CN100556366C - 对诊断信息和图像有全球入口的超声诊断成像系统 - Google Patents

对诊断信息和图像有全球入口的超声诊断成像系统 Download PDF

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CN100556366C
CN100556366C CNB971195811A CN97119581A CN100556366C CN 100556366 C CN100556366 C CN 100556366C CN B971195811 A CNB971195811 A CN B971195811A CN 97119581 A CN97119581 A CN 97119581A CN 100556366 C CN100556366 C CN 100556366C
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ultrasonic
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ultrasonoscopy
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M·A·乌德
P·罗恩卡勒兹
L·S·普夫鲁拉斯
J·索奎特
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ADVANCED TECHNOLOGY LABORATORY Co Ltd
ATL Ultrasound Inc
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Abstract

提供了一个医疗超声诊断成像系统，它能够在数据通信网络，比如Internet上被访问，能够使超声图像，诊断报告以及超声系统诊断信息和操作被普通个人计算机通过使用市场上可买到的软件在实际上任何远程端点被访问。在一个实施方案中，超声系统可从个人计算机被远程操作。本发明的设备和技术使医生可以用他们的超声系统在网络，比如万维网上远程访问、控制和进行诊断，而不需要专门的硬件。

Description

对诊断信息和图像有全球入口的超声诊断成像系统
这是美国专利(申请序列号08/607,894)的后续部分。
技术领域
本发明涉及可使超声系统从远程端点被访问或被控制的超声诊断成像系统的改进。
背景技术
美国专利(申请序列号08/607,894)描述了一种可迅速、轻易地从远程端点升级的超声系统。通过与超声系统的双向通信，性能的增强被远程传输并安装，而不需要找技术服务人员。医生的诊断实践通过他或她的超声系统这些迅速、有效的改进而得到增强。其中，本发明提供了一种对世界范围的超声诊断系统证明和测试这种软件升级的新技术。
在二十世纪九十年代出现的超声诊断成像的附属业务是超声图像管理。超声图像管理系统包括专用工作站、超声系统界面、通过离线地处理和存储超声图像而用来方便超声诊断的超声图像存储器件和网络。这种系统用来使医生在存储介质中积累图像，以后可从工作站调出用于重查和诊断。尽管超声图像管理系统可在安装许多广泛使用的超声系统时提供有用的能力，但它们仍需要大量的投资。图像管理系统的模块和工作站的价格通常在几千美元。一般要求专门的安装，而且图像管理系统常常采用专有硬件和软件，这可能会限制它们的通用性。就需要提供一种超声图像管理系统的优点而没有这些大量的缺点。
发明内容
根据本发明的原理提供了一种医疗诊断超声成像系统，可从地球上实际的任何地点被远程访问、查询或被控制，以提供有关其工作性能、患者图像和报告的信息，或者甚至向远程被控的系统操作提供信息。这些功能可令人惊奇地通过市场上可买到的软件和便宜的个人计算机硬件而实现，使得这些功能容易负担和使用。本发明的实施方案描述了用来改进具有便宜且容易买到的硬件和软件的超声诊断成像系统的技术，使通过使用超声系统被收集的诊断信息能够从远程端点被访问。被描述的本发明的示意实施方案提供了进行以下操作的方式：从超声系统远程访问配置信息，从远程端点在超声系统上进行测试和诊断，甚至还提供了远程控制超声系统操作的能力。本发明的实施方案还可提供市场上可买到的超声图像管理系统的许多功能和特性，但是其价格只是典型的图像管理系统很小的一部分。
本发明的创造性的重要贡献在于采用已有的硬件和软件使超声系统可通过开放体系结构的通信网络而被访问，由此图像管理功能可通过现成的普通个人计算机实现，而不要专门的硬件、软件，或者昂贵的改造。
根据本发明，提供一种获取和存储诊断超声图像或诊断报告的医疗诊断超声系统，其中所述诊断超声图像或诊断报告可以由远程用户直接从该超声系统访问，该系统包括：
用于形成超声图像的图像处理器；
用于产生报告的报告产生器软件包；
存储介质，其位于超声系统上并耦接到该图像处理器和该报告产生器软件包，用于存储超声图象或报告；
超文本传输协议服务器，该超文本传输协议服务器连接成从存储介质读取超声图像和报告，并使系统的图像和报告可以通过通信网络由远程端点的个人计算机、终端或工作站访问；以及
到通信网络的连接，
由此存储在超声系统上的图像或报告可以由来自远程端点的用户直接从产生超声图像或报告的超声系统进行访问。
根据本发明，提供一种获取和存储诊断超声图像或诊断报告的医疗诊断超声系统，其中所述诊断超声图像或诊断报告可以由远程用户直接从该超声系统访问，该系统包括：
用于形成超声图像的图像处理器；
用于产生报告的报告产生器软件包；
一存储介质，其位于超声系统上并耦接到该图像处理器和该报告产生器软件包，用于存储由所述超声系统产生的诊断超声图像或诊断报告；
