如何考量DR的综合性能

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                    <p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; color: rgb(0, 112, 192);"><strong style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"><img src="http://mmbiz.qpic.cn/mmbiz/kFiaamOEjRian1HH0R0eUOoCeBLcQMwLwP8AhIKEgibEZWZ6Aj8JI7ctB2SCxKLuXUNfMEVnjyjE28FWL7b7WmoKQ/0" data-ratio="0.11928429423459244" data-w="" width="auto" width="auto" src="http://mmbiz.qpic.cn/mmbiz/kFiaamOEjRian1HH0R0eUOoCeBLcQMwLwP8AhIKEgibEZWZ6Aj8JI7ctB2SCxKLuXUNfMEVnjyjE28FWL7b7WmoKQ/0" style="color: rgb(62, 62, 62); background-color: rgb(255, 255, 255); font-family: 宋体; font-size: 18.88888931274414px; white-space: normal; word-wrap: break-word !important; box-sizing: border-box !important; width: auto !important; visibility: visible !important;"  /><img data-s="300,640" src="http://mmbiz.qpic.cn/mmbiz/A1DicCH9Vl6PeHuiaxma8LTpukQAcM7BQEjbw2WaKnAOtlOgIibJIw64j8wGn3InhhoB99U126fwM6jkwARaBAPKA/0" data-ratio="0.6679920477137177" data-w=""  />1、品牌与零部件来源：</strong></span><br style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"  /></p><p style=""><br style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"  /></p><p style="">整机性能稳定性如何取决于品牌和整机零部件来源的一致性。品牌价值是产品质量最简约的保证，品牌知名度和美誉度越高，品牌价值越高。而零部件来源的一致性和品牌的同一性，决定了影像链性能的稳定性和零部件间的相互适配性高低。</p><p style=""><br style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"  /></p><p style=""><strong style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; color: rgb(0, 112, 192);">2、品牌：</span></strong></p><p style=""><br style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"  /></p><p style="">在DR领域，目前国外主流品牌依然是西门子、飞利浦、GE。其他品牌有锐珂医疗、岛津、日本佳能、日本东芝、意大利GMM公司、韩国新医科技、加拿大IDC、法国Stephanix、加拿大Visionmax公司、IMIX等。国内主流品牌北京万东、深圳蓝韵、深圳安科、东软等，其他有中科美伦、山东新华、 上海爱申、北京东健、北京德润特、深圳贝斯达、深圳安健、汕头超声、清华同仁、珠海和佳、宁波鑫高益、上海医疗器械厂、航天中兴、杭州美诺瓦、浙江康源等。</p><p style=""><br style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"  /></p><p style=""><strong style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; color: rgb(0, 112, 192);">3、零部件来源：</span></strong></p><p style=""><br style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"  /></p><p style="">主流品牌的DR零部件基本来源是自己的工厂设计制造，零部件相互适配性较高，故障率较低，但价格相对较高。有很多的厂家仅仅是品牌拥有者，不是X线影像产品制造者，所以零部件相互适配性较差，故障率较高，但价格相对低廉。</p><p style=""><br style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"  /></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; color: rgb(0, 112, 192);"><strong style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;">4、设计制造方式：</strong></span></p><p style=""><br style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"  /></p><p style="">主要有三种生产方式：</p><p style=""><br style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"  /></p><p style="">一种是从DR的设计到生产是一条系统整体设计的：为获取优质图像，X线球管、X线高压发生器、滤线器、平板探测器等各零部件之间是预先经过统一规划和设计考虑的，对DR图像信号获取的整个成像链各环节都有质量要求，对摄影系列图像的获取有时间轴上的X线稳定性要求，对数字图像处理系统有快速、实时、高分辨率、图像灰阶多的要求，从X线机到X线平板探测器系统到数字图像系统都由同一品牌公司提供，且所有这些决定了数字化X线摄影系统的性能先进性和系统稳定性，并进而影响图像质量。</p><p style=""><br style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"  /></p><p style="">另一种是采用零部件全球采购模式生产：即X线球管、X线高压发生器、滤线器、平板探测器等基本来自外购，从X线机到X线平板探测器系统到数字图像系统由多家不同的公司提供，设备供应商仅仅是品牌拥有者或影像链中某个零部件的生产商，其整机生产过程实质上就是组装集成过程，类似于在电脑市场采购零部件组装电脑，故业内常将此类设备戏称为“兼容机”。