医学影像存档与通讯系统的开发与初步应用

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

OSTEOCLASTIC RESORPTION OF CANCELLOUS BONE TISSUES OF FEMORAL NECK IN HIP FRACTURE PATIENTS (A SCANNING ELECTRON MICROSCOPIC STUDY)

ＯＳＴＥＯＣＬＡＳＴＩＣＲＥＳＯＲＰＴＩＯＮＯＦＣＡＮＣＥＬＬＯＵＳＢＯＮＥＴＩＳＳＵＥＳＯＦＦＥＭＯＲＡＬＮＥＣＫＩＮＨＩＰＦＲＡＣＴＵＲＥＰＡＴＩＥＮＴＳ（ＡＳＣＡＮＮＩＮＧＥＬＥＣＴＲＯＮＭＩＣＲＯＳＣＯＰＩＣＳＴＵＤＹ）ＣＨＡＩＢｅｎ－ｆｕ（...     

国强PACS的研制及应用

目的研制适合中国国情的ＰＡＣＳ。材料与方法数字成像设备或直接采集图象，或转为ＤＩＣＯＭ后采集，存储以硬盘为主，配以光盘刻录机；图像可回传并在网内互相调阅，可远程会诊，光盘刻录时同时刻入一程序使存储图像可在ＰＡＣＳ以外的 ＰＣ机上做后处理。结果国强 ＰＡＣＳ具备以下几项适合中国国情的特点：①无ＤＩＣＯＭ协议的旧式影像设备可进行数字采集，②光盘刻录的图像可在ＰＣ机上进行多项后处理。③用ＩＮＴＥＲＮＥＴ和ＭＯＤＥＭ两种方式传输。结论国强ＰＡＣＳ既适合中国国情，又与国际标准接轨。     

放射科DICOM标准PACS的设计与实现

目的以我院影像存档及传输系统（ｐｉｃｔｕｒｅａｒｃｈｉｖｉｎｇａｎｄｃｏｍｍｕｎｉｃａｔｉｏｎｓｙｓｔｅｍ，ＰＡＣＳ）的设计、构建为例，探讨适合中国国情的医学数字影像传输（ｄｉｇｉｔａｌｉｍａｇｉｎｇａｎｄｃｏｍｍｕｎｉｃａｔｉｏｎｓｉｎｍｅｄｉｃｉｎｅ，ＤＩＣＯＭ）标准的ＰＡＣＳ发展模式。方法按阶段性发展、模块化结构和ＤＩＣＯＭ标准３个原则设计，并制订出３期发展细节。结果按ＰＡＣＳＩ期设计、构建ＰＡＣＳ模块间的网络连接，实现数字影像的网络传输、及时浏览显示及胶片打印等几个主要功能，并成功地完成了系统在ＤＩＣＯＭ层次的设置、调试和影像交流。结论根据我院ＤＩＣＯＭ标准ＰＡＣＳ的设计，成功地完成Ｉ期系统的构建及运行，初步表明，我院ＰＡＣＳ设计是符合中国国情的ＰＡＣＳ发展的一个可行方案     

Effects of Level Changes of 5-HT and Dopamine in Cerebral Microvasculature on Occurrence of Secondary Damages in Traumatic Brain Injury in Rats

ＥＦＦＥＣＴＳＯＦＬＥＶＥＬＣＨＡＮＧＥＳＯＦ５┐ＨＴＡＮＤＤＯＰＡＭＩＮＥＩＮＣＥＲＥ┐ＢＲＡＬＭＩＣＲＯＶＡＳＣＵＬＡＴＵＲＥＯＮＯＣＣＵＲＲＥＮＣＥＯＦＳＥＣＯＮＤＡＲＹＤＡＭＡＧＥＳＩＮＴＲＡＵＭＡＴＩＣＢＲＡＩＮＩＮＪＵＲＹＩＮＲＡＴＳＫＥ...     

