Interoperative fundus image and report sharing in compliance with integrating the healthcare enterprise conformance and web access to digital imaging and communication in medicine persistent object protocol

AIM:To address issues in interoperability between different fundus image systems,we proposed a web eyepicture archiving and communication system(PACS)framework in conformance with digital imaging and communication in medicine(DICOM)and health level 7(HL7)protocol to realize fundus images and reports sharing and communication through internet.METHODS:Firstly,a telemedicine-based eye care work flow was established based on integrating the healthcare enterprise(IHE)Eye Care technical framework.Then,a browser/server architecture eye-PACS system was established in conformance with the web access to DICOM persistent object(WADO)protocol,which contains three tiers.RESULTS:In any client system installed with web browser,clinicians could log in the eye-PACS to observe fundus images and reports.Multipurpose internet mail extensions(MIME)type of a structured report is saved as pdf/html with reference link to relevant fundus image using the WADO syntax could provide enough information for clinicians.Some functions provided by open-source Oviyam could be used to query,zoom,move,measure,view OICOM fundus images.CONCLUSION:Such web eye-PACS in compliance to WADO protocol could be used to store and communicate fundus images and reports,therefore is of great significance for teleophthalmology.

Can a Ris/Pacs System Really Improve Execution and Reporting Times?

A study of the process timing and organization has been done in a Radiology Department where Radiology Information System (RIS) and Picture Archiving and Communication System (PACS) are working. The workflow times have been directly read from RIS database. In particular, Execution and Reporting steps were considered. Afterwards, data have been analyzed through a statistical elaboration and results were compared with data, coming from studies performed on similar process, collected with a stopwatch method. Possible “bottlenecks” can be evidenced in the process structure. Moreover, comparing hospitals with the same RIS/PACS system, different internal organization is emphasized.

A project plan for construction and cabling of picture archiving and communication system network

Objective To determine a network solution to meet the network requirements of the heavy data flow, load balance, and potential network storms from expansion of picture archiving and communication system (PACS) application.Methods Intel Netstructure 480T Giga Switch was used as the main switch and connected to each building by fiber channel at 1 Giga speed to archive 100 MB/s to each port. At the same time, the in-dependence of the original network construction was physically kept. The layer 3 and 4 switchers were used as load balance to reduce the heavy load of the network, and all the cabling for PACS used the super CAT5 along with the Intel NetStructure 1520 to prepare for potential network storms.Results An advanced intranet was set up to fully meet the high standard requirement of the PACS. The foundation for upgrading the whole network system to 1 Giga application was built to achieve sharing and transmission of images, information, and patient data within the hospital. The base was established for the standardized management of the hospital.Conclusion Good planning is the first step in setting up PACS, and the equipment forms the necessary platform to run PACS and all kinds of hospital information system (HIS). The networking construction is the foundation of e-hospital.

Malignant solitary pulmonary nodules: size and attenuation measured on a PACS and CT workstation

Objective: The aim of our study was to determine the efficiency and effectiveness of picture archiving and communication system(PACS) workstation in detecting the sizes and attenuation of malignant solitary pulmonary nodules(SPNs). Methods: Forty patients with malignant SPNs(diameter ≤ 3 cm) underwent multidetector-row computed tomography(CT) of the chest in a single-breath-hold technique. The raw data were acquired with a collimation of 0.625 mm. The diameters and attenuation of malignant SPNs were measured on PACS and CT workstation respectively. The diameter was defined as the average value of the anteroposterior, lateral and superoinferior diameters on CT scans obtained with a mediastinal window setting. The superoinferior diameters were measured on MPR image. The diameters and attenuation of malignant SPNs and spending time in measuring were recorded. Results: The diameters of malignant SPNs measured on a PACS and CT workstation were 2.09 cm ± 0.87 cm, 2.07 cm ± 0.79 cm, respectively. There was not statistically significant difference in the diameters of malignant SPNs between that measured on a PACS workstation and that on a CT workstation(t = 1.580, P = 0.210 > 0.05). The attenuation of malignant SPNs measured on a PACS and CT workstation were 40.15 HU ± 7.53 HU, 39.99 HU ± 8.13 HU, respectively. There was not statistically significant difference in the attenuation of malignant SPNs between that measured on a PACS workstation and that on a CT workstation(t = 1.008, P = 0.298 > 0.05). The spending time in measuring on a PACS and CT workstation were 55 s ± 4.03 s, 56 s ± 3.95 s, respectively. No statistically significant difference was found in spending time in measuring between that on a PACS workstation and that on a CT workstation(t = 0.958, P = 0.315 > 0.05). Conclusion: The efficiency and effectiveness of PACS workstation is as same as those of CT workstation in detecting the sizes and attenuation of malignant SPNs. It is suggested that the size and attenuation of malignant SPNs are measured on a PACS and CT workstation.

