JP5288815B2 - Medical image display device and report display device - Google Patents

Description

  The present invention relates to a medical image display device that displays a medical image for interpretation, and a report display device that displays a medical report created by reflecting the result of interpretation using the medical image display device.

  In medical institutions, medical image diagnosis support systems for supporting medical diagnosis based on medical images are used.

  The medical image diagnosis support system includes a medical image diagnosis apparatus, a medical image storage apparatus, a medical diagnosis workstation, a medical report creation support apparatus, and a medical report display apparatus.

  The medical image diagnostic apparatus captures a subject and generates medical image data representing a medical image.

  The medical image storage device stores medical image data generated by the medical image diagnostic device and report data generated by the medical report creation support device.

  The medical diagnosis workstation displays a medical image represented by the medical image data stored in the medical image diagnostic apparatus and supports interpretation by the interpreting doctor based on the medical image.

  The medical report creation support apparatus generates report data representing a medical report in response to an instruction from an interpretation doctor or a report creation operator.

  The medical report display device displays a medical report represented by report data stored by the medical image storage device so that the medical doctor can visually check the medical report.

  In such a system, the key image selected by the interpretation doctor at the medical diagnosis workstation can be associated with the medical report generated by the medical report creation support apparatus. In the medical report display device, the medical image associated with the medical report is displayed as necessary, so that the medical doctor can view the key image.

  However, conventionally, a hyperlink to medical image data representing a key image is set in a medical report. Therefore, if the key image is a still image, the clinician can directly view the image selected as the key image by the interpretation doctor.

  However, in recent years, 4D image data and 3D volume data can be acquired by increasing the functionality of medical image diagnostic apparatuses. The image displayed based on these data changes according to the set display conditions. For this reason, when 4D image data or 3D volume data is associated with a medical report as medical image data representing a key image, the same state as the interpreting physician visually observed when the interpreting physician selected the key image It is difficult to reproduce the display on the medical report display device.

  The present invention has been made in consideration of such circumstances, and the object of the present invention is to display the medical image based on the image data based on the image data capable of displaying the medical image under different display conditions. The display state when the image is adopted in the medical report is to be reproduced when the medical report is referred to.

The medical image display device according to the first aspect of the present invention includes a setting unit that sets a variable condition that is at least a part of a plurality of display conditions related to display of at least one medical image in accordance with an artificial designation; Display means for displaying the medical image in accordance with the plurality of display conditions reflecting the setting of the variable condition by the setting means, and an artificial effect of adopting the medical image displayed by the display means in a medical report And a creation unit that creates condition information that represents at least the variable condition set by the setting unit and information related to an application for displaying the medical image .

A report display device according to a second aspect of the present invention includes a setting unit that sets a variable condition that is at least a part of a plurality of display conditions related to display of at least one medical image according to an artificial designation, Display means for displaying the medical image in accordance with the plurality of display conditions reflecting the setting of the variable condition by the setting means; and an artificial effect of adopting the medical image displayed by the display means for a medical report. A medical image display apparatus comprising: a creation unit that creates condition information representing at least the variable condition set by the setting unit and information related to an application for displaying the medical image according to designation. Report display device that constitutes an image diagnosis support system, and obtains report information that represents a medical report And, when at least one medical image is associated with the report information, an image for acquiring medical image data representing the medical image and the condition information created by the creating means with respect to the medical image data obtaining an acquiring unit, and displays the medical report that the report information obtained is represented by the report obtaining means, the pre-Symbol image obtaining means in the display condition expressed on the acquired condition information by the image acquisition unit A display unit that displays a medical image represented by the medical image data that has been displayed based on an application program, and a display that is represented by the condition information based on information about the application that is represented by the condition information acquired by the image acquisition unit. The display means performs processing for displaying the medical image under conditions. Determine the presence or absence of an application program that insufficient I, and a program acquisition means for obtaining the application program if there is an application program to be insufficient.

  According to the present invention, regarding the display of a medical image based on image data that allows a medical image to be displayed under different display conditions, the display state when the medical image is employed in the medical report is referred to the medical report. Sometimes it can be reproduced.

  Hereinafter, an embodiment of the present invention will be described with reference to the drawings.

  FIG. 1 is a block diagram showing a configuration of a medical image diagnosis support system 100 according to the present embodiment.