航海医学研究的心理学特色及方向

航海医学研究的心理学特色及方向周梦生关键词航海医学；心理学ＰＳＹＣＨＯＬＯＧＩＣＡＬＦＥＡＴＵＲＥＯＦＲＥＳＥＡＲＣＨＩＮＮＡＵＴＩＣＡＬＭＥＤＩＣＩＮＥＡＮＤＩＴＳＰＲＯＳＰＥＣＴ￥ＺｈｏｕＸｉｅｓｈｅｎｇ．（ＮａｎｔｏｎｇＭｅｄｉｃａｌＣｏｌｌｅ...     

SUPEKFICIAL RADIA L BRANCH GRAFT WITH VASCULARIZED PEDICLE TO REPAIRLONGDEFECTOFTHERADIALNERVE：AREPORTOF8CASE

ＳＵＰＥＫＦＩＣＩＡＬＲＡＤＩＡＬＢＲＡＮＣＨＧＲＡＦＴＷＩＴＨＶＡＳＣＵＬＡＲＩＺＥＤＰＥＤＩＣＬＥＴＯＲＥＰＡＩＲＬＯＮＧＤＥＦＥＣＴＯＦＴＨＥＲＡＤＩＡＬＮＥＲＶＥ：ＡＲＥＰＯＲＴＯＦ８ＣＡＳＥＳＮｉＡｉ－ｍｉｎ倪爱民ＣｈｅｎＺｈｏｎｇ－ｗｅｉ...     

小型医学影像存档与通讯系统的临床应用

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

OSTEOGENIC POTENTIAL OF RABBIT DERMAL FIBROBLASTS CULTURED IN VITRO: A HISTOCHEMICAL AND RADIOAUTO-GRAPHICAL STUDY

ＯＳＴＥＯＧＥＮＩＣＰＯＴＥＮＴＩＡＬＯＦＲＡＢＢＩＴＤＥＲＭＡＬＦＩＢＲＯＢＬＡＳＴＳＣＵＬＴＵＲＥＤＩＮＶＩＴＲＯ：ＡＨＩＳＴＯＣＨＥＭＩＣＡＬＡＮＤＲＡＤＩＯＡＵＴＯ┐ＧＲＡＰＨＩＣＡＬＳＴＵＤＹＣＨＡＩＢｅｎ－ｆｕ（柴本甫），ＴＡＮＧＸｕｅ－...     

INTRADURAL HERNIATION OF LUMBAR INTERVERTEBRAL DISC：ARE－PORTOFSEVENCASESANDDISCUSSIONOFTHEPATHOLOGICALMEC

ＩＮＴＲＡＤＵＲＡＬＨＥＲＮＩＡＴＩＯＮＯＦＬＵＭＢＡＲＩＮＴＥＲＶＥＲＴＥＢＲＡＬＤＩＳＣ：ＡＲＥ－ＰＯＲＴＯＦＳＥＶＥＮＣＡＳＥＳＡＮＤＤＩＳＣＵＳＳＩＯＮＯＦＴＨＥＰＡＴＨＯＬＯＧＩＣＡＬＭＥＣＨ－ＡＮＩＳＭＬｉａｎＰｉｎｇ连平ＳｕｎＲｏｎｇ－...     

小型医学影像存储与传输系统的临床应用

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

Development of an electronic radiologist's office in a private institute.

A computer system that improves the quality, user-friendliness, accessibility, and management of radiology data (images, reports, databases, knowledge) was implemented at a private institute. A picture archiving and communication system (PACS) was integrated with the radiology information system (RIS). Two servers and 12 personal computers form the integrated system. The first server is dedicated to management and archiving of Digital Imaging and Communications in Medicine (DICOM) images. The second server is dedicated to management of the RIS and archiving of patient data (Structured Query Language database), reports (hypertext markup language [HTML]), and images in the Joint Photographic Experts Group (JPEG) format (mini-PACS). There are three main client-server networks: a common network of imaging modalities (magnetic resonance imaging, computed tomography, ultrasonography, digital radiography) and two fast Ethernet networks (the PACS network and the RIS network). The RIS-PACS is linked remotely with other workstations and servers via Integrated Services Digital Network (ISDN). Images and reports can be distributed to referring physicians in the form of multimedia HTML and JPEG documents, which can also be used for quick and easy archiving, distribution, and reviewing within the institute. However, referring physicians have been reluctant to use electronic reports and images.     

