IHE论文：IHE DICOM 医学影像数据库
亲历IHE测试：从技术准备到体验总结
亲历IHE测试：从技术准备到体验总结一、IHE简介IHE(Integration Healthcare Enterprise)中文常翻译为集成企业医疗。
IHE概念是由美国的医学专家和相关政府部门、信息技术专家和企业共同发起的，目的是提供一种更好的方法让医学信息系统之间更好地进行集成。
1998年，RSNA和HIMSS两个组织牵头，组织有关学会和设备厂商共同建立了IHE。
IHE不是一个组织，是一个用户、厂商、以及顾问机构共同定义基于标准的医疗保健工作流程的国际合作。
至今，IHE没有成立自己的组织，而是通过其发起单位HIMSS和RSNA 开展活动，这就是为什么大家经常可以看到在RSNA期间举Connectathon测试或者在HIMSS期间会举办IHE Interoperability Showcase的活动。
以下都是IHE活动的一部分。
1.动员用户要求厂商寻求IHE方案(IHE教育);2.通过T echnical Framework定义和促进每年的增长目标;3.IHE 通过RSNA IHE 网站促使厂商应用IHE方案(集成声明和成功故事);4.提供标准测试工具使得厂商易于评估其一致性;5.IHE在各种全球性的贸易展览中提供教育报告，如RSNA、HIMSS、ACR、ECR、SCAR、SPIE等;6.通过与不同的国际卫生保健社团(如美国RSNA/HIMSS/ACC，欧洲COCIR，日本JIRA)合作，实现全球化的技术框架(Technical Framework)。
IHE的技术框架是一种详细的、严格组织的文档，这些文档提供了一种容易理解的指导，以便完成特定的系统整合。
技术框架从系统交互的观点出发，把所有的医疗过程抽象成一个个子框架，每个子框架由一些医疗事务以及参与事务的多个独立功能单元组成。
这些功能单元在子框架中被称为角色(Actors)。
事务(Transactions)则定义了角色间交换的信息。
IHE通过在角色间进行基于DICOM或HL7标准的数据交换，保证了系统的开放性和工作流程的自动化。
IHE-C培训内容(林国雄)
文档属性
技术参数
MIME Type：文档存储库的文档类型，如application/pdf
application/dicom Format Code：文档格式代码，如urn:ihe:rad:PDF urn:ihe:rad:TEXT Size:文档字节数 Hash:文档内容哈希值，由文档存储库计算，用于文档注 册库判断文档重复提交 Language:语言代码，参见RFC3066 URI:用于提取文档的HTTP URL，XDS.a使用，XDS.b已 废除该用法
WADO
通过Http方式返回特定格式图像：
http://wadoserver/wado?studyUID=...
参数：
Content Type => DICOM JPEG等 studyUID => 包含对象的检查的UID seriesUID => 包含对象的系列的UID objectUID => 单个对象的UID frameNumber => 被选中的帧的数目 transferSyntax 传输语法 anonymize charset 字符集
rows => 像素的最大数目（垂直） columns => 像素的最大数目（水平） annotation => 将叠加于图像上的文本（人口统
计信息和技术信息分别为“患者”和/或“技术”）
XDS-I
测试工具
/mesasoftware/13.x/dist/ind
说明(Comments) 创建时间(CreationTime) 服务开始/结束时间(ServiceStartTime) 状态(Availability Status):已提交、已审核、已废弃等
医学信息交互集成(IHE)集成模式
ProfilesFrom IHE WikiJump to: navigation, searchIHE Profiles describe the solution to a specific integration problem, and document the system roles (Actors), standards and design details for implementers to develop systems that cooperate to address that problem.IHE Integration and Content Profiles are a convenient way for implementers and users to be sure they're talking about the same solution without having to restate the many technical details that ensure actual interoperability.For convenient reference, each Profile has a short acronym.Each domain specifies a collection of Profiles for problems directly related to their domain.The Profiles listed here may be in one of three states:- Final Text - stable- Trial Implementation - frozen for trial use; changes permitted prior to Final Text- Retired/Deprecated - no longer recommended or maintained by IHEAlternatively, see the alphabetized index of Profiles.Contents[hide]∙ 1 IHE Anatomic Pathology Profiles∙ 2 IHE Cardiology Profiles∙ 3 IHE Eyecare Profiles∙ 4 IHE IT Infrastructure Profiles∙ 5 IHE Laboratory Profiles∙ 6 IHE Patient Care Coordination Profiles∙7 IHE Patient Care Device Profiles∙8 IHE Pharmacy Profiles∙9 IHE Quality, Research, and Public Health Profiles∙10 IHE Radiation Oncology Profiles∙11 IHE Radiology ProfilesThe links below provide brief overviews of each profile (based on the Profile Overview Template).IHE Anatomic Pathology Profiles[APW] - Anatomic Pathology Workflow establishes the continuity and integrity of basic pathology data acquired for examinations being ordered for an identified inpatient or outpatient. It focuses on the main transactions of the ordering, reporting and imaging aspects of the workflow.[ARPH] - Anatomic Pathology Reporting to Public Health transmits anatomic pathology reports to public health organizations (cancer registries, centers for diseases control, screening organizations, etc).