How many times a year can an adult have an x-ray? Possible risks: how many times a year can a child be x-rayed. X-ray of joints

The lungs are a very important human organ, providing the body with oxygen, filtering microthrombi, regulating blood coagulation, responsible for breathing, removing harmful toxins and carcinogens, and for the optimal level of acid-base balance in the blood.

And with any pathological processes, damage, malfunctions in their work, there is a high probability of extremely serious consequences, even lethal.

That is why it is very important to monitor their condition and periodically undergo medical examination. X-ray of the lungs will allow timely detection existing problems, begin the necessary treatment.

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Chest X-ray

Using an X-ray, the lung is examined specifically (in whole, in parts) or the condition of all organs is assessed chest:

• its soft tissues and bones;
• anatomical structures: lungs, heart, pleura, bronchi, trachea, mediastinum, ribs, spine, lymph nodes, vessels, respiratory tract (chest x-ray).

Chest X-ray makes it possible to detect and exclude the development and complications of a number of diseases at the initial stage. Among them:

• cardiovascular;
• lymphatic system;
• pulmonary;
• inflammatory diseases of the pleura.

It helps to identify traumatic injuries lung and costal joints, rib fractures, see foreign bodies in tissues, gastrointestinal tract organs, respiratory tracts, etc.

What does a lung x-ray show?

Up to 90% of cases of all serious pulmonary diseases can be detected by chest x-ray. What this diagnostic method shows:

• Besnier-Beck-Shaiman disease (sarcoidosis);
• emphysema;
• inflammation of the pleura ();
• pneumonia ();
• neoplasms, including malignant tumors;
• (former name - consumption, phthisis);
• pulmonary edema.

It also makes it possible to assess the volume of the lungs, the location of their roots, identify the presence of cavities in the lungs, fluid in pleural cavity, thickening of the diaphragm, determine the level of airiness of the bronchi, etc. This greatly facilitates and speeds up making the correct diagnosis and prescribing the necessary treatment, as a result of which the patient has a greater chance of a positive outcome of the disease and recovery.

Why do they do it in two projections?

Today, X-ray examination is not a screening method, that is, a referral to it is given if there are indications for it or if further examination is necessary after an ambiguous interpretation of the fluorographic image.

When do you need an x-ray of the lungs in two projections, which shows this type research? Indications for this procedure are:

1. Assumption of the presence of tuberculosis. With X-ray in direct projection, it is not always possible to trace the infiltrative darkening of the upper pulmonary lobe. Lateral x-rays provide this opportunity. It also shows better the paths to the roots of the lungs, indicating tuberculosis of the respiratory system.
2. Diagnosis of pneumonia when direct x-ray or clinical findings indicate the possibility of this disease. The lung consists of segments, inflammation affects 1 or more of them. The most accurate way to determine the extent of the lesion and the segments of the lungs affected by inflammation is an x-ray in the lateral projection.
3. Diagnosis of heart diseases. A radiograph in 2 projections allows you to determine its size, control its location in it or in pulmonary artery catheter, assess the condition of the electrodes in the installed pacemaker.
4. Central and peripheral. Double radiography more thoroughly detects the presence of malignant neoplasms (cancerous tumors).
5. Pathological conditions of the pleura. X-rays in frontal and lateral projections are indicated for suspected pleurisy, accumulation of air in the pleural cavity ().
6. Radical edema at the pulmonary roots, enlargement of areas of the bronchi (bronchiectasis), small foci of infiltration, abscesses, cysts. It happens that on an X-ray in a frontal projection they are not very visible, in contrast to lateral photographs, when they are not hidden by the sternum.

How to do an x-ray of the lungs in a direct projection:

1. The subject stands between the X-ray tube and the detector (film): in the anterior projection - facing the detector, in the rear - facing the X-ray tube. In this case, the distance from the chest to the tube is about 2 m.
2. The chin is placed on the holder so that cervical region was in an upright position.
3. You must hold your breath while shooting.
4. Before the procedure, you need to remove jewelry, remove metal objects, and undress to the waist.

In order to take a picture in a lateral projection, the patient stands up, pressing the examined side against the cassette. Keeps arms raised up or crossed above the head (at the crown of the head).

What do healthy lungs look like?

X-rays of the lungs of a healthy person and those with lung diseases make it possible to examine:

• pulmonary fields on both sides of the spine, with linear shadows of the ribs projected onto them;
• V central region images - sternum and shadow shading from the heart;
• above - collarbone;
• in the lower part of the image, under the pulmonary fields, there is the dome of the diaphragm.

