pacs - Brief Introduction
Network1PACS Used in hospital imaging departments, initially mainly used in radiology, after the development of recent years, PACS has been from the simple image storage and communication between a few radiological imaging equipment, expanding to all imaging equipment in the hospital and even different hospitals image of the interoperable, so there are many classifications, such as networking of a few radiological equipment known as Mini PACS (micro PACS); Radiology Department All imaging equipment networking Radiology PACS (Radiology PACS); hospital-wide holistic PACS, the realization of hospital-wide imaging resources **** enjoyment, known as Hospital PACS. PACS with the degree of integration of RIS and HIS has become an important measure of functionality and important standards. the future of PACS will be the formation of regional PACS, the formation of the region, PACS network across the regional wide area network, to realize the network of medical images of the whole society.
Because PACS needs to be connected to all the imaging equipment in the hospital, there must be a unified communication standard to ensure that imaging equipment from different manufacturers can be interconnected. To this end, the ACR-NEMA Digital Imaging and Communication Standards Committee was established in 1983 at the initiative of the Radiological Society of North America (ACR). Numerous manufacturers responded to its initiative and agreed to adopt a common interface standard in their medical radiology equipment so that imaging equipment from different manufacturers could exchange image data with each other. 1985, ACR/NEMA version 1.0 standard was released; 1988, the standard was revised again; 1992, ACR/NEMA version 3 was officially renamed DICOM 3.0 ( Digital lmaging and Communication in Medicine), which can be translated into Chinese as "Digital Imaging and Communication in Medicine Standard". DICOM3.0 has been generally followed by international medical imaging equipment manufacturers, and the imaging equipment produced by them all provide the DICOM3.0 standard communication protocol. Imaging devices that comply with this standard can communicate with each other and can be interconnected with other network communication devices.
The DICOM3.0 standard, which must be supported on the output and input of the system, has become the international norm for PACS. Only PACS built under the DICOM3.0 standard can provide users with the best system connectivity and extended functionality.
pacs - Communication Technology
Network 2 Information technology is the foundation of modern civilization, an important means of support for scientific research and technology development, and a key technology in high technology. The development of information technology has a direct impact on the changes in social productivity and comprehensive national power.
In the past 50 years, due to the rapid development of semiconductor, computer and communication technologies, digitalized information has penetrated into various fields closely related to people's lives. In the field of medical image processing, with the rapid development of radiology (Radiology), a variety of body imaging technologies are provided for medical diagnosis, such as: CT, MRI, DSA (Digital Subtraction), NM (Nuclear Medicine Imaging), US (Ultrasound Scanning Visualization Device), CR (Computerized Projection Radiography), PET (Positron Emission Tomography X-ray), and so on. These new medical imaging technologies provide rich imaging information for clinical diagnosis and improve the diagnosis and treatment level of medical institutions to a considerable extent, but at the same time, they also make the problem of how to effectively manage, process and utilize a large amount of complicated medical image information increasingly prominent and urgently need to be solved.
The rapid development of computer technology, especially high-speed computing equipment, network communications and image acquisition, processing software and hardware technology, a series of breakthroughs for the digital acquisition of medical images, storage, management, processing, transmission and effective use of digital technology to provide a realistic foundation.
PACS system (Picture Archiving & Communication System), i.e., medical image storage and transmission system, which is a combination of radiology, imaging medicine, digital image technology, computer technology and communication technology, which transforms the medical image information into a computerized digital form, and completes the processing of the image information through the high-speed computing device Through the high-speed computing equipment and communication network, it completes the functions of collecting, storing, managing, processing and transmitting the image information, which makes the image information be effectively managed and fully utilized.
PACS main application direction: equipment cluster use: from a variety of imaging equipment or digital equipment to collect images; photo and print a variety of output devices such as *** enjoy and choose; image transmission and distribution: rapid transmission of image data between the departments in the hospital; remote transmission of images and diagnostic reports, etc.; auxiliary medical functions: management, processing, transformation of medical image data. (medical image acquisition and digitization, image storage and management, high-speed transmission of digitized medical images, digital processing and reproduction of images, and integration of image information with other information). In the second-generation PACS system, it has been expanded to a seamless connection of HIS-PACS, turning patient flow into information flow, and focusing on the core of hospital clinical business process reengineering. With the second generation PACS system, it can be easily realized . Paperless and filmless, reduce hospital operating costs, improve overall hospital efficiency, improve the quality of clinical diagnosis, and realize telemedicine.
