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DICOM PS3.17 2020a - Explanatory Information​

Page 131​

 

 

 

 

 

 

 

 

Image LIbrary

 

Observation

 

Observation

 

 

 

CONTAINER

 

 

 

 

 

 

 

 

 

NUM, CODE, TEXT

 

NUM, CODE, TEXT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

R-INFERRED

 

R-INFERRED

CONTAINS

 

CONTAINS

FROM

 

FROM

 

 

 

 

 

 

 

Path, Ellipse, Caliper, ...

SCOORD

R-SELECTED

Image Entry

FROM

IMAGE

Image Entry

IMAGE

Figure I.5-1. Relationships to Images and Coordinates​

R-INFERRED FROM relationships to IMAGE content items specify that the image supports the observation. A purpose of reference​ in an SCOORD content item may specify an analytic operation (performed on that image) that supports or produces the observation.​

I.6 Ob Patterns​

AcommonOB-GYNpatternisthatofseveralinstancesofonemeasurementtype(e.g.,BPD),thecalculatedaverageofthosevalues,​ and derived values such as a gestational age calculated according to an equation or table. The measurements and calculations are​ all siblings in the measurement group. A child content item specifies the equation or table used to calculate the gestational age. All​ measurement types must relate to the same biometric type. For example, it is not allowed to mix a BPD and a Nuchal Fold Thickness​ measurement in the same biometry group.​

Fetal Biometry Measurements

CONTAINER

CONTAINS

BPD = 54 mm NUM

CONTAINS

 

 

CONTAINS

 

 

 

CONTAINS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BPD = 58 mm

 

 

BPD = 56 mm

 

 

 

 

Image LIbrary

 

NUM

 

 

NUM

 

 

 

 

CONTAINER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HAS CON MOD

R-INFERRED

 

 

INFERRED FROM

 

 

 

 

FROM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

derivation = mean

 

 

 

 

 

Equation = (Hadlock84)

 

 

 

 

CODE

 

 

 

 

 

CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Figure I.6-1. OB Numeric Biometry Measurement group Example​

The example above is a gestational age calculated from the measured value. The relationship is to an equation or table. The inferred​ from relationship identifies equation or table in the Concept Name. Codes from CID 12013 “Gestational Age Equations and Tables”​ identify the specific equation or table.​

Another use case is the calculation of a growth parameter's relationship to that of a referenced distribution and a known or assumed​ gestational age. CID 12015 “Fetal Growth Equations and Tables” identify the growth table. Figure I.6-2 shows the assignment of a​ percentile for the measured BPD, against the growth of a referenced population. The dependency relationship to the gestational age​ is a by-reference relationship to the established gestational age. Though the percentile rank is derived from the BPD measurement,​ a by-reference relationship is not essential if one BPD has a concept modifier indicating that it is the mean or has selection status​ (see TID 300 “Measurement”). A variation of this pattern is the use of Z-score instead of percentile rank. Not shown is the expression​ of the normal distribution mean, standard deviation, or confidence limits.​

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Page 132​

DICOM PS3.17 2020a - Explanatory Information​

Biometry Measurements

CONTAINER

CONTAINS

CONTAINS

CONTAINS

 

BPD = 60 mm

BPD = 56 mm

Percentile Rank = 65%

NUM

NUM

NUM

 

 

INFERRED FROM

R-INFERRED

 

FROM

 

 

 

 

Reference Authority = (Hadlock84)

 

 

 

CODE

 

Gestational Age = 160 d

NUM

Figure I.6-2. Percentile Rank or Z-score Example​

Estimatedfetalweight(EFW)isafetussummaryitemasshownbelow.Itiscalculatedfromoneormoregrowthparameters(theinferred​ from relationships are not shown). TID 315 “Equation or Table” allows specifying how the value was derived. Terms from CID 12014​ “OB Fetal Body Weight Equations and Tables” specify the table or equation that yields the EFW from growth parameters.​

"EFW percentile rank" is another summary term. By definition, this term depends upon the EFW and the population distribution of the​ ranking. A Reference Authority content item identifies the distribution. CID 12016 “Estimated Fetal Weight Percentile Equations and​ Tables” is list of established reference authorities.​

Fetus Summary

CONTAINER

CONTAINS

CONTAINS

 

EFW = 3.1kg

Percentile Rank = 65%

NUM

NUM

 

