Automated system and a method for organizing, presenting, and manipulating medical images

We claim:

1. A system for presenting images of anatomical structure for examination by a diagnosing physician, including:

means including one or more display monitors for displaying at least one display container including a display area subdivided into a plurality of presentation areas in a predetermined array;

means for storing an image database including a plurality of images of anatomical structures, the images being separated into a plurality of image groups, in which:

each image group is indexed by a unique group identification; and

each image group is partitioned into one or more ordered image series, each ordered image series including a succession of images which illustrate incrementally registered aspects of an anatomical target, each image series being ordered by assignment to each image in the image series of a numerical position in a respective monotonically changing sequence; and

physician data tables are stored with indexes to unique group identifications and to physician identifiers and including entries specifying output functions and displaying formats;

means for receiving a physician identifier;

means for receiving a group identification;

means connected to the means for receiving, to the means for storing an image database and to the means for displaying at least one display container and responsive to a physician identification and to a group identification for retrieving at least one image series of an image group indexed by the group identification and for displaying the at least one image series in one or more presentation areas of the plurality of presentation areas in a display format contained in the physician data tables; and

means for providing an output from the system according to an output function specified in the physician data tables.

2. The system of claim 1, wherein:

the physician data tables include at least one entry specifying a mode of image series presentation, in which a first mode is a monitor mode and a second mode is a series mode; and

the means for retrieving and displaying including means for ordering the display of the at least one image series in response to mode specification by:

displaying each image series of the at least one image series in the order of its respective sequence in a single respective display container in the at least one display container such that each presentation area of the single respective display container includes no more than one image, in response to designation of the monitor mode; and

displaying each image series of the at least one image series one image at a time in the order of its respective sequence in a single respective presentation area of the plurality of presentation areas, in response to designation of the series mode.

3. The system of claim 2, further including means for synchronizing the presentation of each image series of two or more image series such that whenever the display of one image series of the two or more image series is changed to display a next image in the order of its respective sequence, each other image series of the two or more image series is correspondingly changed by the means for retrieving and displaying.

4. The system of claim 2, wherein:

the at least one display container includes:

a first display container for presenting a first plurality of presentation areas in a predetermined array; and

a second display container for presenting a second plurality of presentation areas in the predetermined array;

the at least one image series includes two or more image series of the image group indexed by the group identification; and

the means for retrieving and displaying displays each image series in the order of its respective sequence in a respective display container such that each presentation area of the respective display container includes no more than one image, in response to designation of the monitor mode of presentation.

5. The system of claim 1, further including:

means for displaying a palette display container on the one or more display monitors, the palette display container for presenting a plurality of presentation areas in an array; and

means for selecting an image of an image series displayed in the at least one display container and reproducing the selected image in a presentation area of the palette display container.

6. A method for presenting images of anatomical structure for examination by a diagnosing physician, the method being executed on a computer display system having:

a display for displaying at least one display container subdivided into a plurality of presentation areas in a predetermined array;

a storage subsystem for storing an image database including a plurality of images of anatomical structures; and

means connected to the storage subsystem and to the at least one display container for retrieving images from the image database and displaying retrieved images in the at least one display container;

the method including the steps of:

storing a plurality of images in the image database;

separating the plurality of images into image groups;

indexing each image group by a unique group identification;

partitioning each image group into one or more ordered image series, each ordered image series including a succession of images which illustrate incrementally registered aspects of an anatomical target, each image series being ordered by assignment to each image in the image series of a numerical position in a respective monotonically changing sequence;

storing a first data table in the storage subsystem, the first data table listing a plurality of referring physician identifiers, each referring physician identifier being indexed from at least one group identification, each referring physician identifier identifying a referring physician and including respective fields specifying output preferences of the identified referring physician for outputting to the identified referring physician images from the display;

storing a second data table in the storage subsystem, the second data table listing a plurality of diagnosing physician identifiers, each diagnosing physician identifier identifying a diagnosing physician and including respective fields specifying format preferences and mode preferences of the identified diagnosing physician for displaying images on the display; and

providing a group identification;

providing a diagnosing physician identifier;

in response to the group identification and the diagnosing physician identifier, retrieving at least one image series of an image group indexed by the group identification and displaying the at least one image series in one or more presentation areas of the plurality of presentation areas in accordance with a format preference specified in fields of the diagnosing physician identifier; and

outputting images from the at least one image series according to output preferences of a referring physician identified by a referring physician identifier indexed from the group identification.

