JP2004057592A - Hospital terminal device and remote diagnostic reading system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a hospital terminal device and a remote diagnostic reading system for creating a medical image file enabling quick and precise diagnostic reading, and transmitting the same to a diagnostic reading center. <P>SOLUTION: The hospital terminal device 20 includes: an input/output means 26 having an input part 28 and a display part 27; an image obtaining means 21 for obtaining the medical image file created by a medical imaging device; an image adjusting means 22 for adjusting at least the contrast of the medical image according to the adjustment data inputted from the input part 28 and recording the adjustment result in the medical image file; a communicating means 24 for transmitting the medical image file to the diagnostic reading center; and a warning means 25 for monitoring whether or not the medical image is subjected to adjustment processing by the image adjusting means and outputting a warning to effect that the image is not yet adjusted when the transmitted medical image file is not yet subjected to image adjustment. <P>COPYRIGHT: (C)2004,JPO

Description

[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention relates to a remote image reading system that transmits a medical image such as a CT image or an MR image taken in a hospital to an image reading center, and enables a diagnosis by an image reading specialist to make an image diagnosis. In particular, the present invention relates to a remote interpretation system capable of efficiently interpreting a high-precision medical image such as a medical image created based on DICOM (Digital Imaging and Communications in Medicine) standard.
[0002]
[Prior art]
Diagnosis of an affected part from a medical image taken by a medical imaging device such as CT, MR, PET or the like (hereinafter referred to as "interpretation") requires a high degree of knowledge and skill. However, there is a nationwide shortage of interpreting specialists with such advanced knowledge and skills. In order to make up for the shortage of such specialists, a remote image interpretation system is practically used as an advanced medical service system that transmits medical images from a hospital to an image interpretation center and enables image interpretation diagnosis by an image interpretation specialist resident at the image interpretation center. Has been Such a conventional system is disclosed in, for example, JP-A-2002-15062.
[0003]
In the conventional remote image reading system, since a medical image created based on the DICOM standard is transmitted from the hospital terminal device as it is, it is necessary for an image reading specialist to perform image reading while adjusting the contrast and the like of each medical image. A medical image file according to the DICOM standard is generated by a medical imaging device installed in a hospital. However, since the DICOM standard is compatible with various types of medical imaging devices, the DICOM standard allows a high degree of freedom in standards regarding image types, image arrangement, and the like. For this reason, some DICOM files have different image types, image arrangements, and the like depending on the type of medical imaging apparatus. Due to this, the medical images displayed at the image interpretation center also vary in display order, display format, and the like, which hinders efficient image interpretation.
[0004]
[Problems to be solved by the invention]
The remote image reading system concentrates and interprets medical images captured by many hospital terminals at an image reading center, and it is required that an image interpreting specialist interpret a large number of medical images accurately and efficiently. However, in the conventional remote image reading system, it is necessary for the image reading specialist to adjust the contrast of the medical image when performing the image reading, and the contrast adjustment operation before the original image reading takes a lot of time, which is an obstacle for performing quick and appropriate image reading. Had become. In particular, the resolution of medical images has been greatly improved with recent technological advances in medical equipment, and according to the DICOM standard, high-precision images of 16-bit gradation expression (65536 steps) have been obtained. For this reason, it is difficult for an image interpretation specialist who has little information on the patient to adjust the contrast to an appropriate level according to the patient's symptoms in a short time, and a lot of wasted time is spent on the adjustment operation.
[0005]
In addition, if the medical images are not arranged in an order suitable for diagnosis, it is necessary to confirm where the necessary medical images are located at the time of image reading, and then access the file, which imposes a heavy burden on the image reading specialist. Furthermore, in a medical imaging device in a hospital, a plurality of medical images that are eventually unnecessary may be created in order to generate a predetermined stereoscopic image. Such medical images are not so important for image interpretation, and transmission of these medical images increases the transmission load. Increasing the transmission load also increases the line occupancy and lowers the utilization efficiency of the interpretation center. These problems have hindered providing more patients with the opportunity to receive advanced medical services of specialists in interpretation, and have hindered efficient interpretation by remote interpretation systems.
[0006]
The present invention has been made in view of the above-described problems of the related art, and creates a medical image file capable of performing a quick and accurate interpretation diagnosis even by an interpretation specialist with poor patient information and transmits the medical image file to an interpretation center. Another object of the present invention is to provide a hospital terminal device for remote reading.
[0007]
Another object of the present invention is to provide a hospital terminal device that transmits only a medical image file necessary for image interpretation.
[0008]
Still another object of the present invention is to provide a remote image reading system capable of uniformly displaying medical image files generated by different types of medical imaging devices at an image reading center.
