JP2009011721A - Medical image management apparatus and program - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a medical image management apparatus and a program which reduces amount of data of a medical image. <P>SOLUTION: An image server 30 receives from a modality 10 a DICOM file including image data of a medical image and incidental information of the image data, divides the received DICOM file into an image data file (a universal image file) and an incidental information file (a DICOM header file), and stores them in a memory section while correlating them with each other. The image server 30 updates diagnostic reading management information stored in the memory section on the basis of diagnostic reading status information received from a diagnostic reading terminal 40. The image server 30 determines whether diagnostic reading of a medical image is finished or not by referring to the diagnostic reading management information and compresses a universal image file stored in the memory section when diagnostic reading is determined to be finished. <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

  The present invention relates to a medical image management apparatus and a program.

  In recent years, computerization of information has been attempted in many medical institutions. For example, an image generation apparatus (modality) such as a CR (Computed Radiography) apparatus, a CT (Computed Tomography) apparatus, or an MRI (Magnetic Resonance Imaging) apparatus uses DICOM (Digital Imaging and Communications in Medicine) as image data obtained by imaging. A DICOM file with accompanying information according to the standard is generated. The image server stores and manages the DICOM file, and provides the DICOM file when there is a request for the DICOM file from a DICOM compatible image viewer terminal. The image viewer terminal displays a medical image on a high-definition monitor based on the DICOM file.

  For example, in a medical image system having a modality, an image viewer terminal, a medical image storage device, etc., the DICOM file generated by the modality is stored in the medical image storage device for one year and stored in another medical image storage device for 10 years. In addition, a technique for storing a DICOM file in a portable storage medium after 10 years or when the storage capacity of the medical image storage device is insufficient has been proposed (see Patent Document 1).

In addition, there are cases where it is desired to refer to an image for explanation or diagnosis of a patient even in an electronic medical record terminal used when creating an electronic medical record or viewing a medical examination result. Electronic medical record terminals generally do not have a function for directly processing a DICOM file, an advanced image processing function, or the like. Therefore, in the image server, a general-purpose image file in which only the image data in the DICOM file is converted into a format such as JPEG (Joint Photographic Experts Group) or PDF (Portable Document Format) in advance is generated, and the Web server function Is provided, a general-purpose image file is provided in response to a request from an electronic medical record terminal.
JP 2002-352216 A

  However, in the image server, in addition to the DICOM file, when saving a general-purpose image file that can respond to a request from an electronic medical record terminal or the like, a plurality of files for the same medical image are held, increasing the storage capacity. Was invited. In addition, since a general-purpose image file is generated regardless of whether there is a reference from an electronic medical record terminal or the like, the processing for generating the general-purpose image file is wasted when it is not referenced.

  Also, medical images require different image quality depending on the purpose of use. For example, when an image interpretation doctor performs image diagnosis, the purpose is to find abnormalities such as lesions in the image, and therefore there should be no deterioration in image quality. In addition, the reference doctor who makes a diagnosis based on a report prepared by the interpreting doctor uses images when explaining to the patient, attaching it to the medical chart, and revisiting the patient. The image quality is not required, but a certain level or higher image quality is required. In addition, when an image is used for the education of a resident or the like, it is not used for diagnosis, and it is sufficient if the image quality is as required. Moreover, since the imaging engineer only wants to refer to the imaging conditions for re-imaging and does not need an image, the image quality does not matter. Therefore, it is not necessary to store the image file in an uncompressed state until a high-quality image is not required.

  The present invention has been made in view of the above-described problems in the prior art, and an object thereof is to reduce the data amount of medical images.

In order to solve the above problem, a medical image management apparatus according to claim 1 is provided.
A communication means for transmitting / receiving data to / from an external device;
First storage means;
When the communication means receives the DICOM file including the image data of the medical image and the incidental information related to the image data, the received DICOM file is divided into an image data file and an incidental information file, and the image data Storage control means for associating and storing the file of the incidental information and the file of the incidental information in the first storage means,
Second storage means for storing interpretation management information for managing the interpretation status of the medical image;
Updating means for updating the interpretation management information stored in the second storage means based on the interpretation status information when the interpretation status information indicating the interpretation status is received by the communication means;
A determination unit that refers to the interpretation management information stored in the second storage unit and determines whether or not the interpretation of the medical image is completed;
A compression unit that compresses the image data file stored in the first storage unit when the determination unit determines that the interpretation of the medical image has been completed;
Is provided.

