Chest fluorography

For many years, chest fluorography has been one of the most popular non-invasive methods for examining the condition of the lungs and bronchi. The main advantage of the method is the absence of pain during the procedure. The manipulation itself lasts only a few minutes, where most of the time is directed to the preparatory stage.

The principle of operation of the lung imaging device is based on the use of X-ray radiation for the standard examination option for radiography. Sometimes these two diagnostic methods are not distinguished by patients due to lack of awareness.

With fluorography (outdated synonyms for X-ray fluorography or X-ray photography), photovisualization of a selected part of the body on a fluorescent screen is characteristic due to the penetrating properties of the radioactive impulses sent.

Fluoroscopy results are available the next day using outdated analog equipment. But most clinics are already equipped with modern digital devices.

The radiation exposure of modern equipment to the respiratory organs is an order of magnitude lower, and it is also characterized by high resolution.

Stereotypes and differences from radiography

When undergoing an examination, it is important to pay attention to the direction issued by the attending physician. If it says that it is necessary to undergo fluorography, you do not need to change the prescription yourself, relying on the classical x-ray to better show the condition of the lungs. Such disregard for the advice of a specialist will only lead to unreasonable radiation exposure to the body. In medicine, exposure dose limits (1 mSv/year) are set only for healthy people when conducting preventive studies (for example, when applying for a job). Limits of radiation doses required for diagnostic purposes (in sick people) are not established by law. It is only indicated that the doctor should strive for a minimum level of exposure, but not to the detriment of the quality of diagnosis. In general, a reasonable postulate, but how is it carried out in practice? But in practice in Russia the average “medical” radiation dose is several times higher than in the UK, USA and France. At the same time, in some of our regions, the average “medical” radiation dose exceeded 3 mSv. Fluorography provides less information than radiography. But the World Health Organization does not recommend the use of traditional film fluorography, even in underdeveloped countries. The solution to the problem was the transition to digital fluorography, which, with high information content, reduces the radiation exposure by several times. Here are the approximate doses of radiation (mSv) that a person receives when examining the chest using various methods:

• radiography (in two projections) – 0,25;
• fluorography (in one projection) – 0,6–1,6;
• radiography – 3,0;
• digital fluorography – 0,01–0,06;
• computed tomography – 3,5–5,0.

So, if nothing bothers you, and you are sent for an x-ray for prophylaxis, then it is better to undergo digital fluorography or radiography (“snapshot”) instead of conventional fluorography. You should definitely refuse to conduct fluoroscopy (when the doctor looks at the patient behind the screen): not only does the patient receive a large dose, his picture will not remain, and the conclusion will be solely on the conscience of the doctor who conducted the study.

Classification of fluorography modes

A preventive examination of the lungs should be done once every 1 years, and for certain categories (for example, in people with chronic diseases or those in other risk groups) – once a year or even 2 times a year.

Patients who are already registered in a tuberculosis dispensary are prescribed a study much more often: at the beginning of the course of therapy, the interval between procedures is about three to four months, depending on the intensity of treatment, the characteristics of the development of the disease, and the individual properties of the body.

With the positive dynamics of treatment, the regimen changes. First, control is carried out approximately every six months, while maintenance therapy continues, and after complete recovery and deregistration, the patient needs to be examined on a general basis – annually.

The use of a digital machine provides a fast snapshot when the image is reconstructed using high-tech software. The result is displayed on a computer monitor, which can be:

• put on digital media;
• print on paper.

The results of the examination are stored in a database, which ensures their availability for the patient and the doctor during the entire observation period. When you enter the last name along with the data on the address of residence, the program will display all previously recorded survey results. It remains only to compare the updated and past information in order to trace the dynamics.

Basic indications

The main task pursued by the diagnostic method is to identify diseases of the lungs or bronchi. It is not for nothing that the technique is considered a preventive approach that prevents serious complications for diseases of the respiratory system.

As a rule, a district therapist or pulmonologist gives a referral to the study when a patient comes to them with characteristic symptoms:

• prolonged persistent cough;
• dyspnea;
• pain syndrome in the chest.

If the above signs are detected, the chance of detecting a pulmonary or bronchial deviation increases significantly. Research often reveals:

• inflammatory process even at the initial stage of development;
• pneumothorax;
• neoplasms of a malignant and benign nature;
• damage to the pleura;
• emphysema.

But most often, even with a preventive examination, tuberculosis is detected, therefore, annual mandatory examinations are recommended, which help prevent the disease, which today leads in a high percentage of death.

In addition to standard indications, there are two more categories for examination: these are family members living with pregnant women or newborns in order to minimize the risk of illness in infants and persons of military age.

The second category will include an unscheduled fluorography for suspected:

• foreign body in the lungs;
• inflammation;
• tuberculosis;
• tumors of the mediastinal organs;
• heart disease, large vessels.

