小型医学影像存档与通讯系统的临床应用

材料与方法　系统硬软件 :①医学影像采集设备为Ｐｈｉｌｉｐｓ公司ＭａｒｃｏｎｉＭｘ 80 0 0Ｍｕｌｔｉｓｌｉｃｅ螺旋ＣＴ ,ＭａｒｃｏｎｉＳｅｌｅＣＴ/ＳＰ螺旋ＣＴ ,ＤＩＣＯＭ 3 .0接口。②图像处理工作站为ＳｇｉＯ2 4.0Ｗｏｒｋｓｔａ ｔｉｏｎ ,2 5 6ＭＢ内存 ,19英寸彩显 ,ＤＩＣＯＭ 3 .0接口。③中央管理系统为奔腾Ⅲ 1ＧＨｚＣＰＵ ,60Ｇ双硬盘 ,3 2ＭＢ显存 ,5 12ＭＢ动态内存 ,15英寸彩显 ,ＤＦＥ 5 3 0ＴＸ 10 /10 0Ｍｂｐｓ自适应以太网卡 ,图像分辨率 80 0× 60 0。④网络结构采用星形总线拓扑结构 (ｓｔａｒｂｕｓｔｏ…     

医学影像存档与通讯系统的构建

医学影像存档与通讯系统(picture archivihg and communi-cation system,PACS)是医院迈向数字化信息时代的重要标志,是医疗信息资源达到充分共享的关键.PACS这一术语是由迈阿密大学医学院的A.J.Duerinckx于1981年提出的,由于它的代表性和国际通用性,一直延用至今并越来越被人们所接受,PACS是建立在医学成像图像处理,工作站及网络设计、数据库软件工程和通讯工程基础上的高技术产品,它的建设是一个复杂的工程,它的发展和普及将对放射医学、影像医学、数字图像技术、计算机应用、现代医疗技术和医院信息系统(HIS)的建设发挥重要的作用.尽管PACS目前仍存在着投资高、技术困难和难以适应荧光屏观察等缺陷,但仍然成为当今国际医学图像界的研究和开发热点.     

Agfa IMPAX 医学影像存档与通讯系统的应用与体会

随着计算机、数字成像和网络技术的迅速发展 ,由此产生了医学影像存档与通讯系统 (ｐｉｃｔｕｒｅａｒｃｈｉｖｉｎｇａｎｄｃｏｍｍｕｎｉｃａｔｉｏｎｓｙｓｔｅｍｓ,ＰＡＣＳ)。该系统通过不断的发展与完善 ,目前已基本解决了医学图像的获取、显示、存储、传送和管理[1] 。1999年 3月 ,我院引进了德国Ａｇｆａ公司的ＰＡＣＳ产品ＩＭＰＡＸ 3 5 ,该产品在国际上已有许多医院安装和应用。现介绍我科的应用情况。一、系统构成通常ＰＡＣＳ系统由 4部分构成 :图像获取、中心控制器、显示工作站和通讯网络[2 ] 。图像获取系统的目的是从成像…     

医学影像存档与通讯系统应用探讨

随着计算机技术、网络技术和半导体技术的迅速发展．世界范围内正经历着一场数字化信息革命。医学影像存档与通讯系统(picture archiving and communication systems．PACS)这一迈向医疗信息化的重要手段对于我们大多数人来讲已经不再陌生，因为我们早已听惯了PACS这个名字，各种专业学术会议上PACS是继RIS(radiologic information     

试论医学影像存档与通讯系统的诊断价值

对于放射影像诊断来讲，以医学影像存档与通讯系统（ＰＡＣＳ）的软拷贝取代沿袭百年的胶片硬拷贝无疑是一次巨大的变革。实现这种变革并非一帆风顺，更不会一蹴而就。在美国和日本的早期ＰＡＣＳ系统中不乏备受放射医生冷落而弃之不用的事例。现在国内有些人以为只要将数字化图像信号采集，大容量存储与计算机网络通讯系统集成起来并配以相应的应用管理软件便可冠以ＰＡＣＳ之名堂皇登室了。其实，这是很大的误解。ＰＡＣＳ作为数字化医学影像诊断的工具自有优劣好差之分。笔者试图从诊断的准确性、快捷性、安全性、经济性、可靠性等几个方…     