</p><p style=""><br style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"  /></p><p style="">还一种为贴牌模式生产，即由某个生产商将自己的产品贴上其他品牌拥有者的品牌标识，由该品牌拥有者负责市场营销。</p><p style=""><br style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"  /></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; color: rgb(0, 112, 192);"><strong style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;">5、技术水平：</strong></span></p><p style=""><br style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"  /></p><p style="">DR的影像链由X线高压发生器、X线球管、滤线器、平板探测器、图像后处理系统等组成。</p><p style=""><br style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"  /></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; color: rgb(255, 0, 0);"><strong style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;">（1）X线高压发生器</strong></span>：主要有工频高压发生器和高频逆变高压发生器，后者又可分为连续式高频逆变高压发生器和计算机控制的脉冲式高频逆变高压发生器，DR均采用高频逆变高压发生器。</p><p style=""><br style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"  /></p><p style="">计算机控制的脉冲式连高频逆变高压发生器，制造工艺复杂，技术难度较高，造价也相对昂贵，但能自动根据成像区衰减状态调整kV、mA等参数，使X线管保持最佳负荷状态，在安全辐射剂量范围内获取最佳图像质量。</p><p style=""><br style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"  /></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; color: rgb(255, 0, 0);"><strong style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;">（2）X线球管</strong></span>：目前在高档DR，为满足连续曝光、采集高品质影像的要求，多使用小焦点、高热容量、高转速、散热效率高的x线管。球管焦点大小决定图像的锐利度和对比度高低。</p><p style=""><br style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"  /></p><p style=""><strong style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; color: rgb(255, 0, 0);">（3）滤线器</span></strong>：目前主要有固定式滤线器和振动式滤线器，前者使用过程中滤线栅固定不动，所以X线通过滤线栅时被矫垂直而不会由于栅线摆动切断X线造成X线穿过滤线器时产生时间差。后者使用过程中由于栅线摆动切断X线造成X线穿过滤线器时产生时间差。</p><p style=""><br style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"  /></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; color: rgb(255, 0, 0);"><strong style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;">（4）平板探测器</strong></span>：作为整个系统最关键的部分，对于系统的分辨率有重要意义。包合了DR图像的空间分辨率、DR图像的对比分辨率和DR图像的时间分辨率。但在实际临床成像过程中 影响分辨率的因素有X线焦点、SID、患者运动、曝光时间、探测器感光灵敏度、像素大小、计算机图像处理、显示器性能等。实际上所谓的图像质量很多决定于厂家开发的图像后处理功能是否完善，这也是系统性能的重要部分。高级影像后处理功能如伪影自检和校正、图像均衡处理、图像降噪处理以及各种CAD辅助诊断和分析软件，采用医学影像专用多芯片组并行处理服务器，将计算机与DR系统完全集成，完全能满足图像质量实时处理的要求，使DR的操作变得更为简单。</p><p style=""><br style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"  /></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; color: rgb(0, 112, 192);"><strong style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;">6、使用的方便性：</strong></span></p><p style=""><br style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"  /></p><p style="">现各厂家高端DR均基于全球统一的多系统控制概念而建立起来了集成化操作系统。这种操作系统在一个工作面上涵盖了X线摄影的所有工作，包括病人数据登记，曝光前准备，曝光程序选择，图像测量以及后处理，图像打印和归档，报告的制作等。</p><p style=""><br style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"  /></p><p style=""><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; color: rgb(0, 112, 192);"><strong style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;">7、配置的合理性：</strong></span></p><p style=""><br style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"  /></p><p style="">放射影像设备综合性能的优劣，图像质量是最简单有效的标志，一台设备的综合性能高低，不是取决于该设备最优秀的那个部件及参数，而是由最差的那个部件及最低的那个参数决定，就好比一只木桶，能装多少水，不是取决于最长的那块木板，而是由最短的那块木板决定，因此，DR时，要特别关注系统中最差的部件和最低的参数是否能够满足需求，各零部件的配置是否合理。