JP2007307290A - Medical image reading system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a medical image reading system capable of appropriately extracting an image for comparison and performing a highly precise comparative interpretation of radiogram. <P>SOLUTION: The system includes: a database 68 where medical image data obtained by photographing a patient, image-related information related to the medical image, and patient information for specifying a patient being a photographing object are stored by mutual correspondence; a reading device 5 for reading the medical image by comparing the image for comparison with the image to be read; and the CPU 61 of a PACS management server 6 for extracting the image information of the image for comparison among the image information stored in the database 68, based on the patient information and image-related information. The reading device 5 includes a display part 55 for displaying at least the image for comparison extracted by the CPU 61 and the image to be read. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

  The present invention relates to a medical image interpretation system, and more particularly to a medical image interpretation system that can interpret a medical image while comparing the image for interpretation and a comparison image.

  In the medical field, an interpretation doctor interprets a medical image obtained by photographing a patient and creates an interpretation report. This interpretation report is used for diagnosis of the patient and serves as a material for diagnosing the presence or absence of a lesion. In order to make an appropriate diagnosis, it is necessary to perform an accurate interpretation, but in order to perform an accurate interpretation, only the image that is the subject of the interpretation is judged. It is meaningful to compare and contrast these etc. retrospectively to past test results. In view of this, an image processing system has been proposed in which an image to be interpreted and a comparative image are displayed side by side on a display unit to perform comparative interpretation (see, for example, Patent Document 1).

  However, in order to display past images suitable for comparison, it is necessary to appropriately search and extract comparison images from past images. However, past images such as modality types and imaging regions are searched. It is complicated for an interpreting doctor to set a search condition for performing the search or to manually select an image to be compared, and efficient interpretation cannot be performed.

In this regard, there is also a medical image display device that automatically detects a past image obtained by photographing the same part as the image to be interpreted and displays it on a monitor different from the image to be interpreted, and enables comparative interpretation. It has been proposed (see, for example, Patent Document 2). Further, the display unit includes a means for acquiring an unread image and a means for acquiring a past image, and detects a past image obtained by photographing the same part as the unread image from an outline of the image and the like as an image suitable for comparative interpretation. A medical image archiving communication system capable of switching display has also been proposed (see, for example, Patent Document 3).
JP 2002-63563 A JP 2000-166878 A Japanese Patent No. 3028980

  However, when performing comparative interpretation, it may be sufficient to use the most recent image taken of the same part as the object of comparison, but accurate interpretation is only performed by comparing the results of multiple tests in time series. Sometimes you can. There are also images that can be used for comparative interpretation even if the types of modalities are different. In this regard, depending on the methods described in Patent Document 2 and Patent Document 3, it is only possible to extract a past image obtained by photographing the same part, and an image to be referred to at the time of comparative interpretation is extracted appropriately and flexibly. There was a problem that I could not.

  Accordingly, the present invention has been made to solve the above-described problems, and an object thereof is to provide a medical image interpretation system capable of appropriately extracting comparative images and performing highly accurate comparative interpretation. It is what.

In order to solve the above-described problem, the medical image interpretation system according to claim 1 includes image information of a medical image obtained by imaging a patient, patient information that can identify the patient as an imaging target, examination related information of the patient, electronic Storage means for storing image-related information including at least one of medical record information and interpretation report information in association with each other;
A terminal device for interpretation that performs interpretation of a medical image by comparing the comparison image and the image to be interpreted;
Image extraction means for extracting image information of the comparison image based on at least one of the patient information and the image related information from among the image information stored in the storage means,
The interpretation terminal device includes a display unit that displays at least the comparison image extracted by the image extraction unit and the interpretation target image.

  The invention according to claim 2 is the medical image interpretation system according to claim 1, wherein the image extraction means is a comparison image based on at least one of the patient information and the image related information. The priority order for extracting image information to be determined is determined.

  According to a third aspect of the present invention, in the medical image interpretation system according to the first or second aspect, the image extraction means is based on at least one of the patient information and the image related information. The number of pieces of image information to be extracted as comparison images is determined.

  According to a fourth aspect of the present invention, in the medical image interpretation system according to any one of the first to third aspects, the image extraction means is at least one of the patient information and the image related information. On the basis of either of them, a layout of a comparative image to be displayed on the display unit is determined.