[0009]
[Means for achieving the object]
The present invention has a configuration in which a medical image file is transmitted to an image interpretation center after creating an adjustment table for unifying a medical image contrast adjustment and a medical image display array suitable for image interpretation by a hospital terminal device. The above object was achieved by minimizing the burden of interpretation on the interpretation specialist as much as possible.
[0010]
The hospital terminal device according to the first aspect of the present invention is an input / output unit having an input unit and a display unit, an image acquisition unit that acquires a medical image file that records a medical image created by a medical imaging device, Image adjustment means for adjusting at least the contrast of the medical image based on the adjustment data input from the input unit, and recording the adjustment result in the medical image file, and communication means for transmitting the medical image file to the image interpretation center And monitors the presence or absence of the medical image adjustment processing by the image adjustment means, and outputs a warning that the image has not been adjusted if the medical image file to be transmitted has not been subjected to the medical image adjustment processing. Warning means for performing the operation.
[0011]
According to this aspect, the medical image file transmitted to the image interpretation center is adjusted to an appropriate contrast, so that the image interpretation specialist can immediately execute the image interpretation without being bothered by the adjustment of the contrast. On the hospital side, since the doctor in charge and the radiologist know the part to be diagnosed from the patient's condition and the like, the contrast can be adjusted relatively easily.
[0012]
In a hospital terminal device according to another aspect of the present invention, the warning unit further includes a transmission prohibiting unit that prohibits transmission of the medical image file to the image interpretation center when the adjustment process is not performed by the image adjustment unit. It is characterized. For example, it is possible to provide a counter for counting the number of adjustment operations performed by the image adjustment unit, and to prevent transmission unless the counter is at least one or more. According to this aspect, it is necessary to transmit the image after adjusting the image on the hospital side, and the image adjustment by the hospital terminal can be more thoroughly performed.
[0013]
A hospital terminal device according to another aspect of the present invention provides an image acquisition unit that acquires a medical image created by a medical imaging device and a medical image file that records attribute information of the medical image and a type of the medical imaging device. A conversion table for converting the determined attribute information into predetermined reference attribute information, and converting the attribute information in the acquired medical image file into reference attribute information based on the conversion table, and performing medical treatment based on the converted reference attribute information. The image processing apparatus is characterized by including a file adjusting unit that creates an adjustment table for displaying an image file, and a communication unit that transmits a medical image file and an adjustment table to an image interpretation center. The file adjustment means converts the attribute information of the DICOM file into reference attribute information by using the conversion table, and creates an adjustment table in which the information is recorded. The reference attribute information provides a uniform display format in both the hospital terminal and the interpretation center. Since the change to the reference attribute information is recorded in the adjustment table, the original attribute information of the DICOM file is maintained as it is. The adjusted DICOM file is displayed based on the adjustment table, and is displayed in a unified display format. With this, even if the display format of the medical image file created by the type of the medical imaging device is not uniform, the medical image file can be displayed in a predetermined unified format. This makes it possible to suppress variations in display due to differences in image quality, thereby enabling more efficient image interpretation.
[0014]
A hospital terminal device according to another aspect of the present invention includes an image acquisition unit that acquires a medical image created by a medical imaging device and a medical image file that records attribute information of the medical image, and whether to hold the medical image file. The predetermined condition for determining whether or not the attribute information is set in association with the attribute information, and the attribute information is read from the acquired medical image file and verified based on the conversion table. File adjustment means for deleting the medical image file when the condition is met;
Communication means for transmitting the verified medical image file to the interpretation center. As a result, it is possible to avoid transmitting an image of low importance to the interpretation center, and it can be expected that this will contribute to more efficient interpretation. Further, by reducing the transmission information, it is possible to reduce the line load and the communication load of both the hospital terminal device and the image reading device.
[0015]
A medical image remote reading system according to a first aspect of the present invention includes a plurality of hospital terminal devices that collect medical image files captured in a hospital and transmit the collected medical image files to an image reading center, and the hospital terminal device is connected via a network. A medical image remote reading system comprising: a connected image reading device for displaying a medical image based on a medical image file received from the hospital terminal. The hospital terminal device according to any one of claims 1 to 4, The medical image reading apparatus, which is based on the medical image and the adjustment table recorded in the medical image file received from the hospital terminal apparatus, sorts the medical images adjusted by the hospital terminal apparatus in a unified order. Is displayed. By unifying the contrast and display arrangement order of both the hospital terminal device and the image reading device in this manner, various processes and operations necessary for image reading, such as image adjustment by the hospital terminal device so as to obtain an image optimal for image reading. Etc. can be more efficiently distributed. This makes it possible to provide a remote image reading system capable of performing accurate and quick image reading.
