醫(yī)學(xué)影像科建設(shè)與管理

1、醫(yī)學(xué)影像科建設(shè)與管理醫(yī)學(xué)影像科 吳振暄隨著計(jì)算機(jī)技術(shù)與醫(yī)學(xué)影像學(xué)的發(fā)展，X射線成像技術(shù)進(jìn)入了數(shù)字化的發(fā)展 時(shí)代，現(xiàn)代醫(yī)學(xué)影像學(xué)是隨著自然科學(xué)和臨床醫(yī)學(xué)科學(xué)的發(fā)展而發(fā)展，醫(yī)學(xué)影像 設(shè)備不斷更新和換代，相應(yīng)的新技術(shù)也不斷誕生，飛速發(fā)展的影像技術(shù)也有效的 幫助臨床解決很多實(shí)際問(wèn)題。所以現(xiàn)代醫(yī)學(xué)影像科的合理建設(shè)發(fā)展與嚴(yán)格的管理 培訓(xùn)至關(guān)重要。我院醫(yī)學(xué)影像科始建于上世紀(jì)70年代初。經(jīng)過(guò)40余載的努力發(fā)展，依托院 士平臺(tái)醫(yī)院優(yōu)勢(shì)學(xué)科，在人才培養(yǎng)、梯隊(duì)建設(shè)、科室設(shè)置和學(xué)術(shù)水平等方面均有 顯著提高與發(fā)展，對(duì)于月中瘤專科性影像診斷來(lái)說(shuō)，專業(yè)、專注、專心一直是我院 診斷的優(yōu)良傳統(tǒng)，影像科的醫(yī)生、技師、護(hù)理人員也本

2、著用專業(yè)專注更專心的態(tài) 度在醫(yī)學(xué)影像的科學(xué)世界里探索與發(fā)展。 多年來(lái)，在月中瘤的早期檢出和定性，月中 瘤術(shù)前評(píng)估，精確放射治療靶區(qū)勾畫以及放療與化療的療效評(píng)估方面積累了豐富 的經(jīng)驗(yàn)。在月中瘤影像診斷和相關(guān)的基礎(chǔ)研究工作中取得了一定的成果，伴隨著新技術(shù)的產(chǎn)生，影像檢查也要隨時(shí)代變遷而發(fā)展， 經(jīng)過(guò)科室主任、副主任及護(hù)士長(zhǎng) 的精密研究和科室同事的一致支持下，影像科成立了各個(gè)管理組，普通放射診斷組、CT（計(jì)算機(jī)X線斷層攝影）影像診斷組、MR磁共振成像）影像診斷組、PET-CT （正電子發(fā)射計(jì)算機(jī)斷層顯像）診斷組，影像檢查技術(shù)組，影像檢查護(hù)理組，放 射性粒子植入組，射頻消融治療組，影像登記組，各組分工明

3、確，制度體系健全， 日常工作合理有序進(jìn)行，在引進(jìn)設(shè)備方面，也有較著重的變革，普通放射設(shè)備在 原有第一臺(tái)的基礎(chǔ)上新增3臺(tái)，分別為銳柯醫(yī)療集團(tuán)（CarestreamHealth ）無(wú)線 傳輸DR西門子醫(yī)療集團(tuán)（SIEMENSLuminos Select胃腸機(jī)及Inspiration乳腺機(jī)。這三臺(tái)設(shè)備分別具有其時(shí)代技術(shù)意義， 在低計(jì)量技術(shù)應(yīng)用及圖像質(zhì)量問(wèn) 題上表現(xiàn)尤為突出，無(wú)線傳輸DR-CARESTREAMDRX-Nova化X射線攝影成像系 統(tǒng)表現(xiàn)卓越，它集成了業(yè)內(nèi)首款無(wú)線、標(biāo)準(zhǔn)規(guī)格的DRX-1數(shù)字平板探測(cè)器。是一 種”神奇的“可以拆卸的" CR-IP板“，優(yōu)點(diǎn)在于使得前來(lái)做X線攝影的臥床

