Plain chest x-ray

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Survey and digital radiography of the chest organs - what is it?

Chest radiography (digital, survey) is a method for early diagnosis of lung diseases. X-ray methods have shown high results in detecting tuberculosis and pneumonia in the initial stages of pathology.

Table of contents:

When used correctly, the examination makes it possible not only to identify the disease, but also to dynamically monitor treatment tactics.

Thanks to the invention of William Conrad Roentgen, humanity has the opportunity for mass screening of the population using fluorography. This helped prevent the widespread spread of tuberculosis infection. Tuberculosis peaked at the beginning of the 20th century. The discovery of X-rays (1895) could not have come at a better time.

Modern technologies have made it possible to improve X-ray installations. Today we have computed tomography, which allows us to obtain sections of the human body every 1 mm. True, CT is characterized by a high radiation dose to a person, and therefore cannot be used for mass research of the population.

Plain radiography of the chest organs - what is it?

Survey radiography of the chest organs is an X-ray examination that allows you to get an idea not only of the condition of the lungs, but also of other structures of the upper half of the body: the heart, the osteoarticular system, the mediastinum, the pleural cavity.

A survey radiography is performed in a direct projection. The image must necessarily visualize the apexes of the pulmonary fields, costophrenic sinuses and peripheral parts of the chest cavity.

In practice, with the help of research it is possible to see infiltrative shadows in tuberculosis and pneumonia (inflammation of the lung tissue). If necessary, radiologists prescribe an additional lateral projection. It helps to establish the prevalence and localization of darkening.

What a panoramic photo of the lungs shows:

  • Infiltrates on the apexes in tuberculosis;
  • Pneumonic foci;
  • Darkening and clearing in other diseases;
  • Peripheral and central cancer;
  • Collapsed lung (atelectasis);
  • Cysts and abscesses;
  • Presence of air in the pleural cavity (pneumothorax).

Radiologists often encounter the diseases described above, but there is also a rare pathology that should not be forgotten. This state of affairs is observed in cystic fibrosis, a disease that a small number of doctors have an idea about. Due to its rare occurrence, the disease is missed on x-rays.

Chest X-ray for bronchitis

Chest X-ray does not show bronchitis! Inflammation of the bronchial tree on a chest x-ray is determined by indirect signs:

  • Strengthening the pulmonary pattern;
  • Thickening and deformation of roots;
  • Increased transparency of the lung fields;
  • Pneumosclerosis in the lower sections;
  • High arrangement of diaphragm domes.

Even if all the above-described symptoms are present for bronchitis, a radiograph alone is not enough. X-rays easily pass through the bronchi, so the bronchial tree is not visible in the images. Only after contrast (bronchography) can they be seen. Such a study is difficult to perform and unpleasant for the patient. Bronchography is used for bronchiectasis to identify damaged bronchi. It is performed only by an experienced radiologist, since the procedure requires high qualifications.

Digital chest radiography - advantages and disadvantages

Digital radiography of the chest organs is one of the promising areas of radiology. Its implementation has made it possible to reduce radiation exposure to humans and improve the quality of X-ray images.

Digital radiography helps analyze photos qualitatively using software applications. Using the software allows you to enlarge the image, improve the sharpness or clarity of the picture.

The human chest cavity consists of many anatomical structures that are difficult to differentiate. A digital X-ray machine produces graphics that allow you to visualize each individual structure.

X-ray of the lungs in pneumonia requires studies in two projections - frontal and lateral. This range of examinations is minimal. If necessary, radiologists prescribe additional studies - computed tomography and magnetic resonance imaging.

Digital technologies are sometimes used instead of fluorography, when the medical institution has no other conditions for conducting a fluoroscopy.

X-ray examination of the lungs - how many can be done

X-ray examination of the lungs is prescribed to some patients 3-4 times a month. The simplicity of the procedure causes concern among patients. They are afraid of radiation and have a legal right to do so.

How long can an X-ray be taken? How much does a radiologist need? Experts evaluate the harms and benefits of radiation and choose the best option. X-rays of the lungs are performed repeatedly during the treatment of pneumonia to assess the dynamics of treatment.

For tuberculosis, X-rays are taken at regular intervals (usually quarterly) over many years.

Interpretation of a chest x-ray for pneumonia - example

On the presented x-ray of the chest cavity organs (direct and right lateral projection) a rounded intensive formation of the lower lobe of the right lung is visualized. The lateral image shows infiltration of the S8-9 area. The roots are stringy due to the vessels. The right costophrenic sinus is veiled. The cardiac shadow is expanded to the left.

Conclusion: X-ray signs of polysegmental pneumonia of the lower lobe of the right lung.

Disease history. Patient R. developed a cough 3 days ago. I took ampicillin, but during therapy the temperature increased to 38 degrees, which forced me to contact my local physician.

On examination: wheezing is heard in the lower lobe of the right lung. The face is hyperemic, breathing is rapid and shallow.