[0016]
BEST MODE FOR CARRYING OUT THE INVENTION
An embodiment of the present invention will be described with reference to the drawings. FIG. 2 shows a basic configuration of the remote image reading system 10 according to one embodiment of the present invention. The remote image interpretation system 10 is configured such that a plurality of hospital terminal devices 20 and an image interpretation device 30 of an image interpretation center are connected via a network 40. The hospital terminal device 20 acquires a medical image captured by various medical imaging devices 80 such as CT and MR in a hospital as a DICOM file which is one mode of a medical image file, performs a predetermined image adjustment, and then executes a network 40. To the interpretation center via the Internet. The image reading device 30 of the image reading center stores the received DICOM file. When the image reading specialist opens the DICOM file stored in the image reading device 30 at the time of image reading, the medical image is displayed on the display unit of the image reading device 30. The result of the diagnostic interpretation by the diagnostic specialist is reported to the hospital as a diagnostic report. The network 40 connecting the hospital terminal device 20 and the image reading device 30 at the image reading center may be a line connection such as a public line (including ISDN) or a dedicated line, or an open network such as the Internet. Good also good.
[0017]
(Configuration of hospital terminal device)
FIG. 1 shows a functional block diagram of a hospital terminal device 20 according to one embodiment of the present invention. The hospital terminal device 20 includes an image file acquisition unit 21 that acquires medical images from medical imaging devices 80a to 80c such as MR, CT, PET, and ultrasound image diagnostic devices in a hospital, and image adjustment and display of the acquired medical images. Image adjustment means 22 for creating an adjustment table for unifying the format, compression means 23 for performing compression processing on data to be transmitted to the image interpretation center 30, and communication means 24 for transmitting a DICOM file or the like after compression processing to the image interpretation center 30 And a warning unit 25 for issuing a warning of image non-adjustment when an image adjustment operation (contrast adjustment) of a medical image is not performed, a display unit 27 for performing an operation of the hospital terminal device 20 and an image adjustment operation, and an input. And an input / output means 26 having a section 28.
[0018]
(DICOM file)
The medical imaging device 80 creates a DICOM file from a medical image of a predetermined part of a patient. The DICOM file is a file created according to the DICOM standard, and the DICOM standard is a standard standardized in the United States to share medical information. The DICOM file contains medical images and tag information. Tag information is various types of attribute information related to medical images, such as patient information, imaging conditions, image information, and display information. The patient information includes information specifying the patient such as a name and a date of birth, and the imaging conditions include an image type such as a primary acquired image and a secondary acquired image, an imaging region, and an X-ray current value at the time of imaging with a medical imaging apparatus. And information on a shooting situation such as a voltage value. The image information includes information indicating the examination ID, the type of the medical imaging device, and the like. The display information includes image contrast, a display area, a series number (a group ID to which the medical image belongs), and other information. Includes the file code of each DICOM file.
[0019]
Imaging by the medical imaging devices 80a to 80c is performed by a radiologist based on an imaging request written by a doctor in charge. The radiographing request includes a radiographing site, radiographing conditions, and the like corresponding to the patient's medical condition. The radiologist captures a plurality of medical images based on the radiographing request. From the plurality of captured medical images, a separate DICOM file is generated for each medical image. A plurality of DICOM files generated by one inspection (imaging based on one imaging request form) are grouped for each inspection unit, and an inspection ID (inspection authentication number) is assigned to each inspection. A plurality of parts may be imaged by one examination. In this case, a series ID is assigned to each part to be imaged as a lower group of one examination ID, and the DICOM file is classified for each series ID. The series generation, division, order of arrangement of medical images, and the like may differ depending on the type of medical imaging apparatus, and are not completely unified.
[0020]
The medical imaging device 80 and the hospital terminal device 20 are usually connected by a private line such as a LAN, and the medical image acquiring unit 21 receives a DICOM for each inspection unit from the medical imaging device 80 via a network 70 such as a LAN line. Get files. In addition, the DICOM file created by the medical imaging device 80 may be recorded on a recording medium such as an FD, a CD-ROM, or a flash memory, and the DICOM file may be obtained via the recording medium.
[0021]
(Image adjustment means)
The medical image files, which are the group of acquired DICOM files, are adjusted for the medical images by the image adjusting unit 22. The image adjustment unit 22 has an automatic deletion function of deleting unnecessary DICOM files from a group of DICOM files under examination (hereinafter, referred to as “examination files”), and a function between the image interpretation device 30 of the image interpretation center and the hospital terminal device 20. And a contrast adjustment function for automatically creating an adjustment table for unifying the display order of the DICOM files and a contrast adjustment function for adjusting the contrast of the image to an optimum contrast according to the patient's condition. Will be described later). Adjustment of the contrast is performed by a hospital doctor or a radiologist via the input / output unit 26.
