X-rays of light

Lungs are one of the most common objects of radiation research. The important role of the X-ray in the study of the morphology of the respiratory system and the recognition of pathological processes is evidenced by the fact that the accepted classifications of many diseases, such as pneumonia, tuberculosis, sarcoidosis, pneumoconiosis, malignant tumors, are largely based on radiological data. It is also known that the lesions of the lungs are hidden, using test fluorographic surveys of the population and the radios of the lungs.

With the development of computed tomography, the value of X-ray in the diagnosis lung diseases increased even more. With its help, it is possible to identify the earliest changes in the organs of the chest cavity. An important place in the assessment of the functional pathology of the lungs, in particular, violations of capillary blood flow in them, occupied a radionuclide method.

Indications for X-ray lungs are very wide: an increase in body temperature, cough, sputum, shortness of breath, chest pain, hemoptysis and many other pathological conditions.

Radial study of the function of the lungs

The functional breathing system consists of many links, among which the systems of pulmonary (external) breathing and blood circulation are of particular importance. The efforts of the respiratory muscles are caused by changes in the volume of the chest and lungs that provide their ventilation. Due to this, inhaled air spreads through the bronchial tree, reaching alveoli. Naturally, violations of bronchial patency lead to a disorder of the external respiration mechanism. In the alveoli, gas diffusion occurs through the alveolar-capillary membrane. The process of diffusion is disturbed both with damage to the walls of the alveoli and in case of violation of capillary blood flow in the lungs.

X-ray study of the function of the lungs

Radiation anatomy of the lungs

On a sightseeing radiograph in a direct projection, the upper 5-6 pairs of ribs are loomed throughout the entire length. Each of them can distinguish the body, front and rear ends. The lower ribs are partially or completely hidden behind the shadow of the mediastinum and organs located in the subjacia. The image of the front ends of the ribs breaks off at a distance of 2-5 cm from Fudina, since rib cartilage does not give distinguishable shadow in the pictures. In people over 17-20 years old, deposits of lime in the form of narrow strips along the edge of the rib and islands in the center of the cartilage appear in these cartilage. Of course, they should not be taken for lung tissue seals. The X-ray of the lungs also shows the image of the bones of the shoulder girdle (clavicles and blades), the soft tissues of the football wall, the mammary glands and organs located in the Food cavity (Lungs, the organs of the mediastinal).

Normal X-ray anatomy of the lungs

Radiation syndromes of lung lesions

Radiation diagnosis of damage and lung diseases is very difficult. It is no coincidence that aphorism is even formulated: “Oh, these lungs are not easy!” Hundreds of diseases in different phases of their development create diverse radiological and radionuclide paintings, and their endless variations seem to be sometimes unique. Nevertheless, an experienced doctor, relying on the results of studying the history and clinical picture, knowledge of normal and pathological anatomy, understands with enviable ease in typical situations and comes to the right conclusion. This is because he learned to determine the morphological substrate of X-ray symptoms, using lung x-rays in his practice. Of course, there are many radiological signs of pulmonary pathology, but among them there are three main ones: darkening of the pulmonary field or part, enlightenment of the pulmonary field or part of it, changes in the pulmonary and root pattern.

Darming the pulmonary field or part

Most lung diseases are accompanied by compaction of the pulmonary tissue, i.e. decrease or absence of its airiness. Sealing tissue absorbs x-ray more strongly. Against the background of a light pulmonary field, a shadow appears or, as they say, darkening. The position, size and form of dimming depend, of course, on the volume of damage. There are several standard darkening options. If the pathological process has captured everything lungs, then the entire pulmonary field is darkened on the radiograph to one degree or another. This syndrome is indicated by the term "vast darkening of the pulmonary field." It is not difficult to detect it - it is striking at the first glance at the picture. However, you need to immediately determine its substrate. The darling of the entire pulmonary field is most often caused by the blockage of the main bronchus and atextase of the corresponding lung.

Donation of the pulmonary field or its part

[1], [2], [3]

Enlightenment of the pulmonary field or part

An increase in the transparency of the pulmonary field or its part may be due to either the presence of air in the pleural cavity (pneumothorax), or a decrease in the amount of soft tissues and, accordingly, an increase in the amount of air in the lung or part of it. This condition may be a consequence of the swelling of the lung tissue (emphysema) or reduced inflow into the lung (anemia of the lung), which is observed mainly with some congenital heart defects.