到通信网络的一个连接；以及
超文本传输协议服务器，该超文本传输协议服务器连接成从存储介质读取超声图像和报告，并使系统的图像和报告可以通过通信网络由远程端点的个人计算机、终端或工作站访问；以及
CGI程序，其与超声系统通信以要求该系统提供所请求的诸如超声图像或诊断报告的信息。
根据本发明，提供一种获取和存储诊断超声图像或诊断报告的医疗诊断超声系统，其中所述诊断超声图像或诊断报告可以由远程用户直接从超声系统访问，该系统包括：
用于形成超声图像的图像处理器；
用于产生报告的报告产生器软件包；
一存储介质，其位于超声系统上并且耦接到该图像处理器和该报告产生器软件包，用于存储由所述超声系统产生的诊断超声图像或诊断报告；
到通信网络的一个连接；
超文本传输协议服务器，该超文本传输协议服务器连接成从存储介质读取超声图像和报告，并使系统的图像和报告可以通过通信网络由远程端点的个人计算机、终端或工作站访问；以及
包括Web页的HTML页面，该Web页中嵌有超声图像或着提供超文本链接到诊断报告，
由此，存储在产生超声图像或报告的该系统上的超声图像或报告可在所述通信网络上被远程访问。
根据本发明，提供一种获取和存储诊断超声图像或诊断报告的医疗诊断超声系统，其中所述诊断超声图像或诊断报告可以由远程用户直接从超声系统访问，该系统包括：
用于形成超声图像的图像处理器；
用于产生报告的报告产生器软件包；
存储介质，其位于超声系统上并耦接到该图像处理器和该报告产生器软件包，用于存储超声图像或报告；
装在该超声系统上用于和远程终端通信的网络软件；
超文本传输协议服务器，该超文本传输协议服务器连接成从存储介质读取超声图像和报告，并使系统的图像和报告可以通过通信网络由远程端点的个人计算机、终端或工作站访问，所述超文本传输协议服务器安装在所述超声系统上并与所述网络软件相配合；
存储在该系统上的HTML页面软件；以及
可由所述超文本传输协议服务器访问的CGI程序，该CGI程序访问由该超声系统上的存储介质存储的诊断超声图像或诊断报告，以由所述超文本传输协议服务器发送到所述远程终端。
在附图中：
图1以方框图的形式示意出根据本发明的原理构成的、在互联网络上工作的超声诊断成像系统，以及可和超声设备交换诊断和超声系统控制信息的个人计算机；
图2更为详细地图示出图1超声设备的互联网络组成部分；
图3更为详细地图示出图1个人计算机的互联网络组成部分；
图4图示出当根据本发明的原理构成的超声系统从远程的个人计算机或终端被访问时出现的其Web主页；
图5图示出通过图4Web主页而被访问的一个具体患者的患者目录Web页；
图6图示出通过图5患者目录Web页而被访问的超声图像Web页；
图7图示出通过图5患者目录Web页而被访问的患者报告Web页，并显示出超声图像的质量没有降低的超声图像；
图8图示出通过图4Web主页而被访问的系统诊断Web页的主菜单；
图9图示出通过图8系统诊断Web页而被访问的配置记录Web页；
图10图示出通过图4Web主页而被访问的系统控制Web页；
图11图示出根据本发明的原理构成的超声系统网络的Web主页；
图12图示出通过图11Web主页而被访问的超声系统网络的一个系统的患者目录Web页；
图13图示出通过图11网络主页而被访问的另一幅中心服务器的患者目录Web页；
图14图示出通过图13网络患者目录Web页而被访问的网络上系统之一的患者目录Web页；
图15以方框图的形式示意出超声系统的局域网；
图16以方框图的形式示意出通过网关连接到Internet(国际互联网)*的超声系统局域网；
图17以方框图的形式示意出通过网络调制解调器连接到远离网络的个人计算机的超声系统局域网。
首先看图1，根据本发明的原理构成的超声诊断成像系统10以方框图形式显示在图中的上半部分。超声系统10构成为可被位于远程的个人计算机100访问。超声系统10包括一些普通的组成部分，包括扫描头12，它可发射超声波到患者体内，接收发射波和身体的内部器官与组织反应后返回的回波，并把收到的回波转换成电子回波信号。电子回波信号经过波束形成器12适当延时并混合，形成回波信息的相干波束。回波信息波束由图像处理器16处理形成超声图像，被存储在存储介质24的图像存储分区24a中。图像也可经过视频处理器(未画出)进一步处理，以适合在系统显示器26上显示的扫描光栅形式存放。
超声系统10在控制面板20的控制之下工作。控制面板20还可使用户用存储在超声系统中的报告产生器软件包22准备所进行的超声检查的诊断报告。诊断报告可被显示出来或在打印机(未画出)上打印出来，也可存储在存储介质24的报告存储分区24b中。
根据本发明的原理，图1的超声系统还包括超文本传输协议(HTTP)服务器30。HTTP服务器连接成可从存储介质24读取超声图像和报告，并使系统的图像和报告可由在远程端点的个人计算机、终端或工作站访问。图1中服务器30通过调制解调器32连接到有线(42)或无线(44)通信网络40。服务器30使通过通信网络40连接成可访问超声系统的用户可得到超声系统10的诊断信息。
一个这种用户的终端显示在图1的下半部分。该用户有市场上可买到的个人计算机(PC)100，包括PC处理器102，显示器108和键盘110。装在个人计算机100上的是市场上可买到的Web浏览器104和网络软件106，这可使用户通过调制解调器132访问Internet上的万维网(World Wide Web)。这样用户可使用市场上可买到的PC硬件和软件通过服务器30在Internet上和超声系统通信。