The diagnosis was confirmed x-ray. In the general blood test, an increase in leukocytes and a shift of the formula to the left due to “rods” are observed.

Any conclusion from our doctors is not a call to action before consulting with a personal doctor!

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X-ray (radiography) of the chest organs: indications and contraindications

To perform chest x-rays in medicine, a very low dose of x-ray radiation is used. The rays passing through the body are absorbed differently by tissues, resulting in an image of the lungs, heart, ribs, sternum and spine being formed on the film or screen.

The method is useful when there are complaints of shortness of breath, cough, fever, chest pain. Radiography is used to diagnose and monitor the treatment of various lung diseases, such as pneumonia, emphysema, and cancer.

Principle of chest radiography

X-rays are a form of radiation, like radio waves or visible light, but with a different wavelength. They penetrate well through many physical objects. After focusing the beam on a specific anatomical area, such as the chest, the X-ray machine briefly increases the intensity of the radiation. It penetrates through the internal organs, absorbed depending on the density of the tissue, and the data obtained is recorded on film or a sensitive screen.

Bones block rays well, while internal organs, muscle and fatty tissues transmit them. That is why the image of the chest looks like light bones, with gray soft tissue around them, and dark air fields of the lungs inside.

Until recently, radiographs were stored only on film. Today, most images are digital files stored electronically. This format ensures ease of analysis, transmission and storage of information. That is why modern X-ray rooms are equipped with digital fluorographs and X-ray machines.

When is a chest x-ray necessary?

The study is prescribed by the doctor after an initial examination, percussion, palpation and auscultation of the lungs.

Indications for chest x-ray examination:

  • difficulty breathing, shortness of breath;
  • persistent cough;
  • discharge of purulent sputum;
  • chest pain;
  • chest wall injury;
  • fever of unknown origin.

Using radiography, doctors can diagnose the following diseases:

Indications for chest x-ray

The study is prescribed for adults and children for the following purposes:

  • assessment of signs and symptoms potentially caused by pathologies of the respiratory, cardiovascular, upper digestive tract and musculoskeletal system of the chest wall;
  • assessment of the involvement of the lungs in the pathological process in systemic diseases affecting the entire body, as well as in the metastasis of malignant tumors from other foci;
  • studies with a known diagnosis to assess the quality of treatment (improvement, recovery, stabilization, progression);
  • examination of patients in intensive care units;
  • preventive examinations of different population groups, in particular, for the diagnosis of pneumoconiosis and tuberculosis;
  • preparation for surgery for lung diseases.

Advantages and disadvantages of the method

Like any medical intervention, chest radiography has advantages and some disadvantages.

  • there is no residual radiation after completion of the diagnosis;
  • if the research rules are followed, the method does not cause side effects;
  • equipment is available in most medical institutions;
  • Obtaining an image, especially with a digital device, is very easy and takes little time, which is especially important in critical medical situations.
  • there is a small chance that X-ray radiation will trigger the process of tumor formation, but the benefits of diagnosis outweigh this risk;
  • To obtain a high-quality image, highly qualified laboratory technicians are required to select the dose of X-ray radiation depending on the characteristics of the patient;
  • For pregnant women, additional measures are required to protect the fetus from radiation (lead aprons, blankets, etc.).

Modern devices pay special attention to reducing the radiation dose while improving image quality. National and international radiology organizations continually review and update standards for techniques used by radiologists.

Modern equipment controls the radiation dose by minimizing the effect on other parts of the body.

Limitations of the method

A chest x-ray is a very informative test, but it has some limitations. Not all pathological conditions can be detected with conventional radiography, for example, small tumors or pulmonary embolism.

There are no contraindications for chest radiography. During pregnancy, it is performed only if absolutely necessary. In this case, the abdominal area is protected with a special apron that does not transmit x-rays. They also use a special partition that prevents radiation from penetrating through the abdominal cavity. However, the danger to the fetus still remains, especially in early pregnancy. Preventive studies (fluorography) are not carried out during pregnancy.

Hazardous Conditions Detected by Research

The main diseases that can be diagnosed using a chest x-ray are:

Pneumonia appears on an x-ray as a light spot on a dark pulmonary background. This is due to swelling of the walls of the alveoli and the entry of inflammatory effusion into their lumen. The main causes of pneumonia are bacterial infection, chest trauma, and inhalation of harmful chemicals or stomach contents.

Congestive heart failure is accompanied by increased pressure in the pulmonary vessels, and in more severe cases, by the accumulation of fluid around the heart (in the pericardial cavity). On an x-ray, this appears as an increase in light linear shadows around the heart (intensification of the pulmonary pattern) and an increase in its size.

Pneumothorax is the accumulation of air in the pleural cavity as a result of injury to the chest, bullous emphysema, or disintegrating tumor. It appears as a thin dark line adjacent to the chest wall. With tension pneumothorax, an x-ray of the lungs is taken during inhalation and exhalation, and it is found that the amount of air does not change or even increases.

