Black spots in the lungs. Limited dimming syndrome. Does X-ray show lung cancer?

In radiology, the spot is called a shadow. A spot-like shadow less than 1 centimeter in diameter is a focal shadow. A focal shadow is a lesion whose size ranges from 0.1 cm to 1.0 cm. These pathological lesions are characteristic of various nosological forms. By origin, these lesions can be of inflammatory and tumor origin, and are also caused by hemorrhage, edema, and atelectasis. X-ray experience proves that lesions in the lungs occur in inflammatory diseases that pathologically change the structure of the pulmonary parenchyma. In our country, foci are also characteristic of tuberculosis (focal tuberculosis). In practice, it often occurs when there are 2-3 lesions in one lung, then radiologists talk about a group of lesions in the lung. Inexperienced and young specialists mistake the cross-section of a vessel, the shadow of the nipples of the mammary gland, as well as calcium deposits in the cartilage of the ribs as focal shadows.

A focal shadow has the following characteristics:

1) Localization of focal shadow.
2) Prevalence of focal shadow.
3) Contours of focal shadow.
4) Intensity of focal shadow.

U of this patient a lesion is detected in the middle lobe of the right lung with a decay cavity in the center (indicated by an arrow). According to the clinic, the patient was diagnosed with tuberculosis.

White spot on x-ray of lungs/white spot on x-ray of lungs/white spots on lungs/two spots on lungs/lung disease spot on lung

For each disease there is a characteristic localization of the outbreak. Tuberculosis (focal tuberculosis and tuberculoma) is characterized by localization in the apices of the lungs and under the collarbone. With pneumonia, the localization can be any, but for inflammatory diseases lungs are characterized by a group of foci (2-3 foci). For peripheral lung cancer or tumor metastasis characteristic feature X-ray shows a single lesion without signs of calcification.

The contours of the lesion can be sharp or blurred. Blurred contours more often indicate an inflammatory cause of the origin of the lesion. If on the radiograph we encounter a single lesion with sharp contours, which is not located in the apex and subclavian region, then the radiologist suspects peripheral cancer. A single focus with sharp contours located at the apex or under the collarbone suggests tuberculosis (focal tuberculosis or tuberculoma).

The following structure of the focus is distinguished: homogeneous or heterogeneous. If we consider the example of pulmonary tuberculosis, then, using these properties, we can tell the phase of the disease, which is taken into account when choosing chemotherapy. A homogeneous focal shadow is characteristic of tuberculosis in the consolidation phase, and a heterogeneous shadow is characteristic of tuberculoma.

This patient showed changes in lung roots, which corresponds to intrathoracic tuberculosis lymph nodes in a patient with prolonged fever and cough.

Small spot on the lung/small spot on the lung/spots in the lungs on x-ray/

When talking about the intensity of a focal shadow, radiologists often compare the intensity with nearby anatomical structures, e.g. blood vessels lungs.

The following intensity of the focus is distinguished:

1) low-intensity shadow - if the focus is visualized with intensity, like a longitudinal section of a vessel.
2) medium-intensity shadow - if the focus is visualized with intensity, like a vessel in an axial section.
3) dense focus (high-intensity shadow) - if the focus is visualized with an intensity higher than the intensity pulmonary vessel in the axial section.

With a low-intensity shadow on the radiograph, depending on the clinic, it is possible to suspect focal pneumonia or tuberculosis in the infiltration phase (focal tuberculosis). A medium-intensity shadow indicates the attenuation of the tuberculosis process, which is most often observed with adequate treatment.

Also, radiologists separately identify a Ghon lesion or a decayed calcified lesion in the lung, which, together with a calcified lymph node, suggests a primary tuberculosis complex.

Each lesion (spot), if you look closely, is unique, and only an experienced radiologist is able to compare the clinical picture with the picture on the x-ray. To avoid unnecessary diagnostic errors, radiography is done in two projections, and is also performed after a certain time to assess the dynamics of the lesion. Let’s say that if a 70-year-old patient who has been smoking all his life has a single lesion in the lung, then it is more correct to regard this formation as lung cancer.

A 76-year-old patient was diagnosed with a shadow in the right lung. Peripheral lung cancer was initially suspected, but the diagnosis for this patient was hamartoma right lung.

Round spot on the lung/pneumonia of the lungs of the right side spots on the lungs/spots on the lungs causes

The round spot on the radiograph corresponds to radiographic round shadow syndrome. Round shadow syndrome is said to occur when the following shadows are visualized on an x-ray:

1) Single shadows of a round shape.
2) Single shadows of a semicircular shape.
3) Single oval-shaped shadows.
4) Multiple round shadows.
5) Multiple semicircular shadows.
6) Multiple oval-shaped shadows.

Also important criterion to tell when a round shadow is visible on an x-ray - this is the size. The size of a round shadow should be more than 1 centimeter since smaller shadows are focal points.

The round shadow, like the hearth, is caused by different pathological reasons in the lung, for example:

1) Inflammatory process.
2) Tumor process.

Also, a round shadow is visualized when there are cavities in the lung with fluid. There are also reasons not related to lung pathology, but in which a round shadow is visualized - this is pleural pathology. These include pleurisy (inflammation of the pleura), pleural tumor, and cyst.

The patient has a cyst filled with fluid.

Spots on the right lung/spot on the left lung/spot on the lungs during fluorography

In order to guess what disease the round shadow belongs to, the radiologist initially answers the following questions:

1) What shape is the shadow?
2) Is there a relationship with surrounding organs?
3) What are the contours of the shadow?
4) What is the structure of the shadow?

The shape of the round shadow delimits the process into pathological process, which is inside and outside the lung. Intrapulmonary pathology is characterized by a round, but also an oval-shaped shadow. An oval-shaped shadow occurs with lung cysts that are filled with fluid. Also, an oval-shaped shadow is a characteristic picture when the cyst has increased in size to such a size that it comes into contact with the diaphragm, pleura, mediastinum, and chest wall.

The contours of a round shadow allow the radiologist to establish the cause of the pathology, therefore they are important feature when describing.

The contours are:

1) Fuzzy or also called unsharp.
2) Clear or sharp.