4、危 重病人可以將探測(cè)器直接置于床板一側(cè)進(jìn)行攝片即可。在西門子醫(yī)療集團(tuán)（SIEMEN且uminos Select胃腸機(jī)投入使用之后，其檢查優(yōu)勢(shì)也逐漸顯露，與第一臺(tái)日本東芝胃腸機(jī)相比較，Luminos Select胃腸機(jī)在透視過(guò)程中的連續(xù)曝光中做了程序化調(diào)整，在保證圖像分辨率的前提下智能調(diào)節(jié)曝光條件，有效減少持續(xù)曝光所帶來(lái)的大劑量照射，將檢查者及操作者的受檢劑量及輻射劑量 有效降低約20% Inspiration乳腺機(jī)的引進(jìn)更是為我院影像技術(shù)再添新的高度，我們?cè)诖嗽O(shè)備基礎(chǔ)上開(kāi)展了乳腺癌的早期篩查檢查，在微細(xì)小鈣化灶的的檢出方 面表現(xiàn)突出。乳腺活檢穿刺的臨床應(yīng)用更是取得了乳腺外科的一致好評(píng)。CT （

5、計(jì)算機(jī)X線斷層攝影）設(shè)備在原有兩臺(tái)荷蘭飛利浦光輝高端CT （PHILIPSBrilliance iCT/64CT）的基礎(chǔ)上引進(jìn)了西門子醫(yī)療集團(tuán)（SIEMENS的SOMATOM Definition AS+,技術(shù)優(yōu)勢(shì)為：時(shí)間分辨率高：秒/圈，采集?。翰杉瑘D像分辨 率高達(dá)30pl/cm ,最先進(jìn)的探測(cè)器技術(shù)超快速稀土陶瓷探測(cè)器UFCTM,余輝效應(yīng)最短。圖像采集系統(tǒng)為飛焦點(diǎn)采樣技術(shù)：雙倍圖像信息，掃描速度快，胸部掃描 僅需6秒（對(duì)于急癥及躁動(dòng)病人受檢更加安全），球館-探測(cè)器系統(tǒng)每旋轉(zhuǎn)一圈， 獲得128層的人體斷層圖像，掃描長(zhǎng)度為350mme mm, s350 mm： 6 s）,掃描 范圍廣，最長(zhǎng)可

6、連續(xù)掃描1980mm圖像重建速度快，對(duì)于我院的優(yōu)勢(shì)三維處理 軟件為月中瘤學(xué)軟件（Oncology）可以將月中瘤自動(dòng)分離，測(cè)量體積，直徑及形態(tài)， 對(duì)于肺部病變，肝臟病變，淋巴結(jié)及全身其他病變，月中瘤學(xué)軟件分別有獨(dú)立的測(cè) 量方法，準(zhǔn)確率較高。利用此設(shè)備的特殊技術(shù)優(yōu)勢(shì)，我們提高了放射性粒子植入 術(shù)的手術(shù)量，節(jié)約了患者時(shí)間，提高了患者的治療質(zhì)量，也是的我們的粒子植入 微創(chuàng)手術(shù)更上一個(gè)新的嫻熟模式。副主任開(kāi)展了CT引導(dǎo)下微波射頻消融術(shù)，對(duì)于腹部微小病灶治療效果甚佳，也同樣的得到了各個(gè)臨床科室的認(rèn)可。這兩項(xiàng) CT引導(dǎo)下技術(shù)說(shuō)明了未來(lái)的影像將不僅局限于診斷、功能成像，分子影像學(xué)， 還要在影像治療學(xué)上發(fā)展（區(qū)

7、別于放射治療學(xué)）。我院的磁共振成像設(shè)備依然是 業(yè)界值得稱贊的荷蘭飛利浦（PHILIPS,）,此設(shè)備具有dStream全數(shù)字影像鏈， 能同時(shí)兼顧高清圖像和超快速成像，提供了質(zhì)量控制和高效工作的雙重保障，以 患者為中心成像的方面更有突出表現(xiàn)，iPatient 技術(shù)更是讓技術(shù)人員控制患者 在行為、條件、解剖學(xué)及生理學(xué)方面的可變性，使得檢查工作連續(xù)而高效。圖像質(zhì)量問(wèn)題的控制一直是影像科的重中之重，雖然現(xiàn)代設(shè)備已經(jīng)在成 像原理方面及數(shù)字計(jì)算方面的將圖像進(jìn)行質(zhì)量控制，影像科每天的兩場(chǎng)大型閱片 會(huì)是科內(nèi)最精彩的片段，由主任親自帶領(lǐng)分析病例，組織討論，每次都使得大家受益匪淺，總是拿著筆記本不停地記錄，對(duì)于圖像