  The medical image diagnosis support system 100 includes a medical image diagnosis apparatus (hereinafter referred to as a modality) 1, a medical image storage apparatus (hereinafter referred to as an image server) 2, a medical report creation support apparatus (hereinafter referred to as a report server), a medical use A diagnostic workstation (hereinafter referred to as an interpretation client) 4 and a medical report display device (hereinafter referred to as a report viewer) 5 are connected to each other via a LAN (local area network) 6. In FIG. 1, the medical image diagnosis support system 100 includes one of each of the above devices, but a plurality of each device may be provided.

  It is desirable that medical image communication between the above-mentioned devices conforms to the standard DICOM (digital imaging and communications in medicine), but another existing standard may be applied as appropriate. Information communication is industry standard TCP / IP (transmission control protocol / internet protocol) communication, and data is exchanged in packets via a network.

  The modality 1 generates a medical image (hereinafter simply referred to as an image) relating to the subject from data obtained by scanning the subject. As the modality 1, various types such as an X-ray CT apparatus and an MRI apparatus can be used as appropriate. Also, the modality 1 creates an information object (hereinafter referred to as an imaging condition object) that represents a condition applied to scanning or medical image generation. The modality 1 transmits medical image data representing the generated medical image and imaging condition objects to the image server 2 as necessary.

  The image server 2 stores medical image data and imaging condition objects transmitted from the modality 1. The image server 2 manages stored medical image data using an image management table. The image server 2 distributes medical image data and imaging condition objects in response to requests from the interpretation client 4 and the report viewer 5.

  The report server 3 stores report data created by the interpretation client 4. The report server 3 manages the stored report data using a report management table. The report server 3 distributes report data in response to a request from the interpretation client 4 or the report viewer 5.

  The interpretation client 4 displays a medical image represented by medical image data stored in the image server 2 and a medical report represented by report data stored in the report server 3. The image interpretation client 4 creates report data in response to a user operation. The interpretation client 4 transmits the created report data to the report server 3 as necessary.

  The report viewer 5 displays a medical image represented by medical image data stored in the image server 2 and a medical report represented by report data stored in the report server 3.

  FIG. 2 is a block diagram showing the configuration of the interpretation client 4.

  The interpretation client 4 includes a data transmission / reception unit 41, a storage unit 42, a display unit 43, an operation unit 44, and a control unit 45.

  The data transmitter / receiver 41 includes a LAN board. The data transmission / reception unit 41 transmits / receives various data via the LAN 4. The storage unit 42 stores various data such as image data and report data. The display unit 43 displays various types of information to be presented to the user such as medical images and medical reports under the control of the control unit 45. The operation unit 44 inputs various instructions and information for operating various functions of the interpretation client 4 by the user according to the user's operation. The control unit 45 controls each unit of the image interpretation client 4 to realize various functions provided in a known image interpretation client. This function includes acquisition of image data from the medical image storage device 2, display of a medical image based on the acquired image data, creation of a medical report, or transmission of medical report data representing the created medical report to the report server 3. Etc. The control unit 45 has a display condition setting function 45a, a display processing function 45b, a shooting condition object acquisition function 45c, a shooting condition object update function 45d, and a shooting condition object transmission function 45e as shown in FIG.

  The display condition setting function 45a sets medical image display conditions based on image data. The display condition setting function 45a sets some of the display conditions according to the user's specification. The display processing function 45 b creates a display image for displaying a medical image based on the image data in accordance with the set display condition, and causes the display unit 43 to display the display image. The imaging condition object acquisition function 45c acquires from the image server 2 an imaging condition object related to a medical image that is a display target. When the medical image being displayed is selected as a key image associated with the medical report, the imaging condition object update function 45d updates the imaging condition object so as to include condition information indicating the display condition of the medical image. The photographing condition object transmission function 45e transmits the photographing condition object updated as described above to the image server 2.

  The control unit 45 includes a processor, and various functions as described above are realized by the processor executing various application programs such as an image display application program and a medical report creation application program.

  FIG. 3 is a block diagram showing the configuration of the report viewer 5.

  The report viewer 5 includes a data transmission / reception unit 51, a storage unit 52, a display unit 53, an operation unit 54, and a control unit 55.

  The data transmitter / receiver 51 includes a LAN board. The data transmission / reception unit 51 transmits / receives various data via the LAN 5. The storage unit 52 stores various data such as image data and report data. The display unit 53 displays various types of information to be presented to the user, such as medical images and medical reports, under the control of the control unit 55. The operation unit 54 inputs various instructions and information for operating various functions of the report viewer 5 by the user according to the user's operation. The control unit 55 controls each unit of the report viewer 5 to realize various functions provided in a known report viewer. For this purpose, the control unit 55 has a report acquisition function 55a, an image acquisition function 55b, and a display processing function 55c as shown in FIG.

