DICOM @ OFFIS

Someone knows how to draw flowchart concerning Protocol DICOM Upper Layer??
And the table 9-10 in the part 8 of the standard (page 31), how can I read it? to draw state machines?

We want to implement the SCU and SCP for DICOM application..
we have found the dcmtk library in C++..
and we want to use C# .. we want to know if it is possible or if there's a dcmtk library with C# ?
If not how we can do this?
And how we use the dcmtk library?

NB: we will use visual studio 2005