[APSR] - Anatomic Pathology Structured Report provides templates for building Anatomic Pathology structured reports in all fields of anatomic pathology (cancers, benign neoplasms as well as non-neoplastic conditions).IHE Cardiology Profiles[CATH] - Cardiac Cath Workflow integrates ordering, scheduling, imaging acquisition, storage and viewing for Cardiac Catheterization procedures[ECHO] - Echocardiography Workflow integrates ordering, scheduling, imaging acquisition, storage and viewing for digital echocardiography[ECG] - Retrieve ECG for Display provides access throughout the enterprise to electrocardiogram (ECG) documents for review purposes[ED] - Evidence Documents adds Cardiology-specific options to the Radiology ED profile for DICOM Structured Reports[STRESS] - Stress Testing Workflow provides ordering and collecting multi-modality data during diagnostic Stress testing procedures[DRPT] - Displayable Reports manages creation and distribution of “display ready” (PDF or CDA) clinical reports from the creating application, to the department, and to the enterprise.[REWF] - Resting ECG Workflow workflow for collecting ECG data in both ordered and unordered procedures, data storage and access, and ECG reporting[IEO] - Image-Enabled Office Workflow integration of an imaging suite (modalities, storage server, and workstations) with an electronic health record system in an ambulatory office setting, including ordering and performance of an imaging exam, report creation, and web-based imaging exam review integration.[CIRC] - Cardiac Imaging Report Content format for a CDA report of a cardiac diagnostic imaging procedure, including discrete data elementsIHE Eyecare Profiles[EYECARE] - Eye Care Workflow manages and distributes the workflow across equipment within the eye clinic.[CHG] - Charge Posting collects and posts timely billable claims related to Eye Care procedures.[ECED] - Eye Care Evidence Documents manages observations, measurements, and peri-procedural results.[ECDR] - Eye Care Displayable Report supports the creation,query/retrieve and reading of ubiquitous display–ready eye care reports.IHE IT Infrastructure ProfilesAlphabetical by name within category.[ATNA] Audit Trail and Node Authentication Basic security through (a) functional access controls, (b) defined security audit logging and (c) secure network communications.[BPPC] Basic Patient Privacy Consents method for recording a patient's privacy consent acknolwedgement to be used for enforcing basic privacy appropriate to the use.[CT] Consistent Time enables system clocks and time stamps of computers in a network to be synchronized (median error less than 1 second).[XCA] Cross-Community Access allows to query and retrieve patient electronic health records held by other communities.[XDM] Cross-enterprise Document Media Interchange transfers documents and metadata using CDs, USB memory, or email attachments.[XDR] Cross-enterprise Document Reliable Interchange exchanges health documents between health enterprises using a web-service basedpoint-to-point push network communication.[XDS] Cross Enterprise Document Sharing share and discover electronic health record documents between healthcare enterprises, physician offices, clinics, acute care in-patient facilities and personal health records.[XDS-SD] Cross-enterprise Sharing of Scanned Documents enables electronic records to be made from legacy paper, film, and other unstructured electronic documents.[XUA] Cross-Enterprise User Assertion communicates claims about the identity of an authenticated principal (user, application, system...) across enterprise boundaries - Federated Identity.[EUA] Enterprise User Authentication enables single sign-on inside an enterprise by facilitating one name per user for participating devices and software.[MPQ] Multi-Patient Queries enables aggregated queries to a Document Registry for data analysis such as provider accreditation, clinical research trial data collection or population health monitoring.[PAM] Patient Administration Management establishes the continuity and integrity of patient data in and across acute care settings, as well as among ambulatory caregivers.