JP6318039B2 - Image display device and image storage device - Google Patents

Description

  The present invention relates to an image display for displaying an image such as an endoscopic image, and an image storage device for storing an image such as an endoscopic image.

  In endoscopy, an image of the patient's body is captured by an endoscope scope inserted into the patient's body. The captured endoscopic image is stored in the server. In recent years, an increasing number of medical institutions have introduced a medical image management system (PACS: Picture Archiving and Communication System) that centrally manages medical images taken in various departments. In the medical image management system, medical images of patients such as endoscopic images, radiographic images, and fundus images can be centrally managed, thereby improving the in-hospital business efficiency.

  After the endoscopy, the doctor creates a test report related to the endoscopy using the terminal device. At that time, an endoscopic image captured in the examination is attached to the report. When attaching an endoscopic image to a report, the doctor reads the image from the medical image management system and determines which image to attach.

JP 2003-1111050 A JP-A-11-73382

  When an endoscopic image is stored in a medical image management system, when displaying an endoscopic image on an image display device, the communication time is longer than when it is stored on a server or terminal device in an endoscopic department. The time until the endoscopic image is displayed on the terminal device also increases. In particular, when the medical image management system is configured by a cloud server and is not installed in the hospital but installed in a remote place such as overseas, the communication time becomes longer. Also, when the terminal device is connected to the endoscope department system via a wireless LAN, the communication time is longer than when the terminal device is connected via a wired LAN.

  The present invention has been made in view of such a situation, and an object thereof is to provide a technique for suppressing an image display delay in a terminal device.

  In order to solve the above problems, an image display device according to an aspect of the present invention is an image display device connected to an image storage device via a network, and the amount of data in an image requested to be transmitted to the image storage device A non-compressed region of interest, a compression rate determination unit that determines the compression rate of the non-target region from the ratio of the non-target region that compresses the data amount, and compression information corresponding to the compression rate to the image storage device A compressed information notifying unit for notifying.

  Another aspect of the present invention is an image storage device. This device is an image storage device connected to an image display device via a network, and compresses the attention area in which the data amount is uncompressed and the data amount in the image requested to be transmitted from the image display device. A compression unit that compresses the data amount of the non-attention area according to the compression rate of the non-attention area determined from the ratio of the non-attention area, and transmits an image in which the non-attention area is compressed to the image display device. An image transmission unit.

  It should be noted that any combination of the above-described constituent elements and a conversion of the expression of the present invention between a method, an apparatus, a system, a recording medium, a computer program, and the like are also effective as an aspect of the present invention.

  According to the present invention, image display delay in a terminal device can be suppressed.

It is a figure showing composition of a medical service support system concerning an embodiment of the invention. It is a figure which shows the internal structure of the terminal device of FIG. It is a figure which shows the internal structure of the medical image management system of FIG. FIGS. 4A to 4B are diagrams illustrating an example of an endoscopic image including an attention area and a non-attention area. FIGS. 5A to 5B are diagrams showing another example of an endoscopic image including a region of interest and a non-region of interest. It is a figure which shows the table which prescribed | regulated the relationship example of the ping response speed between a terminal device and a medical image management system, the area ratio of the non-attention area with respect to the whole image area | region, and the compression rate of a non-attention area. It is a flowchart which shows the flow of the image data transmission process between a terminal device and a medical image management system. It is a figure which shows the structure of the medical service assistance system which concerns on a modification.

  FIG. 1 is a diagram showing a configuration of a medical service support system 1 according to an embodiment of the present invention. The medical service support system 1 is constructed in a medical facility, and supports the medical service in the medical facility. The medical service support system 1 includes an endoscope department system 5, a gateway device 60, a hospital information system (HIS) 70, and a medical image management system 80. The endoscope department system 5 is installed in the endoscope department and is a system for supporting the endoscope business. The endoscope department system 5 includes a plurality of endoscope systems 10a and 10b (hereinafter referred to as “endoscope system 10” unless otherwise distinguished), an endoscope operation support device 30, and a plurality of terminal devices 40a. , 40b (hereinafter referred to as “terminal device 40” unless otherwise specified), and a cleaning device 50, which are interconnected by a network 2a such as a LAN.

  The hospital information system 70 is an in-hospital basic system including an ordering system, an electronic medical record system, a receipt system, and the like. 1 illustrates an example in which the hospital information system 70 and the medical image management system 80 are separate systems, the hospital information system 70 may include the medical image management system 80. The endoscope department system 5 can cooperate with the hospital information system 70, the medical image management system 80, and other department systems (not shown) via the gateway device 60.

