JP2009207509A - Medical image managing apparatus - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a medical image managing apparatus capable of efficiently associating image data generated by an image generating device with patient information in a small-scale medical facility such as a town doctor's office. <P>SOLUTION: The medical image managing apparatus includes a display section for displaying image data, connected to the image generating device 2 to generate image data on patients so that the data can be transmitted/received; a saving section for saving image data; a temporarily saving section for temporarily saving image data; a patient information storing section for storing patient information on a patient to be examined; and a control section. The control section determines whether the image data transmitted from the image generating device should be saved in the saving section in association with any patient information stored in the patient information storing section or should be temporarily saved in the temporarily saving section without being associated with the patient information based on predetermined reference for determination. The image data without being associated with the patient information are saved in the temporarily saving section with corresponding reason information representing the reason for the determination by the control section. <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

  The present invention relates to a medical image management apparatus, and more particularly to a medical image management apparatus used in a small medical facility.

  Conventionally, a patient who is a patient to be examined was imaged using an image generation device such as a CR (Computed Radiography) imaging device or an FPD (Flat Panel Detector) imaging device. 2. Description of the Related Art There is known a diagnostic system that performs image processing such as gradation processing so that an image can be provided for diagnosis, outputs an image processed image, and provides it for interpretation by a doctor.

  In such a diagnostic system, a person who received a patient and issued a radiographing order (acceptance), a person who actually photographed the patient in the radiographing room (engineer), and obtained gradation, etc. Responsible for determining the availability of image diagnosis, and in some cases, responsible for correcting contrast and density (such as an engineer appointed from a general engineer), and interpreting in charge of determining (diagnosing) the presence or absence of disease based on images ( A plurality of persons in charge, such as doctors, share roles and diagnoses are advanced.

  In a large-scale medical facility (hereinafter referred to as a large-scale facility) where the application of such a conventional diagnostic system is assumed, the place in charge of each of the above roles is 1F for reception, underground for radiology, etc. Often located in large hospitals at remote locations. In addition, there are a plurality of image generation apparatuses and engineers who operate the image generation apparatus, and a console for operating the image generation apparatus, a viewer for checking image data by a doctor, and the like are separately provided with respective roles. And in the radiology department, a scene where a plurality of technicians and a plurality of technicians use a plurality of imaging devices to perform imaging simultaneously is stationary, and a plurality of patients are constantly staying in each process. There is a situation.

For this reason, there is a possibility that an error may occur in the association between the image data generated by the image generation apparatus and the patient. Therefore, in order to prevent such mistakes between image data and individual patients, each device is linked via a network, and an ID is issued at each device for each operation in each process. There has been proposed a system for associating the results of each work process (see, for example, Patent Document 1).
The association of IDs assigned to each work in each process is performed, for example, via a network of HIS (Hospital Information System) or RIS (Radiology Information System). (For example, refer to Patent Document 2 and Patent Document 3).

  However, according to the present inventors' investigation, in the case of a relatively small medical facility (hereinafter referred to as a small-scale facility) such as a medical practitioner or a clinic, in many cases, a doctor who examines a patient is alone. Yes, the number of installed image generation devices is also small. In many cases, the assistant positions the patient and the doctor controls the radiation exposure switch after receiving the notification of positioning completion, or the doctor himself performs all operations including the patient positioning.

  In addition, for example, in the case of a large-scale facility, it is often assumed that a plurality of patients are photographed in parallel and there are multiple information systems, but in the case of a small-scale facility, photographing is performed. The number of patients to be performed is not as large as that of large-scale facilities, and there is little risk of multiple information systems becoming complicated.

  Under such circumstances, it is difficult to confuse the captured image with that of another patient. Nevertheless, if a system similar to that of a large-scale facility is used, it is necessary to generate imaging order information starting with the input of the patient's name, and the procedure becomes complicated and the medical efficiency is poor.

In addition, in order to generate imaging order information such as patient information and imaging condition information of a patient in advance and associate the imaging order information with a captured image, each device is connected to a basic system such as RIS / HIS. However, it is costly to construct such a system, and means for ensuring data consistency with the backbone system is also required (for example, Patent Document 4). And Patent Document 5), there is a problem that it becomes a burden for a small-scale facility. Further, even if the number of devices is reduced while maintaining the above-described configuration concept in a large-scale facility, it is difficult to improve medical efficiency, and it is not optimal for a small-scale facility.
US Pat. No. 5,334,851 JP 2002-159476 A JP 2002-311524 A JP 2006-92261 A JP 2003-248723 A

  The present invention has been made in view of such a situation, and in a small-scale medical facility such as a medical practitioner, it is possible to efficiently associate image data generated by an image generation device with patient information. It is an object of the present invention to provide a medical image management device that can be used.

In order to solve the above-mentioned problem, the invention described in claim 1
It is connected to an image generation device that generates image data related to a patient so that data can be transmitted and received,
Display means for displaying the image data;
Storage means for storing the image data;
Temporary storage means for temporarily storing the image data;
Patient information storage means for storing patient information of a patient to be examined;
Based on a predetermined criterion, the image data transmitted from the image generation device is stored in the storage unit in association with any of the patient information stored in the patient information storage unit, or the patient information Control means for determining whether to store in the temporary storage means without associating, and associating reason information indicating the reason for the determination with the image data not associated with the patient information;
Is provided.

The invention according to claim 2 is the invention according to claim 1,
The control unit causes the display unit to display the image data stored in the temporary storage unit together with the reason information.

The invention according to claim 3 is the invention according to claim 1 or 2,
A patient information association input means for inputting the association between the image data stored in the temporary storage means and patient information;
The control means causes the storage means to store image data associated with the patient information by the patient information association input means, and deletes the image data from the temporary storage means.

