医学图像存档和传输系统打印管理服务功能的实现

打印管理是组成医学图像存档和传输(PACS)系统的重要功能模块，必须按照DICOM标准来设计。本简述DICOM中的传输和打印管理服务的基本内容，对打印管理模块的功能进行了分析，在此基础上介绍了打印管理模块的实现，并列出了用DELPHI实现的程序模块以及实现时需注意的一些具体问题。     

医学图像存档和传输系统打印管理服务功能的实现

打印管理是组成医学图像存档和传输(PACS)系统的重要功能模块，必须按照DICOM标准来设计。本简述DICOM中的传输和打印管理服务的基本内容，对打印管理模块的功能进行了分析，在此基础上介绍了打印管理模块的实现，并列出了用DELPHI实现的程序模块以及实现时需注意的一些具体问题。     

医学影像存档与传输系统的设计

本文对在综合性大型医院建立医学影像存档与传输系统的目标、结构、功能和硬件配置进行了论述.重点介绍了以SAN存储结构为核心构造医学影像存档与传输系统服务器组的方法,并对软件模块的功能进行了阐述.     

医学图像存取与传输系统应用的初步探讨

多年前，已有人指出：“一个现代化的医院管理信息系统不仅应做到人、财、物等信息的集中管理，而且还能把文字、数字、图形传送到全院的终端工作室。以数字形式储存的ＭＲＩ、ＣＴ、超声、Ｘ照相等图像将由光导纤维传送到需要的任何地点并显示。”这就是医院的图像存取和通讯系统（ＰｉｃｔｕｒｅＡｃｈｉｅｖｅｍｅｎｔａｎｄＣｏｍｍｕｎｉｃａｔｉｏｎＳｙｓｔｅｍ，ＰＡＣＳ）。作为临床医学的重要环节，影像诊断是不可或缺的，也正因此，ＰＡＣＳ成为ＨＩＳ的重要组成部份。特别是近年来，随着计算机和网络通讯技术的发展，作为远程医…     

数字化成像技术、医学影像存档和通讯系统（PACS）和医学数字图像通讯传输（DICOM）标准

10多年来影像学得到飞跃的发展 ,多种新的数字化人体成像技术如Ｘ -ＣＴ、ＭＲＩ、数字减影血管造影(ＤｉｇｉｔａｌＳｕｂｔｒａｃｔｉｏｎａｎｇｉｏｇｒａｐｈｙ ,ＤＳＡ)、正电子发射型体层成像 (ＰｏｓｉｔｉｖｅＥｌｅｃｔｒｏｎＴｏｍｇｒａｐｈｙ ,ＰＥＴ)、计算机放射性成像 (ＣｏｍｐｕｔｅｄＲａｄｉｏｇｒａｐｈｙ ,ＣＲ)等等 .ＣＴ的问世标志了医学影像设备与计算机相结合的里程碑 .医学影像设备的数字化是现代医学发展的趋势 .Ｘ -ＣＴ、ＭＲＩ、ＰＥＴ及ＳＰＥＣＴ等均属本质数字图像 .ＭＲＩ脑成像发展极快 ,动态成像实时成…     

基于Browser／Server方式的医院图像存储通信系统（PACS）

作者介绍了医院图像存档与传输系统（ＰＡＣＳ）的一种新的实现结构。与常用的体系不同，新系统利用了最新发展的Ｗｏｒｌｄ Ｗｉｄｅ Ｗｅｂ（ＷＷＷ）技术对ＰＡＣＳ进行设计，在实现系统功能的同时，大大降低了运行，维护费用，具有良好的伸缩性和扩展性，可方便地实现业务的分布式处理与代码的集中式维护。     

医学图像后处理研究进展

概要分析和评述了近年来医学图像后处理技术的发展，并主要从图像分割、配准、重建、PACS系统等方面进行了分类综述。     

基于DICOM医学图像的传输和查询系统的设计

目的:随着PACS系统的发展,医学图像的存档管理和传输也变得更加重要,本文就DICOM医学图像在因特网上的的传输和查询展开论述.方法:采用B/S三层体系结构和ASP技术,运用开发的ActiveX控件,完成了DICOM医学图像管理系统的设计.结果:该系统实现了医学图像传输及图像的快速转换、高效查询和显示,并经过测试验证了此技术的可行性.结论:此研究性设计为PASC系统的完善发展奠定了基础,并且对建设现代化数字医院具有参考价值.     