[PDQ] Patient Demographics Query lets applications query by patient demographics for patient identity from a central patient information server.[PIX] Patient Identifier Cross Referencing lets applications query for patient identity cross-references between hospitals, sites, health information exchange networks, etc.[PDQv3] Patient Demographics Query HL7 v3 extends the Patient Demographics Query profile leveraging HL7 version 3.[PIXv3] Patient Identifier Cross-Reference HL7 v3extends the Patient Identifier Cross-Reference profile leveraging HL7 version 3.[PSA] Patient Synchronized Application allows cooperating applications on a workstation to synchronize to selected patient context.[PWP] Personnel White Pages provides basic directory information on human workforce members within an organization.[RID] Retrieve Information for Display provides simple (browser-based) read-only access to clinical information (e.g. allergies or lab results).[XCF] Cross Community Fetch fetches a single or small pre-negotiated list of documents from another community.[XCPD] Cross-Community Patient Discovery supports locating communities with patient electronic health records and the translation of patient identifiers across communities.[XDW] Cross Enterprise Workflow coordinates human and applications mediated workflows across multiple organizations.[DEN] Document Encryption encrypts individual documents and portable media content.[DRR] Document-based Referral Request supports referral requests that are transferred by document sharing (e.g., XDS, XDR, XDM).[DSG] Document Digital Signature is a content profile that specifies digital signatures for documents.[DSUB] Document Metadata Subscription describes the use of subscription and notification mechanism for use within an XDS Affinity Domain and across communities.[HPD] Healthcare Provider Directory supports discovery and management of healthcare provider information, both individual and organizational, in a directory structure.[NAV] Notification of Document Availability supports out-of-band notifications of documents of interest between systems or users.[RFD] Retrieve Form for Data Capture enables EHR applications to directly request forms from clinical trial sponsors and public health reporting.[SVS] Sharing Value Sets distributes centrally managed common, uniform nomenclatures.[XPID] XAD-PID Change Management Updates the relationship between XDS Affinity Domain patient identifiers and other patient identifiers.IHE Laboratory Profiles[LTW] - Laboratory Testing Workflow integrates ordering and performance of in-vitro diagnostic tests by a clinical laboratory inside a healthcare institution.[XD-LAB] - Sharing Laboratory Reports describes the content (human and machine readable) of an electronic clinical laboratory report.[LDA] - Laboratory Device Automation integrates an Automation Manager and robotic laboratory equipment (pre-analytical devices, analyzers, post-analytical devices) in a clinical lab.[LBL] - Laboratory Barcode Labeling integrates robotic specimen container labeling systems with sources of order-related labelling information.[LPOCT] - Laboratory Point Of Care Testing integrates performing and collecting the results of in-vitro testing at the point of care or patient’s bedside.[LCSD] - Laboratory Code Sets Distribution distributes managed sets of clinical laboratory codes (battery, test and observation codes).[ILW] - Inter Laboratory Workflow supports the workflow of orders and results with a subcontracting laboratory.[LAW] - Laboratory Analytical Workflow supports the workflow of test orders and results with IVD specimens on Analyzers.[LSWF] - Laboratory Scheduled Workflow is superseded by Laboratory Testing Workflow.[LIR] - Laboratory Information Reconciliation is superseded by Laboratory Testing Workflow.IHE Patient Care Coordination Profiles[MS] Medical Summaries describes the content and format of Discharge Summaries and Referral Notes.