JP4547896B2 - Medical image management system - Google Patents

Description

  The present invention relates to a medical image management system that manages a medical image obtained by imaging a patient and associated information attached to the medical image in association with each other.

  In the medical field, digitization of medical images taken of patients has been realized. Digitization is performed by various modalities such as a CR (Computed Radiography) apparatus, a CT (Computed Tomography) apparatus, an MRI (Magnetic Resonance Imaging) apparatus, and a cassette reading apparatus. The digitized medical image is provided to a medical image management system (hereinafter referred to as PACS: Picture Archiving and Communication System for medical application) that is centrally managed by a management server together with patient information and examination information of the patient.

  Conventionally, a hospital information management system (hereinafter referred to as HIS: Hospital Information System) that manages hospital information and a radiation department information management system (hereinafter referred to as RIS: Radiological Information System) are connected via a communication network. A system for registering and managing medical images and DICOM basic information conforming to DICOM (Digital Imaging and Communication In Medicine) standards together in a database is disclosed. (For example, see Patent Document 1)

Also, PACS having a character information recognition function is disclosed for incidental information (character information such as patient ID and patient name) incidental to a medical image (see, for example, Patent Document 2).
JP-A-8-7013 JP 2003-58866 A

  In the PACS, when a medical image generated by a modality is transmitted to a management server via a communication network, various information for specifying the medical image, for example, patient information such as a patient name and a patient ID, and examination Date / time, examination ID, examination information such as the name of the doctor who requested the examination, modality device name, operator name, series information related to imaging such as examination part name, medical image generation date / time, image information related to medical images such as bit information, etc. Is attached to the medical image as accompanying information.

  At the time of registering the medical image database, the additional information attached to the medical image is registered in the database in association with the medical image as DICOM basic information related to the medical image.

  However, when only one type of UID is registered corresponding to one type of incidental information, as shown in FIG. 8, even if the patient IDs are different, the examination IDs 31 and 32 are the same. A medical image of another patient is displayed. A UID (Unique Identifier) is an identification number whose uniqueness is guaranteed all over the world.

In a medical image management system, when a medical image received from a modality and its accompanying information (patient ID, patient name, etc.) are registered in the database, there is a difference between the accompanying information already registered in the database and the received accompanying information. If there is, there is a possibility that medical images of different patients are associated and registered with the accompanying information of the same patient, and there is a risk that the management consistency of medical images may not be maintained.
In addition, when a medical image and its supplementary information are registered in the database in the management server and then read again from an image interpretation device, the medical image intended by the operator may not be read due to supplementary information mismatch or image data failure. There is sex.

  SUMMARY OF THE INVENTION An object of the present invention is to provide a medical image management system capable of determining the consistency between old and new medical images and accompanying information when registering medical images and their accompanying information in a database.

The invention according to claim 1
A database for registering and storing a medical image obtained by imaging a patient and basic information generated based on incidental information attached to the medical image in association with each other; and a management unit for managing the basic information registered in the database In a medical image management system configured to include:
When the basic information about the medical image is registered in the database based on the newly generated medical image and the additional information attached to the medical image, the patient information included in the additional information and the database are already registered in the database. First information discriminating means for collating with patient basic information included in the basic information and discriminating whether or not both pieces of information match,
Results of determination by the first information determining means, when the basic patient information included in the basic information that is the registered patient information included in the supplementary information matches, the supplementary information as a new basic information A medical image management system comprising control means for registering in the database.

According to the present invention, when the incidental information of a newly generated medical image is registered in the database as basic information, the patient information included in the incidental information is already registered in the medical image management system. whether consistent with basic patient information included in, to determine its consistency, so that only registered in the database supplementary information is consistent, to retain the integrity of the information in the medical image management system it can. Therefore, it is possible to improve the reliability of information management of the medical image management system .

  The best mode for carrying out the present invention will be described below with reference to the drawings. However, the scope of the invention is not limited to the illustrated examples. In the following description, there are cases where assertive expressions are included for terms and the like, but they show preferred examples of the present invention and limit the meaning and technical scope of the terms of the present invention. Not what you want.