Fuzzy contours for inflammatory diseases are mild. Make a specific diagnosis in this case impossible, but the identified sign narrows the differential series. If the contours are clear, one should assume a lung tumor, tuberculoma, or a fluid cystic formation that does not contain air inside.

The patient has a darkening in the right lung, which is characteristic of lobar pneumonia.

Spot on the lung image/x-ray of the lungs white spot/x-ray of the lungs light spot

A rounded shadow in its structure is visualized as homogeneous or heterogeneous. The shadow is uniform in tuberculoma, but against the background of the shadow, calcium must be a prerequisite. If a round formation is encountered with a cavity inside, then the first thing radiologists think about is a tumor with decay or infiltrative tuberculosis in the decay phase. Cancer is more characterized by a rounded shadow with a cavity, in which uneven internal contours and uneven wall thickness. Tuberculoma is characterized by small, crescent-shaped cavities. A cavity with liquid contents is visualized when the cyst is opened (exit of liquid contents) into the bronchus, as well as in case of a lung abscess, which is accompanied by a serious condition of the patient.

When interpreting a radiograph with a rounded shadow, it happens that despite taking into account all the above signs, the radiologist did not come to a conclusion. Then a prerequisite for making a diagnosis is correct assessment lung tissue that is adjacent to the pathological focus. If the lung tissue surrounding the lesion with blurred contours is intact, then this is a sign of fresh inflammation (acute and subacute phase). Fibrosis of the tissue surrounding the lesion indicates a chronic inflammatory process, which is more often characteristic of tuberculosis. For chronic inflammation Tuberculosis is characterized by a path to the pulmonary root, which is visualized as a bronchus draining the cavity with thickened walls.

This patient has left lung cancer.

The anatomical structure of the lungs, their ability to fill with air, freely passing x-ray radiation, allows you to obtain, during fluoroscopy, an image that reflects everything in detail structural elements lungs. However, darkening in the lungs on an X-ray does not always reflect changes in the tissues of the lung itself, since other organs of the chest are located at the level of the lungs and, therefore, the radiation beam, passing through the body, projects on the film a superimposed image of all organs and tissues , falling within its range.

In this regard, if any darkened formation is detected in the image, before answering the question of what it could be, it is necessary to clearly differentiate the localization of the pathological focus (in the tissues of the chest, diaphragm, pleural cavity or, directly, in the lungs).

Main syndromes on radiographs

On an x-ray taken in the anterior projection, the contours of the lungs form pulmonary fields over the entire area, intersected by symmetrical shadows of the ribs. A large shadow between the pulmonary fields is formed by the combined overlap of the projection of the heart and great arteries. Within the contour of the lung fields, one can see the roots of the lungs located at the same level with the anterior ends of the 2nd and 4th ribs and a slight darkening of the area caused by the rich vascular network located in the lung tissue.

All pathological changes reflected on x-rays can be divided into three groups.

Dimming

Appear on the image in cases where a healthy part of the lung is replaced pathological formation or substance, causing the air part to be displaced by denser masses. As a rule, it is observed in the following diseases:

bronchial obstruction (atelectasis);
accumulation of inflammatory fluid (pneumonia);
benign or malignant tissue degeneration (tumor process).

Change in pulmonary pattern

total (complete) or subtotal (almost complete) blackout;
limited dimming;
round (spherical) shadow;
ring shadow;
focal darkening.

Enlightenment

The clearing in the image reflects a decrease in the density and volume of soft tissues. As a rule, a similar phenomenon occurs during the formation of light air cavities (pneumothorax). Due to specific reflection results of radiography on photographic paper, areas that easily transmit radiation are reflected in a darker color due to the more intense effect of x-rays on the silver ions contained in photographic paper, areas of a denser structure have a light color. The wording “darkening” in the image is actually reflected in the form of a light area or focus.

X-ray showing a pulmonary pattern of healthy lungs

Total blackout syndrome

Total darkening of the lung on an x-ray is a complete or partial darkening (at least 2/3 of the lung field). In this case, gaps are possible in the upper or lower part of the lung. Main physiological reasons manifestations of such a syndrome are the absence of air in the lung cavity, an increase in the density of the tissue of the entire surface of the lung, the content of fluid or any pathological content in the pleural cavity.

Diseases that can cause such a syndrome include:

atelectasis;
cirrhosis;
exudative pleurisy;
pneumonia.

To implement differential diagnosis diseases, it is necessary to rely on two main signs. The first sign is to assess the location of the mediastinal organs. It can be regular or offset, usually in the direction opposite to the darkening focus. The main landmark in identifying the displacement axis is the shadow of the heart, located mostly to the left midline the chest, and the smaller one to the right, and the stomach, the most informative part of which is the air bubble, always clearly visible in the photographs.

The second sign that allows you to identify pathological condition is an assessment of shading uniformity. Thus, with uniform darkening, atelectasis can be diagnosed with a high degree of probability, and with heterogeneous darkening, cirrhosis can be diagnosed. Interpretation of the results obtained using the radiographic method is as follows: comprehensive assessment of all visually detected pathological elements in comparison with anatomical features each individual patient.

Limited dimming syndrome

To identify the causes of limited darkening of the pulmonary field, it is necessary to take an image in two directions - in direct projection and lateral. Based on the results of the obtained images, it is important to assess the localization of the darkening focus. If the shadow in all photographs is located inside the pulmonary field and is similar in size to its contours or has a smaller volume, it is logical to assume a lung lesion.

If there is darkening adjacent to the diaphragm or mediastinal organs with a wide base, extrapulmonary pathologies (fluid inclusions in the pleural cavity) can be diagnosed. Another criterion for evaluating limited shades is size. In this case, two possible options should be considered:

The size of the darkening clearly follows the contours of the affected part of the lung, which may indicate an inflammatory process;
Shade size is smaller normal sizes, the affected segment of the lung, which indicates cirrhosis of the lung tissue or bronchial blockage.

Particular attention should be paid to cases in which there is a darkening of normal dimensions, in the structure of which light foci (cavities) can be traced. First of all, in this case, it is necessary to clarify whether the cavity contains liquid. To do this, a series of photographs are taken in different positions of the patient (standing, lying down or bending over) and changes in the level of the estimated upper limit of the liquid contents are assessed. If fluid is present, a lung abscess is diagnosed, and if it is not present, then the likely diagnosis is tuberculosis.

