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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
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.
fatty liver CT manifestations
Fatty liver, also known as hepatic steatosis, is a metabolic and functional abnormality of the liver that leads to abnormal deposition of fat in liver cells. Fatty liver typically presents characteristic features on a CT scan, generally starting with a decrease in density. The reference standard for decreased density is based on the spleen. Normally, the CT value of the liver is greater than that of the spleen. If the CT value of the liver is lower than that of the spleen, it can be diagnosed as fatty liver. Some focal fatty liver changes can also be diagnosed by CT, mainly manifested by a decrease in density in a particular lobe or segment of the liver, but the blood vessels can still be normally visualized.
MRI manifestations of gallbladder cancer
The manifestations of gallbladder cancer on MRI primarily include significant thickening of the gallbladder wall or a mass within the gallbladder. Generally, it appears as low signal on T1-weighted images and high signal on T2-weighted images. After enhancement, the lesion shows obvious enhancement. If the lesion is large, necrosis may occur internally. Since the gallbladder is close to the liver, if abnormal signals are found in the liver, intrahepatic metastasis should be considered, which further confirms the possibility of gallbladder cancer. Additionally, gallbladder cancer can also invade the nearby bile ducts, causing dilation of the bile ducts, as well as local or distant lymph node metastasis.
Can colitis be detected by an ultrasound?
Colitis cannot be definitively diagnosed with an ultrasound, as ultrasound is primarily used for diagnosing solid organs such as the liver, gallbladder, spleen, kidneys, and pancreas. For hollow organs, the diagnosis is obscured by gas and food inside the intestines, making ultrasound less effective. For patients suspected of having colitis, the best examination is a colonoscopy. A colonoscopy can clearly show the extent and severity of the inflammation. CT scans also hold diagnostic value as they can reveal thickening and edema of the colonic wall. CT scans are less painful compared to colonoscopies, which can be somewhat painful.
Can an MRI detect liver cancer?
Magnetic resonance imaging (MRI) can detect liver cancer. MRI has a high resolution for soft tissues and can multi-dimensionally present the water content and fat content in liver cancer, producing specific signals. MRI can clearly show the size, signal, shape, and the surrounding tissues of liver cancer. It can even detect small liver cancers as tiny as three millimeters and is a preferred method of imaging, more precise than CT.
Can liver cirrhosis be detected by an ultrasound B-scan?
Liver cirrhosis can be diagnosed with an ultrasound. In the early stages of cirrhosis, there are no specific changes in the sonographic pattern visible on ultrasound. Typically, cirrhosis manifests as a decrease in liver volume, with imbalanced proportions of the liver lobes; both the left and right lobes may shrink, with compensatory hypertrophy observed in some cases in the left lobe. The liver capsule appears serrated, and the echoes from the liver area are coarser and stronger, with uneven distribution. It's possible to observe nodules with low or high echoes. The liver vessels vary in thickness, the hepatic veins may narrow, and the portal vein can widen. An enlarged portal vein can lead to symptoms like splenomegaly and ascites.
Gallbladder cancer ultrasonographic appearance
The appearance of gallbladder cancer on color ultrasound depends on the morphology of the cancer, which is mainly divided into five types: small nodular, thick-wall, fragmented, calculous, and mixed type. The small nodular type mainly features a polypoid elevation with a wide base, about 1-1.2 cm in size, and has isoechoic characteristics. The fragmented type is characterized by a wider base and irregular borders, presenting as hypoechoic or isoechoic masses. The calculous type shows an enlarged gallbladder, possibly containing hypoechoic and uneven solid masses that may fill the entire gallbladder. The thick-wall type primarily involves localized or diffuse thickening of the wall. The mixed type is a combination of papillary fragmented type and thick-wall type presence.