JP2009087304A - Medical image system, radiography reading order generator, and program - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To automatically generate radiography reading order information to reduce work burdens of a user. <P>SOLUTION: A radiography reading order generator transmits an acquisition request for acquiring patient information and test information matched to predetermined retrieval conditions to an image server which stores DICOM image data including medical image data and collateral information (such as the patient information, the test information, and series information) (a step S2), and acquires the patient information and the test information provided from the image server (a step S5). Then, the radiography reading order generator generates the radiography reading order information for requesting radiography reading of a medical image corresponding to the patient information and the test information based on the patient information and the test information (a step S6), and transmits the radiography reading order information to a radiography reading terminal (a step S7). <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

  The present invention relates to a medical image system, an interpretation order generation apparatus, and a program.

  In recent years, in the medical field, digitization of medical images taken of patients has been realized. For example, a medical image captured and digitized by an image generation apparatus (modality) such as a CR (Computed Radiography) apparatus, a CT (Computed Tomography) apparatus, or an MRI (Magnetic Resonance Imaging) apparatus is used together with patient information and examination information. It is stored and managed in PACS (Picture Archiving and Communication System). Along with this, the target of image diagnosis by a doctor has shifted from an image output on a film to an image displayed on a monitor.

  By the way, with the increase in the types of photographing devices and higher-resolution images being obtained, technological advancements have demanded more specialized expertise in doctor diagnosis. In addition, since the amount of images to be taken is increasing, it is difficult for a clinician to make an image diagnosis while facing a patient. Therefore, in a large-scale hospital, a doctor who specializes in interpretation (an interpretation doctor) diagnoses an image, creates an interpretation report (report), and a clinician often diagnoses a disease name based on the result.

In the device for the interpretation doctor to create an interpretation report, for example, when displaying a list of interpretation target images, the progress of the interpretation report creation (uninterpreted, during interpretation, already interpreted) and the examination is waiting for a definitive diagnosis There has been proposed a display for indicating whether or not a state is present (see Patent Document 1).
JP 2007-94515 A

  However, when a clinician requests an interpretation to the interpretation doctor, hand over a paper slip or send the interpretation order information to the interpretation terminal for creating an interpretation report through an electronic medical record terminal or ordering system at the time of imaging. There was a need. When using paper vouchers, the clinician must create a voucher describing the contents of the interpretation request using an electronic medical record terminal, etc., and the interpreting physician must enter the patient information and examination information described on the voucher at the interpretation terminal. did not become. On the other hand, when sending the interpretation order information from the electronic medical record terminal or the like to the interpretation terminal, the clinician has to generate the interpretation order information by inputting the interpretation request contents for each examination to be interpreted. In any case, when an image interpretation request is made, an operation by the user is required, which is a complicated operation.

  The present invention has been made in view of the above-described problems in the prior art, and it is an object of the present invention to automatically generate interpretation order information and reduce the work burden on the user.

  In order to solve the above-mentioned problem, the invention described in claim 1 includes a medical image obtained by imaging a patient to be examined, patient information corresponding to the medical image and / or examination information, and storage means for storing the information. An image server that provides various types of information in response to a request, an image interpretation order generation device, and an image interpretation terminal are connected via a communication network so that data communication is possible, and the image interpretation order generation device includes: Acquisition request transmitting means for transmitting an acquisition request for patient information and / or examination information stored in the storage means to the image server, and acquisition for acquiring patient information and / or examination information provided from the image server Interpretation order information for requesting interpretation of a medical image corresponding to the patient information and / or examination information based on the acquired patient information and / or examination information Comprising the interpretation order information generation means for generating for, and a interpretation order information transmitting means for transmitting the interpretation order information the generated to the interpretation terminal.

  According to a second aspect of the present invention, in the medical image system according to the first aspect, the interpretation order information generation unit is configured to generate the interpretation order information based on patient information and / or examination information acquired by the acquisition unit. Set the urgent level, interpretation doctor or work item.

  The image interpretation order generating apparatus according to claim 3 includes a medical image obtained by photographing a patient to be examined, patient information corresponding to the medical image, and / or examination information, and various types according to an external request. Acquisition request transmission means for transmitting an acquisition request for patient information and / or examination information stored in the storage means to an image server that provides information, and patient information and / or examination provided from the image server Based on the acquired patient information and / or examination information, acquisition means for acquiring information, and interpretation order information for generating interpretation order information for requesting interpretation of a medical image corresponding to the patient information and / or examination information Generating means, and interpretation order information transmitting means for transmitting the generated interpretation order information to the interpretation terminal.

