JP2006320444A - Method and program for displaying medical image, method and program for distributing medical image, and server for medical image - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To call operator's attention when an apparatus displaying a medical image is manufactured without approval by the Pharmaceutical Affairs Law. <P>SOLUTION: The method for displaying a medical image is used for a terminal that displays a medical image on the basis of medical image data. The method comprises a step (a) for acquiring information regarding the terminal when an operator requires to browse a medical image by operating the terminal, a step (b) for determining whether or not the terminal is manufactured with approval by the Pharmaceutical Affairs Law on the basis of the attribute information acquired at step (a), and a step (c) for displaying information that calls operator's attention along with the medical image on a display section of the terminal when the terminal is determined at step (b) to be manufactured without approval by the Pharmaceutical Affairs Law. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

  The present invention relates to a medical image display method and a medical image display program used in various terminal devices capable of displaying a medical image using a medical image management system that manages a digitized medical image. Furthermore, the present invention relates to a medical image server that accumulates medical image data and distributes the medical image data to various terminal devices, and a medical image distribution method and a medical image distribution program used in the medical image server.

  Conventionally, imaging methods using radiation (X-rays, α-rays, β-rays, γ-rays, electron beams, ultraviolet rays, etc.) have been used in various fields, and especially in the medical field, it is the most important for diagnosis. It is one of the means. Since the first X-ray photography was realized, the X-ray photography method has been improved many times, and at present, a method combining a fluorescent screen and an X-ray film has become mainstream. On the other hand, in recent years, various digitized devices such as X-ray CT, ultrasound, and MRI have been put into practical use as devices used for medical image diagnosis, such as diagnostic information processing systems in hospitals. Construction is going on. A lot of research for digitizing X-ray images has also been made, but a radiographic method using a stimulable phosphor has been established and attracts attention as a replacement for conventional X-ray photography.

  A stimulable phosphor (storable phosphor) is a part of its radiation energy that is stored when irradiated with radiation. After that, when it is irradiated with excitation light such as visible light, it emits light according to the stored energy. It has been known for a long time. In the radiography method using this, a radiographic image of a subject such as a human body is photographed and recorded on a recording sheet coated with a stimulable phosphor, and when this recording sheet is scanned with excitation light such as laser light, stimulating light is emitted. Therefore, the image data is obtained by photoelectrically reading this light. After appropriately processing this image data, it can be output to a display such as a CRT or printed on a film by a laser printer or the like to display a radiation image as a visible image.

  Such a radiographic method has performance comparable to that of a conventional X-ray photography method in terms of imaging sensitivity and image quality. For example, compared with the conventional X-ray photography method, the exposure area is extremely wide, and the response of the photostimulated light to the exposure amount is almost proportional over the entire exposure area. For this reason, no matter what radiation dose the subject is photographed, it is possible to capture the emission region where the image exists and normalize it into a digital signal without excess or deficiency. Further, by combining the signal obtained in this way with an appropriate image processing method, it is possible to provide a steady and high-quality image even under various shooting conditions. Furthermore, since the digitized image information is obtained directly, not only can a large amount of data be stored for a long period of time without causing image deterioration, but also development into a medical diagnosis information system is possible. Become.

  By the way, in medical institutions such as hospitals, various terminal devices are connected to an image server via a LAN, and an image management system such as a PACS (Pictures Archive and Communication System) that manages digitized images is used. Thus, even in a terminal device other than a medical image display device having a high-resolution monitor for displaying a medical image, for example, a terminal device for electronic medical records having a relatively low-resolution monitor, the medical image can be viewed. Can do.

  However, due to the revision of the Pharmaceutical Affairs Law, under the Pharmaceutical Affairs Law, which will be enforced from April 2005, unless the person has received permission to sell highly managed medical devices, the company will sell and grant highly managed medical devices. However, it must not be displayed for the purpose of sale or conferment. A medical image display device for displaying a medical image corresponds to a highly managed medical device, and a person who satisfies a predetermined standard is approved and manufactured and sold. Such approval is not required for manufacturing and marketing. Therefore, it is problematic from the viewpoint of the Pharmaceutical Affairs Law to use a terminal device for electronic medical records having a relatively low resolution monitor for browsing medical images, and sufficient image quality for diagnosis can be obtained. There is a risk that the doctor will miss an abnormal shadow when diagnosing the patient.