医学影像存档与通讯系统的开发与初步应用

目的 通过组建简便医学影像存档与通讯系统（ｐｉｃｔｕｒｅ ａｒｃｈｉｖｉｎｇ ａｎｄ ｃｏｍｍｕｎｉｃａｔｉｏｎ ｓｙｓｔｅｍｓ,ＰＡＣＳ）实现影像诊断设备的网络化,诊断报告书写计算机化,标准化。方法 ＣＴ,ＭＲＩ和Ｓｕｎ Ａｄｖａｎｔａｇｅ Ｗｉｎｄｏｗｓ１２．０工作站连接成医学数字影像传输（ＤＩＣＯＭ）网络;ＤＩＣＯＭ 与各图像浏览及诊断报告书写终连接成以太网网络;二者再通过集线器连接成ＰＡＣ     

应用图像浏览软件构建简易医学影像存档与通讯系统的研究

目的论证利用数字影像与通信标准（Digital Imaging and Communications in Medicine,DICOM）图像浏览软件构建简易医学影像存档与通讯系统（picture archiving and communication systems,PACS）,实现医学影像全院性共享及远程会诊的方法及其可行性。方法利用医院现有的局域网、各个科室现有PC机,采用互联网上免费DICOM图像浏览软件,通过网络及软件设置,将具有DICOM接口并开放的影像设备（如CR、DR、CT、MRI、DSA、数字胃肠及具有网络接口的激光胶片相机等）与PC机连接。结果具有DICOM图像浏览软件的PC机实现实时传输、调阅影像图像,达到类PACS效果。同时可以利用互联网,实现远程会诊。结论利用DICOM图像浏览软件构建简易PACS系统方法简单、经济、实用,特别适合在各中小型医院。     

医学影像存档与通讯系统在影像诊断教学中的初步应用

目的 评价医学影像存档与通讯系统(picture archiving and communication systems，PACS)在医学影像诊断教学中的应用价值。方法 利用GE PACS和天助公司的放射信息管理系统(radiology information system，RIS)、终端图文工作站等硬件、软件配置，构建大屏幕多媒体阅片室，设置典型影像教学片库，开辟电子学习室，直接从PACS调取图像制作多媒体幻灯教学课件和制备考试题库。结果 成功完成了各项构建，在PACS设置的教学分类片库中积累了有价值的影像资料近5000例，改变了传统的影像教学方法，实现了影像教学的实时化、多样化，在影像诊断教学和实习中获得一致好评，提高了教学质量。结论 PACS有利于提高医学影像诊断学的教学质量，值得完善和推广。     

医学影像存档与通讯系统发展方案及其设计模式的论证和选择

医学影像存档与通讯系统（ｐｉｃｔｕｒｅａｒｃｈｉｖｉｎｇａｎｄｃｏｍｍｕｎｉｃａｔｉｏｎｓｙｓｔｅｍｓ,ＰＡＣＳ）发展方案的设计是数字化放射科发展规划中一个非常重要的基础环节,其关系到投资是否得当、现有资源能否充分利用、系统运行的稳定可靠和可持续发展性等问题。因此,ＰＡＣＳ的设计过程必须包括对放射科设备现状和发展规划、系统功能要求和管理流程的设计、投资力度及效益回报等进行论证、分析,最终获得合理的系统结构和设计模式。不同医院医学影像部门的设备序列、投资状况、技术支持水平存在较大差别,ＰＡＣＳ方案…     

分布式混合结构PACS系统设计及实施

近年来,医学影像存储和通讯系统(Picture archiving and communications system,PACS)开始出现在国内大型医院,是管理医疗影像设备如CT、MRI、DR等产生的医学图像的信息系统.PACS的先进性、实用性是不容置疑的,然而其推广的进程却十分缓慢,尤其是中小医院.究其原因:其一,整套全院PACS(C/S结构服务器/客户端)费用昂贵,报价数以百万计,而高档的影像服务器在购置后不能被完全利用,造成资源浪费,而随时间延长,计算机硬件的飞速发展而贬值[1].其二,由于医院信息系统(HIS)在国内的发展早于PACS,很多需要实施PACS的医院已有基础网络及硬件环境,就要求PACS的实施要充分利用HIS、RIS系统的硬件及网络.要加快中小医院数字化进程,迫切需要解决如何用最小成本实现具有较好扩展性的全院PACS问题.我们经过实践探索,在我们医院设计实施了分布式PACS系统.     

