JP2011092219A - Medical image management device - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a medical image management device, having both a console function and a server function, and conducting the image processing directly for RAW data generated in an image generating device. <P>SOLUTION: This medical image management device includes: a communicating part 35 connected to the image generating device 2 generating image data about a patient to transmit and receive data to and from each other, and receiving RAW data of a photographed image generated by the image generating device 2; a control part 31 generating display image data from the RAW data received by the communicating part 35; and an image DB management part 38 having an RAW data area 38a for saving the RAW data received by the communicating part 35 leaving it intact as the RAW data and a display data area 38b saving the display image data generated by the control part 31 in association with the RAW data. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention relates to a medical image management apparatus, and more particularly to a medical image management apparatus used in a small medical facility.

  Conventionally, a patient who is a patient to be examined was imaged using an image generation device such as a CR (Computed Radiography) imaging device or an FPD (Flat Panel Detector) imaging device. 2. Description of the Related Art There is known a diagnostic system that performs image processing such as gradation processing so that an image can be provided for diagnosis, outputs an image processed image, and provides it for interpretation by a doctor.

  In such a diagnosis system, the person who received the patient and issued the imaging order (acceptance), the person who actually photographed the patient in the imaging room (engineer), and the gradation, etc. were obtained. Responsible for determining the availability of image diagnosis, and in some cases, responsible for correcting contrast and density (such as an engineer appointed from a general engineer), and interpreting in charge of determining (diagnosing) the presence or absence of disease based on images ( A plurality of persons in charge, such as doctors, share roles and diagnoses are advanced.

  In a large-scale medical facility (hereinafter referred to as a large-scale facility) for which application of such a conventional diagnostic system is assumed, there are a plurality of image generation apparatuses and engineers who operate the image generation apparatus. A console and a viewer for checking image data by a doctor or the like are also provided separately for each role.

In order to prevent the image data from being confused with individual patients, an ID is issued at each device for each work in each process, and each device, for example, HIS (Hospital Information System) And RIS (Radiology Information System) systems that are linked to each other via a network that supports a core system and associate the results of work processes performed by each device (for example, patent literature) 1 to Patent Document 3).
In the case of such a configuration, means for ensuring data consistency with the backbone system is also required (see, for example, Patent Document 4 and Patent Document 5).

In the case of such a system, the original image data (RAW data) obtained by photographing is converted into a format conforming to the DICOM standard after being subjected to some image processing in a console or the like, and transmitted to a HIS or RIS server. And stored in the storage means of the server. Then, the doctor performs interpretation / diagnosis while confirming the image data stored in the storage means with a viewer or the like.
US Pat. No. 5,334,851 JP 2002-159476 A JP 2002-311524 A JP 2006-92261 A JP 2003-248723 A

  However, the image processing in the console or the like is performed by the engineer in charge, and image processing suitable for performing processing that is desired by the doctor and interpretation / diagnosis is not always performed. Therefore, there is a demand for doctors to perform image processing independently when performing interpretation / diagnosis with a viewer. In addition, when performing image processing in a computer-aided detection system for detecting an affected area, such as detection of breast cancer, direct image processing is performed directly on RAW data, not processed data. Preferably it is done.

  However, the viewer can refer to the image data stored in the storage unit of the server. However, the RAW data is not transmitted to the storage unit of the server, and only the image data after image processing is transmitted. It has become so. The amount of data of the image data after the image processing is smaller than that of the RAW data during various processes and compression. For this reason, when interpretation / diagnosis is performed, only density and contrast can be changed to some extent, and image processing cannot be performed freely as in RAW data. The RAW data is temporarily stored in the storage unit of the console, and after the image data after image processing is transmitted to the server, it is sequentially discarded. For this reason, it has been impossible to restore the image data to the RAW data state and perform image processing again at the stage where the doctor interprets and diagnoses.

  On the other hand, according to the investigation by the inventors of the present application, in the case of a relatively small medical facility (hereinafter referred to as a small-scale facility) such as a practitioner or clinic, in many cases, there is one doctor who examines a patient. In many cases, a doctor also serves as an engineer who performs imaging and the like, and the number of installed image generating apparatuses and the number of rooms such as examination rooms are small.

For this reason, it is inefficient to use separate devices for the console for image processing, the viewer for image interpretation / diagnosis, and the server for storing / accumulating image data.
In addition, if a system similar to that of a large-scale facility is used in such a small-scale facility, it is necessary to generate imaging order information starting with the input of the patient's name. bad. Furthermore, there is a problem that it is necessary to construct a large-scale system for linking each device, and the burden of capital investment and the like is increased.
Therefore, in a small-scale facility, a compact system that matches the actual situation is desired.

  The present invention has been made in view of such a situation, and has a medical image management apparatus that has functions of a console and a server and can directly perform image processing on RAW data generated by an image generation apparatus. It is intended to provide.

In order to solve the above-mentioned problem, the invention described in claim 1
It is connected to an image generation device that generates image data related to a patient so that data can be transmitted and received,
RAW data receiving means for receiving RAW data as image data generated by the image generating device;
Display data generating means for generating display image data from the RAW data received by the RAW data receiving means;
A RAW data area for storing the RAW data received by the RAW data receiving unit as RAW data, and a display image for storing the display image data generated by the display data generating unit in association with the RAW data A storage means having a data area;
A medical image management apparatus comprising:

The invention according to claim 2 is the medical image management apparatus according to claim 1,
The display data generation means includes an image processing unit that performs image processing on the RAW data, and a data conversion unit that converts the RAW data into image data in a format that conforms to a general-purpose standard for display. It is characterized by being.

According to the first aspect of the present invention, since the RAW data of the captured image generated by the image generation device is stored in the RAW data area as it is, image processing can be performed on the RAW data. For this reason, the degree of freedom of image processing is high, a doctor or the like can perform desired image processing at the stage of interpretation and diagnosis, and an image suitable for diagnosis can be obtained.
In addition, since it is possible to perform image processing directly on RAW data, it is more effective to perform image processing on image data that has not been processed as much as possible, such as image processing performed to detect breast cancer. In this case, it is possible to obtain a favorable result.