As related technology, the following Patent Document 1 discloses a medical image diagnostic apparatus capable of simultaneously displaying on a monitor diagnostic information including medical image information currently being diagnosed and reference information including medical image information, and information used therefor A display method is disclosed. In this information display method, a medical image information database in which reference information including medical image information and related information is registered is stored in a recording unit in advance, and a plurality of information including at least one reference information can be displayed on the display unit at the same time. It is said. However, this information display method cannot call the operator's attention when the device displaying the medical image is not a device manufactured under the approval of the Pharmaceutical Affairs Law.
JP 2000-175912 A (first page, FIG. 2)

  Therefore, in view of the above points, the present invention provides a medical image display method capable of calling an operator's attention when a device displaying a medical image is not a device manufactured under the approval of the Pharmaceutical Affairs Law, and It is an object of the present invention to provide a medical image delivery method, a medical image display program, a medical image delivery program, and a medical image server.

  In order to solve the above problems, a medical image display method according to the present invention is a medical image display method used in a terminal device that displays a medical image based on medical image data, and the operator operates the terminal device. Step (a) for obtaining information related to the terminal device when requesting browsing of a medical image, and manufacturing the terminal device with approval of the Pharmaceutical Affairs Law based on the attribute information acquired in step (a) Step (b) for determining whether or not the device is a device that has been approved, and if the terminal device is determined not to be a device manufactured under the approval of the Pharmaceutical Affairs Law in step (b) A step (c) of displaying information for arousing together with the medical image on the display unit of the terminal device.

  A medical image distribution method according to the present invention is a medical image distribution method used in a medical image server that accumulates medical image data and distributes medical image data in response to a request from the terminal device. Steps (a) and (a) for retrieving information relating to a terminal device from among information relating to a plurality of terminal devices registered in advance in the image server when distribution of medical image data is requested. Step (b) for determining whether or not the terminal device is a device manufactured with approval of the Pharmaceutical Affairs Law based on the attribute information, and from the terminal device according to the determination result in step (b) And (c) distributing the requested contents of the medical image data.

  The medical image display program according to the present invention is a medical image display program used in a terminal device that displays a medical image based on medical image data, and the operator requested browsing of the medical image by operating the terminal device. At the time, based on the procedure (a) for acquiring information on the terminal device and the attribute information acquired in the procedure (a), whether or not the terminal device is a device manufactured with the approval of the Pharmaceutical Affairs Law. The procedure (b) for determining whether or not the terminal device is determined to be a device manufactured under the approval of the Pharmaceutical Affairs Law in the procedure (b). The CPU executes the procedure (c) for displaying on the display unit of the terminal device together with the image.

  A medical image distribution program according to the present invention is a medical image distribution program used in a medical image server that accumulates medical image data and distributes medical image data in response to a request from the terminal device. When the delivery of medical image data is requested, a procedure (a) for retrieving information related to the terminal device from information related to a plurality of terminal devices registered in advance in the image server is searched in the procedure (a). From the terminal device according to the procedure (b) for determining whether or not the terminal device is a device manufactured with the approval of the Pharmaceutical Affairs Law based on the attribute information, and the determination result in the procedure (b) The CPU executes the procedure (c) for changing the content of the requested medical image data and delivering it.

  A medical image server according to the present invention is a medical image server that accumulates medical image data and distributes medical image data in response to a request from a terminal device, and a registration unit that registers information about a plurality of terminal devices; When a delivery request for medical image data is requested from a terminal device, information related to the terminal device is searched from information related to a plurality of terminal devices registered by the registration means, and based on the searched attribute information, Search means for determining whether or not the terminal device is a device manufactured under the approval of the Pharmaceutical Affairs Law, and changing the content of the medical image data requested from the terminal device according to the determination result by the search means Image distribution means for distributing.

  According to the present invention, information on a terminal device is obtained, and based on the information, it is determined whether or not the terminal device is a device manufactured under the approval of the Pharmaceutical Affairs Law. Can be displayed on the display unit of the terminal device together with the medical image when it is determined that the device is not a device manufactured under the approval of the Pharmaceutical Affairs Law.

