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10.4 Ресурс ImagingStudy - Назначение

Imaging Integration Work GroupMaturity Level: 3 Trial UseSecurity Category: Patient Compartments: Patient

Представление содержимого, полученного на устройствах медицинской визуализации в формате DICOM. Исследование включает в себя ряд серий, каждая из которых содержит ряд экземпляров пар служба-объект (SOP-экземпляров - изображений или других данных), полученных или произведённых в одном контексте. Вся серия получена одним и тем же способом - модальностью (например рентген, КТ, МРТ, УЗИ), однако исследование может состоять из нескольких серий различного способа получения.

ImagingStudy provides information on a DICOM imaging study, and the series and imaging objects in that study. It also provides information on how to retrieve that information (in a native DICOM format, or in a rendered format, such as JPEG). ImagingStudy is used to make available information about all parts of a single DICOM study.

This resource provides mappings of its elements to DICOM attributes. DICOM attributes are identified by a 32-bit tag, presented in canonical form as two four-digit hexadecimal values within parentheses and separated by a comma, e.g. (0008,103E). The name and value representation (data type) of each attribute can be found in DICOM Part 6 Data Dictionary . The use of the attributes in the context of information objects, including detailed description of use, can be found in DICOM Part 3 Information Object Definitions . Attributes used in the DICOM query information models, such as "Number of Instances in Study", can be found in DICOM Part 4 Annex C .

ImagingStudy provides access to significant DICOM information but will only eliminate the need for DICOM query (e.g., QIDO-RS) in the simplest cases. The DICOM instances are not stored in the ImagingStudy resource; use of a DICOM WADO-RS server or other storage mechanism is needed.

An ImagingStudy SHALL reference one DICOM Study, and MAY reference a subset of that Study. More than one ImagingStudy MAY reference the same DICOM Study or different subsets of the same DICOM Study.

ImagingStudy is used for DICOM imaging and associated information. Use Media to track non-DICOM images, video, or audio. Binary can be used to store arbitrary content. DocumentReference allow indexing and retrieval of clinical “documents” with relevant metadata.

На этот ресурс ссылаются ChargeItem, ClinicalImpression, DiagnosticReport и Observation

Структура

ИмяФлагиКард.ТипОписание и ограниченияdoco
.. ImagingStudy TUDomainResourceСерия изображений, созданных в одном исследовании (одна или несколько серий изображений)
Элементы, определённые в прародителе: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierIdentifiers for the whole study
... status ?!Σ1..1coderegistered | available | cancelled | entered-in-error | unknown
ImagingStudyStatus (Required)
... modality Σ0..*CodingМодальность всей серии, если есть фактические способы получения
AcquisitionModality (Extensible)
... subject Σ1..1Reference(Patient | Device | Group)Who or what is the subject of the study
... encounter Σ0..1Reference(Encounter)Encounter with which this imaging study is associated
... started Σ0..1dateTimeКогда было начато исследование
... basedOn Σ0..*Reference(CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task)Request fulfilled
... referrer Σ0..1Reference(Practitioner)Referring physician
... interpreter Σ0..*Reference(Practitioner)Кто интерпретировал изображения
... endpoint Σ0..*Reference(Endpoint)Study access endpoint
... numberOfSeries Σ0..1unsignedIntКоличество серий в исследовании
... numberOfInstances Σ0..1unsignedIntКоличество экземпляров в исследовании
... procedureReference Σ0..1Reference(Procedure)The performed Procedure reference
... procedureCode Σ0..*CodeableConceptThe performed procedure code
ImagingProcedureCode (Extensible)
... location Σ0..1Reference(Location)Where ImagingStudy occurred
... reasonCode Σ0..*CodeableConceptWhy the study was requested
Procedure Reason Codes (Example)
... reasonReference Σ0..*Reference(Condition | Observation | Media | DiagnosticReport | DocumentReference)Why was study performed
... note Σ0..*AnnotationUser-defined comments
... description Σ0..1stringОписание, созданное в учреждении
... series Σ0..*BackboneElementКаждое исследование содержит одну или больше серий экземпляров
.... uid Σ1..1idDICOM Series Instance UID for the series
.... number Σ0..1unsignedIntЧисловой идентификатор этой серии
.... modality Σ1..1CodingМодальность экземпляров в этой серии
AcquisitionModality (Extensible)
.... description Σ0..1stringКороткое человекочитаемое итоговое заключение по серии
.... numberOfInstances Σ0..1unsignedIntКоличество экземпляров в серии
.... endpoint Σ0..*Reference(Endpoint)Series access endpoint
.... bodySite Σ0..1CodingИсследованная часть тела
SNOMED CT Body Structures (Example)
.... laterality Σ0..1CodingЛатеральность части тела
Laterality (Example)
.... specimen Σ0..*Reference(Specimen)Specimen imaged
.... started Σ0..1dateTimeКогда началась серия
.... performer Σ0..*BackboneElementWho performed the series
..... function Σ0..1CodeableConceptType of performance
ImagingStudy series performer function (Required)
..... actor Σ1..1Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson)Who performed the series
.... instance 0..*BackboneElementОтдельный SOP-экземпляр из этой серии
..... uid 1..1idDICOM SOP Instance UID
..... sopClass 1..1CodingТип DICOM-класса
sopClass (Extensible)
..... number 0..1unsignedIntНомер этого изображения в серии
..... title 0..1stringОписание экземпляра

doco Документация по этому формату

UML-диаграмма (Legend)