  According to the second aspect of the present invention, since image processing can be performed on the RAW data, the degree of freedom of image processing is improved, and a desired image processing is performed when a doctor performs interpretation or diagnosis. Thus, an image suitable for diagnosis or the like can be obtained. In addition, since the RAW data is converted into image data in a format conforming to the general-purpose display standard in the data conversion unit, an image based on the converted image data can be displayed on a general-purpose viewer (display unit). The effect of.

  Hereinafter, a small-scale diagnosis system 1 to which an embodiment of a medical image management apparatus according to the present invention is applied will be described with reference to FIGS. The present invention is not limited to the illustrated example.

  FIG. 1 is a block diagram showing a system configuration of the small-scale diagnosis system 1, and FIG. 2 is a diagram schematically showing a flow of image data between main apparatuses in the present embodiment.

  The small-scale diagnosis system 1 is a system applied to a relatively small-scale medical facility such as a practitioner or a clinic. As shown in FIG. 1, an ultrasonic diagnostic apparatus (US: ultrasonography) 2a that is an image generation apparatus 2 An endoscope (ES) 2b, an electrocardiogram recording device (ECG) 2c, a CR reading device 2d, a medical image management device 3, and a receiving device 4 are included. The image generation device 2, the medical image management device 3, and the reception device 4 are connected to a communication network (hereinafter simply referred to as “network”) 5 such as a LAN (Local Area Network) via a switching hub (not shown), for example. The medical image management apparatus 3 is preferably a WS (workstation) provided in an examination room where a doctor is resident. The WS that operates as the medical image management apparatus 3 may be configured to control activation of each image generation apparatus 2, processing conditions, and the like.

  In general, DICOM (Digital Image and Communications in Medicine) standard is used as a communication method in a hospital, and DICOM MWM (Modality Worklist Management) or DICOM MPPS (DICOM MPPS) is used for communication between devices connected to a LAN. Modality Performed Procedure Step) is used. Note that the communication method applicable to this embodiment is not limited to this. In addition, a device that does not comply with the DICOM standard may be included in devices connected to the LAN. In the present embodiment, the CR reading device 2d does not support the DICOM standard.

  Hereinafter, each apparatus which comprises the small-scale diagnosis system 1 is demonstrated.

The image generation apparatus 2 captures an image of a patient's diagnosis target region as a subject, digitally converts the captured image to generate image data of the captured image (captured image information), or records a predetermined examination result to record an image. This is image generation means (modality) for generating data.
As shown in FIG. 1, in this embodiment, as an image generation device (modality) 2, an ultrasound diagnostic device (US) 2a, an endoscope (ES) 2b, an electrocardiogram recording device (ECG) 2c, and a CR reading device 2d are used. It has. Note that the image generation device 2 is not limited to this. For example, a CT imaging device (CT), a magnetic resonance imaging device (MRI), a mammography device (mammography), or the like is used as an image. You may provide as the production | generation apparatus 2. FIG. In addition, a digital camera or the like that captures the appearance of the body such as skin may be used as the image generation device 2.
Furthermore, it is good also as a structure provided with two or more image generation apparatuses 2 of the same kind, for example including two CR readers 2d. Further, the combination of the image generation devices 2 provided in the small-scale diagnosis system 1 is not limited to the one exemplified here.

  The ultrasonic diagnostic apparatus 2a is an ultrasonic probe that outputs ultrasonic waves, and an electronic device that is connected to the ultrasonic probe and converts sound waves (echo signals) received by the ultrasonic probe into image data of a captured image of the internal tissue. (Both not shown). The ultrasonic diagnostic apparatus 2a sends an ultrasonic wave from the ultrasonic probe into the body, receives the sound wave (echo signal) reflected by the body tissue again by the ultrasonic probe, and uses the electronic device to capture a captured image corresponding to the echo signal. It is designed to generate.

  The ultrasonic diagnostic apparatus 2 a is connected to a conversion device 21 that is a conversion means (converter) that performs conversion from an analog signal to a digital signal. The ultrasonic diagnostic apparatus 2 a is connected to the network 5 via the conversion device 21. It is connected to the. Thus, even when data in a format that does not conform to the standards (for example, communication protocol) of other external devices connected to the network 5 is output from the ultrasonic diagnostic apparatus 2a, the conversion apparatus 21 appropriately converts the data. Thus, data can be transmitted / received to / from an external device connected to the network 5.

  In the present embodiment, the conversion device 21 has a function of giving a UID (unique ID) for specifying image data in the small-scale diagnosis system 1 to the image data in a format conforming to the DICOM standard. The UID is composed of identification information (hereinafter referred to as “modality ID”) of the image generation device 2, numbers indicating the shooting date and time, and the like. In this embodiment, it is assumed that the modality ID includes information indicating the type of the image generation device 2.

The conversion device 21 includes an input unit (not shown) such as a keyboard having character input keys, numeric input keys, and the like, and also serves as input means for inputting patient information for specifying a patient to be imaged. ing.
Here, patient information includes the patient's patient ID, patient name (kanji / kana / ASCII), patient's gender, date of birth, age, etc., as well as the patient's medical date, imaging time, reception number, physician in charge, etc. The patient information widely included in the information specifying the patient is, for example, the patient ID, the patient name, the sex, and the date of birth. Note that it is not necessary to input all of these in the conversion device 21, and no patient information may be input. When the conversion device 21 is designed to input only the patient ID as patient information, the input unit of the conversion device 21 may be a numeric keypad, for example.

  The UID and patient information given by the conversion device 21 become supplementary information attached to the image data of the generated captured image.

