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Shen Jiang Chao
Radiology
About me
Having worked in the field of radiology for 20 years, currently working at the Radiology Department of Shaoxing Central Hospital, promoted to Associate Chief Physician in 2016. I have rich experience in diagnosing chest, abdomen, and musculoskeletal imaging, particularly in the diagnosis of systemic tumors. I have participated in various medical continuing education training programs and have published several papers in multiple core journals.
Proficient in diseases
Lung cancer, liver cancer, abortion, adrenal tumor, hepatitis B, vascular tumor, intracranial tumor, uterine tumor, cervical cancer.
Voices
Teratoma B-ultrasound manifestation
Teratomas are tumors that occur in germ cells and can develop in many parts of the body. For example, they can occur within the central nervous system, mediastinum, and pelvic cavity, with the latter being more common. On ultrasound, teratomas have typical features, mainly presenting as abnormal masses. These masses predominantly show mixed echogenicity, with strong echogenicity being more pronounced, appearing as strongly echogenic masses. The strong echogenicity primarily refers to contents including teeth, and also visible are areas of medium to low echogenicity, which are mainly composed of fat and hair. Benign teratomas have smooth borders, while malignant teratomas have irregular borders and are generally larger in size.
Ultrasound manifestation of renal cancer
Kidney cancer is the most common type of kidney malignancy. Pathologically, it is mainly divided into clear cell renal cell carcinoma, chromophobe renal cell carcinoma, papillary renal carcinoma, and collecting duct carcinoma, with clear cell renal cell carcinoma being the most common. Ultrasonographically, it usually appears as round or oval masses, varying in size but generally around 2-4 cm, exhibiting low to medium echo patterns. If the tumor is larger, greater than 5 cm, it may show changes in mixed echo patterns due to possible internal bleeding or cystic changes when the tumor is large. When kidney cancer is suspected on ultrasound, it is best to further proceed with enhanced MRI or enhanced CT scanning.
Difference between liver hemangioma and liver cancer in ultrasound
Liver hemangiomas display a variety of appearances on ultrasound, including hyper-echoic, hypo-echoic, and mixed echoes. Typically, hemangiomas appear on ultrasound as round or oval hyper-echoic masses, with internal echoes that may show a sieve-like change. In contrast, liver cancer primarily appears as hypo-echoic on ultrasound, and liver cancer symptoms are more varied because most liver cancers develop on the basis of cirrhosis. In addition to hypo-echoic masses, there are other manifestations, such as an incomplete liver capsule, widened liver fissures, spleen enlargement, and dilated portal veins, which are used to differentiate from hemangiomas.
Gallbladder cancer CT manifestations
Gallbladder cancer commonly occurs in females, and its causes may be related to chronic and long-term irritation from cholecystitis and gallstones. On a CT scan, based on the tumor's pathological classification and growth patterns, it can be divided into the following types: The first type is the infiltrative type, which is characterized by irregular thickening of the gallbladder wall, usually greater than 1 cm, with a rough edge, and significant enhancement is seen after contrast enhancement. The second type is the mass-forming type, which presents as a large soft tissue mass filling the gallbladder, also showing significant enhancement after injection of contrast agent. The third type is the nodular type, which presents as either single or multiple nodules that protrude into the gallbladder cavity, appearing papillary or cauliflower-like. The fourth type is the obstructive type, generally a tumor at the neck of the gallbladder, causing obstruction of the common bile duct.
Pleural inflammation CT manifestations
The causes of pleurisy mainly include tuberculous, purulent, bacterial, tumorous, traumatic, and rheumatic types, with the tuberculous type being the most common. Pleurisy is predominantly characterized by pleural effusion, which generally looks similar on a CT scan. CT scans cannot distinguish the cause of pleurisy. A small amount of pleurisy manifests as a minor amount of free effusion, appearing as an arc or crescent of uniform density along the posterior chest wall. As the effusion gradually increases to a moderate or large amount, it can compress lung tissue, leading to compressive atelectasis. In cases of large volume effusion, aside from causing atelectasis, it can also significantly push the mediastinum towards the healthy side.