What do healthy lungs look like on an X-ray? They have a bag-like shape, resembling a semi-cone with a rounded, widened apex. The lung fields are symmetrical on both sides, equally intense, without infiltrative or focal shadows, without enhancing the pulmonary pattern. Their peripheral parts are transparent (this gives a dark, black color on the pictures); the vascular pattern should not be visible in them.

The number of pulmonary lobes corresponds to the norm - 5 (3 lobes in the right and 2 in the left lungs). Roots healthy lungs clearly structured, have standard sizes, and have no extensions. A healthy organ does not delay X-rays, looks uniform in the picture, there are no spots on it. In the central part, near the roots, a network of blood vessels and bronchi is visible.

The cardiac shadow should normally protrude no more than 1 cm on the right side, and should not extend beyond the midclavicular line, which runs vertically down from the center of the clavicle, on the left side. The trachea is located in the center. There are clearings under the domes of the diaphragm, the intercostal spaces are uniform.

Transcript: what does the darkening in the picture mean?

The existing clearing (they are also darkening in the lungs on an x-ray, since the picture is a negative), their shape, shade, intensity of the lines allow the radiologist to make an accurate conclusion about the condition of the lungs, draw up short description radiographs.

The transcript must indicate in which projection the x-ray was performed. Various darkenings indicate the following diseases:

1. Pneumonia. Both on the frontal and lateral projections, pronounced high-intensity shadows, large and small focal darkening are noticeable. Reduced transparency of the lung fields.
2. Tuberculosis. There are many small darkened foci, an intense pulmonary line, and an increased pulmonary pattern.
3. Exudative pleurisy. Due to the accumulation of fluid in the costophrenic sinus, a thin darkened strip appears on the image on the lower edge of the costal arch. The trachea is displaced or pulled forward.
4. Pulmonary edema. Uneven shadows in the form of flakes.
5. Venous stagnation pulmonary circulation (pulmonary circle). Extension of the roots, giving them a shape similar to the wings of a butterfly.
6. Malignant neoplasms (lung cancer). The X-ray shows rounded shadows different sizes having clear boundaries.
7. Emphysema. The image shows consolidation of the diaphragm and increased airiness in the lung fields.
8. Peritonitis. Interpretation of an x-ray of the lungs indicates the accumulation of gases in the area abdominal cavity in the absence of a cleared area under the domes of the diaphragm.
9. Atelectasis (collapse of the lung lobe). X-ray in the lateral projection shows darkening of the posterior mediastinum.
10. Heart diseases. The enlargement of the ventricle and atria is indicated by the rounded border of the shadow of the heart: the left - on the right, the right - on the left. In addition, the enlarged right ventricle gives rise to shadowing on the left side on the X-ray in the posterior-anterior direct projection.

It is very important to begin interpreting an x-ray by assessing the quality of the image, because incorrect projection and patient’s posture will result in inaccurate images. A correct radiograph shows 2–3 thoracic vertebrae, the spinous processes of the vertebrae are located at an equal distance between the clavicles. The right dome of the diaphragm is higher than the left, projected in the area of ​​the 6th rib.

How many times can an adult take?

X-rays can detect a number of lung diseases at the very first stage, which significantly increases the patient’s chances of recovery.

But is an x-ray of the lungs harmless, how often can it be done for an adult? this procedure without harming the body? Sanitary rules and regulations establish the permissible safe proportion of preventive ionizing radiation equal to 1 mSv per year. It is unacceptable to exceed a dose of 5 mSv in a year.

For information: when performing radiography on film X-ray machines of older modifications in 1 procedure human body acquires a radiation dose of approximately 0.3 mSv, with modern digital equipment - about 0.03 mSv.

The decision on how often to take an X-ray of the lungs is determined by a number of factors:

• the health status of the person being examined;
• nature and stage of the disease;
• technical equipment of the X-ray room;
• the pursued purpose of the x-ray is preventive or diagnostic;
• patient's age.

Preventive x-rays are relatively healthy person should be done once a year. Diagnostic examination allows for 1–2 x-rays per year.

Citizens, work activity which are associated with enterprises Catering or work in children's institutions of various types, are required to be examined every six months. Persons suffering from severe forms of disease, when the harm caused to the body is many times greater than the harm from the radiation received, and x-rays cannot be replaced by another, more safe procedure, the doctor can prescribe the procedure much more often - even up to 3 times a week.

