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### DICOM标准与服务类规范概述 #### 一、引言在医学成像与通信领域，Digital Imaging and Communications in Medicine (DICOM) 标准是必不可少的技术规范。该标准确保了不同医疗设备和系统之间的互操作性，使得图像和其他医疗信息能够安全有效地交换和管理。本文将基于“DICOM帮助文档4”的部分内容——《数字成像与医学通信系统（DICOM）第四部分：服务类规范》（PS3.4-2008版），详细介绍DICOM标准中的关键概念和服务类规范。 #### 二、DICOM标准简介 DICOM是由美国国家电气制造商协会（NEMA）发布的医学成像和通信标准。它旨在解决医学图像的存储、检索、管理和传输问题。该标准包括多个部分，每个部分关注不同的技术方面： - **第一部分**：概述和基础。 - **第二部分**：数据结构和编码。 - **第三部分**：信息对象定义。 - **第四部分**：服务类规范。 - **第五部分**：应用框架。 - **第六部分**：验证方法。 - **第七部分**：配置文件。 - **第八部分**：网络通信。 #### 三、服务类规范的重要性 **服务类规范**（Service Class Specifications）是DICOM标准中的一个重要组成部分，它定义了各种服务类，如存储服务类、打印管理服务类等。这些服务类规定了实现特定功能的服务的行为和交互方式。例如，存储服务类描述了如何在不同系统之间存储和检索医学图像。 #### 四、服务类规范细节 **PS3.4-2008** 版本的服务类规范主要包括以下方面： 1. **服务类定义**：对服务类进行详细的定义，包括它们的目的、适用范围以及与其他服务类的关系。 2. **服务类元素**：详细描述服务类中的具体元素，如命令集、数据元素等。 3. **服务交互**：定义服务类中各个实体之间的交互过程，包括请求和响应消息的格式。 4. **异常处理**：提供关于如何处理错误条件的指南，确保系统的健壮性和可靠性。 5. **安全性考虑**：强调在实现服务类时需要注意的安全事项，保护敏感的医疗信息。 #### 五、服务类示例 1. **存储服务类**：用于在不同的系统之间存储和检索医学图像。它涉及到图像的发送、接收和确认等过程。 2. **查询/检索服务类**：支持用户根据特定标准查询和检索图像或其他医疗信息。这通常涉及到复杂的搜索逻辑和过滤选项。 3. **打印管理服务类**：规范了如何通过网络将医学图像发送到打印机进行打印的过程。 #### 六、共识和技术发展 DICOM标准是在众多专家和技术人员的共同努力下形成的。尽管参与人员可能存在不同的意见，但最终达成的共识是为了推动整个行业的进步。随着技术的发展，DICOM标准也在不断地更新和完善，以适应新的需求和技术挑战。 #### 七、结论对于从事医学设备和系统开发的专业人士而言，了解并掌握DICOM标准是非常重要的。它不仅有助于确保产品和服务的质量，还能够促进不同系统之间的互操作性，提高医疗服务的整体效率。通过深入研究DICOM的帮助文档，特别是服务类规范部分，开发者可以更好地理解和应用这一关键技术标准，为患者提供更高质量的医疗服务。《数字成像与医学通信系统（DICOM）第四部分：服务类规范》为医疗设备和系统开发提供了坚实的基础和支持。通过遵循这些规范，可以确保医学图像和其他医疗信息的安全传输和有效利用，进而改善医疗服务的质量和效率。

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- Standard -

PS 3.4-2008

Digital Imaging and Communications in Medicine (DICOM)

Part 4: Service Class Specifications

Published by

National Electrical Manufacturers Association

1300 N. 17th Street

Rosslyn, Virginia 22209 USA

translation into other languages, reserved under the Universal Copyright Convention, the Berne

Convention for the Protection of Literacy and Artistic Works, and the International and Pan

American Copyright Conventions.

PS 3.4-2008

Page 2

- Standard -

NOTICE AND DISCLAIMER

The information in this publication was considered technically sound by the consensus of persons

engaged in the development and approval of the document at the time it was developed.

