醫(yī)院多維數(shù)字影像網(wǎng)絡(luò)平臺(tái)全院級(jí)PACS系統(tǒng)設(shè)計(jì)方案

XX市XX醫(yī)院

多維數(shù)字影像網(wǎng)絡(luò)平臺(tái)

全院級(jí)PACS系統(tǒng)

設(shè)計(jì)方案

2021年1月

目錄

第一章數(shù)字醫(yī)療的時(shí)代的機(jī)遇與挑戰(zhàn).......................................7

1.1數(shù)字化醫(yī)療時(shí)代的到來(lái)..........................................................7

1.2數(shù)字醫(yī)療的特點(diǎn)................................................................7

1.2.1以病人為中心的業(yè)務(wù)工具的數(shù)字化.............................................7

1.2.2診斷信息的全面性...........................................................7

1.2.3醫(yī)療資源的網(wǎng)絡(luò)化...........................................................7

1.2.4醫(yī)院管理的信息化...........................................................7

第二章多維數(shù)字影像網(wǎng)絡(luò)平臺(tái)..............................................8

XX市XX醫(yī)院..............................................................

多維數(shù)字影像網(wǎng)絡(luò)平臺(tái).........................................................................................................-1-

全院級(jí)PACS系統(tǒng).................................................................................................................................-7-

第一章數(shù)字醫(yī)療的時(shí)代的機(jī)遇與挑戰(zhàn).........................................9

1.1數(shù)字化醫(yī)療時(shí)代的到來(lái)....................................................9

1.2數(shù)字醫(yī)療的特點(diǎn).........................................................9

1.2.1以病人為中心的業(yè)務(wù)工具的數(shù)字化.............................................9

1.2.2診斷信息的全面性...........................................................9

1.2.3醫(yī)療資源的網(wǎng)絡(luò)化...........................................................9

1.2.4醫(yī)院管理的信息化...........................................................9

第二章多維數(shù)字影像網(wǎng)絡(luò)平臺(tái)...............................................10

第四章XX市XX醫(yī)院全院級(jí)PACS項(xiàng)目需求分析.............................11

4.1醫(yī)院介紹...............................................................11

4.L1XX市XX醫(yī)院介紹...........................................................11

4.1.2XX市XX醫(yī)院介紹.........................................................12

4.2PACS/RIS系統(tǒng)總體要求.................................................13

4.3PACS/RIS系統(tǒng)規(guī)范性需求...............................................15

4.4PACS/RIS系統(tǒng)性能需求.................................................15

4.5PACS/RIS系統(tǒng)建設(shè)目標(biāo).................................................15

4.5.1PACS建設(shè)目標(biāo).............................................................15

4.5.2本期PACS建設(shè)實(shí)現(xiàn)目標(biāo)....................................................16

4.5.3后續(xù)PACS建設(shè)實(shí)現(xiàn)目標(biāo)....................................................16

第五章PACS/RIS系統(tǒng)總體設(shè)計(jì)方案..........................................17

5.1設(shè)計(jì)原則...............................................................17

5.2標(biāo)準(zhǔn)性................................................................17

5.3系統(tǒng)集成...........................................17

5.4工作流程控制.................................................................17

5.5圖像調(diào)閱速度.................................................................17

5.6穩(wěn)定性.......................................................................17

5.7安全性.......................................................................17

5.8后續(xù)開(kāi)發(fā)能力................................................................18

5.9實(shí)用性.......................................................................18

5.10先進(jìn)性......................................................................18

5.11三層架構(gòu)總體規(guī)劃及示意圖..................................................18

5.12硬件設(shè)計(jì)方案...............................................................19

5.13醫(yī)院數(shù)據(jù)量核算.............................................................20

5?14分級(jí)存儲(chǔ)解決方案............................................................21

5.15SAN網(wǎng)絡(luò)架構(gòu)...............................................................22

5.16PACS主服務(wù)雙機(jī)熱備.......................................................23

5.16.1概念....................................................................23

5.16.2技術(shù)優(yōu)點(diǎn)...............................................................24

5.16.3雙機(jī)熱備工作模式.........................................................24

5.16.4雙機(jī)熱備實(shí)現(xiàn)機(jī)制.........................................................24

5.16.4.1數(shù)據(jù)同步............................................................24

5.16.4.2流量切換............................................................24

5.16.4.2.1通過(guò)VRRP實(shí)現(xiàn)流量切換...........................................24