ImagingStudy (DomainResource)Identifiers for the ImagingStudy such as DICOM Study Instance UID, and Accession Numberidentifier : Identifier [0..*]The current state of the ImagingStudy (this element modifies the meaning of other elements)status : code [1..1] « The status of the ImagingStudy. (Strength=Required)ImagingStudyStatus! »Список всех значений Series.ImageModality, которые являются фактическими модальностями получения, т. е. те, что перечислены в контекстной группе 29 стандарта DICOM (набор значений OID 1.2.840.10008.6.1.19)modality : Coding [0..*] « Тип данных полученного изображения в экземпляре. (Strength=Extensible)AcquisitionModality+ »The subject, typically a patient, of the imaging studysubject : Reference [1..1] « Patient|Device|Group »The healthcare event (e.g. a patient and healthcare provider interaction) during which this ImagingStudy is madeencounter : Reference [0..1] « Encounter »Дата и время начала исследованияstarted : dateTime [0..1]Список заказов на диагностику, которые привели к выполнению данного визуализирующего исследованияbasedOn : Reference [0..*] « CarePlan|ServiceRequest|Appointment| AppointmentResponse|Task »Запрашивающий/направляющий врачreferrer : Reference [0..1] « Practitioner »Кто прочитал исследование и интерпретировал изображения или другое содержимоеinterpreter : Reference [0..*] « Practitioner »The network service providing access (e.g., query, view, or retrieval) for the study. See implementation notes for information about using DICOM endpoints. A study-level endpoint applies to each series in the study, unless overridden by a series-level endpoint with the same Endpoint.connectionTypeendpoint : Reference [0..*] « Endpoint »Number of Series in the Study. This value given may be larger than the number of series elements this Resource contains due to resource availability, security, or other factors. This element should be present if any series elements are presentnumberOfSeries : unsignedInt [0..1]Number of SOP Instances in Study. This value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are presentnumberOfInstances : unsignedInt [0..1]The procedure which this ImagingStudy was part ofprocedureReference : Reference [0..1] « Procedure »The code for the performed procedure typeprocedureCode : CodeableConcept [0..*] « The performed procedure type. (Strength=Extensible)ImagingProcedureCode+ »The principal physical location where the ImagingStudy was performedlocation : Reference [0..1] « Location »Description of clinical condition indicating why the ImagingStudy was requestedreasonCode : CodeableConcept [0..*] « The reason for the study. (Strength=Example)ProcedureReasonCodes?? »Indicates another resource whose existence justifies this StudyreasonReference : Reference [0..*] « Condition|Observation|Media| DiagnosticReport|DocumentReference »Per the recommended DICOM mapping, this element is derived from the Study Description attribute (0008,1030). Observations or findings about the imaging study should be recorded in another resource, e.g. Observation, and not in this elementnote : Annotation [0..*]The Imaging Manager description of the study. Institution-generated description or classification of the Study (component) performeddescription : string [0..1]SeriesThe DICOM Series Instance UID for the seriesuid : id [1..1]Числовой идентификатор этой серии в исследованииnumber : unsignedInt [0..1]Модальность последовательности этой серииmodality : Coding [1..1] « Тип данных полученного изображения в экземпляре. (Strength=Extensible)AcquisitionModality+ »Описание серииdescription : string [0..1]Number of SOP Instances in the Study. The value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are presentnumberOfInstances : unsignedInt [0..1]The network service providing access (e.g., query, view, or retrieval) for this series. See implementation notes for information about using DICOM endpoints. A series-level endpoint, if present, has precedence over a study-level endpoint with the same Endpoint.connectionTypeendpoint : Reference [0..*] « Endpoint »The anatomic structures examined. See DICOM Part 16 Annex L (http://dicom.nema.org/medical/dicom/current/output/chtml/part16/chapter_L.html) for DICOM to SNOMED-CT mappings. The bodySite may indicate the laterality of body part imaged; if so, it shall be consistent with any content of ImagingStudy.series.lateralitybodySite : Coding [0..1] « Коды для описания анатомического расположения. Могут включать указание латеральности. (Strength=Example)SNOMEDCTBodyStructures?? »The laterality of the (possibly paired) anatomic structures examined. E.g., the left knee, both lungs, or unpaired abdomen. If present, shall be consistent with any laterality information indicated in ImagingStudy.series.bodySitelaterality : Coding [0..1] « Коды для описания латеральности места на теле (левый, правый и т. п.). (Strength=Example)Laterality?? »The specimen imaged, e.g., for whole slide imaging of a biopsyspecimen : Reference [0..*] « Specimen »Дата и время начала серииstarted : dateTime [0..1]PerformerDistinguishes the type of involvement of the performer in the seriesfunction : CodeableConcept [0..1] « The type of involvement of the performer. (Strength=Required)ImagingStudySeriesPerformerFu...! »Indicates who or what performed the seriesactor : Reference [1..1] « Practitioner|PractitionerRole| Organization|CareTeam|Patient|Device|RelatedPerson »InstanceThe DICOM SOP Instance UID for this image or other DICOM contentuid : id [1..1]Тип DICOM-экземпляраsopClass : Coding [1..1] « The sopClass for the instance. (Strength=Extensible)sopClass+ »Номер этого экземпляра в серииnumber : unsignedInt [0..1]Описание экземпляраtitle : string [0..1]Indicates who or what performed the series and how they were involvedperformer[0..*]Отдельный SOP-экземпляр из серии, например изображение, или состояние представленияinstance[0..*]Каждое исследование содержит одну или больше серий изображений или другого содержимогоseries[0..*]

XML-шаблон

<ImagingStudy xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Identifiers for the whole study --></identifier>
 <status value="[code]"/><!-- 1..1 registered | available | cancelled | entered-in-error | unknown -->
 <modality><!-- 0..* Coding Модальность всей серии, если есть фактические способы получения  --></modality>
 <subject><!-- 1..1 Reference(Patient|Device|Group) Who or what is the subject of the study --></subject>
 <encounter><!-- 0..1 Reference(Encounter) Encounter with which this imaging study is associated --></encounter>
 <started value="[dateTime]"/><!-- 0..1 Когда было начато исследование -->
 <basedOn><!-- 0..* Reference(CarePlan|ServiceRequest|Appointment|
   AppointmentResponse|Task) Request fulfilled --></basedOn>
 <referrer><!-- 0..1 Reference(Practitioner) Referring physician --></referrer>
 <interpreter><!-- 0..* Reference(Practitioner) Кто интерпретировал изображения --></interpreter>
 <endpoint><!-- 0..* Reference(Endpoint) Study access endpoint --></endpoint>
 <numberOfSeries value="[unsignedInt]"/><!-- 0..1 Количество серий в исследовании -->
 <numberOfInstances value="[unsignedInt]"/><!-- 0..1 Количество экземпляров в исследовании -->
 <procedureReference><!-- 0..1 Reference(Procedure) The performed Procedure reference --></procedureReference>
 <procedureCode><!-- 0..* CodeableConcept The performed procedure code  --></procedureCode>
 <location><!-- 0..1 Reference(Location) Where ImagingStudy occurred --></location>
 <reasonCode><!-- 0..* CodeableConcept Why the study was requested --></reasonCode>
 <reasonReference><!-- 0..* Reference(Condition|Observation|Media|
   DiagnosticReport|DocumentReference) Why was study performed --></reasonReference>
 <note><!-- 0..* Annotation User-defined comments --></note>
 <description value="[string]"/><!-- 0..1 Описание, созданное в учреждении -->
 <series>  <!-- 0..* Каждое исследование содержит одну или больше серий экземпляров -->
  <uid value="[id]"/><!-- 1..1 DICOM Series Instance UID for the series -->
  <number value="[unsignedInt]"/><!-- 0..1 Числовой идентификатор этой серии -->
  <modality><!-- 1..1 Coding Модальность экземпляров в этой серии  --></modality>
  <description value="[string]"/><!-- 0..1 Короткое человекочитаемое итоговое заключение по серии -->
  <numberOfInstances value="[unsignedInt]"/><!-- 0..1 Количество экземпляров в серии -->
  <endpoint><!-- 0..* Reference(Endpoint) Series access endpoint --></endpoint>
  <bodySite><!-- 0..1 Coding Исследованная часть тела --></bodySite>
  <laterality><!-- 0..1 Coding Латеральность части тела --></laterality>
  <specimen><!-- 0..* Reference(Specimen) Specimen imaged --></specimen>
  <started value="[dateTime]"/><!-- 0..1 Когда началась серия -->
  <performer>  <!-- 0..* Who performed the series -->
   <function><!-- 0..1 CodeableConcept Type of performance --></function>
   <actor><!-- 1..1 Reference(Practitioner|PractitionerRole|Organization|CareTeam|
     Patient|Device|RelatedPerson) Who performed the series --></actor>
  </performer>
  <instance>  <!-- 0..* Отдельный SOP-экземпляр из этой серии -->
   <uid value="[id]"/><!-- 1..1 DICOM SOP Instance UID -->
   <sopClass><!-- 1..1 Coding Тип DICOM-класса  --></sopClass>
   <number value="[unsignedInt]"/><!-- 0..1 Номер этого изображения в серии -->
   <title value="[string]"/><!-- 0..1 Описание экземпляра -->
  </instance>
 </series>
</ImagingStudy>

