JP2009232970A - Medical image managing device, printed image order setting method and program - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To print a plurality of medical images collectively without changing the order of radiography if the plurality of medical images are selected as objects for printing from a series of medical images captured by the serial radiography. <P>SOLUTION: According to the medical image managing device 3, if a medical image is selected by the operation of a control part 34 from candidates for printing displayed in an output image selection column of a printing screen (an imager printing screen 354 and a universal printing screen 355) while other medical images are already selected as objects for printing, the order of printing of the selected medical images is set so that the selected medical image and the already selected other medical images continue in the order of thumbnails displayed in the output image selection column. If medical images belonging to the series of medical images captured by the serial radiography are included in the thumbnails, the order of the thumbnails continues in the order of the medical images belonging to the series of the medical images captured by the serial radiography. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to a medical image management apparatus, a print image order setting method, and a program.

Conventionally, various techniques have been proposed for a user to specify an image to be output to a printer or the like and an output order. For example, in Patent Document 1, in a copying machine or the like, a thumbnail image of a series of images read by an image reading device is displayed on a display unit, and a thumbnail image displayed by a user is dragged and dropped to a predetermined position. A technique that enables selection of an image to be output, specification of an output order, specification of an output layout, and the like is described.
JP-A-11-252326

  By the way, in the medical field, a diagnostic target region of a patient is imaged using an image generation device such as CR (Computed Radiography), CT (Computed Tomography), MRI (magnetic resonance imaging), or endoscopic imaging device. Interpretation diagnosis is performed in which a medical image is interpreted by a doctor. In recent years, interpretation work on a monitor has become common, and on a diagnostic screen for interpretation, a doctor uses a mouse, keyboard, or other operation means to perform medical images necessary for diagnosis from among the captured medical images. The images are rearranged as appropriate, and the images used for diagnosis are displayed in a display order that is easy to diagnose, and interpretation diagnosis is performed.

  The medical image used for the interpretation diagnosis is printed on a film by an imager for delivery to another medical facility, or is printed on a paper by a printer for informed consent to a patient. Conventionally, when a medical image is printed by an imager, a printer, or the like, an image to be printed is selected on a print screen and a layout or the like is designated. For example, thumbnail images of captured medical images are displayed in chronological order on the print screen, and it is common to select a medical image to be printed from the displayed thumbnail images using an operation means such as a mouse. Is.

  Here, in a small medical facility such as a medical practitioner, there is a demand for mixing medical images captured by a plurality of types of image generation apparatuses on one film for the purpose of reducing film costs. At this time, handling of a series of medical images obtained by continuously photographing a certain range of the subject (for example, from the chest to the abdomen) by CT, MRI, or the like becomes a problem.

  That is, the series of medical image groups described above needs to be printed together in the order of photographing. However, when a medical image to be printed is selected by the operation means, the shooting order may be changed depending on the selection order, or may be taken by another image generation device between images belonging to a series of medical images. Some medical images may be inserted. This cannot make an efficient diagnosis.

  An object of the present invention is to enable printing in a lump without destroying the shooting order when a plurality of medical images are selected from a series of medical images acquired by continuous shooting as a print target. is there.

In order to solve the above-mentioned problem, the invention described in claim 1
Display means for displaying a plurality of medical images including a series of medical image groups acquired by continuous imaging;
Storage means for storing the plurality of medical images and the display order of the plurality of medical images to be displayed on the display means;
Operating means for selecting a medical image to be printed from among a plurality of medical images displayed on the display means;
Control means for setting the print order of the medical images selected as the print target by the operation means to be the display order stored in the storage means;
Is provided.

The invention according to claim 2 is the invention according to claim 1,
Among the plurality of medical images stored in the storage unit, the display order of the medical images belonging to the series of medical image groups is continuous in the order of photographing the medical images belonging to the series of medical image groups.

The invention according to claim 3 is the invention according to claim 1 or 2,
An instruction means for instructing a change in the display order of the plurality of medical images stored in the storage means;
The control unit belongs to the series of medical images when the medical image instructed to change the display order by the instruction unit includes a plurality of medical images belonging to a series of medical images acquired by continuous shooting. It is determined whether or not a change in display order is instructed so that a plurality of medical images are consecutive in the photographing order, and the display order is changed so that a plurality of medical images belonging to the series of medical images are consecutive in the photographing order. When it is determined that an instruction is given, the display order instructed by the instruction means is stored in the storage means, and the display order is changed so that a plurality of medical images belonging to the series of medical image groups are consecutive in the photographing order. When it is determined that the instruction is not instructed, the instruction unit does not accept an instruction to change the display order of the plurality of medical images.

The invention according to claim 4 is the invention according to any one of claims 1 to 3,
The control unit causes the display unit to display a print image for each page in which the medical images selected as the print target are arranged based on the print layout in the set print order.

The invention according to claim 5 is the invention according to any one of claims 1 to 4,
The control unit displays a medical image selected as a print target by the operation unit among a plurality of medical images displayed on the display unit in distinction from other unselected medical images.

The invention described in claim 6
A display step of displaying a plurality of medical images including a series of medical image groups acquired by continuous imaging on a display means;
A printing target selection step for selecting a medical image to be printed from among the plurality of displayed medical images by an operation means;
The image order set so that the print order of the medical images selected as the print target by the operation means becomes the display order stored in the storage means for storing the display order of the plurality of medical images to be displayed on the display means. A setting process;
including.

The invention according to claim 7 is the invention according to claim 6,
Among the plurality of medical images stored in the storage unit, the display order of the medical images belonging to the series of medical image groups is continuous in the order of photographing the medical images belonging to the series of medical image groups.

The invention according to claim 8 is the invention according to claim 6 or claim 7,
In the image order setting step, a series of medical images acquired by continuous photographing on a medical image instructed to change the display order by an instruction unit that instructs to change the display order of the plurality of medical images stored in the storage unit. When a plurality of medical images belonging to the image group are included, it is determined whether or not a change in display order is instructed so that the plurality of medical images belonging to the series of medical image groups are consecutive in the photographing order, When it is determined that a display order change is instructed so that a plurality of medical images belonging to the medical image group are consecutive in the photographing order, the display order instructed by the instruction means is stored in the storage means, and the series The display means changes the display order of the plurality of medical images when it is determined that the display order is not instructed so that the plurality of medical images belonging to the medical image group are consecutive in the photographing order. It does not accept the instruction.

The invention according to claim 9 is the invention according to any one of claims 6 to 8,
It further includes a print image display step of displaying, on the display means, a print image for each page in which the medical image selected as the print target is arranged based on the print layout in the set print order.

The invention according to claim 10 is the invention according to any one of claims 6 to 9, wherein
In the display step, a medical image selected as a print target by the operation unit among a plurality of medical images displayed on the display unit is displayed separately from other unselected medical images.

The invention according to claim 11
Computer
Display means for displaying a plurality of medical images including a series of medical image groups acquired by continuous imaging;
Storage means for storing the display order of the plurality of medical images and the plurality of medical images to be displayed on the display means;
Operating means for selecting a medical image to be printed from among a plurality of medical images displayed on the display means;
Control means for setting the print order of the medical images selected as the print target by the operation means to be the display order stored in the storage means;
To function as.

The invention according to claim 12 is the invention according to claim 11,
Among the plurality of medical images stored in the storage unit, the display order of the medical images belonging to the series of medical image groups is continuous in the order of photographing the medical images belonging to the series of medical image groups.

The invention according to claim 13 is the invention according to claim 10 or claim 11,
Further functioning as an instruction means for instructing a change in display order of the plurality of medical images stored in the storage means,
The control unit belongs to the series of medical images when the medical image instructed to change the display order by the instruction unit includes a plurality of medical images belonging to a series of medical images acquired by continuous shooting. It is determined whether or not a change in display order is instructed so that a plurality of medical images are consecutive in the photographing order, and the display order is changed so that a plurality of medical images belonging to the series of medical images are consecutive in the photographing order. When it is determined that an instruction is given, the display order instructed by the instruction means is stored in the storage means, and the display order is changed so that a plurality of medical images belonging to the series of medical image groups are consecutive in the photographing order. Is not instructed, the instruction unit does not accept an instruction to change the display order of the plurality of medical images.

The invention according to claim 14 is the invention according to any one of claims 10 to 13,
The control unit causes the display unit to display a print image for each page in which the medical images selected as the print target are arranged based on the print layout in the set print order.

The invention according to claim 15 is the invention according to any one of claims 10 to 14,
The control unit displays a medical image selected as a print target by the operation unit among a plurality of medical images displayed on the display unit in distinction from other unselected medical images.

  According to the present invention, when a medical image selected as a printing target includes any of a plurality of medical images belonging to a series of medical images acquired by continuous shooting, the series of the continuously shot images. Medical images that do not belong to the medical image group may enter between medical images that belong to the medical image group, or the imaging order between the medical images belonging to the series of medical images that have been continuously captured may be disrupted. This makes it possible to print a plurality of medical images belonging to a series of medical image groups acquired by continuous shooting as a group without changing the shooting order.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. However, the scope of the invention is not limited to the illustrated examples.

[Configuration of small-scale diagnostic system 1]
FIG. 1 is a block diagram showing a system configuration of a small-scale diagnosis system 1 according to the present embodiment, and FIG. 2 shows an arrangement example of each apparatus in a medical facility when the small-scale diagnosis system 1 is applied. is there.

  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 , A CT apparatus 2b, a CR reading apparatus 2c, a medical image management apparatus 3, a receiving apparatus 4, an imager 5, a general-purpose printer 6, and a client PC (Personal Computer) 7. Each device constituting the small-scale diagnosis system 1 is connected to a communication network (hereinafter simply referred to as “network”) 8 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 a small medical facility such as a practitioner or a clinic, each device is arranged as shown in FIG. 2, for example.
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, a medical image management apparatus 3 for displaying a medical image or the like obtained by photographing a diagnosis target part of a patient for diagnosis by a doctor is arranged on a consultation desk (not shown) in the examination room 13. Yes. In the examination room 13, an imager 5 for printing medical images, a general-purpose printer 6, an ultrasonic diagnostic apparatus 2a that is less necessary in a space isolated from the viewpoint of privacy, and the like are 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, a CR reader 2c that reads an image from the CR cassette in which the image is recorded, and a client PC 7 are disposed. Further, an examination room 16 is provided next to the radiation imaging room 15, and a CT apparatus 2 b and a client PC 7 are disposed in the examination room 16.