In layman's terms, the emergence of PACS systems is similar to the replacement of film cameras with digital cameras. In the past, when patients underwent imaging tests (such as fracture films), they had to wait for the film to be developed before the doctor could diagnose them. But now directly from the examination equipment to read out the image to the computer to observe the diagnosis, greatly improving the efficiency of the PACS system extends to the hospital's other work is also digitized management (such as medical records book is no longer handwritten, the checklist is no longer handwritten, statistics on the workload of the doctor is no longer relying on nurses to count manually)
pacs - System Composition
Systems in accordance with the size of the size of image archiving and transmission system (PACS), the system will be able to provide a more accurate picture of the patient. and transmission system (PACS) can be divided into four main categories: departmental; hospital image distribution system; the entire hospital PACS system; hospital-wide PACS-based remote radiology system.
Based on the need to solve different problems, there are a variety of PACS system design solutions, but in general, the PACS system consists of imaging acquisition equipment, remote and near-range display equipment, storage equipment and remote and near-range communication equipment and other four parts. Imaging acquisition equipment, including various types of tomography imaging systems and various radiographic technology to form the film and other hard-copy digital scanning acquisition equipment; image display equipment, including a variety of image terminals, image workstations; image storage equipment, including hard and soft disks, tapes and CD-ROMs, and other storage equipment; communications equipment, including modems, network cards, telephone switching systems, computer local networks, wide-area networks, public data networks and other hardware communication modules and equipment. PACS provides four main functions in the field of medical information: observation of medical images on diagnostic, reporting, consultation and remote workstations; storage of images in storage media suitable for short-term or long-term preservation according to the nature of the images; communication using local area networks (LANs), wide area networks (WANs), and public ****communication facilities; and the provision of an integrated information system to the user.PACS aims to To promote the formation of a digital hospital environment, improve diagnostic efficiency, and reduce costs. Relative to the traditional film-based medical image system, filmless PACS has numerous advantages: digital images instead of film reduces the cost of manufacturing and purchasing film and the corresponding chemicals; filmless archiving, which saves the original hardcopy and the related management costs, manpower and space, reduces the number of staff managing the film, and there will no longer be a loss of film, misplaced, aging and other issues, which Greatly reduce the cost of hospitals, can be more effective use of the huge medical image resources to provide better service to patients, but also to achieve a more efficient, low-cost observation, storage and transmission of medical images. At the same time, the use of advanced computer storage and powerful image compression and network transmission capabilities, has been stored on the image of multiple copies of the image becomes simple and direct, rapid access to the image, according to the diagnosis of the need to be flexible to deal with the image, can be realized within the hospital and even remote hospitals between the medical image information **** enjoyment, to facilitate the provision of telemedicine services.
pacs - key technologies
Key technologies PACS involves a number of technologies, which include: computers, communications, file storage, data acquisition, display, image data compression, artificial intelligence, optoelectronic devices, software, standardization and system integration. key technical issues involved in PACS standardization technology: the application of standardization technology is very important in the establishment of PACS. important. Due to the different image formats of imaging equipment produced by various manufacturers, the network interface standards are inconsistent, which hinders the exchange and communication of medical digital images; acquisition of digital image information: first of all, it is necessary to realize the digitization of images.CT, MRI, DSA, CR, DR and some ultrasound imaging are already digital imaging, and through the acquisition of the interface module or device, the digital image information can be taken out of the host computer and constitute a data file to the storage device. constitute a data file to the storage device for display or transmission. A large number of X-ray imaging systems are still in the non-digital image stage, and digitizers are usually purchased to digitize them. Due to the different image formats of various imaging devices produced by various manufacturers, the network interface standards are inconsistent, hindering the exchange and communication of medical digital images; image compression technology: the amount of medical image data is large, and the establishment of PACS in many technical difficulties are related to image compression, transmission, display and so on. How can the image compression, is one of the focus of many years of image processing technology research, due to the medical image of medical diagnosis of the reliability of the impact is very large.
Commonly used only lossless compression algorithms; medical image archiving and management: after the realization of the digital image, it can be stored in categories in computer media, such as disks, CD-ROMs, especially CD-ROM memory, with its affordability is widely used. A CD-ROM can store hundreds of images; medical image display and communication technology: computer technology for medical image observation provides a "digital information monitor" combination mode, greatly facilitating and accelerating the formation of medical image resources, turnover and access. Computer hardware and software technology and multimedia technology, so that the medical image display image monitors and image workstations can almost instantly display the entire image. Medical image communication, first of all, through the local area network in the hospital to realize the patient image information access, followed by a dedicated network or the Internet to realize the image of the remote call and off-site diagnosis.
pacs - development
System composition PACS is a modern mode and trend of diagnostic imaging, is a high-tech with brilliant prospects, its development and popularization will play a significant role in promoting the development of medicine. The traditional way of copying medical images into an electronic soft copy way to promote the application of PACS in the hospital is very necessary, with the progress of digital imaging technology, computer technology and network technology, many hospitals in China, its imaging equipment is gradually updated to digital, the application and popularization of PACS has become an unstoppable trend of modern medical. In the 1990s, in order to improve the hospital's modern management level and work efficiency, medical institutions at all levels have paid great attention to the construction of hospital information systems, and many hospitals have established hospital information systems of different scales. As far as the development of hospital information system is concerned, most of the hospital information system belongs to the category of Hospital Information System (HIS), which mainly focuses on the financial management of hospital personnel; while PACS, which is also an important part of the digital hospital environment, is relatively slow to develop.
