A chest x-ray bronchitis: how it looks on x-ray?
Bronchitis in medicine is a group of diseases in which a diffuse lesion of the bronchi an inflammatory nature. Bronchitis can be simple or complicated, leaking in several forms – Muco-purulent, obstructive, and mixed. X-ray bronchitis is used quite often, however, his main task is to help in the differential diagnosis between diseases of the bronchi and other lung pathologies.
The pathogenesis of the disease and classical picture
After performing x-ray examination, in the case of simple forms of the disease, in the picture there are no specific signs of bronchitis, you can see only increased pulmonary pattern, predominantly in the lower lung. This is due to the fact that in inflammation the activation of the immune system which throws in the blood of substances called «mediators of inflammation». They increase the permeability of blood vessels and cause the migration of immune cells to the inflammation site.
More information on x-ray may be obtained if there is suspicion of obstructive bronchitis. In such cases, the use of x-rays gives important information for diagnosis of pathology. The picture shows a few symptoms:
- The increase in the connective tissue of the lungs.
- Pulmonary hypertension.
- Increased airiness of the lungs (emphysema).
- Changing the size of the heart.
Strengthening connective tissue component occurs due to the thickening of the walls of the bronchi during inflammation. As a result of this process in the images, especially around the roots of the lungs, the bronchi are visible in the sky, bordered on the outside by a narrow shadow. This figure is similar to the way rails look, the symptom is called «tram rails».
If the bronchus in the picture has a cross section, it looks like a ring-shaped shadow with irregular contours. Also pulmonary pattern may be a mesh in the case of advanced fibrosis. This helps to determine whether the bronchitis on x-ray chronic or acute.
Due to narrowing of the lumen of the bronchi of small caliber develops, the increased airiness of lung tissue. A chest x-ray taken for bronchitis, can detect this, and to differentiate this condition from other diseases, leading to increased transparency of the lungs. In the picture you will notice an increase of the lung fields with flattened diaphragm and low. The mobility of the latter is reduced.
The transparency of light is almost unchanged on the inhale and exhale. The larger branches of the pulmonary vessels expanded, but towards the periphery, their diameter decreases sharply, there is a «jump gauge», and the roots look like cut off.
The sternum may be shifted forward, which combined with an increase pozitivnogo space. Thus there is a decrease in blood flow to the heart, which its dimensions are reduced. It is important to understand how the heart bronchitis, as there are signs of pulmonary hypertension. However, in other diseases that occur with increasing pressure in the pulmonary circulation, will not be observed reducing the size of the heart, which allows us to distinguish between them.
Additional methods of research
A characteristic picture of chronic bronchitis observed in x-rays, is that often enough the overview picture of the chest. Sighting radiography and shooting in different projections are used when it is necessary to exclude such diagnoses as cancer, pulmonary embolism and pneumonia.
In cases where conventional radiation study cannot give a definite answer to the question, apply the methodology with the use of contrast.
The symptoms of bronchitis at bronhografii quite diverse. In connection with inflammation extending to the mouths of the bronchial glands, which enters the contrast. The bronchi themselves are deformed, have irregular contours, sometimes spasmatic. Small branches can be filled with contrast, the penetration of which is impeded by many obstructions. Can also determine the presence of small cavities, the accumulation of mucus in the cavities of the bronchi, which causes a variety of filling defects x-ray contrast agent.
Quite informative method is scintigraphy of the lungs. This radionuclide study, which is carried out with the aim of the study of physiology and pathology. It allows doctors to assess the level of perfusion of blood in the lungs, and the parameters of their ventilation and pulmonary capillary blood flow, receiving both qualitative and quantitative data. They will characterize the flow of gases in the lungs and the excretion of them, as well as the level of gas exchange within the alveoli.
During scintigraphy the patient is intravenously administered isotope-labeled particles, which, once in the bloodstream, followed by the right atrium and thence into the pulmonary circulation. The equipment measure the radiation of gamma-quanta on the basis of which determine the shape and size of the lung in four projections:
- Front video.
- The back is straight.
- The left-hand side.
- The right-hand side.
Next, the computer evaluates the level of accumulation of radioisotopes in different parts of the lungs. It is also possible inhalation scintigraphy, during which the patient inhales a suspension containing the labeled particles. The method of measurement in this case is not fundamentally different.
On the images note the filling defects of the bronchi, impaired distribution of contrast agents that represent areas with compromised blood flow and ventilation – emphysematous Bulla. Lung fields increased. Computed tomography is also able to detect the fate of emphysematous lung tissue and thickened bronchi.
An alternative method
Most data on the condition of the bronchial tree doctors can obtain by fibrobronchoscopy, however, its implementation is not always possible. It should not be administered to critically ill patients, patients with heart disease, bronchial asthma in the acute stage or active infectious processes.