Important! Detection of multiple cavities with limited darkening of the lung characteristic of pneumonia caused by staphylococcus. Such a lesion has an unfavorable prognosis, and often treatment is only possible through surgery.

X-ray shows limited darkening of the lungs in two projections

Round shadow syndrome

I state round shadow syndrome when the spot on the lungs has a round or oval shape in two photographs taken perpendicular to each other, that is, from the front and the side. To decipher the results of radiography when a round shadow is detected, they rely on 4 signs:

form of shading;
localization of darkening relative to nearby organs;
clarity and thickness of its contours;
structure of the internal shadow field.

Since the shadow reflected on the image within the lung field may actually be located outside it, assessing the shape of the darkening can greatly facilitate diagnosis. Thus, a round shape is characteristic of intrapulmonary formations (tumor, cyst, infiltrate filled with inflammatory contents). An oval shadow in most cases is the result of compression round education, the walls of the lung.

The structure of the internal shadow field is also highly informative. If, when analyzing the results, the heterogeneity of the shadow is obvious, for example, lighter foci, then with a high degree of probability, it is possible to diagnose the disintegration of necrotic tissue (with disintegrating cancer or disintegration of tuberculous infiltrate) or the formation of a cavity. Darker areas may indicate partial calcification of tuberculoma.

A clear and dense contour indicates the presence of a fibrous capsule, characteristic of hydatid cyst. Round shadow syndrome includes only those shadows that are more than 1 cm in diameter; shadows with a smaller diameter are considered lesions.

Ring shadow syndrome

A ring-shaped spot on the lung on an x-ray is the easiest syndrome to analyze. As a rule, a ring-shaped shadow appears on an x-ray as a result of the formation of a cavity filled with air. Required condition, in which the detected darkening is referred to as ring-shaped shadow syndrome - this is the preservation of a closed ring when taking pictures in all projections and in various positions of the patient’s body. If in at least one of the series of photographs the ring does not have a closed structure, the shadow can be considered an optical illusion.

If a cavity is detected in the lung, the uniformity and thickness of its walls should be assessed. Thus, with a large and uniform thickness of the contour, one can assume the inflammatory origin of the cavity, for example, a tuberculous cavity. A similar picture is observed with an abscess, when purulent melting of tissue occurs and the contents are removed through the bronchi. However, with an abscess, the remains of pus, most often, continue to be in the cavity and their complete removal enough a rare event, so usually such a cavity is a tuberculous cavity.

The unevenly wide walls of the ring indicate the process of decay of lung cancer. Necrotic processes in tumor tissue can cause the formation of a cavity, but since necrosis develops unevenly, tumor masses remain on the inner walls of the cavity, creating the effect of an “uneven” ring.

Important! The main difficulty in assessing the ring-shaped shadow is determining the localization of the formation, since in most cases a similar syndrome is observed in extrapulmonary processes (deformation of the ribs, gases in the intestines, gases in the pleural cavity).

The image shows a ring-shaped shadow in the lower lobe of the right lung

Focal opacification syndrome

Spots on the lungs larger than 1 mm and smaller than 1 cm are considered lesions. On an x-ray, you can see from 1 to several lesions located at a considerable distance from each other or in a group. If the area of distribution of foci does not exceed 2 intercostal spaces, the lesion (dissemination) is considered limited, and if the foci are distributed over a larger area, it is considered diffuse.

The main criteria for assessing focal darkening are:

area of distribution and location of foci;
shadow contours;
darkening intensity.

When one or more dark spots are located in upper sections lung - a clear sign of tuberculosis. Many foci with limited spread are a sign of focal pneumonia or the result of the disintegration of a tuberculous cavity, located, as a rule, slightly above the detected foci. IN the latter case, a round or ring-shaped shadow may also be observed in the picture.

The reason for the appearance of a single darkening in any part of the lung is, first of all, considered the likelihood of developing cancer or tumor metastasis. This is also evidenced by the clear contours of the shadow. Fuzzy contours indicate the inflammatory origin of the darkening.

To assess the intensity of darkening, they are compared with the image of the vessels visualized in the image. If the severity of the lesion is inferior to the shadow of the vessel, this is a low-intensity darkening characteristic of focal pneumonia or infiltrated tuberculosis. With medium and strong darkening of the focus, when the severity is equal to or darker than the vascular pattern, one can judge the attenuation of the tuberculosis process.

Since extensive dissemination of lesions can indicate more than 100 diseases, to distinguish between causes, the size of the shadows should be assessed. Thus, the smallest foci covering the entire area of the lung may indicate pneumoconiosis, miliary tuberculosis or focal pneumonia.

The image shows small focal shadows

Important! Regardless of what changes are observed on an x-ray of the lungs, when analyzing the results, one should take into account the presence of a normal pulmonary pattern, which is characterized by the presence of shadows of the vascular system.

In the vast majority of cases, a final diagnosis cannot be made on the basis of lung x-rays, since analysis of the resulting image allows us to identify only a syndrome characteristic of a particular disease. If the x-ray showed darkening of any area, then to clarify the diagnosis and assess the dynamics of the development of the disease, it is necessary to carry out a complex laboratory research And additional diagnostics using MSCT, bronchography, biopsy, etc.

If spots are found on the x-ray, do not despair. The presence of darkening or flashing does not always indicate development serious illnesses. Often the cause of stain formation is low quality fluoroscope. And even incorrect position patient during the procedure, also shows spots on the lung image. To find out the exact cause, you need to consult your doctor.

Studying the image

What do the spots mean?

White spotty formations on an x-ray of the lungs may be a consequence of the following diseases:

Inflammation of the lungs.
Bronchitis.
Tuberculosis.

If a patient has had pneumonia or bronchitis in the recent past, and an x-ray shows spots on the lungs, this means that residual effects of the disease are occurring in the body. With proper treatment, the nodules will soon resolve.

Spots on the photo

When diagnosing tuberculosis, light-colored formations will be located in the upper parts of the lungs. With proper treatment, the area of inflammation decreases. During the recovery stage, dark spots in the lungs will appear on x-ray, which indicates tissue scarring.

Dimming

If fluoroscopy shows dark or black spots, this may indicate chronic form the course of pneumonia. As a rule, darkening appears in the acute stage. During the healing process, the darkening disappears.

