基于DICOM的医学影像设备接口设计与实现

医学影像存档与通讯系统(Picture Archiving and Communication Systems,PACS)是目前医院信息化建设的热点,医学数字成像和通信标准(Digital Imaging and Communication in Medicine,DICOM)是有关医学图像及其相关信息的数据编码及通讯的国际标准,支持DICOM标准是医学影像设备并入PACS网络的必要条件。为使目前尚不符合DICOM标准的影像设备有效并入PACS系统,必须为其添加DICOM接口。我们介绍了DICOM信息模型并实现了接口的软件系统,重点介绍了应用VisualC 编程实现DICOM服务中的C-STORE和DCM文件的读写功能。     

DICOM医学图像扩展模型的研究

医学图像存档和通讯系统PACS(Picture Archivingand Communication System)促进了医学图像的共享，但是该系统只能提供基于关键字的医学图像检索，不能进行基于语义内容检索，本研究在现有图像处理、分析和理解技术的基础上对医学图像的内容信息进行了划分，并对PACS系统的医学成像和通讯标准DICOM(Digital Imaging and Communicationin Medicine)信息模型进行了扩充，增加有关图像内容的信息，提出了DICOM信息模型的扩展模型。通过该模型来组织医学信息的存储和检索可以满足基于关键词和基于图像语义内容检索的需要，最后在该模型的框架下实现了超声心动图像基于形状特征的检索。     

图像存档和通讯系统的要求条件

疾病诊断成像技术的应用是现代医疗系统的基础。在临床上,由于检查次数的增加和检查方式的扩大,使得医学图像的数量迅速增加。其结果导致了医疗系统面临着一个问题,那就是医学图像数据的存储和传送。图像存档及通讯系统PACS(Pic-ture Archiving and Communications Sys-tems)作为一种技术,可以代替使用胶片或纸张的图像显示,传送和管理。图像存档及通讯系统以数字计算技术为基础,用电子的方式处理图像,取代了传统的硬拷贝形式。PACS系统的主要目标是提供一种方便、经济的观察、存储和重新诊断图像的手     

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中的DICOM标准分析及应用

DICOM是PACS系统中被国际认可的医学图像标准。本文分析了DICOM标准的主要部分，特别是信息对象定义、服务类和服务对象、数据组织格式、通讯机制等部分。结合广州医学院附属第二医院的实际情况，阐述了DICOM标准如何在PACS中应用。     

计算机在超声医学图像处理中的应用

介绍了计算机在超声医学图像处理领域的应用,着重讨论了超声医学成像和超声医学图像管理的方法与应用,具体分析了医院医学图像存档及通信系统(PACS)中B超影像工作站的结构与功能。     

PACS系统影像存储解决方案

医学图像存档与传输系统(PACS)是目前数字化医院建设的重点和难点,PACS系统需要一个高性能的影像存储系统支撑.本文分析了PACS系统影像存储的特点,介绍了分级存储机制实现对医学影像的存储管理,并比较了三种在线存储设备解决方案的优点和缺点.     

医学图像DICOM格式转换软件的设计与实现

PACS（图像存档与通讯系统）应遵循DICOM（医学数字图像通讯）标准。目前国内存在大量不符合DICOM标准的影像设备,为了使这些设备也应用于PACS,我们使用面向对象方法设计和实现了一个具有良好扩充性的格式转换工具包,可进行DICOM格式与各种通用图像格式之间的转换,并具有视频输入与格式转换工具包,可进行DICOM格式与各种通用图像格式之间的转换,并具有视频输入与扫描仪输入的接口。该工具包提供一组DICOM API,可供Windows平台的各种编程环境使用。     

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。     

The Information Security Needs in Radiological Information Systems—an Insight on State Hospitals of Iran, 2012

Picture Archiving and Communications System (PACS) was originally developed for radiology services over 20 years ago to capture medical images electronically. Medical diagnosis methods are based on images such as clinical radiographs, ultrasounds, CT scans, MRIs, or other imaging modalities. Information obtained from these images is correlated with patient information. So with regards to the important role of PACS in hospitals, we aimed to evaluate the PACS and survey the information security needed in the Radiological Information system. First, we surveyed the different aspects of PACS that should be in any health organizations based on Department of Health standards and prepared checklists for assessing the PACS in different hospitals. Second, we surveyed the security controls that should be implemented in PACS. Checklists reliability is affirmed by professors of Tehran Science University. Then, the final data are inputted in SPSS software and analyzed. The results indicate that PACS in hospitals can transfer patient demographic information but they do not show route of information. These systems are not open source. They don’t use XML-based standard and HL7 standard for exchanging the data. They do not use DS digital signature. They use passwords and the user can correct or change the medical information. PACS can detect alternation rendered. The survey of results demonstrates that PACS in all hospitals has the same features. These systems have the patient demographic data but they do not have suitable flexibility to interface network or taking reports. For the privacy of PACS in all hospitals, there were passwords for users and the system could show the changes that have been made; but there was no water making or digital signature for the users.     

