JP2015179535A - medical image management server, link setting program, and medical image management program - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a technique for setting a link to a medical image data piece contained in bundled image data obtained by recording a plurality of medical image data pieces in one file, and extracting the medical image data piece in the bundled image data on the basis of the link.SOLUTION: A medical image management server comprises storage means, memory means, extraction means, and transmission means, and the storage means stores bundled image data having a plurality of medical image data pieces and additional information including image order information. The memory means memorizes an image type of the bundled image data and an image order in an associated manner. The extraction means extracts a medical image data piece from the bundled image data stored in the storage means.

Description

  The present invention sets a link to medical image data included in bundle image data (also called enhanced data or multiframe image data) in which a plurality of medical image data is recorded in one file, and based on the link, The present invention relates to a technique for extracting medical image data.

  Medical image data generated by a medical image diagnostic apparatus such as an X-ray CT apparatus, an MRI apparatus, an ultrasonic diagnostic apparatus, or a nuclear medicine diagnostic apparatus is managed by a server that manages images and can be viewed on a terminal in the network. ing. An apparatus that supports the creation of an interpretation report receives medical image data from a server, displays it on a monitor, and uses it for interpretation. The interpretation report is a document that represents a problem that is interpreted from the medical image obtained by the interpretation doctor interpreting the displayed medical image. In an apparatus that supports the creation of an interpretation report, medical image data may be linked to an interpretation report (see, for example, “Patent Document 1”).

  In linking medical image data, an apparatus that supports the creation of an interpretation report generates link data indicating a storage destination of medical image data, and embeds the link data in the interpretation report. Conventionally, since each medical image data is one file, it is possible to specify medical image data to be linked by including the file name in the link data.

  In recent years, in the DICOM standard, a concept of bundle image data in which a plurality of medical image data is recorded in one file has appeared. A plurality of pieces of medical image data generated by the medical image diagnostic apparatus are collected into one file. This bundle image data is also called enhanced data or multi-frame image data. If each piece of medical image data is a single file, it is necessary to establish communication each time each piece of medical image data is transmitted / received. Therefore, a device that transmits and receives medical image data, Therefore, a large amount of communication is necessary, and a great load is generated on communication traffic. However, with bundle image data, all medical images can be transmitted and received in a single communication, so that a large amount of communication is not required and communication traffic is reduced.

  When such bundle image data is assumed, if the conventional linking method is adopted, that is, the medical image data recorded in the bundle image data does not have a file name, the file name of the bundle image data is linked. If the method included in the data is adopted, the medical image data actually cited in the interpretation report is a small part of the bundle image data, but the whole bundle image data is received in order to obtain the medical image data. Need arises. Then, it takes a considerable time to display the desired medical image data, and the efficiency of the medical practice referring to the interpretation report is extremely lowered. Depending on the terminal that browses the interpretation report, resources may not be able to withstand this large-capacity bundle image data, and the medical efficiency in that case is severely degraded. Further, when the entire bundle image data is received, a great load is generated on the communication traffic in the network.

JP 2005-301453 A

  The present invention has been made in view of the above problems, and an object of the present invention is to set a link to medical image data included in bundled image data in which a plurality of medical image data is recorded in one file, and the link It is an object of the present invention to provide a technique for extracting medical image data from bundled image data based on the above.

  In order to solve the above-described problem, a first aspect of the present invention provides a bundle image data including a plurality of pieces of medical image data and accompanying information including image order information commonly attached to the plurality of pieces of medical image data. A medical image management server having storage means for storing and transmitting medical image data linked to the interpretation report to a terminal for displaying the interpretation report, wherein the medical image diagnostic apparatus from which the bundle image data has been acquired; Storage means for storing the image type of the bundle image data and the image order in association with each other, image order information included in the link data of the medical image data, and the medical image diagnostic apparatus from which the medical image is acquired or the medical image Extraction means for extracting medical image data from the bundle image data stored in the storage means based on the image type of the image, and medical images extracted by the extraction means Further comprising transmitting means for transmitting the over data to the terminal, and characterized.

  According to a second aspect of the present invention, bundle image data including a plurality of pieces of medical image data and additional information including image order information commonly attached to the plurality of pieces of medical image data is used as the plurality of pieces of medical image data. Link data generating means for generating link data embedded in the interpretation report, including image order information of medical image data to be linked, and a computer that displays the report creation screen of the interpretation report It is made to function as a link data embedding means for embedding the link data generated by the link data generating means in the interpretation report.

  The third aspect of the present invention has storage means for storing bundled image data having a plurality of medical image data and additional information including image order information that is commonly attached to the plurality of medical image data. A computer that transmits medical image data linked to the interpretation report to a terminal that displays the interpretation report, a medical image diagnostic apparatus from which the bundled image data is acquired, or an image type of the bundled image data and the image order A medical image based on the storage means for storing the image in association with each other, the image order information included in the link data of the medical image data, and the medical image diagnostic apparatus from which the medical image is acquired or the image type of the medical image An extraction unit for extracting data from the bundle image data stored in the storage unit, and a transmission for transmitting the medical image data extracted by the extraction unit to the terminal. Thereby it means and, to function, and wherein.

It is a figure which shows the system configuration | structure of a medical image management system. It is a figure which shows the data structure of bundle image data. It is a figure which shows the detailed structure which handles bundle image data in a report preparation terminal. It is a figure which shows the detailed structure of a report browsing terminal. It is a figure which shows the detailed structure of the image management server which manages bundled image data. It is a flowchart which shows the 1st aspect of the link operation | movement using presence position information. It is a schematic diagram which shows an example of the file structure management table created at the time of expansion | deployment of bundle image data. It is a schematic diagram which shows the link data using presence position information. It is a flowchart which shows the 2nd aspect of the link operation | movement using image order information. It is a schematic diagram which shows the link data using image order information. It is a flowchart which shows the operation | movement which transmits the linked medical image data based on the link data using presence position information. It is a schematic diagram which shows the aspect which transmits medical image data based on the link data using presence position information. It is a flowchart which shows the operation | movement which transmits the linked medical image data based on the link data using image order information. It is a schematic diagram which shows the aspect which transmits medical image data based on the link data using image order information. It is a schematic diagram which shows a transmission number setting table. It is a flowchart which shows the modification of the operation | movement which transmits the linked medical image data based on the link data containing presence position information. It is a schematic diagram which shows the aspect which extracts several medical images using the link data containing presence position information. It is a flowchart which shows the modification of the operation | movement which transmits the linked medical image data based on the link data containing image order information. It is a schematic diagram which shows the aspect which extracts several medical images using the link data containing image order information. It is a block diagram which shows the structure of the report preparation terminal on the assumption that bundle image data is changed. It is a figure which shows the modification of a structure of the image management server 3 on the assumption that the change of bundle image data is changed. It is a flowchart which shows the operation | movement which absorbs the change of bundle image data and transmits linked medical image data based on the link data comprised by presence position information. It is an example which shows the data structure of the link data produced including presence position information and generation information. It is an example which shows the change history currently recorded on the image database. It is a flowchart which shows the operation | movement which absorbs the change of bundle image data and transmits linked medical image data based on the link data comprised by the image order information. It is an example which shows the data structure of the link data produced including image order information and generation information. It is a further example which shows the change history currently recorded on the image database.

  Hereinafter, each preferred embodiment of the link setting technique according to the present invention will be described in detail with reference to the drawings.

(Configuration of medical image management system)
FIG. 1 is a diagram illustrating a system configuration of a medical image management system according to an embodiment of a link setting technique.

  The medical image management system 1 is a system that stores medical image data received from the medical image diagnostic apparatus 2 and enables browsing. The medical image diagnostic apparatus 2 is a so-called modality such as an X-ray CT apparatus, an MRI apparatus, an ultrasonic diagnostic apparatus, and a nuclear medicine diagnostic apparatus. The medical image diagnostic apparatus 2 images a subject and transmits medical image data as a result of the imaging to the medical image management system 1. Medical image data is data representing an image in a subject.