[First embodiment]
In the first embodiment, when digital medical image data (hereinafter referred to as a DICOM original image) conforming to the DICOM standard generated by the medical image generation system and its supplementary information are input to the PACS, the supplementary information is provided. An example will be described in which consistency between basic information managed in the PACS and basic information managed in the PACS is determined. Here, the determination of consistency means determining whether or not pieces of information to be compared match each other.

FIG. 1 shows a system configuration of the PACS 13 according to the present invention.
The PACS 13 is connected to the information management system 11 and the medical image generation system 12 via the communication network N.

  The information management system 11 comprehensively manages information such as personal information such as name, gender, and age of all patients, and medical history. In addition, it generates patient order information including patient information related to the patient such as the patient ID, name, and sex of the patient to be imaged, the test ID of the test, the imaging part specified in the test, the test information such as the imaging method, The generated examination order information is managed by adding identification information (hereinafter referred to as order ID) of the examination order information, and the generated examination order information is transmitted to the control device 121 of the medical image generation system 12. As the information management system 11, HIS and RIS are applicable.

  The medical image generation system 12 includes a control device 121, an image reading device 122a, an image photographing device 122b, and an image generation device 123.

Next, the system configuration of the medical image generation system 12 will be described.
The control device 121 distributes the inspection order information to the image capturing device 122b and the image generation device 123 based on the inspection order information transmitted from the information management system 11 via the communication network N. In addition, a transmission destination of digital image data distributed from the image reading device 122a or the image generation device 123 via the communication network is designated.

  The image reading device 122a reads a medical image of the radiographic image from the cassette in which the radiographic image is recorded in the image capturing device 122b, and converts the medical image into a DICOM original image. The converted digital image and its accompanying information are transmitted to the management server 133 via the communication network N. An example of the image reading apparatus is a cassette reading apparatus.

The image capturing device 122b and the image generating device 123 are image capturing devices such as CT, CR, and MRI. Some of them record the radiographic images taken in a cassette that incorporates a fluorescent plate that can be carried, while others record it in a fluorescent plate that is built in the apparatus.
The image reading device 122a and the image generating device 123 read an image or shoot based on the inspection order issued by the control device 121, and generate a DICOM original image. Then, the generated DICOM original image is transmitted to the management server 133 through the communication network N together with the accompanying information.

Next, the configuration of each device of the PACS 13 will be described.
The PACS 13 includes a control device 131, an image interpretation device 132, a management server 133, a database 134, and an image output device 135.

  When there are a plurality of management servers 133, the control device 131 registers in which database 134 in which management server 133 the medical images distributed from the medical image generation system 12 via the communication network N and the accompanying information are registered. Determine the destination and register. At this time, a queue file, which is a history file indicating whether or not registration has been normally performed, is created.

  The control device 131 receives the DICOM original image and its accompanying information from the image generation device 123. In order to perform reference and search of the medical image received from the monitor of the control device 131 at high speed, a request for generating 8-bit compressed image data (for example, image data compliant with the JPE2000 standard) from this image is sent to the management server 133. The compressed image data thus generated is registered in the image DB 134a via the communication network N. As a specific example of the apparatus, a general personal computer can be used.

  The image interpretation device 132 is for interpretation by a doctor. For example, the image interpretation device 132 includes a high-definition monitor and the like. The DICOM original image generated by the image generation device 123 and its supplementary information, and the medical image registered in the database 134. And the incidental information is received via the communication network N, and the medical image is displayed on the high-definition monitor or the like. As a specific device example, a personal computer having a high-definition monitor can be used.

  The management server 133 determines various consistency between the DICOM original image received through the communication network N and its accompanying information, and the patient included in the DICOM original image and its accompanying information transmitted from the medical image generation system 12. This is management means for registering information, examination information, series information, and image information in the database 134 for each data type.

  The database 134 includes an image DB (Data Base) 134a, an image information table DB 134b, a DICOM basic information DB 134c, and a check DB 134d.