When blood, pus or inflammatory exudate accumulates in the pleural cavity, they speak of pleural effusion. It is caused by pleurisy, pleural empyema, congestive heart failure, pulmonary embolism, or chest trauma. Often, effusion can be detected only in the area of ​​the diaphragmatic angles, so it is very important to follow the imaging technique so that the entire chest is imaged.

Cardiomegaly is an enlarged heart, which may be a sign of hypertension, valvular disease, or dilated cardiomyopathy. It is diagnosed by measuring the size of the heart shadow and its relationship to the diameter of the chest.

An X-ray of the lungs can also reveal an accumulation of air in the abdominal cavity - pneumoperitoneum. This condition occurs with abdominal injuries, complications after operations on the abdominal organs, and intestinal perforation. It looks like a dark streak of air under the diaphragm.

Emphysema is one of the most common causes of death in patients with chronic lung diseases. X-ray is one of the main methods for diagnosing this dangerous condition, which is manifested by increased airiness of the lung tissue, deformation and increase in the size of the chest.

Chest X-ray is often crucial in making a diagnosis and determining treatment for a patient. That is why it is important to carry it out not only with modern equipment, but also to ensure that X-ray technicians and radiologists are well trained.

The radiologist tells and shows what is normal on a chest x-ray:

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Chest X-ray

Chest X-ray is performed not so much to diagnose pneumonia, but to determine the localization of infiltrative shadows and determine the type of damage to the lung tissue

Chest X-ray in children: method errors in pneumonia

Chest X-ray is used in medicine to detect pneumonia, cancer, tuberculosis, and monitor the dynamics of treatment for various pathological diseases of the lung tissue. The methods have been used in medicine for over 100 years.

European researchers carefully studied the possibilities of lung radiography and came to the conclusion that chest X-rays have large errors. X-rays of the lungs in children show pneumonia where there is none. On the contrary, with minor infiltrative foci, the study does not visualize the pathology.

Chest X-ray for pneumonia in children - method errors. An X-ray image shows mucus, accumulation of bacteria, leukocytes, pus, tissue breakdown products, but these morphological elements are not always observed in pneumonia.

Mucus in the bronchi can occur in the following nosological forms:

• Bacterial viral pneumonia;

In most cases, with such changes, the radiologist determines the diagnosis of pneumonia, but errors are possible. Some specialists make this description to avoid lawsuits from patients. It is better to carry out preventive treatment than to miss pneumonia - this approach is used in the clinic when interpreting chest x-rays.

European researchers argue that radiography is not a universal way to diagnose the disease. The rationality of the research raises questions in many cases.

If the attending doctor listens to wheezing in the chest, the patient has a cough, slight fever, difficulty breathing, an increase in white blood cells is observed in the tests, treatment is carried out as for pneumonia, even if the picture shows a negative result.

According to research, the X-ray picture of pneumonia significantly lags behind the clinical symptoms of the disease. In the early stages of the disease, an x-ray may show normal, although after a few days an infiltrative lesion will appear.

After treatment of pneumonia, on the contrary, abnormal darkening can be observed for several months, which requires excessive therapy. Obviously, a thorough clinical examination and examination of the patient's life history is more important than radiography.

To confirm the conclusion, European researchers cite a number of interesting facts.

When rhinitis appears, the question of the etiology of inflammation of the nasal mucosa is important to the doctor. With allergies, the sputum is mucous in nature. Bacterial rhinitis is characterized by the appearance of serous or purulent masses. The color of nasal discharge is extremely important for a specialist to determine the type of infection.

Chest X-ray and other radiation methods for diagnosing pneumonia

The following radiation methods are used to diagnose pneumonia:

1. X-ray of the chest organs - shows the heart, lungs, blood vessels in order to determine organic, inflammatory traumatic pathology;

2. Computed tomography of the lungs visualizes the smallest details. It is used to detect pneumonia only in emergency cases, when the nature of the darkening remains unclear with simple radiography. Small cancerous nodes also appear as infiltrative shadows;

3. Ultrasound of the chest to determine fluid in the pleural cavity. Ultrasound also helps determine the cause of pleurisy;

4. Magnetic resonance imaging is used to assess the severity of inflammatory changes. Allows you to visualize blood vessels, the heart, and the bone structure of the chest cavity. MRI provides additional information when identifying tumors, excess fluid, and infectious inflammation.

A biopsy can be used to determine the nature of morphological changes. The method makes it possible to study histological changes in tissue due to inflammatory or cancerous pathology. The puncture collection of biopsy material can be controlled using X-rays, computed tomography, magnetic resonance imaging, and ultrasound.

Plain radiography of the chest organs for bacterial pneumonia

When diagnosing diseases of the pulmonary parenchyma, X-rays visualize the accumulation of various components: mucus, leukocytes, elements of tissue decay.