  The report acquisition function 55a acquires report data representing the medical report requested to be displayed by the user from the report server 3. The image acquisition function 55b acquires image data representing the medical image from the image server 2 when the user requests display of a medical image associated with the medical report. The image acquisition function 55b also acquires a shooting condition object related to the acquired image data if it is stored in the image server 2. The display processing function 55c displays a medical report or medical image represented by report data or image data.

  The control unit 55 includes a processor, and various functions as described above are realized by the processor executing various application programs such as a report display application program.

  Next, the operation of the medical image diagnosis support system 100 configured as described above will be described. The medical image diagnosis support system 100 can similarly realize various operations implemented in a similar existing system, but the description thereof is omitted. In the following, a specific operation in the medical image diagnosis support system 100 will be described.

  When an interpreting doctor uses the interpretation client 4 to create or edit a medical report, if the interpreting doctor intends to perform an interpretation based on a medical image that is captured by the modality 1 and stored in the image server 2, the interpreting doctor will interpret the medical report. 4 is operated to request display of a desired medical image. In response to this request, the control unit 45 of the image interpretation client 4 starts the processing shown in FIG. Note that the control unit 45 separately executes report creation processing for creating or editing a medical report.

  In step Sa <b> 1, the control unit 45 acquires medical image data representing the requested medical image and an imaging condition object related to the medical image data from the image server 2. In step Sa2, the control unit 45 creates a display image for displaying the medical image represented by the acquired medical image data according to the default display condition, and causes the display unit 43 to display the display image.

  With the medical image displayed in this manner, the control unit 45 shifts to the standby state of steps Sa3 and Sa4. In this standby state, the control unit 45 waits for a request to change the display condition of the medical image or to associate the medical image being displayed with the medical report being created or edited.

  If the user requests to change the display condition by operating the operation unit 44, the control unit 45 proceeds from step Sa3 to step Sa5. In step Sa5, the control unit 45 sets new display conditions reflecting the designation made by the user operating the operation unit 44. The display conditions include multiple types of conditions, but the user's specifications may be reflected in all of these conditions, or other conditions are fixed by reflecting the user's specifications only in some conditions. It may be determined.

  Which condition is variable is arbitrary, but in the present embodiment, three of the time phase, the display condition correction amount, and the display method are variable.

  The time phase represents a temporal relationship between medical images when a plurality of medical images are displayed in association with each other. The time phase is determined, for example, as “second phase of three phases”.

  The display condition correction amount represents a correction amount when the display state is changed (corrected) for each time phase. The display condition correction amount is set by, for example, an enlargement ratio, display coordinates, or a rotation angle.

  The display method represents a relationship between display methods of medical images when a plurality of medical images are displayed in association with each other. The display method is, for example, the display position, size, or display form (tile display / stack display / cine display) of each medical image.

  When the setting of the new display condition is completed, in step Sa6, the control unit 45 creates a display image for displaying the medical image in accordance with the newly set display condition, and displays the display image to be displayed. The display screen of the unit 43 is updated. Thereafter, the control unit 45 returns to the standby state of steps Sa3 and Sa4.

  On the other hand, if the image interpretation doctor determines that the medical image displayed on the display unit 43 is suitable for the key image, he / she operates the operation unit 44 to request an association with the medical report. Then, the control unit 45 proceeds from step Sa4 to step Sa7. In step Sa7, the control unit 45 passes the identification information of the medical image being displayed to the report creation process as information for identifying the key image. Then, in the report creation process, this identification information is included in the report data as key image information associated with the medical report being created or edited. Usually, this identification information is included in the report data as information of the link destination of the hyperlink.

  In step Sa8, the control unit 45 updates the imaging condition object acquired in step Sa1 so as to include condition information representing the currently set display condition. In the condition information, only settings for variable conditions may be described, or all display conditions may be described. In the present embodiment, the condition information includes at least three variable conditions of time phase, display condition correction amount, and display method, and information related to the image display application. FIG. 5 is a diagram illustrating a description example of information regarding the time phase, the display condition correction amount, the display method, and the image display application in the photographing condition object. In step Sa9, the control unit 45 transmits the updated shooting condition object to the image server 2. With this, the control unit 45 ends the process shown in FIG.

  When the imaging condition object updated as described above reaches the image server 2, the image server 2 overwrites the imaging condition object already stored with the updated imaging condition object.