The image DB (Data Base) 134a includes a DICOM original image 71 generated by an image generation system, a DICOM compressed image 72 for display on a high-definition monitor used in an image interpretation apparatus, and a general-purpose monitor such as a general personal computer. An 8-bit JPEG2000 image 73 for display and a thumbnail image 74 for index display for image search are registered. Since the medical image has a larger data amount than other data, a storage device for storing the image may be provided separately.
As an example of this storage device, a mass storage device NAS (Network Attached Storage) integrated with a hard disk, a network interface, an OS, a management utility, and the like that is directly connected to a network is applicable.

  In the image information table DB 134b, DICOM compressed image information TBL (Table) 61, JPEG image information TBL62, index image information TBL63, and image information TBL64 are purchased. Each TBL stores the following information.

The DICOM compressed image information TBL 61 stores a path indicating the storage destination of the DICOM compressed image 72 and a file size.
The JPEG image information TBL 62 stores a path indicating the storage destination of the JEPEG2000 image 73 and a file size.
The index image information TBL 63 stores a path indicating the storage destination of the thumbnail image 74 and a file size.
The image information TBL 64 stores a path indicating the storage destination of the DICOM original image 71 and a file size.

Patient basic information TBL41, examination information TBL42, series information TBL43, and image information TBL44 are registered in the DICOM basic information DB 134c.
Each TBL stores the following UID.

  The patient basic information TBL41 stores a patient UID for specifying patient information such as a patient name and a patient ID. The patient's name (ASCII, kana, kanji) associated with the patient UID, patient ID, patient date of birth, gender, and other items related to the patient are stored.

  The examination information TBL42 stores a patient UID, a study date and time, an examination ID, a study instance UID for specifying the name of a doctor who requested the examination, and the like. Then, various item information relating to the examination such as examination date, examination ID, examination interpretation doctor name and the like associated with the study instance UID is stored.

  In the series information TBL43, a study instance UID, a name indicating a modality type, a modality series number, a name of an operator who operates the modality, a maximum and minimum pixel value readable by the modality, and an inspection part are specified. A series instance UID is stored. The name indicating the modality type associated with the series instance UID, the modality series number, the name of the operator who operated the modality, the maximum and minimum pixel values readable by the modality, and the modality and imaging related to the examination site. Various item information is stored.

  The image information TBL 44 stores a series instance UID and an SOP (Service / Object Pair) instance UID. Then, bit information such as an image number, a generation time, and an assigned bit assigned when a medical image associated with the SOP instance UID is generated, a DICOM original image, a DICOM compressed image, a JPEG2000 image, and a thumbnail image Stores various item information related to image management and image generation such as a file path name to each image and a compression rate.

  As shown in FIG. 5, by storing a plurality of UIDs in one TBL, each TBL (41 to 44) is associated with each other and managed in the DICOM basic information DB 134c.

  The check DB 134e stores a UID consistency check TBL51.

  The UID consistency check TBL51 stores patient information for collation for determining consistency used in the information managed in the PACS 13 and various UIDs that have been issued and registered in the DICOM basic information DB 27. Has been.

  The image output device 135 is a device that outputs the digital image data generated by the image generation device 123 or the digital image data registered in the database 134 in the management server 133 to a recording medium such as film or paper. For example, a laser imager is applicable.

Next, the management server 133 will be described.
FIG. 2 shows an internal block diagram of the management server 133, and the configuration and functions of each unit will be described below.
The management server 133 includes a control unit 21, a display unit 22, an input unit 23, a communication control unit 24, a RAM (Random Access Memory) 25, a storage unit 26, and a memory 27.

The control unit 21 is configured by a CPU (Central Processing Unit) or the like, and manages by executing various programs such as a system program stored in the storage unit 26 and a consistency determination processing program (see FIG. 4) according to the present invention. The server 133 is controlled centrally.
The first information determination unit and the control unit can be realized by the cooperation of the consistency determination processing program and the control unit 21.

  The display unit 22 includes a monitor such as a CRT (Cathode Ray Tube) or an LCD (Liquid Crystal Display), and displays various image data and associated information according to control by the control unit 21.