The mucous membrane of the bronchi may be sterile, but pathological shadows can be seen on a plain X-ray of the chest organs. This situation is associated with damage to the interstitium located between the pulmonary alveoli. With viral inflammation, it is possible to damage exclusively the lung tissue without changing the alveolar acini. Such forms are difficult to diagnose clinically, since in laboratory tests the leukocytes do not increase. In rare cases, lymphocytosis can be observed. X-rays clearly visualize viral inflammatory reactions, but there is no effective etiological treatment.

According to the accepted standard, when the attending physician receives a diagnosis of pneumonia from a radiologist, he treats as for bacterial pneumonia. The approach is considered correct from the point of view that even with viral pneumonia, the prescription of antibiotics prevents the addition of bacteria, which eliminates secondary infection and a possible lawsuit.

On the 5th day of viral pneumonia with cough and fever, a relapse of viral fever is observed, which can be mistaken for exacerbation of inflammation, since the focus of inflammation at this moment may increase in size. During dynamic monitoring of the patient after chest x-ray, it is necessary to add antibacterial drugs. Thus, massive antibacterial therapy is carried out, although in fact pneumonia is caused by a virus, against which antibiotics are powerless.

There are specific x-ray syndromes of viral pneumonia that radiologists are not familiar with, since there is no need to diagnose the pathology. The immune system copes with such pathogens on its own, but not always. The massive swine flu epidemic showed human vulnerability to new mutated viral forms.

Even timely plain radiography of the chest organs made it possible to identify an infiltrative focus. Death of a person occurred every other day, despite timely diagnosis of the disease.

Thus, a chest x-ray raises a number of serious questions for doctors:

1. Is it really necessary to treat pneumonia if the x-ray is normal;

2. Should antibiotics be prescribed if an infiltrative shadow is detected on the image, when there are symptoms of viral inflammation and allergies;

3. Should antibacterial treatment be intensified in case of negative dynamics of pneumonic foci, because X-ray signs lag behind the clinical picture in development.

Clinical experience and common sense suggest that approaches to conducting plain radiography and images of the chest cavity in two projections require revision.

Digital radiography - what is it?

Digital chest radiography has made it possible to reduce the patient's radiation dose while maintaining the quality of the examination. The mechanism of layer-by-layer scanning of the chest cavity with a thin X-ray beam made it possible to study every smallest detail.

Modern fluorographs, based on the principles of digital radiography, reduce the dose of human radiation exposure by approximately 100 times. Despite the reduction in radiation exposure, digital scanning is not used in children.

Regarding the use of X-ray examination in a child, experts have a well-established opinion regarding the danger of DNA changes under the influence of X-rays. Radiation damages DNA, leading to developmental abnormalities.

In European countries, a technology is used in which, if pneumonia is suspected, bacterial culture of sputum is done. When culturing bacteria, microbial inflammation of the lung tissue should be suspected, although the infection may accompany a viral lesion. In such a situation, there is no particular need to perform x-ray diagnostics for children. If an improvement in the child’s condition is observed during antibacterial treatment, there is no rationality in radiography.

Only if the clinical picture worsens is additional x-ray diagnostics required. Only infants 3-6 years old are recommended to be hospitalized. Strong antibiotics should not be prescribed. If first-line therapy fails, targeted therapy is initiated after culture results are available. The conclusion of radiography does not play a significant role.

In any case, the tactics of diagnosis and treatment are determined by the doctor.

General X-ray of the lungs in children - diagnostic tactics

X-rays do not allow us to obtain the true size of the chest. It is more difficult to determine the true indicators with digital radiography. The correct selection of technical parameters that determine the quality of the image is essential.

X-ray diagnostics is performed for children of any age, but the indication for its use is the inability to establish a diagnosis using alternative methods. Any radiography is carried out only after referral from the treating specialist.

Determining the risk to the health of a small patient is the task of the doctor. The patient can write a refusal if desired. You cannot force a person to take an x-ray against his wishes. Explain to the child's parents the risks of a lack of diagnosis and the harm of an X-ray examination. All facts must be recorded in the patient’s outpatient card or medical history.

Any bone damage in children requires x-ray diagnostics, which is enshrined in law. The health hazard from fractures is greater than the harm from radiation examination. This approach is used in medicine. The rationality of its use is beyond doubt.

If a child complains of redness, swelling, or redness, symptoms of an inflammatory disease should be suspected.

An urgent x-ray of the lungs in children is prescribed when the following symptoms are detected:

1. temperature rise above 39 degrees;

2. Complaints of chest pain;

3. Laboratory indicators of severe inflammation.

A mandatory chest x-ray is prescribed to a child not so much to make a diagnosis, but to clarify the location and determine the extent of infiltration.

X-ray examination is prescribed for heart diseases when the child has heart failure. Prescribing the procedure to children in the first year of life should be carried out with extreme caution. Indication for examination: suspicion of acute inflammatory process, bronchial foreign bodies.

Fluorography is not performed until the age of 18. An annual examination would influence cell growth and division. To prevent unnecessary mutations, screening X-ray fluorography examinations are not performed for children. X-rays are prescribed only for strict indications.