  The medical image management system 1 is configured by connecting an image management server 3, a report creation terminal 4, and a report browsing terminal 5 via a network N. Each of the image management server 3, the report creation terminal 4, and the report browsing terminal 5 is configured by a so-called computer, and includes at least a CPU, an HDD, a RAM, and a communication interface. The report creation terminal 4 and the report browsing terminal 5 are configured by connecting an input interface such as a keyboard and a mouse and a monitor such as a CRT display and a liquid crystal display to this computer.

  Each of the image management server 3, the report creation terminal 4, and the report browsing terminal 5 is equipped with an operating system and a control application that runs on the operating system. The control application is read from the HDD, loaded into the RAM, instructions are executed by the CPU, and data is input / output via the communication interface.

  In some cases, a plurality of medical image diagnostic apparatuses 2, report creation terminals 4, and report browsing terminals 5 are installed on the network N. A plurality of the report browsing terminals 5 have different performances, and there may be a difference in performance.

  In such a medical image management system 1, when medical image data is generated in the medical image diagnostic apparatus 2, the medical image diagnostic apparatus 2 transmits the medical image data to the image management server 3. The image management server 3 stores the received medical image data after registering the database.

  When the image interpretation doctor is requested to interpret the medical image, the image interpretation doctor interprets the medical image using the report creation terminal 4 and creates an image interpretation report. The interpretation report is a document in which the result of interpretation of a medical image is described. The report creation terminal 4 receives medical image data from the image management server 3 as a first display device and displays it on a monitor, displays a report creation screen on the monitor, and creates an interpretation report according to the operation of the input interface. I will do it.

  A link of medical image data may be attached to the interpretation report. For example, when the operator drags the displayed medical image data using the input interface and drops it on a character string in the interpretation report, the report creation terminal 4 generates link data representing the dragged medical image data. The link data is embedded in the interpretation report data in association with the dropped character string.

  This report creation terminal 4 is a terminal constituted by two computers, a report creation device 4a for creating an interpretation report and an image display device 4b for displaying medical image data, even if it is a single computer. May be.

  When the report creation device 4a and the image display device 4b are configured, a monitor for displaying a report creation screen is arranged on the report creation device 4a side, and a monitor for displaying medical image data is arranged on the image display device 4b. The report creation device 4a and the image display device 4b are communicable by LAN connection or the like, and are linked to each other.

  For example, data communication is performed with each other so that the report creation device 4a and the image display device 4b operate in conjunction with each other by LAN connection. As the interlocking operation, for example, the cursor can be moved from the monitor of the report creation device 4a to the monitor of the image display device 4b. In addition, the report creation device 4a takes over the drag state of the dragged medical image data. Also, link data of medical image data is transmitted from the image display device 4b to the report creation device 4a. In addition, medical image data is received by the image display device 4b in response to a link data request operation performed by the report creation device 4a.

  A requesting doctor such as the attending physician who requested the interpretation uses the report browsing terminal 5 to browse the interpretation report. The report browsing terminal 5 receives the created interpretation report and displays this interpretation report on a monitor as a second display device. When an image link character string or the like of medical image data is pasted on the interpretation report, when the operator selects the link character string using the input interface, the report viewing terminal 5 displays the link data embedded in the interpretation report. Is sent to the image management server 3 to request medical image data represented by the link data.

  When receiving the link data from the report browsing terminal 5, the image management server 3 analyzes the link data and transmits medical image data indicated by the link data to the report browsing terminal 5.

  When receiving the medical image data, the report browsing terminal 5 displays the received medical image data on the monitor.

  The medical image data handled in such a medical image management system 1 includes medical image data (hereinafter referred to as normal medical image data) in which one image is a single file, or a plurality of medical image data. The bundle image data 100 recorded in the The bundled image data 100 is also commonly called enhanced data or multiframe image data. The bundle image data 100 is generated when the subject is imaged by the medical image imaging apparatus 2 and transmitted to the image management server 3. According to the bundle image data 100, since all the generated medical image data can be transmitted by one communication, communication traffic is reduced.

  FIG. 2 is a diagram showing a data configuration of the bundle image data 100 handled by the medical image management system 1.

  The bundle image data 100 is composed of three parts: an image information area 110, a common incidental information area 120, and a frame information area 130.

  In the image information area 110, each medical image data 111 belonging to each series generated by the medical image photographing apparatus 2 is recorded. The recording order of the medical image data 111, in other words, the order of arrangement of the medical image data 111 included in the bundled image data 100 from the top of the data is disparate regardless of the series and the display order. The medical image data 111 arranged on the first image may be the third image of the second series, and the medical image data 111 arranged on the second image may be the fifth image of the first series. Here, the series indicates a group of certain medical image data 111, and is divided, for example, for each imaging region or for each imaging condition. The first series is divided into a medical image data group obtained by photographing the head portion, and the second series is divided into a medical image data group obtained by photographing the abdominal portion. The first series is divided into a medical image data group obtained by photographing with administration of a contrast agent, and the second series is divided into a medical image data group obtained by photographing without administration of a contrast agent.

  In the image information area 110, data size information 112 is added to the head of each medical image data 111, and the data amount of the medical image data 111 arranged below the data size information 112 is described. ing. By adding the size information 112 of this data, it is possible to recognize the number of bytes in the image information area 110 where the medical image data 111 arranged in the Xth frame exists.

  In the common incidental information area 120, specific information of the bundle image data 100 is described. For example, the specific information of the bundle image data 100 includes the patient ID 121 of the subject imaged by the medical image diagnostic apparatus 2, the examination ID, the type and body name of the medical image diagnostic apparatus 2, and the bundle image data 100 itself. One series ID, image ID, or the like is given.

  In the frame information area 130, individual supplementary information of each medical image data 111 recorded in the bundle image data 100 is described. In particular, in the frame information area 130, shooting position information 131 and image order information 132 are described. The imaging position information 131 is information representing the imaging position of the medical image data 111 on the subject in a coordinate system. The image order information 132 is information determined by the medical image diagnostic apparatus 2 and attached to the medical image data 111, and is also used as information indicating the display order when displaying the medical image data 111 included in the bundle image data 100. .

  The image order information 132 includes group information 133 and in-group order information 134. The group information 133 represents to which group each of the medical image data 111 recorded in the bundle image data 100 belongs. The in-group order information 134 represents the number of pieces of medical image data 111 in the group.

  The group information 133 is given for each series, for example. The in-group order information 134 is given for each order in the series, for example. On the bundle image data 100, Stack (stack ID) is added as the group information 133. As the intra-group order information 134, a IndexID (Temporary Index ID, Temporary Index ID) is assigned on the bundled image data 100. For example, if certain image order information 132 is “SatcID: 2” and “TindexID: 3”, the medical image data 111 corresponding to this image order information 132 is the third group of medical image data 111. When the bundle image data 100 is displayed, the third image is displayed as the second group of medical images.

  The image order information 132 may include information defined by DICOM such as ImageType, InStackPosition Number, frame Acquisition Number, and Diffusesequence in addition to StackID and IndexID. Some medical image diagnostic apparatuses 2 create bundled image data 100 in such a manner that a series ID is associated with a series ID and a stack ID is associated with the order in the series. ImageType is information indicating the image type, and there are cases where the meanings of the Index and StackID are interchanged by this ImageType. When the image management server 3 manages the bundled image data 100 and when the report creation terminal 4 disassembles the bundled image data 100 into the medical image data 111 and displays them respectively, the ImageID is referred to and the StackID and IndexID are stored. Analyze the meaning and determine which is the series and which represents the order within the series.

  A pair of the photographing position information 131 and the image order information 132 is attached to the frame information area 130 for each medical image data 111. In addition, the pairs of the imaging position information 131 and the image order information 132 are arranged in an order that follows the recording order of the medical image data 111 arranged in the image information area 110. Therefore, for the medical image data 111 arranged in the third image information area 110, the series and order of the medical image data 111 are specified by referring to the third image order information 132 in the frame information area 130.