众所周知的Internet是互联网络技术发展的结果，它可使在一个端点的计算机和计算机网络与在另一个端点的计算机和计算机网络相互通信。互联网络技术的基础研制是在美国政府的国防部高级研究计划局(DARPA，Defense Advenced Research Projects Agency)的领导下于六十年代开始的，是为了满足科学家和军方能在计算机网络上交换信息的需要。对通信网络两种基本方法是可行的，线路交换网络和数据包交换网络。线路交换网络通过在两点之间形成专用线路而工作。线路交换网络的一个例子是美国电话网。只要一个电话用户通过交换技术连接到另一个电话，该线路的容量就确定了，且不会由网络的其他应用而减少。因而线路交换的优点是一旦线路形成就可保证容量，缺点是成本，因为线路成本是固定的，而不论网络利用水平如何。
数据包交换采用一种不同的方法。从一个网络用户到另一个用户的消息被分成称作数据包的分立信息单元。数据包由高速路由器引导通过网络从发送者端点到接收者端点，而路由器查寻网络中从发送者到接收者的路径。在接收者端点，各个数据包被接收并重编以重新形成原来的信息。数据包交换的优点是通过对不同发送者交织数据包，网络可同时处理很多消息。数据包交换的缺点是当网络利用增加时，更高的通信量会使经过网络传送一条消息的所有数据包所需的时间减慢。
由于成本和性能上的优点，数据包交换方法成为互联网络计算机的选择。因为许多计算机可以共享一个网络，并以短数据包组迅速通信，专用线路的成本就可以避免。而且对更高容量的要求可由日益提高的计算机性能来满足。计算机技术的进展提供了以不断提高的数据传输速率处理更大数量数据的能力。
DARPA的任务是把大量政府和民间的计算机网络连接在一个统一的网络互联体，即互联网中。互联网是一组以协作方式工作的相互连接的网络。使得互联网可行的一些最重要的发展来源于由DARPA发起的研究计划。这一研究有着非常重要的结果：它为相互通信的数据包交换网络建立了网络标准，而和它们基本的硬件特性无关。这些标准允许在计算机网络间进行全球通信，同时允许各个用户采用(或继续使用)他们各自所选的硬件。公共标准可使参与者分别使用和管理他们各自的网络硬件，而同时其他用户领域中的数据无缝地相互作用。这一成就导致产生最著名的互联网连接，现在普遍称作Internet及其互联的万维网(World Wide Web)。本发明把Internet全球可联性的优点和万维网的好处用到超声波上，以使医生增强超声诊断的实践，以及使超声技术人员加强系统的服务能力。
如上所述Internet是便于在许多连接到网上的用户之间传输数据的网络的网。万维网(Web)是产生在Internet上使数据传输更加容易、更加合理的一种高级用户界面的名字。Web向用户提供分类菜单系统。菜单页或屏幕被显示给用户，用户通过它可轻易地从另一台计算机或主机索取信息。Web的主要功能是能够通过称作超文本连接(hypertext link)的显示单元进行非线性连接或从一组信息跳到另一组。当屏幕以超文本连接的特征显示出一些东西时，通常是蓝色文本或彩色图形轮廓，用户就能够点中超文本单元，并立即转到由超文本指明的数据或信息，而不论该数据是在和被显示信息相同的主机上还是在位于世界上其他地方的某一另外的主机上。之后该用户能够点回到原来的屏幕显示，或者进行一系列连接到所需信息，该信息可随后从该主机传送或下载。在Internet上，含有前缀“http://”的网址(Web address)代表具有超文本连接能力的网屏(Web screen)，它符合Internet Engineering Task Force已公布的“RFC”标准。通过超文本连接用户能够迅速跟随指示和参考说明找到精确的信息。通过连接返回的信息可以经过编码以多种形式再生，包括文本文档，图像、图形、视频显示，甚至声音。Web超文本连接的这一功能由本发明直接用到超声系统和诊断超声信息上。
现在转到图2，显示了根据本发明的原理构成的超声系统更详细的方框图。系统物理地连接到网络的界面称作接口(port)。在图2中超声系统通过串行接口31连接到互联网。在超声系统的数字域和电话系统的模拟域之间转换的通用硬件设备叫作调制解调器(modem)。调制解调器32把来自串行接口31的串行数字数据转换成适合在电话线中传输的模拟信号。调制解调器还把到来的模拟电话信号转换成数字数据经过串行接口31，并由超声系统使用。合适的调制解调器可从Hayes Microcomputer Products，Inc.得到，该公司建立了有许多调制解调器生产厂家采用的标准。
和调制解调器32的通信是由称为PPP(point-to-pointprotocol，点对点协议)的软件建立的，如图中方框48所示。PPP是能够使多个网络协议在调制解调器线路或其他串行连接上使用的一种标准。其他标准可以采用，比如SLIP(Serial Line InternetProtocol，串行线路Internet协议)，允许在调制解调器线路或其他串行连接上使用称为TCP/IP(以下将讨论)的通信协议的一种标准，或者CSLIP(Compressed Serial Line Internet Protocol，压缩SLIP)，SLIP的一种特殊形式。在超声系统中安装了PPP软件之后，它必须相对其操作的超声系统和调制解调器进行初始化或配置。配置信息控制PPP软件使之和一些特征兼容，比如所用的串行接口，所用调制解调器的类型，电话线、主机电话号码和拨号方法，以及登录顺序和密码等。一般地，配置信息在启动连接时提供和启动网络连接有关的设置，以及和连接建立之后所进行过程有关的设置。PPP软件结合在一些用于IBM兼容PC机的操作系统软件包中，比如MicrosoftCorporation of Redmond，Washington的Windows95。用于苹果个人计算机的PPP软件可从Intercon Systems Corporation of Herndon，Virginia得到，这只是其中之一。