  The endoscope 2b is a tube in which a small photographing device is provided at the distal end portion of a flexible tube (both not shown), and the photographing device includes an objective optical system including, for example, an optical lens and the like. And an imaging unit disposed at the imaging position of the objective optical system, and an illumination unit that is configured by an LED (Light Emitting Diode) or the like and performs illumination necessary for imaging (none of which is shown) . The imaging unit includes a solid-state imaging device such as a CCD (Charge Coupled Device) or a CMOS (Complementary Metal-Oxide Semiconductor), and photoelectrically converts it into an electrical signal having an amount corresponding to the amount of incident light. The objective optical system is configured to condense an area illuminated by the illuminating unit with an optical lens and form an image on a solid-state imaging device included in the imaging unit, and light incident on the solid-state imaging device is photoelectrically converted. As a result, the image data of the captured image is output as an electrical signal.

  The electrocardiogram recording device 2c acquires and records waveform data by detecting an electrocardiogram waveform, and transmits the generated image data (waveform data) to the medical image management device 3.

The CR reader 2d reads image data from a CR cassette (not shown), which is a radiographic image conversion medium in which radiographic image information obtained by imaging a diagnostic target region is recorded.
The CR cassette incorporates a radiation image conversion plate including a stimulable phosphor sheet that accumulates radiation energy, for example, and irradiation of radiation irradiated from a radiation source (not shown) of a radiation imaging apparatus (not shown) during imaging. Arranged in the area. The CR cassette accumulates an amount of radiation in the stimulable phosphor layer of the stimulable phosphor sheet in accordance with the radiation transmittance distribution of the site to be diagnosed when irradiated with radiation. Record the radiological image information of the site to be diagnosed.

The CR reader 2d irradiates the stimulable phosphor sheet in the CR cassette loaded in the apparatus with excitation light when the CR cassette in which the radiological image information of the diagnosis target region is recorded is loaded. The stimulated light emitted from the sheet is photoelectrically converted, and the obtained image signal is A / D converted to generate image data of a photographed image.
The CR reading device 2d may be an integrated device integrated with the radiation imaging apparatus.

Note that the endoscope 2b, the electrocardiogram recording device 2c, and the CR reading device 2d are provided with a function of assigning the above-described UID to the generated image data.
The endoscope 2b and the electrocardiogram recording apparatus 2c include an input unit (not shown) such as a keyboard having character input keys, numeric input keys, and the like, and patient information for specifying a patient to be imaged. Input is possible.
In addition, the patient information input in the input part of each apparatus is not specifically limited, It can also be set as not inputting patient information at all. In the case where the apparatus has a specification for inputting only a patient ID as patient information, the input unit may be a numeric keypad, for example.
The UID and patient information become incidental information attached to the image data of the captured image generated by each image generation device 2.

The image data transmitted from the ultrasound diagnostic apparatus 2a via the conversion device 21 and the image data transmitted from the endoscope 2b and the electrocardiogram recording apparatus 2c are all DICOM image data conforming to the DICOM standard. In DICOM image data, there is a case where patient information such as a patient ID for identifying a patient is attached and a case where patient information is not attached. In FIG. 2, the endoscope 2b is shown as an example.
The image data generated by the CR reading device 2d is CRRAW image data (hereinafter simply referred to as “RAW data”) that does not conform to the DICOM standard, and patient information such as a patient ID is attached to the image data. Is transmitted to the medical image management apparatus 3 in a state where it is not.

  As shown in FIG. 2, the medical image management apparatus 3 includes a server combined machine 3a including an image DB management unit 38 that stores patient information and image data in association with each other, and is connected to the server combined machine 3a. It comprises a reference machine 3b that can refer to image data stored in the image DB management unit 38 of the machine 3a.

Each of the server combined machine 3a and the reference machine 3b is a computer including a control unit 31, a storage unit 32, and the like.
For example, when there are a first examination room and a second examination room (both not shown) as examination rooms where a doctor examines a patient in a facility to which the small-scale diagnosis system 1 is applied, the server combined machine 3a and Each reference machine 3b is installed in each examination room. The installation locations of the server combined machine 3a and the reference machine 3b are not limited to those shown here.

The server combined machine 3a and the reference machine 3b can share data stored in the image DB management unit 38, and the image data and the patient information are associated with each other and newly written in the image DB management unit 38. Is a client machine that can display images and perform interpretation, diagnosis, and the like.
The medical image management apparatus 3 may include a monitor with a higher definition than a monitor (display unit) used in a general PC (Personal Computer).

FIG. 2 is an explanatory diagram schematically showing the functional configuration of the medical image management apparatus 3 (server combined machine 3a) and the flow of image data transmitted from the image generation apparatus 2.
As shown in FIG. 2, the medical image management apparatus 3 (server combined machine 3a) includes a control unit 31, a storage unit 32, an input unit 33, a display unit 34, and a communication unit 35 configured by a CPU (central processing unit) or the like. , I / F 36, image DB management unit 38, etc., and each unit is connected by a bus 40. The reference machine 3b has the same configuration as the server combined machine 3a shown in FIG. 2 except that the image DB management unit 38 is not provided.

The storage unit 32 includes a ROM (read only memory), a RAM (Random Access Memory), etc. (not shown).
The ROM includes, for example, an HDD (Hard Disk Drive), a semiconductor non-volatile memory, and the like. Various programs are stored in the ROM, and image data of the captured image is adjusted to an image quality suitable for diagnosis. Image processing parameters (a look-up table defining a gradation curve used for gradation processing, frequency processing enhancement degree, etc.) and the like are stored.
The RAM forms a work area that temporarily stores various programs, input or output data, parameters, and the like that are read from the ROM and executed by the control unit 31 in various processes that are executed and controlled by the control unit 31. . In the present embodiment, the RAM temporarily stores image data, patient information, and the like received from the image generation device 2.
In the present embodiment, the storage unit 32 functions as a patient information storage unit that stores patient information of a patient.

  The control unit 31 reads various programs such as system programs and processing programs stored in the ROM, expands them in the RAM, and starts display data generation processing and patient information association processing described later according to the expanded programs. It is a control means of the medical image management apparatus 3 that executes various processes.