JSON-шаблон

{doco
  "resourceType" : "ImagingStudy",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Identifiers for the whole study
  "status" : "<code>", // R!  registered | available | cancelled | entered-in-error | unknown
  "modality" : [{ Coding }], // Модальность всей серии, если есть фактические способы получения 
  "subject" : { Reference(Patient|Device|Group) }, // R!  Who or what is the subject of the study
  "encounter" : { Reference(Encounter) }, // Encounter with which this imaging study is associated
  "started" : "<dateTime>", // Когда было начато исследование
  "basedOn" : [{ Reference(CarePlan|ServiceRequest|Appointment|
   AppointmentResponse|Task) }], // Request fulfilled
  "referrer" : { Reference(Practitioner) }, // Referring physician
  "interpreter" : [{ Reference(Practitioner) }], // Кто интерпретировал изображения
  "endpoint" : [{ Reference(Endpoint) }], // Study access endpoint
  "numberOfSeries" : "<unsignedInt>", // Количество серий в исследовании
  "numberOfInstances" : "<unsignedInt>", // Количество экземпляров в исследовании
  "procedureReference" : { Reference(Procedure) }, // The performed Procedure reference
  "procedureCode" : [{ CodeableConcept }], // The performed procedure code 
  "location" : { Reference(Location) }, // Where ImagingStudy occurred
  "reasonCode" : [{ CodeableConcept }], // Why the study was requested
  "reasonReference" : [{ Reference(Condition|Observation|Media|
   DiagnosticReport|DocumentReference) }], // Why was study performed
  "note" : [{ Annotation }], // User-defined comments
  "description" : "<string>", // Описание, созданное в учреждении
  "series" : [{ // Каждое исследование содержит одну или больше серий экземпляров
    "uid" : "<id>", // R!  DICOM Series Instance UID for the series
    "number" : "<unsignedInt>", // Числовой идентификатор этой серии
    "modality" : { Coding }, // R!  Модальность экземпляров в этой серии 
    "description" : "<string>", // Короткое человекочитаемое итоговое заключение по серии
    "numberOfInstances" : "<unsignedInt>", // Количество экземпляров в серии
    "endpoint" : [{ Reference(Endpoint) }], // Series access endpoint
    "bodySite" : { Coding }, // Исследованная часть тела
    "laterality" : { Coding }, // Латеральность части тела
    "specimen" : [{ Reference(Specimen) }], // Specimen imaged
    "started" : "<dateTime>", // Когда началась серия
    "performer" : [{ // Who performed the series
      "function" : { CodeableConcept }, // Type of performance
      "actor" : { Reference(Practitioner|PractitionerRole|Organization|CareTeam|
     Patient|Device|RelatedPerson) } // R!  Who performed the series
    }],
    "instance" : [{ // Отдельный SOP-экземпляр из этой серии
      "uid" : "<id>", // R!  DICOM SOP Instance UID
      "sopClass" : { Coding }, // R!  Тип DICOM-класса 
      "number" : "<unsignedInt>", // Номер этого изображения в серии
      "title" : "<string>" // Описание экземпляра
    }]
  }]
}

Turtle-шаблон

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:ImagingStudy;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:ImagingStudy.identifier [ Identifier ], ... ; # 0..* Identifiers for the whole study
  fhir:ImagingStudy.status [ code ]; # 1..1 registered | available | cancelled | entered-in-error | unknown
  fhir:ImagingStudy.modality [ Coding ], ... ; # 0..* Модальность всей серии, если есть фактические способы получения
  fhir:ImagingStudy.subject [ Reference(Patient|Device|Group) ]; # 1..1 Who or what is the subject of the study
  fhir:ImagingStudy.encounter [ Reference(Encounter) ]; # 0..1 Encounter with which this imaging study is associated
  fhir:ImagingStudy.started [ dateTime ]; # 0..1 Когда было начато исследование
  fhir:ImagingStudy.basedOn [ Reference(CarePlan|ServiceRequest|Appointment|AppointmentResponse|Task) ], ... ; # 0..* Request fulfilled
  fhir:ImagingStudy.referrer [ Reference(Practitioner) ]; # 0..1 Referring physician
  fhir:ImagingStudy.interpreter [ Reference(Practitioner) ], ... ; # 0..* Кто интерпретировал изображения
  fhir:ImagingStudy.endpoint [ Reference(Endpoint) ], ... ; # 0..* Study access endpoint
  fhir:ImagingStudy.numberOfSeries [ unsignedInt ]; # 0..1 Количество серий в исследовании
  fhir:ImagingStudy.numberOfInstances [ unsignedInt ]; # 0..1 Количество экземпляров в исследовании
  fhir:ImagingStudy.procedureReference [ Reference(Procedure) ]; # 0..1 The performed Procedure reference
  fhir:ImagingStudy.procedureCode [ CodeableConcept ], ... ; # 0..* The performed procedure code
  fhir:ImagingStudy.location [ Reference(Location) ]; # 0..1 Where ImagingStudy occurred
  fhir:ImagingStudy.reasonCode [ CodeableConcept ], ... ; # 0..* Why the study was requested
  fhir:ImagingStudy.reasonReference [ Reference(Condition|Observation|Media|DiagnosticReport|DocumentReference) ], ... ; # 0..* Why was study performed
  fhir:ImagingStudy.note [ Annotation ], ... ; # 0..* User-defined comments
  fhir:ImagingStudy.description [ string ]; # 0..1 Описание, созданное в учреждении
  fhir:ImagingStudy.series [ # 0..* Каждое исследование содержит одну или больше серий экземпляров
    fhir:ImagingStudy.series.uid [ id ]; # 1..1 DICOM Series Instance UID for the series
    fhir:ImagingStudy.series.number [ unsignedInt ]; # 0..1 Числовой идентификатор этой серии
    fhir:ImagingStudy.series.modality [ Coding ]; # 1..1 Модальность экземпляров в этой серии
    fhir:ImagingStudy.series.description [ string ]; # 0..1 Короткое человекочитаемое итоговое заключение по серии
    fhir:ImagingStudy.series.numberOfInstances [ unsignedInt ]; # 0..1 Количество экземпляров в серии
    fhir:ImagingStudy.series.endpoint [ Reference(Endpoint) ], ... ; # 0..* Series access endpoint
    fhir:ImagingStudy.series.bodySite [ Coding ]; # 0..1 Исследованная часть тела
    fhir:ImagingStudy.series.laterality [ Coding ]; # 0..1 Латеральность части тела
    fhir:ImagingStudy.series.specimen [ Reference(Specimen) ], ... ; # 0..* Specimen imaged
    fhir:ImagingStudy.series.started [ dateTime ]; # 0..1 Когда началась серия
    fhir:ImagingStudy.series.performer [ # 0..* Who performed the series
      fhir:ImagingStudy.series.performer.function [ CodeableConcept ]; # 0..1 Type of performance
      fhir:ImagingStudy.series.performer.actor [ Reference(Practitioner|PractitionerRole|Organization|CareTeam|Patient|Device|RelatedPerson) ]; # 1..1 Who performed the series
    ], ...;
    fhir:ImagingStudy.series.instance [ # 0..* Отдельный SOP-экземпляр из этой серии
      fhir:ImagingStudy.series.instance.uid [ id ]; # 1..1 DICOM SOP Instance UID
      fhir:ImagingStudy.series.instance.sopClass [ Coding ]; # 1..1 Тип DICOM-класса
      fhir:ImagingStudy.series.instance.number [ unsignedInt ]; # 0..1 Номер этого изображения в серии
      fhir:ImagingStudy.series.instance.title [ string ]; # 0..1 Описание экземпляра
    ], ...;
  ], ...;
]

Changes since R3

ImagingStudy
ImagingStudy.status
  • Added Mandatory Element
ImagingStudy.modality
  • Renamed from modalityList to modality
  • Change value set from http://hl7.org/fhir/ValueSet/dicom-cid29 to http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html
ImagingStudy.subject
  • Renamed from patient to subject
  • Type Reference: Added Target Types Device, Group
ImagingStudy.encounter
  • Added Element
ImagingStudy.basedOn
  • Type Reference: Added Target Types ServiceRequest, Appointment, AppointmentResponse, Task
  • Type Reference: Removed Target Types ReferralRequest, ProcedureRequest
ImagingStudy.procedureReference
  • Max Cardinality changed from * to 1
ImagingStudy.procedureCode
  • Add Binding http://www.rsna.org/RadLex_Playbook.aspx (extensible)
ImagingStudy.location
  • Added Element
ImagingStudy.reasonCode
  • Added Element
ImagingStudy.reasonReference
  • Added Element
ImagingStudy.note
  • Added Element
ImagingStudy.series.uid
  • Type changed from oid to id
ImagingStudy.series.modality
  • Change value set from http://hl7.org/fhir/ValueSet/dicom-cid29 to http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html
ImagingStudy.series.specimen
  • Added Element
ImagingStudy.series.performer
  • Type changed from Reference(Practitioner) to BackboneElement
ImagingStudy.series.performer.function
  • Added Element
ImagingStudy.series.performer.actor
  • Added Mandatory Element
ImagingStudy.series.instance.uid
  • Type changed from oid to id
ImagingStudy.series.instance.sopClass
  • Type changed from oid to Coding
  • Add Binding http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1 (extensible)
ImagingStudy.uid
  • deleted
ImagingStudy.accession
  • deleted
ImagingStudy.availability
  • deleted
ImagingStudy.context
  • deleted
ImagingStudy.reason
  • deleted
ImagingStudy.series.availability
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

See R3 <--> R4 Conversion Maps (status = 2 tests of which 2 fail to execute.)