[Device configuration of each device of the small-scale diagnosis system 1]
Hereinafter, each apparatus which comprises the small-scale diagnosis system 1 is demonstrated.
The image generation apparatus 2 is an image generation unit (modality) that performs imaging using a patient's diagnosis target site (examination site) as a subject, and digitally converts the captured image to generate a medical image. A medical image is an image used for interpretation diagnosis in the medical field.

  In the image generation device 2, a single image or a multi-slice image is generated. A single image refers to one medical image generated by one imaging. For example, a medical image captured by the radiation imaging apparatus 22 and read by the CR reading apparatus 2c corresponds to a single image. A multi-slice image refers to a series of medical images generated by continuously photographing a certain range of an object (for example, from the chest to the abdomen). For example, a medical image group generated by continuous imaging from the chest to the abdomen by the CT apparatus 2b corresponds to a multi-slice image. Each medical image belonging to a multi-slice image is called a slice image.

As shown in FIG. 1, in the present embodiment, an ultrasonic diagnostic apparatus (US) 2a, a CT apparatus 2b, and a CR reading apparatus 2c are provided as the image generation apparatus 2. Note that the image generation device 2 is not limited to this, and for example, an endoscope, 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 2c. 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 8 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 8 is output from the ultrasound 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 8.

  In the present embodiment, the conversion device 21 stores image attribute information such as a series ID, slice number, total number of slices, slice number of a representative image, imaging date / time, examination ID, and examination site in a format conforming to the DICOM standard. It has a function to add to medical images.

The series ID is a unique ID for specifying a medical image or a series of medical images in the small-scale diagnosis system 1. If a single image is used, one series image is a multi-slice image. If there is, one is assigned to a series of medical image groups. That is, the same series ID is assigned to each slice image belonging to the multi-slice image. In the present embodiment, the series ID is configured to include information indicating the type of the image generation device 2.
The slice number is a number assigned to identify individual medical images in the medical image group assigned the same series ID. In the present embodiment, numbers 1 to n (n is the total number of slice images) are assigned to the individual slice images belonging to the multi-slice image in the shooting order. In the case of a single image, 1 is assigned.
The total number of slices is a value indicating the total number of medical images included in the medical image group to which the same series ID is assigned. In the case of a multi-slice image, the total number of slice images belonging to the multi-slice image is given. In the case of a single image, 1 is assigned.
The slice number of the representative image is a slice number of a representative slice image (referred to as a representative image) in the medical image group to which the same series ID is assigned. The representative image is, for example, an image in which a slice number is located at the center in a series of slice image groups, and is determined in advance by 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 information such as patient ID, patient name (kanji / kana / ASCII), gender, date of birth, age, etc., as well as treatment date, imaging time, reception number, doctor in charge, etc. The patient information input in the conversion device 21 includes, 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 image attribute information and patient information provided by the conversion device 21 become supplementary information attached to the medical image generated by the ultrasonic diagnostic apparatus 2a.

  The CT apparatus 2b includes a radiation (X-ray) source that can rotate around the subject, a radiation detector that is located on the opposite side of the radiation source across the subject, a slide base that translates the subject relative to the radiation source, and image processing The computer etc. which perform are performed. The CT apparatus 2b rotates the radiation source around the subject and slides the subject to continuously irradiate the subject with radiation, and the radiation that has passed through the subject is detected by a radiation detector to acquire image data of the subject. . Then, image reconstruction of the image data detected by the radiation detector is performed using a computer, and a tomographic image of the subject is generated.

The CR reader 2c reads image data from a CR cassette (not shown) which is a radiographic image conversion medium in which radiographic image information obtained by photographing a subject is recorded.
The CR cassette incorporates, for example, a radiation image conversion plate including a stimulable phosphor sheet that accumulates radiation energy, and a radiation irradiation region irradiated from a radiation source (not shown) of the radiation imaging apparatus 22 at the time of imaging. Placed inside. When the CR cassette is irradiated with radiation, an amount of radiation according to the radiation transmittance distribution of the subject is accumulated in the photostimulable phosphor layer of the photostimulable phosphor sheet. Record radiation image information.

When the CR cassette in which the radiographic image information of the subject is recorded is loaded, the CR reading device 2c irradiates the stimulable phosphor sheet in the CR cassette loaded in the device with excitation light, thereby The stimulated light emitted is photoelectrically converted, and the obtained image signal is A / D converted to generate image data.
The CR reading device 2c may be an integrated device integrated with the radiation imaging device 22.

The CT device 2b and the CR reading device 2c are provided with a function of giving the above-described image attribute information to the generated medical image.
The CT apparatus 2b and the CR reading apparatus 2c are provided with an input unit (not shown) such as a keyboard having character input keys and numeric input keys, and input patient information for specifying a patient to be imaged. It 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 image attribute information and the patient information become supplementary information attached to the medical image generated by each image generation device 2. In the present embodiment, each image generation device 2 connected to the network 8 transmits a medical image to the medical image management device 3 in a DICOM file format conforming to the DICOM standard. The DICOM file is composed of an image part and a header part. In the image portion, image data of a medical image is written, and in the header portion, incidental information related to the medical image is written.
When the image generation device 2 is a device that does not conform to the DICOM standard such as a digital camera, the image generation device 2 transmits a medical image in the JPEG format to the medical image management device 3. In this case, the series ID is assigned to the medical image in the medical image management apparatus 3 based on the shooting date and time of the medical image.

  The medical image management apparatus 3 is installed, for example, in the examination room 13 and stores a medical image generated by the image generation apparatus 2 in association with patient information in an image DB (Data Base) 331, or a doctor displays an image or the like. Thus, it may be a device for performing interpretation diagnosis and the like, and may be provided with a monitor with a higher definition than a monitor (display unit) used in a general PC (Personal Computer).

  As shown in FIG. 3, the medical image management apparatus 3 includes a control unit 31, a RAM 32, a storage unit 33, an operation unit 34, a display unit 35, a communication unit 36, a media drive 37, and the like. They are connected by a bus 38.

  The control unit 31 is configured by a CPU (Central Processing Unit) or the like, reads various programs such as a system program and a processing program stored in the storage unit 33, expands them in the RAM 32, and displays output described later according to the expanded programs. Various processes including a control process (see FIG. 6) are executed.

  The RAM 32 temporarily stores a work area for temporarily storing various programs, input or output data, parameters, and the like that can be executed by the control unit 31 read from the storage unit 33 in various processes controlled by the control unit 31. Form.

The storage unit 33 includes an HDD (Hard Disk Drive), a semiconductor nonvolatile memory, or the like. In addition to storing various programs as described above, the storage unit 33 stores image processing parameters for adjusting a medical image to an image quality suitable for diagnosis (a lookup table defining a gradation curve used for gradation processing). , Frequency processing enhancement level, etc.) are stored.
The storage unit 33 also stores an image DB (Data Base) 331 for storing a medical image (referred to as an original image) transmitted from the image generation device 2, a diagnostic image (described in detail later) generated from the original image, and a thumbnail image. Have.

  The image DB 331 includes an image information table 331a that stores information related to medical images stored in the image DB 331. FIG. 4 shows an example of the image information table 331a. As shown in FIG. 4, the image information table 331a includes a “record number” field, a “series ID” field, a “slice number” field, a “total slice number” field, a “representative image” field, a “shooting date” field, “Examination ID” field, “Examination site” field, “Patient ID” field,... “Original image” field, “Diagnostic image” field, “Thumbnail image” field, etc. The image related information, patient information, file storage location, etc. relating to the single medical image (single image, each slice image) are stored as one record.

  The “original image” field is a field for storing information indicating the file storage location of the original image. The “diagnostic image” field stores information indicating a file storage location of the diagnostic image. The “thumbnail image” field is a field for storing information indicating the file storage location of the thumbnail image.

  By the information stored in the image information table 331a, the original image, the diagnostic image and the thumbnail image created from the original image are associated with the patient information and the series ID and slice number for identifying the image, and the patient information, The type of the image generating device 2, the shooting date, etc. are stored as key information so as to be searchable.

  The operation unit 34 includes a keyboard having cursor 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. Is output to the control unit 31 as an input signal.

  The display unit 35 is configured to include a monitor such as a CRT (Cathode Ray Tube) or an LCD (Liquid Crystal Display), for example, and displays various screens according to instructions of display signals input from the control unit 31.

  The communication unit 36 is configured by a network interface or the like, and transmits / receives data to / from an external device connected to the network 8 via a switching hub.

  The media drive 37 is configured such that a portable recording medium M such as a CD-R (Compact Disk Recordable), a DVD-R (Digital Versatile Disk Recordable), or an MO (Magnet Optical) disk is detachable. A device that reads or writes data from and to M.

  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 8, 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, etc.) is input by the input unit via this reception input screen, a patient information list of the received patients is created (updated), stored in the storage unit, and transmitted by the communication unit. It transmits to the medical image management apparatus 3 as appropriate.

  The imager 5 records a latent image by laser exposure on a transmission type recording medium (film) based on the medical image transmitted from the medical image management device 3, and visualizes the latent image by thermal phenomenon processing. Printer.

  The general-purpose printer 6 is a printer that records an image on a reflective recording medium (paper medium, sticker, etc.) by an ink jet method or a laser method.

  The client PC 7 is a computer device that displays a medical image transmitted from the medical image management device 3, for example.

[Diagnosis flow]
Next, the flow of diagnosis for one patient in a small-scale medical 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 storage unit in the reception device 4. . The patient information list is generated, for example, when the first patient of the day is received and input, and is updated to a new patient information list every time the next patient is received and input. The patient information list is appropriately transmitted from the storage unit in the reception apparatus 4 to the medical image management apparatus 3 and stored in the RAM 32 of the medical image management apparatus 3.

  When the patient to whom the reception number is assigned moves to the examination room 13, the doctor makes an inquiry to the patient and determines whether or not to perform imaging and which image generation device 2 to perform imaging. If it is determined that imaging is necessary, the doctor in the medical image management apparatus 3 displays a patient information list screen (not shown) that displays the patient information list transmitted from the reception apparatus 4 by a predetermined operation of the operation unit 34. ) On the display unit 35, and by selecting the patient information of the patient to be diagnosed from the displayed patient information list, the viewer screen 351 for the patient is displayed on the display unit 35.

  FIG. 5 shows an example of the viewer screen 351. The viewer screen is a diagnostic screen for displaying a medical image used for diagnosis and allowing a doctor to perform interpretation diagnosis. As shown in FIG. 5, the viewer screen 351 has a patient display column 71 that displays the patient ID and patient name of the patient selected as the diagnosis target, and it is visually recognized which patient viewer screen 351 is currently displayed. It can be done. If the list screen button 72 is operated, it is possible to return to the patient information list screen.