5.16.4.2.2通過(guò)動(dòng)態(tài)路由實(shí)現(xiàn)流量切換........................................25

5.16.5應(yīng)用限制...............................................................26

5.16.6H3C實(shí)現(xiàn)的技術(shù)特色......................................................26

5.16.7數(shù)據(jù)服務(wù)器的雙機(jī)熱備+.業(yè)務(wù)服務(wù)（分離）......................................26

5.16.8安全性.................................................................27

5.17WORKLIST月艮務(wù)...........................................................27

5.18網(wǎng)絡(luò)布局結(jié)構(gòu)圖.............................................................28

5.19數(shù)據(jù)流動(dòng)設(shè)計(jì)...............................................................29

5.20數(shù)據(jù)的生命周期管理.........................................................30

5.21未來(lái)系統(tǒng)的規(guī)劃.............................................................32

5.22高可用、高安全性...........................................................32

5.22.1RAID技術(shù)................................................................32

5.22.2部件冗余..................................................................33

5.23ST-PACS/RIS系統(tǒng)安全性方案...............................................33

5.23.1PACS系統(tǒng)數(shù)據(jù)安全........................................................33

3.23.2通過(guò)IP控制..............................................................33

5.23.3DICOM客戶IP管理......................................................34

5.23.4PACS系統(tǒng)權(quán)限安全........................................................36

5.24數(shù)據(jù)備份、容災(zāi)方案...................................................37

5.24.1備份策略..................................................................38

5.24.2數(shù)據(jù)恢復(fù)..................................................................39

5.25應(yīng)急預(yù)案.............................................................40

5.25.1應(yīng)急規(guī)劃原則..............................................................40

5.25.2軟件級(jí)別故障.............................................................40

工作站................................................................40

服務(wù)器...............................................................41

5.253操作系統(tǒng)級(jí)別故障..........................................................41

5.25.3.1工作站...............................................................41

5.25.3.2服務(wù)器..............................................................42

5.25.4硬件故障..................................................................42

工作站................................................................42

服務(wù)器...............................................................42

網(wǎng)絡(luò)故障..............................................................43

5.25.5PACS/RIS系統(tǒng)故障應(yīng)急流程................................................43

第六章PACS/RIS系統(tǒng)解決方案..........................................45

6.1影像設(shè)備數(shù)據(jù)獲取方案...............................45

6.1.1標(biāo)準(zhǔn)DIC0M設(shè)備連接.......................................................45

6.1.2非DIC0M設(shè)備的連接.......................................................46

6.2影像科數(shù)字化流程管理設(shè)計(jì)..............................................47

6.2.1病人預(yù)約登記...............................................................48

6.2.2病人到檢..................................................................48

6.2.3圖像歸檔存儲(chǔ)...............................................................48

6.2.4獲取圖像...................................................................49

6.2.5書(shū)寫(xiě)診斷報(bào)告...............................................................49

6.2.6審核診斷報(bào)告...............................................................50

6.2.7專業(yè)的診斷數(shù)據(jù)流..........................................................50

6.3ST-PACS/RIS系統(tǒng)服務(wù)....................................................51

6.3.1數(shù)據(jù)庫(kù)服務(wù)管理.............................................................51

632DICOM服務(wù)管理............................................................52

6.3.3多影像設(shè)備數(shù)據(jù)支持.........................................................52

6.3.4流量控制服務(wù)..............................................................53

6.3.5數(shù)據(jù)匹配與管理.............................................................53

6.3.6存儲(chǔ)管理..................................................................53

6.3.7系統(tǒng)控制管理...............................................................54

6.3.8HIS/RIS連接服務(wù)管理.......................................................54

6.3.9RIS服務(wù)系統(tǒng)...............................................................55

6.4超聲診斷科PACS/RIS系統(tǒng)建設(shè)方案........................................58

6.4.1超聲診斷科室情況...........................................................58

6.4.2超聲系統(tǒng)架構(gòu)...............................................................59

6.4.3預(yù)約登記工作站.............................................................60

6.4.4超聲診斷工作站.............................................................61

6.4.4.1權(quán)限登錄系統(tǒng)...........................................................61

6.4.4.2圖像獲取功能...........................................................62

6.4.4.3圖像處理功能...........................................................63

6.4.4.4診斷報(bào)告功能...........................................................63

6.4.4.5病歷管理...............................................................64

6.4.5主任管理工作站..............................................................65

6.4.6優(yōu)異的診斷報(bào)告系統(tǒng)特點(diǎn)回顧.................................................66

