Refine DICOM classification labels and loading

PACS_DICOM处理/数据处理网页端/README.md

@@ -1,6 +1,6 @@
-# PACS DICOM 网页端
+# DICOM 阅片分类系统
 
-本目录提供本地 DICOM 检查浏览、序列查看和序列部位标注界面。
+本目录提供本地 DICOM 检查浏览、序列查看和序列分类标注界面。
 
 ## Docker 启动
 
@@ -40,10 +40,10 @@ uvicorn app:app --host 127.0.0.1 --port 8107
 - 中间序列列表：从已处理 DICOM 目录扫描 DICOM 头信息。
 - 右侧查看器：支持轴位原始、矢状位重建、冠状位重建，窗宽窗位、旋转、切片进度条。
 - 影像操作：支持鼠标滚轮缩放、拖拽平移、按钮缩放和复位。
-- 图像叠层：可显示/隐藏患者、检查、方向、张数、窗宽窗位和缩放信息。
+- 图像叠层：可显示/隐藏患者、检查、张数、窗宽窗位和缩放信息。
 - DICOM 信息：查看患者、检查、序列、像素间距、切片间距等元数据。
-- 序列列表：默认按拍摄时间升序排序，可切换时间升降序或张数升降序；略过序列固定在最下方，并在略过分组内继续按当前排序规则排列。
+- 序列列表：默认按拍摄时间升序排序，可切换时间升降序或张数升降序；略过/不采用序列固定在最下方，并在略过/不采用分组内继续按当前排序规则排列。
-- 序列标注：选择略过、平扫 CT、头颈部、胸部、上腹部、下腹部、盆腔；略过可与部位共存；DICOM 标识含 CHEST/ABDOMEN 时会自动预选胸部/上腹部；切换界面前会提示保存；上腹部需继续选择动脉期、门静脉期或无法判别。
+- 序列标注：选择略过/不采用、平扫 CT、头颈部、胸部、上腹部、下腹部、盆腔；略过/不采用可与部位共存；DICOM 标识含 CHEST/ABDOMEN 时会自动预选胸部/上腹部；切换界面前会提示保存；上腹部需继续选择动脉期、门静脉期、延迟期或无法判别，胸部需继续选择肺窗、纵隔窗或无法判别。
 - AI 识别：配置 Kimi 后，可把序列张数及轴位原始、矢状位重建、冠状位重建代表图像传入 AI，自动给出部位、期相和备注建议。
 - 设置：支持用户创建、角色权限展示、数据库状态和 AI 配置查看。
 - 标注写入 PostgreSQL 表 `pacs_dicom_series_annotations`，人工标注和 AI 标注分别记录。

PACS_DICOM处理/数据处理网页端/app.py

@@ -64,14 +64,15 @@ WINDOWS = {
 }
 
 BODY_PARTS = {"head_neck", "chest", "upper_abdomen", "lower_abdomen", "pelvis"}
-PHASES = {"arterial", "portal_venous", "unknown", ""}
+PHASES = {"arterial", "portal_venous", "delayed", "unknown", ""}
+CHEST_WINDOWS = {"lung", "mediastinal", "unknown", ""}
 ROLES = {
     "管理员": ["查看DICOM", "编辑标注", "AI识别", "用户创建", "权限控制", "系统设置"],
     "阅片员": ["查看DICOM", "编辑标注", "AI识别"],
     "访客": ["查看DICOM"],
 }
 
-app = FastAPI(title="PACS DICOM Viewer")
+app = FastAPI(title="DICOM 阅片分类系统")
 app.mount("/static", StaticFiles(directory=STATIC_DIR), name="static")
 
 TOKENS: dict[str, str] = {}
@@ -91,6 +92,9 @@ class AnnotationIn(BaseModel):
     upper_abdomen_phase: str = ""
     manual_upper_abdomen_phase: str = ""
     ai_upper_abdomen_phase: str = ""
+    chest_window: str = ""
+    manual_chest_window: str = ""
+    ai_chest_window: str = ""
     plain_ct: bool = False
     manual_plain_ct: bool | None = None
     ai_plain_ct: bool | None = None
@@ -187,6 +191,9 @@ def ensure_annotation_table() -> None:
         upper_abdomen_phase text NOT NULL DEFAULT '',
         manual_upper_abdomen_phase text NOT NULL DEFAULT '',
         ai_upper_abdomen_phase text NOT NULL DEFAULT '',
+        chest_window text NOT NULL DEFAULT '',
+        manual_chest_window text NOT NULL DEFAULT '',
+        ai_chest_window text NOT NULL DEFAULT '',
         plain_ct boolean NOT NULL DEFAULT false,
         manual_plain_ct boolean,
         ai_plain_ct boolean,
@@ -208,6 +215,12 @@ def ensure_annotation_table() -> None:
         ADD COLUMN IF NOT EXISTS manual_upper_abdomen_phase text NOT NULL DEFAULT '';
     ALTER TABLE public.pacs_dicom_series_annotations
         ADD COLUMN IF NOT EXISTS ai_upper_abdomen_phase text NOT NULL DEFAULT '';
+    ALTER TABLE public.pacs_dicom_series_annotations
+        ADD COLUMN IF NOT EXISTS chest_window text NOT NULL DEFAULT '';
+    ALTER TABLE public.pacs_dicom_series_annotations
+        ADD COLUMN IF NOT EXISTS manual_chest_window text NOT NULL DEFAULT '';
+    ALTER TABLE public.pacs_dicom_series_annotations
+        ADD COLUMN IF NOT EXISTS ai_chest_window text NOT NULL DEFAULT '';
     ALTER TABLE public.pacs_dicom_series_annotations
         ADD COLUMN IF NOT EXISTS plain_ct boolean NOT NULL DEFAULT false;
     ALTER TABLE public.pacs_dicom_series_annotations
@@ -475,6 +488,10 @@ def valid_phase(value: Any) -> str:
     return value if value in PHASES else ""
 