  According to a fourth aspect of the present invention, in the interpretation order generation device according to the third aspect, the interpretation order information generation means is configured to determine the interpretation order based on patient information and / or examination information acquired by the acquisition means. Set information urgency, interpretation doctor or work item.

  According to the fifth aspect of the present invention, the computer includes a medical image obtained by imaging the patient to be examined, patient information corresponding to the medical image and / or examination information, and various kinds of computers according to an external request. Acquisition request transmitting means for transmitting an acquisition request for patient information and / or examination information stored in the storage means to an image server for providing information, patient information and / or examination information provided from the image server Based on the acquired patient information and / or examination information, interpretation order information generation means for generating interpretation order information for requesting interpretation of a medical image corresponding to the patient information and / or examination information , A program for functioning as interpretation order information transmitting means for transmitting the generated interpretation order information to an interpretation terminal.

  According to the first, third, and fifth aspects of the present invention, the interpretation order information is automatically generated based on the patient information and / or examination information, so that the work burden on the user can be reduced.

  According to the second and fourth aspects of the invention, more detailed interpretation order information can be generated by setting an urgency level, an interpretation doctor, or a work item.

Hereinafter, an embodiment of a medical image system according to the present invention will be described with reference to the drawings.
FIG. 1 shows a system configuration of the medical image system 100. As shown in FIG. 1, a medical image system 100 includes an electronic medical record terminal 10, an RIS (Radiological Information System) 20, a modality 30, an image server 40, an interpretation order generation device 50, and an interpretation terminal. 60 are connected to each other via a communication network N such as a LAN (Local Area Network), and each is configured to be capable of data communication.

  The electronic medical record terminal 10 has an electronic medical record function for creating an electronic medical record, and stores a patient's medical condition, diagnosis result, and the like. The electronic medical record terminal 10 generates imaging order information for requesting imaging of the patient based on an instruction input from the clinician, and transmits the imaging order information to the RIS 20. The imaging order information includes the patient ID, patient name, date of birth, sex, modality, examination site, procedure, direction, body position, imaging conditions, etc. of the patient to be examined.

  The RIS 20 performs information management such as medical appointment reservation, diagnosis result report, results management, and material inventory management in the radiology department. The RIS 20 transmits the imaging order information received from the electronic medical record terminal 10 to the modality 30 and the image server 40.

  The modality 30 images the patient to be examined in accordance with the imaging order information received from the RIS 20, and generates image data of a medical image (hereinafter referred to as medical image data). Further, the modality 30 generates incidental information related to medical image data based on the imaging order information. Then, the modality 30 attaches supplementary information to the medical image data, generates DICOM image data conforming to the DICOM standard, and transmits the DICOM image data to the image server 40. The incidental information includes patient information, examination information, series information, and the like. Patient information is information about a patient, such as patient ID, patient name, date of birth, and sex. Examination information relates to examinations such as examination date, examination time, reception number (number associated with each examination), modality, examination site, imaging direction, body position, requested department, requested doctor, examination description (examination reason, etc.) Information. The series information is data including a series ID indicating the unit (series) of a series of medical images for each modality 30 generated in one examination and the type of the modality 30. As the modality 30, modalities for capturing various types of medical images, such as a CR apparatus, a CT apparatus, an MRI apparatus, an endoscope apparatus, and an ultrasonic diagnostic apparatus, can be applied.

  The image server 40 stores and manages DICOM image data. The image server 40 provides various types of information to the external device in response to various information acquisition requests transmitted from the external device.

  FIG. 2 shows a functional configuration of the image server 40. As shown in FIG. 2, the image server 40 includes a control unit 41, an operation unit 42, a display unit 43, a communication unit 44, a ROM (Read Only Memory) 45, and a storage device 46. It is connected.

  The control unit 41 includes a CPU (Central Processing Unit), a RAM (Random Access Memory), and the like, and comprehensively controls the processing operation of each unit of the image server 40. Specifically, the CPU reads various processing programs stored in the ROM 45 in response to an operation signal input from the operation unit 42 or an instruction signal received by the communication unit 44, and a work piece formed in the RAM. Expand to the area and perform various processes in cooperation with the program.

  The operation unit 42 includes a keyboard having cursor keys, numeric input keys, various function keys, and the like, and a pointing device such as a mouse. The control unit 42 controls operation signals input by keyboard operation or mouse operation. 41 is output.

  The display unit 43 is configured by an LCD (Liquid Crystal Display), and displays various screens based on display data input from the control unit 41.