The program according to claim 2 is:
Computer
A communication means for transmitting / receiving data to / from an external device,
First storage means,
When the communication means receives the DICOM file including the image data of the medical image and the incidental information related to the image data, the received DICOM file is divided into an image data file and an incidental information file, and the image data Storage control means for associating and storing the file of the incidental information and the file of the incidental information in the first storage means,
Second storage means for storing interpretation management information for managing the interpretation status of the medical image;
Updating means for updating the interpretation management information stored in the second storage means based on the interpretation status information when the interpretation status information indicating the interpretation status is received by the communication means;
A determination unit that refers to the interpretation management information stored in the second storage unit and determines whether the interpretation of the medical image is completed;
A compression unit that compresses the image data file stored in the first storage unit when the determination unit determines that the interpretation of the medical image has been completed;
To function as.

  According to the present invention, since the image data file is compressed when the interpretation of the medical image is completed by referring to the interpretation management information, the image quality can be maintained until the interpretation is completed, and after the interpretation is completed. Can limit the amount of medical image data. Further, by dividing the DICOM file into an image data file and an accompanying information file, only the image data file can be compressed.

  Hereinafter, an embodiment of a medical image management apparatus according to the present invention will be described with reference to the drawings.

[System configuration of medical imaging system]
FIG. 1 shows a system configuration of the medical image system 100. As shown in FIG. 1, the medical image system 100 includes a modality 10, an RIS (Radiological Information System) 20, an image server 30, an image interpretation terminal 40, and an electronic medical record terminal 50. The devices are connected via a communication network N so that data communication is possible.

  The RIS 20 is configured by a computer having a control unit, a storage unit, an operation unit, a display unit, a communication unit, and the like, and performs information management such as medical appointment reservation, diagnosis result report, results management, and material inventory management in the radiology department. . The RIS 20 receives the registration of the inspection order input by the electronic medical record terminal 50, generates inspection order information based on the registered inspection order, and transmits it to the modality 10. In addition, the RIS 20 receives the examination order information from the electronic medical record terminal 50 and transmits the examination order information to the modality 10. The examination order information is data indicating the contents of the examination order for imaging and diagnosis. Further, the RIS 20 transmits an acquisition request for acquiring a DICOM header file to be described later to the image server 30.

  Further, the RIS 20 receives the interpretation order information from the electronic medical record terminal 50 and transmits the interpretation order information to the image server 30 and the interpretation terminal 40. Interpretation order information is information indicating the type of interpretation of a medical image, the priority of interpretation, and the state of interpretation.

  The modality 10 is an image generation device that images a patient and generates image data of a medical image. The modality 10 adds a supplementary information conforming to the DICOM standard to the image data of the taken medical image, generates a DICOM file, and transmits it to the image server 30. The DICOM file includes image data of medical images and incidental information related to the image data. The incidental information includes patient information, examination information, series information, image information, and the like. Patient information is data set for each patient, such as the patient's name, patient ID, and sex. The examination information is data indicating examination conditions such as an examination instance UID that identifies an examination, an examination site, an imaging direction, and a body position. The series information is data including a series ID indicating the unit (series) of a series of medical images for each modality 10 generated in one examination and the type of the modality 10. The image information is data about a medical image including an SOP instance UID that identifies the medical image. The modality 10 images the patient based on the examination order information received from the RIS 20. Also, incidental information is generated based on the inspection order information.

  The image server 30 is a medical image management apparatus that stores and manages image data of medical images and incidental information corresponding to the image data. The image server 30 receives the DICOM file from the modality 10. As shown in FIG. 2, the image server 30 divides the received DICOM file into an image data file (hereinafter referred to as a general-purpose image file) and an accompanying information file (hereinafter referred to as a DICOM header file). And save.

  In response to a file acquisition request received from another device, the image server 30 transmits a DICOM header file, a general-purpose image file, or a DICOM file obtained by combining these two files to the other device. Here, the acquisition request includes file specification information (patient information, examination information, series information, SOP instance UID, or a combination of these information) for specifying a file to be acquired.