[XPHR] Exchange of Personal Health Record describes the content and format of summary information extracted from a PHR system for import into an EHR system, and visa versa.[FSA] Functional Status Assessments describes the content and format of Functional Status Assessments that appear within summary documents.[QED] Query for Existing Data queries data repositories for clinical information on vital signs, problems, medications, immunizations, and diagnostic results.[IC] Immunization Content exchanges immunization data.[CM] Care Management exchanges information between HIT systems and applications used to manage care for specific conditions.[PPOC] Patient Plan of Care exchanges data related to creating and managing individualized patient care between and among HIT systems.[RCG] Request for Clinical Guidance obtains decision support when ordering medications, determining appropriate immunizations, diagnostic tests, et cetera.[EDR] Emergency Department Referral communicates medical summary data from an EHR System to an EDIS System.Emergency Department Encounter Profiles[TN] Triage Note records the act of triaging a patient upon presentation to the emergency department.[NN] Nursing Note records the act of nursing care delivered to a patient in the emergency department.[CTNN] Composite Triage and Nursing Note records the act of both triage and nursing care delivered to a patient in the emergency department.[EDPN] ED Physician Note records care delivered to a patient in the emergency department.Antepartum Profiles[APS] Antepartum Summary records the aggregation of significant events, diagnoses, and plans of care during an antepartum episode.[APHP] Antepartum History and Physical records data often collected at the initial ambulatory office visit for a pregnant patient.[APL] Antepartum Laboratory records results from standard laboratory tests administered during an antepartum episode.[APE] Antepartum Education records educational material provided during the office visit(s) for the antepartum episode.Labor and Delivery Profiles[LDHP] Labor and Delivery History and Physical records data that is often collected during initial admission to a birthing facility.[LDS] Labor and Delivery Summary records data often collected during the labor and delivery period at a birthing facility.[MDS] Maternal Discharge Summary records data often collectedpost-delivery until discharge from the birthing facility.IHE Patient Care Device Profiles[DEC] Device Enterprise Communication transmits information from medical devices at the point of care to enterprise applications.[PIV] Point of Care Infusion Verification communicates medication orders to an infusion pump or pump management system.[IDCO] Implantable Device Cardiac Observation specifies the creation, transmission, and processing of discrete data elements and report attachments associated with cardiac device interrogations (observations) or messages.[RTM] Rosetta Terminology Mapping harmonizes the use of existing nomenclature terms defined by the ISO/IEEE 11073-10101 nomenclature standard, it is required to be used in all PCD transactions (Note: RTM is a constrained value set).[ACM] Alarm Communication Management communicates alarms, ensuring the right alarm with the right priority gets to the right individuals with the right content.[IPEC] Infusion Pump Event Communication communicates clinical and technical events from an infusion pump to an information system for recording, action or presentation to a user.IHE Pharmacy Profiles[CMPD] Community Medication Prescription and Dispense integrates prescription, validation and dispensation of medication in the ambulatory sector.[PRE] Pharmacy Prescription Document records a prescription.[PADV] Pharmacy Pharmaceutical Advice Document records pharmaceutical advice in response to a prescription.