PACS and Web-based image distribution and display.

Picture archiving and communication system (PACS) delivers images to the display workstations mostly through digital image communication in medicine (DICOM) protocols in radiology departments, and there are lots of medical applications in healthcare community needing to access PACS images for different application purposes. In this paper, we first reviewed a hospital-integrated PACS image data flow and typical diagnostic display software architecture, and discussed some Web technologies and Web-based image application server architectures, as well as image accessing and viewing methods in these architectures. Then, we present one approach to develop component-based image display architecture and use image processing and display component to build a diagnostic display workstation, and also, give a method to integrate this component into Web-based image distribution server to enable users using Web browsers to access, view and manipulate PACS DICOM images as easy as with PACS display workstations. Finally, we test and evaluate the performance of image loading and displaying by using the diagnostic display workstation and the component-based Web display system, the experimental results show that the image distribution and display performance from the Web server to browser clients is similar with that of the image loading and displaying procedure of the diagnostic workstation as more browser clients accessing the Web server at same time. We also discuss the advantages and disadvantages of the Web-based image distribution and display in different medical applications.     

一种基于Windows NT平台的DICOM服务器

目的：建立一个基于ＷｉｎｄｏｗｓＮＴ平台的ＤＩＣＯＭ服务器来接收、存储、分发和管理医学图像。材料和方法：用普通微机服务器,通过计算机网络,把符合ＤＩＣＯＭ标准的医学影像设备连接起来。结果：利用我们自行研制的ＤＩＣＯＭ服务器软件已经成功地实现了与我院ＧＥ公司的核磁共振成像设备和ＰＨＩＬＩＰＳ公司的ＣＴ扫描仪之间的通讯,使得这些成像设备产生的图象能够在放射科和临床科室之间相互传输和显示。结论：在普通微机服务器上研制ＤＩＣＯＭ软件,成本低、适合中国国情、易于推广应用。     

Enterprise-wide PACS: beyond radiology, an architecture to manage all medical images

RATIONALE AND OBJECTIVES: Picture archiving and communication systems (PACS) have the vocation to manage all medical images acquired within the hospital. To address the various situations encountered in the imaging specialties, the traditional architecture used for the radiology department has to evolve. MATERIALS AND METHODS: We present our preliminarily results toward an enterprise-wide PACS intended to support all kind of image production in medicine, from biomolecular images to whole-body pictures. Our solution is based on an existing radiologic PACS system from which images are distributed through an electronic patient record to all care facilities. This platform is enriched with a flexible integration framework supporting digital image communication in medicine (DICOM) and DICOM-XML formats. In addition, a generic workflow engine highly customizable is used to drive work processes. RESULTS: Echocardiology; hematology; ear, nose, and throat; and dermatology, including wounds, follow-up is the first implemented extensions outside of radiology. CONCLUSION: We also propose a global strategy for further developments based on three possible architectures for an enterprise-wide PACS.     

How Radiologists Are Paid: An Economic History,Part IV: End of the Bubble

During the first decade of the 21st century, the imaging bubble began to burst. The combination of digitized images, the DICOM standard, and affordable PACS sharply increased radiologists’ productivity but also allowed an imaging study to be read from anywhere, creating the field of teleradiology and increased competition for radiologists. Increasing numbers of insurers contracted with radiology benefits managers to help control radiology utilization, and the Deficit Reduction Act of 2005 mandated spending cuts across the government. Consolidation of multiple Current Procedural Terminology codes and the reassessment of calculations used to estimate the utilization of a CT or an MRI scanner exerted additional downward pressure on radiology reimbursements. All of these factors, combined with more radiologists completing residency and the delayed retirement of older radiologists after the 2008 financial crisis, brought the imaging bubble to an end.     