X-rays aimed at examining the lungs are prescribed to pregnant women only after carefully weighing all the risks, especially in the 1st trimester of pregnancy. If the procedure cannot be avoided, it is better to undergo it using the latest equipment, covering the abdomen and pelvic area with a lead protective apron. X-rays are not contraindicated for nursing mothers because they do not affect lactation and the composition of milk.

How often can a child be treated?

Many mothers and fathers are concerned about how often can an X-ray of a child’s lungs be done? Radiation exposure can harm growing cells child's body, sometimes provokes gene mutations, damage and DNA strand breakage.

In this regard, it is advisable to carry out x-ray examinations of the lungs of children, as well as adults, no more than once a year.

The only exception is the suspicion of severe forms pulmonary diseases ( malignant neoplasms, tuberculosis, acute inflammation etc.), when there are no other diagnostic methods, and complications from the disease are greater than the damage caused to health by the procedure. How many times can children be x-rayed in these cases? Each episode requires a personal decision, approximately 5-6 x-rays per year. In some cases:

• if tuberculosis is suspected - once every 3 months to monitor the dynamics of the treatment process;
• for pneumonia - 3–4 days after taking antibiotics, to establish the effectiveness of their use;
• at radiation therapy malignant neoplasms of the lungs, when the primary goal is destruction cancer cells, and not the effect of radiation on healthy cells- daily.

It is advisable for children to have x-rays performed using digital equipment, which will significantly reduce the amount of radiation exposure.

Attention: radiography of a minor child is performed only with the consent of the parents; up to the age of 12, one of the parents is present during the X-ray session in the X-ray room.

Where to do it?

When deciding where to get an X-ray of the lungs, a person is given a choice at his own discretion:

• municipal clinic (hospital);
• private paid clinic.

Many modern medical institutions have staff at their disposal experienced specialists, the latest equipment giving accurate results, minimizing radiation exposure. Citizens are usually received by appointment; the results of the examination are explained in detail to the patient and handed over in 2 forms: printed and/or digital.

In a number of cities in Russia, Belarus, Ukraine, Kazakhstan, Invitro, a Russian medical company, does lung x-rays, as well as a number of other clinics. Their radiographs meet all accepted standards and are accepted in all medical institutions.

Is the procedure possible at home?

It happens that a person is not able to visit the X-ray room for a number of reasons:

• due to old age;
• for health;
• due to any physical disability.

In these cases, it is possible to take an x-ray of the lungs at home.

The procedure is performed using a portable, mobile X-ray device. The most modern of them - digital - have microprocessor control and work in parallel with a computer. Based on the results of the x-ray, the radiologist immediately draws up a detailed report. The radiographs are given to the patient.

X-ray or fluorography?

Like X-rays, fluorography is the photographing of images of organ shadows from an optical device (fluorescent screen) onto film, but, unlike X-rays, in a very small size (1 cm x 1 cm), or onto a computer display from a special chip built into the receiver .

Due to the increase in tuberculosis, mandatory preventive fluorography was introduced for the population, which must be completed annually.

Important: children under the age of 18 are prohibited from undergoing preventive fluorography!

Which is more accurate?

So what is more accurate - x-ray or fluorography of the lungs? Let's compare pictures of these two methods:

1. X-rays of the lungs. They have higher resolution and can be enlarged to very large sizes. Clear, allow you to obtain accurate data and deliver correct diagnosis. X-rays make it possible to record changes occurring during the course of the disease, the dynamics of the disease, and the development of pathologies.
2. Fluorographic images of the lungs. The image has lower resolution than an x-ray. The small size of the images makes it possible to show only a general picture of the condition of the lungs and heart. Deviations from the norm of insignificant size (less than 0.5 cm) look like barely visible threads. Foci of infiltration in pneumonia exceeding 0.5 cm are noticeable, but only if they are located in clean areas of the lung fields. If a disease is suspected, the patient is also sent for an x-ray, which may not confirm the presumptive diagnosis. And this adds additional radiation exposure to the body.

Conclusion: X-ray of the lungs is more precise method than fluorography.

Which is more harmful?