  The viewer screen 351 includes an image display field 73 for displaying medical images used for diagnosis among the medical images of the patient to be diagnosed, and a thumbnail image display field 74 for displaying a list of thumbnail images of the medical images of the patient to be diagnosed. Is provided. The generation of the thumbnail image will be described later.

  In addition, a tile / stack setting button 80 is provided on the viewer screen 351. The tile / stack setting button 80 is a button for setting a display method (tile display or stack display) for displaying a multi-slice image in the image display field 73. Stack display is a display method in which all slice images belonging to a multi-slice image are displayed in an overlapping manner. In the stack display, only one slice image is displayed in the image display field 73. The displayed image can be switched by operating the operation unit 34. Tile display is a display method in which all images belonging to a multi-slice image are expanded and displayed in the image display field 73.

In addition, the viewer screen 351 is provided with an image capture button 81a and an image capture button 81b.
The image capture button 81a captures a medical image transmitted from the various image generation devices 2 connected to the network 8 as an image of a patient (a patient displayed in the patient display column 71) currently being diagnosed. It is a button for instructing. In the present embodiment, the image capture button 81a corresponds to the type of the image generation apparatus 2 connected to the network 8 (ultrasonic diagnostic apparatus (US) 2a, CT apparatus 2b, CR reader 2c). Three types “US”, “CT”, and “CR” are arranged on the viewer screen 351. When the image generation apparatus 2 of another type (for example, an endoscope or MRI) is connected to the network 8, an image capture button 81a corresponding to the image generation apparatus 81 is provided.
The image capture button 81b is used to display a medical image transmitted from the image generation apparatus 2 such as a digital camera via an interface such as a USB (not shown) of a patient who is currently diagnosed (a patient displayed in the patient display column 71). This is a button for instructing to capture as an image.

  When any of the image capture buttons 81a or 81b is pressed (clicked) on the viewer screen 351 by the operation unit 34, the viewer screen 351 of the patient to be diagnosed is closed or the image capture button is released. In the meantime, the medical image transmitted from the image generation device 2 of the type corresponding to the pressed image capture button 81a or 81b is captured as the medical image of the patient to be diagnosed, and the captured medical image is the original image. It is stored in the image DB 331 in association with the patient information of the patient. The captured medical image is displayed in the image display field 73 as a medical image used for diagnosis, and the thumbnail image is generated and displayed in the thumbnail image display field 74 (see FIG. 10).

  Note that when a medical image is transmitted from the type of image generation device 2 in which the image capture button 81a or 81b is not pressed, the medical image is stored in an undetermined image storage unit (not shown) provided in the storage unit 33. Is done.

  The viewer screen 351 is provided with a date button 75. When one of the date buttons is pressed, a thumbnail image of a medical image taken on the date indicated by the date button pressed by the patient to be diagnosed is read from the image DB 331, and the read thumbnail image is displayed as a thumbnail image. It is additionally displayed in the column 74.

  The viewer screen 351 is provided with various tool buttons 83 for displaying the images displayed in the image display field 73 in an easy-to-see manner. Examples of the tool button 83 include various image processing buttons for performing image processing such as density contrast adjustment processing, black-and-white reversal processing, and enlargement / reduction processing on the displayed diagnostic image, and annotations to be superimposed on the lesion portion of the diagnostic image. There are buttons for selecting the shape.

  The viewer screen 351 further includes an image output button 82a for designating the imager 5 as a medical image output destination, an image output button 82b for designating the general-purpose printer 6 as a medical image output destination, and a medical image output destination. An image output button 82c for designating a recording medium, and an image output button 82d for designating an external device (here, the client PC 7 or the like) as a medical image output destination.

  When the viewer screen 351 is displayed, the doctor presses the image capture button 81a or 82b corresponding to the image generation apparatus 2 that performs imaging of the patient using the operation unit 34. A radiographer, such as a radiographer or nurse, takes the patient in front of the image generation apparatus 2 (ultrasound diagnostic apparatus 2a, CT apparatus 2b) or radiographic apparatus 22 that performs imaging, and the patient. Imaging is performed using the diagnosis target part as a subject. For example, the radiographer performs imaging with the radiation imaging apparatus 22, sets a cassette imaged in the radiation imaging apparatus 22 in the CR reader 2 c, and reads a radiation image recorded in the cassette. In the image generation device 2, a medical image is generated based on the photographing and is transmitted to the medical image management device 3.

  In the medical image management apparatus 3, when the medical image transmitted from the image generation apparatus 2 is received, the transmission source of the medical image is determined by referring to the series ID attached to the received medical image, the reception path, or the like. It is determined whether the image capture button 81a or 81b corresponding to the type of the image generation device 2 has been pressed in advance. When the image capture button 81 a or 81 b corresponding to the type of the image generation apparatus 2 that is the transmission source is pressed in advance, the received medical image is displayed as the patient medical image displayed in the patient display column 71 of the viewer screen 351. Captured and displayed in the image display field 73.

  When the imaging is completed, the patient returns to the examination room 13, and the doctor performs image diagnosis of the patient based on the diagnostic image displayed on the viewer screen 351.

[Operation of Medical Image Management Device 3]
Next, the operation of the medical image management apparatus 3 will be described in detail.
FIG. 6 shows a flow of display output control processing executed by the control unit 31 when patient information of a patient to be diagnosed is selected from the patient information list screen displayed on the display unit 35 by the operation unit 34. . The processing is realized by software processing through cooperation between the control unit 31 and a program stored in the storage unit 33.

  First, a viewer screen 351 for the patient selected on the patient information list screen is displayed on the display unit 35 (step S1). Next, an image capturing process is executed (step S2).

  FIG. 7 shows a flow of the image capturing process executed in step S2 of FIG. The processing is realized by software processing through cooperation between the control unit 31 and a program stored in the storage unit 33.

  The image capture button 81a or 81b is pressed by the operation unit 34, and a medical image transmitted from the image generation device 2 corresponding to the pressed image capture button 81a or 81b is received via the communication unit 36 or an interface (not shown). (Step S100), a display image array is generated in the RAM 32, and the image ID and reception order of the received medical images are stored as initial values of the display image array (Step S101).

  FIG. 12A and FIG. 15A show an example of the display image array created in step S101. The display image array is an array for storing display information (image ID, order) of medical images in the image display field 73 of the viewer screen 351. As shown in FIGS. 12 (a) and 15 (a), the display image array is array NO. The number indicating the display order (order), the image ID for identifying the image, and the information indicating the selection state as the output target (print target) image are stored in association with each other. The display order is a display order at the time of displaying a medical image, and specifically refers to an arrangement order of images displayed on the viewer screen 351. In step S101, first, an array for the number of received (captured) medical images is generated, and “No” is set as the initial value in the “selected state”. Next, for each medical image, a number indicating the reception order of the medical image is sequentially stored in “sequence” of the array, and an image ID is stored in “image ID”. For example, when the medical images received in step S100 are three images ID = A1, A2, and A3, and received in the order of A1, A2, and A3, the display image arrangement is as shown in FIG. It becomes the arrangement | sequence shown to 15 (a). In this example, for convenience, the image IDs are A1, A2, and A3. However, in this embodiment, a series ID (series ID + slice number in each slice image of a multi-slice image) is used as the image ID. Shall.

  Next, the received medical image is associated with the patient information of the patient selected on the patient information list screen, and is registered (stored) in the image DB 331 as an original image (step S102).

  Next, a diagnostic image is generated based on the original image (step S103), and registered (stored) in the image DB 331 in association with the selected patient information and the original image (step S104). Here, the diagnostic image is an image used when displayed in the image display field 73 on the viewer screen 351, and the original image is stored in the image DB 331 as received. When image processing is performed in accordance with a doctor's operation, the image processed image is overwritten and saved. In step S103, another file in which the file name of the original image is changed is created.

  Next, the original image is reduced to generate a thumbnail image (step S105), and is registered (stored) in the image DB 331 in association with the selected patient information, original image, and diagnostic image (step S106). The process proceeds to step S3 in FIG.

  As shown in FIG. 4, the image DB 331 stores image related information including the series ID of the medical image transmitted from the image generation device 2, patient information, the file storage location of the original image, and the file storage location of the diagnostic image. The image information table 331a for storing the thumbnail image file storage location and the like is provided. When each image is registered in the image DB 331, information is registered in the image information table 331a. By this image information table 331a, the original image, the diagnostic image and the thumbnail image created from the original image are associated with the patient information and the series ID and slice number for identifying the image, and the patient information and the image generating device 2 It is saved so that it can be searched according to the type and shooting date.

  When the image capturing process is completed, a diagnostic image designation process is executed (step S3).

  8 to 9 show a flow of the diagnostic image designation process executed in step S3 of FIG. The processing is realized by software processing through cooperation between the control unit 31 and a program stored in the storage unit 33.

  First, the captured medical image is displayed on the viewer screen 351 (step S201). That is, based on the display image arrangement stored in the RAM 32, the diagnostic image of the medical image captured by the image capture process is read from the image DB 331 and displayed in the image display field 73, and the corresponding thumbnail image is displayed. Are read out and displayed in the thumbnail image display field 74 in the order of shooting date and time. FIG. 10A shows an example of the viewer screen 351 displayed in step S201.

  In the viewer screen 351, it is determined whether or not an instruction to change the diagnostic image displayed in the image display field 73 is input by the operation unit 34 (step S202). When an instruction to change the diagnostic image is input (step S202; YES), it is determined whether or not the instruction is an instruction to add a diagnostic image to be displayed in the image display field 73 (step S203). If it is determined that the instruction is not an instruction to add a diagnostic image (step S203; NO), the process proceeds to step S211. The instruction to add a diagnostic image to be displayed in the image display field 73 can be performed by, for example, selecting a thumbnail image to be added in the thumbnail image display field 74 by double-clicking with the operation unit 34, or the like. The thumbnail image displayed in the thumbnail image display field 74 can be added if other medical images of the same patient are stored in the image DB 331. For example, when a desired date is pressed with the date button 75 by the operation unit 34, a thumbnail image of the patient to be diagnosed taken on the date is displayed in the thumbnail image display field 74. In the case of a multi-slice image, the image displayed in the thumbnail image display field 74 is only one representative image.

If it is determined that the instruction is an instruction to add a diagnostic image (step S203; YES), the image information table 331a of the image DB 331 is referred to, and the image instructed to be additionally displayed belongs to a multi-slice image. Is determined (step S204). Specifically, whether or not a certain image is a slice image belonging to a multi-slice image is determined based on whether or not the total number of slices of the record of the target image in the image information table 331a is 2 or more. .
If it is determined that the image instructed to add is not a slice image belonging to the multi-slice image (step S204; NO), the image instructed to add is determined as a display target (step S208).