Plain radiograph for bilateral polysegmental pneumonia

Digital radiographs in frontal and lateral projection: right lower lobe parenchymal pneumonia

Survey image of the chest organs: left-sided upper lobe abscess pneumonia

Second opinion of medical experts

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X-ray of the OGK

What is a plain chest x-ray? The X-ray procedure itself is absolutely painless and does not require any uncomfortable tissue sampling or complex diets. Using special equipment, X-rays are passed through the body, the result of their penetration remains on the film in the form of a two-dimensional projection. Depending on the structure of the tissue (more precisely, on its density), the rays pass at different time intervals, as a result of which denser structures (bones) remain white in the image, and tissues of lower density remain dark.

Modern equipment allows using digital X-rays to obtain high-precision images with the ability to store them on digital media, while the harmful effects on humans are reduced by almost half. But even an ordinary non-digital X-ray provides much more information than a fluorogram, and is also more harmless.

X-ray of the chest cavity can be overview, when all organs in the chest cavity are clearly visible in the image, and targeted, when attention is concentrated on the study of one of them. An overview image of the chest shows the condition of all organs of the respiratory system (lungs, bronchi, respiratory tract, trachea, etc.), in addition, the heart, its vessels, and some lymph nodes are visible.

Why is OGK x-ray prescribed?

A chest x-ray is often called an x-ray, but this is not entirely correct. X-rays are prescribed in cases where visual diagnosis or description of symptoms is not enough:

  1. If desired, instead of the mandatory fluorography procedure, you can take a detailed X-ray of the chest, thus there will be less harm and the information will be more accurate. Also, X-rays of the OGK are prescribed to clarify the results of fluorography in the presence of differentiated spots or darkening.
  2. To determine the etiology of various lung diseases, in order to most accurately diagnose inflammatory processes, neoplasms, pneumonia, pleurisy, etc.
  3. For various types of lymphomas, X-rays can be used to assess the condition of the lymph nodes.
  4. If heart problems are suspected, the procedure makes it possible to detect heart defects, myocardial or pericardial disease at an early stage.
  5. If there is a suspicion of traumatic problems with the spine (from fractures to hernias and pinching), for rib fractures.

How does an X-ray of the OGK occur?

If you have been prescribed a chest x-ray, you do not need to worry about any special preparations. There is no need to follow a diet or follow any special instructions. The specifics of the procedure will depend on where exactly it takes place. In hospitals and other medical institutions, a special office is used for this, the walls and doors of which are lined with metal that does not transmit X-rays.

The patient is required to undress from the waist up, approach the device, take a deep breath and hold his breath for a couple of moments. All these simple manipulations must be done not spontaneously, but at the command of the radiologist. It is better to remove metal objects, they can create interference.

In addition, there are mobile devices that can take pictures in different projections even of a lying patient, which is especially important in the case of spinal injuries when the patient cannot rise on his own. In very severe cases, MRI is prescribed as a means of the most complete and accurate diagnosis; its principle is also similar to digital x-ray.

Standard r-graphy assumes the following:

  • The photo will be ready within half an hour. A competent and experienced radiologist will be able to indicate to you the main key points in the image if you ask him to do so, but only your attending physician can give a complete transcript. Don’t forget about this, especially if you came to take an X-ray on the direction of a doctor.
  • The procedure is very simple and completely painless, it is safe for both adults and children, but you can not resort to it too often in order to avoid excessive influence of X-rays on the body.
  • No preparation is needed, and the process itself takes a few minutes, most of which you will spend changing clothes.

Usually, X-rays of the OGK are taken in a direct projection, but sometimes it is recommended to perform it in several projections at once. This picture is taken in the following cases:

  1. When there is a suspicion of pneumonia (frontal and lateral projection).
  2. Anterior, posterior and lateral photographs are taken in case of suspected oncology to determine the volume and nature of tumors in the lungs.
  3. On the recommendation of a doctor, when there are shadows of an uncertain nature in the image and it is necessary to determine their size and location.
  4. To assess the dynamics of treatment for severe diseases of the lungs or other chest organs.

Contraindications for X-rays

Contraindications for x-rays are extremely rare, but there are still several cases that are worth paying attention to, for example, pregnant women and young children undergo x-rays in rare cases and only as prescribed by a doctor. It is strictly forbidden to take an x-ray if:

  • Open or internal bleeding, especially heavy bleeding.
  • Diseases associated with disruption of the structure of blood vessels, atherosclerosis.
  • Pneumo- and hemothorax.
  • General serious condition of the patient.
It is also worth remembering that small children often have pictures taken in the presence of adults; if in this case you are an accompanying adult, be sure to make sure that you are given protection; there is no point in being exposed to radiation again.

