JP7035696B2 - Medical image management server and medical image display system - Google Patents

Description

The present invention relates to a medical image management server and a medical image display system.

In recent years, the digitization of information has progressed in the medical field as well, and medical information such as medical record information and medical images is managed as electronic data. Interpretation of medical images is also performed on the monitor. Various modality is used to generate medical images, and a single examination may generate tens to hundreds of medical images. When a large number of medical images are generated by the same examination, it is often the case that a predetermined number of medical images are displayed simultaneously on one screen, and the screens are switched to sequentially read images.

For example, in an image display device that tiles a series of images generated by an image inspection, the user can easily reach an image including a lesion by devising the arrangement of the images when the images are divided into multiple pages and tiled. A possible technique has been proposed (see Patent Document 1). The tile display is to display a plurality of images side by side so as to be spread in a tile shape.

Japanese Unexamined Patent Publication No. 2016-41227

However, when displaying a plurality of medical images in tiles on the viewer screen (image display screen) in a display device in which the user interprets images, the medical images are acquired one by one from the medical image management server in which the medical images are stored. Since it takes a lot of time to display all the medical images, the image display speed is slow and it may take time to read the image.

For example, when displaying 10 medical images on the display device (browser side), the process of transmitting an image request from the display device to the server and transmitting the image from the server to the display device is performed 10 times. .. Specifically, the display device sends a request for the first image to the server, the server sends a request for the first image to the display device, and then the display device sends a request for the second image to the server. , The server sends the second image to the display device, and the same process is repeated up to the tenth image.

The present invention has been made in view of the above-mentioned problems in the prior art, and an object of the present invention is to shorten the image display time and the image interpretation time when displaying a plurality of medical images.

In order to solve the above problems, the invention according to claim 1 is a medical image management server for displaying a plurality of medical images on a display device connected to enable data communication via a communication network, and a plurality of medical image management servers are displayed in advance. A means for creating a combined image by arranging the plurality of medical images in a tile shape under conditions, and a storage means for storing the created combined image and the plurality of medical images in association with each other for each of the plurality of conditions. When there is a display request from the storage control means and the display device for at least one or more of the plurality of medical images via the communication network, the set conditions and the combination associated with the plurality of medical images are associated with each other. It includes an image providing means for acquiring an image from the storage means and transmitting the acquired combined image to the display device via the communication network.
The invention according to claim 2 is the medical image management server according to claim 1 , wherein the creating means deletes information other than essential items included in the header information when creating the combined image.

The invention according to claim 3 is the medical image management server according to claim 1 or 2 , wherein the creating means arranges the plurality of medical images in a tile shape with a preset number of columns and rows. The combined image including the number of medical images equal to or less than the product of the number of columns and the number of rows is created for each same display screen.

The invention according to claim 4 is the medical image management server according to any one of claims 1 to 3 , wherein the creating means is a case where the plurality of medical images are generated by a predetermined modality. In addition, the combined image is created.

The invention according to claim 5 is an acquisition means for acquiring a position designated on the combined image displayed on the display device in the medical image management server according to any one of claims 1 to 4 . Then, it is specified which of the medical images included in the combined image the acquired position is in the area corresponding to the medical image, and the medical image corresponding to the specified area is acquired from the storage means. In order to display the acquired medical image on the full screen of the display device, an individual image providing means for transmitting the acquired medical image to the display device via the communication network is provided.

The invention according to claim 6 comprises a display device, a medical image management server connected to the display device via a communication network so as to be capable of data communication, and a medical image management server for displaying a plurality of medical images on the display device. In the display system, the medical image management server is a creating means for creating a combined image by arranging the plurality of medical images in a tile shape in advance under a plurality of conditions, and the created combined image for each of the plurality of conditions. When there is a display request for at least one or more of the plurality of medical images from the display device via the communication network and the storage control means for storing the plurality of medical images in the storage means in association with each other. An image providing means that acquires a combined image associated with the set conditions and the plurality of medical images from the storage means and transmits the acquired combined image to the display device via the communication network. Be prepared.
The invention according to claim 7 is the medical image display system according to claim 6 , wherein the creating means deletes information other than essential items included in the header information when creating the combined image.

According to the present invention, it is possible to shorten the image display time and the image interpretation time when displaying a plurality of medical images.

It is a system block diagram of the medical image display system in embodiment of this invention. It is a block diagram which shows the functional configuration of a medical image management server. It is a figure which shows the example of the system setting data. It is a figure which shows the example of the user setting data. It is a figure which shows the folder structure of the combined image storage area. This is an example of the information included in the header information of the image file of the combined image. It is a block diagram which shows the functional structure of a display device. It is a flowchart which shows the combined image creation process executed by a medical image management server. This is an example of a combined image created for tile display. It is a flowchart which shows the image display process executed by a medical image management server. (A) is an example of a combined image created for tile display. (B) is an example in which the medical image specified on the combined image is displayed on the full screen. It is a figure which shows the display method of the image when the display device has a plurality of monitors. This is an example of a combined image created when tile display is performed on a two-sided monitor using the display method 2.

