons with arrows (UP/DOWN),
which are used for lifting and lowering the C-arm on its mobile stand.
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6 Controls
6.3 Hand switch and foot switch
General The Ziehm Vision is equipped with a hand switch and a two-pedal foot
switch.
Hand switch
Fig. 6-5 Hand switch
Two-pedal foot
.
switch
Fig. 6-6 Two-pedal foot switch
Radiation is initiated either with the hand switch or the fluoroscopy pedal
of the foot switch.
The default pedal assignment of the two-pedal foot switch is as follows:
− Left pedal: Fluoroscopy
− Right pedal: Save image (→ Ch. 8.7, p. 8-10)
Note
The foot switch pedals are able to be assigned with customer-specific
functions. If this is the case, the respective functions are indicated on
labels on the foot switch itself and on the C-arm stand.
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Switching the System On 7
7.1 Preparing the system
Before switching on the system, e.g. after a transport, you must connect General
the two system components to each other and also connect the whole
system to the power supply.
WARNING
Never connect the monitor cart and C-arm stand when the monitor cart
is already connected to the power supply or switched on.
Damage to the electronics of the system cannot be excluded if this
warning is ignored!
To prepare the unit, do the following:
• Unwind the coupling cable from the upper cable support on the back
of the monitor cart (→ Fig. 2-6, p. 2-11 or → Fig. 2-4, p. 2-9).
• Plug the coupling cable connector into the socket located at the side
of the C-arm stand and lock the connector (→ Fig. 2-1, p. 2-7).
• Make sure that a suitable supply voltage is available and that the
socket-outlet is properly grounded and fused.
• Check the power plug on the monitor cart power cable (→ Fig. 2-6,
p. 2-11 or → Fig. 2-4, p. 2-9) and the socket-outlet for compatibility.
• Connect the system to the power supply.
• Make sure that the inclination of the system does not exceed 5° from
the level in operating position.
• Put on suitable protective clothing.
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7 Switching the System On
7.2 Switching the system on
Both the C-arm stand and the monitor cart have buttons for switching the
system on or off (→ Fig. 7-1, p. 7-2). Each of the two buttons switches on
or off both system components simultaneously.
Fig. 7-1 ON/OFF switches on the C-arm stand (left) and on the
monitor cart (right)
CAUTION
Ziehm Vision with USB port: Do not plug the USB storage device into
the USB interface until the system has fully completed its power-up
sequence.
Note
Due to background radiation, the Dose Area Product display (if
enabled) may indicate some small value after power-up of the system.
Note
As part of the power-up sequence, the radiation warning lamp may light
up. This is a system test and does not mean that radiation is released.
To switch on the system, do the following:

• Press the ON switch.
The system is switched on. The ON switch is illuminated now.
Customer-specific The default settings after power-up vary from system to system,
initial settings according to the customer-specific setup. You may e.g. choose your
preferred start screen yourself (→ Ch. 20.2.4, p. 20-5).
Furthermore, you may choose to have a certain anatomical program and
various live image settings (→ Ch. 9, p. 9-1) preset as default after
power-up. You cannot make these presettings yourself.
• Please contact your service engineer if you wish to make or modify

the initial settings.
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7.3 EMERGENCY STOP button
There is an EMERGENCY STOP button on both the C-arm stand and the
monitor cart of the Ziehm Vision, enabling you to switch off all electrical
functions of the unit in case of emergencies.
To switch off the system in an emergency situation, do the

following:
• Fully press down the EMERGENCY STOP button.

The EMERGENCY STOP button is locked in this position. The system
switches off immediately. All electrical functions of the system are
disabled.
• To unlock the EMERGENCY STOP button, press the red knob of the
EMERGENCY STOP button with a slight twist.
The unit remains switched off. You can switch the unit back on with
the ON switch.
Note
If the system cannot be switched on, the EMERGENCY STOP button
may have been actuated inadvertently, e.g. during a transport. Check
whether the EMERGENCY STOP button is locked and unlock it if
applicable.
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7.4 Key switch
The Ziehm Vision monitor cart is equipped with a key switch. Depending
on your chosen configuration, it is used for locking either the entire
system (Power on) or only the radiation function (X-ray on/off) of the
unit. This allows you to prevent unauthorized persons from switching on
the unit or initiating radiation.
Fig. 7-3 Key switch for locking the entire system (left) or the
radiation function (right), Lock position
Power on With the Power on key switch you can completely switch off the unit
(equivalent to OFF switch) and lock it. When you remove the key while it
is in the Lock position, the Ziehm Vision can no longer be switched on
with the ON switch.
To be able to switch on and operate the Ziehm Vision, you must first
insert the key and turn it to the Unlock position. While in the Unlock
position, the key cannot be removed.
X-Ray on/off With the X-Ray on/off key switch, you can lock the radiation function of
the unit. When you remove the key while it is in the Lock position, it is
possible to switch on the Ziehm Vision and to use functions such as
patient data management or image postprocessing. However, it is not
possible to initiate radiation with the hand or foot switch.
To be able to initiate radiation, you must first insert the key and turn it to
the Unlock position. While in the Unlock position, the key cannot be
removed.
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Standard Fluoroscopic Operations 8
8.1 Overview
To perform a standard fluoroscopy, you must always make the following Steps and settings
steps and settings:
• Create a new patient folder in the Patient operating mode, or activate

the desired patient folder in the Patient or Archive operating mode.
• Select the desired fluoroscopy mode in the Fluoroscopy or

Subtraction operating mode. If you have not activated a patient
folder before, the system automatically creates and activates a patient
folder.
• Select the fluoroscopy program.
• Generate the fluoroscopic image.
• Save the fluoroscopic image.
• Print out the fluoroscopic image, if desired.
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8 Standard Fluoroscopic Operations
8.2 Fluoroscopy modes
Fluoroscopy During fluoroscopy, radiation is interrupted at certain intervals (pulsed).

modes The length (pulse width) and frequency (pulse rate) of the radiation
interval are preset for each anatomical program and are displayed on the
control panel.
The Ziehm Vision provides two different pulsed fluoroscopy modes:
− Continuous pulse fluoroscopy (→ Ch. 8.2.1, p. 8-2)
− Digital radiography (snapshot) (→ Ch. 8.2.2, p. 8-4)
Anatomical Both fluoroscopy modes work with automatic exposure rate control
programs (AERC), unless manual exposure rate setting has been selected
explicitly by the user (→ Ch. 8.3, p. 8-5).
The tube voltage and the tube current are adjusted automatically, taking
into account the selected fluoroscopy program (→ Ch. 8.4, p. 8-7) as well
as the thickness and structure of the object.
Automatic exposure rate control (AERC) reduces the radiation burden of
both patient and operating staff to a minimum and prevents
overexposure of the screened body region.
8.2.1 Continuous pulse fluoroscopy
In continuous pulse fluoroscopy mode, the system emits radiation pulses

as long as you press the radiation switch.
Pulse rate You may adjust the pulse rate. The lower the pulse rate setting, the lower
the radiation dose.
Pulse width The pulse width is indicated in percent and cannot be modified. A pulse
width of 100% corresponds to 40 ms (U.S.A.: 30 ms).
Pulse settings for The pulse width and pulse rate for each anatomical program are preset
anatomical in the Configuration operating mode under Service Settings. You
programs cannot make these presettings yourself.
• Please contact your service engineer if you wish to set or modify the
pulse width and/or pulse rate values for one or more anatomical
programs.
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To generate an image in the continuous pulse fluoroscopy mode,

do the following:
• Press the Continuous Pulse Fluoroscopy button.
The preset pulse width and pulse rate for the selected anatomical
program are indicated on the Pulsewidth % and Pulses /s displays
on the control panel.
The pulse rate setting buttons are displayed in the dynamic control
area.
Fig. 8-2 Pulse rate setting

(on systems with a nominal frequency of 60 Hz)
• Press the button for the desired pulse rate, e.g. 2 pulses / s.
• Initiate radiation.
For each individual anatomical program, certain filter factors can be Filter factors
preset for the continuous pulse fluoroscopy mode. This is done in the
Configuration operating mode under Service Settings. You cannot
make these presettings yourself.
filter factors for one or more anatomical programs.
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8.2.2 Digital radiography (snapshot)
In snapshot mode, the radiation time does not depend on how long you
press the radiation switch. For each anatomical program, a specific
AERC characteristic is stored on the system for the digital radiography
mode. The fluoroscopy parameters are adjusted using the respective
AERC characteristic, and radiation is terminated automatically
afterwards.
The pulse rate setting buttons are displayed in the dynamic control area.
You cannot make any further settings with these buttons, though.
Fields of The snapshot mode is suitable for examinations involving no patient

application movement. The aim of snapshot mode is to generate high-quality static
images, e.g. for printing / documentation purposes.
To generate an image in the snapshot mode, do the following:

• Press the Snapshot button.
• To deactivate the snapshot mode, press the Continuous Pulse

Fluoroscopy button.
Note
When you activate the snapshot mode, the Cine button disappears
from the control panel.
Filter factors For each individual anatomical program, certain filter factors can be
preset for the snapshot mode. This is done in the Configuration
operating mode under Service Settings. You cannot make these
presettings yourself.
filter factors for one or more anatomical programs.
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8.3 Manual exposure rate setting
The tube voltage and the tube current are usually adjusted automatically
by the system’s automatic exposure rate control. You may, however, set
the exposure rate also manually, if necessary.
WARNING
To protect the health of patients and staff against high radiation doses,
the manual dose rate setting mode remains blocked until you have
initiated radiation in one of the fluoroscopy modes with automatic
exposure rate control at least once.
Only use the manual exposure rate setting mode in exceptional
circumstances. The automatic exposure rate control provides optimum
image quality while minimizing the dose rate.
To generate an image in the manual exposure rate setting mode, do

the following:
• Select the desired anatomical program (→ Ch. 8.4.1, p. 8-7).
• Select one of the fluoroscopy modes with automatic exposure rate

control:
− Continuous pulse fluoroscopy
or or
− Snapshot
(→ Ch. 8.2, p. 8-2).
• Initiate radiation for a brief moment.
• Press the Manual Exposure Rate Setting button.

The kV value which has been automatically determined is saved for
subsequent fluoroscopies, and the system switches to the manual
mode.
The setting buttons are displayed in the dynamic control area.
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Fig. 8-3 Settings in the manual exposure rate setting mode
• Select the desired kV and mA values using the Up Arrow and Down
Arrow buttons. Each time you press an arrow button, the value is
increased/decreased by 1 kV or 0.1 mA.
To deactivate the manual exposure rate setting mode, do the

following:
• Press the Manual Exposure Rate Setting button.
or or
• Press the Off button in the dynamic control area.

The manual exposure rate setting mode is deactivated.
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8.4 Fluoroscopy programs
8.4.1 Anatomical programs
The following anatomical programs are available:

Bones
The Bones anatomical program is optimized for visualizing any part of
the human skeleton. It is used mainly in orthopedics.
Heart
The Heart anatomical program is optimized for visualizing the heart and
the thorax. It is used e.g. in heart surgery or also dilatations in the heart
region.
Abdomen
The Abdomen anatomical program is optimized for visualizing any
anatomical structure in the abdominal region. It is used e.g. in urology,
for cholangiographies and for preparing dilatations and stent
implantations.
Soft
The Soft anatomical program is optimized for visualizing soft tissues. It
is used e.g. for foreign body localization and for visualization of syringe
needles and skin contours.
To activate an anatomical program, do the following:
• Press the button for the desired anatomical program.

The button is highlighted in yellow.
The anatomical program remains active until you choose another
program.
If required, a number of supplementary functions can be combined with
any anatomical program:
− Metal artifact correction (→ Ch. 8.4.2, p. 8-8)
− Reposition (→ Ch. 8.4.3, p. 8-8)
− High Quality (→ Ch. 8.4.4, p. 8-8)
− Large Patient (→ Ch. 8.4.5, p. 8-9)
For each of these anatomical programs, certain filter factors can be Filter factors
preset. This done in the Configuration operating mode under Service
Settings. You cannot make these presettings yourself.
filter factors.
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8.4.2 Metal artifact correction function
The metal artifact correction function corrects a possible flaring of the

fluoroscopic image resulting from metal objects in the beam path and
increases contrast at tube voltages above 50 kV.
The metal artifact correction function can be combined with any
anatomical program.
To activate the metal artifact correction function, do the following:
• Press the Metal button.

To deactivate the metal artifact correction function, do the
following:
• Press the Metal button again.

The button returns to its gray color, and the metal artifact correction
function is deactivated.
8.4.3 Reposition function
The reposition function uses special filter settings to reduce motion

blurring in the fluoroscopic images.
The reposition function can be combined with any anatomical program.
To activate the reposition function, do the following:
• Press the Reposition button.

To deactivate the reposition function, do the following:
• Press the Reposition button again.

The button returns to its gray color, and the reposition function is
deactivated.
8.4.4 High quality function
The high quality function further enhances the image quality.

The high quality function can be combined with any anatomical
program. In the DSA and cine loop mode, the high quality function is
automatically activated. If you activate the high quality function in
another mode and initiate radiation, an audible alarm sounds.
Keep the radiation time as short as possible, since the high quality
function uses a higher radiation dose.
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To activate the high quality function, do the following:
• Press the High Quality button.

The button is highlighted in yellow. When you initiate radiation, an
audible alarm sounds.
To deactivate the high quality function, do the following:

The button returns to its gray color, and the high quality function is
deactivated.
8.4.5 Large patient function
The large patient function enables screening of patients of heavy built.

The large patient function can be combined with any anatomical
program.
To activate the large patient function, do the following:

• Press the Large Patient button.
To deactivate the large patient function, do the following:

The button returns to its gray color, and the large patient function is
deactivated.
8.5 Screen display during radiation
While radiation is active, the current fluoroscopic image is displayed on Fluoroscopic

the live screen. image
When you terminate radiation (by releasing the hand or foot switch), the
last fluoroscopic image is displayed on the live monitor (Last Image
Hold).
This image remains displayed until it is replaced by a new fluoroscopic
image.
During the exposure, the tube voltage and the tube current are Fluoroscopy
determined by the system, and the values are shown on the Voltage and parameters
Current displays of the control panel.
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Optical signals During the exposure (fluoroscopy or direct radiography), the yellow
radiation warning lamp on the monitor cart and the X-ray symbol on the
control panel are illuminated. (→ Ch. 6.1.1, p. 6-1).
8.6 Dose area product
The dose area product is saved for each patient folder and updated with
each exposure, so that you can always see the total dose received by a
patient until now. This also includes the dose area product for images
which have not been saved.
Display on the When you activate a patient folder and switch to the Fluoroscopy or
control panel Subtraction operating mode, the total dose received by the patient until
now is shown in the Dose Area Product display.
Image information When you generate a new fluoroscopic image or open a saved image,
on the monitor the total dose area product for the active patient folder is displayed on the
monitor (→ Ch. 16.2.4, p. 16-3).
8.7 Saving
CAUTION
When the hard disk is full, the oldest patient folder will be overwritten
without warning.
Before saving an image, make sure that there is enough free hard disk
space, and regularly back up the patient folders which are still needed
on external storage media or on a network.
Image number Each saved image automatically receives an image number. These
image numbers are assigned and incremented consecutively for each
separate patient folder.
Unsaved images (those without a number) will be replaced by a new
fluoroscopic image during the next fluoroscopy.
Default foot switch Usually the save image function is assigned to the right pedal of the two-
assignment pedal foot switch. Depending on the customer-specific configuration, the
foot switch pedals may be programmed with other functions and are
labeled accordingly in this case.
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To save the last image displayed on the live monitor to the active
patient folder, do the following:
• Press the Save button.
or or
• If the right foot switch pedal is programmed with the save image
function:
Press the right pedal of the two-pedal foot switch. 2
During the save operation, the save symbol is displayed on the live
monitor.
When the save operation has been completed, the image number is
displayed on the monitor (→ Ch. 16.2.2, p. 16-1).
You can configure the Ziehm Vision so that during each fluoroscopy a Autostore
new image will be saved automatically as soon as you terminate radiation
(autostore).
To activate the autostore function, do the following:

• Press the Save button for approx. 2 seconds.
The autostore function is activated. The Save button is highlighted in
yellow. During each subsequent fluoroscopy, a new image is
automatically saved as soon as you terminate radiation.
To deactivate the autostore function, do the following:

• Press the Save button briefly.
The button returns to its gray color, and the autostore function is
deactivated.
Alternatively, you can activate and deactivate the autostore function in
the Configuration operating mode under Operation Settings
(→ Ch. 20.2.2, p. 20-3).
When you attempt to save an image and there is not enough hard disk Auto-delete
space left, the patient folders and/or images on the hard disk will be function
overwritten automatically and without confirmation prompt in the
following order:
• First, the oldest patient folder is overwritten. If there is still not enough
disk space for the save operation, then the second oldest, third oldest,
etc., patient folder are deleted. However, the active patient folder is
never deleted.
• If a patient folder contains one or more protected images, only the

unprotected images are deleted, but not the protected images or the
folder itself.
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• If it is not possible to free up enough space on the hard disk for the
save operation due to the large number of protected images, an
audible alarm sounds and the following alert message appears on the
control panel:
Not enough space on hard disk.
Required: xyz. Available: xyz.
The save operation is aborted.
Cine loop When you attempt to generate a cine loop, the system will check whether
the remaining hard disk space is sufficient for the selected number of
images (→ Ch. 12.2, p. 12-1). If disk space is insufficient, the
unprotected patient folders and/or images are deleted in the above order.
If this does not free up sufficient disk space either, no cine loop is
acquired.
Note
If more than 75% of the hard disk is full, the exact percentage of used
hard disk space will be displayed on the screen during power-up of the
system. This gives you an approximate idea of the remaining hard disk
space.
8.8 Printing the live monitor image
The print live monitor image function is available in the following

operating modes: Fluoroscopy, Subtraction, Post Process,
Measurement and Archive. This function is only enabled if the monitor
cart is equipped with a video printer. The function always prints out the
image which is displayed at full-screen size on the live monitor.
The text information that is displayed on the screen together with the
image (name of the patient, angle of rotation of the image, etc.) will
appear as a text block on a gray background at the left margin of the
printout.
If you have performed measurements in an image and saved them
subsequently, the measured values are printed on a second page.
To print out the live monitor image on the video printer, do the
following:
• Press the Print Live Monitor Image button.
The image displayed on the live monitor is printed.
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8.9 Warning signals and faults
8.9.1 Permanent warning during radiation
Active radiation (both during fluoroscopy and direct radiography) is

indicated by two optical signals:
− The yellow radiation warning lamp on the monitor cart is illuminated.
− The X-ray symbol on the control panel is illuminated.
8.9.2 Interval warning during radiation
In order to prevent radiation from being accidentally generated over a Warning function
long time, the system has a warning function. After each 5 minutes of
elapsed total radiation time per patient, the system issues the following
interval warning:
− After 4 min. 55 sec., the following message appears on the control
panel:
The radiation time is 5 minutes. Switch off alarm?
− 5 seconds later, an audible alarm sounds.
CAUTION
If you do not switch off the alarm after 30 seconds max., radiation will be
terminated automatically.
You can see the total radiation time for the active patient folder on the
Radiation Time display.
To switch off the alarm, do the following:

• In the message window
The radiation time is 5 minutes. Switch off alarm?
press the Yes button.
The audible alarm is not started or stops (if it is already sounding). The
total radiation time remains displayed.
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8.9.3 Temperature monitoring
The thermal conditions in the generator are indicated by the

Temperature symbol.
Active Cooling During power-up of the system, the cooling pump is switched on
automatically. This function significantly prolongs the time until the
generator reaches its shutdown temperature.
8.9.4 Error and alert messages
In the event of faults, the corresponding error and alert messages are
displayed as text in a message window on the control panel. Error and
alert messages always start with the letter E.
At the same time, an audible alarm sounds.
For a detailed explanation of the messages, please refer to →
Appendix A.3.2, p. A-8.
• In case of faults, please communicate the fault code number and the
serial number of the system to your after-sales service center.
• To close a message window which displays an error or alert message,
press the Yes button.
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Adjusting Live Images 9
9.1 Overview
The Ziehm Vision offers the following functions for adjusting the Individual
appearance of the live image to your individual needs: adjustment
• Contrast/Brightness:
Monitor settings
• Contrast/Brightness:
Contrast and brightness adjustment of individual images
(windowing)
• Filter:
Recursive filter, stack filter and edge filter
• Magnify:
Electronic image magnification
• Zoom:
To enlarge a selected image detail
• Grayscale Inversion:
To display an image with negative grayscale
• Iris Collimator
• Vertical Slot Collimator
• Image Swapping:
To move an image to the other monitor
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9 Adjusting Live Images
• Reverse Up/Down:
Vertical image reversal
• Reverse Left/Right:
Horizontal image reversal
• Image Rotation
• Text:
Text functions (→ Ch. 16, p. 16-1)
Any adjustments (except texts) which are applied to a live image on the
live monitor remain valid for all subsequent live images until you choose
other settings.When you save an image, it will be saved with all rotations,
reversals, filter settings, texts and markers, etc. All these modifications
(except texts) are visible when the image is displayed as a thumbnail in
the mosaic.
9.2 Contrast and brightness settings for the CRT monitors
Function You can adjust the contrast and brightness of both monitors. These
settings affect any image or thumbnail image mosaic displayed on the
monitors and remain in force until you make new monitor settings or
restart the system.
Initial settings You can preset the initial monitor settings which are valid after power-up
of the system for both monitors in the Configuration operating mode
under Monitor / Dose (→ Ch. 20.4, p. 20-11).
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Fig. 9-1 Monitor settings and step windowing
To adjust the contrast and brightness of both monitors, do the

following:
• Press the Contrast/Brightness button.
The monitor setting buttons are displayed in the dynamic control area.
Fig. 9-2 Monitor setting and step windowing buttons
• Use the arrow buttons to set the desired brightness and contrast.
The new settings are reflected immediately on both monitors.
• If you want to restore the initial settings, press the Home button.
Contrast and brightness are reset to the initial settings. Step
windowing is reset to step 0.

The monitor setting buttons disappear from the dynamic control area.
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Ambient light The Ziehm Vision is equipped with an ambient light sensor. The sensor
sensor works automatically, so you do not need to activate it explicitly. The
screen brightness is continuously readjusted to match any change in
ambient light conditions during operation. The readjustment procedure is
quite slow (up to 1 minute in duration) in order to suppress monitor
flickering.
Proper functioning of the ambient light sensor can be checked in the
Configuration operating mode (→ Ch. 20.4, p. 20-11).
9.3 Contrast and brightness adjustment of individual images

(windowing)
Function The Windowing function allows you to adjust the contrast and brightness
of the image on the live monitor. These settings affect any newly-
acquired live image which is displayed on the live monitor and remain in
force until you make new windowing settings. When you save the live
image, the corresponding windowing values are saved together with the
image.
After activating the windowing function, you can select a number of gray
levels, which are then stretched over the entire range of 1024 gray levels
of the original image on the live monitor. To achieve this effect, you adjust
the width and the level of the so-called contrast window.
The number of gray levels defines the width of the contrast window. The
width of the contrast window affects the image contrast. 1024 gray levels
correspond to the value W 100 on the Ziehm Vision.
The position of the selected gray levels on the original image grayscale
(ranging from 0 to 1024 gray levels) defines the level of the contrast
window. The level of the contrast window affects the image brightness.
Example:
You select all gray levels between 325 and 875. These gray levels are
then mapped (stretched) to the range of 0 to 1024 gray levels in the
processed image. This enhances the contrast.
Gray levels 0 to 324 of the original image are displayed as black, and
gray levels 876 to 1024 of the original image are displayed as white. This
means that the processed image is darker than the original image.
There are two different windowing modes available:
− Standard windowing:
The standard windowing mode allows you to freely choose the level
and width of the contrast window.
− Step windowing:
With step windowing, you choose between several predefined
windowing steps. These steps are preset and cannot be modified.
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The chosen windowing values are shown on the monitor as W X for the
width and L X for the level.
Note
When you change the windowing values of a single cine loop image, the
change will apply to all images of the respective cine loop.
To set the brightness and contrast in standard windowing mode, do

the following:
• Press the WNDW button.

The windowing setting buttons appear.
Fig. 9-4 Buttons for standard windowing
• Under Width, set the number of gray levels using the arrow buttons.
The chosen width is indicated by the length of the blue bar in the
dynamic control area. The changes are reflected immediately in the
image on the live monitor.
• Under Level, set the brightness range using the arrow buttons.
The chosen level is indicated by the position of the slider in the
• If you want to restore the factory settings (level 50, width 100), press
the Home button.
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To set the brightness and contrast with step windowing, do the

following:
• Select the desired windowing step using the arrow buttons.

The settings are reflected immediately in the image on the live
monitor.
• If you want to restore the factory settings for step windowing, press
the Home button.
Step windowing is reset to step 0. Simultaneously, brightness and
contrast are reset to the initial settings.
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9.4 Filters
You may apply different filters to the live image. The following filters are
available:
− Recursive filter
− Edge filter
− Stack filter (LIH)
Fig. 9-6 Filter settings in the live image
9.4.1 Recursive filter
The recursive filter adds the specified number of images during

fluoroscopy. Each newly-acquired image is superimposed by the result
of the previous addition with a certain weighting factor.
The higher the number of images you select, the greater the noise Noise suppression
suppression, but also the greater motion blurring.
There are three recursive filter levels, each corresponding to a preset
number of images between 1 and 16.
To set the recursive filter for the live image, do the following:
• Press the Filter button.
The filter setting buttons are displayed in the dynamic control area.
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Fig. 9-7 Filter settings for recursive, edge and stack filter
• Under Recursive, select the desired recursive filter level by pressing

the corresponding button.
The filter acts on the live image on the live monitor. The chosen
recursive filter level is shown on the monitor as NR X.
The filter setting buttons disappear from the dynamic control area.
Configuration The specific settings for the individual recursive filter levels are made in
the Configuration operating mode under Service Settings. You cannot
make these presettings yourself.
• Please contact your service engineer if you wish to set the individual
recursive filter levels or modify the present settings.
9.4.2 Edge filter
Edge enhancement The edge filter allows you to select a greater or lesser degree of edge
enhancement within the image. There are 4 levels available:
Level Meaning
Off No edge enhancement (original fluoroscopic image)
1 Slight edge enhancement
2 Medium edge enhancement
3 Strong edge enhancement
-1 Unsharp mask to reduce noise
Table 9-1 Edge filter levels
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To set the edge filter for the live image, do the following:
Fig. 9-8 Filter settings
• Under Edge, select the desired edge filter level by pressing the
corresponding button.
The filter acts on the live image on the live monitor. The chosen edge
filter level is shown on the monitor as RTE Y.
9.4.3 Stack filter
The stack filter generates and adds a specified number of images after
radiation has been terminated.
The higher the number of images you select, the greater the noise Noise suppression
suppression, but also the greater motion blurring if the patient moves
during image generation. You can choose between the following number
of images: 1 image (Off), 2, 4, 8, 16 images.
To set the stack filter for the live image, do the following:
Fig. 9-9 Filter settings
• Under LIH, select the desired stack filter level by pressing the
corresponding button.
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The filter acts on the live image on the live monitor. The chosen stack
filter level is shown on the monitor as LIH Z.
9.5 Electronic image magnification
Function The image intensifier’s format selection function (‘magnification’)

magnifies the fluoroscopic image electronically, whereby the image
resolution increases proportionally to the magnification factor. This
function is not available on a Ziehm Vision FD.
For 23 cm i.i. systems, the magnification levels 23 cm, 15 cm and 10 cm
are available. For 31 cm i.i. systems, the magnification levels 31 cm, 23
cm and 15 cm are available.
The current image magnification level is automatically indicated on the
Magnify button.
To select the image magnification level, do the following:

• Press the Magnify button.
The current level is indicated on the button.
The magnification level setting buttons are displayed in the dynamic
control area.
Fig. 9-10 Image magnification levels
• Select the desired image magnification level.

The settings become immediately valid on the live monitor. The
chosen image magnification level is shown on the monitor as MAG X.
• Press the Magnify button.
The magnification level setting buttons disappear from the dynamic
control area.
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9.6 Digital image zooming
The zoom function allows you to enlarge a certain image detail. There Function
are three zoom levels available. The desired image detail can be
controlled either with the arrow buttons or with the integrated touchpad.
Touchpad
Fig. 9-11 Zoom function for the live image
To enlarge an image detail, do the following:

• Press the Zoom button.
The active image also appears on the reference monitor.
The zoom function buttons are displayed in the dynamic control area.
Fig. 9-12 Zoom function settings
• Select the desired zoom factor by pressing the corresponding button,

e.g. 4 X.
A marking circle appears in the center of the live image on the live
monitor. The image area within the marking circle is displayed on the
reference monitor with the chosen zoom level.
• Move the marking circle to the desired image area using the arrow
buttons.
The chosen image detail is displayed on the reference monitor with
the chosen zoom level.
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• If you want to move the marking circle back to the center of the live
image, press the Home button.

The zoom function buttons disappear from the dynamic control area.
To enlarge an image detail with the help of the touchpad, do the

following:

e.g. 4 X.
A marking circle appears in the center of the live image on the live
• Move the marking circle to the desired position by gliding your finger
slightly across the touchpad.

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9.7 Grayscale inversion
The grayscale inversion function allows you to represent the live image Function
with a negative grayscale.
To represent an image with a negative (or positive) grayscale, do

the following:
• Press the Grayscale Inversion button.
The live image is represented with a negative grayscale on the live
monitor, and the button is highlighted in yellow.
• Press the Grayscale Inversion button again.

The live image is again represented with a positive grayscale, and the
button returns to its gray color.
9.8 Collimation
The system is equipped with an iris and a slot collimator. These Function
collimators allow you to limit the area of exposure of the patient just to the
region of interest.
This offers the following advantages:
− Reduction of the radiation burden
− Less chance of flaring
− Better detail rendition and higher contrast
9.8.1 Iris collimator
The iris collimator can be adjusted steplessly. Normally, the iris collimator
is completely open, and only the Close Iris Collimator button is visible
on the control panel. As soon as you start closing the iris collimator, the
Open Iris Collimator button appears on the control panel.
To adjust the iris collimator, do the following:

• Press the Close Iris Collimator button until the collimator aperture on
the live monitor is as desired.
The Open Iris Collimator button appears on the control panel.
• Press the Open Iris Collimator button until the collimator aperture on
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In addition, you can fully open the iris collimator in one step:
• Press the Open Iris Collimator Fully button.
9.8.2 Slot collimator
The slot collimator can be adjusted steplessly. Normally, the slot

collimator is completely open, and only the Close Vertical Slot
Collimator button is visible on the control panel. As soon as you start
closing the slot collimator, the Open Vertical Slot Collimator, Rotate
Vertical Slot Collimator CW and Rotate Vertical Slot Collimator CCW
buttons appear on the control panel.
To adjust the slot collimator, do the following:

• Press the Close Vertical Slot Collimator button until the collimator
aperture on the live monitor is as desired.
The Open Vertical Slot Collimator, Rotate Vertical Slot Collimator
CW and Rotate Vertical Slot Collimator CCW buttons appear on the
control panel.
• Press the Open Vertical Slot Collimator button until the collimator
aperture on the live monitor is as desired.
• Press the Rotate Vertical Slot Collimator CW button until the

collimator orientation on the live monitor is as desired.
• Press the Rotate Vertical Slot Collimator CCW button until the
collimator orientation on the live monitor is as desired.
In addition, you can fully open the slot collimator or reset it to the 0°
position, each in one step:
• Press the Open Vertical Slot Collimator Fully button.
The slot collimator opens completely.
• Press the Rotate Vertical Slot Collimator to 0° button.