X-ray results of the OGK and their interpretation

It is impossible for a person without medical education to independently understand the condition of the chest organs from an image. However, the radiologist will answer your basic questions, and he will also make basic notes for the doctor. And the attending physician will describe in detail what exactly the chest x-ray will show. The main points recorded in the x-ray protocol:

  1. The projection in which the picture was taken (there can be three of them: anterior, posterior and lateral).
  2. The location of the heart, its size (enlarged or normal), the condition of its muscles.
  3. The presence or absence of shadows in the lungs (normally there should not be any); if there are shadows, then their meaning is described: neoplasms, abscesses, parasitic accumulations, edema, etc.
  4. Characteristics of the pulmonary pattern (presence/absence of its deformation); if there is deformation, this indicates problems with blood vessels and, as a result, insufficient blood supply.
  5. A description of the structure of the roots of the lungs, their changes indicate the presence of oncology or lack of blood supply, stagnation of blood.
  6. Structural changes in the diaphragm (normally they should not be present).
  7. Places of transition of the costal pleura into the pleura of the diaphragm (the sinuses should normally be free).
  8. Condition of the lymph nodes (their size, shape and uniformity).

Digital X-rays will give a more accurate idea of ​​the presence of deviations from the norm, since with a regular image the data can be distorted due to too long or, conversely, insufficient exposure. If at least one of the indicators described in the protocol differs from the norm, this indicates the presence of a disease. Only a specialized doctor can make an accurate diagnosis and prescribe treatment; you should absolutely not self-medicate or look for advice on the Internet.

In what cases will the results be inaccurate?

The accuracy of the result of a standard x-ray examination, especially if there is a suspicion of deviation from the norm of any of the indicators, can always be questioned. Of course, the more modern the equipment, the more accurate the image, for example, X-rays are more accurate than fluorography, digital X-rays will give an even more accurate result than a regular one, and MRI builds a three-dimensional model, allowing you to look inside the chest from all sides. In addition to the above factors, it is also worth considering:

  • Human factor. An experienced radiologist will give more accurate results even with the simplest equipment.
  • Any equipment tends to break down and, accordingly, needs regular maintenance and adjustments, which also affects the quality of the image.
  • If the patient violated the protocol (forgot to remove metal jewelry, exhaled prematurely, involuntarily coughed or sneezed while the rays were passing through).
  • Anatomical features. Some abnormalities are in a difficult location to access because they are covered by too many layers of bone or muscle, making them difficult to diagnose in a timely manner.

Source: http://brulant.ru/health/rentgenografiya-ogk/

Chest X-ray: conclusion. Plain radiography of the chest organs

Plain chest x-ray is a classic projection method of examination. It is used in the diagnosis of pathological changes in the cavity, the systems located in it, as well as nearby anatomical structures. Next, let's take a closer look at how a chest x-ray is performed. The conclusion of the study (its brief description) will also be given in the article.

General information

Chest X-ray is considered one of the most common diagnostic methods today. As with other examinations of other parts of the body, one type of ionizing radiation is used during the procedure. With film radiography, the radiation dose is on average 0.3 mSv (millisieverts), with digital radiography - 0.3 mSv.

Anatomical tissue structure

What does a chest x-ray show? The conclusion of the study is drawn up based on an assessment of the state of the visible elements in the image. In particular, the transparency and shape of the areas onto which lung tissue is projected (pulmonary fields), their structure formed by the shadows of blood vessels (figure), the location of the roots, the position and configuration of the diaphragmatic domes and sinuses in the pleural cavities, the size and type of the mediastinum (heart, including).

Research Opportunities

Chest X-ray is prescribed if the following diagnoses are suspected or to clarify:

  • Hydrothorax.
  • Pneumothorax.
  • Pneumonia.
  • Heart failure.
  • Interstitial lung diseases.
  • Hernia in the esophageal diaphragmatic opening.
  • Rib fractures.

Chest X-ray (the norm will be described below) allows us to identify pathological changes in the bones, soft tissues, structures of the mediastinum, lungs, and pleura. Most often, the study reveals pneumonia and congestive heart failure. In addition to being diagnostic, chest radiography is also a screening method. However, in this case, it has insufficient clinical value, as a result of which additional studies are prescribed (bronchoscopy, CT, etc.).

Information content

In some cases, the test result may be false negative. This may be due to projection layering from the shadow of the pathology focus onto the shadows of a healthy anatomical structure (for example, the mediastinum, diaphragm). Also, the lack of information is determined in some cases by the low intensity of the focus. This may be inflammation in the initial stage, especially against the background of agranulocytosis. A false negative conclusion may be a consequence of an inadequate projection of the study. This usually happens with a rib fracture or mediastinal pathology. If a chest x-ray turns out to be uninformative, a CT scan is prescribed, which is free of these shortcomings.

Preparing for the study

As such, there are no rules of behavior before the procedure. There is no need to diet. Immediately before a chest x-ray is performed, you should remove all jewelry that could come into contact with the radiation area. To get a clear picture, the specialist may ask the patient to hold their breath. Chest radiography is not performed for pregnant and lactating women.

Result

After the examination, the specialist gives a transcript. There is no reason for concern if all structures are located correctly, are of normal size, there are no growths on them, and no foreign bodies are found in the chest cavity itself. The following signs are considered deviations:

  • Changes in the size of blood vessels.
  • The presence of infection or an increase in the size of organs.
  • Fractures or deformations of the cavity bones.