Структура

ИмяФлагиКард.ТипОписание и ограниченияdoco
.. ImagingStudy TUDomainResourceСерия изображений, созданных в одном исследовании (одна или несколько серий изображений)
Элементы, определённые в прародителе: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier Σ0..*IdentifierIdentifiers for the whole study
... status ?!Σ1..1coderegistered | available | cancelled | entered-in-error | unknown
ImagingStudyStatus (Required)
... modality Σ0..*CodingМодальность всей серии, если есть фактические способы получения
AcquisitionModality (Extensible)
... subject Σ1..1Reference(Patient | Device | Group)Who or what is the subject of the study
... encounter Σ0..1Reference(Encounter)Encounter with which this imaging study is associated
... started Σ0..1dateTimeКогда было начато исследование
... basedOn Σ0..*Reference(CarePlan | ServiceRequest | Appointment | AppointmentResponse | Task)Request fulfilled
... referrer Σ0..1Reference(Practitioner)Referring physician
... interpreter Σ0..*Reference(Practitioner)Кто интерпретировал изображения
... endpoint Σ0..*Reference(Endpoint)Study access endpoint
... numberOfSeries Σ0..1unsignedIntКоличество серий в исследовании
... numberOfInstances Σ0..1unsignedIntКоличество экземпляров в исследовании
... procedureReference Σ0..1Reference(Procedure)The performed Procedure reference
... procedureCode Σ0..*CodeableConceptThe performed procedure code
ImagingProcedureCode (Extensible)
... location Σ0..1Reference(Location)Where ImagingStudy occurred
... reasonCode Σ0..*CodeableConceptWhy the study was requested
Procedure Reason Codes (Example)
... reasonReference Σ0..*Reference(Condition | Observation | Media | DiagnosticReport | DocumentReference)Why was study performed
... note Σ0..*AnnotationUser-defined comments
... description Σ0..1stringОписание, созданное в учреждении
... series Σ0..*BackboneElementКаждое исследование содержит одну или больше серий экземпляров
.... uid Σ1..1idDICOM Series Instance UID for the series
.... number Σ0..1unsignedIntЧисловой идентификатор этой серии
.... modality Σ1..1CodingМодальность экземпляров в этой серии
AcquisitionModality (Extensible)
.... description Σ0..1stringКороткое человекочитаемое итоговое заключение по серии
.... numberOfInstances Σ0..1unsignedIntКоличество экземпляров в серии
.... endpoint Σ0..*Reference(Endpoint)Series access endpoint
.... bodySite Σ0..1CodingИсследованная часть тела
SNOMED CT Body Structures (Example)
.... laterality Σ0..1CodingЛатеральность части тела
Laterality (Example)
.... specimen Σ0..*Reference(Specimen)Specimen imaged
.... started Σ0..1dateTimeКогда началась серия
.... performer Σ0..*BackboneElementWho performed the series
..... function Σ0..1CodeableConceptType of performance
ImagingStudy series performer function (Required)
..... actor Σ1..1Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson)Who performed the series
.... instance 0..*BackboneElementОтдельный SOP-экземпляр из этой серии
..... uid 1..1idDICOM SOP Instance UID
..... sopClass 1..1CodingТип DICOM-класса
sopClass (Extensible)
..... number 0..1unsignedIntНомер этого изображения в серии
..... title 0..1stringОписание экземпляра

doco Документация по этому формату

UML-диаграмма (Legend)

ImagingStudy (DomainResource)Identifiers for the ImagingStudy such as DICOM Study Instance UID, and Accession Numberidentifier : Identifier [0..*]The current state of the ImagingStudy (this element modifies the meaning of other elements)status : code [1..1] « The status of the ImagingStudy. (Strength=Required)ImagingStudyStatus! »Список всех значений Series.ImageModality, которые являются фактическими модальностями получения, т. е. те, что перечислены в контекстной группе 29 стандарта DICOM (набор значений OID 1.2.840.10008.6.1.19)modality : Coding [0..*] « Тип данных полученного изображения в экземпляре. (Strength=Extensible)AcquisitionModality+ »The subject, typically a patient, of the imaging studysubject : Reference [1..1] « Patient|Device|Group »The healthcare event (e.g. a patient and healthcare provider interaction) during which this ImagingStudy is madeencounter : Reference [0..1] « Encounter »Дата и время начала исследованияstarted : dateTime [0..1]Список заказов на диагностику, которые привели к выполнению данного визуализирующего исследованияbasedOn : Reference [0..*] « CarePlan|ServiceRequest|Appointment| AppointmentResponse|Task »Запрашивающий/направляющий врачreferrer : Reference [0..1] « Practitioner »Кто прочитал исследование и интерпретировал изображения или другое содержимоеinterpreter : Reference [0..*] « Practitioner »The network service providing access (e.g., query, view, or retrieval) for the study. See implementation notes for information about using DICOM endpoints. A study-level endpoint applies to each series in the study, unless overridden by a series-level endpoint with the same Endpoint.connectionTypeendpoint : Reference [0..*] « Endpoint »Number of Series in the Study. This value given may be larger than the number of series elements this Resource contains due to resource availability, security, or other factors. This element should be present if any series elements are presentnumberOfSeries : unsignedInt [0..1]Number of SOP Instances in Study. This value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are presentnumberOfInstances : unsignedInt [0..1]The procedure which this ImagingStudy was part ofprocedureReference : Reference [0..1] « Procedure »The code for the performed procedure typeprocedureCode : CodeableConcept [0..*] « The performed procedure type. (Strength=Extensible)ImagingProcedureCode+ »The principal physical location where the ImagingStudy was performedlocation : Reference [0..1] « Location »Description of clinical condition indicating why the ImagingStudy was requestedreasonCode : CodeableConcept [0..*] « The reason for the study. (Strength=Example)ProcedureReasonCodes?? »Indicates another resource whose existence justifies this StudyreasonReference : Reference [0..*] « Condition|Observation|Media| DiagnosticReport|DocumentReference »Per the recommended DICOM mapping, this element is derived from the Study Description attribute (0008,1030). Observations or findings about the imaging study should be recorded in another resource, e.g. Observation, and not in this elementnote : Annotation [0..*]The Imaging Manager description of the study. Institution-generated description or classification of the Study (component) performeddescription : string [0..1]SeriesThe DICOM Series Instance UID for the seriesuid : id [1..1]Числовой идентификатор этой серии в исследованииnumber : unsignedInt [0..1]Модальность последовательности этой серииmodality : Coding [1..1] « Тип данных полученного изображения в экземпляре. (Strength=Extensible)AcquisitionModality+ »Описание серииdescription : string [0..1]Number of SOP Instances in the Study. The value given may be larger than the number of instance elements this resource contains due to resource availability, security, or other factors. This element should be present if any instance elements are presentnumberOfInstances : unsignedInt [0..1]The network service providing access (e.g., query, view, or retrieval) for this series. See implementation notes for information about using DICOM endpoints. A series-level endpoint, if present, has precedence over a study-level endpoint with the same Endpoint.connectionTypeendpoint : Reference [0..*] « Endpoint »The anatomic structures examined. See DICOM Part 16 Annex L (http://dicom.nema.org/medical/dicom/current/output/chtml/part16/chapter_L.html) for DICOM to SNOMED-CT mappings. The bodySite may indicate the laterality of body part imaged; if so, it shall be consistent with any content of ImagingStudy.series.lateralitybodySite : Coding [0..1] « Коды для описания анатомического расположения. Могут включать указание латеральности. (Strength=Example)SNOMEDCTBodyStructures?? »The laterality of the (possibly paired) anatomic structures examined. E.g., the left knee, both lungs, or unpaired abdomen. If present, shall be consistent with any laterality information indicated in ImagingStudy.series.bodySitelaterality : Coding [0..1] « Коды для описания латеральности места на теле (левый, правый и т. п.). (Strength=Example)Laterality?? »The specimen imaged, e.g., for whole slide imaging of a biopsyspecimen : Reference [0..*] « Specimen »Дата и время начала серииstarted : dateTime [0..1]PerformerDistinguishes the type of involvement of the performer in the seriesfunction : CodeableConcept [0..1] « The type of involvement of the performer. (Strength=Required)ImagingStudySeriesPerformerFu...! »Indicates who or what performed the seriesactor : Reference [1..1] « Practitioner|PractitionerRole| Organization|CareTeam|Patient|Device|RelatedPerson »InstanceThe DICOM SOP Instance UID for this image or other DICOM contentuid : id [1..1]Тип DICOM-экземпляраsopClass : Coding [1..1] « The sopClass for the instance. (Strength=Extensible)sopClass+ »Номер этого экземпляра в серииnumber : unsignedInt [0..1]Описание экземпляраtitle : string [0..1]Indicates who or what performed the series and how they were involvedperformer[0..*]Отдельный SOP-экземпляр из серии, например изображение, или состояние представленияinstance[0..*]Каждое исследование содержит одну или больше серий изображений или другого содержимогоseries[0..*]