The slot collimator is reset to the 0° position.
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9.8.3 Virtual collimator
The Ziehm Vision is equipped with a virtual collimator, allowing you to Function
adjust the collimators without radiation. Using this feature, you can
significantly reduce patient exposure.
To perform a virtual collimation, do the following:

• Press the Open Iris Collimator Fully button.
The iris collimator opens completely.
• Press the Open Vertical Slot Collimator Fully button.

The vertical slot collimator opens completely.
• Select the desired anatomical program (→ Ch. 8.4.1, p. 8-7).

• Initiate radiation for a brief moment.
The generated image is displayed on the live monitor.
• Adjust the iris and the slot collimator as desired without radiation.
The areas of the image that will not be visible later are shown beneath
a gray overlay. The collimator boundaries are represented by white
edges.
9.9 Image swapping
With the image swapping function, you can move an image from one Function
monitor to the other. This allows you to generate two images and to
compare them directly to one another.
To compare an image with a live image, do the following:

• Generate a live image.
The image is displayed on the live monitor.
• Press the Image Swapping button.

The first image is moved to the reference monitor.
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• Generate a second live image.

The image is displayed on the live monitor. Now you can compare the
images on the two monitors to one another.
9.10 Image reversal and image rotation
Function The image reversal and image rotation functions are used for individual
adjustment of the image orientation on the live monitor.
You can use these functions to align the image orientation with the
patient’s orientation. To make orientation easier for the operator, a label
is attached to both the image intensifier and the generator housing,
showing a patient in supine position. If the patient is positioned as
illustrated by the label, then the image orientation on the live monitor
corresponds to the patient’s orientation.
Both image reversal and image rotation are produced digitally and
without the need to initiate any further radiation.
9.10.1 Horizontal and vertical image reversal
• Press the reverse up/down button.

The button is highlighted in yellow. On the live monitor, the image
appears with top and bottom reversed, and a symbol for up/down
reversal is displayed.
• Press the Reverse Left/Right button.
The button is highlighted in yellow. On the live monitor, the image
appears with left and right side reversed, and a symbol for left/right
reversal is displayed.
Image reversal is symbolized on the monitor by an R which is either
mirrored left-right or upside-down.
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9.10.2 Image rotation
• Press the Rotate Image CW button until the image orientation on the
live monitor is as desired.
The image is rotated steplessly in clockwise direction.
• Press the Rotate Image CCW button until the image orientation on
The image is rotated steplessly in counter-clockwise direction.
The chosen angle of rotation is shown on the monitor as R X.
As soon as an image is rotated, it assumes a circular shape. The image Ziehm Vision FD
has a square shape only in the following angle positions: 0°/360°, 90°,
180°, 270°.
To reset the angle of rotation to 0°, do the following:

• Press the Rotate Image to 0° button.
The image is reset to the 0° position.
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Data Management 10
10.1 Organization of patient and image data
Patient and image data is managed in the Patient (→ Ch. 10.2, p. 10-2)
and Archive operating modes (→ Ch. 10.3, p. 10-7). All data of a patient
is stored in a patient folder on the hard disk. All image data is assigned
to the corresponding patient folder.
When you switch to the Fluoroscopy or Subtraction operating mode
and no patient folder is active, the system will automatically create a new
patient folder (→ Ch. 10.1.2, p. 10-2).
10.1.1 Patient folders
In order to be able to relate the fluoroscopic images to a certain patient, Function

you must always create or activate a patient folder before acquiring an
image or a cine loop.
You can create as many patient folders as desired on the hard disk. In Storage capacity
each patient folder, you can store as many images as you wish. The total
number of images is limited only by the hard disk size (‘image memory’).
The size of the image memory depends on the chosen system
configuration.
When you save an image for which there would be no more space on the Auto-delete
hard disk otherwise, the oldest patient folder on the hard disk is function
automatically overwritten (→ Ch. 8.7, p. 8-10). If the oldest patient folder
contains one or more protected images (→ p. 10-24), only the
unprotected images are deleted, though. The folder itself as well as the
protected images are preserved.
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10 Data Management
10.1.2 Generated patient folders
When you switch on the system, a new patient folder is automatically

generated and activated. If you do not activate another patient folder
before switching to the Fluoroscopy or Subtraction operating mode, all
images are saved to this automatically generated patient folder.
Generated data The patient name which is generated is composed of the time of day and
date, e.g. P_12_34_01_04_03 for a patient folder which was created on
April 1, 2003 at 12:34 o’clock. In addition, a patient ID called PAT xyz is
entered. If you have predefined default data for the Hospital,
Department and Doctor input boxes, this data is also written to the
generated patient folder.
All images and/or cine loops will be saved to the generated patient folder
until you activate another patient folder. You may edit or complete all
patient data later (→ Ch. 10.2.2, p. 10-5).
If the system has generated such a patient folder, but no images or cine
loops have been saved to it, the generated patient folder will be deleted
during the next power-up of the Ziehm Vision.
10.2 Managing patient data
Patient data is managed in the Patient operating mode. When you create
a new patient folder, you may retrieve the patient’s data from a DICOM
server under certain conditions (→ Ch. 11.2, p. 11-1).
Length of the The length of the patient ID is limited by the system to 64 digits.
patient ID
Display of the If the patient number cannot be displayed completely in the fluoroscopic
patient ID image, it is represented in the form 1234567....
In the read-only boxes in the Archive operating mode, only the first 18 or
24 digits of the patient ID are displayed. In the Patient ID input box in the
Patient operating mode, you can scroll through the whole patient ID
using the arrow keys of the keypad.
Access. No. You can manually enter a hospital-specific internal administrative

number (Access. No.), or scan / import it with the patient data.
Subject You can enter a subject for each patient folder, which is saved together
with the patient data.
Editing data You can edit all data in an existing patient folder or add new data at any
time.
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10 Data Management
When you have created a new patient folder or activated an existing Importing images
patient folder, you can import one or more images or a series of images from a DICOM
from a DICOM server into this patient folder (→ Ch. 11.5, p. 11-12). server
Note
The date formats may vary, depending on the customer-specific
settings. In this manual, all date formats appear in the format
DD.MM.YYYY.
To activate the Patient operating mode, do the following:

• Press the Patient tab.
The input boxes of the Patient operating mode as well as the
alphanumeric keypad are now available on the control panel.
Buttons for Input

the input boxes
boxes
Alpha-
numeric
keypad
Fig. 10-1 Patient operating mode
When you have activated a patient folder, the corresponding data is

displayed in the input boxes.
10.2.1 Creating a new patient folder on the Ziehm Vision
When you create a new patient folder, you may choose between the
following ways of entering the patient data:
− You enter the patient data manually using the alphanumeric keypad.
− You retrieve the patient data from the DICOM server (Query or
Worklist, → Ch. 11.2, p. 11-1).
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10 Data Management
10.2.1.1 Entering patient data manually

The Patient operating mode is activated.
Note
You may predefine default data for the Hospital, Department and
Doctor input boxes. The desired data is entered in the Configuration
operating mode under Basic Settings.
• Press the New button.

The input boxes are cleared (if any data has been displayed before in
them), with the exception of those with default data (→ Ch. 20.3.3,
p. 20-10).
You may now enter the patient data.
• Press the button of the desired input box, e.g. the Last Name button.
The button is highlighted in yellow. The cursor jumps to the
corresponding input box.
Note
To type an uppercase letter, press and release the Shift key before
entering the respective letter. The Shift key is valid for one subsequent
letter. If you want to type several consecutive uppercase letters, press
the Caps Lock key before entering the letters.
• Enter the patient data with the help of the alphanumeric keypad. To
move to the next input box, always press the Enter key.
You must fill in at least the Last Name input box. The length of the
patient number must not exceed 64 digits. If you do not enter any
patient ID, the system automatically assigns a number in the Patient
ID box.
• Save the new patient folder and the data entered by pressing the
Save button.
The new patient folder is automatically activated. A blank fluoroscopy
mask with the newly-entered patient data appears on the live monitor.
You may now proceed to generating fluoroscopic images, which will be
assigned to the newly-created patient folder automatically:
• Switch to the Fluoroscopy or Subtraction operating mode and
or
generate the desired fluoroscopic images (→ Ch. 8, p. 8-1).
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10 Data Management
10.2.2 Modifying patient data
You can modify the patient data in any existing patient folder at any time.
You can use the name of the patient, the patient ID or a subject to search
for the patient folder whose data you want to modify.
Any patient data changes affect all existing and future images as well as Effects
the active image.
CAUTION
If you use the patient ID to search for a patient folder, please verify the
search result by checking the patient name. It may happen occasionally
that a patient ID is assigned more than once on a DICOM network.
To modify the data in an existing patient folder, do the following:

The input boxes may contain data you want to delete.

The data in all input boxes is deleted.
• Press the Search button.
A thumbnail mosaic with all patient folders is displayed on the
reference monitor. Each patient folder is symbolized by the most
recent image contained in it.
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10 Data Management
In the dynamic control area, the input boxes for searching as well as
an alphabetically sorted list of all patient folders are displayed.
Fig. 10-3 Input boxes for searching and hit list
Now you can browse through the patient folder mosaic with the help of
the arrow buttons or enter the desired search string:
• Enter the search string using the alphanumeric keypad.
Note
The search function is not case-sensitive.
With each letter you enter, the alphabetical hit list is more and more
confined to match the search string.
The All button appears, allowing you to re-display the entire list.
• Select the desired item on the list using the arrow buttons and press
the OK button.
The data of the selected patient is transferred to the input boxes. You
may overwrite this data now.
• Press the button of the input box whose data you want to modify.
• Overwrite the data you want to modify.

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10 Data Management
A message window with a confirmation prompt is displayed:
• Press the Overwrite button.

The existing data in the patient folder is overwritten by the newly-
entered ones.
or or

A new patient folder with the modified data is created.
10.3 Image data management
Image data is managed in the Archive operating mode.
To activate the Archive operating mode, do the following:

• Press the Archive tab.
The read-only boxes and buttons for managing the patient folders appear
Hard Disk
display
List
Read-
only Arrow
boxes buttons
Fig. 10-4 Archive operating mode with USB storage device (option)
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Mosaic All patient folders on the hard disk are displayed as a thumbnail mosaic
(up to 16 images at a time) on the reference monitor, each folder being
represented by its most recent image. In addition, the following
information appears for each patient folder of the mosaic: name of the
patient and number of images contained in the folder. You can browse
through the thumbnail mosaic using the arrow buttons.
List of patient The list shows the names of all patient folders in the order in which they
folders were created. The most recent folder appears at the bottom of the list, the
oldest one at the top.
The name of the folder which is marked by the cursor on the reference
monitor is highlighted by a yellow bar in the list, and the related data is
displayed in the read-only boxes. You cannot enter or edit any data in
these read-only boxes.
Arrow buttons Using the arrow buttons you can move the cursor around the list and
simultaneously from one patient folder or image to another on the
reference monitor.
Hard Disk display The Hard Disk display indicates the percentage of used hard disk space.
10.3.1 Processing patient folders
The following functions for navigation and patient folder processing are
available in the Archive operating mode:
− Search:
To search for a patient folder (→ Ch. 10.3.2, p. 10-15)
− Pos 1:
To place the cursor on the first patient folder in the mosaic
− End:
To place the cursor on the last patient folder in the mosaic
− Mark:
To mark one or more patient folders
− Delete:
To delete patient folders
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− Invert entire archive:

To invert the grayscale of all images on the hard disk
− Print:
To print marked patient folders on the video printer
− CD/DVD:
To write marked patient folders to CD or DVD
− USB:
To save marked patient folders to a USB storage device
− DICOM Store:
To save marked patient folders to a DICOM server (→ Ch. 11.3,
p. 11-8)
− Backup:
To select patient folders and back them up to a USB storage device
or a CD/DVD (→ Ch. 10.3.7, p. 10-30)
− Restore CD/DVD:
To retrieve backed-up patient folders from a CD or DVD (→ p. 10-36)
− Restore USB:
To retrieve backed-up patient folders from a USB storage device
(→ p. 10-33)
Depending on the chosen configuration, your Ziehm Vision may be CD writer or DVD
equipped with a CD writer or alternatively with a DVD writer. With a CD writer
writer, data can be written to or retrieved from CDs only. With a DVD
writer, data can be written to or retrieved from both CDs and DVDs.
Images in the following graphics formats have a file size of approx. 2 MB: Image file sizes
− 8 bit BMP
− 16 bit TIF
− DICOM
− Multimedia
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Besides that, you may also save the images with reduced resolution and
color depth in the following formats:
− DICOM 512×512 8 Bit
− JPEG 512×512
Images with reduced resolution and color depth have a file size of
approx. 256 KB (1/4 MB).
Note
It is not possible to save a patient folder to a floppy disk.
Marking All processing functions affect exclusively the marked patient folders.
The only exception is the delete function: In this case it is possible to
delete either all marked patient folders, or all unmarked patient folders,
or only the patient folder where the cursor is.
As soon as the marked patient folders have been output on a printer or
saved to a storage medium, they will automatically become unmarked.
To mark one or more patient folders, do the following:
• Select the desired patient folder in the thumbnail mosaic on the

reference monitor using the arrow buttons.
• Press the Mark button.
The patient folder is now marked and receives the label M.
• If you want to mark further patient folders in addition, repeat the

procedure.
To unmark a patient folder, do the following:
• Select the desired marked patient folder on the reference monitor

using the arrow buttons.
The patient folder becomes unmarked.
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You can delete a patient folder only if does not contain any protected Deleting patient
images. When you try to delete a folder which contains protected images, folders
the folder itself as well as the protected images remain on the hard disk.
Only the unprotected images are deleted. If you want to delete protected
images, you must unprotect them first (→ p. 10-24).
To delete one or more patient folders, do the following: Deleting
CAUTION
A deleted patient folder is irretrievably lost.
Back up the patient folders you want to delete, or make sure that they
are really no longer needed.
• Mark the patient folders you want to delete and press the Delete
Marked Items button.
The following confirmation prompt is displayed:
or or
• Mark the patient folders you do not want to delete and press the
Delete Unmarked Items button.
or or
• Use the arrow buttons to select an individual patient folder you want
to delete and press the Delete button.
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• Confirm by pressing the Yes button.

The patient folders are deleted from the hard disk. If one of the
selected patient folders contains any protected images, only the
unprotected images will be deleted, and the following message
appears on the control panel:
Patient folder with protected images cannot be deleted!
Inverting the entire If you are used to working with negative images (e.g. because you are a
archive radiologist), you can invert the grayscale of all images on the hard disk in
one step. This function is not available for cine loops, DSA cine loops,
MSA and RSA images. Images that have already been saved with a
negative grayscale remain as they are.
To invert all images or to undo the grayscale inversion, do the

following:
• Press the Invert All button.
The grayscale of all images on the hard disk is inverted. In mosaic
view, the images are always represented with a positive grayscale.
The negative grayscale will not become visible until you display an
image at full-screen size.
• Terminate the Archive operating mode, or press the Invert All button
again.
The grayscale inversion of all images is undone.
Printing on video You can mark one or more patient folders and print all images contained
printer in them in one go. Besides, you can print the image displayed on the live
monitor (→ Ch. 8.8, p. 8-12).
To print all images of one or several patient folders on the video

printer, do the following:
• Mark the desired patient folders.
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• Press the Print button.

All images of the marked folders are output on the video printer
mounted in the monitor cart.
A progress indicator in a message window on the control panel
informs you about the status of the print operation. The Cancel button
appears, enabling you to interrupt the print operation.
Once they have been printed, the patient folders become unmarked.
following:
The images of one or more patient folders can be saved to a standard Saving to USB
USB storage device in the following formats: storage device
− TIF with 16 bit color depth
− JPEG with a resolution of 512×512 pixels and 8 bit color depth
− DICOM
− DICOM with a resolution of 512×512 pixels and 8 bit color depth
The storage format is defined in the Configuration operating mode
under Storage Media (→ Ch. 20.5.2, p. 20-14).
Whenever you save images in standard DICOM format or ‘reduced’ Ziehm DICOM
DICOM format (with a resolution of 512×512 pixels and 8 bit color depth) Viewer
to a USB storage device, the Ziehm DICOM Viewer program is
automatically saved to the USB storage device as well. This program
enables you to view the DICOM images on any PC with Microsoft®
Windows operating system (version Microsoft® Windows 98 or
higher).
To save one or more patient folders to a USB storage device, do the

following:
• Plug the USB storage device into the USB port on the monitor cart.
• Press the USB button.

The marked patient folders are saved to the USB storage device. A
progress indicator in a message window on the control panel informs
you about the status of the save operation. The Cancel button
appears, enabling you to interrupt the save operation.
Once they have been saved, the patient folders become unmarked.
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Writing to CD or The images of one or more patient folders can be written to CD or DVD
DVD in the following formats:
− DICOM
− Multimedia (Video CD or MPEG2)
Ziehm DICOM Whenever you write images in standard DICOM format or ‘reduced’
Viewer DICOM format (with a resolution of 512×512 pixels and 8 bit color depth)
to a CD/DVD, the Ziehm DICOM Viewer program is automatically written
to the CD/DVD as well. This program enables you to view the DICOM
images on any PC with Microsoft® Windows operating system (version
Microsoft® Windows 98 or higher).
To write one or more patient folders to CD or DVD, do the following:

• Insert a CD or DVD into the CD or DVD writer mounted in the monitor

cart.
• Press the CD/DVD button.
The following messages appear one after the other:
Checking CD/DVD...
Write images to CD/DVD?
• Confirm by pressing the Yes button. A progress indicator in a

message window on the control panel informs you about the status of
the write operation.
Once the write operation has been completed successfully, the
following message is displayed:
Writing of CD/DVD completed successfully
• Press the OK button.
Once they have been written to CD or DVD, the patient folders
become unmarked.
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10.3.2 Finding and displaying a patient folder
The following criteria can be used to search for a patient folder: Search criteria
− Name of the patient (Last Name box)
− Patient number (Patient ID box)
− Keyword (Subject box)
You can combine these search criteria using an AND operation. Thus,
you could look e.g. for all patients called Miller with the subject Knee.
CAUTION
To find a patient folder, do the following:

The Archive operating mode is activated.
The input boxes for searching are displayed in the dynamic control
area. A list of all patient names is displayed.
Now you can enter the desired search string(s).

Note
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• Press the Back button.
You are returned to the Archive screen. The data of all patients who
match the search string(s) is displayed in the list.
• Select the desired patient folder using the arrow buttons.

All images contained in this patient folder are displayed as thumbnails
on the reference monitor. The most recent image is highlighted by a
white frame. Cine loop sequences are symbolized by their last image
and bear the label C.
Other buttons and read-only boxes for processing individual images
(→ Ch. 10.3.5, p. 10-20) or cine loops (→ Ch. 12.5, p. 12-8) appear
Thumbnail display The thumbnails in the mosaic reflect all the modifications applied to them
after fluoroscopy (e.g. contrast adjustment, rotation, zoom).
Image information The information pertaining to the image which is marked by the cursor on
the reference monitor is displayed on the control panel:
Fig. 10-6 Archive operating mode: Read-only boxes displaying

image information
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10.3.3 Activating a patient folder
To be able to save new images to an existing patient folder, you must

activate this patient folder before switching to the Fluoroscopy or
Subtraction operating mode. You can activate an existing patient folder
either in the Patient or Archive operating mode.
To activate a patient folder in the Patient operating mode, do the

following:
The input boxes may contain data you want to delete.

The data in all input boxes is deleted.
A thumbnail mosaic with all patient folders is displayed on the
reference monitor. Each patient folder is symbolized by the most
recent image contained in it.
In the dynamic control area, the input boxes for searching as well as
an alphabetically sorted list of all patient folders are displayed.
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Now you can browse through the patient folder mosaic with the help of
the arrow buttons or enter the desired search string:
Note
• Select the desired item on the list using the arrow buttons.

The data of the selected patient is transferred to the input boxes, and
the patient folder is activated. Now you can switch to the
Fluoroscopy or Subtraction operating mode.
To activate a patient folder in the Archive operating mode, do the

following:
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Note

The patient data and the buttons for image and cine loop processing
appear in the dynamic control area.

The patient folder is activated now. Now you can switch to the
Fluoroscopy or Subtraction operating mode.
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10.3.4 Browsing through the active patient folder
In the Fluoroscopy, Subtraction and Post Process operating modes,

you can display all images of the active patient folder at full-screen size
without having to switch to the Archive operating mode.
• Activate the desired patient folder (→ Ch. 10.3.3, p. 10-17).
• Switch to the desired operating mode (Fluoroscopy, Subtraction or

Post Process).
• Use the arrow buttons to browse through the active patient folder.
The Down Arrow button moves you to the image with the next lower
image number.
The Up Arrow button moves you to the image with the next higher
image number.
10.3.5 Processing and outputting images in a patient folder
Once you have displayed (→ Ch. 10.3.2, p. 10-15) or activated

(→ Ch. 10.3.3, p. 10-17) a patient folder, you can process and output the
images and the cine loops that are stored there. Different read-only
boxes and buttons are displayed on the control panel for that purpose.
Read-
only
boxes
Buttons for Arrow

marking buttons for
and navigating
deleting on the
monitor
Buttons
for
printing
Buttons for
saving
Fig. 10-10 Archive operating mode with displayed patient folder
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The read-only boxes show patient data and image information. The Read-only boxes
Images (Total) box shows how many images or cine loops are stored in
the patient folder. If the cursor is on a cine loop within the patient folder,
the Images box shows the number of images that make up the cine loop.
If the cursor is on an individual image, the number 1 appears there.
We will now discuss how to process and output individual images. For Image processing
information on how to process and output cine loops in a patient folder, and output
please refer to → Ch. 12.5, p. 12-8.
The following functions are available in a displayed or active patient
folder for navigating within the folder and for displaying and processing
individual images:
− OK (with displayed patient folder only):
To display an image at full-screen size on the live monitor and to
activate the displayed patient folder
− Full-Screen Image:
To display an image at full-screen size on the reference monitor
Mosaic:
To reset the live monitor to the mosaic view
The Mosaic button appears as soon as you have chosen the full-
screen view on the live monitor.
− Pos 1:
To place the cursor on the first image of the patient folder
− End:
To place the cursor on the last image of the patient folder
− Mark:
To mark one or more images
− Protect:
To protect marked images against being deleted
− Delete:
To delete images
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− DICOM Retrieve:
To import images from a DICOM server into the displayed or active
patient folder (→ Ch. 11.5, p. 11-12)
− Print:
To print marked images on the video printer
− DICOM Print:
To print out marked images on a DICOM network printer
(→ Ch. 10.3.5, p. 10-20)
− Floppy:
To save marked images to floppy disk
− CD/DVD:
To write marked images to CD or DVD
− USB:
To save marked images to a USB storage device
− DICOM Store:
To save marked images to a DICOM server (→ Ch. 10.3.5, p. 10-20)
Any action which is performed affects exclusively the marked images, or

the image where the cursor is. There are, however, a few exceptions to
this rule:
− Delete protection: You can only protect the image where the cursor
is.
− Delete: You can delete either all marked images, or all unmarked
images, or only the image where the cursor is.
As soon as the marked images have been output on a printer or saved to
a storage medium, they will automatically become unmarked. Protected
images, however, will remain delete-protected even after output.
CD writer or DVD Depending on the chosen configuration, your Ziehm Vision may be
writer equipped with a CD writer or alternatively with a DVD writer. With a CD
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Images that have been saved to a floppy disk or a USB storage device Further processing
or written to CD or DVD cannot be re-imported from the storage medium
into the system. For opening and processing these externally saved
images, you need a separate PC which is equipped with the appropriate
drives and software.
− 8 bit BMP
− 16 bit TIF
− DICOM
− Multimedia
− DICOM 512×512 8 Bit
− JPEG 512×512
To display an image at full-screen size on the live monitor, do the Full-screen image
following:
• Select the desired image in the thumbnail mosaic on the reference
monitor using the arrow buttons.

The selected image is displayed at full-screen size on the live monitor.
Simultaneously, the displayed patient folder is activated.
To display an image at full-screen size on the reference monitor, do

the following:
• Press the Full-Screen Image button.

The selected image is displayed at full-screen size on the reference
monitor. The Mosaic button appears, enabling you to restore the
mosaic view on the reference monitor.
To mark one or more images, do the following: Marking

• Select the desired image on the reference monitor using the arrow
buttons.
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The image is now marked and receives the label M.
• If you want to mark further images in addition, repeat the procedure.
To unmark an image, do the following:

• Select the desired marked image on the reference monitor using the
arrow buttons.

The image becomes unmarked.
Protecting To protect one or more images, do the following:

buttons.
• Press the Protect button.

The image is now delete-protected and receives the label P.
• If you want to protect further images, repeat the procedure.
To unprotect an image, do the following:

• Select the desired protected image using the arrow buttons.

The image becomes unprotected.
Note
Patient folders containing protected images cannot be deleted
automatically. If many folders on the hard disk contain protected images,
the auto-delete function (→ p. 8-11) may not be working properly, and
you will be unable to save new images.
To avoid this situation, regularly back up the patient folders which are
still needed to external storage media or to a DICOM server. You can
then manually delete those patient folders or unprotect them and allow
the auto-delete function to free up space on your hard disk.
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To delete one or more images from a patient folder, do the Deleting

following:
CAUTION
Deleted images are irretrievably lost.
Back up the images you want to delete or make sure that they are really
no longer needed.
• Mark the images you want to delete and press the Delete Marked
Items button.
or or
• Mark the images you do not want to delete and press the Delete
Unmarked Items button.
or or
• Use the arrow buttons to select an individual image you want to delete
and press the Delete button.
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The images are deleted from the patient folder.

If you happen to select protected images, only the unprotected ones
will be deleted, and the following message appears on the control
panel:
Protected images have not been deleted!
Printing on video You can mark one or more images in the patient folder and print them all
printer in one go. Besides, you can print the image displayed on the live monitor
(→ Ch. 8.8, p. 8-12).
To print out images on the video printer, do the following:

• Position the cursor on the desired image, or mark the images you
want to print.

The marked images are printed on the video printer mounted in the
monitor cart. A progress indicator in a message window on the control
panel informs you about the status of the print operation. The Cancel
button appears, enabling you to interrupt the print operation.
Once they have been printed, the images become unmarked.
following:
Saving to floppy You can save images to floppy disk in 8 bit BMP format only.
disk
The floppy disk must have been preformatted on an external MS DOS®
compatible PC. The floppy disk drive which is mounted in the system
does not support formatting.
To save an image to floppy disk, do the following:
• Position the cursor on the desired image.
• Insert a formatted floppy disk into the floppy disk drive mounted in the
monitor cart.
• Press the Floppy Disk button.
The marked image is saved to the floppy disk. A progress indicator in
a message window on the control panel informs you about the status
of the save operation. The Cancel button appears, enabling you to
interrupt the save operation.
Once it has been saved, the image becomes unmarked.
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You can save images to a standard USB storage device in the following Saving to USB
formats: storage device
− DICOM
higher).
To save images to a USB storage device, do the following:

want to save.
The marked images are saved to the USB storage device. A progress
indicator in a message window on the control panel informs you about
the status of the save operation. The Cancel button appears,
enabling you to interrupt the save operation.
Once they have been saved, the images become unmarked.
You can write images to CD or DVD in the following formats: Writing to CD or

DVD
− DICOM
− Multimedia (Video CD or MPEG2 format)
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To write images to CD or DVD, do the following:

want to write to CD or DVD.

cart.
Checking CD/DVD...
the write operation. The Cancel button appears, enabling you to
interrupt the write operation.
Once they have been written to CD or DVD, the images become
unmarked.
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10.3.6 Comparing saved images
You may display saved images either from one patient folder or from
several different patient folders at full-screen size on the live and
reference monitor and compare them to each other.
To compare two images from the same patient folder, do the

following:
• Activate the Archive operating mode.
• Display the desired patient folder (→ Ch. 10.3.2, p. 10-15).

buttons.

The image is displayed at full-screen size on the live monitor.
• Using the arrow buttons, select the second desired image and press
the Full-Screen Image button.
The second image is displayed at full-screen size on the reference
mosaic view on the live monitor.
You may compare the two images now.
To compare two images from different patient folders, do the

following:
• Activate the Archive operating mode.

buttons.

The image is displayed at full-screen size on the live monitor.
• Display the desired second patient folder (→ Ch. 10.3.2, p. 10-15).

• Using the arrow buttons, select the second desired image and press
the Full-Screen Image button.
The second image is displayed at full-screen size on the reference
mosaic view on the live monitor.
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You may compare the two images now.
10.3.7 Making backup copies of patient folders
You can back up the patient folders stored on the hard disk to a USB
storage device or a CD/DVD. To select the patient folders you want to
back up, you can use different search criteria (Last Name, Patient ID,
Subject) and/or the image creation date. You can combine all these
search criteria and also the image creation date (if desired) using an AND
operation. Thus, you could e.g. search for and back up all patients called
Miller with the subject Knee.
Fig. 10-11 Archive Backup operating mode
Selecting patient You can back up only entire patient folders with all images contained in
folders them. To determine which folders are to be backed up, you use the image
creation date and certain search criteria:
− Selection using the image creation date
When you enter e.g. a period between 01.01.YYYY and 31.01.YYYY,
all patient folders containing images that were created between
January 1, YYYY and January 31, YYYY will be backed up. These
folders are backed up in their entirety, including the images that were
not created within the specified period of time.
− Selection using search criteria
You can specify the patient folders you want to back up by entering
the patient name (Last Name), patient number (Patient ID) and/or the
Subject as search criteria.
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The search criteria and the time period are automatically combined by an
AND operation.
In addition, you can back up all patient folders to the chosen storage
medium.
10.3.7.1 Backup to USB storage device
The maximum number of images that fit on a USB storage device Storage capacity
depends on the storage capacity of the device used as well as the
percentage of images with reduced resolution and color depth
(→ p. 10-23). To be able to back up images on a USB storage device, the
latter must be empty.
During backup, the system will check automatically whether the
remaining disk space is sufficient for the next folder to be backed up. If
the folder is too large to fit on the connected USB storage device, you will
be prompted by a message to plug another USB storage device into the
USB port.
You can restore the data which has been backed up to a USB storage Restoring backed-
device to the system’s hard disk at any time (→ p. 10-33). If the backup up data
copy has been distributed to several USB storage devices, you must plug
in the USB storage devices in the same order as during the backup
procedure for restoring the data.
To back up selected patient folders to a USB storage device, do the

following:
• Press the Backup button.
The backup setting buttons are displayed in the dynamic control area.
The Start Date input box contains by default the date 01.01.1970.
The End Date input box contains by default the current date.
Fig. 10-12 Backup setting buttons
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• Plug a USB storage device into the USB port.