PACS中集中打印系统的研制

随着计算机、通信、数字图像后处理、系统集成等技术的发展和医学图像通信接口标准的不断完善,医学影像存储与传输系统（picture archiving and communication system,PACS）已成为一个高度集成的数据平台,使得医学影像的存储、传输、显示和处理能在无胶片的状态下进行,在放射科工作流程得到极大改善的同时,更加方便医师使用医学影像信息。     

The impact of a picture archiving and communication system (PACS) upon an intensive care unit

OBJECTIVE: The aim of the study was to assess the effect of the introduction of PACS (Picture Archiving and Communication System) upon image availability in an Intensive Care Unit (ICU) and the consequent impact upon the behaviour of the ICU physicians, in terms of the initiation of image-based clinical actions. DESIGN: A before and after study was used to compare the speed of image availability prior to, and following, the implementation of a hospital-wide PACS. SETTING: The research was part of an economic evaluation of PACS at Hammersmith Hospital, West London. PATIENTS AND PARTICIPANTS: All ICU patients who were X-rayed during two pre-PACS and one post-PACS data collection periods were included within the study. MEASUREMENTS: The times of: the X-ray request; acquisition; availability on ICU; and of any image-based clinical action taken by the ICU physician were recorded by radiographers and ICU physicians. RESULTS: PACS significantly reduced the time between request and image availability on ICU for routine X-rays but did not have any measurable impact upon the time clinical actions were initiated by ICU physicians. The data on non-routine images were statistically inconclusive. CONCLUSIONS: This study shows that PACS significantly improves the speed of delivery of routine images to the ICU, but it appears that the instigation of image-based clinical actions is determined by other organisational factors in ICU, such as ward rounds, rather than the availability of the image for viewing. Further work is required on non-routine X-rays to clarify the impact of PACS on physician behaviour in clinically urgent situations.     

Integration of multiple direct digital imaging sources in a picture archiving and communication system (PACS)

OBJECTIVES: The aim of this report was to describe a flexible picture archiving and communication system (PACS) able to handle and communicate digital image data from various radiography systems and other sources. METHODS: The radiographic image is acquired using the vendor's own software. Following image capture, a "request for update" message (appending a record to an Access database) activates our PACS engine, "DigiMerge". Images from sources with no patient-related organizing software, e.g. TWAIN-compatible scanners and digital cameras, are handled by a self-developed program, "MedCom-T". DigiMerge generates and maintains one database based on all manufacturers' databases (software: VixWin 2000, Digora for Windows, Dimaxis Pro, Sidexis, CDR DICOM for Windows, Trophy for Windows). This database contains patient information, image information and image path. The program "DigiView" searches a patient and displays patient and image data from the database generated by DigiMerge. With DigiView, images can be viewed at any workstation in the dental school, but only temporary changes can be made (contrast, brightness, etc.) and no image can be deleted. RESULTS: The PACS is currently installed on 86 workstations. Statistics collected by DigiMerge reveal that approximately 2000 new digital images are recorded each month, half of which are radiographs and the other half are clinical photographs. Statistics collected by DigiView reveal that 500-800 digital images are opened per week. CONCLUSIONS: The self-developed PACS is able to manage images from a range of digital modalities each providing its own image data format.     

小型医学影像存储与传输系统的临床应用

目的 探索小型医学图像存档与通讯系统(minimizing picture archiving and communication system，mini—PACS)在实际工作中的应用，逐步实现科室内的无胶片化管理。方法 建立基于PC机的局域网，连接CT、MR、数字胃肠机、DSA、激光相机等医学影像设备，整合数字图像网络(digital imaging network，DIN)和医学图像诊断系统(medical diagnostic imaging system，MDIS)，组成放射科信息管理系统(radiology information system，RIS)。RIS系统通过其中1台安装双网卡的PC工作站与医院信息系统(hospital information system，HIS)相连。结果 系统在2年多的时间内得到连续使用，放射科信息管理系统得以实现和完善。在现有的数字化影像设备上实现了符合医学数字图像传输标准3．0(digital imaging communication in medicine，DICOM3．0)格式的图像采集、储存、传输、打印、浏览功能。图像和诊断报告信息通过Microsoft Access数据库管理，不同设备上保存的在线图像为3～6个月，所有图像用CD—R光盘刻录，作为离线永久保存，已有32700多份诊断报告存入数据库；HIS终端可有限制地从该系统获得图像和诊断信息。结论 mini—PACS系统投入和运行成本低、维护简单、性能可靠，可基本实现PACS的重要功能，在中、小医院具有良好的应用前景。     