The invention according to claim 4 is the invention according to any one of claims 1 to 3,
Patient information is attached to the image data,
The control means compares patient information incidental to the image data with patient information stored in the patient information storage means, and makes the determination based on the comparison result.

  According to the present invention, it is possible to provide a medical image management apparatus capable of efficiently associating image data generated by an image generation apparatus with patient information in a small-scale medical facility such as a practitioner. .

  Hereinafter, a small-scale diagnosis system 1 to which an embodiment of a medical image management apparatus according to the present invention is applied will be described with reference to FIGS. The present invention is not limited to the illustrated example.

  FIG. 1 is a block diagram showing a system configuration of the small-scale diagnosis system 1, FIG. 2 is a diagram schematically showing a flow of image data between main apparatuses in the present embodiment, and FIG. The example of arrangement | positioning in the medical facility of each apparatus at the time of applying the small-scale diagnosis system 1 is shown.

  The small-scale diagnosis system 1 is a system applied to a relatively small-scale medical facility such as a practitioner or a clinic. As shown in FIG. 1, an ultrasonic diagnostic apparatus (US: ultrasonography) 2a that is an image generation apparatus 2 An endoscope (ES) 2b, an electrocardiogram recording device (ECG) 2c, a CR reading device 2d, a medical image management device 3, and a receiving device 4 are included. The image generation device 2, the medical image management device 3, and the reception device 4 are connected to a communication network (hereinafter simply referred to as “network”) 5 such as a LAN (Local Area Network) via a switching hub (not shown), for example. The medical image management apparatus 3 is preferably a WS (workstation) provided in an examination room where a doctor is resident. The WS that operates as the medical image management apparatus 3 may be configured to control activation of each image generation apparatus 2, processing conditions, and the like.

  In general, DICOM (Digital Image and Communications in Medicine) standard is used as a communication method in a hospital, and DICOM MWM (Modality Worklist Management) or DICOM MPPS (DICOM MPPS) is used for communication between devices connected to a LAN. Modality Performed Procedure Step) is used. Note that the communication method applicable to this embodiment is not limited to this. In addition, a device that does not comply with the DICOM standard may be included in devices connected to the LAN. In the present embodiment, the CR reading device 2d does not support the DICOM standard.

For example, in a small-scale medical facility such as a practitioner or a clinic, each device is arranged as shown in FIG.
That is, when entering the entrance 10, there are a reception 11 and a waiting room 12 for receiving a patient. The receptionist 11 is arranged with a counter person in charge, and the person in charge gives a reception number tag printed with a reception number for distinguishing individual patients in the order of reception, for example. The reception device 11 is provided with a reception device 4, and the window manager listens to the patient's name, and inputs the correspondence between the reception number and the patient name to the reception device 4.

  Next to the waiting room 12, there is provided an examination room 13 where a doctor examines and diagnoses a patient across a door or the like. For example, on the examination desk (not shown) in the examination room 13, for the diagnosis by the doctor, a photographed image obtained by photographing the diagnosis target part of the patient, a test result regarding the examination performed on the patient, and the like. A medical image management apparatus 3 (server combined machine 3a described later) to be displayed is arranged. In the examination room 13, an ultrasonic diagnostic apparatus 2a which is less necessary in a space isolated from the viewpoint of privacy and the like is also installed.

  In addition, a radiation imaging room 15 for performing radiation imaging is provided on the opposite side of the examination room 13 across the corridor 14. In the radiation imaging room 15, a radiation imaging apparatus 22 that captures an image using a CR cassette and a CR reader 2d that reads an image from the CR cassette on which the image is recorded are disposed. Further, an examination room 16 is provided next to the radiation imaging room 15, and an endoscope 2 b and an electrocardiogram recording device 2 c are disposed in the examination room 16. Although not shown, a medical image management apparatus 3 (a reference machine 3b to be described later) is disposed in each of the radiation imaging room 15 and the examination room 16.

  Hereinafter, each apparatus which comprises the small-scale diagnosis system 1 is demonstrated.

The image generation apparatus 2 captures an image of a patient's diagnosis target region as a subject, digitally converts the captured image to generate image data of the captured image (captured image information), or records a predetermined examination result to record an image. This is image generation means (modality) for generating data.
As shown in FIG. 1, in this embodiment, as an image generation device (modality) 2, an ultrasound diagnostic device (US) 2a, an endoscope (ES) 2b, an electrocardiogram recording device (ECG) 2c, and a CR reading device 2d are used. It has. The image generation device 2 is not limited to this, and for example, a CT imaging device (CT), a magnetic resonance imaging device (MRI), or the like may be provided as the image generation device 2. In addition, a digital camera or the like that captures the appearance of the body such as skin may be used as the image generation device 2.
Furthermore, it is good also as a structure provided with two or more image generation apparatuses 2 of the same kind, for example including two CR readers 2d. Further, the combination of the image generation devices 2 provided in the small-scale diagnosis system 1 is not limited to the one exemplified here.

  The ultrasonic diagnostic apparatus 2a is an ultrasonic probe that outputs ultrasonic waves, and an electronic device that is connected to the ultrasonic probe and converts sound waves (echo signals) received by the ultrasonic probe into image data of a captured image of the internal tissue. (Both not shown). The ultrasonic diagnostic apparatus 2a sends an ultrasonic wave from the ultrasonic probe into the body, receives the sound wave (echo signal) reflected by the body tissue again by the ultrasonic probe, and uses the electronic device to capture a captured image corresponding to the echo signal. It is designed to generate.