  The input unit 23 includes a keyboard and a pointing device such as a mouse and a touch panel, and outputs various signals input via the keyboard and the pointing device to the control unit 21.

  The communication control unit 24 is connected to a communication network such as a LAN (Local Area Network) provided in the hospital, and includes an interface for transmitting and receiving data to and from various devices connected to the network.

The RAM 25 stores various data generated when the control unit 21 executes various programs.
Also, the normal folder 25a for temporarily storing the incidental information determined to be consistent when the control unit 21 determines the consistency of the incidental information, and the incidental information determined to be inconsistent are temporarily stored. And an inconsistent folder 25b for storing the data.

  The storage unit 26 stores various programs and data executed by the control unit 21. Specifically, a consistency determination processing program for determining the consistency between the medical image input to the PACS 13 and the accompanying information is stored.

  The storage unit 26 includes a magnetic or optical storage medium or a semiconductor memory. This storage medium may be fixedly provided in the storage unit 26 or may be configured to be detachable.

Next, the operation in the first embodiment will be described.
The operation of the management server 133 will be described with reference to FIGS.

FIG. 3 shows an overview of consistency determination processing in the PACS 13.
As shown in FIG. 3, in the management server 133, the consistency check unit 3a determines the consistency between the input DICOM compliant data Din inputted in the PACS 13 and the registered DICOM compliant data Dm already registered. The data determined to be taken is registered in the database 3b in the PACS 13, and the data judged not to be matched is registered in the other database 3c. The data registered in the database 3c is waiting for update.
By registering inconsistent data in the database 3c separately from normal data, data loss can be avoided and the reliability of the database 134 can be improved.

Next, the consistency determination process executed by the management server 133 will be specifically described with reference to FIG.
In the consistency determination process shown in FIG. 4, the DICOM original image and the accompanying information attached to the header of the image data are received from the image generation system 12 (step S101).

  Next, additional information to be registered in the DICOM basic information DB 134c necessary for the consistency determination process is acquired (read) from the header of the received image data, and the patient UID, study instance UID, series instance UID, Various UIDs such as the SOP instance UID, patient name, patient ID, examination date, examination appointment date, and the like are extracted. The various extracted information is stored in the RAM 25 (step S102).

  Next, in the control unit 21, among various information stored in the RAM 25, a PN tag (character information identification information) including a character code such as a patient name, a date tag such as an examination date, and a future date tag such as an examination appointment date A tag data consistency determination process for determining consistency such as is performed (step S103).

  As a result of the character code consistency check process (step S103), when it is determined to be normal (step S104; YES), the UID consistency check process is performed on the various UIDs (step S105).

When it is determined that the UID consistency check process (step S106) is normal (step S106; YES), the control unit 21 performs the PACS consistency check process (step S107).
In the intra-PACS consistency check process (step S107), it is determined whether or not the various UIDs in the various TBLs 41 to 44 are appropriately associated.

  As an example of inconsistency (step S108: No) determined in the PACS consistency check process (step S107), for example, when the SOP instance UID is duplicated, the series UID is the same, the examination UID, and the patient ID are the same. If they are different, it is inconsistent when the examination UID is the same and the patient ID is different, or when the patient ID is the same and the patient name, the date of birth of the patient, or the gender of the patient is different. To be judged.

  If it is determined that the PACS consistency check process is normal (step S108; YES), the DICOM original image is registered in the image DB 134a, and the accompanying information is registered in the image information TBLDB 134b. In addition, various UIDs with which the matching results match are registered in the check DB 134e.

  On the other hand, if it is determined that there is a mismatch in any of the character code consistency check process (step S103), the UID consistency check process (step S105), and the PACS consistency check process (step S107) (steps S104, S106, S108). NO), an inconsistent folder 25b temporarily stored in the RAM 25 is separately provided, and the medical image and its accompanying information are registered in the database 3c as NG data.

  As described above, according to the first embodiment, the management server 133 determines the consistency between the incidental information newly entered in the PACS 13 and the basic information already stored in the PACS 13. Only the incidental information that conforms to the DICOM standard and is consistent with the basic information stored in the PACS 13 can be registered in the database 134 in the PACS 13 as basic information. Therefore, the consistency of information in the PACS 13 can be maintained, and the reliability for information management can be improved.