INFERRED FROM

INFERRED FROM

R-INFERRED

FROM

 

 

Equation = EFW by AC,FL, Hadlock 1984

Equation = (Hadlock 1991)

 

CODE

CODE

 

Gestational Age = 232 d

NUM

Figure I.6-3. Estimated Fetal Weight​

I.7 Selected Value​

When multiple observations of the same type exist, one of these may be the selected value. Typically, this value is the average of​ the others, or it may be the last entered, or user chosen. TID 310 “Measurement Properties” provides a content item with concept​ name of (121404, DCM, "Selection Status") and a value set specified by DCID 224 “Selection Method”.​

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DICOM PS3.17 2020a - Explanatory Information​

Page 133​

CONTAINS

BPD = 5.3 mm NUM

Observation Group

CONTAINER

CONTAINS

 

 

CONTAINS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BPD = 5.1 mm

 

 

BPD = 5.2 mm

 

NUM

 

 

NUM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HAS PROPERTIES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Selection Status = user chosen

 

 

 

 

CODE

 

 

 

 

 

 

 

Figure I.7-1. Selected Value Example​

There are multiple ways that a measurement may originate. The measurement value may result as an output of an image interactive,​ systemtool.Alternatively,theusermaydirectlyenterthevalue,orthesystemmaycreateavalueautomaticallyasthemeanofmultiple​ measurement instances. TID 300 “Measurement” provides that a concept modifier of the numeric content item specify the derivation​ of the measurement. The concept name of the modifier is (121401, DCM, "Derivation"). CID 3627 “Measurement Type” provides​ concepts of appropriate measurement modifiers. Figure I.7-2 illustrates such a case.​

Observation Group

CONTAINER

CONTAINS

BPD = 5.1 mm NUM

CONTAINS CONTAINS CONTAINS

BPD = 5.2 mm

 

BPD = 5.3 mm

 

 

 

Gestational Age = 150 d

NUM

 

NUM

 

 

 

NUM

 

 

 

 

 

 

 

HAS CONCEPT MOD HAS PROPERTIES

R-INFERRED

FROM

Measurement Type = mean CODE

Selected value = user chosen CODE

Figure I.7-2. Selected Value with Mean Example​

I.8 OB-GYN Examples​

The following are simple, non-comprehensive illustrations of report sections.​

I.8.1 Example 1: OB-GYN Root with Observation Context​

The following example shows the highest level of content items for a second or third trimester OB exam. Subsequent examples show​ details of section content,​

Nest​

Code Meaning of Concept Name​

CodeMeaningorExample​

TID​

 

 

Value​

 

 

1​

OB-GYN Ultrasound Procedure Report​

TID 5000​

 

1.1​

Language of Content Item and​

English​

TID 1204​

 

 

Descendants​

 

 

 

1.2​

Subject Name​

Jane Doe​

TID 1007​

 

1.3​

Subject ID​

123-45-6789​

TID 1007​

 

1.4​

Procedure Study Instance UID​

1.2.842.111724.7678.32.34​TID 1005​

 

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Page 134​

DICOM PS3.17 2020a - Explanatory Information​

 

 

Nest​

Code Meaning of Concept Name​ CodeMeaningorExample​

TID​

 

 

Value​

 

 

1.5​

Procedure Study Component UID​

1.2.842.111724.7678.55.34​TID 1005​

 

1.6​

Procedure Accession Number​

20011007-21​

TID 1005​

 

1.7​

Image Library​

 

TID 5000​

 

1.7.1​

 

IMAGE 1​

TID 5000​

 

1.7.2​

 

IMAGE 2​

TID 5000​

 

1.7.n​

 

IMAGE N​

TID 5000​

 

1.8​

Patient Characteristics​

 

TID 5001​

 

1.8.n​

 

 

TID 5001​

 

1.9​

Summary​

 

TID 5002​

 

1.9.n​

 

 

TID 5002​

 

1.10​

Fetal Biometry Ratios​

 

TID 5004​

 

1.10.n​

 

 

TID 5004​

 

1.11​

Long Bones​

 

TID 5006​

 

1.11.n​

 

 

TID 5006​

 

1.12​

Fetal Cranium​

 

TID 5007​

 

1.12.n​

 

 

TID 5007​

 

1.13​

Biophysical Profile​

 

TID 5009​

 

1.13.n​

 

 

TID 5009​

 

1.14​

Amniotic Sac​

 