• Press the Last Name button and enter a search string in the related
input box.
Note
• If desired, press the Patient ID button and enter a patient number in
the related input box.
• If desired, press the Subject button and enter a search string in the
related input box.
• If you want to confine the image creation period, press the Start Date
button and enter another date in the related input box.
• If you want to confine the image creation period, press the End Date
Press the Show Selected button.

All patient folders shown on the list are backed up to the USB storage
device. A progress indicator in a message window informs you about
the status of the backup operation.
If there is not enough disk space left on the connected USB storage
device, the following message appears:
Please plug in another USB storage device.
• Plug another USB storage device into the USB port. Make sure to
label the USB storage devices so that you can later identify the order
in which they were connected.
To back up all patient folders to a USB storage device, do the

following:
The End Date input box contains by default the current date. This
period covers all possible image data.
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• Plug a USB storage device into the USB port.

All patient folders are backed up to the USB storage device. A
progress indicator in a message window informs you about the status
of the backup operation.
If there is not enough disk space left on the connected USB storage
device, the following message appears:
Please plug in another USB storage device.
• Plug another USB storage device into the USB port. Make sure to
label the USB storage devices so that you can later identify the order
in which they were connected.
To restore backed-up data from a USB storage device to the hard

disk, do the following:
• Plug the USB storage device that contains the first part of the backup
copy into the USB port.
• Press the Restore USB button.
All patient folders and images that have been backed up to the USB
storage device before are restored and saved to the system’s hard
disk. All restored patient folders are re-created on the hard disk, in
addition to the already existing ones.
• Plug all further USB storage devices used for the backup into the USB
port (if applicable). Make sure to connect them in the same order as
during the backup procedure.
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10.3.7.2 Backup to CD or DVD
Storage capacity A CD can store up to 320 images or up to 2,500 images with reduced
resolution and color depth (→ p. 10-23). The maximum number of
images depends on the percentage of images with reduced resolution
and color depth. Since the contents of a patient folder cannot be
distributed to several CDs, it is not possible to back up patient folders that
contain more than 250 images or 2,500 images with reduced resolution
and color depth.
A DVD can store up to 2,000 images or up to 8,000 images with reduced
resolution and color depth (→ p. 10-23). The maximum number of
images depends on the percentage of images with reduced resolution
and color depth. Since the contents of a patient folder cannot be
distributed to several DVDs, it is not possible to back up patient folders
that contain more than 2,000 images or 8,000 images with reduced
resolution and color depth.
During backup, the system will check automatically whether the
remaining disk space is sufficient for the next folder to be backed up. If
the folder is too large to fit on the CD or DVD in the drive, you will be
prompted by a message to insert another CD or DVD into the drive.
Restoring backed- You can restore the data which has been backed up to CD or DVD to the
up data system’s hard disk at any time (→ p. 10-36). If the backup copy has been
distributed to several CDs or DVDs, you must insert the CDs or DVDs in
the same order as during the backup procedure for restoring the data.
To back up selected patient folders to CD or DVD, do the following:

The End Date input box contains by default the current date.
• Insert an empty CD or DVD into the CD or DVD writer.

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• Press the Last Name button and enter a search string in the related
input box.
Note
• If desired, press the Patient ID button and enter a patient number in
the related input box.
• If desired, press the Subject button and enter a search string in the
related input box.
• If you want to confine the image creation period, press the Start Date
• If you want to confine the image creation period, press the End Date
• Press the Show Selected button.

The following message appears:
Checking CD/DVD...
All patient folders shown on the list are backed up to the CD or DVD.
A progress indicator in a message window informs you about the
status of the backup operation.
If there is not enough disk space left on the inserted CD or DVD, the
following message appears:
Please insert new CD/DVD.
• Insert another CD or DVD. Make sure to label the CDs or DVDs so

that you can later identify the order in which they were inserted.
Once the write operation has been completed successfully, the following
message is displayed:
To back up all patient folders to CD or DVD, do the following:

The End Date input box contains by default the current date. This
period covers all possible image data.
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10 Data Management
• Insert an empty CD or DVD into the CD or DVD writer.

The following message appears:
Checking CD/DVD...
All patient folders are backed up to the CD or DVD. A progress
indicator in a message window informs you about the status of the
backup operation.
If there is not enough disk space left on the inserted CD or DVD, you
will be prompted to insert another disk into the drive:
Please insert new CD/DVD.
• Insert another CD or DVD. Make sure to label the CDs or DVDs so

that you can later identify the order in which they were inserted.
Once the write operation has been completed successfully, the following
message is displayed:
To restore backed-up data from a CD or DVD to the hard disk, do the

following:
• Insert the CD or DVD that contains the first part of the backup copy
into the CD or DVD writer.
• Press the Restore CD/DVD button.
All patient folders and images which have been backed up to the CD
or DVD before are restored and saved to the system’s hard disk. All
restored patient folders are re-created on the hard disk, in addition to
the already existing ones.
• Insert all further CDs or DVDs used for the backup into the
corresponding drive (if applicable). Make sure to insert them in the
same order as during the backup procedure.
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DICOM Functions 11
11.1 Prerequisites
Depending on the DICOM Classes integrated in the system (→ Ch. 2.3,

p. 2-4), you can use certain DICOM functions. To be able to do so, the
system must be connected to a DICOM network.
11.2 Downloading patient data from a DICOM server
When creating a new patient folder (→ Ch. 10.2.1, p. 10-3), you can
download the patient data from the DICOM server (Query or Worklist).
The following prerequisites must be given: Prerequisites

− The Ziehm Vision must be connected to a DICOM server.
− The desired patient data must be stored on the DICOM server
already.
− You must know the patient ID of the respective patient.
11.2.1 Query
The Query DICOM function enables you to download a patient’s data

(e.g. first name, last name) from the DICOM server.
CAUTION
To download patient data from a DICOM server, do the following:

Note
You may predefine default data for the Hospital, Department and
Doctor input boxes. The desired data is entered in the Configuration
operating mode under Basic Settings.
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The input boxes are cleared (if any data has been displayed before in
them), with the exception of those with default data (→ Ch. 20.3.3,
p. 20-10).
• Press the Patient ID button and enter the patient ID of the patient you
are looking for.
The patient ID is displayed in the Patient ID box.
• Press the Query button.
The patient data record is downloaded from the DICOM server and
appears automatically in the input boxes.
• If necessary, complete any missing data.

• Save the new patient folder and the downloaded data by pressing the
Save button.
The new patient folder is automatically activated. A blank fluoroscopy
mask with the downloaded patient data appears on the live monitor.
11.2.2 Downloading a Worklist
Contents of the You can download a specific Worklist from the DICOM server. The
Worklist Worklist contains the patient data as well as the examinations which are
scheduled for the patient.
Time span of the You can use a filter to determine the time span that is covered by the
Worklist Worklist. The following filter criteria are available for that purpose:
− Default setting: Today (0:00 a.m. – 12:00 p.m.)
− Yesterday (0:00 a.m. – 12:00 p.m.)
− Yesterday and today (0:00 a.m. – 12:00 p.m.)
− Now +/– 8 hours
Filters for Worklist Besides you can limit the contents of the Worklist to be downloaded using
download the following criteria:
− Patient Name (Last Name)
− Patient ID (Patient ID)
− Hospital-specific internal administrative number (Access. No.)
− Specific procedure step (Req. Proc. ID)
Opening the Once you have downloaded the Worklist of the current day, you can open
Worklist offline it as often as you like, even if the Ziehm Vision is no longer connected to
the DICOM server. In this case, the word OFFLINE appears in the
Worklist on the monitor.
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When you try to open a Worklist in offline mode although no Worklist has
been downloaded for the current day from the DICOM server yet, the
message No connection to server appears, and no Worklist is
displayed.
11.2.2.1 Downloading a Worklist for a specific time span
To download a Worklist that covers a specific time span from a

DICOM server, do the following:
• Press the Worklist button.
The filter criteria for limiting the contents of the Worklist to be
downloaded are displayed. If you already specified a patient name
(Name), patient ID (Patient ID) or a hospital-specific internal
administrative number (Access. No.) in the Patient operating mode,
this data appears automatically in the corresponding boxes.
Fig. 11-16 Filter criteria for limiting the Worklist contents
• Select the time span to be covered by the Worklist.

• If there is any data displayed in the Name, Patient ID and/or Access.
No. boxes, press the Delete button.
The Name, Patient ID and/or Access. No. boxes are cleared.
The data of all patients scheduled for the specified time span is
downloaded from the DICOM server. A list of all downloaded data
appears on the control panel.
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Fig. 11-1 DICOM Worklist
• Press the Apply button.

The downloaded patient data appears in the input boxes of the
Patient operating mode. The new patient folder is automatically
activated. A blank fluoroscopy mask with the downloaded patient data
appears on the live monitor.

• If you have completed any missing data, save the new patient folder
by pressing the Save button.
11.2.2.2 Downloading a patient-specific Worklist
CAUTION
To download a patient-specific Worklist from a DICOM server, do

the following:
• Press the Name button and enter the last name of the desired patient.
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• Press the Patient ID button and enter the patient ID of the desired
patient.
• Press the Access No. button and enter the hospital-specific internal
administrative number of the desired patient.
downloaded are displayed. Any data you have already entered in the
Name, Patient ID or Access. No. boxes appears automatically in the
corresponding boxes.
• If you want to limit the time span covered by the Worklist to be

downloaded, select the desired time span.
The data of the selected patient is downloaded from the DICOM
server. A list with all patient-specific data downloaded appears on the
control panel. If you have entered a name or the first letter(s) of a
name as filter criterion, all matching items are listed.
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Fig. 11-3 Patient-specific Worklist


11.2.2.3 Downloading a Worklist for a procedure step
To download a Worklist that refers to a specific procedure step from

a DICOM server, do the following:
downloaded are displayed. If you already specified a patient name
(Name), patient ID (Patient ID) or a hospital-specific internal
administrative number (Access. No.) in the Patient operating mode,
this data appears automatically in the corresponding boxes.
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• Press the Req. Proc. ID button and enter the ID of the desired
procedure step.
• If there is any data displayed in the Name, Patient ID and/or Access.
No. boxes, press the Delete button.
The Name, Patient ID and/or Access. No. boxes are cleared.
The data of the specified procedure step is downloaded from the
DICOM server. The cursor is automatically positioned on the list item.
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Fig. 11-5 Worklist for a procedure step


11.3 Saving images from one or several patient folders
DICOM Store If the system is connected to a DICOM network, you can save images
from one or more patient folders to a DICOM server.
Transferring If you send only images to the DICOM server which are not stored there
images already, all images are actually transferred and saved. Images that are
already stored on the DICOM server are not saved there again. Images
that have been downloaded from the DICOM server with the Retrieve
function will not be re-transferred to the DICOM server.
CAUTION
Never modify any patient data in a patient folder after having transferred
images from this patient folder to the DICOM server!
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To save all images from one or several patient folders to a DICOM

server, do the following:
• Position the cursor on the desired patient folder, or mark the desired
patient folders.
• Press the DICOM Store button.

The marked patient folders are transferred to the DICOM server and
saved there.
informs you about the status of the save operation. The Cancel button
Images that have been successfully transferred receive the label D.
Once they have been transferred, the patient folders become
unmarked.
11.3.1 Saving and printing images and cine loops
Once you have displayed or activated a patient folder, you can save the
images and cine loops which are stored there to the DICOM server and/
or print them on a DICOM network printer.
For information on generating cine loops, see → Ch. 12, p. 12-1.
To print out images or cine loops on a DICOM network printer, do

the following:

or

• Position the cursor on the desired image or cine loop.
or
or
• Mark the images or cine loops you want to print.
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• Press the DICOM Print button.

The marked images or cine loops are printed on the DICOM network
printer.
Once they have been printed, the images or cine loops become
unmarked.
To save images or cine loops to a DICOM server, do the following:


or

• Position the cursor on the desired image or cine loop.
or
or
• Mark the images or cine loops you want to save.

The marked images or cine loops are transferred to the DICOM server
and saved there.
Once they have been saved, the images or cine loops become
unmarked.
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11.4 Saving or printing single cine loop images
If the system is connected to a DICOM network, you can save one or

several single images from an open cine loop to the DICOM server and/
or print them on a DICOM network printer.
To print out images from a cine loop on a DICOM network printer,

do the following:
• Open the desired cine loop (→ Ch. 12.3, p. 12-4).

The individual images of the cine loop are displayed as a thumbnail
image mosaic on the reference monitor.
or
or
• Mark the images you want to print.
• Press the DICOM Print button.

The marked images are printed on the DICOM network printer.
To save cine loop images to a DICOM server, do the following:

• Open the desired cine loop (→ Ch. 12.3, p. 12-4).

image mosaic on the reference monitor.
or
or
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• Mark the images you want to save.

The marked images are transferred to the DICOM server and saved
there.
Once they have been transferred, the images become unmarked.
11.5 Importing images and cine loops from a DICOM server
After displaying or activating a patient folder in the Archive or Patient

operating mode, you can download images and cine loops (image level
query/retrieve) or entire series of images and cine loops (series level
query/retrieve) from the connected DICOM server and save them to the
displayed or active patient folder.
You can download images and cine loops with a size of up to 27 MB from
the DICOM server. The maximum number of images in each patient
folder is not limited as long as the overall storage capacity of the system
is not exceeded.
To import one or more images from the DICOM server into a patient
folder, do the following:
or or


or
• Press the Retrieve or DICOM Retrieve button.

The Studies, Series and Images lists with the related buttons are
displayed on the control panel. The Studies list contains all studies
which are available on the server.
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Fig. 11-6 Studies, Series and Images retrieval lists, with items on
the Studies list
• Select the desired study from the Studies list using the arrow buttons.
• Press the Refresh button next to the Studies list.

All series of the selected study appear in the Series list.
the Studies and Series lists
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• Using the arrow buttons, position the cursor on the desired series in
the Series list.
• Press the Refresh button next to the Series list.
All images of the selected series are displayed in the Images list.
Fig. 11-8 Studies, Series and Images retrieval lists, with items on all
lists
• Using the arrow buttons, position the cursor on the image of the
Images list you want to import.
or
or
• Mark the images you want to import in the Images list.
Fig. 11-9 Images list with marked item
• Press the Retrieve button next to the Images list.

The marked images are downloaded from the DICOM server to the
patient folder. A progress indicator in a message window on the
control panel informs you about the status of the transfer operation.
Images that have been successfully downloaded receive the label R.
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CAUTION
Do not switch off the system during image data transfer!
The transfer time depends on the network interface card and the
network load.
To import a series of images from the DICOM server into a patient

folder, do the following:
or or


or

• Press the Retrieve or DICOM Retrieve button.
The Studies, Series and Images lists with the related buttons are
displayed on the control panel. The Studies list contains all studies
which are available on the server.
the Studies list
• Select the desired study from the Studies list using the arrow buttons.
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• Press the Refresh button next to the Studies list.

All series of the selected study appear in the Series list.
the Studies and Series lists
• Using the arrow buttons, position the cursor in the Series list on the
series whose images you want to import.
• Press the Retrieve button.
The images of the series are downloaded from the DICOM server to
the patient folder. A progress indicator in a message window on the
control panel informs you about the status of the transfer operation.
Images that have been successfully downloaded receive the label R.
CAUTION
Do not switch off the system during image data transfer!
The transfer time depends on the network interface card and the
network load.
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Cine Loops 12
12.1 Overview
A cine loop consists of several fluoroscopic images that are acquired in General
sequence. It can be replayed like a movie later and also post-edited.
Cine loops are useful whenever dynamic movement needs to be Applications

visualized. Typical fields of application are:
− Orthopedics:
You can generate a cine loop for visualizing movements of the
skeletal system.
− Vascular surgery:
You can combine a cine loop with DSA (→ Ch. 13.2, p. 13-2) to
visualize a contrast medium flow.
12.2 Generating a cine loop
You can define the recording speed (frame rate) and the length (number Settings
of images) of the sequence for each cine loop you want to acquire. With
a maximum system configuration of the Ziehm Vision, the following
values are available:
− Recording speed:
1, 2, 4, 8, 12.5 or 25 frames per second
(on systems with 25 frames/second)
1, 2, 5, 10, 15 or 30 frames per second
(on systems with 30 frames/second and Ziehm Vision FD)
− Length:
100, 200, 300, 400 images per cine loop
If you choose the option Auto, all images that are generated during
radiation time are automatically saved. With this option, you do not
need to determine the recording length prior to fluoroscopy.
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You can preset the recording speed and the length of the cine loop in the
Configuration operating mode under Operation Settings
(→ Ch. 20.2.5, p. 20-6). You can, however, modify these settings during
operation for each individual cine loop you acquire.
Fig. 12-1 Cine loop settings (on systems with 30 frames/s)
Saving a cine loop The cine loop images are automatically saved during radiation. The first
image of the cine loop is saved as the start image, the last one as the stop
image.
How many images are actually saved depends on the cine loop length
you have chosen:
− If you terminate radiation before reaching the selected cine loop
length, only the images generated during radiation time will be saved.
− If radiation is continued beyond the selected cine loop length, only the
last images will be saved; the first images are lost.
− If you have chosen the Auto option, all images that are generated
during radiation time are automatically saved.
Storage capacity Before you initiate fluoroscopy, the system checks automatically whether
there is enough hard disk space available for the preset cine loop. If,
despite the auto-delete function (→ p. 8-11), it is not possible to free up
enough disk space, an audible alarm sounds and the following alert
message appears on the control panel:
Not enough space on hard disk. Required: xyz. Available: xyz.
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To free up disk space for a cine loop, do the following:
• Unprotect all protected images of a stored patient folder (→ p. 10-24)

and then delete the patient folder from the hard disk.
or
• Decrease the length of the cine loop you want to acquire.
• Make a backup to a USB storage device or a CD/DVD as soon as

possible and then delete the patient folders you have backed up
before from the hard disk.
Note
As long as the snapshot fluoroscopy mode is active, the Cine button is
hidden on the control panel.
To acquire a cine loop, do the following:

• Press the Cine button.
The cine loop setting buttons are displayed in the dynamic control
area.
Fig. 12-2 Cine loop setting buttons on systems with 25 frames/s (left)
and 30 frames/s (right)
• Select the desired cine loop length or the Auto function under
Length.
• Select the desired recording speed under Frames/s.

The cine loop is acquired and saved.
• Terminate radiation.
The new cine loop is now automatically replayed at the preset frame
rate in an endless loop on the live monitor. You can control and edit
the cine loop (→ Ch. 12.4, p. 12-6).
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12.3 Opening a saved cine loop
You can re-open and replay a cine loop saved on the hard disk at any
time.
To open a cine loop saved on the hard disk, do the following:

Note
With each letter you enter, the alphabetical list is more and more

All images contained in this patient folder are displayed as thumbnails
on the reference monitor. The most recent image is highlighted by a
white frame. Cine loop sequences are symbolized by their last image
and bear the label C.
• Select the desired cine loop in the patient folder using the arrow
buttons.
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The first image of the cine loop is displayed at full-screen size on the
live monitor. The cine loop number in the patient folder is shown in the
image as CINE XY.
mosaic on the reference monitor.
The buttons for controlling and editing a cine loop during playback and
for processing and outputting individual cine loop images appear on the
control panel:
Buttons for
controlling and
editing the cine
loop
Buttons for
processing and
outputting cine
loop images
Fig. 12-3 Archive operating mode during cine loop playback

(on systems with 30 frames/s)
• Press the Play button.

The cine loop is replayed in an endless loop on the live monitor.
During playback, a moving indicator shows the position of the
currently displayed image within the cine loop.
The buttons in the dynamic control area are used to control and edit the
cine loop which is replayed on the live monitor (→ Ch. 12.4, p. 12-6). If
you have opened a DSA cine loop, additional buttons for editing are
displayed in the dynamic control area. The buttons in the lower half of the
control panel are used to process and output the individual images of the
cine loop (→ Ch. 12.6, p. 12-15).
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12.4 Controlling and editing a cine loop during playback
As soon as a newly-acquired or saved cine loop is replayed on the live

monitor, the buttons for controlling and editing the cine loop are displayed
in the dynamic control area.
When you replay a DSA cine loop, additional buttons for the following
functions are displayed in the dynamic control area:
− Mask image control (→ Ch. 13.6, p. 13-11)
− Pixel shift (→ Ch. 13.7, p. 13-13)
− Landmarking (→ Ch. 13.8, p. 13-14)
Fig. 12-4 Buttons for controlling and editing a cine loop during
playback (without DSA) on systems with 25 frames/s
(above) and 30 frames/s (below)
All the settings that you make in the dynamic control area always affect
the cine loop which is marked by a white frame on the monitor.
You can control cine loop playback in the following ways:
Changing the cine • To change the playback speed of the cine loop, choose another value
loop speed under Frms/s.
• To stop cine loop playback, press the Stop button.
The Play button appears.
• To scroll through the cine loop, press the Forward or Backward

arrow button.
The longer you press the button, the faster the cine loop images are
opened one after the other.
• To continue cine loop playback, press the Play button.
The Stop button appears.
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The following options are available for editing a cine loop during Editing options
playback:
− Trimming the cine loop
− Cleaning up the cine loop
You can trim the cine loop for playback, e.g. if the contrast medium has Trimming the cine
been injected too late, thus making the first images of the cine loop loop
useless. This is done by defining a new start image and a new stop image
for cine loop playback.
To trim the cine loop, do the following:

• Press the Stop button.
Now you can scroll through the individual images of the cine loop with
the help of the arrow buttons.
• Select the desired start image using the arrow buttons.
• Press the Start Img button.
• Select the desired stop image using the arrow buttons.
• Press the Stop Img button.

The cine loop sequence is trimmed.

The trimmed cine loop sequence is replayed in an endless loop.
• To replay the entire original cine loop, press the Complete button.
You can delete all images outside the trimmed cine loop, i.e. those before Cleaning up the
the start image and those after the stop image. cine loop
Note
Once you have cleaned up the cine loop, you can no longer restore the
original cine loop with the Complete button.
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To clean up a cine loop, do the following:

• Press the Clean up button.

All images which are not enclosed between the start image and the
stop image are deleted without confirmation prompt.
12.5 Processing and outputting saved cine loops
Once you have displayed (→ Ch. 10.3.2, p. 10-15) or activated

(→ Ch. 10.3.3, p. 10-17) a patient folder, you can process the images
and the cine loops that are stored there. Different read-only boxes and
buttons are displayed on the control panel for that purpose. In the mosaic
on the reference monitor, cine loop sequences are symbolized by their
last image and bear the label C.
Read-
only
boxes
Buttons for Arrow

marking buttons for
and navigating
deleting on the
monitor
Buttons
for printing
Buttons for
saving
Fig. 12-5 Archive operating mode with displayed patient folder
We will now discuss how to process and output cine loops. For
information on how to process and output individual images in a patient
folder, please refer to → Ch. 10.3.5, p. 10-20.
The following cine loop processing functions are available in a displayed
or active patient folder:
− Mark:
To mark one or more cine loops
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− Protect:
To protect marked cine loops against being deleted
− Delete:
To delete cine loops
− DICOM Retrieve:
To import cine loops from a DICOM server (→ Ch. 11.5, p. 11-12)
− Print:
To print out marked cine loops on the video printer
− DICOM Print:
To print out marked cine loops on a DICOM network printer
(→ Ch. 11.3.1, p. 11-9)
− Floppy: You cannot save a cine loop to floppy disk because a floppy
disk stores only one image.
− CD/DVD:
To write marked cine loops to CD or DVD
− USB:
To save marked cine loops to a USB storage device
− DICOM Store:
To save marked cine loops to a DICOM server (→ Ch. 11.3.1,
p. 11-9)
Any action which is performed affects exclusively the marked cine loops,
or the cine loop where the cursor is. There are, however, a few
exceptions to this rule:
− Delete protection: You can only protect the cine loop where the
cursor is.
− Delete: You can delete either all marked cine loops, or all unmarked
cine loops, or only the cine loop where the cursor is.
As soon as marked cine loops have been output on a printer or saved to
cine loops, however, will remain delete-protected even after output.
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Image file sizes Images in the following graphics formats have a file size of approx. 2 MB:
− 8 bit BMP
− 16 bit TIF
− DICOM
− Multimedia
− DICOM 512×512 8 Bit
− JPEG 512×512
Further processing Cine loops that have been saved to a USB storage device or written to
CD or DVD cannot be re-imported from the storage medium into the
system. For opening and processing these externally saved cine loops,
you need a separate PC which is equipped with the appropriate drives
and software.
Replaying a cine To replay a cine loop, do the following:

loop
• Select the desired cine loop in the thumbnail mosaic on the reference

The start image of the cine loop is displayed on the live monitor.
mosaic on the reference monitor.
The buttons for controlling and editing the selected cine loop
(→ Ch. 12.4, p. 12-6) and for processing and outputting single cine
loop images (→ Ch. 12.6, p. 12-15) appear on the control panel.
The cine loop is replayed on the live monitor.
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To mark one or more cine loops, do the following: Marking

• Select the desired cine loop on the reference monitor using the arrow
buttons.

The cine loop is now marked and receives the label M.
• If you want to mark further cine loops in addition, repeat the

procedure.
To unmark a cine loop, do the following:

• Select the desired marked cine loop on the reference monitor using
the arrow buttons.

The cine loop becomes unmarked.
To protect one or more cine loops, do the following: Protecting
• Select the desired cine loop on the reference monitor using the arrow
buttons.
The cine loop is now protected and receives the label P.
• If you want to protect further cine loops, repeat the procedure.
To unprotect a cine loop, do the following:
• Select the desired protected cine loop using the arrow buttons.
The cine loop becomes unprotected.
Note
Patient folders containing protected cine loops or images cannot be
deleted automatically. If many folders on the hard disk contain protected
cine loops or images, the auto-delete function (→ p. 8-11) may not be
working properly, and you will be unable to save new images.
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Deleting To delete one or more cine loops from a patient folder, do the
following:
CAUTION
Deleted cine loops are irretrievably lost.
Back up the cine loops you want to delete or make sure that they are
really no longer needed.
• Mark the cine loops you want to delete and press the Delete Marked
Items button.
or or
• Mark the cine loops you do not want to delete and press the Delete
or or
• Using the arrow buttons, position the cursor on the cine loop you want
to delete, and then press the Delete button.

The cine loops are deleted from the patient folder.
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You can mark one or more cine loops and print all images contained in Printing on video
them in one go. Besides, you can print the image displayed on the live printer
monitor (→ Ch. 8.8, p. 8-12).
To print out a cine loop on the video printer, do the following:

• Position the cursor on the desired cine loop or mark the cine loops you
want to print.

The marked cine loops are output on the video printer mounted in the
Once they have been printed, the cine loops become unmarked.
following:
You can save cine loop images to a standard USB storage device in the Saving to USB
following formats: storage device
− DICOM
higher).
To save cine loops to a USB storage device, do the following:

want to save.
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12 Cine Loops

The marked cine loops are saved to the USB storage device. A
progress indicator in a message window on the control panel informs
you about the status of the save operation. The Cancel button
Once they have been saved, the cine loops become unmarked.
Writing to CD or You can write cine loop images to CD or DVD in the following formats:
DVD
− DICOM
To write cine loops to CD or DVD, do the following:


cart.
Checking CD/DVD...
Once they have been written to CD or DVD, the cine loops become
unmarked.
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12 Cine Loops
12.6 Processing and outputting single cine loop images
As soon as you open a saved cine loop in the Archive operating mode
(→ Ch. 12.3, p. 12-4), the individual images of the cine loop are
displayed as a thumbnail mosaic on the reference monitor.
When you place the cursor on an individual image of the thumbnail
mosaic, this image is automatically displayed at full-screen size on the
live monitor.
The following functions are available for processing single images of a
cine loop:
− Mark:
To mark one or more images
− Protect:
To protect images against being deleted
− Delete:
To delete images
− Print:
To print out marked images on the video printer
− DICOM Print:
To print out marked images on a DICOM network printer (→ Ch. 11.4,
p. 11-11)
− Floppy:
To save marked images to floppy disk
− CD/DVD:
To write marked images to CD or DVD
− USB:
To save marked images to a USB storage device
− DICOM Store:
To save marked images to a DICOM server (→ Ch. 11.4, p. 11-11)
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12 Cine Loops
Any action which is performed affects exclusively the marked images, or

the image where the cursor is. There are, however, a few exceptions to
this rule:
− Delete protection: You can only protect the image where the cursor
is.
− Delete: You can delete either all marked images, or all unmarked
images, or only the image where the cursor is.
As soon as the marked images have been output on a printer or saved to
images, however, will remain delete-protected even after output.
Further processing Images that have been saved to a floppy disk or a USB storage device
or written to CD or DVD cannot be re-imported from the storage medium
into the system. For opening and processing these externally saved
images, you need a separate PC which is equipped with the appropriate
drives and software.
Image file sizes Images in the following graphics formats have a file size of approx. 2 MB:
− 8 bit BMP
− 16 bit TIF
− DICOM
− Multimedia
− DICOM 512×512 8 Bit
− JPEG 512×512
Marking To mark one or more images of a cine loop, do the following:

• Select the desired image in the thumbnail mosaic on the live monitor
using the arrow buttons.

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12 Cine Loops

• Select the desired marked image using the arrow buttons.
To protect one or more images of a cine loop, do the following: Protecting


The image is now delete-protected and receives the label P.
• To protect further images, repeat the procedure.

• Select the desired protected image with the arrow buttons and press
the Protect button.
Note
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12 Cine Loops
Deleting To delete one or more images of a cine loop, do the following:
CAUTION
no longer needed.
• Mark the images you want to delete.
• Press the Delete Marked Items button.

or or
• Mark the images you do not want to delete.
Press the Delete Unmarked Items button.

or or
• Select the individual image you want to delete using the arrow
buttons.
• Press the Delete button.
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12 Cine Loops

You can mark one or more images of the cine loop and print them all in Printing on video
one go. Besides, you can print the image displayed on the live monitor printer
(→ Ch. 8.8, p. 8-12).
To print out images from a cine loop on the video printer, do the
following:
want to print.