  Further, when a new medical image of a patient and its accompanying information are generated, the presence / absence of predetermined accompanying information defined in the DICOM standard is determined. Only medical images and supplementary information that are determined to have all the predetermined supplementary information are registered in the database 134 as basic information.

  When the supplementary information is not attached to the medical image at all or a part of it is missing by performing the consistency determination process, the relevant medical image and the accompanying information are registered in the database 3c, and normal data It is separated.

[Second Embodiment]
The first embodiment is an example in which the consistency between a medical image newly generated by the medical image generation system 12 and its accompanying information and basic information already registered in the database 134 is determined.
In the second embodiment, after the medical image generated by the medical image generation system 12 and its accompanying information are registered in various DBs in the database 134, the medical image and its accompanying information are managed in the PACS. An example of determining consistency with history information will be described.

  First, the configuration of the PACS in the second embodiment will be described. The configuration of the PACS in the second embodiment is the same as that of the PACS 13 described in the first embodiment. Only functional parts different from those shown in FIG.

  That is, the PACS 13 in the second embodiment is connected to the information management system 12 and the medical image generation system 12 via the communication network N. The PACS 13 includes the control device 131, the image reading device 132, the management server 133, and the database 134. The image output device 135 is included. The management server 133 includes a control unit 21, a display unit 22, an input unit 23, a communication control unit 24, a RAM 25, and a storage unit 26.

In the second embodiment, the control unit 21 includes a CPU and the like, and executes various programs such as a system program stored in the storage unit 26 and a history information consistency determination processing program (see FIG. 6) according to the present invention. As a result, the management server 133 is comprehensively controlled.
The history storage means, the second information determination means, the image information determination means, and the control means can be realized in cooperation with the history information consistency determination processing program and the control unit 21.

In the second embodiment, the RAM 25 includes a normal folder 25a and an inconsistent folder 25b, and information to the storage queue file 2a and image information TBL64, which are request history information when registering a DICOM original image in the image DB 134a. This is a history storage means for temporarily storing various history files such as a history file 2b, a communication history file 2c, and an image phase management history file 2d as storage history information.
The history file determined to be normal in the history information consistency determination process described later is deleted, and the history file determined to be inconsistent is stored in the inconsistent data folder 25b.

The following history information is stored in the various history files 2a to 2d.
The Storage queue file 2a is a registration history file used when registering the DICOM original image 71 in the image DB 134a.
The history file 2b is information storage history information to the image information TBL64.
The communication history file 2c is communication history information between the management server 134 and each device constituting the medical data processing system 1.
The image phase management history file 2d is generation history information of converted images in which a DICOM compressed image image 72, a JPEG2000 image 73, and a thumbnail image 74 are generated from the DICOM original image 71.

Next, the operation in the second embodiment will be described.
FIG. 6 shows a flow of history information consistency determination processing after registration of the database 134, and FIG. 7 shows a conceptual diagram of image storage processing executed in the management server 133.

  The Storage queue 2a has a directory structure according to the date. When executing the history information consistency determination process, the date setting of the storage queue file 2a, which is a registration history file when registering the DICOM original image in the image DB 134a, is specified by performing management settings from the control device 131. Then, the stage queue file 2a is read out one by one from all the date directories up to the day before the day on which the previous history information consistency determination process was performed.

The following consistency determination is sequentially performed for each medical image corresponding to the read Storage queue file 2a file.
In addition, the history information consistency determination process for the storage queue file 2a and the medical image in the mismatch folder 25b is not performed, and the consistency determination process is performed for the next storage queue file 2a.

  One medical image existing in the Storage queue file 2a is designated, and it is determined whether or not the basic information registered in the DICOM basic information DB 134b matches the history information of the Storage queue file 2a. Step S201).