8、質(zhì)量更是要求嚴(yán)格但是， 在科 室管理及科室業(yè)務(wù)水平方面，主任一方面注重科學(xué)管理，加強(qiáng)科室業(yè)務(wù)學(xué)習(xí)，同 時(shí)又毫不保留的將自身的專業(yè)知識(shí)和臨床經(jīng)驗(yàn)傳授給年輕同事。 他制定了完善的 科室管理和業(yè)務(wù)學(xué)習(xí)制度，多年來(lái)一直加強(qiáng)疑難病例隨訪和科室內(nèi)的回顧性讀片。每周的輪流業(yè)務(wù)學(xué)習(xí)講座加大了青年醫(yī)生的自學(xué)、交流的壓力和動(dòng)力。他在影像科內(nèi)部實(shí)行的X線、CK磁共振，PET-C邙各崗位工作的輪換，切實(shí)提高 了年輕醫(yī)生的各種影像綜合、分析、判斷能力。檢查中選擇合適的檢查協(xié)議及細(xì)心的影像護(hù)理工作同等重要，技術(shù)人員只 要掌握好檢查方法及病人在檢查過(guò)程中的配合就好。而影像護(hù)士相對(duì)來(lái)說(shuō)就非常 辛苦了，檢查前宣教，最佳靜脈通道

9、的選擇建立，保證檢查秩序的有序進(jìn)行及檢 查時(shí)的仔細(xì)查對(duì)，檢查前的準(zhǔn)備，檢查過(guò)程中謹(jǐn)慎觀察及檢查預(yù)后都是做好影像 檢查的重要環(huán)節(jié)，也是整個(gè)患者檢查中付出最多的崗位， 耐心，細(xì)致的態(tài)度一直 浮現(xiàn)在她們的臉龐，是也正是只有這樣的白衣天使守護(hù)在影像科， 才使得影像檢 查變得安全、安心。護(hù)理工作也是影像科抓的最勤，表現(xiàn)最好的管理組，每周定 期開(kāi)會(huì)，總結(jié)經(jīng)驗(yàn)，學(xué)習(xí)培訓(xùn)新技術(shù)，在護(hù)士長(zhǎng)的帶領(lǐng)下，每位護(hù)理人員都嚴(yán)于律己，在工作上眼勤，手勤，腿勤，都具有敏銳的觀察力，秉承著“一切為了 患者的安全，為了患者的一切安全”工作理念去工作， 這才使我們影像科護(hù)理團(tuán) 隊(duì)具有著這么高的素質(zhì)，這么精的質(zhì)量。醫(yī)學(xué)影像科一直奉行

10、用細(xì)心的護(hù)理， 精 湛的技術(shù)，達(dá)到一流的診斷。使得再大的門診檢查量我們也依舊能夠保質(zhì)， 保量 的順利完成工作。我們堅(jiān)信，用專業(yè)的心，醫(yī)學(xué)影像科的建設(shè)會(huì)更加附有專業(yè)魅力，做專注 的事，醫(yī)學(xué)影像科的管理才會(huì)變的盎然生機(jī)， 也只有這樣，我們的醫(yī)院才會(huì)更加 興旺，我們的國(guó)家才會(huì)更加富強(qiáng)。Construction and management of medical imaging departmentMedical Imaging Division Li Wenwu Yang Guihua Wu ZhenxuanWith the development of computer technology an

11、d medical imaging technology, X ray imaging technology has entered the era of digital development. Modern medical imaging is developing with the development of natural science and clinical medicine. The new technology is also being is very important.Our hospital medical imaging department was founde

12、d in the early 70's, after more than 40 years of development, relying on the scientific platform of the scientific research, the professional, focused and focused on the scientific world of medical imaging, which has been used to explore and develop. In the early detection and treatment of tumor

13、, the efficacy of radiotherapy and chemotherapy is also the focus. The results were obtained in the study of tumor imaging and related basic research. The imaging examination should be developed with the change of times, and the imaging examination should be developed with the change of the times. I