Consensus does not necessarily mean that there is unanimous agreement among every person

participating in the development of this document.

NEMA standards and guideline publications, of which the document contained herein is one, are

developed through a voluntary consensus standards development process. This process brings

together volunteers and/or seeks out the views of persons who have an interest in the topic

covered by this publication. While NEMA administers the process and establishes rules to

promote fairness in the development of consensus, it does not write the document and it does not

independently test, evaluate, or verify the accuracy or completeness of any information or the

soundness of any judgments contained in its standards and guideline publications.

NEMA disclaims liability for any personal injury, property, or other damages of any nature

whatsoever, whether special, indirect, consequential, or compensatory, directly or indirectly

resulting from the publication, use of, application, or reliance on this document. NEMA disclaims

and makes no guaranty or warranty, expressed or implied, as to the accuracy or completeness of

any information published herein, and disclaims and makes no warranty that the information in

this document will fulfill any of your particular purposes or needs. NEMA does not undertake to

guarantee the performance of any individual manufacturer or seller’s products or services by

virtue of this standard or guide.

In publishing and making this document available, NEMA is not undertaking to render professional

or other services for or on behalf of any person or entity, nor is NEMA undertaking to perform any

duty owed by any person or entity to someone else. Anyone using this document should rely on

his or her own independent judgment or, as appropriate, seek the advice of a competent

professional in determining the exercise of reasonable care in any given circumstances.

Information and other standards on the topic covered by this publication may be available from

other sources, which the user may wish to consult for additional views or information not covered

by this publication.

NEMA has no power, nor does it undertake to police or enforce compliance with the contents of

this document. NEMA does not certify, test, or inspect products, designs, or installations for

safety or health purposes. Any certification or other statement of compliance with any health or

safety–related information in this document shall not be attributable to NEMA and is solely the

responsibility of the certifier or maker of the statement.

PS 3.4-2008

Page 3

- Standard -

CONTENTS

Clause Page

NOTICE AND DISCLAIMER ............................................................................................................ 2

CONTENTS ..................................................................................................................................... 3

FOREWORD.................................................................................................................................. 10

1 SCOPE AND FIELD OF APPLICATION.................................................................................. 11

2 NORMATIVE REFERENCES................................................................................................. 11

3 DEFINITIONS .......................................................................................................................... 12

3.1 REFERENCE MODEL DEFINITIONS .......................................................................... 12

3.2 SERVICE CONVENTIONS DEFINITIONS .................................................................... 12

3.3 DICOM INTRODUCTION AND OVERVIEW DEFINITIONS ......................................... 12

3.4 DICOM UPPER LAYER SERVICE DEFINITIONS ........................................................ 12

3.5 DICOM MESSAGE EXCHANGE DEFINITIONS ........................................................... 12

3.6 DICOM INFORMATION OBJECT DEFINITIONS.......................................................... 12

3.7 DICOM CONFORMANCE.............................................................................................. 13

3.8 DICOM DATA STRUCTURES AND ENCODING.......................................................... 13

3.9 DICOM SERVICE CLASS DEFINITIONS...................................................................... 13

3.10 DEVICE INDEPENDENT PIXEL VALUES................................................................... 14

4 SYMBOLS AND ABBREVIATIONS ......................................................................................... 14

5 CONVENTIONS ...................................................................................................................... 15

5.1 ENTITY-RELATIONSHIP MODEL ................................................................................. 15

5.1.1 Entity..................................................................................................................... 15

5.1.2 Relationship .......................................................................................................... 15

5.2 SEQUENCES................................................................................................................. 16

5.3 RESPONSE STATUS VALUES..................................................................................... 16

5.4 USAGE SPECIFICATION .............................................................................................. 16

6 DICOM INFORMATION MODEL............................................................................................. 17

6.1 INFORMATION OBJECT DEFINITION ......................................................................... 18

6.1.1 Composite IOD ..................................................................................................... 18

6.1.2 Normalized IOD .................................................................................................... 19

6.2 ATTRIBUTES................................................................................................................. 19

6.3 ON-LINE COMMUNICATION AND MEDIA STORAGE SERVICES ............................. 19

6.3.1 DIMSE-C Services................................................................................................ 19