XML-шаблон

<ImagingStudy xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Identifiers for the whole study --></identifier>
 <status value="[code]"/><!-- 1..1 registered | available | cancelled | entered-in-error | unknown -->
 <modality><!-- 0..* Coding Модальность всей серии, если есть фактические способы получения  --></modality>
 <subject><!-- 1..1 Reference(Patient|Device|Group) Who or what is the subject of the study --></subject>
 <encounter><!-- 0..1 Reference(Encounter) Encounter with which this imaging study is associated --></encounter>
 <started value="[dateTime]"/><!-- 0..1 Когда было начато исследование -->
 <basedOn><!-- 0..* Reference(CarePlan|ServiceRequest|Appointment|
   AppointmentResponse|Task) Request fulfilled --></basedOn>
 <referrer><!-- 0..1 Reference(Practitioner) Referring physician --></referrer>
 <interpreter><!-- 0..* Reference(Practitioner) Кто интерпретировал изображения --></interpreter>
 <endpoint><!-- 0..* Reference(Endpoint) Study access endpoint --></endpoint>
 <numberOfSeries value="[unsignedInt]"/><!-- 0..1 Количество серий в исследовании -->
 <numberOfInstances value="[unsignedInt]"/><!-- 0..1 Количество экземпляров в исследовании -->
 <procedureReference><!-- 0..1 Reference(Procedure) The performed Procedure reference --></procedureReference>
 <procedureCode><!-- 0..* CodeableConcept The performed procedure code  --></procedureCode>
 <location><!-- 0..1 Reference(Location) Where ImagingStudy occurred --></location>
 <reasonCode><!-- 0..* CodeableConcept Why the study was requested --></reasonCode>
 <reasonReference><!-- 0..* Reference(Condition|Observation|Media|
   DiagnosticReport|DocumentReference) Why was study performed --></reasonReference>
 <note><!-- 0..* Annotation User-defined comments --></note>
 <description value="[string]"/><!-- 0..1 Описание, созданное в учреждении -->
 <series>  <!-- 0..* Каждое исследование содержит одну или больше серий экземпляров -->
  <uid value="[id]"/><!-- 1..1 DICOM Series Instance UID for the series -->
  <number value="[unsignedInt]"/><!-- 0..1 Числовой идентификатор этой серии -->
  <modality><!-- 1..1 Coding Модальность экземпляров в этой серии  --></modality>
  <description value="[string]"/><!-- 0..1 Короткое человекочитаемое итоговое заключение по серии -->
  <numberOfInstances value="[unsignedInt]"/><!-- 0..1 Количество экземпляров в серии -->
  <endpoint><!-- 0..* Reference(Endpoint) Series access endpoint --></endpoint>
  <bodySite><!-- 0..1 Coding Исследованная часть тела --></bodySite>
  <laterality><!-- 0..1 Coding Латеральность части тела --></laterality>
  <specimen><!-- 0..* Reference(Specimen) Specimen imaged --></specimen>
  <started value="[dateTime]"/><!-- 0..1 Когда началась серия -->
  <performer>  <!-- 0..* Who performed the series -->
   <function><!-- 0..1 CodeableConcept Type of performance --></function>
   <actor><!-- 1..1 Reference(Practitioner|PractitionerRole|Organization|CareTeam|
     Patient|Device|RelatedPerson) Who performed the series --></actor>
  </performer>
  <instance>  <!-- 0..* Отдельный SOP-экземпляр из этой серии -->
   <uid value="[id]"/><!-- 1..1 DICOM SOP Instance UID -->
   <sopClass><!-- 1..1 Coding Тип DICOM-класса  --></sopClass>
   <number value="[unsignedInt]"/><!-- 0..1 Номер этого изображения в серии -->
   <title value="[string]"/><!-- 0..1 Описание экземпляра -->
  </instance>
 </series>
</ImagingStudy>

JSON-шаблон

{doco
  "resourceType" : "ImagingStudy",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Identifiers for the whole study
  "status" : "<code>", // R!  registered | available | cancelled | entered-in-error | unknown
  "modality" : [{ Coding }], // Модальность всей серии, если есть фактические способы получения 
  "subject" : { Reference(Patient|Device|Group) }, // R!  Who or what is the subject of the study
  "encounter" : { Reference(Encounter) }, // Encounter with which this imaging study is associated
  "started" : "<dateTime>", // Когда было начато исследование
  "basedOn" : [{ Reference(CarePlan|ServiceRequest|Appointment|
   AppointmentResponse|Task) }], // Request fulfilled
  "referrer" : { Reference(Practitioner) }, // Referring physician
  "interpreter" : [{ Reference(Practitioner) }], // Кто интерпретировал изображения
  "endpoint" : [{ Reference(Endpoint) }], // Study access endpoint
  "numberOfSeries" : "<unsignedInt>", // Количество серий в исследовании
  "numberOfInstances" : "<unsignedInt>", // Количество экземпляров в исследовании
  "procedureReference" : { Reference(Procedure) }, // The performed Procedure reference
  "procedureCode" : [{ CodeableConcept }], // The performed procedure code 
  "location" : { Reference(Location) }, // Where ImagingStudy occurred
  "reasonCode" : [{ CodeableConcept }], // Why the study was requested
  "reasonReference" : [{ Reference(Condition|Observation|Media|
   DiagnosticReport|DocumentReference) }], // Why was study performed
  "note" : [{ Annotation }], // User-defined comments
  "description" : "<string>", // Описание, созданное в учреждении
  "series" : [{ // Каждое исследование содержит одну или больше серий экземпляров
    "uid" : "<id>", // R!  DICOM Series Instance UID for the series
    "number" : "<unsignedInt>", // Числовой идентификатор этой серии
    "modality" : { Coding }, // R!  Модальность экземпляров в этой серии 
    "description" : "<string>", // Короткое человекочитаемое итоговое заключение по серии
    "numberOfInstances" : "<unsignedInt>", // Количество экземпляров в серии
    "endpoint" : [{ Reference(Endpoint) }], // Series access endpoint
    "bodySite" : { Coding }, // Исследованная часть тела
    "laterality" : { Coding }, // Латеральность части тела
    "specimen" : [{ Reference(Specimen) }], // Specimen imaged
    "started" : "<dateTime>", // Когда началась серия
    "performer" : [{ // Who performed the series
      "function" : { CodeableConcept }, // Type of performance
      "actor" : { Reference(Practitioner|PractitionerRole|Organization|CareTeam|
     Patient|Device|RelatedPerson) } // R!  Who performed the series
    }],
    "instance" : [{ // Отдельный SOP-экземпляр из этой серии
      "uid" : "<id>", // R!  DICOM SOP Instance UID
      "sopClass" : { Coding }, // R!  Тип DICOM-класса 
      "number" : "<unsignedInt>", // Номер этого изображения в серии
      "title" : "<string>" // Описание экземпляра
    }]
  }]
}

