1. 1 What is a PACS system?
PACS (Picture Archiving and Communication System) is usually called medical image computer archiving and transmission system or medical image system, which is an important part of hospital information system. It uses computer and network technology to digitize medical images, and its goal is to replace the current analog medical image system. It mainly solves five problems: the collection and digitization of medical images, the storage and management of images, the high-speed transmission of digital medical images, the digital processing and reproduction of images, and the fusion of image information with other information. PACS follows the international medical imaging standard DICOM 3.0.
The origin and history of 1.2 PACS system
The concept of PACS was put forward in the early 1980s. The idea of establishing PACS is mainly caused by two main factors: first, the emergence of digital imaging equipment, such as CT equipment, so that medical images can be obtained directly from inspection equipment; The other is the development of computer technology, which enables the storage, communication and display of large-capacity digital information to be realized. In the early 1980s, the hospital management information system based on large computers in developed countries such as Europe and America has basically completed the research stage and turned to implementation. In the mid-1980s, the research work gradually turned to medical service systems, such as clinical information system and PACS. Laboratories and experimental systems for PACS research have been established in Europe, Japan and the United States. With the development of technology, some practical PACS have been established in the early 1990s.
In the middle and late 1980s, the medical imaging system mainly used special equipment, and the price of the whole system was very expensive. By the mid-1990s, the appearance of computer graphics workstations and the development of network communication technology made the overall price of PACS drop. In the late 1990s, with the rapid improvement of microcomputer performance and the rapid development of network, PACS can be established at a level that can be accepted by more hospitals.
The digital image format produced by early digital medical imaging equipment is a proprietary format determined by various equipment manufacturers and cannot be used by others. This problem has greatly affected the development of PACS, and attracted the attention of scholars, manufacturers, academic and industry groups committed to medical imaging research. 1982, American Radiological Society (ACR) and Electrical Appliance Manufacturing Association (NEMA) jointly organized a research group. 1985 formulated a set of format standards for digital medical images, namely ACR-NEMA 1.0 standard, and then 1988 completed ACR-NEMA 2.0. With the development of network technology, people realize that it is not enough to have only image format standards, and communication standards also play a very important role in PACS. Subsequently, in 1993, ACR and NEMA added communication specifications on the basis of ACR-NEMA 2.0 standard, and modified the definition of some information in image format according to the E-R model of image inspection information flow characteristics, and formulated DICOM 3.0 standard. This standard has been accepted by the world's major medical imaging equipment manufacturers, so it has become a de facto industrial standard.
In recent years, DICOM environment has been specially provided at the annual North American Radiology Conference to organize the interconnection of imaging equipment among manufacturers. With the continuous development of application, DICOM standard is constantly updated, and the types of medical images it supports are also increasing. It has been extended from the original ACR-NEMA standard to only support radiological images to support endoscopy, pathology and other images. Some scholars are studying the processing of medical graphics, sounds and other information, while others are studying the communication between DICOM and other medical information transmission standards such as HL7. People have realized that medical imaging system should be an important part of hospital information system, and PACS should communicate with other systems to form a complete hospital information.
The development trend of 1.3 PACS system
His (Hospital Information System)-Hospital Information System
Ris (Radiological Information System)-Radiological Information System.
Fusion of PACS and HIS /RIS
For many years, although PACS and HIS /RIS have been independently developed with different standards, their trend is to eventually integrate with each other in the whole development process. The reason for this is the following：
(1) From the perspective of HIS /RIS, the development of technology requires that the medical information in HIS /RIS should include not only digital and written records, but also graphics, images and sounds. PACS is the source of diagnostic images, so HIS /RIS needs to integrate PACS.
(2) According to the development demand of PACS, if the patient statistics can be obtained directly from HIS /RIS, it will avoid entering such information repeatedly, improve the efficiency of the hospital and reduce data loss.
Advantages of 1.4 PACS system
-Improve the quality of hospitals.
-Save manpower
-Save movie costs.
—— Save technician's operation time.
-saving patient waiting time
-Enjoy the information of the hospital.
-Improve the efficiency of imaging instruments.
-Realize real remote consultation and medical treatment.
1.5dicon standard
DICOM (Medical Digital Imaging Communication) is a communication standard between medical imaging instruments and software. This standard is the current international standard for medical image communication and storage. As long as the instrument or software meets this standard, it can be connected to PACS network system.