China's PACS system development also exists the following problems: little research and development funds; most hospitals have outdated medical image equipment, few standard digital interfaces, especially the ability to use the network to transmit medical images of the equipment is even more rare; hospitals are backward in the construction of information infrastructures, and most of the medical staff are unfamiliar with the computer application environment; the development of the HIS/RIS system often ignored the standardization problem, and it was difficult to develop a standardized HIS/RIS system. system often ignored the standardization problem, it is difficult to carry out integration with PACS system; most of the imaging equipment is imported from abroad, in such an environment, PACS development and application process needs to be considered in the Chinese culture. the development of PACS should be focused on: the improvement of the information infrastructure of the hospital; the transformation of the old image equipment; the standardization of the existing hospital information system. As the research on PACS in China is still in the primary stage, various technical problems will be encountered when constructing PACS.
In the design of the PACS system should be fully considered when the system to achieve the function of the choice of size should be fully considered the actual conditions of the hospital do not rush. Large hospitals with strong funds due to the work carried out earlier in this regard, and has constituted a small or part of the PACS, then you can consider the establishment of a more complete PACS. small and medium-sized hospitals due to financial and technical reasons, it is best to first build a small or part of the PACS on the one hand to accumulate experience, rather than just catching up with the fashion. Hospitals can build different sizes of PACS systems according to their own conditions and needs, and gradually over to the digital hospital. Especially important is that the development of the field of medical imaging is closely related to the progress of technology, the progress of the field of medical imaging is the actual requirements of hospitals, universities and other research institutions, technology development and business objectives of enterprises to promote each other's results, PACS system development and application of the same need for hospitals, research institutions and the business community's strong support and good cooperation.
pacs - Outlook
System Components PACS originally evolved from processing digital images in radiology departments. However, with the process of PACS standardization, especially ACR-NEMA (American College of Radiology ＆ National Electrical Manufactures ′ Association, American College of Radiology and National Electrical Manufactures ′ Association ) DICOM (digital The general acceptance of the DICOM (digital imaging and communications in medicine) 3.0 standard has expanded PACS to all areas of medical imaging, such as cardiology, pathology, ophthalmology, dermatology, nuclear medicine, ultrasound, and dentistry.
In the hospital management system of the 21st century, PACS systems will occupy a dominant position in medical diagnostic analysis.
PCAS system in the application involves digital storage of images, no film management, saving a lot of manpower and material resources for developing, preserving film and records; such as: the cost of chemicals, processing and maintenance costs, storage costs, placement costs, labor costs, access to the costs, delivery costs; can provide more doctors networked collaborative work; to provide remote consultation function, saving manpower and material resources, and can improve the hospital's consultation capacity. At the same time, it can improve the hospital's consultation ability and expand its popularity. It can realize the automation of data statistics, which is of great significance for scientific research and analysis, and at the same time, it can carry out statistics on the workload and status of the departmental staff, which can discover the weak links of management, better evaluate the staff, motivate the staff, and create greater benefits for the department. Diagnostic reports can be standardized, print out illustrated medical records, while generating electronic medical records, the formation of community electronic medical records center, to provide patients with electronic medical records to store query services to increase the impact on the user. *** Enjoy output devices, saving equipment investment, such as laser cameras, DICOM cameras, etc.. Reduce, eliminate duplicate work. Higher productivity , lower running costs and more revenue. No more lost inspection materials and films.
For the clinic: Provide faster and more efficient access to patient information. Provide more medical services by joining forces with neighboring hospitals. Convenient for clinicians to access patient information at any time.
For radiologists: convenience. Read films at home or in the office, without having to squeeze into a centralized reading area Quickly get the patient's previous films. Exam data is available in seconds. A variety of images, such as ultrasound, MRI, CT, DSA, etc. can be directly referred to the comparison, and the corresponding image processing, easy to diagnose. Reduces workload and improves work efficiency. Images can be utilized permanently. Directly get the original image without distortion for academic communication.
For patients: Reduce hospitalization time. Faster diagnosis and treatment. Simultaneous reference to multiple test results. Faster reporting time. Ability to get expert services .
Auxiliary medical functions: management, processing and transformation of medical image data.