Hereinafter, the best mode for carrying out the present invention will be described in detail with reference to the drawings. The same constituent elements are denoted by the same reference numerals, and the description thereof is omitted.
FIG. 1 is a block diagram showing a configuration of a medical information system including various apparatuses using a medical image display method according to an embodiment of the present invention. As shown in FIG. 1, in this medical information system, a reception terminal 1 used for patient reception, a doctor terminal 2 used by a doctor to input the contents of diagnosis and treatment, and an electronic medical record are created. An electronic medical record management terminal 3 for managing the medical image, a medical image photographing device 4 for recording a radiation image on a recording sheet by irradiating the subject with radiation, and a radiographic image recorded on the recording sheet A medical image reading device 5 that photoelectrically reads information to generate image data, a medical image processing device 6 that receives image data from the medical image reading device 5 and performs various processes, and a process in the medical image processing device 6 The image server 7 that records the image data that has been subjected to, the medical image display device 8 that displays or outputs the medical diagnostic image and its supplementary information, and the radiography for the radiographic image captured A report creation terminal 9 used for creating a report, a report server 10 that records a shooting report, and a report confirmation terminal 11 that displays or outputs the shooting report are connected to each other via a LAN (local area network). Has been.

  The medical image processing device 6 and the medical image display device 8 have a high-resolution monitor for displaying medical images, and are manufactured upon approval by the Pharmaceutical Affairs Law. On the other hand, since the reception terminal 1, the doctor terminal 2, the electronic medical record management terminal 3, the report creation terminal 9, and the report confirmation terminal 11 are not particularly considered to display a medical image, they are relatively low. It has a resolution monitor and is manufactured without regulatory approval. However, these terminals can also display medical images by accessing the image server 7 and obtaining medical image data.

  A medical image display method and a medical image display program according to an embodiment of the present invention are used when displaying medical images on various terminal devices, and a device displaying a medical image is Information on whether the device is manufactured with approval (hereinafter referred to as “medical device”) or not manufactured under the Pharmaceutical Affairs Law (hereinafter referred to as “non-medical device”). give. In the following, a case where the medical image display method according to the present embodiment is used in the medical image display device 8 will be described as an example.

  FIG. 2 is a block diagram showing a configuration of a medical image display apparatus using the medical image display method according to the embodiment of the present invention. The medical image display device 8 includes an input unit 81 such as a keyboard and a mouse used for inputting various commands and the like, and a display unit 82 having a monitor such as a high-resolution CRT or LCD display for displaying medical images. A central processing unit (hereinafter referred to as a CPU) 83 to which an input unit 81 and a display unit 82 are connected via an interface 89, a memory 84, a hard disk 85, and a hard disk for controlling writing and reading of data in the hard disk 85 It includes a control unit 86, a DVD driver 87 for writing / reading data to / from a DVD (digital versatile disk), and a network interface 88 for connecting to a LAN. These parts 83 to 88 are connected to each other via a bus line.

  The hard disk 85 stores software (medical image display program) for causing the CPU 83 to perform an operation. As a recording medium for recording software, in addition to the built-in hard disk 85, a DVD-ROM, CD-ROM, external hard disk, flexible disk, MO, MT, or the like can also be used.

Next, functional blocks 83a to 83d configured by the CPU 83 and software (medical image display program) will be described.
When the operator requests browsing of a medical image by operating the input unit 81, the image display management unit 83a receives, for example, desired medical image data from the image server 7 shown in FIG. The unit 83b is controlled to acquire the attribute information of the terminal device.

  A computer used as a terminal device has a database called “registry” in the case of a system using Windows (registered trademark) in order to store setting data of the system and application software. This registry is recorded on a recording medium such as a hard disk in the terminal device. In this embodiment, when the medical image display program is installed in the terminal device, initial setting data and terminal device attribute information necessary for displaying the medical image are stored in the registry. Here, the attribute information is information used for identifying whether the terminal device is a medical device or a non-medical device. For example, when the medical device is shipped from a factory, the medical device is used. Attribute information for identifying this is set in the registry.

  Therefore, the attribute information acquisition unit 83b acquires the attribute information from the registry of the terminal device to which the browsing request is input when there is a browsing request for the medical image, and the terminal device is based on the acquired attribute information. It is determined whether the device is a medical device or a non-medical device.

  When it is determined that the terminal device is a non-medical device, the signal processing unit 83c performs signal processing for displaying information for alerting the operator together with the medical image. For example, when a medical image display program is executed in the electronic medical record management terminal 3 shown in FIG. 1, the terminal device is determined to be a non-medical device, so the signal processing unit 83c alerts the operator. Display data for overlay display of character information to be displayed on a medical image is generated.