Enlightenment of the pulmonary field or its part

[4], [5], [6], [7], [8]

Changes in the pulmonary and root pattern

Changes in the pulmonary pattern - syndrome, often observed with lung diseases. Often it is combined with a violation of the structure of the root of the lung. This is understandable: after all, the pulmonary drawing is formed primarily by arteries emanating from the root, so many pathological processes affect both the parenchyma of the lung and its root.

Changes in the pulmonary and root drawing

[9], [10]

Radiation symptoms of lung lesions

Lung damage and diaphragm

With an acute closed or open injury to the chest yuchet and lungs, all the victims need radiation research. The issue of the urgency of its implementation and volume is solved on the basis of clinical data. The main task is to exclude 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 value of radiation methods is increased due to the difficulty of clinical examination of patients due to shock, acute respiratory failure, subcutaneous emphysema, hemorrhage, sharp pain, etc.

[11], [12], [13], [14]

Sharp pneumonia

Acute pneumonia is manifested by inflammatory infiltration of pulmonary tissue. In the infiltrate zone, the alveoli is filled with exudate, and therefore the airiness of the lung tissue decreases and it is stronger than normal, absorbs X-ray radiation. In this regard, an X-ray study is the leading method of pneumonium recognition. The X-ray of the lungs allows you to establish the prevalence of the process, reactive changes in the roots of the lungs, the pleura, diaphragm, timely detect complications and control the effectiveness of therapeutic measures.

[15], [16], [17]

Thromboembolism of the lung artery branches

Thromboembolism of the pulmonary artery branches occurs due to embolism of the lower extremities and pelvis (especially often with thrombophlebitis or phlebotrombosis of the iliac segment of the venous system), thrombitized lower or upper hollow veins, hearts (with thrombondocarditis). Clinical diagnosis is far from always reliable. The plain triad of symptoms - shortness of breath, hemoptysis, pain in the side - is noted only in 1/4 of patients, so a radial study has exceptional value.

Chronic bronchitis and pulmonary emphysema

Chronic bronchitis is a group of common diseases in which there is a diffuse inflammatory lesion of the bronchial tree. Distinguish between simple (uncomplicated) and complicated bronchitis. The latter is manifested in three forms: obstructive, mucous-humble and mixed bronchitis.

[18], [19], [20], [21]

Chronic pneumonia and limited non-specific pneumosclerosis

X-ray examination allows you to recognize all forms and stages of the course of chronic pneumonia. The images determine the infiltration of pulmonary tissue. It determines heterogeneous darkening due to a combination of infiltration and sclerosis, coarse fibrous grains, gaps of bronchi, bordered by a strip of peribronchial sclerosis. The process can capture part of the segment, part of the share, a whole share or even everything is easy. In the shadow of the infiltrate, individual cavities containing liquid and gas can be visible. The picture is complemented by fibrous deformation of the root of the light and pleural layering around the affected area of the lung.

[22], [23]

Pneumoconiosis

In the modern development of industrial and agricultural production, the problem of prevention and early recognition of dust lesions of the lungs - pneumoconiosis - acquired exceptional importance.

Lung tuberculosis

All measures to combat tuberculosis are based on the principle of preventing infection and early recognition of the disease. The goals of early detection are testing fluorographic surveys of various contingents of the healthy population, as well as the correct and timely diagnosis of tuberculosis in outpatient clinics, clinics and hospitals of the general-medical network. In accordance with this classification, the following forms of respiratory tuberculosis are distinguished.

Primary lung cancer

Primary lung cancer in the early phases of development, it does not give distinct subjective symptoms and a clear clinical picture. The discrepancy between the clinical manifestations of the disease and anatomical changes is the reason that the patient does not consult a doctor. There should be an obstacle in the path of the disease - a mass examination of the population using fluorography or radiography. Contingents are subject to annual examination, which most often develop lung cancer: smoking men over 45 years old and faces suffering from chronic lung diseases. In all patients in whom the X-ray found changes, it is necessary to exclude cancer first of all.

Diffuse (disseminated) lung lesions

Under diffuse (dissensized) lung lesions, the common changes in both lungs in the form of scattering of foci, an increase in the volume of interstitial tissue or a combination of these conditions are understood.

[24], [25], [26], [27], [28]. [29], [30], [31]

Pleurisy

The pleural cavity of a healthy person contains 3-5 ml of a “lubricant” fluid. This amount is not detected by radiation methods. When the fluid volume increases to 15-20 ml, it can be detected using ultrasound. In this case, the patient should be in the position of lying on the sore side: then the liquid will accumulate in the lowest (outer) section of the pleural cavity, where it is determined.

X-ray symptoms of lung lesions