  According to the first aspect of the present invention, in addition to patient information and information input regarding examinations, images such as computerized information accumulated as an electronic medical record and information described in an interpretation report created after interpretation The comparison image used for comparative interpretation is extracted with reference to various information related to the image, so that not only the most recent image obtained by photographing the same part but also the one that is not necessarily the most recent in time series, the type of modality is Even if they are different, if there is an image that can be used as a reference for comparative interpretation, it can be extracted appropriately and flexibly.

  In addition, the image extraction means automatically extracts the comparison image even if the image interpretation doctor does not set the search extraction condition by himself, so that the image to be referred to at the time of the comparative image interpretation can be extracted easily and efficiently. There is an effect.

  According to the second aspect of the present invention, the priority order for extracting the image information to be the comparison image is automatically determined based on at least one of the patient information and the image related information. It is possible to appropriately and flexibly extract an image suitable for the above.

  According to the invention described in claim 3, since the number of image information to be extracted as a comparison image is automatically determined based on at least one of patient information and image related information, for example, a plurality of progress images Compare multiple images so that it is possible to interpret images more accurately if multiple images are compared, and only the most recent image is extracted if it is sufficient to compare only the most recent images. Images necessary for proper interpretation can be extracted without excess or deficiency. As a result, an efficient and highly accurate comparative interpretation can be easily performed.

  According to the invention described in claim 4, since the layout of the comparison image to be displayed on the display unit is automatically determined based on at least one of the patient information and the image related information, it is compared with the image to be interpreted. It is possible to display the image for use in a layout most suitable for comparative interpretation, and it is possible to easily perform efficient and accurate comparative interpretation.

  Hereinafter, an embodiment of a medical image interpretation system according to the present invention will be described with reference to FIGS. 1 to 4. However, the scope of the invention is not limited to the illustrated examples.

  As shown in FIG. 1, a medical image interpretation system 1 is a PACS (Picture Archiving) that is an information management system that centrally manages image information of digitized medical images together with patient patient information, examination information, and the like. and Communication System), information related to medical images is managed. The medical image interpretation system 1 includes a modality 2, an examination order management device 3, a PACS management server 6, an interpretation device 5, and the like, which are connected to a LAN (Local Area Network) via a switching hub (not shown), for example. ) And a communication network (hereinafter simply referred to as “network”) 7 such as a WAN (Wide Area Network).

  As a communication method in the medical image interpretation system 1, for example, DICOM (Digital Image and Communications in Medicine) standard is used. In communication between devices connected to a LAN, DICOM MWM (Modality Worklist Management) or DICOM MPPS (Modality Performed Procedure Step) is used. Note that the communication method applicable to this embodiment is not limited to this.

  The modality 2 is an imaging device that generates image information (hereinafter referred to as medical image data) of a medical image obtained by imaging a patient, and includes, for example, an MRI (Magnetic Resonance Imaging) device, a CR (Computed Radiography). ) Apparatus, CT (Computed Tomografhy), MRT (Magnetic Resonance Imaging), FPD (Flat Panel Detector), mammography apparatus (mammography), ultrasonic diagnostic apparatus, endoscope apparatus, etc. can be used as modality 2. Note that the type and number of modalities 2 installed in the medical image interpretation system 1 are not particularly limited.

  The examination order management apparatus 3 manages examination and imaging order information in the medical image interpretation system 1, and is composed of a CPU (Central Processing Unit), a RAM (Random Access Memory), an HDD, etc. Is a computer that includes a storage unit that stores information, an input unit, a display unit, a communication unit that transmits and receives information to and from each device connected to the network 7, and the like.

  For example, patient information, examination-related information, and the like are input from the input unit of the examination order management apparatus 3. Here, patient information is information that can identify a patient, and includes various information related to the patient, such as information related to the patient's name, patient ID, age, sex, and patient medical history. The examination-related information refers to information related to the examination performed on the patient and the contents of imaging (for example, examination type, examination date, modality ID indicating the type of modality 2 used for imaging, imaging date, imaging site, etc.). .