  On the other hand, if it is determined that the image for which additional display is instructed is a slice image belonging to the multi-slice image (step S204; YES), it is determined whether tile display is set as the display method for the multi-slice image. (Step S205). If it is determined that the tile display is set (step S205; YES), all slice images of the multi-slice image including the slice image instructed to be added are determined as display targets (step S206). If it is determined that tile display is not set as the display method of the multi-slice image (that is, stack display is set) (step S205; NO), the top of the multi-slice image including the slice image instructed to be added Are determined as display targets (step S207).

  When the display target image is determined, information about the image determined as the display target is additionally written in the display image array of the RAM 32 (step S209), and the diagnostic image of the image determined as the display target is read from the image DB 331. And is displayed at the end of the image display field 73 (step S210). When tile display is set, the display order of the slice images in the multi-slice image determined as the display target is the slice number order, that is, the imaging order.

  It is determined whether or not the instruction input by the operation unit 34 is an instruction to delete any of the diagnostic images displayed in the image display field 73 from the image display field 73 (step S211). If it is determined that it is not an instruction to delete any of the diagnostic images from the image display field 73 (step S211; NO), the process proceeds to step S218. Here, the instruction to delete the diagnostic image displayed in the image display column 73 from the image display column 73 is, for example, selected by clicking the diagnostic image to be deleted in the image display column 73 with the operation unit 34, This can be done by pressing the “select and clear display” button of the tool button 83 or the like.

  If it is determined that the instruction is an instruction to delete (clear) the diagnostic image from the image display field 73 (step S211; YES), the image information table 331a of the image DB 331 is referred to, and the image for which deletion has been instructed is referred to. It is determined whether the slice image belongs to the multi-slice image (step S212). If it is determined that the image instructed to be deleted is not a slice image belonging to the multi-slice image (step S212; NO), the image instructed to be deleted is determined as a deletion target (step S215).

  On the other hand, if it is determined that the image instructed to be deleted is a slice image belonging to the multi-slice image (step S212; YES), it is determined whether tile display is set as the display method of the multi-slice image (step S212; YES). Step S213). If it is determined that the tile display is set (step S213; YES), all slice images of the multi-slice image including the slice image instructed to be deleted are determined as deletion targets (step S214). If it is determined that tile display is not set as the display method of the multi-slice image (that is, stack display is set) (step S213; NO), the image instructed to be deleted is determined as a deletion target ( Step S215).

  When the image to be deleted is determined, information on the image determined as the deletion target is deleted from the display image array in the RAM 32 (step S216), and the diagnostic image determined as the deletion target is deleted from the image display column 73. (Step S217).

  It is determined whether or not the instruction input by the operation unit 34 is an instruction to change the display order of the diagnostic images displayed in the image display field 73 (step S218). If it is determined that the instruction is not an instruction to change the display order of the diagnostic images (step S218; NO), the process returns to step S202. Here, in order to change the display order of the diagnostic images displayed in the image display field 73, for example, one image in the image display field 73 is selected by the operation unit 34 and dragged to another image whose display order is changed. It can be done by dragging and dropping one image in the image display field 73 of the image display field 73 to the boundary line between the images to be inserted by the operation unit 34.

  If it is determined that the instruction is an instruction to change the display order of the diagnostic images (step S218; YES), an image order changing process is executed (step S219).

  FIG. 11 shows a flow of the image order changing process executed in step S219 of FIG. The processing is realized by software processing through cooperation between the control unit 31 and a program stored in the storage unit 33.

  First, it is determined whether or not the instruction to change the image display order input by the operation unit 34 is an instruction to insert an image between certain images displayed in the image display field 73 (step S2001). If it is determined that the instruction is not an image insertion instruction between images (step S2001; NO), the process proceeds to step S2009.

  If it is determined that the instruction to change the image display order input by the operation unit 34 is an instruction to insert an image between certain images displayed in the image display field 73 (step S2001; YES), the multi-slice image Whether tile display is set as the display method is determined (step S2002). If it is determined that tile display is set (step S2002; YES), it is determined whether or not the instructed image insertion destination is between slice images belonging to a multi-slice image (step S2003). If it is determined that the slice images belong to the multi-slice image (step S2003; YES), the image moving process is canceled (step S2004), and the process returns to step S202 in FIG.

  On the other hand, if it is determined that the instructed image insertion destination is not between slice images belonging to the multi-slice image (step S2003; NO), whether or not the instructed image is a slice image belonging to the multi-slice image is determined. Determination is made (step S2005). If it is determined that the slice image belongs to the multi-slice image (step S2005; YES), all slice images of the multi-slice image including the slice image instructed to be inserted are determined as movement targets (step S2006). When it is determined that the tile display is not set as the display method of the multi-slice image, that is, the stack display is set (step S2002; NO), or the slice in which the inserted instruction belongs to the multi-slice image If it is determined that the image is not an image (step S2005; NO), the image instructed to be inserted is determined as a movement target (step S2007).

  When the image to be moved is determined, the “order” of the display image arrangement is changed so that the image order of the image determined as the movement target is the image insertion destination (step S2008), and the process proceeds to step S2009. .

  It is determined whether or not the instruction for changing the image display order input by the operation unit 34 is an instruction for replacing the images displayed in the image display field 73 (step S2009). If it is determined that the instruction is not an image replacement instruction (step S2009; NO), the process proceeds to step S2017.

  If it is determined that the instruction for changing the image display order input by the operation unit 34 is an instruction for replacing the images displayed in the image display field 73 (step S2009; YES), a tile is displayed as a multi-slice image display method. It is determined whether display is set (step S2010). If it is determined that the tile display is set (step S2010; YES), it is determined whether or not the instructed images are slice images in the same multi-slice image (step S2011). If it is determined that the slice images are in the same multi-slice image (step S2011; YES), the image moving process is canceled (step S2012), and the process proceeds to step S202 in FIG.

  If it is determined that the replacement-instructed images are not slice images in the same multi-slice image (step S2011; NO), whether any of the replacement-instructed images is a slice image belonging to the multi-slice image. Is determined (step S2013). When it is determined that any of the images instructed to replace is a slice image belonging to the multi-slice image (step S2013; YES), all the slice images of the multi-slice image including the instructed slice image are moved together. The target is determined (step S2014).

  When it is determined that the tile display is not set as the display method of the multi-slice image, that is, the stack display is set (step S2010; NO), or any of the images instructed to be replaced is a multi-slice image. When it is determined that the slice image does not belong (step S2013; NO), the image instructed to be replaced is determined as a movement target (step S2015).

  When the image to be moved is determined, the image order of the images to be moved instructed to be exchanged is changed, and the “order” of the display image arrangement is changed (step S2016). Then, the diagnostic images in the image display field 73 are displayed in the display order specified by the display image arrangement in the RAM 32 (step S2017), and the process returns to step S202 in FIG.

  In step S202 of FIG. 8, when the instruction to change the diagnostic image displayed on the viewer screen 351 is not input by the operation unit 34 (step S202; NO), the process proceeds to step S4 of FIG.

  Through the above-described diagnostic image designation processing, it is possible to designate a medical image used for diagnosis and a display order in accordance with the operation of the operation unit 34.

  Here, in the viewer screen 351, when the operation unit 34 instructs to add, delete, or change the image order to be displayed in the image display field 73, the change in the display image arrangement and the image display by the above-described diagnostic image designation processing are performed. The display changes in the column 73 are illustrated separately for the stack display and the tile display.

(In case of stack display)
FIGS. 12 to 13 show examples of changes in the display image arrangement when the stack display is set. FIG. 14 shows a change in display of the image display column 73 based on the display image arrangement shown in FIGS. 12 to 13, A1, A2,... Indicate the image ID of a single image, and M1-1, M1-2,... Indicate the image ID of each slice image of the multi-slice image. “M1” of M1-1 indicates an ID for identifying a multi-slice image, and “−1” indicates the first slice (slice number = 1) of the multi-slice image M1. For convenience of explanation, it is assumed that the number of slices of the multi-slice image is five.

FIG. 12A shows an example of a display image arrangement at the start of diagnostic image designation processing. FIG. 14A schematically shows an image display field 73 displayed based on FIG.
For example, in the state in which the diagnostic image is displayed based on the display image arrangement shown in FIG. 12A (display of FIG. 14A), the operation unit 34 causes the diagnostic image of image ID = M1-1 to be When the additional display is instructed, the display image arrangement is changed to the arrangement shown in FIG. 12B, and the display in the image display column 73 is changed to the display shown in FIG.

  In the state where the diagnostic image is displayed based on the display image arrangement shown in FIG. 12B (display of FIG. 14B), additional display of diagnostic images with image IDs = A4 to A7 is performed by the operation unit 34. Is displayed, the display image arrangement is changed to the arrangement shown in FIG. 12C, and the display in the image display column 73 is changed to the display shown in FIG.

  In the state where the diagnostic image is displayed based on the display image arrangement shown in FIG. 12C (display of FIG. 14C), the operation unit 34 instructs to delete the diagnostic image with the image ID = A3. In this case, the display image arrangement is changed to the arrangement shown in FIG. 12D, and the display in the image display column 73 is changed to the display shown in FIG.

  In a state where the diagnostic image is displayed based on the display image arrangement shown in FIG. 12D (display of FIG. 14D), the operation unit 34 uses the diagnostic image of image ID = A2 and image ID = A6. When the replacement is instructed, the display image arrangement is changed to the arrangement shown in FIG. 12E, and the display in the image display column 73 is changed to the display shown in FIG.

  In a state where the diagnostic image is displayed based on the display image arrangement shown in FIG. 12E (display of FIG. 14E), the diagnostic image with the image ID = A7 is selected by the operation unit 34 as image ID = A6. When an instruction to insert after the diagnostic image is input, the display image arrangement is changed to the arrangement shown in FIG. 13A, and the display of the image display column 73 is changed to the display shown in FIG. Be changed.

  In a state in which a diagnostic image is displayed based on the display image arrangement shown in FIG. 13A (display of FIG. 14F), diagnosis with image ID = M1-1 and image ID = A2 is performed by the operation unit 34. When the replacement of the image for use is instructed, the display image arrangement is changed to the arrangement shown in FIG. 13B, and the display in the image display column 73 is changed to the display shown in FIG.