Once they have been printed, the cine loop images become
unmarked.
following:
You can save cine loop images to floppy disk in 8 bit BMP format only. Saving to floppy
® disk
The floppy disk must have been preformatted on an external MS DOS
compatible PC. The floppy disk drive which is mounted in the system
does not support formatting.
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12 Cine Loops
To save a cine loop image to floppy disk, do the following:

• Position the cursor on the image you want to save.
monitor cart.
• Press the Floppy button.
The image is saved to the floppy disk. A progress indicator in a
the save operation. The Cancel button appears, enabling you to
interrupt the save operation.
Saving to USB You can save cine loop images to a standard USB storage device in the
storage device following formats:
− DICOM
Ziehm DICOM Whenever you save images in standard DICOM format or ‘reduced’
higher).
To save cine loop images to a USB storage device, do the following:

want to save.
The marked images are saved to the USB storage device. A progress
indicator in a message window on the control panel informs you about
the status of the save operation. The Cancel button appears,
enabling you to interrupt the save operation.
Once they have been saved, the cine loop images become unmarked.
Writing to CD or You can write cine loop images to CD or DVD in the following formats:
DVD
− DICOM
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12 Cine Loops

Whenever you write images in standard DICOM format or ‘reduced’ Ziehm DICOM
To write cine loop images to CD or DVD, do the following:


cart.
Checking CD/DVD...
Confirm by pressing the Yes button. A progress indicator in a
Once they have been written to CD or DVD, the cine loop images
become unmarked.
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Subtraction Modes 13
13.1 Overview
The Ziehm Vision provides three subtraction modes (DSA, MSA and Applications
RSA), which are used mainly in vascular surgery. As the generation of an
MSA and/or RSA image requires a cine loop with DSA, MSA and RSA
can be performed exclusively in conjunction with a DSA.
DSA (Digital Subtraction Angiography) mode generates a conventional DSA

subtracted image. This means that one image is subtracted from the
other, so that only the differences between the images become visible.
On the Ziehm Vision, DSA is always combined with a cine loop
(→ Ch. 12, p. 12-1).
MSA (Maximum Opacification Subtraction Angiography) mode MSA

generates a subtracted image showing the entire path of the contrast
medium flow during the acquisition run with maximum contrast
opacification. The MSA image is generated from the DSA cine loop
without any additional radiation.
An RSA image (Roadmapping Subtraction Angiography) is generated in RSA

three steps:
− The MSA image is inverted.
− A new DSA image is generated.
− The new DSA image is superimposed over the inverted MSA image.
Thus, during an interventional procedure, surgeons can clearly see
where they are moving (e.g. with a catheter) within the contrast medium
path generated.
You can acquire as many RSA images as desired during one session.
Before acquiring a DSA cine loop, you must create or activate a patient Saving
folder. The DSA cine loop, the MSA image and the RSA images are
saved to the active patient folder in the order in which they have been
generated and may be re-opened or post-processed later.
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13 Subtraction Modes
Image types In subtraction mode, three types of images are generated:

− Mask image
The mask image is the fluoroscopic image from which the native
images are subsequently subtracted. The mask image is always
acquired first.
− Native image
Generally speaking, a native image is an original fluoroscopic image
without any modification. In the subtraction modes, the native image
is the image which is subtracted from the mask image.
− Subtracted image
A subtracted image is the result of the subtraction process: mask
image minus native image.
Showing or hiding You can preset whether the native image shall appear on the reference
the native image monitor during the acquisition of a DSA cine loop, MSA image or RSA
image. This is done in the Configuration operating mode under
Operation Settings (→ Ch. 20.2.6, p. 20-7). If you deactivate the option
DSA Native on, you may display a reference image on the reference
monitor during the entire subtraction procedure. If you activate the option
DSA Native on, any image which is displayed on the reference monitor
will disappear as soon as you switch to the Subtraction operating mode.
Cine loop Each DSA is automatically combined with a cine loop. The first image of
the cine loop is saved as the mask image, and all subsequent native
images are subtracted from the mask image.
13.2 Acquiring a DSA cine loop
Prerequisite To be able to acquire a DSA cine loop, you must create a new patient
folder (→ Ch. 10.2.1, p. 10-3) or activate an existing patient folder
(→ Ch. 10.3.3, p. 10-17) first.
Length of the DSA With a DSA cine loop, the system automatically saves all images that are
cine loop generated during radiation time. In the DSA cine loop settings, the Auto
option is preset. You cannot select a defined length for a DSA cine loop
(→ p. 12-2).
To acquire a DSA cine loop, do the following:

• Press the Subtraction tab.
The Subtraction operating mode is activated.
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• Press the DSA button.

The cine loop setting buttons are displayed in the dynamic control
area.
The Auto option is preset under Length and cannot be changed.
• Set the desired frame rate for the DSA cine loop under Frms/s
(→ Ch. 12.2, p. 12-1).
• Press the hand switch or the left pedal of the two-pedal foot switch.
The following message appears on the control panel:
A countdown of 5 seconds is performed on the live monitor. After 2

seconds, radiation is released automatically.
After the mask has been acquired, the request ...Injection appears on
the title bar of the control panel.
• Inject the contrast medium.

Cine loop acquisition continues. The subtracted images are displayed
on the live monitor. If you have activated the function DSA Native on,
the native images are displayed on the reference monitor.
The cine loop is automatically saved to the active patient folder. It is
replayed in an endless loop on the live monitor.
The buttons for controlling and editing the cine loop (→ Ch. 12.4,
p. 12-6) as well as the MSA (→ Ch. 13.3, p. 13-4), LM (landmarking,
→ Ch. 13.8, p. 13-14) and P-Sh (pixel shift → Ch. 13.7, p. 13-13)
buttons appear in the dynamic control area.
Fig. 13-6 Buttons for controlling and editing a DSA cine loop during
playback on systems with 25 frames/s (left) and
30 frames/s (right)
The Subtraction operating mode remains active. When you initiate

radiation again, a new DSA cine loop is acquired with the defined
settings.
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Filter factors Various filter factors can be set for the DSA mode in the Configuration
filters for the DSA mode.
Windowing values The initial windowing values (width and level of the contrast window) for
the DSA mode can be set in the Configuration operating mode under
Service Settings. You cannot make these presettings yourself.
windowing values for the DSA mode.
13.3 Acquiring an MSA image
To acquire an MSA image, do the following:
• Generate a DSA cine loop (→ Ch. 13.2, p. 13-2).

The cine loop is replayed in an endless loop on the live monitor. The
buttons for controlling and editing the cine loop as well as the MSA
button appear in the dynamic control area.
30 frames/s (right)
• Press the MSA button.

An MSA image is generated without any further release of radiation.

The MSA image is automatically saved to the active patient folder.
The buttons for controlling and editing the cine loop disappear from
the dynamic control area. The RSA button appears.
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Fig. 13-8 Dynamic control area after the acquisition of an MSA

image
Various filter factors can be set for the MSA mode in the Configuration Filter factors
filters for the MSA mode.
The initial windowing values (width and level of the contrast window) for Windowing values
the MSA mode can be set in the Configuration operating mode under
windowing values for the MSA mode.
13.4 Acquiring an RSA image
To acquire an RSA image, do the following:
• Generate a DSA cine loop (→ Ch. 13.2, p. 13-2).
• Generate an MSA image (→ Ch. 13.3, p. 13-4).

The RSA button appears in the dynamic control area.

image
• Press the RSA button.

The RSA button disappears from the dynamic control area, and the
buttons for landmarking (→ Ch. 13.8, p. 13-14) and pixel shift
(→ Ch. 13.7, p. 13-13) appear instead.
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Fig. 13-10 Dynamic control area in RSA mode
A DSA image is generated. The MSA image is inverted, so that the
contrast medium path appears white instead of black. The DSA image
(not inverted) is superimposed over the MSA image.
The combined last subtracted image remains displayed on the live
monitor and is saved automatically to the patient folder.
• If you want to acquire another RSA image, initiate radiation again.

You can acquire and save as many RSA images as you wish.
Filter factors Various filter factors can be set for the RSA mode in the Configuration
filters for the RSA mode.
Windowing values The initial windowing values (width and level of the contrast window) for
the RSA mode can be set in the Configuration operating mode under
windowing values for the RSA mode.
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13.5 Generating MSA and RSA images from a saved DSA cine
loop
You can open a saved DSA cine loop and generate an MSA image or
RSA images later without having to re-inject any contrast medium. You
can do this either in the active patient folder (→ Ch. 13.5.1, p. 13-7) or in
any patient folder on your system (→ Ch. 13.5.2, p. 13-8).
13.5.1 Opening and postprocessing a DSA cine loop in an active patient

folder
To generate MSA or RSA images from a saved DSA cine loop when
the respective patient folder is already active, do the following:
• Activate the Subtraction operating mode.
• Use the arrow buttons to browse through the active patient folder.
The images and cine loops which are stored in the patient folder are
displayed at full-screen size on the reference monitor.
• Once you have opened the desired DSA cine loop, press the Image
Swapping button.
The first image of the DSA cine loop is displayed at full-screen size on
the live monitor. The buttons for controlling and editing the cine loop
as well as the MSA button appear in the dynamic control area.
30 frames/s (right)


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image


13.5.2 Opening and postprocessing any DSA cine loop
To generate MSA or RSA images from any saved DSA cine loop, do
the following:
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• Select the desired DSA cine loop in the patient folder using the arrow
buttons.

The buttons for controlling and editing the cine loop appear on the
control panel. The Subtraction button appears in the dynamic control
area.
Fig. 13-14 Buttons for controlling and editing a DSA cine loop,
including Subtraction button, on systems with 25 frames/s
(above) and 30 frames/s (below)
• Press the Subtraction button in the dynamic control area.

The buttons for controlling and editing the cine loop as well as the
MSA button appear in the dynamic control area.
30 frames/s (right)

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image


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13.6 Editing a DSA cine loop
As soon as a newly-acquired (→ Ch. 13.2, p. 13-2) or saved

(→ Ch. 12.3, p. 12-4) DSA cine loop is replayed on the live monitor, the
buttons for controlling and editing the cine loop are displayed in the
playback on systems with 25 frames/s (left) and 30 frames/
s (right)
All the settings that you make in the dynamic control area always affect
the cine loop which is marked by a white frame on the monitor.
You can control cine loop playback in the following ways:
• To change the playback speed of the cine loop, choose another value Changing the cine
under Frms/s. loop speed
• To stop cine loop playback, press the Stop button.
The Play button appears.
• To continue cine loop playback, press the Play button.

The Stop button appears.
The following options are available for editing a cine loop during Editing options
playback:
− Trimming the cine loop
− Cleaning up the cine loop
− Defining another mask image
You can trim the cine loop for playback, e.g. if the contrast medium has Trimming the cine
been injected too late, thus making the first images of the cine loop loop
useless. This is done by defining a new start image and a new stop image
for cine loop playback.
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To trim the cine loop, do the following:

• Select the desired start image with the arrow buttons and press the
Start Img button.
• Select the desired stop image with the arrow buttons and press the
Stop Img button.
The cine loop sequence is trimmed.

The trimmed cine loop sequence is replayed in an endless loop.
• To replay the entire original cine loop, press the Complete button.
Cleaning up the You can delete all images outside the trimmed cine loop, i.e. those before
cine loop the start image and those after the stop image.
Note
Once you have cleaned up the cine loop, you can no longer restore the
original cine loop with the Complete button.
To clean up a cine loop, do the following:

• Press the Clean up button.

All images which are not enclosed between the start image and the
stop image are deleted without confirmation prompt.
Defining a mask You can define a mask image other than the original one for a DSA cine
image loop (→ p. 13-2).
To define an image of the cine loop as mask image, do the

following:
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• Select the image you want to define as mask image with the arrow
buttons and press the Mask button.

The cine loop is replayed. During cine playback, all images of the cine
loop are subtracted from the defined mask image.
To deactivate the mask image, do the following:

• Press the Mask off button.
The cine loop is replayed without subtraction. The former mask image
remains stored in the cine loop, only its mask function is deactivated.
13.7 Pixel shift
Possible patient or C-arm movements between the acquisition of the Function

mask image and the acquisition of the native image may lead to artifacts
in the subtracted image. Using the pixel shift function, you can move the
mask image and thus re-align the two images once again.
You can use the pixel shift function in the following situations:
− After the acquisition of a DSA cine loop in the Subtraction operating
mode
− During playback of a saved DSA cine loop in the Archive operating
mode
− After the acquisition of an RSA image in the Subtraction operating
mode
As long as you have not saved the modified image yet, you can undo the
mask image shift with the Home button.
To correct artifacts in a subtracted image, do the following:

• Press the P-Sh button.
• Using the four arrow buttons, move the mask image pixel by pixel until
it has reached the desired position. You can move the image by up to
8 pixels into each direction.
The corrected image is saved.
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13.8 Landmarking
Function With the landmarking function, you can superimpose a certain proportion
of the mask image (70% max.) onto the subtracted image, thus providing
anatomical landmarks for better orientation.
You can use the landmarking function in the following situations:
− After the acquisition of a DSA cine loop in the Subtraction operating
mode
− During playback of a saved DSA cine loop in the Archive operating
mode
− After the acquisition of an RSA image in the Subtraction operating
mode
As long as you have not saved the modified image yet, you can undo the
mask image overlay with the Home button.
To overlay a certain proportion of the mask image onto the

subtracted image (landmarking), do the following:
• Press the LM button.
• To increase the visible mask image amount in the subtracted image,

press the Up Arrow button until reaching the desired level.
• To decrease the visible mask image amount in the subtracted image,

press the Down Arrow button until reaching the desired level.

The image with the mask image overlay is saved.
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Post-Processing Images 14
14.1 Overview
Saved images can be post-processed at any time in the Post Process General
operating mode. Any adjustments which you make in the Post Process
operating mode affect only the selected image (exception: monitor
settings).
The following post-processing functions are available: Post-processing

functions
− Contrast/Brightness:
Monitor settings
− Contrast/Brightness:
Contrast and brightness adjustment of individual images
(windowing)
− Filter:
Edge filter
− Zoom:
To enlarge a selected image detail
− Grayscale Inversion:
To display an image with negative grayscale
− Vertical Slot Collimator:

Digital collimation (image crop)
− Horizontal Slot Collimator:

Digital collimation (image crop)
− Reverse Up/Down:
Vertical image reversal
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14 Post-Processing Images
− Reverse Left/Right:
Horizontal image reversal
− Image Rotation
− Text:
Text functions (→ Ch. 16, p. 16-1)
Saving the changes Any modification is reflected immediately in the live monitor image. When
you save an image, any modifications are saved as well and will be
visible both when you re-open the image and in mosaic view. However,
you can post-process an image as often as desired and also undo any
changes you have made before.
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14.2 Activating the post-processing functions
To activate an image for post-processing it, do the following:

• Locate the desired patient folder in the Archive operating mode and
display it (→ Ch. 10.3.2, p. 10-15).
• Open the image you want to post-process.
The selected image is displayed at full-screen size on the live monitor.
• Press the Post Proc. tab.

The Post Process operating mode is activated.
Fig. 14-1 Post Process operating mode
Now you can post-process the selected image. You can browse through
the active patient folder on the live monitor using the arrow buttons. In
addition, you can mark and delete individual images.
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14.3 Contrast and brightness settings for the CRT monitors
Function You can adjust the contrast and brightness of both monitors. These
settings affect any image or thumbnail image mosaic displayed on the
monitors and remain in force until you make new monitor settings or
restart the system.
The monitor settings are not saved together with the image.
Initial settings You can preset the initial monitor settings which are valid after power-up
of the system for both monitors in the Configuration operating mode
under Monitor / Dose (→ Ch. 20.4, p. 20-11).
Fig. 14-2 Monitor settings and step windowing
To adjust the contrast and brightness of both monitors, do the

following:
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• Use the arrow buttons to set the desired brightness and contrast.
The new settings are reflected immediately on both monitors.
• If you want to restore the initial settings, press the Home button.
Contrast and brightness are reset to the initial settings. Step
windowing is reset to step 0.

The Ziehm Vision is equipped with an ambient light sensor. The sensor Ambient light
works automatically, so you do not need to activate it explicitly. The sensor
screen brightness is continuously readjusted to match any change in
ambient light conditions during operation. The readjustment procedure is
flickering.
Proper functioning of the ambient light sensor can be checked in the
Configuration operating mode (→ Ch. 20.4, p. 20-11).
14.4 Contrast and brightness adjustment of individual images

(windowing)
The Windowing function allows you to adjust the contrast and brightness Function
of the image on the live monitor. These settings affect only the selected
image. If you save an image, the modified windowing values are saved
as well, even if you have retrieved the image from the archive.
After activating the windowing function, you can select a number of gray
levels, which are then stretched over the entire range of 1024 gray levels
of the original image on the live monitor. To achieve this effect, you adjust
the width and the level of the so-called contrast window.
The number of gray levels defines the width of the contrast window. The
width of the contrast window affects the image contrast. 1024 gray levels
correspond to the value W 100 on the Ziehm Vision.
The position of the selected gray levels on the original image grayscale
(ranging from 0 to 1024 gray levels) defines the level of the contrast
window. The level of the contrast window affects the image brightness.
Example:
You select all gray levels between 325 and 875. These gray levels are
then mapped (stretched) to the range of 0 to 1024 gray levels in the
processed image. This enhances the contrast.
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Gray levels 0 to 324 of the original image are displayed as black, and
gray levels 876 to 1024 of the original image are displayed as white. This
means that the processed image is darker than the original image.
There are two different windowing modes available:
− Standard windowing:
The standard windowing mode allows you to freely choose the level
and width of the contrast window.
− Step windowing:
With step windowing, you choose between several predefined
windowing steps. These windowing steps are preset and cannot be
modified.
The chosen windowing values are shown on the monitor as W X and L Y.
To set the brightness and contrast in standard windowing mode, do

the following:
• Press the WNDW button.

The windowing setting buttons appear.
Fig. 14-5 Buttons for standard windowing
• Under Width, set the number of gray levels using the arrow buttons.
The chosen width is indicated by the length of the blue bar in the
• Under Level, set the brightness range using the arrow buttons.
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The chosen level is indicated by the position of the slider in the

• If you want to restore the factory settings (level 50, width 100), press
the Home button.
To set the brightness and contrast with step windowing, do the

following:
• Select the desired windowing step using the arrow buttons.

The settings are reflected immediately in the image on the live
monitor.
• If you want to restore the factory settings for step windowing, press
the Home button.
Step windowing is reset to step 0. Simultaneously, brightness and
contrast are reset to the initial settings.
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14.5 Edge filter
The edge filter allows you to select a greater or lesser degree of edge
enhancement within the image. There are 4 levels available:
Level Meaning
Off No edge enhancement (original fluoroscopic image)
1 Slight edge enhancement
2 Medium edge enhancement
3 Strong edge enhancement
-1 Unsharp mask to reduce noise
Table 14-1 Edge filter levels
To set the edge filter for the image, do the following:

The edge filter setting buttons are displayed in the dynamic control
area.
Fig. 14-7 Edge filter settings
• Select the desired edge filter level by pressing the corresponding

button.
The filter acts on the live image on the live monitor. The chosen edge
filter level is shown on the monitor as RTE X.
The edge filter setting buttons disappear from the dynamic control
area.
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14.6 Digital image zooming
The zoom function allows you to enlarge a certain image detail. There
are three zoom levels available. The desired image detail can be
controlled either with the arrow buttons or with the integrated touchpad.
Touchpad
Fig. 14-8 Zoom function in the Post Process operating mode
To enlarge an image detail, do the following:


e.g. 4 X.
A marking circle appears in the center of the image on the live
• Move the marking circle to the desired image area using the arrow
buttons.
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To enlarge an image detail with the help of the touchpad, do the

following:

e.g. 4 X.
A marking circle appears in the center of the image on the live
• Move the marking circle to the desired position by gliding your finger
slightly across the touchpad.

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14.7 Grayscale inversion
The grayscale inversion function allows you to represent the active Function
image with a negative grayscale.
To represent an image with a negative (or positive) grayscale, do

the following:
• Press the Grayscale Inversion button.
The image is represented with negative grayscale on the live monitor.
• Press the Grayscale Inversion button again.

The image is again represented with a positive grayscale.
14.8 Image rotation
• Press the Rotate Image CW button until the desired setting becomes
visible on the live monitor.
The image is rotated steplessly in clockwise direction.
• Press the Rotate Image CCW button until the desired setting
becomes visible on the live monitor.
The image is rotated steplessly in counter-clockwise direction.
The chosen angle of rotation is shown on the monitor as R X.
As soon as an image is rotated, it assumes a circular shape. The image Ziehm Vision FD
180°, 270°.
14.9 Horizontal and vertical image reversal
• Press the Reverse Up/Down button.

On the live monitor, the image appears with top and bottom reversed,
and a symbol for up/down reversal is displayed.
• Press the Reverse Left/Right button.

On the live monitor, the image appears with left and right side
reversed, and a symbol for left/right reversal is displayed.
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Image reversal is symbolized on the monitor by an R which is either

mirrored left-right or upside-down.
14.10 Digital collimation (image crop)
• Press the Close Vertical Slot Collimator button until the desired
setting becomes visible on the live monitor.
The vertical slot collimator closes steplessly.
• Press the Open Vertical Slot Collimator button until the desired
The vertical slot collimator opens steplessly.
• Press the Close Horizontal Slot Collimator button until the desired
The horizontal slot collimator closes steplessly.
• Press the Open Horizontal Slot Collimator button until the desired
The horizontal slot collimator opens steplessly.
14.11 Marking and deleting images
Browsing through You can browse through an active patient folder in the Post Process
the patient folder operating mode without having to switch to the Archive operating mode.
The live monitor always shows the selected image at full-screen size.
Marking To mark one or more images, do the following:

• Select the desired image on the live monitor using the arrow buttons.

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• Select the desired marked image on the live monitor using the arrow
buttons.

The image becomes unmarked.
To protect one or more images, do the following: Protecting

• Select the desired image on the live monitor using the arrow buttons.

The image is now protected and receives the label P.
• If you want to protect further images, repeat the procedure.

• Select the desired protected image using the arrow buttons.

The image becomes unprotected.
Note
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To delete one or more images from a patient folder, do the

following:
CAUTION
no longer needed.
• Mark the images you want to delete and press the Delete Marked
Items button.
or or
• Mark the images you do not want to delete and press the Delete
or or
• Select the individual image you want to delete using the arrow
buttons.

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14.12 Outputting images
You can save individual images to hard disk (→ Ch. 8.7, p. 8-10) or Output options
floppy disk or print them on the video printer in the Post Process
operating mode as well. These actions are always applied to the selected
image or to the marked images.
When you save an image, the changes applied to it are saved as well and
will be visible the next time you open the image. However, you can post-
process an image as often as desired and also undo any changes you
have made before.
You can save images to floppy disk in 8 bit BMP format only. Saving to floppy
disk
A 3.5" high-density floppy disk (1.44 MB) stores one image. The floppy
disk must have been preformatted on an external MS DOS® compatible
PC. The floppy disk drive which is mounted in the system does not
support formatting.
To save an image to floppy disk, do the following:

• Mark the image you want to save.
monitor cart.
• Press the Floppy Disk button.
The marked image is saved to the floppy disk. A progress indicator in
a message window on the control panel informs you about the status
of the save operation.
Once it has been saved, the image becomes unmarked.
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To print images on the video printer, do the following:

• Select the image you want to print.
or or
• Mark the images you want to print.

panel informs you about the status of the print operation.
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Measurements 15
15.1 Measuring functions
The Ziehm Vision lets you measure various distances and angles in a General
saved fluoroscopic image. You can use the same measuring method
several times in an image.
Fig. 15-1 Measurement operating mode
The following functions are available for that purpose:

− Calibration:
To have an absolute scale for measurements, you must acquire the
length of a reference object prior to each measurement.
− Length or distance (2-Point):
Measures the length of a line.
− 3-point measurement (3-Point):

Measures the lengths of two contiguous lines and the interior angle
between them. In addition, the angle difference to a full circle is
calculated.
− 4-point measurement (4-Point):
Measures the lengths of two noncontiguous lines and the angle
between them. In addition, the angle difference to 180° is calculated.
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− 4-point ratio measurement (4-Point Ratio)

Computes the length ratio between two lines.
All measurements you perform in a fluoroscopic image are shown
simultaneously in the image. The measuring points are identified by
capital letters which are assigned in alphabetic order. This means that
the designation of the measuring points may vary, depending on the
order in which you perform the different measurements.
Measuring The larger the distance between the object of measurement and the
inaccuracy image intensifier, the more inaccurate the measurement will be.
Therefore position the object of measurement as closely as possible to
the image intensifier or use the electronic magnification function,
especially if the object of measurement is very small.
The measuring resolution on the screen is 512 pixels. With a 31 cm i.i.,
this results in a pixel distance of 310/512 = 0.6 mm in relation to the
object of measurement.
Zoom function If you change the zoom factor (→ Ch. 14.6, p. 14-9) after making a
measurement, the measured values will no longer be correct. In this
case, the following message will be displayed on the control panel:
Measurement invalid due to zoom factor change.
Thumbnail mosaic The measurements that you have performed on an image are not visible
in the thumbnail mosaic view.
Cine loop When you perform a measurement on a cine loop image and save it, this
measurement is saved for all images of the cine loop and visible in all
cine loop images.
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15.2 Calibrating
To have an absolute scale for a measurement, you must first acquire a

reference length. For that purpose, you must screen a reference object
of a known length or distance (e.g. a ruler or a balloon catheter with
radiopaque markers). Then you mark the known distance or length in the
fluoroscopic image and enter the corresponding value manually.
Point A Point B
Fig. 15-2 Calibrating
Measurements on a fluoroscopic image will only provide accurate results Validity of the
if, during the acquisition of the relevant calibration image, the reference calibration
object has been placed in exactly the same plane as the object to be
measured later.
If the position of the patient or the C-arm is changed after the calibration,
you must repeat the calibration before performing a new measurement.
To perform a calibration, do the following:
The measuring points may have different designations, depending on the Designation of the
order in which the measurements are performed (→ p. 15-2). In the measuring points
following procedure, the measuring points are designated as A and B by
way of example.
• Screen the reference object in the Fluoroscopy operating mode.
The reference object must be in the same plane as the object you
want to measure.
The image is displayed on the live monitor.
• Press the Measure tab.
The Measurement operating mode is activated.
• Press the Calibration button.
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The buttons and boxes for the calibration function are displayed in
the dynamic control area.
Fig. 15-3 Calibration function
Two white marker squares appear in the fluoroscopic image on the

live monitor; they mark the exact measuring points. The measuring
points are called A and B, and the marker square next to point A is
highlighted by a double frame.
The two marker squares are connected by a line. This line symbolizes
the reference length which is to be determined.
• Move marker square A with the four arrow buttons to the desired first
measuring point on the reference object, e.g. the first radiopaque
marker on a balloon catheter.
• Press the Next Measuring Point button.

Marker square B is now highlighted by a double frame.
• Move the second marker square with the four arrow buttons to the
desired second measuring point on the reference object, e.g. the
second radiopaque marker on a balloon catheter.
• Enter the length of the reference object in the Reference Length

input box.
• Press the Enter button.
• If you wish to modify the length you have entered, press the Delete
button and enter another value.
The acquired and saved calibration value remains in force until you
switch off the system.
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15.3 Measuring a length or distance
This function measures the distance between any two points defined by
you.
Point A Point B
Fig. 15-4 Distance measurement
To be able to measure a length or distance, you must perform a Prerequisite

calibration first (→ Ch. 15.2, p. 15-3). The calibration value remains in
force until you switch off the system.
To measure a length or distance, do the following:
following procedure, the measuring points are designated as A and B by
way of example.
• Open the desired image in the Archive operating mode (→ Ch. 10.3,
p. 10-7).
The Measurement operating mode is activated. The selected image
is displayed at full-screen size on the live monitor.
• Press the 2-Point button.
Note
If the 2-Point button is unavailable, you must perform a calibration first.
The buttons for controlling the length or distance function are

displayed in the dynamic control area.
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Fig. 15-5 Length or distance function
Two white marker squares appear in the fluoroscopic image on the

points are called A and B, and the marker square next to point A is
The two marker squares are connected by a line. This line symbolizes
the length or distance which is to be determined.
• Move marker square A to the starting point of the desired line using
the four arrow buttons.
The Reference Length read-only box shows the reference length
which was entered during calibration.
The Length 1 read-only box shows the current length of the distance.
• When the marker square has reached the desired starting point, press
the Next Measuring Point button.
• Move the second marker square to the final point of the desired length
or distance using the four arrow buttons.
The current length of the distance is indicated in the Length 1 read-
only box on the control panel. The value is immediately adjusted as
soon as you change the position of one of the two measuring points.
• If you want to change the position of a measuring point, press the
Next Measuring Point button until the desired marker square starts
flashing, and then move it to the desired new position.
The length of the modified distance is indicated in the Length 1 read-
only box on the control panel.

The image with the measurement is saved.
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You can edit any distance or length measurement as long as the patient Editing a distance
folder containing the image with the respective measurement is active. or length
measurement
Note
You cannot edit any distance/length measurements in images that have
been retrieved from the archive. The arrow buttons are unavailable.
However, you can delete existing length or distance measurements and
make new ones.
To edit a distance or length measurement, do the following:

• Press the Edit button.
The marker square is on one of the measuring points.
• Press the Next Measuring Point button until the marker square is on
the measuring point whose position you want to change.
• Move the marker square to the desired position using the arrow
buttons.

You can repeat this procedure as often as you want as long as the patient
folder is active.
To delete a length or distance measurement, do the following:
The measured length or distance is deleted.
To jump from one measurement to the next one, do the following:

The marker square is on one of the measuring points of the first
measurement.

The marker square jumps to one of the measuring points of the next
measurement.
• Repeat these two steps until the marker square has reached one of
the measuring points of the desired measurement.
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15.4 3-point measurement
A 3-point measurement determines the lengths of two contiguous lines,

the angle between them and the angle difference to a full circle.
360° – Angle
Point B
Angle
Point A Point C
Fig. 15-6 3-point measurement
Prerequisite To be able to measure a length or distance, you must perform a

To perform a 3-point measurement, do the following:
Designation of the The measuring points may have different designations, depending on the
measuring points order in which the measurements are performed (→ p. 15-2). In the
following procedure, the measuring points are designated as A, B and C
by way of example.
p. 10-7).
Note
The buttons for controlling the 3-point measurement function are

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Fig. 15-7 3-point measurement function
Three white marker squares appear in the fluoroscopic image on the

points are called A, B and C, and the marker square next to point A is
• Move the marker square to the desired point A using the four arrow
buttons.

The current length and angle values are displayed together with their
designations in the Length 1 (distance 1), Length 2 (distance 2),
Angle (interior angle) and 360° – Angle (angle difference to a full
circle) read-only boxes. The values are immediately adjusted as soon
as you change the position of one of the measuring points.
• Move the second marker square to the desired point B using the four
arrow buttons.

Marker square C is now highlighted by a double frame.
• Move the third marker square to the desired point C using the four
arrow buttons.