Hereinafter, an embodiment of the medical image display system according to the present invention will be described. However, the scope of the invention is not limited to the illustrated examples.

FIG. 1 shows the system configuration of the medical image display system 100.
As shown in FIG. 1, the medical image display system 100 is composed of a medical image management server 10, modalities 20, 20, ..., And display devices 30, 30, ..., Each of which is composed of a medical image management server 10. Data communication is possible via the communication network NT. It should be noted that each of the display devices 30, 30, ... May be connected to the medical image management server 10 via the communication network NT as needed. In the medical image display system 100, the medical images stored in the medical image management server 10 can be displayed on each of the display devices 30, 30, ....

Modality 20 takes a picture of a patient (subject) and generates image data of a medical image. Modality 20 includes, for example, NM (Nuclear Medicine), ES (Endoscope), CR (Computed Radiography), DR (Digital Radiography), CT (Computed Tomography), MRI (Magnetic Resonance Imaging). , US (UltraSonography) and the like are used. The image data of the medical image is transmitted to the medical image management server 10, and is stored and managed by the medical image management server 10.

Usually, medical images generated by NM and ES are often displayed in tiles in the initial state. The tile display is to display a plurality of images side by side in a tile shape in the horizontal direction and the vertical direction. The user roughly searches for an image that seems to have an abnormality on the tile display screen, and then displays the image that seems to have an abnormality on the full screen to check in detail.

The medical image management server 10 stores the image data of the medical image generated in the modality 20 and manages it for each patient and each examination. Examples of the medical image management server 10 include a PACS (Picture Archiving and Communication System) and the like.

FIG. 2 shows a functional configuration of the medical image management server 10. The medical image management server 10 includes a control unit 11, a communication unit 12, a RAM (Random Access Memory) 13, a storage unit 14, and the like, and each unit is connected by a bus 15.

The control unit 11 is composed of a CPU (Central Processing Unit) and the like, and comprehensively controls the processing operation of each unit of the medical image management server 10. Specifically, the CPU reads out various processing programs stored in the storage unit 14 and develops them in the RAM 13, and performs various processing in cooperation with the programs.

The communication unit 12 is configured by a network interface or the like, and transmits / receives data to / from an external device connected via the communication network NT. For example, the communication unit 12 receives the image data of the medical image obtained by photographing the patient by the modality 20. Further, the communication unit 12 transmits display data for displaying various screens to the display device 30 in response to a request from the display device 30.

The RAM 13 forms a work area for temporarily storing various programs, input or output data, parameters, etc. read from the storage unit 14 in various processes executed and controlled by the control unit 11.

The storage unit 14 is composed of an HDD (Hard Disk Drive), a non-volatile semiconductor memory, or the like, and stores various processing programs, parameters, files, and the like necessary for executing the program. For example, the storage unit 14 has a Web server program for realizing a function as a Web server that provides various Web screens to the Web browser by communicating with the Web browser mounted on the display device 30 by the HTTP protocol, or the Web. An application program or the like that operates on a server and provides a medical image or the like to a user of the display device 30 via a Web browser is stored.

Further, the storage unit 14 stores the user management table 141, the image management DB (database) 142, the system setting data 143, and the user setting data 144. Further, the storage unit 14 has a medical image storage area 145 and a combined image storage area 146.

The user management table 141 is a table for managing users (medical workers) who use the medical image display system 100. In the user management table 141, a user ID, a password, a name, an affiliation, an e-mail address, and the like are stored in association with each user.

In the image management DB 142, incidental information (header information) of the medical image is retrievably stored for each medical image stored in the medical image storage area 145. Ancillary information includes patient information, examination information, series information, and image information.
The patient information includes the patient ID, the patient's name, the date of birth, the gender, and the like.
The inspection information includes the inspection instance UID, the inspection date and time, and the like.
Series information includes series instance UIDs, modality, parts, and the like.
The image information includes a SOP instance UID, an image number, an image generation date and time, an imaging direction, a file path indicating a storage location of a medical image, and the like. The image number is a number indicating the number of the image in the same inspection.

The system setting data 143 and the user setting data 144 are setting conditions for creating a combined image.

The system setting data 143 is setting data associated with a medical facility that uses the medical image display system 100. FIG. 3 shows an example of system setting data 143. In the system setting data 143, the "number of columns" and the "number of rows" in the tile display are associated with the "modality" for which the combined image is created. "Modality" is a modality corresponding to a medical image (examination) for which a combined image should be created. The medical image generated by the "modality" included in the system setting data 143 becomes the original medical image when creating the combined image. The "number of columns" is the number of medical images arranged in the horizontal direction when creating a combined image. The "number of lines" is the number of medical images arranged in the vertical direction when creating a combined image. In the system setting data 143 shown in FIG. 3, it is set that the medical images generated by the modality "NM" are arranged in tiles of 3 columns x 3 rows to create a combined image, and the modality "ES" is used. The generated medical images are set to be arranged in tiles of 3 columns × 3 rows to create a combined image.