  FIG. 3 is a diagram showing a detailed configuration for handling the bundled image data 100 in the report creation terminal 4 operated by the interpretation doctor.

  The report creation terminal 4 displays the medical image data 111 to be interpreted, displays the report creation screen, supports the interpretation report creation, and links the displayed medical image data 111 to the character strings in the interpretation report. I do.

  The report creation terminal 4 includes an operation unit 401. The operation unit 401 is composed of an input interface operated mainly by an interpreting doctor. The operation unit 401 inputs a signal indicating a report creation operation and a link operation to the report creation device 4a and the image display device 4b.

  In addition, the report creation terminal 4 includes a report creation unit 402, a report display control unit 403, and a report display unit 404 for displaying the report creation screen and supporting the interpretation report creation. Each of these configurations is realized by the report creation device 4a, which is a computer, executing an operating system and a control application. Each of these configurations is realized in particular by a report creation program.

  The report creation unit 402 mainly includes a CPU disposed in the report creation device 4a. The report creation unit 402 creates an interpretation report. In accordance with the pressing signal input from the operation unit 401, characters such as characters and symbols associated with the input pressing signal are embedded in the interpretation report.

  The report display control unit 403 mainly includes a CPU and a GPU arranged in the report creation device 4a. The report display control unit 403 generates drawing data representing a report creation screen and causes the report display unit 404 to display the drawing data. The report display unit 404 mainly includes a monitor. The report display control unit 403 reflects the interpretation report being created by the report creation unit 402 in the drawing data. The interpretation report updated by the report creation unit 402 is reflected in the drawing data created by the report display control unit 403 in real time and displayed on the report display unit 404.

  The report creation terminal 4 also includes an image receiving unit 405, an image developing unit 406, an image display control unit 407, and an image display unit 408 for displaying the medical image data 111 to be interpreted. Each of these configurations is realized by the image display device 4b being a computer executing an operating system and a control application. Each of these configurations is realized in particular by a viewer program.

  The image receiving unit 405 mainly includes a communication interface. The image receiving unit 405 receives normal image data and bundled image data 100 from the image management server 3.

  The image development unit 406 is mainly configured to include a CPU. The image development unit 406 decomposes the bundle image data 100 into medical image data 111 included in the bundle image data 100, analyzes the bundle image data 100, and creates a file structure management table. The file structure management table is a pair of a memory address indicating a development destination of the developed medical image data 111, image order information 132 of the medical image data 111, and presence position information in the bundle image data 100.

  The presence position information is information indicating where in the bundled image data 100 the linked medical image data 111 exists. This existence position information is an offset value indicating the number of bytes from the beginning of the bundle image data 100.

  The image display control unit 407 mainly includes a CPU and a GPU. The image display control unit 407 causes the image display unit 408 to display each medical image data 111 decomposed by the image development unit 406. The image display unit 408 is a monitor provided in the image display device 4b. The image display control unit 407 refers to the file structure management table and displays the medical image data 111 for each group of the medical image data 111 in the display order according to the intra-group order information 134. For example, the display area of the monitor is set for each group, and the medical image data 111 of the same group is displayed in the display area so as to be superimposed according to the arrangement order.

  Since the meanings of “StackID” and “IndexID” are different depending on the bundle image data 100, the image development unit 406 identifies information for identifying the medical image diagnostic apparatus 2 taken from the common incidental information area 120 of the bundle image data 100. To get. Then, referring to the table indicating which of the StackID and IndexID represents the group and the order for each machine name of the medical image diagnostic apparatus 2, which corresponds to the group information 133 and which corresponds to the intra-group order information 134 It is displayed after judging whether to do.

  In addition, the report creation terminal 4 includes a link generation unit 409, a clock IC 411, and a link data embedding unit 410 for linking the displayed medical image data 111 to a character string in the interpretation report. The link generation unit 409 and the clock IC 411 are provided in the image display device 4b. The link data embedding unit 410 is provided in the report creation device 4a.

  Each of these configurations is realized by the report creation device 4a and the image display device 4b that are computers executing an operating system and a control application, respectively. Each configuration of the image display device 4b and the report creation device 4a is realized by a control program for linking that is stored according to the respective roles.

  The link generation unit 409 mainly includes a CPU. The link generation unit 409 generates link data of the medical image data 111 to be embedded in the interpretation report. When one or more of the medical image data 111 displayed on the monitor of the image display device 4b is dragged and dropped on the character string in the interpretation report, the link generation unit 409 drags and drops the medical image that has been dragged and dropped. Each link data specifying the data 111 is generated.

  If the medical image data 111 is derived from the bundle image data 100, the link generation unit 409 determines which of the plurality of medical image data 111 in which the dragged and dropped medical image data 111 is recorded in the bundle image data 100. The image specifying information indicating whether it corresponds to is generated and included in the link data.

  The image specifying information indicating which medical image data 111 in the bundle image data 100 is linked is the presence position information or the image order information 132. If a data string existing from a position corresponding to the existence position information is extracted from the bundle image data 100, the linked medical image data 111 is extracted. Also, if the arrangement order of the image order information 132 included in the link data is counted in the frame information area 130, and the data sequence recorded in the same order of recording as the arrangement order is extracted from the image information area 110, The linked medical image data 111 is extracted.

  The image order information 132 and the presence position information of the medical image data 111 displayed by the file structure management table created by the image development unit 406 are specified. The link generation unit 409 refers to the file structure management table, and generates link data by including existing position information and image order information 132 of medical image data to be linked in the link data.

  Link data embedding unit 410 mainly includes a CPU. The link data embedding unit 410 is realized by a link control program on the report creation device 4a side included in the report creation program for realizing the report creation unit 402. The link data embedding unit 410 receives the link data generated by the link generation unit 409 from the image display device 4b side, and embeds the received link data in the interpretation report in association with the character string to be dropped. . That is, the link data is added to the interpretation report data while being associated with the character string data.

  When the link is embedded by the link data embedding unit 410, the report display control unit 403 causes the report display unit 404 to display that the link processing has been performed. For example, the report display control unit 403 changes the display color of the character string to be linked to blue or the like, creates drawing data in which this character string is underlined, and causes the report display unit 404 to display the drawing data.

  FIG. 4 is a diagram showing a detailed configuration of the report browsing terminal 5 operated by the viewer of the interpretation report.

  The report browsing terminal 5 displays an interpretation report and medical image data 111 linked to the interpretation report. The report browsing terminal 5 includes a report storage unit 501, a display control unit 502, a display unit 503, an operation unit 504, a link destination request unit 505, and an image reception unit 506.

  The operation unit 504 is mainly configured by an input interface operated by a doctor who wants to browse an interpretation report. The operation unit 504 inputs a signal indicating a report display operation and a signal indicating an operation for requesting link destination data to the report browsing terminal 5. The display unit 503 is mainly composed of a monitor. The display unit 503 displays an interpretation report and linked medical image data 111.

  The report storage unit 501 mainly includes a RAM. The report storage unit 501 temporarily stores an interpretation report to be displayed. The interpretation report is stored in a report server on the network N (not shown) and is received from this report server. The report storage unit 501 temporarily stores the interpretation report received from the report server.

  Link destination request unit 505 mainly includes a CPU and a communication interface. The link destination request unit 505 generates a command for requesting a link destination linked to the interpretation report, and transmits the command to the image management server 3. When the viewer selects a link on the interpretation report using the operation unit 504, the link data is acquired from the interpretation report stored in the report storage unit 501. Then, the link destination request unit 505 attaches the acquired link data to the request command and transmits it to the image management server 3.

  The image receiving unit 506 mainly includes a communication interface. The image receiving unit 506 receives the medical image data 111 from the image management server 3. The image receiving unit 506 receives the linked medical image data 111 transmitted by the image management server 3 according to the link data transmitted by the link destination request unit 505.