  The endoscope system 10 includes an endoscope scope 11, an endoscope processing device 12, and a display device 13. The endoscope scope 11 is inserted into a patient's body, and the inside of the body is imaged at the timing when the doctor presses the release switch of the endoscope scope 11. The endoscope scope 11 includes a solid-state imaging device (for example, a CCD image sensor, a CMD image sensor, or a CMOS image sensor) and a signal processing circuit. The solid-state imaging device converts incident light into an electrical signal, and the signal processing circuit performs signal processing such as A / D conversion and noise removal on the image data photoelectrically converted by the solid-state imaging device to perform an endoscope processing apparatus. 12 is output.

  The endoscope processing device 12 acquires an image captured by the endoscope scope 11. The endoscope processing device 12 outputs the acquired image to the display device 13 and causes the display device 13 to display the acquired image. It is also possible to display an image being captured in real time. In addition, the endoscope processing apparatus 12 transmits the image acquired from the endoscope scope 11 to the medical image management system 80 and files it in the storage unit in the medical image management system 80.

  The endoscope operation support apparatus 30 controls the entire endoscope department system 5 in an integrated manner. The endoscope work support apparatus 30 is configured by a server, for example. The terminal device 40 is a terminal device used by a user who is engaged in the medical facility such as a doctor or a nurse, and is composed of a PC, a tablet, a PDA, or the like, for example. When a portable terminal device such as a tablet or PDA is used, an access point (not shown) is installed on the network 2a and connected to the network 2a by a wireless LAN. The cleaning device 50 is a device for cleaning and disinfecting the endoscope scope 11 that has been used for inspection and treatment.

  The endoscope operation support apparatus 30 supports various operations performed by the user of the terminal device 40 by executing various application programs related to the endoscope operation in accordance with operations from the terminal device 40 connected to the network 2a. For example, an examination report creation support program is executed to assist a doctor in creating an examination report. When a doctor operates the terminal device 40 to input a test report, the endoscopic work support device 30 receives the test report transmitted from the terminal device 40 and stores it in the storage unit. Further, the endoscope operation support apparatus 30 accumulates the cleaning history of the cleaning apparatus 50 in the storage unit as cleaning information.

  FIG. 2 is a diagram showing an internal configuration of the terminal device 40 of FIG. The terminal device 40 includes a communication unit 41, a control unit 42, a storage unit 43, a display unit 44, and an operation input unit 45. The control unit 42 includes an operation reception unit 421, a line speed detection unit 422, an operation reception unit 421, a transmission request unit 423, a compression rate determination unit 424, and a display control unit 425. In the present embodiment, in order to pay attention to the image acquisition / display function from the medical image management system 80, only functions related to the image acquisition / display function are depicted as functional blocks of the control unit 42 in FIG.

  The function of the control unit 42 can be realized by cooperation of hardware resources and software resources. Processors, ROM, RAM, and other LSIs can be used as hardware resources. Programs such as operating systems and applications can be used as software resources.

  FIG. 3 is a diagram showing an internal configuration of the medical image management system 80 of FIG. The medical image management system 80 is configured by a server, for example. The medical image management system 80 includes a communication unit 81, a control unit 82, a storage unit 83, and an operation input unit 85. The control unit 82 includes a transmission request receiving unit 821, an attention area detection unit 822, an attention area information notification unit 823, a non-attention area compression unit 824, and an image transmission unit 825. In the present embodiment, in order to pay attention to the compression / transmission function of an image to be transmitted to the terminal device 40, only functions related to the image compression / transmission function are depicted as functional blocks of the control unit 82 in FIG. The function of the control unit 82 can also be realized by cooperation of hardware resources and software resources. The storage unit 83 includes, for example, an HDD, an SSD, and the like, and includes a medical image storage unit 831. Hereinafter, it demonstrates more concretely, referring FIG.2 and FIG.3.