[0022]
The image adjustment unit 22 will be described with reference to FIG. FIG. 3 is a functional block diagram showing the basic functions of the image adjustment unit 22. The image adjustment unit 22 includes a file adjustment unit 51 that implements an automatic deletion function or a manual deletion function and an adjustment table creation function of unnecessary DICOM files from the DICOM files acquired from the medical imaging device 80, and a medical image in each DICOM file. And a contrast adjustment unit 52 for adjusting the contrast of the DICOM file and rewriting the adjusted contrast as tag information of the DICOM file. In the present embodiment, the image adjustment unit 22 including both the file adjustment unit 51 and the contrast adjustment unit 52 is shown. However, a configuration including only one of the file adjustment unit 51 and the contrast adjustment unit 52 may be adopted. It is possible.
[0023]
The file adjustment unit 51 will be described. As described above, the medical imaging device 80 may generate an image (primary image) serving as a basis for generating a predetermined stereoscopic image, and such a medical image may be included in an examination file. Such a medical image is information that is not so important for an image reading specialist and can be removed. If the display format differs for each model of the medical imaging device 80 and the display order and arrangement of the medical images are not unified into a predetermined order suitable for diagnosis, etc., the interpretation specialist will match the display format. It is necessary to switch between heads to make a decision, which places a heavy burden on the specialist in interpretation. Further, it is desirable that the same display is displayed between the hospital terminal device 20 and the image interpretation device 30 of the image interpretation center for communication between the hospital and the image interpretation center. Therefore, in the present invention, the file adjustment unit 51 deletes unnecessary DICOM files and creates an adjustment table for displaying the order and arrangement of medical images in a predetermined unified manner. The hospital terminal device 20 and the image reading device 30 can display in a unified format according to the adjustment table.
[0024]
FIG. 4 is a diagram showing a screen display example in which each medical image of the DICOM file in one examination ID acquired from a certain medical imaging device 80 is displayed as it is. FIG. 5 shows an example of a screen display after adjustment in which each medical image of the DICOM file of FIG. 4 is displayed based on the adjustment table created by the file adjustment unit 51. In FIG. 4, a medical image of a chest (dark image) and a medical image of a lung field (whitish image) are displayed in an alternate order in one series. FIG. 5 shows that the DICOM file is divided into two series, a chest region and a lung field, and each DICOM file is divided into corresponding series and displayed.
[0025]
Depending on the type of the medical image apparatus 80, some of them are arranged and arranged as shown in FIG. 5 from the beginning. Such attribute information on the display of the medical image is recorded in the DICOM file as “display information” in the tag information. The display information in the tag information differs depending on the model of the medical imaging device 80, and thus the above-described display variation occurs. According to the present invention, a DICOM file unnecessary for image interpretation is deleted, attribute information specific to a specific type of medical imaging device is converted into predetermined reference attribute information, and unified display is performed based on the converted reference attribute information. Create an adjustment table to do
[0026]
The division condition of the series based on the tag information (attribute information), the condition for changing the display order, and the condition for deleting the DICOM file are stored in advance in the adjustment information storage unit 53 (see FIG. 3) according to the model of the medical imaging apparatus 80. It is set as a conversion table. The file adjustment unit 51 reads a deletion condition and a conversion condition for converting tag information (attribute information) from the conversion table of the adjustment information storage unit 53 at the time of the adjustment processing. The DICOM file to be deleted is deleted, and an adjustment table creation process is executed based on whether the corresponding tag information of each DICOM file matches the conversion condition. That is, since various information related to the medical image of each DICOM file is recorded as tag information, the file adjustment unit 51 reads the tag information from the DICOM file and processes the read tag information based on the adjustment condition. Referring to FIGS. 4 and 5, the two parts of the chest and lung field are divided into separate series based on the read tag information on the imaging part, and each DICOM file corresponds to each part. Sort into series and create adjustment table for display. Whether to re-divide into lower series and whether to change the display arrangement order is determined based on adjustment conditions set in a conversion table set in advance for each type of medical imaging apparatus 80. The conversion table is set in the adjustment information storage unit 53 in advance.