  Here, the overlay display refers to a display method in which patterns and colors are superimposed by using a plurality of screens for a plurality of images. As information for alerting the operator, for example, character information such as “for reference” and “x” may be displayed.

  When it is determined that the terminal device is a medical device, the display control unit 83d displays a medical image on the display unit 82 based on the medical image data received by the image display management unit 83a, and the terminal device Is determined to be a non-medical device, a medical image is displayed on the display unit 82 based on the display data generated by the signal processing unit 83c.

  FIG. 3 is a diagram illustrating a display example of a medical image on a medical device. When a medical image is displayed on a medical device such as the medical image display device 8 or the medical image processing device 6 shown in FIG. 1, as shown in FIG. 3 based on the medical image data received by the image display management unit 83a. Medical images are displayed.

  FIG. 4 is a diagram illustrating a display example of a medical image on a non-medical device. When a medical image is displayed on a non-medical device such as the electronic medical record management terminal 3 and the report creation terminal 9 shown in FIG. 1, based on the display data generated by the signal processing unit 83c, as shown in FIG. A medical image in which character information “for reference” is inserted is displayed.

  Next, a medical image display method according to an embodiment of the present invention will be described with reference to FIGS. FIG. 5 is a flowchart showing a medical image display method according to an embodiment of the present invention.

  When the operator inputs a command by operating the operation unit 81 of the terminal device (in this example, the medical image display device 8), in step S11, the image display management unit 83a determines that the input command is a medical image. It is confirmed whether or not it is a browsing request. When the input command is a request for viewing a medical image, the image display management unit 83a receives desired medical image data from an image server or the like, and in step S12, the attribute information acquisition unit 83b Get attribute information of. On the other hand, if the input command is not a request for viewing a medical image, the process related to image display is terminated.

  In step S13, the attribute information acquisition unit 83b determines whether the terminal device is a medical device or a non-medical device based on the acquired attribute information, and the determination result is transmitted to the signal processing unit 83c and the display control. Passed to the part 83d. If it is determined that the terminal device is a medical device, the process proceeds to step S15. If it is determined that the terminal device is a non-medical device, the process proceeds to step S14.

  In step S14, the signal processing unit 83c generates display data in which information for alerting the operator is overlaid on the medical image. In step S15, the display control unit 83d displays a medical image on the display unit 82 based on whether the terminal device is a medical device or a non-medical device. When the terminal device is a medical device, a medical image as shown in FIG. 3 is displayed. When the terminal device is a non-medical device, the operator's attention is drawn as shown in FIG. For this reason, a medical image in which information is overlaid is displayed.

  As a result, when viewing a medical image on a terminal device that is not particularly considered to display a medical image, information for alerting the operator is displayed, so the operator can display the displayed medical image. Can be recognized as a reference medical image that is not sufficient for diagnosis.

Next, a medical image distribution method according to an embodiment of the present invention will be described.
FIG. 6 is a block diagram showing a configuration of an image server using the medical image distribution method according to the embodiment of the present invention. The image server 7 includes an input unit 71 such as a keyboard and a mouse used for inputting various commands, a display unit 72 such as a CRT or LCD display for displaying an operation image, and an interface 78. A central processing unit (hereinafter referred to as CPU) 73 to which an input unit 71 and a display unit 72 are connected, a memory 74, a hard disk 75, a hard disk control unit 76 for controlling writing and reading of data in the hard disk 75, and a LAN And a network interface 77 for connection. These portions 73 to 77 are connected to each other via a bus line.

Next, functional blocks 73a to 73d configured by the CPU 73 and software (medical image distribution program) will be described.
The attribute information registration unit 73a registers attribute information of various terminal devices that can display medical images by using an image management system such as PACS that manages digitized images. The attribute information of various terminal devices is read from the registry of each terminal device and recorded on a recording medium such as the hard disk 75 in the image server 7. Alternatively, the operator may input and register the attribute information of each terminal device using the input unit 71 of the image server 7.

  The attribute information search unit 73b, when requested to distribute medical image data from the terminal device, retrieves the attribute information of the terminal device from the attribute information of various terminal devices registered by the attribute information registration unit 73a. Based on the retrieved attribute information, it is determined whether the terminal device is a medical device or a non-medical device.