  The ultrasonic diagnostic apparatus 2 a is connected to a conversion device 21 that is a conversion means (converter) that performs conversion from an analog signal to a digital signal. The ultrasonic diagnostic apparatus 2 a is connected to the network 5 via the conversion device 21. It is connected to the. Thus, even when data in a format that does not conform to the standards (for example, communication protocol) of other external devices connected to the network 5 is output from the ultrasonic diagnostic apparatus 2a, the conversion apparatus 21 appropriately converts the data. Thus, data can be transmitted / received to / from an external device connected to the network 5.

  In the present embodiment, the conversion device 21 has a function of giving a UID (unique ID) for specifying image data in the small-scale diagnosis system 1 to the image data in a format conforming to the DICOM standard. The UID is composed of identification information (hereinafter referred to as “modality ID”) of the image generation device 2, numbers indicating the shooting date and time, and the like. In this embodiment, it is assumed that the modality ID includes information indicating the type of the image generation device 2.

The conversion device 21 includes an input unit (not shown) such as a keyboard having character input keys, numeric input keys, and the like, and also serves as input means for inputting patient information for specifying a patient to be imaged. ing.
Here, patient information includes the patient's patient ID, patient name (kanji / kana / ASCII), patient's gender, date of birth, age, etc., as well as the patient's medical date, imaging time, reception number, physician in charge, etc. The patient information widely included in the information specifying the patient is, for example, the patient ID, the patient name, the sex, and the date of birth. Note that it is not necessary to input all of these in the conversion device 21, and no patient information may be input. When the conversion device 21 is designed to input only the patient ID as patient information, the input unit of the conversion device 21 may be a numeric keypad, for example.

  The UID and patient information given by the conversion device 21 become supplementary information attached to the image data of the generated captured image.

  The endoscope 2b is a tube in which a small photographing device is provided at the distal end portion of a flexible tube (both not shown), and the photographing device includes an objective optical system including, for example, an optical lens and the like. And an imaging unit disposed at the imaging position of the objective optical system, and an illumination unit that is configured by an LED (Light Emitting Diode) or the like and performs illumination necessary for imaging (none of which is shown) . The imaging unit includes a solid-state imaging device such as a CCD (Charge Coupled Device) or a CMOS (Complementary Metal-Oxide Semiconductor), and photoelectrically converts it into an electrical signal having an amount corresponding to the amount of incident light. The objective optical system is configured to condense an area illuminated by the illuminating unit with an optical lens and form an image on a solid-state imaging device included in the imaging unit, and light incident on the solid-state imaging device is photoelectrically converted. As a result, the image data of the captured image is output as an electrical signal.

  The electrocardiogram recording device 2c acquires and records waveform data by detecting an electrocardiogram waveform, and transmits the generated image data (waveform data) to the medical image management device 3.

The CR reader 2d reads image data from a CR cassette (not shown), which is a radiographic image conversion medium in which radiographic image information obtained by imaging a diagnostic target region is recorded.
The CR cassette incorporates a radiation image conversion plate including a stimulable phosphor sheet that accumulates radiation energy, for example, and is irradiated from a radiation source (not shown) of the radiation imaging apparatus 22 (see FIG. 3) during imaging. It is arranged in the radiation irradiation area. The CR cassette accumulates an amount of radiation in the stimulable phosphor layer of the stimulable phosphor sheet in accordance with the radiation transmittance distribution of the site to be diagnosed when irradiated with radiation. Record the radiological image information of the site to be diagnosed.

The CR reader 2d irradiates the stimulable phosphor sheet in the CR cassette loaded in the apparatus with excitation light when the CR cassette in which the radiological image information of the diagnosis target region is recorded is loaded. The stimulated light emitted from the sheet is photoelectrically converted, and the obtained image signal is A / D converted to generate image data of a photographed image.
The CR reading device 2d may be an integrated device integrated with the radiation imaging device 22.

Note that the endoscope 2b, the electrocardiogram recording device 2c, and the CR reading device 2d are provided with a function of assigning the above-described UID to the generated image data.
The endoscope 2b and the electrocardiogram recording apparatus 2c include an input unit (not shown) such as a keyboard having character input keys, numeric input keys, and the like, and patient information for specifying a patient to be imaged. Input is possible.
In addition, the patient information input in the input part of each apparatus is not specifically limited, It can also be set as not inputting patient information at all. In the case where the apparatus has a specification for inputting only a patient ID as patient information, the input unit may be a numeric keypad, for example.
The UID and patient information become incidental information attached to the image data of the captured image generated by each image generation device 2.

As shown in FIG. 2, the image data transmitted from the ultrasound diagnostic apparatus 2a via the conversion apparatus 21 and the image data transmitted from the endoscope 2b and the electrocardiogram recording apparatus 2c are all in accordance with the DICOM standard. DICOM image data. In DICOM image data, there is a case where patient information such as a patient ID for identifying a patient is attached and a case where patient information is not attached.
Further, the image data generated by the CR reading device 2d is CRRaw image data that does not conform to the DICOM standard, and this image data is transmitted to the medical image management device 3 without patient information such as a patient ID. .

  As shown in FIG. 2, the medical image management apparatus 3 includes a server combined machine 3a including an image DB management unit 38 (see FIG. 4) that stores patient information and image data in association with each other, and the server combined machine 3a. And a reference machine 3b that can refer to the image DB management unit 38 of the server combined machine 3a.

Each of the server combined machine 3a and the reference machine 3b is a computer including a control unit 31, a storage unit 32 (see FIG. 4), and the like, for example, an examination room 13 in which a doctor examines a patient and each image generation device 2 Is installed in the inspection room 16 or the like. The server combined machine 3a and the reference machine 3b can share data stored in the image DB management unit 38, and the image data and the patient information are associated with each other and newly written in the image DB management unit 38. Is a client machine that can display images and perform interpretation, diagnosis, and the like.
The medical image management apparatus 3 may include a monitor with a higher definition than a monitor (display unit) used in a general PC (Personal Computer).