非DICOM设备标准化的实现技术

我国的现有医疗影像设备的接口种类繁杂,只是部分较先进的设备才具有标准数字接口.为了将这些设备接入PACS,需要将从现有设备中获取的图像转换为DICOM3 0格式,并赋予其DICOM标准中的某种角色,以利于实现PACS等网络的建设.本文提出了一种实现DICOM标准化的可行技术.     

Business Model for the Security of a Large-Scale PACS,Compliance with ISO/27002:2013 Standard

Data security is a critical issue in an organization; a proper information security management (ISM) is an ongoing process that seeks to build and maintain programs, policies, and controls for protecting information. A hospital is one of the most complex organizations, where patient information has not only legal and economic implications but, more importantly, an impact on the patient’s health. Imaging studies include medical images, patient identification data, and proprietary information of the study; these data are contained in the storage device of a PACS. This system must preserve the confidentiality, integrity, and availability of patient information. There are techniques such as firewalls, encryption, and data encapsulation that contribute to the protection of information. In addition, the Digital Imaging and Communications in Medicine (DICOM) standard and the requirements of the Health Insurance Portability and Accountability Act (HIPAA) regulations are also used to protect the patient clinical data. However, these techniques are not systematically applied to the picture and archiving and communication system (PACS) in most cases and are not sufficient to ensure the integrity of the images and associated data during transmission. The ISO/IEC 27001:2013 standard has been developed to improve the ISM. Currently, health institutions lack effective ISM processes that enable reliable interorganizational activities. In this paper, we present a business model that accomplishes the controls of ISO/IEC 27002:2013 standard and criteria of security and privacy from DICOM and HIPAA to improve the ISM of a large-scale PACS. The methodology associated with the model can monitor the flow of data in a PACS, facilitating the detection of unauthorized access to images and other abnormal activities.     

Computers in imaging and health care: Now and in the future

Early picture archiving and communication systems (PACS) were characterized by the use of very expensive hardware devices, cumbersome display stations, duplication of database content, lack of interfaces to other clinical information systems, and immaturity in their understanding of the folder manager concepts and workflow reengineering. They were implemented historically at large academic medical centers by biomedical engineers and imaging informaticists. PACS were nonstandard, home-grown projects with mixed clinical acceptance. However, they clearly showed the great potential for PACS and filmless medical imaging. Filmless radiology is a reality today. The advent of efficient softcopy display of images provides a means for dealing with the ever-increasing number of studies and number of images per study. Computer power has increased, and archival storage cost has decreased to the extent that the economics of PACS is justifiable with respect to film. Network bandwidths have increased to allow large studies of many megabytes to arrive at display stations within seconds of examination completion. PACS vendors have recognized the need for efficient workflow and have built systems with intelligence in the management of patient data. Close integration with the hospital information system (HIS)-radiology information system (RIS) is critical for system functionality. Successful implementation of PACS requires integration or interoperation with hospital and radiology information systems. Besides the economic advantages, secure rapid access to all clinical information on patients, including imaging studies, anytime and anywhere, enhances the quality of patient care, although it is difficult to quantify. Medical image management systems are maturing, providing access outside of the radiology department to images and clinical information throughout the hospital or the enterprise via the Internet. Small and medium-sized community hospitals, private practices, and outpatient centers in rural areas will begin realizing the benefits of PACS already realized by the large tertiary care academic medical centers and research institutions. Hand-held devices and the Worldwide Web are going to change the way people communicate and do business. The impact on health care will be huge, including radiology. Computer-aided diagnosis, decision support tools, virtual imaging, and guidance systems will transform our practice as value-added applications utilizing the technologies pushed by PACS development efforts. Outcomes data and the electronic medical record (EMR) will drive our interactions with referring physicians and we expect the radiologist to become the informaticist, a new version of the medical management consultant.     

PACS课程实验教学内容初探

目的：PACS是医学影像获取、存储、显示、处理、传输和管理的技术综合与集成。它基于现代计算机和网络通讯技术,以数字化方式获取、管理、应用和共享医学影像和诊断信息。结合实践教学提高大学生全面、综合的PACS知识素质与技能越来越得到重视。因此,本文对高校PACS课程实验教学内容进行初步研究和探索。方法：在分析PACS技术特点及其实践教学重要性的基础上,本文主要从医学信息标准、数字化医学影像应用、医学影像设备和计算机软硬件技术与网络通讯等四方面对PACS课程实验内容进行探索。结果：较为详细地描述了PACS在医学信息标准、数字化医学影像应用、医学影像设备和计算机软硬件技术与网络通讯各技术层面相应的实验内容。结论：本文对于PACS系统课程所需要开展的实验内容进行了初步的研究和探索。由于PACS系统的技术复杂性和临床应用领域的特殊性．目前社会上对PACS课程在实验教学内容设置方面的研究成果较少。虽然文中所提出的实验内容在合理性和实际可行性方面都需要进一步完善提高,但该研究成果具有相当的启发意义和价值。     

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.     