  When the patient information, the examination related information, and the like are input from the input unit, the examination order management apparatus 3 performs examination order information on what kind of examination and imaging are performed on which patient based on the information. Is generated. The inspection order management apparatus 3 issues the inspection order to the modality 2 by notifying the modality 2 of the generated inspection order information via the network 7. The examination order management apparatus 3 associates the patient information input from the input unit with examination-related information and the like, and transmits them to the PACS management server 6 via the network 7.

  Next, the image interpretation device 5 is a terminal device for image interpretation for the image interpretation doctor performing image interpretation on the medical image data (interpretation target image) used for image interpretation to display an image or the like that is the object of image interpretation and perform image interpretation diagnosis or the like. 2, the computer includes a CPU 51, a RAM 52, a storage unit 53, an input unit 54, a display unit 55, a communication unit 56, and the like, and each unit is connected by a bus 57.

  The storage unit 53 includes an HDD (Hard Disc), a semiconductor nonvolatile memory, and the like, and stores various programs such as a system program and a processing program. The CPU 51 reads various programs stored in the storage unit 53, expands them in the RAM 52, and executes various processes in accordance with the expanded programs.

  In particular, in this embodiment, the interpretation target image and the comparison image sent from the PACS management server 6 are sent to the CPU 51 via the communication unit 56, and the CPU 51 displays the display unit based on the sent information. In 55, an image to be interpreted and a comparison image are displayed.

  The display unit 55 is configured to include a monitor such as a CRT (Cathode Ray Tube) or an LCD (Liquid Crystal Display), for example, and at least an image to be interpreted and an image for comparison according to an instruction of a display signal input from the CPU 51. And can be displayed. Note that the image interpretation device 5 may include a display unit 55 having a higher definition than that of a general computer in order to enable precise image diagnosis.

  The input unit 54 includes, for example, a keyboard having cursor keys, numeric input keys, and various function keys (not shown), and a pointing device such as a mouse, and can input an interpretation result by an interpreting doctor. Yes. The input unit 54 outputs an instruction signal input by a key operation on the keyboard or a mouse operation to the CPU 51.

  The CPU 51 generates interpretation report information based on information input from the input unit 54, medical image data that is an interpretation target image, and the like. Interpretation report information includes, for example, the name of the interpreting physician, whether or not the interpretation was performed (whether or not the interpretation was completed), what gradation the interpretation was made, and what medical image data was used for the diagnosis A detailed report (comments), whether a detailed inspection or re-examination is necessary, the timing of the detailed inspection or re-inspection, what kind of detailed inspection or re-inspection is required, and the image to be interpreted depends on the screening. Or not. The CPU 51 associates the patient information input from the input unit 54 with the examination-related information and the like, and transmits them to the PACS management server 6 via the network 7.

  As shown in FIG. 3, the PACS management server 6 includes a CPU (Central Processing Unit) 61, a RAM (Random Access Memory) 62, an HDD, etc., and a storage unit 63 for storing various programs, an input unit 64, a display unit 65, a computer configured to include a communication unit 66 that transmits and receives information to and from each device connected to the network 7, and each unit is connected by a bus 67. Further, the PACS management server 6 includes a database 68 (see FIG. 1) as storage means.

  The PACS management server 6 includes medical image data acquired by the modality 2, patient information input from the examination order management apparatus 3 and the like, examination related information, and interpretation report information generated by the interpretation apparatus 5. It is transmitted via the communication unit 66. Of these pieces of information, examination-related information and interpretation report information are referred to as “image-related information” related to medical image data.

  The PACS management server 6 performs processing in cooperation with the CPU 61 and a program stored in the storage unit 63, thereby relating the patient information, medical image data corresponding to the patient, and the image information. Image-related information is stored in the database 68 in association with each other.

  In addition, the PACS management server 6 performs the process in cooperation with the CPU 61 and the program stored in the storage unit 63, so that the patient information and the image related information are stored in the medical image data stored in the database 68. Based on (inspection-related information and interpretation report information), it functions as an image extraction means for extracting image information of the comparison image.

  Below, the image extraction process which CPU61 implement | achieves in cooperation with a program is demonstrated concretely. In the present embodiment, the storage unit 63 matches the comparison condition for determining whether or not the medical image data (interpretation target image) used for interpretation is a case for comparative interpretation and the comparison condition. In this case, a comparative interpretation determination table in which image conditions relating to which image should be extracted as a comparison image is stored. When performing the image extraction process, the CPU 61 reads out the program from the storage unit 63 and develops it in the work area of the RAM 62, and refers to the comparative interpretation determination table to determine whether or not to perform comparative interpretation. Which image is used as a comparison image is determined.