  Further, the image server 30 stores the interpretation order information received from the RIS 20 and manages the status of interpretation in the interpretation terminal 40.

  The image interpretation terminal 40 is a device that displays a medical image and various information related to the medical image based on the DICOM file. The image interpretation terminal 40 transmits an acquisition request for acquiring a DICOM file to the image server 30. A user such as an interpretation doctor performs interpretation on the interpretation terminal 40. The interpretation terminal 40 displays various information related to interpretation based on the interpretation order information received from the RIS 20.

  The electronic medical record terminal 50 has an electronic medical record function for creating an electronic medical record, and displays a medical image based on a general-purpose image file for use in diagnosis of a reference doctor. The electronic medical record terminal 50 transmits an acquisition request for acquiring a general-purpose image file to the image server 30.

  In addition, the electronic medical record terminal 50 generates interpretation order information and examination order information based on an operation signal from the operation unit by a user operation, and transmits it to the RIS 20.

[Functional configuration of image server]
FIG. 3 shows a functional configuration of the image server 30. As shown in FIG. 3, the image server 30 includes a control unit 31, an operation unit 32, a display unit 33, a communication unit 34, a ROM (Read Only Memory) 35, a storage unit 36, and the like. ing.

  The control unit 31 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 30. Specifically, the CPU reads various processing programs stored in the ROM 35 in accordance with an operation signal input from the operation unit 32 or an instruction signal received by the communication unit 34, and a work piece formed in the RAM. Expand to the area and perform various processes in cooperation with the program.

  The operation unit 32 includes a keyboard having cursor keys, numeric input keys, various function keys, and the like, and a pointing device such as a mouse. The operation unit 32 controls operation signals input by key operations or mouse operations on the keyboard. To 31.

  The display unit 33 is configured by an LCD (Liquid Crystal Display), and displays various screens based on display data input from the control unit 31.

  The communication unit 34 includes a LAN (Local Area Network) adapter, a router, a TA (Terminal Adapter), and the like, and external devices such as a modality 10, an RIS 20, an image interpretation terminal 40, and an electronic medical record terminal 50 connected via the communication network N. Send and receive data to and from.

  The communication unit 34 employs a general-purpose Web communication protocol such as HTTP (HyperText Transfer Protocol) when transmitting a DICOM header file to the RIS 20 or a general-purpose image file to the electronic medical record terminal 50. The communication unit 34 adopts a DICOM compatible protocol when transmitting a DICOM file to the image interpretation terminal 40 or receiving a DICOM file from the modality 10.

  The ROM 35 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 36 is a storage device such as a hard disk, and stores data such as general-purpose image files and DICOM header files. In addition, the storage unit 36 stores an interpretation order information table 361. The interpretation order information table 361 is a table that stores one or more pieces of interpretation order information received from the RIS 20. When receiving the interpretation order information from the RIS 20 through the communication unit 34, the control unit 31 adds the interpretation order information as a record to the interpretation order information table 361. That is, one record of the interpretation order information table 361 corresponds to the interpretation order information.

  The control unit 31 refers to the interpretation order information table 361 and manages the interpretation status of the medical image in the interpretation terminal 40. Here, the interpretation order information, which is one record in the interpretation order information table 361 and the interpretation order information table 361, is interpretation management information for managing the interpretation status of the medical image.

  FIG. 4 shows the data structure of the interpretation order information table 361. As shown in FIG. 4, the interpretation order information table 361 includes one or a plurality of records including fields of “NO”, “inspection instance UID”, “interpretation type”, “priority”, and “state”.

  Here, “NO” is a record number. The “interpretation type” is a field indicating the type of interpretation for a medical image. Specifically, as the value of “interpretation type”, “normal interpretation” in which one doctor interprets a medical image, “double interpretation” in which two doctors individually interpret the same medical image, Two doctors at different levels, such as approved physicians who approve the interpretation report, interpret the same medical image individually, and the two doctors individually interpret the same medical image. There is a “comparison interpretation” in which each doctor interprets each interpretation report and interprets a medical image.

  The “priority” is a field indicating the priority of image interpretation for a medical image. Specifically, the value of “priority” includes “normal” and “priority” indicating that interpretation is performed with priority.