X-rays can reveal the presence of swelling, tumors, and wounds. These signs are considered pathological.

Progress of the procedure

As a rule, a plain chest x-ray is performed. The patient needs to undress to the waist and remove all metal elements from himself. The patient presses his chest tightly against the device and holds his breath. After this, the photograph is taken on a special film. In some cases, two images are taken: from the side and from the front. The procedure generally lasts several minutes. The examination does not cause any discomfort or pain. A chest x-ray for a child is no different from the procedure for an adult.

Projections

Typically the patient is positioned between the detector (film) and the x-ray tube. As a rule, the picture is taken in frontal and lateral (right or left) projections. In the first case, the image is obtained from behind (the patient turns his back to the detector) and from the front (the patient turns his face to the film). If necessary, radiography is performed in a lying position on one of the sides. For example, to detect hydrothorax, which moves when changing body positions. For better visualization, the patient will be asked to bend backward. When diagnosing pneumothorax, the picture is taken while exhaling.

Clinical picture

Various factors may indicate pathology. For example, these may be missing or additional elements: clearing or darkening, increasing or decreasing the transparency of the background of the lungs, depleting or enriching the pulmonary pattern, etc. Each additional shadow element has its own characteristics: quantity, configuration, size, displacement, contours, structure, intensity. They are not only clinically important, but also greatly contribute to differential diagnosis. In addition, these features also have practical value in the process of planning surgical intervention, biopsy, and bronchoscopy.

Pathological formations

Among them are:

  • Foci or foci (limited areas of tissue).
  • Pleural effusion (darkening of interlobar fissures and sinuses or parietal darkening of one or another prevalence).
  • Air cavities (zones of clearing against the background of lung tissue).
  • Diffuse changes of various types (cystic, miliary, reticular).
  • Air in the pleural cavity (a thin line is visible, separated from the chest by a clearing zone without a pulmonary pattern).

Finally

In the differential diagnosis of pathologies of the mediastinum and lungs, the analysis of additional signs is of particular importance. These include, in particular, the volume of tissue, the structure and position of the diaphragmatic domes, the airiness of the bronchi, the location and shape of the mediastinal shadows. The assessment of these signs is especially important during medical examinations and examinations of persons employed in hazardous work. Many pathologies are often asymptomatic or detected by chance. In this regard, experts recommend regular chest x-rays. Where to do the research? Today, almost all clinics have a special room where diagnostics are performed. As a rule, the patient receives a referral during an examination with a therapist. You can also make an appointment for a chest x-ray yourself. The specialist performing the procedure will give a full explanation of the results and, if necessary, recommend which doctors to contact next.

Source: http://www.syl.ru/article/171009/new_rentgenografiya-grudnoy-kletki-zaklyuchenie-obzornaya-rentgenografiya-organov-grudnoy-kletki

Chest X-ray: digital and overview

Digital radiography of the chest organs differs from the survey analogue in the way the image is obtained. If during an X-ray examination of the lungs the image is obtained on film, then during a digital examination the image is transferred to a computer screen.

A thin X-ray beam passes linearly through the entire chest, and each point is recorded on the receiver.

During a general radiographic examination of the chest cavity, the tube emits a powerful stream of radiation, which, passing through the thickness of the tissue, illuminates the film. During the study, a high radiation dose is generated on the patient, and additional tissues are irradiated.

In terms of radiation exposure to humans, digital fluorography is preferable to plain chest radiography. In terms of quality and resolution, the second option is preferable.

Modern technologies make it possible to reduce radiation during x-ray diagnostics by focusing a thin beam of x-ray radiation at a certain point and rotating it in a circle or along horizontal lines. In this case, the image receiving unit moves after the tube.

What does a digital chest x-ray show?

A digital or plain chest x-ray shows:

  • gender (along the contours of the shadow of the mammary glands);
  • how strong is the inhalation during exposure: the right dome of the diaphragm is located at the level of the 6th rib with a full inhalation;
  • was there any rotation of the patient during exposure (according to the distance between the clavicles and the spinous processes of the thoracic vertebrae on both sides).

A posteroanterior radiograph of the lungs is performed most often, but an anteroposterior projection is also common (specially marked on the image).

There are no significant differences in quality and structural features between digital and plain radiography of the lungs.

X-ray for chronic obstructive bronchitis

How to Read a Digital Chest X-Ray

Doctors begin reading digital radiography by assessing:

  • soft tissues;
  • osteoarticular system;
  • location of the tracheal shadow;
  • structures of the aortic arch (are there any calcifications);
  • contours of the heart shadow;
  • roots of the lungs: structural or deformed;
  • pulmonary fields. Physiological and pathological clearings and darkenings may be observed in them;
  • bone-diaphragmatic sinuses: are they free?

When is a chest x-ray prescribed?

