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X-rays of light
Last reviewed: 23.01.2024
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Lungs are one of the most frequent objects of radiation research. The fact that accepted classifications of many diseases, for example pneumonia, tuberculosis, sarcoidosis, pneumoconiosis, malignant tumors, are largely based on radiographic data on the important role of the radiologist in the study of the morphology of the respiratory organs and the recognition of pathological processes. It is also known that the latent lung lesions are detected using fluorographic tests of the population and lung X-rays.
With the development of computed tomography, the importance of X-rays in the diagnosis of lung diseases has increased even more. With its help, it is possible to identify the earliest changes in the organs of the thoracic cavity. An important place in the evaluation of functional pathology of the lungs, in particular violations of capillary blood flow in them, was taken by the radionuclide method.
Indications for x-rays of the lungs are very wide: fever, cough, sputum, shortness of breath, chest pain, hemoptysis and many other pathological conditions.
Radiation examination of lung function
The functional system of breathing consists of many links, among which the systems of pulmonary (external) respiration and blood circulation are of particular importance. Efforts of respiratory muscles cause changes in the volume of the chest and lungs, which ensure their ventilation. Inhaled air due to this spreads through the bronchial tree, reaching the alveoli. Naturally, violations of bronchial patency lead to a breakdown in the mechanism of external respiration. In the alveoli, diffusion of gases through the alveolar-capillary membrane occurs. The process of diffusion is disturbed both in the defeat of the walls of the alveoli, and in the violation of capillary blood flow in the lungs.
Radiation anatomy of the lungs
On the survey radiograph in a direct projection, almost all along the top 5-6 pairs of ribs appear. Each of them can be distinguished body, front and back ends. The lower ribs are partially or completely hidden behind the mediastinal shadow and organs located in the sub-diaphragmatic space. The image of the anterior ends of the ribs terminates at a distance of 2-5 cm from the fudina, as the costal cartilages do not give a discernible shadow on the pictures. In people older than 17-20 years in these cartilages appear deposits of lime in the form of narrow strips along the edge of the rib and islets in the center of the cartilage. They, of course, should not be taken for compaction of lung tissue. X-ray of the lungs also shows the image of the bones of the shoulder girdle (clavicles and scapula), the soft tissues of the fudal wall, mammary glands and organs located in the food cavity ( lungs, mediastinum organs).
Normal X-ray of the anatomy of the lungs
Radiation syndromes of pulmonary disease
Radiation diagnosis of injuries and lung diseases is very difficult. It is no accident that the aphorism is formulated: "Oh, these lungs are not easy!" Hundreds of diseases in different phases of their development create a variety of X-ray and radionuclide pictures, and their endless variations seem sometimes unrepeatable. Nevertheless, an experienced physician, relying on the results of studying the history and clinical picture, knowledge of normal and pathological anatomy, with an enviable ease understands typical situations and comes to the correct conclusion. This is because he has learned to determine the morphological substrate of radiologic symptoms, using the X-ray of lungs in his practice. Of course, there are many x-ray signs of pulmonary pathology, but among them there are three main ones: darkening of the pulmonary field or its part, enlightening the pulmonary field or its part, changes in the pulmonary and root pattern.
Darkening of the pulmonary field or part of it
Most lung diseases are accompanied by compaction of the lung tissue, i.e. Decrease or absence of its airiness. Sealed cloth absorbs X-rays more strongly. Against the background of a light pulmonary field, a shadow appears or, as is customary, a blackout. The position, size and shape of the darkening depend, naturally, on the amount of damage. There are several types of darkening options. If the pathological process has captured all of the lungs, then on the roentgenogram the entire pulmonary field is darkened to some extent. This syndrome is denoted by the term "extensive darkening of the pulmonary field". It is not difficult to detect it - it catches your eye when you first look at the picture. However, you must immediately determine its substrate. Darkening of the entire pulmonary field is most often caused by occlusion of the main bronchus and atelectasis of the corresponding lung.
Darkening of the pulmonary field or part of it
[1], [2], [3], [4], [5], [6], [7]
Enlightenment of the pulmonary field or its part
The increase in the transparency of the pulmonary field or a part of it can be caused either by the presence of air in the pleural cavity (pneumothorax), or by a decrease in the number of soft tissues and, accordingly, an increase in the amount of air in the lung or its part. This condition can be the result of bloating of the lung tissue (emphysema) or a decreased influx into the lung (anemia of the lung), which is observed mainly in certain congenital heart defects.