  In the present embodiment, the control unit 31 performs image processing on the RAW data (“RAW image data” in FIG. 2) stored in the RAW data area 38 a of the image DB management unit 38, and the image processing This is a display data generation means that includes a data conversion unit 31b that converts the RAW data subjected to the process into image data (display image data) in a format that conforms to the DICOM standard, and converts the RAW data into display image data. Even if image processing by the image processing unit 31a or image data conversion by the data conversion unit 31b is performed once, the original RAW data itself is stored in the RAW data area 38a as it is.

  The image processing unit 31a performs various types of image processing on the RAW data while referring to the image processing parameters and the like. Examples of the image processing performed by the image processing unit 31a include the following.

<Tone conversion processing>
The gradation conversion process is a process for adjusting density and contrast at the time of image output. When a doctor diagnoses the presence or absence of a human body structure disease by interpreting a captured image, the presence or absence of the disease is determined based on the density and contrast (gradation) of the structure on the captured image. For this reason, by adjusting the density and contrast suitable for interpretation, it is possible to support a doctor's disease detection operation.
The gradation conversion processing is performed in two stages, for example, normalization processing and conversion processing using a basic LUT (lookup table), and gradation conversion is performed so that a desired signal value range and gradation characteristics are finally obtained. Is to do. In the storage unit 32, an LUT indicating the gradation characteristics is prepared as a basic LUT, and the image processing unit 31a performs individual signal adjustment on the target image by normalization processing, and then uses the basic LUT. Signal value conversion is performed.

<Frequency processing (noise reduction processing)>
The frequency processing is processing for reducing noise components included in the image signal of the captured image. For example, processing is performed such that the degree of noise suppression is increased in a low density portion where noise is conspicuous, and the level of noise suppression is reduced in a high density portion where noise is not conspicuous.

  In the frequency processing, the image processing unit 31a performs multi-resolution decomposition processing that removes a predetermined high frequency component from the image signal of the photographed image, for example, by filtering using a low-pass filter, and obtains a smooth change in the signal value. . Further, the image processing unit 31a then adjusts the degree of enhancement of the image by sequentially executing processes such as an edge / noise information acquisition process, an edge smoothing process, an edge enhancement / noise suppression process, and a restoration process.

  Note that the image processing performed by the image processing unit 31a is not limited to the example illustrated here. For example, image processing or the like in a computer-aided detection (CAD) system that detects a lesion such as breast cancer by applying a predetermined algorithm may be performed. Note that the image processing unit 31 a may be provided separately from the control unit 31.

The data conversion unit 31b attaches a predetermined header to the RAW data stored in the RAW data area 38a of the image DB management unit 38, so that the data conversion unit 31b has a format that conforms to the DICOM standard, which is a format that conforms to the general-purpose display standard. This is converted to image data.
The general-purpose standard for display converted by the data converter 31b is not limited to the DICOM standard. For example, the data conversion unit 31b may convert the RAW data into image data in a JPEG format, a bitmap format, or the like, which is a format conforming to a general-purpose display standard. When RAW data is converted into JPEG format image data, bitmap format image data, or the like, even a general computer that does not include a display unit (viewer) 34 corresponding to the DICOM standard can display images in a browser or the like. You can browse. The data converter 31b may be capable of converting RAW data into display image data of a plurality of methods.

In the present embodiment, when the RAW data of the photographed image is transmitted from the image generation device 2 such as the CR reading device 2d and stored in the RAW data area 38a, the control unit 31 automatically sets the image under a preset condition. The image processing by the processing unit 31a is performed, and the data conversion unit 31b converts the RAW data into display image data in a format conforming to the DICOM standard.
The display image data converted by the data conversion unit 31b is associated with the original RAW data and stored in the display data area 38b of the image DB management unit 38.

  Further, when a signal instructing the image processing by the image processing unit 31a or the data conversion by the data conversion unit 31b is input from the input unit 33 or the like, the control unit 31 stores the RAW stored in the RAW data area 38a. Data corresponding to the display image data instructed to be redone is retrieved and extracted from the data. The searched / extracted RAW data is subjected to image processing by the image processing unit 31a and data conversion by the data converting unit 31b in accordance with a user input instruction.

  The input unit 33 includes a keyboard having character input keys, numeric input keys, various function keys, and the like, and a pointing device such as a mouse, and a key pressing signal pressed by the keyboard and an operation signal by the mouse. To the control unit 31 as an input signal.

The display unit 34 includes a monitor such as a CRT (Cathode Ray Tube) or an LCD (Liquid Crystal Display), for example, and displays various screens according to instructions of a display signal input from the control unit 31.
A pressure sensitive (resistive film pressure type) touch panel (not shown) in which transparent electrodes are arranged in a grid is formed on the screen of the display unit 34, and the display unit 34 and the input unit 33 are configured integrally. It may be a touch screen. In this case, the touch panel is configured to detect the XY coordinates of the power point pressed with a finger, a touch pen, or the like as a voltage value, and to output the detected position signal to the control unit 31 as an operation signal.

  In the present embodiment, the display unit 34 can display a patient information list screen 341 (see FIG. 3) that displays a list of patient information (patient information list) acquired from the receiving device 4 described later. The patient information list screen 341 includes a search filter column 61 in which a search filter for searching patient information can be set, a patient ID column 62 for inputting a patient ID of a patient to be searched, and a patient name column for inputting a patient name. 63, and the user inputs arbitrary information in each of these fields and then presses the search start button 64 (operates the search start button on the screen with the input unit 33 such as a mouse), and thereby the desired information is displayed. Patient information can be searched and extracted. Further, when it is desired to perform a search by inputting more detailed conditions, a detailed search condition can be set by pressing a detailed search button 65.