DARPA的互联网络研究计划的成绩之一是建立了一套广泛使用的网络协议，称作TCP/IP Internet Protocol Suite(Internet协议组)。TCP/IP是根据其两个最常用的协议命名的，Internet协议(InternetProtocol，IP)和传输控制协议(Transmission Control Protocol，TCP)。IP协议控制数据的路由，TCP协议控制数据的传输。TCP/IP提供通过称为网关(gateway)的数据包传输设备进行互联的公用方式。网关是连接两个或多个网络并在其间路由数据包的专门的互连网络计算机。
当超声系统具有其想传输到Internet上的数据时，数据通过TCP/IP，如图中方框46所示。TCP把数据分成称作TCP数据包的段，它具有文件头信息，用来以适当的顺序对数据段进行跟踪、检查和排序。因为一个数据块在Internet上以分离的数据包发送，各个数据包可由网关确定不同的路由，所以不能保证数据包含以正确顺序或没有错误地到达其目的地。TCP数据包提供了一种保证数据包传送、完整性和排序的方式。在接收端根据TCP数据包的文件头信息对数据包进行错误检查，无错数据段被确认，数据包就按顺序排列并重组成原来的数据块。发送器保持跟踪数据段的确认，如果一个数据段没有被及时确认，发送器再次发送该数据包。如果数据段在初始的发送中丢失或接受顺序有错，TCP留住收到的数据段直到所有数据段都在接收端被计及，这时它们可按正确完整的顺序排序，以重组为原来的数据块。
在发送端，TCP数据包穿过IP，IP把数据段变成IP数据包或数据报的形式。数据报包含提供寻址信息的IP文件头，网关用寻址信息使数据报路由到其正确目的地。IP文件头包含源地和目的地的Internet地址，使网关正确选定数据的路由，并使接收器确认收到数据报。IP尽最大力量去传送所有数据报，但不能保证其传送。传送的保证由TCP通过上述的确认和再发送来提供。
如同PPP软件，TCP/IP需要对具体的超声系统和其环境进行配置。对TCP/IP典型的配置信息包括：局域网类型的信息，如果该超声系统和其他超声设备有局域联网(如以太网或令牌环网)；和局域网上其他系统的地址有关的信息；网关地址，如果系统执行路由器的功能；超声设备的用户姓名和进入密码；超声系统上的服务器地址；超声系统的Internet地址(IP地址)；以及局域网的隐含主域。和PPP一样，TCP/IP软件也和一些系统软件包一起提供，比如Windows95，对苹果计算机可从InterCon得到。
任何互联网，特别是Internet，成功运行的关键是每个直接连到互联网上的系统或“主机”：需要有唯一的地址。每个直接连到Internet上的用户必须从称为网络信息中心(Network InformationCenter(WIC))的中心管理机构获取IP地址，NIC利用计算机化的中介(computerized mediation)向那些申请地址的用户分配IP地址。一个IP地址有32位长，8位一组以四个十进制符号表示，由句点分开，比如699.59.9.114(这里用作例子的IP地址是无效的)。IP地址根据连接到Internet上的网络的大小进行分类，A类地址用于非常大的网络，B类地址用于中等大小的网络(255到65000个用户)，比如大学网，C类地址用于小型网络(少于256个用户)，比如放射诊所或医院。重要地是，IP地址不指定各个计算机或设备，而是指定到Internet的连接点。如果一个超声系统有两个到Internet的连接点，每一个都必须有独立的IP地址。这种方式扩展的结果是局域网可使用子网络地址，其中每个局域设备有一个子网络地址，该网络在单个主机用具有的IP地址连到Internet，IP地址向所有局域系统提供到Internet的入口。当网络的子地址对Internet本身的用户不可见时，子网络寻址是允许的。
NIC管理的另一种允许的Internet寻址是域名(domain name)寻址。因为很多用户更愿意用有意义的词语来命名地址，而不是用数字，所以NIC可分配给用户主域和子域名，用户可自由地增加另外的子域名，用户对这些子域名有对其网络的映射责任。主域是主要的分类，商业用户被分配的域名是COM，教育机构的域名是EDU，政府部门的域名是GOV，等等。例如，对美国政府所有的退伍军人管理局医院的超声科的一个假定的域名可以是ULTRA SOUND.VAHOSPITAL.GOV。
在图2中TCP/IP连接到局域网媒体上，这里是以太网接点50。以太网接点50把该超声系统连接到局域网的其他系统上。在以太网网络中网络上的系统必须在允许的最大相互距离内，并且都连接到相同的物理网络线路上。数据在以太网络上可以被高速传输(以前是每秒10兆比特；现行版本具有高达每秒100兆比特的速度)，每个系统只在没有其他系统正在该系统上传输时而被允许传输。一种称作带有冲突避免的载波检测多路接入(Carrier Sense Multiple Access withCollision Avoidance(CSMA/CA))的技术可防止两个系统同时使用网络线路。超声系统可被连接到其他类型的局域网中，比如令牌环网络，其中所有系统都连接到一个连接的链中，该链使信息通过网络中的每个系统。在图示实施方案中TCP/IP配置为可在局域以太网上或在世界范围的Internet上通信。
和TCP/IP以及PPP相配合的网络软件是HTTP服务器30。HTTP服务器是一种软件程序，Web浏览器可用它从超声系统得到入口信息。HTTP服务器响应外部请求的方法是显示信息Web页和连接到其他Web页以及诸如超声图像和报告等信息的超文本接点。HTTP服务器也可响应外部请求而进行和超声系统上某个按钮或控制有关的具体操作，以下将更全面地描述。