  The display control unit 502 mainly includes a CPU and a GPU. The display control unit 502 displays the interpretation report and the medical image data 111 on the display unit 503. The display control unit 502 reads an interpretation report from the report storage unit 501 and causes the display unit 503 to display the read interpretation report. When the image receiving unit 506 receives the medical image data 111 linked to the interpretation report from the image management server 3, the display control unit 502 causes the display unit 503 to display the received medical image data 111.

  FIG. 5 is a diagram showing a detailed configuration of the image management server 3 that manages the bundled image data 100.

  The image management server 3 performs database management of normal image data and bundled image data 100, transmission processing of the normal image data and bundled image data 100 to the report creation terminal 4, and transmission processing of linked medical image data 111. I do.

  First, the image management server 3 manages the image reception unit 301, the received image analysis unit 302, the normal image data registration unit 303, the bundle image data registration unit 304, and the image for database management of the normal image data and the bundle image data 100. A storage unit 305 and an image database 306 are provided. Each of these configurations is realized by the image management server 3 being a computer executing an operating system and an image management program.

  The image receiving unit 301 mainly includes a communication interface. The image receiving unit 301 receives normal medical image data or bundled image data 100 transmitted from the medical image diagnostic apparatus 2.

  The received image analysis unit 302 mainly includes a CPU. The received image analysis unit 302 determines whether the received data is normal medical image data or bundled image data 100. The received data is analyzed, and if the frame information area 130 exists, the bundle image data 100 is generated and a program that functions as the bundle image data registration unit 304 is developed and executed so as to be processed by the bundle image data registration unit 304. . If the frame information area 130 does not exist, a program that functions as the normal image data registration unit 303 is expanded and executed so that the normal image data is processed by the normal image data registration unit 303 as normal image data. When the normal medical image data and the bundle image data 100 are accompanied by information such as a code indicating the type, the received image analysis unit 302 refers to the information to determine whether the image data is normal image data or bundle image data. It is judged whether it is 100.

  The normal image data registration unit 303 mainly includes a CPU. The normal image data registration unit 303 registers the received normal image data in the image database 306 and stores the received normal image data in the image storage unit 305.

  The image database 306 mainly includes an HDD. The image database 306 is a database of received normal image data and bundled image data 100. A record that stores the patient name and patient ID of the image data, the type and body name of the photographed medical image diagnostic apparatus 2, and the storage destination indicating where the image storage unit 305 stored the data is stored.

  The image storage unit 305 mainly includes an HDD. The image storage unit 305 stores the received normal image data and bundled image data 100.

  The normal image data registration unit 303 creates a record of the stored normal image data from the incidental information attached to the normal image data and the image storage destination, and stores it in the image database 306.

  The bundle image data registration unit 304 mainly includes a CPU. The bundle image data registration unit 304 registers the incidental information and the image storage destination of the received bundle image data 100 in the image database 306 and causes the image storage unit 305 to store them.

  When the bundle image data registration unit 304 registers the bundle image data 100 in the image database 306, the bundle image data registration unit 304 refers to the common incidental information area 120 and the frame information area 130 of the bundle image data 100 and records them in the bundle image data 100. The supplementary information of each medical image data 111 and the pair of group information 133 and in-group order information 134 of each medical image data 111 recorded in the bundle image data 100 are extracted and bundled for each medical image data 111. It is included in the record of the image data 100.

  In addition, the image management server 3 includes an image transmission unit 307 for transmission processing of normal image data and bundled image data 100 to the report creation terminal 4. Each of these configurations is realized by the image management server 3 being a computer executing an operating system and an image management program.

  The image transmission unit 307 mainly includes a CPU and a communication interface. The image transmission unit 307 transmits normal image data and bundled image data 100 to the report creation terminal 4. When a command representing a list request for image data is transmitted from the report creation terminal 4, the image database 306 is searched using an inspection key attached to the command, and a corresponding record is extracted. When the extracted record is transmitted to the report creation terminal 4 and information indicating one piece of image data is received from the report creation terminal 4, the image transmission unit 307 searches the image database 306 and determines the storage location of the image data. The information to be represented is acquired, and the normal image data and the bundled image data 100 existing in the acquired storage destination are transmitted to the report creation terminal 4.

  The image management server 3 also includes an image extraction unit 308 for transmission processing of the linked medical image data 111. Each of these configurations is realized by the image management server 3 being a computer executing an operating system and an image management program.

  The image extraction unit 308 mainly includes a CPU. The image extraction unit 308 extracts the linked medical image data 111 from the bundle image data 100 and transmits the extracted medical image data 111 to the report browsing terminal 5 that requested the link destination. When link data is received from the report viewing terminal 5, the linked medical image data 111 in the bundle image data 100 is extracted using the image specifying information included in the link data. Then, the common incidental information area 120 and the frame information area 130 are added to the extracted medical image data 111 and transmitted to the report browsing terminal 5.

  When the image specifying information is the location information, the image extraction unit 308 extracts data corresponding to the data amount indicated by the data size information 112 described immediately after the data from the data indicated by the location information. . This extracted data corresponds to the medical image data 111 linked.

  When the image specifying information is the image order information 132, the image extraction unit 308 counts the arrangement order of the image order information 132 in the frame information area 130, and the image information area 110 has the same number of recording orders as the arrangement order. After the existing data, the data amount indicated by the data size information 112 is extracted. This extracted data corresponds to the medical image data 111 linked.

  Hereinafter, various processes relating to the bundle image data 100 in the medical image management system 1 having each of the above-described configurations will be described.

(First mode of linking process)
First, a description will be given of a linking process when the presence position information is included in the link data as image specifying information. FIG. 6 is a flowchart showing a first mode of the linking operation using the presence position information.

  In the report creation terminal 4, when the image receiving unit 405 receives the bundle image data 100 from the image management server 3 (S01), the image development unit 406 analyzes the bundle image data 100 (S02), and the bundle image data 100 file. A structure management table is created (S03).

  FIG. 7 is a schematic diagram illustrating an example of a file structure management table created when the bundled image data 100 is expanded.

  The image expansion unit 406 sequentially decomposes the bundle image data 100 into the common incidental information area 120, the frame information area 130, and each medical image data 111, and expands the bundle image data 100 on the RAM in order from the top. At this time, the memory address numbers on the RAM indicating the respective storage areas are stored in the file structure management table.

  Further, the image development unit 406 associates a stack ID that identifies the data stored in these areas with the common incidental information area 120, the frame information area 130, and the memory address number indicating the storage area of each bundled image data 100. The IndexID pair is stored in the file structure management table. When the medical image data 111 is expanded on the RAM, the image order information 132 recorded in the same order as the expansion order in the frame information area 130 is read as the expansion data identification information, and the expanded medical image data 111 It is stored in the file structure management table in association with the memory address number.

  Furthermore, when storing the common incidental information area 120, the frame information area 130, and each medical image data 111 in the RAM, the image development unit 406 calculates the data amount of the decomposed data in order from the data head of the bundle image data 100. Add. This added value corresponds to the offset value of the next data. The image development unit 406 stores the offset value in association with each other in the file structure management table.

  When the file structure management table of the bundle image data 100 is created, the image display control unit 407 refers to the file structure management table and displays the medical image data 111 in the order of IndexId for each StackID (S04).

  Here, when an operation for displaying the next image using the operation unit 401 is performed, the image display control unit 407 includes image order information 132 representing the next image order of the medical image data 111 currently displayed. The paired memory address number is read from the file structure management table, and the medical image data 111 stored in the storage area on the RAM corresponding to the memory address number is displayed on the image display unit 408.

  For example, as illustrated in FIG. 7, when an operation for displaying the next image is performed in the state where the medical image data 111 with StackID: 2 and IndexID: 3 is displayed, the image display control unit 407 displays the StackID: 2 and The index ID: 4 is searched from the file structure management table, the medical image data 111 in the storage area corresponding to the address numbers 601 to 700 associated with the corresponding expanded data identification information is read, and is displayed in the image display unit 408. Display.