Turtle-шаблон

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:ImagingStudy;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:ImagingStudy.identifier [ Identifier ], ... ; # 0..* Identifiers for the whole study
  fhir:ImagingStudy.status [ code ]; # 1..1 registered | available | cancelled | entered-in-error | unknown
  fhir:ImagingStudy.modality [ Coding ], ... ; # 0..* Модальность всей серии, если есть фактические способы получения
  fhir:ImagingStudy.subject [ Reference(Patient|Device|Group) ]; # 1..1 Who or what is the subject of the study
  fhir:ImagingStudy.encounter [ Reference(Encounter) ]; # 0..1 Encounter with which this imaging study is associated
  fhir:ImagingStudy.started [ dateTime ]; # 0..1 Когда было начато исследование
  fhir:ImagingStudy.basedOn [ Reference(CarePlan|ServiceRequest|Appointment|AppointmentResponse|Task) ], ... ; # 0..* Request fulfilled
  fhir:ImagingStudy.referrer [ Reference(Practitioner) ]; # 0..1 Referring physician
  fhir:ImagingStudy.interpreter [ Reference(Practitioner) ], ... ; # 0..* Кто интерпретировал изображения
  fhir:ImagingStudy.endpoint [ Reference(Endpoint) ], ... ; # 0..* Study access endpoint
  fhir:ImagingStudy.numberOfSeries [ unsignedInt ]; # 0..1 Количество серий в исследовании
  fhir:ImagingStudy.numberOfInstances [ unsignedInt ]; # 0..1 Количество экземпляров в исследовании
  fhir:ImagingStudy.procedureReference [ Reference(Procedure) ]; # 0..1 The performed Procedure reference
  fhir:ImagingStudy.procedureCode [ CodeableConcept ], ... ; # 0..* The performed procedure code
  fhir:ImagingStudy.location [ Reference(Location) ]; # 0..1 Where ImagingStudy occurred
  fhir:ImagingStudy.reasonCode [ CodeableConcept ], ... ; # 0..* Why the study was requested
  fhir:ImagingStudy.reasonReference [ Reference(Condition|Observation|Media|DiagnosticReport|DocumentReference) ], ... ; # 0..* Why was study performed
  fhir:ImagingStudy.note [ Annotation ], ... ; # 0..* User-defined comments
  fhir:ImagingStudy.description [ string ]; # 0..1 Описание, созданное в учреждении
  fhir:ImagingStudy.series [ # 0..* Каждое исследование содержит одну или больше серий экземпляров
    fhir:ImagingStudy.series.uid [ id ]; # 1..1 DICOM Series Instance UID for the series
    fhir:ImagingStudy.series.number [ unsignedInt ]; # 0..1 Числовой идентификатор этой серии
    fhir:ImagingStudy.series.modality [ Coding ]; # 1..1 Модальность экземпляров в этой серии
    fhir:ImagingStudy.series.description [ string ]; # 0..1 Короткое человекочитаемое итоговое заключение по серии
    fhir:ImagingStudy.series.numberOfInstances [ unsignedInt ]; # 0..1 Количество экземпляров в серии
    fhir:ImagingStudy.series.endpoint [ Reference(Endpoint) ], ... ; # 0..* Series access endpoint
    fhir:ImagingStudy.series.bodySite [ Coding ]; # 0..1 Исследованная часть тела
    fhir:ImagingStudy.series.laterality [ Coding ]; # 0..1 Латеральность части тела
    fhir:ImagingStudy.series.specimen [ Reference(Specimen) ], ... ; # 0..* Specimen imaged
    fhir:ImagingStudy.series.started [ dateTime ]; # 0..1 Когда началась серия
    fhir:ImagingStudy.series.performer [ # 0..* Who performed the series
      fhir:ImagingStudy.series.performer.function [ CodeableConcept ]; # 0..1 Type of performance
      fhir:ImagingStudy.series.performer.actor [ Reference(Practitioner|PractitionerRole|Organization|CareTeam|Patient|Device|RelatedPerson) ]; # 1..1 Who performed the series
    ], ...;
    fhir:ImagingStudy.series.instance [ # 0..* Отдельный SOP-экземпляр из этой серии
      fhir:ImagingStudy.series.instance.uid [ id ]; # 1..1 DICOM SOP Instance UID
      fhir:ImagingStudy.series.instance.sopClass [ Coding ]; # 1..1 Тип DICOM-класса
      fhir:ImagingStudy.series.instance.number [ unsignedInt ]; # 0..1 Номер этого изображения в серии
      fhir:ImagingStudy.series.instance.title [ string ]; # 0..1 Описание экземпляра
    ], ...;
  ], ...;
]

Changes since Release 3

ImagingStudy
ImagingStudy.status
  • Added Mandatory Element
ImagingStudy.modality
  • Renamed from modalityList to modality
  • Change value set from http://hl7.org/fhir/ValueSet/dicom-cid29 to http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html
ImagingStudy.subject
  • Renamed from patient to subject
  • Type Reference: Added Target Types Device, Group
ImagingStudy.encounter
  • Added Element
ImagingStudy.basedOn
  • Type Reference: Added Target Types ServiceRequest, Appointment, AppointmentResponse, Task
  • Type Reference: Removed Target Types ReferralRequest, ProcedureRequest
ImagingStudy.procedureReference
  • Max Cardinality changed from * to 1
ImagingStudy.procedureCode
  • Add Binding http://www.rsna.org/RadLex_Playbook.aspx (extensible)
ImagingStudy.location
  • Added Element
ImagingStudy.reasonCode
  • Added Element
ImagingStudy.reasonReference
  • Added Element
ImagingStudy.note
  • Added Element
ImagingStudy.series.uid
  • Type changed from oid to id
ImagingStudy.series.modality
  • Change value set from http://hl7.org/fhir/ValueSet/dicom-cid29 to http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html
ImagingStudy.series.specimen
  • Added Element
ImagingStudy.series.performer
  • Type changed from Reference(Practitioner) to BackboneElement
ImagingStudy.series.performer.function
  • Added Element
ImagingStudy.series.performer.actor
  • Added Mandatory Element
ImagingStudy.series.instance.uid
  • Type changed from oid to id
ImagingStudy.series.instance.sopClass
  • Type changed from oid to Coding
  • Add Binding http://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1 (extensible)
ImagingStudy.uid
  • deleted
ImagingStudy.accession
  • deleted
ImagingStudy.availability
  • deleted
ImagingStudy.context
  • deleted
ImagingStudy.reason
  • deleted
ImagingStudy.series.availability
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

See R3 <--> R4 Conversion Maps (status = 2 tests of which 2 fail to execute.)