6.3.2 DIMSE-N Services................................................................................................ 19

6.4 DIMSE SERVICE GROUP............................................................................................. 19

6.5 SERVICE-OBJECT PAIR (SOP) CLASS....................................................................... 19

6.5.1 Normalized and Composite SOP Classes............................................................ 20

6.6 ASSOCIATION NEGOTIATION..................................................................................... 20

6.7 SERVICE CLASS SPECIFICATION .............................................................................. 20

7 DICOM MODEL OF THE REAL WORLD................................................................................ 20

Annex A VERIFICATION SERVICE CLASS (Normative) ......................................................... 21

PS 3.4-2008

Page 4

- Standard -

A.1

OVERVIEW ................................................................................................................... 21

A.1.1 Scope ................................................................................................................... 21

A.2 SCU/SCP BEHAVIOR ................................................................................................... 21

A.3 DIMSE-C SERVICE GROUP........................................................................................ 21

A.4 VERIFICATION SOP CLASS ........................................................................................ 21

A.5 ASSOCIATION NEGOTIATION .................................................................................... 21

A.6 CONFORMANCE .......................................................................................................... 21

A.6.1 Conformance supporting the SCU role ................................................................ 21

A.6.2 Conformance Supporting the SCP Role .............................................................. 22

A.6.3 Conformance statement....................................................................................... 22

Annex B STORAGE SERVICE CLASS (Normative) ................................................................. 23

B.1 OVERVIEW ................................................................................................................... 23

B.1.1 Scope ................................................................................................................... 23

B.1.2 Service Definition ................................................................................................. 23

B.2 BEHAVIOR .................................................................................................................... 23

B.2.1 Behavior of an SCU.............................................................................................. 23

B.2.2 Behavior of an SCP.............................................................................................. 24

B.2.3 Statuses ............................................................................................................... 24

B.3 ASSOCIATION NEGOTIATION .................................................................................... 24

B.3.1 Extended Negotiation ........................................................................................... 25

B.4 CONFORMANCE .......................................................................................................... 28

B.4.1 Conformance as An SCP ..................................................................................... 28

B.4.2 Conformance as An SCU..................................................................................... 29

B.4.3 Conformance Statement Requirements............................................................... 30

B.4.4 Specialized Conformance .................................................................................... 31

B.5 STANDARD SOP CLASSES......................................................................................... 31

B.5.1 Specialization for Standard SOP Classes............................................................ 34

B.6 RETIRED STANDARD SOP CLASSES ........................................................................ 36

Annex C QUERY/RETRIEVE SERVICE CLASS (Normative).................................................... 37

C.1 OVERVIEW ................................................................................................................... 37

C.1.1 Scope ................................................................................................................... 37

C.1.2 Conventions ......................................................................................................... 37

C.1.3 Query/retrieve Information Model......................................................................... 37

C.1.4 Service Definition ................................................................................................. 37

C.2 QUERY/RETRIEVE INFORMATION MODEL DEFINITION ......................................... 39

C.2.1 Entity-Relationship Model Definition..................................................................... 39

C.2.2 Attributes Definition.............................................................................................. 39

C.3 STANDARD QUERY/RETRIEVE INFORMATION MODELS........................................ 44

C.3.1 Patient Root Query/Retrieve Information Model .................................................. 44

C.3.2 Study Root Query/Retrieve Information Model .................................................... 45

C.3.3 Patient/Study Only Query/Retrieve Information Model......................................... 45

C.3.4 Additional Query/Retrieve Attributes .................................................................... 45

C.4 DIMSE-C SERVICE GROUPS ...................................................................................... 46

C.4.1 C-FIND Operation.................................................................................................... 46

C.4.2 C-MOVE Operation .............................................................................................. 52

C.4.3 C-GET Operation ................................................................................................. 57

C.5 ASSOCIATION NEGOTIATION .................................................................................... 62

C.5.1 Association Negotiation for C-FIND SOP Classes............................................... 63

C.5.2 Association Negotiation for C-MOVE SOP Classes ............................................ 65