[0027]
The adjustment table will be described more specifically with reference to FIG. When a group of DICOM files is acquired by the image acquiring means 21, an "adjustment table" is created for each inspection unit. The adjustment table is an examination ID assigned to each examination and data indicating the display order of image files. Each medical image is displayed according to the grouping (series) and the arrangement order by the adjustment table. FIG. 6 shows an example of the adjustment table. FIG. 6A shows an example of an adjustment table created immediately after acquiring a DICOM file from the medical imaging apparatus 80. FIG. 6B shows a case where the file adjustment unit 51 deletes a file and changes the arrangement order. It is an example of the adjustment table after it. In the figure, “images 1 to n” of each series indicate the arrangement order of DICOM files for each series, and DICOM file names XX1 to XX15 are the names of DICOM files.
[0028]
Comparing the adjustment tables 81 and 82 before and after the adjustment, each of the series 1 and 2 before the adjustment processing is subdivided into the lower series 1-1 and the series 2-2 after the adjustment processing. The order of arrangement of each DICOM file has been changed. According to the adjustment table 81 before the adjustment processing, the DICOM file XX2 is arranged in the image 2 that is the second image of the series 1, but the adjustment table 82 after the adjustment processing indicates that the DICOM file XX2 is the first image of the series 1-1. Image 1 which is the image of FIG. Therefore, the order of the image 3 of the series 1 is increased to the order of the image 2 of the series 1 after the adjustment. Similarly, DICOM files XX4, XX, and 8 are adjusted as the classification of series 1-1, and DICOM files XX12, 13, and 14 of series 2 are reclassified as series 2-2. Although not shown in FIG. 6, unnecessary DICOM files are deleted. The reason why the arrangement order is changed or the file is deleted as described above is to reduce the image reading load on the image reading specialist as described above.
[0029]
Next, adjustment of contrast will be described.
Since the medical image of the DICOM file is a monotone image, it is difficult to distinguish subtle shades of the diagnosis target site unless the contrast is properly adjusted. Therefore, when diagnosing (interpreting) a medical image, it is necessary to adjust the medical image to an appropriate contrast in accordance with a part to be diagnosed, a medical condition, and the like. The image data according to the DICOM standard contains enormous contrast data of 16-bit expression (65536 gradations). If predetermined information such as a patient's condition is known, a part to be checked with particular care can be known. Accurate contrast adjustment can be performed smoothly. However, since the image reading specialist at the image reading center does not know the condition of the patient or the like, the image reading is performed while adjusting for various contrasts and searching for the presence or absence of an abnormality, which requires a great deal of time.
[0030]
On the other hand, the doctor in charge at the hospital or the radiologist who has taken the medical image knows the patient's condition in detail, and can perform appropriate contrast adjustment relatively smoothly. Therefore, according to the present invention, a hospital technician familiar with the patient's medical condition, such as a doctor in charge of the patient or a radiologist in charge of imaging, adjusts the contrast of the medical image by the hospital terminal device 20 to an optimal value according to the medical condition. Then, the DICOM file is transmitted to the image reading device 30 of the image reading center. In this way, by adjusting the medical image to the optimal contrast at the hospital side and transmitting it to the image interpretation center, the image interpretation specialist at the image interpretation center does not need to adjust the contrast, and the image can be immediately interpreted simply by displaying the medical image. It is possible to read images with great precision.
[0031]
The contrast adjustment unit 52 outputs the medical image of the DICOM file to the display unit 27 and adjusts the contrast of the medical image based on the adjustment data input from the input unit 28. FIG. 7 shows a display example of the display unit 27 when adjusting the contrast. A list for each examination ID (inspection number) is displayed on the right side of the lower column in FIG. 7, and the image of the DICOM file is displayed by specifying a desired examination ID from the display list. When the examination ID is specified, as shown on the right side of the upper column, the medical images of the corresponding group of DICOM files are displayed as small images such as thumbnails. By specifying a desired medical image from the medical images (in FIG. 7, a medical image surrounded by a rectangular frame is specified), an enlarged view of the medical image is displayed in the right column. The image interpretation device 30 of the image interpretation center also makes a diagnosis by image interpretation based on such an enlarged view. The keys on the left side of the lower column are operation keys.
[0032]
The designation of the examination ID and the designation of the medical image are performed using a mouse. Adjustment of the contrast is also performed by operating the mouse. For example, by moving the mouse to the left or right in the X-axis direction on the left enlarged screen, the center of the contrast gradation is shifted in either the high or low direction, and by moving it up or down in the Y-axis direction, the contrast gradation is shifted. Adjust the key range. It is also possible to display a slide bar on the screen and move the bar with a mouse to adjust the contrast. The contrast of the image is adjusted by a doctor in charge or the like, and is desirably adjusted so that the diagnosis target site of the patient can be confirmed best.
[0033]
FIG. 8 illustrates how the medical image changes by adjusting the contrast. FIG. 8A is an image adjusted to meet the lung field conditions.