  The operation receiving unit 421 of the terminal device 40 receives an operation performed on the operation input unit 45 by the user. In the present embodiment, an endoscope image display request is received. An endoscope image display request may be generated in association with a report display request in addition to a case where the endoscope image display request is generated alone. When a doctor activates an examination report creation support application, the examination report creation support application displays a preview of the endoscopic image captured by the endoscopy or all the endoscopic images of the patient on the report creation screen. Let

  The line speed detection unit 422 detects the communication speed between the terminal device 40 and the medical image management system 80. For example, ping is used to detect the communication speed. The line speed detection unit 422 transmits an ICMP (Internet Control Message Protocol) echo request packet to the medical image management system 80 and receives the echo reply packet from the medical image management system 80. The round trip time between the terminal device 40 and the medical image management system 80 is detected from the time from when the echo request packet is transmitted until the echo reply packet is received. The line speed detection may be executed every time an image display request is received, or may be executed periodically (for example, once a day, once every hour) regardless of the display request.

  When the transmission request unit 423 receives an image display request based on an operation from the operation reception unit 421, an instruction from the examination report creation support application, or the like, identification information (for example, a file name) of the image and attention area information of the image Is sent to the medical image management system 80. The attention area of the image refers to an important area related to the affected part in the endoscopic image, and includes, for example, a biopsy site, a bleeding site, a tumor, and a polyp.

  The endoscopic image captured in the examination is checked by the doctor who performed the examination before or during the creation of the report, and the endoscopic image displayed on the terminal device 40 by the checked doctor is displayed at a location related to the affected part. The mark is overwritten. For example, marks indicating a biopsy site, a bleeding site, and a tumor position in the endoscopic image are drawn on the endoscopic image. Information on the marks overwritten on the image by the doctor (specifically, the mark type and coordinate position) is added to the image file as metadata.

  When the transmission request reception unit 821 of the medical image management system 80 receives the transmission request for the identification information of the endoscopic image and the attention area information of the image from the terminal device 40, the attention area detection unit 822 displays the attention area of the image. Is detected. As described above, when metadata is added to the image, a region of interest is detected from the metadata. Further, the attention area detection unit 822 may detect a location related to the affected part by image recognition from the endoscopic image. For example, a tumor position can be detected by matching with tumor pattern data. Further, the bleeding site can be detected based on the density information of the red component in the image.

  The attention area information notification unit 823 notifies the terminal device 40 of attention area information including the position of the attention area detected by the attention area detection unit 822. The compression rate determination unit 424 of the terminal device 40 makes a transmission request to the medical image management system 80 based on the attention area information notified from the medical image management system 80 and the communication speed detected by the line speed detection unit 422. Determine the compression ratio of the image.

  In this embodiment, the data amount of the entire region of the image is not compressed, but the data amount of the attention region including the important portion is not compressed, and the data amount of the non-attention region not including the important portion is compressed. The compression rate determination unit 424 determines the compression rate of the non-attention area from the ratio between the attention area and the non-attention area and the communication speed. Since the area that can be compressed increases as the ratio of the non-target region to the entire region increases, the data compression rate of the non-compressed region can be reduced. Conversely, the smaller the ratio of the non-target area to the entire area, the smaller the area that can be compressed. In addition, the higher the communication speed, the smaller the latency, and a larger amount of data can be sent in a short time, so the data compression rate can be reduced. On the other hand, the slower the communication speed, the higher the latency, making it impossible to send a large amount of data in a short time. Therefore, the data compression rate is increased to reduce the image data amount.

  The transmission request unit 423 notifies the medical image management system 80 of compression information corresponding to the compression rate determined by the compression rate determination unit 424. As the compression information, the determined compression rate may be sent as it is, or compression mode information corresponding to the determined compression rate may be sent.

  The non-attention area compression unit 824 of the medical image management system 80 compresses the data of the non-attention area of the image based on the compression information notified from the transmission request unit 423. For example, when the image is in JPEG format, the data amount of the non-target area is compressed by increasing the quantization step of the non-target area. The quantization step is increased as the compression rate notified from the terminal device 40 increases. When the image is in the BMP format, the data amount of the non-target area is compressed by omitting the lower bits of the pixel data of the non-target area. As the compression rate notified from the terminal device 40 increases, the number of lower bits to be omitted is increased. Note that the file format of the image and the compression method of the attention area are examples, and any of the existing file format and compression method may be adopted.

  The image transmission unit 825 transmits the image data in which the data amount of the non-target region is compressed by the non-target region compression unit 824 to the terminal device 40. The display control unit 425 of the terminal device 40 decompresses and decodes the image data received from the medical image management system 80 and causes the display unit 44 to display the image data.