  The communication unit 44 includes a LAN adapter, a router, a TA (Terminal Adapter), and the like, and is connected to an external device such as the RIS 20, the modality 30, the interpretation order generation device 50, and the interpretation terminal 60 connected via the communication network N. Send and receive data.

  The ROM 45 is constituted by a nonvolatile semiconductor memory or the like, and stores a control program, parameters and files necessary for executing the program, and the like.

  The storage device 46 is composed of a hard disk or the like, and stores DICOM image data and the like generated by the modality 30. The DICOM image data includes medical image data and incidental information (patient information, examination information, series information, etc.) corresponding to each medical image data.

  The control unit 41 searches for the patient information and examination information stored in the storage device 46 based on the search condition in response to the patient information and examination information acquisition request transmitted from the interpretation order generation apparatus 50. And the control part 41 controls the communication part 44, and transmits the patient information and test | inspection information which match search conditions to the interpretation order production | generation apparatus 50. FIG.

  In addition, the control unit 41 controls the communication unit 44 in response to the DICOM image data acquisition request transmitted from the interpretation terminal 60 to cause the interpretation terminal 60 to transmit the DICOM image data.

  The interpretation order generation device 50 acquires patient information and examination information from the image server 40, and generates interpretation order information based on the patient information and examination information.

  FIG. 3 shows a functional configuration of the interpretation order generation apparatus 50. As shown in FIG. 3, the interpretation order generation device 50 includes a control unit 51, an operation unit 52, a display unit 53, a communication unit 54, a ROM 55, and a storage unit 56, and each unit is connected by a bus 57. .

  The control unit 51 includes a CPU, a RAM, and the like, and comprehensively controls processing operations of each unit of the image interpretation order generation device 50. Specifically, the CPU reads various processing programs stored in the ROM 55 in response to an operation signal input from the operation unit 52 or an instruction signal received by the communication unit 54, and a work piece formed in the RAM. Expand to the area and perform various processes in cooperation with the program.

  The operation unit 52 includes a keyboard having cursor keys, numeric input keys, various function keys, and the like, and a pointing device such as a mouse, and controls operation signals input by keyboard operations or mouse operations. To 51.

  The display unit 53 is configured by an LCD, and displays various screens based on display data input from the control unit 51.

  The communication unit 54 includes a LAN adapter, a router, a TA, and the like, and exchanges data with external devices such as the image server 40 and the image interpretation terminal 60 connected via the communication network N.

  The ROM 55 is configured by a nonvolatile semiconductor memory or the like, and stores a control program, parameters and files necessary for executing the program, and the like.

  The storage unit 56 is a storage device such as a hard disk, and stores data such as an urgency level setting table 561, an interpretation doctor setting table 562, a work item setting table 563, and the like.

  The urgency level setting table 561 is a table for associating the modalities for which photographing has been performed with the urgency levels, and each modality has an interpretation time limit such as “within 3 hours”, “within 1 day”, “within 3 days”, or the like. It is set as an urgency level. For example, for the modality used in the emergency room, the urgency is set so that the interpretation is completed within “3 hours”.

  The interpretation doctor setting table 562 is a table that associates the modality, the examination part, and the day of the week when the radiographing is performed with the interpretation doctor, and the interpretation doctor is set for each modality, the examination part, and the combination of the day of the week. For example, doctors corresponding to modalities and specialized fields for each examination region, and doctors scheduled to work according to the work status of each doctor are set.

  The work item setting table 563 is a table that associates the modalities and inspection parts for which imaging has been performed with work items, and sets work items for combinations of modalities and inspection parts. The work item indicates the type of interpretation order, such as "interpretation" that describes what has been noticed by diagnosing a medical image, "double interpretation" in which two doctors individually interpret the same medical image, etc. There is. For example, in the case of PET (Positron Emission Tomography) inspection or the like, when “high skill” is required, “double interpretation” is set.

  The control unit 51 controls the communication unit 54 to transmit an acquisition request for patient information and examination information stored in the storage device 46 to the image server 40.

  Further, the control unit 51 acquires patient information and examination information provided from the image server 40 via the communication unit 54.

  Further, the control unit 51 generates interpretation order information for requesting interpretation of a medical image corresponding to the patient information and examination information based on the acquired patient information and examination information. When generating the interpretation order information, the control unit 51 sets the urgency of the interpretation order information, the interpretation doctor, and the work item based on the patient information and the examination information.

  In addition, the control unit 51 controls the communication unit 54 to transmit the generated interpretation order information to the interpretation terminal 60.