In the chest radiograph, the lungs are projected on both sides of the central shadow (cardiac mediastinal shadow large blood vessel), and the lower part is bordered by the diaphragm. This is called the lung field. The lung field extends from the collarbone to the upper apex, where the lung is drawn from the upper part of the lung, the upper part of the upper rib, which is a horizontal line from the tip of the second rib, and the middle between the horizontal line, which is drawn from the tip of the fourth rib and the upper lung The lung field, below it, is referred to as the lower lung field. The area around the hilum is called the hilum and is distinguished from the lung field (Latest Medical Dictionary 2nd Edition). In short, when it is considered that the diagnosis of the lung field is important from the medical condition, it is necessary to adjust the contrast to the lung field condition.
[0034]
FIG. 8B is a screen in which the contrast is adjusted to the mediastinal condition. The mediastinum refers to the thoracic cavity at the center of the rib cage between the left and right pleural cavities. The mediastinum is divided into upper and lower parts by a line connecting the sternal angle and the lower edge of the fourth thoracic vertebral body, and the lower part is further divided into three parts: anterior, middle and posterior. This includes the thymus, heart and its large vessels, trachea, esophagus, thoracic duct, lymph nodes, vagus nerve, phrenic nerve, and sympathetic trunk ganglion (Latest Medical Dictionary 2nd Edition). Therefore, when it is necessary to diagnose these parts, it is necessary to adjust the contrast under the mediastinal condition. As is clear from the difference between the displayed images in FIGS. 8A and 8B, the images displayed by the contrast adjustment are completely different.
[0035]
As is clear from the above examples, it is extremely important for a radiologist to transmit a contrast-adjusted image at the hospital, which is well aware of the patient's condition, in order to perform rapid and accurate interpretation. Therefore, in the present invention, the doctor in charge or the like adjusts the contrast of the medical image using the hospital terminal device 20, overwrites the adjusted contrast value in the tag information of the DICOM file, and transmits it to the image reading device 30 of the image reading center. When the DICOM file received by the image reading device 30 of the image reading center is opened, an image having the adjusted contrast is displayed on the image reading device. Therefore, the specialist in image interpretation performs an image interpretation centering on the medical image with the adjusted contrast, and can perform an accurate image interpretation only by performing fine adjustment or the like of the contrast as necessary, thereby enabling extremely efficient diagnosis.
[0036]
(Interpretation device of the interpretation center)
FIG. 9 shows a functional block diagram of the image reading apparatus 30 according to one embodiment of the present invention.
The DICOM file and the adjustment table transmitted from the hospital terminal 20 are stored in the file storage unit 32 via the communication unit 31. The file storage means may be constituted by a database server. The DICOM file stored in the file storage unit 32 can be read for each examination ID and displayed on the display unit 36 by operating the input / output unit 35. When there is a display request of the DICOM file, the image display control means 33 reads the DICOM file in a predetermined order according to the description of the adjustment table, and records the medical image as tag information of the DICOM file adjusted by the hospital terminal device 20. The display is displayed on the display unit 36 according to the contrast.
[0037]
The hospital terminal device 20 and the image reading device 30 of the image reading center described above are realized by a CPU, a storage device (ROM, RAM, various registers, and the like), and various control programs stored in the storage device and controlling the operation of the CPU. It is also possible.
[0038]
(Processing procedure of hospital terminal equipment)
FIG. 10 is a flowchart showing a processing procedure of the hospital terminal device 20 according to an embodiment of the present invention. The hospital terminal device acquires a plurality of DICOM files periodically or for each examination from the medical imaging device (S101). Acquiring the DICOM file includes not only the case where the hospital terminal device 20 requests and acquires the DICOM file from the medical imaging device 80 but also the case where the DICOM file transmitted from the medical imaging device 80 is passively received. Next, unnecessary DICOM files are deleted from the acquired DICOM files, and an adjustment table is created (S102).
[0039]
Further, the medical image of each DICOM file is adjusted to an appropriate contrast based on the operation of the attending physician or radiologist, and the contrast information is overwritten with the tag information of the DICOM file (S103). When the adjustment of the medical image is completed, it is checked whether or not the contrast of the medical image has been adjusted (S104). If the contrast has been adjusted (S105; Yes), the compression of the DICOM file and the adjustment table for one inspection is performed. Then, encryption is performed (S107), and the compressed DICOM file and adjustment table are transmitted to the image reading device 30 of the image reading center. If the contrast adjustment operation has not been performed (S104; No), a warning to that effect is issued (S105). The warning is based on the screen display, and it is also possible to add sound or the like as needed. Further, the user is requested to select whether to adjust the contrast together with the warning display or to transmit the image without any adjustment. If contrast adjustment is not performed (S106; No), compression and encryption processing is performed (S107), and then transmitted to the image reading device 30 of the image reading center (S108). When adjusting the contrast (S106; Yes), the process returns to step S103 to adjust the contrast. Thereafter, the image data is compressed and encrypted together with the adjusted DICOM file and adjustment table, and transmitted to the image reading apparatus 30 of the image reading center (S107, 108).