The user setting data 144 is setting data associated with each user (medical worker such as a doctor or a technician) who uses the medical image display system 100. FIGS. 4A to 4C show examples of user setting data 144 of user A, user B, and user C, respectively. In addition, in FIGS. 4 (a) to 4 (c), 144A, 144B, 144C are described in order to show that it is the user setting data of different users. In the user setting data 144A, 144B, 144C, the "number of columns" and the "number of rows" in the tile display are associated with the "modality" for which the combined image is created. The details of "modality", "number of columns", and "number of rows" are the same as those of the system setting data 143.

The image data of the medical image received from the modality 20 is stored in the medical image storage area 145.

The image data of the combined image is stored in the combined image storage area 146.
FIG. 5 shows the folder structure of the combined image storage area 146. As shown in FIG. 5, in the combined image storage area 146, the "year" folder, the "month" folder, the "day" folder, the "hour" folder, the "inspection instance UID" folder, the "modality" folder, and the "number of columns" Folders and "number of lines" folders are hierarchically organized.

The "year" folder, "month" folder, "day" folder, and "hour" folder are folders corresponding to the date and time (image generation date and time) when multiple medical images that were the source of the combined image were generated. .. Actually, the folder name is a numerical value indicating the year, month, day, and time.
The "inspection instance UID" folder is a folder corresponding to the inspection related to the medical image that is the source of the combined image. Actually, the character string indicating the inspection instance UID is the folder name.
The "modality" folder is a folder corresponding to the modality 20 in which the medical image that is the source of the combined image is generated. Actually, the character string indicating the modality is the folder name.
The "number of columns" folder is a folder corresponding to the number of columns (the number of medical images arranged in the horizontal direction) when the combined image is created. Actually, the number indicating the number of columns is the folder name.
The "number of lines" folder is a folder corresponding to the number of lines (the number of medical images arranged vertically) when the combined image is created. Actually, the number indicating the number of lines is the folder name.

In the "Number of rows" folder, the medical images that are the source of the combined images are arranged horizontally for the number of columns corresponding to the "Number of columns" folder and vertically for the number of rows corresponding to the "Number of rows" folder. The image file of the combined image is stored. Even if the modality for creating the combined image, the number of columns, and the number of rows overlap in the system setting data 143 and the plurality of user setting data 144, the combined image is managed by managing the combined image in such a folder structure. The combined image of the conditions need only be created once.

When combined images are created for multiple screens (multiple pages) in the same inspection, a "001" folder, a "002" folder, a "003" folder, and so on are created in the lower hierarchy of the "number of lines" folder. And the combined image is stored in the folder of numbers corresponding to each page. For example, when the "number of columns" is M and the "number of rows" is N, the image numbers of the medical images of the examination corresponding to the "examination instance UID" folder are "1" to "1" in the "001" folder. A combined image (first page) created by arranging medical images of "M × N" is stored. Further, in the "002" folder, among the medical images of the examination corresponding to the "inspection instance UID" folder, the medical images having the image numbers "MxN + 1" to "2x (MxN)" were created side by side. The combined image (second page) is stored.

Alternatively, when creating multiple combined images in the same inspection, instead of creating a folder corresponding to each page in the lower hierarchy of the "number of lines" folder, the file name of the combined image is set to the page number of each page. , Multiple files may be stored in the "Number of Lines" folder.

When the control unit 11 receives the medical image from the modality 20, the control unit 11 arranges a plurality of medical images related to the same examination in a tile shape to create a combined image. That is, the control unit 11 functions as a creating means.
The control unit 11 creates a combined image when a plurality of medical images are generated by a predetermined modality. Specifically, the control unit 11 creates a combined image when the plurality of medical images are generated by the "modality" included in the system setting data 143 or the user setting data 144 of the storage unit 14. ..

The control unit 11 arranges a plurality of medical images in a tile shape with a preset number of columns and rows, and displays a combined image including a number of medical images equal to or less than the product of the number of columns and rows on the same display screen (page). Create for each. For example, when the number of medical images related to the same examination is equal to or less than the product of the number of columns and the number of rows in the tile display, the control unit 11 creates one combined image. When the number of medical images related to the same examination is larger than the product of the number of columns and the number of rows in the tile display, the control unit 11 creates a combined image including the number of medical images by the number of columns and the product of the number of rows. The number of medical images included in the combined image corresponding to the final page (final display screen) may be less than the product of the number of columns and the number of rows in the tile display.

When creating the combined image, the control unit 11 deletes tag information other than the information essential for the image format to reduce the amount of data as much as possible. FIG. 6 shows an example of information included in the header information when a combined image is created in the JPEG 2000 image format. FIG. 6 shows essential items included in the header information of the image file of the combined image and the type of each information. Required items included in the header information are Box Length, Box Type, Height, Width, Number of Components, Bits per component, Compression type. ), Color space unknown (whether the color space of the image data is known), Intellectual Property (whether it contains intellectual property information).