  In the state where the diagnostic image is displayed based on the display image arrangement shown in FIG. 13B (display of FIG. 14G), the diagnostic image with the image ID = M1-1 is selected by the operation unit 34 as the image ID. = When the instruction to insert after A6 is input, the display image arrangement is changed to the arrangement shown in FIG. 13C, and the display in the image display column 73 is changed to the display shown in FIG. The

  In the state where the diagnostic image is displayed based on the display image arrangement shown in FIG. 13C (display of FIG. 14H), the operation unit 34 deletes the diagnostic image with the image ID = M1-1. When instructed, the display image arrangement is changed to the arrangement shown in FIG. 13D, and the display in the image display column 73 is changed to the display shown in FIG.

  As described above, since only one multi-slice image is displayed in the stack display, addition, deletion, and change of the image order of multi-slice images are handled in the same manner as in the case of a single image.

(Tile display)
FIGS. 15 to 16 show examples of changes in the display image arrangement when the tile display is set. FIG. 17 shows a change in display of the image display column 73 based on the display image arrangement shown in FIGS. 15 to 16, A1, A2,... Indicate the image ID of a single image, and M1-1, M1-2,... Indicate the image ID of each slice image of the multi-slice image. “M1” of M1-1 indicates an ID for identifying a multi-slice image, and “−1” indicates the first slice (slice number = 1) of the multi-slice image M1. For convenience of explanation, it is assumed that the number of slices of the multi-slice image is five.

FIG. 15A shows an example of a display image arrangement at the start of diagnostic image designation processing. FIG. 17A schematically shows the image display field 73 displayed based on FIG.
For example, in the state where the diagnostic image is displayed based on the display image arrangement shown in FIG. 15A (display of FIG. 17A), the operation unit 34 causes the diagnostic image with the image ID = M1-1 to be displayed. When the additional display is instructed, the display image arrangement is changed to the arrangement shown in FIG. 15B, and the display in the image display column 73 is changed to the display shown in FIG. In the case of tile display, when one slice image of the multi-slice images M1 is instructed to be added, as shown in FIG. 17B, all the slice images M1-1 to M1-5 of the multi-slice image M1 are displayed. It is additionally displayed.

  In a state where the diagnostic image is displayed based on the display image arrangement shown in FIG. 15B (display of FIG. 17B), additional display of diagnostic images with image IDs = A4 to A7 is performed by the operation unit 34. Is displayed, the display image arrangement is changed to the arrangement shown in FIG. 15C, and the display in the image display column 73 is changed to the display shown in FIG.

  In the state where the diagnostic image is displayed based on the display image arrangement shown in FIG. 15C (display of FIG. 17C), the operation unit 34 instructs to delete the diagnostic image with the image ID = A3. In this case, the display image arrangement is changed to the arrangement shown in FIG. 15D, and the display in the image display column 73 is changed to the display shown in FIG.

  In the state where the diagnostic image is displayed based on the display image arrangement shown in FIG. 15D (display of FIG. 17D), the diagnostic image with image ID = A2 and image ID = A6 is operated by the operation unit 34. When the replacement is instructed, the display image arrangement is changed to the arrangement shown in FIG. 15E, and the display in the image display column 73 is changed to the display shown in FIG.

  In the state where the diagnostic image is displayed based on the display image arrangement shown in FIG. 15E (display of FIG. 17E), the diagnostic image of image ID = A7 is selected by the operation unit 34 as image ID = A6. When an instruction for insertion is input after the diagnostic image, the display image arrangement is changed to the arrangement shown in FIG. 16A, and the display in the image display column 73 is changed to the display shown in FIG. Be changed.

  In the state where the diagnostic image is displayed based on the display image arrangement shown in FIG. 16A (display shown in FIG. 17F), the diagnosis of image ID = M1-1 and image ID = A2 is performed by the operation unit 34. When the replacement of the image for use is instructed, the display image arrangement is changed to the arrangement shown in FIG. 16B, and the display in the image display column 73 is changed to the display shown in FIG. In the case of tile display, when replacement of one slice image of the multi-slice image M1 with another image is instructed, as shown in FIG. 17G, all slice images M1- of the multi-slice image M1 are displayed. 1 to M1-5 are moved to the position of the replacement destination image without breaking the order of slice numbers.

  In the state where the diagnostic image is displayed based on the display image arrangement shown in FIG. 16B (display of FIG. 17G), the diagnostic image with the image ID = M1-1 is selected by the operation unit 34 as the image ID. = When an instruction to insert after A6 is input, the display image arrangement is changed to the arrangement shown in FIG. 16C, and the display in the image display column 73 is changed to the display shown in FIG. The In the case of tile display, when an instruction to insert one slice image of the multi-slice images M1 behind the other images is given, as shown in FIG. 17 (h), all slice images of the multi-slice image M1 are displayed. M1-1 to M1-5 are moved together to a position behind other images.

  In the state where the diagnostic image is displayed based on the display image arrangement shown in FIG. 16C (display of FIG. 17H), the operation unit 34 deletes the diagnostic image with the image ID = M1-1. When instructed, the display image arrangement is changed to the arrangement shown in FIG. 16D, and the display in the image display column 73 is changed to the display shown in FIG. In the case of tile display, when deletion of one slice image of the multi-slice images M1 is instructed, as shown in FIG. 17 (i), all the slice images M1-1 to M1-5 of the multi-slice image M1. Is deleted.

  As described above, in the tile display, when addition, deletion, or change of the image order of one slice image among the multi-slice images is instructed, all the slice images are integrated without breaking the order of the slice numbers. Added, deleted, or changed in image order.

  Returning to FIG. 6, in step S <b> 4, various diagnostic processes (image processing and annotation display) are performed on the diagnostic image displayed on the viewer screen 351 in accordance with the input from the operation unit 34. . The diagnostic image file subjected to the image processing is overwritten on the image after the image processing and stored in the image DB 331. In the file subjected to image processing, the image itself may be overwritten, or the image processing parameters may be overwritten on the accompanying information.

Whether or not any one or more of the diagnostic images displayed in the image display field 73 is selected as an output target (print target) image (referred to as an output image) by the operation unit 34 on the viewer screen 351. Is determined (step S5). Specifically, the selection of the diagnostic image displayed in the image display field 73 is performed by, for example, clicking with the operation unit 34 or clicking with the Shift key held down to select a plurality of images. Can do. Further, as shown in FIG. 10B, the selected image among the diagnostic images displayed in the image display field 73 is displayed separately from other unselected images such as surrounded by a thick color frame. Is done.
If it is determined that one or more images have been selected as output images (step S5; YES), the “selected state” of the display image array is changed from “No” to “Yes” for the selected images (step S5). S6).
On the other hand, if it is determined that one or more images are not selected as output images (step S5; NO), the process proceeds to step S7.

  When any of the image output buttons 82a to 82d is pressed by the operation unit 34 (step S7), display / array takeover processing is executed (step S8).

  FIG. 18 shows a flow of the display / array takeover process executed in step S8 of FIG. The processing is realized by software processing through cooperation between the control unit 31 and a program stored in the storage unit 33.

  First, an image output destination is determined based on the pressed image output button (step S301). If it is determined that the image output destination is an external device or a recording medium (step S301; host output, media output), it is determined whether tile display is set as the display method of the multi-slice image (step S302). ). If it is determined that the tile display is set (step S302; YES), it is determined whether there is a multi-slice image in the display image array stored in the RAM 32 (step S303). If it is determined that there is a multi-slice image in the image display array (step S303; YES), the slice images in the same multi-slice image are combined into one in the display image array (step S304), The process proceeds to S305.

  In the present embodiment, when the image output destination is an external device or a recording medium and the display setting is tile display, all of a series of slice images are output when a multi-slice image is output. Therefore, as a candidate for the output image, only a representative image of the multi-slice images may be displayed so as to be selectable. Therefore, in step S304, the slice images in the same multi-slice image are combined into one in the display image arrangement. Specifically, slice information other than the representative image is deleted from the display image array, and the order of the images after deletion is moved up. The “selected state” is set to “Yes” when any one of the multi-slice images is “Yes”. By the processing in step S304, only the representative image is displayed in the output image selection fields 92 and 95 for selecting an output image on the host output screen 352 and the media output screen 353 described later.

  When it is determined that the image output destination is the imager 5 or the general-purpose printer 6 (step S301; imager output, general-purpose printing), when the stack display is set (step S302; NO), or when the display image arrangement is multi-slice If no image is included (step S303; NO), the process proceeds to step S305.

  In step S305, an output image array for setting an output image is generated in the RAM 32 (step S305), and information on an array in which the “selected state” in the display image array is “Yes” is set in the output image array ( In step S306, the process proceeds to step S9 in FIG.

  The output image array is an array for setting an output image and its output order, and stores an array NO, an output order (order), and an image ID (see FIG. 25). The output order is a printing order when outputting a medical image (at the time of printing). Specifically, when a medical image is printed by the imager 5 or the general-purpose printer 6, the order of the images on the print layout is indicated. The output order is a number indicating the output order of individual medical images. In step S306, in the display image array, the image ID of the array whose “selection state” is Yes is “image ID”, and the number indicating the display order between the selected images on the viewer screen 351 is “order” as the output order. Stored. For example, when the display image array is in the state shown in FIG. 24A, the output image array generated in step S306 is the array shown in FIG. Thus, the image selected as the output image by operating the operation unit 34 on the viewer screen 351 is set as the output image in the output image array.

  In step S9 of FIG. 6, the image output destination is determined based on the pressed image output button (step S9). When it is determined that the image output destination is an external device (step S9; host output), a host output screen 352 is displayed on the display unit 35 (step S10).

  FIG. 19 shows an example of the host output screen 352. As shown in FIG. 19, the host output screen 352 includes a transmission destination selection button 91, an output image selection field 92, a transmission button 93, and the like. The transmission destination selection button 91 is an operation button for selecting an external device (registered in advance, for example, the client PC 7) as a transmission destination of the output image. The output image selection field 92 is an area for selecting an image to be output to an external device, and a list of thumbnail output images of candidate images to be output to the external device. The transmission button 93 is an operation button for instructing transmission of an output image.

In step S10, the thumbnail image of the diagnostic image displayed in the image display field 73 of the viewer screen 351 immediately before switching to the host output screen 352 is displayed based on the display image arrangement stored in the RAM 32. Are displayed side by side in the output image selection field 92 in the display order (only representative images in the case of multi-slice images). For example, when tile display is set on the viewer screen 351 and the display state of the image display field 73 is the state shown in FIG. 10B, the output image selection field 92 shown in FIG. 19 is displayed. In this way, the image used by the doctor for the diagnosis on the viewer screen 351 is displayed as an output target candidate without changing the display order, so the doctor can output an output image to be transmitted to the external device from the images used for the diagnosis. It becomes possible to select easily, and the operability at the time of output image selection can be improved.
In step S 10, the selection state of the output image on the viewer screen 351 is taken over by the host output screen 352 based on the display image arrangement stored in the RAM 32, and is selected on the viewer screen 351 in the output image selection field 92. The output image thus displayed is displayed separately from other unselected images. For example, it is highlighted by being surrounded by a thick color frame.