Black spots on an x-ray of the lungs may indicate development cancer diseases. However, no conclusions can be drawn based on fluoroscopy alone. To confirm or refute the diagnosis, the doctor prescribes a series of tests and additional examinations. If you suspect cancer lungs, a complex analysis is prescribed lung tissue which is carried out in a hospital.

Darkening in the photo

Dark formations on an x-ray of the lungs, provided the patient is feeling relatively normal, can confirm the fact many years of smoking. In children, darkened areas on the image indicate the presence of foreign body in the organ. In this case, surgical intervention is required.

White spots

Unfortunately, a bright spot on an x-ray of the lungs is not always a sign of residual effects of the disease.

Often, white formations in the image indicate the development of such ailments:

Inflammation.
Atelectasis.
Pathological processes in pleurisy.
The development of diseases associated with human professional activity.

If light spots are detected in the image, the doctor must prescribe a number of additional tests. Since any deviations from the norm must be clarified through a comprehensive examination of the patient. Experienced specialist will never make a diagnosis based on one test result. To identify the real reason, a radiologist, can determine repeated fluoroscopy in different projections.

White spots

In the initial stage of tuberculosis, white formations also appear in the image. This process indicates primary tissue damage pathogenic bacteria. An eloquent sign of tuberculosis at the first stage is a characteristic light path from the site of inflammation to the root system.

Pneumonia spots

To understand that the picture showed the presence of pneumonia, the specialist must know what it looks like this pathology. Spotty formations in pneumonia can have different locations and dimensions:

Small with limited margins up to 3 mm.
Segmental – located within the boundaries of a segment.
Subtotal – all fields, with the exception of the upper lobes.
Total formations covering the entire surface of the lungs.

As inflammation develops, white spots with unclear, blurred contours form in the lungs. In this case, the severity of the severity depends on the degree of development of the disease. The more advanced the disease, the more pronounced the spots in the picture.

Light spots

Summing up

If the X-ray image shows spots of black or white, it is necessary to undergo additional examination. It is important to understand that if the radiographer’s work is poor, white and dark formations are only side effect functioning of the device. To establish an accurate diagnosis, a specialist will definitely prescribe a series of examinations and tests. Only after receiving all the results, the doctor has the opportunity to assess the picture of the patient’s condition.

A white spot on an X-ray of the lungs with smooth, clear contours of medium intensity - such a conclusion from a radiologist is common. It reflects infiltrative changes in the lung tissue or “plus shadow” syndrome.

What to do if a white spot is detected on the x-ray

When performing a chest x-ray or fluorography in a patient with tuberculosis, a white spot on the x-ray reflects either an inflammatory lesion of the lung tissue or destructive changes in the parenchyma with the formation of abscesses, tubercles, and caverns. Correctly, this symptom should be called darkening, since it reflects the characteristics of the passage x-rays through objects and their color display on a radiograph.

A white shadow in a photograph is also observed when:

pneumonia;
atelectasis;
exudative pleurisy;
occupational diseases (silicosis, talcosis, asbestosis).

X-rays with white spots of various origins: 124.3 – breast piercing, 124.4 – fraction in soft tissues chest, 124.5 – professional cementosis, 124.6a – contrast during bronchography, 124.6b – pneumonic focus, 124.7 – interlobar pleurisy (arrows indicate artifact)

This syndrome is a sign of many pathological changes in the lungs, but we will consider the most common options.

If spots are detected, additional research is necessary to determine the cause of the pathology. For these purposes, a radiologist may prescribe an X-ray examination in additional projections or perform layer-by-layer computed tomography or magnetic resonance imaging.

What does a spot look like on an x-ray with pneumonia?

In pneumonia, the spot on the x-ray image has a length depending on the size of the lesion in the pulmonary parenchyma:

limited – up to 3 cm in diameter;
segmental – within a segment;
subtotal – the entire field, with the exception of the tops;
total.

Pneumonia is an inflammatory disease that affects the alveolar tissue with accumulation of fluid in the acini. Pathogenesis forms a specific x-ray picture of the disease.

X-ray. Focal pneumonia in the lower lobe on the right

The white spot with pneumonia has fuzzy, blurred contours. Its intensity can be low or high, depending on the characteristics of the exudate (inflammatory fluid in the lumen of the alveoli). A path from the root approaches the site of its localization due to lymphangitis.

Atelectasis of the lung or x-ray semiotics of triangular spots on the image

Lung atelectasis is a disease accompanied by the collapse of a segment, lobe or lung tissue completely against the background of cessation of bronchial ventilation. Radiologically, such changes are called limited darkening, since they do not extend beyond the segment or subsegment and have a triangular shape.

Atelectasis of the middle lobe of the right lung - frontal and lateral radiographs

How to identify atelectasis in an image:

the size of the spot coincides with the size of the changed segment;
triangular darkening in the lungs can be seen in frontal and lateral projections;
during inhalation photographs the size of the spot does not increase;
the narrow end of the triangular shadow is directed towards the root;
Holtzknecht-Jacobson symptoms are observed during fluoroscopy (suction of the mediastinum towards the lesion during exhalation).

The morphological substrate of the pathology is the accumulation of infiltrative fluid in the alveoli, infiltration of lung tissue, and tumor growth in the pulmonary parenchyma.

Spontaneous atelectasis occurs in 1-3% of patients due to a defect in surfactant (the substance that forms the framework of the alveoli).

Schematic representation of the topography of segmental atelectasis

Limited darkening during collapse of the lungs requires knowledge of the segmental structure of the lungs, as it reflects atelectasis of a certain segment. By establishing the topography of the shadow, the doctor can guess which bronchus is affected. The substrate of formation (infiltrate, additional tissue, exudate) is almost impossible to determine on the basis of a radiograph.

What does a white spot mean in a picture of tuberculosis?

In tuberculosis, a focal spot on a chest x-ray indicates the infiltrative stage of the disease, when mycobacteria begin to infect the lung tissue. In this case, the x-ray shows a path to the root from the side of the lesion (due to lymphangitis). Such radiological symptoms are called “primary tuberculosis focus”.

Radiographs at various types tuberculosis

Multiple small disseminated shadows on both sides indicate miliary tuberculosis.