The control unit 11 stores the created combined image and a plurality of medical images that are the source of the combined image in the storage unit 14 in association with each other. That is, the control unit 11 functions as a memory control means. Specifically, the control unit 11 creates a folder for storing the combined image in the combined image storage area 146 of the storage unit 14, and stores the combined image in the created folder. By storing the combined image in the lower hierarchy of the "inspection instance UID" folder of the examination related to the plurality of medical images that are the source of the combined image, the combined image and the plurality of medical images that are the source of the combined image are stored. The image (inspection) is associated with. Further, the combined image is stored in the "number of columns" folder and the "number of rows" folder corresponding to the number of columns and the number of rows when the combined image is created, so that the medical image included in the combined image is stored in the horizontal direction. You can see the number of and the number in the vertical direction. In addition, when a plurality of combined images (multiple pages) are created in the same inspection, the combined image is one of the number folders corresponding to each page in the lower hierarchy of the "number of lines" folder of the combined image storage area 146. Depending on whether it is stored in, it is possible to know from which image to which image is included in the same inspection.

When multiple combined images are created in the same inspection and the file name of each combined image is associated with the page number, this file name is used to start from which image included in the same inspection. You can see if it contains the second image.

The control unit 11 displays a plurality of medical images on the display device 30 connected so as to be capable of data communication via the communication network NT.

The control unit 11 acquires a combined image associated with the plurality of medical images from the storage unit 14 when there is a display request for at least one or more of the plurality of medical images from the display device 30 via the communication network NT. Then, the acquired combined image is transmitted to the display device 30 via the communication network NT. That is, the control unit 11 functions as an image providing means.

The control unit 11 acquires a position designated on the combined image displayed on the display device 30. That is, the control unit 11 functions as an acquisition means.
The control unit 11 identifies which of the medical images included in the combined image corresponds to the acquired position, and acquires the medical image corresponding to the specified area from the storage unit 14. In order to display the acquired medical image on the full screen of the display device 30, the acquired medical image is transmitted to the display device 30 via the communication network NT. That is, the control unit 11 functions as an individual image providing means.

The display device 30 is a computer device such as a PC (Personal Computer) or a tablet. The display device 30 is used when reading a medical image or the like.

FIG. 7 shows the functional configuration of the display device 30. The display device 30 includes a control unit 31, an operation unit 32, a display unit 33, a communication unit 34, a RAM 35, a storage unit 36, and the like, and each unit is connected by a bus 37.

The control unit 31 is composed of a CPU and the like, and comprehensively controls the processing operation of each unit of the display device 30. Specifically, the CPU reads out various processing programs stored in the storage unit 36, develops them in the RAM 35, and performs various processing in cooperation with the programs.

The operation unit 32 is configured to include a keyboard equipped with cursor keys, character / number input keys, various function keys, and a pointing device such as a mouse, and controls operation signals input by key operations on the keyboard or mouse operations. Output to unit 31. When the operation unit 32 is composed of a touch panel laminated on the display unit 33, the operation signal corresponding to the position of the touch operation by the user's finger or the like is output to the control unit 31.

The display unit 33 is configured to include a monitor such as an LCD (Liquid Crystal Display), and displays various screens according to instructions of display signals input from the control unit 31.

The communication unit 34 is configured by a network interface or the like, and transmits / receives data to / from an external device connected via the communication network NT.

The RAM 35 forms a work area for temporarily storing various programs, input or output data, parameters, etc. read from the storage unit 36 in various processes executed and controlled by the control unit 31.

The storage unit 36 is composed of an HDD, a non-volatile semiconductor memory, or the like, and stores various processing programs, parameters, files, and the like necessary for executing the program. For example, the storage unit 36 stores a Web browser program or the like for realizing a Web browser.

Next, the operation in the medical image display system 100 will be described.
FIG. 8 is a flowchart showing a combined image creation process executed by the medical image management server 10. This processing is realized by software processing in collaboration with the CPU of the control unit 11 and the program stored in the storage unit 14.

In the medical image management server 10, when a medical image is received from the modality 20 via the communication unit 12, the control unit 11 stores the received medical image in the medical image storage area 145 of the storage unit 14, and also stores the received medical image in the medical image storage area 145. The image management DB 142 of the above stores the incidental information of the medical image.

Next, the control unit 11 acquires the medical image received from the modality 20 from the medical image storage area 145 of the storage unit 14 (step S1). At this time, when there are a plurality of medical images related to the same examination, the control unit 11 acquires the plurality of medical images from the medical image storage area 145.

Next, the control unit 11 acquires the system setting data 143 and the user setting data 144 stored in the storage unit 14 (step S2).