FIG. 4 is a principal block diagram showing a functional configuration of the medical image management apparatus 3 (server combined machine 3a).
As shown in FIG. 4, the medical image management apparatus 3 (server combined machine 3a) includes a control unit 31, a storage unit 32, an input unit 33, a display unit 34, and a communication unit 35 configured by a CPU (central processing unit) or the like. , I / F 36, image DB management unit 38, etc., and each unit is connected by a bus 40. The reference machine 3b has the same configuration as the server combined machine 3a shown in FIG. 4 except that the image DB management unit 38 is not provided.

The storage unit 32 includes a ROM (read only memory), a RAM (Random Access Memory), etc. (not shown).
The ROM includes, for example, an HDD (Hard Disk Drive), a semiconductor non-volatile memory, and the like. Various programs are stored in the ROM, and image data of the captured image is adjusted to an image quality suitable for diagnosis. Image processing parameters (a look-up table defining a gradation curve used for gradation processing, frequency processing enhancement degree, etc.) and the like are stored.
The RAM forms a work area that temporarily stores various programs, input or output data, parameters, and the like that are read from the ROM and executed by the control unit 31 in various processes that are executed and controlled by the control unit 31. . In the present embodiment, the RAM temporarily stores image data, patient information, and the like received from the image generation device 2.
In the present embodiment, the storage unit 32 functions as a patient information storage unit that stores patient information of a patient.

  The control unit 31 reads various programs such as system programs and processing programs stored in the ROM, expands them in the RAM, and executes various processes including patient information association processing described later according to the expanded programs. It is a control means of the image management apparatus 3.

  The input unit 33 includes a keyboard having character input keys, numeric input keys, various function keys, and the like, and a pointing device such as a mouse, and a key pressing signal pressed by the keyboard and an operation signal by the mouse. To the control unit 31 as an input signal.

The display unit 34 includes, for example, a monitor such as a CRT (Cathode Ray Tube) or an LCD (Liquid Crystal Display), and displays various screens according to instructions of a display signal input from the control unit 31. It functions as a display means.
A pressure sensitive (resistive film pressure type) touch panel (not shown) in which transparent electrodes are arranged in a grid is formed on the screen of the display unit 34, and the display unit 34 and the input unit 33 are configured integrally. It may be a touch screen. In this case, the touch panel is configured to detect the XY coordinates of the power point pressed with a finger, a touch pen, or the like as a voltage value, and to output the detected position signal to the control unit 31 as an operation signal.

  In the present embodiment, the display unit 34 can display a patient information list screen 341 (see FIG. 5) that displays a list of patient information (patient information list) acquired from the receiving device 4 described later. The patient information list screen 341 includes a search filter column 61 in which a search filter for searching patient information can be set, a patient ID column 62 for inputting a patient ID of a patient to be searched, and a patient name column for inputting a patient name. 63, and the user inputs arbitrary information in each of these fields and then presses the search start button 64 (operates the search start button on the screen with the input unit 33 such as a mouse), and thereby the desired information is displayed. Patient information can be searched and extracted. Further, when it is desired to perform a search by inputting more detailed conditions, a detailed search condition can be set by pressing a detailed search button 65.

  As shown in FIG. 5, in this embodiment, the patient information list screen 341 includes a medical date, reception time, reception number, medical fee, doctor in charge, patient ID, patient name, patient name (kanji / kana / ASCII) ), Patient information such as gender, date of birth, and age is displayed as a list. In addition, the content displayed on the patient information list screen 341 is not limited to what was illustrated here. Only a part of them may be displayed, or more items may be displayed.

When a patient is selected by selecting an arbitrary patient column from the patients displayed on the patient information list screen 341 (selecting an arbitrary patient column on the screen with the input unit 33 such as a mouse), The display screen of the display unit 34 transitions to a patient display screen 342 (see FIG. 6) corresponding to the selected patient.
As described above, in this embodiment, the patient to be examined can be selected from the patient information list screen 341 of the display unit 34.

  As shown in FIG. 6, the patient display screen 342 has a patient display column 71 for displaying the patient ID and patient name of the selected patient, and it is possible to visually recognize which patient display screen 342 is currently displayed. It is like that. If the list screen button 72 is operated, the patient information list screen 341 can be returned.

The patient display screen 342 is provided with an image display field 73 for displaying an image and a thumbnail display field 74 for displaying a thumbnail of the image.
The patient display screen 342 is provided with an image data selection button 75 for selecting image data for the patient. By selecting desired image data with the image data selection button 75, the image can be displayed in the image display column 73 and the thumbnail display column 74. The image data selection button 75 can be switched by the display classification switching button 76 according to the classification according to the date or the type of the image generation apparatus (modality) 2.

  In addition, the patient display screen 342 is provided with an examination hold button 77 for inputting that the examination of the patient image is to be suspended, and an examination end button 78 for inputting the end of the examination.

The patient display screen 342 is provided with an image capture button 81 for capturing image data from an external device. The image capture button 81 includes an image capture button 81a for capturing image data from various image generation devices 2 connected to the network 5, and an image capture button 81b for capturing image data from various devices such as a digital camera. .
In the present embodiment, the image capture button 81a is the type of the image generation device 2 connected to the network 5 (ultrasound diagnosis device (US) 2a, endoscope (ES) 2b, electrocardiogram recording device (ECG) 2c, Corresponding to the CR reader 2d), four types of "CR", "US", "ES", and "ECG" are arranged on the patient display screen 342.
In addition, when other image generation apparatuses 2 are connected to the network 5, an image capture button 81 corresponding to the image generation apparatus 2 is provided.