要特别防止出现大马拉小车或小马拉大车现象。</p><p style=""><br style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"  /></p><p style=""><strong style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important; color: rgb(0, 112, 192);">8、总评：</span></strong></p><p style=""><br style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"  /></p><p style="">由于DR系统的工作效率提高、一台DR设备可以取代近 3台常规胶片摄影设备的工作量、因此装备DR后，科室的工作安排和责任也要做相应调整。DR系统在提高工作效率的同时，也会给放射科带来增加患者信息电子化管理的需求。所以建议在购置DR的同时都应该着手进行考虑围绕DR系统建立高效的RIS系统和PACS系统的规划和设计。从PACS的开发角度看，DR系统作为 PACS的影像采集终端，其要能够与PACS系统双向通讯，与PACS系统兼容就完成 。</p><p style=""><br style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"  /></p><p style="">但是从医院的角度，购买 DR系统的还需考虑医院的影像全数字化的工作流程的需求．推进医院信息化建设，提高医院整体工作效率，真正发挥数字化影像的技术优势，尽可能减低医院设备的投入成本，避免在添置了DR还需考虑软件兼容性或解决未来软件升级等问题。所以建议购买 DR系统的医院尽可能考虑有实力生产 DR的厂家本身也是 PACS系统的主要制造商，具备非常完整的PACS产品，使影像DR系统和PACS系统统一。DR系统的兼容性、稳定性、可扩展性、安全性、经济性等也是选择DR性能之一。</p><p style=""><img src="http://mmbiz.qpic.cn/mmbiz/rz7R73cuHRrv6jdOCoJeZmYwvEAIoHpY0a7yJL2egiaEokLTpwkIsIRTzTFUic09aEThKHS4hrEcSqU0lAS3tu5g/0" data-ratio="0.14784394250513347" data-w="487" width="auto" src="http://mmbiz.qpic.cn/mmbiz/rz7R73cuHRrv6jdOCoJeZmYwvEAIoHpY0a7yJL2egiaEokLTpwkIsIRTzTFUic09aEThKHS4hrEcSqU0lAS3tu5g/0" style="word-wrap: break-word !important; 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box-sizing: border-box !important;"></span></strong></span></legend></p><p style="margin-top: 0px; margin-bottom: 0px; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; background-color: rgb(255, 255, 255); color: rgb(51, 51, 51); font-family: 宋体; font-size: 14px; line-height: 24px; orphans: 2; widows: 2; box-sizing: border-box !important;"><span style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;">平台的理念：分享维修经验，为工程师提供技术配件支持，为临床使用者提供医疗器械使用保养维护信息，关注我们传递正能量。</span></p><p style="margin-top: 0px; margin-bottom: 0px; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; background-color: rgb(255, 255, 255); color: rgb(51, 51, 51); font-family: 宋体; font-size: 14px; line-height: 24px; orphans: 2; widows: 2; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 仿宋; font-size: 19px; word-wrap: break-word !important; box-sizing: border-box !important;">微信公众号:</span></p><p style="margin-top: 0px; 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white-space: pre-wrap; background-color: rgb(255, 255, 255); color: rgb(51, 51, 51); font-family: 宋体; font-size: 14px; line-height: 24px; orphans: 2; widows: 2; box-sizing: border-box !important;"><span style="max-width: 100%; font-family: 仿宋; font-size: 19px; word-wrap: break-word !important; box-sizing: border-box !important;">群主微信号：</span><span style="max-width: 100%; font-family: sans-serif; font-size: 16px; word-wrap: break-word !important; box-sizing: border-box !important;"> </span></p><p style="margin-top: 0px; margin-bottom: 0px; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; background-color: rgb(255, 255, 255); color: rgb(51, 51, 51); font-family: 宋体; font-size: 14px; line-height: 24px; orphans: 2; widows: 2; box-sizing: border-box !important;"><strong style="max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"><span style="max-width: 