Next, the control unit 11 determines whether or not the modality 20 that generated the medical image acquired in step S1 is the target of the initial tile display (step S3). The initial tile display means that when displaying a medical image, first, a plurality of medical images are displayed side by side in a tile shape. Specifically, the control unit 11 acquires the modality 20 that generated the medical image from the incidental information of the medical image, and the modality 20 is the setting data (system setting data 143 or user setting data) acquired in step S2. It is determined whether or not it is included in the "modality" of 144).

When the modality 20 that generated the medical image is the target of the initial tile display (step S3; YES), that is, when the modality 20 that generated the medical image is included in the "modality" of the setting data acquired in step S2. The control unit 11 creates a combined image by arranging a plurality of medical images in a tile shape (horizontal direction and vertical direction) according to the setting data (step S4). Specifically, the control unit 11 acquires the "number of columns" and "number of rows" associated with the "modality" that generated the medical image in the system setting data 143 or the user setting data 144, and this "number of rows". Create a combined image by arranging a plurality of medical images in the order of image numbers in a tile shape with "number of columns" and "number of rows".

9 (a) and 9 (b) show examples of combined images 40A and 40B created for tile display of 3 columns × 3 rows. Arrange multiple medical images included in the same test in order from left to right, and after arranging 3 images, move to the next (bottom) line, and arrange medical images in order from left to right, 3 lines When the minutes are over, one combined image is completed. Then, it moves to the next page (display screen). The combined image 40A shown in FIG. 9A is a combined image on the first page, and the combined image 40B shown in FIG. 9B is a combined image on the second page. The numbers (1 to 18) shown in the regions 41 to 58 corresponding to the original medical images included in the combined images 40A and 40B are image numbers corresponding to the medical images.

Next, the control unit 11 stores the created combined image in the combined image storage area 146 of the storage unit 14 in association with a plurality of medical images that are the source of the combined image (step S5). Specifically, the control unit 11 creates a folder for storing the combined image in the combined image storage area 146 of the storage unit 14, and stores the image file of the combined image in the created folder.

More specifically, the control unit 11 determines whether or not the "year" folder corresponding to the year in which the medical image included in the combined image was generated has already been created in the combined image storage area 146, and corresponds to this. If the "Year" folder has not been created, create the "Year" folder.
Next, the control unit 11 determines whether or not a "month" folder corresponding to the month in which the medical image included in the combined image is generated has already been created in the lower hierarchy of the "year" folder, and corresponds to this. If the "Month" folder has not been created, create a "Month" folder.
Next, the control unit 11 determines whether or not the "day" folder corresponding to the day when the medical image included in the combined image is generated has already been created in the lower hierarchy of the "month" folder, and corresponds to this. If the "Days" folder has not been created, create a "Days" folder.
Next, the control unit 11 determines whether or not the "hour" folder corresponding to the time when the medical image included in the combined image is generated has already been created in the lower hierarchy of the "day" folder, and corresponds to this. If the "Time" folder has not been created, create the "Time" folder. When the image generation dates and times of the plurality of medical images included in the combined image are different, the image generation date and time of the plurality of medical images may be matched to the oldest one.

Next, the control unit 11 has already created a "test instance UID" folder corresponding to the test instance UID of the test in which the medical image included in the combined image is generated in the lower hierarchy of the "time" folder. If the corresponding "inspection instance UID" folder has not been created, the "inspection instance UID" folder is created.
Next, the control unit 11 determines whether or not a "modality" folder corresponding to the modality of the test in which the medical image included in the combined image is generated has already been created in the lower hierarchy of the "test instance UID" folder. However, if the corresponding "modality" folder has not been created, create a "modality" folder.
Next, the control unit 11 determines whether or not a "number of columns" folder corresponding to the number of medical images included in the combined image arranged in the horizontal direction has already been created in the lower hierarchy of the "modality" folder. However, if the corresponding "Number of columns" folder has not been created, create a "Number of columns" folder.
Next, the control unit 11 determines whether or not a "number of rows" folder corresponding to the number of medical images included in the combined image arranged in the vertical direction has already been created in the lower hierarchy of the "number of columns" folder. Judging, if the corresponding "number of lines" folder has not been created, create a "number of lines" folder.

Next, the control unit 11 determines whether or not the modality 20 that generated the medical image has created a combined image with all the setting data among the setting data that is the target of the initial tile display (step S6). ..
If the setting data for which the combined image has not been created remains (step S6; NO), the process returns to step S4 and the process is repeated. In this way, a combined image of "number of columns" x "number of rows" included in the setting data in which the modality 20 that generated the medical image is the target of the initial tile display is created.

In step S6, when the modality 20 that generated the medical image created a combined image with all the setting data that is the target of the initial tile display (step S6; YES), or in step S3, the medical image was generated. If the modality 20 is not the target of the initial tile display (step S3; NO), the combined image creation process ends.

FIG. 10 is a flowchart showing an image display process executed by the medical image management server 10. This processing is realized by software processing in collaboration with the CPU of the control unit 11 and the program stored in the storage unit 14.