FIG. 4 shows an example of the comparative interpretation determination table.
The CPU 61 is configured to be able to identify character information stored in the database 68 such as patient information and image-related information. For example, the CPU 61 compares “comparison” with examination-related information associated with medical image data that is an image to be interpreted. When there is a description “interpretation required, examination ID: 0001” and there is information that the report state is not “interpreted”, the CPU 61 determines that the image to be interpreted corresponds to the comparison condition A in FIG. to decide. Then, the CPU 61 searches the database 68 for medical image data corresponding to “examination ID: 0001” described as the examination related information, and extracts it as a comparison image.
Further, when the examination-related information includes the characters “examination”, the CPU 61 determines that the image to be interpreted corresponds to the comparison condition B in FIG. 4, and is the same as when the medical image data is acquired. The latest medical image data (with the newest imaging date) is retrieved from the medical image data accompanied by the modality ID indicating that it has been acquired by the modality 2 and extracted as a comparative image.
Further, in the patient information and the examination related information, when “the patient's age on the photographing date is 30 years or older”, “gender is female”, and the image to be interpreted is “chest CR examination” The CPU 61 determines that the image to be interpreted corresponds to the comparison condition C in FIG. 4, searches for an ultrasound diagnostic image attached with the photographing date information of the same period, and extracts it as a comparison image. In addition, in the case where the ultrasonic diagnostic image accompanied with the imaging date information of the same period is not stored in the database 68, the medical image data acquired in the latest chest CR examination is searched and extracted as a comparison image. .
Furthermore, there is information that the past interpretation report information of the patient related to the image to be interpreted includes the characters “necessary examination required” or “re-examination required” and the report status is not “interpreted”. In this case, the CPU 61 determines that the interpretation target image corresponds to the comparison condition D in FIG. Then, the CPU 61 searches medical image data attached to the latest past interpretation report among the examinations described as “necessary for detailed examination”, and extracts them as comparison images.
If there is information that there is medical image data taken within the past five years for the same part in the patient information and the examination related information, the CPU 61 determines that the image to be interpreted corresponds to the comparison condition E in FIG. Judge that. Then, the CPU 61 retrieves the latest medical image data from the medical image data for the same part and extracts it as a comparison image.

  As described above, the CPU 61 determines whether there is information that matches any of the comparison conditions defined in the comparative interpretation determination table in the patient information and the image related information associated with the medical image data that is the interpretation target image. If the comparison condition is met, a comparison image is extracted from the database 68 according to the comparative interpretation determination table. The contents set in the comparative interpretation determination table, the comparison conditions, the contents of the image conditions, and the like are not limited to those exemplified here. The contents set in the comparative interpretation determination table, the comparison conditions, the contents of the image conditions, and the like are not limited to those set in advance, and can be set or changed by the user according to the use environment of the system. It may be.

  When priority is set in advance for the comparison conditions defined in the comparative interpretation determination table, and patient information and image related information associated with medical image data that is an interpretation target image satisfy a plurality of comparison conditions Then, medical image data to be extracted is determined according to a comparison condition having a high priority order. For example, in FIG. 4, the comparison condition A with priority 1 is set with the highest priority, and the comparison condition E with priority 5 is set with the lowest priority. Therefore, for example, when the patient information and the image related information associated with the medical image data that is the image to be interpreted satisfy both the comparison condition B and the comparison condition D, the comparison condition B is given priority, and the medical image data The most recent medical image data is extracted as a comparative image from among the medical image data to which a modality ID indicating that it has been acquired with the same modality 2 as that acquired. The method of assigning priorities is not limited to the one illustrated here, and the user may be able to set priorities by himself.

  Further, in the present embodiment, the description has been made mainly on the example of extracting the latest medical image data such as the comparison condition B. However, when the comparison condition is met, for example, the medical images taken with the same modality 2 are used. A plurality of medical image data may be extracted retroactively such as extracting all image data. In addition, when there are a plurality of medical image data, how many of them are extracted or the number of images to be extracted as comparison images is also based on patient information and image related information associated with medical image data that is an image to be interpreted. The comparative interpretation determination table may be set so as to be determined.

