医药学论文：WEB双向DICOM传输在远程会诊中的应用

Abstract This paper discussed the tele-transportation and application of the DICOM format medical images on WEB,and provided a new B/S structure mode of two-way tele-consultation between doctors,and expounded the technologies related to tele-consultation,such as PACS and HIS background connection based on HL7 back standard,tele SSL VPN technology,wireless application,lossless compression,multi-points consultation and logical isolation technology of virtual network.This application provides a new practical scheme for breaking through the limitation of intranet of medical service and full use of medical resource.

关键词： WEB；DICOM；PACS；远程会诊
1 国内外现状及设计思想
国内有用DICOM网关在WWW网站上浏览PACS图像的文献报道［5］，但这种方式尚存在以下缺陷：(1)通过WEB获取的PACS图像不是DICOM格式，而是经过转换的GIF或JPEG格式，由于这类格式图像不能进行窗宽窗位的调整，达不到医生精确阅片的要求；(2)WEB浏览终端不具有上传DICOM格式图像的功能，会诊流程是单向的，无法实现基于医生间相互沟通而称之为真正意义上的远程会诊；(3)WEB使用Windows的IE浏览软件，IE是Internet网上最主要的不安全因素之一，所以通常的WEB远程会诊应用存在着安全隐患。