C.5.3 Association Negotiation for C-GET SOP Classes................................................ 67

C.6 SOP CLASS DEFINITIONS .......................................................................................... 70

PS 3.4-2008

Page 5

- Standard -

C.6.1

Patient Root SOP Class Group............................................................................ 70

C.6.2 Study Root SOP Class Group.............................................................................. 77

C.6.3 Patient/Study Only SOP Class Group .................................................................. 82

Annex D STUDY CONTENT NOTIFICATION SERVICE CLASS (Normative) .......................... 83

Annex E PATIENT MANAGEMENT SERVICE CLASS (Normative).......................................... 84

Annex F PROCEDURE STEP SOP CLASSES (Normative) ...................................................... 85

F.1 OVERVIEW.................................................................................................................... 85

F.1.1 Scope ................................................................................................................... 85

F.1.2 Study Management Functional Model .................................................................. 85

F.1.3 Study Management Information Model................................................................. 85

F.1.4 Study Management States ................................................................................... 85

F.1.5 Modality Performed Procedure Step Management States ................................... 85

F.1.6 General Purpose Scheduled Procedure Step Management States ..................... 86

F.1.7 General Purpose Performed Procedure Step Management States .................... 88

F.2 CONFORMANCE OVERVIEW ...................................................................................... 89

F.2.1 Association Negotiation ........................................................................................ 89

F.3 DETACHED STUDY MANAGEMENT SOP CLASS...................................................... 90

F.4 STUDY COMPONENT MANAGEMENT SOP CLASS .................................................. 90

F.5 STUDY MANAGEMENT META SOP CLASS................................................................ 90

F.6 SPECIALIZED SOP CLASS CONFORMANCE............................................................. 90

F.7 MODALITY PERFORMED PROCEDURE STEP SOP CLASS..................................... 90

F.7.1 DIMSE Service Group .......................................................................................... 90

F.7.2 Operations ............................................................................................................ 90

F.7.3 Modality Performed Procedure Step SOP Class UID .......................................... 97

F.7.4 Conformance Requirements ................................................................................ 97

F.8 MODALITY PERFORMED PROCEDURE STEP RETRIEVE SOP CLASS.................. 98

F.8.1 DIMSE Service Group .......................................................................................... 98

F.8.2 Operations ............................................................................................................ 99

F.8.3 Modality Performed Procedure Step Retrieve SOP Class UID .......................... 103

F.8.4 Conformance Requirements .............................................................................. 103

F.9 MODALITY PERFORMED PROCEDURE STEP NOTIFICATION SOP CLASS ........ 104

F.9.1 DIMSE service group.......................................................................................... 104

F.9.2 Notifications ........................................................................................................ 104

F.9.3 Modality Performed Procedure Step Notification SOP Class UID...................... 106

F.9.4 Conformance Requirements .............................................................................. 106

F.10 GENERAL PURPOSE SCHEDULED PROCEDURE STEP SOP CLASS ................ 107

F.10.1 DIMSE Service Group........................................................................................ 107

F.10.2 Operations.......................................................................................................... 107

F.10.3 General Purpose Scheduled Procedure Step SOP Class UID .......................... 109

F.10.4 Conformance Requirements.............................................................................. 109

F.11 GENERAL PURPOSE PERFORMED PROCEDURE STEP SOP CLASS ............... 110

F.11.1 DIMSE Service Group........................................................................................ 110

F.11.2 Operations.......................................................................................................... 110

F.11.3 General Purpose Performed Procedure Step SOP Class UID .......................... 122

F.11.4 Conformance Requirements.............................................................................. 122

Annex G RESULTS MANAGEMENT SERVICE CLASS (Normative)...................................... 124

Annex H PRINT MANAGEMENT SERVICE CLASS (Normative)............................................ 125

H.1 SCOPE ........................................................................................................................ 125

H.2 PRINT MANAGEMENT MODEL ................................................................................. 125

H.2.1 Print Management Data Flow Model.................................................................. 125

H.2.2 Print Management Service Class Structure ....................................................... 128

H.2.3 Print Management SOP Classes ....................................................................... 129

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