  As shown in FIG. 3, in the present embodiment, the patient information list screen 341 includes the medical date, reception time, reception number, medical fee, doctor in charge, patient ID, patient name (kanji / kana / ASCII) of the visiting patient. ), Patient information such as gender, date of birth, and age is displayed as a list. In addition, the content displayed on the patient information list screen 341 is not limited to what was illustrated here. Only a part of them may be displayed, or more items may be displayed.

When a patient is selected by selecting an arbitrary patient column from the patients displayed on the patient information list screen 341 (selecting an arbitrary patient column on the screen with the input unit 33 such as a mouse), The display screen of the display unit 34 transitions to a patient display screen 342 (see FIG. 4) corresponding to the selected patient.
As described above, in this embodiment, the patient to be examined can be selected from the patient information list screen 341 of the display unit 34, and the patient selection means is configured by the patient information list screen 341 and the input unit 33. Has been.

  As shown in FIG. 4, the patient display screen 342 has a patient display column 71 for displaying the patient ID and patient name of the selected patient, and it is possible to visually recognize which patient display screen 342 is currently displayed. It is like that. If the list screen button 72 is operated, the patient information list screen 341 can be returned.

The patient display screen 342 is provided with an image display field 73 for displaying an image and a thumbnail display field 74 for displaying a thumbnail of the image.
The patient display screen 342 is provided with an image data selection button 75 for selecting image data for the patient. By selecting desired image data using the image data selection button 75, an image based on the image data can be displayed in the image display column 73 and the thumbnail display column 74. The image data selection button 75 can be switched by the display classification switching button 76 according to the classification according to the date or the type of the image generation apparatus (modality) 2.

  In addition, the patient display screen 342 is provided with an examination hold button 77 for inputting that the examination of the patient image is to be suspended, and an examination end button 78 for inputting the end of the examination.

The patient display screen 342 is provided with an image capture button 81 for capturing image data from an external device. The image capture button 81 includes an image capture button 81a for capturing image data from various image generation devices 2 connected to the network 5, and an image capture button 81b for capturing image data from various devices such as a digital camera. .
In the present embodiment, the image capture button 81a is the type of the image generation device 2 connected to the network 5 (ultrasound diagnosis device (US) 2a, endoscope (ES) 2b, electrocardiogram recording device (ECG) 2c, Corresponding to the CR reader 2d), four types of "CR", "US", "ES", and "ECG" are arranged on the patient display screen 342.
In addition, when other image generation apparatuses 2 are connected to the network 5, an image capture button 81 corresponding to the image generation apparatus 2 is provided.

The image capture button 81 is used to specify (specify) a patient associated with the image data generated by the image generation device 2. When one of the image capture buttons 81 is pressed (operated) on the patient display screen 342, the patient to be associated when the image data is captured is designated (specified) as the patient displayed on the patient display screen 342. ) When the patient is designated, the image data transmitted from the image generation device 2 to the medical image management device 3 is associated with the patient information of the designated patient. The image data associated with the patient information of the patient is stored in the confirmed image area of the display data area 38b of the image DB management unit 38. Further, an image based on the image data is displayed in the image display field 73 of the patient display screen 342 of the patient, and a thumbnail image of the image is displayed in the thumbnail display field 74 (see FIG. 5).
As described above, in the present embodiment, by pressing the image capture button 81 on the patient display screen 342 of the display unit 34, it is possible to designate a patient to be associated with the image data, and the patient display screen 342. The input unit 33 constitutes patient designation means.

  In addition, the patient display screen 342 is provided with an image output button 82 for outputting the captured image by printing, mail transmission, and the like, a display switching button 83 for switching the display of the image display column layout, and the like. .

The communication unit 35 is configured by a network interface or the like, and transmits / receives data to / from an external device such as various image generation devices 2 connected to the network 5 via a switching hub.
In the present embodiment, the communication unit 35 is a patient information list acquisition unit that acquires from the reception device 4 a patient information list created (updated) by the reception device 4 described later.
The communication unit 35 is a RAW data receiving unit that receives RAW data (CRRAW image data) from the image generating device 2 that does not comply with the DICOM standard, such as the CR reading device 2d.

  The I / F 36 manages medical images when there are a plurality of medical image management apparatuses 3 (for example, when there is one server combined machine 3a and one reference machine 3b as shown in FIG. 2). This is an interface for connecting the apparatuses 3 and controlling the transmission and reception of data between the medical image management apparatuses 3.

The image DB (Data Base) management unit 38 is configured by an HDD or the like, and is a storage unit that stores image data of a captured image in association with patient information.
As shown in FIG. 2, the image DB management unit 38 stores the image transmitted from the image generation device 2, and is transmitted from the image generation device 2 that does not comply with the DICOM standard, such as the CR reading device 2d. A RAW data area 38a for storing RAW data (CRRAW image data) in its original form, and a display data area 38b for storing display image data generated based on the RAW data are provided. Note that the display image data is stored in association with the original RAW data.
In the display data area 38b, image data that could not be associated with a confirmed image area (not shown) that stores image data associated with patient information of the patient as a confirmed image and patient information of the patient. And an unconfirmed image area (not shown) for storing the image as an unconfirmed image.

  Here, image data conversion processing and patient information association processing by the control unit 31 will be described.

  When the image data is transmitted from the image generation device 2, the control unit 31 determines whether the image data is RAW image data (RAW data). If the image data is RAW data that does not conform to the DICOM standard, the control unit 31 stores the image data in the RAW data area 38a. After the image processing unit 31a performs image processing such as gradation processing and frequency processing, the data conversion unit 31b converts the image data into a format that conforms to a general-purpose display standard such as the DICOM standard. Accompanying information (RAW data information) indicating the original RAW data is attached to the converted image data (display image data).