6.5放射科普放科室PACS/RIS系統(tǒng)建設(shè)方案....................................67

6.5.1普放科室專業(yè)工作站及軟件功能...............................................67

6.5.1.1報(bào)告/圖象調(diào)閱...........................................................67

6.5.1.2診斷報(bào)告...............................................................68

6.5.1.3報(bào)告審核...............................................................68

6.5.1.4具有嚴(yán)格的分級(jí)用戶診斷權(quán)限管理..........................................69

6.5.2普放科室診斷報(bào)告工作站基本功能.............................................69

6.5.2.1系統(tǒng)完全符合國(guó)際標(biāo)準(zhǔn)的DICOM3.0標(biāo)準(zhǔn)....................................69

6.5.2.2數(shù)據(jù)庫(kù)管理：............................................................69

6.5.2.3DICOM查詢服務(wù).......................................................69

6.5.2.4DICOMCFING查詢......................................................69

6.5.2.5可提供中英文兩種系統(tǒng)任用戶選擇..........................................69

6.5.2.6光盤(pán)刻錄功能：..........................................................69

6.527自動(dòng)數(shù)據(jù)歸檔功能：......................................................70

6.5.2.8膠片打印管理功能：......................................................70

6.5.2.9圖像優(yōu)化處理：..........................................................71

6.5.2.10智能圖像曲線變換：.....................................................71

1區(qū)域均衡化軟件包：.....................................................71

2圖像裁減及DICOM重建軟件包：.........................................71

6.5.2.13專業(yè)、精確的測(cè)量手段：.................................................72

6.5.2.14圖像處理系統(tǒng)：.........................................................72

6.5.2.15網(wǎng)絡(luò)獲取和傳輸數(shù)據(jù)：...................................................73

6.5.3CR和DR圖像的高端功能.....................................................73

組織均衡化功能.........................................................73

653.2圖像拼接功能...........................................................75

653.3組織透視鏡.............................................................76

6.5.4數(shù)字胃腸圖像的高端功能......................................................76

圖像拼接功能..........................................................76

數(shù)字減影功能..........................................................76

6.5.5乳腺高端診斷功能............................................................77

6.6CT和MRI科室多維數(shù)字影像網(wǎng)絡(luò)平臺(tái).....................................77

6.6.1ANYTHINK多維數(shù)字影像網(wǎng)絡(luò)平臺(tái)簡(jiǎn)介.......................................77

6.6.2ANYTHINK多維數(shù)字影像網(wǎng)絡(luò)平臺(tái)特點(diǎn).......................................79

6.6.2』內(nèi)容豐富，全方位影像診斷................................................80

比“通用型影像處理系統(tǒng)”更符合中國(guó)用戶....................................80

662.3協(xié)同工作，優(yōu)勢(shì)明顯......................................................80

662.4兼容PACS,優(yōu)化MCS,包含PACS.................................................................................81

6.6.3后處理基本功能..............................................................81

影像瀏覽...............................................................81

663.2測(cè)量和標(biāo)注.............................................................81

6.63.3圖像和處理結(jié)果保存....................................................81

6.63.4光盤(pán)刻錄..............................................................81

663.5膠片打印...............................................................82

663.6診斷報(bào)告...............................................................82

6.63.7圖像和數(shù)據(jù)的檢索.......................................................82

6.63.8數(shù)據(jù)錄入...............................................................82

6.6.4CT高端診斷功能.............................................................83

三維重建...............................................................83

CTA減影功能..........................................................84

6.6.43一鍵式全自動(dòng)全身骨去除功能.............................................84

CT高級(jí)血管分析功能....................................................84

CT全自動(dòng)冠脈分析功能..................................................85

CT鈣化積分軟件包.....................................................85

CT心功能分析軟件.....................................................86

CT肺結(jié)節(jié)分析軟件包....................................................86

CT灌注分析...........................................................86

0齒科分析..............................................................86

664.11CT結(jié)腸分析...........................................................87

2CT肋骨分析..........................................................87

3CT脊柱分析..........................................................87

6.6.5MR高端診斷功能............................................................88

三維重建...............................................................88

ADC測(cè)量..............................................................88

6.6.53MR圖像拼接...........................................................89

MR灌注分析...........................................................89

MR心臟分析...........................................................89

6.6.5.6波譜分析...............................................................89

665.7圖像融合..............................................................89

功能ADC圖譜......................................................90

彌散張量DTI.......................................................................................................................90