Peripheral bronchogenic carcinoma: Enhancement pattern evaluation on PACS and CT workstations

Objective: The aim of the study was to determine the efficiency and effectiveness of picture archiving and communication system(PACS) workstation in detecting enhancement pattern of peripheral bronchogenic carcinoma. Methods: The 62 patients with peripheral bronchogenic carcinoma underwent two-phase contrast material-enhanced multislices computed tomography(MSCT) of the chest in a single-breath-hold technique. Two spiral CT scans were obtained at 25 s and 90 s respectively after nonionic contrast material was administrated via the antecubital vein at a rate of 4 m L/s by using an autoinjector. Precontrast and postcontrast attenuation on every scan were measured on PACS and CT workstations respectively and peak height was calculated. Enhancement pattern was evaluated on the image obtained at 90 s after injection of contrast medium on PACS and CT workstations respectively. Results: No statistically significant difference in precontrast attenuation, postcontrast attenuation at 25 s and 90 s was found between these measured on a PACS workstation [(40.21 ± 7.03) HU;(55.53 ± 11.09) HU;(75.95 ± 13.45) HU] and those [(39.01 ± 8.95) HU;(56.01 ± 10.91) HU;(76.03 ± 11.95) HU] on a CT workstation(t = 1.140, P = 0.256 > 0.05; t = 1.580, P = 0.149 > 0.05; t = 1.505, P = 0.150﹥0.05). The peak height that calculated on a PACS workstation was 35.74 HU(20 HU). There was not statistically significant difference in peak height between that calculated on a PACS workstation and that on a CT workstation [(37.02 ± 12.05) HU; t = 2.001, P = 0.099 > 0.05]. The tumors showed same enhancement pattern on PACS workstation and CT workstation. Of the 62 cases, 38 showed homogeneous enhancement, 17 showed heterogeneous enhancement, five showed peripheral enhancement, two showed central enhancement, at 90 s. The enhancement pattern revealed on PACS workstation was consistent with feature of peripheral bronchogenic carcinoma. Conclusion: The efficiency and effectiveness of PACS workstation is as same as those of CT workstation in detecting enhancement pattern of peripheral bronchogenic carcinoma.

医学影像学教学模式的现状与实践

医学影像学是临床医学中一门实践性极强辅助学科,同时也是发展迅猛,日新月异的学科,在现代医疗中扮演着越来越重要的角色。文章通过对影像医学教学的基本要求、教学目标和目的进行说明,采用影像存储和传输系统(picture archiving and communication system,PACS)结合以问题为基础的教学法(problem-based learning,PBL)及以案例为基础的教学法(case-based learning,CBL)教学法进行实践。针对非影像专业学员学习时间短、学习任务重,学员影像基础和需求迥异,部分非影像专业学员自身对医学影像学的重视不足以及放射基地重视不足等问题。文章阐述了PACS与PBL、CBL教学法、钉钉、微信及SPARK学习平台等学习沟通平台相结合,并增加专职人员对基地管理、带教老师一对一指导,以及不断加强科室建设、安排名师上课来提高科室影响力等多种混合教学模式的解决对策,来唤起学员学习影像相关知识的内驱力,达到提高学员轮转学习效果的目的。