A single large shadow with a cavity inside (clearance) and a fluid level - an abscess formed against the background of destruction of the lung parenchyma - “ring shadow” syndrome.

A spot on an X-ray of the lungs in the projection of the pulmonary fields reflects a pathological process, the causes of which should be established by additional research.

During the annual medical examination, the patient is offered to undergo fluorography to check the condition of the lungs. The procedure is to obtain an image internal organs a person when X-rays pass through the tissues of his body. Thanks to X-rays of the lungs, it is possible to early stages diagnose various diseases in the lung, the symptoms of which have not yet appeared in humans - tuberculosis, lung cancer, atelactase, etc.

What does a classic x-ray of the lungs look like?

Classic X-ray of the lungs

The human lungs look like this in the picture: the right and left lungs on the sides of the spine, the shadow of the heart, the collarbone, the ribs, the dome of the diaphragm. The images obtained are deciphered by specialists who assess the condition of the patient’s lungs according to the following scheme:

how the lungs are located in the chest relative to other organs;
number of pulmonary lobes;
the shape of the paired organ and its size;
pulmonary pattern.

Lung tissue healthy person have a homogeneous and uniform structure. In some cases, dark or light colored spots appear on x-rays. This may indicate the presence serious pathologies, and about physiological processes in the lungs that are not a deviation from the norm. However, having received such an image, the patient anxiously begins to look for information about the meaning of darkening or light circles in the image. What they mean will be explained below.

Reasons for the appearance of spots in the photo

There are many reasons for the appearance of dark spots on the lungs. When a pathological process affects an organ, its structure changes noticeably - areas with compactions appear, which, when exposed to X-rays, absorb rays in more than healthy tissue. This is why dark areas are visible in the pictures. These areas can vary in shape and size:

Focal darkening. Usually detected during inflammation and cancer processes in organ tissues. They look like small spots, up to 10 mm in diameter. Based on their presence, it is impossible to make a correct diagnosis. Needed additional research– CT scan, blood, urine and sputum tests.
Round shading. They are visualized as single round shadows. Usually they are an indicator of the inflammatory process in the lung tissue. This picture is indicative of pneumonia, abscesses, benign formations in this organ, bronchial asthma, and even rib fractures. Less commonly, round single dark spots indicate oncological processes in the lungs.
Segmental darkening. Localized in the shape of a triangle (triangles) on one or both lobes. They can be either single or multiple. Single segmental opacities may indicate a foreign object in the organ or tumors within the bronchi, which can be either benign or malignant. Multiple segments on the images indicate the presence of pneumonia, central cancer lungs, narrowing of the central bronchus, pleurisy, oncology of neighboring organs.
Darkening of fuzzy shape. These dark areas do not have defined contours and cannot be compared with geometric shapes. Most often, the presence of such dark areas of uncertain shape indicates infectious lesions lung – staphylococcal pneumonia, exudative pleurisy.
Lobar darkening. These are clearly defined and clearly visible shadow boundaries in photographs, having curved, convex and other shapes. This type of darkening indicates chronic diseases in the bronchi.

What dark spots look like on an x-ray in various diseases

Spots in the lungs on x-rays may appear due to the following diseases:

Tuberculosis

With this disease, the upper parts of the organ are seriously affected. In the image, this is manifested by the presence of multiple darkened lesions of small size - up to 2 mm in diameter. In this case, foci can merge, forming larger locations.

Pneumonia

In pneumonia, the presence of dark areas is noted in the lower parts of the lung tissue. The symptoms of the disease will be most clearly visible in the photographs at the time of the development of the disease. Visually, this will be manifested by an increase in the root of the lung due to the infiltration process, a change in the pulmonary pattern, shadows with an indistinct, blurry contour and numerous spots of different diameters.

With pneumonia, on an X-ray of the lungs, these spots have unclear contours and a heterogeneous structure.

In addition to pneumonia, the presence of multiple lesions in the lower parts of the pulmonary lobes indicates the consequences of pneumonia or bronchitis. With complete recovery, these marks will disappear.

Lungs' cancer

Lung cancer is a life-threatening condition. Its manifestations can also be noticeable during fluorography or x-rays. It is worth noting that in the presence of formations up to 2 mm in diameter, x-rays will not be able to detect the tumor. It is visualized on photographs when it reaches a diameter of more than 3 mm. For accurate diagnosis, x-rays are performed in two projections at once - lateral and direct.

In the image, if cancer is suspected, the following signs can be detected: a shadow on the periphery of the lung with a vague and bumpy outline, a thin outline of rays around the cancer focus, a large white spot stands out against the background of a strong shadow - this is how the picture of tumor disintegration appears.

However, when diagnosing oncology, you should not rely only on the image. The patient is referred to specialists who take a tissue biopsy and conduct additional studies - MRI, CT of the organ - to make the correct diagnosis.

Pleurisy

Pleurisy is inflammation of the pulmonary lining. In this case, the darkening is not explained by obstruction of air in those zones. In this case, fluid accumulates in the cavities from the folds of the pleura.

In the presence of dry pleurisy, the dome of the diaphragm is raised upward and the lung tissue is opaque. With effusion pleurisy, the angle of the diaphragm is smoothed due to the accumulation of fluid, Bottom part lung is darkened by an oblique border.

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Smoker's lungs

Heavy smokers also show dark spots on fluorograms or x-rays. They are explained by the thickening of the pulmonary pattern and the formation of cavities in the bronchi. The roots of the lungs in smokers are blurred - it is difficult to determine their structural boundaries. The blurring of the contours of the roots is explained by an increase in the pulmonary vessels due to respiratory failure. In addition, the image of a heavy smoker can reveal bronchitis, tuberculosis, and lung tumors.

Presence of a foreign body in the lungs

Dark spots in the lungs can be caused by the presence of foreign object. This can most often be found in children who are careless with small objects. Unfortunately, it is not always possible to detect an object in the bronchi or lungs on an x-ray due to swelling of the organ, so endoscopy is preferable to x-rays.

Listed above are the main reasons for the appearance of dark spots on the lungs on X-rays. It is very important to know that the shadows in the image itself look like the lightest areas, because... these are negatives. And vice versa - enlightenments in this paired organ will be reflected in the negatives as the darkest fragments. It is impossible to understand the symptoms of the disease and make a correct diagnosis based only on photographs. This should be done by a qualified radiologist.