0血氧依賴分析BOLD......................................................................................................90

1全身彌散分析........................................................90

2MRI子序列排序功能..................................................90

6.7介入科室PACS/RIS系統(tǒng)建設(shè)方案........................................91

6.7.1組織透視鏡功能.............................................................91

6.7.2數(shù)字減影功能...............................................................91

6.7.3智能血管狹窄分析功能......................................................91

6.7.4室壁運(yùn)動(dòng)分析功能..........................................................91

6.7.5旋轉(zhuǎn)三維分析...............................................................91

6.7.6雙平面冠狀動(dòng)脈三維重建....................................................91

6.7.7介入專家級(jí)診斷報(bào)告系統(tǒng).....................................................92

冠狀動(dòng)脈狹窄的輔助分析與診斷模塊.......................................92

心臟及外周血管高級(jí)史理模塊.............................................92

6.8內(nèi)窺鏡科室PACS/RIS系統(tǒng)建設(shè)方案.......................................92

6.8.1科室情況介紹...............................................................93

6.8.2系統(tǒng)構(gòu)成...................................................................93

6.8.3功能介紹...................................................................94

6.8.3.1預(yù)約登記系統(tǒng)...........................................................94

6.8.3.2圖像采集功能...........................................................95

6.8.3.3自動(dòng)照片控制...........................................................96

6.8.3.4報(bào)告功能...............................................................96

6.8.3.5病歷管理...............................................................97

6.8.3.6光盤(pán)刻錄.................................................................97

6.8.3.7統(tǒng)計(jì)功能.................................................................97

6.8.3.8主任管理系統(tǒng)............................................................97

6.9病理科室PACS/RIS系統(tǒng)建設(shè)方案........................................98

6.9.1通用醫(yī)學(xué)圖像分析系統(tǒng)..........................................................98

6.9.2工作流程......................................................................99

6.9.3方案設(shè)計(jì).....................................................................100

6.10心電科室PACS/RIS系統(tǒng)建設(shè)方案......................................101

6.11ST-CALLER叫號(hào)終端系統(tǒng)建設(shè)方案.....................................102

6.11.1叫號(hào)系統(tǒng)結(jié)構(gòu)圖..............................................................102

6.11.2工作流程....................................................................102

6.11.3產(chǎn)品功能介紹................................................................102

6.12與HIS及體檢進(jìn)行無(wú)縫連接.............................................103

6.12.1PACS與HIS、體檢融合方案..................................................104

6.12.2PACS與HIS信息交互解決方案................................................104

6.12.3PACS和HIS、體檢融合后的工作流程..........................................105

6.12.4PACS系統(tǒng)與其他系統(tǒng)進(jìn)行無(wú)縫連接...........................................106

6.13建設(shè)臨床(Web)服務(wù)器系統(tǒng).............................................106

第七章遠(yuǎn)程會(huì)診系統(tǒng)..................................................108

7.1主要功能..............................................................108

7.2遠(yuǎn)程會(huì)診案例.........................................................109

第八章數(shù)字化心臟及介入工作平臺(tái)系統(tǒng)...................................110

8.1方案概述..............................................................110

8.1.1系統(tǒng)建設(shè)目標(biāo).................................................................110

8.1.2項(xiàng)目建設(shè)內(nèi)容.................................................................110

8.1.3系統(tǒng)設(shè)計(jì)與結(jié)構(gòu)...............................................................111

8.1.4系統(tǒng)業(yè)內(nèi)應(yīng)用情況............................................................111

8.1.5系統(tǒng)建設(shè)精髓-----實(shí)現(xiàn)“五化”.................................................111

8.2穩(wěn)定成熟和擴(kuò)展性......................................................112

8.2.1統(tǒng)一設(shè)計(jì)，統(tǒng)一平臺(tái)...........................................................112

822自主研發(fā)，掌握源代碼.........................................................113

8.4醫(yī)院需求分析..........................................................114

8.4.1系統(tǒng)建立的必要性.............................................................114

8.4.2項(xiàng)目建設(shè)目標(biāo).................................................................115

8.5XX產(chǎn)品構(gòu)架..........................................................116

8.5.1系統(tǒng)設(shè)計(jì)簡(jiǎn)要說(shuō)明.............................................................116

851.1、醫(yī)生診斷工作平臺(tái)........................................................116

851.2、手術(shù)流程管理系統(tǒng)........................................................117