本发明的示意实施方案使用称作Apache的一种流行的Web服务器，它被编译并安装在超声系统上。Apache服务器是公共领域软件，可从Internet上的地址http://www/apache.org/下载，它符合NCSA标准。当下载软件时，特别是对商业应用，必须得注意，版权法和软件所有者及开发者的权力应严格遵守。
和前述软件一样，服务器必须针对超声系统作特别配置。Apache服务器具有超过250条指令用于为其预计的应用而配置服务器。Apache有一个重要的配置文件处理安全性。该配置文件控制外来者对超声系统的单元和信息的入口。入口可限制到超声系统指定的驱动器、目录和文件，并限制为只读。入口还可限制到某些用户和同时出现的用户的具体数量，以及所需的密码。服务器记录登录文件的位置，即访问该系统的用户的文件。配置文件识别服务器所用的接口量以及服务器的管理人员。配置文件保存服务器所用文件的位置，包括服务器根目录和Web页的地址，以及服务器使用的CGI程序(下面将描述)。服务器可能配置的其他特性包括如多种语言能力等功能。
根据外部请求，HTTP服务器30把超文本标记语言(HTML)页面34发送到查询的Web浏览器。HTML页面描述的东西Web浏览器将在远程终端的屏幕上显示，包括按钮、文本、图像、活动的实时循环图像、声音等等。HTML页面可以按照在许多参考文中发表的指南在软件中直接编码，比如HTML and CGI Unleashed，John December和MarkGinsburg著，由Sams.net Publishing，Indianapolis，Indiana出版。简单的HTML页面可用市场上可买到的桌面出版(desk-toppublishing)软件和字处理软件书写，然后用称作Internet Assistant的软件编码成HTML形式，该软件可通过Microsoft的主页在WWW.microsoft.com下载。另外，称作“Webmaker”的公共领域软件可从Internet上下载，用来制作Web页。Web页包含HTML数据标志，它描述该页面在远程终端怎样由Web浏览器表述。到超声图像文件的连接由Web页代码中的IMG标志提供。HREF超文本旁注提供连接到同一超声设备上其他Web页的方式，或者连接到网络上或Web上任何其他主机的Web页。一旦HTML页面形成，它们就被拷贝到超声设备中，其存储地址提供给HTTP服务器。无论何时远程终端要求看超声设备的一个特定的Web页时，HTTP服务器30负责找到该页面并把它的内容送回给查询者。
图2的超声系统包括许多小的可执行程序，称作公共网关接口(Common Gateway Interface，CGI)程序，如36所示。CGI程序提供了HTML页面和超声系统的硬件及软件之间的接口。CGI程序和超声系统通信，要求系统进行操作或提供信息，比如图像、报告或现有状态等。在示意实施方案中，CGI程序通过动态地产生其中嵌有所查询信息的常规(custom)HTML页面来响应对信息的外部请求。下面的实例图示出CGI程序的工作过程，它提供了超声图像和报告的患者目录(patdir)，所选超声图像的显示(dispimage)，根据输入变量而执行任务的通用目的程序(doaction)，进行系统诊断(dodiag)，以及为网络上许多超声设备提供患者目录(serverdir)。
示意实施方案中的CGI程序保存在超声系统的硬盘的目录“cgi-bin”中。在进行其操作中，CGI程序读取存在24中的超声图像和报告，选取并运行存在28中的诊断例行程序，并通过超声系统控制器18配合超声系统的控制。作为CGI程序的一个实例，表1示意出可取出超声图像并使图像嵌入HTML页面的CGI程序代码。在示意实施方案中为了执行速度和避免远程干扰的安全性，CGI程序用C语言编译。CGI程序也可用来将超声图像编成和Web页兼容的数据格式。不过在示意实施方案中，这种重新格式化不是必须的，因为超声系统设计为以GIF(Graphic Interchange Format，图像交换格式)格式存储超声图像，这种图像格式能够被大多数Web浏览器读取。
图2专门改动的超声系统可由图3所示的标准的Internet兼容的个人计算机终端访问。个人计算机的中央处理器(CPU)根据键盘110和鼠标(未画出)的操作运行PC软件，并在显示器108的屏幕上显示超声数据和图像。CPU运行Web浏览器软件104，通过对个人计算机配置的TCP/IP和PPP协议146和148访问Internet。到网络的接点是通过PC的串行接口131和调制解调器132。该PC可通过以太网接点150联网到其它设备。TCP/IP和PPP可从前面所列的资源点获得。Web浏览器可从Netscape Communications Corporation of Mountain View，California获得，或者Internet Explorer浏览器可从MicrosoftCorporation获得，一般都包括在Windows 95操作系统软件中。可以看出，不需要那些不能在市场上轻易买到的专门的硬件和软件来访问本发明的超声系统。
根据本发明的原理构成的超声系统的一些使用实例参照图4到14示出。除了参考标号和示例性的IP地址以外，这些附图是当远程终端的浏览器连到本发明的示意实施方案时所得的Web浏览器屏幕的实际打印图。
图4示出根据本发明构成的超声系统的Web主页，标识为HDI1000#1。如图所示，该Web主页由Netscape Web浏览器获取。通常的浏览器控制按钮可在Web URL指示器202上面看到。URL指示器202显示用来连接超声系统HDI 1000#1的地址，为http://699.59.9.114/hdil.html。地址中的html后缀表明以超文本Web页显示。
