基于區(qū)域平臺的PACS影像系統(tǒng)應(yīng)用

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摘要 隨著國內(nèi)醫(yī)療體制的逐步完善與醫(yī)療市場的進一步開放，數(shù)字化醫(yī)院越來越成為社會關(guān)注的熱點，成為影響醫(yī)療水平，服務(wù)質(zhì)量和醫(yī)院競爭力的重要因素。目前，醫(yī)院的HIS(醫(yī)院信息系統(tǒng))、LIS（檢驗科信息系統(tǒng)）已相當成熟，支撐著醫(yī)院正常運作；然而，由于像RIS（放射科信息系統(tǒng)）、PACS（圖像歸檔與通信系統(tǒng)）等信息系統(tǒng)涉及到各種醫(yī)療信息的集成問題，一直以來都沒有得到很好的應(yīng)用。
本文著重對平臺建設(shè)和遠程會診系統(tǒng)應(yīng)用進行研究和學習，通過對HL7和DICOM標準的剖析，充分吸收了IHE技術(shù)框架的設(shè)計思想，提出了一個數(shù)字化醫(yī)院的解決方案。
為了實現(xiàn)醫(yī)療數(shù)據(jù)的交換與共享，國外的一些權(quán)威機構(gòu)已經(jīng)制定了一些行業(yè)標準，如HL7和DICOM。隨著越來越多的設(shè)備供應(yīng)商和軟件開發(fā)商對標準的遵循，使得原先各自獨立的醫(yī)療信息的共享成為可能。
對于異構(gòu)醫(yī)療信息系統(tǒng)之間的集成來說。這些醫(yī)療數(shù)據(jù)交換標準是必須的，但尚不足夠。在醫(yī)療環(huán)境中很多醫(yī)療信息系統(tǒng)雖然應(yīng)用了HL7、DICOM等標準，但是它們的實現(xiàn)方式各不相同，導(dǎo)致它們實際上并不能互相通訊，很多時候仍舊不得不依賴手工方式。為此，RSNA和HIMSS于1998年聯(lián)合發(fā)起了IHE(Integrating the Healthcare Enterprise)項目。它是一項推進整合現(xiàn)代醫(yī)療保健機構(gòu)信息系統(tǒng)的倡議，其基本目標是確保提供給醫(yī)療保健專業(yè)人員對病人診斷必需的所有信息是正確的、可用的。IHE倡議既是鼓勵整合的一個過程，也為其提供了一個論壇。為了獲得特定的臨床應(yīng)用目標，它在現(xiàn)有消息通訊標準（如DICOM和HL7）的基礎(chǔ)上定義了一個技術(shù)框架，其中包含了為實現(xiàn)這個框架的一個嚴格的驗證過程。
基于HL7等標準，建立區(qū)域衛(wèi)生信息平臺，消除信息“孤島”，從而實現(xiàn)區(qū)域內(nèi)的醫(yī)療信息互聯(lián)互通。區(qū)域平臺的建設(shè)是使用符合國際和國家信息標準的HIE(Healthcare Information Exchange，衛(wèi)生信息交換平臺)的技術(shù)方案，將各業(yè)務(wù)子系統(tǒng)、醫(yī)療機構(gòu)、醫(yī)療保險組織和區(qū)域衛(wèi)生管理系統(tǒng)無縫鏈接，讓信息得以在各個體系內(nèi)互聯(lián)互通。

關(guān)鍵字 圖像存檔通信系統(tǒng)，醫(yī)用信息系統(tǒng)集成，衛(wèi)生信息交換平臺，醫(yī)學數(shù)字成像與通信標準，PACS，應(yīng)用

Based on the regional platform system application of PACS image
Abstract With the improvement of domestic medical system and further opening of medical market, digitalized hospital has become the cynosure of the society and an important factor which affects the level of medical treatment, service quality and competition ability of hospital. Recently, HIS and LIS have matured, supporting the daily operation of hospital. However, the applications of information systems such as RIS, PACS still cannot be well achieved, because they involve problems relating to the integration of diverse medical information.
This article through to the HL7 and DICOM standard, fully absorb the design idea of IHE technical framework, put forward a solution of digital hospital, and focus on study and application of PACS image based on the regional platform are introduced.
To achieve the exchange and share of medical data, some authoritarian structures have established a series of standards, such as HL7 and DICOM. With more and more equipment venders and software development corporations following these standards, the share of independent medical information becomes possible.
For the integration of heterogeneous medical information systems, these data exchange standards are indispensable and far from enough. Standards such as DICOM, HL7 etc. have been applied in many medical information systems, but in fact they cannot communicate with each other for their different ways of implementation. Therefore the exchange of information still relies on manual operation in many cases. For this reason RSNA and HIMSS jointly launched IHE(Integrating the Healthcare Enterprise) project in 1998. It is an initiative designed to stimulate the integration of the information systems that support modern healthcare institutions. Its fundamental objective is to ensure that in the care of patients all required information for medical decisions is both correct and available to healthcare professionals.
Based on HL7 standard, the establishment of regional health information platform, elimination information ”isolated island”, so as to realize regional medical information connectivity. Regional platform construction is the use of information with international and national standards of HIE (Healthcare Information Exchange) of the technical scheme, each business subsystem, medical institutions and medical insurance organization and regional health management system seamlessly, allowing information to connectivity within the system.
Keywords Picture Archiving and Communication System（PACS），Integrating the Healthcare Enterprise（IHE），Healthcare Information Exchange（HIE），Digital Imaging and Communication in Medicine（DICOM），PACS，Application

目錄
第一章 緒論 1
1.1 PACS的概念 1
1.2 PACS的發(fā)展歷程[4][5] 4
1.3 PACS國內(nèi)外發(fā)展狀況研究 5
1.3.1 國外發(fā)展狀況研究[6] 5
1.3.2 國內(nèi)發(fā)展狀況研究 6
第二章PACS相關(guān)標準的研究 9
2.1 HL7標準[12] 9
2.1.1 HL7的概念 9
2.1.2 HL7的組成 9
2.2 DICOM標準 10
2.2.1 DICOM的概念 10
2.2.2 DICOM的組成[17][18] 11
2.2.3 DICOM的相關(guān)概念[19][20][21..