Enlightenment of the pulmonary field or its part
[8], [9], [10], [11], [12], [13], [14]
Changes in pulmonary and root patterns
Changes in the lung pattern - a syndrome often observed with lung diseases. Often it is combined with a violation of the structure of the lung root. This is understandable: after all, the pulmonary pattern is formed primarily by the arteries emanating from the root, so many pathological processes affect both the lung parenchyma and its root.
Changes in pulmonary and root patterns
[15], [16], [17], [18], [19], [20], [21], [22], [23]
Radiation symptoms of lung lesions
Damage to the lungs and diaphragm
In acute closed or open trauma of the thorax and lungs, all victims need radiation study. The question of the urgency of its implementation and scope is decided on the basis of clinical data. The main task is to eliminate damage to the internal organs, assess the condition of the ribs, sternum and spine, and also detect possible foreign bodies and establish their localization. The importance of radiation methods is increased due to the difficulty of clinical examination of patients due to shock, acute respiratory failure, subcutaneous emphysema, hemorrhage, severe soreness, etc.
[24], [25], [26], [27], [28], [29]
Acute pneumonia
Acute pneumonia is manifested by inflammatory infiltration of the lung tissue. In the infiltration zone, the alveoli are filled with exudate, so the airiness of the lung tissue decreases and it absorbs X-rays more than normal. In this regard, X-ray examination is the leading method of recognizing pneumonia. X-ray of the lungs allows to establish the prevalence of the process, reactive changes in the roots of the lungs, pleura, diaphragm, timely detect complications and monitor the effectiveness of therapeutic measures.
Thromboembolism of the branches of the pulmonary artery
Thromboembolism of the branches of the pulmonary artery occurs as a result of skidding of the embolus from the veins of the lower limbs and pelvis (especially often with thrombophlebitis or phlebothrombosis of the ileum-femoral segment of the venous system), thrombosed lower or upper vena cava, and the heart (with thromboendocarditis). Clinical diagnosis is not always reliable. The classic triad of symptoms - shortness of breath, hemoptysis, pain in the side - is noted only in 1/4 of patients, therefore, radiation research is of exceptional value.
Chronic bronchitis and emphysema
Chronic bronchitis is a group of common diseases in which there is a diffuse inflammatory lesion of the bronchial tree. There are simple (uncomplicated) and complicated bronchitis. The latter is manifested in three forms: obstructive, mucopurulent and mixed bronchitis.
[35], [36], [37], [38], [39], [40], [41], [42], [43]
Chronic pneumonia and limited nonspecific pneumosclerosis
X-ray examination allows you to recognize all forms and stages of the course of chronic pneumonia. The pictures determine the infiltration of the lung tissue. It causes a non-uniform darkening due to a combination of infiltration and sclerosis, coarse fibrous cords, bronchial lumens bordered by a band of peribronchial sclerosis. The process can capture part of the segment, part of the share, a whole fraction or even the entire lung. In the shadow of the infiltration, separate cavities containing liquid and gas can be seen. The picture is supplemented with fibrotic deformity of the lung root and pleural layers around the affected lung.
Pneumoconiosis
With the modern development of industrial and agricultural production, the problem of prevention and early recognition of pulmonary lung lesions - pneumoconiosis - has acquired exceptional significance.
Pulmonary tuberculosis
The basis of all measures to combat tuberculosis is the principle of preventing infection and early recognition of the disease. The objectives of early detection are testing fluorographic examinations of various contingents of a healthy population, as well as correct and timely diagnosis of tuberculosis in outpatient clinics, polyclinics and hospitals of the general medical network. In accordance with this classification, the following forms of tuberculosis of the respiratory system are distinguished.
Primary lung cancer
Primary lung cancer in the early phases of development does not give distinctive subjective symptoms and a clear clinical picture. The mismatch of clinical manifestations of the disease and anatomical changes is the reason that the patient does not consult a doctor. On the path of the disease there must be a barrier - a mass survey of the population using fluorography or roentgenography. Every year contingents are subject to an annual survey, in which lung cancer most often develops: smokers are over 45 years old and persons suffering from chronic lung diseases. In all patients, in whom X-rays of the lungs have detected changes, it is necessary first and foremost to exclude cancer.
Diffuse (disseminated) lung injury
By diffuse (disseminated) lung lesions, the common changes in both lungs are understood as the scattering of foci, the increase in the volume of interstitial tissue, or a combination of these conditions.
[47], [48], [49], [50], [51], [52], [53], [54], [55], [56], [57]
Pleurisy
In the pleural cavity of a healthy person contains 3-5 ml of a "lubricant" liquid. This amount is not detected by radiotherapy. When the volume of the liquid increases to 15-20 ml, it can be detected by ultrasound. Thus the patient should be in a position lying on a sick side: then the liquid will accumulate in the lowest (outer) part of the pleural cavity, where it is determined.