医学成像和通讯系统的CORBA设计方案

针对目前医学信息系统的异构带来了彼此之间通讯和信息共享的困难 ,对象管理组 (OMG)制定了CORBAMed软件规范 ,规定了医学信息系统的软件架构 ,定义各种服务的接口。本文尝试将 CORBA应用于医学图像存档和通讯系统 ,提出 CORBA解决方案的 PACS系统模型 ,分析了软件系统的视图层次 ,最后讨论了CORBAMed的相关服务。     

PACS诊断工作站匹配小型DSA在介入治疗中的应用

目的 探讨PACS诊断工作站与小型DSA匹配在介入治疗中的应用价值。方法 PACS诊断工作站通过视频采集一转换方式采集岛津公司的WHA-50N／S小型DSA的PH-DSA方式获得的视频图像，使用DIGOM 3．0国际标准。对采用该系统检查治疗的67例图像资料进行分析，评价该工作站的使用效能。结果 将PACS诊断工作站与小型DSA相接后，将原来的PH-DSA视频图像转变为10～25帧／S的数字DSA图像，可上传输至PACS，达到资料共享。提高了图像后处理的功能。应用该系统获得的数字图像能够保持原设备的清晰程度，无明显失真，可以显示1～2mm的3～4级血管。结论采用小型DSA与PACS诊断工作站相匹配，可以为介入治疗的开展提供可靠的保障。     

基于病案的教学查房结合PACS在影像科医师培养中的应用

目的探讨在影像科医师培养中,基于病案(CBL)的教学查房结合医学影像存储与通讯系统(PACS)对医师影像诊断能力培养的价值。方法对2018年在北京大学第三医院放射科轮转CT的41名培训医师,应用PACS对其进行CBL教学查房,对照组为2017年轮转CT的39名培训医师(未进行CBL教学)。从PACS随机抽取每名医师书写的10份报告(报告时间为培训最后1个月),对开展CBL教学前后培训医师的报告书写质量评分并计算优良率。评分标准包括病灶征象描述全面准确、报告内容条理清晰规范、诊断结论逻辑清晰合理、能回答临床提出的问题、提出的下一步诊疗建议合理准确以及无漏诊。同时采用调查问卷的方式评价培训医师对CBL教学查房的主观感受,包括全面系统的认识疾病、提高临床思维能力、读片能力和学习兴趣、PACS对学习的帮助5方面,采用百分比表示。结果1)进行CBL教学查房后,培训医师报告质量评分提高(P<0.01)。2)培训医师对调查问卷5方面满意率分别为90.2%、68.3%、80.5%、75.6%和80.5%。结论应用PACS进行CBL教学查房是培养影像科医师诊断能力的有效方法。     

影像存储与传输系统实施规范的探讨

目的 通过制定和遵循影像存储与传输系统（picture archiving and communication system,PACS）的实施规范,以提高PACS安装速度,降低PACS故障率和安装实施成本.方法 PACS实施规范包括系统安装前的需求分析、实施计划书的制定、工作表单的编写、与HIS等软件接口开发、PACS软件实施中的规范要求、项目验收6个工作步骤.结果 本实施规范是笔者多年对多个医院PACS实施和维护经验的总结.只有规范化操作和实施,才能降低PACS故障率,提高项目建设速度.结论 PACS系统涉及多个领域,需要不断总结,才能达到最佳实施效率.     

PACS在颈椎后方结构测量及其临床意义

目的　利用图像存储传输系统(PACS)结合CT片测量颈椎后方解剖学结构,为临床颈椎椎弓根置钉提供资料。 方法　利用PACS结合CT片,由5名脊柱外科医师对2000例正常人颈椎椎弓根的矢状位及横断为进行精确测量,得出椎弓根的长度、宽度、高度、向内侧倾斜、向头、尾侧倾斜角度的数据值, 并分别计算各节段左右侧椎弓根测量值的均值和标准差,进行统计学分析。 结果　寰椎入钉点距离一般在后弓中点旁开17～20 mm,在C2～7各椎弓根均有髓腔,C2～7椎弓根的高度大于宽度,C3、C4椎弓根直径最小,仍可置入3.5 mm的螺钉。寰枢椎螺钉在矢状面入钉角向头侧倾斜为正角,下颈椎螺钉向尾侧倾斜为负角,C4接近水平, C5～7负角逐渐增大, C7可达-19°左右。在横断位上测量的椎弓根的进钉角度显示,其中C2最小,下颈椎椎弓根具有变异性,术前利用CT片通过PACS进行精确测量,指导术中准确选钉与安全置钉具有指导性意义。 结论　应用PACS系统结合CT片术前测量,能够指导术中安全置入颈椎椎弓根螺钉,明显减少并发症,是一种值得推广的方法。     

Automated Recognition of Lateral from PA Chest Radiographs: Saving Seconds in a PACS Environment

Images acquired in a two-view digital chest examination are frequently not electronically distinguishable. As a result the lateral and posterioanterio (PA) images are often improperly positioned on a PACS work station. A series of 1998 chest radiographs (999 lateral, 999 PA or AP) were used to develop a neural network classifier. The images were down-sampled to 16 × 16 matrices, and a feed-forward neural network was trained and tested using the leave-one-out method. Using five nodes in the hidden layer, the neural network correctly identified 987 of the 999 test cases (98.8%) (average of six runs). The simple architecture and speed of this technique suggests that it would be a useful addition to PACS work station software. The accumulated time saved by correctly positioning the lateral and PA chest images on the work station monitors in accordance with each radiologists hanging protocols was estimated to be about 1 week of radiologist time per year.     