  The image capture button 81 is used to specify (specify) a patient associated with the image data generated by the image generation device 2. When one of the image capture buttons 81 is pressed (operated) by the input unit 33 on the patient display screen 342, a patient to be associated when the image data is captured is displayed on the patient display screen 342. Designated (identified) by the patient. When the patient is designated, the image data transmitted from the image generation device 2 to the medical image management device 3 is associated with the patient information of the designated patient. The image data associated with the patient information of the patient is stored in the confirmed image area 38a of the image DB management unit 38. An image based on the image data is displayed in the image display field 73 of the patient display screen 342 of the patient, and a thumbnail image of the image is displayed in the thumbnail display field 74 (see FIG. 7).

  In addition, the patient display screen 342 is provided with an image output button 82 for outputting the captured image by printing, mail transmission, etc., a display switching button 83 for switching the display of the layout of the image display field, and the like. .

In addition, the patient display screen 342 is provided with an unconfirmed image reception button 84 for notifying that an unconfirmed image has been received. The undetermined image reception button 84 is displayed on the patient display screen 342 when an undetermined image is stored in the undetermined image area 38b by patient information association processing described later.
Thus, in the present embodiment, the patient associated with the image data can be specified by pressing the image capture button 81 by the input unit 33 on the patient display screen 342 of the display unit 34.

When the unconfirmed image reception button 84 is pressed, the display screen of the display unit 34 transitions to an unconfirmed image confirmation screen 343 (see FIG. 8).
As shown in FIG. 8, the unconfirmed image confirmation screen 343 can visually recognize a list of unconfirmed images and a patient list. An indeterminate image refers to image data that has not been associated with patient information by patient information association processing described below. The patient information list screen 341 displayed on the unconfirmed image confirmation screen 343 is the same as the patient information list screen 341 shown in FIG.

The unconfirmed image confirmation screen 343 displays a number display field 91 for displaying a number assigned to each unconfirmed image, a thumbnail display field 92 for displaying a thumbnail of the unconfirmed image, and a time when the unconfirmed image is stored. A time display column 93 and a reason display column 94 for displaying the reason for determining that the image is an unconfirmed image are provided.
The unconfirmed image confirmation screen 343 is provided with an unconfirmed image association button 95 for associating an unconfirmed image with patient information. When the input unit 33 selects an unconfirmed image, selects a patient to be associated with the unconfirmed image from the patient list, and presses the unconfirmed image association button 95, the image data of the unconfirmed image is selected. Patient information is associated and can be stored in the confirmed image area 38a.
As described above, in this embodiment, the patient to be associated with the image data can be designated by pressing the unconfirmed image association button 95 on the unconfirmed image confirmation screen 343 of the display unit 34. Patient information association input means is configured.

The communication unit 35 is configured by a network interface or the like, and transmits / receives data to / from an external device such as various image generation devices 2 connected to the network 5 via a switching hub.
In the present embodiment, the communication unit 35 acquires a patient information list created (updated) by the receiving device 4 described later from the receiving device 4.

  The I / F 36 includes the medical image management apparatus 3 when there are a plurality of medical image management apparatuses 3 (for example, as shown in FIG. 2, when there is one server combined machine 3a and two reference machines 3b). This is an interface that connects the devices and controls data transmission / reception between the medical image management apparatuses 3.

The image DB management unit (Data Base) 38 is configured by an HDD or the like, and stores image data of captured images in association with patient information.
As illustrated in FIG. 4, the image DB management unit 38 associates the confirmed image region 38 a functioning as a storage unit that stores image data of the confirmed image associated with the patient information of the patient with the patient information of the patient. And an undetermined image area 38b that functions as a temporary storage unit that stores image data of an undetermined image that has not been performed.

  The reception device 4 is a computer device for performing registration, accounting, insurance score calculation, etc. of patients who come to the hospital, and is composed of a storage unit composed of a CPU, ROM, RAM, etc., an input composed of a keyboard, a mouse, etc. , A display unit configured by a CRT, an LCD, and the like, a communication unit (none of which is shown) that controls communication with each device connected to the network 5, and the like. When receiving a reception input screen is instructed from the input unit, the reception device 4 displays a reception input screen (not shown) on the display unit by software processing in cooperation with the CPU and a program stored in the storage unit. When reception information (reception number + patient name) is input by the input unit via the reception input screen, a patient information list of the received patient is created (updated), stored in the storage unit, and appropriately transmitted by the communication unit. It transmits to the medical image management apparatus 3.

  Next, the flow of diagnosis for one patient in a small-scale facility to which the small-scale diagnosis system 1 is applied will be described.

  When the patient comes to the hospital, a reception number tag is given to the patient at the reception 11, and various patients constituting the patient information list such as the patient reception number and the patient name received by the operation of the input unit at the reception device 4. Information input (acceptance input) is performed. In the reception device 4, when a patient reception number, patient information, and the like are input, a list of patient information (patient information list) is generated (updated) and stored in a predetermined area of the RAM. The patient information list is generated, for example, when the first patient of the day is received and inputted, stored in a predetermined area of the RAM, and updated to a new patient information list every time the next patient is received and inputted.

  When the patient to whom the reception number is assigned moves to the examination room 13, an inquiry is performed by a doctor, and imaging and examination to be performed are determined.

