The hierarchy of ultrasound systems at Hitachi Medical Systems America has a new flagship. Particularly noteworthy on the HI Vision 900 is an elastographic capability that characterizes pathologies based on ultrasonic measurements of the relative stiffness of tissue. This real-time feature, E-mode, uses color mapping, either side by side with the B-mode image or superimposed on it. A strain ratio measurement quantifies elasticity by comparing two regions of interest.