  The interpretation terminal 60 is a terminal such as a PC (Personal Computer) that has a monitor that displays a medical image and is installed for the purpose of a doctor creating an interpretation report of the medical image. The interpretation terminal 60 acquires DICOM image data to be interpreted from the image server 40 according to the interpretation order information received from the interpretation order generation device 50, and displays a medical image and supplementary information on the monitor.

Next, the operation will be described.
FIG. 4 is a ladder chart showing processing in the medical image system 100.
First, in the modality 30, a patient to be examined is photographed, and additional information is attached to medical image data to generate DICOM image data. When DICOM image data is transmitted from the modality 30 to the image server 40, the DICOM image data is received by the communication unit 44 in the image server 40, and the DICOM image data is stored in the storage device 46 by the control unit 41. (Step S1).

  In the radiogram interpretation order generation device 50, an acquisition request for acquiring patient information and examination information that match a predetermined search condition is transmitted to the image server 40 by the communication unit 54 under the control of the control unit 51 (DICOM). Query) (step S2). The search condition is determined by the inspection date and modality, for example, the inspection by “CR” of “today”. Acquisition requests from the image interpretation order generation device 50 to the image server 40 are periodically made, such as every five minutes.

  In the image server 40, when an acquisition request for patient information and examination information is received from the interpretation order generation device 50 by the communication unit 44, the control unit 41 stores the patient stored in the storage device 46 based on the search condition. Information and inspection information are retrieved (step S3). Note that only the patient information and examination information corresponding to the newly added DICOM image data since receiving the previous acquisition request is searched. FIGS. 5A and 5B show examples of search results with the inspection date “August 12, 2007” and the modality “CR”. As shown in FIGS. 5 (a) and 5 (b), patient information such as patient ID, patient name, date of birth, and gender that matches the examination date and modality set as the search conditions, and the requested department, requesting doctor, The inspection information such as the reception number, the inspection date, the inspection description, the modality, and the inspection part is extracted. And according to control of the control part 41, the patient information and test | inspection information which match search conditions are transmitted to the interpretation order production | generation apparatus 50 by the communication part 44 (step S4).

  In the interpretation order generating apparatus 50, the control unit 51 acquires patient information and examination information provided from the image server 40 via the communication unit 54 (step S5). Then, based on the acquired patient information and examination information, the control unit 51 performs a medical image interpretation order information generation process corresponding to the patient information and examination information (step S6).

Here, the interpretation order information generation processing will be described with reference to FIG.
First, the order number of the interpretation order information is assigned by the control unit 51 (step T1), and the contents of the patient information and examination information acquired from the image server 40 are described as interpretation order information (step T2).

  Next, the control unit 51 refers to the urgency level setting table 561 based on the modalities included in the examination information, and sets the urgency level corresponding to the modality for which imaging was performed (step T3).

  Next, the control unit 51 refers to the interpretation doctor setting table 562 based on the modality, the examination part, and the examination date included in the examination information, and the interpretation doctor corresponding to the modality, the examination part, and the day of the week on which the imaging was performed. It is set (step T4).

  Next, the control unit 51 refers to the work item setting table 563 based on the modality and the examination part included in the examination information, and sets the work item corresponding to the modality and the examination part for which imaging has been performed (step). T5).

  FIG. 7 shows an example of interpretation order information generated based on the search results (patient information and examination information) shown in FIG.

  In the interpretation order generation device 50, after the interpretation order information generation processing, the interpretation unit information is transmitted to the interpretation terminal 60 by the communication unit 54 under the control of the control unit 51 (step S7).

  In the interpretation terminal 60, based on the interpretation order information received from the interpretation order generation device 50, a work list of medical images to be interpreted is displayed on the monitor (step S8). In the work list, the urgency level, work item, and the like are displayed together with the identification information of the medical image. The interpretation doctor selects an image to be interpreted from the displayed work list. Then, the image interpretation terminal 60 transmits an acquisition request for acquiring DICOM image data of the selected image to be interpreted to the image server 40 (step S9).

  In the image server 40, when the communication unit 44 receives a DICOM image data acquisition request from the interpretation terminal 60, the control unit 41 reads the DICOM image data of the image to be interpreted from the storage device 46, and the communication unit 44. Is transmitted to the radiogram interpretation terminal 60 (step S10).

In the interpretation terminal 60, DICOM image data is acquired from the image server 40 (step S11), and a medical image is displayed on the monitor (step S12). Then, an interpretation report is created by the operation input of the interpretation doctor (step S13).
Thus, the process in the medical image system 100 ends.