Quite often, in order to carry out the most informative and exact condition respiratory organs, doctors prescribe such a common test as x-rays. This procedure is often indicated in order to clarify the result of previously performed fluorography or based on the general clinical picture of the patient’s condition. For example, with certain lung diseases, the density of some lung tissues becomes increased. In the resulting images, each of which shows the condition of the lungs, similar phenomena are noted in the form of spots and darkening in the lungs on the X-ray.

If a patient is informed of the discovery of spots, the first reaction of most is fear, many think that it is malignancy. Cancer gives some darkening, but is far from the only reason for the appearance of spots. In order to avoid wasting unnecessary nerves, and also to begin to act as quickly as possible when blackouts are detected, it is worth studying their types, as well as becoming familiar with the main reasons for their occurrence.

Causes of spots on the received images

The main reasons for the appearance of spots or darkening in an X-ray photo may be following reasons dark spots in the lungs:

If such darkening is detected, doctors usually prescribe additional forms of examination. This is based precisely on a large number of reasons that can lead to their formation. Competent treatment is prescribed only after the nature of the formations and the causes of darkening in the lungs have been fully established. Taken into account usual symptoms and health status.

When diagnosed with pneumonia, an x-ray is the only option to identify a serious illness.

What spots might there be in the picture?

In the process of conducting an additional medical examination and carefully studying the resulting images, the specialist evaluates the darkening according to the following parameters:

The location of the spot is the upper, lower or middle part of the lung. It can also be the outer, inner and middle lobe of this organ. This way you can get a clear picture of the disease;
The size makes it possible to determine the total area of pathology;
Level of expression. Based on this feature, the degree of density of the lesion present can be determined. The severity can be moderate, weak and intense;
General outline. Pay attention to whether the stain has smooth or uneven edges. Often on this basis it is possible to determine the nature of education.

In addition to the differences listed above, spots in the image can be classified according to other criteria. Doctors must take them into account in order to establish a more accurate diagnosis.

Spots and dark spots that occur in the lungs and trachea can be characterized by their location, but also by appearance and general form. The distribution is as follows:

Share. The spot has a clear outline and can be particularly concave or significantly convex. Darkening can develop against the background of inflammation, cirrhosis or destruction. If a spot of this type is located in the middle or lower part of the lung, the doctor may suspect a malignant formation.
Focal. These are relatively small centimeter-sized formations that can prove the presence of inflammation, the development of pathology of veins and blood vessels, as well as the development of peripheral cancer, dangerous tuberculosis, and sudden onset pulmonary infarction. If such lesions were found against the background of headache, cough and pain, bronchial pneumonia can be judged.
Indefinite in form. These are special spots that do not have a bright expression or outline. To give the patient the most accurate diagnosis, more modern types of examination, such as CT or MRI, are prescribed. Such white spots often indicate pathologies such as pleurisy, pneumonia, hemorrhage, as well as various types of tumors. The diagnosis is clarified not only with the help of CT, but also by laboratory tests.
Liquid. This is direct evidence of pulmonary edema. The fluid collected in the lungs may be due to increased pressure in numerous vessels and the degree of permeability of their alveolar wall. In this case, the liquid immediately enters the lung tissue, disrupting their functionality.
Segmental. We are talking about darkening in the form of a triangle. This is evidence of pathologies such as a cancerous tumor, various benign formations, pneumonia, the presence of metastases coming from other organs, tuberculosis and fluid accumulation. The doctor’s competence is very important here, since the earlier measures are taken, the greater the chance the patient will have if a fatal pathology is detected.
Focus. As a rule, these are single spots, the size of which is on average 1 cm. Such lesions occur against the background of pneumonia, with increased fluid content in the organs, breathing, tuberculosis, and they can also be cysts and purulent abscesses.

Staging accurate diagnosis based on the appearance and location of the spots alone, it is impossible. It is for this reason that additional high-quality examination is required.

If darkening is visible in the image, you should immediately consult a doctor who can identify or exclude the presence of a dangerous disease.

Decoding of received images

A few minutes after the fluorography office, a person receives a picture and its detailed transcript. The comments to the image may contain the following information in the form: medical terms, each of which characterizes certain health problems:

Enlargement of the roots of the right or left lung, which may indicate bronchitis or pneumonia; Heavy roots are special pathological changes that occur due to smoking or acute bronchitis;
The presence of an in-depth pattern of the vessels of the right or left lung indicates a violation of blood circulation in the respiratory organs, various problems with blood vessels and the heart, bronchitis, as well as inflammation in the lungs, which may be the initial stage of the oncological process;
Fibrosis and fibrous tissue are a consequence of previously suffered surgical interventions, injuries;
Focal shadows, which are specific shadows. If such shadows are accompanied by an increase in the general vascular pattern, the doctor can judge pneumonia;
Calcifications of the right or left lung - means that the person had contact with a patient with tuberculosis. At the same time, the healthy body of an uninfected person encloses the rod in a calcium shell. It is the power of immunity that prevents the spread of infection;
Changes in the diaphragm - all this can be the consequences of problems such as obesity, pleurisy, diseases of the gastrointestinal tract.

Spots and shadows found in the image can be evidence of several dozen of the most various diseases, it is for this reason that after the x-ray it is necessary to continue qualitative medical examination right or left lung.

Follow-up examination

To conduct further examination, the doctor may send the patient to a pulmonologist or oncologist, where he will be shown to undergo certain specific procedures. Here are the most common ones:

This may be a diaskintest, which can determine the presence of tuberculosis. If we compare this procedure with Mantoux, which quite often gives a false and inaccurate result, such an examination does not respond to BCG, which often shows in a child complete absence Problems. This is an ideal opportunity to diagnose tuberculosis as accurately as possible.
The study of sputum of children and adults is another mandatory analysis that is carried out in the laboratory. Based on the results obtained, it is possible to detect tubercle bacilli, the presence of malignant cells, as well as various impurities that may be characteristic of certain pathological conditions.
Quite often doctors prescribe more modern method examinations - computed tomography of the lungs. This is an additional, informative method for diagnosing diseases of the lung tissue, pleura and mediastinum. It turned out that this is the most reliable method.
Lung bronchoscopy or tracheobronchoscopy may also be used. Performed this procedure through medical endoscopes that are quite flexible in design and are inserted through the nose. Through this form of examination, you can see the lungs and also take material, completely painlessly. Collected material, as a rule, are subjected to subsequent diagnostics - bacterial, histological and cytological.