First, the control unit 11 performs a login process in response to an access from any display device 30 in the medical image display system 100 (step S11).
Specifically, in the display device 30, when the user inputs a URL (Uniform Resource Locator) for accessing the medical image management server 10 from the Web browser via the operation unit 32, the control unit 31 is input. Based on the URL, it connects to the medical image management server 10 via the communication unit 34.
In the medical image management server 10, the control unit 11 provides the display device 30 with display data for displaying the login screen via the communication unit 12. The display data of various Web screens including the login screen transmitted to the display device 30 by the Web server function of the medical image management server 10 is processed by the HTML, the style sheet, the image data, and the display device 30. Includes a script etc. to execute.

On the display device 30, the login screen is displayed on the display unit 33. When the user inputs the user ID and password by the operation from the operation unit 32 on the login screen, the control unit 31 transmits the input user ID and password to the medical image management server 10 via the communication unit 34. ..

In the medical image management server 10, when the user ID and password are received by the communication unit 12, the control unit 11 matches any combination of the user ID and password registered in advance in the user management table 141 of the storage unit 14. Determine whether or not to do so, and perform login processing.

Next, the control unit 11 acquires the setting data corresponding to the logged-in user from the storage unit 14 (step S12). Specifically, when the user setting data 144 corresponding to the logged-in user is stored in the storage unit 14, the control unit 11 acquires the user setting data 144. On the other hand, when the user setting data 144 corresponding to the logged-in user is not stored in the storage unit 14, the control unit 11 acquires the system setting data 143 from the storage unit 14.

Next, the control unit 11 refers to the image management DB 142 of the storage unit 14, causes the display unit 33 of the display device 30 to display the inspection list, and accepts the selection of the inspection to be displayed from the inspection list (step). S13). That is, the control unit 11 receives a display request for the medical image related to the examination selected from the display device 30 via the communication network NT. For example, the control unit 11 identifies the selected test by transmitting the test instance UID of the selected test from the display device 30 to the medical image management server 10.

Next, the control unit 11 determines whether or not the modality 20 of the inspection to be displayed is the target of the initial tile display (step S14). Specifically, the control unit 11 refers to the image management DB 142 of the storage unit 14 to acquire the modality 20 corresponding to the inspection selected as the display target, and the modality 20 is set to be acquired in step S12. It is determined whether or not the data (system setting data 143 or user setting data 144) is included in the "modality".

When the modality 20 of the inspection to be displayed is the target of the initial tile display (step S14; YES), that is, when the modality 20 of the inspection to be displayed is included in the "modality" of the setting data acquired in step S12. The control unit 11 acquires a combined image associated with the plurality of medical images generated by the selected examination from the storage unit 14 (step S15). Specifically, the control unit 11 corresponds to the inspection modality 20 of the display target in the combined image storage area 146 of the storage unit 14 in the lower hierarchy of the "inspection instance UID" folder corresponding to the selected inspection. The image file of the combined image is acquired from the folder corresponding to the "number of columns" and "number of rows" corresponding to the "modality" included in the setting data in the lower hierarchy of the "modality" folder.

Next, the control unit 11 controls the communication unit 12 and transmits the acquired combined image to the display device 30 via the communication network NT in order to display the acquired combined image on the display unit 33 of the display device 30 (step S16). ).
On the display device 30, the combined image is displayed on the display unit 33. When the page feed operation is performed in the operation unit 32 of the display device 30, the control unit 31 transmits information indicating the page feed operation to the medical image management server 10 via the communication unit 34. The control unit 11 of the medical image management server 10 acquires the combined image corresponding to the next page from the combined image storage area 146 and transmits it to the display device 30 based on the information indicating the page feed operation. On the display device 30, the combined image corresponding to the next page is displayed on the display unit 33.

Next, the control unit 11 acquires the coordinate position specified by the user on the combined image displayed on the display unit 33 in the display device 30 (step S17). When the user operates the operation unit 32 on the display device 30, puts the mouse pointer on any area on the combined image and double-clicks, the control unit 31 sets the coordinate position of the double-click to the communication unit 34. It is transmitted to the medical image management server 10 via. The control unit 11 of the medical image management server 10 acquires the coordinate position transmitted from the display device 30.

Next, the control unit 11 identifies the medical image corresponding to the acquired coordinate position (step S18). Specifically, the control unit 11 calculates the number of the medical image (image number) corresponding to the acquired coordinate position in the same examination, and the medical image specified by the user from the image number. To identify. That is, the control unit 11 specifies which of the medical images included in the combined image the acquired coordinate position is in the area corresponding to the medical image, and identifies the medical image corresponding to the specified area.