  When the interpreting doctor selects a range of a predetermined character string input to the interpretation report using the operation unit 401 (S05) and starts dragging the displayed medical image data 111 (S06), the link generating unit 409 The offset value is read from the item on the file structure management table corresponding to the displayed medical image data 111 (S07). Further, the link generation unit 409 reads information for specifying the bundle image data 100 from the common incidental information area 120 of the bundle image data 100 (S08).

  For example, as shown in FIG. 7, if the medical image data 111 is dragged while the medical image data 111 with StackID: 2 and IndexID: 4 is displayed, StackID: 2 and IndexID: on the file structure management table are displayed. The offset value of 900 Kbytes is read out from the item 4 relating to the medical image data 111.

  When the link generation unit 409 reads the offset value and the specific information of the bundle image data 100, the link generation unit 409 generates link data including these (S09).

  FIG. 8 is a schematic diagram showing link data using the presence position information.

  The link generation unit 409 generates link data in which the IP address of the image management server 3 specified in advance, the specific information of the bundle image data 100, and the location information are paired. The IP address of the image management server 3 is stored in advance in the HDD or inquired from the AE title of the image management server 3 or the like. The specific information of the bundle image data 100 includes, for example, the type of the medical image diagnostic apparatus 2 used for imaging such as an X-ray CT apparatus and an MRI apparatus, the patient ID of the patient who is the information subject of the bundle image data 100, and the examination ID. It is a pair. The location information is an offset value such as 900 Kbytes read from the file structure management table.

  When the link data is generated, the link data embedding unit 410 embeds the generated link data in the image interpretation report in association with the range-selected character string data (S10).

  As described above, in this medical image management system 1, information specifying the bundle image data 100 is linked with the existing position information indicating the existing position in the bundle image data 100 of the medical image data 111 to be linked. By configuring the data, it is possible to identify which position in which bundle image data 100 is linked, and to set a link to the medical image data 111 that is one data element in the bundle image data 100. it can.

  In this embodiment, the file structure management table is created by calculating the offset value at the time of image development. However, a storage area for the bundle image data 100 is secured, and the bundle image data 100 is stored in the storage area. The data is stored in order from the beginning of the data, it is determined whether the data in the storage area is dragged, and the storage area of the dragged data is the position of the entire bundle image data 100. And the result may be used as an offset value.

  Further, offset value information is written in the frame information of each medical image data 111 stored in the bundle image data 100 in addition to the shooting position information and the image order information 132 at the generation stage of the bundle image data 100. Alternatively, the added offset value information may be included in the link data as the existing position information.

(Second mode of linking process)
Next, the linking process when the image order information 132 is included in the link data will be described. FIG. 9 is a flowchart showing a second mode of the linking operation using the image order information 132.

  In the report creation terminal 4, when the image receiving unit 405 receives the bundle image data 100 from the image management server 3 (S11), the image development unit 406 analyzes the bundle image data 100 (S12), and the bundle image data 100 file. A structure management table (see FIG. 7) is created (S13).

  When the file structure management table of the bundle image data 100 is created, the image display control unit 407 refers to the file structure management table and displays the medical image data 111 in the order of IndexId for each StackID (S14).

  When the interpretation doctor selects a range of a predetermined character string input to the interpretation report using the operation unit 401 (S15) and starts dragging the displayed medical image data 111 (S16), the link generation unit 409 StackID and IndexID are read out from the items on the file structure management table corresponding to the displayed medical image data 111 (S17). Further, the link generation unit 409 reads information for specifying the bundle image data 100 from the common incidental information area 120 of the bundle image data 100 (S18).

  For example, as shown in FIG. 7, if the medical image data 111 is dragged while the medical image data 111 with StackID: 2 and IndexID: 4 is displayed, the medical image displayed on the file structure management table is displayed. StackID: 2 and IndexID: 4 are read from the items regarding the data 111.

  When the Stack ID and the Index ID of the dragged medical image data 111 and the specific information of the bundle image data 100 are read, the link generation unit 409 generates link data including these (S19).

  FIG. 10 is a schematic diagram showing link data using the image order information 132.

  The link generation unit 409 generates link data in which the IP address of the image management server 3 specified in advance, the specific information of the bundle image data 100, and the image order information 132 are paired. The image order information 132 includes StackID: 2 and IndexID: 4 read from the file structure management table.

  When the link data is generated, the link data embedding unit 410 embeds the generated link data in the interpretation report in association with the range-selected character string data (S20).

(Linked image transmission process corresponding to the first link process)
Next, a description will be given of a process of transmitting a linked medical image when presence position information is included in link data as image specifying information. FIG. 11 is a flowchart showing an operation of transmitting the linked medical image data 111 to the report browsing terminal 5 based on the link data using the presence position information. FIG. 12 is a schematic diagram showing a mode in which the medical image data 111 is transmitted.

  First, when the image management server 3 receives an acquisition request for linked medical image data 111 including link data from the report browsing terminal 5 (S21), the image extraction unit 308 identifies specific information of the bundle image data 100 from the link data. Is taken out (S22).

  When the specific information of the bundle image data 100 is extracted, as shown in FIG. 12A, the image extraction unit 308 searches the image database 306 using the specific information as a search key (S23). The information indicating the image storage destination paired with the image storage destination is acquired, and the bundle image data 100 existing in the storage destination represented by the information indicating the image storage destination is specified from the image storage unit 305 (S24).

  Next, as shown in FIG. 12B, the image extraction unit 308 extracts an offset value from the link data (S25), and a linked medical image starting from the offset value with the head of the bundle image data 100 as a reference. The data 111 is specified (S26). For example, when the offset value is 900 Kbytes, the medical image data 111 starting from the 900 Kbyte data from the top of the bundle image data 100 is specified.

  When the medical image data 111 is specified, as shown in FIG. 12C, the image extraction unit 308 reads the data size information 112 existing in the header of the medical image data 111 (S27), and the offset A data string of the data amount represented by the data size information 112 is extracted from the value as the linked medical image data 111 (S28).

  Then, as shown in FIG. 12 (d), the image extraction unit 308 extracts the common incidental information area 120 and at least the necessary part of the frame information area 130 from the bundle image data 100 and attaches them to the medical image data 111. (S29) The extracted medical image data 111 is transmitted to the report browsing terminal 5 (S30).

(Linked image transmission process corresponding to the second link process)
A process for transmitting a link destination medical image when the image order information 132 is included in the link data as the image specifying information will be described. FIG. 13 is a flowchart showing an operation of transmitting the linked medical image data 111 to the report browsing terminal 5 based on the link data using the image order information 132. FIG. 14 is a schematic diagram showing a mode in which the medical image data 111 is transmitted.

  First, when the image management server 3 receives an acquisition request for linked medical image data 111 including link data from the report browsing terminal 5 (S31), the image extraction unit 308 identifies specific information of the bundle image data 100 from the link data. Is taken out (S32).

  When the specific information of the bundle image data 100 is extracted, as shown in FIG. 14A, the image extraction unit 308 searches the image database 306 using the specific information as a search key (S33). The information indicating the image storage destination paired with the image storage destination is acquired, and the bundle image data 100 existing in the storage destination represented by the information indicating the image storage destination is specified from the image storage unit 305 (S34).

  Next, as shown in FIG. 14B, the image extraction unit 308 extracts StackID and IndexID from the link data (S35), and is the same as the extracted StackID and IndexID from the frame information area 130 of the bundled image data 100. The image order information 132 is searched from the bundled image data 100 (S36). For example, when StackID: 2 and IndexID: 4 are extracted as the image order information 132 from the link data, the image order information 132 representing the StackID: 2 and IndexID: 4 is retrieved from the bundle image data 100.

  When the image order information 132 in the bundled image data 100 is specified, as shown in FIG. 14C, the image extraction unit 308 counts the arrangement order of the specified image order information 132 (S37). . When the arrangement order is specified, the image extraction unit 308 records the same number of recording orders as the arrangement order in the image information area 110 while tracing the data size information 112 as shown in FIG. The obtained medical image data 111 is specified (S38).