  The signal processing unit 73c reads the image data requested to be distributed from a recording medium such as the hard disk 75, and when it is determined that the terminal device is a non-medical device, information for alerting the operator is obtained. Signal processing for display together with medical images is performed. For example, when distribution of medical image data is requested from the electronic medical record management terminal 3 shown in FIG. 1, the terminal device is determined to be a non-medical device, and therefore the signal processing unit 73c receives the operator's attention. Signal processing is performed on the medical image data read from the recording medium so as to insert character information for arousing into the medical image.

  When it is determined that the terminal device that requested the distribution of the medical image data is a medical device, the distribution control unit 73d distributes the medical image data read from the recording medium such as the hard disk 75 to the terminal device. When it is determined that the terminal device is a non-medical device, the display data subjected to signal processing by the signal processing unit 73c is distributed to the terminal device.

  Next, a medical image distribution method according to an embodiment of the present invention will be described with reference to FIGS. FIG. 7 is a flowchart showing a medical image delivery method according to an embodiment of the present invention.

  When a request from the terminal device is received, in step S21, the attribute information search unit 73b confirms whether or not the received request is a medical image data distribution request. If the received request is a distribution request for medical image data, in step S22, the attribute information search unit 73b selects the medical image from the attribute information of various terminal devices registered in advance in the image server 7. The attribute information of the terminal device that transmitted the data distribution request is searched, and the signal processing unit 73c reads the medical image data recorded on the recording medium. On the other hand, if the received request is not a medical image data distribution request, the processing related to the distribution of medical image data is terminated.

  In step S23, the attribute information search unit 73b determines whether the terminal device is a medical device or a non-medical device based on the searched attribute information, and the determination result is transmitted to the signal processing unit 73c and the distribution control. Delivered to the unit 73d. If it is determined that the terminal device is a medical device, the process proceeds to step S25. If it is determined that the terminal device is a non-medical device, the process proceeds to step S24.

  In step S24, the signal processing unit 73c generates medical image data in which information for alerting the operator is inserted into the medical image. In step S25, the distribution control unit 73d distributes medical image data based on whether the terminal device is a medical device or a non-medical device. When the terminal device is a medical device, the medical image data read from the recording medium is distributed to the terminal device, and when the terminal device is a non-medical device, it is generated by the signal processing unit 73c. The medical image data is distributed to the terminal device. As a result, a medical image as shown in FIG. 3 is displayed on the medical device, and a medical image in which information for alerting the operator is inserted is displayed as shown in FIG. 4 on the non-medical device. Is done.

  In the above embodiment, it is determined whether the terminal device is a medical device or a non-medical device using the attribute information stored in the registry of the terminal device. When the terminal device is used, it is determined whether the terminal device is a medical device or a non-medical device based on information such as the model number and specifications of the terminal device or the IP address. May be. Alternatively, based on tag information defined in DICOM (Digital Imaging and Communications in Medicine), which is a network standard for medical imaging equipment, it is determined whether the terminal device is a medical equipment or a non-medical equipment. You may make it do.

  The present invention can be used in an image server that stores medical image data, and various terminal devices that can display medical images based on medical image data distributed from the image server.

It is a block diagram which shows the structure of the medical information system containing the various apparatuses using the medical image display method which concerns on one Embodiment of this invention. It is a block diagram which shows the structure of the medical image display apparatus using the medical image display method which concerns on one Embodiment of this invention. It is a figure which shows the example of a display of the medical image in a medical device. It is a figure which shows the example of a display of the medical image in a non-medical device. It is a flowchart which shows the medical image display method which concerns on one Embodiment of this invention. It is a block diagram which shows the structure of the image server using the medical image delivery method which concerns on one Embodiment of this invention. It is a flowchart which shows the medical image delivery method which concerns on one Embodiment of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Reception terminal 2 Doctor's terminal 3 Electronic medical record management terminal 4 Medical image photographing device 5 Medical image reading device 6 Medical image processing device 7 Image server 8 Medical image display device 9 Report creation terminal 10 Report server 11 Report confirmation terminal 71, 81 input Unit 72, 82 Display unit 73, 83 CPU
73a Attribute information registration unit 73b Attribute information search unit 73c Signal processing unit 73d Distribution control unit 74, 84 Memory 75, 85 Hard disk 76, 86 Hard disk control unit 77, 88 Network interface 78, 89 Interface 83a Image display management unit 83b Attribute information acquisition 83c Signal processor 83d Display controller 87 DVD driver