  The report data created with the above processing is transmitted from the interpretation client 4 to the report server 3 and stored in the report server 3.

  When a clinician reads a medical report using the report viewer 5, the clinician operates the operation unit 54 of the report viewer 5 to request display of a desired medical report. In response to this request, the control unit 55 of the report viewer 5 starts the process shown in FIG.

  In step Sb1, the control unit 55 acquires report data representing the requested medical report from the report server 3, and causes the display unit 53 to display the medical report represented by the report data.

  With the medical report displayed in this way, the control unit 55 shifts to the standby state in step Sb2. In this standby state, the control unit 55 waits for a request to display a medical image associated with the medical report being displayed. If such a request is made, the control unit 55 proceeds from step Sb2 to step Sb3. In step Sb3, the control unit 55 acquires from the image server 2 medical image data representing the requested medical image and an imaging condition object related to the medical image data.

  In step Sb4, the control unit 55 confirms whether or not the acquired shooting condition object includes condition information. If the condition information is included, in step Sb5, the control unit 55 refers to the information of the image display application included in the shooting condition object, and sets the display condition represented by the condition information included in the shooting condition object. It is confirmed whether or not an image display application necessary for displaying a medical image in the display state is present in the report viewer 5.

  When the necessary image display application is insufficient, in step Sb6, the control unit 55 acquires an application program for executing the insufficient image display application. The acquisition of the application program can be realized by downloading from the Web, for example. However, since not all of the missing application programs can be acquired, the acquisition of such application programs is abandoned. When the acquisition of the application is completed, the control unit 55 proceeds to step Sb7. If all necessary image display applications exist, the control unit 55 passes step Sb6 and proceeds from step Sb5 to step Sb7.

  In step Sb7, the control unit 55 sets display conditions based on the condition information included in the shooting condition object acquired in step Sb3, and then proceeds to step Sb9. If there is a display condition that cannot be set by the report viewer 5 among the display conditions represented in the condition information, a default display condition or a display condition specified by the user may be set as the display condition. If the shooting condition object contains no condition information, the control unit 55 proceeds from step Sb4 to step Sb8. In step Sb8, the control unit 55 sets the display condition without referring to the shooting condition object. Here, a default display condition may be set, or a display condition may be set according to designation by the user. Then, after setting the display conditions, the control unit 55 proceeds to step Sb9.

  In step Sb9, the control unit 55 creates a display image for displaying the medical image represented by the medical image data acquired in step Sb3 according to the display conditions set in step Sb7 or step Sb8, and displays the display image on the display unit. 53 is displayed.

  As described above, according to the present embodiment, the condition information indicating the display condition of the key image on the interpretation client 4 when the medical image is determined as the key image in the interpretation client 4 is included in the imaging condition object. When the report viewer 5 displays the key image, the key image is displayed according to the display conditions represented by the condition information included in the shooting condition object related to the key image. Therefore, the display state of the key image at the time of interpretation by the interpretation client 4 can be reproduced when the key image is displayed at the time of report reference by the report viewer 5. As a result, since the clinician can see the key image in the same state that the image interpretation doctor was viewing when selecting the key image, the medical report with the reference of the key image by the clinician can be viewed. Verification becomes efficient. This embodiment is particularly useful when the image data representing the key image can be changed in various ways, such as 4D data or 3D volume data.

  According to the present embodiment, the condition information is included in the imaging condition object, so there is no need to increase the number of information objects attached to the medical image. For this reason, the effort concerning the management of the information object is not increased.

  Further, according to the present embodiment, since the information related to the image display application is included in the condition information, the image display application necessary for reproducing the display state according to the display condition represented in the condition information is displayed in the report viewer 5. Can be confirmed. According to the present embodiment, when the necessary image display application is insufficient, the report viewer 5 acquires an application program for executing it. Therefore, it is possible to more accurately reproduce the display state according to the display condition represented in the condition information.

  This embodiment can be variously modified as follows.

  The condition information may be included in an information object other than the shooting condition object. As a corresponding information object, for example, a GSPS (grayscale softcopy presentation state) object defined by DICOM can be cited. Moreover, it is good also as an information object only for condition information. In this case, the information object including the condition information may be stored in the server that originally stored the information object. However, the information object can be stored in the image server 2, the report server 3, or other servers.

  The shooting condition object may be managed by a management table dedicated to the shooting condition object. The shooting condition object may be stored by a server other than the image server 2 such as a server for storing the shooting condition object or the report server 3.

