DCMTK - PACS
概述
本篇将介绍如何利用DCMTK在Windows 10系统中部署一个简单的PACS系统，并利用DCMTK提供的工具来验证PACS提供的四类服务。
概念
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PACS
PACS是 Picture Archiving and Communication System 的简称，主要用于医院的数字医疗设备如 CT、MR（磁共振）、US（超声成像、X-Ray、 DSA （数字减影、 CR（计算机成像）、ECT 等设备所产生的数字化医学图像信息的采集、存储、管理、诊断和信息处理。
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DCMTK是由offis公司提供的开源项目，已经基本实现了DICOM协议的所有内容。在github上有其代码库的镜像 https://github.com/DCMTK/dcmtk
安装DCMTK
在Windows 10，安装DCMTK十分方便，可以直接通过Windows第三方包管理器chocolatey来安装。（需要预先安装一下）
以管理员权限启动一个命令行工具，运行以下命令
> choco install dcmtk
安装完毕后，我们就可以开始着手启动PACS了。
启动PACS
dcmqrscp.exe
在DCMTK中，PACS的服务是由 dcmqrscp.exe 来提供的。
DICOM协议中规定了PACS至少支持以下5种服务
- Verification - 验证服务器是否符合DICOM标准
- Storage - 将DICOM对象存储到PACS服务器
- Query - 根据指定的关键字查询PACS数据库
- Retrieve - 从PACS服务器下载图像到本地
- Storage commitment(DCMTK开源版本不支持）
开源版本的dcmqrscp.exe 支持前4种服务。这四种服务分别对应了DCMTK中的
echoscu.exe → Verification
storescu.exe → Storage
findscu.exe → Query
movescu.exe → Retrieve
顺便提一下，“*scp”*是 Service Class Provider的简称，“*scu”*是 Service Class User的简称。它们都是DICOM标准中的概念。
dcmqrscp.cfg 配置文件
DCMTK中包含了一个dcmqrscp.cfg 的sample，里边注释挺全的，可以拿来参考。
#
# Global Configuration Parameters
#
# 监听端口
NetworkTCPPort = 10001
# 定义PDU传输时刻的最大长度
MaxPDUSize = 16384
# 允许的最大连接数
MaxAssociations = 16
#
# Default settings for specific character set behavior:
# SpecificCharacterSet = fallback
#
# Uncomment to override response character set with UTF-8 and enable
# transliteration and discarding of unsupported characters:
# SpecificCharacterSet = "ISO_IR 192", override, discard, transliterate
#
# UserName = <not used>
# GroupName = <not used>
HostTable BEGIN
#
# The HostTable defines symbolic names for collections of network
# DICOM Application Entities. A symbolic name can represent a single
# application entity or it can represent a group of application entities.
# Each DICOM application entity is defined by a triple consisting of
# Application Entity Title, host name and TCP/IP port number.
#
# Entry Format: SymbolicName = ( AETitle, HostName, Portnumber ), ... |
# SymbolicName = SymbolicName, ...
#
# NOTE: in the current implementation you cannot substitute an IP address
# for a hostname.
#
acme1 = (ACME1, PC098, 5678)
acmeCTcompany = acme1
# acme2 = (ACME2, acmehost2, 5678)
# acmeCTcompany = acme1, acme2
# united1 = (UNITED1, unitedhost1, 104)
# united2 = (UNITED2, unitedhost2, 104)
# unitedMRcompany = united1, united2
#
HostTable END
VendorTable BEGIN
#
# The VendorTable is used by the dcmqrdb and dcmqrti applications.
# You can give a vendor name (r.h.s. entry below) to the dcmqrti
# program and it will talk to all hosts and AEs of the vendor.
# The dcmqrdb program can use the vendor table to restrict move destination
# to hosts belonging to a vendor.
# Also, the dcmqrti and dcmqrdb programs use the name defined on the left hand side
# as the vendor name to display above images.
#
# The format:
# VendorName = SymbolicName
# The symbolic name should be defined in the HostTable.
#
"Acme CT Company" = acmeCTcompany
# "United MR Company" = unitedMRcompany
#
VendorTable END
AETable BEGIN
#
# Each row of the AETable defines an Application Entities (AE) Title known
# to the dcmqrdb application. Each AE Title represents a separate
# image database located in the specified file system directory (storage area).
# Each AE Title has read/write, quota and peer access restrictions.
#
# Entry Format: AETitle StorageArea Access Quota Peers
# AccessFormat: R | RW | W
# Quota Format: ( maxStudies, maxBytesPerStudy )
# Peers Format: ( Hostname, AETitle, Portnumber ), ... |
# Entry in HostTable |
# ANY
#
# COMMON /home/dicom/db/COMMON R (200, 1024mb) ANY
ACME_STORE C:\temp\PACS RW (9, 1024mb) acmeCTcompany
# UNITED_STORE /home/dicom/db/UNITED_STORE RW (9, 1024mb) unitedMRcompany
#
AETable END
启动
运行以下指令
> dcmqrscp.exe -d --config "path\to\dcmqrscp.cfg"
同PACS交互
Verification
在DCMTK中通过 echoscu.exe 来完成。
> echoscu localhost 10001 -aet ACME1 -aec ACME_STORE -d
成功运行后，会有以下类似打印
Storage
在DCMTK中通过 storescu.exe 来完成。
storescu localhost 10001 c:\temp\IMG00002 -aet ACME1 -aec ACME_STORE -d
运行成功的话，会有以下类似打印。
Query
在DCMTK中通过 findscu.exe 来完成。
findscu.exe -v -S -aec ACME_STORE -aet ACME1 localhost 10001 -k QueryRetrieveLevel=STUDY -k StudyDate -k StudyDescription -k StudyInstanceUID
成功运行后，会有以下类似打印
记住这个1.2.840.113704.1.111.8132.1603688240.1 ，后面验证Retrieve会用到。
Retrieve
在DCMTK中通过 movescu.exe 来完成。
movescu.exe -v -S -aec ACME_STORE -aet ACME1 -aem ACME1 --port 5678 -od c:\temp2 localhost 10001 -k QueryRetrieveLevel=STUDY -k StudyInstanceUID=1.2.840.113704.1.111.8132.1603688240.1 -d
成功运行后，会有以下类似打印
在下载路径 C:\temp2 下，我们可以看到新文件下载完成了。
总结
至此，我们安装好了DCMTK，启动了PACS，然后简单验证了PACS的四种服务。
🔚