  “State” is a field indicating the state of interpretation of a medical image. Specifically, as the value of “status”, “standby” indicating a status waiting for interpretation, “complete” indicating a status where interpretation is completed, “interruption” indicating a status where interpretation is interrupted, double Interpretation by one doctor in interpretation or comparative interpretation has been completed, and `` one person completed '' waiting for interpretation by the second doctor, interpretation by the interpreting doctor in confirmation interpretation has been completed, and waiting for approval by an approved doctor There are “waiting for approval”, “waiting for comparison” in which the interpretation by two doctors in the comparative interpretation is completed and waiting for interpretation by the comparison by another doctor.

  The value (initial value) of “state” when received from the RIS 20 by the communication unit 34 is “standby”.

  When the communication unit 34 receives the DICOM file from the modality 10, the control unit 31 divides the DICOM file into a general-purpose image file and a DICOM header file as shown in FIG. Then, the control unit 31 stores the general-purpose image file and the DICOM header file in the storage unit 36 in association with each other. For example, the general-purpose image file and the DICOM header file are associated with each other by attaching the SOP instance UID included in the incidental information to the file name of the general-purpose image file. The general-purpose image file may be in any image format such as bitmap, JPEG, JPEG2000, etc., but until the interpretation is completed, an image format that can provide a medical image with an image quality suitable for interpretation, such as a bitmap format. The general-purpose image file is saved.

  In addition, the control unit 31 causes a DICOM header file, a general-purpose image file, or a DICOM file to be transmitted to the other device via the communication unit 34 in response to a file acquisition request received from the other device by the communication unit 34. More specifically, when the communication unit 34 receives a DICOM header file acquisition request from the RIS 20, the control unit 31 reads the DICOM header file specified by the file specification information included in the acquisition request from the storage unit 36. Then, the DICOM header file is transmitted to the RIS 20 via the communication unit 34. When the communication unit 34 receives a general-purpose image file acquisition request from the electronic medical record terminal 50, the control unit 31 reads out the general-purpose image file designated by the file designation information included in the acquisition request from the storage unit 36. Then, the general-purpose image file is transmitted to the electronic medical record terminal 50 via the communication unit 34. When the communication unit 34 receives a DICOM file acquisition request from the image interpretation terminal 40, the control unit 31 uses a general-purpose image file and a DICOM header corresponding to the DICOM file specified by the file specification information included in the acquisition request. The file is read from the storage unit 36, the two files are combined to generate a DICOM file, and the generated DICOM file is transmitted to the image interpretation terminal 40 via the communication unit 34.

  In addition, the communication unit 34 receives interpretation status information indicating the interpretation status from the interpretation terminal 40. The interpretation status information includes five types of information: interpretation completion information, first interpretation completion information, second interpretation completion information, approval completion information, and comparative interpretation completion information. The interpretation status information is a generic name of these five types of information. It is. Here, “interpretation completion information” is information indicating that interpretation has been completed in normal interpretation and confirmation interpretation. The “first interpretation completion information” is information indicating that interpretation by the first doctor has been completed in double interpretation and comparative interpretation. “Second interpretation completion information” is information indicating that interpretation by a second doctor has been completed in double interpretation and comparative interpretation. “Approval completion information” is information indicating that the approval by the approver is completed in the confirmation interpretation. The “comparative interpretation completion information” is information indicating that interpretation by comparison by a doctor different from the doctors who performed the two interpretations in the comparative interpretation has been completed. Also, these interpretation status information includes an “examination instance UID” that specifies an examination regarding one or a plurality of medical images to be interpreted.

  The control unit 31 receives the interpretation status information (interpretation completion information, first interpretation completion information, second interpretation completion information, approval completion information, comparative interpretation completion information) from the interpretation terminal 40 by the communication unit 34. The interpretation order information table 361 is updated based on the interpretation status information.

  When the communication unit 44 receives the interpretation completion information, the control unit 31 reads the value of the “inspection instance UID” included in the interpretation completion information, and searches for a record that matches the “inspection instance” in the interpretation order information table 361. . If the interpretation type of the matching record is “normal interpretation” and the state is “standby”, the state is changed from “standby” to “completed”. If the interpretation type of the matching record is “confirmation interpretation” and the state is “standby”, the state is changed from “standby” to “waiting for approval”.