 

See the Profiles & Extensions and the Альтернативные определения: Основное определение XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions & the Анализ зависимостей

PathОписаниеТипСсылка
ImagingStudy.status The status of the ImagingStudy.RequiredImagingStudyStatus
ImagingStudy.modality
ImagingStudy.series.modality
Тип данных полученного изображения в экземпляре.ExtensibleAcquisitionModality
ImagingStudy.procedureCode The performed procedure type.Extensiblehttp://www.rsna.org/RadLex_Playbook.aspx
ImagingStudy.reasonCode The reason for the study.ExampleProcedureReasonCodes
ImagingStudy.series.bodySite Коды для описания анатомического расположения. Могут включать указание латеральности.ExampleSNOMEDCTBodyStructures
ImagingStudy.series.laterality Коды для описания латеральности места на теле (левый, правый и т. п.).ExampleLaterality
ImagingStudy.series.performer.function The type of involvement of the performer.RequiredImagingStudySeriesPerformerFunction
ImagingStudy.series.instance.sopClass The sopClass for the instance.Extensiblehttp://dicom.nema.org/medical/dicom/current/output/chtml/part04/sect_B.5.html#table_B.5-1

A referenced DICOM SOP instance could be:

  • A single- or multi-frame, still or video image captured by a variety of imaging modalities, such as X-ray, MR, and ultrasound;
  • A set of various presentation parameters, including annotation and markup;
  • A set of measurements or a report, including radiation dose report and CAD analysis;
  • An encapsulated PDF or CDA document;
  • A list of instances, such as key “of interest” images, or instances to be “deleted”; or
  • Other DICOM content.

DICOM Series Instance UID and SOP Instance UID use the id datatype, and are encoded directly. For example, an image with SOP Instance UID of 2.16.124.113543.1154777499.30246.19789.3503430045.1.1 is encoded in ImagingStudy.series.instance.uid as “2.16.124.113543.1154777499.30246.19789.3503430045.1.1”.

The ImagingStudy’s DICOM Study Instance UID is encoded in the ImagingStudy.identifier element, which is of the Identifier datatype. When encoding a DICOM UID in an Identifier datatype, use the Identifier system of “urn:dicom:uid”, and prefix the UID value with “urn:oid:”. Therefore, an ImagingStudy with DICOM Study Instance UID of 2.16.124.113543.1154777499.30246.19789.3503430046 is encoded as:


	"identifier":{
		"system":"urn:dicom:uid",
		"value":"urn:oid:2.16.124.113543.1154777499.30246.19789.3503430046"
	} 

The study accession number can also be encoded as an Identifier using the “ACSN” identifier type, as follows:


  "identifier":{
		"type" : {
			"coding" : [
				{
					"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
					"code" : "ACSN"
				}
			]
		},
		"system":"http://ginormoushospital.org/accession",
		"value":"GH334103"
	} 

The ImagingStudy.endpoint elements and ImagingStudy.series.endpoint elements indicate network services that can be used to access the studies, series, or instances; for example, a DICOM WADO-RS server. An ImagingStudy.series.endpoint of a particular Endpoint.connectionType provides that service for that series, and all contained instances. An ImagingStudy.endpoint of a particular connection type provides that service for all series in that study that do not have a specified Endpoint of that type, and their contained instances. That is, an ImagingStudy.series.endpoint overrides an ImagingStudy.endpoint of the same connection type. Systems can determine if a particular study, series, or instance is available or offline by interacting with the endpoint. Since each study, or individual series of a study can be stored on different imaging archive servers, per-series endpoints are required. For the identified services and use cases, all instances within a series would be stored together, and thus instance-level endpoints are not defined.

Different Endpoint connection types may have different capabilities, protocols or requirements; and the specified Endpoint.address may require manipulation. See below for the details on use of imaging-related Endpoint connection types.

An Endpoint.connectionType of code dicom-wado-rs, system http://terminology.hl7.org/CodeSystem/endpoint-connection-type, identifies a DICOM WADO-RS service. The Endpoint.address identifies the HTTP(S) service base url. That is, only the scheme, authority and path are included. Sub-services, such as study, shall not be specified. The path shall not contain a trailing slash.

The DICOM WADO-RS (Web Access to DICOM Objects, RESTful mode) service uses a RESTful approach to instance retrieval. This service allows for retrieval of native DICOM SOP instances, or instances “rendered” into other formats, including JPEG and MPEG. The media type of a response is specified by the request Accept header (preferred); or, by the accept query parameters. Supported media types depend on the capabilities of the WADO-RS server and the classification of the instance as “single frame,” “multi-frame,” “video,” “text,” or “other.” The WADO-RS service also allows retrieval of study or series level information.

The path to retrieve a DICOM instance is constructed by appending the appropriate sub-resource paths to the Endpoint.address value.

For example, using the following information in a fictional ImagingStudy resource:

  • the WADO-RS service base url of “https://pacs.hospital.org/wado-rs” found in an ImagingStudy.endpoint.address,
  • the DICOM Study Instance UID of “urn:oid:1.2.250.1.59.40211.12345678.678910” found in an ImagingStudy.identifier having Identifier.system of “urn:dicom:uid”,
  • the DICOM Series Instance UID of “1.2.250.1.59.40211.789001276.14556172.67789” found in ImagingStudy.series.uid, and
  • the DICOM SOP Instance UID of “1.2.250.1.59.40211.2678810.87991027.899772.2” found in ImagingStudy.series.instance.uid
we can construct the WADO-RS URL to issue an HTTP GET for a native DICOM PS3.10 instance file (if consistent with the Accept header):


https://pacs.hospital.org/wado-rs/studies/1.2.250.1.59.40211.12345678.678910/series/1.2.250.1.59.40211.789001276.14556172.67789/instances/1.2.250.1.59.40211.2678810.87991027.899772.2

Query parameters on the "rendered" sub-resource can control other aspects of the rendering including: the rendered dimensions, the quality (compression ratio), the region of interest to render, the brightness/contrast (window center/width) adjustments, and whether to “burn” patient or study demographics into the rendered result. Specific frames of a multi-frame instance may be retrieved using the frames sub-resource.

For example, provided the Accept header indicates a preference for image/jpeg, the example above can be extended with parameters that cause a JPEG thumbnail (100 columns by 100 rows) of a region extending from the top-left corner of the original image, across 1000 and down 3000 pixels, to be retrieved (additional sub-resource and parameters emphasized):


https://pacs.hospital.org/wado-rs/studies/1.2.250.1.59.40211.12345678.678910/series/1.2.250.1.59.40211.789001276.14556172.67789/instances/1.2.250.1.59.40211.2678810.87991027.899772.2/rendered?viewport=100,100,0,0,1000,3000

For further details on DICOM WADO-RS capabilities including additional rendering parameters, see DICOM PS 3.18 .

An Endpoint.connectionType of code dicom-wado-uri, system http://terminology.hl7.org/CodeSystem/endpoint-connection-type, identifies a DICOM WADO-URI service. The Endpoint.address identifies the HTTP(S) service base url. That is, only the scheme, authority and path are included. Neither a question mark (“?”) nor any query parameters shall be included.

The DICOM WADO-URI (Web Access to DICOM Objects, URI mode) service uses HTTP query parameter syntax. This service allows for retrieval of native DICOM instances, or instances “rendered” into other formats, including JPEG and MPEG. The media type of a response is specified by the request Accept header (preferred); or, by the contentType query parameter. Supported media types depend on the classification of the instance as “single frame,” “multi-frame,” “video,” “text,” or “other.”

The query to retrieve a DICOM instance is constructed by appending the appropriate query parameters to the Endpoint.address value.