7. The method of claim 6, further including:

providing mode fields in the diagnosing physician identifiers, each mode field specifying a mode of image series presentation, in which a first mode is a monitor mode and a second mode is a series mode;

displaying one image series in the order of its respective sequence in one display container such that each presentation area of the display container includes no more than one image of the at least one image series, in response to designation of the monitor mode; and

displaying one image series one image at a time in the order of its respective sequence in a single respective presentation area of one display container, in response to designation of the series mode.

8. The method of claim 7, further including the steps of:

displaying a first display container including a first plurality of presentation areas in a predetermined array;

displaying a second display container including a second plurality of presentation areas in the predetermined array;

the step of retrieving and displaying including retrieving two image series of the image group indexed by the group identification; and

the step of retrieving and displaying including displaying each image series in the order of its respective sequence in a respective display container means such that each presentation area of the respective display container means includes one image, in response to designation of the monitor mode of presentation.

9. The method of claim 7, further including the steps of:

in the step of retrieving and displaying, retrieving two image series of the image group indexed by the group identification and displaying each image series one image at a time in the order of its respective sequence in a single respective presentation area.

10. The method of claim 9, further including synchronizing the presentation of each image series of the two image series such that whenever the display of one image series of the two image series is changed to display the next image in the order of its respective sequence, each other image series of the two image series is correspondingly changed.

11. A computer display system for presenting images of anatomical structure for examination, including:

monitor means for presenting graphical images;

means for displaying a first display container and a second display container on the monitor means, the first display container including a first preselected number of substantially rectangular presentation areas in a first substantially rectangular array, and the second display container including a second preselected number of substantially rectangular presentation areas in a second substantially rectangular array;

at least one data storage device for storing:

an image database including a plurality of images of anatomical structure, the images being separated into image groups, in which:

each image group is indexed by a unique group identification, wherein each group identification names a respective image group and includes an identification of a patient whose anatomy is illustrated by the image group; and

each image group is partitioned into one or more ordered image series, each ordered image series including a succession of images which illustrate incrementally registered aspects of an anatomical target, each image series being ordered by assignment to each image in the image series of a position in a respective monotonically changing sequence;

a first table data structure listing a plurality of referring physician identifiers, each referring physician identifier being indexed from at least one group identification, each referring physician identifier identifying a referring physician and including respective fields specifying output preferences of the identified referring physician for outputting to the identified referring physician images from the monitor means; and

a second table data structure listing a plurality of diagnosing physician identifiers, each diagnosing physician identifier identifying a diagnosing physician and including respective fields specifying format preferences and mode preferences of the identified diagnosing physic an for displaying images on the monitor means;

application means connected to the monitor means, to the at least one data storage device and to the means for displaying the first and second display containers and responsive to a user-selected group identification and a diagnosing physician identifier for displaying at least two image series of an image group indexed by the user-selected group identification, said application means further for:

formatting each image series for display on the monitor means in accordance with format preferences specified in fields of the diagnosing physician identifier; displaying each image series on the monitor means in the order of its respective sequence in a respective display container such that each presentation area of the respective display container includes no more than one image; and

outputting images from said at least two image series according to output preferences of a referring physician identified by a referring physician identifier indexed from the user-specified group identification.

12. The computer display system of claim 1, further including:

means for displaying a palette display container on the monitor means, the palette display container including a plurality of presentation areas in an array; and

means coupled to the means for displaying first and second display containers for picking an image of an image series displayed in the first or second display container and reproducing the selected image in a presentation area of the palette display container.

13. The computer display system of claim 1, wherein:

the respective fields of each diagnosing physician identifier specify:

a mode of image series presentation;

a rectangular array format; and

rectangular array dimensions; and

the application means includes respective means for:

presenting an image series in a mode specified by a diagnosing physician identifier;

presenting rectangular arrays in the first and second display containers in a format specified by the diagnosing physician identifier; and

presenting the rectangular arrays in dimensions specified by the diagnosing physician identifier.