PACS图像显示器质量控制的初步研究

目的探讨放射科PACS系统中图像显示器的质量保证(QA)、质量控制(QC)问题。方法参考美国医学物理学会第18工作组(AAPMTG18)制定的测试图和质量评估标准,利用光度计、显示器校正软件,对3种型号的BARCOCRT灰阶显示器进行季度性定量检测。内容包括:DICOM灰阶标准显示函数校正、最高亮度和最低亮度检测、亮度均一性检测、显示器分辨率、几何失真校正。结果显示器的各项性能指标都符合AAPMTG18规范。放射科95%的医学图像依靠PACS显示器做出了诊断。结论PACS图像显示器的质量控制是确保数字化医疗环境优质性的重要措施。     

Hospital-wide distribution of nuclear medicine studies through a broadband digital network

Nuclear medicine provides a good environment for the evaluation of picture archiving and communication systems (PACS) because of the relatively small quantity of digital data that are generated, leading to reduced requirements for storage, display, and transmission compared with those found in radiology. The PACS in nuclear medicine is characterized by use of a single computer as a central storage, display, and analysis node. Images are acquired with use of small, low-cost computers attached to each camera. This network configuration offers advantages of convenience, but with great reliance on a single computer. A campus-wide picture network is under development at Washington University employing broadband cable television technology supplemented by baseband Ethernet (Digital Equipment Corp, Maynard, MA) components. All areas of diagnostic radiology and nuclear medicine are connected via a PACS testbed project. A radiology information system, supporting over 250 terminals, provides digital tracking of patients and report generation and retrieval. A new image workstation is under development in conjunction with Digital Equipment Corp. This system will permit display in multiple windows of report information and images from various modalities. A lung scan demonstration project is now beginning that is designed to test the value of a PACS in nuclear medicine. Digitally acquired chest radiographs will be displayed on an image workstation in nuclear medicine along with digital ventilation and perfusion lung scans. It is hoped that time-consuming logistic bottlenecks now encountered in lung scan interpretation will be reduced.     

Integrating digital systems: commitment and collaboration

One year ago, the radiology department at Ball Memorial Hospital, a 350-bed facility in Muncie, IN, was completely film-based. The need to support a new all-digital, 35-room emergency department (ED) hastened the facility's transition to a digital environment. Today, with the exception of mammography, the hospital's imaging services are now digital. To develop and implement the project, the hospital formed an internal implementation team. An independent consultant was also hired to evaluate the impact of these new technologies and to provide an estimated cost payback. After research, site visits, and vendor demonstrations, the hospital selected a single vendor for its picture archiving and communication system (PACS), digital radiography (DR), computed radiography (CR), and overall project management. The DR system was installed in the ED to provide digital image capture for a full range of trauma exams. The ED also initially began utilizing a Web-based PACS distribution originally implemented for after-hours teleradiology. The majority of the hospital's imaging studies are captured with 2 multi-cassette CR systems that serve 7 exam rooms in the radiology department. The hospital also installed remote operations panels to expedite entry of patient and exam information. Technologists readily embraced both CR and DR systems. The Web distribution system now transmits images to hospital-based computers and to 150 remote referring physicians. The PACS platform automatically e-mails key images and radiology reports to referring physicians. Authorized physicians can also request reports and images on an as-needed basis. The PACS vendor had previously performed multiple integrations with the radiology information system (RIS) vendor; the integration of PACS and RIS was extremely smooth. One of the critical components of a successful conversion is experienced, dedicated management. The hospital retained professional project management services to facilitate implementation and to ensure adequate training for all users.