  When the communication unit 34 receives the first interpretation completion information, the control unit 31 reads the value of the “inspection instance UID” included in the first interpretation completion information and matches the “inspection instance UID” of the interpretation order information table 361. Search for the record you want. If the interpretation type of the matching record is “double interpretation” and the state is “standby”, the state is changed from “standby” to “one person completed”. If the interpretation type of the matching record is “comparison interpretation” and the state is “standby”, the state is changed from “standby” to “one person completed”.

  When the communication unit 34 receives the second interpretation completion information, the control unit 31 reads the value of the “inspection instance UID” included in the second interpretation completion information and matches the “inspection instance UID” of the interpretation order information table 361. Search for the record you want. If the interpretation type of the matching record is “double interpretation” and the state is “one person completed”, the state is changed from “one person completed” to “completed”. If the interpretation type of the matching record is “comparison interpretation” and the state is “one person completed”, the state is changed from “one person completed” to “waiting for comparison”.

  When the communication unit 34 receives the approval completion information, the control unit 31 reads the value of the “inspection instance UID” included in the approval completion information and searches for a record that matches the “inspection instance UID” in the interpretation order information table 361. To do. If the interpretation type of the matching record is “confirmation interpretation” and the state is “waiting for approval”, the state is changed from “waiting for approval” to “completed”.

  When the communication unit 34 receives the comparison interpretation completion information, the control unit 31 reads the value of the “inspection instance UID” included in the comparison interpretation completion, and records a record that matches the “inspection instance UID” in the interpretation order information table 361. Search for. If the interpretation type of the matching record is “comparison interpretation” and the status is “waiting for comparison”, the status is changed from “waiting for comparison” to “completed”.

  That is, the “state” in the interpretation order information table 361 changes from “standby” to “completed” when the interpretation completion information is received in the case of normal interpretation. In the case of double interpretation, the first interpretation completion information is received to change from “standby” to “one person completion”, and the second interpretation completion information is received to change from “one person completion” to “complete”. In the case of confirmation interpretation, interpretation completion information is received and changed from “standby” to “waiting for approval”, and approval completion information is received and changed from “waiting for approval” to “complete”. In the case of comparative interpretation, the first interpretation completion information is received to change from “standby” to “one person completion”, and the second interpretation completion information is received to change from “one person completion” to “comparison waiting”. When the completion information is received, the status changes from “waiting for comparison” to “completed”.

  The control unit 31 stores the image data corresponding to the “inspection instance UID” of the record in which the value of the “state” is “completed” by updating the interpretation order information table 361, and is stored in the storage unit 36. Compress general-purpose image files. Specifically, the control unit 31 stores one or a plurality of general-purpose image files that store image data in which the value of the inspection instance UID of the inspection information included in the incidental information is the value of the “inspection instance UID” of the record Compress. Here, the compression includes both compressing an uncompressed file and increasing the compression rate of an already compressed file. Any compression method such as JPEG or JPEG2000 may be used. Once the interpretation by the interpreting doctor is completed, there is no problem even if the image quality is somewhat degraded by compressing the general-purpose image file.

[Functional structure of interpretation terminal]
FIG. 5 shows a functional configuration of the image interpretation terminal 40. As shown in FIG. 5, the interpretation terminal 40 includes a control unit 41, an operation unit 42, a display unit 43, a communication unit 44, a ROM 45, a storage unit 46, and the like, and each unit is connected by a bus 47.

  The control unit 41 includes a CPU, a RAM, and the like, and comprehensively controls processing operations of each unit of the image interpretation terminal 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 composed of a high-definition monitor such as an LCD, and displays various screens based on display data input from the control unit 41. In particular, the display unit 43 displays a medical image when the interpretation doctor performs interpretation.

  The communication unit 44 includes a LAN adapter, a router, a TA, and the like, and transmits / receives data to / from an external device such as the image server 30 connected via the communication network N.

  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 unit 46 is a storage device such as a hard disk and stores various data.