  If another viewer application (for example, DICOM viewer) that can reproduce the display state in accordance with the display condition represented in the condition information is installed in the report viewer 5, the above-mentioned application program is not acquired without performing acquisition of the missing application program. A viewer application may be used.

  It is also possible to realize a workstation (client) having both the function of the interpretation client 4 and the function of the report viewer 5.

  Note that the present invention is not limited to the above-described embodiment as it is, and can be embodied by modifying the constituent elements without departing from the scope of the invention in the implementation stage. In addition, various inventions can be formed by appropriately combining a plurality of components disclosed in the embodiment. For example, some components may be deleted from all the components shown in the embodiment.

1 is a block diagram showing a configuration of a medical image diagnosis support system 100 according to an embodiment of the present invention. The block diagram which shows the structure of the interpretation client 4 in FIG. The block diagram which shows the structure of the report viewer 5 in FIG. The flowchart which shows the process sequence of the control part 45 in FIG. The figure which shows the example of description in the imaging | photography condition object of the information regarding a time phase, a display condition correction amount, a display method, and an image display application. The flowchart which shows the process sequence of the control part 55 in FIG.

Explanation of symbols

  DESCRIPTION OF SYMBOLS 1 ... Medical image diagnostic apparatus (modality), 2 ... Medical image storage apparatus (image server), 3 ... Medical report preparation assistance apparatus (report server), 4 ... Medical diagnostic workstation (interpretation client), 5 ... Medical report display apparatus (Report viewer), 41 ... data transmission / reception unit, 42 ... storage unit, 43 ... display unit, 44 ... operation unit, 45 ... control unit, 45b ... display processing function, 45a ... display condition setting function, 45c ... acquisition of shooting condition object 45d ... Shooting condition object update function, 45e ... Shooting condition object transmission function, 51 ... Data transmission / reception unit, 52 ... Storage unit, 53 ... Display unit, 54 ... Operation unit, 55 ... Control unit, 55a ... Report acquisition function, 55b ... Image acquisition function, 55c ... Display processing function, 100 ... Medical image diagnosis support system.

Claims (5)

Setting means for setting a variable condition that is at least a part of a plurality of display conditions related to display of at least one medical image in accordance with an artificial specification;
Display means for displaying the medical image according to the plurality of display conditions reflecting the setting of the variable condition by the setting means;
The variable condition set by the setting means in response to an artificial designation to adopt the medical image displayed by the display means in a medical report, and information relating to an application for displaying the medical image; A medical image display device comprising: creation means for creating condition information representing at least the above.   The variable condition includes the correlation of the time when the plurality of medical images are acquired, the amount of change in the display state of the medical image, the relative relationship between the display states of the plurality of medical images to be simultaneously displayed, and the medical image. The medical image display apparatus according to claim 1, further comprising at least one of image processing execution conditions used for performing the processing. An acquisition means for acquiring medical image data representing the medical image from the medical image storage device and an object representing an operation condition of the medical image diagnostic device for obtaining the medical image data;
The creating unit updates the object acquired by the acquiring unit with respect to the medical image data representing the medical image that is designated to be adopted in the medical report so as to at least represent the variable condition. the medical image display device according to claim 1 or 2, characterized in that to create the condition information. Setting means for setting a variable condition that is at least a part of a plurality of display conditions related to display of at least one medical image in accordance with an artificial specification;
Display means for displaying the medical image according to the plurality of display conditions reflecting the setting of the variable condition by the setting means;
The variable condition set by the setting means in response to an artificial designation to adopt the medical image displayed by the display means in a medical report, and information relating to an application for displaying the medical image; A report display device that constitutes a medical image diagnosis support system together with a medical image display device comprising a creation means for creating condition information that represents at least
A report acquisition means for acquiring report information representing a medical report;
An image acquisition means for acquiring medical image data representing the medical image and the condition information created by the creation means for the medical image data when at least one medical image is associated with the report information; ,
The displays an medical report, the medical obtained by pre Symbol image obtaining means in the display condition expressed on the acquired condition information by the image acquiring means for the report information obtained by the report acquisition means represents Display means for displaying a medical image represented by the image data based on an application program ;
An application that is insufficient for the display means to perform processing for displaying the medical image under the display condition represented in the condition information based on information related to the application represented in the condition information acquired by the image acquisition means A program acquisition means for determining the presence or absence of a program and acquiring the application program when there is a lacking application program;
A report display device comprising:   The said display means displays the said medical report, and displays the said medical image according to the display of the said medical image linked | related with the said medical report having been artificially designated. Report display device described in 1.

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