What is more harmful - X-ray of the lungs or fluorography? Harm here refers to the dose of radioactive radiation acquired during the process. The radiation dose on a film X-ray machine ranges from 0.1 to 0.3 mSv per session. Fluorography today is performed using digital equipment. Digital fluorography gives an approximate dose of 0.04 mSv per session.

Conclusion: fluorography gives a lower dose of radiation than x-rays, which means it is less harmful.

Which is better: CT or X-ray?

The CT method is based on computed tomography) also involves scanning with X-rays, but passing through the body at different angles.

The resulting images are combined using a computer into an overall picture, which makes it possible to examine the organ from all sides. CT scan or x-ray of the lungs - which is better and more informative, which is less harmful?

Large diagnostic capabilities has a CT scan, since thanks to it you can see not only lung structure, but also blood vessels, anatomical processes taking place in the lungs, their internal structures, even differing from each other in density by only 0.1%. The use of a contrast agent increases the accuracy of the data obtained to 98%.

But x-rays have their advantages:

• the dose of radioactive radiation is much lower (for CT scans it ranges from 3 to 10 mVs);
• its cost is several times cheaper;
• Almost all, even municipal, medical institutions have X-ray equipment, so it is more accessible.

When deciding where to take an X-ray of the lungs would be more correct, and where you still need to undergo a CT scan, listen to the point of view of professionals: they will compare the share of what you receive radiation exposure, will take into account the nature of the disease being diagnosed and will be able to provide the necessary direction.

Useful video

From next video you can find out useful information about x-ray:

Conclusion

1. Nowadays, taking an X-ray of the lungs is not difficult. There are a number of medical institutions, both municipal and private, offering this service to the population.
2. The procedure allows you to examine the lungs and identify up to 90% of lung diseases.
3. In case of severe pathologies that threaten the health and life of the patient, it can be performed quite often.

X-ray of the lungs in two projections is performed in diagnostic purposes. When it is necessary to identify pathological changes in the chest (pneumothorax, cancer), there are no more reliable methods than radiation methods.

The study is carried out strictly according to indications, when the benefit from it is greater than the harm. For example, during pregnancy and for children, radiation exposure is dangerous due to the occurrence of genetic mutations. Doctors prescribe radiation exposure to these categories of the population only as a last resort.

Purpose and preparation for radiography in two projections

An X-ray of the lungs in the right or left lateral projection is prescribed in the following cases:

• to detect heart disease and pathological changes in the pulmonary fields;
• control of catheter placement in the heart, pulmonary artery, as well as for the purpose of assessing pacemaker electrodes;
• in the diagnosis of pneumonia, inflammatory changes in the bronchi, bronchiectasis.

X-ray of the lungs in two projections does not require special preparation, but a person will have to perform some manipulations:

1. Remove clothing and foreign objects that cover the examination area.
2. Leave on the table mobile phone and keys, as well as other items that can accumulate radioactive radiation.

In the process of performing an X-ray of the lungs, it is necessary to follow all the recommendations of the x-ray technician. It is important to hold your breath while taking a photo to avoid dynamic blur.

Direct (posterior-anterior) projection during radiography of the lungs

Direct (posterior-anterior) projection during chest x-ray is performed as often as possible if pneumonia is suspected or. There are some technical subtleties when implementing it:

• the ideal focal length between the X-ray tube and the human chest should be on average 2 meters;
• when placing the patient on the stand, the x-ray technician ensures that the chin is positioned on a special holder;
• The height of the clamp is adjusted so that the cervical spine is straightened. When installed, a person leans his hands against the screen, and his chest is projected in the central part of the cassette;
• When exposing the photo, you must hold your breath.

This is how a posteroanterior (direct) projection is performed when diagnosing respiratory diseases.

Lower lobe pneumonia on x-ray of the lungs in direct projection

Anteroposterior view of the lungs

An anteroposterior photograph of the lungs in combination with left or right lateral projections is performed in the supine position. How to take a direct shot:

• the patient is placed on the couch;
• the head end rises up;
• the cassette is placed under the patient's back, and the distance between and the object of study is selected as directed by the doctor. It should be taken into account that there should not be any place in the path of penetration of X-rays. foreign objects;
• exposure is carried out with a deep breath.

Performing right and left lateral chest films

To perform lateral images of the lungs (left and right), special positioning is required:

• hands are placed behind the head;
• the left side leans against the cassette;
• When exposed, you hold your breath or take a deep breath.

The patient is placed next to the cassette on the side that needs to be x-rayed.