FIG. 11A shows an example of a combined image 60 created for tile display of 3 columns × 3 rows. The size of the combined image 60 is 900 × 900. In FIG. 11A, the X-axis is taken in the horizontal direction and the Y-axis is taken in the vertical direction, and the upper left coordinate of the combined image 60 is set to (0,0). When creating the combined image 60, since the display screen is divided into equal parts and each medical image is arranged, the size of the entire image (900 × 900) and the number of divided screens (3 columns × 3 rows) are used. It is possible to determine which of the medical images included in the combined image 60 the coordinate position specified by the user is within the regions 61 to 69.

Specifically, the region 61 surrounded by four points (0,0), (300,0), (300,300), and (0,300) corresponds to the medical image of image number 1. Further, the area 62 surrounded by the four points (300, 0), (600, 0), (600, 300), and (300, 300) corresponds to the medical image of image number 2. Further, the area 63 surrounded by the four points (600,0), (900,0), (900,300), and (600,300) corresponds to the medical image of image number 3. Further, the area 64 surrounded by four points (0,300), (300,300), (300,600), and (0,600) corresponds to the medical image of image number 4. Further, the area 65 surrounded by the four points (300, 300), (600, 300), (600, 600), and (300, 600) corresponds to the medical image of image number 5. Further, the area 66 surrounded by four points (600,300), (900,300), (900,600), and (600,600) corresponds to the medical image of image number 6. Further, the area 67 surrounded by four points (0,600), (300,600), (300,900), and (0,900) corresponds to the medical image of image number 7. The area 68 surrounded by the four points (300,600), (600,600), (600,900), and (300,900) corresponds to the medical image of image number 8. Further, the area 69 surrounded by four points (600,600), (900,600), (900,900), (600,900) corresponds to the medical image of image number 9.

Next, the control unit 11 acquires the specified medical image from the medical image storage area 145 of the storage unit 14, and communicates to display the acquired medical image on the full screen of the display unit 33 of the display device 30. The unit 12 is controlled and transmitted to the display device 30 via the communication network NT (step S19). Specifically, the control unit 11 refers to the image management DB 142 of the storage unit 14, acquires a file path in which the image file of the specified medical image is stored, and stores the medical image based on the file path. A target medical image is acquired from the area 145, and the medical image is transmitted to the display device 30 by the communication unit 12.

For example, in the combined image 60 shown in FIG. 11A, when the position designated by the user is within the area 61, the display device 30 displays the medical image of the image number “1” as shown in FIG. 11B. 70 is displayed on the full screen of the display unit 33.

In step S14, if the modality 20 of the test to be displayed is not the target of the initial tile display (step S14; NO), the control unit 11 stores the medical image generated by the selected test as the medical image of the storage unit 14. Acquired from the storage area 145 (step S20).
Next, the control unit 11 controls the communication unit 12 and transmits the acquired medical image to the display device 30 via the communication network NT in order to display the acquired medical image on the display unit 33 of the display device 30 normally (step). S21).
After step S19 or step S21, the image display process ends.

In the image display processing, the case where the medical image management server 10 accepts the display request for the medical image related to the selected inspection by selecting the inspection to be displayed by the user in step S13 has been described. It may be a display request for at least one or more of a plurality of medical images related to an examination, instead of a display request for the whole.

As described above, according to the present embodiment, when the medical image is received from the modality 20, the medical image generated by the modality 20 is set to be read in tile display, and the setting data is followed. , You can create a combined image for tile display in advance. Therefore, when reading an image on the display device 30, the medical image management server 10 may transmit the combined image to the display device 30 and display the combined image on the display device 30, and the initial display of the medical image and the page may be performed. Images can be displayed quickly when sending. Therefore, it is possible to shorten the image display time and the image interpretation time when displaying a plurality of medical images.

The reason why the communication speed is improved by using the combined image created from a plurality of medical images is that the file size of the combined image is smaller than the total file size of the individual medical images. Will be. In the combined image, it is sufficient to have only the information of the required items in the header part, and the data that each medical image has as the header information becomes unnecessary, so that the file size as a whole becomes small.
The second reason is that the number of communications between the display device 30 and the medical image management server 10 is reduced by combining the images. In the past, when reading a plurality of medical images on a display device, it was necessary to send a request for that image to a medical image management server, but when combined into one image as in the present embodiment, the display device It is only necessary to send a request from the medical image management server 10 to the medical image management server 10 once, and to send an image from the medical image management server 10 to the display device 30 once.

Further, by specifying the medical image corresponding to this position based on the position designated on the combined image, the medical image designated by the user can be displayed on the full screen.

The description in the above embodiment is an example of the medical image display system according to the present invention, and is not limited thereto. The detailed configuration and detailed operation of each device constituting the system can be appropriately changed without departing from the spirit of the present invention.

For example, in the above embodiment, the case where the timings of the combined image creation process and the image display process are different has been described, but when the tile display is required, the combined image may be created. Specifically, if there is a change or addition in the setting data (system setting data 143 or user setting data 144), or if there is no other setting condition that is the same as the changed or added setting data, at that time, The combined image corresponding to the changed or added setting data does not exist in the combined image storage area 146. In such a case, a combined image may be created when there is a display request from the display device 30.

