When a patient is not feeling well and goes to the hospital, the clinician will first conduct medical activities such as routine history taking and physical examination, followed by the doctor will often need to further draw blood for laboratory tests and bill for examinations, such as prescribing various imaging examinations such as X-ray, CT, MR, SPECT/CT or PET/CT, ultrasound, etc. based on the patient’s medical history and physical examination. Then, with the gradual increase of imaging techniques, how to choose the best imaging examination method to come up with a fast and correct diagnosis has always been a question that clinicians and patients want to explore. Different imaging examinations have their own advantages and disadvantages and scope of application When choosing imaging examinations, one should weigh the advantages and disadvantages, and according to the condition, the examination chosen should be convenient, safe, less painful and less costly as the first choice, provided that the diagnosis can be made correctly. In some difficult cases, if the diagnosis cannot be confirmed by one kind of examination, it is necessary to combine several kinds of examinations: examination or repeat examination for further clarification, such as CT or MR and SPECT/CT when it is difficult to diagnose by X-ray or ultrasound; and when it is difficult to determine the benign or malignant nature of small lung nodule lesions, regular follow-up according to international standard follow-up guidelines, dynamic observation of the size, morphology and density of small lung nodules The patient should be followed up regularly according to the international standard follow-up guidelines to dynamically observe the size, morphology and density changes of pulmonary nodules for early diagnosis and early treatment: 1. What should I do if I have fever, cough, chest tightness, chest pain and panic? Patients with the above-mentioned symptoms of fever, cough, chest tightness, chest pain and panic should visit the respiratory or cardiovascular department, and the doctor may first prescribe X-ray chest plain film and lung CT examination; X-ray chest film can examine most of the chest diseases, and its disadvantage is that it is easy to miss the diagnosis of small lesions and lesions that are overlapped. When the diagnosis cannot be clearly made by plain chest X-ray, CT examination should be chosen. CT can detect small lesions and lesions that are overlapped, and is especially suitable for screening of early lung cancer. Patients who present with chest tightness, chest pain and panic and palpitations, the doctor may recommend you to have an electrocardiogram, cardiac ultrasound, chest vascular CTA or coronary CTA examination when you visit cardiovascular department or respiratory department in order to find out whether there is ischemia in the myocardium, whether there is a coarctation aneurysm, whether there is stenosis, occlusion or thrombosis in the coronary arteries and pulmonary vessels, etc. Our 128-row high-end CT can quickly complete CTA examination of large blood vessels and coronary arteries in the chest with low-dose scanning. For patients with acute chest pain, timely CTA examination can obtain clear images and clear diagnosis, and aortic coarctation and pulmonary infarction can be diagnosed in the first time through timely chest CTA examination, which has saved the lives of many patients. Guidelines for the management of pulmonary nodules: (1) Isolated pure ground-glass nodules (pGGN) ≤5 mm in diameter do not require CT follow-up observation. (2) mixed ground glass nodules (mGGN) ≥5 mm in diameter, reviewed at 3 months – no change – annual follow-up for 3 years; (3) multiple ground glass nodules (GGN) ≤5 mm in diameter, observed at 2 and 4 years follow-up; (4) multiple pGGN with at least 1 lesion >5 mm in diameter >5mm, but no particularly prominent lesions, 3-monthly review – no change – annual follow-up for 3 years; (5) multiple GGN, after treatment of prominent lesions, 3-monthly review – growth or no change – malignant (especially for mGGN >5mm in diameter). 2.What should I do if I find a breast nodule or lump? If a lump is found, ultrasound and mammography are the conventional methods of examination for breast surgeons, and the combination of these two methods can make a qualitative diagnosis of most breast diseases. MRI is an important clinical guideline. Hangzhou Hospital of Traditional Chinese Medicine has a breast surgery department, which is a key discipline at the municipal level, and has complete and advanced imaging equipment for breast examination, including X-ray mammography, ultrasound, MRI and SPECT/CT. How to choose breast imaging: (1) Young women under 40 years old, asymptomatic health checkups prefer ultrasound; those with clinical suspicion of breast lesions and those with family history of breast tumors or high-risk groups: choose: X-ray mammography + ultrasound, X-ray mammography + MR, preferably X-ray mammography + MR, preferably X-ray mammography + MR. (2) Dense breast with more glands: ultrasound + MR; (3) Preoperative examination of breast mass: X-ray mammography + ultrasound + MR to facilitate staging and prevent missing multiple foci or metastases; optimization of examination methods is essential for early detection of breast cancer lesions. With the continuous development of imaging medicine, the early detection rate of breast cancer will continue to improve, allowing early and early diagnosis and treatment of breast lesions. 