基于层次分析法的植物神经系统活动度及平衡性的评价模型研究

目的:植物神经功能状态的参数异常是心血管疾病预后不良的标志。本研究拟提出一种基于层次分析法定量评价植物神经系统活动度及平衡性的新方法。 方法:通过层次分析将心率变异性参数分为时域参数、频域参数、非线性参数3层指标,根据各层指标的两两相对重要性构造判断矩阵,计算出各层指标的权重,经过一致性检验验证判断矩阵的可靠性。经过自身对照实验获得数据对模型进行验证。 结果:随着应激程度的增加,交感神经张力呈增加趋势,副交感神经张力呈降低趋势,两者的平衡性呈增加趋势。 结论:本研究设计的模型能一定程度上反映植物神经系统的变化,有一定的理论研究价值。     

Integration of Temporal Subtraction and Nodule Detection System for Digital Chest Radiographs into Picture Archiving and Communication System (PACS): Four-year Experience

Since May 2002, temporal subtraction and nodule detection systems for digital chest radiographs have been integrated into our hospital’s picture archiving and communication systems (PACS). Image data of digital chest radiographs were stored in PACS with the digital image and communication in medicine (DICOM) protocol. Temporal subtraction and nodule detection images were produced automatically in an exclusive server and delivered with current and previous images to the work stations. The problems that we faced and the solutions that we arrived at were analyzed. We encountered four major problems. The first problem, as a result of the storage of the original images’ data with the upside-down, reverse, or lying-down positioning on portable chest radiographs, was solved by postponing the original data storage for 30 min. The second problem, the variable matrix sizes of chest radiographs obtained with flat-panel detectors (FPDs), was solved by improving the computer algorithm to produce consistent temporal subtraction images. The third problem, the production of temporal subtraction images of low quality, could not be solved fundamentally when the original images were obtained with different modalities. The fourth problem, an excessive false-positive rate on the nodule detection system, was solved by adjusting this system to chest radiographs obtained in our hospital. Integration of the temporal subtraction and nodule detection system into our hospital’s PACS was customized successfully; this experience may be helpful to other hospitals.     

胶片集中打印中提高信息识别率的分析与策略

目的 探寻医学影像存储与传输系统(PACS)集中打印中提升胶片信息识别率的有效方法.方法 分析各成像设备胶片布局中四角信息布局对识别率的影响因素;针对不同的影响因素,通过修改设备的四角信息格式、调整胶片格式、优化选片布局、修改放射信息系统存取号(RIS ACCESSION NUMBER)、引入正则表达式的正确性校验以及多次识别等优化方法识别胶片信息.结果 应用此方法对普放检查集中打印系统进行测试,在信息识别的准确性和有效性方面得到了显著的改进.结论 信息识别优化方法提高了胶片的信息识别率,为数字影像和通信标准(DICOM)电子胶片集中打印模式的实施提供了关键技术保障.     

Towards a Theory of PACS Deployment: An Integrative PACS Maturity Framework

Owing to large financial investments that go along with the picture archiving and communication system (PACS) deployments and inconsistent PACS performance evaluations, there is a pressing need for a better understanding of the implications of PACS deployment in hospitals. We claim that there is a gap in the research field, both theoretically and empirically, to explain the success of the PACS deployment and maturity in hospitals. Theoretical principles are relevant to the PACS performance; maturity and alignment are reviewed from a system and complexity perspective. A conceptual model to explain the PACS performance and a set of testable hypotheses are then developed. Then, structural equation modeling (SEM), i.e. causal modeling, is applied to validate the model and hypotheses based on a research sample of 64 hospitals that use PACS, i.e. 70 % of all hospitals in the Netherlands. Outcomes of the SEM analyses substantiate that the measurements of all constructs are reliable and valid. The PACS alignment—modeled as a higher-order construct of five complementary organizational dimensions and maturity levels—has a significant positive impact on the PACS performance. This result is robust and stable for various sub-samples and segments. This paper presents a conceptual model that explains how alignment in deploying PACS in hospitals is positively related to the perceived performance of PACS. The conceptual model is extended with tools as checklists to systematically identify the improvement areas for hospitals in the PACS domain. The holistic approach towards PACS alignment and maturity provides a framework for clinical practice.     

The design and development of a physician-oriented PACS for the enhancement of e-hospital facilities

Recent advancements in modern medical diagnoses have required a huge increase of the use of equipment such as CT and ultrasound machines. Correspondingly, the storage and dissemination of these medical images have become an important issue to medical professionals. Unfortunately, management of these images has traditionally been slow and cumbersome. With the prevalence of the personal computer, however, along with increased network bandwidth, it is now possible to handle this information electronically as well as wirelessly. The Picture Archiving and Communication System (PACS) is at the forefront of this revolution. Yet, commercially available PACS software is generally prohibitively expensive for hospitals with limited financial resources. A dilemma among many hospitals is deciding how to acquire and implement the proper PACS system without unduly affecting the budget. In this paper, a full function, efficient, and economical PACS system is presented as a viable, non-compromising option for many small and medium-sized hospitals. This system, designed and developed mainly by the physicians and technicians of Puli Christian Hospital (PCH), with the assistance from academia, allows for customization to fit the needs of individual hospitals. This system can be used as the foundation of a hospital's health information infrastructure and to enhance e-hospital service.