数字化模式下医学影像学CBL教学法的应用

目的:探讨数字化模式下以病例为基础的医学影像学教学模式在临床教学工作中的应用价值。方法:利用医院影像存储及传输系统和放射科信息系统,构建医学影像学数字化教学病例库,将该病例库中的示教病例应用于北京大学医学部八年制医学影像学的临床教学。比较数字化模式与传统胶片模式的教学效果。结果:成功构建了能满足教学需要的数字化教学病例库,该病例库收集了1300余例典型示教病例,将这些示教病例应用于临床教学工作,取得良好的教学效果,明显提高了学生对教学工作的满意度,并取得了较理想测试成绩。结论:数字化模式下CBL教学法改变了医学影像学传统胶片式教学模式,实现了在PACS/RIS环境下的数字化医学影像学教学,教学质量得到明显提高。

基于PACS的PBL联合CBL模式在血管超声教学中的应用

目的探讨应用以问题为基础的教学(PBL)、以案例为基础的教学(CBL)联合影像存档与传输系统(PACS)在血管超声临床教学中的价值。方法将2024年1月—2024年6月在血管超声科实习的本科生60例随机分为两组。试验组30例,应用PBL、CBL教学模式联合PACS系统进行教学;对照组30例,以传统教学方式,小讲课形式进行学习。学习30 d后出科,通过专业考核及问卷满意度调查评价教学效果。结果试验组学生的理论考核、操作考核、报告分析考核成绩均高于对照组,差异有统计学意义(P<0.05)。在问卷调查中,学生对试验组教学模式的满意度优于对照组,差异有统计学意义(P<0.05)。结论应用PBL、CBL教学模式联合PACS系统进行血管超声诊断的实习教学,有助于提升教学效果,同时提高学生满意度。

基于PACS系统网络数据库结合微课在妇产科超声诊断学教学中的应用研究

目的分析基于影像归档和通信系统(Picture Archiving and Communication System,PACS)网络数据库结合微课在妇产科超声诊断学教学中的应用效果。方法选取2020年1—6月在新疆石河子大学第一附属医院超声医学科实习的32名医学影像学专业本科生纳入传统教学组,选取2020年7—12月在本院实习的32名医学影像学专业本科生纳入PACS系统+微课组。比较两组学生考试成绩、评判性思维能力及教学满意度。结果PACS系统+微课组学生考试成绩、评判性思维能力评分、教学满意度高于传统教学组,差异有统计学意义(P均<0.05)。结论基于PACS系统网络数据库结合微课在妇产科超声诊断学教学中应用,可提高学生考试成绩及批判思维能力,提升教学质量,利于提高学生对教学的满意度。

模块式教学联合基于PACS的CBL教学法在医学影像学见习中的应用

目的探讨模块式教学联合基于数字化影像存储及传输系统(picture archiving and communication systems,PACS)的以案例为导向的教学法(case-based learning,CBL)在医学影像学见习教学中的应用价值。方法2022年9—12月,选择中南大学湘雅二医院学习的2019级五年制临床医学133名学生作为研究对象,按学号顺序分组,试验组66名,采用基于PACS系统的CBL联合模块教学模式。对照组67名,采用传统多媒体幻灯片(powerpoint,PPT)面授式教学方法,通过专业考核和问卷调查评估教学效果。结果试验组学生的读片测验和卷面测验成绩均高于对照组,差异有统计学意义(P<0.05)。问卷调查各项指标显示试验组的满意度高于对照组,差异有统计学意义(P<0.05)。结论模块式教学联合基于PACS的CBL教学法能激发医学生的学习兴趣,更深入地学习影像学知识,提高了医学影像学见习教学的效果。