在图4主页的中间是三个提供连接到其他超声信息或控制的超文本按钮。当远程终端的用户用计算机鼠标或键盘按键点动第一个按钮204，View save/Recall Data时，CGI程序“patdir”被运行，产生患者信息Web页，其中嵌有患者的超声图像，并提供超文本连接到该患者的患者报告。这一患者目录Web页显示在图5中。该Web页包含两幅从超声系统的图像存储区24a取得的小幅超声图像212和214。远程终端用户可在任何一个小幅图像上点动，以观看具有原始图像质量的全尺寸透视图，或者用小幅图像显示实时图像序列。远程终端通过点中小幅图像上面的“Image”或“cineloop”选项来选中这些选项。当远程终端用户点中“Image”，然后再点中小幅图像212，超声系统的HTTP服务器30返回具有大幅再现所选图像的Web页，如图6所示。图6中的地址条显示出超声系统发送出标识为“DAT_SR_1”的图像，它以“GIF”图像格式保存。为了保证传输速度，图5患者目录中的小幅图像可根据JPEG标准压缩和可读，而图6的全尺寸图像就用GIF图像格式传输而不损失图像质量。
通过点中在图6左上部的浏览器“Back”按钮，远程终端用户返回到图5的Web页。远程终端用户现在可点中Patient Report按钮212。根据这个超文本连接按钮的触发，HTTP服务器30运行称作“prtreport”的CGI程序，它把存在存储区24b中的指定患者的诊断报告检索出来，并把它们嵌入Web页中由服务器发送。服务器返回图7所示的Web页，它包含患者报告信息。由本发明给于超声波的Internet功能还提供了另一种性能，即能够让远程终端用户制作新的患者报告或编辑旧报告。远程终端用户在同一个终端打开字处理应用程序。使用图6和图7中浏览器上部的“Edit”(编辑)功能，远程终端用户拷贝超声图像和患者报告，接着把它们粘贴到字处理文档中。例如，远程终端用户可先粘贴超声图像，然后在图像下面粘贴患者报告。之后用户可编辑患者报告的文本文件，修改收到的报告或产生一个新报告。使用字处理程序的图形功能，远程终端用户可旋转、拖动、或指定超声图像的特定细节以在报告中容易参考。新报告可在远程终端上存档，或者送到远程端点，或者甚至在Internet上直接从远程用户的终端发送电子邮件到有关的医生。另外，带有图像的患者报告可直接从连接到远程用户终端的计算机打印机上打印出来。
再次使用Back按钮(或者合适的超文本连接)，远程终端用户可回到图4的主页。当远程终端用户点中第二个超文本按钮206，PerformSystem Diagnostics(进行系统诊断)，HTTP服务器就发送相连的系统诊断菜单Web页，如图8所示。系统诊断菜单上的每个超文本连接按钮都会引起以不同变量运行CGI程序“dodiag”，这使超声系统进行系统诊断或显示系统状态信息，比如测试和错误记录等。当进行超声系统可操作性的远程诊断时，这些远程控制功能是需要的。例如，点中按钮222，Perform Configuration Test(进行配置测试)，使dodiag CGI程序运行超声系统存储的超声诊断例行程序28，并返回包含这些测试结果记录的Web页，如图9所示。
在远程安装超声软件升级版之后，在超声系统上远程地进行诊断测试的能力特别有用。在新软件安装之后，这一功能用来运行系统诊断例行程序，以检查新软件和使其性能有效。如图9所示，这些有效性的测试结果返回到远程的安装者，以确认新软件安装成功。
图8的系统诊断菜单另一个对超声软件升级特别有用的功能是按钮224，show system Version Numbers(显示系统版本号)。点中这一按钮使超声诊断程序返回安装在超声系统上的软件级别或版本号。知道超声系统软件现在的版本或级别是任何超声系统升级安装的必要条件。
Perform System diagnositics(进行系统诊断)的功能可由现场的技术服务人员用膝上型计算机实现。当技术人员和超声系统在一起时，不需要用调制解调器互连，网络连接可以直接进行。在这种情况中，电缆从膝上型计算机的串行接口131(图3)连接到超声系统的串行接口31(图2)。或者，以太网接点50和150当然可以相互连接。在两种情况中，维修人员对超声系统的访问和查询如上述进行，不过直接网络连接的数据速率快得多。这样，来访的技术人员可以用他的膝上型计算机进行系统诊断，检查出错记录，检验配置和软件级别，以及其他系统维护和修理活动。
点中Back回到超声系统的主页图4，可以看到第三个超文本按钮是有效的，即System Operation Control(系统操作控制)。点中这个按钮208使HTTP服务器30运行CGI程序“Syscontrol”(系统控制)。系统控制CGI程序产生Web页，其中嵌有由超声系统最新产生的超声图像，如图10中间所示。在超声图像的右边和下面显示出超声系统的用户控制。显示的超声系统控制都是超文本图形。点中这些按钮可使系统控制CGI程序命令超声系统控制器18根据所选控制的功能改变超声系统的操作。在示意实施方案中，超声图像右边的按钮描出系统的硬键(Hardkey)模式控制开关，图像下面的按钮描出软键(softkey)控制，用来改变在所选模式中可用的系统参数。最下面描出的硬键Update(更新)不是超声系统控制，而是对本发明的这一远程控制功能的控制。点中Update会使HTTP服务器和超声系统的CGI程序用超声系统最新产生的超声图像更新远程显示的图像。