The new values of the modified distances are indicated in the
respective boxes on the control panel.
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Editing a 3-point You can edit any 3-point measurement as long as the patient folder
measurement containing the image with the respective measurement is active.
Note
You cannot edit any 3-point measurements in images that have been
retrieved from the archive. The arrow buttons are unavailable. However,
you can delete existing 3-point measurements and make new ones.
To edit a 3-point measurement, do the following:

buttons.

folder is active.
To delete a 3-point measurement, do the following:
The 3-point measurement is deleted.

measurement.
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measurement.
15.5 4-point measurement
A 4-point measurement determines the lengths of two noncontiguous

lines, the angle between them and the angle difference to 180°.
180° – Angle
Point B
Point C
Angle
Point A
Point D
Fig. 15-8 4-point measurement

To perform a 4-point measurement, do the following:
following procedure, the measuring points are designated as A, B,C and
D by way of example.
p. 10-7).
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Note
The buttons for controlling the 4-point measurement function are

Fig. 15-9 4-point measurement function
Four white marker squares appear in the fluoroscopic image on the

points are called A, B, C and D, and the marker square next to point
A is highlighted by a double frame.
buttons.

The current length and angle values are displayed together with their
designations in the Length 1 (distance 1), Length 2 (distance 2),
Angle (interior angle) and 180° – Angle read-only boxes. The values
are immediately adjusted as soon as you change the position of one
of the measuring points.
arrow buttons.

arrow buttons.
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Marker square D is now highlighted by a double frame.
• Move the marker square to the desired point D using the four arrow
buttons.


You can edit any 4-point measurement as long as the patient folder Editing a 4-point
containing the image with the respective measurement is active. measurement
Note
You cannot edit any 4-point measurements in images that have been
retrieved from the archive. The arrow buttons are unavailable. However,
you can delete existing 4-point measurements and make new ones.
To edit a 4-point measurement, do the following:

buttons.
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folder is active.
To delete a 4-point measurement, do the following:

The 4-point measurement is deleted.

measurement.

measurement.
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15.6 4-point ratio measurement
A 4-point ratio measurement determines the lengths of two

noncontiguous lines and their length ratio.
Point B
Point C
Point A
Point D
Fig. 15-10 4-point ratio measurement

To perform a 4-point ratio measurement, do the following:
following procedure, the measuring points are designated as A, B,C and
D by way of example.
p. 10-7).
• Press the 4-Point Ratio button.
Note
If the 4-Point Ratio button is unavailable, you must perform a calibration
first.
The buttons for controlling the 4-point ratio measurement function

are displayed in the dynamic control area.
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Fig. 15-11 4-point ratio measurement function
Four white marker squares appear in the fluoroscopic image on the

points are called A, B, C and D, and the marker square next to point
A is highlighted by a double frame.
buttons.

The current length and length ratio values are displayed in the Length
1 (distance 1), Length 2 (distance 2) and Length 1 / Length 2 (length
ratio) read-only boxes. The values are immediately adjusted as soon
as you change the position of one of the measuring points.
arrow buttons.

arrow buttons.

Marker square D is now highlighted by a double frame.
• Move the marker square to the desired point D using the four arrow
buttons.
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You can edit any 4-point ratio measurement as long as the patient folder Editing a 4-point
containing the image with the respective measurement is active. ratio measurement
Note
You cannot edit any 4-point ratio measurements in images that have
been retrieved from the archive. The arrow buttons are unavailable.
However, you can delete existing 4-point ratio measurements and make
new ones.
To edit a 4-point ratio measurement, do the following:

buttons.

folder is active.
To delete a 4-point ratio measurement, do the following:
The 4-point ratio measurement is deleted.
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measurement.

measurement.
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Displayed Texts and Text Functions 16
16.1 Overview
On a Ziehm Vision, the image always has a circular shape. On a Ziehm Shape of displayed
Vision FD, the image normally has a square shape. As soon as an image image
is rotated on a Ziehm Vision FD, it assumes a circular shape. The image
180°, 270°.
Some image information is always displayed automatically as text on the Image information
monitor. Detailed patient and image data can be found on the control
panel (→ Ch. 10.3, p. 10-7).
In addition, you may enter your own text or markers directly onto the
fluoroscopic image in a text annotation area on the monitor and save a
note together with the image.
16.2 Image information on the monitor
16.2.1 Upper left corner of the monitor
In this area, the last name, first name, patient ID and date of birth of the Patient data
patient are displayed. Patient data is entered or corrected in the Patient
operating mode (→ Ch. 10.2, p. 10-2).
16.2.2 Upper right corner of the monitor
In this area, the name of the hospital, the attending physician and Hospital data
department are displayed.
The hospital data can be entered in the Configuration operating mode
under Basic Settings (→ Ch. 20.3.3, p. 20-10) and may have been
corrected later in the Patient operating mode, if necessary
(→ Ch. 10.2.1, p. 10-3).
As soon as you have saved an image, its image number is displayed Image number and
(→ Ch. 8.7, p. 8-10). For marked or protected images, the label M or P is label
displayed directly behind the image number.
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16 Displayed Texts and Text Functions
DICOM status If the image has already been transferred to a DICOM server
(→ Ch. 11.3.1, p. 11-9) or imported from a DICOM server into the Ziehm
Vision (→ Ch. 11.5, p. 11-12), a label saying DICOM X is displayed:
− DICOM D: The image has been transferred successfully to the
DICOM server
− DICOM C: The image has been transferred successfully to the
DICOM server and stored safely (Storage Commitment)
− DICOM R: The image has been imported from the DICOM server into
the Ziehm Vision
Image type If a cine loop, DSA, MSA or RSA image is displayed, a corresponding
label (CINE, DSA, MSA, RSA) shows up.
16.2.3 Lower left corner of the monitor
Image reversal Image reversal is symbolized on the monitor by an R which is either

mirrored upside-down or left-right. This symbol appears in the following
cases:
− The live image is reversed (→ Ch. 9.10.1, p. 9-16).
− An image which has been saved with reversal is displayed
(→ Ch. 14.9, p. 14-11).
Recursive filter The chosen recursive filter level (→ Ch. 9.4.1, p. 9-7) is shown as NR X.
Edge filter The chosen edge filter level (→ Ch. 9.4.2, p. 9-8 or → Ch. 14.5, p. 14-8)
is shown as RTE X.
Stack filter The chosen stack filter level (→ Ch. 9.4.3, p. 9-9) is shown as LIH X.
Angle of rotation The angle of rotation which has been chosen for the image
(→ Ch. 9.10.2, p. 9-17 or → Ch. 14.8, p. 14-11) is shown as R X.
Windowing values The chosen windowing values (→ Ch. 9.3, p. 9-4 or → Ch. 14.4, p. 14-5)
are shown as W X and L Y.
Time and date of The time and date of saving are automatically assigned by the system
saving and cannot be edited.
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16.2.4 Lower right corner of the monitor
The following fluoroscopy parameters are displayed here: Fluoroscopy

parameters
− Tube voltage in kV
− Tube current in mA
− Dose area product in cGy cm2
− Total radiation time accumulated until now for the active patient folder
in seconds (→ Ch. 8.6, p. 8-10)
The values are automatically assigned by the system and cannot be
edited.
Furthermore, the image magnification level chosen for the image is Image
shown as MAG X. magnification level
Below the fluoroscopy parameters, an abbreviation indicates which Anatomical

anatomical program was used for generating the image: program
Abbreviation Anatomical program

BONE Bones
HRT Heart
ABD Abdomen
SOFT Soft
DSA DSA
MSA MSA
RSA RSA
Table 16-1 Abbreviations for anatomical programs
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16.3 Entering and editing text
Activating the Text You can activate the Text operating mode from the following operating
operating mode modes:
− Fluoroscopy
− Subtraction
− Post Process
− Measurements
• Simply press the Text button in the corresponding operating mode.
The Text operating mode is activated.
Fig. 16-1 Text operating mode
You may add the following elements to a fluoroscopic image on the live
monitor:
− Any desired text
− An arrow in various sizes pointing to different directions
− The markers L or R in various sizes

The arrow and the marking letters are available in three sizes (large,
medium, small). The chosen size is indicated in the center of the arrow
block. The default size is always large. The size can be modified with the
Size button.
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Fig. 16-2 Arrow block and size indication
The texts, markers or arrows that you have added to the image are not Thumbnail mosaic
visible in the thumbnail mosaic view.
In the Text operating mode, you may furthermore enter a note on the Note
current image. This note is displayed in the Archive operating mode
together with the image information (→ Fig. 10-6, p. 10-16).
To add a text to the fluoroscopic image, do the following:

• Press the Text button.
The cursor on the control panel jumps to the text input box.
• Enter the desired text using the alphanumeric keypad which is

displayed on the control panel.
Note
The text appears both in the input box on the control panel and in the
fluoroscopic image on the monitor. The text in the fluoroscopic image
is surrounded by a marker frame.
• Move the text to the desired position using the arrow buttons.
• If you want to undo an input, press the Cancel button.
The text and its position are deleted.
or
or
• If you want to confirm your input, press the OK button.

The marker frame disappears. The text input box on the control panel
is cleared.
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The previously active operating mode is reactivated.
To add a marker to the fluoroscopic image, do the following:
• Select the arrow or the marking letter you want to insert by pressing
the corresponding button.
The arrow or the marking letter appear in the fluoroscopic image on
the monitor.
• Move the arrow or marking letter to the desired position using the
arrow buttons.
• Press the Size button until the desired size has been reached.
The chosen size (large, medium, small) is indicated in the center of
the arrow block.
• If you want to undo an input, press the Cancel button.
The arrow or marking letter and its position are deleted.
or
or
• If you want to confirm your input, press the OK button.

The previously active operating mode is reactivated.
To edit a text annotation, do the following:

• Press the Edit button until the cursor on the monitor jumps to the
annotation you want to edit.
• Enter the new text using the alphanumeric keypad.
To delete a text annotation, do the following:

annotation you want to delete.
To edit a marker, do the following:

marker you want to edit.
• Make the desired changes.
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To delete a marker, do the following:

marker you want to delete.
To enter a note on an image, do the following:

• Press the Note button.
The cursor on the control panel jumps to the note input box.
• Enter the desired note using the alphanumeric keypad which is

displayed on the control panel.
Note
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Image Documentation 17
17.1 Overview
Optionally, different image documentation systems can be incorporated

into the monitor cart.
The following systems are available:
− Video printer
− Video cassette recorder
Up to 2 of these systems can be accommodated in the mounting frame
below the control panel.
The following documentation options are available in addition:
− Storage media: CD or DVD (→ p. 10-27), USB storage device
(→ p. 10-27), floppy disk (→ p. 10-26)
− DICOM interface (→ p. 11-1)
17.2 Output to video printer
The print live monitor image function is available in the following

operating modes: Fluoroscopy, Subtraction, Post Process,
Measurement and Archive. This function is only enabled if the monitor
cart is equipped with a video printer. The function always prints out the
image which is displayed at full-screen size on the live monitor.
To print out the image on the live monitor on the video printer, do
the following:
The text information that is displayed on the monitor together with the
image (name of the patient, angle of rotation of the image, etc.) will
appear as a text block on a gray background at the left margin of the
printout.
If you have performed measurements in an image and saved them
subsequently, the measured values are printed on a second page.
Note
When you launch the print job directly from the video printer, the
resulting hard copy will be an exact reproduction of the live monitor.
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17 Image Documentation
Further information For further information, please refer to the video printer’s separate
operating instructions provided with this system.
17.3 Record and playback on video cassette recorder
The VCR button is displayed on the control panel only if the monitor cart
is equipped with a video cassette recorder. The video cassette recorder
is controlled using buttons that appear on the control panel.
Fig. 17-1 Buttons for controlling the video cassette recorder
Automatic If you have activated the Automatic Recording function, video

recording recording starts automatically as soon as you release radiation.
If you have not activated the Automatic Recording function, you must
start video recording with the buttons on the control panel.
To activate the Automatic Recording function, do the following:

• Press the VCR button.
The buttons for controlling the video cassette recorder are displayed
• Press the Automatic Recording option.

The check box receives a check mark. The Automatic Recording
function is active now.
To record fluoroscopic images to video tape, do the following:
• Insert a video tape into the video cassette recorder.

• Press the REC button on the control panel.

The REC+Play+PAUSE buttons are active now.
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• If you have activated the Automatic Recording function: Initiate

radiation.
The PAUSE button is automatically deactivated and the fluoroscopic
images are recorded on the video tape.
or or
• If you have not activated the Automatic Recording function: Press

the PAUSE button.
The fluoroscopic images are recorded on the video tape.
or
• Press the PAUSE button.
Video recording stops.
You can replay the recorded images using the integrated video cassette Playback
recorder. The images are displayed on the live monitor.
To replay the fluoroscopic images on the video cassette recorder,

do the following:
• Insert the video tape into the video cassette recorder.

• Press the Play button on the control panel.

The fluoroscopic images are displayed one after the other on the live
monitor.
• Press the PAUSE button.

A still image is displayed on the live monitor.
The video image is available at the video output socket for further
processing.
For further information, please refer to the video cassette recorder’s Further information
separate operating instructions supplied with this system.
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Laser Positioning Device 18
As an option, the system may be equipped with a laser positioning device
at the image intensifier and/or generator.
The laser positioning device uses diode laser modules which emit laser
radiation. Do not under any circumstances look directly at the laser
beam or any scattered laser radiation – either with the naked eye or with
optical instruments.
The laser positioning device is a Class 2M laser product according to IEC
60825-1:2001-11. Make sure to comply with all operating safety
precautions when using the laser positioning device. The maximum
output of continuous laser radiation, measured at the beam exit, is <1
mW. The wavelength of the emitted radiation is 635 nm.
The laser positioning device generates a laser-beam crosshair, the
central point of which marks the position of the central X-ray beam on the
patient.
For safety, the laser positioning device is switched off automatically after
1 minute.
WARNING
LASER RADIATION – DO NOT LOOK INTO THE BEAM!
Do not look directly with optical instruments into the laser beam
apertures, since doing so can be hazardous to your eyes!
Laser Class II in accordance with FDA 21 CFR, Subchapter J, section
1040.10-11.
Please observe the provisions of IEC 60825-1:2001, Section 3, “User’s
Guide” for operation of the laser positioning device.
18.1 Applications
You can use the laser positioning device for the following tasks:
− As alignment aid for positioning the C-arm
− For foreign body localization
− As a navigational aid for nail fixations
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18 Laser Positioning Device
Positioning aid The laser positioning device allows you to position the C-arm exactly
above the patient without having to initiate radiation:
• Press the Laser button.
A laser-beam crosshair is generated, the central point of which
corresponds to the position of the central X-ray beam.
• Position the C-arm in such a way above the patient that the central
point of the laser-beam crosshair is exactly in the center of the region
to be screened.
Foreign body You can use the laser positioning device also for foreign body
localization localization: For that purpose, you must activate the on-screen crosshair
on the monitor first (→ Ch. 20.2.3, p. 20-4).
To localize a foreign body with the help of the laser positioning

device, do the following:
The foreign body becomes visible in the image on the live monitor.
• Position the C-arm in such a way above the patient that the center of
the crosshair on the screen lies exactly over the foreign body in the
fluoroscopic image.
• Press the Laser button.
The laser positioning device’s laser-beam crosshair now marks the
patient’s skin exactly above the point where the foreign body lies, thus
allowing a precise determination of the point of surgical incision.
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Direct Radiography 19
19.1 Overview
The Ziehm Vision can also be used for making direct radiographic film
exposures. This option is not available for the Ziehm Vision FD.
Direct radiographies are only possible if your system is equipped with a
film cassette holder (optional accessory).
19.2 Fitting the film cassette holder
To fit the film cassette holder for direct radiographic exposures

onto the image intensifier, do the following:
• Pull the spring-loaded securing lever on the film cassette holder

outward.
• Slide the film cassette holder over the supporting ridge on the image
intensifier.
• Release the spring-loaded securing lever.
• The securing lever engages above the supporting ridge.
• Insert a loaded film cassette fully into the film cassette holder from the
side.
Image intensifier
Securing lever Film cassette holder
Film cassette
Fig. 19-1 Fitting the film cassette holder and inserting the film
cassette
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19 Direct Radiography
19.3 Making a direct radiographic exposure
For direct radiography, you can set the following maximum collimator
apertures for the film or cassette size used:
31 cm image intensifier (not available in the U.S.A.):
− 24 cm
− 30 cm; the visible image has a diameter of max. 27 cm
23 cm image intensifier:
− 24 cm; the visible image has a diameter of 23 cm
WARNING
Make sure that the selected collimator aperture does not exceed the
cassette size used.
Manual settings For tube voltage, use the value that the system has automatically
selected during the previous fluoroscopy. If necessary, you can correct
this value manually.
The mAs value (tube current in mA × time in seconds) is always set
manually.
The tube current ranges from 15 mA to 20 mA. The system automatically
adjusts this value to reach the manually set value. The exposure time is
also computed automatically from the manually set value and appears
rounded to the first digit after the decimal point on the display.
To make a direct radiographic exposure, do the following:
WARNING
Make sure that the film cassette holder is properly attached to the image
intensifier, so that the cassette cannot fall down onto the patient!
• Press the Radiography tab.

The Radiography operating mode is activated. The buttons for
controlling the direct radiography functions are displayed in the
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Fig. 19-2 Radiography operating mode (film size 30 cm is not

available in the U.S.A.)
• Select the desired film size (e.g. 24 cm) by pressing the button with
the same label.
In the U.S.A., only the film size 24 cm is available.
• Set the desired tube voltage value using the arrow buttons.
The selected value appears on the Voltage display.
• Set the desired tube current × time (mAs) value using the arrow
buttons.
The selected value appears on the mAs display.
• Initiate radiation using the hand switch. In the Radiography operating

mode, you cannot initiate radiation with the foot switch.
An audible alarm will sound throughout the entire exposure time.
Radiation is terminated automatically after the preset exposure time.
You can interrupt the exposure before the selected exposure time has
elapsed by releasing the hand switch.
• Withdraw the film cassette.
• Remove the film cassette holder from the image intensifier.
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System Configuration 20
20.1 Overview
In the Configuration operating mode, you can make a wide variety of General
presettings.
The following setting options are available for that purpose:
− Operation settings
− Basic settings
− Defining the initial settings for the monitors, checking the sensor and
the dose meter (Monitor / Dose)
− Managing storage media (Storage Media)
The Vision Center control panel on the C-arm stand also provides access Service settings
to the Service Settings. This access is password-protected.
Consequently, the following settings and/or actions can and must be
made by a service engineer only:
− Settings for anatomical programs
− DICOM settings
− Collimator adjustments
− Uploading machine data to floppy disk
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20 System Configuration
20.2 Operation settings
Function Under Operation Settings you define the settings which determine the
operational conditions during fluoroscopy.
• Press the Config tab.
The Configuration operating mode is activated. The Operation
Settings controls appear.
Fig. 20-1 Configuration operating mode
20.2.1 Autotransfer
Moving the Under Autotransfer you activate or deactivate the Autotransfer

fluoroscopic image function (automatic image swapping).
Fig. 20-2 Autotransfer
− Autotransfer activated:
When you initiate radiation, the fluoroscopic image on the live monitor
is moved automatically to the reference monitor.
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− Autotransfer deactivated:
When you initiate radiation, the fluoroscopic image on the live monitor
is automatically deleted.
When you switch on the system, the Autotransfer function is deactivated
by default. If you activate the Autotransfer function during operation, it
will be deactivated automatically when you switch off the system.
To activate the Autotransfer function, do the following:

• Press the Autotransfer option.
The check box receives a check mark.
The Autotransfer function remains active until you switch off the
system.
20.2.2 Autostore
Under Autostore you activate or deactivate the autostore (automatic

saving) function.
Fig. 20-3 Autostore
− Autostore activated:
During each fluoroscopy, a new image will be saved automatically as
soon as you terminate radiation.
− Autostore deactivated:
The system does not save the images automatically. You must save
the desired fluoroscopic images manually (→ p. 8-10).
When you switch on the system, the autostore function is deactivated by
default. If you activate the autostore function during operation, it will be
deactivated automatically when you switch off the system.
Alternatively, you can activate the autostore function by means of the
Save button (→ p. 8-11).
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To activate the autostore function, do the following:

• Press the Autostore option.
The autostore function remains active until you switch off the system.
20.2.3 Displaying a crosshair
Positioning aid Under Crosshair you determine whether a crosshair is displayed as

positioning aid (e.g. for foreign body localization, see → Ch. 18.1,
p. 18-1) in the image on the live monitor during fluoroscopy. The central
point of the crosshair corresponds to the position of the central X-ray
beam. In addition you can set whether you want to activate the crosshair
together with the laser positioning device (→ Ch. 18.1, p. 18-1) when
pressing the Laser button.
Fig. 20-4 Crosshair
− Crosshair activated:
The crosshair is always displayed in the image on the live monitor.
− Crosshair deactivated:
No crosshair is displayed on the live monitor.
When you switch on the system, the crosshair is deactivated by default.
If you display the crosshair during operation, this setting will be valid only
for the current session.
− with Laser on activated:
When you press the Laser button, the crosshair is activated together
with the laser positioning device.
− with Laser on deactivated:
When you press the Laser button, only the laser positioning device is
activated.
To display the crosshair, do the following:

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• Press the Crosshair option.

The crosshair remains displayed until you switch off the system.
To have the crosshair activated with the Laser button, do the

following:
• Press the Crosshair – with Laser on option.
When you press the Laser button, the crosshair is activated together
with the laser positioning device.
20.2.4 Defining the start screen
Under Start Screen you determine which operating mode is activated by

default after power-up of the Ziehm Vision.
Fig. 20-5 Start screen
The following options are available:

− Fluoro:
After power-up of the system, the Fluoroscopy operating mode is
activated.
− Subtraction:
After power-up of the system, the Subtraction operating mode is
activated.
− Patient:
After power-up of the system, the Patient operating mode is
activated.
The default start screen is configured according to the customer’s
wishes.
To define the start screen, do the following:

• Press the option for the desired operating mode.
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As from the next power-up of the system, the selected operating
mode will be activated automatically.
20.2.5 Cine loop settings
Under Cine you preset the recording speed (frame rate) and length for
the acquisition of cine loops. You can change these preset values during
operation for each cine loop you acquire.
Fig. 20-6 Cine loop settings
To preset the recording speed for cine loops, do the following:

• Select the desired value for the recording speed (in frames per
second) under Rate with the help of the arrow buttons.

When you acquire a cine loop, the selected value is preset under
Frames/s (→ p. 12-3).
To preset the length of cine loops, do the following:

• Select the desired number of frames under Length with the help of
the arrow buttons.

When you acquire a cine loop, the selected value is preset under
Length (→ p. 12-3).
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20.2.6 Showing or hiding the native image
Under DSA you determine whether the native image is displayed on the
reference monitor during generation of a DSA/MSA/RSA (→ Ch. 13.2,
p. 13-2, → Ch. 13.3, p. 13-4, → Ch. 13.4, p. 13-5).
Fig. 20-7 Showing or hiding the native image
− Native on activated:
When you generate a DSA cine loop or MSA/RSA images, the native
image is displayed on the reference monitor.
− Native on deactivated:
image is not displayed. Before switching to the Subtraction operating
mode, you may open a reference image on the reference monitor,
which remains displayed there during the entire subtraction process.
To display the native image in the Subtraction operating mode, do

the following:
• Press the option Native on under DSA.

image is displayed on the reference monitor.
20.2.7 Discarding the operation settings
After having defined or modified the operation settings, these settings

must be applied first in order to become valid in the system. As long as
the settings or changes have not been applied yet, you can discard them,
so that the previous settings remain valid.
To discard the operation settings which have not been applied yet,
do the following:
• Press the Cancel button.
or
• Quit the Configuration operating mode without applying the settings.
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20.3 Basic settings
Function Under Basic Settings you make different settings which directly affect
the user interface, e.g. default data for the date or department.
Usually, the basic settings are made by the service engineer when
putting the system into service. However, you can modify the basic
settings if you wish to.
• Press the Basic Settings button.
The controls and input boxes for the basic settings are displayed in
Fig. 20-8 Basic settings
20.3.1 Setting the system date and the system time
The system date and the system time must be entered once in order to
enable the unit to store and display the date and time of saving together
with the image data.
Date format The displayed date format may vary depending on the customer-specific
settings (order of day, month and year; dot or slash as date separator).
The set date format is also used for displaying patient data in the Patient
(→ Ch. 10.2, p. 10-2) and Archive (→ Ch. 10.3, p. 10-7) operating
modes. Throughout this manual, the DD.MM.YYYY date format is used.
• If you want to change the date format, please contact your service
engineer.
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To set the system date and system time, do the following:

The Configuration operating mode is activated.
• Press the Time button.
The button is highlighted in yellow, and the cursor jumps to the Time
input box.
• Enter the system time in the Time input box using the format
hh:mm:ss.
• Press the Date button.
The button is highlighted in yellow, and the cursor jumps to the Date
input box.
• Enter the system date in the Date input box.

20.3.2 Determining the live monitor
Under Live Image you determine which monitor will serve as the live
monitor.
The live monitor is the monitor where the live fluoroscopic image is
displayed. The remaining monitor serves as reference monitor, where
the saved fluoroscopic images from the image memory are opened and
displayed.
Fig. 20-9 Determining the live monitor
The following options are available:

− Live Image left:
The left monitor is the live monitor and the right monitor is the
reference monitor
− Live Image right:
The right monitor is the live monitor and the left monitor is the
reference monitor
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To determine the live monitor, do the following:

• Press the option Live Image left or Live Image right.

20.3.3 Entering the hospital data
In order to avoid having to type the same hospital data for each new
patient folder you create, you can enter default data for the Hospital,
Department and Doctor input boxes (→ Ch. 10.2.1, p. 10-3). This data
appears automatically in the Patient operating mode.
To define default data for the Hospital, Department and Doctor input
boxes, do the following:
• Press the Hospital button.
The button is highlighted in yellow, and the cursor jumps to the
Hospital input box.
• Enter the desired name in the Hospital input box.

• Press the Department button and enter the desired name in the
Department input box.
• Press the Doctor button and enter the desired name in the Doctor
input box.
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20.3.4 Discarding the basic settings
After having defined or modified the basic settings, these settings must
be applied first in order to become valid in the system. As long as the
settings or changes have not been applied yet, you can discard them, so
that the previous settings remain valid.
To discard the basic settings which have not been applied yet, do
the following:
• Press the Cancel button.
or
• Quit the Configuration operating mode without applying the settings.
20.4 Monitor / Dose
Under Monitor / Dose, you can define the initial settings for the monitors, Function
check proper functioning of the integrated ambient light sensor and
perform a dose meter check (→ Appendix A.1.4, p. A-2).
Fig. 20-10 Monitor settings, ambient light sensor
Under Brightness and Contrast you define the default settings for both Initial settings for
monitors after power-up of the system. monitors
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To define the initial settings for the monitors, do the following:

• Press the Monitor / Dose button.
The monitor setting controls appear.
Fig. 20-11 Initial monitor settings
• Use the arrow buttons under Brightness and Contrast to set the
desired brightness and contrast.

The values for the initial monitor settings are saved now. When you
switch on the system the next time, the chosen initial monitor settings
are valid.
Ambient light The ambient light sensor is always active. It measures the ambient light
sensor level and continuously readjusts the screen brightness to match any
change in the ambient light conditions. The readjustment procedure is
flickering.
Fig. 20-12 Sensor indicator
To check the correct functioning of the ambient light sensor, do the

following:
• Watch the Sensor indicator to see whether the ambient light sensor
reacts to changes in the ambient light level.
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20.5 Storage media
Under Storage Media you can define the graphics formats used for Function
saving images to different storage media and delete data from different
external storage media.
Fig. 20-13 Storage media
− 8 bit BMP
− 16 bit TIF
− DICOM
− Multimedia
− DICOM 512×512 8 Bit
− JPEG 512×512
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20.5.1 Floppy disk storage format
Graphics formats When you save selected images to a floppy disk in the Archive operating
mode (→ p. 10-26), the images are saved automatically in 8 bit BMP
format.
Consequently, 8 Bit BMP is automatically set under Floppy Format.
Fig. 20-14 Floppy disk format
20.5.2 Defining the USB device storage format
Graphics formats For saving selected images to a USB storage device in the Archive
operating mode (→ p. 10-27), the following graphics formats are
available:
− TIF with a color depth of 16 bit (for further use on a PC)
− JPEG with a resolution of 512×512 pixels and a color depth of 8 bit
(for further use on a PC)
− DICOM (for further use on a DICOM network or viewing with a
DICOM viewer)
− DICOM with a resolution of 512×512 pixels and a color depth of 8
bit (for further use on a DICOM network or viewing with a DICOM
viewer)
Under USB Format you determine which of these graphics formats is
used for saving images to a USB storage device. In the Archive
operating mode, you have no possibility to set the desired graphics
format when saving.
Fig. 20-15 USB Format
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To define the USB device storage format, do the following:

• Press the Storage Media button.
• Press the desired storage format option under USB Format.

20.5.3 Defining the CD / DVD storage format
Depending on the chosen configuration, your Ziehm Vision may be CD writer or DVD
equipped with a CD writer or alternatively with a DVD writer. With a CD writer
For writing selected images to CD or DVD in the Archive operating mode Graphics formats
(→ p. 10-27), the following graphics formats are available:
− TIF with a color depth of 16 bit (for further use on a PC)
− JPEG with a resolution of 512×512 pixels and a color depth of 8 bit
(for further use on a PC)
− DICOM (for further use on a DICOM network or viewing with a
DICOM viewer)
− DICOM with a resolution of 512×512 pixels and a color depth of 8
bit (for further use on a DICOM network or viewing with a DICOM
viewer)
− Multimedia (Video CD or MPEG2 format, for playback on a PC and
DVD player)
Under CD/DVD you determine which of these graphics formats is used
for writing images to CD or DVD. In the Archive operating mode, you
have no possibility to set the desired graphics format when saving.
Fig. 20-16 CD/DVD format
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To define the CD/DVD storage format, do the following:

• Press the desired storage format option under CD / DVD Format.

20.5.4 Deleting data from storage media
To delete all images from a floppy disk, do the following:

• Press the Erase Floppy Disk button.

The following confirmation prompt is displayed: Do you really want
to erase the floppy disk?
All images are deleted from the floppy disk.
To delete all images from a USB storage device, do the following:

• Press the Erase USB button.