14. A computer display system for presenting images of anatomical structure for examination, including:

monitor means for presenting graphical images;

means for displaying at least one display container on the monitor means, the at least one display container including a preselected number of substantially rectangular presentation areas in a substantially rectangular array; and

at least one data storage device for storing:

an image database including a plurality of images of anatomical structure, the images being separated into image groups, in which:

each image group is indexed by a unique group identification, wherein each group identification names a respective image group and includes an identification of a patient whose anatomy is illustrated by the image group; and

each image group is partitioned into one or more ordered image series, each ordered image series including a succession of images which illustrate incrementally registered aspects of an anatomical target, each image series being ordered by assignment to each image in the image series of a position in a respective monotonically changing sequence;

a first table data structure listing a plurality of referring physician identifiers, each referring physician identifier being indexed from at least one group identification, each referring physician identifier identifying a referring physician and including respective fields specifying output preferences of the identified referring physician for outputting to the identified referring physician images from the monitor means; and

a second table data structure listing a plurality of diagnosing physician identifiers, each diagnosing physician identifier identifying a diagnosing physician and including respective fields specifying format preferences and mode preferences of the identified diagnosing physician for displaying images on the monitor means;

application means connected to the monitor means, to the at least one data storage device and to the means for displaying at least one display container and responsive to a user-selected group identification and a diagnosing physician identifier for displaying at least two image series of an image group indexed by the user-selected group identification, said application means further for:

formatting each image series for display on the monitor means in accordance with format preferences specified in fields of the diagnosing physician identifier;

displaying each image series on the monitor means one image at a time in the order of its respective sequence in a respective presentation area; and

outputting images from said image group according to output preferences of a referring physician identified by a referring physician identifier indexed from the user-specified group identification.

15. The computer display system of claim 2, further including:

means for displaying a palette display container on the monitor means, the palette display container including a plurality of presentation areas in an array; and

means coupled to the means for displaying at least one display container for picking an image of an image series displayed in the at least one display container and reproducing the selected image in a presentation area of the palette display container.

16. The computer display system of claim 2, wherein:

the respective fields of each diagnosing physician identifier specify:

a mode of image series presentation;

a rectangular array format; and

rectangular array dimensions; and

the application means includes respective means for:

presenting an image series in a mode specified by a diagnosing physician identifier;

presenting rectangular arrays in the at least one display container in a format specified by the diagnosing physician identifier; and

presenting the rectangular arrays in dimensions specified by the diagnosing physician identifier.

Description Submit all comments and votes

BACKGROUND OF THE INVENTION

The invention relates to the organization, presentation, and manipulation of images. More particularly, the invention provides efficient, user-friendly means and procedures for presenting images of anatomical structure and the like for examination.

The invention is also concerned with the activation of a display container for medical images in a context of a plurality of display containers, and with the presentation of icons without distracting the attention of a user from medical images which are being examined.

Magnetic resonance imaging (MRI) is an important, non-invasive imaging modality that is widely used by radiologists to examine internal anatomy to aid in the analysis of trauma and the diagnosis of disease. An MRI study provides a multi-planar representation of an anatomical target in the form of one or more image series. The images of a series may be parallel planar "slices" of the anatomical target which are incrementally registered along an imaging axis. Another imaging technology may produce image sequences which include non-parallel views that are incrementally registered about an axis of rotation or over a non-planar surface.

MRI technology is well understood. See, for example, MRI OF THE KNEE by Jerrol H. Mink, et al, Raven Press Ltd. (New York, N.Y. 1987) and the work by F.W. Wehrli, et al, entitled PARAMETERS DETERMINING THE OCCURRENCE OF NMR IMAGES published by the General Electric Company, Medical Systems Operations, in 1983.

