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。     

PACS与DICOM

近几年来随着医院信息化的深入发展及数字影像时代的到来，医学图像归档和通讯系统（picture archiving and communication system，PACS）在我国已开始逐渐发展起来。不少PACS软件产品都称是依据医学数字成像和交换（digital imaging and communication in medicine，DICOM）标准^[1]开发并与DICOM兼容的。但是对PACS、DICOM的理解及PACS究竟如何遵从DICOM标准都是一个值得深入探讨的问题。     

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.     

DICOM医学图像采集的方法与实践

医学图像采集是PACS的重要环节,也是PACS实用化的关键。本文比较了几种常见的图像采集方法,重点介绍了通过DICOM接口的图像采集,在详细阐明了DICOM网络的概念和DICOM消息交换的规范之后,介绍了我们编写的DICOM医学图像采集软件,本软件是在Windows平台上利用SocketAPI编写而成,提供了DICOM标准定义的验证、存储、查询和检索等服务,测试结果表明,本软件能够顺利地与成像设备连接并采集图像。     

DICOM医学图像的存储与管理

随着数字化医学成像设备在医院的广泛使用,对医学图像及相关数据的存档管理以及在不同科室之间的数据共享的要求越来越迫切,这就需要建立PACS(图像存档和通讯系统),这方面国外已经发展了很多年,我国目前处于起步阶段.本文参照PACS系统的一个已经被国际认可的医学图像标准即医学成像和通讯标准DICOM(digital imaging and communication in medicine),研究了标准的各个部分,特别是兼容性、信息对象定义(IOD)、服务对象对类(SOP)、数据编码等部分,就具体实现PACS系统的一个重要方面即医学图像的存档和管理做了深入的探讨,在此基础上建立了医学图像数据库系统,为实现医学图像信息的网络共享打下了基础.     

PACS中的标准DICOM

医学数字图像通讯标准DICOM3.0(Digital Imaging and Communication in Medicine Ⅲ）是医学信息学领域中正在广泛使用的工业标准，DICOM3.0正在成为医院医学影像存档与通讯系统PACS（Picture Archiving and Communication System)事实上的国际标准。本文介绍了DICOM3．0的产生，组成和E－R建模基础，介绍了DICOM的国内外发展情况。     

Web PACS浏览工作站的构建

目的：作为B／S客户端的Web浏览器实现了Web PACS浏览工作站分布式的特点，但它却不支持DICOM格式，本文利用Java技术构建基于DICOM标准的web PACS浏览工作站，扩展了常用Web浏览器（以IE为主）对医学影像的处理功能。方法：首先根据DICOM3．0标准编写DICOM核心类以实现对DICOM文件的解析，在此基础上利用Java开发环境JDK1．6及Java开发工具Eclipse3．2优化Applet界面布局，在Applet中加载图像并实现图像及病人基本信息的显示，完成基本的图像处理功能．最后利用Java Plug-in技术将Applet加载至Web浏览器，从而实现了分布式Web PACS浏览工作站的构建。结果：本研究开发的具有DICOM图像浏览功能的Java Applet，用户界面友好，操作简便，能将每一台连网的PC机变成“浏览工作站”，能高效加载DICOM图像至Web浏览器，单幅、多幅、动态放映等显示模式间可灵活切换．实现了窗宽／窗位调整、图像平滑、锐化等基本图像处理操作。结论：DICOM图像浏览的Java Applet实现是构建Web PACS浏览工作站的关键．为医学影像的广域共享，远程影像教学和远程会诊提供了思路，将推动PACS工作模式进入新的纪元。     

浅析PACS中的DICOM标准

随着医学影像设备的广泛应用以及PACS的快速发展，为了统一各种数字化影像设备的图像数据格式和数据传输标准而诞生的DICOM标准已经成为医学数字成像和通讯的共同标准。本文简要的介绍了DICOM标准的历史以及DICOM数据集和DICOM文件格式的组织形式。     

HIS和PACS集成的DICOM方式

HIS和PACS的集成是医院信息系统发展面临的重要问题，本文讨论了DICOM3.0提供的HIS和PACS的接口，介绍了HIS和PACS集成的DICOM方式。     

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。     

Extracting data from a DICOM file

DICOM v3.0 is a vendor-independent standard for digital medical images that describes a file format and network protocol for the exchange of images between computer systems. When simply viewing a DICOM file, it is not necessary for the user to understand the details of the entire DICOM standard. However, understanding parts of the standard is essential when DICOM files are read and processed by a user-generated program. This paper offers an overview of information a user needs to write a program for extracting the image and acquisition parameters from a DICOM file.     