The following confirmation prompt is displayed: Do you really want
to erase the USB device?
All images are deleted from the USB storage device.
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C-Arm Power Assist (U.S. Option) 21
21.1 Function
The C-arm Power Assist – an optional accessory for peripheral vascular

flow procedures – is a joystick-controlled, motor-driven package for
power-assisted positioning of the mobile imaging system. One set of
motors drives the mobile imaging system left and right, parallel to the
patient, while another motor extends and retracts the C-arm across the
patient. Therefore, the C-arm can be driven, instead of pushed, along a
desired path to visualize the vascular anatomy of a contrast media
injection.
Note
The C-arm Power Assist does not contain any additional circuitry that
emits electromagnetic interference, and is not affected by
electromagnetic interference.
21.2 Operating instructions
Each steering wheel has a cable guard to push cables on the floor out of
the way. These guards interfere with the power-assisted drive
engagement when they are in the upward position. Therefore, make sure
that all guards are pushed down before engaging the Power Assist.
Fig. 21-1 Push cable guards down
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21 C-Arm Power Assist (U.S. Option)
21.3 Using the C-arm Power Assist
• Pull the steering & braking lever upward to release the wheel brake
(→ Fig. 21-2, p. 21-2).
• Stand at the rear of the C-arm and turn the steering & braking lever
clockwise until you see the green engagement indicator light
illuminate. This will occur when the handle points directly to the left.
Note
Notice that in power-assist mode the direction of the lower wheels is
fixed parallel to the patient.
• Release the extend/retract brake on the C-Arm.
Drive system status light

(green when lit)
Steering & braking lever.

Pull up to release brake.
Fig. 21-2 Steering & braking lever and indicator light
• Hold the joystick (in either hand) with the flat portion of the joystick
body towards you. Rest your thumb on the flat area of the joystick
body, as shown in → Fig. 21-3, p. 21-3.
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Image grab
button
Rest thumb
across flat
portion of Use index
joystick body finger to
activate fluoro
button
Fig. 21-3 Joystick
Note
You should be facing the C-arm control panel when using the joystick.
• To drive the C-arm base left, push the joystick to the left and vice
versa. Push the joystick back or forward to retract or extend the C-
arm.
• There are two fluoro activation buttons. Press either to activate

fluoroscopy.
WARNING
Use care when handling the joystick. The buttons on the side of the
joystick deliver an X-ray dose when pressed.
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Appendix
A.1 Regular checks
A.1.1 Routine checks to be performed by the user
The following safety checks must be performed at regular intervals:
Check Interval Remarks

X-ray generator Monthly Check for physical damage.
Radiation switches Monthly Must initiate radiation only if
pressed permanently. Releasing
them must terminate radiation
after 1 sec max. (depending on
the stack filter settings).
Radiation signals Monthly During the exposure, the yellow
radiation warning lamp on top of
the monitor housing and the X-ray
symbol on the control panel must
be illuminated.
Audible alarm Monthly Must sound in direct radiography
mode during the whole exposure
time, and in fluoroscopy mode
after 5 min.
Information labels Monthly All warning and information labels
must be properly attached and
easily legible.
Power cable Monthly Must not show any signs of
physical damage.
C-arm stand Whenever Clean when dirty.
wheels necessary
Table A-1 Regular checks
Note
A detailed maintenance schedule can be found in the “Ziehm Vision
Technical Manual”. Technical information necessary to repair or
upgrade the Ziehm Vision system will be made available by Ziehm
Imaging to authorized and qualified personnel upon request.
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Appendix
A.1.2 Consistency test according to national regulations
At regular intervals, at least once a month, you must check whether the
system shows any deviations from the reference values by performing a
consistency test.
Note
The relevant radiation protection regulations of the country of installation
must be observed.
A.1.3 Checking the exposure rate control
Quantitative method:
The system is in its initial state after switching it on.
The following value must be achieved:
70+3kV
Measured with a patient equivalent filter 25 mm Al + 1.5 mm Cu inserted
in the X-ray beam.
A.1.4 Dose meter check (optional feature)
Test interval You should check the dose meter each time you switch on the system.
You must perform and document a dose meter check once a month when
you perform the consistency test.
To test the dose meter, do the following:

The ambient light sensor indicator and the Dose Meter Check button
appear in the dynamic control area.
A-2 Ziehm Vision

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Appendix
Fig. A-1 Sensor / dose meter check functions
• Press the Dose Meter Check button.

The test is started. It takes 30 seconds. A message window with a
progress indicator and the message DAP test running is displayed.
A Cancel button appears in addition, enabling you to interrupt the
check.
Once the test is complete, and if the measured values are within the
tolerance limits, the message DAP ok; actual value: xyz is
displayed.
If the measured values are beyond the tolerance limits, the following
message appears:
DAP fault; nominal value: x, actual value: y
• If the values are beyond the tolerance limits, repeat the dose meter
check.
• If the values measured are still beyond the tolerance limits, contact
your service engineer.
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Appendix
A.1.5 Checking the useful beam
Inspection interval Together with the consistency test, it is necessary to check the size and
centering of the useful X-ray beam.
Centering To determine the correct alignment of the ray beam to the center of the
image intensifier and any possible deviation, do the following:
• Angulate the C-arm by 180°, so that the X-ray generator is above and
the image intensifier is below.
• Place a reference or test object (e.g. measuring board, graduated

collimator test tool) exactly in the center of the image intensifier.
• Close the iris collimator as far as possible and initiate radiation by

pressing the hand or foot switch. The object should appear exactly in
the center of the fluoroscopic image.
Collimator diameter The size of the collimator diameter in the image plane must not differ from
accuracy the nominal image diameter by more than 2% of the source–image
receptor distance (SID). The SID and the nominal image diameter
depend on the image intensifier size.
Size SID Nominal image size

31 cm 97 cm Dia. 27.0 cm
23 cm 97 cm Dia. 20.1 cm
Digital flat-panel 111 cm 19.8 cm × 19.8 cm
detector
Table A-2 Nominal image diameter
Maximum radiation When the iris collimator is completely open, the edges of the collimator
field size must be just visible on the monitor.
WARNING
Contact your after-sales service center in case of any non-conformities!
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Appendix
A.1.6 Leakage in the cooling system
If you observe any moisture on the outside of the C-arm stand during Moisture
operation, leakage of the cooling system might be the reason. Cooling penetration
may be diminished or fail completely in such cases.
If there is leakage in the generator area, the cooling pump switches off, Leakage in the
and a message window with an alert appears on the control panel. generator
WARNING
Contact your after-sales service center in case of any moisture
penetration or leakage of the generator!
A.1.7 Gettering the image intensifier tube (n/a for Ziehm Vision FD)
To increase the useful life of the image intensifier, we recommend Increasing the
gettering the image intensifier tube after a period of 6 months of useful life
continuous non-use or storage.
To getter the image intensifier tube, do the following:
• Switch on the system.
• Leave it switched on for at least 1 hour.
• Do not initiate radiation during this time!
We recommend keeping an operator’s log, where all operating times, Operator’s log
gettering times and maintenance events are recorded.
A.1.8 Gain adjustment and pixel correction (Ziehm Vision FD)
Every 6 months, gain adjustment and pixel correction must be carried out
on a Ziehm Vision FD. Please contact your after-sales service center for
that purpose.
WARNING
If the live image shows streaks although the gain adjustment and pixel
correction procedures have been performed at regular intervals, please
contact your after-sales service center!
Ziehm Vision A-5

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Appendix
A.2 Cleaning, disinfection, sterilization
Preparation Always switch off the system and disconnect it from the power supply
before cleaning or disinfecting it.
A.2.1 Cleaning
Recommended For cleaning the system, use only water with mild detergents applied with
detergents a damp cloth. Never use abrasive cleansing agents, organic solvents or
detergents which contain solvents (e.g. alcohol, petroleum ether, liquid
stain remover).
WARNING
Take care that no liquids penetrate into the unit through sockets, plugs,
ventilation holes or gaps (at integrated external devices such as video
printers or video cassette recorders).
Never apply spray cleaners directly onto the unit!
Cleaning the For cleaning the monitor screens, use only pure alcohol or a mixture
monitor screens consisting of 1/3 alcohol and 2/3 distilled water. Wipe the screen and
surrounding painted surfaces dry with a soft cotton cloth immediately
after cleaning.
A.2.2 Disinfection
Please use one of the following tested and approved disinfectants:

− Terralin
− Dax YT
− Antifect AF
• Dilute the disinfectant according to the manufacturer’s instructions.
• Dampen a cloth with the solution.
• Thoroughly wipe the outside of the unit with this cloth.
No alcohol or Never use pure alcohol or Sagrotan, since these substances may
Sagrotan corrode the surfaces.
No disinfecting Never use disinfecting sprays, since the liquid droplets may penetrate
sprays inside the unit, endangering safe system operation. Electronic modules
may be damaged, and explosive air/solvent vapor mixtures may develop.
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Appendix
A.2.3 Sterilization
The disposable covers (optional accessories) are sterile upon delivery.
CAUTION
The disposable covers are not re-sterilizable.
Be sure to discard the disposable covers properly after use!
A.3 Faults
A.3.1 Types of faults
The following fault types are detected and indicated:
A.3.1.1 Alerts during power-up
Alert messages are displayed in a message window on the control panel.

An audible alarm sounds. If you get an alert message during system
power-up, you can close the message window and continue to work with
the system. However, the system will not be fully operational.
• Press the Yes button in the message window.
The message window is closed.
A.3.1.2 Errors during power-up
Error messages are displayed in a message window on the control panel.

An audible alarm sounds. Although you can close the message window,
you cannot continue to work with the system.
The message window is closed. In some cases, a new message
window with another error message is displayed.
WARNING
If an error message is displayed, the system is not ready for operation!
The error must be corrected by your after-sales service center!
Please communicate the error code number (E...) and the serial number
of the system to your after-sales service center.
Ziehm Vision A-7

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A.3.1.3 Alerts during operation
Alert messages are displayed in a message window on the control panel.

An audible alarm sounds. If you get an alert message during system
operation, radiation is not interrupted, and you can continue to initiate
radiation. However, the system will not be fully operational.
The message window is closed.
A.3.1.4 Errors during operation
Error messages are displayed in a message window on the control panel.

An audible alarm sounds. Radiation is interrupted and you can no longer
initiate any radiation.
The message window is closed. In some cases, a new message
window with another error message is displayed.
WARNING
If an error message is displayed, the system is not ready for operation!
The error must be corrected by your after-sales service center!
Please communicate the error code number (E...) and the serial number
of the system to your after-sales service center.
WARNING
Please contact your after-sales service center also if a certain error
occurs frequently!
A.3.2 List of errors and alerts
If an alert appears, do the following:

The message window is closed. You may continue to work. The
system is not fully operational.
If an error occurs, do the following:
• Contact your after-sales service center.
A-8 Ziehm Vision

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Appendix
Code Type Description

E1000 Error Thin filament defective
E1001 Error Thick filament defective
E1002 Error No V-Sync
E1003 Error Operating temperature not yet reached, please wait
E1004 Alert Cooling phase in process, please wait
E1005 Error Temperature 2 too low
E1006 Alert Temperature 2 too high
E1007 Error Machine data corrupt
E1008 Error Interrupt 1 flipflop defective
E1009 Error Interrupt 2 flipflop defective
E1010 Error HW signal XRay active during power-up
E1011 Error CAN XRay Enable active during power-up
E1012 Error D/A converter reference voltage defective
E1013 Error D/A converter kV defective
E1014 Error Oil overtemperature switch active
E1015 Error Wrong machine data version
E1016 Error Moisture sensor alarm
E1050 Alert High-voltage fault
E1051 Alert High-voltage fault (anode)
E1052 Alert High-voltage fault (cathode)
E1053 Alert mA peak value fault
E1054 Alert kV nominal/actual value fault
E1055 Alert mA nominal/actual value fault
E1056 Alert XRay Enable fault
E1057 Alert Life monitoring missing
E1058 Alert Hardware monitoring missing
E1059 Alert External radiation interrupt (XRayBreak)
E1060 Alert Signal / XRay missing
E1061 Alert High-voltage arc
E1062 Alert Nominal kV value greater max. kV value
E1063 Alert Nominal mA value greater max. mA value
E1066 Alert CAN fault line active
E1067 Error Basic heating faults
Table A-3 List of error and alert messages
Ziehm Vision A-9

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Appendix

E1068 Error V-Sync faults
E1069 Alert Temperature sensor 1
E1070 Alert Temperature sensor 2
E1071 Error Signal / XRay without radiation
E1072 Error Oil overtemperature switch active
E1073 Error Moisture sensor alarm
E1074 Error kV value too high (no radiation)
E1095 Alert Generator overheated, recovery time %d seconds
E1098 Error Generator power-up fault
E1099 Error Generator fault
E1100 Alert Hand switch 1 pressed during power-up
E1101 Alert Hand switch 2 pressed during power-up
E1102 Alert Foot switch 1 pressed during power-up
E1108 Error Short circuit in hand switch 1
E1110 Error Short circuit in foot switch 1
E1116 Error XRay Enable present during power-up
E1117 Error External I/O fault
E1118 Error Wrong EEPROM checksum
E1132 Alert Short circuit in hand switch 1
E1133 Alert Short circuit in hand switch 2
E1134 Alert Short circuit in foot switch 1
Table A-3 List of error and alert messages (cont.)
A-10 Ziehm Vision

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Appendix

E1140 Alert XRay Enable not active
E1141 Alert CAN fault line active
E1142 Alert External I/O fault
E1143 Error Error Lifemonitoring Imaging System
E1148 Alert Timeout post-fluoro time (LIH)
E1172 Error XRay Enable without switch
E1173 Error CAN fault line active
E1174 Error External I/O fault
E1175 Error Error Lifemonitoring Imaging System
E1197 Error Main interface XRay break fault
E1198 Error Main interface power-up fault
E1199 Error Main interface fault
E1200 Error Timeout main interface (1)
E1201 Error Timeout main interface (2)
E1202 Error Timeout while reading power-up errors
E1203 Error Timeout generator machine data (1)
E1206 Error Timeout generator pulse width
E1207 Error Timeout filament selection
E1208 Error Timeout measuring range selection
Ziehm Vision A-11

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Appendix

E1209 Error Timeout kVmA setpoint value
E1210 Error Timeout while reading collimator limit value (1)
E1211 Error Timeout while reading collimator limit value (2)
E1212 Error Timeout ack system running
E1213 Alert Timeout while reading XRay break errors
E1214 Alert Timeout XRay break: interface busy
E1215 Error Internal error %d
E1216 Alert Internal alert %d
E1217 Error Error while clearing hard disk %d
E1218 Error Timeout CAN module %d
E1219 Error Unexpected ACK from CAN module %d
E1220 Alert XRay assigned to function switch (%d), ignored!
E1221 Alert XRAY command assigned to function switch (%d), ignored!
E1222 Alert Temperature limit alert: Reduce radiation power!
E1223 Error CAN bus cannot be addressed during power-up!
E1224 Error CAN module missing:
E1225 Alert Radiation allowed after technique values are displayed!
E1226 Error CAN modules missing:
E1227 Error CAN module faulty: %d
E1228 Error CAN module 6 U544 faulty
E1229 Error CAN bus faulty BUS OFF
E1230 Error Only CAN module 6 U544 present
E1231 Error CAN module(s) not connected correct ( stand alone ? )
E1232 Error Timeout: no answer from a CAN module
E1233 Error Memory full. Image can not be stored!
E1234 Error dis8000.ini missing!
E1235 Error No acknowledge to %d from %d
E1299 Error Image system fault
E1300 Error SPI interface MAX 504
E1301 Alert Overtemperature
E1302 Error Reference voltage MAX 504
E1303 Error Output voltage MAX 504
A-12 Ziehm Vision

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Appendix

E1350 Error SPI interface MAX 504
E1351 Alert Overtemperature
E1352 Alert Actual value too high
E1353 Alert Actual value too low
E1354 Error Output voltage MAX 504
E1355 Error CAN fault line active
E1358 Alert Output voltage beyond tolerance
E1398 Error PPS power-up fault
E1399 Error PPS fault
E1400 Error Servo %d position fault
E1401 Error Servo %d not connected
E1402 Error Servo %d not ready
E1449 Error Vision Track fault
E1450 Error Servo position fault
E1451 Error Servo not connected
E1452 Error Servo not ready
E1499 Error II power supply fault
E1500 Alert Radiation alert lamp defective
E1501 Alert CRT high voltage
E1502 Alert Video voltage
E1503 Alert Video signal
E1504 Alert CRT filament
E1505 Alert Horizontal deflection
E1506 Alert 150V supply
E1507 Alert Vertical deflection
E1509 Alert V-Blank signal missing
E1516 Alert Radiation alert lamp defective
E1517 Alert CRT high voltage
E1518 Alert Video voltage
E1519 Alert Video signal
E1520 Alert CRT filament
E1521 Alert Horizontal deflection
Ziehm Vision A-13

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Appendix

E1522 Alert 150V supply
E1523 Alert Vertical deflection
E1599 Error Monitor fault
E1600 Alert Busy printer 1 active
E1601 Alert Busy printer 2 active
E1620 Alert Printer 1 busy error
E1649 Error U525 fault
E1700 Alert kVmA table: kV not ascending
E1701 Alert kVmA table: Power not ascending
E1702 Alert kVmA table not finished
E1703 Alert kV maximal value too high
E1704 Alert mA maximal value too high
E1705 Error No extern video signal
E1708 Error Generator pulse error
E1709 Error No VSync
E1710 Error No interrupt
E1711 Error No communication PPC-generator
E1712 Error mA from generator invalid
E1713 Error XRAY not allowed
E1714 Error Max mA value cannot be read
E1716 Error SDRAM PPC defective
E1717 Error GammaLUT PPC defective
E1718 Error Offset adjustment not possible
E1719 Error Gain adjustment not possible
E1720 Error Hardware Version, Release
E1721 Error IRQ3 error
E1722 Error VSync corrupt 30/25 Hz
A-14 Ziehm Vision

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Appendix

E1723 Error Video standard unknown
E1724 Error Boot program unknown
E1725 Error M-Data unknown
E1726 Alert Collimator does not support DAP values
E1727 Error Flatpanel not supported in this version
E1732 Error Reference voltage defektive
E1733 Error AD14 offset adjustment defektive
E1734 Error AD14 gain adjustment defektive
E1735 Error AD14 gain*4 adjustment defektive
E1736 Error AD8 offset adjustment defektive
E1737 Error AD8 gain adjustment defektive
E1738 Error No extern video signal
E1740 Error Hardware doesn’t support grid regulation
E1741 Error Hardware doesn’t support motion detection
E1742 Error Hardware doesn’t support DAP calculation
E1743 Error Hardware doesn’t support automatic dose reduction
E1799 Error Error PPC
Ziehm Vision A-15

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Appendix
A.4 Labels on the Ziehm Vision
For U.S.A., see → p. A-40
I
1*
D
F E
B 2)
G
C
I
Fig. A-2 Labels on the C-arm stand (Ziehm Vision)
1*
I
D
H
F E
B 2)
G
C
I
Fig. A-3 Labels on the C-arm stand (Ziehm Vision FD)
A-16 Ziehm Vision

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Appendix
E J 1)
1)
Fig. A-4 Labels on systems with laser positioning device on the

image intensifier (left) and on the generator (right)
E J 1)
1) J

digital flat-panel detector (left) and on the generator (right)
(Ziehm Vision FD)
Ziehm Vision A-17

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Appendix
1(
1^
(optional)
1%
1& 1^
(optional)
1! 1$
G 1@
1#
Fig. A-6 Labels on a Ziehm Vision monitor cart with flat-screen
monitors
1( 1^
(optional)
1%
1& 1^
(optional)
1! 1$
G 1@
1#
Fig. A-7 Labels on a Ziehm Vision monitor cart with CRT monitors
A-18 Ziehm Vision

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Appendix
No. Label Comments

B Ziehm Vision
Ziehm Vision FD
Table A-4 Labels on the Ziehm Vision (outside the U.S.A.)
Ziehm Vision A-19

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Appendix
No. Label Comments

C Ziehm Vision
Ziehm Vision FD
Table A-4 Labels on the Ziehm Vision (outside the U.S.A.) (cont.)
A-20 Ziehm Vision

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Appendix
No. Label Comments

D Ziehm Vision
Ziehm Vision FD
E —
F —
G Please observe accompanying documents!
H —
I —
J Only on systems with laser positioning device
1) Only on systems with laser positioning device
Ziehm Vision A-21

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Appendix
No. Label Comments

1! Ziehm Vision
Ziehm Vision, only on 200V systems sold in

Japan
Ziehm Vision, only on 100V systems sold in

Japan
A-22 Ziehm Vision

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Appendix
No. Label Comments

1! Ziehm Vision FD
1@ Equipotential grounding
1# Spare earth ground connection
1$ Protection Class I, Type B
1% —
Only on systems sold in Japan
1^ DICOM Only on systems with DICOM option and RJ45

connection, connection optionally either in the
upper or lower half of the monitor cart
1& TX RX Only on systems with DICOM option and fiber-
optic connection
Ziehm Vision A-23

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Appendix
No. Label Comments

1* Ziehm Vision
Ziehm Vision FD
A-24 Ziehm Vision

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Appendix
No. Label Comments

1( Ziehm Vision
Ziehm Vision FD
2) Only on systems sold in China
Ziehm Vision A-25

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Appendix
A.5 Focal spot position
A.5.1 Ziehm Vision
Reference axis
Horizontal
deviation of X-ray
tube
Focal spot
(red dot)
Anode angle
Fig. A-8 Focal spot position on systems with 23 cm i.i. (Ziehm

Vision)
A-26 Ziehm Vision

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Appendix
A.5.2 Ziehm Vision FD
280
7.2° 7.2°
Reference axis
1110
Focal spot
(red dot)
Fig. A-9 Focal spot position on systems with digital flat-panel

detector (Ziehm Vision FD)
Ziehm Vision A-27

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Appendix
A.6 Heat capacity
Heating curve Heating curve at 110 kV / 3.2 mA

Temp. (Heat capacity 800,000 J, continuous heat dissipation 50 W)
(°C)
80
70
60
50
40
30
0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32
Time (min.)
Fig. A-10 Heating curve (Model D-064R)
Cooling curve
Temp.
Cooling curve
(°C)
90
80
70
60
50
40
30
20
10 20 30 40 50 60 70 80 90 100 110 120 130 140 150 160 170 180 190 200 210 220 230 240 250 260
Time (min.)
Fig. A-11 Cooling curve (Model D-064R)
A-28 Ziehm Vision

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Appendix
A.7 Scattered radiation in the significant zone of occupancy
A.7.1 Ziehm Vision
Distribution of scattered radiation in the significant zone of occupancy of the C-

arm stand
Measurement conditions in accordance with EN 60601-1-3:1994

Exposure conditions: Automatic control, 76 kV / 5.9 mA / 448 W
Rectangular water phantom 25 cm × 25 cm × 15 cm + 1.5 mm Cu
Measuring instrument: Radcal 9015
Height above floor in cm
Copper
Water
phantom
45 cm X-ray focus – floor : 25 cm phantom – image intensifier anti-scatter grid distance
Distance to central ray beam in cm
Patient
positioning Significant zone of
occupancy
80 × 60 × 200 cm
Fig. A-12 Scattered radiation Ziehm Vision
Ziehm Vision A-29

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Appendix
A.7.2 Ziehm Vision FD
Distribution of scattered radiation in the significant zone of occupancy of the C-

arm stand
Measurement conditions in accordance with EN 60601-1-3:1994

Exposure conditions: Automatic control, 89 kV / 15.8 mA / pulse duration 16 ms
/ 30 pulses/s / 700 W
Rectangular water phantom 25 cm × 25 cm × 15 cm + 1.5 mm Cu
Measuring instrument: Radcal 1515
Copper
Water
phantom
Significant zone
of occupancy
80×60×200cm
Fig. A-13 Scattered radiation Ziehm Vision FD
A-30 Ziehm Vision

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Appendix
A.8 Dimensions
C-arm stand with

31 cm i.i.
25° 90°
220
430
680
760
970
910
345
155
480 - 700
1630 - 1850
2150 - 2370
225° 225°
10° 10°
575
1785 - 2215
760
450 - 880
420
700
800
Fig. A-14 Dimensions of a Ziehm Vision C-arm stand with 31 cm i.i.
Ziehm Vision A-31

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Appendix
C-arm stand with

23 cm i.i.
45° 90°
220
430
680
788
1000
910
345
155
445 - 665
1665 - 1885
2125 - 2345
225° 225°
10° 10°
475
1780 - 2210
760
515 - 945
700
800
Fig. A-15 Dimensions of a Ziehm Vision C-arm stand with 23 cm i.i.
A-32 Ziehm Vision

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Appendix
Ziehm Vision FD
C-arm stand
Fig. A-16 Dimensions of a Ziehm Vision FD C-arm stand
Ziehm Vision A-33

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Appendix
Monitor cart with

18.1" flat-screen
monitors
Fig. A-17 Dimensions of a Ziehm Vision monitor cart with 18.1" flat-
screen monitors
Monitor cart with

CRT monitors
Fig. A-18 Dimensions of a Ziehm Vision monitor cart with CRT

monitors
A-34 Ziehm Vision

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Appendix
A.9 Technical data
For U.S.A., see → p. A-48
A.9.1 Ziehm Vision

Nominal supply voltage / 230 VAC, 50/60 Hz
frequency
Power supply fuse rating L 16 A
Required residual current IN ≥ 16 A, IAN = 30 mA
circuit breaker (RCD)
Nominal supply current 8 A continuous,
16 A short-time
Power supply in standby 1.95 A / 450 W
mode (applies to the following configuration: CRT monitors,
System
printer UP-980, CD writer, floppy disk drive)

The values depend on the integrated documentation
systems.
Internal fusing 15 A quick-blow (2 pcs.)
Maximum line impedance ≤ 0.6 Ω
Equipment protection Protection Class I, Type B ( ), ordinary equipment,
classification continuous operation
Radiation controlled area 23/31 cm i.i. and digital flat-
(with generator in panel detector: 4m
lowermost position and C-
arm vertical)
Table A-5 Technical data of the Ziehm Vision
Ziehm Vision A-35

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Appendix
Power Direct radiography: 40–110 kV

(n/a for Ziehm Vision FD) 15 mA min./20 mA max.,
1.5 mAs min./100 mAs
max.
Fluoroscopy: 40–110 kV
0.1–20 mA
− Pulsed mode: Pulse width 10–30 ms;

Ziehm Vision FD: Pulse
width 16 ms (invariable);
1, 2, 4, 8, 12.5, 25 pulses/s
(systems with 25 pulses/s)
1, 5, 10, 15, 30 pulses/s
(systems with 30 pulses/s,
also Ziehm Vision FD)
Digital radiography 40–110 kV
(snapshot): 0.1 mA min./20 mA max.
Generator
Operating frequency: 40 kHz

Max. operating data Fluoroscopy: 110 kV / 18 mA
80 kV / 20 mA
Direct radiography: 110 kV / 15 mA
(n/a for Ziehm Vision FD) 80 kV / 20 mA
Digital radiography: 110 kV / 18 mA
80 kV / 20 mA
Max. power output Fluoroscopy: 1980 W (110 kV / 18 mA)
Direct radiography: 1650 W (110 kV / 15 mA)
Digital radiography: 1980 W (110 kV / 18 mA)
Nominal electric power 2000 W at 100 kV / 20 mA / 0.1 s
X-ray tube Single-focus stationary-anode tube
Focal spot nominal size, 0.6 acc. to IEC
with respect to reference
axis (→ Fig. A-8, p. A-26)
Focal spot horizontal +/- 0.5 mm (controlled)
tolerance, with respect to
reference axis (→ Fig. A-8,
p. A-26)
Table A-5 Technical data of the Ziehm Vision (cont.)
A-36 Ziehm Vision

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Appendix
Anode angle, with respect 9°

to reference axis
(→ Fig. A-8, p. A-26)
Generator
Anode material Tungsten

Total filtration Ziehm Vision: ≥ 3 mm Al, including 0.05 mm Cu
Ziehm Vision FD: ≥ 3 mm Al
Maximum X-ray tube 10800 mAs/h
loading factors for
1h;3mA (at 110 kV)
Tube Scintillator: Cesium iodide
Image intensifier
Nominal sizes: 31 / 23 / (17) cm or

23 / 17 / (10) cm
Anti-scatter grid Pb 8/40
Detector Scintillator: Cesium iodide

Digital flat-panel
Size: 19.8 cm × 19.8 cm

detector
Resolution: 1024 × 1024

Anti-scatter grid Pb 8/40
18.1" flat-screen monitors Screen size: 460 mm (18.1")

Resolution: 1280 × 1024 / 50 Hz
Monitors
CRT monitors Screen size: 440 mm (17")

Bandwidth: 100 MHz
Resolution: 1125 lines / 75 Hz
During storage Temperature: –10°C to +60°C
Environmental
conditions
Relative air humidity: 95% max.