Plain radiography of the chest organs is prescribed if there is a suspicion of lung diseases: pneumonia, tuberculosis, sarcoidosis, cancer. Digital fluorography is prescribed for preventive screening.

According to the resolution of the Ministry of Health, for the early detection of tuberculosis, every person must undergo preventive fluorography once a year. Its dose is only 0.015 mSv.

With survey radiography in direct projection, a person receives radiation equal to 0.18 mSv. State medical institutions are equipped with special equipment - Pulmoscan or Multiscan X-ray machines, which operate on a digital principle.

If, during fluorography, pathological shadows are detected in the pulmonary fields, doctors prescribe radiography in frontal and lateral projections, which have a higher resolution, thanks to which it will show the radiological syndrome better.

What lungs look like in digital photographs

The pulmonary fields on a digital image appear as dark spots with a linear heaviness formed by the pulmonary pattern and the structural roots of the lungs, made by the shadows of the pulmonary arteries and veins.

Photo of an X-ray of the lungs with an hydatid cyst

The size of the lungs varies not only from the weight and age characteristics of the person, but also from the water component of the pulmonary parenchyma. With age, the elasticity of the lungs decreases, the water in the tissues becomes less, which is reflected on the X-ray image by an increase in pneumotization (the lung fields become darker).

The pulmonary pattern normally does not extend more than 1 cm to the periphery of the chest. It intensifies with stagnant changes, when Kerley lines are traced (septal septa between the alveolar acini).

The costophrenic sinuses have sharp angles. With pleurisy, they flatten and contain fluid levels.

A chest x-ray with pleurisy shows a horizontal level of fluid in the lower half of the pleural cavity. If pleurisy is detected, plain or digital radiography is prescribed to determine the dynamics of the disease. The last study is radiography of the thoracic part of the body in frontal and lateral projections. It will clearly confirm the complete cure of pleurisy or the presence of complications.

We apologize to readers for the pun, because without medical knowledge it is difficult to understand how digital fluorography differs from plain X-ray diagnostics of the lungs. We try to “chew the grain” of each topic, but this does not always work.

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Source: http://x-raydoctor.ru/rentgen/grudnaja-kletka/rentgenografiya-tsifrovaya-obzornaya.html

Chest X-ray

Everyone had to undergo x-rays. This is a mandatory procedure that even the healthiest person should undergo no more than a couple of times a year. Officially employed people undergo X-rays as part of a medical examination, and private entrepreneurs and the unemployed are reminded of the procedure once a year by employees of medical institutions.

What is the difference between chest x-ray and fluorography?

Surely this question immediately arose in your mind. In fact, these two procedures are really the same thing. But only fluorography is considered a more outdated method of diagnosing chest organs. While radiography not only allows you to give a more accurate result, but also irradiates the patient less intensely.

And yet, chest radiography in most modern medical institutions (especially public ones) is not prescribed so often today, and preference is given to outdated fluorography. The latter allows you to get only a general idea of ​​the state of the organs. And only if any suspicious changes are noticeable on the fluorographic image, the patient is prescribed an x-ray. In order not to expose yourself to risk and to be confident in the result of the examination, it is best to immediately contact the medical institution where the X-ray room is equipped.

Plain radiography of the chest organs

The image taken during a survey X-ray clearly shows the heart, respiratory tract, lungs, blood vessels, and lymph nodes. Using this procedure, a large number of diseases can be detected, including even lung cancer.

In most cases, chest radiography is prescribed for the following purposes:

  1. X-rays can help identify the cause of a persistent cough or shortness of breath. Patients with chest pain are also often sent for x-rays.
  2. A chest x-ray will help to dot the i's if there is a suspicion of rib fractures or lung damage.
  3. Some infectious diseases, such as lung cancer, cystic fibrosis and pneumonia, are detected using this procedure.
  4. X-rays clearly demonstrate problems of the cardiovascular system (if any).

Quite often there are cases when X-rays of the chest organs made it possible to identify foreign objects that had somehow entered the body.

How do you prepare for x-rays and interpret the results?

As such, there are no rules for preparing for the X-ray procedure. Only pregnant women and young nursing mothers should not expose themselves to radiation and should not have a chest x-ray. You should not follow any diet before the x-ray. Immediately before the procedure, you will have to remove all jewelry that may fall into the radiation zone. And for the photo to be successful, you will need to hold your breath for a couple of minutes.

Today, digital plain chest radiography is increasingly being performed. Thanks to the use of modern technologies, the picture is clearer and more contrasting.

After the procedure, the doctor must interpret the image. There is no reason to worry when the size and location of all organs are normal, there are no growths on them, and there are no foreign bodies in the chest.

The following factors are considered abnormal in chest radiography:

  • increased size of organs or the presence of infection in them;
  • changes in the size of blood vessels should be alarming;
  • deformation or fracture of the chest bones.

X-rays allow you to determine the presence of wounds, tumors, and swelling. And all these factors are considered pathology.

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Source: http://womanadvice.ru/rentgenografiya-grudnoy-kletki