  The communication unit 44 receives the interpretation order information from the RIS 20. The control unit 41, based on the interpretation order information, the examination order information generated in the electronic medical record terminal 50, and the like, the examination instance UID, SOP instance UID, interpretation type, and interpretation of medical image data to be interpreted. A list of priorities, interpretation states, etc. is displayed on the display unit 43.

  Then, when a DICOM file to be interpreted is specified by an operation from the operation unit 42 of the interpretation doctor, the control unit 41 transmits a DICOM file acquisition request to the image server 30 via the communication unit 44. Let When the communication unit 44 receives the DICOM file from the image server 30, the control unit 41 causes the display unit 43 to display a medical image or the like based on the DICOM file.

  Then, based on the medical image displayed on the display unit 43, the interpretation type, the priority of interpretation, and the like, normal interpretation, double interpretation, confirmation interpretation, or comparative interpretation is performed by an interpretation doctor or the like.

  Then, by an operation from the operation unit 42 such as an interpreting doctor, the control unit 41 receives the interpretation completion information, the first interpretation completion information, the second interpretation completion information, the approval completion information, or the comparative interpretation completion information as the interpretation status information. It is generated and transmitted to the image server 30 via the communication unit 44.

  Specifically, in the case of normal interpretation, when a user operation indicating that interpretation is completed is performed on the operation unit 42, the control unit 41 transmits interpretation completion information to the image server 30.

  In the case of double interpretation, when a user operation indicating that the interpretation by the first doctor is completed is performed on the operation unit 42, the control unit 41 transmits first interpretation completion information to the image server 30. Then, when a user operation indicating that the interpretation by the second doctor is completed is performed, the control unit 41 transmits second interpretation completion information to the image server 30.

  In the case of confirmation interpretation, when a user operation indicating that interpretation is completed is performed on the operation unit 42, the control unit 41 transmits interpretation completion information to the image server 30. When the user operation for approving the interpretation report by the approver is performed, the control unit 41 transmits approval completion information to the image server 30.

  Further, in the case of comparative interpretation, when a user operation indicating that interpretation by the first doctor is completed is performed on the operation unit 42, the control unit 41 transmits first interpretation completion information to the image server 30. Then, when a user operation indicating that the interpretation by the second doctor is completed is performed, the control unit 41 transmits second interpretation completion information to the image server 30. Then, when a user operation is performed to the effect that interpretation by comparison of each interpretation report by another doctor is completed, the control unit 41 transmits comparison interpretation completion information to the image server 30.

  FIG. 6 shows an example of an interpretation screen 430 in normal interpretation displayed on the display unit 43. As shown in FIG. 6, an image display area 431, a report area 432, an image processing button group 433, and an image interpretation completion button 434 are displayed on the image interpretation screen 430. The image display area 431 is an area where a medical image based on the image data in the DICOM file is displayed. The report area 432 is an area for inputting an interpretation report as a result of diagnosis of an image by the interpretation doctor. The image processing button group 433 includes an enlargement button, a reduction button, a contrast change button, a density change button, and the like, and image processing is performed on the image displayed in the image display area 431 according to the operated button. The processed image is displayed in the image display area 431. The interpretation completion button 434 is a button that is selected when the interpretation is completed.

  The interpretation doctor interprets the medical image displayed in the image display area 431 and inputs an interpretation report in the report area 432 by an operation from the operation unit 42. When the interpretation is completed, the interpretation doctor selects an interpretation completion button 434 displayed on the display unit 43 by an operation from the operation unit 42. The control unit 41 causes the image server 30 to transmit interpretation completion information via the communication unit 44 when the interpretation completion button 434 is selected.

[Specific operation of image server]
FIG. 7 is a flowchart showing processing executed in the image server 30. Note that this flowchart is processing focusing on one DICOM file for convenience of explanation.

  As shown in FIG. 7, the communication unit 34 receives a DICOM file from the modality 10 (step S1).

  Then, the control unit 31 divides the DICOM file into a DICOM header file and a general-purpose image file and saves them in the storage unit 36 (step S2). At this time, the control unit 31 associates the DICOM header file with the general-purpose image file. The communication unit 34 receives interpretation order information from the RIS 20. Then, the received interpretation order information is added to the interpretation order information table 361 as a record.