  When the medical image data 111 is specified from the bundle image data 100 as shown in FIG. 14E, the image extraction unit 308 extracts the medical image data 111 (S39). Then, as shown in FIG. 14F, the image extraction unit 308 extracts the common incidental information area 120 and the frame information area 130 from the bundle image data 100 and adds them to the medical image data 111 (S40). The medical image data 111 is transmitted to the report browsing terminal 5 (S41).

(Modified example of transmission processing of linked images)
In addition to the linked medical image data 111, the medical image management system 1 according to this modified example transmits a plurality of medical image data 111 arranged in the order of the preceding and following images to the report browsing terminal 5.

  The image extraction unit 308 further includes an HDD and has a transmission number setting table. FIG. 15 is a schematic diagram showing a transmission number setting table.

  In the transmission number setting table, information on the number of sheets other than the linked medical image data 111 to be transmitted to the report browsing terminal 5 is stored in a pair with information indicating each of the plurality of report browsing terminals 5 existing on the network N. ing. If the number information is 1, in addition to the medical image data 111 linked to the report browsing terminal 5 associated with the number information, one image before and after the medical image data 111 linked in image order. The medical image data 111 corresponding to is also transmitted. If the number information is 0, no data other than the linked medical image data 111 is transmitted.

  FIG. 16 is a flowchart showing a modified example of the operation of transmitting the medical image data 111 linked by the link data including the presence position information to the report browsing terminal 5. FIG. 17 is a schematic diagram illustrating a mode in which a plurality of medical images are extracted using link data including presence position information.

  When the image management server 3 receives the link data from the report browsing terminal 5 and identifies the bundle image data 100, the image extraction unit 308 extracts the offset value from the link data as shown in FIG. 17A (S51). ), The linked medical image data 111 starting from the offset value with reference to the head of the bundle image data 100 is specified (S52). This linked medical image data 111 is called a key image.

  When the key image is specified, as shown in FIG. 17B, the image extraction unit 308 counts the recording order in the image information area 110 of the medical image data 111 serving as the key image (S53). As shown in FIG. 17C, the image order information 132 located in the same order as the obtained recording order is specified in the frame information area 130 (S54).

  As shown in FIG. 17D, the image extraction unit 308 refers to the transmission number setting table and stores the medical image data 111 before and after the key image to be transmitted to the report browsing terminal 5 that requested the link destination other than the key image. Each number is confirmed (S55). The medical image data 111 before and after the key image transmitted other than the key image is referred to as a front and rear image.

  Then, as shown in FIG. 17E, the image extracting unit 308 adds and subtracts each natural number up to the confirmed number to the IndexID of the key image to specify the image order information 132 of the preceding and following images (S56). ) And search from the frame information area 130 (S57). For example, when the image order information 132 of the key image is StackID: 2 and IndexID: 3, and the number information associated with the report browsing terminal 5 that transmitted the link data in the transmission number setting table is 1, StackID: 2 And the image order information 132 with the IndexID: 2 and the image order information 132 with the StackID: 2 and the IndexID: 4 are searched from the frame information area 130.

  When the image order information 132 of the preceding and following images is searched, the image extraction unit 308 counts the order of arrangement of the searched image order information 132 of the preceding and following images in the frame information area 130, as shown in FIG. Then, as shown in (g) of FIG. 17, the preceding and following images existing in the recording order equal to the counted arrangement order are identified (S59) and extracted from the bundled image data 100 (S60).

  Then, the front and rear images are transmitted to the report browsing terminal 5 together with the key image, and the front and rear images are displayed together with the key image on the report browsing terminal 5.

  FIG. 18 is a flowchart showing a modified example of the operation for transmitting the medical image data 111 linked by the link data including the image order information 132 to the report browsing terminal 5. FIG. 19 is a schematic diagram showing a mode in which a plurality of medical images are extracted using link data including the image order information 132.

  First, when link data is transmitted from the report viewing terminal 5, the image extracting unit 308 refers to the transmission number setting table before and after transmitting the link data to the report viewing terminal 5, as shown in FIG. The number of images before and after the image is confirmed (S61).

  When the number of images before and after is confirmed, the image extraction unit 308 extracts the StackID and IndexID of the key image from the link data (S62), and adds and subtracts each natural number up to the confirmed number of images to the IndexID of the key image. The image order information 132 is specified (S63), and searched from the frame information area 130 as shown in FIG. 19B (S64).

  When the image order information 132 of the preceding and following images is searched, the image extracting unit 308 arranges the searched key image and the image order information 132 of the preceding and following images in the frame information area 130 as shown in FIG. The order is counted (S65), and as shown in FIG. 19D, key images and front and rear images existing in the same number of recording order as the counted arrangement order are identified (S66) and extracted from the bundle image data 100 ( S67).

  Then, the front and rear images are transmitted to the report browsing terminal 5 together with the key image, and the front and rear images are displayed together with the key image on the report browsing terminal 5.

  In this modification, the number of images before and after transmission is tabulated in association with the report browsing terminal 5, but in addition to the report browsing terminal 5 that requested the link destination, the CPU, RAM, broadband or narrow band of the terminal is requested. Such a configuration may be acquired, the performance of the terminal may be calculated, and the number of transmissions may be determined based on the calculation result.

  Further, the same items as those in the file structure management table are included in the record of the image database 306, and the storage location of the key image and the storage location of the preceding and succeeding images are referred to the image database 306 without analyzing the bundled image data 100. It may be specified and read from the storage location.

  In this case, the bundle image data registration unit 304 analyzes the bundle image data 100, and stores the memory address number indicating the storage destination on the image storage unit 305 of the medical image data 111 recorded in the bundle image data 100, and the medical The image order information 132 of the image data 111 and the offset value are included in the record of the bundle image data 100 and stored.

  Then, the image extraction unit 308 reads the medical image data 111 of the storage destination corresponding to the memory address number paired with the offset value included in the link data from the image storage unit 305, so that the linked medical image data 111 can be extracted. Further, the medical image data 111 linked to the memory address number paired with the image order information 132 included in the link data is read from the image storage unit 305 to extract the linked medical image data 111. Can do.

  Further, the image extraction unit 308 reads the image order information 132 paired with the offset value included in the link data on the image database 306, or uses the image order information 132 included in the link data, and uses this image order information 132. The image order information 132 of the preceding and succeeding images is acquired from the 132 and the transmission number setting table, and the medical image data 111 of the storage destination corresponding to the memory address number paired with the acquired image order information 132 is obtained from the image storage unit 305. By reading, the linked medical image data 111 and the preceding and subsequent medical image data 111 can be extracted.

(Further modifications of link data generation processing and image transmission processing)
The bundled image data 100 generated by the medical image diagnostic apparatus 2 may be changed after being registered in the image management server 3. Even if the contents of the bundle image data 100 are changed, the medical image data linked using the link data generated before that can be specified and transmitted to the report browsing terminal 5. Hereinafter, a description will be given of link data generation processing on the premise that the bundled image data 100 is changed and processing for specifying linked medical image data and transmitting it to the report browsing terminal 5.

  FIG. 20 is a block diagram illustrating a configuration of the report creation terminal 4 on the assumption that the bundled image data 100 is changed.

  This report creation terminal 4 further includes a clock IC 411. The clock IC 411 measures the current time. The link generation unit 409 uses the clock IC 411 to include generation information in the link data.

  The generation information included in the link data is information indicating the generation of the bundle image data 100 at the time of link data generation. Specifically, this generation information is the date and time when link data is generated. The link generation unit 409 acquires the date / time information at that time from the clock IC 411, and includes the date / time information in the link data as generation information when generating the link data.

  FIG. 21 is a diagram illustrating a modified example of the configuration of the image management server 3 when it is assumed that the bundle image data 100 is changed.

  The image management server 3 further performs data content change processing and change history management processing of the normal image data and the bundled image data 100. The image management server 3 includes a data change unit 309 for data content change processing and change history management processing of normal image data and bundled image data 100. The data change unit 309 is realized by the image management server 3 being a computer executing an operating system and an image management program.

