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Toasts G. I., Medvedsky V. V.
List of questions:
- To acquaint with opportunities of beam diagnostic methods in pulmonology.
- To provide methods of X-ray inspection of a respiratory organs.
- To study a X-ray pattern of a respiratory organs normal.
- To consider a X-ray pattern of the most widespread diseases of a respiratory organs.
Since implementation of a x-ray diagnostic method in medical practice a respiratory organs is a subject of a constant and most mass method of inspection. Despite that. that in medicine there is rather large number of methods of research of bodies of a chest cavity practically not in one case do not do without radiological inspection. For more than 100-year period of development of a radiology se diagnostic opportunities and technical armament considerably increased that belongs also to X-ray pulmonology.
Now the radiological method of studying of a condition of a respiratory organs is not the only thing. Broad application in clinical practice was found by endoscopy, radionuclide diagnosis, a termografiya, an ekhografiya, etc. However among these methods the radiology holds a specific place, differing from them in a wide field of a review, combined with direct visual perception of the found changes. In this plan the reasonable combination of various methods is the most productive way of diagnosis on condition of the most effective use of opportunities of each of them.
Techniques of X-ray inspection of a respiratory organs
At X-ray inspection of a respiratory organs natural conditions of contrast are created. Therefore the main methods of research (roentgenoscopy and a X-ray analysis) are the most widespread and informative methods of research.
The roentgenoscopy gives the chance to conduct examination spatially, polipozitsionno, in the movement. Raying is begun with an ortoskopiya - i.e. inspected is in vertical position. The roentgenoscopy is carried out in a straight line, lateral and slanting provisions of the patient. Trokhoskopiya - inspection of horizontally located patient at the vertical course of a x-ray beam. And at last, a lateroskopiya - inspection of also horizontally located patient with the horizontal course of a x-ray beam.
The X-ray analysis is also main method of inspection of the patient with suspicion on a lung disease. Its advantages in comparison with roentgenoscopy the following: the best detectability of thin anatomical and pathological structures, smaller beam loading, big objectivity and a possibility of a comparative assessment with the previous methods of inspection. The X-ray analysis happens survey and aim, is carried out in standard projections (a straight line and lateral projections) and slanting projections. The X-ray analysis with direct increase in the image, a X-ray analysis in various phases of breath is carried out. Implementation of an aim X-ray analysis is possible.
Recently for the purpose of economy of expensive photographic materials the large picture frame fluorography which is carried out during the patient's raying is used.
The X-ray analysis is summatsionny display of bodies and fabrics through which there passed the x-ray beam. It can create some difficulties in interpretation of the received image. The tomography - a method of layer-by-layer research of bodies and fabrics found broad application in X-ray pulmonology. Receiving well allocated cut of body requires the synchronous movement of two components: a source of radiation and the chart recorder, i.e. x-ray (the cabin and a x-ray film around the object of research interesting us. The tomography allows to define exact localization of object, prevalence of pathological process, to study a condition of a trakhebronkhialny tree, to specify interest in pathological process of intrathoracic lymph nodes. Shortcomings of a method are oho labor input, big beam loading and cost of the inspection. Kind of a tomography is the zonografiya allowing to receive more "thick sections".
The computer x-ray tomography is applied to identification of changes of a chest wall, a mediastinum, a trachea and a pleura, a preoperative assessment of prevalence of pathological process. The method allows to determine, by a conditional scale of Haunsfild, density of each fabric.
Kimografiya and elektrokimografiya are methods of a functional assessment of activity of a respiratory organs. However in connection with emergence of other methods of a functional assessment of activity of a respiratory organs these methods are practically not used.
Electrox-ray analysis - registration of the image of a respiratory organs on a semiconductor selenic plate. Thanks to so-called effect borders between various educations come to light clearly.
Effective method of studying of morphology and function of a bronchial tree is the bronchography. This artificial contrasting of a bronchial tree under local anesthesia or the general anesthesia.
The angiopulmonografiya belongs to methods of research of vessels of lungs. The technique matters in diagnosis of pathology of vessels of a small circle of blood circulation, a tromemboliya of branches of a pulmonary artery, a functional condition of pulmonary fabric. Distinguish the general and selection angiography.
The diagnostic pneumoperitoneum, diagnostic pneumomediastinum, diagnostic pheumothorax is applied to clarification of localization of pathological processes.
Magnetic rezonantsnaya the tomography is used in some cases when the listed above techniques of X-ray inspection and a x-ray computer tomography were insufficient for clarification of nature of pathological process. Features of a technique allow to use it at suspicion on existence of volume processes in a mediastinum and roots of lungs, vascular pathology.
In a type of the fact that ultrasonic waves do not get through the containing air, alveoluses use of ultrasound in diagnosis of diseases of a respiratory organs is limited to detection of pleural exudates.