Precautionary measures

Chest X-ray is contraindicated in women. Radiation exposure to the fetus due to ionizing radiation involves the appearance of genetic mutations, which can lead to developmental abnormalities.

When performing the study, it is necessary to protect the human pelvic and abdominal area with a special lead apron.

In an outpatient setting (in a clinic), when a doctor prescribes radiography in two projections, postero-anterior images should be taken rather than anteroposterior, which is due to the greater reliability of the former.

When choosing lateral images (left or right), you must rely on the doctor’s prescription with a description.

The norm in photographs in two projections

The norm in photographs in two projections is characterized by the following indicators:

• The width of the chest on a direct radiograph is twice as wide as cross dimension hearts;
• pulmonary fields are symmetrical on both sides;
• the spinous processes are located evenly in the vertical plane;
• intercostal spaces are uniform.

Deviation from normal values ​​in photographs of the lungs in two projections during pneumonia is the presence of additional intense shadows on the frontal and lateral radiographs.

Venous congestion in the lesser circle will be characterized by a special shape of the roots, which in the image resembles “butterfly wings”. With swelling in lung tissue flake-like uneven darkening will appear.

Changes in the heart on direct and lateral x-rays

Changes in the heart on x-rays are combined with an enlargement of the right or left ventricles and atria. With an increase in size on the left, the roundness of the left border of the cardiac shadow will be visualized on the x-ray.

The image with expansion of the right contours of the heart will appear as an expansion of the shadow of the right ventricle. In this case, an increase in the shadow of the right ventricle is observed on the posteroanterior radiograph.

What influences the result of the study

When taking x-rays, it is important that the patient learn to hold their breath until exposure, which will prevent the need to repeat the x-ray.

Incorrect centering of the chest during radiography may interfere with visualization of the costophrenic sinus.

Distortion of the results is also observed when a person has a lateral curvature spinal column.

In two projections, radiography is performed if any disease is suspected that is accompanied by damage chest cavity, and the purpose of taking a side shot is no different from a straight shot.

Particular attention should be paid to the laterogram– a special study to determine the presence of fluid level in the costophrenic sinus. During the examination, the person is placed on his side and an X-ray image is taken with the X-ray beam directed towards the front. In this case, the cassette is installed from the back of the back. In the presence of exudative pleurisy, a thin strip of darkening can be traced in the lower part of the costal arch, reflecting the accumulation of fluid in the costophrenic sinus.

X-ray examination of the heart is often supplemented by contrasting the esophagus with barium. This allows you to clearly monitor the pressure of the aorta on the esophagus or identify various deviations of the aortic arch.

Against the background of pathology, an increase in the pulmonary pattern may be observed. In this case, the results have a radial direction, and the veins are located in the horizontal plane.

Thus, in two projections, X-ray images are prescribed for diagnostic purposes to identify diseases of the cardiovascular and respiratory systems.

IN modern world the most popular diagnostic method various diseases is an x-ray. Using it, you can obtain an image of the human skeleton and observe possible changes internal organs. Everyone has long known about the dangers of X-rays for the human body. But the population also understands that after one procedure, the harm caused to the body is invisible, that is, it is practically harmless.

There is a categorical ban on irradiation for women expecting a child at any stage and children. But even they can be an exception in cases of necessity, because the chance that X-ray rays will hit a child is almost zero.

X-rays and safety

Since medicine does not stand still, radiography today is not the most dangerous device emitting radioactive radiation. The further technological progress moves, the more the environment is saturated with radiation substances. So today there are harmful cosmic metals in the soil that can harm a person much more than x-rays.

For a long time known fact is the information that we can receive a dose from one x-ray exposure in a few days of our usual life.

Also, in the practice of medical institutions there are much more dangerous devices, in relation to which x-rays are harmless to the body. In addition, doctors who know how to reduce the radiation dose are specially trained to perform X-ray irradiation. This means that during radiography only a small part of the possible radiation is used, but the main thing is the timely detection of problems, which is much more important.

Doctors say that the body is irradiated only at the moment the equipment is started, and the duration of the procedure cannot be measured in ordinary time. That is, if you take x-rays 2 times a day, then of course the radiation will be significant, but will not cause rapid malignant formations.

Irradiation

Peculiar view electromagnetic radiation is the emission of x-rays. X-ray equipment is designed so that it produces radioactive waves that are short but have great penetrating power and can pass through the bones and tissues of the body. A special feature is its ability to illuminate hidden from human eyes organs and produce images internal structure person.