  When it is determined that the image output destination is a recording medium (step S9; media output), a media output screen 353 is displayed on the display unit 35 (step S11).

  FIG. 20 shows an example of the media output screen 353. As shown in FIG. 20, the media output screen 353 is provided with a write destination designation field 94, an output image selection field 95, a write button 96, and the like. The write destination designation field 94 is an area for designating an output (write) destination of the output image. The output image selection field 95 is an area for selecting an image to be output to the recording medium, and a list of images to be output to the recording medium is displayed as thumbnail images. The write button 96 is an operation button for instructing output (writing) of an output image to a recording medium.

In step S11, the thumbnail image of the diagnostic image displayed in the image display field 73 of the viewer screen 351 immediately before switching to the media output screen 353 is displayed based on the display image arrangement stored in the RAM 32. Are displayed side by side in the output image selection field 95 in the display order (only representative images in the case of multi-slice images). For example, when the tile display is set on the viewer screen 351 and the display state of the image display field 73 is the state shown in FIG. 10B, the output image selection field 95 shown in FIG. 20 is displayed. In this way, the image used by the doctor for the diagnosis on the viewer screen 351 is displayed as an output target candidate without changing the display order. Therefore, the doctor outputs an output image to be output to the recording medium from the images used for the diagnosis. It becomes possible to select easily, and the operability at the time of output image selection can be improved.
In step S11, the selection state of the output image on the viewer screen 351 is taken over by the media output screen 353 based on the display image arrangement stored in the RAM 32. In the output image selection field 95, the viewer screen 351 The selected output image is displayed separately from other unselected images. For example, it is highlighted by being surrounded by a thick color frame.

  When it is determined that the image output destination is the imager 5 (step S9; imager output), the imager print screen 354 is displayed on the display unit 35 (step S12).

  FIG. 21 shows an example of the imager print screen 354. As shown in FIG. 21, the imager print screen 354 is provided with an output image selection field 97, a print image display field 98, a page number display field 99, a print layout selection button 100, a print button 101, and the like. The output image selection column 97 is an area for selecting an image to be output to the imager 5, that is, an image to be printed in the imager 5, and a list of images to be printed is displayed as thumbnail images. . The print image display field 98 is an area for displaying a print layout and an image for each page printed by the imager 5. The page number display field 99 is an area for displaying the page number of the page displayed in the print image display field 98 and instructing page feed. The print layout selection button 100 is an operation button for designating the layout (print layout) of an image to be printed by the imager 5.

In step S12, the thumbnail image of the diagnostic image displayed in the image display field 73 of the viewer screen 351 immediately before switching to the imager print screen 354 is displayed based on the display image arrangement stored in the RAM 32. Are displayed in the output image selection column 97 in the displayed order. For example, when the display state of the image display field 73 on the viewer screen 351 is the state shown in FIG. 10B, the output image selection field 97 shown in FIG. 21 is displayed. In this way, the image used by the doctor for diagnosis on the viewer screen 351 is displayed as a candidate for printing without destroying the display order. Therefore, the doctor outputs an output image to be printed by the imager 5 from among the images used for diagnosis. It becomes possible to select easily, and the operability at the time of output image selection can be improved.
In step S12, the selection state of the output image on the viewer screen 351 is taken over by the imager print screen 354 based on the display image arrangement stored in the RAM 32, and is selected on the viewer screen 351 in the output image selection field 97. The output image thus displayed is displayed separately from other unselected images. For example, the output image selected on the viewer screen 351 is highlighted by being surrounded by a thick color frame. Further, in the print image display column 98, diagnostic images of images selected as print targets in the viewer screen 351 and the output image selection column 97 are arranged in the order set in the output image arrangement based on the print layout. Is displayed. In step S12, the print image display field 98 is displayed based on a default print layout (for example, 3 × 3, 4 × 4, etc.) by default, and the print layout information is stored in the RAM 32. .

  As described above, the imager print screen 354 displays an output image selection field 97 for selecting an output image that is an image to be printed, and a print image for each page in which the selected output image is arranged based on the print layout. Since a print image display field 98 is provided, a user such as a doctor can immediately check the diagnostic image and the print image of the print target image on the same screen after selecting the print target image. It is possible to quickly and accurately select an image to be printed and to determine a print layout.

  If it is determined that the image output destination is the general-purpose printer 6 (step S9; general-purpose printing), a general-purpose print screen 355 is displayed on the display unit 35 (step S13). Since the general-purpose print screen 355 is the same except that the heading is different from the imager print screen 354, description and illustration are omitted.

  When output screens 352 to 354 corresponding to the image output buttons 82a to 82d pressed by the operation unit 34 are displayed on the display unit 35, an output image order setting process is executed (step S14).

  22 to 23 show a flow of the output image order setting process executed in step S14 of FIG. The processing is realized by software processing through cooperation between the control unit 31 and a program stored in the storage unit 33. In the following description, the output screens 352 to 355 displayed on the display unit 35 are collectively referred to as output screens.

  First, an image output destination is determined (step S401). If it is determined that the image output destination is an external device or a recording medium (step S401; host output, media output), the process proceeds to step S405. When it is determined that the output destination of the image is the imager 5 or the general-purpose printer 6 (step S401; imager output, general-purpose printing), any one of the print layout selection buttons 100 is operated by the operation unit 34, and the print layout is selected. It is determined whether or not a change has been instructed (step S402). When it is determined that a print layout change has been instructed by pressing one of the print layout selection buttons 100 by the operation unit 34 (step S402; YES), information indicating the print layout instructed by the operation unit 34 is displayed. The information is stored (overwritten) in the print layout information in the RAM 32 (step S403), and the number of image arrangements in the print image display field 98 is changed to the instructed print layout and displayed (step S404). Then, the process proceeds to step S405.

  It is determined whether or not an instruction to change the output image has been input by the operation unit 34 (step S405). When an instruction to change the output image is input by the operation unit 34 (step S405; YES), it is determined whether or not the instruction is an instruction to add an output image (step S406). Specifically, the instruction to add the output image is performed by, for example, double-clicking the thumbnail image displayed in the output image selection column (output image selection column 92, 95, or 97; the same applies hereinafter) by the operation unit 34. This can be done by selecting. If it is determined that it is not an instruction to add an output image (step S406; NO), the process proceeds to step S419.

  If it is determined that the instruction is an instruction to add an output image (step S406; YES), it is determined whether there is an image already selected as an output image (step S407). If it is determined that there is an image that has already been selected as an output image (step S407; YES), the image that has already been selected and the image that has been selected as an additional output image in step S406 (addition instruction) The arrangement order of the thumbnails in the output image selection field 97 is compared (step S408). Specifically, the display image arrangement stored in the RAM 32 is referred to, and the order corresponding to the selected image and the already selected image is compared, whereby the thumbnails in the output image selection field 97 of the image are compared. The order is compared.

  As a result of the comparison, if it is determined that the arrangement order of the thumbnails in the output image selection column 97 of the image instructed to add is earlier than the arrangement order of the thumbnails of the already selected images (step S408; previous), the addition is performed. The output order of the instructed image is determined before the already selected image (when there are a plurality of already selected images), the output order of the image instructed to be added to the output image array of the RAM 32 is determined. Information is additionally written, and the “order” of the output image array is changed based on the determined output order (step S409). Then, the process proceeds to step S412.

  As a result of the comparison, if it is determined that the arrangement order of the thumbnails in the output image selection field 97 of the image instructed to be added is sandwiched in the order of the thumbnails of the already selected images (step S408; sandwiched) The output order of the image instructed to be added is determined between the images that have already been selected (between the images that sandwich the order of the thumbnails of the images instructed to add), and the output order of the image instructed to be added is added to the output image array of the RAM 32. Information is additionally written, and the order of the output image array is changed based on the determined output order (step S410). Then, the process proceeds to step S412.

  As a result of the comparison, if it is determined that the arrangement order of the thumbnails of the image instructed to add is behind the arrangement order of the thumbnails of the already selected images (step S408; after), the output of the image instructed to add is output. The order is determined at the end, and the information of the image instructed to be added is additionally written in the output image array of the RAM 32, and the order of the output image array is changed based on the determined output order (step S411). . Then, the process proceeds to step S412.

  On the other hand, when there is no image already selected (step S407; NO), the output order of the image instructed to be added is determined at the end, and the information of the image instructed to add is additionally written in the output image array of the RAM 32. In addition, the order of the output image arrangement is changed based on the determined output order (step S411), and the process proceeds to step S412.

In step S412, the thumbnail image of the image instructed to be added displayed in the output image selection field is highlighted by, for example, being surrounded by a thick color frame. Next, the output destination is determined (step S413). When the output destination is the imager 5 or the general-purpose printer 6 (step S413; imager output, general-purpose printing), an image instructed to be added to the print image display column 98 is based on the order set in the output image array. It is displayed (step S414).
On the other hand, when the output destination is an external device or a recording medium (step S413; host output, media output), the process proceeds to step S415.

  It is determined whether or not the instruction input by the operation unit 34 is an instruction to cancel the selection state (setting) as the output image (that is, an instruction to delete from the output image) (step S415). Specifically, the instruction to cancel the selection as the output image can be given by, for example, selecting the thumbnail image to be deselected in the output image selection column by right-clicking with the operation unit 34, and the like. If it is determined that the instruction is not an instruction to delete the selected state as the output image (step S415; NO), the process returns to step S401.

  If it is determined that the instruction is an instruction to cancel the selection state as an output image (step S415; YES), information on the image for which deselection is instructed is deleted from the output image arrangement in the RAM 32 (step S416). ) The highlighted display of the thumbnail image of the image instructed to be deselected in the output image selection column is canceled (step S417). Further, when the output destination is the imager 5 or the general-purpose printer 6 (step S418; imager output, general-purpose printing), the image instructed to be deselected is deleted from the print image display column 98 (step S419), and the processing is performed. Returns to step S401.

When the instruction to change the output image is not input by the operation unit 34 (step S405; NO), the process proceeds to step S15 in FIG.
With the output image order setting process, an image selected from the output target candidates by the operation unit 34 can be set as an output image, and the output order of the selected output image can be set.