In the prior art, the transparencies produced by an MRI system would be manually mounted in their series sequence on long light boxes where they would be read and annotated by radiologists. Following examination, the images would be physically stored in a patient's medical history folder. Recently, automated systems for archiving, retrieving, and presenting MRI images have been developed. In these systems, the images are conventionally converted to multi-bit, pixelated data representations which are formatted, stored, and retrieved using file management techniques. However, most conventional file management techniques are adapted for storage, retrieval, and presentation of documents, rather than images. Of course, these systems give even less consideration to the specialized requirements for storage and presentation of images showing internal anatomy.

Even the addition of a directly-manipulated user interface in conventional image storage and presentation systems does little to adapt these systems to the special needs of radiologists who must consider and manipulate many images in particular ways for special purposes. Furthermore, each radiologist has a highly personal mode of examination. For example, one radiologist may wish to examine a first sequence of transparencies in its entirety and then a second, related sequence before trying to correlate between individual images of the sequences. Another radiologist may wish to examine sequences in parallel by simultaneously considering images taken of the same anatomical plane under different conditions of exposure. Even currently-available database systems which have been adapted for storage and presentation of radiological images have not automated the presentation modalities of image series. Instead, a radiologist must provide for the individual retrieval and presentation of each and every stored image. In these systems, the images are individually identified and processed for storage and presentation without correlation to other images in their respective sequences. Furthermore, the existing systems do not provide for concurrent presentation of related image series.

Moreover, the currently available automated image storage systems are awkward and difficult to use, providing little in the way of means for direct manipulation of image presentation formats and images which are displayed for analysis.

SUMMARY OF THE INVENTION

Therefore, it is a primary objective of this invention to provide an automated system for storage, retrieval, and presentation of medical images which is especially adapted for the presentation of medical image sequences and which affords the user with a flexible and responsive set of functions that permit direct manipulation of the modes of image presentation and of the presented images themselves.

The invention is embodied in a computer display system which presents images of anatomical structure and the like for examination. The system includes the following combination:

a first display container including a first preselected number of substantially rectangular presentation areas in a substantially rectangular array;

a second display container including a second preselected number of substantially rectangular presentation areas in a substantially rectangular array;

an image database including a plurality of images of anatomical structure, the images being separated into image groups in which:

each image group is indexed by a unique group identification; and

each image group is partitioned into one or more ordered image series, each ordered image series including a succession of images which illustrate incrementally registered aspects of an anatomical target, each image series being ordered by assignment to each image in the image series of a position in a respective monotonically changing sequence;

a mechanism connected to the image database and to the first and second display container and responsive to a group identification for displaying at least two image series of an image group indexed by the patient identification, wherein:

each image series is displayed in the order of its respective sequence in a respective display container such that each presentation area of the respective display container includes no more than one image; or,

all of the image series are displayed in one display container and each image series is displayed one image at a time in the order of its respective sequence in a respective presentation area of the display container.

For direct manipulation of an interactive computer system with an output means for presenting visual displays wherein a user is presented with a visual display that includes a control display container (control panel), the invention further includes the following combination:

a first bounded display area presented by the output means, the first display area including:

a control panel; and

a plurality of icons displayed in the control panel;

a second bounded display area presented separately from the first display area by the output means;

a cursor mechanism connected to the output means for displaying and moving a cursor in a display area; and

a functional mechanism coupled to the first and second display areas and the to the cursor mechanism for presenting the control panel in the second display area in response to movement of the cursor from the first to the second display area.

Also, in an interactive computer system with an output means for presenting visual displays wherein a user is presented with a display that includes a directly-manipulated display container for presenting program output, the invention is embodied in a combination, in which:

a cursor mechanism is connected to the output means for displaying and moving a cursor;

a control display area is provided in the display in which a plurality of icons are displayed in a predetermined order;

a pointing mechanism is provided, with connection to the cursor mechanism, for positioning the cursor and selecting icons in response to direct manual manipulation by a user; and

an icon rotation mechanism is provided, with connection to the pointing mechanism and to the cursor mechanism, which responds to a position of the cursor inside the display container by changing the shape of the cursor at the position to the shape of an icon of the plurality of icons and by changing the shape of the cursor to the shapes of the other icons in the plurality of icons, such that the shape of the cursor is changed one shape at a time and in the predetermined order, in response to direct manual manipulation of the pointing mechanism.