If a doctor suspects lung cancer based on an x-ray, a tumor marker test may be prescribed. The analysis makes it possible to detect specific proteins that are usually produced by emerging malignant tumors.

Summing up

If darkening or light spots, do not panic when you see the picture. The optimal solution in this case, there will be strict adherence to the doctor’s recommendations. The specialist will conduct a more detailed additional examination to clarify the diagnosis. This is the only way to develop the maximum quality treatment, take timely measures and thereby prevent quite serious complications.

The structure of the lungs, as well as the air inside them, allows the use of X-rays for medical diagnosis. A fairly common problem is darkening of the lungs on x-rays. However, there is no need to panic right away. This may indicate problems not with the lungs, but, for example, with some other organs that are located directly next to them. This is because the images are simply superimposed on each other. That is why, when a similar phenomenon is detected on an x-ray, it is necessary to delve deeper into the understanding of what darkening in the lungs means. It is thanks to this that you can choose the right therapy and get rid of the source of inflammation.

X-ray

On an x-ray, if taken from the front, you can see the outline of the lungs. They form special fields that are intersected by edges. There is a close-up view of the heart and arteries superimposed on each other. In addition, you can notice a slight darkening in the lungs in the image, which is located near the 2nd and 4th ribs. It speaks of a rich vascular network. Next, let's look at the abnormal changes that can be seen on x-rays.

Dimming

Darkening appears in the image in cases where a healthy place in the lungs is affected. This is due to the fact that due to pathological changes, air is displaced. This is observed with blockage of the bronchi, accumulation of fluid, that is, pneumonia, as well as with tumors.

Problems with pulmonary pattern

Similar problems are the most common. They occur when various types diseases. It should be noted that several groups are included in such violations. There are dark spots in the lungs focal type, shadow of a round shape, total or subtotal, limited.

Enlightenment

Clearing indicates the presence of any problems associated with a decrease in the volume and density of lung tissue. This is associated with the development of a disease such as pneumothorax. It is characterized by the fact that an air cavity has appeared in the lung. On an x-ray, areas that are easily visible will have a darker color, otherwise there will be a light color. It should be noted that when we're talking about about darkening in the lungs on an x-ray, then in fact it is talking about a light area in the image.

Total blackout

If we talk about what darkening in the lungs means, it is necessary to consider the main problems. One of these is the total type of shadow. It represents partial or complete coverage of the lung. Gaps may be observed either in the lower or in the upper part of the organ. The reason for this is the lack of air, an increase in tissue density, and the presence of liquid.

A similar phenomenon can cause cirrhosis, pleurisy and some other diseases. This also includes pneumonia.

Darkening in the lungs is diagnosed quite easily. First, it is necessary to assess the location of the organs, because sometimes some displacement may be observed. The reference point is the shadow of the heart. The second feature is an assessment of the uniformity of shading. If it is homogeneous, then most likely there is a problem with the occurrence of atelectasis, heterogeneous - cirrhosis. After receiving the image, the interpretation of the result always depends entirely on the condition of the person and directly on the characteristics of his body.

Limited dimming

Next, we will consider the causes of darkening in the lungs of a limited type. In order to understand what factors led to this, it is necessary to take an x-ray in two directions. Be sure to scan the front and sides. After the images are taken, it is important to pay attention to where the darkening is located. If it is located inside the pulmonary field, then most likely we are talking about diseases associated with the lungs. If the darkening is slightly adjacent to the diaphragm, then other diseases that are in no way related to this organ can be diagnosed.

Another important criterion for diagnosis is size. The darkening can follow the contours of the lung, which indicates inflammation. If we are talking about cirrhosis or blockage, then its size will be less than normal. Sometimes in the latter case there are small gaps. They may appear due to the presence of fluid. That is why it is necessary to take a series of photographs in different poses to understand how serious the condition is. If fluid is present, then the person most likely develops an abscess; if not, then tuberculosis. However, these diagnoses are imprecise. For each patient they will be set depending on the characteristics of his body and complaints.

Round shadow

Round-shaped dark spots in the lungs are diagnosed in cases where the shadow has an oval shape. In order to decipher the results, it is necessary to rely on several factors at once. It's about clarity, thickness, location, shape and structure. Sometimes the shadow may not apply to pulmonary field, therefore, by estimating the shape one can obtain a large number of diagnostic information. Most often, the round shape occurs with various intrapulmonary formations. It could be a cyst, tumor, and so on. If a person has heterogeneity, it means that we are talking about cancer or tuberculosis. Clear and flat contours are characteristic of the cyst. Round blackouts include only those that have a diameter of at least 1 centimeter. In other cases they are called foci.

Ring shadow

Ring-shaped darkening in the lungs is the simplest when it comes to diagnosis. This happens because a person develops a cavity in the lungs that contains air. A ring-shaped shadow is such only if the shape of a closed ring is preserved in any projection. If there is no closed ring in one of the pictures, then the darkening is an optical illusion.

When such a cavity is discovered in the lung, it is necessary to examine it in detail. Special attention You need to pay attention to uniformity and thickness. Tuberculosis can be suspected if the image shows a large and uniform thickness of the walls. With an abscess, a similar picture is observed. However, the latter disease is confirmed quite rarely. This is due to the fact that pus is removed through the bronchi on its own quite rarely, so it cannot cause darkening of a similar shape in the picture.

If the ring has wide walls, then the person has lung cancer. Tumor formations can cause similar effects on images. However, due to the fact that necrosis is uneven, the ring may not be perfectly even.

It is also important to pay attention to the location of this ring. The fact is that it often speaks of various diseases, have nothing to do with the lungs.