[DIS] Pharmacy Dispense Document records the dispensation of medication to a patient.[HMW] Hospital Medication Workflow integrates prescription, validation, dispensation, distribution and administration of medication inside healthcare institutions.IHE Quality, Research, and Public Health Profiles[CRD] Clinical Research Document describes the content pertinent to the clinical research use case required within the Retrieve Form forData-Capture (RFD) pre-population parameter.[DSC] Drug Safety Content describes the content pertinent to the drug safety use case required within the Retrieve Form for Data-Capture (RFD) pre-population parameter.[EHCP] Early Hearing Care Plan assists with the early detection, documentation of and intervention for hearing loss by enabling electronic communication of care plan content and instructions available to all authorized providers of care as jurisdictionally directed by the Public Health EHDI Program.[MCH-BFDrpt] Maternal Child Health-Birth and Fetal Death Reporting defines the EHR content that may be used to pre-populate and transmit birth and fetal death information to vital records systems for vital registration purposes.[PRPH-Ca] Physician Reporting to a Public Health Repository –Cancer Registry defines the data elements to be retrieved from the EMR and transmitted to the cancer registry or to a healthcare provider.[RPE] Retrieve Process for Execution enables a healthcare provider to access a process definition, such as a research protocol and to execute automated activities, without leaving an EMR session.IHE Radiation Oncology Profiles[BRTO] Basic Radiation Therapy Objects integrates the flow of treatment planning data from CT to Dose Review for basic treatments[MMRO] Multimodality Registration for Radiation Oncology integrates PET and MRI data into the contouring and dose review process.[ARTI] Advanced Radiotherapy Objects Interoperability adds additional RT treatment techniques to those defined in BRTO[TDW] Treatment Delivery Workflow standards-based radiation therapy treatment scheduling using workflow[DCOM] Dose Compositing transfers spatially-related dose information between systems.[ECSI] Enterprise-Centric Scheduling InteroperabilityIHE Radiology ProfilesProfiles for Workflow[SWF] Scheduled Workflow integrates ordering, scheduling, imaging acquisition, storage and viewing for Radiology exams.[PIR] Patient Information Reconciliation coordinates reconciliation of the patient record when images are acquired for unidentified (e.g. trauma), or misidentified patients.[PWF] Post-Processing Workflow provides worklists, status and result tracking for post-acquisition tasks, such as Computer-Aided Detection or Image Processing.[RWF] Reporting Workflow provides worklists, status and result tracking for reporting tasks, such as dictation, transcription and verification.[IRWF] Import Reconciliation Workflow manages importing images from CDs, hardcopy, XDS-I, etc. and reconciling identifiers to match local values.[MAWF] Mammography Acquisition Workflow handles mammography-specific exceptions to routine image acquisition based on Scheduled Workflow.Profiles for Content[NMI] Nuclear Medicine Image specifies how Nuclear Medicine images and result screens are created, exchanged, used and displayed.[MAMMO] Mammography Image specifies how Mammography images and evidence objects are created, exchanged, used and displayed.[ED] Evidence Documents specifies how data objects such as digital measurements are created, exchanged, and used.[SINR] Simple Image and Numeric Report specifies how Diagnostic Radiology Reports (including images and numeric data) are created, exchanged, and used.[REM] Radiation Exposure Monitoring specifies how radiation details from imaging procedures are created, exchanged and used.