851.3、手術(shù)監(jiān)控記錄系統(tǒng)........................................................117

851.4、手術(shù)音視頻整合平臺(tái)......................................................118

8.6系統(tǒng)建設(shè)功能..........................................................119

8.6.1綜合信息管理平臺(tái)建立實(shí)現(xiàn)數(shù)據(jù)宏觀應(yīng)用......................................119

8.6.2醫(yī)生診斷工作平臺(tái)..........................................................119

設(shè)計(jì)原則..............................................................119

862.2術(shù)前手術(shù)評(píng)估，使醫(yī)生細(xì)致了解病人病情...................................120

8.6.23術(shù)中多數(shù)據(jù)整合，全面支持手術(shù)工作.......................................120

8.6.2.4方便快捷出具診斷報(bào)告...................................................121

8.6.3手術(shù)室流程管理優(yōu)化.........................................................121

8.53.1高效的手術(shù)過(guò)程管理....................................................122

8.53.2全面嚴(yán)謹(jǐn)?shù)男g(shù)中監(jiān)控記錄................................................122

8.53.3準(zhǔn)確細(xì)致的手術(shù)劃價(jià)....................................................123

8.534方便靈活的庫(kù)房管理及統(tǒng)計(jì)核算...........................................123

8.6.4數(shù)字化手術(shù)視教及醫(yī)患溝通系統(tǒng)...............................................124

數(shù)字介入中心視教整合平臺(tái)特點(diǎn)..........................................124

數(shù)字介入中心視教整合平臺(tái)功能..........................................125

第九章NM?NET核醫(yī)學(xué)功能化網(wǎng)絡(luò)系統(tǒng)..................................130

9.1病人預(yù)約..............................................................130

9.2電子叫號(hào)..............................................................130

9?3病史問(wèn)診...............................................................130

9.4注射管理..............................................................131

9.5藥品管理..............................................................131

9.6檢查管理....................................................131

9.7高級(jí)影像融合后處理工作站及報(bào)告系統(tǒng)..........................132

9.7.1影像融合功能..............................................................132

9.7.2腫瘤分析功能..............................................................132

9.7.3DR-NM圖像融合..........................................................132

第十章項(xiàng)目管理及實(shí)施方案............................................133

10.1項(xiàng)目工作小組..........................................................133

10?2項(xiàng)目組織架構(gòu)..........................................................133

10.2.1項(xiàng)目的組織形式...........................................................133

10.2.2項(xiàng)目團(tuán)隊(duì)組織結(jié)構(gòu)........................................................134

10.2.3項(xiàng)目經(jīng)理負(fù)責(zé)制度........................................................135

10.3實(shí)施步驟.............................................................135

10.3.1項(xiàng)目準(zhǔn)備階段.............................................................135

10.3.2項(xiàng)目啟動(dòng)階段.............................................................135

10.3.3項(xiàng)目實(shí)施階段.............................................................135

10.3.4項(xiàng)目變更管理.............................................................136

10.3.5測(cè)試驗(yàn)收方案.............................................................136

10.4項(xiàng)目實(shí)施計(jì)劃...............................................140

1041硬件實(shí)施及質(zhì)量保證措施....................................................140

10.4.2PACS/RIS系統(tǒng)實(shí)施.........................................................141

10.5項(xiàng)目資源需求.........................................................144

10.6溝通計(jì)劃措施........................................................144

10.7項(xiàng)目的質(zhì)量保證措施...................................................145

10.8項(xiàng)目風(fēng)險(xiǎn)管理........................................................146

10.9項(xiàng)目文檔管理........................................................146

第十一章項(xiàng)目培訓(xùn)計(jì)劃................................................148

11.1硬件部分.............................................................148

11.2軟件部分.............................................................149

11.2.1培訓(xùn)計(jì)戈IJ...........................................................................................................................................149

11.2.2培訓(xùn)內(nèi)容....................................................................150

第一章數(shù)字醫(yī)療的時(shí)代的機(jī)遇與挑戰(zhàn)

1.1數(shù)字化醫(yī)療時(shí)代的到來(lái)

隨著計(jì)算機(jī)網(wǎng)絡(luò)及醫(yī)療診斷工具的成熟，現(xiàn)代化的醫(yī)療行業(yè)正進(jìn)入一個(gè)歷史性變化的時(shí)期，

數(shù)字化醫(yī)療正在改變我們的傳統(tǒng)醫(yī)療模式，并帶來(lái)醫(yī)療診斷和管理