  When the communication unit 34 receives the interpretation status information indicating the interpretation status from the interpretation terminal 40 (step S3), the control unit 31 applies the corresponding information in the interpretation order information table 361 based on the received interpretation status information. The field “state” of the record to be updated is updated (step S4). Then, the control unit 31 checks whether the value of the “state” is “completed” (step S5). That is, it is checked whether the compression condition is satisfied.

  As a result of the check in step S5, when the value of the field “state” of the record is not “completed” (step S6; No), when the interpretation order information table 361 is updated again, the control unit 31 It is checked whether the value of the “state” is “completed” (steps S3 to S5). On the other hand, when the value of the field “state” of the record is “complete” (step S6; Yes), the general-purpose image file is compressed by the control unit 31 (step S7).

[Operation of medical imaging system]
Next, an operation in the medical image system 100 when confirmation interpretation is performed in the interpretation terminal 40 will be described. 8 and 9 are ladder charts showing operations in the medical image system 100.

  The electronic medical record terminal 50 generates image interpretation order information and examination order information based on a user operation. Then, the generated interpretation order information and inspection order information are transmitted to the RIS 20. Then, the RIS 20 receives the interpretation order information and the inspection order information (step S101).

  The RIS 20 transmits the received inspection order information to the modality 10 (step S102). The RIS 20 transmits the received interpretation order information to the image server 30 and the interpretation terminal 40 (step S103).

  The modality 10 captures a patient based on the examination order information received from the RIS 20, and generates a DICOM file (step S104). The modality 10 transmits the generated DICOM file to the image server 30 (step S105).

  When receiving the DICOM file generated by the modality 10, the image server 30 divides the DICOM file into a DICOM header file and a general-purpose image file. Then, the DICOM header file and the general-purpose image file are saved (step S106).

  The interpretation terminal 40 displays a screen for allowing the user to perform confirmation interpretation based on the interpretation order information received from the RIS 20 (step S107). Then, the user performs a user operation on the operation unit 42 to acquire a medical image to be interpreted. Then, the image interpretation terminal 40 transmits a DICOM file acquisition request to the image server 30 based on an operation signal based on a user operation (step S108).

  Upon receiving the DICOM acquisition request from the image interpretation terminal 40, the image server 30 stores the DICOM header file corresponding to the DICOM file specified by the file specification information included in the DICOM acquisition request and the general-purpose image file. The file and the general-purpose image file are specified, and these files are combined to generate a DICOM file (step S109).

  Then, the image server 30 transmits the generated DICOM file to the image interpretation terminal 40 (step S110). Based on the received DICOM file, the image interpretation terminal 40 displays the medical image and various information related to the medical image on the display unit 43 (step S111).

  Then, the image interpretation doctor interprets the medical image displayed on the display unit 43 on the image interpretation terminal 40. When the user operation indicating that the interpretation is completed is performed, the interpretation terminal 40 transmits the interpretation completion information to the image server 30 (step S112).

  When receiving the image interpretation completion information from the image interpretation terminal 40, the image server 30 updates the image interpretation order information table 361 (step S113). Specifically, the “state” in the field of the corresponding record is updated from “standby” to “waiting for approval”.

  Then, the image server 30 checks whether or not there is a record whose “state” value, which is a field of the interpretation order information table 361, is “completed” (step S114).

  Next, the approver doctor approves the medical image displayed on the display unit 43 on the image interpretation terminal 40. Then, when a user operation for approving a medical image is performed, the interpretation terminal 40 transmits approval completion information to the image server 30 (step S115).

  When receiving the approval completion information from the image interpretation terminal 40, the image server 30 updates the image interpretation order information table 361 (step S116). Specifically, the “status” of the corresponding record is updated from “waiting for approval” to “completed”.

  Then, the image server 30 checks whether or not there is a record in which the value of “state” that is a field of the interpretation order information table 361 is “completed” (step S117).

  As a result of the confirmation in step S117, since there is a record whose “state” is “completed”, the image server 30 compresses the general-purpose image file corresponding to this record (step S118).