  The data changing unit 309 mainly includes a CPU. The data changing unit 309 changes the contents of the normal image data and the bundle image data 100. When communication data that changes the contents of the bundle image data 100 stored in the image management server 3 is received from a terminal that handles image data connected to the network N, the data changing unit 309 reflects the changed contents. The communication data includes supplementary information of the medical image data 111 described in the frame information area 130 such as the image order information 132.

  The data changing unit 309 identifies the medical image data 111 to be deleted based on the supplementary information included in the communication data, reads the normal image data and the bundled image data 100 to be changed from the image storage unit 305, and adds the changes. The change of the bundle image data 100 is, for example, a part of the medical image data 111 recorded in the bundle image data 100, a group change of the medical image data 111, or a rearrangement of the image order within the group. .

  When the communication data for deleting some of the medical image data 111 is received, the data changing unit 309 deletes the medical image data 111 to be deleted and the corresponding supplementary information described in the frame information area 130 from the bundle image data 100. . That is, the shooting position information 131 and the image order information 132 to be deleted are also deleted.

  Further, the data changing unit 309 includes the intra-group order information 134 in the bundle image data 100 of the other medical image data 111 arranged in the same group as the deleted medical image data 111 and after the image order of the deleted medical image data 111. Increase the value.

  The data change unit 309 includes a change history management unit 310 that registers change contents in the image database 306. The change history management unit 310 registers the change history in the image database 306. The change history is information indicating change contents in which the change is made before and after the change, and generation information indicating the change date and time.

  For example, if the medical image data 111 of a certain group in a certain order is deleted, the change history management unit 310 adds the generation information indicating the change date and time to the image database 306, and stores each medical image registered in the image database 306. The intra-group order information 134 of the image data 111 is rewritten to information that is a pair of the order before the change and the order after the change.

  The change history management unit 310 registers this change history every time a change is made. For example, it is assumed that the medical image data 111 in a certain group is deleted twice. In this case, the change history management unit 310 adds the new two generation information for the two deletions to the bundled image data 100. Further, in response to the two deletions, the intra-group order information 134 registered in the image database 306 is changed to the order before the change by the first deletion, the order changed by the first deletion, and the second time. Rewrite the information as a pair with the order changed by deletion.

  The image extraction unit 308 identifies which medical image data 111 in the current bundle image data 100 corresponds to the image identification information included in the link data by referring to the change history in the image database 306, and the identification is performed. Medical image data 111 is extracted.

  The generation information may be information representing a version, that is, a version, as information representing the generation of the bundle image data 100. In this case, when storing the bundle image data 100 in the image management server 3, the bundle image data registration unit 304 adds generation information such as “1” indicating the first version to the bundle image data 100. Alternatively, when the bundle image data 100 is generated by the medical image diagnostic apparatus 2, the first generation information is attached. When the contents of the bundle image data 100 are changed, the data change unit 309 changes the generation information in the bundle image data 100 to a value representing a new version. The change history management unit 310 writes generation information representing this version to the change history. The link generation unit 409 includes the generation information described in the bundle image data 100 in the link data.

(First transmission processing of linked images on the premise that the bundle image data 100 is changed)
FIG. 22 is a flowchart illustrating an operation of absorbing the change of the bundle image data 100 and transmitting the linked medical image data 111 to the report browsing terminal 5 based on the link data configured by the presence position information.

  First, when the image management server 3 receives communication data including link data from the report browsing terminal 5 and requesting acquisition of the linked medical image data 111 (S71), the image extraction unit 308 reads bundle image data from the link data. 100 specific information is extracted, and the bundle image data 100 is specified from the image storage unit 305 with reference to the specific information and the image database 306 (S72).

  Next, the image extraction unit 308 extracts the offset value and generation information from the link data (S73), and reads the change history from the record of the specified bundle image data 100 (S74).

  FIG. 23 shows an example of the data structure of link data created including presence position information and generation information. For example, when link data is generated on January 1, 2005, the clock IC 411 measures January 1, 2005 and temporarily stores it. When the medical image data 111 that starts with the offset value of the bundle image data 100 having an offset value of 900 Kbytes is linked to the interpretation report, the link generation unit 409 generates “2005050101” temporarily stored in the generation. Link data is generated including information and “900” as presence position information. The link data including the generation information and the location information is embedded in the interpretation report by the link data embedding unit 410.

  FIG. 24 is an example showing the change history recorded in the image database 306. For example, when the medical image data 111 corresponding to the data string 200K to 300 Kbytes of the bundle image data 100 is first deleted on January 1, 2004 by the data changing unit 309, the image database 306 stores this deletion target. In the record of the bundle image data 100, the generation information represented by “20040401” and the modification content represented by “200 to 300 deletion” are recorded as the change history. Further, the data string 200K to 300 Kbytes is deleted on January 1, 2006, the data string 1200K to 1300 Kbytes is deleted on June 1, 2006, and the data strings 400K to 500 Kbytes are deleted on January 1, 2007. When deleted, these changes are sequentially recorded.

  When the image extraction unit 308 reads the offset value, the generation information, and the change history, the image extraction unit 308 compares the generation information read from the link data with the generation information described in the change history (S75). If the generation information read from the link data is older than the generation information described in the change history (S75, Yes), the change contents paired with the generation information newer than the generation information read from the link data in the change history are displayed. Referring to the offset value read from the link data, the offset value in the current bundle image data 100 is converted (S76).

  For example, the link data in FIG. 23 and the change history in FIG. 24 are taken as examples. When the generation information represented by “20050101” of the link data is compared with the generation information represented by “20040401” of the change history, the offset value is not converted because the generation information of the link data is newer. This is because the offset value included in the link data already reflects the change of the bundle image data 100 on January 1, 2005.

  Next, when the generation information represented by “20050101” of the link data is compared with the generation information represented by “20060601” of the change history, since the generation information of the link data is older, the offset included in the link data Further compare the value with the change. As a result of the comparison, the offset value included in the link data is 900K, the deleted data string is 500K to 600K, and the offset value included in the link data is later than the deleted data string. The offset value read from the data is changed to a value reflecting this change content. The location indicated by the offset value included in the link data is because the offset value has been raised by the change on January 1, 2006. The image extraction unit 308 calculates the size of the deleted data string, and subtracts the calculation result from the offset value read from the link data. As a result, the offset value read from the link data is converted to “800K”.

  Next, when the generation information represented by “20050101” of the link data is compared with the generation information represented by “20060601” of the change history, since the generation information of the link data is older, the offset included in the link data Further compare the value with the change. As a result of the comparison, the value obtained by converting the offset value included in the link data is 800K, the deleted data string is 1200K to 1300K, and the offset value included in the link data is earlier than the deleted data string. Therefore, no further conversion is performed on the offset value read from the link data.

  Next, when the generation information represented by “20050101” of the link data is compared with the generation information represented by “20070101” of the change history, since the generation information of the link data is older, the offset included in the link data Further compare the value with the change. As a result of comparison, the value obtained by converting the offset value included in the link data is 800K, the deleted data string is 400K to 500K, and the offset value included in the link data is later than the deleted data string. Therefore, the offset value read from the link data is changed to a value reflecting this change content. As a result, the offset value read from the link data is converted to “700K”.

  The conversion processing of the read offset value is sequentially performed on all the change histories. This conversion process is performed on the offset value read from the link data, and the offset value included in the link data is not converted.

  When the offset value in the current bundle image data 100 is obtained by this conversion processing, the file structure management table stored in the image database 306 is read (S77), and the offset value obtained by the conversion is searched (S78). The medical image data 111 is read from the storage area on the image storage unit 305 indicated by the storage destination information stored corresponding to the offset value to be stored (S79). Then, the read medical image data 111 is transmitted to the report viewing terminal 5 together with the common incidental information area 120 and the frame information area 130 attached to the bundle image data 100, and the image transmission process is ended.

(Second transmission processing of linked images on the premise that the bundle image data 100 is changed)
FIG. 25 is a flowchart illustrating an operation of absorbing the change of the bundle image data 100 and transmitting the linked medical image data 111 to the report browsing terminal 5 based on the link data configured by the image order information 132. .