[PERF] CT/MR Perfusion Imaging specifies encoding of Contrast Perfusion imaging data using Enhanced CT/MR DICOM objects.[DIFF] MR Diffusion Imaging specifies encoding of MR Diffusion imaging data using Enhanced MR DICOM objects.Profiles for Presentation[KIN] Key Image Note lets users flag images as significant (e.g. for referring, for surgery, etc.) and add notes.[CPI] Consistent Presentation of Images maintains consistent intensity and image transformations between different hardcopy and softcopy devices.[PGP] Presentation of Grouped Procedures facilitates viewing and reporting individual requested procedures (e.g. head, chest, abdomen) that an operator has grouped into a single scan.[FUS] Image Fusion integrates different systems creating, registering and displaying fused image sets and storing their results.[BIR] Basic Image Review defines baseline features and user interface relevant to simple review of DICOM images.Profiles for Infrastructure[PDI] Portable Data for Imaging provides reliable interchange of image data and diagnostic reports on CDs, DVDs or USB for importing, printing, or optionally, displaying in a browser.[XDS-I.b] Cross-enterprise Document Sharing for Imaging.b Update extends XDS to share images, diagnostic reports and related information across a group of care sites.[TCE] Teaching File and Clinical Trial Export lets users flag images and related information for automatic routing to teaching file authoring or clinical trials management systems.[ARI] Access to Radiology Information shares images, diagnostic reports, and related information inside a single network.[ATNA] Audit Trail and Node Authentication - Radiology Option defines Radiology-specific audit trail messages and security measures to protect the confidentiality of patient information.[CHG] Charge Posting provides timely procedure details from modalities to billing systems.Retrieved from "/index.php?title=Profiles"。
pacs的标准
pacs的标准
PACS（Picture Archiving and Communication System）是医学
影像存档和传输的标准化系统。
以下是PACS的一些标准：
1. DICOM（Digital Imaging and Communications in Medicine）：DICOM是医学影像领域最常用的标准，用于在不同设备和厂
家之间传输和存储医学影像。
DICOM定义了数据格式、通信
协议和图像存储方法，确保影像的一致性和互操作性。
2. HL7（Health Level Seven International）：HL7是用于医疗
信息系统（包括PACS）之间交换和共享数据的国际标准。
它
定义了一种通用的消息格式和通信协议，用于将不同系统中的患者信息和医学影像数据整合到一起。
3. IHE（Integrating the Healthcare Enterprise）：IHE是一个医
疗行业联盟，旨在推动不同供应商和系统之间的互操作性。
它制定了一系列与PACS相关的技术规范和实施指南，确保不同PACS系统间的无缝集成和协作。
4. ISO（International Organization for Standardization）：ISO制定了许多与医学影像和PACS相关的国际标准，例如ISO 12052（PACS安全）、ISO 13485（医疗器械质量管理体系）等。
这些标准的存在确保了不同设备和系统之间的互操作性，使得医学影像能够在不同环境中无缝传输、存储和访问。
IHE医疗系统的整合发展与应用
Audit Record Repository
Evidence Creator Order Placer Report Manager
External Report Repository Access Performed Procedure Step Manager
Report Reader
Image Archive
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Performed Work Status Update [42]
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IHE第五年技術架構簡介
❖IHE Integration Profiles (T.F. Rev. 5.5) ➢第一冊: Integration Profiles ➢第二冊: Transactions 1-31 ➢第三冊: Transactions 32-46 ➢第四冊: National Extensions
IHE技術發展背景 ❖技術架構公開討論(Submit and review comments) ➢技術架構文件:
HL7在HIS中的应用
HL7在HIS中的应用[导读]目前，国际上正在制定HL7版本3(HL7 V.3)和电子病历标准。
HL7 V.3采用了面向对象的中间件技术和XML语言。
美国医疗信息和管理系统协会(HIMSS)和北美放射学会共同组织了IHE(Integrating the Healthcare Enterprise)，从流程角度规范临床信息系统(CIS)。
近年来，北京大学人民医院在不断完善现有系统的基础上，正在建设医学图像存储传输处理系统(PACS)、检验科信息管理系统(LIS)、手术室信息管理系统(ORIS)、临床监护信息管理系统、电子病历系统(CPR)、门诊信息系统等。
在建设这些系统的过程中，采用HL7技术进行系统集成。
首先试点的是PACS与HIS 的互连。
这是国内首例HL7应用尝试，受到各个方面的关注。
国内传统的HIS建设方法大多依靠一家HIS开发商，制约了医院HIS建设的发展速度。
在HIS与PACS、LIS等系统互联中，大多采用打开对方数据库直接读写的方法。
这种方法存在很多弊病，在大量系统互连的情况下十分危险。
采用HL7集成HIS正在成为国际HIS建设的发展趋势。
国内HIS的技术已经与发达国际的水平十分接近，发展速度明显变慢，只有专业化才能够进一步提高。
因而，集成将成为一种主流。
目前，国际上正在制定HL7版本3(HL7 V.3)和电子病历标准。
HL7 V.3采用了面向对象的中间件技术和XML语言。
美国医疗信息和管理系统协会(HIMSS)和北美放射学会共同组织了IHE(Integrating the Healthcare Enterprise)，从流程角度规范临床信息系统(CIS)。
HL7、IHE、DICOM (DICOM是医学图象传输标准)正在紧密合作，构造整个医疗行业信息化的基本框架，代表了国际HIS的发展方向。