During operation Temperature: +15°C to +35°C
Ziehm Vision A-37

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Appendix
C-arm Source/image receptor 970 mm

distance:
Vertical free space 750 mm
(generator/i.i.):
Vertical free space 895 mm
(generator/digital flat-panel
Dimensions
detector):
Immersion depth: 680 mm
Orbital rotation: 115° / 135° a
Angulation: ± 225°
Swiveling (panning): ±10°
Horizontal movement: 220 mm
Vertical movement: 430 mm
C-arm stand With 23 cm i.i. approx. 280 kg (also
applies to Ziehm Vision
Weight
FD)
Monitor cart With flat-screen monitors: approx. 183 kg
With CRT monitors: approx. 203 kg
a. Option, not available with 31 cm i.i.
CAUTION
Temperatures above 40°C and relative air humidity above 60% may
cause stains on the printer’s heat-sensitive paper.
WARNING
If you expect ambient air temperatures below 0°C, empty the cooling
tank in the C-arm stand foot with the help of the two filler and vent hoses
supplied with the system.
Re-fill the cooling tank with water before putting the system into service.
A-38 Ziehm Vision

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Appendix
A.9.2 Laser positioning device
Laser Class Class 2M acc. to IEC 60825-

1:2001-11
Max. power output < 1 mW
of continuous laser radiation,
measured at the laser beam
apertures
Wavelength of the radiation 635 nm
Table A-6 Technical data of laser positioning device
A.9.3 Dose measurement chamber
Absorber 2.8 mm Al
Sensitivity pC
(75 kV; 2.7 mm Al HVL)
≥ 800 --------------
mGy • cm2
Measuring range of DAP (0.1–104) mGy • cm2/s
power
Voltage range (35–150) kV
Voltage correction → Fig. A-19, p. A-40
Aluminum equivalent < 0.4 mm
Table A-7 Technical data of dose measurement chamber
Ziehm Vision A-39

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Appendix
Voltage correction
(Absorber: 2.8 mm Al filtration taken into consideration)
Correction factor
Fig. A-19 Voltage correction of dose measurement chamber
A.10 Labels on the Ziehm Vision (U.S.A.)
1#
3$
H
1$ 2(
1$ 1%
1^
1&
1!+1@
3%+3&
C+E
3#+3*
1& i
1%
1$ 3@+3^ B
3! J
1*
1^ G
3)
1#
Fig. A-20 Labels on the C-arm stand (U.S.A.)
A-40 Ziehm Vision

26366-5_4.12_EN_00
Appendix
I 1& 1% 1$
1*
1$
1^
1%
1*
1&
image intensifier (left) and on the generator (right) (U.S.A.)
2* 2*
2^
2%
2$
2&
1)
1(
2) 2@
2#
Fig. A-22 Labels on a Ziehm Vision monitor cart with flat-screen
monitors (U.S.A.)
Ziehm Vision A-41

26366-5_4.12_EN_00
Appendix
2* 2*
2^
2%
2$
2&
1)
1(
2) 2@
2#
Fig. A-23 Labels on a Ziehm Vision monitor cart with CRT monitors
(U.S.A.)
No. Label Comments

B —
C —
D Only on systems sold in Canada
Table A-8 Labels on the Ziehm Vision (U.S.A.)
A-42 Ziehm Vision

26366-5_4.12_EN_00
Appendix
No. Label Comments

E —
F Only on systems sold in Canada
G —
H —
I —
J —
Table A-8 Labels on the Ziehm Vision (U.S.A.) (cont.)
Ziehm Vision A-43

26366-5_4.12_EN_00
Appendix
No. Label Comments

1) Please observe accompanying documents!
1! —
1@ Only on systems sold in Canada
1# —
1$ Only on systems with laser positioning device
1% Only on systems with laser positioning device
1^ Only on systems with laser positioning device
1& Only on systems with laser positioning device
1* Only on systems with laser positioning device
A-44 Ziehm Vision

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Appendix
No. Label Comments

1( a —
1( b Only on 220 VAC systems sold in the U.S.A.
2) —
2! Only on systems sold in Canada
2@ Equipotential grounding
2# Spare earth ground connection
2$ Protection Class I, Type B
2% —
Ziehm Vision A-45

26366-5_4.12_EN_00
Appendix
No. Label Comments

2^ Only on systems with DICOM option and RJ45
connection, connection optionally either in the upper
or lower half of the monitor cart
2& Only on systems with DICOM option and fiber-optic

connection
2* —
2( —
3)
3!
A-46 Ziehm Vision

26366-5_4.12_EN_00
Appendix
No. Label Comments

3@
3^ Only on systems sold in Canada
3#
3* Only on systems sold in Canada
3$
3%
3& Only on systems sold in Canada
Ziehm Vision A-47

26366-5_4.12_EN_00
Appendix
A.11 Technical data Ziehm Vision (U.S.A.)
Nominal supply voltage / 120 VAC, 60 Hz 230 VAC, 60 Hz

frequency
Power supply fuse rating L 20 A L16 A
Required residual current IN ≥ 20 A, IAN = 30 mA IN ≥ 16 A, IAN = 30 mA
Nominal supply current 10 A continuous, 8 A continuous,
22 A short-time 16 A short-time
Power supply in standby 3.75 A / 450 W 1.95 A / 450 W
mode
(applies to the following configuration: CRT monitors,
System

systems.
Internal fusing 20 A quick-blow (2 pcs.) 15 A quick-blow (2 pcs.)
Maximum line impedance ≤ 0.6 Ω ≤ 0.6 Ω
Radiation controlled area 23/31 cm i.i.: 4 m 23/31 cm i.i.: 4 m
(with generator in
arm vertical)
Table A-9 Technical data of the Ziehm Vision (U.S.A.)
A-48 Ziehm Vision

26366-5_4.12_EN_00
Appendix
Power
Direct radiography: 40–110 kV 40–110 kV
15 mA min./20 mA max., 15 mA min./20 mA max.,
1.5 mAs min./100 mAs 1.5 mAs min./100 mAs
max. max.
Fluoroscopy: 40–110 kV 40–110 kV
0.1–15 mA 0.1–20 mA
− Pulsed mode: Pulse width 10–30 ms Pulse width 10–30 ms
1,2,5,10,15,30 pulses/s 1,2,5,10,15,30 pulses/s
Digital radiography 40–110 kV 40–110 kV
(snapshot): 0.1 mA min./20 mA max. 0.1 mA min./20 mA max.
Operating frequency: 40 kHz 40 kHz
Max. operating data
Generator
Fluoroscopy 110 kV / 15 mA 110 kV / 18 mA

80 kV / 20 mA 80 kV / 20 mA
Direct radiography: 110 kV / 15 mA 110 kV / 15 mA
80 kV / 20 mA 80 kV / 20 mA
Digital radiography: 110 kV / 15 mA 110 kV / 18 mA
80 kV / 20 mA 80 kV / 20 mA
Max. power output
Fluoroscopy: 1650 W (110 kV / 15 mA) 1980 W (110 kV / 18 mA)
Direct radiography: 1650 W (110 kV / 15 mA) 1650 W (110 kV / 15 mA)
Digital radiography: 1650 W (110 kV / 15 mA) 1980 W (110 kV / 18 mA)
Nominal electric power 2000 W at 100 kV / 20 mA / 0.1 s
Focal spot nominal size 0.6 acc. to IEC 0.6 acc. to IEC
Total filtration ≥ 3 mm Al, including 0.05 mm Cu
Image intensifier
Nominal sizes: 31 / 23 / (17) cm or 23 / 17 / (10) cm

Anti-scatter grid Pb 8/40 Pb 8/40
Table A-9 Technical data of the Ziehm Vision (U.S.A.) (cont.)
Ziehm Vision A-49

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Appendix
18.1" flat-screen monitors

Screen size: 460 mm (18.1") 460 mm (18.1")
Resolution: 1280 × 1024 / 60 Hz 1280 × 1024 / 50 Hz
Monitors
CRT monitors
Screen size: 440 mm (17") 440 mm (17")
Bandwidth: 100 MHz 100 MHz
Resolution: 1068 lines / 90 Hz 1125 lines / 75 Hz
Environmental
conditions

C-arm Source/image receptor distance: 970 mm

Vertical free space (generator/i.i.): 750 mm
Dimensions

C-arm stand With 23 cm i.i.: approx. 280 kg
Weight

Table A-9 Technical data of the Ziehm Vision (U.S.A.) (cont.)
A-50 Ziehm Vision

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Appendix
A.12 Technical data Ziehm Vision (Japan)
Nominal supply voltage / 100 VAC, 50/60 Hz 230 VAC, 50/60 Hz

frequency
Power supply fuse rating 20 or 30 A 20 or 30 A
Required residual current IN ≥ 20 A, IAN = 30 mA IN ≥ 16 A, IAN = 30 mA
Nominal supply current 10 A continuous, 8 A continuous,
22 A short-time 16 A short-time
Power supply in standby 450 VA (4.5 A) 450 VA (2.25 A)
mode
(applies to the following configuration: CRT monitors,
System

systems.
Internal fusing 20 A quick-blow (2 pcs.) 15 A quick-blow (2 pcs.)
Maximum line impedance ≤ 0.6 Ω ≤ 0.6 Ω
Radiation controlled area 23/31 cm i.i.: 4 m 23/31 cm i.i.: 4 m
(with generator in
arm vertical)
Power
Direct radiography: 40–110 kV 40–110 kV
12 mA min./20 mA max., 15 mA min./20 mA max.,
1.5 mAs min./100 mAs 1.5 mAs min./100 mAs
max. max.
Generator
Fluoroscopy: 40–110 kV 40–110 kV

0.1–12 mA 0.1–20 mA
− Pulsed mode: Pulse width 10–30 ms Pulse width 10–30 ms
1,2,5,10,15,30 pulses/s 1,2,5,10,15,30 pulses/s
Digital radiography 40–110 kV 40–110 kV
(snapshot): 0.1 mA min./20 mA max. 0.1 mA min./20 mA max.
Operating frequency: 40 kHz 40 kHz
Table A-10 Technical data of the Ziehm Vision (Japan)
Ziehm Vision A-51

26366-5_4.12_EN_00
Appendix
Max. operating data

Fluoroscopy 110 kV / 12 mA 110 kV / 18 mA
65 kV / 20 mA 80 kV / 20 mA
Direct radiography: 110 kV / 12 mA 110 kV / 15 mA
65 kV / 20 mA 80 kV / 20 mA
Digital radiography: 110 kV / 12 mA 110 kV / 18 mA
65 kV / 20 mA 80 kV / 20 mA
Max. power output
Fluoroscopy: 1320 W (110 kV / 12 mA) 1980 W (110 kV / 18 mA)
Direct radiography: 1320 W (110 kV / 12 mA) 1650 W (110 kV / 15 mA)
Digital radiography: 1320 W (110 kV / 12 mA) 1980 W (110 kV / 18 mA)
Nominal electric power 1320 W at 100 kV / 13.2 2000 W at 100 kV / 20 mA
(IEC 60601-2-7, 6.8.2)
Generator
mA / 0.1 s / 0.1 s
Focal spot nominal size, 0.6 acc. to IEC
with respect to reference
axis (→ Fig. A-8, p. A-26)
Focal spot horizontal +/- 0.5 mm
tolerance, with respect to
reference axis (→ Fig. A-8,
p. A-26)
Anode angle, with respect 9°
to reference axis
(→ Fig. A-8, p. A-26)
Anode material Tungsten
Total filtration ≥ 3 mm Al, including 0.05 mm Cu
Maximum X-ray tube 10800 mAs/h
loading factors for
1h;3mA (at 110 kV)
EIA 343, 60 Hz refresh rate, like NTSC, no color
Video standard
of output

Image intensifier
Nominal sizes: 31 / 23 / (17) cm or 23 / 17 / (10) cm

Anti-scatter grid Pb 8/40 Pb 8/40
Table A-10 Technical data of the Ziehm Vision (Japan) (cont.)
A-52 Ziehm Vision

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Appendix
18.1" flat-screen monitors

Screen size: 460 mm (18.1") 460 mm (18.1")
Resolution: 1280 × 1024 / 60 Hz 1280 × 1024 / 50 Hz
Monitors
CRT monitors
Screen size: 440 mm (17") 440 mm (17")
Bandwidth: 100 MHz 100 MHz
Resolution: 1068 lines / 90 Hz 1125 lines / 75 Hz
Environmental
conditions

C-arm Source/image receptor distance: 970 mm

Vertical free space (generator/i.i.): 750 mm
Dimensions

C-arm stand With 23 cm i.i.: approx. 280 kg
Weight

Table A-10 Technical data of the Ziehm Vision (Japan) (cont.)
Ziehm Vision A-53

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Appendix
A-54 Ziehm Vision

26366-5_4.12_EN_00
Index
Archive (operating mode) 10-7, 11-12

Numerals Archive (tab) 6-6, 10-7, 10-15, 10-18, 10-31,
10-32, 10-33, 10-34, 10-35, 10-36, 11-
180° – Angle (read-only box) 15-12 9, 11-10, 11-11, 11-12, 11-15, 12-4,
2-Point (button) 15-5 13-8
360° – Angle (read-only box) 15-9 Arrow
3-Point (button) 15-8 Adding to an image 16-6
4-Point (button) 15-11 Auto-delete function 8-11
4-Point Ratio (button) 15-15 Automatic exposure rate control 8-2
Autostore 20-3
Activating 8-11, 20-4
Autotransfer 20-2
A Activating 20-3
Abdomen (anatomical program) 8-7

Access. No. (button) 11-5
Accessories included in the scope of delivery B
4-2
Accessories, optional 2-6 Backup
Accessories, optional (U.S.A.) 2-6 Patient folders 10-30
Acquiring Restoring from CD/DVD 10-36
Cine loop 12-3 Restoring from USB storage device 10-
Active Cooling 8-14 33
Alarm (radiation time) 8-13 Selecting patient folders 10-30
Switching off 8-13 Selection using search criteria 10-30
Alert messages 8-14 Selection using the image creation date
Alerts 10-30
During operation A-8 To CD/DVD 10-34
During power-up A-7 To USB storage device 10-31
List of errors and alerts A-8 Backup (button) 10-31, 10-32, 10-34, 10-35
Alphanumeric keypad 6-9 Backup copy
Ambient light sensor 9-4, 14-5, 20-12 Restoring from CD/DVD 10-36
Function check 20-12 Restoring from USB storage device 10-
Anatomical programs 8-7 33
Abdomen 8-7 Selecting patient folders 10-30
Activating 8-7 Selection using search criteria 10-30
Bones 8-7 Selection using the image creation date
Deactivating 8-7 10-30
Heart 8-7 To CD/DVD 10-34
Soft 8-7 To USB storage device 10-31
Angle (read-only box) 15-9, 15-12 Basic settings 20-8
Angle of rotation Determining the live monitor 20-9
Information on the monitor 16-2 Discarding 20-11
Angulation Entering the hospital data 20-10
C-arm 5-8 System date 20-8
Archive System time 20-8
Inverting the entire archive 10-12 Basic Settings (button) 20-8, 20-9, 20-10
Ziehm Vision i
26365-5.04.DE.00
Index
Bones (anatomical program) 8-7 Button ‘Heart’ 6-4

Bones (button) 6-4 Button ‘High Quality’ 6-2, 8-9
Brake Button ‘Hospital’ 20-10
C-arm stand 5-5 Button ‘Image Swapping’ 6-3, 9-15
Monitor cart 5-4 Button ‘Invert All’ 10-12
Brightness Button ‘Large Patient’ 6-3, 8-9
Monitor 9-2 Button ‘Laser’ 6-5, 18-2
Restoring the initial settings 9-3, 14-5 Button ‘LM’ 13-14
Setting 14-4 Button ‘Magnify’ 6-5, 9-10
Setting on flat-screen monitors 2-12 Button ‘Manual Exposure Rate Setting’ 6-3,
Button ‘2-Point’ 15-5 8-5
Button ‘3-Point’ 15-8 Button ‘Mark’ 10-10, 10-24, 11-14, 12-11,
Button ‘4-Point Ratio’ 15-15 14-12, 14-13
Button ‘4-Point’ 15-11 Button ‘Mask off’ 13-13
Button ‘Access. No.’ 11-5 Button ‘Mask’ 13-13
Button ‘Backup’ 10-31, 10-32, 10-34, 10-35 Button ‘Metal’ 6-4, 8-8
Button ‘Basic Settings’ 20-8, 20-9, 20-10 Button ‘Monitor / Dose’ 20-12, A-2
Button ‘Bones’ 6-4 Button ‘Mosaic’ 10-21
Button ‘Calibration’ 15-3 Button ‘MSA’ 13-4, 13-7, 13-9
Button ‘CD/DVD’ 10-14, 10-28, 12-14 Button ‘Name’ 11-4
Button ‘CD/DVD’ (Backup) 10-35, 10-36 Button ‘New’ 10-4, 10-5, 10-17, 11-2
Button ‘Cine’ 6-3, 12-3 Button ‘Next Measuring Point’ 15-4, 15-6,
Button ‘Clean up’ 12-8, 13-12 15-9, 15-12, 15-13, 15-16, 15-17
Button ‘Close Horizontal Slot Collimator’ 4-12 Button ‘Open Horizontal Slot Collimator
Button ‘Close Iris Collimator’ 6-3, 9-13 ’14-12
Button ‘Close Vertical Slot Collimator’ 6-4, Button ‘Open Iris Collimator Fully’ 6-3, 9-14,
9-14, 14-12 9-15
Button ‘Complete’ 12-7, 13-12 Button ‘Open Iris Collimator’ 9-13
Button ‘Continuous Pulse Fluoroscopy’ 6-2, Button ‘Open Vertical Slot Collimator Fully’
8-3, 8-5 6-4, 9-14, 9-15
Button ‘Contrast/Brightness’ 6-5, 9-3, 9-5, Button ‘Open Vertical Slot Collimator’ 9-14,
9-6, 14-4, 14-6, 14-7 14-12
Button ‘Date’ 20-9 Button ‘Patient ID’ 11-2, 11-5
Button ‘Delete Marked Items’ 10-11, 10-25, Button ‘PAUSE’ 17-3
12-12, 14-14 Button ‘Play’ 12-6, 13-11, 13-13, 17-3
Button ‘Delete Unmarked Items’ 10-11, Button ‘Print Live Monitor Image’ 6-5, 8-12,
10-25, 12-12, 14-14 10-13, 10-26, 12-13, 12-19
Button ‘Delete’ 10-11, 10-25, 12-12, 14-14 Button ‘Print’ 10-13, 12-13, 14-16
Button ‘Delete’ (Measurement) 15-4 Button ‘Protect’ 10-24, 12-11, 14-13
Button ‘Department’ 20-10 Button ‘P-Sh’ 13-13
Button ‘DICOM Print’ 11-10, 11-11 Button ‘Query’ 11-2
Button ‘DICOM Retrieve’ 11-12, 11-15 Button ‘REC’ 17-2
Button ‘DICOM Store’ 11-9, 11-10, 11-12 Button ‘Refresh’ 11-13, 11-16
Button ‘Doctor’ 20-10 Button ‘Reposition’ 6-4, 8-8
Button ‘Dose Meter Check’ A-2 Button ‘Restore CD/DVD’ 10-36
Button ‘Down Arrow’ 6-5 Button ‘Restore USB’ 10-33
Button ‘DSA’ 6-8, 13-3 Button ‘Retrieve’ 11-12, 11-15, 11-16
Button ‘Erase Floppy Disk’ 20-16 Button ‘Reverse Left/Right’ 6-3, 9-16, 14-11
Button ‘Erase USB’ 20-16 Button ‘Reverse Up/Down’ 6-3, 9-16, 14-11
Button ‘Filter’ 6-5, 9-7, 9-9 Button ‘Rotate Image CCW’ 6-3, 9-17, 14-11
Button ‘Floppy Disk’ 10-26, 14-15 Button ‘Rotate Image CW’ 6-3, 9-17, 14-11
Button ‘Full-Screen Image’ 10-21 Button ‘Rotate Image to 0°’ 6-3, 9-17
Button ‘Grayscale Inversion’ 6-5, 9-13, 14-11
ii Ziehm Vision
26365-5.04.DE.00
Index
Button ‘Rotate Vertical Slot Collimator CCW’ Dimensions A-31

9-14 Illustration 2-7, 2-8
Button ‘Rotate Vertical Slot Collimator CW’ Steering 5-5
9-14 Transport position 5-1
Button ‘Rotate Vertical Slot Collimator to 0°’ CD
6-4, 9-14 Backup copy 10-34
Button ‘RSA’ 13-5, 13-8, 13-10 Restoring backed-up data 10-36
Button ‘Save’ 6-5, 8-11, 16-5, 16-6 Saving a cine loop 12-14
Button ‘Search’ (Archive operating mode) Saving images 10-27
10-15, 10-18, 12-4 Saving patient folders 10-14
Button ‘Search’ (Patient operating mode) Saving single cine loop images 12-21
10-5, 10-17 Storage format 10-14, 10-27, 12-14,
Button ‘Size’ 16-6 20-15
Button ‘Snapshot’ 6-2, 8-4, 8-5 CD/DVD (button in Backup) 10-35, 10-36
Button ‘Soft’ 6-4 CD/DVD (button) 10-14, 10-28, 12-14
Button ‘Start Img’ 12-7, 13-12 Checks
Button ‘Stop Img’ 12-7, 13-12 Checking the useful beam A-4
Button ‘Stop’ 12-6, 12-7, 12-8, 13-11, 13-12 Consistency test A-2
Button ‘Storage Media’ 20-15, 20-16 Regular checks A-1
Button ‘Text’ 6-5, 16-4, 16-5 Routine checks by the user A-1
Button ‘Time’ 20-9 Cine (button) 6-3, 12-3
Button ‘Up Arrow’ 6-4 Cine loop 12-1
Button ‘USB’ 10-13, 10-27, 12-14 Acquiring 12-3
Button ‘USB’ (Backup) 10-32, 10-33 Applications 12-1
Button ‘VCR’ 6-5, 17-2, 17-3 Auto setting 12-1
Button ‘WNDW’ 9-5, 14-6 Changing the playback speed 12-6,
Button ‘Worklist’ 11-3, 11-5, 11-6, 11-7 13-11
Button ‘Zoom’ 6-5, 9-11, 9-12, 14-9, 14-10 Cleaning up 12-8, 13-12
Buttons Controlling 12-6, 13-11
ON/OFF 6-9 Defining a mask image 13-12
UP/DOWN 6-9 Deleting 12-12
Buttons on the control panel 6-1, 6-2 Deleting single images 12-18
Frame rate 12-1
Length 12-1
Marking 12-11
C Marking single images
Mosaic view
12-16
12-15
Cable connections 4-3 Opening 12-4
Cables Presetting the length 20-6
Coupling cable 4-3, 7-1 Presetting the recording speed 20-6
Power cable 4-3, 7-1 Printing on video printer 12-13
Calibrating 15-3 Printing single images 12-19
Calibration (button) 15-3 Processing 12-6, 12-8, 13-11
C-arm Processing single images 12-15
Angulation 5-8 Protecting 12-11
Horizontal movement 5-10 Protecting single images 12-17
Movements 5-6 Replaying 12-4, 12-6, 12-10, 13-11
Orbital rotation 5-7 Saving single images to a USB storage
Swiveling (panning) 5-9 device 12-20
Vertical movement 5-11 Saving single images to floppy disk 12-20
C-arm power assist (U.S. option) 21-1 Saving to hard disk 12-2
C-arm stand 2-7 Start image 12-7, 13-11
Brake 5-5 Stop image 12-7, 13-11
Ziehm Vision iii

26365-5.04.DE.00
Index
Trimming 12-7, 13-11 Setting 14-4

Unmarking 12-11 Setting on flat-screen monitors 2-12
Unprotecting 12-11 Contrast/Brightness (button) 6-5, 9-3, 9-5,
Writing single images to CD/DVD 12-21 9-6, 14-4, 14-6, 14-7
Writing to CD/DVD 12-14 Control panel 6-1
Clean up (button) 12-8, 13-12 Elements 6-1
Cleaning A-6 Cooling curve A-28
Monitor A-6 Cooling System, Active 8-14
Recommended detergents A-6 Coupling cable 4-3, 7-1
Close Horizontal Slot Collimator (button) Crosshair 20-4
14-12 Showing 20-4
Close Iris Collimator (button) 6-3, 9-13 Current (display) 6-7, 8-9
Close Vertical Slot Collimator (button) 6-4,
9-14, 14-12
Collimators
Iris collimator
Slot collimator
9-13
9-14
D
Virtual collimator 9-15 Date (button) 20-9
Complete (button) 12-7, 13-12 Date format 20-8
Config (tab) 6-6, 20-2, 20-3, 20-4, 20-5, 20-6, Date of saving
20-7, 20-9, 20-10, 20-15, 20-16, A-2 Information on the monitor 16-2
Configuration 4-4 Delete (button in Measurement mode) 15-4
Ambient light sensor 20-12 Delete (button) 10-11, 10-25, 12-12, 14-14
Autostore 20-3 Delete Marked Items (button) 10-11, 10-25,
Autotransfer 20-2 12-12, 14-14
Basic settings 20-8 Delete protection 10-24
CD/DVD storage format 20-15 Removing from a cine loop 12-11
Checking the ambient light sensor 20-12 Removing from an image 10-24
Crosshair 20-4 Delete Unmarked Items (button) 10-11,
Deleting all images from a floppy disk 10-25, 12-12, 14-14
20-16 Deleting
Deleting all images from a USB storage All images from a floppy disk 20-16
device 20-16 All images from a USB storage device
Determining the live monitor 20-9 20-16
Discarding the operation settings 20-7 Cine loop 12-12
Entering the hospital data 20-10 Image 10-25, 14-14
Floppy disk storage format 20-14 Patient folders 10-11
Monitor / Dose 20-11 Single cine loop images 12-18
Operation settings 20-2 Department (button) 20-10
Service settings 20-1 Department (input box) 20-10
Storage media 20-13 DICOM
System date 20-8 Downloading a Worklist 11-2
System time 20-8 Downloading patient data 11-1
USB device storage format 20-14 Images (list) 11-12
Configuration (operating mode) 20-1 Networkability 2-3
Consistency test A-2 Series (list) 11-12
Continuous pulse fluoroscopy 8-2 Studies (list) 11-12
Continuous Pulse Fluoroscopy (button) 6-2, DICOM network printer
8-3, 8-5 Printing images 11-9
Contrast DICOM Print (button) 11-10, 11-11
Monitor 9-2 DICOM Retrieve (button) 11-12, 11-15
Restoring the initial settings 9-3, 14-5 DICOM server
Downloading a Worklist 11-2
iv Ziehm Vision
26365-5.04.DE.00
Index
Downloading patient data 11-1

Importing images 11-12 E
Saving patient folders 11-8
DICOM Store 11-8 Edge filter 9-8
DICOM Store (button) 11-9, 11-10, 11-12 Information on the monitor 16-2
Digital collimation 14-12 Levels 9-8, 14-8
Digital radiography 8-4 Edge filter (post-processing) 14-8
Digital zoom 9-11 Edges
Zoom factor 9-11, 9-12, 14-9, 14-10 Enhancement 9-8
Digital zoom (post-processing) 14-9 Electronic image magnification 9-10
Dimensions Emergencies
C-arm stand A-31 Switching off 7-3
Monitor cart with CRT monitors A-34 EMERGENCY STOP button 2-4, 7-3
Monitor cart with flat-screen monitors Enhancement
A-34 Edges 9-8
Direct radiography 19-1 Entire archive
Collimator apertures 19-2 Grayscale inversion 10-12
Film cassette holder 19-1 Erase Floppy Disk (button) 20-16
Making 19-2 Erase USB (button) 20-16
Tube current 19-2 Error
Disinfection A-6 During operation A-8
Displays During power-up A-7
Current 6-7, 8-9 List of errors and alerts A-8
Dose Area Product 6-7 Error messages 8-14
mAs 19-3 Exposure rate control, automatic 8-2
Pulses /s 6-7 Exposure rate setting, manual 8-5
Pulsewidth % 6-7
Radiation Time 6-7, 8-13
Tube current × time 19-3
Voltage
Displays on the control panel
6-6, 8-9, 19-3
6-1
F
Doctor (button) 20-10 Film cassette holder 19-1
Doctor (input box) 20-10 Fitting 19-1
Dose Area Product (display) 6-7 Filter (button) 6-5, 9-7, 9-9
Dose measurement chamber Filters
Technical data A-39 Edge filter 9-8
Voltage correction A-40 Edge filter (post-processing) 14-8
Dose Meter Check (button) A-2 In the live image 9-7
Down Arrow (button) 6-5 Noise suppression 9-7, 9-9
DSA 13-1 Recursive filter 9-7
DSA (button) 6-8, 13-3 Stack filter 9-9
DSA cine loop 13-1 First power-up of the system 4-3
Acquiring 13-2 Flat-screen monitors
DVD Dimensions of monitor cart A-34
Backup copy 10-34 Monitor settings 2-12
Restoring backed-up data 10-36 Floppy disk
Saving a cine loop 12-14 Deleting all images 20-16
Saving images 10-27 Saving images 10-26, 14-15
Saving patient folders 10-14 Saving single cine loop images 12-20
Saving single cine loop images 12-21 Storage format 10-26, 14-15, 20-14
Storage format 10-14, 10-27, 12-14, Floppy Disk (button) 10-26, 14-15
20-15 Fluoro (tab) 6-6
Fluoroscopy (operating mode) 6-2, 8-1
Ziehm Vision v
26365-5.04.DE.00
Index
Defining as start screen 20-5 Heart (button) 6-4

Fluoroscopy modes 8-2 Heat capacity A-28
Continuous pulse fluoroscopy 8-2 Heating curve A-28
Digital radiography (snapshot) 8-4 High Quality (button) 6-2, 8-9
Fluoroscopy parameters High quality (function) 8-8
Information on the monitor 16-3 Horizontal image reversal 9-16
Fluoroscopy programs 8-7 Horizontal image reversal (post-processing)
Focal spot position A-26 14-11
Foot switch 6-10 Horizontal movement
Foreign body localization 18-2 C-arm 5-10
Four-Point (button) 15-11 Hospital (button) 20-10
Four-Point Ratio (button) 15-15 Hospital (input box) 20-10
Frame rate Hospital data
Cine loop 12-1 Entering 20-10
Full-screen image 10-23 Information on the monitor 16-1
Displaying an image at full-screen size
10-23
Full-Screen Image (button) 10-21
Functions
High quality 8-8
I
Large patient 8-9 Illustrations
Metal artifact correction 8-8 C-arm stand 2-7, 2-8
Reposition 8-8 Dimensions of C-arm stand A-31, A-32
Functions, optional 2-4 Dimensions of monitor cart A-34
Monitor cart with CRT monitors 2-10,
2-11
Monitor cart with flat-screen monitors 2-9
G Transport position of the C-arm stand 5-2
Transport position of the monitor cart 5-3
Gettering the image intensifier tube A-5 Image
Graphics format Adding a marker 16-6
CD/DVD 10-14, 10-27, 12-14, 20-15 Adding an arrow 16-6
Floppy disk 10-26, 14-15, 20-14 Adding text 16-5
USB storage device 10-13, 10-27, 12-13, Comparing 9-15
20-14 Deleting 10-25, 14-14
Grayscale inversion Displaying at full-screen size 10-23
All images 10-12 Documenting 17-1
Entire archive 10-12 Edge enhancement 9-8
Image 9-13 Grayscale inversion 9-13
Undoing the grayscale inversion 10-12 Grayscale inversion (post-processing)
Grayscale Inversion (button) 6-5, 9-13, 14-11 14-11
Grayscale inversion (post-processing) Importing from DICOM server 11-12
Image 14-11 Inverting all images 10-12
Left/right 9-16
Marking 10-23, 14-12
Mirroring (reversal) 9-16
H Mirroring (reversal) (post-processing)
14-11
Hand switch 6-10 Note 16-5
Hard disk Print live monitor image on video printer
Saving a cine loop 12-2 8-12
Saving images 8-10 Printing on DICOM network printer 11-9
Heart (anatomical program) 8-7
vi Ziehm Vision
26365-5.04.DE.00
Index
Printing on video printer 10-26, 14-16,

17-1 J
Processing 10-20
Protecting 10-24, 12-11, 14-13 Japan
Recording on video cassette recorder Technical data A-51
17-2
Replaying on video cassette recorder
17-3
Rotating
Rotating (post-processing)
9-17
14-11
K
Rotating to 0° 9-17 Key switch 2-4, 7-4
Saving to floppy disk 10-26, 14-15 Power on 7-4
Saving to hard disk 8-10 X-Ray on/off 7-4
Saving to USB storage device 10-27, Keypad, alphanumeric 6-9
12-13
Undoing the grayscale inversion 9-13
Undoing the grayscale inversion of all
images 10-12
Unmarking 10-24, 14-13
L
Unprotecting 10-24, 14-13 Labels
Up/down 9-16 C-arm stand A-16
Writing to CD/DVD 10-27 Generator A-17
Image crop 14-12 Image intensifier A-17
Image data Monitor cart A-18
Managing 10-7 Landmarking 13-14
Image detail Large Patient (button) 6-3, 8-9
Enlarging 9-11 Large patient (function) 8-9
Image documentation 17-1 Laser
Image information 16-1 Laser Class 3-5, 18-1
Image magnification level 6-5 Laser positioning device 3-5
Image number 8-10 Maintenance 3-5
Information on the monitor 16-1 Laser (button) 6-5, 18-2
Image reversal Laser positioning device 18-1
Horizontal image reversal 9-16 Applications 18-1
Vertical image reversal 9-16 Localizing foreign bodies 18-2
Image rotation 9-17 Technical data A-39
Image rotation (post-processing) 14-11 Last Image Hold 8-9
Image swapping 9-15 Leakage in the cooling system A-5
Image Swapping (button) 6-3, 9-15 Left/right 9-2, 9-16
Images (DICOM list) 11-12 Information on the monitor 16-2
Importing Length
Images from DICOM server 11-12 Cine loop 12-1
Input box ‘Department’ 20-10 Length 1 (read-only box) 15-6, 15-9, 15-12,
Input box ‘Doctor’ 20-10 15-16
Input box ‘Hospital’ 20-10 Length 1 / Length 2 (read-only box) 15-16
Input box ‘Reference Length’ 15-4 Length 2 (read-only box) 15-9, 15-12, 15-16
Input box ‘Time’ 20-9 Length or distance
Invert All (button) 10-12 Measuring 15-5
Iris collimator 9-13 Live Image left (option button) 20-10
Closing 9-13 Live Image right (option button) 20-10
Opening 9-13 Live monitor 2-11
Opening fully 9-14, 9-15 Defining 20-9
LM (button) 13-14
Ziehm Vision vii