For example, using the following information in a fictional ImagingStudy resource:

  • the WADO-URI service base url of “https://pacs.hospital.org/wado-uri” found in an ImagingStudy.endpoint.address,
  • the DICOM Study Instance UID of “urn:oid:1.2.250.1.59.40211.12345678.678910” found in an ImagingStudy.identifier having Identifier.system of “urn:dicom:uid”,
  • the DICOM Series Instance UID of “1.2.250.1.59.40211.789001276.14556172.67789” found in ImagingStudy.series.uid, and
  • the DICOM SOP Instance UID of “1.2.250.1.59.40211.2678810.87991027.899772.2” found in ImagingStudy.series.instance.uid
we can construct the WADO-URI URL to issue an HTTP GET for a native DICOM PS3.10 instance file (if consistent with the Accept header):


https://pacs.hospital.org/wado-uri?requestType=WADO&studyUID=1.2.250.1.59.40211.12345678.678910&seriesUID=1.2.250.1.59.40211.789001276.14556172.67789&objectUID=1.2.250.1.59.40211.2678810.87991027.899772.2

Additional query parameters can control other aspects of the rendering including rendered dimensions, quality (compression ratio), the region of interest within the image to render, brightness/contrast (window center/width) adjustments, whether to “burn” patient or study demographics into the rendered result, and which frame of a multi-frame instance to retrieve.

For example, provided the Accept header indicates a preference for image/jpeg, the example above can be extended with parameters that cause a JPEG thumbnail (100 columns by 100 rows) of the left half of the image to be retrieved (additional parameters emphasized):


https://pacs.hospital.org/wado-uri?requestType=WADO&studyUID=1.2.250.1.59.40211.12345678.678910&seriesUID=1.2.250.1.59.40211.789001276.14556172.67789&objectUID=1.2.250.1.59.40211.2678810.87991027.899772.2&rows=100&columns=100&region=0,0,0.5,1 

For further details on DICOM WADO-URI capabilities including additional rendering parameters, see DICOM PS 3.18 .

An Endpoint.connectionType of code ihe-iid, system http://terminology.hl7.org/CodeSystem/endpoint-connection-type, identifies an IHE Invoke Image Display (IID) service. The Endpoint.address identifies the HTTP(S) service base url. That is, only the scheme, authority and path are included. Neither a question mark (“?”) nor any query parameters shall be included.

The IHE Invoke Image Display (IID) service provides a standardized mechanism to launch a viewer in a particular study context. (IID also supports invoking a particular patient context, but that is not profiled here.) An IID-type Endpoint should be used only at the study level. As well as invoking the viewer on a particular study, query parameters can request particular viewer capabilities, image quality, and more.

To launch a viewer, append the appropriate query parameters to Endpoint.address value.

For example, using the following information in a fictional ImagingStudy resource:

  • the WADO-URI service base url of “https://pacs.hospital.org/IHEInvokeImageDisplay” found in an ImagingStudy.endpoint.address,
  • the DICOM Study Instance UID of “urn:oid:1.2.250.1.59.40211.12345678.678910” found in an ImagingStudy.identifier having Identifier.system of “urn:dicom:uid”,
we can construct the IID URL to invoke a diagnostic quality viewer on the indicated study:


https://pacs.hospital.org/IHEInvokeImageDisplay?requestType=STUDY&studyUID=1.2.250.1.59.40211.12345678.678910&diagnosticQuality=true

For further details on IHE Invoke Image Display capabilities including additional parameters, see the IHE Technical Frameworks , or the introduction on the IHE IID Profile Wiki .

Amy, a family physician, would like to see a list of available studies for her patient, Alex. Her EHR client makes a FHIR call for all ImagingStudy objects available for Alex. In the response, she is able to see the study date, procedure, modality, and accession number, for each study returned. There is enough information provided in the response to obtain a thumbnail via a WADO-RS call, or to launch a viewer using an IHE Radiology - Invoke Image Display (IID) profile call using the url elements found in the ImagingStudy.

Joe Angina complains of shortness of breath and occasional chest pain to his primary care physician, Dr. Pat Down at Local MultiClinic, who orders a stress echocardiogram; the order is created as a FHIR Task resource to manage the workflow, with a link to a ServiceRequest resource with the details of the request. The order is scheduled and assigned to cardiologist Dr. Art Skann, also at Local MultiClinic.

On the scheduled day of the exam, Joe arrives at the echo lab to meet with Dr. Skann and have the study done. Dr. Skann’s workstation shows the daily list of Task, and he follows the link to retrieve the ServiceRequest. (He may follow the links through the referenced Patient resource to access Joe’s electronic medical record, but that is not the concern of this storyboard.)

The Task and ServiceRequest has been transcoded to a DICOM Modality Worklist Scheduled Procedure Step, and in the echo lab the equipment has downloaded the Modality Worklist. The study is performed, and the acquired images and sonographer’s preliminary measurements are stored in the Local MultiClinic Picture Archiving and Communication System (PACS). The PACS creates an ImagingStudy resource for each study it manages.

Dr. Skann interprets the study on a PACS workstation, and he selects two key image frames to be included in the diagnostic report; this selection is stored back to the PACS as a DICOM Key Object Selection with the title "For Report Attachment", and the PACS makes it available (transcodes it) as a FHIR ImagingStudy resource. Dr. Skann dictates the report using a structured data entry report writing program, including a recommendation for a cardiac catheterization procedure, and signs it. The report writing program formats the report as a CDA document, retrieves the ImagingStudy resource, and inserts the referenced key images into the report.

Dr. Down meets again with Joe, and they review the results of the stress test. Joe has a question about the findings that the key images in the report do not show, so Dr. Down uses the Local MultiClinic EMR to query the PACS for the full ImagingStudy resource and uses the references there to open an image display for the full study. Joe agrees to proceed to catheterization, and Dr. Down sends a referral to the Ginormous University Hospital cath department and triggers the PACS to share the echo study through the Metropolitan Health Information Exchange.

The PACS creates an imaging study as an ImagingStudy resource, which includes all the images but excludes the sonographer’s preliminary measurements (which as a matter of policy are not shared outside the Local MultiClinic). The imaging study is published to the Metro HIE. (In accordance with IHE XDS-I , the images themselves are not directly published to the HIE, but available for on-demand retrieval from the PACS.)

At Ginormous Hospital, Dr. Cora Plummer receives the cath referral, and looks up the study in the Metro HIE registry. She retrieves the study ImagingStudy, and uses it to access the shared images, which she uses to prepare for the cath procedure.

Параметры поиска для этого ресурса. Также к нему применяются общие параметры. Более подробную информацию о поиске в REST, обмене сообщениями и сервисах см. в разделе Поиск.

ИмяТипОпределениеВыражениеIn Common
basedonreferenceПорядок изображенияImagingStudy.basedOn
(Appointment, AppointmentResponse, CarePlan, Task, ServiceRequest)
bodysitetokenИзучаемая часть телаImagingStudy.series.bodySite
dicom-classtokenТип экземпляраImagingStudy.series.instance.sopClass
encounterreferenceThe context of the studyImagingStudy.encounter
(Encounter)
endpointreferenceThe endpoint for the study or seriesImagingStudy.endpoint | ImagingStudy.series.endpoint
(Endpoint)
identifiertokenIdentifiers for the Study, such as DICOM Study Instance UID and Accession numberImagingStudy.identifier30 Resources
instancetokenSOP Instance UID for an instanceImagingStudy.series.instance.uid
modalitytokenМодальность серииImagingStudy.series.modality
patientreferenceКто был субъектом исследованияImagingStudy.subject.where(resolve() is Patient)
(Patient)
29 Resources
performerreferenceThe person who performed the studyImagingStudy.series.performer.actor
(Practitioner, Organization, CareTeam, Device, Patient, PractitionerRole, RelatedPerson)
reasontokenThe reason for the studyImagingStudy.reasonCode
seriestokenDICOM Series Instance UID for a seriesImagingStudy.series.uid
starteddateВремя начала исследованияImagingStudy.started
statustokenThe status of the studyImagingStudy.status
subjectreferenceКто был субъектом исследованияImagingStudy.subject
(Group, Device, Patient)