Week 4 - Jiahao

This week was quite exciting since there were introduction lectures for first-year radiology residents. It was surprising that new radiology residents start their residency in the beginning of summer not as college terms usually starts in late August, which means after the end of medical school education, new residents is about to work in hospital as well as never finish learning.

 These intro lectures were given by the third-year residents as their fellow, who just finished their second-year exams. The intros covered very fundamental knowledge that as a new radiologist should be familiar with to start their work, which is also very friendly to me because I finally was able to catch up most of the materials except for very little anatomy terms appearing sporadically. Very basic skills, such as how to use the image reading system, customizing the platform and how to open images from different sources, were discussed at first. Then seniors lead to topics on different rotations that new residents would have chance to shadow in the future, like chest X-ray, CT, neuroradiology, pediatric radiology, etc. So, it was more like how to train a qualified radiologist at the very first step, thus I was really benefited to get to know how to analyze images at the very beginning level just as what was covered in Dr. Prince’s lecture on Friday.

 For chest X-ray, the first is to figure out whether it was taken as AP or PA from heart size since the X-ray has a cone-beam shape meaning objects near the X-ray source will have a larger projection. Then it should be examined for the outline to see any bone fracture as well as examine lung ribs in order. Lung CT images have a different story, which are very sensitive for lung nodules and pulmonary embolism. Firstly, the two lung lobes are to be examined in turn from top slices to bottom and vice versa. Then the trachea as well as airways need to be observed for any tumor. Lymph nodes are useful for diagnosis. When it comes to abdomen, liver, pancreas, spleen, kidney should be noted in turn. For bone parts, sagittal view can be helpful for any spine fracture. Neuro part can never get rid of head CT, MRI and PET/CT. Angiography is often the gold standard for aneurysm or vascular malformation. For head CT, midline shift is an important feature to be noticed followed by basal cisterns with a 6-point star. Symmetry and ventricular size are also characteristic for any diagnosis. Besides, always note the bone part like any skull fracture. MRI for head can be always complex with different acquisition protocols like T1, T2, FLAIR and diffusion. Stroke was taken as example here in DWI and ADC. Since stroke involves hypoxia, which leads to the malfunction of ATPase causing the nerve cell swelling due to water, the area often has abnormal diffusion phenomenon, thus can be seen in DWI and ADC. This was a very interesting case, because it involves many backgrounds from biology, physics as well as physiology, showing that in order to truly understanding and applying something into medical trail, many aspects need to be considered.

 Since I am doing biomedical engineering research also related to medicine, although from a different perspective focusing on scientific and engineering view, I feel like it is also important to understand in a broader way and learn to communicate with people from other backgrounds to seek possible collaboration or to apply possible techniques to other fields.