Technology breakthroughs in high-speed, high-capacity, and high performance desk-tip computers and workstations make the possibility of integrating multimedia medical data to better support clinical decision making, computer-aided education, and research not only attractive, but feasible. To systemically evaluate results from increasingly automated image segmentation it is necessary to correlate them with the expert judgments of radiologists and other clinical specialists interpreting the images. These are contained in increasingly computerized radiological reports and other related clinical records. But to make automated comparison feasible it is necessary to first ensure compatibility of the knowledge content of images with the descriptions contained in these records. Enough common vocabulary, language, and knowledge representation components must be represented on the computer, followed by automated extraction of image-content descriptions from the text, which can then be matched to the results segmentation is essential to obtain the structured image descriptions needed for matching against the experts descriptions. We have developed a new approach to medical image analysis which helps generate such descriptions: a knowlege-based object-centered hierarchical planning method for automatically composing the image analysis processes. The problem-solving steps of specialists are represented at the knowledge level in terms of goals, tasks, adn domain objects and concepts separately from the implementation level for specific representations of different image types, ang generic analysis methods. This system can serve as a major functional component in incrementally building and updating a structured and integrated hybrid information system of patient data. This approach has been tested for magnetic resonance image interpretation, and has achieved promising results.