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。     

Leveraging Internet Technologies with DICOM WADO

The digital imaging and communications in medicine (DICOM) 3.0 standard was first officially ratified by the national electrical manufacturers association in 1993. The success of the DICOM open standard cannot be overstated in its ability to enable an explosion of innovation in the best of breed picture archiving and communication systems (PACS) industry. At the heart of the success of allowing interoperability between disparate systems have been three fundamental DICOM operations: C-MOVE, C-FIND, and C-STORE. DICOM C-MOVE oversees the transfer of DICOM Objects between two systems using C-STORE. DICOM C-FIND negotiates the ability to discover DICOM objects on another node. This paper will discuss the efforts within the DICOM standard to adapt this core functionality to Internet standards. These newer DICOM standards look to address the next generation of PACS challenges including highly distributed mobile acquisition systems and viewing platforms.     

Mastering DICOM with DVTk

The Digital Imaging and Communications in Medicine (DICOM) Validation Toolkit (DVTk) is an open-source framework with potential value for anyone working with the DICOM standard. DICOM’s flexibility requires hands-on experience in understanding ways in which the standard’s interpretation may vary among vendors. DVTk was developed as a clinical engineering tool to aid and accelerate DICOM integration at clinical sites. DVTk is used to provide an independent measurement of the accuracy of a product’s DICOM interface, according to both the DICOM standard and the product’s conformance statement. DVTk has stand-alone tools and a framework with which developers can create new tools. We provide an overview of the architecture of the toolkit, sample scenarios of its utility, and evidence of its relative ease of use. Our goal is to encourage involvement in this open-source project and attract developers to build off and further enrich this platform for DICOM integration testing.     

The JAVA-based DICOM query interface DicoSE

DICOM 3 is a very elaborate standard for the communication between medical image devices. It is published in several parts by the National Electrical Manufacturers Association (NEMA). To adequately visualize the data structure defined in parts 3, 5 and 6 of the DICOM standard, we implemented the web based Dicom Search Engine (DicoSE). It allows for querying the DICOM standard data dictionary for defined data fields and visualizes the topology of the data which is inherently present in DICOM datasets. For the administration of the underlying data a web based administration interface is provided. The service is entirely based on freely available software.     

DICOM Standard Conformance in Veterinary Medicine in Germany: a Survey of Imaging Studies in Referral Cases

In 2016, the recommendations of the DICOM Standards Committee for the use of veterinary identification DICOM tags had its 10th anniversary. The goal of our study was to survey veterinary DICOM standard conformance in Germany regarding the specific identification tags veterinarians should use in veterinary diagnostic imaging. We hypothesized that most veterinarians in Germany do not follow the guidelines of the DICOM Standards Committee. We analyzed the metadata of 488 imaging studies of referral cases from 115 different veterinary institutions in Germany by computer-aided DICOM header readout. We found that 25 (5.1%) of the imaging studies fully complied with the “veterinary DICOM standard” in this survey. The results confirmed our hypothesis that the recommendations of the DICOM Standards Committee for the consistent and advantageous use of veterinary identification tags have found minimal acceptance amongst German veterinarians. DICOM does not only enable connectivity between machines, DICOM also improves communication between veterinarians by sharing correct and valuable metadata for better patient care. Therefore, we recommend that lecturers, universities, societies, authorities, vendors, and other stakeholders should increase their effort to improve the spread of the veterinary DICOM standard in the veterinary world.     