Patchy darkening

It is necessary to consider what focal opacities are. Foci are considered to be spots that are larger than 1 mm and smaller than 1 cm. Sometimes in the picture you can see several similar formations at once, which are either next to each other or chaotically. If the distribution of foci does not exceed 2 spaces between the ribs, then such focal inflammation is limited, otherwise it is diffuse. In order to carry out accurate diagnosis, it is necessary to consider the contours, intensity and area over which the lesions are distributed. If there are similar symptoms, then most likely the person develops tuberculosis. With pneumonia, the image will show a huge number of lesions. A round or ring-shaped shadow may also appear.

If we are talking about a single darkening, then the doctor may assume that these are metastases from a tumor or cancer. If the contours are as clear as possible, then this confirms the diagnosis. Fuzzy outlines indicate the development of inflammation. In order to assess the intensity of the darkening, it is necessary to compare it with the vessels that are visible in the image. If the severity of the darkening is less, then we are talking about focal type pneumonia.

The results of fluorography can reveal not only the onset of tuberculosis, but also many inflammatory diseases and processes affecting the lungs, bronchi and nearby tissues.

Be examined at for preventive purposes preferably once a year. If there is a history of respiratory disease or there is a threat to the respiratory system due to professional activity, can appoint additional examinations– it is not dangerous to health.

Types of dark spots in the lungs

What is it - darkening in the lungs on fluorography, and how can they be classified?

Depending on the lesion, darkening of the following nature can be seen in the image:

focal;
segmental;
shared;
focal;
indicating the presence of liquid;
indefinite shape with blurred contours.

All changes in the lung tissue are reflected in the image and change the clinical picture.

The causes of darkening in the lungs can be:

pulmonary tuberculosis in various stages and forms;
oncological processes;
collapse of the lung - the formation of an impassable area for air;
purulent-inflammatory processes - abscesses;
problems with the pleura - the membrane that separates the respiratory system from the rest of the organs located in the chest;
accumulation of fluid in the pleural area.

Dark spots in the image also appear when there are problems in the organs, which also fall into the focus of the X-ray machine. This happens when the lymph nodes become enlarged due to inflammatory processes in any parts of the body, neoplasms on the spine or ribs in the chest, with problems with the esophagus - for example, with its pathological expansion.

If during fluorography a darkening is revealed in the image, this does not mean that they will immediately “lock you up” in a tuberculosis dispensary and begin to “force” feed you tuberculosis pills. As you can already see, a dark area in the image does not always indicate problems with the respiratory system.

First, a detailed X-ray examination will be prescribed, during which the chest will be photographed in several projections. It is very important that the image is then read by an experienced radiologist to avoid errors that could seriously affect the patient's health.

If there is darkening in the lungs, the diagnosis is made based on detailed X-ray data.

Reasons for blackouts

Focal opacities appear in the lungs as small nodules - up to 10 mm in diameter. Cause their appearance vascular disorders, initial stages oncological processes and diseases respiratory organs. In order to accurately identify the cause, in addition to x-rays, it is necessary to do a computed tomography scan and undergo general tests, which, in addition to the “duty” tests - urine and blood, also include sputum.

Collecting sputum for examination is a common procedure for pulmonary diseases.

Despite the patient's complaints of cough and chest pain, a blood test may not show any changes. This clinical picture is typical for focal tuberculosis, so routine examinations will continue to accurately establish the diagnosis.

Focal shadows also appear in the image during myocardial infarction or lung cancer. Symptoms of a heart attack may resemble in many ways acute development tuberculosis.

Additional symptoms: chest pain, displaced in left side and radiating to the side and back, hemoptysis. With myocardial infarction, thrombophlebitis of the lower extremities develops.

Lung cancer is detected through blood tests.

Segmental shadows are visible on the image as segments with clear contours - in most cases they have a triangular shape. If the segment is single, this may be a consequence of: traumatic damage to the lung tissue, the presence of an endobronchial tumor of various etiologies, the presence of a foreign body - children often inhale small parts of toys.

If there are several segments, then the patient may be diagnosed with:

pneumonia varying degrees severity in acute or chronic form;
tuberculosis;
narrowing of the central bronchial branch due to stenosis;
the presence of metastases in surrounding organs;
accumulation of fluid in the pleural area.

The lobar darkening has clear contours that are clearly visible in the image. This picture indicates the presence of chronic pulmonary diseases– purulent tissue lesions, bronchiectasis or others. If bronchial obstruction is visible on the image, the presence of a malignant process can be suspected.

Focal opacities appear with the following problems in the lungs and surrounding tissues:

pneumonia;
accumulation of fluid in the pleural tissue - effusion;
the occurrence of eosinophilic infiltrate – helminthic infestation;
bronchial asthma;
abscess.

Cause focal shadows in the tumor image various etiologies, bone calluses that have grown on the ribs after fractures.

Causing increasing swelling of the organ, accumulates when intravascular pressure increases during ischemia or general intoxication body.

Pathologies expressed by darkening of an indeterminate shape can be signs of many diseases:

inflammatory processes caused by staphylococcal infection;
accumulation of pleural fluid;
heart attack;
exudative pleurisy.

Therefore, you should not diagnose yourself if, when you receive a form from the fluorography office, there will be an inscription on it indicating the presence of changes. Next, a detailed photograph will be taken and only then, according to the specialist’s description, a decision will be made on further diagnostic activities to determine how to treat the disease that has arisen.

Photo transcript

Conclusions from a radiologist with a suspected diagnosis may look like this:

The roots are compacted and expanded - possible: bronchitis, pneumonia, bronchial asthma.
The presence of stringy roots in the image is characteristic of exacerbations of chronic bronchitis and may indicate smoking abuse.
Increased vascular pattern may be a symptom of: problems of cardio-vascular system, inflammation, bronchitis, cancer in the initial stage.
The presence of fibrous tissue indicates a history of respiratory disease.
If the radiologist’s report says: focal shadows, this is a signal for the doctor: to prescribe additional examinations. Such symptoms indicate the presence of pneumonia in the upper or middle sections or tuberculosis.
If there are clear spots on the image caused by the presence of calcifications, the patient does not require treatment. The subject came into contact with patients with tuberculosis or bacterial pneumonia, but his body defeated the disease on its own. The infection was isolated by calcium salt deposits.

Pictures can also be described as follows.

There are aperture changes. Such anomalies develop for genetic reasons, due to adhesive processes in the chest, chronic diseases of the digestive organs - liver, esophagus, stomach, intestines.