  Here, in the imager print screen 354 and the general-purpose print screen 355, when the output unit is instructed to be added or deleted by the operation unit 34, the change in the output image sequence and the print image display column 98 in the output image order setting process described above. The display change is illustrated separately in the case of stack display and the case of tile display.

(In case of stack display)
25 and 26 show an example of the change in the output image arrangement when the stack display is set. 27 and 28 show changes in the display of the print image display column 98 based on the output image arrangement shown in FIGS. In FIGS. 25 to 28, A1, A2,... Indicate image IDs of single images, and M1-1, M1-2,... Indicate image IDs of the slice images of the multi-slice image. “M1” of M1-1 indicates an ID for identifying a multi-slice image, and “−1” indicates the first slice (slice number = 1) of the multi-slice image M1.
Note that the display image array at the time of execution of the display / array takeover processing step S306 is as shown in FIG. 24A, and the output image selection field 97 of the imager print screen 354 and the general-purpose print screen 355 is shown in FIG. It is assumed that the image with the image ID stored in the display image array shown in FIG. In addition, the information shown in FIG. 25A is set in the output image array based on the display image array shown in FIG. 24A, and the print image display field 98 of the imager print screen 354 and the general-purpose print screen 355 is set. In FIG. 27, an image with an image ID shown in FIG. 27A is displayed as an output image. The print layout is shown as 4 × 3.

  For example, in the state where the output images are set in the order of images shown in the print image display field 98 in the output image array shown in FIG. When the image with the image ID = M1-1 is additionally selected as an output image by 34, the output image arrangement is changed to the arrangement shown in FIG. 25B, and the display in the print image display column 98 is shown in FIG. ) Is displayed.

  In the state where the output images are set in the image order shown in the print image display field 98 in the output image array shown in FIG. 25B (display shown in FIG. 27B), the operation unit 34 controls the output image selection field 97. When the image with the image ID = A1 is additionally selected in this order, the output image arrangement is changed to the arrangement shown in FIG. 25C, and the display in the print image display column 98 is changed to the display shown in FIG. Be changed.

  In the state where the output images are set in the image order shown in the print image display field 98 in the output image array shown in FIG. 25C (display shown in FIG. 27C), the operation unit 34 controls the output image selection field 97. When the image with the image ID = A5 is additionally selected, the output image arrangement is changed to the arrangement shown in FIG. 25D, and the display in the print image display column 98 is changed to the display shown in FIG. The

  In the state where the output images are set in the image order shown in the print image display field 98 in the output image array shown in FIG. 25D (display shown in FIG. 27D), the operation unit 34 controls the output image selection field 97. When an image with the image ID = M2-1 is additionally selected, the output image arrangement is changed to the arrangement shown in FIG. 25E, and the display in the print image display column 98 is changed to the display shown in FIG. Be changed.

  In the state where the output images are set in the image order shown in the print image display field 98 in the output image array shown in FIG. 25E (display shown in FIG. 27E), the operation unit 34 controls the output image selection field 97. When deletion of the image with the image ID = A2 is instructed from the output image, the output image arrangement is changed to the arrangement shown in FIG. 26A, and the display in the print image display column 98 is shown in FIG. The display is changed.

  In the state where the output images are set in the image order shown in the print image display field 98 in the output image array shown in FIG. 26A (display shown in FIG. 28A), the operation unit 34 controls the output image selection field 97. When deletion of the image with the image ID = M1-1 from the output image is instructed, the output image array is changed to the array shown in FIG. 26A, and the display in the print image display column 98 is displayed in FIG. ) Is displayed.

  Thus, in the stack display, only one image can be selected as an output image in the multi-slice image. Addition and deletion of each image as an output image are stored in the output image array in the order of thumbnails regardless of whether they are single images or multi-slice images.

(Tile display)
FIG. 29 to FIG. 30 show examples of changes in the output image arrangement when the stack display is set. FIG. 31 shows a change in display of the print image display column 98 based on the output image arrangement shown in FIGS. 29 to 31, A1, A2,... Indicate the image ID of a single image, and M1-1, M1-2,... Indicate the image ID of each slice image of the multi-slice image. “M1” of M1-1 indicates an ID for identifying a multi-slice image, and “−1” indicates the first slice (slice number = 1) of the multi-slice image M1.
Note that the display image array at the time of execution of step S306 of the display / array takeover process is as shown in FIG. 24B, and the output image selection field 97 of the imager print screen 354 and the general-purpose print screen 355 is shown in FIG. It is assumed that the image with the image ID stored in the display image array shown in FIG. Further, the information shown in FIG. 29A is set in the output image array based on the display image array shown in FIG. 24B, and the print image display field 98 of the imager print screen 354 and the general-purpose print screen 355 is set. Suppose that an image with an image ID shown in FIG. 31A is displayed as an output image. The print layout is shown as 4 × 3.

  In the state where the output images are set in the image order shown in the print image display field 98 in the output image array shown in FIG. 29A (display shown in FIG. 31A), the operation unit 34 controls the output image selection field 97. When the image with the image ID = A1 is additionally selected as the output image, the output image arrangement is changed to the arrangement shown in FIG. 29B, and the display in the print image display column 98 is the display shown in FIG. Changed to

  In the state where the output images are set in the image order shown in the print image display column 98 in the output image arrangement shown in FIG. 29B (display shown in FIG. 31B), the operation unit 34 controls the output image selection column 97. When the image with the image ID = A3 is additionally selected as the output image, the output image arrangement is changed to the arrangement shown in FIG. 29C, and the display in the print image display column 98 is the display shown in FIG. Changed to

  In the state where the output images are set in the image order shown in the print image display field 98 in the output image array shown in FIG. 29C (display shown in FIG. 31C), the operation unit 34 controls the output image selection field 97. When the image with the image ID = M1-2 is additionally selected as the output image, the output image arrangement is changed to the arrangement shown in FIG. 29D, and the display in the print image display column 98 is shown in FIG. The display is changed.

  In the state where the output images are set in the image order shown in the print image display field 98 in the output image array shown in FIG. 29D (display shown in FIG. 31D), the operation unit 34 controls the output image selection field 97. When the image with the image ID = M1-1 is additionally selected as the output image, the output image arrangement is changed to the arrangement shown in FIG. 29E, and the display of the print image display column 98 is shown in FIG. The display is changed.

  In the state in which the output images are set in the image order shown in the print image display field 98 in the output image array shown in FIG. When the image with the image ID = M1-4 is additionally selected as the output image, the output image arrangement is changed to the arrangement shown in FIG. 30A, and the display in the print image display column 98 is shown in FIG. The display is changed.

  In the state where the output images are set in the image order shown in the print image display column 98 in the output image arrangement shown in FIG. 30A (display shown in FIG. 31F), the operation unit 34 controls the output image selection column 97. When the image with the image ID = M1-3 is additionally selected as the output image, the output image arrangement is changed to the arrangement shown in FIG. 30B, and the display in the print image display column 98 is shown in FIG. The display is changed.

  In the state where the output images are set in the image order shown in the print image display column 98 in the output image arrangement shown in FIG. 30B (display shown in FIG. 31G), the operation unit 34 controls the output image selection column 97. When the images of image ID = A5 and A6 are additionally selected as output images, the output image array is changed to the array shown in FIG. 30C, and the display of the print image display column 98 is shown in FIG. The display is changed.

  In the state where the output images are set in the image order shown in the print image display column 98 in the output image array shown in FIG. 30C (display shown in FIG. 31H), the operation unit 34 uses the image ID = A4. When deletion from the output image is instructed, the output image array is changed to the array shown in FIG. 30D, and the display in the print image display column 98 is changed to the display shown in FIG. .

  In the state in which the output images are set in the image order shown in the print image display field 98 in the output image array in FIG. When deletion from the output image is instructed, the output image arrangement is changed to the arrangement shown in FIG. 30C, and the display in the print image display column 98 is changed to the display shown in FIG. .

  As described above, when the tile display is set, even if the same multi-slice image as the image selected as the output image has already been selected, the order of the thumbnails stored in the order of the slice numbers. Since the output order of the selected images is automatically set so that the selected output image and the already selected image are successively arranged in the order of the slice number, the same multi-slice image It is possible to prevent another single image or slice image from entering between the slice images, or the imaging order of the slice images in the multi-slice image from being disrupted.

In step S15 of FIG. 6, when the output button (send button 93, write button 96, print button 101) on the displayed output screen is pressed by the operation unit 34 (step S15), an output image is output to the output destination. The images (diagnostic images) selected as are output in the set output order (step S16).
For example, when the output destination is an external device, external images designated via the communication unit 36 in the output order in which the images set as output images (diagnostic image files) in the output image array are set. It is transmitted to the device (for example, client PC 7). When a representative image of a multi-slice image is set in the output image array, all slice images of the multi-slice image are output in the order of slice numbers.
When the output destination is a recording medium, the recording medium loaded in the specified media drive 37 in the output order in which the image (diagnostic image file) set as the output image in the output image array is set Written to M. When a representative image of a multi-slice image is set in the output image array, all slice images of the multi-slice image are written to the recording medium M in the order of slice numbers.
When the output destination is the imager 5, the image (diagnostic image file) set as the output image in the output image array is output via the communication unit 36 together with the print layout information in the output order in which the image is set. Sent to. Alternatively, the images (diagnostic images) set in the output image array are arranged and combined on the print layout in the set output order, and the combined image is transmitted to the imager 5.
When the output destination is the general-purpose printer 6, the image (diagnosis image file) set as the output image in the output image array is general-purpose via the communication unit 36 together with the print layout information in the output order set. It is transmitted to the printer 6. Alternatively, the images (diagnosis images) set in the output image array are arranged on the print layout in the output order set and are combined, and the combined image is transmitted to the general-purpose printer 6.

  When an instruction to close the output screen is input by the operation unit 34 (step S17), the screen of the display unit 35 returns to the viewer screen 351 (step S18), and when the end button 84 is clicked on the viewer screen 351 (step S18). S19), this process ends.

  As described above, according to the medical image management apparatus 3 in the present embodiment, when stack display or tile display is set, the print screen (imager print screen 354, general-purpose print screen 355) is operated by the operation unit 34. When a medical image is selected from among the print candidates displayed in the output image selection field 97 of (), and other medical images (including both single images and multi-slice images) are already selected as print targets, The image order of the selected medical image is set so that the selected medical image and the already selected other medical image are consecutive in the order of the thumbnail numbers in the output image selection field 97.

  Further, the order of thumbnail numbers in the output image selection field 97 is set in the photographing order in the same multi-slice image by the image order changing process, so a single image or another multi-slice is set between medical images in the same multi-slice image. It is possible to prevent the image from entering or the shooting order of slice images within the same multi-slice image from being lost, and printing can be performed in a single batch without changing the shooting order of multi-slice images. It becomes.