100%; font-size: 20px; color: rgb(255, 0, 0); word-wrap: break-word !important; box-sizing: border-box !important;">    shanying916</span></strong></p><fieldset class="brcolor" style="white-space: normal; margin: 0px; padding: 5px; border: 1px solid rgb(0, 187, 236); max-width: 100%; color: rgb(62, 62, 62); font-family: 微软雅黑; line-height: 24px; font-size: 12px; background-color: rgb(248, 247, 245); word-wrap: break-word !important; box-sizing: border-box !important;"><legend style="padding: 0px; max-width: 100%; color: rgb(51, 51, 51); margin: 0px 10px; border-width: 0px; word-wrap: break-word !important; box-sizing: border-box !important;"><span class="bkcolor" style="max-width: 100%; margin: 0px; padding: 5px 10px; border: 0px; color: rgb(255, 255, 255); font-weight: bold; font-size: 14px; border-top-left-radius: 5px; border-top-right-radius: 5px; border-bottom-right-radius: 5px; border-bottom-left-radius: 5px; background-color: rgb(0, 187, 236); word-wrap: break-word !important; box-sizing: border-box !important;"><span style="max-width: 100%; margin: 0px; padding: 0px; border: 0px; word-wrap: break-word !important; box-sizing: border-box !important;">复制上面微信号</span><img data-s="300,640" data-ratio="1.35" data-w="20" src="http://mmbiz.qpic.cn/mmbiz/A1DicCH9Vl6NE8iaIXiblrE1WKyXQz6qbATAS0VZxTKlGupjMMNvicoNs9vhvYGBr83wmsdO1ouTw7kVDibk9w6VoMg/0" class="" id="c6" width="auto" width="auto" src="http://mmbiz.qpic.cn/mmbiz/A1DicCH9Vl6NE8iaIXiblrE1WKyXQz6qbATAS0VZxTKlGupjMMNvicoNs9vhvYGBr83wmsdO1ouTw7kVDibk9w6VoMg/640" style="margin: 0px; padding: 0px; border: 0px; word-wrap: break-word !important; box-sizing: border-box !important; visibility: visible !important; width: auto !important;"  /><span style="max-width: 100%; margin: 0px; padding: 0px; border: 0px; word-wrap: break-word !important; box-sizing: border-box !important;">联系我哟</span></span></legend><blockquote style="padding: 0px; border: 0px; max-width: 100%; word-wrap: break-word !important; box-sizing: border-box !important;"><p style="margin-top: 0px; margin-bottom: 0px; max-width: 100%; word-wrap: normal; min-height: 1em; white-space: pre-wrap; padding: 0px; border: 0px; box-sizing: border-box !important;"><span style="max-width: 100%; margin: 0px; padding: 0px; border: 0px; color: rgb(255, 192, 0); font-size: 14px; word-wrap: break-word !important; box-sizing: border-box !important;"></span><span style="max-width: 100%; color: rgb(255, 192, 0); margin: 0px; padding: 0px; border: 0px; font-size: 14px; word-wrap: break-word !important; box-sizing: border-box !important;">? </span><span style="max-width: 100%; color: rgb(127, 127, 127); margin: 0px; padding: 0px; border: 0px; line-height: 28px; word-wrap: break-word !important; box-sizing: border-box !important;">定期推送</span><span style="max-width: 100%; color: rgb(255, 192, 0); margin: 0px; padding: 0px; border: 0px; line-height: 28px; word-wrap: break-word !important; box-sizing: border-box !important;">医械资讯</span><span style="max-width: 100%; margin: 0px; padding: 0px; border: 0px; line-height: 28px; word-wrap: break-word !important; box-sizing: border-box !important;"><span style="max-width: 100%; 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