The goal of this paper is to present a multi-media telecommunication architecture based on ATM technology, which provides reliable and effective transmission of still and motion high resolution (1024x1024 up to 4096x4096, 16 or 32 bits/pixel radiological and pathological images or part of them. The peculiarities of such architecture are the following. 1) Provide Quality of Service (QoS) awareness by means of inter and intra flow synchronization mechanisms. 2) Provide mechanisms of reliable transmission of data. 3) Provide the capability of remote manipulation of a Region of Interest (RoI), defined as a portion of a still or motion picture which is represented and coded with a higher quality than the remaining part of the picture