A chest x-ray: preparation, conduct, results


The lungs are one of the most frequent objects x-ray examination. Many dangerous diseases of the respiratory system occur without any symptoms and are difficult to identify at an early stage by regular inspection. A chest x-ray allows us to obtain black-and-white image of the chest through which the specialist has the possibility to see pathological changes, and plan appropriate treatments.

Radiography is widespread due to the high informativeness and low cost method. Research is indispensable in therapy, pulmonology, Phthisiology, Oncology practice in the field of thoracic surgery. A chest x-ray greatly simplifies the identification of pneumonia and pleurisy of different origin, malignant tumors at an early stage of development, metastasis to lungs and bronchi as well as pneumothorax, tuberculosis, systemic diseases (lupus, sarcoidosis and others) and professional changes of the respiratory system (anthracosis, silicosis).

In addition to diagnosis of existing pathologies, x-ray of respiratory organs annually as a preventive measure in the population that fall into the risk group. It includes employees of hazardous industries – miners, masons, workers of the chemical enterprise; people living in adverse environmental conditions and relatives of TB patients.

X-ray examination of the lungs reveals the following pathology:

  • Inflammation of the lungs (pneumonia).
  • Pneumothorax/hydrothorax (accumulation of air/fluid in pleural cavity).
  • Chronic lung disease – silikaty, sarcoidosis, systemic lupus erythematosus.
  • TB.
  • Malignant and benign tumors.

With the help of x-rays possible early detection of serious diseases, which is several times increases the success of treatment and reduces the likelihood of negative consequences.

However, it is important to note that radiography is not 100% correct – in some cases, the images show a false-negative result that is most often associated with an incorrectly selected position of the patient during the scanning or pathological lesion is too small for the size. In such cases to confirm the diagnosis, the doctor may refer the patient for a CT with a higher accuracy than chest x-ray.

Preparation and methodology

Typically, before the procedure x-ray of the lungs, the patient visits a General practitioner or pulmonologist, who forwards it to the survey. Training before the study do not hold. Immediately before the procedure you should remove all metal objects and jewelry from the head and neck, as they can distort the final result.

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The procedure of scanning does not take much time – patient undress to the waist and takes the desired position, which depends on the choice of projection. Most often used front or rear projection. The patient during the procedure, standing face-to-tape (for capturing images in direct projection) or back (rear projection). In some cases, under special conditions, and body position changes. For example, for the diagnosis of pneumothorax pictures do lying on the side.

The timing of the receipt of the results depend on the type of apparatus in which scanning occurred.

Modern devices are equipped with digital recorders, whereby the process of taking pictures takes a few seconds – they just appear on the screen. The machines of the old sample to fade out using the x-ray film, therefore, to display pictures takes some time.

The transcript of study results

The analysis of the received images are organized by qualified specialists, as a person without special education it is difficult to distinguish normal from pathology. There are certain criteria and algorithm description x-ray, which the doctors painted detail status of each anatomical education. Signs by which one can diagnose the pathology, a lot, but there are three the most important enlightenment pulmonary fields or parts, the darkening of the pulmonary field or part and change root and pulmonary pattern.

Enlightenment pulmonary fields is talking about?

Plots of enlightenment in the picture appear as a result of increased airiness of lung tissue. Such changes are often accompanied by pneumothorax (air getting into the pleural cavity), emphysema (reducing the amount of tissue with increased amount of air in this area), low blood flow to the lung (anemia), which often accompanies congenital heart disease.

Darkening of the lung fields

The shaded areas of the lung tissue in the images caused by the compaction of the soft tissues, leading to reduction or complete lack of airiness. Pockets of stronger seals absorb x-rays, whereby a light lung fields appear shadows, or, in the language of radiologists, areas of darkening. These changes on x-rays characteristic of many diseases of bronchopulmonary system, and the extent of injury depends on the level of darkening. A shadow over the entire volume of the lung often accompanies atelectasis and obstruction of the main bronchus.

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Changing root and pulmonary pattern

The change in the pattern of lungs – is also common pathological symptom. Often it is accompanied by disruption of the structure of the roots of the lung. The roots of the lung – anatomical structures, including the main bronchus, pulmonary vein and pulmonary artery.

Signs of pneumonia on x-rays

Acute pneumonia is always accompanied by infiltration of the soft tissues. In the area of inflammation the filling of the alveoli with exudate, therefore reduces the airiness of the lungs, and pathologically modified areas intensively absorb x-rays. X-ray examination is the main method of diagnosis of pneumonia, as it reveals the extent of the inflammatory process, the intensity of the changes in the roots of the lungs, the pleura, and the diaphragm. In addition, radiography helps to timely detect complications and to monitor the effectiveness of treatments.

Chronic bronchitis

Chronic bronchitis – a fairly common pathology, which is expressed in the pronounced inflammatory process in the bronchial tree of various etiologies. Radiological signs of bronchitis are:

  • Changes in the structure of the root of the lung.
  • Root advanced and vague.
  • Pulmonary the drawing is amplified and modified.
  • The bronchial walls are thickened.

Pulmonary tuberculosis

There are several forms of pulmonary tuberculosis:

  • Disseminated tuberculosis – the picture shows numerous small lesions up to 2 mm with clear contours.
  • Focal tuberculosis on radiographs determined one or more foci up to 2 cm Foci are often rounded shape, often several lesions coalesce into one.

  • Infiltrative tuberculosis – in the picture of the lungs revealed focal or widespread blackout with irregular contours. Most often the foci of infiltration are located in the upper lobes of the lungs from affected area often traced the «track» going to the root of the lung.
  • Cavernous tuberculosis – a sign of the disintegration of lung tissue is patchy darkening with a pronounced awakening in the center of the hearth.
  • Caseous pneumonia is one of the most severe forms of the disease. Rentgenograficheski it is defined by a massive blackout one share or more, a homogeneous structure with a gradual transition in inhomogeneous as the collapse of lung tissue.
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X-ray for lung cancer

Radiological signs of lung cancer, and his clinical symptoms, many, and in some cases it is rather difficult to identify. The main change on the x-rays are parts of the blackout, showing the main elements of the pathological process:

  • Primary tumor, with different characteristics depending on the initial localization of the tumors — there are Central and peripheral forms of lung cancer. Depending on the type of tumor growth is divided into nodular, infiltrative and extensive.
  • Intrathoracic metastases.

  • Secondary pathological changes of bronchiectasis, atelectasis, pneumonitis, pleurisy, fibrosis.

Radiological signs of Central cancer do not appear early on, but only after germination in the bronchial tree; in this case violated the patency of the bronchus and in the picture it reflected a picture of atelectasis or emphysema. Peripheral cancer is characterized by the appearance of foci of rounded or irregular oval shapes of different sizes, with a homogeneous structure and clear contours.

A chest x-ray – informative method that allows doctors to detect serious diseases and prevent the development of dangerous complications.