  Also, since the image order of the print candidate medical images is set in the thumbnail display order of the output image selection field 97, the order of the thumbnails displayed in the output image selection field corresponds to the image order of the print candidate medical images. It becomes easy to grasp the display position of the selected medical image on the screen.

  The imager print screen 354 and the general-purpose print screen 355 include an output image selection field 97 for displaying a print target candidate image, and a print image for each page in which medical images selected as print targets are arranged based on the print layout. Since the print image display field 98 to be displayed is provided, a user such as a doctor can check the print image, and can quickly and accurately select an image to be printed.

  Further, in the imager print screen 354 and the general-purpose print screen 355, a thumbnail image selected as a print target among medical images displayed as print target candidates is distinguished from thumbnail images of other unselected images by a color frame or the like. Since highlighting is performed, a user such as a doctor can easily recognize which image has been selected, and operability when selecting an output image can be improved.

In addition, the description in this Embodiment mentioned above is an example of the suitable small-scale diagnosis system which concerns on this invention, and is not limited to this.
For example, in the above-described embodiment, the external device that is the output destination of the medical image has been described as the client PC 7 in the medical facility, but the present invention is not limited to this. For example, a configuration may be used in which a medical image is transmitted to a system of another medical facility that is linked via a WAN (Wide Area Network), the Internet, or the like.

  In the above description, an example in which a hard disk, a semiconductor nonvolatile memory, or the like is used as a computer-readable medium of the program according to the present invention is disclosed, but the present invention is not limited to this example. As another computer-readable medium, a portable recording medium such as a CD-ROM can be applied. A carrier wave is also applied as a medium for providing program data according to the present invention via a communication line.

  In addition, the detailed configuration and detailed operation of each device constituting the small-scale diagnosis support system can be changed as appropriate without departing from the spirit of the present invention.

It is a figure which shows the example of whole structure of the small-scale diagnosis system in this Embodiment. 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 shown in FIG. It is a principal part block diagram which shows the functional structure of the medical image management apparatus shown in FIG. It is a figure which shows an example of the image information table of image DB of FIG. It is a figure which shows an example of the viewer screen displayed on the display part of FIG. It is a flowchart which shows the display output control process performed by the control part of FIG. It is a flowchart which shows the image taking-in process performed in step S2 of FIG. It is a flowchart which shows the diagnostic image designation | designated process performed in step S3 of FIG. It is a flowchart which shows the diagnostic image designation | designated process performed in step S3 of FIG. It is a figure which shows an example of a display at the time of displaying the medical image taken in on the viewer screen shown in FIG. FIG. 10 is a flowchart showing image order change processing executed in step S219 of FIG. 9. FIG. It is a figure which shows an example of the change of a display image arrangement | sequence by execution of the diagnostic image designation | designated process in case stack display is set. It is a figure which shows an example of the change of a display image arrangement | sequence by execution of the diagnostic image designation | designated process in case stack display is set. It is a figure which shows the change of a display of the diagnostic image in a viewer screen when a display image arrangement | sequence changes as shown to FIGS. 12-13. It is a figure which shows an example of the change of the display image arrangement | sequence by execution of the diagnostic image designation | designated process in case the tile display is set. It is a figure which shows an example of the change of the display image arrangement | sequence by execution of the diagnostic image designation | designated process in case the tile display is set. It is a figure which shows the change of a display of the diagnostic image in a viewer screen when a display image arrangement | sequence changes as shown to FIGS. 15-16. It is a flowchart which shows the display / array takeover process performed in step S8 of FIG. It is a figure which shows an example of the host output screen displayed on the display part of FIG. It is a figure which shows an example of the media output screen displayed on the display part of FIG. It is a figure which shows an example of the imager print screen displayed on the display part of FIG. It is a flowchart which shows the output image order setting process performed in step S14 of FIG. It is a flowchart which shows the output image order setting process performed in step S14 of FIG. It is a figure which shows an example of the display image arrangement | sequence at the time of execution of step S306 of FIG. It is a figure which shows an example of the change of the output image arrangement | sequence by execution of the output image order setting process in case stack display is set. It is a figure which shows an example of the change of the output image arrangement | sequence by execution of the output image order setting process in case stack display is set. FIG. 27 is a diagram illustrating a change in a print image when the output image arrangement is changed as illustrated in FIG. 25-26. FIG. 27 is a diagram illustrating a change in a print image when the output image arrangement is changed as illustrated in FIG. 25-26. It is a figure which shows an example of the change of the output image arrangement | sequence by execution of the output image order setting process in case the tile display is set. It is a figure which shows an example of the change of the output image arrangement | sequence by execution of the output image order setting process in case the tile display is set. It is a figure which shows the change of a print image when an output image arrangement | sequence changes as shown to FIGS. 29-30.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Small scale diagnostic system 2 Image generation apparatus 2a Ultrasonic diagnostic apparatus 2b CT apparatus 2c CR reader 3 Medical image management apparatus 4 Reception apparatus 5 Imager 6 General-purpose printer 7 Client PC
8 Network 21 Conversion device 22 Radiography device 31 Control unit 32 RAM
33 storage unit 331 image DB
34 Operation unit 35 Display unit 351 Viewer screen 352 Host output screen 353 Media output screen 354 Imager print screen 36 Communication unit 37 Media drive 38 Bus 73 Image display field 74 Thumbnail image display field

Claims (15)

Display means for displaying a plurality of medical images including a series of medical image groups acquired by continuous imaging;
Storage means for storing the plurality of medical images and the display order of the plurality of medical images to be displayed on the display means;
Operating means for selecting a medical image to be printed from among a plurality of medical images displayed on the display means;
Control means for setting the print order of the medical images selected as the print target by the operation means to be the display order stored in the storage means;
A medical image management apparatus comprising:   2. The display order of medical images belonging to the series of medical image groups among the plurality of medical images stored in the storage unit is continuous in the order of photographing medical images belonging to the series of medical image groups. Medical image management device. An instruction means for instructing a change in the display order of the plurality of medical images stored in the storage means;
The control unit belongs to the series of medical images when the medical image instructed to change the display order by the instruction unit includes a plurality of medical images belonging to a series of medical images acquired by continuous shooting. It is determined whether or not a change in display order is instructed so that a plurality of medical images are consecutive in the photographing order, and the display order is changed so that a plurality of medical images belonging to the series of medical images are consecutive in the photographing order. When it is determined that an instruction is given, the display order instructed by the instruction means is stored in the storage means, and the display order is changed so that a plurality of medical images belonging to the series of medical image groups are consecutive in the photographing order. 3. The medical image management apparatus according to claim 1, wherein when it is determined that no instruction is issued, an instruction to change a display order of the plurality of medical images by the instruction unit is not accepted.   The said control means makes the said display means display the printing image for every page which has arrange | positioned the medical image selected as said printing object based on the printing layout in the said set printing order on any one of Claims 1-3. The medical image management apparatus described.   5. The control unit according to claim 1, wherein the control unit displays a medical image selected as a print target by the operation unit among a plurality of medical images displayed on the display unit, separately from other unselected medical images. The medical image management apparatus according to any one of the above. A display step of displaying a plurality of medical images including a series of medical image groups acquired by continuous imaging on a display means;
A printing target selection step for selecting a medical image to be printed from among the plurality of displayed medical images by an operation means;
The image order set so that the print order of the medical images selected as the print target by the operation means becomes the display order stored in the storage means for storing the display order of the plurality of medical images to be displayed on the display means. A setting process;
Print image order setting method.   The display order of medical images belonging to the series of medical image groups among a plurality of medical images stored in the storage unit is continuous in the order of photographing medical images belonging to the series of medical image groups. Print image order setting method.   In the image order setting step, a series of medical images acquired by continuous photographing on a medical image instructed to change the display order by an instruction unit that instructs to change the display order of the plurality of medical images stored in the storage unit. When a plurality of medical images belonging to the image group are included, it is determined whether or not a change in display order is instructed so that the plurality of medical images belonging to the series of medical image groups are consecutive in the photographing order, When it is determined that a display order change is instructed so that a plurality of medical images belonging to the medical image group are consecutive in the photographing order, the display order instructed by the instruction means is stored in the storage means, and the series The display means changes the display order of the plurality of medical images when it is determined that the display order is not instructed so that the plurality of medical images belonging to the medical image group are consecutive in the photographing order. Print image order setting method according to claim 6 or claim 7 does not accept the instruction.   The print image display step of displaying a print image for each page in which the medical image selected as the print target is arranged based on a print layout in the set print order on the display unit. The print image order setting method according to the item.   10. The display step according to claim 6, wherein, in the plurality of medical images displayed on the display unit, the medical image selected as a print target by the operation unit is displayed separately from other unselected medical images. The print image order setting method according to any one of the above. Computer
Display means for displaying a plurality of medical images including a series of medical image groups acquired by continuous imaging;
Storage means for storing the display order of the plurality of medical images and the plurality of medical images to be displayed on the display means;
Operating means for selecting a medical image to be printed from among a plurality of medical images displayed on the display means;
Control means for setting the print order of the medical images selected as the print target by the operation means to be the display order stored in the storage means;
Program to function as.   12. The display order of medical images belonging to the series of medical image groups among a plurality of medical images stored in the storage unit is continuous in the order of imaging of medical images belonging to the series of medical image groups. program. Further functioning as an instruction means for instructing a change in display order of the plurality of medical images stored in the storage means,
The control unit belongs to the series of medical images when the medical image instructed to change the display order by the instruction unit includes a plurality of medical images belonging to a series of medical images acquired by continuous shooting. It is determined whether or not a change in display order is instructed so that a plurality of medical images are consecutive in the photographing order, and the display order is changed so that a plurality of medical images belonging to the series of medical images are consecutive in the photographing order. When it is determined that an instruction is given, the display order instructed by the instruction means is stored in the storage means, and the display order is changed so that a plurality of medical images belonging to the series of medical image groups are consecutive in the photographing order. The program according to claim 10 or 11, wherein when it is determined that no instruction is given, an instruction to change the display order of the plurality of medical images by the instruction unit is not accepted.   14. The control unit according to claim 10, wherein the display unit displays a print image for each page in which the medical image selected as the print target is arranged based on a print layout in the set print order. The listed program.   15. The control unit according to claim 10, wherein the control unit displays a medical image selected as a print target by the operation unit among a plurality of medical images displayed on the display unit in distinction from other unselected medical images. The program as described in any one.

Images