Imaging exams: don’t judge a hero by its cost Recently, some patients come to the hospital to ask for this test or that test, and even a small cold actually asked to do CT or MRI, and so on, such phenomena are common. So what exactly are the contributions of medical imaging groups to patients? What are the pros and cons of each of them? What are the contraindications to each? Usually, the medical imaging group includes X-ray, interventional radiology, CT, MRI, ultrasound, nuclear medicine and so on, which have different diagnostic values and limits due to their different imaging principles and operation methods. Fluoroscopy When you have a cold and cough, chest pain, see if there are flaky shadows, corn-like shadows, lumpy shadows, to diagnose whether there is inflammation, tuberculosis, tumor; when you have abdominal pain, see if there is free gas under the diaphragm, gas and liquid flat, to diagnose whether it is intestinal perforation or intestinal obstruction; when you suspect whether the contraceptive ring is dislodged and want to see if it is in place, —— all of the above are subject to X-ray fluoroscopy. Its greatest advantage is that it allows for a multi-directional, dynamic view of the condition and its adjacent relationships by turning the patient, which not only allows for a conclusion in the shortest possible time, but also at low cost. Therefore, when gastrointestinal discomfort requires gastrointestinal imaging, barium enema to see if it is an ulcer, cancer, polyps, esophageal varices, tuberculosis; when cancer requires interventional intubation chemotherapy; when unfortunately hit by iron filings need to be positioned to take foreign objects; when fracture manipulation reset several times after failure; —— these are inseparable from X-ray fluoroscopy. Of course, X-ray fluoroscopy is not without its drawbacks, mainly in that it does not leave any objective records, and its diagnostic level depends entirely on the level of that doctor, which does not facilitate consultation, does not facilitate the comparison of the disease before and after; in addition, the examination of the skeletal system is not as clear as X-ray plain film. When you accidentally twist your foot and want to see if it is fractured, your doctor will give you a request for an x-ray to see if the trabeculae are twisted or interrupted in order to diagnose the fracture. Once the fracture has been diagnosed, a phase of treatment is followed by another x-ray to see if there is scab formation and a before and after comparison to see alignment, alignment and growth. X-rays can be used to observe almost the entire skeletal system, such as inflammation, tuberculosis, tumors, cysts, trauma, bone age, metabolic diseases, and degeneration of the head, shoulders, vertebrae, extremities, and pelvis, but its biggest drawback is that it cannot be used to observe the condition dynamically like fluoroscopy. In addition to the above-mentioned conventional X-ray, there are also some special X-rays, such as: if you unintentionally feel a lump in your breast in the shower, your doctor will request a mammogram to clarify whether it is lobular hyperplasia, breast cyst, or breast cancer; when the ordinary X-ray plain film cannot grasp the subtle structure of the lesion, your doctor will ask you to take an additional magnification to highlight the subtle structure of the lesion. Sometimes both fluoroscopy and plain film are necessary, such as intravenous pyelogram to determine the presence of negative stones, hydronephrosis and kidney function, and hysterosalpingogram to determine the patency of the fallopian tubes and to find the cause of infertility (but not during acute inflammation of the reproductive organs, menstruation, uterine bleeding and pregnancy). Interventional treatment For patients with congenital heart disease who are ready for surgery, not only chest fluoroscopy and plain film are required, but also cardiovascular angiography; and cerebral angiography can help to understand the malformation of their blood vessels, aneurysm, vascular occlusion and blood supply of the aneurysm. Therefore, these special examinations —- angiography has now developed into interventional radiology, and it integrates diagnosis and treatment into one, becoming the third treatment method after medical and surgical treatment. It can perform embolization of tumors, chemotherapy; it can be used to control bleeding, such as: traumatic bleeding, bleeding from gastroesophageal varices, bleeding from tumors, bleeding from ulcers; treatment of vascular diseases, such as: arteriovenous malformations, arteriovenous fistulas, and aneurysms; dilation of ductal stenosis. Contraindications include systemic failure, excessive age, poor heart, lung, liver and kidney function, hyperthyroidism and contrast allergy. CT So, what are the advantages of CT examination? It has unique value in the cranial nervous system, for example, in the diagnosis of its tumors, abscesses, granulomas, parasites, hemorrhages, infarcts, herniated discs, developmental malformations, etc. In the diagnosis of chest diseases, it can be used to determine whether there are lymph nodes or metastases in the mediastinum by plain scan with enhancement, and to see whether there is any narrowing or obstruction of the bronchi. In the abdomen, it can be used to look at the liver, gallbladder, pancreas, spleen and kidneys in terms of occupancy and trauma. However, it is expensive and, like the above-mentioned tests, there is the problem of X-ray radiation. Therefore, attention should be paid to X-ray protection for patients, especially for pregnant women and children. Therefore, the emergence of ultrasound and magnetic resonance diagnosis has some significance on this point. Magnetic resonance MRI can be used to diagnose cerebral infarction, brain and spinal cord tumors, hematoma, congenital anomalies of the spinal cord and spinal cord cavitation, and is significantly better than CT in the display of the brainstem, subparietal region, greater occipital foramen, spinal cord and intervertebral disc. It can also observe the relationship between the lesion and blood vessels, such as the relationship between mediastinal tumor and its surrounding blood vessels, which is of great help to the surgeon in providing surgical plan and judging the healing. The disadvantages are: high examination cost, long examination time, and limitation in the display of bones and gastrointestinal tract. Not only that, it also has certain contraindications, such as: people with pacemakers need to stay away from MRI equipment, and those with metal implants in the body, such as metal clips, not only affect the image of MRI, but also cause serious consequences to patients. Ultrasound Ultrasound diagnosis can be used for diagnosis of pregnancy, localization of fetal position and placenta, determination of multiple births, stillbirths, fetal malformations and gravidity. It is also used in the diagnosis of tumors, hemangiomas, abscesses, stones and ascites in the liver, gallbladder, pancreas, spleen and kidney, and in the examination of diseases of the bladder, prostate, uterus, ovaries, eyes and thyroid gland. Of course, ultrasound has its limitations, for example, in skeletal, pulmonary and gastrointestinal examinations, and the skill and experience of the examining physician may also affect the diagnosis to some extent. Finally, it is important to emphasize that the complementary nature of each image does not allow for a generalization of its advantages and disadvantages. This is also the case with the recent development of comparative imaging, which allows for a comparison between images, the diagnosis of different diseases from the same image, and the diagnosis of different images of the same disease, in order to reach a definitive diagnosis.