X-rays are a kind of glow that a person is not able to see, but at the same time they are able to illuminate through absolutely any object, regardless of structure and density. It is precisely because of these abilities that x-rays are necessary for use in medical institutions. After all, only having an accurate picture, and not just assumptions about the state of the internal organs, is it possible to correctly identify the disease and methods of its treatment.

But, despite the presented advantages, it still poses a danger to humans. After all, it is x-ray irradiation considered the most dangerous of all radiation influences. But the intensity of radiation and its duration are dangerous. That is why in medical institutions they work only on equipment with low intensity and an imperceptible duration of the procedure. All this indicates that even x-rays 2 times a day double dose irradiation is not capable of significantly negatively affecting the body. But this does not mean that the emergence of cancer cells in the future is categorically excluded.

X-ray during pregnancy

Of course, there is a certain ban on conducting research into the disease in pregnant women in this particular way, because it is impossible to guarantee that radiation will not affect the development of the child. In most known cases, X-rays did not affect the baby’s health in any way, but it is impossible to say that in a particular case it will be the same and the baby will be born without significant deviations. And, of course, it is necessary to take into account the duration of pregnancy.

If the need for an X-ray still remains, for the diagnosis of limbs or other parts of the body surrounding the abdomen, then protection is used, designed to reduce the direct exposure of the unborn child. With its use, the procedure can be considered safe for the child.

X-ray examinations in medicine still play a leading role. Sometimes without data it is impossible to confirm or make a correct diagnosis. Every year, techniques and X-ray technology are improved, become more complex, and become safer, but, nevertheless, the harm from radiation remains. Minimization negative influence diagnostic radiation is a priority task of radiology.

Our task is to understand, at a level accessible to anyone, the existing figures of radiation doses, their units of measurement and accuracy. Let's also touch on the topic of reality. possible problems health problems that this type of medical diagnosis can cause.

What is X-ray radiation

X-rays are a stream of electromagnetic waves with wavelengths in the range between ultraviolet and gamma radiation. Each type of wave has its own specific effect on the human body.

At its core, X-ray radiation is ionizing. It has high penetrating ability. Its energy poses a danger to humans. The higher the dose received, the higher the harmfulness of radiation.

About the dangers of exposure to X-ray radiation on the human body

Passing through the tissues of the human body, X-rays ionize them, changing the structure of molecules, atoms, in simple terms - “charging” them. The consequences of the resulting radiation can manifest themselves in the form of diseases in the person himself (somatic complications), or in his offspring (genetic diseases).

Each organ and tissue is affected differently by radiation. Therefore, radiation risk coefficients have been created, which can be seen in the picture. How more value coefficient, the higher the susceptibility of the tissue to the effects of radiation, and hence the risk of complications.

Most susceptible to radiation hematopoietic organs- red bone marrow.

The most common complication appearing in response to irradiation are blood pathologies.

A person experiences:

• reversible changes in blood composition after minor amounts of radiation;
• leukemia – a decrease in the number of leukocytes and a change in their structure, leading to disruptions in the body’s functioning, its vulnerability, and decreased immunity;
• thrombocytopenia – a decrease in the content of platelets, blood cells responsible for clotting. This pathological process may cause bleeding. The condition is aggravated by damage to the walls of blood vessels;
• hemolytic irreversible changes in the composition of the blood (decomposition of red blood cells and hemoglobin) as a result of exposure to powerful doses of radiation;
• erythrocytopenia - a decrease in the content of red blood cells (red blood cells), calling process hypoxia ( oxygen starvation) in tissues.

FriendnopathologistsAnd:

• development of malignant diseases;
• premature aging;
• damage to the lens of the eye with the development of cataracts.

Important: X-ray radiation becomes dangerous in case of intensity and duration of exposure. Medical equipment uses low-energy radiation of short duration, so it is considered relatively harmless when used, even if the examination has to be repeated many times.

A single exposure to radiation that a patient receives during conventional radiography increases the risk of developing a malignant process in the future by approximately 0.001%.

note: unlike exposure to radioactive substances, the harmful effects of rays stop immediately after turning off the device.

The rays cannot accumulate and form radioactive substances, which will then become independent sources of radiation. Therefore, after an x-ray, no measures should be taken to “remove” radiation from the body.

In what units are the doses of received radiation measured?