我们正在紧跟国际发展潮流，探索中国医院信息化与国际接轨的途径。
HL7与HIS互连技术HL7是医疗领域不同应用之间电子数据传输的协议，是由HL7组织制定并由ANSI批准实施的一个行业标准。
IHE, HL7和 和和 和 HITSP 中的临床文档标准
IHE, HL7和HITSP 中的临床文档标准 鲍永坚GE 医疗集团引论文档已在电子健康记录（EHR ）中广泛应用于医疗健康信息交换。
数字文档具有可持久性、可认证性、以及内容和相关语境的完整性。
数字文档的这些特征和纸质记录环境很类似，可以支持目前医学文档管理所有的业务和法律要求。
而且，数字文档能够以结构化和编码的方式表达信息内容，从而使许多新的应用成为可能：信息查询、临床决策等等。
HL7临床文档架构第二版（CDA R2）是在临床文档应用中最为广泛使用的标准，得到了许多医疗卫生信息技术标准的开发和促进组织的支持，如IHE 和HITSP 等。
针对不同应用用例，它们开发了基于CDA 的文档内容标准。
本文试图HL7、IHE 和HITSP 开发的这些标准之间的关系。
首先，我们对基于CDA 的文档内容规范过程作一个简要介绍。
临床文档架构临床文档架构————CDACDA 是HL7第三版标准（HL7 V3）的一部分，专门规定临床文档内容的标准化。
CDA 只规范文档内容表达，不涉及文档的交换机制。
在一个完整的文档解决方案中，还必须定义交换标准。
例如，IHE XDS 集成规范家族就包括了文档交换和发布、订阅的基础架构（通过WEB 服务传送的ebXML 消息），和不断扩展增加的临床信息内容标准（大部分内容标准基于CDA ）。
在本文中，我们只讨论文档的内容规范。
如其名称所示（字母A 表示架构），CDA 提供了一个能够表达所有可能文档的通用架构。
所有的CDA 文档都用XML 编码表达。
下图示出CDA 架构的基本构件（忽略了CDA 文档的最简单形式：第一层（L1）非结构化文档）。
图中所有的构件事实上都是一个RIM 模型（RIM 本身也是HL7 V3标准的一部分）。
关于CDA RIM 模型的正式描述见[1]。
图1。
CDA 文档架构第二层（L2）CDA 文档包含一个或多个章节，它们采用复合模式[2]的结构。
一个章节可以包含子章节，子章节再包含子章节，这样无限继续。
DICOM医学图像文件格式解析与信息提取
（） ３ 完成特殊的工作（ 如在胶片上打印图像） ；
（） ４ 工作流程的管理（ 支持 ＷＯ Ｋ ＩＴ和状态 Ｒ ＬＳ 信息 ） ； （） ５ 可视图像的质量和一致性 。
简而 言 之 ， Ｉ Ｏ 标 准 是 基 于 内 容 的 医学 图 ＤＣ Ｍ
ＺＨｏ Ｆｅ ｇ Ｕ ｎ
【ｂｔ ｃ】 Ｔ ｉｐｐｒ ｒｆ ｅ ｒ ｅ ｔ ＩＯ ｔ ｄｒ，ｎ ｙｉｏ ｔ ＩＯ ｌ ｆ ｍ ｔｔｅ ｓ ｏ Ｅ Ｄ Ａｓ ｆ ｈ ＤＣ Ｍ ｆ ｒ ａ， ｅ ｆ Ａ — ｓ ｉｌ ｃｂ ｅ ａ ｄ ｌ ｓ ｅ ｉ ｏ ｅ ｈ ｕ Ｌ
Ｍ ｄ ｉ ）是美 国放射学会 和美 国电器制造商协会 ｅｉｎ ， ｃｅ 组织制定的专 门用于医学 图像存储和传输的标准 。 经过十多年的发展 ， 该标 准已经被 医疗设备生产商 和医疗界广泛接受 ， 为医学 图像信息学领域的国 成
际通 用标 准 。
信息对象可以完成五个方面的功能 ： （） １传输和存储完整 的对象 （ 如图像 、 波形和文
据元素一 一对应。它 由组号 和元素 号构成 ， 如 例 （０ ８０２ ） ０ ０ ，０ ０就是组号为 ０ ００ ， ｘ０ ８元素号为 ＯＯ ２ ｘ ００ 的“ 检查 日期” 数据元素 的 Ｔ ｇ ａ 号。Ｄ Ｃ Ｍ 的数据 ＩＯ 字典定义 了许多数据元素标记 ， 涵盖 了大多数 的应
用需 要 。组号 为偶 数 的 是标 准 数 据元 素 ， 体 含 义 具 在 ＤＩＯＭ 的数 据 字 典 中定 义 ； 号 为 奇 数 的为 私 Ｃ 组
・
有数据元素 ， 由用户在使用过程中定义。
３ ・ ２
第 １ 卷・ ５ １ 第 期
周峰 ： Ｉ Ｏ 医学 图像文件格式解析与信息提取 ＤＣ Ｍ
IHE测试培训-放射学1
RWF事务（RAD-39）
RAD 39 - Work item Performed Procedure Step In Progress
GP-PPS状态：
RWF事务（RAD-40）
RAD 40- Work item Performed Procedure Step Completed
RWF事务（RAD-41）
IHE China Connectathon 集成模式介绍
内容
RWF (报告工作流程) SINR (简单的影像和数字报告） ED （证据文档） REM (辐射曝光监控)
IHE Radiology Workflow
report
report
ADT (Registration) report Report Repository Image Display Film Lightbox
RAD 41 - Work item Completed
RWF事务（RAD-42）
RAD 42 - Performed Work Status Update
SINR
Simple Image and Numeric Report 简单的影像和数字化报告
Simple Image Report Pattern
基本流程可以作为SWF，PWF等流程的一部分
ED的角色及事务
Transactions
事务
RAD-10 RAD-43
定义
Storage Commitment Evidence Documents Stored
说明
存储确认 证据文档存储，包括 Mammography CAD SR Basic Text SR Enhanced SR Comprehensive SR Chest CAD SR DICOM Query/Retrieve Study Root C-Find C-Move C-Store
DICOM,医学图像存储与传输标准
DICOM 对象
影像属性(attribute) 像素资料(pixel data) ▪ Patient Name：張三 ▪ Patient ID：01001111 ▪ Date of birth：631012 ▪ Sex：男 ▪ Modality：CT ▪ Station name：
FDMS 1.0 ▪ Study Date：19990226
▪ ①DICOM消息交换的网络支持层（DICOM第 八部分） 这部分处于最低层，是其它层次的基础 其中主要定义： 医学图像及相关信息的网络传输协议
DICOM消息交换的网络支持层
▪ ②DICOM消息服务（DICOM第四、五、 七部分）
这几部分详细定义了DIMSE及其对图 像相关信息的查询、存储、打印等服务
方框表示信息实体
诊断系列（series）
诊断系列（series）
复合对象实例 （composite object instance）
复合对象实例 （composite object instance）
复合对象实例 （composite object instance）
图4.2 IOD的层次信息结构
P159
数据元素 （Data Element）
标签 （Tag）
值类型
（Value Represent）
值长度
（Value Length）
元素值 （Value Field）
图 4.7 数 据 元 素 的 通 用 结 构 (P168)
•数据集
▪ 数据集（Data Set）是IOD实例化的编码表示，由数据元素 组成，每个数据元素包含了该IOD实例的一个属性值
信息对象定义的层次结构
患者（patient） 门诊（study） 诊断（series）
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IHE论文：IHE下医学影像数据库架构及其关键技术研究
【中文摘要】数据库技术是现代计算机应用系统开发的核心技术,
也是“信息高速公路”的重要支撑技术,数据库技术与多种技术结合
已经成为当前数据库研究发展的一个重要趋势。而医学影像数据库技
术是一种面向医学影像特定领域的数据库管理技术,它是医院信息系
统的数据存储中心,也是PACS系统和其它一些涉及到医学信息的医
院信息系统的重要组成部分。医学影像数据库是建立在影像数据库、
影像处理、计算机网络技术以及医学领域知识基础上,支持医学影像
数据有效存储、传输、检索和管理的数据库技术。如何有效地存储、
传输、检索和管理海量医学影像数据,是影像数据库系统实现中必须
解决的重要问题。在医院信息系统建设过程中,各个部门的信息系统
通常采用不同的数据库和技术来构建,如病人信息系统、病房管理系
统、电子病历系统、行政管理系统和医学影像管理系统等。这些系统
大多是相互独立的应用系统,就像一个个“信息孤岛”,由于不同的数
据库提供商提供的数据库不同,所以在各个环节之间存在着数据交流
不便的问题。而异构数据库集成则能解决这一主要问题,它是在已经
存在的多个异构的、分布的数据库之间搭建一个操作平台,这样医生
就可以使用一个医院管理信息系统来连接彼此分散的各个应用系统,
实现同...
