Plus applications user manual  2.9.0.e3e8b4a
Software library for tracked ultrasound image acquisition, calibration, and processing.
Ultrasound image orientation


The acquired ultrasound image orientation (which direction is left/right, which direction is towards the probe) depends on a number of factors, such as settings on the ultrasound device (horizontal, vertical flip), transducer type, and image acquisition hardware/software settings. When a transducer is calibrated (the image to probe transform is determined), the calibration is valid for one particular image orientation, therefore it is important to be able to exactly identify the current image orientation.

Plus defines the image orientation using a two or three letter acronym, the first and second letter specify the transducer principal axes directions corresponding to the +x and +y directions in the image coordinate system, respectively. The third letter is only defined for three-dimensional probes and represents the +z direction in the image coordinate system.

Transducer axes definition

The following transducer principal axes directions are defined:

Directions for commonly used transducer types:


Definition of ultrasound image orientation

The ultrasound image axes are defined as follows:

In B-mode images typically each scanline displayed approximately vertically (x = near constant, y = 0..n). In RF-mode images each scanline is stored in a 'row' (x = 0..n, y = constant).

The image orientation can be defined by specifying which transducer axis corresponds to the x and y image axes, respectively.

There are four possible orientations for 2D B-mode images:

There are four possible orientations for RF-mode images:

There are eight possible orientations for 3D B-mode images:

Image orientation in Plus

Plus always uses MF image orientation internally for 2D B-mode images and MFA for 3D B-mode images and FM orientation for 2D RF-mode images. Plus performs any required flipping operations between M<->U, F<->N, A<->D when importing images from the imaging device (based on the PortUsImageOrientation attribute of the Device element in the device set configuration file).

Transposing operation (conversion between M<->N, F<->U, etc.) is not performed automatically, because this conversion typically requires scan conversion instead of a simple reordering of the pixels, that is why orientations for B-mode and RF-mode images are different.


The image x axis points towards the same direction as the U (unmarked) transducer axis. The image y axis points towards the same direction as the F (far) transducer axis. Therefore, the ultrasound image orientation is: UF.


How to check that the UsImageOrientation attribute is set correctly:


Image orientation in the Ultrasonix software

The Ultrasonix software shows an image orientation marker (blue "U" symbol) at the marked / near corner of the image.