  First, when the image management server 3 receives an acquisition request for linked medical image data 111 including link data from the report browsing terminal 5 (S81), the specific information of the bundle image data 100 is extracted from the link data, and this specific information is extracted. The bundle image data 100 is specified from the image storage unit 305 with reference to the image database 306 (S82).

  Next, the image extracting unit 308 extracts StackID, IndexID, and generation information from the link data (S83), and reads the change history from the record of the specified bundle image data 100 (S84).

  FIG. 26 shows an example of the data structure of the link data created including the image order information 132 and the generation information. For example, when link data is created on January 1, 2006, and the linking for the medical image data 111 with StackID: 2 and IndexID: 4 is made in the interpretation report, the link generation unit 409 generates “20060601” as a generation. Link data is generated by including “StackID = 2 & IndexID = 4” as information and as location information. The link data including the generation information and the image order information 132 is embedded in the interpretation report by the link data embedding unit 410.

  FIG. 27 is a further example showing the change history recorded in the image database 306. For example, when the medical image data 111 with StackID: 2 and IndexID: 3 included in the bundle image data 100 is deleted by the data changing unit 309 on January 1, 2007, the image database 306 becomes a deletion target. In the record of the bundle image data 100, the generation information represented by “20070101” as the change history and the medical image data after the medical image data 111 in which the image order is deleted in the same group as the deleted medical image data 111 are used. Before and after the change of the group information 133 and the in-group order information 134 of the image data are recorded. When the medical image data 111 with StackID: 2 and IndexID: 3 is deleted, the fact that the medical image data 111 with StackID: 2 and IndexID: 4 is changed to StackID: 2 and IndexID: 3, StackID: 2 and IndexID: 5 Are recorded to indicate that the medical image data 111 has a StackID of 2 and a IndexID of 4.

  When the image extraction unit 308 reads StackID and IndexID and generation information from the link data and reads the change history from the image database 306, the image extraction unit 308 compares the generation information read from the link data with the generation information described in the change history (S85). ). When the generation information read from the link data is older than the generation information described in the change history (S85, Yes), the change contents paired with the new generation information than the generation information read from the link data in the change history are displayed. Referring to, StackID and IndexID read from the link data are converted into StackID and IndexID in the current bundled image data 100 (S86).

  For example, the link data in FIG. 27 and the change history in FIG. 28 are taken as examples. When the generation information represented by “20060101” of the link data is compared with the generation information represented by “20070101” of the change history, since the generation information of the link data is older, the StackID and IndexID included in the link data are the same. Search whether there exists before the change described in the change contents. As a result of the search, StackID: 2 and IndexID: 4 included in the link data are found in the item before the change described in the change content. Therefore, the StackID and the IndexID read from the link data are changed to those after the change described in the change content. Change to item. As a result, the StackID and the IndexID read from the link data are converted into “StackID = 2 & IndexID = 3”.

  When the StackID and the IndexID in the current bundle image data 100 are obtained by this conversion processing, the image extraction unit 308 reads the file structure management table of the bundle image data 100 stored in the image database 306 (S87), and the file structure The image order information 132 having the same StackID and IndexID newly obtained from the management table is searched (S88), and the storage area on the image storage unit 305 indicated by the storage destination information stored corresponding to the image order information 132 Medical image data 111 is read out from (S89). Then, the read medical image data 111 is transmitted to the report viewing terminal 5 together with the common incidental information area 120 and the frame information area 130 attached to the bundle image data 100, and the image transmission process is ended.

  As described above, in the medical image management system 1, information specifying the bundle image data 100 and presence position information indicating the position of the medical image data 111 to be linked in the bundle image data 100 are included in the link data. In addition, by including the medical image data 111 to be linked with the image order information 132 indicating the image order in the bundle image data 100, a link can be set to the medical image data that is one data element in the bundle image data. It is possible to extract and browse only linked data strings from the bundle image data.

  Accordingly, since it is not necessary to link the entire bundle image data, communication traffic is reduced when viewing the interpretation report. Further, it is possible to save the trouble of searching for the medical image data actually cited in the interpretation report from the transmitted bundle image data, and the medical efficiency is improved.

  In addition, when the linked medical image data 111 is transmitted, the linked medical image data 111 and a plurality of medical image data 111 before and after the image order may be transmitted together. The medical image data 111 before and after the medical image data 111 linked to the interpretation report is often regarded as important in diagnosis and the like. Therefore, conventionally, a person browsing the interpretation report acquires these images separately from the image management server 3. Or, conventionally, these images are also linked when creating an interpretation report. In this modified example, the medical image data 111 before and after can be browsed without requiring such work, so that medical efficiency and interpretation efficiency are improved.

  Further, generation information at the time of receiving the bundle image data 100 is attached to the link data, a change history of the bundle image data 100 is recorded, and the generation information included in the link data and the change history are compared and contrasted. You may make it calculate which data of the present bundle image data 100 the information which specifies the medical image data 111 contained in link data corresponds. As a result, even if the contents of the bundle image data 100 are changed, it is possible to continue to link the appropriate medical image data 111 using the link data in the interpretation report created before that, so that the linking is highly effective. .

DESCRIPTION OF SYMBOLS 1 Medical image management system 2 Medical image diagnostic apparatus 3 Image management server 301 Image receiving part 302 Received image analysis part 303 Normal image data registration part 304 Bunch image data registration part 305 Image storage part 306 Image database 307 Image transmission part 308 Image extraction part 309 Data change unit 310 Change history management unit 4 Report creation terminal 4a Report creation device 4b Image display device 401 Operation unit 402 Report creation unit 403 Report display control unit 404 Report display unit 405 Image reception unit 406 Image development unit 407 Image display control unit 408 Image display unit 409 Link generation unit 410 Link data embedding unit 411 Clock IC
5 Report browsing terminal 501 Report storage unit 502 Display control unit 503 Display unit 504 Operation unit 505 Link destination request unit 506 Image reception unit 100 Bundled image data 110 Image information area 111 Medical image data 112 Data size information 120 Common incidental information area 130 Frame information area 131 Shooting position information 132 Image order information 133 Group information 134 In-group order information N Network

Claims (3)

The terminal has a storage means for storing bundled image data having a plurality of medical image data and additional information including the image order information attached to the plurality of medical image data in common, and the interpretation is displayed on a terminal that displays the interpretation report. A medical image management server that transmits medical image data linked to a report,
A medical image diagnostic apparatus from which the bundle image data has been acquired, or storage means for storing the image type of the bundle image data and the image order in association with each other;
The bundle image in which the medical image data is stored in the storage unit based on the image order information included in the link data of the medical image data and the medical image diagnostic apparatus from which the medical image is acquired or the image type of the medical image Extraction means to extract from the data;
Transmitting means for transmitting medical image data extracted by the extracting means to the terminal;
Providing
A medical image management server characterized by the above. A bundle of image data having a plurality of medical image data and additional information including image order information attached to the plurality of medical image data in common is developed and displayed on the plurality of medical image data. The computer that displays the report creation screen
Link data generation means for generating link data embedded in the interpretation report, including image order information of medical image data to be linked;
Link data embedding means for embedding the link data generated by the link data generating means in the interpretation report;
A link setting program characterized in that it is made to function. The terminal has a storage means for storing bundled image data having a plurality of medical image data and additional information including the image order information attached to the plurality of medical image data in common, and the interpretation is displayed on a terminal that displays the interpretation report. A computer that sends medical image data linked to the report,
A medical image diagnostic apparatus from which the bundle image data has been acquired, or storage means for storing the image type of the bundle image data and the image order in association with each other;
The bundle in which medical image data is stored in the storage unit based on the image order information included in the link data of the medical image data and the medical image diagnostic apparatus from which the medical image is acquired or the image type of the medical image Extraction means for extracting from the image data;
Transmitting means for transmitting medical image data extracted by the extracting means to the terminal;
Make it work,
A medical image management program characterized by

Images