After the RAW data is converted into display image data, or when the image data transmitted from the image generation apparatus 2 is display image data in accordance with the DICOM standard, the control unit 31 further displays the display data. It is determined whether or not a patient ID as patient information is attached to the image data. When a patient ID is attached to the display image data, the patient ID and other patient information are collated with patient information such as a patient ID stored in the storage unit 32 on the medical image management apparatus 3 side. To do. If there is a patient whose patient information matches in the storage unit 32, the display image data is associated with the patient, and is stored in the confirmed image area of the display data area 38b of the image DB management unit 38 as a confirmed image. . On the other hand, if there is no matching patient, it is determined as an indeterminate image and stored in the indeterminate image area of the display data area 38b of the image DB management unit 38.
On the other hand, if the patient ID is not attached to the display image data, it is determined whether or not the image capture button 81 is pressed in any of the client machines (server combined machine 3a or reference machine 3b). When the image capture button 81 is pressed, the display image data is captured by the client machine for which the image capture button 81 is pressed, and the display image data is designated by the image capture button 81. Are stored in the confirmed image area of the display data area 38b of the image DB management unit 38 as a confirmed image.
As described above, in the present embodiment, the control unit 31 functions as an association unit that associates the image data transmitted from the image generation device 2 with the patient information of the patient designated by pressing the image capture button 81. .
On the other hand, when the image capture button 81 is not pressed, the display image data is determined as an undetermined image and stored in the undetermined image area of the display data area 38b of the image DB management unit 38.

The display image data once stored in the fixed image area of the display data area 38b can be referred to in other client machines. Then, when a user such as a doctor inputs from the input unit 33 that the user such as a doctor wants to redo the image processing in the client machine, the control unit 31 determines that there is RAW data associated with the display image data. The corresponding RAW data is extracted from the RAW data stored in the area 38a. The RAW data is subjected to image processing according to user input.
If there is no RAW data associated with the display image data, image processing is performed on the display image data in accordance with a user input. In this case, limited image processing such as image density correction and contrast correction can be performed.

  The reception device 4 is a computer device that is installed in a reception (not shown) and performs reception registration, accounting calculation, insurance score calculation, and the like of a patient who has visited the hospital, and a storage unit including a CPU, ROM, RAM, and the like, An input unit configured by a keyboard, a mouse, and the like, a display unit configured by a CRT, an LCD, and the like, a communication unit (not shown) that controls communication with each device connected to the network 5, etc. It is configured with. When receiving a reception input screen is instructed from the input unit, the reception device 4 displays a reception input screen (not shown) on the display unit by software processing in cooperation with the CPU and a program stored in the storage unit. When reception information (reception number + patient name) is input by the input unit via the reception input screen, a patient information list of the received patient is created (updated), stored in the storage unit, and appropriately transmitted by the communication unit. It transmits to the medical image management apparatus 3.

  Next, the flow of diagnosis for one patient in a small-scale facility to which the small-scale diagnosis system 1 is applied will be described.

  When the patient comes to the hospital, a reception number tag is given to the patient at the reception, and various types of patient information constituting the patient information list such as the patient reception number and the patient name received by the operation of the input unit in the reception device 4 Is input (acceptance input). In the reception device 4, when a patient reception number, patient information, and the like are input, a list of patient information (patient information list) is generated (updated) and stored in a predetermined area of the RAM. The patient information list is generated, for example, when the first patient of the day is received and inputted, stored in a predetermined area of the RAM, and updated to a new patient information list every time the next patient is received and inputted.

  When the patient to whom the receipt number is assigned moves to the examination room, an inquiry is performed by a doctor, and imaging and examination to be performed are determined.

When it is determined that the affected area needs to be imaged by the interview, the imaging operator who performs imaging such as a radiographer or nurse takes an image generation apparatus 2 (ultrasound diagnostic apparatus 2a, The patient is taken in front of the endoscope 2b, the electrocardiogram recording device 2c, or the CR reading device 2d), and the patient's diagnosis target region is imaged and the image data of the captured image is generated. For example, when the image generation device 2 is the CR reading device 2d, the radiation imaging device performs imaging, the CR cassette imaged in the radiation imaging device is set in the CR reading device 2d, and the radiation image recorded in the CR cassette is read. I do. When the image generation apparatus 2 performs shooting and generation of image data in accordance with the operation of the camera operator, the above-described UID is assigned to the generated image data. Further, in the case of an apparatus conforming to the DICOM standard such as the endoscope 2b, when patient information is input, UID and patient information are added to the generated image data.
The image data generated by each image generation device 2 is transmitted to the medical image management device 3 together with accompanying information such as UID and patient information.

  As illustrated in FIG. 6, when image data is transmitted from the image generation device 2 to the medical image management device 3, the control unit 31 of the medical image management device 3 determines whether the image data is RAW image data (RAW data). Is determined (step S101). If the image data is RAW data (step S101: YES), the control unit 31 stores the image data in the RAW data area 38a (step S102). Then, the image processing unit 31a performs image processing such as gradation processing and frequency processing (step S103), and the data conversion unit 31b performs image data in a format that conforms to a general-purpose display standard such as the DICOM standard (display image). Data) (step S104). RAW data information indicating the original RAW data is attached to the converted display image data.

When the RAW data is converted into display image data (step S104), or when the image data transmitted from the image generation device 2 is not RAW data (when the display data is DICOM standard or the like) (step S101: NO) ), The control unit 31 performs a patient information association process (step S105) for associating the display image data with the patient information of the patient stored in the storage unit 32.
In the present embodiment, the medical image management apparatus 3 displays the captured image based on the image data on the patient display screen 342 (FIG. 5) of the patient by associating the display image data with any patient. It becomes a state where interpretation, diagnosis, etc. can be performed.
When the display image data and the patient are associated with each other and the display image data can be displayed on the patient display screen 342, the doctor displays the captured image received from the image generation device 2 on the medical image management device. 3 is displayed on the display unit 34 and referred to for interpretation and medical examination of the patient.

Here, the patient information association processing in the present embodiment will be described with reference to FIGS.
As shown in FIG. 7, when the display image data is received or when the display image data is generated from the RAW data (step S1), the control unit 31 adds the patient ID as patient information to the display image data. Is determined as to whether or not it is attached (step S2). When the patient ID is attached to the display image data (step S2: YES), the control unit 31 adds the display image data to the patient information stored in the storage unit 32. It is further determined whether or not there is an incidental patient ID (step S3).