  Further, the display layout of the medical image for interpretation and the comparative image displayed on the screen for comparative interpretation in the interpretation device 5 is also based on the patient information and the image related information associated with the medical image data that is the interpretation target image. The comparative interpretation determination table may be set so as to be determined.

  Next, the operation of the medical image interpretation system 1 in this embodiment will be described.

  When patient information, examination-related information, etc. are input to the examination order management apparatus 3 and the patient is accepted for examination and imaging, the examination order management apparatus 3 generates examination order information and sends the examination order information to the modality 2. To issue an inspection order. The modality 2 to which the examination order has been issued performs patient examination and imaging according to the examination order, and medical image data is generated.

  Patient information, examination-related information, etc. input by the examination order management device 3 and medical image data generated by the modality 2 are sent to the PACS management server 6, and patient information, examination-related information, etc. and medical image data correspond to each other. Attached and stored in the database 68.

  When interpretation is performed, the CPU 61 of the PACS management server 6 cooperates with the program to perform comparative interpretation on a predetermined interpretation target image (medical image data used for interpretation) while referring to the comparative interpretation determination table. It is necessary to determine which image should be used as a comparison image. At this time, if the image to be interpreted meets a plurality of comparison conditions, a comparison image is determined according to the priority order defined in the comparative interpretation determination table. Further, the number of medical image data extracted as the comparison image and the display layout of the image to be interpreted and the comparison image may be determined.

  Whether or not to perform comparative interpretation is determined, and in the case of performing comparative interpretation, when a comparison image is determined and extracted, the image to be interpreted and the comparison image are transferred from the PACS management server 6 to the interpretation apparatus 5 in the network 7. Sent through. Note that whether or not to perform the comparative image interpretation and the process of extracting the comparison image may be started when the image interpretation device 5 transmits an instruction signal to send the image to be interpreted to the PACS management server 6, or PACS It may be started by sending a matter to be interpreted to the management server 6.

  When the image to be interpreted and the comparison image are transmitted from the PACS management server 6 to the image interpretation device 5, the CPU 51 of the image interpretation device 5 displays the transmitted image to be interpreted and the image for comparison on the display unit 55 in a predetermined layout. . As described above, when the CPU 61 of the PACS management server 6 determines the display layout of the image to be interpreted and the comparative image based on the comparative interpretation determination table, the layout is displayed on the display unit 55. Is done.

  When the image to be interpreted and the comparison image are displayed on the display unit 55 of the image interpretation device 5, the image interpretation doctor makes an image interpretation diagnosis while comparing and contrasting them, and a predetermined comment such as an interpretation comment from the input unit 54 of the image interpretation device 5 is displayed. Enter the matter. The CPU 51 generates image interpretation report information based on the input information, and transmits the generated image interpretation report information to the PACS management server 6 via the network 7. When the CPU 61 of the PACS management server 6 receives the interpretation report information, the CPU 61 of the PACS management server 6 identifies the patient, medical image data, and the like as the interpretation target from the information described in the interpretation report information, and interprets the interpretation report information and the interpretation target. Various information such as patient information of the patient and medical image data taken for the patient are associated with each other and stored in the database 68 which is a storage unit. In the next and subsequent interpretations, it is necessary to perform comparative interpretation based on image-related information and patient information including the interpretation report information stored in the database 68, and if so, which image should be the comparative image The process of determining is performed.

  As described above, according to the present embodiment, a comparative image used for comparative interpretation is described in an interpretation report created after interpretation, as well as information input before examination or imaging, such as patient information. Since extraction is based on image-related information such as image interpretation report information, not only the most recent image obtained by photographing the same part, but also comparisons are not necessarily the most recent in time series or those of different modalities 2 If there is an image that can be used for interpretation, it can be extracted appropriately and flexibly, and high-accuracy interpretation can be performed.

  In addition, when the CPU 61 of the PACS management server 6 cooperates with the program, it is necessary to perform comparative interpretation on a predetermined interpretation target image while referring to the comparative interpretation determination table, and if so, which image is a comparison image. Since it is possible to extract images that should be referred to during comparative interpretation without having to set search and extraction conditions by themselves, the interpretation diagnosis can be made more efficient. Can do.