 
+def valid_chest_window(value: Any) -> str:
+    return value if value in CHEST_WINDOWS else ""
+
+
 def bool_or_none(value: Any) -> bool | None:
     if value is None:
         return None
@@ -502,6 +519,12 @@ def effective_phase(manual_phase: str, ai_phase: str, body_parts: list[str], ski
     return valid_phase(manual_phase) or valid_phase(ai_phase)
 
 
+def effective_chest_window(manual_window: str, ai_window: str, body_parts: list[str], skipped: bool) -> str:
+    if "chest" not in body_parts:
+        return ""
+    return valid_chest_window(manual_window) or valid_chest_window(ai_window) or "unknown"
+
+
 def effective_plain_ct(manual_plain_ct: bool | None, ai_plain_ct: bool | None, fallback: bool, skipped: bool) -> bool:
     if manual_plain_ct is not None:
         return manual_plain_ct
@@ -522,6 +545,10 @@ def normalize_annotation(row: dict[str, Any] | None, default_skipped: bool = Fal
     ai_phase = valid_phase(row.get("ai_upper_abdomen_phase") or "")
     if not manual_phase and not ai_phase:
         manual_phase = valid_phase(row.get("upper_abdomen_phase") or "")
+    manual_chest_window = valid_chest_window(row.get("manual_chest_window") or "")
+    ai_chest_window = valid_chest_window(row.get("ai_chest_window") or "")
+    if not manual_chest_window and not ai_chest_window:
+        manual_chest_window = valid_chest_window(row.get("chest_window") or "")
     body_parts = merge_parts(manual_parts, ai_parts, skipped)
     plain_ct = effective_plain_ct(
         bool_or_none(row.get("manual_plain_ct")),
@@ -536,6 +563,9 @@ def normalize_annotation(row: dict[str, Any] | None, default_skipped: bool = Fal
         "upper_abdomen_phase": effective_phase(manual_phase, ai_phase, body_parts, skipped),
         "manual_upper_abdomen_phase": manual_phase,
         "ai_upper_abdomen_phase": ai_phase,
+        "chest_window": effective_chest_window(manual_chest_window, ai_chest_window, body_parts, skipped),
+        "manual_chest_window": manual_chest_window,
+        "ai_chest_window": ai_chest_window,
         "plain_ct": plain_ct,
         "manual_plain_ct": bool_or_none(row.get("manual_plain_ct")),
         "ai_plain_ct": bool_or_none(row.get("ai_plain_ct")),
@@ -548,16 +578,18 @@ def normalize_annotation(row: dict[str, Any] | None, default_skipped: bool = Fal
     }
 
 
-def dicom_auto_annotation(meta: dict[str, str]) -> tuple[list[str], str]:
+def dicom_auto_annotation(meta: dict[str, str]) -> tuple[list[str], str, str]:
     marker = f"{meta.get('BodyPartExamined', '')} {meta.get('SeriesDescription', '')}".upper()
     parts: list[str] = []
     phase = ""
+    chest_window = ""
     if "CHEST" in marker and "chest" not in parts:
         parts.append("chest")
+        chest_window = "unknown"
     if "ABDOMEN" in marker and "upper_abdomen" not in parts:
         parts.append("upper_abdomen")
         phase = "unknown"
-    return parts, phase
+    return parts, phase, chest_window
 
 
 def get_annotations(ct_number: str) -> dict[str, dict[str, Any]]:
@@ -568,6 +600,7 @@ def get_annotations(ct_number: str) -> dict[str, dict[str, Any]]:
             SELECT
                 series_instance_uid, body_parts, manual_body_parts, ai_body_parts,
                 upper_abdomen_phase, manual_upper_abdomen_phase, ai_upper_abdomen_phase,
+                chest_window, manual_chest_window, ai_chest_window,
                 plain_ct, manual_plain_ct, ai_plain_ct, skipped, ai_skipped, notes, updated_at, ai_model, updated_by
             FROM public.pacs_dicom_series_annotations
             WHERE ct_number = {sql_literal(ct_number)}
@@ -609,7 +642,7 @@ def scan_study(ct_number: str) -> dict[str, Any]:
         file_map[uid] = [path for path, _ in items]
         raw_annotation = annotations.get(uid)
         annotation = normalize_annotation(raw_annotation)
-        auto_parts, auto_phase = dicom_auto_annotation(first)
+        auto_parts, auto_phase, auto_chest_window = dicom_auto_annotation(first)
         can_apply_auto = bool(auto_parts) and not annotation.get("body_parts")
         if can_apply_auto:
             annotation["manual_body_parts"] = auto_parts
@@ -617,7 +650,10 @@ def scan_study(ct_number: str) -> dict[str, Any]:
             if auto_phase:
                 annotation["manual_upper_abdomen_phase"] = auto_phase
                 annotation["upper_abdomen_phase"] = auto_phase
-            auto_annotation_rows.append((uid, first, auto_parts, auto_phase))
+            if auto_chest_window:
+                annotation["manual_chest_window"] = auto_chest_window
+                annotation["chest_window"] = auto_chest_window
+            auto_annotation_rows.append((uid, first, auto_parts, auto_phase, auto_chest_window))
         default_skipped = len(items) < 80 and (not raw_annotation or annotation.get("updated_by") == "system")
         if default_skipped:
             annotation["skipped"] = True
@@ -657,13 +693,14 @@ def scan_study(ct_number: str) -> dict[str, Any]:
             }
         )
 
-    for uid, first, auto_parts, auto_phase in auto_annotation_rows:
+    for uid, first, auto_parts, auto_phase, auto_chest_window in auto_annotation_rows:
         try:
             pg_scalar(
                 f"""
                 INSERT INTO public.pacs_dicom_series_annotations (
                     ct_number, study_instance_uid, series_instance_uid, series_description,
                     body_parts, manual_body_parts, upper_abdomen_phase, manual_upper_abdomen_phase,
+                    chest_window, manual_chest_window,
                     updated_by, updated_at
                 )
                 VALUES (
@@ -675,6 +712,8 @@ def scan_study(ct_number: str) -> dict[str, Any]:
                     {sql_literal(json.dumps(auto_parts, ensure_ascii=False))}::jsonb,
                     {sql_literal(auto_phase)},
                     {sql_literal(auto_phase)},
+                    {sql_literal(auto_chest_window)},
+                    {sql_literal(auto_chest_window)},
                     'system',
                     now()
                 )
@@ -683,6 +722,8 @@ def scan_study(ct_number: str) -> dict[str, Any]:
                     manual_body_parts = EXCLUDED.manual_body_parts,
                     upper_abdomen_phase = EXCLUDED.upper_abdomen_phase,
                     manual_upper_abdomen_phase = EXCLUDED.manual_upper_abdomen_phase,
+                    chest_window = EXCLUDED.chest_window,
+                    manual_chest_window = EXCLUDED.manual_chest_window,
                     updated_by = 'system',
                     updated_at = now()
                 WHERE pacs_dicom_series_annotations.updated_by = 'system'
@@ -713,7 +754,7 @@ def scan_study(ct_number: str) -> dict[str, Any]:
                     '',
                     false,
                     true,
-                    {sql_literal(f'少于80张默认略过（{count}张）')},
+                    {sql_literal(f'少于80张默认略过/不采用（{count}张）')},
                     'system',
                     now()
                 )
@@ -1008,6 +1049,8 @@ def save_annotation_payload(
     ai_parts: list[str],
     manual_phase: str,
     ai_phase: str,
+    manual_chest_window: str,
+    ai_chest_window: str,
     manual_plain_ct: bool | None,
     ai_plain_ct: bool | None,
     skipped: bool,
@@ -1023,6 +1066,12 @@ def save_annotation_payload(
     manual_phase = valid_phase(manual_phase)
     ai_phase = valid_phase(ai_phase)
     phase = effective_phase(manual_phase, ai_phase, body_parts, skipped)
+    manual_chest_window = valid_chest_window(manual_chest_window)
+    ai_chest_window = valid_chest_window(ai_chest_window)
+    if "chest" not in body_parts:
+        manual_chest_window = ""
+        ai_chest_window = ""
+    chest_window = effective_chest_window(manual_chest_window, ai_chest_window, body_parts, skipped)
     plain_ct = effective_plain_ct(manual_plain_ct, ai_plain_ct, False, skipped)
     ensure_annotation_table()
     pg_scalar(
@@ -1031,6 +1080,7 @@ def save_annotation_payload(
             ct_number, study_instance_uid, series_instance_uid, series_description,
             body_parts, manual_body_parts, ai_body_parts,
             upper_abdomen_phase, manual_upper_abdomen_phase, ai_upper_abdomen_phase,
+            chest_window, manual_chest_window, ai_chest_window,
             plain_ct, manual_plain_ct, ai_plain_ct,
             skipped, ai_skipped, notes, ai_result, ai_model, updated_by, updated_at
         )
@@ -1045,6 +1095,9 @@ def save_annotation_payload(
             {sql_literal(phase)},
             {sql_literal(manual_phase)},
             {sql_literal(ai_phase)},
+            {sql_literal(chest_window)},
+            {sql_literal(manual_chest_window)},
+            {sql_literal(ai_chest_window)},
             {'true' if plain_ct else 'false'},
             {sql_bool_or_null(manual_plain_ct)},
             {sql_bool_or_null(ai_plain_ct)},
@@ -1065,6 +1118,9 @@ def save_annotation_payload(
             upper_abdomen_phase = EXCLUDED.upper_abdomen_phase,
             manual_upper_abdomen_phase = EXCLUDED.manual_upper_abdomen_phase,
             ai_upper_abdomen_phase = EXCLUDED.ai_upper_abdomen_phase,
+            chest_window = EXCLUDED.chest_window,
+            manual_chest_window = EXCLUDED.manual_chest_window,
+            ai_chest_window = EXCLUDED.ai_chest_window,
             plain_ct = EXCLUDED.plain_ct,
             manual_plain_ct = EXCLUDED.manual_plain_ct,
             ai_plain_ct = EXCLUDED.ai_plain_ct,
@@ -1085,6 +1141,9 @@ def save_annotation_payload(
             "upper_abdomen_phase": phase,
             "manual_upper_abdomen_phase": manual_phase,
             "ai_upper_abdomen_phase": ai_phase,
+            "chest_window": chest_window,
+            "manual_chest_window": manual_chest_window,
+            "ai_chest_window": ai_chest_window,
             "plain_ct": plain_ct,
             "manual_plain_ct": manual_plain_ct,
             "ai_plain_ct": ai_plain_ct,
@@ -1110,6 +1169,8 @@ def save_annotation(ct_number: str, series_uid: str, data: AnnotationIn, user: s
         ai_parts=data.ai_body_parts,
         manual_phase=data.manual_upper_abdomen_phase or data.upper_abdomen_phase,
         ai_phase=data.ai_upper_abdomen_phase,
+        manual_chest_window=data.manual_chest_window or data.chest_window,
+        ai_chest_window=data.ai_chest_window,
         manual_plain_ct=data.manual_plain_ct if data.manual_plain_ct is not None else (data.plain_ct if data.plain_ct and data.ai_plain_ct is None else None),
         ai_plain_ct=data.ai_plain_ct,
         skipped=data.skipped,
@@ -1168,7 +1229,7 @@ def parse_ai_json(content: str) -> dict[str, Any]:
     try:
         return json.loads(text)
     except Exception:
-        return {"body_parts": [], "upper_abdomen_phase": "", "skipped": False, "notes": content[:800]}
+        return {"body_parts": [], "upper_abdomen_phase": "", "chest_window": "", "plain_ct": False, "skipped": False, "notes": content[:800]}
 
 
 @app.post("/api/series/{ct_number}/{series_uid}/ai")
@@ -1189,8 +1250,9 @@ def ai_classify(ct_number: str, series_uid: str, _: AIRequest, user: str = Depen
                 "lower_abdomen(下腹部), pelvis(盆腔)。一个序列可包含多个部位。"
                 "如果不是可用于标注的平扫CT影像、定位像、剂量报告或无法判断，请 skipped=true。"
                 "请同时判断 plain_ct 是否为平扫CT。"
-                "如果包含上腹部，请判断期相: arterial(动脉期)、portal_venous(门静脉期)、unknown(无法判别)。"
+                "如果包含上腹部，请判断期相: arterial(动脉期)、portal_venous(门静脉期)、delayed(延迟期)、unknown(无法判别)。"
-                "只返回JSON: {\"body_parts\":[],\"upper_abdomen_phase\":\"\",\"plain_ct\":false,\"skipped\":false,\"notes\":\"\"}。"
+                "如果包含胸部，请判断窗位: lung(肺窗)、mediastinal(纵隔窗)、unknown(无法判别)。"
+                "只返回JSON: {\"body_parts\":[],\"upper_abdomen_phase\":\"\",\"chest_window\":\"\",\"plain_ct\":false,\"skipped\":false,\"notes\":\"\"}。"
                 f"PACS张数: {series_row.get('count', 0)}。"
                 f"序列描述: {series_row.get('description','')}；DICOM部位: {series_row.get('body_part_dicom','')}。"
             ),
@@ -1232,6 +1294,11 @@ def ai_classify(ct_number: str, series_uid: str, _: AIRequest, user: str = Depen
     phase = suggestion.get("upper_abdomen_phase", "")
     if phase not in PHASES or "upper_abdomen" not in body_parts:
         phase = ""
+    chest_window = valid_chest_window(suggestion.get("chest_window", ""))
+    if "chest" not in body_parts:
+        chest_window = ""
+    elif not chest_window:
+        chest_window = "unknown"
     current = normalize_annotation(series_row.get("annotation", {}))
     annotation = save_annotation_payload(
         ct_number=ct_number,
@@ -1241,6 +1308,8 @@ def ai_classify(ct_number: str, series_uid: str, _: AIRequest, user: str = Depen
         ai_parts=[] if skipped else body_parts,
         manual_phase=current.get("manual_upper_abdomen_phase", ""),
         ai_phase="" if skipped else phase,
+        manual_chest_window=current.get("manual_chest_window", ""),
+        ai_chest_window="" if skipped else chest_window,
         manual_plain_ct=current.get("manual_plain_ct"),
         ai_plain_ct=None if skipped else plain_ct,
         skipped=skipped,

PACS_DICOM处理/数据处理网页端/static/app.js

@@ -22,6 +22,9 @@ const app = {
   drag: null,
   seriesSort: "timeAsc",
   showOverlay: true,
+  thumbUrls: new Map(),
+  thumbObserver: null,
+  thumbSeries: new WeakMap(),
 };
 
 const $ = (id) => document.getElementById(id);
@@ -97,7 +100,11 @@ function timeKey(series) {
 }
 
 function phaseLabel(value) {
-  return { arterial: "动脉期", portal_venous: "门静脉期", unknown: "无法判别" }[value] || "";
+  return { arterial: "动脉期", portal_venous: "门静脉期", delayed: "延迟期", unknown: "无法判别" }[value] || "";
+}
+
+function chestWindowLabel(value) {
+  return { lung: "肺窗", mediastinal: "纵隔窗", unknown: "无法判别" }[value] || "";
 }
 
 function partLabel(value) {
@@ -254,7 +261,6 @@ async function selectStudy(ctNumber) {
     setSeries(data.series || []);
     refreshStudyAnnotationSummary();
     renderStudies();
-    if (app.series.length) selectSeries(app.series[0].series_uid);
   } catch (err) {
     $("seriesGrid").innerHTML = `<p class="error-line">${escapeHtml(err.message)}</p>`;
   }
@@ -270,7 +276,7 @@ function seriesTags(series) {
   const annotation = series.annotation || {};
   const tags = [];
   if (annotation.skipped) {
-    tags.push({ label: "略过", source: annotation.ai_skipped ? "ai" : "manual" });
+    tags.push({ label: "略过/不采用", source: annotation.ai_skipped ? "ai" : "manual" });
   }
   if (annotation.plain_ct) {
     tags.push({ label: "平扫CT", source: annotation.manual_plain_ct !== null && annotation.manual_plain_ct !== undefined ? "manual" : "ai" });
@@ -280,7 +286,19 @@ function seriesTags(series) {
   }
   const phase = phaseLabel(annotation.upper_abdomen_phase);
   if (phase) {
-    tags.push({ label: phase, source: annotation.manual_upper_abdomen_phase ? "manual" : "ai" });
+    tags.push({
+      label: phase,
+      source: annotation.manual_upper_abdomen_phase ? "manual" : annotation.ai_upper_abdomen_phase ? "ai" : "",
+      warn: annotation.upper_abdomen_phase === "unknown",
+    });
+  }
+  const chestWindow = chestWindowLabel(annotation.chest_window);
+  if (chestWindow) {
+    tags.push({
+      label: chestWindow,
+      source: annotation.manual_chest_window ? "manual" : annotation.ai_chest_window ? "ai" : "",
+      warn: annotation.chest_window === "unknown",
+    });
   }
   if (series.body_part_dicom) tags.unshift({ label: series.body_part_dicom, source: "" });
   return tags;
@@ -288,6 +306,7 @@ function seriesTags(series) {
 
 function renderSeries() {
   const grid = $("seriesGrid");
+  if (app.thumbObserver) app.thumbObserver.disconnect();
   grid.innerHTML = "";
   for (const series of app.series) {
     const skipped = Boolean(series.annotation?.skipped);
@@ -300,18 +319,18 @@ function renderSeries() {
       <div class="thumb">
         <img alt="" />
         <b>${Number(series.count || 0)} 张</b>
-        ${skipped ? "<i>略过</i>" : ""}
+        ${skipped ? "<i>略过/不采用</i>" : ""}
       </div>
       <div class="series-copy">
         <strong>${escapeHtml(series.description || "未命名序列")}</strong>
         <span class="shot-time">拍摄 ${escapeHtml(timeRange(series))}</span>
         <small>序列 ${escapeHtml(series.series_number || "-")} · ${escapeHtml(series.rows || "-")}×${escapeHtml(series.columns || "-")} · ${escapeHtml(series.modality || "")}</small>
-        <div class="tag-line">${tags.length ? tags.map((tag) => `<em class="${tag.source ? `tag-${tag.source}` : ""}">${escapeHtml(tag.label)}</em>`).join("") : "<em>未标注</em>"}</div>
+        <div class="tag-line">${tags.length ? tags.map((tag) => `<em class="${[tag.source ? `tag-${tag.source}` : "", tag.warn ? "tag-warn" : ""].filter(Boolean).join(" ")}">${escapeHtml(tag.label)}</em>`).join("") : "<em>未标注</em>"}</div>
       </div>
     `;
     card.onclick = () => selectSeries(series.series_uid);
     grid.appendChild(card);
-    loadThumb(series, card.querySelector("img"));
+    queueThumb(series, card.querySelector("img"));
   }
 }
 
@@ -321,14 +340,53 @@ function imageUrlFor(series = app.activeSeries, index = app.slice, windowName =
 
 async function loadThumb(series, img) {
   try {
+    const key = thumbKey(series);
+    if (app.thumbUrls.has(key)) {
+      img.src = app.thumbUrls.get(key);
+      return;
+    }
     const index = Math.floor((Number(series.count) || 1) / 2);
     const blob = await request(imageUrlFor(series, index, "soft", "axial")).then((res) => res.blob());
-    img.src = URL.createObjectURL(blob);
+    const url = URL.createObjectURL(blob);
+    app.thumbUrls.set(key, url);
+    img.src = url;
   } catch (_) {
     img.removeAttribute("src");
   }
 }
 
+function thumbKey(series) {
+  return `${series.ct_number || app.study?.ct_number || ""}:${series.series_uid}`;
+}
+
+function queueThumb(series, img) {
+  const key = thumbKey(series);
+  if (app.thumbUrls.has(key)) {
+    img.src = app.thumbUrls.get(key);
+    return;
+  }
+  if (!("IntersectionObserver" in window)) {
+    loadThumb(series, img);
+    return;
+  }
+  if (!app.thumbObserver) {
+    app.thumbObserver = new IntersectionObserver(
+      (entries) => {
+        for (const entry of entries) {
+          if (!entry.isIntersecting) continue;
+          const target = entry.target;
+          app.thumbObserver.unobserve(target);
+          const queuedSeries = app.thumbSeries.get(target);
+          if (queuedSeries) loadThumb(queuedSeries, target);
+        }
+      },
+      { rootMargin: "320px 0px" },
+    );
+  }
+  app.thumbSeries.set(img, series);
+  app.thumbObserver.observe(img);
+}
+
 function maxSlice() {
   if (!app.activeSeries) return 0;
   if (app.plane === "sagittal") return Math.max(0, Number(app.activeSeries.columns || 1) - 1);
@@ -367,6 +425,7 @@ function resetViewer() {
   $("imageEmpty").classList.remove("hidden");
   $("sliceText").textContent = "0 / 0";
   $("saveState").textContent = "已保存";
+  clearAnnotationControls();
   app.dirty = false;
   app.saving = false;
   resetViewState();
@@ -386,19 +445,12 @@ function windowInfo() {
   };
 }
 
-function orientationLabels() {
-  if (app.plane === "sagittal") return { top: "H", bottom: "F", left: "A", right: "P" };
-  if (app.plane === "coronal") return { top: "H", bottom: "F", left: "R", right: "L" };
-  return { top: "A", bottom: "P", left: "R", right: "L" };
-}
-
 function updateOverlay() {
   const overlay = $("imageOverlay");
   overlay.classList.toggle("hidden", !app.showOverlay || !app.activeSeries);
   $("overlayToggle").textContent = app.showOverlay ? "隐藏信息" : "显示信息";
   if (!app.activeSeries) return;
   const s = app.activeSeries;
-  const orient = orientationLabels();
   const win = windowInfo();
   const age = ageText(s.patient_birth_date, s.study_date || app.study?.study_date);
   const sex = s.patient_sex || "";
@@ -412,10 +464,6 @@ function updateOverlay() {
     s.institution_name || "",
     s.manufacturer || "",
   ].filter(Boolean).map(escapeHtml).join("<br />");
-  document.querySelector(".ov-left-mid").textContent = orient.left;
-  document.querySelector(".ov-right-mid").textContent = orient.right;
-  document.querySelector(".ov-top-mid").textContent = orient.top;
-  document.querySelector(".ov-bottom-mid").textContent = orient.bottom;
   document.querySelector(".ov-left-bottom").textContent = `Img:${app.slice + 1}/${maxSlice() + 1}`;
   document.querySelector(".ov-right-bottom").innerHTML = `WW:${Math.round(win.ww)}<br />WL:${Math.round(win.wl)}<br />Zoom:${app.zoom.toFixed(2)}`;
 }
@@ -451,6 +499,9 @@ function cloneAnnotation(annotation = {}) {
     upper_abdomen_phase: annotation.upper_abdomen_phase || "",
     manual_upper_abdomen_phase: annotation.manual_upper_abdomen_phase || "",
     ai_upper_abdomen_phase: annotation.ai_upper_abdomen_phase || "",
+    chest_window: annotation.chest_window || "",
+    manual_chest_window: annotation.manual_chest_window || "",
+    ai_chest_window: annotation.ai_chest_window || "",
     plain_ct: Boolean(annotation.plain_ct),
     manual_plain_ct: annotation.manual_plain_ct ?? null,
     ai_plain_ct: annotation.ai_plain_ct ?? null,
@@ -471,6 +522,11 @@ function effectivePhase() {
   return app.draft.manual_upper_abdomen_phase || app.draft.ai_upper_abdomen_phase || "";
 }
 
+function effectiveChestWindow() {
+  if (!effectiveParts().includes("chest")) return "";
+  return app.draft.manual_chest_window || app.draft.ai_chest_window || "unknown";
+}
+
 function effectivePlainCt() {
   if (!app.draft) return false;
   if (app.draft.manual_plain_ct !== null && app.draft.manual_plain_ct !== undefined) return Boolean(app.draft.manual_plain_ct);
@@ -484,6 +540,17 @@ function setLabelSource(input, source) {
   label.classList.toggle("ai-selected", source === "ai");
 }
 
+function clearAnnotationControls() {
+  $("annotationNotes").value = "";
+  document.querySelectorAll(".part-grid input, input[name=phase], input[name=chestWindow]").forEach((input) => {
+    input.checked = false;
+    input.disabled = true;
+    setLabelSource(input, "");
+  });
+  $("phaseBox").classList.remove("visible");
+  $("chestWindowBox").classList.remove("visible");
+}
+
 function applyAnnotationControls() {
   if (!app.draft) return;
   const parts = new Set(effectiveParts());
@@ -513,6 +580,14 @@ function applyAnnotationControls() {
     setLabelSource(input, app.draft.manual_upper_abdomen_phase === input.value ? "manual" : app.draft.ai_upper_abdomen_phase === input.value ? "ai" : "");
   });
   $("phaseBox").classList.toggle("visible", parts.has("upper_abdomen"));
+
+  const chestWindow = effectiveChestWindow();
+  document.querySelectorAll("input[name=chestWindow]").forEach((input) => {
+    input.checked = input.value === chestWindow;
+    input.disabled = false;
+    setLabelSource(input, app.draft.manual_chest_window === input.value ? "manual" : app.draft.ai_chest_window === input.value ? "ai" : "");
+  });
+  $("chestWindowBox").classList.toggle("visible", parts.has("chest"));
 }
 
 function hydrateAnnotation() {
@@ -525,6 +600,7 @@ function updateLocalAnnotation(annotation) {
   const normalized = cloneAnnotation(annotation);
   normalized.body_parts = asList(annotation.body_parts);
   normalized.upper_abdomen_phase = annotation.upper_abdomen_phase || "";
+  normalized.chest_window = annotation.chest_window || "";
   app.draft = normalized;
   app.activeSeries.annotation = normalized;
   const index = app.series.findIndex((item) => item.series_uid === app.activeSeries.series_uid);
@@ -545,6 +621,9 @@ function annotationPayload() {
     upper_abdomen_phase: effectivePhase(),
     manual_upper_abdomen_phase: app.draft.manual_upper_abdomen_phase,
     ai_upper_abdomen_phase: app.draft.ai_upper_abdomen_phase,
+    chest_window: effectiveChestWindow(),
+    manual_chest_window: app.draft.manual_chest_window,
+    ai_chest_window: app.draft.ai_chest_window,
     plain_ct: effectivePlainCt(),
     manual_plain_ct: app.draft.manual_plain_ct,
     ai_plain_ct: app.draft.ai_plain_ct,
@@ -610,6 +689,9 @@ function handlePartChange(event) {
   } else if (BODY_PARTS.includes(value)) {
     if (input.checked) {
       app.draft.manual_body_parts = uniq([...app.draft.manual_body_parts, value]);
+      if (value === "chest" && !app.draft.manual_chest_window && !app.draft.ai_chest_window) {
+        app.draft.manual_chest_window = "unknown";
+      }
     } else {
       app.draft.manual_body_parts = app.draft.manual_body_parts.filter((part) => part !== value);
       app.draft.ai_body_parts = app.draft.ai_body_parts.filter((part) => part !== value);
@@ -617,10 +699,15 @@ function handlePartChange(event) {
         app.draft.manual_upper_abdomen_phase = "";
         app.draft.ai_upper_abdomen_phase = "";
       }
+      if (value === "chest") {
+        app.draft.manual_chest_window = "";
+        app.draft.ai_chest_window = "";
+      }
     }
   }
   app.draft.body_parts = effectiveParts();
   app.draft.upper_abdomen_phase = effectivePhase();
+  app.draft.chest_window = effectiveChestWindow();
   app.draft.plain_ct = effectivePlainCt();
   applyAnnotationControls();
   markDirty();
@@ -635,6 +722,15 @@ function handlePhaseChange(event) {
   markDirty();
 }
 
+function handleChestWindowChange(event) {
+  if (!app.draft) return;
+  app.draft.manual_chest_window = event.target.value;
+  if (app.draft.ai_chest_window !== event.target.value) app.draft.ai_chest_window = "";
+  app.draft.chest_window = effectiveChestWindow();
+  applyAnnotationControls();
+  markDirty();
+}
+
 async function runAI() {
   if (!app.study || !app.activeSeries) return;
   const button = $("aiClassify");
@@ -866,6 +962,7 @@ function wire() {
   $("resetView").addEventListener("click", resetViewState);
   document.querySelectorAll(".part-grid input").forEach((input) => input.addEventListener("change", handlePartChange));
   document.querySelectorAll("input[name=phase]").forEach((input) => input.addEventListener("change", handlePhaseChange));
+  document.querySelectorAll("input[name=chestWindow]").forEach((input) => input.addEventListener("change", handleChestWindowChange));
   $("annotationNotes").addEventListener("input", () => {
     if (!app.draft) return;
     app.draft.notes = $("annotationNotes").value;

PACS_DICOM处理/数据处理网页端/static/index.html

@@ -3,14 +3,14 @@
   <head>
     <meta charset="utf-8" />
     <meta name="viewport" content="width=device-width, initial-scale=1" />
-    <title>PACS DICOM Viewer</title>
+    <title>DICOM 阅片分类系统</title>
     <link rel="stylesheet" href="/static/styles.css" />
   </head>
   <body>
     <div id="loginOverlay" class="login-overlay">
       <form id="loginForm" class="login-panel">
         <div class="brand-mark">PACS</div>
-        <h1>DICOM 阅片标注</h1>
+        <h1>DICOM 阅片分类系统</h1>
         <label>
           <span>账号</span>
           <input id="username" autocomplete="username" value="admin" />
@@ -29,7 +29,7 @@
         <div class="product">
           <div class="logo-dot"></div>
           <div>
-            <strong>PACS DICOM Viewer</strong>
+            <strong>DICOM 阅片分类系统</strong>
             <span id="activeStudyLabel">未选择检查</span>
           </div>
         </div>
@@ -92,14 +92,8 @@
             <div class="image-wrap">
               <img id="dicomImage" alt="" />
               <div id="imageOverlay" class="image-overlay">
-                <div class="crosshair crosshair-v"></div>
-                <div class="crosshair crosshair-h"></div>
                 <div class="ov ov-left-top"></div>
                 <div class="ov ov-right-top"></div>
-                <div class="ov ov-left-mid"></div>
-                <div class="ov ov-right-mid"></div>
-                <div class="ov ov-top-mid"></div>
-                <div class="ov ov-bottom-mid"></div>
                 <div class="ov ov-left-bottom"></div>
                 <div class="ov ov-right-bottom"></div>
               </div>
@@ -123,7 +117,7 @@
                 <span><i class="ai-dot"></i>AI</span>
               </div>
               <div class="part-grid">
-                <label class="skip-option"><input type="checkbox" value="skip" />略过</label>
+                <label class="skip-option"><input type="checkbox" value="skip" />略过/不采用</label>
                 <label class="plain-option"><input type="checkbox" value="plain_ct" />平扫CT</label>
                 <label><input type="checkbox" value="head_neck" />头颈部</label>
                 <label><input type="checkbox" value="chest" />胸部</label>
@@ -136,7 +130,16 @@
                 <div class="phase-options">
                   <label><input name="phase" type="radio" value="arterial" />动脉期</label>
                   <label><input name="phase" type="radio" value="portal_venous" />门静脉期</label>
-                  <label><input name="phase" type="radio" value="unknown" />无法判别</label>
+                  <label><input name="phase" type="radio" value="delayed" />延迟期</label>
+                  <label class="warn-option"><input name="phase" type="radio" value="unknown" />无法判别</label>
+                </div>
+              </div>
+              <div id="chestWindowBox" class="phase-box chest-window-box">
+                <span>胸部窗位</span>
+                <div class="phase-options chest-window-options">
+                  <label><input name="chestWindow" type="radio" value="lung" />肺窗</label>
+                  <label><input name="chestWindow" type="radio" value="mediastinal" />纵隔窗</label>
+                  <label class="warn-option"><input name="chestWindow" type="radio" value="unknown" />无法判别</label>
                 </div>
               </div>
               <div class="annotation-actions">

PACS_DICOM处理/数据处理网页端/static/styles.css

@@ -471,6 +471,12 @@ button:disabled {
   background: rgba(240, 181, 78, 0.1);
 }
 
+.tag-line .tag-warn {
+  border-color: rgba(251, 113, 133, 0.72);
+  color: #fecdd3;
+  background: rgba(251, 113, 133, 0.1);
+}
+
 .viewer-pane {
   min-width: 0;
   display: grid;
@@ -556,27 +562,6 @@ button:disabled {
   display: none;
 }
 
-.crosshair {
-  position: absolute;
-  opacity: 0.72;
-}
-
-.crosshair-v {
-  top: 4%;
-  bottom: 4%;
-  left: 50%;
-  width: 1px;
-  background: #ff3b30;
-}
-
-.crosshair-h {
-  left: 3%;
-  right: 3%;
-  top: 50%;
-  height: 1px;
-  background: #21c55d;
-}
-
 .ov {
   position: absolute;
   max-width: 42%;
@@ -594,30 +579,6 @@ button:disabled {
   text-align: right;
 }
 
-.ov-left-mid {
-  left: 12px;
-  top: 50%;
-  transform: translateY(-50%);
-}
-
-.ov-right-mid {
-  right: 54px;
-  top: 50%;
-  transform: translateY(-50%);
-}
-
-.ov-top-mid {
-  top: 12px;
-  left: 50%;
-  transform: translateX(-50%);
-}
-
-.ov-bottom-mid {
-  bottom: 12px;
-  left: 50%;
-  transform: translateX(-50%);
-}
-
 .ov-left-bottom {
   left: 14px;
   bottom: 12px;
@@ -747,6 +708,12 @@ button:disabled {
   box-shadow: inset 3px 0 0 rgba(240, 181, 78, 0.95);
 }
 
+.phase-options label.warn-option:has(input:checked) {
+  border-color: rgba(251, 113, 133, 0.78);
+  color: #fecdd3;
+  background: rgba(251, 113, 133, 0.12);
+}
+
 .part-grid .skip-option:has(input:checked) {
   border-color: rgba(240, 181, 78, 0.72);
   background: rgba(240, 181, 78, 0.12);
@@ -780,10 +747,14 @@ button:disabled {
 
 .phase-options {
   display: grid;
-  grid-template-columns: repeat(3, minmax(110px, 1fr));
+  grid-template-columns: repeat(4, minmax(100px, 1fr));
   gap: 8px;
 }
 
+.chest-window-options {
+  grid-template-columns: repeat(3, minmax(110px, 1fr));
+}
+
 .annotation-actions {
   display: grid;
   grid-template-columns: 118px minmax(0, 1fr);