[0040]
(File adjustment processing procedure)
FIG. 11 is a flowchart showing one embodiment of the DICOM file selection and alignment process (FIG. 10; S102). First, in this step, an adjustment table is created based on the DICOM file and the information in the adjustment information storage unit 53 (S201). Next, the type of the medical imaging device 80 is read from the tag information of the DICOM file (S202), and it is confirmed whether or not the DICOM file is created by a special model (S203). If it is not based on a special model (S203; No), the standard setting table is set as a conversion table (S204). If it is a special model (S203; Yes), a setting table corresponding to the model is set as a conversion table (S205). In the conversion table, criteria for determining whether to delete the read DICOM file and whether to adjust the arrangement order are set.
[0041]
Next, the image type is read from the tag information of the DICOM file (S206), and it is confirmed from the conversion table whether the DICOM file is to be deleted (S207). In the case of the image type to be deleted (S207; Yes), the DICOM file is deleted (S208), the corresponding DICOM file is deleted from the adjustment table (S209), and the same processing is executed for the next DICOM file (S216). Yes).
[0042]
If the image type is not a deleted file (S207; No), predetermined tag contents are read based on the conversion table to confirm the necessity of rearrangement (S210). If the read content of the predetermined tag is the same as the tag content of the immediately preceding DICOM file (S211; Yes), the processing of the next DICOM file is executed (S216; Yes). If the content of the tag of the read DICOM file is different from that immediately before (S211; No), the current DICOM file name is deleted from the adjustment table, and the order of the next DICOM file is increased (S212). Next, it is checked whether or not a subseries having the same tag content exists in the same series. If the subseries exists (S213; Yes), the current DICOM file name is added to the end of the subseries. If it does not exist (S213; No), a new subseries is created below the series, the current DICOM file name is registered therein (S215), and the same processing is executed for the next DICOM file. (S216; Yes). The same processing is repeated, and when there is no more DICOM file to be processed next (S216; Yes), this processing step ends, and the flow proceeds to step 103.
[0043]
(Processing procedures such as image contrast adjustment)
FIG. 12 is a flowchart of an image contrast adjustment processing procedure according to an embodiment of the present invention. Adjustment of the contrast of a medical image is started by an operation of starting adjustment by a doctor in charge or a radiologist (S301). When the adjustment is started, first, the adjustment counter is cleared to “0” (S302), the authority to process the GUI operation event is acquired (S303), and a predetermined adjustment process is executed based on the operation input from the input unit or the input of the adjustment data. I do. When a predetermined input operation is performed, contrast adjustment processing (S304: Yes, S308), deletion of a DICOM file (S305; Yes, S309), copying of a DICOM file (S306; Yes, S310), and the like are executed. Each time any of these processes is executed, the adjustment counter is incremented by one (S311). The adjustment processing of the medical image is repeated until there is an input for completing the image adjustment processing (S303 to S307; No).
[0044]
The input of the completion of the image adjustment processing means an instruction to transmit the DICOM file to the image reading device 30 of the image reading center. If there is an input of completion of the image adjustment processing (S307; Yes), it is checked whether or not the adjustment counter is 0 (S312). If the counter is 0, a warning is issued that the image has not been adjusted. (S313). When the image adjustment is performed in response to the warning (S314; Yes), the image adjustment process is repeated (S303 to S307; No). When the adjustment counter is not 0 (S312; No) and when the adjustment process is not performed even when the counter is 0 (S314 No), the adjustment is terminated (S315). Proceed to step S104 to execute predetermined processing.
[0045]
In the above description, the DICOM file is mainly described. This has been mainly described because the DICOM standard is a de facto standard in the medical standard at present, and the present invention is not limited to only the processing of the DICOM file. That is, a hospital that obtains an image file other than the DICOM file and performs any one of processing such as adjustment of rearrangement of transmission files, adjustment of image contrast and the like, creation of a display adjustment table, or all of these processings The terminal device and the remote image reading system are also included in the scope of the present invention as objects of the present invention.