Design and Implementation of Disaster Recovery and Business Continuity Solution for Radiology PACS

In the digital era of radiology, picture archiving and communication system (PACS) has a pivotal role in retrieving and storing the images. Integration of PACS with all the health care information systems e.g., health information system, radiology information system, and electronic medical record has greatly improved access to patient data at anytime and anywhere throughout the entire enterprise. In such an integrated setting, seamless operation depends critically on maintaining data integrity and continuous access for all. Any failure in hardware or software could interrupt the workflow or data and consequently, would risk serious impact to patient care. Thus, any large-scale PACS now have an indispensable requirement to include deployment of a disaster recovery plan to ensure secure sources of data. This paper presents our experience with designing and implementing a disaster recovery and business continuity plan. The selected architecture with two servers in each site (local and disaster recovery (DR) site) provides four different scenarios to continue running and maintain end user service. The implemented DR at University Hospitals Health System now permits continuous access to the PACS application and its contained images for radiologists, other clinicians, and patients alike.     

数字化影像信息系统在医院的移动应用

目的：构建全套完整无线数字化影像信息系统，使各科医务人员能够操作该系统在整个医院范围内安全、快速、简便的进行医疗应用。材料和方法：基于医院现有GE Centricity PACS／RIS的企业级架构和WEB技术向临床发布影像的应用，以多台戴尔PowerEdge服务器分别用作PACS服务器、RIS服务器、HIS服务器和PACS—web服务器。网络连接设备使用戴尔Powerconnect交换机和TP—LINK无线宽带路由器。用户终端移动设备使用戴尔Latitude笔记本电脑。首先依托医院现有的有线网络构架，选择具有代表性的科室，如放射科、神经外科、神经内科、预防保健科、质控科，并将无线宽带路由器通过双绞线连接至以太网接口，设置无线宽带路由器指定IP地址、子网掩码，设置路由器工作模式，MAC地址过滤、SSID并且禁用SSID广播、频道和加密属性。建立起集中控制式无线网络。在用户终端设置无线适配器，设置为与路由器相同的SSID、频道和加密属性。测试终端移动设备和服务器之间的连接，并且交给最终用户使用。结果：用户使用终端移动设备进行医疗工作日常操作移动性便携性明显优于原系统。而医疗软什的使用与原系统相同，无须另外培训。神经外科和神经内科的临床医生可以手持终端移动设备在患者床前边查房边做病程记录，并且同时通过浏览器基于IHE规范要求优先调阅关键帧影像，通过TruRez增量传输技术降低对无线网络带宽的要求，以web浏览的形式快速从GE Centricity PACS—web服务器实时渊用患者的影像资料。预防保健科和质控科通过HIS和RIS查询进行疾病分类、例数统计，快速生成报表，进行传染病监控和质罱控制。放射科医生需要经常从PACS服务器调用大量的DICOM格式文件，由于无线宽带路由器的带宽为54M，是原有线网络100M带宽的一半，调用时间有所延长。结论：使用医用无线网络系统的通信交流方式较传统方式更加迅速便捷。各种医务人员使用终端移动设备可以在医疗机构内任意漫游、高速传输影像、报告、病历以及其他电子文档。当影像浏览信息极大丰富时（如扩展对心电信息、电生理、超声、病理等信息），正确的操作者可以在正确的时间、安全的获得正确的、完善的临床诊断应用需要的综合诊断信息。对操作者而言简单明了，能够在所有医疗通信系统中使用而无需考虑制造商的因素。     

ATM网络环境下视频会议技术在PACS超声子系统中的应用

本文提出了视频会议技术在PACS尤其在其超声子系统中应用的新思路,它将目前电视会议厂商的成熟技术运用在医院的PACS建设上,为PACS中最难实现的超声子系统找到了很好的解决方案,实现了超声子系统中动态图像的实时交换,和交互的实时性,极大提高了效率,文中还详细证券交易服如何选取图像格式、如何建立操作连接、如何选择网络传输方式等具体问题。     

Radiologists in the IT era: the Saitama experience

In recent years, intra-hospital computerisation including picture archiving and communication system (PACS) and electronic medical chart system (EMCS) has been rapidly introduced in Japan. The current system has, however, encountered many problems, such as, storage format of images, quality of diagnostic monitors, and compatibility of PACS and EMCS introduced by multi-vendors. In 2003, Saitama Medical University Hospital introduced PACS and EMCS, which can prevent inconsistency and loss of medical care information and can be linked to provide high quality medical care. This paper describes how radiologists should be involved in a hospital information system as specialists of PACS, based on our experience.