新形势下医学影像专业线上实践教学模式的应用探讨

医学影像专业实践教学的主要内容是浏览大量的医学图像,分析图像特征并给出诊断意见。随着当今信息时代和硬件设备的发展,实践教学的模式已经不局限于常规医院科室内胶片阅片,而是传统模式与新型高效的、内容丰富的依托互联网的实践学习模式互相结合与补充。不同新型的线上实践模式近年来得到了迅猛发展并逐渐发展完善,有利于学生高效地掌握学科的基础及前沿知识,对教师教学能力及业务能力的提高也有促进作用。教师通过融合线上实践教学的新模式对学生进行讲授、讨论、互动交流,可激发学生的学习兴趣,活跃课堂的教学氛围,更重要的是提升了学生影像思维和临床思维的能力和水平。文章根据医学影像实践教学的要求并结合本单位的线上实践教学经验对近年来不同的线上教学模式进行介绍,为其他教学医院提供参考。

基于PACS系统的CBL教学法在超声医学科住院医师规范化培训中的初步应用

目的:在初步构建的基于图像存储和传输系统(PACS)的临床超声病例库的基础上,探讨应用案例教学法(CBL)在超声医学住院医师规范化培训教学中的应用价值。方法:将2020年于我院进行超声医学科住院医师规范化培训的40名学员分为对照组和试验组,分别应用传统的带教方法和基于PACS系统的CBL教学法进行教学。通过超声理论知识考核、临床思维与决策考核及问卷调查的形式,评价试验组和对照组学员的教学效果和带教老师的教学满意度。结果:试验组在超声理论知识成绩、超声临床思维与决策能力考试的成绩均显著高于对照组(P<0.05),试验组在超声理论学习和学员之间交流和自我语言表达能力等方面的评分均显著高于对照组(P<0.05)。结论:基于PACS系统的CBL教学法不仅可以有效提高学员的临床思维决策能力、语言表达能力,还可以提高老师的带教水平及学员的满意度。

三明治教学法联合PACS系统在医学影像诊断学教学中的应用

目的 探讨医学影像诊断学教学中采用三明治(Sandwich)教学法联合图像存储与传输(picture archiving communication system,PACS)系统的效果。方法 选取2020年9月—2021年8月遵义医科大学医学影像学院共计45名本科学生作为对照组,采用传统教学模式,选取2021年9月—2022年8月遵义医科大学医学影像学院共计45名本科学生作为研究组,采用Sandwich教学法联合PACS系统,对2组考核成绩、学习兴趣、批判思维能力及教学质量满意度进行比较。结果研究组基础理论、影响分析、报告书写、鉴别诊断评分[(89.19±3.26)分(、95.76±2.85)分(、89.06±2.74)分、(91.58±4.09)分]较对照组[(81.06±3.11)分(、84.73±3.67)分、(80.39±3.25)分、(81.89±4.11)分]更高,差异均有统计学意义(P <0.001);2组教学后学习兴趣评分提高,研究组[(8.79±1.02)分]评分较对照组[(7.34±0.95)分]更高,差异均有统计学意义(P <0.001);2组教学后批判性思维量表中文版(critical thinking disposition inventoryChinese version,CTDI-CV)评分提高,研究组评分较对照组更高,差异均有统计学意义(P <0.001);研究组教学质量满意度评分较对照组更高,差异均有统计学意义(P <0.001)。结论 Sandwich教学法联合PACS系统应用于医学影像诊断学教学中,可提高考核成绩及学习兴趣,改善批判思维能力,提高教学质量满意度。

多元教学方式在眼科住院医师规范化培训中的应用

浙江大学医学院附属第二医院眼科中心在眼科住院医师规范化培训(以下简称住培)中,针对以往教学中存在的主要问题,开拓性地将基于案例学习(case-based learning, CBL)和基于问题学习(problem-based learning, PBL)相结合的病案教学、基于医学影像存储传输系统(picture archiving and communication system, PACS)的影像教学、基于湿实验室(Wet-lab)的临床实操教学有机结合,形成了一套多元化、全方位、系统化的教学方式。这种多元教学方式在浙江大学医学院附属第二医院眼科中心住培的应用过程中取得了较好的效果。2020年至2022年,眼科住培学员参加住培结业考核,首次通过率均高于浙江省眼科住培学员同年住培结业考试首次通过率。本文对浙江大学医学院附属第二医院眼科中心多元教学方式相关情况进行了系统的总结,以便对全面提升眼科住培质量有所助益。