  As described above, according to the present embodiment, the image server 30 updates the interpretation order information table 361 stored in the storage unit 36 based on the interpretation status information received from the interpretation terminal 40. Then, the image server 30 refers to the interpretation order information table 361, determines whether or not the interpretation of the medical image is completed, and compresses the general-purpose image file when it is determined that the interpretation is completed. Therefore, the image quality can be maintained until the interpretation is completed, and the data amount of the medical image can be reduced after the interpretation is completed. Further, by dividing the DICOM file into an image data file and an accompanying information file, only the image data file can be compressed. Since the DICOM file occupies most of the data amount is the image data portion, it can be effectively compressed. For this reason, more patients and examination images can be stored. Further, data backup can be performed in a short time due to the reduction of the total file capacity.

  Further, since the image server 30 stores a general-purpose image file that can respond to requests from any device, it is possible to refer to a medical image without using a dedicated viewer terminal that supports a DICOM file. Further, the data amount can be reduced as compared with the case where both the DICOM file and the general-purpose image file are stored. Since the general-purpose image file is also used when a DICOM file is requested, there is no waste even if it is generated in advance. Further, even after the general-purpose image file is transferred to the low-speed and high-capacity library device, the image can be referred to using a Web browser such as an electronic medical record terminal connected to the network.

  Further, since it is stored in a state of being divided into a general-purpose image file and a DICOM header file, only the DICOM header file needs to be read when only the supplementary information is used. Since the DICOM header file does not include an image portion, processing can be performed at high speed.

  The description in the above embodiment is an example of the medical image management apparatus according to the present invention, and the present invention is not limited to this. The detailed configuration and detailed operation of each part constituting the apparatus can be changed as appropriate without departing from the spirit of the present invention.

1 is a system configuration diagram of a medical image system in an embodiment of the present invention. It is a data block diagram before and after the division | segmentation of a DICOM file. It is a block diagram of an image server. It is a data block diagram of an interpretation order information table. It is an interpretation terminal block diagram. It is a figure which shows an example of an interpretation screen. It is a flowchart which shows the process performed in an image server. It is a ladder chart figure which shows the processing tail performed among RIS, modality, an image server, and an interpretation terminal. It is a ladder chart figure which shows the processing tail performed among RIS, modality, an image server, and an interpretation terminal.

Explanation of symbols

10 modalities 20 RIS
30 Image server 31 Control unit 32 Operation unit 33 Display unit 34 Communication unit 35 ROM
36 Storage Unit 37 Bus 40 Interpretation Terminal 41 Control Unit 42 Operation Unit 43 Display Unit 44 Communication Unit 45 ROM
46 Storage Unit 47 Bus 50 Electronic Medical Record Terminal 100 Medical Image System 361 Interpretation Order Information Table 430 Interpretation Screen 431 Image Display Area 432 Report Area 433 Image Processing Button Group 434 Interpretation Complete Button N Communication Network

Claims (2)

A communication means for transmitting / receiving data to / from an external device;
First storage means;
When the communication means receives the DICOM file including the image data of the medical image and the incidental information related to the image data, the received DICOM file is divided into an image data file and an incidental information file, and the image data Storage control means for associating and storing the file of the incidental information and the file of the incidental information in the first storage means,
Second storage means for storing interpretation management information for managing the interpretation status of the medical image;
Updating means for updating the interpretation management information stored in the second storage means based on the interpretation status information when the interpretation status information indicating the interpretation status is received by the communication means;
A determination unit that refers to the interpretation management information stored in the second storage unit and determines whether or not the interpretation of the medical image is completed;
A compression unit that compresses the image data file stored in the first storage unit when the determination unit determines that the interpretation of the medical image has been completed;
A medical image management apparatus comprising: Computer
A communication means for transmitting / receiving data to / from an external device,
First storage means,
When the communication means receives the DICOM file including the image data of the medical image and the incidental information related to the image data, the received DICOM file is divided into an image data file and an incidental information file, and the image data Storage control means for associating and storing the file of the incidental information and the file of the incidental information in the first storage means,
Second storage means for storing interpretation management information for managing the interpretation status of the medical image;
Updating means for updating the interpretation management information stored in the second storage means based on the interpretation status information when the interpretation status information indicating the interpretation status is received by the communication means;
A determination unit that refers to the interpretation management information stored in the second storage unit and determines whether the interpretation of the medical image is completed;
A compression unit that compresses the image data file stored in the first storage unit when the determination unit determines that the interpretation of the medical image has been completed;
Program to function as.

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