  When it is determined to be normal, a determination is made as to whether or not the basic information in the DICOM basic information DB 134c matches the basic information in the image information TBLDB 134b, and the presence or absence of the corresponding medical image is determined. (Step S202)

  When the presence of the corresponding medical image is confirmed, the history information of the history file 2b indicating the storage history in the image information TBL 134b, the file path name of the thumbnail image 74 from the image information TBL64, the file path name of the JPEG2000 image 73, and the compression Each file path name such as the file path name of the image 72 and the file contents such as the file size is not 0 and the first 64 bytes of the file are not all 0 are read, and whether or not the file path name and file contents match the history information. The consistency is determined (step S203).

  If the file path name and file content of the corresponding medical image are determined normally, the file path name of the medical image in the communication history file 2c, the image type (DICOM compressed image, JPEG2000 image, thumbnail image), data size, checksum Whether the history information and the basic information stored in the image information TBL 64 match is determined (step S204).

  Here, the checksum is calculated in advance by calculating the total value of the data, transmitting the total data value when transmitting the data, and calculating the total value of the received data on the receiving side. This is inspection data for comparison with the total value.

  When basic information such as the file path name, image type, data size, and checksum in the image information TBL64 is determined to be normal, the SOP instance UID, AE (DICOM in the image phase management history file 2d output from the DICOM communication library It is determined whether or not the history information such as (Application Entity) title matches the history information in the Storage queue file 2a (step S205).

If all the consistency determinations are processed normally, the corresponding storage queue file 2a is deleted.
If there is an error in one image, an error log is output to the history file 2b as a countermeasure against the problem, and the corresponding storage queue file is not deleted.

  Judgment of the consistency between the medical image registered in the database 134 and its accompanying information is performed in a time zone during which the medical image generation system is operating, such as at night, when the communication load is low and other processing is difficult to be hindered.

  As described above, according to the second embodiment, after the newly generated medical image and its accompanying information are registered in the database 134 as basic information, the management server 133 stores various history files at the time of storage. It is determined whether or not the basic information registered in the database 134 matches, and the consistency is determined. If the consistency is not achieved, the history information is stored. Therefore, the mismatch information is stored based on the stored history information. It is possible to maintain the consistency of information in the medical image management system by correcting, deleting, and the like. Therefore, it is possible to improve the reliability of information management of the medical image management system.

  Further, based on the history file 2b, the image file path name and the file contents are confirmed, and it is determined whether or not the medical image can be read normally, and whether or not a defect has occurred. Thus, it is possible to check the image defect of the medical image managed in the medical image management system.

  It is also possible to operate by combining the components of the PACS 13 in the first embodiment and the second embodiment, and check the consistency of the medical image and its supplementary information before and after registering the database 134 to unify it. Management of information can be performed.

1 shows a system configuration of a medical data processing system 1. The internal block diagram of a management server is shown. The schematic of the consistency judgment process of DICOM standard conformity data is shown. The database 134 shows a consistency judgment processing flow before registration. The association between TBL and UID in the DICOM basic information DB 134c is shown. The history information consistency determination processing flow after registration in the database 134 is shown. 2 is a conceptual diagram of image storage processing executed in the management server 133. FIG. A conventional medical image and incidental information management method will be described.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Medical data processing system 11 Information management system 12 Medical image generation system 13 Medical image management system 121 Control apparatus 122a Image reading apparatus 122b Image photographing apparatus 123 Image generation apparatus 124 Image output apparatus 131 Control apparatus 132 Image interpretation apparatus 133 Management server 134 Database 134a Image DB
134b Image information TBLDB
134c DICOM basic information DB
135d DB for checking

Claims (1)

A database for registering and storing a medical image obtained by imaging a patient and basic information generated based on incidental information attached to the medical image in association with each other; and a management unit for managing the basic information registered in the database In a medical image management system configured to include:
When basic information about a medical image is registered in the database based on a newly generated medical image and incidental information attached to the medical image, the patient information included in the incidental information and the database are already registered in the database. First information discriminating means for collating with patient basic information included in the basic information and discriminating whether or not both pieces of information match,
Results of determination by the first information determining means, when the basic patient information included in the basic information that is the registered patient information included in the supplementary information matches, the supplementary information as a new basic information A medical image management system comprising: control means for registering in the database.

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