BRIEF DESCRIPTION OF THE DRAWINGS

The invention, and its achievement of the above-stated objective, will be understood when the following detailed description is read in connection with the below-described drawings, in which:

FIG. 1 is a block diagram illustrating basic components of an automated system for storing, retrieving, and displaying medical images;

FIG. 2 is a block diagram illustrating in greater detail certain components of the system of FIG. 1;

FIG. 3 is an illustration of a display container output on a monitor of the system of FIG. 1 for a presentation of medical images according to one mode of the invention;

FIG. 4 is an illustration showing a display container for presentation of medical images according to a second mode of the invention;

FIG. 5 is an illustration showing a working palette display container presented on a monitor of the system of FIG. 1;

FIG. 6 illustrates the organization of a medical image database according to the invention;

FIG. 7 is a flow diagram illustrating how the database of FIG. 6 is accessed;

FIG. 8 is a flow diagram illustrating how the system of FIGS. 1 and 2 presents images according to the first mode of the invention;

FIG. 9 is a block diagram illustrating presentation of images according to the first mode of the invention;

FIG. 10 is a flow diagram illustrating how the system of FIGS. 1 and 2 presents images according to the second mode of the invention;

FIG. 11 is a block diagram illustrating presentation of images in a database of FIG. 6 according to the second mode of the invention;

FIG. 12 is a flow diagram illustrating a procedure for indicating an active monitor according to the invention;

FIG. 13 is a flow diagram illustrating a procedure for rotating image manipulation icons according to the invention;

FIGS. 14a through 14d are illustrations of display containers showing icon rotation according to the procedure of FIG. 13;

FIG. 15 is a flow diagram illustrating annotation rotation according to the invention;

FIG. 16 is an illustration showing a display container with annotation rotation according to the procedure of FIG. 15.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

The invention is intended to operate in connection with an image database which stores medical images for retrieval and presentation. Although the following description assumes that the images are data representations of pixelated images conventionally produced from the output of medical imaging technology such as MRI, X-ray, and CAT, this is not intended to limit such images to such sources. The inventors contemplate that the means and processes presented in this description would apply as well to a database of synthetically-created medical images.

In the preferred embodiment and best mode of this invention, the medical images are, in fact, those produced from an MRI apparatus. As is known, such an apparatus produces series, or sequences of images, which represent successively deeper planar slices of an anatomical target. In the examples given below, the anatomical target is the head of a human patient and it is assumed that three distinct series of images have been taken of the target. Two of these series are termed "axial". The images of an axial series represent parallel, planar images of cross-sectional anatomy taken along an imaginary vertical axis of the head. Each axial series is generated to emphasize particular anatomical features by varying parametric values of the MRI process. In this regard, see Chapter 1 of the Mink et al reference. The two axial series described in this embodiment are the well-known axial T1 and axial T2 sequences. The third series is a sagittal sequence in which the images are anatomical cross-sections lying in planes parallel to the median plane of the head.

It is assumed, without further explanation, that axial and sagittal images obtained from an MRI apparatus will have been digitized and rendered into conventional scanned, pixelated data representations that can be processed by the computer system illustrated in FIG. 1. In FIG. 1, the system includes a DOS-based personal computer or work station 10 which has the capability to concurrently execute an application process 12 and a plurality of interface processes 14. The application process which, preferably, is written in the well-known C language, embodies processes and functions of the invention as described later in further detail. The interface processes 14 include commercially available programs as well as processes which can be constructed by the reasonably skilled computer programmer with the following description in hand. The interface processes 14 are connected to standard I/O devices such as a conventional trackball mechanism 16, a conventional QWERTY keyboard 22, and output devices 23 such as a full grey scale printer, a facsimile machine, and a modem (none of which is illustrated). The trackball mechanism 16 is a conventional picking device that includes a left button 18, a right button 19, and a rotation ball 20. The trackball mechanism 16 provides a user with the means for directly manipulating the position and functions of a cursor. The keyboard 22 is manually operated to input alphanumeric characters. The output devices 23 operate conventionally to provide tangible, visual results produced by the invention as described in further detail below. An image database 24 includes one or more conventional on-line storage devices for storage of medical image data representations which have been generated as described above. Therefore, the image database 24 includes not only the storage hardware, but also the stored images and all necessary indices. An output device 25 in the form of a multi-screen apparatus provides the means by which the images stored in the image database 24 are arranged and presented to a practitioner for examination, manipulation, and disposition. In the preferred embodiment, the device includes three separate output monitors 26, 27, and 28 which are connected by a coupling mechanism 29 to the interface processes 14 for control by the application process 12.