PACS (picture archiving and communication systems) or the future workplace of the radiologist

PACS (picture archiving and communication systems) is a synonym for the replacement of the traditional photographic film by means of technologies that will communicate and store images exclusively in digital form. Digital mass storage will replace the film archives and will be linked to all image sources by means of a data communication network. More significantly, PACS will also introduce a novel type of image-evaluation modality, the diagnostic image work station. Images will be displayed on TV monitors. In addition, a variety of support functions will become available for image handling and processing. The replacement of the light box by a digital work station will definitely cause dramatic changes in the radiologist's work.     

医学图像存储与传输系统的初步应用与效益分析

目的：通过组建及应用大型医学图像存储与传输系统（PACS），总结PACS对医院工作方法、管理及服务等诸方面的贡献。方法：运用质量因素处理（QFD）的方法对医院诊断与非诊断性劳动比值、科研数据可查询率（％）、胶片查询、单位服务成本、病人等待时间等方面的分析，比较建立及应用PACS前后之间的诸多参数及因素。结果：组建PACS后，急诊影像检查时间平均减少64％、数据信息保存比率提高了50％、出报告时间缩短、胶片用量节省33％、图像检索的时间效率提高95％，以及其他诸多方面都有不同程度的改善和提高。结论：组建1个真正符合医院具体实际情况的大型PACS系统非常重要，因为它将对医院的工作方法、管理等方面起到积极的推动作用，加快和促进医院向更快、更高的数字化方向发展。     

Picture archiving and communication system (PACS) networking: three implementation strategies

This paper outlines the diverse Picture Archiving and Communication Systems (PACS) networking implementation strategies at the University of California at Los Angeles, the University of Florida, and the University of Kansas. At the University of California at Los Angeles, a very high-speed network has been integrated into a hierarchical networking strategy, resulting in an entirely customized network for the local transmission of images. The University of Florida has chosen to implement networks for local transmission of images using commercially available equipment. The University of Kansas, specializing in teleradiology applications, uses commercial telecommunication circuits to implement long distance referral services to small hospitals.     

Hanging protocol and viewers for a dental full picture [corrected] archiving and communication system (PACS) [corrected

OBJECTIVES: Study objectives were: to develop a hanging protocol for displaying digital transmission radiographic images of oral and maxillofacial regions using a dental DICOM (digital imaging and communication in medicine) viewer and a dental Web viewer; and to give information on a system that allows patients and health professionals to share image information. METHODS: For the hanging protocol, alphanumeric tags were defined and used in a DICOM modality worklist. These tags consisted of layout information to display images on monitors by the type of projection method and assignment information to display images of template for intraoral full-mouth survey that were numbered and slotted according to tooth position. Tooth code and algorithm for assignment of images for intraoral full-mouth survey were determined. Expanded correspondence for viewers was used for modalities without tags. Images could be edited by quality control system. An electronic medical record (EMR) system, a radiological information system (RIS) and a picture archiving and communication system (PACS) with servers, terminals and viewers were set up in a patient-centred hospital environment. RESULTS: Using the hanging protocol, the viewers displayed digital transmission radiographic images automatically on display areas on one or multiple monitors showing intraoral, panoramic and extraoral views produced during various examinations. The images were also displayed using the coupling function of EMR and RIS. Users can compare the images taken at various times more efficiently. CONCLUSION: The new system using a dental DICOM viewer and a dental Web viewer is the most advanced for examining oral and maxillofacial regions compared with medical viewers. Our local but clinically operational hanging protocol should be a good model for DICOM Working Group 22.     

Picture archiving and communication system (PACS): A progressive approach with small systems

PACS represents the natural evolution from working with digital modalities (e.g. CT, US, MRI, CR) towards a global digital environment where the film based activities are progressively replaced by their digital counterpart. The advantages of the technique and the drawbacks of the first implementations are described, as well as the recent advances in terms of technology, architecture, medical integration and cost-effectiveness. The so called ‘second generation’ PACS concept is presented with its features: modular architecture, progressive implementation, multi-vendor environment, integration with the Hospital Information System, standardization. This approach is particularly suited for progressive implementation in an existing hospital, in contrast to the possible topdown construction of a filmless radiology department, as a project for a totally new hospital. The implementation into the university hospital AZ-VUB is described as case study.