  FIGS. 4A and 4B are diagrams illustrating an example of an endoscopic image 90 including an attention area and a non-attention area. An endoscopic image 90 shown in FIG. 4A is divided into a plurality of regions. Specifically, it is divided into 5 parts each in the horizontal direction and the vertical direction, and the area is divided into 25 blocks as a whole. In the endoscopic image 90, three biopsy marks 91a to 93a indicating biopsy locations drawn by a doctor's operation are added. The attention area detection unit 822 detects a block including a mark drawn by a doctor's operation and its surrounding blocks as the attention area. In FIG. 4A, the attention area detection unit 822 detects an area formed by 9 (= 3 × 3) blocks around the block including the biopsy mark 91a as the attention area 91b. Similarly, attention areas 92b-93b are detected for the biopsy marks 92a-93a. In addition, the designer can arbitrarily set the authorization rules for the peripheral blocks.

  FIGS. 5A to 5B are diagrams showing another example of the endoscopic image 94 including the attention area and the non-attention area. The endoscopic image 94 shown in FIG. 5A is also divided into 25 blocks. In the endoscopic image 94, two biopsy marks 95a to 96a that are drawn by a doctor's operation and indicate biopsy locations are added. The attention area detection unit 822 detects an area formed by 9 (= 3 × 3) blocks around the block including the biopsy mark 95a as the attention area 95b. Similarly, the attention area 96b is detected for the biopsy mark 96a.

  FIG. 6 is a table that defines an example of the relationship between the ping response speed between the terminal device 40 and the medical image management system 80, the area ratio of the non-attention area to the entire image area, and the compression ratio of the non-attention area. In the example of FIG. 6, the ping response time is defined as an average of four times. In the example shown in FIG. 4A, when the ping response speed is 22 ms, the area ratio of the non-target area is 28%, and therefore, the compression ratio of the non-target area is 40% with reference to FIG. FIG. 4B shows the data compression rate of each block.

  In the example shown in FIG. 5A, when the ping response speed is 33 ms, the area ratio of the non-attention area is 44%. Therefore, referring to FIG. 6, the compression ratio of the non-attention area is 50%. FIG. 5B shows the data compression rate of each block.

  FIG. 7 is a flowchart showing a flow of image data transmission processing between the terminal device 40 and the medical image management system 80. The line speed detection unit 422 of the terminal device 40 transmits a ping to the medical image management system 80 (S10). A ping response unit (not shown) of the medical image management system 80 transmits a ping response to the terminal device 40 (S11). The transmission request unit 423 of the terminal device 40 transmits the identification information of the image to be transmitted and the transmission request of the attention area information of the image to the medical image management system 80 (S12).

  The attention area detection unit 822 of the medical image management system 80 detects the attention area of the image, and the attention area information notification unit 823 notifies the terminal device 40 of attention area information including information on the attention area (S13). The compression rate determination unit 424 of the terminal device 40 calculates the compression rate of the non-attention area of the image based on the ping response speed and the attention area information (S14). The transmission request unit 423 notifies the medical image management system 80 of compression information corresponding to the calculated compression rate (S15). The non-attention area compression unit 824 of the medical image management system 80 compresses the non-attention area of the image based on the compression information (S16). The image transmission unit 825 transmits the image data in which the non-attention area is compressed to the terminal device 40 (S17). The display control unit 425 of the terminal device 40 displays the received image data on the display unit 44 (S18).

  As described above, according to the present embodiment, the terminal device 40 receives image data from the medical image management system 80 by adjusting the compression rate of the image data acquired from the medical image management system 80 according to the line speed. The delay when acquiring and displaying the preview can be reduced. When compressing image data, compress the data of the non-attention area without compressing the data of the attention area including the part related to the affected area, thereby reducing the data amount of the entire image without degrading the image quality of the attention area. Can be reduced.

  On the examination report creation screen, a large number of endoscopic images of the patient who is the subject of the examination may be displayed in a list. When the communication speed between the terminal device 40 and the medical image management system 80 is slow, it takes time to acquire a large number of endoscopic images and display all of them, and stresses the doctors and nurses who are users. Become. In this regard, according to the present embodiment, when the communication speed is low, display delay can be suppressed by increasing the compression rate of the image data and reducing the data amount. In addition, since the image quality of important portions in the image is maintained, adverse effects on medical work can be minimized. A doctor or nurse who is a user can operate the operation input unit 45 as necessary to notify the medical image management system 80 of a transmission request for non-compressed image data. The system 80 transmits uncompressed image data to the terminal device 40.

  The present invention has been described based on the embodiments. This embodiment is an exemplification, and it will be understood by those skilled in the art that various modifications can be made to combinations of the respective constituent elements and processing processes, and such modifications are also within the scope of the present invention. is there.

