透視動態影像數位化系統建置及評估 (以神經放射血管攝影為例)

Design and Evaluation of a DICOM compliant Video-fluoroscopy Imaging System (An Investigation in Neuroradiology Angiography)

張美彥(Mei-Yen Chang)

指導教授 ： 劉建財

臺北醫學大學/醫學院/醫學資訊研究所/碩士(2007年)

https://doi.org/10.6831/TMU.2007.00143

摘要

透視檢查是屬於一種特殊的X光檢查，可以即時提供病患身體內部器官或組織構造之連續X光影像或即時動態視訊。在放射線學的檢查中，它被應用於許多不同的檢查或流程中，例如經皮腎造口術(PCN)、鋇劑食道吞嚥攝影檢查、心導管等等介入性檢查。這些即時動能透視影像同樣具有診斷回顧、教學及研究的價值，應該被視為病人的診療紀錄，和病歷一樣的被完整保存。傳統的動態透視影像可以利用外接的錄放影機，以錄影帶做為媒介儲存、記錄。但受限於錄影帶的本身的性質，只能從頭開始依序的搜尋段落，即便已經知道想查閱的某段影像在那個段落，卻也無法直接播放該影像。這使得這些錄影帶的資料無法有效的管理。在現階段中，DICOM 3.0(Digital Imaging and Communications in Medicine)標準中已公告支援MPEG-2的動態影像壓縮格式。在國內，多數已完成建置影像儲傳系統(Picture Achieving and Communication Systems,簡稱PACSs)的醫院，依據DICOM的標準來儲存和管理一般靜態的X光影像。現在正是時候將動態透視影像擷像、數位化並整合到醫院的PACS系統中，這樣可以有更佳的儲存方式、影像資源共享及影像資料管理。雖然DICOM標準中定義了支援MPEG-2的壓縮結構，但卻也表示，臨床醫學是否可以接受MPEG2失真壓縮的影像，不在DICOM標準的研究範圍內。本研究論文的目的在於建立「透視動態影像數位化系統」，將動態透視影像轉為符合DICOM MPEG2標準的影像，並整合入醫院的PACS系統中，並且從臨床診斷的觀點評估系統接受度。我們利用現有血管攝影的系統中，同時具備傳統的錄影機及數位擷像系統的檢查儀器，針對頭頸部之透視檢查影像，分別錄製「傳統錄影帶的NTSC訊號影像」及「DICOM-MPEG2數位影像」，請放射專科醫師針對所收集個案進行評估，證實DICOM MPEG2格式的動態透視影像與傳統的錄影帶所記錄影像，且有相同或更佳的影像品質。

關鍵字

動態透視檢查影像 ； 訊號壓縮 ； 使用者接受度評估 ； DICOM標準

並列摘要

Fluoroscopy is a special type of x-ray that provides continuous x-ray images (or live video) of a patient’s organ structures in real time. It is used in many types of examinations and procedures, such as Percutaneous Nephrostomy (PCN), Barium Swallow, cardiac catheterization, and so on. The live fluoroscopy video is valuable for diagnosis review, teaching and research. They need to be stored as a part of the patient’s medical records. Traditionally, the live fluoroscopic video can be saved by using video tapes. Since the nature of sequential access to a video tape, we cannot directly play or view a specific image. This makes the management of video tapes inefficient. Currently the DICOM 3.0 (Digital Imaging and Communications in Medicine) Standard supports the MPEG-2 live video compression format. Most hospitals in Taiwan have developed their Picture Achieving and Communication Systems (PACSs) based on the DICOM standard to store and manage static x-ray images. Thus, it is the time for live fluoroscopic video to be captured, digitalized and integrated into the PACS for better storage, sharing and management. Although the DICOM supports the MPEG-2 compression scheme, it indicates that whether the clinicians can accept the lossy compression of MPEG-2 images is beyond the scope of the DICOM Standard. The paper presented here proposes approaches to develop a DICOM MPEG2 compliant fluoroscopic video management system integrated seamlessly with other hospital systems, and presents methods to evaluate the system acceptance from the viewpoint of clinicians. We conclude that the quality of the fluoroscopic video represented by the DICOM MPEG-2 specification is as good as or better than that represented by traditional video tapes.

並列關鍵字

Video-fluoroscopy images ； signal compression ； User acceptance evaluation ； DICOM

參考文獻

1. 王彥迪, 醫學影像之無失真動態壓縮技術的研發, 國立成功大學電機工程學系研士論文, 2005.06

25. Stewart C. Bushong. Radiologic Science for Technologists. Eighth Edition,2004.

6. Bassignani MJ, Dwyer SJ 3rd, Ciambotti JM, Olazagasti JM, Moran R, Moynihan S, Weaver AC, Snyder AM. Review of technology: planning for the development of telesonography. J Digit Imaging. 2004 Mar;17(1):18-27.

8. Cabral, J.E., Jr. Yongmin Kim. Multimedia systems for telemedicine and their communications requirements. Volume: 34, Issue: 7. Communications Magazine, IEEE. Jul 1996.

9. Close RA, Abbey CK, Morioka CA, Whiting JS. Evaluation of layer decomposition for multiframe quantitative coronary angiography. Med Phys. 2002 Mar;29(3):311-8.