When it is determined that the affected part needs to be photographed by the inquiry, the doctor displays the patient information list screen 341 on the display unit 34 of the medical image management apparatus 3 and selects the patient information of the patient to be examined. The patient display screen 342 of the patient is displayed. In addition, a radiographer such as a radiographer or a nurse performs imaging of a patient by using the image generation apparatus 2 (an ultrasonic diagnostic apparatus 2a, an endoscope 2b, an electrocardiogram recording apparatus 2c, or a CR reading apparatus 2d). The patient is taken forward, the patient's diagnosis target part is photographed as a subject, and image data of the photographed image is generated. For example, when the image generation device 2 is the CR reading device 2d, the radiation imaging device 22 performs imaging, the CR cassette that has been imaged by the radiation imaging device 22 is set in the CR reading device 2d, and the radiation image recorded in the CR cassette is recorded. Read. When the image generation apparatus 2 performs shooting and generation of image data in accordance with the operation of the camera operator, the above-described UID is assigned to the generated image data. Further, in the case of an apparatus conforming to the DICOM standard such as the endoscope 2b, when patient information is input, UID and patient information are added to the generated image data.
The image data generated by each image generation device 2 is transmitted to the medical image management device 3 together with accompanying information such as UID and patient information.

When image data is transmitted from the image generation device 2 to the medical image management device 3, the control unit 31 of the medical image management device 3 associates the image data with the patient information of the patient stored in the storage unit 32. Perform the association process. In this embodiment, the medical image management apparatus 3 displays a captured image based on the image data on the patient display screen 342 (FIG. 7) of the patient by associating the image data with any patient, It becomes a state where diagnosis and the like can be performed.
When the image data is associated with the patient and the image data can be displayed on the patient display screen 342, the doctor displays the captured image received from the image generation device 2 on the display unit of the medical image management device 3. 34 is displayed and referred to for interpretation and patient examination.

Here, the patient information association processing in the present embodiment will be described with reference to FIGS. 9 to 14.
As shown in FIG. 9, when receiving the image data, the control unit 31 determines whether or not the image data is a DICOM image (step S1). If the received image data is a DICOM image (step S1; YES), the control unit 31 determines whether or not a patient ID is attached to the image data as patient information (step S2). When the patient ID is attached to the image data (step S2: YES), the control unit 31 includes the patient ID attached to the image data in the patient information of the patient stored in the storage unit 32. It is further determined whether there is a match (step S3).

  If the patient ID does not match the patient ID of any patient stored in the storage unit 32 (step S3: NO), the control unit 31 determines that the image data is an unconfirmed image, and the patient ID is The reason information indicating that the image is determined to be an indeterminate image because they do not match is associated with the image data (step S4).

  When the patient ID matches the patient ID of any patient stored in the storage unit 32 (step S3: YES), as shown in FIG. 10, the control unit 31 adds the patient name ( It is determined whether or not a Chinese character (hereinafter referred to as “Kanji name”) is attached (step S51). When the kanji name is attached to the image data (step S51: YES), the control unit 31 further determines whether or not the kanji name is included in the patient information in the storage unit 32 with the matching patient ID. Judgment is made (step S52). If the corresponding patient information includes a kanji name (step S52: YES), the control unit 31 determines whether or not the kanji name matches the kanji name attached to the image data (step S52). S53). If the kanji name attached to the image data does not match the kanji name included in the patient information in which the patient ID in the storage unit 32 matches (step S53: NO), the control unit 31 Is determined as an unconfirmed image, and reason information indicating that it is determined as an unconfirmed image because the names of the Chinese characters do not match is associated with the image data (step S54).

  When the kanji name is not attached to the image data (step S51: NO), the kanji name is attached but the corresponding patient information in the storage unit 32 does not include the kanji name (step S52). : NO), and if the kanji name attached to the image data matches the kanji name included in the patient information in the storage unit 32 (step S53: YES), the control unit 31 proceeds to step S54. Skip processing.

  Next, as shown in FIG. 11, the control unit 31 determines whether or not a patient name (kana: hereinafter referred to as “kana name”) is attached to the image data (step S61). If the image data includes a Kana name (step S61: YES), the control unit 31 further includes the Kana name in the patient information in the storage unit 32 with the matching patient ID. It is determined whether or not (step S62). If the corresponding patient information includes the Kana name (step S62: YES), the control unit 31 determines whether or not the Kana name also matches the Kana name attached to the image data (Step S63). ). If the Kana name attached to the image data does not match the Kana name included in the patient information in the storage unit 32 (step S63: NO), the control unit 31 sets the image data as an unconfirmed image. The reason information indicating that it is determined as an indeterminate image because the names of Kana do not match is associated with the image data (step S64).

  If the image data does not include the Kana name (step S61: NO), if the Kana name is included but the corresponding patient information in the storage unit 32 does not include the Kana name (step S62: NO), and if the Kana name attached to the image data matches the Kana name included in the patient information in the storage unit 32 (step S63: YES), the control unit 31 performs the process of step S64. To skip.

  Next, as shown in FIG. 12, the control unit 31 determines whether or not a patient name (ASCII: hereinafter referred to as “ASCII name”) is attached to the image data (step S71). When the ASCII name is attached to the image data (step S71: YES), the control unit 31 further determines whether or not the ASCII name is included in the patient information in the storage unit 32 with the matching patient ID. Judgment is made (step S72). When the ASCII name is included in the corresponding patient information (step S72: YES), the control unit 31 determines whether the ASCII name also matches the ASCII name attached to the image data (step S72). S73). If the ASCII name attached to the image data does not match the ASCII name included in the patient information in the storage unit 32 (step S73: NO), the control unit 31 sets the image data as an unconfirmed image. The reason information indicating that the image is determined as an indeterminate image because the ASCII names do not match is associated with the image data (step S74).

  When the ASCII name is not attached to the image data (step S71: NO), when the ASCII name is attached but the corresponding patient information in the storage unit 32 does not include the ASCII name (step S72: NO), and when the ASCII name attached to the image data matches the ASCII name included in the patient information in the storage unit 32 (step S73: YES), the control unit 31 skips step S74. .