14、t was set up by the Department Director, deputy directorand the assistant director. The imaging department was set up. CT (magnetic resonance imaging) imaging, MR (positron emission computed tomography) imaging, PET-CT(positron emission tomography) imaging, and radiation. Frequency ablation treatmen

15、t group, the image registration group, the division of labor is clear, the system is perfect, the daily work of a reasonable and orderly, in the introduction of equipment, also has a more focused, ordinary radiation equipment on the basis of the original 3 units, respectively, DR (CarestreamHealth)

16、wireless transmission Luminos, SIEMENSmedical group (SIEMENS)Select Inspiration breast machine, Wireless transmission DR-CARESTREAMDRX-Nodvigaital X-ray radiography system performance excellence, which integrates the industry's first wireless, Standard Specification for digital DRX-1flat panel d

17、etector. It is a "magical" detachable "CR-IP plate" advantages of is making to come and do radiography of critically ill patientswith bedcan be detectors placed directly on one side of the bed board were taken sheet can be. Put into use in the Siemens (Siemens) Luminos select gas

18、trointestinal and the advantage is gradually revealed, and the firstJapanese Toshiba gastrointestinal machine compared Select Luminos gastrointestinal machine in the perspective of continuous exposure in the process of adjustment, in order to ensure the image resolution under the premise of intellig

19、ent regulation of exposure conditions, effectivelyreduce the exposure to large doses of radiation, and the operator's dose and radiation dose effectively reduce the introduction of 20%.Inspiration breast machine is to add a new height, we carried out early screening of breast cancer, the clinica

20、l use of breast biopsy should be madeof breast surgery .CT (PHILIPS iCT/64CT CT) based on the introduction of PHILPS medical group (Brilliance) Definition AS+ SOMATOMte,chnical advantages: seconds / circle, collection of thin: acquisition, image resolution up to 30pl/cm, the most advanced detector t

21、echnology ultra fast rare earth ceramic detector UFCTM,afterglow effect is the shortest. For flying focus sampling technique: double image information, fast scanning speed, scan of the chest only 6 seconds (for emergency and restlessness patients examined more secure), arena - detector system rotate

22、s a circle was , obtained 128 slice human tomographic images, the length of the scan for 350mm mm, S350: 6 s), wide range of scanning, the longest continuous scanning 1980 mm, fast speed of image reconstruction, for the advantages of 3D processing software for Oncology (Oncology) software can automa

23、tic separation of tumor, measuring body Product, diameter and morphology, for the lung lesions, lesions of the liver, lymph nodes and other systemic diseases, oncology software respectively independent measuring method, the rate of accuracy is high. The use of special technical advantages of this de

24、vice, we improve the amount of radioactive particles implantation surgery, section about the patient time and improve the quality of treatment of patients with, and our particle implantation minimally invasive surgery more on a new model of skilled. Deputy director to carry out the CT guided microwa

25、ve ablation, for the treatment of small lesions in the abdomeneffect is very good, the samehas been all pro bed department approval. The two CT guided technology that images of the future will not Imaging, molecular imaging, molecular imaging, as well as the industry's highly acclaimed (iPatient

26、, dStream), the industry's magnetic resonance imaging device is still the industry's acclaimed Holland PHILPS(PHILIPS, , which has the dual protection of quality control and efficient work, Make inspection work continuously and efficiently.Image quality control has been the focus of the imag

27、e, although modern equipment has been in the imaging principle and digital calculation of the image quality control, image division every day, two large reading piece will be Kone's most brilliant fragments, the director personally led the analysis of cases, the organization discussed, always ta

28、ke a notebook to record, for the quality of the image is strict but, in the department management and business level, director of scientific management, strengthening the Department business learning, and without reservation of their professional knowledge and clinical experience toyoung colleagues.

29、 To develop a sound managementsystem and business system, for many years has been to strengthen the follow-up and management of patients in the Department of medical imaging, the weekly business study, the exchange of pressure and power.Inspection protocols and careful selection of appropriate inspe

30、ction protocols and care work equally important, technical staff as long as a good examination method and patients in the examination process, and the image is very hard, and the nurse is relatively speaking, to ensure the orderly conduct and examination of the examination, examination of the important link, is also the entire patient examination in their faces, is only such a White Angel Guardian All work under the leadership of thecatch, which makes the imaging has become a safe, secure. Nursing work