关注IHE关键影像标记在PACS中的应用

关键影像标记通过指定一组事务处理的定义,将影像检查序列中一帧或多帧关键影像与其对应的注释信息进行关联。本文对该集成模型的角色、事务处理以及相关的DICOM内容进行了分析。     

Benefits of the DICOM Modality Performed Procedure Step

A few years ago, the Digital Imaging and Communications in Medicine standard introduced a network transaction that is initiated by modality equipment, mainly at the beginning and at the end of the acquisition. This transaction, the Modality Performed Procedure Step (MPPS), is sent to the Picture Archiving and Communication System and/or to the Radiology Information System. It carries information about what really has been performed by the modality equipment during acquisition. In this paper, we present MPPS and discuss its benefits. We show how MPPS enables efficient radiology workflow and how it ensures accuracy and completeness of imaging information. We think our paper helps bridge the gap between MPPS implementation and deployment. By understanding all the MPPS benefits, the end user becomes aware of the great enhancement in patient care that this transaction provides.     

论坛专题报告之二 Employing Industry Standards for System Integration in Digital Radiology Department

１．INTRODUCTIONSincethepastdecade熏RadiologyInformationSystem穴RIS雪andPictureArchivingandCommunicationSys鄄tem穴PACS雪havebeingemployedinanincreasednumberofradiologyde鄄partmentstoimproveprocesspro鄄ductivity熏providebetterqualityofimagingservices熏andreducemedicalerrors．Intherecentyears熏systemin鄄tegrationhasbecomethemajorneedofthehealthcareprovidersworld鄄wide熏todrivethedirectionofthede鄄velopmentofRISandPACStowardsafullyintegrateddigitalradiologyde鄄partment．Openindustrys…     

The value of susceptibility-weighted imaging (SWI) in patients with non-neonatal hypoxic-ischemic encephalopathy

ObjectiveIn susceptibility-weighted imaging (SWI) in the normal brain, cortical veins appear hypointense due to paramagnetic properties of deoxy-hemoglobin. Global cerebral anoxia decreases cerebral oxygen metabolism, thereby increasing oxy-hemoglobin levels in cerebral veins. We hypothesized that a lower cerebral oxygen extraction fraction in comatose patients with non-neonatal hypoxic-ischemic encephalopathy (IHE) produces a pattern of global rarefied or pseudo-diminished cortical veins due to higher oxy-hemoglobin.Purpose(1) To investigate the topographic relationship between susceptibility effects in cortical veins and related diffusion restrictions on diffusion-weighted imaging (DWI) in patients with IHE. (2) To relate imaging findings to patterns of altered resting activity on surface EEG.MethodsTwenty-three IHE patients underwent MRI. EEG patterns were used to classify the depth of coma. Regional vs. global susceptibility changes on SWI and patterns of DWI restrictions were compared with the depth of coma.ResultsAll patients exhibited areas of restricted cortical diffusion and SWI abnormalities. The dominant DWI restrictions encompassed widespread areas along the precuneus, frontal and parietal association cortices and basal ganglia. For SWI, nineteen patients had generalized bi-hemispherical patterns, the EEG patterns correlated with coma grades III–V. Four patients had focal decreases of deoxy-hemoglobin following DWI restrictions; associated with normal EEGs.ConclusionFocal patterns of diamagnetic effects on SWI according to relative decreases in deoxy-hemoglobin due to reduced metabolic demand are associated with normal EEG in IHE patients. Global patterns indicated increased depth of coma and widespread cortical damage.Clinical relevanceThe results indicate a potential diagnostic value of SWI in patients with IHE.     

基于 IHE 医学影像信息系统的优化与实践简

目的优化医学影像检查的工作流程,促进信息系统的无缝集成。方法从IHE集成模式的预定工作流程集成模式入手,对医院PACS建设在IHE 集成模式开展与应用情况进行回顾与分析,并对传统工作流程进行改造与优化。结果基于IHE标准集成模式RIS与PACS的一体化集成,不仅使影像部门的工作流更加流畅,而且使数据流更加平滑。结论基于IHE医学影像信息系统,可以充分利用有限资源,缩短病人检查的周转时间,提高医疗服务质量。     

PACS在我院的建设和应用

目的:通过构建医学影像与传输系统(PACS),实现医院医学影像信息工作的管理和服务的数字化网络。方法:根据医院的特点,进行整体的规划,采用适合的系统架构和单元设计,逐步予以实施。结果:目前已完成全部建设任务,并对系统进行不断地测试,使其更加完善,同时进行了一些临床应用。结论:我院PACS 2 a来运行的结果表明,该系统性能稳定,达到了设计和实际运行的要求。     

集成医疗卫生企业（IHE）的集成性声明文档

IHE集成性声明文档是一份由IHE提供商撰写并公开发布的关于其产品符合IHE技术框架（Technical Framework）程度的遵从性文件.本文对该文档的结构,内容和组成格式进行了说明,以帮助国内医院信息集成商及广大医疗卫生系统用户进一步学习理解.     

异构PACS间互操作的方法研究

目的 建立数字医学影像平台,解决异构PACS间数据的互操作性问题.方法 基于医学影像数据交互的业务特点,设计了分层的系统架构,对业务流程进行了标准化.结果 构建合理的区域医学影像平台的模型,为实现影像数据的互操作提供了懈决方法.结论 设计方案灵活可扩展性强,减少了医疗数据区域化互操作的成本,提高数据的可管理性及有效性.     

基于IHE XDS／XCA的跨区域医疗信息共享交换系统设计

该系统是在遵循IHE XDS．b（Cross-enterprise documentsharing）和IHE XCA（Cross-Community Access）技术规范基础上,采用SOA（Service Oriented Architecture）和EDA（Event Driving Architecture）技术架构及网格概念。设计和开发的一种跨区域（Cross-Community）医疗信息共享交换（EHR）系统。系统由四个层次组件组成：一个市级注册中心（XDSRegistry）;多个区级域XDS注册中心,每一个对应相应的行政管理域;与域级注册中心相对应的多个文档存储池（XDS Repository）;以及提供病人基本信息的文档源代理（XDS Source Actor Agents）。通过对该系统进行海量医疗文档数据发布、用户查询和图像提取等操作进行的压力测试和评估结果表明。该EHR系统可用于中、大城市多区域、多医疗机构之间的医疗信息共享交换和医疗协同。     

实现IHE PIX核心匹配算法的关键技术

患者身份的唯一性识别与整合是实现区域医疗信息共享的基础。IHEPIX是国际上公认的解决患者身份唯一性问题的技术框架,着重介绍了在“医联工程”中实现IHE PiX匹配算法的三种关键技术：身份信息框架、多级停用词划分、关键信息项排序。该匹配算法在项目中的成功运用证实了这些关键技术的有效性。