  Next, as shown in FIG. 13, the control unit 31 determines whether or not the image data is accompanied by birth date information (hereinafter simply referred to as “birth date”) (step S81). When the date of birth is attached to the image data (step S81: YES), the control unit 31 further includes the date of birth in the patient information in the storage unit 32 with the matching patient ID. It is determined whether or not (step S82). When the corresponding patient information includes the date of birth (step S82: YES), the control unit 31 determines whether or not the date of birth also matches the date of birth attached to the image data ( Step S83). If the date of birth attached to the image data does not match the date of birth included in the patient information in the storage unit 32 (step S83: NO), the control unit 31 does not store the image data. It is determined as a confirmed image, and reason information indicating that it is determined as an indeterminate image because the date of birth does not match is associated with the image data (step S84).

  When the date of birth is not attached to the image data (step S81: NO), the date of birth is attached but the date of birth is not included in the corresponding patient information in the storage unit 32. (Step S82: NO), and when the date of birth attached to the image data matches the date of birth included in the patient information in the storage unit 32 (Step S83: YES), the control unit 31 performs the step S84 is skipped.

  Next, as shown in FIG. 14, the control unit 31 determines whether or not gender information (hereinafter simply referred to as “gender”) is attached to the image data (step S91). When sex is attached to the image data (step S91: YES), the control unit 31 further determines whether or not gender is included in the patient information in the storage unit 32 with the matching patient ID. (Step S92). When gender is included in the corresponding patient information (step S92: YES), it is determined whether or not the gender matches the gender attached to the image data (step S93). When the gender incidental to the image data does not match the gender included in the patient information in the storage unit 32 (step S93: NO), the control unit 31 sets the image data as an undetermined image. The reason information indicating that the image is determined to be an indeterminate image because the gender does not match is associated with the image data (step S94).

Next, the control unit 31 determines whether or not reason information indicating that the image data is determined to be an indeterminate image is associated (FIG. 9: step S10). When the reason information is not associated with the image data (step S10: NO), the control unit 31 associates the image data with the patient with the matching patient ID in the storage unit 32 and sets it as a confirmed image. The image is stored in the confirmed image area 38a of the image DB management unit 38 (step S11).
When the reason information is associated with the image data (step S10: YES), the control unit 31 determines that the image data is an undetermined image, and associates the image data with the image data. The reason information is stored in the undetermined image area 38b of the image DB management unit 38 (step S14).

On the other hand, when the image data is not a DICOM image (step S1: NO), or when the patient ID is not attached to the image data (step S2: NO), as shown in FIG. In any one of the client machines including the dual-purpose machine 3a and the reference machine 3b, it is determined whether or not the image capture button 81 is pressed (step S12). In any client machine, when the image capture button 81 is pressed (step S12: YES), the control unit 31 associates the image data with the patient information of the patient specified by the image capture button 81. Then, it is stored in the confirmed image area 38a of the image DB management unit 38 as a confirmed image (step S13).
On the other hand, when the image capture button 81 is not pressed in any client machine (step S12: NO), the control unit 31 determines that the image data is an indeterminate image, and the image capture button has not been pressed. Reason information indicating that it is determined to be a confirmed image is associated with the image data (step S14).

After associating the image data determined to be an indeterminate image with the reason information, the control unit 31 displays the image data and the reason information associated with the image data as the undetermined image region 38b of the image DB management unit 38. (Step S15).
And the unconfirmed image reception button 84 is displayed on the patient display screen 342 currently displayed on the display part 34 (step S16), and a process is complete | finished.

  Next, the undetermined image association processing in the present embodiment will be described with reference to FIG. The undetermined image association process is executed when the undetermined image association button 84 displayed on the patient display screen 342 is pressed.

As shown in FIG. 15, the control unit 31 displays an unconfirmed image confirmation screen 343 on the display unit 34 (step S151). Next, when selecting patient information to be associated with image data that has become an undetermined image by the input unit 33 and pressing the undetermined image association button 95 (step S152), the control unit 31 selects the image data of the selected undetermined image. And the patient information are associated with each other and stored as a confirmed image in the confirmed image region 38a of the image DB management unit 38 (step S153), and the image data is deleted from the undetermined image region 38b of the image DB management unit 38 (step S154). ). At this time, if there are no more undetermined images in the undetermined image area 38b, the undetermined image association button 84 displayed on the patient display screen 342 is deleted.
Next, the control unit 31 determines whether or not an end is instructed by the input unit 33 (step S155). When the end is not instructed by the input unit 33 and another unconfirmed image and patient information are selected (step S155: NO), the control unit 31 returns to the process of step S152 and the end is instructed (step S155: NO). Step S155: YES), the process ends.

  As described above, according to the present embodiment, when CRRAW image data without patient information is sent from the CR reading device 2d, or patient information is received from various image generating devices 2 in accordance with the DICOM standard. Even when DICOM image data not attached is sent, when a patient to be associated with image data is designated, it can be associated with patient information of the designated patient. In addition, the user can know why the image data has become an indeterminate image by associating the image data that has become an indeterminate image with the reason information that the image data has become indeterminate and displaying it. . As a result, the user can efficiently make a determination for associating the undetermined image with the patient information.

In the present embodiment, first, it is determined whether or not a patient ID is attached to the image data received from the image generating apparatus 2 received from the image generating apparatus 2, and the patient ID is attached to the image data. However, the patient information is associated with the patient information stored in the storage unit 32, but the patient information association process is not limited to this. For example, when the image capture button 81 of any client machine is pressed, the patient information and image data of the patient selected / designated by the client machine without determining whether or not the patient ID is given May be configured to be associated with each other.
With this configuration, there are many cases of shooting using a CR cassette, or cases where image data is often transmitted without assigning a patient ID even when using the DICOM standard-compliant image generation device 2 When there are few client machines and there is little possibility of an error in the correspondence between image data and patient information without checking the patient ID, the processing can be simplified according to the circumstances of the facility.