System Integration and DICOM Image Creation for PET-MR Fusion

This article demonstrates a gateway system for converting image fusion results to digital imaging and communication in medicine (DICOM) objects. For the purpose of standardization and integration, we have followed the guidelines of the Integrated Healthcare Enterprise technical framework and developed a DICOM gateway. The gateway system combines data from hospital information system, image fusion results, and the information generated itself to constitute new DICOM objects. All the mandatory tags defined in standard DICOM object were generated in the gateway system. The gateway system will generate two series of SOP instances of each PET-MR fusion result; SOP (Service Object Pair) one for the reconstructed magnetic resonance (MR) images and the other for position emission tomography (PET) images. The size, resolution, spatial coordinates, and number of frames are the same in both series of SOP instances. Every new generated MR image exactly fits with one of the reconstructed PET images. Those DICOM images are stored to the picture archiving and communication system (PACS) server by means of standard DICOM protocols. When those images are retrieved and viewed by standard DICOM viewing systems, both images can be viewed at the same anatomy location. This system is useful for precise diagnosis and therapy.     

JJ1017 Committee Report: Image Examination Order Codes—Standardized Codes for Imaging Modality, Region, and Direction With Local Expansion: An Extension of DICOM

The digital imaging and communications in medicine (DICOM) standard includes parts regarding nonimage data information, such as image study ordering data and performed procedure data, and is used for sharing information between HIS/RIS and modality systems, which is essential for IHE. To bring such parts of the DICOM standard into force in Japan, a joint committee of JIRA and JAHIS established the JJ1017 management guideline, specifying, for example, which items are legally required in Japan, while remaining optional in the DICOM standard. In Japan, the contents of orders from referring physicians for radiographic examinations include details of the examination. Such details are not used typically by referring physicians requesting radiographic examinations in the United States, because radiologists in the United States often determine the examination protocol. The DICOM standard has code tables for examination type, region, and direction for image examination orders. However, this investigation found that it does not include items that are detailed sufficiently for use in Japan, because of the above-mentioned reason. To overcome these drawbacks, we have generated the JJ1017 code for these 3 codes for use based on the JJ1017 guidelines. This report introduces the JJ1017 code. These codes (the study type codes in particular) must be expandable to keep up with technical advances in equipment. Expansion has 2 directions: width for covering more categories and depth for specifying the information in more detail (finer categories). The JJ1017 code takes these requirements into consideration and clearly distinguishes between the stem part as the common term and the expansion. The stem part of the JJ1017 code partially utilizes the DICOM codes to remain in line with the DICOM standard. This work is an example of how local requirements can be met by using the DICOM standard and extending it.     

Linking Whole-Slide Microscope Images with DICOM by Using JPEG2000 Interactive Protocol

The use of digitized histopathologic specimens (also known as whole-slide images (WSIs)) in clinical medicine requires compatibility with the Digital Imaging and Communications in Medicine (DICOM) standard. Unfortunately, WSIs usually exceed DICOM image object size limit, making it impossible to store and exchange them in a straightforward way. Moreover, transmitting the entire DICOM image for viewing is ineffective for WSIs. With the JPEG2000 Interactive Protocol (JPIP), WSIs can be linked with DICOM by transmitting image data over an auxiliary connection, apart from patient data. In this study, we explored the feasibility of using JPIP to link JPEG2000 WSIs with a DICOM-based Picture Archiving and Communications System (PACS). We first modified an open-source DICOM library by adding support for JPIP as described in the existing DICOM Supplement 106. Second, the modified library was used as a basis for a software package (JVSdicom), which provides a proof-of-concept for a DICOM client–server system that can transmit patient data, conventional DICOM imagery (e.g., radiological), and JPIP-linked JPEG2000 WSIs. The software package consists of a compression application (JVSdicom Compressor) for producing DICOM-compatible JPEG2000 WSIs, a DICOM PACS server application (JVSdicom Server), and a DICOM PACS client application (JVSdicom Workstation). JVSdicom is available for free from our Web site (), which also features a public JVSdicom Server, containing example X-ray images and histopathology WSIs of breast cancer cases. The software developed indicates that JPEG2000 and JPIP provide a well-working solution for linking WSIs with DICOM, requiring only minor modifications to current DICOM standard specification.