Lung x-ray is a method of general radiological examination, which consists in obtaining radiographs in direct and lateral (right or left) projections. The choice of projection is determined by the task of the study and the localization of the pathological process. Lung x-ray in projections is used to diagnose tumor, inflammatory, systemic diseases, malformations, traumatic injuries of the tracheobronchial tree, pleura, lungs, blood vessels and heart, dynamic monitoring of the course of diseases.
X-ray is used for preventive examination of the lungs and detection of latent processes – inflammatory, infectious, tumor, degenerative-dystrophic, systemic, occupational diseases, anomalies of the bronchopulmonary, vascular and cardiac systems in the absence of clinical symptoms. Lung x-ray can be prescribed for complaints of prolonged cough, shortness of breath, thoracalgia, subfebrility, listening to wheezing, weakening of breathing, pleural friction noise, etc.
The result in most cases allows us to verify a specific nosological form (pneumonia, pleurisy, bronchitis, tuberculosis, mediastinitis, emphysema, atelectasis, aneurysm of large vessels and the heart). When detecting tumors, pleurisy, lymphadenopathy, lung x-ray requires other diagnostic methods (lymph node biopsy, bronchoscopy, pleural puncture, etc.). Lung x-ray is indicated for chest injuries to detect rib fractures, pneumothorax, hemothorax, chylothorax.
Methodology of conducting
Lung x-ray and chest is performed without prior preparation. To interpret the results, it is advisable to present to the radiologist the data of the previous lung examination. A frontal chest X-ray is performed during an overview X-ray. The patient needs to expose his chest, taking off his clothes, underwear, jewelry, and tie a protective apron on his belt. The patient stands in front of a special shield containing an embedded cassette with an X-ray film. The X-ray tube generating X-rays is located behind the patient. While taking the picture, the X-ray technician asks the patient not to move, take a deep breath and not breathe for a few seconds. The need to perform radiography in lateral projections is determined by the radiologist after the appearance of the survey image.
Interpretation of results
With an overview lung x-ray, the shadow of the heart and large vessels, pulmonary fields, ribs are clearly visible. Normally, the pulmonary fields are determined without additional shadows, a moderately pronounced vascular pattern, not enlarged heart size. The presence of large-focal shading may indicate severe lung inflammation, lung atelectasis with bronchial obstruction by a tumor. With small focal shading, pulmonary tuberculosis, sarcoidosis, pneumoconiosis or dissemination of the tumor process should be suspected. Cavities in the lungs can characterize pulmonary tuberculosis, benign and malignant tumors, suppuration, cysts.
With the strengthening of the pulmonary pattern detected on radiographs, there is reason to think about the protracted course of bronchitis, occupational lung diseases. The accumulation of liquid contents in the pleural cavity indicates exudative pleurisy. Increased transparency of the lung tissue characterizes emphysema of the lungs. An increase in the mediastinal shadow is observed in mediastinal tumors, sarcoidosis, thymoma, lymphoma. An enlarged heart shadow may be a sign of cardiomyopathy, heart failure, or heart disease. Based on the identification and combination of radiological features, the radiologist issues a conclusion or an assumption about the presence of the disease.
Radioscopy and lung x-ray in pulmonology are review studies that dictate the need for further detailed examination. Fluoroscopy is necessary to study the morphological picture of the lungs and their functional state (the nature of movements, the position and amplitude of the displacement of the diaphragm, the movement of rib shadows, changes in the contrast of the pulmonary background during breathing, dynamic changes in additional shadow formations, etc.). During lung x-ray, only structural morphological changes are viewed. However, radiography makes it possible to detect more subtle changes in lung tissue, has greater image clarity and the possibility of documenting the pathological process.
Compared with fluorography, lung x-ray assumes a lower effective radiation dose (0.1 mSv versus 0.3 mSv, respectively), has a large image size (30×40 cm), but has large time and cost costs. On the basis of lung x-ray, a decision is made on the expediency of further clarifying diagnostics – tomography, CT of the lungs, MRI of the lungs, bronchography, angiopulmonography, etc.