TID 5010​

 

1.14.n​

 

 

TID 5010​

 

ThefollowingexampleshowsthehighestlevelofcontentitemsforaGYNexam.Subsequentexamplesshowdetailsofsectioncontent.​

Nest​

Code Meaning of Concept Name​CodeMeaningorExample​

TID​

 

 

Value​

 

 

1​

OB-GYN Ultrasound Procedure​

 

TID 5000​

 

 

Report​

 

 

 

1.1​

Subject Name​

Jane Doe​

TID 1007​

 

1.2​

Subject ID​

123-45-6789​

TID 1007​

 

1.3​

Image Library​

 

TID 5000​

 

1.3.1​

 

IMAGE 1​

TID 5000​

 

1.3.2​

 

IMAGE 2​

TID 5000​

 

1.3.n​

 

IMAGE N​

TID 5000​

 

1.4​

Patient Characteristics​

 

TID 5001​

 

1.4.n​

 

 

TID 5001​

 

1.5​

Findings​

 

TID 5012​

 

1.5.1​

Findings Site​

Ovary​

TID 5012​

 

1.5.n​

 

 

TID 5012​

 

1.6​

Findings​

 

TID 5013​

 

1.6.1​

Findings Site​

Ovarian Follicle​

TID 5013​

 

1.6.2​

Laterality​

Left​

TID 5013​

 

1.6.n​

 

 

TID 5013​

 

- Standard -​

 

DICOM PS3.17 2020a - Explanatory Information​

 

Page 135​

Nest​

Code Meaning of Concept Name​CodeMeaningorExample​

TID​

 

 

Value​

 

 

1.7​

Findings​

 

TID 5013​

 

1.7.1​

Findings Site​

Ovarian Follicle​

TID 5013​

 

1.7.2​

Laterality​

Right​

TID 5013​

 

1.7.n​

 

 

TID 5013​

 

1.8​

Pelvis and Uterus​

 

TID 5015​

 

1.8.n​

 

 

TID 5015​

 

I.8.2 Example 2: OB-GYN Patient Characteristics and Procedure Summary​

Nest​

Code Meaning of Concept Name​

Code Meaning or Example​

TID​

 

 

Value​

 

 

1​

OB-GYN Ultrasound Procedure Report​

 

TID 5000​

 

 

….​

 

TID 5000​

 

1.8​

Patient Characteristics​

 

TID 5001​

 

1.8.1​

Gravida​

5​

TID 5001​

 

1.8.2​

Para​

3​

TID 5001​

 

1.8.3​

Aborta​

2​

TID 5001​

 

1.8.4​

Ectopic Pregnancies​

1​

TID 5001​

 

1.9​

Summary​

 

TID 5002​

 

1.9.1​

LMP​

20010101​

TID 5002​

 

1.9.2​

EDD​

20010914​

TID 5002​

 

1.9.3​

EDD from LMP​

20010914​

TID 5002​

 

1.9.4​

EDD from average ultrasound age​

20010907​

TID 5002​

 

1.9.5​

Gestational age by ovulation date​

185 d​

TID 5002​

 

1.9.6​

Fetus Summary​

 

TID 5003​

 

1.9.6.1​

EFW​

2222 g​

TID 300​

 

1.9.6.1.1​

+/-, range of measurement uncertainty​

200 g​

TID 310​

 

1.9.6.1.2​

Equation​

EFW by AC, BPD, Hadlock​

TID 315​

 

 

 

1984​

 

 

1.9.6.2​

Comment​

Enlarged cisterna magna​

TID 5003​

 

1.9.6.3​

Comment​

Choroid plexus cyst​

TID 5003​

 

I.8.3 Example 3: OB-GYN Multiple Fetus​

 

 

 

Nest​

Code Meaning of Concept Name​

Code Meaning or Example​

TID​

 

 

Value​

 

 

1​

OB-GYN Ultrasound Procedure Report​

 

TID 5000​

 

1.n​

….​

 

TID 5000​

 

1.5​

Summary​

 

TID 5002​

 

1.5.1​

EDD from LMP​

20020325​

TID 5002​

 

1.5.2​

Fetus Summary​

 

TID 5003​

 

1.5.2.1​

Fetus ID​

A​

TID 1008​

 

1.5.2.2​

EFW​

1.6 Kg​

TID 300​

 

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Источник: https://studfile.net/preview/14585770/

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