  When the patient ID matches the patient ID of any patient stored in the storage unit 32 (step S3: YES), the control unit 31 displays the display image data as shown in FIG. It is determined whether or not the patient name (kanji: hereinafter referred to as “kanji name”) is attached (step S41). If the display image data includes a kanji name (step S41: YES), it is further determined whether or not the kanji name is included in the patient information in the storage unit 32 with the matching patient ID. (Step S42). If the corresponding patient information includes a kanji name (step S42: YES), it is determined whether or not the kanji name also matches the kanji name attached to the display image data (step S43). . If the kanji name attached to the display image data does not match the kanji name included in the patient information in the storage unit 32 (step S43: NO), the control unit 31 displays the display image data. Are determined to be unconfirmed images (step S12).

  If the display image data is not accompanied by a kanji name (step S41: NO), if the kanji name is attached but the corresponding patient information in the storage unit 32 does not include the kanji name (step) S42: NO), and when the kanji name attached to the display image data matches the kanji name included in the patient information in the storage unit 32 (step S43: YES), as shown in FIG. The control unit 31 determines whether or not a patient name (kana: hereinafter referred to as “kana name”) is attached to the display image data (step S51). When the Kana name is attached to the display image data (step S51: YES), it is further determined whether or not the Kana name is included in the patient information in the storage unit 32 with the matching patient ID. (Step S52). If the corresponding patient information includes a Kana name (step S52: YES), it is determined whether the Kana name also matches the Kana name attached to the display image data (step S53). . If the Kana name attached to the display image data does not match the Kana name included in the patient information in the storage unit 32 (step S53: NO), the control unit 31 displays the display image data. Are determined to be unconfirmed images (step S12).

  If the Kana name is not attached to the display image data (step S51: NO), the Kana name is attached but the corresponding patient information in the storage unit 32 does not include the Kana name (step S51). S52: NO), and if the Kana name attached to the display image data matches the Kana name included in the patient information in the storage unit 32 (step S53: YES), as shown in FIG. The control unit 31 determines whether or not a patient name (ASCII: hereinafter referred to as “ASCII name”) is attached to the display image data (step S61). If the ASCII name is attached to the image data (step S61: YES), it is further determined whether or not the ASCII name is included in the patient information in the storage unit 32 with the matching patient ID (step S61). S62). If the ASCII name is included in the corresponding patient information (step S62: YES), it is determined whether or not the ASCII name also matches the ASCII name attached to the display image data (step S63). . When the ASCII name attached to the display image data does not match the ASCII name included in the patient information in the storage unit 32 (step S63: NO), the control unit 31 displays the display image data. Are determined to be unconfirmed images (step S12).

  When the ASCII name is not attached to the display image data (step S61: NO), when the ASCII name is attached but the corresponding patient information in the storage unit 32 does not include the ASCII name (step) S62: NO), and when the ASCII name attached to the display image data matches the ASCII name included in the patient information in the storage unit 32 (step S63: YES), as shown in FIG. The control unit 31 determines whether or not the display image data is accompanied by birth date information (hereinafter simply referred to as “birth date”) (step S71). When the date of birth is attached to the display image data (step S71: YES), whether or not the date of birth is further included in the patient information in the storage unit 32 with the matching patient ID. Judgment is made (step S72). When the date of birth is included in the corresponding patient information (step S72: YES), it is determined whether the date of birth also matches the date of birth attached to the display image data ( Step S73). When the date of birth attached to the display image data does not match the date of birth included in the patient information in the storage unit 32 (step S73: NO), the control unit 31 performs the display. The image data is determined to be an undetermined image (step S12).

When the date of birth is not attached to the display image data (step S71: NO), the date of birth is attached, but the date of birth is not included in the corresponding patient information in the storage unit ( Step S72: NO), and when the date of birth attached to the display image data matches the date of birth included in the patient information in the storage unit (step S73: YES), as shown in FIG. In addition, the control unit 31 determines whether or not sex information (hereinafter simply referred to as “sex”) is attached to the display image data (step S81). When sex is attached to the display image data (step S81: YES), it is further determined whether or not the patient information in the storage unit 32 with the matching patient ID includes gender (step S81). S82). When gender is included in the corresponding patient information (step S82: YES), it is determined whether or not the gender matches the gender attached to the display image data (step S83). When the gender incidental to the display image data does not match the gender included in the patient information in the storage unit 32 (step S83: NO), the control unit 31 does not display the display image data. It is determined as a confirmed image (step S12).
If the gender incidental to the display image data matches the gender included in the patient information in the storage unit 32 (step S83: YES), the control unit 31 stores the display image data. In association with the patient with the matching patient ID in the unit 32, it is stored in the confirmed image area of the display data area 38b of the image DB management unit 38 as a confirmed image (step S9).

On the other hand, when the patient ID is not attached to the display image data (step S2: NO), as shown in FIG. 7, the control unit 31 includes any one of the server combination machine 3a and the reference machine 3b. In the client machine, it is determined whether or not the image capture button 81 is pressed (step S10). In any client machine, when the image capture button 81 is pressed (step S10: YES), the display image data is associated with the patient information of the patient specified by the image capture button 81, The final image is stored in the final image area of the display data area 38b of the image DB management unit 38 as a final image (step S11).
On the other hand, when the image capture button 81 is not pressed in any client machine (step S10: NO), the control unit 31 determines that the display image data is an unconfirmed image (step S12).

  When determining that the display image data is an undetermined image, the control unit 31 stores the display image data in the undetermined image area of the display data area 38 b of the image DB management unit 38.