Further, the display device 30 may have a plurality of monitors such as a two-sided configuration and a three-sided configuration, and may be configured to be able to display a plurality of screens at the same time. When the display device 30 has a plurality of monitors, the number of monitors and the display order of medical images are set in advance for each user or each device (display device 30), and the combination is performed in each case. All you have to do is create an image. Regarding the monitor configuration (number of monitors) of the display device 30, when the display device 30 is connected to the medical image management server 10, information may be transmitted from the display device 30 to the medical image management server 10.

When the display device 30 has a monitor having a two-sided configuration, in the display method 1 shown in FIG. 12A, medical images are arranged in order from left to right on the first monitor 331, and after arranging one line, the next Move to the (bottom) line, arrange the medical images in order from left to right, and after arranging for the predetermined number of lines, move to the monitor 332 on the second side and arrange the medical images in the same manner.
On the other hand, in the display method 2 shown in FIG. 12B, the number of columns of tile display from left to right across the monitors in a state where the monitor 333 on the first side and the monitor 334 on the second side are virtually connected in the horizontal direction. After arranging the medical images in the order of twice as much as the above, move to the next (bottom) line, and arrange the medical images in the order from left to right.

FIG. 13 shows an example of the combined images 80A and 80B created when the display method 2 shown in FIG. 12B is used to display tiles of 3 columns × 3 rows on a two-sided monitor. When "two-sided monitor", "three columns x three rows", and "display method 2" are set for the user or the display device 30, the medical image management server 10 displays the combined images 80A and 80B. Create it in advance. The size of the combined images 80A and 80B is 900 × 900. The numbers (1 to 18) described in the regions 81 to 98 corresponding to the original medical images included in the combined images 80A and 80B are the image numbers corresponding to the medical images. In the display device 30, when the upper left area 84 of the combined image 80B displayed on the second monitor is designated, the medical image of the image number “4” is displayed on the full screen of the second monitor.

In the above description, an example in which an HDD or a non-volatile semiconductor memory is used as a computer-readable medium in which a program for executing each process is stored has been disclosed, but the present invention is not limited to this example. As another computer-readable medium, a portable recording medium such as a CD-ROM can be applied. Further, a carrier wave may be applied as a medium for providing program data via a communication line.

10 Medical image management server 11 Control unit 12 Communication unit 14 Storage unit 20 Modity 30 Display device 31 Control unit 32 Operation unit 33 Display unit 34 Communication unit 36 Storage unit 40A, 40B Combined image 60 Combined image 70 Medical image 80A, 80B Combined image 100 Medical image display system 143 System setting data 144 User setting data 145 Medical image storage area 146 Combined image storage area NT communication network

Claims (7)

A medical image management server that displays multiple medical images on a display device connected to enable data communication via a communication network.
A means for creating a combined image by arranging the plurality of medical images in a tile shape in advance under a plurality of conditions.
A storage control means for associating the created combined image with the plurality of medical images and storing them in the storage means for each of the plurality of conditions.
When there is a display request from the display device for at least one of the plurality of medical images via the communication network, the storage means stores the set conditions and the combined image associated with the plurality of medical images. An image providing means that is acquired from the above and transmits the acquired combined image to the display device via the communication network.
Medical image management server with. The medical image management server according to claim 1 , wherein the creating means deletes information other than essential items included in the header information when creating the combined image. The creating means arranges the plurality of medical images in a tile shape with a preset number of columns and rows, and displays the combined image including the number of medical images equal to or less than the product of the number of columns and the number of rows. The medical image management server according to claim 1 or 2, which is created for each screen. The medical image management server according to any one of claims 1 to 3, wherein the creating means creates the combined image when the plurality of medical images are generated by a predetermined modality. An acquisition means for acquiring a position designated on the combined image displayed on the display device, and
It is specified which of the medical images included in the combined image the acquired position is in the area corresponding to the medical image, and the medical image corresponding to the specified area is acquired from the storage means, and the acquisition is performed. An individual image providing means for transmitting the acquired medical image to the display device via the communication network in order to display the obtained medical image on the full screen of the display device.
The medical image management server according to any one of claims 1 to 4. A medical image display system including a display device, a medical image management server connected to the display device via a communication network so as to be capable of data communication, and displaying a plurality of medical images on the display device.
The medical image management server is
A means for creating a combined image by arranging the plurality of medical images in a tile shape in advance under a plurality of conditions.
A storage control means for associating the created combined image with the plurality of medical images and storing them in the storage means for each of the plurality of conditions.
When there is a display request from the display device for at least one of the plurality of medical images via the communication network, the storage means stores the set conditions and the combined image associated with the plurality of medical images. An image providing means that is acquired from the above and transmits the acquired combined image to the display device via the communication network.
Medical image display system equipped with. The medical image display system according to claim 6, wherein the creating means deletes information other than essential items included in the header information when creating the combined image.

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