3.How to choose imaging examination for patients with stomach pain, blood in stool, abdominal pain, diarrhea and emaciation? When patients have the above mentioned digestive symptoms, splenogastroenterologists or gastroenterologists will choose endoscopy and barium meal imaging of the gastrointestinal tract according to their conditions; usually ultrasound is used as a routine preliminary examination of abdominal lesions, while CT or MR enhanced examination of the abdomen can further clarify the diagnosis and differential diagnosis of tumor lesions of the liver and spleen, pancreas, biliary tract, gastrointestinal tract, etc., which can correctly diagnose most of the abdominal diseases and improve the accuracy of disease diagnosis. MRI is often used in cases where the differential diagnosis between ultrasound and CT is difficult; abdominal plain film, ultrasound and intravenous pyelogram are often chosen for urinary tract diseases such as hematuria and renal colic, and CT is particularly advantageous in total urinary tract examination and detection of microscopic stones, while CT urography (CTU) and MR urography (MRU) are helpful in the diagnosis of urinary tract obstruction lesions. In patients with acute abdominal pain, sometimes doctors will perform abdominal enhancement or abdominal CTA examination urgently to clarify whether there is intestinal ischemia, perforation or vascular lesions, and surgery will be performed promptly after a clear diagnosis. 4.What is the best test for patients with traumatic brain injury, dizziness, headache and nasal congestion? If the patient has dizziness or headache, the neurosurgeon or quintuple surgeon will suggest you to do a CT head examination first to observe whether there is bleeding or occupancy, etc. The purpose of CT examination for patients with trauma history is to clarify whether there is fracture and bleeding, and patients without trauma history can suggest or find head or sinus or nasopharynx lesions; if the CT examination for trauma patients suggests normal, but the patient still feels unwell or comatose, the doctor will suggest Further MRI examination to clarify whether there is brain contusion or axonal injury, because CT examination of brain axonal injury is normal in most cases, while the patient may be in a coma and MR examination can detect brain axonal injury. MR is more advantageous in the qualitative diagnosis of central nervous system diseases, especially in the early detection of cerebral infarction, encephalitis, multiple sclerosis and other demyelinating lesions and intracranial occupations, and CT is more advantageous in trauma and fractures. 5. Trauma or neck How to choose the examination method for thoracic, lumbar and limb joint diseases? Patients with trauma or cervicothoracic lumbar back or extremity joint discomfort should go to the orthopedic injury department or surgery. X-ray plain film examination is mainly used for spine, bone and joint trauma and tumor lesions, but the shortcomings of plain film cannot directly show early bone changes, spinal canal spinal cord lesions, muscles, tendons, meniscus and intervertebral disc lesions, while MRI has advantages in this regard, where MRI has the advantage of showing joint structures, soft tissues and The MRI is superior to CT in showing the spinal canal spinal cord and bone marrow lesions, but inferior to CT and X-ray plain film in showing calcification; CT routine examination and multi-directional reconstruction in trauma can clearly show the fine structure fractures and bone changes in the spine and joints, etc. X-ray film, CT and MR imaging are commonly used in orthopedic patients, and often several imaging examinations are combined to meet the clinical diagnostic needs for a clear diagnosis. Preventing missed diagnosis or misdiagnosis. 6.What should I do if I find a lump in a part of my body? If a patient accidentally finds a lump in a certain part of the body, he or she must see a doctor. For example, a breast lump should be seen by a breast surgeon or general surgeon, a female lower abdominal lump should be seen by an obstetrics and gynecology doctor or a surgeon, and a neck lump should generally be seen by a doctor in the department of ophthalmology or general surgery. If you don’t know which department to go to, you can also go to the oncology department first. The oncologist will give you a thorough examination and prescribe relevant imaging tests. Patients who find lumps are recommended to consult as early as possible and have ultrasound, CT, MR or SPECT/CT imaging examinations to clarify the diagnosis as soon as possible. Sometimes difficult cases can also be guided by CT or ultrasound for puncture biopsy to clarify the diagnosis and achieve the purpose of early diagnosis and early treatment to improve the survival quality and survival rate of patients. Patients with indications for surgery are recommended to undergo surgery as early as possible; while for patients who are not willing to undergo surgery, interventional therapy, radiofrequency ablation, particle implantation and other treatment methods can be adopted at present.