  FIG. 8 is a diagram illustrating a configuration of the medical service support system 1 according to the modification. Although FIG. 1 shows a configuration in which the medical image management system 80 is installed in the hospital, the medical image management system 80 may be constructed in a server outside the hospital connected via the Internet 3 or a dedicated line. In this case, since the transmission distance between the terminal device 40 and the medical image management system 80 becomes long, the image data compression technique according to the present embodiment becomes more effective.

  In the above-described embodiment, the example in which the line speed detection process and the compression rate determination process are performed on the terminal device 40 side has been described. In this regard, the line speed detection process and the compression rate determination process may be performed on the medical image management system 80 side. In this case, it is only necessary to notify the medical image management system 80 from the terminal device 40 of an image transmission request including image identification information.

  In the above-described embodiment, the compression rate of the non-target region is uniform in all blocks, but the compression rate may be weighted. For example, the compression rate determination unit 424 may decrease the compression rate for blocks closer to the attention region among the blocks belonging to the non-target region, and set the compression rate higher for blocks farther from the attention region.

  In the above-described embodiment, an area including an important part in one endoscopic image is set as an attention area. However, a plurality of endoscopic images held in the medical image storage unit 831 are focused on an image basis. You may classify | categorize into an image and an unattended image. For example, an endoscopic image to which a flag of a report attached image is added among a plurality of endoscopic images may be selected as the attention image. An endoscopic image of a patient who has an order for examination or treatment may be selected as the attention image. The medical image management system 80 transmits the endoscopic image selected as the target image to the terminal device 40 without compression. The endoscopic image selected as the non-focused image is transmitted to the terminal device 40 after being subjected to the above-described compression. Note that the endoscopic image selected as the non-attention image may be uniformly compressed without selecting the attention area and the non-attention area. Further, the attention area may be compressed at a compression rate lower than the compression ratio of the non-attention area while selecting the attention area and the non-attention area.

  DESCRIPTION OF SYMBOLS 1 Medical work support system, 5 Endoscope department system, 2 Network, 10 Endoscope system, 11 Endoscope, 12 Endoscope processing apparatus, 13 Display apparatus, 30 Endoscope work support apparatus, 40 Terminal apparatus , 41 communication unit, 42 control unit, 421 operation reception unit, 422 line speed detection unit, 423 transmission request unit, 424 compression rate determination unit, 425 display control unit, 43 storage unit, 44 display unit, 45 operation input unit, 50 Cleaning device, 60 gateway device, 70 hospital information system, 80 medical image management system, 81 communication unit, 82 control unit, 821 transmission request receiving unit, 822 attention region detection unit, 823 attention region information notification unit, 824 non-attention region compression Unit, 825 image transmission unit, 83 storage unit, 831 medical image recording Part, 85 operation input unit.

Claims (2)

An image display device connected to an image storage device via a network,
A transmission request unit for transmitting to the image storage device a transmission request for identification information of the endoscope image to be transmitted to the image storage device and attention area information of the endoscopic image;
A communication speed detecting unit for detecting a communication speed between the image display device and the image storage device;
The image storage device receives attention area information including information related to the attention area set in an area including a biopsy site, a bleeding site, or a tumor site in the endoscopic image from the image storage device, In the endoscopic image, an attention area for which the data amount is uncompressed, a ratio of the non-attention area for compressing the data amount, and a compression rate determination unit that determines the compression rate of the non-attention area from the communication speed
A compression information notification unit for notifying the image storage device of compression information corresponding to the compression rate;
An image display device comprising: An image storage device connected to an image display device via a network,
A transmission request receiving unit that receives identification information of an endoscopic image and a transmission request of attention area information of the endoscopic image from the image display device;
A region of interest detection unit that detects a region including a biopsy site, a bleeding site, or a tumor site in the endoscopic image as a region of interest;
An attention area information notification section for notifying the image display device of attention area information including information on the attention area detected by the attention area detection section;
From the image display device, from the endoscopic image, the attention area where the data amount is uncompressed, the ratio of the non-attention area where the data amount is compressed, and the communication speed between the image display device and the image storage device A compression unit that receives compression information corresponding to the calculated compression rate from the image display device, and compresses the data amount of the non-target region according to the compression rate of the non-target region;
An image transmission unit for transmitting an endoscope image in which the non-attention area is compressed to the image display device;
An image storage device comprising: