Refine skip and manual save annotations

PACS_DICOM处理/数据处理网页端/README.md

@@ -43,7 +43,7 @@ uvicorn app:app --host 127.0.0.1 --port 8107
 - 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。
 - 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。
-- 序列标注：选择略过、平扫 CT、头颈部、胸部、上腹部、下腹部、盆腔；点击后自动保存；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、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。
 - 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

@@ -483,8 +483,6 @@ def bool_or_none(value: Any) -> bool | None:
 
 
 def merge_parts(manual_parts: list[str], ai_parts: list[str], skipped: bool) -> list[str]:
-    if skipped:
-        return []
     merged: list[str] = []
     for part in manual_parts + ai_parts:
         if part in BODY_PARTS and part not in merged:
@@ -493,14 +491,12 @@ def merge_parts(manual_parts: list[str], ai_parts: list[str], skipped: bool) ->
 
 
 def effective_phase(manual_phase: str, ai_phase: str, body_parts: list[str], skipped: bool) -> str:
-    if skipped or "upper_abdomen" not in body_parts:
+    if "upper_abdomen" not in body_parts:
         return ""
     return valid_phase(manual_phase) or valid_phase(ai_phase)
 
 
 def effective_plain_ct(manual_plain_ct: bool | None, ai_plain_ct: bool | None, fallback: bool, skipped: bool) -> bool:
-    if skipped:
-        return False
     if manual_plain_ct is not None:
         return manual_plain_ct
     if ai_plain_ct is not None:
@@ -529,22 +525,35 @@ def normalize_annotation(row: dict[str, Any] | None, default_skipped: bool = Fal
     )
     return {
         "body_parts": body_parts,
-        "manual_body_parts": [] if skipped else manual_parts,
+        "manual_body_parts": manual_parts,
-        "ai_body_parts": [] if skipped else ai_parts,
+        "ai_body_parts": ai_parts,
         "upper_abdomen_phase": effective_phase(manual_phase, ai_phase, body_parts, skipped),
-        "manual_upper_abdomen_phase": "" if skipped else manual_phase,
+        "manual_upper_abdomen_phase": manual_phase,
-        "ai_upper_abdomen_phase": "" if skipped else ai_phase,
+        "ai_upper_abdomen_phase": ai_phase,
         "plain_ct": plain_ct,
-        "manual_plain_ct": None if skipped else bool_or_none(row.get("manual_plain_ct")),
+        "manual_plain_ct": bool_or_none(row.get("manual_plain_ct")),
-        "ai_plain_ct": None if skipped else bool_or_none(row.get("ai_plain_ct")),
+        "ai_plain_ct": bool_or_none(row.get("ai_plain_ct")),
         "skipped": skipped,
         "ai_skipped": ai_skipped,
         "notes": row.get("notes", ""),
         "updated_at": row.get("updated_at", ""),
         "ai_model": row.get("ai_model", ""),
+        "updated_by": row.get("updated_by", ""),
     }
 
 
+def dicom_auto_annotation(meta: dict[str, str]) -> tuple[list[str], str]:
+    marker = f"{meta.get('BodyPartExamined', '')} {meta.get('SeriesDescription', '')}".upper()
+    parts: list[str] = []
+    phase = ""
+    if "CHEST" in marker and "chest" not in parts:
+        parts.append("chest")
+    if "ABDOMEN" in marker and "upper_abdomen" not in parts:
+        parts.append("upper_abdomen")
+        phase = "unknown"
+    return parts, phase
+
+
 def get_annotations(ct_number: str) -> dict[str, dict[str, Any]]:
     try:
         ensure_annotation_table()
@@ -553,7 +562,7 @@ 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,
-                plain_ct, manual_plain_ct, ai_plain_ct, skipped, ai_skipped, notes, updated_at, ai_model
+                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)}
             """
@@ -586,6 +595,7 @@ def scan_study(ct_number: str) -> dict[str, Any]:
     series_list = []
     file_map = {}
     default_skip_rows = []
+    auto_annotation_rows = []
     for uid, items in grouped.items():
         items.sort(key=sort_key)
         first = items[0][1]
@@ -593,13 +603,18 @@ 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)
-        default_skipped = len(items) < 80 and not annotation.get("body_parts") and not annotation.get("plain_ct")
+        auto_parts, auto_phase = 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
+            annotation["body_parts"] = auto_parts
+            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))
+        default_skipped = len(items) < 80 and (not raw_annotation or annotation.get("updated_by") == "system")
         if default_skipped:
             annotation["skipped"] = True
-            annotation["manual_body_parts"] = []
-            annotation["ai_body_parts"] = []
-            annotation["body_parts"] = []
-            annotation["plain_ct"] = False
         if default_skipped:
             default_skip_rows.append((uid, first, len(items)))
         series_list.append(
@@ -636,6 +651,42 @@ def scan_study(ct_number: str) -> dict[str, Any]:
             }
         )
 
+    for uid, first, auto_parts, auto_phase 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,
+                    updated_by, updated_at
+                )
+                VALUES (
+                    {sql_literal(ct_number)},
+                    {sql_literal(first.get('StudyInstanceUID', ''))},
+                    {sql_literal(uid)},
+                    {sql_literal(first.get('SeriesDescription', '') or '未命名序列')},
+                    {sql_literal(json.dumps(auto_parts, ensure_ascii=False))}::jsonb,
+                    {sql_literal(json.dumps(auto_parts, ensure_ascii=False))}::jsonb,
+                    {sql_literal(auto_phase)},
+                    {sql_literal(auto_phase)},
+                    'system',
+                    now()
+                )
+                ON CONFLICT (ct_number, series_instance_uid) DO UPDATE SET
+                    body_parts = EXCLUDED.body_parts,
+                    manual_body_parts = EXCLUDED.manual_body_parts,
+                    upper_abdomen_phase = EXCLUDED.upper_abdomen_phase,
+                    manual_upper_abdomen_phase = EXCLUDED.manual_upper_abdomen_phase,
+                    updated_by = 'system',
+                    updated_at = now()
+                WHERE pacs_dicom_series_annotations.updated_by = 'system'
+                  AND jsonb_array_length(pacs_dicom_series_annotations.body_parts) = 0
+                """,
+                timeout=8,
+            )
+        except Exception:
+            pass
+
     for uid, first, count in default_skip_rows:
         try:
             pg_scalar(
@@ -662,13 +713,6 @@ def scan_study(ct_number: str) -> dict[str, Any]:
                 )
                 ON CONFLICT (ct_number, series_instance_uid) DO UPDATE SET
                     skipped = true,
-                    body_parts = '[]'::jsonb,
-                    manual_body_parts = '[]'::jsonb,
-                    ai_body_parts = '[]'::jsonb,
-                    upper_abdomen_phase = '',
-                    manual_upper_abdomen_phase = '',
-                    ai_upper_abdomen_phase = '',
-                    plain_ct = false,
                     notes = CASE
                         WHEN pacs_dicom_series_annotations.notes = ''
                         THEN EXCLUDED.notes
@@ -676,8 +720,7 @@ def scan_study(ct_number: str) -> dict[str, Any]:
                     END,
                     updated_by = 'system',
                     updated_at = now()
-                WHERE jsonb_array_length(pacs_dicom_series_annotations.body_parts) = 0
+                WHERE pacs_dicom_series_annotations.updated_by = 'system'
-                  AND pacs_dicom_series_annotations.plain_ct IS NOT TRUE
                 """,
                 timeout=8,
             )
@@ -991,14 +1034,14 @@ def save_annotation_payload(
             {sql_literal(series_uid)},
             {sql_literal(series_row.get('description', ''))},
             {sql_literal(json.dumps(body_parts, ensure_ascii=False))}::jsonb,
-            {sql_literal(json.dumps([] if skipped else manual_parts, ensure_ascii=False))}::jsonb,
+            {sql_literal(json.dumps(manual_parts, ensure_ascii=False))}::jsonb,
-            {sql_literal(json.dumps([] if skipped else ai_parts, ensure_ascii=False))}::jsonb,
+            {sql_literal(json.dumps(ai_parts, ensure_ascii=False))}::jsonb,
             {sql_literal(phase)},
-            {sql_literal('' if skipped else manual_phase)},
+            {sql_literal(manual_phase)},
-            {sql_literal('' if skipped else ai_phase)},
+            {sql_literal(ai_phase)},
             {'true' if plain_ct else 'false'},
-            {sql_bool_or_null(None if skipped else manual_plain_ct)},
+            {sql_bool_or_null(manual_plain_ct)},
-            {sql_bool_or_null(None if skipped else ai_plain_ct)},
+            {sql_bool_or_null(ai_plain_ct)},
             {'true' if skipped else 'false'},
             {'true' if ai_skipped else 'false'},
             {sql_literal(notes)},
@@ -1031,14 +1074,14 @@ def save_annotation_payload(
     return normalize_annotation(
         {
             "body_parts": body_parts,
-            "manual_body_parts": [] if skipped else manual_parts,
+            "manual_body_parts": manual_parts,
-            "ai_body_parts": [] if skipped else ai_parts,
+            "ai_body_parts": ai_parts,
             "upper_abdomen_phase": phase,
-            "manual_upper_abdomen_phase": "" if skipped else manual_phase,
+            "manual_upper_abdomen_phase": manual_phase,
-            "ai_upper_abdomen_phase": "" if skipped else ai_phase,
+            "ai_upper_abdomen_phase": ai_phase,
             "plain_ct": plain_ct,
-            "manual_plain_ct": None if skipped else manual_plain_ct,
+            "manual_plain_ct": manual_plain_ct,
-            "ai_plain_ct": None if skipped else ai_plain_ct,
+            "ai_plain_ct": ai_plain_ct,
             "skipped": skipped,
             "ai_skipped": ai_skipped,
             "notes": notes,

PACS_DICOM处理/数据处理网页端/static/app.js

@@ -16,6 +16,8 @@ const app = {
   searchTimer: null,
   statusTimer: null,
   saveTimer: null,
+  dirty: false,
+  saving: false,
   pendingImage: null,
   drag: null,
   seriesSort: "timeAsc",
@@ -147,7 +149,8 @@ async function login(event) {
   }
 }
 
-function logout() {
+async function logout() {
+  await confirmSaveIfDirty();
   app.token = "";
   localStorage.removeItem("pacs_web_token");
   showLogin(true);
@@ -216,6 +219,7 @@ function renderStudies() {
 }
 
 async function selectStudy(ctNumber) {
+  if (app.study?.ct_number && app.study.ct_number !== ctNumber) await confirmSaveIfDirty();
   app.study = app.studies.find((item) => item.ct_number === ctNumber) || { ct_number: ctNumber };
   app.series = [];
   app.activeSeries = null;
@@ -243,10 +247,10 @@ function sourceTag(value, annotation) {
 
 function seriesTags(series) {
   const annotation = series.annotation || {};
-  if (annotation.skipped) {
-    return [{ label: "略过", source: annotation.ai_skipped ? "ai" : "manual" }];
-  }
   const tags = [];
+  if (annotation.skipped) {
+    tags.push({ label: "略过", 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" });
   }
@@ -319,7 +323,8 @@ function resetViewState() {
   applyTransform();
 }
 
-function selectSeries(seriesUid) {
+async function selectSeries(seriesUid) {
+  if (app.activeSeries?.series_uid && app.activeSeries.series_uid !== seriesUid) await confirmSaveIfDirty();
   const series = app.series.find((item) => item.series_uid === seriesUid);
   if (!series) return;
   app.activeSeries = series;
@@ -340,7 +345,9 @@ function resetViewer() {
   $("dicomImage").removeAttribute("src");
   $("imageEmpty").classList.remove("hidden");
   $("sliceText").textContent = "0 / 0";
-  $("saveState").textContent = "自动保存";
+  $("saveState").textContent = "已保存";
+  app.dirty = false;
+  app.saving = false;
   resetViewState();
   updateOverlay();
 }
@@ -434,7 +441,7 @@ function cloneAnnotation(annotation = {}) {
 }
 
 function effectiveParts() {
-  if (!app.draft || app.draft.skipped) return [];
+  if (!app.draft) return [];
   return uniq([...app.draft.manual_body_parts, ...app.draft.ai_body_parts]);
 }
 
@@ -444,7 +451,7 @@ function effectivePhase() {
 }
 
 function effectivePlainCt() {
-  if (!app.draft || app.draft.skipped) return false;
+  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);
   if (app.draft.ai_plain_ct !== null && app.draft.ai_plain_ct !== undefined) return Boolean(app.draft.ai_plain_ct);
   return Boolean(app.draft.plain_ct);
@@ -469,22 +476,22 @@ function applyAnnotationControls() {
     }
     if (value === "plain_ct") {
       input.checked = effectivePlainCt();
-      input.disabled = app.draft.skipped;
+      input.disabled = false;
       setLabelSource(input, app.draft.manual_plain_ct !== null && app.draft.manual_plain_ct !== undefined ? "manual" : app.draft.ai_plain_ct !== null && app.draft.ai_plain_ct !== undefined ? "ai" : "");
       return;
     }
     input.checked = parts.has(value);
-    input.disabled = app.draft.skipped;
+    input.disabled = false;
     setLabelSource(input, app.draft.manual_body_parts.includes(value) ? "manual" : app.draft.ai_body_parts.includes(value) ? "ai" : "");
   });
 
   const phase = effectivePhase();
   document.querySelectorAll("input[name=phase]").forEach((input) => {
     input.checked = input.value === phase;
-    input.disabled = app.draft.skipped;
+    input.disabled = false;
     setLabelSource(input, app.draft.manual_upper_abdomen_phase === input.value ? "manual" : app.draft.ai_upper_abdomen_phase === input.value ? "ai" : "");
   });
-  $("phaseBox").classList.toggle("visible", !app.draft.skipped && parts.has("upper_abdomen"));
+  $("phaseBox").classList.toggle("visible", parts.has("upper_abdomen"));
 }
 
 function hydrateAnnotation() {
@@ -507,17 +514,17 @@ function updateLocalAnnotation(annotation) {
 }
 
 function annotationPayload() {
-  const bodyParts = app.draft.skipped ? [] : effectiveParts();
+  const bodyParts = effectiveParts();
   return {
     body_parts: bodyParts,
-    manual_body_parts: app.draft.skipped ? [] : app.draft.manual_body_parts,
+    manual_body_parts: app.draft.manual_body_parts,
-    ai_body_parts: app.draft.skipped ? [] : app.draft.ai_body_parts,
+    ai_body_parts: app.draft.ai_body_parts,
-    upper_abdomen_phase: app.draft.skipped ? "" : effectivePhase(),
+    upper_abdomen_phase: effectivePhase(),
-    manual_upper_abdomen_phase: app.draft.skipped ? "" : app.draft.manual_upper_abdomen_phase,
+    manual_upper_abdomen_phase: app.draft.manual_upper_abdomen_phase,
-    ai_upper_abdomen_phase: app.draft.skipped ? "" : app.draft.ai_upper_abdomen_phase,
+    ai_upper_abdomen_phase: app.draft.ai_upper_abdomen_phase,
     plain_ct: effectivePlainCt(),
-    manual_plain_ct: app.draft.skipped ? null : app.draft.manual_plain_ct,
+    manual_plain_ct: app.draft.manual_plain_ct,
-    ai_plain_ct: app.draft.skipped ? null : app.draft.ai_plain_ct,
+    ai_plain_ct: app.draft.ai_plain_ct,
     skipped: app.draft.skipped,
     ai_skipped: app.draft.ai_skipped,
     notes: $("annotationNotes").value,
@@ -526,6 +533,8 @@ function annotationPayload() {
 
 async function saveAnnotationNow() {
   if (!app.study || !app.activeSeries || !app.draft) return;
+  if (app.saving) return;
+  app.saving = true;
   $("saveState").textContent = "保存中";
   const uid = app.activeSeries.series_uid;
   try {
@@ -534,16 +543,30 @@ async function saveAnnotationNow() {
       body: JSON.stringify(annotationPayload()),
     });
     $("saveState").textContent = "已保存";
+    app.dirty = false;
     updateLocalAnnotation(data);
   } catch (err) {
     $("saveState").textContent = err.message;
+  } finally {
+    app.saving = false;
   }
 }
 
-function queueSave(delay = 450) {
+function markDirty() {
   clearTimeout(app.saveTimer);
-  $("saveState").textContent = "待保存";
+  app.dirty = true;
-  app.saveTimer = setTimeout(saveAnnotationNow, delay);
+  $("saveState").textContent = "未保存";
+}
+
+async function confirmSaveIfDirty() {
+  if (!app.dirty) return;
+  const shouldSave = window.confirm("当前标注尚未保存，是否先保存？");
+  if (shouldSave) {
+    await saveAnnotationNow();
+  } else {
+    app.dirty = false;
+    $("saveState").textContent = "未保存";
+  }
 }
 
 function handlePartChange(event) {
@@ -553,14 +576,6 @@ function handlePartChange(event) {
   if (value === "skip") {
     app.draft.skipped = input.checked;
     if (!input.checked) app.draft.ai_skipped = false;
-    if (input.checked) {
-      app.draft.manual_body_parts = [];
-      app.draft.ai_body_parts = [];
-      app.draft.manual_upper_abdomen_phase = "";
-      app.draft.ai_upper_abdomen_phase = "";
-      app.draft.manual_plain_ct = null;
-      app.draft.ai_plain_ct = null;
-    }
   } else if (value === "plain_ct") {
     if (input.checked) {
       app.draft.manual_plain_ct = true;
@@ -585,7 +600,7 @@ function handlePartChange(event) {
   app.draft.upper_abdomen_phase = effectivePhase();
   app.draft.plain_ct = effectivePlainCt();
   applyAnnotationControls();
-  queueSave();
+  markDirty();
 }
 
 function handlePhaseChange(event) {
@@ -594,7 +609,7 @@ function handlePhaseChange(event) {
   if (app.draft.ai_upper_abdomen_phase !== event.target.value) app.draft.ai_upper_abdomen_phase = "";
   app.draft.upper_abdomen_phase = effectivePhase();
   applyAnnotationControls();
-  queueSave();
+  markDirty();
 }
 
 async function runAI() {
@@ -610,6 +625,7 @@ async function runAI() {
     updateLocalAnnotation(data);
     $("annotationNotes").value = data.notes || "";
     $("saveState").textContent = "AI 结果已保存";
+    app.dirty = false;
   } catch (err) {
     $("saveState").textContent = err.message;
   } finally {
@@ -618,6 +634,7 @@ async function runAI() {
 }
 
 async function openInfo() {
+  await confirmSaveIfDirty();
   if (!app.study || !app.activeSeries) return;
   const data = await json(`/api/dicom-info?ct_number=${encodeURIComponent(app.study.ct_number)}&series_uid=${encodeURIComponent(app.activeSeries.series_uid)}&index=${app.slice}`);
   const content = $("infoContent");
@@ -660,6 +677,7 @@ function roleCards(roles) {
 }
 
 async function openSettings() {
+  await confirmSaveIfDirty();
   const [settings, status] = await Promise.all([json("/api/settings"), fetch("/api/status").then((res) => res.json())]);
   $("settingsContent").innerHTML = `
     <section class="settings-section">
@@ -828,7 +846,13 @@ function wire() {
   $("annotationNotes").addEventListener("input", () => {
     if (!app.draft) return;
     app.draft.notes = $("annotationNotes").value;
-    queueSave(900);
+    markDirty();
+  });
+  $("saveAnnotation").addEventListener("click", saveAnnotationNow);
+  window.addEventListener("beforeunload", (event) => {
+    if (!app.dirty) return;
+    event.preventDefault();
+    event.returnValue = "";
   });
   document.querySelectorAll("[data-close]").forEach((button) => {
     button.addEventListener("click", () => $(button.dataset.close).classList.add("hidden"));

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

@@ -114,7 +114,7 @@
               <div class="annotation-head">
                 <div>
                   <h2>部位标注</h2>
-                  <span id="saveState">自动保存</span>
+                  <span id="saveState">已保存</span>
                 </div>
                 <button id="aiClassify" class="ghost-btn ai-btn">AI 识别</button>
               </div>
@@ -140,6 +140,7 @@
                 </div>
               </div>
               <div class="annotation-actions">
+                <button id="saveAnnotation" class="primary-btn save-btn">保存标注</button>
                 <input id="annotationNotes" class="note-input" placeholder="备注" />
               </div>
             </aside>

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

@@ -785,6 +785,9 @@ button:disabled {
 }
 
 .annotation-actions {
+  display: grid;
+  grid-template-columns: 118px minmax(0, 1fr);
+  gap: 10px;
   margin-top: 10px;
 }
 
@@ -792,6 +795,10 @@ button:disabled {
   height: 38px;
 }
 
+.save-btn {
+  height: 38px;
+}
+
 .modal {
   position: fixed;
   inset: 0;