构建基于PACS的医学影像教学资源中心提升教学质量

[目的]构建基于图像存档与传输系统(picture archiving and communication system,PACS)的数字化医学影像教学资源中心,提升医学影像学教学质量。[方法]设计电子教案(electronic teaching file,ETF)生成模块,并把它整合在PACS系统报告工作站,配置电子教案服务器,建立电子教案数据库,并通过与PACS系统交互的接口模块,实现影像电子教案的制作,然后利用医院PACS系统中海量的数字化医学影像资料,建立数字化医学影像教学资源中心。[结果]通过整合在PACS系统报告工作站中的电子教案生成模块,选择典型病例、感兴趣病例,并经过简单的处理后自动快速地生成电子教案,成功构建数字化医学影像教学资源中心。[结论]基于PACS系统成功构建数字化医学影像教学资源中心,最大限度实现医学影像教学资源共享,将改变医学影像学教学模式,极大地提升医学影像学教学质量。

基于PACS多元立体化教学模式在医学影像本科实习教学中的应用

医学影像学是一门实践性很强的应用学科,图像存档与传输系统(PACS)系统存储大量临床和影像学信息,且具有高效率、高质量影像图像处理功能。利用PACS系统可将多种教学资源、教学方法和教学手段融入实习教学过程中,实现以学生学习为中心、教师教学为主导多元化和立体化教学模式,有助于提高影像实习生的报告书写能力、读片能力及临床操作能力。

医学影像学见习应用PACS教学法与传统读片教学法的对比研究

将中南大学湘雅医学院2010级临床医学五年制197名学生随机分成两组,在医学影像学见习教学过程中分别应用影像存储及传输系统(PACS)教学法(98人)及传统读片教学法(99人),学期结束时对两组学生考试成绩进行分析,并对PACS组学生进行问卷调查及结果分析。统计数据显示,PACS组学生读片测验及卷面考试中,病例分析题成绩显著高于传统读片组,问卷调查显示PACS组学生大多数认可该教学方法。因此,应用PACS教学有助于提高学生的临床分析能力及主动学习的能力,是学生欢迎的教学方式。但对医学影像学基本知识的传授,应用PACS法较传统读片法并无明显优势。

基于PACS以PBL为核心的CBL在临床医学专业型硕士研究生培养中的实践——以“恶性腹腔积液”病例为例

临床诊疗、科研思维训练在临床医学专业硕士研究生的培养中具有重要地位。基于PCAS以PBL为核心的CBL能够将临床诊疗和临床科研思维训练有机结合,可以作为消化系统疾病临床教学非常有效的方法,进一步提高临床医学专业硕士研究生的学习兴趣,增强学生主动获取知识、善于提出临床问题并且解决问题的能力,为培养高素质临床医学专业人才进行了有益的尝试与探索。

利用PACS病例检索实施案例式教学在医学影像学示教中的作用

目的探索利用数字化影像存档与传输系统(picture archiving and communication system,PACS)病例检索实施案例式教学在医学影像学实践教学活动中的作用。方法对临床医学专业二个小班进行医学影像学示教(A、B班,共80人,每班40人)。A班作为研究组,采用让学生利用PACS自己检索示教内容相关病例并做出分析和总结的教学法;B班作为对照组,采用传统PPT面授式教学法;通过随堂小测试及教学满意度调查问卷评估两种方法的教学效果。结果研究组小测验成绩和教学满意度分别为(90.2±3.4)和(92.0%±3.5%);对照组分别为(85.5±4.6)和(85.0%±6.5%)。研究组的小测验成绩及教学满意度均高于对照组(P=0.038,P=0.014)。结论利用PACS病例检索实施案例式教学在医学影像学实践教学活动中能更好地提高教学效果,具有较高的应用价值。