  In the present embodiment, the patient list similar to the patient information list screen 341 is displayed on the unconfirmed image confirmation screen 343, but the way of displaying the patient information is not limited to this. For example, it may be possible to automatically search and display only the patients whose examination date matches the date on which the unconfirmed image is received, or to display only the patients who have been photographed with the same modality as the unconfirmed image. You may do it.

  In the present embodiment, when an unconfirmed image is received, the unconfirmed image association button 84 is displayed on the patient display screen 342 to notify the user, but the unconfirmed image is received. The notification means to the user in this case is not limited to this. For example, a button similar to the unconfirmed image association button 84 may be displayed on the patient information list screen 341, or a pop-up menu screen is activated, and an input from the screen causes the unconfirmed image confirmation screen 343 to be displayed. It may be possible to make a transition.

  In this embodiment, the CR reading device 2d is not provided with an input means for inputting patient information. However, the CR reading device 2d may be provided with an input means for inputting patient information. Good.

  In the present embodiment, the image data associated with the patient information is stored in the image DB management unit 38 of the medical image management apparatus 3, but the storage means for storing the image data is not limited to this. For example, it may be stored in an external storage device or a removable storage means.

In the present embodiment, the patient information list screen 341 and the input unit 33 constitute a patient selection means. By selecting an arbitrary patient from the list displayed on the patient information list screen 341, the patient display screen 342 is displayed. Although the case where it changed to was demonstrated to the example, a patient selection means is not limited to this.
For example, a patient search screen having an information input field for inputting information serving as a search key is displayed, and a patient ID, a patient nomination, and the like are input from the input unit 33 to the information input field, and the corresponding patient is searched. The patient display screen 342 may be transitioned to. In this case, the patient search screen and the input unit 33 constitute patient selection means.

In the present embodiment, the medical image management apparatus 3 has a configuration in which two reference machines 3b are connected to the server combined machine 3a. However, the configuration of the medical image management apparatus 3 is limited to this. Not. For example, the medical image management apparatus 3 may be configured by only the server combined machine 3a, or may be configured by connecting three or more reference machines 3b.
Further, the arrangement of the server combined machine 3a and the reference machine 3b is not limited to that shown in FIG. 3. For example, one of the reference machines 3b may be installed in the reception 11. Further, one medical image management apparatus 3 may be installed corresponding to each image generation apparatus 2.

    In addition, the present invention is not limited to the above-described embodiment, and can be changed as appropriate.

It is a figure showing the example of whole composition of small scale diagnostic system 1 in this embodiment. It is explanatory drawing which shows typically the flow of the image data between the main apparatuses which comprise the small-scale diagnosis system 1 shown in FIG. It is a figure which shows the example of arrangement | positioning in the medical facility of each apparatus at the time of applying the small-scale diagnosis system 1 shown in FIG. It is a principal part block diagram which shows the functional structure of the medical image management apparatus applied to the small-scale diagnosis system 1 shown in FIG. It is a figure which shows an example of the patient information list screen displayed on the display part of FIG. It is a figure which shows an example of the patient display screen displayed on the display part of FIG. It is a figure which shows an example of the patient display screen of FIG. It is a figure which shows an example of the unconfirmed image confirmation screen displayed on the display part of FIG. It is a flowchart which shows the patient information matching process performed by the control part of FIG. It is a flowchart which shows the content of the process A among the patient information matching processes of FIG. It is a flowchart which shows the content of the process B among the patient information matching processes of FIG. It is a flowchart which shows the content of the process C among the patient information matching processes of FIG. It is a flowchart which shows the content of the process D among the patient information matching processes of FIG. It is a flowchart which shows the content of the process E among the patient information matching processes of FIG. It is a flowchart which shows the undetermined image confirmation process performed by the control part of FIG.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Small-scale diagnostic system 2 Image generation apparatus 2a Ultrasound diagnostic apparatus 2b Endoscope 2c Electrocardiogram recording apparatus 2d CR reader 3 Medical image management apparatus 4 Reception apparatus 5 Network 21 Conversion apparatus 22 Radiography apparatus 31 Control part 32 Storage part 33 Input unit 34 Display unit 341 Patient information list screen 342 Patient display screen 343 Unconfirmed image confirmation screen 35 Communication unit 36 I / F
38 Image DB management unit 38a Determined image area 38b Undefined image area 40 Bus

Claims (4)

It is connected to an image generation device that generates image data related to a patient so that data can be transmitted and received,
Display means for displaying the image data;
Storage means for storing the image data;
Temporary storage means for temporarily storing the image data;
Patient information storage means for storing patient information of a patient to be examined;
Based on a predetermined criterion, the image data transmitted from the image generation device is stored in the storage unit in association with any of the patient information stored in the patient information storage unit, or the patient information Control means for determining whether to store in the temporary storage means without associating, and associating reason information indicating the reason for the determination with the image data not associated with the patient information;
A medical image management apparatus comprising:   The medical image management apparatus according to claim 1, wherein the control unit causes the display unit to display the image data stored in the temporary storage unit together with the reason information. A patient information association input means for inputting the association between the image data stored in the temporary storage means and patient information;
The control means causes the patient information association input means to store the image data associated with the patient information in the storage means and delete the image data from the temporary storage means. The medical image management apparatus according to 2. Patient information is attached to the image data,
The said control means compares the patient information incidental to the said image data with the patient information memorize | stored in the said patient information storage means, The said determination is performed based on this comparison result, The any one of Claims 1-3. The medical image management apparatus according to Item.

Images