

Li Hu Chen

About me
Attending physician in the Department of Medical Imaging at the First Hospital of Shijiazhuang City.
Proficient in diseases
Conventional radiology, CT, MRI, DSA, ultrasound, nuclear medicine, imaging, etc.

Voices

Can a uterine prolapse be detected with an ultrasound?
Uterine prolapse is generally not diagnosed through ultrasound, as the standard for diagnosing uterine prolapse is a gynecological exam. During the gynecological examination, the level to which the cervix has descended is observed, whether it is in the middle of the vagina or has reached the vaginal opening, and in severe cases of uterine prolapse, the cervix can protrude out of the vaginal opening. Of course, if there is uterine prolapse, it can also be detected during an ultrasound, where the significantly lower position of the uterus is evident. However, in reality, to diagnose uterine prolapse, an ultrasound is not strictly necessary; a simple gynecological exam can suffice for diagnosis.

Liver cancer B-ultrasound manifestations
Generally speaking, for diseases of the hepatobiliary system, most of us conduct examinations using ultrasound because it is very convenient, safe, involves no radiation, and the results are relatively quick. Generally, liver cancer can appear as hypoechoic, hyperechoic, or mixed echogenicity on ultrasound. Most such liver cancer nodules may have a complete capsule, but some may not have a complete capsule. Overall, this type of liver cancer tends to grow expansively and invasively, compressing the surrounding normal liver tissue, and possibly showing some halo signs around it. The vast majority of liver cancers do not occur independently; they usually develop gradually from cirrhosis. Therefore, there is often an enlargement of the portal vein, and in some cases of liver cancer with metastasis, thrombosis in the portal vein can be seen.

Subarachnoid hemorrhage MR manifestations
Subarachnoid hemorrhage is typically visible on an MR scan, where blood presence can be detected in the cerebral sulci. MR stands for Magnetic Resonance, and it offers various scanning sequences such as T1, T2, diffusion imaging, and fluid-attenuated inversion recovery (FLAIR). Although it may sound complex, these sequences can show high signals in areas of the brain sulci where normally there should be no distinctive signals or colors. After a subarachnoid hemorrhage, these areas show up as brightly lit on the images. Hence, magnetic resonance imaging is particularly sensitive to even small amounts of subarachnoid hemorrhage, especially noticeable in the diffusion imaging sequences where these bright signals are prominently visible.

Ultrasound presentation of intrahepatic bile duct stones
Intrahepatic bile duct stones can generally be detected via ultrasound, as they show up as strong echoes due to their solid nature which reflects sound waves back to the surface. However, the majority of these intrahepatic bile duct stones are asymptomatic. Since they rarely cause dilation of the intrahepatic bile ducts, and as long as the bile ducts do not appear dilated, thickened, or tortuous on the ultrasound, they usually do not have any significant impact. Therefore, most intrahepatic bile duct stones do not require treatment and can be managed through observation.

Can gallbladder cancer be detected by ultrasound?
If there is gallbladder cancer, we can detect it by conducting an ultrasound examination, checking the liver, gallbladder, pancreas, and spleen, or simply performing an upper abdominal ultrasound. This is because an ultrasound is typically the first choice for examining the hepato-biliary system. Why? Because it's the most convenient and quickest method. Other examinations such as CT scans or MRI often require a prior appointment, especially MRI, which may need booking days in advance. However, ultrasounds are usually done on the same day and the results are immediate, making it the preferred method for examining the liver and gallbladder. Moreover, ultrasound is quite sensitive for gallbladder cancer. It can reveal if the gallbladder wall is particularly thickened, either locally or extensively, which often suggests the presence of gallbladder cancer, or if there is a large mass of soft tissue in the area of the gallbladder fossa, which might also adhere to the surrounding liver, raising suspicions of gallbladder cancer. Additionally, if there are unusually large polyps, particularly those over 1cm or with a notably wide base, gallbladder cancer should also be considered.

Post-pleurisy chest X-ray presentation
Patients with pleurisy, after their recovery, often exhibit certain signs on chest X-rays, such as thickening and adhesion of the pleura, and blunting of the costophrenic angle. These conditions commonly arise because diseases like pleurisy might have a somewhat extended duration or are not detected timely, lacking prompt medical treatment. Hence, pleural thickening is prone to occur, visible on X-rays at the lung margins, where localized soft tissue density appears slightly thicker. Normally, the edge of the lung at the costophrenic angle would be quite sharp, but after pleural thickening, this angle becomes blunted or even rounded. In some cases, encapsulated effusions might be seen on a chest X-ray as a spindle-shaped high-density shadow near the chest wall, which appears as a notably bright shadow.

Can liver hemangioma be definitively diagnosed by ultrasound?
If there is a hemangioma on the liver, it can generally be diagnosed through an ultrasound of the liver and biliary system. This is because hemangiomas have some characteristic appearances on ultrasound imaging. First, it's essential to understand the structure of the liver hemangioma which can be roughly considered as sponge-like, with a structure similar to a sponge containing many fine structures. When ultrasound is applied, this sponge-like structure will demonstrate strong echogenicity, appearing as a large mass with medium to strong echogenic responses. Thus, it is quite evident on ultrasound and has relatively high specificity, so it can generally be diagnosed through ultrasound. If the appearance is not typical, further examination with an enhanced CT scan can be carried out for diagnosis.

Gallbladder cancer B-ultrasound manifestations
Gallbladder cancer can be diagnosed using ultrasound. On ultrasound, this type of gallbladder cancer can generally be divided into three types. One type is the thick-walled gallbladder cancer, which appears as uneven thickening of the gallbladder wall, resembling thick, non-elastic leather. The second type is the mass-forming type, which is relatively easier to diagnose. It appears as a solid mass taking over the entire gallbladder, often invading the nearby liver, and the normal shape of the gallbladder has disappeared. The third type is the intraluminal type, where on ultrasound, you can see the tumor attached to the gallbladder wall, which is relatively wider and larger.

Can cirrhosis be detected by ultrasound B?
If there are signs of hardening in the liver, which we call cirrhosis, an ultrasound, specifically a hepatobiliary ultrasound, can detect it. Especially in the middle and late stages, cirrhosis has some characteristic features on an ultrasound. First, one can observe the size of the liver. By the middle and late stages, the liver usually shrinks—a slight enlargement may occur early on, but it generally progressively diminishes. Additionally, the texture of the liver becomes harder, and through the ultrasound, the texture appears uneven with a bumpy feeling, or in other words, there can be seen a diffuse and uneven echo. However, for early-stage cirrhosis, a standard ultrasound may not be as sensitive. Nowadays, there are digital liver ultrasounds specifically designed to measure the degree of liver hardness, which provide objective data to help diagnose more sensitively and objectively. This method can definitely detect the condition.

Tuberculosis X-ray Chest Radiograph Manifestations
If it is tuberculosis, it is generally visible on an X-ray chest film. Of course, some especially early-stage or tiny lesions might not be detected except by CT. However, typical cases of tuberculosis can be diagnosed with a chest X-ray. Often, on the chest X-ray, the apices of both lungs—the uppermost parts—might show cloud-like, vague shadowy areas that are slightly brighter than the normal lung tissue but with unclear edges. Additionally, there are some cases of secondary tuberculosis, which are more severe, featuring tuberculomas which are more evenly dense and have smoother edges. These can be seen in the lungs. However, such typical severe tuberculomas are becoming less common clinically because medications are used more promptly now, and people seek treatment in a timely manner. Cases like chronic fibrocavitary tuberculosis are becoming increasingly rare, mostly seen in older patients who have been on medication for many years.