  As described above, according to the medical image system 100, the interpretation order generation apparatus 50 transmits a request for acquiring patient information and examination information stored in the storage device 46 to the image server 40, and the image server 40. The patient information and examination information provided from the patient is acquired, and based on the acquired patient information and examination information, interpretation order information for requesting interpretation of a medical image corresponding to the patient information and examination information is automatically generated. Therefore, the user's work burden can be reduced. In addition, since a paper slip is not used when requesting interpretation, it is not necessary for the interpretation doctor to input patient information and examination information at the interpretation terminal 60, and input errors can be avoided.

  Further, when the interpretation order generating apparatus 50 generates the interpretation order information, more detailed interpretation order information can be generated by setting the urgency level, the interpretation doctor, and the work item.

  Since the interpretation order information includes patient information and examination information, the interpretation terminal 60 can create an interpretation report while referring to the patient information and examination information.

  Further, the interpretation order generation device 50 acquires patient information and examination information from DICOM image data of a medical image that has been taken and stored in the image server 40, and generates interpretation order information. Therefore, the interpretation order generation information is generated. Shooting is always performed before the image is read, and there is no situation where there is no image to be interpreted at the time of interpretation.

  The description in the above embodiment is an example of the medical image system according to the present invention, and the present invention is not limited to this. The detailed configuration and detailed operation of each device constituting the system can be appropriately changed.

  For example, in the above embodiment, the case where the interpretation order generation device 50 is an independent device has been described. However, the function of generating the interpretation order information may be realized by software in the image server 40.

1 is a system configuration diagram of a medical image system according to an embodiment of the present invention. It is a block diagram which shows the functional structure of an image server. It is a block diagram which shows the functional structure of an image interpretation order production | generation apparatus. It is a ladder chart which shows the process in a medical image system. It is an example of the result of having searched with an inspection date and modality as a search condition. It is a flowchart which shows interpretation order information generation processing. It is an example of interpretation order information.

Explanation of symbols

10 Electronic medical record terminal 20 RIS
30 modality 40 image server 41 control unit 42 operation unit 43 display unit 44 communication unit 45 ROM
46 Storage Device 47 Bus 50 Interpretation Order Generation Device 51 Control Unit 52 Operation Unit 53 Display Unit 54 Communication Unit 55 ROM
56 Memory 57 Bus 60 Interpretation Terminal 100 Medical Image System N Communication Network

Claims (5)

A medical image obtained by photographing a patient to be examined, an image server having storage means for storing patient information and / or examination information corresponding to the medical image, and providing various types of information in response to an external request, and an interpretation order generation device A medical image system in which the image interpretation terminal is connected to be able to perform data communication via a communication network,
The interpretation order generation device includes:
An acquisition request transmitting means for transmitting an acquisition request for patient information and / or examination information stored in the storage means to the image server;
Obtaining means for obtaining patient information and / or examination information provided from the image server;
Based on the acquired patient information and / or examination information, interpretation order information generating means for generating interpretation order information for requesting interpretation of a medical image corresponding to the patient information and / or examination information;
Interpretation order information transmitting means for transmitting the generated interpretation order information to the interpretation terminal;
A medical image system comprising: The interpretation order information generation means sets the urgency of the interpretation order information, the interpretation doctor or the work item based on the patient information and / or examination information acquired by the acquisition means.
The medical image system according to claim 1. The storage for the medical image obtained by photographing the patient to be examined, the patient information corresponding to the medical image and / or the examination information, and the image server that provides various information in response to an external request An acquisition request transmitting means for transmitting an acquisition request for patient information and / or examination information stored in the means;
Obtaining means for obtaining patient information and / or examination information provided from the image server;
Based on the acquired patient information and / or examination information, interpretation order information generating means for generating interpretation order information for requesting interpretation of a medical image corresponding to the patient information and / or examination information;
Interpretation order information transmitting means for transmitting the generated interpretation order information to an interpretation terminal;
An interpretation order generation device comprising: The interpretation order information generation means sets the urgency of the interpretation order information, the interpretation doctor or the work item based on the patient information and / or examination information acquired by the acquisition means.
The interpretation order generation device according to claim 3. Computer
The storage for the medical image obtained by photographing the patient to be examined, the patient information corresponding to the medical image and / or the examination information, and the image server that provides various information in response to an external request An acquisition request transmitting means for transmitting an acquisition request for patient information and / or examination information stored in the means;
Acquisition means for acquiring patient information and / or examination information provided from the image server;
Interpretation order information generating means for generating interpretation order information for requesting interpretation of a medical image corresponding to the patient information and / or examination information based on the acquired patient information and / or examination information;
Interpretation order information transmitting means for transmitting the generated interpretation order information to an interpretation terminal;
Program to function as.

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