[0046]
【The invention's effect】
As described above, according to the present invention, by adjusting the contrast and the like of the acquired medical image by the hospital terminal device according to the condition of the patient and the like, the medical image interpretation center can immediately display a medical image suitable for image interpretation. Will be possible. As a result, according to the present invention, it becomes possible for an image reading specialist to concentrate on the reading of medical images, which is the primary task, and more accurate and quick image reading becomes possible. In addition, by deleting unnecessary medical image files, medical images of low importance are removed from transmission data, and the line load and the communication load of the hospital terminal device and the image reading device can be reduced. Furthermore, since the display format and the like of the medical image file transmitted from the hospital terminal device to the image interpretation center are configured to be converted into a predetermined unified format by the hospital terminal device, the medical image reading device of the image interpretation center has a stable and consistent medical image file. Since the display can be performed, the load on the image reading specialist can be reduced, and quick and efficient image reading can be performed.
[Brief description of the drawings]
FIG. 1 is a functional block diagram of a hospital terminal device according to an embodiment of the present invention.
FIG. 2 is a diagram showing a connection form of the remote image reading system according to the embodiment of the present invention.
FIG. 3 is a functional block diagram illustrating a basic function of an image adjustment unit.
FIG. 4 is a screen display example in which each medical image of a DICOM file in one examination ID acquired from a medical imaging apparatus is displayed as it is.
FIG. 5 is a screen display example after adjustment of a plurality of DICOM files of FIG. 4 by a file adjustment unit 51;
FIG. 6 is a diagram illustrating an example of an adjustment table. (A) is an example of an adjustment table created immediately after acquiring a DICOM file from the medical imaging device 80, and (b) is an adjustment after the file adjustment unit 51 deletes a file and changes the arrangement order. It is an example of a table.
FIG. 7 is a screen display example of a display unit when adjusting contrast.
FIG. 8 is a screen display example showing how a medical image changes by adjusting contrast.
FIG. 9 is a functional block diagram of the image reading apparatus according to the embodiment of the present invention.
FIG. 10 is a flowchart showing a processing procedure of the hospital terminal device according to an embodiment of the present invention.
FIG. 11 is a flowchart showing an embodiment of an image file selection and alignment process (FIG. 10; S102).
FIG. 12 is a flowchart of an image contrast processing procedure according to an embodiment of the present invention.
[Explanation of symbols]
10 Remote reading system
20 Hospital terminal equipment
22 Image adjustment means
26 Hospital terminal input means
30 Image interpretation equipment at image interpretation center
35 Input means of image reading device
40 Network
70 Private line such as LAN
80 Medical imaging devices (CT, MR, PET, etc.)
81, 82 Adjustment table

Claims (5)

Input / output means having an input unit and a display unit,
Image acquisition means for acquiring a medical image file that records a medical image created by a medical imaging device,
Image adjustment means for adjusting at least the contrast of the medical image based on the adjustment data input from the input unit, and recording an adjustment result in the medical image file.
Communication means for transmitting the medical image file to an image interpretation center;
It monitors the presence or absence of the adjustment processing of the medical image by the image adjustment means, and when the medical image file to be transmitted has not been subjected to the adjustment processing of the medical image, issues a warning that the image has not been adjusted. Warning means to output,
Hospital terminal device provided with. The warning means further comprises a transmission prohibiting means for prohibiting the transmission of the medical image file to the image interpretation center when the image adjustment processing by the image adjusting means is not performed. 2. The hospital terminal device according to 1. Image acquisition means for acquiring a medical image created by a medical imaging device and a medical image file recording attribute information thereof,
A conversion table for converting the attribute information determined according to the type of the medical imaging device into predetermined reference attribute information,
File adjustment for converting the attribute information in the acquired medical image file into the reference attribute information based on the conversion table, and creating an adjustment table for displaying the medical image file based on the converted reference attribute information Means,
A hospital terminal device, comprising: communication means for transmitting the medical image file and the adjustment table to an image interpretation center. Image acquisition means for acquiring a medical image created by a medical imaging device and a medical image file recording attribute information thereof,
A predetermined condition for determining whether to retain the medical image file, a conversion table set in association with the attribute information,
File adjustment means for reading out the attribute information from the acquired medical image file, verifying the attribute information based on the conversion table, and deleting the medical image file when the attribute information matches the predetermined condition of the conversion table,
A communication unit for transmitting the medical image file after verification to an image interpretation center. A plurality of hospital terminal devices that collect medical image files photographed in a hospital and transmit the collected medical image files to an interpretation center, and the hospital terminal devices are connected via a network, and are based on the medical image files received from the hospital terminals. A medical image remote display system comprising: an image reading device that displays a medical image,
The hospital terminal device comprises the hospital terminal device according to any one of claims 1 to 4,
Based on the medical image and the adjustment table recorded in the medical image file received from the hospital terminal device, the image reading device, the medical image after adjustment by the hospital terminal device in a unified order A remote reading system characterized by displaying.

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