这些功能意味着医生能够在距患者几千英里之外进行超声检查，只需要有一双手在患者的位置握住和操作超声探头。著名的放射学家和回波心脏病专家的技能现在可用来对准世界上任何地方的诊断环境。任何EMT或医疗队员可在远距的医生的指导下握住和操作探头，而医生控制设备工作以产生最好的、最有诊断性的超声图像。因为Internet接点可发送和接收音频和视频信息，医者对超声探头持有者的指导可以在和发送超声信息相同的Internet接点上发送。医生可在2D(二维)和Color(彩色)模式或其他任何所需模式之间来回转换，或者研究组织结构和血液流动情况。在另一个实施方案中，医生可在一系列空间不同的图像中各个二维图像和三维模式之间转换，这一系列空间分离的图像可被转变成三维显示方式。一接到通知就可马上把不同的诊断病例送到对该病例类型最合适的专家那里。远距医疗包含远距检查，因为出诊医生的到达现在不受地理上的限制。
在示意实例方案中，超声系统本身是基于个人计算机结构的，并用多任务操作系统实现超声设备的功能，如描述于U.S.Pat.(appl.SNATL-140)，提交于1996年9月12日。该操作结构使超声系统能够以正常方式用于诊断检查，而远程终端用户同时向超声系统查询图像、报告和信息。多任务操作系统使超声系统的中央处理器能够以时间交织方式完成正常的超声成像任务和网络通信任务。对系统的操作者和远程终端的访问者，他们各自不同的功能对他们自己来说是实时执行的，而不与另一方的活动冲突。这意味着，例如，医生可以监视超声波扫描人员(ultrasongrapher)操作超声系统的过程，对一个患者从超声系统中检索诊断图像和患者报告，同时超声波扫描人员在对另一个患者进行的诊断检查过程中。
上面的Web浏览器屏幕是从一个独立的超声系统的网络服务器上获得的。正如上面指出的，也能够把多个超声系统连接在局域网中，该局域网利用一个连接到Internet的服务器。局域网服务器包括图2超声系统的通信单元30、31、34、36、46和48。这样一个超声系统局域网的Web主页显示在图11中。如Netscape地址条所示，远程终端用户的Web浏览者连接到该局域网HDI服务器的IP地址699.59.9.114。HDI服务器234是在Internet上具有接点和地址的唯一设备超声系统都在局域网上具有子网络地址，比如hdi1，hdi2，hdi3等，它们由HDI服务器234管理。局域网服务器画在主页的较低图像234′中，在服务器上面是连接到局域网的八套超声系统的图像。超声系统中的两套，HDI1000#1和HDI 1000#7可看出以实心边界被加以突出，这种突出在Web浏览器屏幕上以亮色表示，表明局域网上这两套系统当前是活动的。点中二者之一将把远程终端用户带到所选系统的主页。点动HDI1000#7系统的图像将执行局域网服务器上的HREF连接到HDI1000#7系统的HTTP服务器，这将返回该系统的主页，如图12所示。从#7系统的这一主页远程终端用户可读取患者报告和图像，从系统存储区删除检查结果，进行系统诊断，或者直接连接到System Operation Control(系统操作控制)以控制HDI1000#7系统的操作。
局域网的一个优点是网络上的所有系统都能利用局域服务器保存超声图像和患者报告，使它们可被远距的出诊医生访问，甚至是在超声系统不工作的时候。当网络上的所有超声系统都利用HDI服务器234来保存其诊断结果时，所有这些信息都可在Internet上被访问，甚至是在超声系统由于在别处使用而断线或者在一天结束时被关机的时候。远程用户终端可以连接到HDI服务器234的HTTP服务器30，在图11的主页上点中HDI服务器234，把远程用户带到如图13所示的患者目录Web页。该患者目录Web页列出了有报告或图像存在局域网HDI服务器234上的所有患者的姓名，以及患者在其上被检查的超声系统的编号。远程终端用户可点中患者的姓名而读取该患者检查结果的报告和超声图像。或者在被医生审查或归档后从HDI服务器234上删除患者的记录。在屏幕的底部用户能够连接到当前正在局域网上活动的超声系统上。如果远程终端用户选取了图13Web页上一个患者的姓名，所选患者的图像和报告就由局域网服务器检索并显示出来，如图14的患者目录屏幕所示。和图5Web页的情况一样，从患者目录Web页有超文本连接到超声图像和报告。
一些局域超声网络结构显示在图15～17中。在图15中，四个超声系统、一个个人计算机244和一个局域网服务器242由集线器(hub)240连成局域网。集线器240是一种用来互连几根串行数据线的简单器件，可在市场上从Farallon Corporation买到，价格大约为$250。局域网服务器242的硬件可以只是具有上述网络通信单元的个人计算机，还有扩展存储器用来存储由网络的超声系统保存的大量超声图像和报告。个人计算机244的用户可以访问局域网服务器，以及该局域网，或“内联网(intranetwork)”的各个活动超声系统，其方式和上述对于可从外部访问的“互联网”的方式相同。
图16的网络结构和图15相似，只不过局域网现在通过网关250可进行Internet访问。因为可以预料大多数医生不想管理和维护他们各自的网关和路由器，所以网关最通常是通过连到Internet服务供应商的调制解调器或高数据速率接点来实现的。用较低的月服务费Internet服务供应商就可处理互联网的复杂事务，对之医生会高度依赖但几乎没有操作兴趣。