26365-5.04.DE.00
Index
Locking Monitor cart 2-9

Entire system 7-4 Brake 5-4
X-rays 7-4 Dimensions A-34
Dimensions with flat-screen monitors
A-34
Steering 5-4
M Transport position
Monitor cart, illustration
5-2
2-9, 2-10, 2-11
Magnification, electronic 9-10 Monitor settings
Magnify (button) 6-5, 9-10 18.1" flat-screen monitors 2-12
Manual exposure rate setting 8-5 Brightness 9-2, 14-4
Activating 8-5 Contrast 9-2, 14-4
Deactivating 8-6 Mosaic (button) 10-21
Manual Exposure Rate Setting (button) 6-3, Mosaic view 10-8
8-5 Movement
Mark (button) 10-10, 10-24, 11-14, 12-11, C-arm 5-6
14-12, 14-13 MSA 13-1
Marker MSA (button) 13-4, 13-7, 13-9
Adding to an image 16-6 MSA image
Deleting 16-7 Acquiring 13-4
Editing 16-6
Marking
Cine loop 12-11
Image 10-23, 14-12 N
Patient folders 10-10
Single cine loop images 12-16 Name (button) 11-4
mAs (display) 19-3 Native image 13-2
Mask (button) 13-13 Hiding 20-7
Mask image 13-2 Showing 20-7
Mask off (button) 13-13 Networkability 2-3
Measure (tab) 6-6, 15-3, 15-5, 15-11 New (button) 10-4, 10-5, 10-17, 11-2
Measurement Next Measuring Point (button) 15-4, 15-6,
2-point measurement 15-5 15-9, 15-12, 15-13, 15-16, 15-17
3-point measurement 15-8 Noise suppression
4-point measurement 15-11 Recursive filter 9-7
4-point ratio measurement 15-15 Stack filter 9-9
Button ‘Delete’ 15-4 Note on the image 16-5
Calibrating 15-3
Length or distance 15-5
Length ratio 15-16
Reference length
Reference object
15-6, 15-9, 15-16
15-3
O
Measurement (operating mode) 15-1 OFF switches 6-9, 7-2
Measuring functions 15-1 ON/OFF switches 6-9, 7-2
Metal (button) 6-4, 8-8 Open Horizontal Slot Collimator (button)
Metal artifact correction 8-8 14-12
Activating 8-8 Open Iris Collimator (button) 9-13
Deactivating 8-8 Open Iris Collimator Fully (button) 6-3, 9-14,
Metal artifact correction (function) 8-8 9-15
Monitor / Dose 20-11 Open Vertical Slot Collimator (button) 9-14,
Monitor / Dose (button) 20-12, A-2 14-12
Monitor assignment 2-11 Open Vertical Slot Collimator Fully (button)
6-4, 9-14, 9-15
viii Ziehm Vision

26365-5.04.DE.00
Index
Operating modes Processing 10-8

Archive 10-7, 11-12 Saving to USB storage device 10-13
Configuration 20-1 Search criteria 10-15
Fluoroscopy 8-1 Searching 10-5, 10-15
Measurement 15-1 Storage capacity 10-1
Patient 10-2, 11-12 Subject 10-2
Post Process 14-1, 14-12, 14-15 Unmarking 10-10
Radiography 19-2, 19-3 Writing to CD/DVD 10-14
Subtraction 8-1 Patient ID
Text 16-4 Display 10-2
Operation settings 20-2 Length 10-2
Autostore 20-3 Patient ID (button) 11-2, 11-5
Autotransfer 20-2 PAUSE (button) 17-3
CD/DVD storage format 20-15 Pixel shift 13-13
Crosshair 20-4 Play (button) 12-6, 13-11, 13-13, 17-3
Defining the start screen 20-5 Post Proc. (tab) 6-6, 14-3
Discarding 20-7 Post Process 14-1
Floppy disk storage format 20-14 Activating an image 14-3
USB device storage format 20-14 Digital zoom 14-9
Option button ‘Live Image left’ 20-10 Edge filter 14-8
Option button ‘Live Image right’ 20-10 Image reversal 14-11
Optional accessories 2-6 Image rotation 14-11
Optional accessories (U.S.A.) 2-6 Inverting the image grayscale 14-11
Optional functions 2-4 Printing images on video printer 14-16
Orbital rotation Protecting an image 14-13
C-arm 5-7 Saving images to floppy disk 14-15
Post Process (operating mode) 14-12, 14-15
Power cable 4-3, 7-1
Print (button) 10-13, 12-13, 14-16
P Print Live Monitor Image (button) 6-5, 8-12,
10-13, 10-26, 12-13, 12-19
Patient (operating mode) 10-2, 11-12 Printing
Activating 10-3 Cine loops on video printer 12-13
Defining as start screen 20-5 Images on DICOM network printer 11-9
Patient (tab) 6-6, 10-3, 10-4, 10-5, 10-17, Images on video printer 10-26, 14-16,
11-1, 11-3, 11-4, 11-6 17-1
Patient data Live monitor image on video printer 8-12
Downloading from DICOM server 11-1 Measured values 8-12
Editing 10-5 Patient folders on video printer 10-12
Entering manually 10-4 Single cine loop images on video printer
Information on the monitor 16-1 12-19
Managing 10-2 Text information 8-12
Patient folders 10-1 Protect (button) 10-24, 12-11, 14-13
Activating 10-17 Protecting
Backup 10-30 Cine loop 12-11
Backup to CD/DVD 10-34 Image 10-24, 12-11, 14-13
Backup to USB storage device 10-31 Image (post-processing) 14-13
Creating a new patient folder 10-3 Protective grounding 3-4
Deleting 10-11 P-Sh (button) 13-13
Displaying image information 10-16 Pulses /s (display) 6-7
Editing data 10-5 Pulsewidth % (display) 6-7
Marking 10-10
Printing on video printer 10-12
Ziehm Vision ix
26365-5.04.DE.00
Index
RSA image
Q Acquiring 13-5
Query (button) 11-2
S
R Safety instructions
Electromagnetic compatibility 3-3
Radiation controlled area 3-3 Environmental compatibility 3-6
Radiation time Equipotential grounding 3-4
Alarm 8-13 General safety instructions 3-1
Warning function 8-13 Laser radiation 3-5
Radiation Time (display) 6-7, 8-13 Protective grounding 3-4
Radiography (operating mode) 19-2, 19-3 X-rays 3-2
Radiography (tab) 6-6, 19-2 Save (button) 6-5, 8-11, 16-5, 16-6
Read-only box ‘180° – Angle’ 15-12 Saving
Read-only box ‘360° – Angle’ 15-9 Cine loops to CD/DVD 12-14
Read-only box ‘Angle’ 15-9, 15-12 Cine loops to hard disk 12-2
Read-only box ‘Length 1 / Length 2’ 15-16 Images to CD/DVD 10-27
Read-only box ‘Length 1’ 15-6, 15-9, 15-12, Images to floppy disk 10-26, 14-15
15-16 Images to hard disk 8-10
Read-only box ‘Length 2’ 15-9, 15-12, 15-16 Images to USB storage device 10-27,
Read-only box ‘Reference Length’ 15-6, 12-13
15-9, 15-12, 15-16 Patient folders to CD/DVD 10-14
REC (button) 17-2 Patient folders to DICOM server 11-8
Recursive filter 9-7 Patient folders to USB storage device
Information on the monitor 16-2 10-13
Levels 9-7 Single cine loop images to a USB storage
Noise suppression 9-7 device 12-20
Reference Length (input box) 15-4 Single cine loop images to CD/DVD
Reference Length (read-only box) 15-6, 12-21
15-9, 15-12, 15-16 Single cine loop images to floppy disk
Reference monitor 2-11 12-20
Refresh (button) 11-13, 11-16 Scattered radiation A-29
Reposition (button) 6-4, 8-8 Search (button in Archive operating mode)
Reposition (function) 8-8 10-15, 10-18, 12-4
Restore CD/DVD (button) 10-36 Search (button in Patient operating mode)
Restore USB (button) 10-33 10-5, 10-17
Retrieve (button) 11-12, 11-15, 11-16 Search criteria for patient folders 10-15
Reverse Left/Right (button) 6-3, 9-16, 14-11 Security key switch 7-4
Reverse Up/Down (button) 6-3, 9-16, 14-11 Series (DICOM list) 11-12
Rotate Image CCW (button) 6-3, 9-17, 14-11 Service settings 20-1
Rotate Image CW (button) 6-3, 9-17, 14-11 Size (button) 16-6
Rotate Image to 0° (button) 6-3, 9-17 Slot collimator 9-14
Rotate Vertical Slot Collimator CCW (button) Closing 9-14
9-14 Opening 9-14
Rotate Vertical Slot Collimator CW (button) Opening fully 9-14
9-14 Rotating 9-14
Rotate Vertical Slot Collimator to 0° (button) Rotating to 0° 9-14
6-4, 9-14 Snapshot 8-4
RSA 13-1 Snapshot (button) 6-2, 8-4, 8-5
RSA (button) 13-5, 13-8, 13-10 Soft (anatomical program) 8-7
x Ziehm Vision
26365-5.04.DE.00
Index
Soft (button) 6-4 Swiveling (panning)

Stack filter 9-9 C-arm 5-9
Information on the monitor 16-2 System
Noise suppression 9-9 ON/OFF switches 7-2
Number of images 9-9 Preparing 7-1
Standard fluoroscopy 8-1 Switching on 7-2
Standard windowing 9-4 System date 20-8
Standard windowing (post-processing) 14-6 System time 20-8
Start image of a cine loop 12-7, 13-11
Start Img (button) 12-7, 13-12
Start screen
Defining
Steering
20-5 T
C-arm stand 5-5 Tab ‘Archive’ 6-6, 10-7, 10-15, 10-18, 10-31,
Monitor cart 5-4 10-32, 10-33, 10-34, 10-35, 10-36, 11-
Step windowing 9-4 9, 11-10, 11-11, 11-12, 11-15, 12-4,
Step windowing (post-processing) 14-6 13-8
Sterilization A-7 Tab ‘Config’ 6-6, 20-2, 20-3, 20-4, 20-5, 20-6,
Stop (button) 12-6, 12-7, 12-8, 13-11, 13-12 20-7, 20-9, 20-10, 20-15, 20-16, A-2
Stop image of a cine loop 12-7, 13-11 Tab ‘Fluoro’ 6-6
Stop Img (button) 12-7, 13-12 Tab ‘Measure’ 6-6, 15-3, 15-5, 15-11
Storage format Tab ‘Patient’ 6-6, 10-3, 10-4, 10-5, 10-17,
CD/DVD 10-14, 10-27, 12-14, 20-15 11-1, 11-3, 11-4, 11-6
Floppy disk 10-26, 14-15, 20-14 Tab ‘Post Proc.’ 6-6, 14-3
USB storage device 10-13, 10-27, 12-13, Tab ‘Radiography’ 6-6, 19-2
20-14 Tab ‘Subtraction’ 6-6, 13-2
Storage media 20-13 Technical data A-35
Storage Media (button) 20-15, 20-16 Temperature in the generator 8-14
Studies (DICOM list) 11-12 Temperature monitoring 8-14
Subject 10-2 Temperature symbol 6-7, 8-14
Subtracted image 13-2 Text
Subtraction (operating mode) 6-8, 8-1 Adding to an image 16-5
Defining as start screen 20-5 Deleting 16-6
Subtraction (tab) 6-6, 13-2 Editing 16-6
Subtraction modes Text (button) 6-5, 16-4, 16-5
Acquiring a DSA cine loop 13-2 Text (operating mode) 16-4
Acquiring an MSA image 13-4 Three-point (button) 15-8
Acquiring an RSA image 13-5 Time (button) 20-9
DSA 13-1 Time (input box) 20-9
Landmarking 13-14 Time of saving
Mask image 13-2 Information on the monitor 16-2
MSA 13-1 Touchpad (digital zoom) 9-12
Native image 13-2 Transport position
Pixel shift 13-13 C-arm stand 5-1
RSA 13-1 Monitor cart 5-2
Subtracted image 13-2 Two-pedal foot switch 6-10
Switches Assignment 6-10
Hand switch 6-10 Two-Point (button) 15-5
Two-pedal foot switch 6-10
Switching off in emergency situations 7-3
Switching on
First power-up of the system 4-3
Ziehm Vision xi
26365-5.04.DE.00
Index
Printing patient folders 10-12

U Printing the live monitor image 8-12
Virtual collimator 9-15
U.S.A. Vision Center (control panel) 6-1
C-arm power assist (option) 21-1 Voltage (display) 6-6, 8-9, 19-3
Labels on the C-arm stand A-40
Labels on the generator A-41
Labels on the image intensifier A-41
Labels on the monitor cart
Optional accessories
A-42
2-6
W
Unpacking the system 4-1 Warning function (radiation time) 8-13
Up Arrow (button) 6-4 Warning symbols
Up/down 9-2, 9-16 Temperature 6-7, 8-14
Information on the monitor 16-2 X-rays 6-7, 8-10, 8-13
UP/DOWN buttons 6-9 Windowing 9-4, 14-5
USB (button in Backup) 10-32, 10-33 Restoring the factory settings 9-5, 9-6,
USB (button) 10-13, 10-27, 12-14 14-7
USB storage device Standard windowing 9-4
Backup copy 10-31 Step windowing 9-4
Deleting all images 20-16 Windowing values
Restoring backed-up data 10-33 Information on the monitor 16-2
Saving images 10-27, 12-13 WNDW (button) 9-5, 14-6
Saving patient folders 10-13 Worklist
Saving single cine loop images 12-20 Downloading from DICOM server 11-2
Storage format 10-13, 10-27, 12-13, Worklist (button) 11-3, 11-5, 11-6, 11-7
20-14 Writing
Backup to CD/DVD 10-34
Cine loops to CD/DVD 12-14
Images to CD/DVD 10-27
V Patient folders to CD/DVD 10-14
Single cine loop images to CD/DVD
VCR (button) 6-5, 17-2, 17-3 12-21
Vertical image reversal 9-16
Vertical image reversal (post-processing)
14-11
Vertical movement X
C-arm 5-11
Vertical slot collimator X-ray symbol 6-7, 8-10, 8-13
Opening fully 9-14, 9-15
Rotating to 0° 9-14
Video
BNC socket
VIDEO OUT
2-16
2-16
Z
Video output 2-16 Zoom 9-11
Video signal 2-16 Zoom factor 9-11, 9-12, 14-9, 14-10
Video cassette recorder Zoom (button) 6-5, 9-11, 9-12, 14-9, 14-10
Documenting an image 17-1 Zoom (post-processing) 14-9
Recording images 17-2 Zoom factor
Replaying images 17-3 Digital zoom 9-11, 9-12, 14-9, 14-10
Video printer
Documenting an image 17-1
Printing a cine loop 12-13
Printing images 10-26, 14-16, 17-1
xii Ziehm Vision

26365-5.04.DE.00
Manufacturer’s Declaration regarding
Electromagnetic Compatibility according to
IEC 60601-1-2 (Class A)
Guidance and Manufacturer’s Declaration – electromagnetic emissions

The Ziehm Vision is intended for use in the electromagnetic environment specified below. The
customer or the user of the Ziehm Vision should assure that it is used in such an environment.
Emissions tests Compliance Electromagnetic environment – guidance

RF emissions Group 1 The Ziehm Vision uses RF energy only for its
according to internal function. Therefore, its RF emissions
CISPR 11 are very low and are not likely to cause any
interference in nearby electronic equipment.
RF emissions Class A The Ziehm Vision is suitable for use in all
according to establishments other than domestic and those
CISPR 11 directly connected to the public low-voltage
power supply network that supplies buildings
Harmonic emissions Not applicable
used for domestic purposes.
according to
IEC 61000-3-2
Voltage fluctuations/ Not applicable
flicker emissions
according to
IEC 61000-3-3
Table 1 Guidance and Manufacturer’s Declaration – electromagnetic emissions
Ziehm Vision 1
28027 Rev. 10/2004
Manufacturer’s Declaration regarding Electromagnetic Compatibility according to IEC 60601-1-2
(Class A)
Guidance and Manufacturer’s Declaration – electromagnetic immunity

Immunity tests IEC 60601 Compliance Electromagnetic environment

test level level – guidance
Electrostatic + 6 kV contact + 6 kV contact Floors should be wood, concrete
discharge (ESD) discharge discharge or ceramic tile. If floors are
according to covered with synthetic material,
+ 8 kV air + 8 kV air
IEC 61000-4-2 discharge discharge the relative humidity should be at
least 30%.
Electrical fast + 2 kV for power + 2 kV for power Mains power quality should be
transient/burst supply lines supply lines that of a typical commercial or
according to hospital environment.
+ 1 kV for input/ + 1 kV for input/
IEC 61000-4-4
output lines output lines
Surge according to + 1 kV differential + 1 kV differential Mains power quality should be
IEC 61000-4-5 mode mode that of a typical commercial or
hospital environment.
+ 2 kV common + 2 kV common
mode mode
Voltage dips, short < 5% UT for 0.5 < 5% UT for 0.5 Mains power quality should be
interruptions, and cycle (> 95% dip) cycle (> 95% dip) that of a typical commercial or
voltage variations hospital environment.
40% UT for 5 40% UT for 5
on power supply
cycles (60% dip) cycles (60% dip) If the user of the Ziehm Vision
input lines
requires continued operation
according to 70% UT for 25 70% UT for 25
during power mains
IEC 61000-4-11 cycles (30% dip) cycles (30% dip)
interruptions, it is recommended
< 5% UT for 5 s < 5% UT for 5 s that the Ziehm Vision be
(> 95% dip) (> 95% dip) powered from an uninterruptible
power supply or battery.
Power frequency 3 A/m 3 A/m Power frequency magnetic fields
(50/60 Hz) should be at levels characteristic
magnetic field of a typical location in a typical
according to commercial or hospital
IEC 61000-4-8 environment.
NOTE: UT is the AC mains voltage prior to application of the test level
Table 2 Guidance and Manufacturer’s Declaration – electromagnetic immunity
2 Ziehm Vision
28027 Rev. 10/2004
(Class A)


Portable and mobile RF
communications equipment
should be used no closer to the
Ziehm Vision, including cables,
than the recommended
separation distance calculated
from the equation applicable to
the frequency of the transmitter.
Recommended separation
distance:
Conducted RF 3 Vrms 3 Vrms d = 1.2 × SQRT(P)
according to
150 kHz to 80
IEC 61000-4-6
MHz
Radiated RF 3 V/m 3 V/m d = 1.2 × SQRT(P) 80 MHz to
according to 800 MHz
80 MHz to 2.5
IEC 61000-4-3
GHz
d = 2.3 × SQRT(P) 800 MHz to
2.5 GHz
where P is the maximum output
power rating of the transmitter in
watts (W) according to the
transmitter manufacturer and d is
the recommended separation
distance in meters (m).
Field strengths from fixed RF
transmitters, as determined by
an electromagnetic site survey a,
should be less than the
compliance level b in each
frequency range.
Interference may occur in the
vicinity of equipment marked with
the following symbol:
Ziehm Vision 3
28027 Rev. 10/2004
(Class A)

NOTE 1: At 80 MHz and 800 MHz, the higher frequency range applies.
NOTE 2: These guidelines may not apply in all situations. Electromagnetic propagation is
affected by absorption and reflection from structures, objects and people.
a Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless)
telephones and land mobile radios, amateur radio, AM and FM radio broadcast and TV
broadcast cannot be predicted theoretically with accuracy. To assess the electromagnetic
environment due to fixed RF transmitters, an electromagnetic site survey should be considered.
If the measured field strength in the location in which the Ziehm Vision is used exceeds the
applicable RF compliance level above, the Ziehm Vision should be observed to verify normal
operation. If abnormal performance is observed, additional measures may be necessary, such
as re-orienting or relocating the Ziehm Vision.
b
Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 3 V/m.
4 Ziehm Vision
28027 Rev. 10/2004
(Class A)
Recommended separation distances between portable and mobile RF communications

equipment and the Ziehm Vision
The Ziehm Vision is intended for use in an electromagnetic environment in which radiated RF
disturbances are controlled. The customer or the user of the Ziehm Vision can help prevent
electromagnetic interference by maintaining a minimum distance between portable and mobile RF
communications equipment (transmitters) and the Ziehm Vision as recommended below,
according to the maximum output power of the communications equipment.
Rated Separation distance according to frequency of transmitter

maximum m
output power
of transmitter 150 kHz to 80 MHz 80 MHz to 800 MHz 800 MHz to 2.5 GHz
W d = 1.2 × SQRT(P) d = 1.2 × SQRT(P) d = 2.3 × SQRT(P)
0.01 0.12 0.12 0.23

0.1 0.38 0.38 0.73
1 1.2 1.2 2.3
10 3.8 3.8 7.3
100 12 12 23
For transmitters rated at a maximum output power not listed in the above table, the distance
can be determined using the equation in the respective column header, where P is the
maximum output power rating of the transmitter in watts (W) according to the transmitter
manufacturer.
NOTE 1: An additional factor of 10/3 is used in calculating the recommended separation
distance for transmitters in the frequency range 80 MHz to 2.5 GHz to decrease the likelihood
that mobile/portable communications equipment could cause interference if it is inadvertently
brought into patient areas.
Table 4 Recommended separation distances between portable and mobile RF communications
Ziehm Vision 5
28027 Rev. 10/2004
(Class A)
6 Ziehm Vision
28027 Rev. 10/2004
Manufacturer’s Declaration regarding
Electromagnetic Compatibility according to
IEC 60601-1-2 (Class B)
Guidance and Manufacturer’s Declaration – electromagnetic emissions

Emissions tests Compliance Electromagnetic environment – guidance

RF emissions Group 1 The Ziehm Vision uses RF energy only for its
according to internal function. Therefore, its RF emissions
CISPR 11 are very low and are not likely to cause any
interference in nearby electronic equipment.
RF emissions Class B The Ziehm Vision is suitable for use in all
according to establishments, including domestic
CISPR 11 establishments and those directly connected to
the public low-voltage power supply network
Harmonic emissions Class A
that supplies buildings used for domestic
according to
purposes.
IEC 61000-3-2
Voltage fluctuations/ Complies
flicker emissions
according to
IEC 61000-3-3
Table 1 Guidance and Manufacturer’s Declaration – electromagnetic emissions
Ziehm Vision 1
28028 Rev. 10/2004
(Class B)


Electrostatic + 6 kV contact + 6 kV contact Floors should be wood, concrete
discharge (ESD) discharge discharge or ceramic tile. If floors are
according to covered with synthetic material,
+ 8 kV air + 8 kV air
IEC 61000-4-2 discharge the relative humidity should be at
discharge
least 30%.
Electrical fast + 2 kV for power + 2 kV for power Mains power quality should be
transient/burst supply lines supply lines that of a typical commercial or
according to hospital environment.
+ 1 kV for input/ + 1 kV for input/
IEC 61000-4-4
output lines output lines
Surge according to + 1 kV differential + 1 kV differential Mains power quality should be
IEC 61000-4-5 mode mode that of a typical commercial or
hospital environment.
+ 2 kV common + 2 kV common
mode mode
Voltage dips, short < 5% UT for 0.5 < 5% UT for 0.5 Mains power quality should be
interruptions, and cycle (> 95% dip) cycle (> 95% dip) that of a typical commercial or
voltage variations hospital environment.
40% UT for 5 40% UT for 5
on power supply
cycles (60% dip) cycles (60% dip) If the user of the Ziehm Vision
input lines
requires continued operation
according to 70% UT for 25 70% UT for 25
during power mains
IEC 61000-4-11 cycles (30% dip) cycles (30% dip)
interruptions, it is recommended
< 5% UT for 5 s < 5% UT for 5 s that the Ziehm Vision be
(> 95% dip) (> 95% dip) powered from an uninterruptible
power supply or battery.
Power frequency 3 A/m 3 A/m Power frequency magnetic fields
(50/60 Hz) should be at levels characteristic
magnetic field of a typical location in a typical
according to commercial or hospital
IEC 61000-4-8 environment.
NOTE: UT is the AC mains voltage prior to application of the test level
2 Ziehm Vision
28028 Rev. 10/2004
(Class B)


Portable and mobile RF
communications equipment
should be used no closer to the
Ziehm Vision, including cables,
than the recommended
separation distance calculated
from the equation applicable to
the frequency of the transmitter.
Recommended separation
distance:
Conducted RF 3 Vrms 3 Vrms d = 1.2 × SQRT(P)
according to
150 kHz to 80
IEC 61000-4-6
MHz
Radiated RF 3 V/m 3 V/m d = 1.2 × SQRT(P) 80 MHz to
according to 800 MHz
80 MHz to 2.5
IEC 61000-4-3
GHz
d = 2.3 × SQRT(P) 800 MHz to
2.5 GHz
where P is the maximum output
power rating of the transmitter in
watts (W) according to the
transmitter manufacturer and d is
the recommended separation
distance in meters (m).
Field strengths from fixed RF
transmitters, as determined by
an electromagnetic site survey a,
should be less than the
compliance level b in each
frequency range.
Interference may occur in the
vicinity of equipment marked with
the following symbol:
Ziehm Vision 3
28028 Rev. 10/2004
(Class B)

NOTE 1: At 80 MHz and 800 MHz, the higher frequency range applies.
a Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless)
telephones and land mobile radios, amateur radio, AM and FM radio broadcast and TV
broadcast cannot be predicted theoretically with accuracy. To assess the electromagnetic
environment due to fixed RF transmitters, an electromagnetic site survey should be considered.
If the measured field strength in the location in which the Ziehm Vision is used exceeds the
applicable RF compliance level above, the Ziehm Vision should be observed to verify normal
operation. If abnormal performance is observed, additional measures may be necessary, such
as re-orienting or relocating the Ziehm Vision.
b
Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 3 V/m.
4 Ziehm Vision
28028 Rev. 10/2004
(Class B)
Recommended separation distances between portable and mobile RF communications

The Ziehm Vision is intended for use in an electromagnetic environment in which radiated RF
disturbances are controlled. The customer or the user of the Ziehm Vision can help prevent
electromagnetic interference by maintaining a minimum distance between portable and mobile RF
communications equipment (transmitters) and the Ziehm Vision as recommended below,
according to the maximum output power of the communications equipment.
Rated Separation distance according to frequency of transmitter

maximum m
output power
of transmitter 150 kHz to 80 MHz 80 MHz to 800 MHz 800 MHz to 2.5 GHz
W d = 1.2 × SQRT(P) d = 1.2 × SQRT(P) d = 2.3 × SQRT(P)
0.01 0.12 0.12 0.23

0.1 0.38 0.38 0.73
1 1.2 1.2 2.3
10 3.8 3.8 7.3
100 12 12 23
For transmitters rated at a maximum output power not listed in the above table, the distance
can be determined using the equation in the respective column header, where P is the
maximum output power rating of the transmitter in watts (W) according to the transmitter
manufacturer.
NOTE 1: An additional factor of 10/3 is used in calculating the recommended separation
distance for transmitters in the frequency range 80 MHz to 2.5 GHz to decrease the likelihood
that mobile/portable communications equipment could cause interference if it is inadvertently
brought into patient areas.
Table 4 Recommended separation distances between portable and mobile RF communications
Ziehm Vision 5
28028 Rev. 10/2004
(Class B)
6 Ziehm Vision
28028 Rev. 10/2004

ZIEHM - Vision - R MANUAL

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ZIEHM - Vision - R MANUAL

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Table of Contents

About this Manual 1

Copyright Quality Standards

1 About this Manual 1-1

2 System Overview 2-1

3 Safety Instructions 3-1

4 Putting the System into Service 4-1

5 Mechanical Handling 5-1

5.4.2 Angulation ......................................................................................... 5-8

7 Switching the System On 7-1

8 Standard Fluoroscopic Operations 8-1

9 Adjusting Live Images 9-1

9.8.2 Slot collimator ................................................................................... 9-14

10 Data Management 10-1

11 DICOM Functions 11-1

12 Cine Loops 12-1

13 Subtraction Modes 13-1

Ziehm Vision III

14 Post-Processing Images 14-1

16 Displayed Texts and Text Functions 16-1

17 Image Documentation 17-1

18 Laser Positioning Device 18-1

19 Direct Radiography 19-1

20 System Configuration 20-1

21 C-Arm Power Assist (U.S. Option) 21-1

A.7 Scattered radiation in the significant zone of occupancy.................................. A-29

In this manual, the following notations and formats will be used to

Element Format Example

Ziehm Vision 1-1

1-2 Ziehm Vision

Computer-controlled anatomical programs ensure optimal exposure rate Anatomical

The superior penetration capabilities of the digital high-frequency Radiation dose

Ziehm Vision 2-1

Image adjustment Comprehensive real-time image processing functions (customizable

Image management A patient-based image management system providing a 16-image

2-2 Ziehm Vision

Ziehm Vision 2-3

This manual describes a system with maximum configuration. The

2-4 Ziehm Vision

2.4 Options (U.S.A.)

This manual describes a system with maximum configuration. The

Ziehm Vision 2-5

2.5 Optional accessories

2.6 Optional accessories (U.S.A.)

− Hand surgery table

2-6 Ziehm Vision

2.7 Parts of the system

2.7.1 C-arm stand

C-arm Image intensifier with

Fig. 2-1 Mobile C-arm stand of Ziehm Vision

Ziehm Vision 2-7

Ziehm Vision FD C-arm Digital flat-panel detector

Lifting Swivel arm

2-8 Ziehm Vision

2.7.2 Monitor cart

2.7.2.1 Monitor cart with 18.1" flat-screen monitors

Button panels for Button panels for

Floppy disk Control

Foot lever for Foot lever for

TX/RX Coupling cable

Ziehm Vision 2-9

On the rear side of each flat-screen monitor, there is an ON/OFF switch.

2.7.2.2 Monitor cart with CRT monitors