FIG. 2 shows certain architectural aspects of the best mode for practicing the invention in a system such as that illustrated in FIG. 1. In FIG. 2, the interface processes 14 include a conventional directly-manipulated user interface 14a which is directly connected to a screen driver 14b. The screen driver 14b is connected to the trackball mechanism 16 and the keyboard 22, passing inputs from these devices by conventional means directly to the user interface 14a. The screen driver 14b also operates in conjunction with the user interface 14a to provide the pixel information necessary to draw and manipulate graphics on the monitors 26, 27, and 28.

The graphics include a cursor, display containers which give a visible structure for image presentation, and a control panel in which icons and function buttons are displayed. It is assumed that the user interface includes the ability not only to generate a cursor, but also to move the cursor among the monitors in response to trackball motion. It is further presumed that the user interface includes the ability to highlight icons and control buttons which have been "pointed to" by the cursor and "clicked" by a trackball mechanism button. The interface processes 14 further include an image subsystem 14c and a low level video controller 14d. The image subsystem 14c accesses the image database 23 for retrieval of stored images. Image selection is made by the application process 12 and indicated by control signals coupled to the image subsystem 14c. In response to control signals which designate images to be retrieved, the image subsystem 14c obtains the data representations of the specified images and enters them into a high-capacity working memory 33 as directed by the application process 12. The application process 12 further specifies how and which images in the working memory 33 are to be output on the monitors 26, 27, and 28. Thus, the pixel information representing database images flows from the working memory 33, through the image subsystem 14c to the monitors 26, 27, and 28. Control over the display apparatus 25 is provided by the coupling mechanism 29 in the form of a video card which has separately accessed and separately controlled memories for Red, Green, and Blue pixels. These memories are indicated by reference numerals 29a, 29b, and 29c, respectively. The memories of the video card are controlled by a low-level video controller 14d, which receives control signals from the image subsystem 14c. The image subsystem 14c generates control input for the low-level controller 14d in response to control signals generated by the application process 12.

In the architecture illustrated in FIG. 2, each of the memories 29a, 29b, and 29c is connected by a respective gun of a tri-color output to a particular video monitor. In particular, the Red memory 29a is connected by way of a Red (R) video output connector to the monitor 26, the Green memory 29b by a Green (G) video output connector to the monitor 27, and the Blue memory 29c by a Blue (B) video output connector to the monitor 28. The monitors 26, 27, and 28 are operated in the monochromatic mode and the memories 29a, 29b, and 29c are operated effectively as frame buffers for the monitors to which they are connected. This architecture merely reflects the design choices of the inventors in implementing the invention, and is not intended to limit the use of equivalent architectures. For example, instead of separate video monitors 26, 27, and 28, a designer might select an architecture which provides separate display containers (windows) on a single, large video monitor so that each window operates as a separate, independently-controlled monitor.

The application program 12 employs object-oriented programming techniques to provide programming controls and cues to the user interface 14a and the imaging subsystem 14c. Controls and cues are in an object list 34 which is initiated and updated as needed by the application process 12. The object list has a conventional structure in that it includes a plurality of objects, each of which represents some feature or attribute of a display which is presented on one of the monitors 26, 27, or 28. Objects in the object list 34 are conventionally indexed. Each object includes one or more application process functions and any data necessary to establish machine state when the object is encountered or otherwise identified during system operation.

The application process 12 maintains and increments an icon index 35 whose output is provided to the user interface 14a for accessing the object list 34 in a procedure described later in greater detail.