Such precautions allow the recognition of comorbidities such as fibrosis or sclerosis. Also, with the help of a small image, it is possible to determine the localization:

• cysts;
• cavern;
• abscesses;
• infiltrates;
• accumulations of gases.

Despite the productivity of the technique, fluorography can hardly be called the main argument for the diagnosis of pulmonary pathologies. Often it is necessary to use auxiliary tests, including sputum analysis, radiography, MRI with contrast.

Pregnancy and other contraindications

Contraindication to manipulation is pregnancy and childhood. It is believed that the minimum threshold is 15 years, since before this time it will be difficult for children to endure increased radiation exposure.

Among the relative contraindications, which are sometimes ignored in case of excess of benefit over possible harm, are:

• claustrophobia;
• dyspnea;
• general severe condition.

But sometimes even pregnancy, which is a contraindication for almost all types of diagnostics, does not become an obstacle to the procedure. It should be done only after prior consultation with your doctor. Control should be carried out by a specialist throughout the manipulation.

An important factor in the success of diagnosis and safety for the fetus is the appointment of an examination after 25 weeks. During this period, he has already formed the main systems.

The reasons for “photographing” the respiratory system of pregnant women and women during the breastfeeding period should be as strong as possible. Preventive X-ray examinations are not carried out for pregnant women and children under 15 years of age.

Decryption Features

Usually, the results are given to the patient in his hands, and he already takes them to the attending physician or at the place of work, or the results are sent to a narrow specialist, if we are talking about an inpatient department of a hospital.

But when the picture gets to the subject, he often tries to figure it out on his own with the designations indicated there, as well as the encrypted conclusion of the diagnostician. If the person is healthy, then in the conclusion it will be noted that the changes are within the age norm. The following conclusions are possible on the basis of the survey, when detected:

• focal shadows;
• root changes;
• root bands;
• fibrosis;
• strengthening of the vascular pattern;
• calcifications;
• layers;
• adhesions;
• aperture change.

About focal shadows, blackouts, the diameter of which is up to 10 mm, testify. With their localization in the middle or lower part, the likelihood of developing pneumonia is high. And if focal shadows are fixed in the upper lobe, this may indicate the onset of tuberculosis.

An important parameter for recognizing a problem is the expansion or compaction of the roots, in which are located:

• pulmonary vein, artery;
• small vessels;
• bronchial arteries;
• bronchus;
• The lymph nodes.

If, upon detection of such a patient, there is no obvious discomfort, then such violations may indicate chronic inflammation of the lung or bronchitis. The fact that the roots are heavy speaks of the same disease. This is often found in the fluorogram of smokers.

When fibrous masses are clearly seen on imaging, this means that the lungs have undergone the following interventions:

• infectious;
• inflammatory;
• surgical.

Moreover, scars are sometimes traced even in images of quite healthy people.

Strengthening of the vascular pattern may indicate the active stage of bronchitis, pneumonia. But sometimes the same symptoms signal problems regarding the functioning of the cardiovascular system, destabilization of blood circulation.

Some patients are most afraid of the news of the discovery of calcifications, this may indicate encapsulated foci of tuberculosis, or pneumonia.

In practice, this means that the bacteria that cause the disease were packaged by the body in a special shell based on calcium salts. Thus, the body has preserved the disease, and with a healthy lifestyle, rational nutrition, the disease may “not wake up” until the end of his life.

The fact that a person has been ill with tuberculosis is also indicated by pleuroapical layers. Outwardly, in the picture, they appear as a thickening. But pleuroapical layers, but already together with adhesions and pain indicate pleurisy.

Quite rarely, there are situations of changes in the diaphragm, which may be the result of not only pleurisy, but also obesity, diseases of the gastrointestinal tract. The reason for the changes can also be hereditary pathologies, or the deformation of previously formed adhesions.

The radiologist will necessarily indicate in the conclusion about the condition of the sinuses, so in this case they designate pleural folds, which are formed in different-sized cavities. In the absence of violations, all sinuses will be free. If adhesions or fluid are found, an additional examination is necessary.

The final point of decoding is the displacement, or expansion of the shadow of the mediastinum. In clinical practice, the mediastinum is called other organs that are localized in the chest cavity:

• aorta;
• small vessels;
• thymus;
• The lymph nodes;
• esophagus;
• heart muscle;
• trachea.

Most often, this indicator is chosen as the basis for the diagnosis of diseases of the cardiovascular system. For example, with hypertension, the heart may be enlarged, which will be displayed as an enlarged shadow of the mediastinum.

Also, a shift in the shadow may indicate a neoplasm, the presence of air in the pulmonary system, or the presence of pleural fluid, which accumulate in certain areas disproportionately. Additional tests may be required for a definitive diagnosis.

For fluorography, no preliminary preparation is required, it is enough to fulfill the requirements of the operator.

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