【英文摘要】The database technology has become one of the
core technologies in the development of modern computer
application system. It also supports the development of
information superhighway. The combining of database technology
with Multi-technology is a main trend at present. The medical
image database is the specific areas of medical image-oriented
database management technology. Medical image database is the
data storage center in medical information systems, and it’
s the important content of the PACS and other...
【关键词】IHE DICOM 医学影像数据库
【英文关键词】IHE DICOM Medical Images Database
【索购全文】联系Q1：138113721 Q2：139938848
【目录】IHE下医学影像数据库架构及其关键技术研究摘要
5-6Abstract6-7引言13-141 绪论
14-181.1 选题来源和依据141.2 医学影像数据库发
展状况14-151.2.1 国外研究状况14-151.2.2 国内
研究状况151.3 本选题在实际应用方面的价值
15-161.4 本文的主要内容16-171.5 章节安排
17-182 相关标准和技术介绍18-272.1 IHE 架构介
绍18-222.1.1 IHE 概述182.1.2 放射科技术框架
18-222.1.3 IHE 的现实意义222.2 DICOM 标准介绍
22-252.2.1 DICOM 简介222.2.2 DICOM 文件格式结
构22-232.2.3 数据组织形式23-252.2.4 DICOM 的
信息模型图252.3 本章小结25-273 医学影像数据库
设计27-363.1 数据库技术27-293.1.1 数据库技术
的发展27-283.1.2 面向专门应用领域的数据库技术
283.1.3 医学影像数据库28-293.2 异构数据库集成
系统概述293.3 医学影像数据库系统架构
29-313.3.1 医学影像数据库构建29-303.3.2 医学
影像数据库系统架构30-313.4 异构数据库管理系统设计
31-353.4.1 各系统功能介绍32-333.4.2 异构数据
集成模型设计33-353.4.3 异构数据库集成的优点
353.6 本章小结35-364 医学影像数据库关键技术
36-494.1 医学影像传输技术36-404.1.1 医疗数据
通信问题的提出36-374.1.2 DICOM 网络协议模型
37-384.1.3 DICOM 网络通信结构38-394.1.4 医学
影像传输功能的实现39-404.2 医学影像显示技术
40-454.2.1 DICOM 文件信息的提取40-424.2.2
DICOM 文件的显示42-434.2.3 Modality LUT 转换
434.2.4 开窗显示技术（VOI LUT 变换）43-454.2.5
基于DCMTK 实现DICOM 影像的显示454.3 医学影像数据库
安全技术45-484.3.1 用户认证46-474.3.2 数据库
中数据的安全47-484.4 医学影像数据库系统的优点
484.5 本章小结48-495 应用系统设计
49-545.1 总体设计框图495.2 系统设计
49-525.2.1 系统主界面49-505.2.2 影像管理设计
50-515.2.3 查询显示设计51-525.2.4 备份管理设
计525.3 本章小结52-546 系统测试及结果
54-596.1 C++Test 概述54-586.1.1 建立测试环境
54-566.1.2 静态测试56-576.1.3 动态测试
57-586.1.4 生成报表586.3 本章小结58-59
结论59-60参考文献60-64附录A C++Test 总结
64-68附录B 开发文档68-72在学研究成果
72-73致谢73