Claims (10)

A medical image display method used in a terminal device that displays a medical image based on medical image data,
A step (a) of acquiring information related to the terminal device when the operator requests browsing of the medical image by operating the terminal device;
A step (b) for determining whether or not the terminal device is a device manufactured under the approval of the Pharmaceutical Affairs Law based on the attribute information acquired in step (a);
When it is determined in step (b) that the terminal device is not a device manufactured under the approval of the Pharmaceutical Affairs Law, information for alerting the operator is displayed on the display unit of the terminal device together with the medical image. Step (c);
A medical image display method comprising:   When step (c) determines in step (b) that the terminal device is not a device manufactured under the approval of the Pharmaceutical Affairs Law, character information for alerting the operator is displayed on the medical image. The medical image display method according to claim 1, comprising performing processing for overlay display. A medical image distribution method used in a medical image server that accumulates medical image data and distributes medical image data in response to a request from a terminal device,
A step (a) of retrieving information relating to a terminal device from information relating to a plurality of terminal devices registered in advance in the image server when distribution of medical image data is requested from the terminal device;
A step (b) for determining whether the terminal device is a device manufactured under the approval of the Pharmaceutical Affairs Law based on the attribute information searched in step (a);
(C) changing the contents of the medical image data requested from the terminal device according to the determination result in step (b), and delivering
A medical image delivery method comprising:   In step (c), when it is determined in step (b) that the terminal device is not a device manufactured under the approval of the Pharmaceutical Affairs Law, information for alerting the operator is inserted into the medical image. The medical image distribution method according to claim 3, comprising generating image data. A medical image display program used in a terminal device that displays a medical image based on medical image data,
When an operator requests browsing of a medical image by operating a terminal device, a procedure (a) for acquiring information related to the terminal device;
A procedure (b) for determining whether or not the terminal device is a device manufactured with the approval of the Pharmaceutical Affairs Law based on the attribute information acquired in the procedure (a);
When it is determined in step (b) that the terminal device is not a device manufactured under the approval of the Pharmaceutical Affairs Law, information for alerting the operator is displayed on the display unit of the terminal device together with the medical image. Step (c);
A medical image display program for causing the CPU to execute   When it is determined in step (c) that the terminal device is not a device manufactured under the approval of the Pharmaceutical Affairs Law in step (b), character information indicating that is displayed in an overlay manner on the medical image The medical image display program according to claim 5, comprising performing the process. A medical image distribution program used in a medical image server that accumulates medical image data and distributes medical image data in response to a request from a terminal device,
A procedure (a) for retrieving information relating to a terminal device from information relating to a plurality of terminal devices registered in advance in the image server when delivery of medical image data is requested from the terminal device;
A procedure (b) for determining whether or not the terminal device is a device manufactured with the approval of the Pharmaceutical Affairs Law based on the attribute information retrieved in the procedure (a);
A procedure (c) for changing the contents of the medical image data requested from the terminal device in accordance with the determination result in the procedure (b) and delivering;
A medical image distribution program for causing a CPU to execute   When the procedure (c) is determined in the procedure (b) that the terminal device is not a device manufactured under the approval of the Pharmaceutical Affairs Law, information for calling the operator's attention is inserted into the medical image The medical image delivery program according to claim 7, comprising generating image data. A medical image server that accumulates medical image data and distributes medical image data in response to a request from a terminal device,
Registration means for registering information on a plurality of terminal devices;
When a request for distribution of medical image data is made from a terminal device, information related to the terminal device is searched from information related to a plurality of terminal devices registered by the registration unit, and based on the searched attribute information, Search means for determining whether or not the terminal device is a device manufactured under the approval of the Pharmaceutical Affairs Law;
According to the determination result by the search means, an image distribution means for changing and distributing the contents of the medical image data requested from the terminal device;
A medical image server comprising:   A medical image in which information for alerting an operator is inserted into a medical image when the image distribution unit determines that the terminal device is not a device manufactured under the approval of the Pharmaceutical Affairs Law by the search unit The medical image server of claim 9, comprising generating data.