  Furthermore, since the priority order for extracting image information to be a comparative image is automatically determined based on patient information and image related information, an image most suitable for comparative interpretation can be extracted efficiently and used for interpretation. it can.

  In addition, when automatically determining the number of comparison images to be extracted based on patient information and image related information, it is possible to extract images necessary for appropriately performing comparative interpretation without excess or deficiency.

  In addition, when automatically determining the layout of the comparative image to be displayed on the display unit 55 during the comparative interpretation based on the patient information and the image related information, the determination is based on the patient information and the image related information. The image to be interpreted and the comparative image can be displayed in a layout most suitable for comparative interpretation.

  It is also possible to introduce into the medical image interpretation system 1 an electronic medical chart system that digitizes and accumulates various information related to patients, examinations, imaging, and the like. When an electronic medical record system is introduced, information (for example, patient information, interpretation report information, medical image data, etc.) input from an electronic medical record input terminal (not shown) and managed as an electronic medical record is hereinafter referred to as “electronic medical record information”. May be stored and accumulated in the database 68 of the PACS management server 6. In this case, the electronic medical record information is included in the image related information together with the examination related information and the interpretation report information. Then, the CPU 61 of the examination order management apparatus 3 determines whether or not to perform comparative interpretation on medical image data (interpretation target image) used for interpretation, and which image to extract as a comparison image when performing comparative interpretation. At the time of determination, whether or not the electronic medical record information is suitable for the comparison condition and the image condition is determined.

  In the present embodiment, patient information, examination related information, and the like are input from the input of the examination order management apparatus 3. However, input means for patient information, examination related information, and the like are not limited thereto. For example, the modality 2 may be provided with an input means for inputting patient information, examination related information, and the like. In addition, a reading device for reading barcodes and various tags is provided in the medical image interpretation system 1, and a barcode and various tags that can be read by the reading device are assigned to the patient and modality 2 to input patient IDs and modalities 2. The input of the modality ID indicating the type may be performed by the reading device.

  In this embodiment, the case where the database 68 of the PACS management server 6 functions as a storage unit has been described as an example, but the storage unit is not limited to this. In the present embodiment, the CPU 51 of the PACS management server 6 functions as an image extraction unit by cooperating with the program. However, the image extraction unit is not limited to the CPU 51 of the PACS management server 6.

  In addition, it is needless to say that the present invention is not limited to the above embodiment and can be modified as appropriate.

It is the block diagram which showed the principal part structure of one Embodiment of the medical image interpretation system which concerns on this invention. It is the block diagram which showed the principal part structure of the image interpretation apparatus applied to the medical image interpretation system shown in FIG. It is the block diagram which showed the principal part structure of the PACS management server applied to the medical image interpretation system shown in FIG. It is the figure which showed an example of the comparative interpretation determination table applied to this embodiment.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Medical image interpretation system 2 Modality 3 Inspection order management apparatus 5 Interpretation apparatus 6 PACS management server 7 Network 51 CPU
55 Display 61 CPU
62 RAM
63 storage unit 68 database

Claims (4)

Image-related information including at least one of image information of a medical image obtained by imaging a patient, patient information that can identify the patient to be imaged, examination-related information, electronic medical record information, and interpretation report information of the patient; Storage means for storing them in association with each other;
A terminal device for interpretation that performs interpretation of a medical image by comparing the comparison image and the image to be interpreted;
Image extraction means for extracting image information of the comparison image based on at least one of the patient information and the image related information from among the image information stored in the storage means,
The medical image interpretation system, wherein the interpretation terminal device includes a display unit that displays at least the comparison image extracted by the image extraction unit and the interpretation target image.   The said image extraction means determines the priority which extracts the image information used as an image for a comparison based on at least any one of the said patient information or the said image relevant information. Medical image interpretation system.   3. The image extracting means determines the number of image information to be extracted as the comparison image based on at least one of the patient information and the image related information. Medical image interpretation system described in 1. The said image extraction means determines the layout of the image for a comparison displayed on the said display part based on at least any one of the said patient information or the said image relevant information. The medical image interpretation system according to any one of the above.

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