Gallbladder stones CT manifestations
Gallstones typically display characteristic features on a CT scan. Depending on the calcium content and the chemical composition of the stones, they can appear as high-density, isodense, or low-density stones. High-density stones present as multiple areas of increased density within the gallbladder, though they can also be solitary. A solitary high-density stone generally appears as a concentric circle with low central density surrounded by high density. Isodense stones have the same density as bile, which sometimes makes them difficult to distinguish. Low-density stones, which are primarily cholesterol stones, can sometimes contain gas, appearing as low-density shadows. CT is not the first choice for diagnosing gallstones; abdominal ultrasound is generally preferred.
Can gallbladder cancer be detected by ultrasound?
Gallbladder cancer can also be detected by ultrasound, which is the preferred imaging method for diagnosing hepatobiliary diseases. Ultrasound can detect space-occupying lesions in hepatobiliary diseases early on. It is sensitive enough to detect lesions as small as one centimeter, or even a few millimeters. In the case of space-occupying lesions of the gallbladder, particularly gallbladder cancer, there are no particularly obvious signals on ultrasound. Ultrasound of the gallbladder is merely used as a screening tool, not as a definitive diagnostic method. If gallbladder cancer is suspected, further investigations such as MRI or enhanced CT are generally required, but the final diagnosis still relies on pathology.
Can pleurisy be seen on a chest X-ray?
Pleurisy can also be detected in chest radiographs, but it depends on the type. There are two types of pleurisy: dry and wet. Dry pleurisy cannot be clearly identified, while wet pleurisy, which is mostly caused by tuberculosis, can show more typical characteristics. Tuberculous pleurisy primarily manifests as pleural effusion. A small amount of pleural effusion on an X-ray appears as blunting of the costophrenic angle on the same side and blurring of the diaphragm. A moderate amount of pleural effusion is shown on the chest radiograph as a uniformly consistent high-density shadow on the same side, which appears higher on the outside and lower on the inside, with an arc-shaped shadow. The muscle costophrenic angle and diaphragm are obscured. A large amount of pleural effusion presents as a high-density shadow in the pleural cavity on the same side, with the mediastinal cardiac silhouette clearly shifting to the interlateral side.
The main manifestations of gallbladder cancer on MRI
Gallbladder cancer is more common in females and is generally believed to be associated with chronic stimulation from chronic cholecystitis and gallstones. On MRI, gallbladder cancer can be categorized into several types based on case classification and growth patterns: first, the infiltrative type; second, the nodular type; third, the mass-forming type; and fourth, the obstructive type. Regardless of the pathological type of gallbladder cancer, the tumor tissue appears as a heterogeneous low signal on T1 and a heterogeneous high signal on T2. After enhancement, the tumor shows heterogeneous enhancement. If there is invasion into the liver, the boundary with liver tissue is unclear. MRI has significant advantages in assessing invasion of adjacent organs and metastasis, and can provide great value for surgery or treatment planning.
Colorectal Cancer CT Manifestations and Differential Diagnosis
Early-stage colon cancer is difficult to clearly detect on a CT scan. In the moderate to late stages, colon cancer has more typical manifestations on CT, mainly characterized by thickening of the colon wall, irregular narrowing of the intestinal lumen, and stiffness of the intestinal wall. After enhancement, significant enhancement can be observed. The pericolonic fat space may appear blurred, and in the late stages, small lymph nodes can be seen, and even distant metastasis, most commonly to the liver, can be detected. It is necessary to differentiate colon cancer from colonic inflammation. Inflammatory lesions are usually more widespread and have typical clinical features such as fever and abdominal pain. It is also necessary to differentiate from lymphoma, as lymphomas also cause narrowing of the intestinal lumen but the narrowing is not eccentric and the intestinal wall remains soft, generally not leading to obstruction, whereas in late-stage colon cancer, colonic obstruction can be observed.