The display image data once stored in the fixed image area of the display data area 38b can be referred to in other client machines. Then, in the client machine, when a user such as a doctor inputs that he / she wants to perform image processing again, the control unit 31 determines whether or not RAW data information is attached to the display image data, and RAW data If the information is incidental, the corresponding RAW data is extracted from the RAW data stored in the RAW data area 38a. And the control part 31 performs an image process with respect to this raw data according to a user's input.
On the other hand, when there is no RAW data associated with the display image data, image processing is performed on the display image data in accordance with a user input.

  As described above, according to the present embodiment, when RAW data is transmitted from the image generation apparatus 2 such as the CR reading apparatus 2d, the RAW data is converted into display image data, and the RAW data itself is also managed by the image DB. Stored in section 38. For this reason, when a user such as a doctor wants to redo the image processing of the display image data, the image processing can be redone for the RAW data. Thereby, the degree of freedom of image processing that can be performed by a doctor or the like at the time of interpretation / diagnosis is increased, and image processing more suitable for interpretation / diagnosis can be performed.

  In addition, when RAW data without patient information is sent from the CR reading device 2d, or DICOM image data without patient information is sent from various image generating devices 2 conforming to the DICOM standard. Even when the patient associated with the image data is designated, it can be associated with the patient information of the designated patient. Therefore, even when the medical image management apparatus 3 has a configuration in which the captured image cannot be displayed on the display unit 34 unless the image data is associated with any patient, the image data and the patient information Can be efficiently associated with each other, and the captured image can be read and diagnosed.

  In this embodiment, when the display image data is determined to be an undetermined image, the display image data is stored in the undetermined image area of the display data area 38b. Is determined, the image data and the patient information are automatically associated according to some predetermined allocation rule, and the image thus determined is confirmed in the display data area 38b. You may make it preserve | save in an area | region.

In this embodiment, first, it is determined whether or not a patient ID is attached to the display image data. If the patient ID is attached to the image data, the patient ID and the storage unit 32 are always included. However, the patient information association process is not limited to this. For example, when the image capture button 81 of any client machine is pressed, the patient information and display image of the patient selected / designated by the client machine without determining whether or not the patient ID is given You may comprise so that data may be matched.
With this configuration, display image data can be transmitted without assigning a patient ID even when there is a lot of photographing using a CR cassette, or even when using the DICOM standard-compliant image generation device 2. When there are many, there are few client machines, and when there is little possibility that an error will occur in the correspondence between image data and patient information without checking the patient ID one by one, the processing can be simplified according to the circumstances of the facility. it can.

  In the present embodiment, the CR reading device 2d is not provided with an input unit for inputting patient information. However, the CR reading device 2d may be provided with an input unit for inputting patient information. Good.

  In the present embodiment, the display image data associated with the patient information is stored in the image DB management unit 38 of the medical image management apparatus 3. However, the storage means for storing the display image data is used here. It is not limited. For example, it may be stored in an external storage device or a removable storage means.

In the present embodiment, the medical image management apparatus 3 has a configuration in which one reference machine 3b is connected to one server combined machine 3a. However, the configuration of the medical image management apparatus 3 is as follows. It is not limited to this. For example, the medical image management apparatus 3 may be configured only by the server combined machine 3a, or two or more reference machines may be connected to the server combined machine 3a.
In the present embodiment, the server combined machine 3a and the reference machine 3b have been described as examples in the first examination room and the second examination room, respectively. However, the server combined machine 3a and the reference machine 3b The arrangement is not limited to this, and for example, the reference machine 3b may be arranged at the reception. In this case, the reference machine 3b may also serve as the receiving device 4. Further, the reference machine 3b may be disposed in an examination room or the like, or one medical image management apparatus 3 may be installed corresponding to each image generation apparatus 2.

  In addition, the present invention is not limited to the above-described embodiment, and can be changed as appropriate.

It is a figure which shows the example of whole structure of the small-scale diagnosis system in this embodiment. It is explanatory drawing which shows typically the flow of the image data between the main structures which comprise the functional structure of the medical image management apparatus 3 applied to the small scale diagnostic system shown in FIG. 1, and a small scale diagnostic system. It is a figure which shows an example of the patient information list screen displayed on the display part of FIG. It is a figure which shows an example of the patient display screen displayed on the display part of FIG. It is a figure which shows an example of the patient display screen of FIG. It is a flowchart which shows the image data conversion process performed by the control part of FIG. It is a flowchart which shows the patient information matching process performed by the control part of FIG. It is a flowchart which shows the content of the process A among the patient information matching processes of FIG. It is a flowchart which shows the content of the process C among the patient information matching processes of FIG. It is a flowchart which shows the content of the process E among the patient information matching processes of FIG. It is a flowchart which shows the content of the process G among the patient information matching processes of FIG. It is a flowchart which shows the content of the process I among the patient information matching processes of FIG.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Small scale diagnostic system 2 Image generation apparatus 2a Ultrasound diagnostic apparatus 2b Endoscope 2c Electrocardiogram recording apparatus 2d CR reader 3 Medical image management apparatus 3a Server combined machine 3b Reference machine 4 Reception apparatus 5 Network 15 Message screen 21 Conversion apparatus 31 Control Unit 32 Storage Unit 33 Input Unit 34 Display Unit 341 Patient Information List Screen 342 Patient Display Screen 35 Communication Unit 36 I / F
38 Image DB management unit 38a RAW data area 38b Display data area 40 Bus

Claims (2)

It is connected to an image generation device that generates image data related to a patient so that data can be transmitted and received,
RAW data receiving means for receiving RAW data as image data generated by the image generating device;
Display data generating means for generating display image data from the RAW data received by the RAW data receiving means;
A RAW data area for storing the RAW data received by the RAW data receiving unit as RAW data, and a display image for storing the display image data generated by the display data generating unit in association with the RAW data A storage means having a data area;
A medical image management apparatus comprising: The display data generation means includes an image processing unit that performs image processing on the RAW data, and a data conversion unit that converts the RAW data into image data in a format that conforms to a general-purpose standard for display. The medical image management apparatus according to claim 1, wherein:

Images