最后，图17图示一种网络结构，通过它医生可以用或不用Internet直接访问他的超声系统。集线器240连接到网络/调制解调器252(net/modem)，它可从远程个人计算机100经无线或电话网络40被连接到。使用高级通信协议，比如文件传输协议(File TransferProtocol，FTP)；或者用低级TCP/IP作为基础的网络文件共享(Network File Sharing，NFS)，医生可直接拨号进他的网络并读取诊断信息，而不需要经过Internet入口。对那些到其超声系统网络只要求有特定有限入口的用户来说，图17的结构对医生远程访问其超声系统网络及其信息提供了简单而安全的方式。
当本发明的Internet和万维网的超声功能以软件形式体现时，可作为对没有这些功能的已有超声系统的升级被轻易地安装，不论是通过在超声系统上直接安装，还是通过连接调制解调器或网络硬件。软件升级的安装甚至可以远程进行，如U.S.Pat.(申请序列号08/607,894)所描述的，或者由系统的生产厂家提供简单的指南给超声系统所有者，使所有者能够自己具备该能力。

Claims (11)

1.一种获取和存储诊断超声图像或诊断报告的医疗诊断超声系统，其中所述诊断超声图像或诊断报告可以由远程用户(100)直接从该超声系统(10)访问，该系统包括：
用于形成超声图像的图像处理器；
用于产生报告的报告产生器软件包；
存储介质(24)，其位于超声系统(10)上并耦接到该图像处理器和该报告产生器软件包，用于存储超声图象或报告；
超文本传输协议服务器(30)，该超文本传输协议服务器连接成从存储介质(24)读取超声图像和报告，并使系统的图像和报告可以通过通信网络(40)由远程端点的个人计算机、终端或工作站访问；以及
到通信网络(40)的连接，
由此存储在超声系统(10)上的图像或报告可以由来自远程端点(110、112)的用户(100)直接从产生超声图像或报告的超声系统(10)进行访问。
2.根据权利要求1的医疗诊断超声系统，其中在所述网络上发送Web数据的装置包括HTTP服务器。
3.根据权利要求2的医疗诊断超声系统，其中在所述网络上发送Web数据的装置还包括存储的HTML页面。
4.一种获取和存储诊断超声图像或诊断报告的医疗诊断超声系统，其中所述诊断超声图像或诊断报告可以由远程用户(100)直接从该超声系统(10)访问，该系统包括：
用于形成超声图像的图像处理器；
用于产生报告的报告产生器软件包；
一存储介质(24)，其位于超声系统(10)上并耦接到该图像处理器和该报告产生器软件包，用于存储由所述超声系统产生的诊断超声图像或诊断报告；
到通信网络(40)的一个连接(32)；以及
超文本传输协议服务器(30)，该超文本传输协议服务器连接成从存储介质(24)读取超声图像和报告，并使系统的图像和报告可以通过通信网络(40)由远程端点的个人计算机、终端或工作站访问；以及
CGI程序(36)，其与超声系统通信以要求该系统提供所请求的诸如超声图像或诊断报告的信息。
5.根据权利要求4的医疗诊断超声系统，其中所述CGI程序包括为在所述网络连接上访问而存取超声图像或诊断报表文件的装置。
6.根据权利要求4的医疗诊断超声系统，其中所述CGI程序包括在所述网络连接上存取该超声系统的诊断信息的装置。
7.一种获取和存储诊断超声图像或诊断报告的医疗诊断超声系统，其中所述诊断超声图像或诊断报告可以由远程用户(100)直接从超声系统(10)访问，该系统包括：
用于形成超声图像的图像处理器；
用于产生报告的报告产生器软件包；
一存储介质(24)，其位于超声系统(10)上并且耦接到该图像处理器和该报告产生器软件包，用于存储由所述超声系统产生的诊断超声图像或诊断报告；
到通信网络(40)的一个连接(32)；
超文本传输协议服务器(30)，该超文本传输协议服务器连接成从存储介质(24)读取超声图像和报告，并使系统的图像和报告可以通过通信网络(40)由远程端点的个人计算机、终端或工作站访问；以及
包括Web页的HTML页面(34)，该Web页中嵌有超声图像或着提供超文本链接到诊断报告，
由此，存储在产生超声图像或报告的该系统(10)上的超声图像或报告可在所述通信网络(40)上被远程访问。
8.一种获取和存储诊断超声图像或诊断报告的医疗诊断超声系统，其中所述诊断超声图像或诊断报告可以由远程用户(100)直接从超声系统(10)访问，该系统包括：
用于形成超声图像的图像处理器；
用于产生报告的报告产生器软件包；
存储介质(24)，其位于超声系统(10)上并耦接到该图像处理器和该报告产生器软件包，用于存储超声图像或报告；
装在该超声系统(10)上用于和远程终端(108、110)通信的网络软件(46)；
超文本传输协议服务器(30)，该超文本传输协议服务器连接成从存储介质(24)读取超声图像和报告，并使系统的图像和报告可以通过通信网络(40)由远程端点的个人计算机、终端或工作站访问，所述超文本传输协议服务器(30)安装在所述超声系统(10)上并与所述网络软件(46)相配合；
存储在该系统上的HTML页面软件(34)；以及
可由所述超文本传输协议服务器(30)访问的CGI程序(36)，该CGI程序访问由该超声系统(10)上的存储介质(24)存储的诊断超声图像或诊断报告，以由所述超文本传输协议服务器(30)发送到所述远程终端(108、110)。
9.根据权利要求8的医疗诊断超声系统，其中所述网络软件包括TCP/IP软件。
10.根据权利要求9的医疗诊断超声系统，其中所述网络软件还包括PPP软件。
11.根据权利要求8的医疗诊断超声系统，其中所述HTML页面软件可由所述服务器访问，以发送超声图像或诊断报告到远程终端。
CNB971195811A 1996-09-25 1997-09-25 对诊断信息和图像有全球入口的超声诊断成像系统 Expired - Lifetime CN100556366C (zh)

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