IMAGE PRESENTATION

The invention is practiced on a system architecture corresponding to that illustrated and discussed above. The invention is concerned with the presentation of one or more medical image series for consideration, analysis, and disposal by a user such as a radiologist. The invention includes at least two modes for presenting medical image series. The first mode is illustrated in FIG. 3.

FIG. 3 illustrates what is termed the "monitor" mode of image presentation. FIG. 3 illustrates a rectangular display container which is produced on one or more monitors for presentation of image series. The series shown in FIG. 3 is an axial T2 series including 18 images. The display container is subdivided into a rectangular array of 20 presentation areas. In the monitor mode of image presentation, an image series is shown in a single display container in its sequence order such that each presentation area of the display container includes one image of the sequence. Only one image series at a time is shown in any display container. Separate series are shown in separate display containers. The axial T2 sequence illustrated in FIG. 3 is ordered by assignment to each image in the series of a monotonically increasing number. The number assigned to an image represents the image's position in the sequence of which it is a member. In FIG. 3, therefore, the image in the upper left-hand presentation area is the first image of the axial T2 sequence, with the next image in the sequence being assigned the number 2 and being displayed in the next presentation area of the display container to the right of the presentation area where image number 1 is shown.

In the monitor mode of the presentation, a display container such as that illustrated in FIG. 3 is output on all but one of the monitors or monitor equivalents supported by the system. Thus, in FIGS. 1 and 2, a display container such as shown in FIG. 3 would be presented on, for example, monitors 26 and 27, with monitor 28 being reserved for presentation of a work product palette as described below. This permits more than one image series to be presented, with each image series being presented in its sequence order in a presentation area of a respective display container on a particular monitor. Since co-relative series such as axial T1 and axial T2 typically consist of an identical number of images taken at identical planes, identical side-by-side presentations of axial T1 and T2 series on adjacent monitors in the manner illustrated in FIG. 3 contributes significantly to a radiologist's ability to differentially analyze the images.

FIG. 4 illustrates a second presentation mode of the invention which is termed the "series" mode. In the series mode, a display container comprising a rectangular array of rectangular presentation areas is displayed on one or more monitors. For example, the display container in FIG. 4 includes four substantially rectangular presentation areas numbered 1, 2, 3, and 4 in the drawing. In the invention, each presentation area of a series mode display container is employed to display an image series, one image at a time, in the order of its respective sequence. In this regard, consider presentation area 2 in which an axial T2 series is illustrated. Assume that the axial T2 series is identical to that illustrated in FIG. 3. Thus, the images of the axial T2 series would be shown in presentation area 2 beginning with image 1 and continuing sequentially until image 18 is shown. Assume next that a co-relative axial T1 series comprising 18 images is presented in presentation area 1 in the display container of FIG. 4. An important feature of the invention termed "coupling" is employed to synchronize the presentation of the axial T1 and T2 series so that whenever an image of one series is changed to the next image in the series, the other series is changed identically to display the image of the other series occupying the same sequence position. Thus, if presentation area 1 in the display container of FIG. 4 displays image 1 of the axial T1 series and then riffles through the images of the series, the display in presentation area 2 would identically riffle through the images of the axial T2 series, beginning with image 1. The invention contemplates that the coupling feature of the series mode of presentation will synchronize image presentation only between co-relative image series. Thus, for example, an axial T1 series would be coupled for a presentation with an axial T2 series, but not with a sagittal T1 series such as that shown in presentation area 4 of the display container in FIG. 4.

The series mode of presentation is practiced by presenting the display container of FIG. 4 on all available monitors or monitor equivalents except one, which is also reserved for the working palette display container.

Refer now to FIG. 5 for an illustration of the working palette display container. This display container is presented on one monitor of a multi-monitor system, such as monitor 28 in FIGS. 1 and 2. The working palette display container has a substantially rectangular aspect and is subdivided into a rectangular array of individual presentation areas. The working palette is provided to receive individual images which are picked and copied from presentation areas in monitor mode or series mode display containers. The working palette allows a radiologist to assemble the images which are deemed to be the most important in illustrating trauma or disease for provision to a referring physician. For example, the axial image displayed in presentation area 3 of the working palette display container may have been copied there from presentation area 12 in the monitor mode display container of FIG. 3.