It is difficult for a person far from medicine and radiology to understand the abundance of specific terminology, dose numbers and units in which they are measured. Let's try to bring the information to an understandable minimum.

So, what is the dose measured in? x-ray radiation? There are many units of measurement for radiation. We won't go into everything in detail. Becquerel, curie, rad, gray, rem - this is a list of the main quantities of radiation. They are used in various measurement systems and areas of radiology. Let us dwell only on those that are practically significant in x-ray diagnostics.

We will be more interested in X-rays and sieverts.

The level of penetrating radiation emitted by an X-ray machine is measured in a unit called “roentgen” (P).

To evaluate the effect of radiation on humans, the concept was introduced equivalent absorbed dose (EDD). In addition to EPD, there are other types of doses - all of them are presented in the table.

The equivalent absorbed dose (in the picture - Effective equivalent dose) is a quantitative amount of energy that the body absorbs, but it takes into account the biological response of body tissues to radiation. It is measured in sieverts (Sv).

A sievert is approximately comparable to the value of 100 roentgens.

The natural background radiation and doses delivered by medical X-ray equipment are much lower than these values, so they are measured using the values ​​of a thousandth (milli) or one millionth (micro) of Sievert and Roentgen.

In numbers it looks like this:

• 1 sievert (Sv) = 1000 millisievert (mSv) = 1,000,000 microsievert (µSv)
• 1 roentgen (R) = 1000 milliroentgen (mR) = 1,000,000 milliroentgen (µR)

To estimate the quantitative part of the radiation received per unit of time (hour, minute, second), the concept is used - dose rate, measured in Sv/h (sievert-hour), μSv/h (microsievert-hour), R/h (roentgen-hour), μR/h (micro-roentgen-hour). Likewise - in minutes and seconds.

It can be even simpler:

• total radiation is measured in roentgens;
• the dose received by a person is in sieverts.

Radiation doses received in sieverts accumulate over a lifetime. Now let's try to find out how many sieverts a person receives.

Natural radiation background

The level of natural radiation is different everywhere, it depends on the following factors:

• altitude above sea level (the higher, the harder the background);
• geological structure of the area (soil, water, rocks);
• external reasons - the material of the building, the presence of nearby enterprises that provide additional radiation exposure.

Note:The most acceptable background is considered to be one in which the radiation level does not exceed 0.2 μSv/h (microsievert-hour), or 20 μR/h (micro-roentgen-hour)

The upper limit of the norm is considered to be up to 0.5 μSv/h = 50 μR/h.

Over several hours of exposure, a dose of up to 10 μSv/h = 1 mR/h is allowed.

All types X-ray studies fit into safe standards for radiation exposure, measured in mSv (millisieverts).

Permissible radiation doses for humans accumulated over a lifetime should not exceed the limits of 100-700 mSv. Actual exposure values ​​for people living at high altitudes may be higher.

On average, a person receives a dose of 2-3 mSv per year.

It is summed up from the following components:

• radiation from the sun and cosmic radiation: 0.3 mSv – 0.9 mSv;
• soil-landscape background: 0.25 – 0.6 mSv;
• radiation from housing materials and buildings: 0.3 mSv and above;
• air: 0.2 – 2 mSv;
• food: from 0.02 mSv;
• water: from 0.01 – 0.1 mSv:

In addition to the external dose of radiation received, the human body also accumulates its own deposits of radionuclide compounds. They also represent a source of ionizing radiation. For example, in bones this level can reach values ​​from 0.1 to 0.5 mSv.

In addition, there is irradiation with potassium-40, which accumulates in the body. And this value reaches 0.1 – 0.2 mSv.

note: To measure background radiation, you can use a conventional dosimeter, for example RADEKS RD1706, which gives readings in sieverts.

Forced diagnostic doses of X-ray irradiation

The amount of equivalent absorbed dose for each x-ray examination may vary significantly depending on the type of examination. The radiation dose also depends on the year of manufacture of the medical equipment and the workload on it.

Important: modern X-ray equipment produces radiation tens of times lower than the previous one. We can say this: the latest digital X-ray technology is safe for humans.

But we will still try to give average figures for the doses that a patient can receive. Let us pay attention to the difference between the data produced by digital and conventional X-ray equipment:

• digital fluorography: 0.03-0.06 mSv (the most modern digital devices produce radiation in a dose of 0.002 mSv, which is 10 times lower than their predecessors);
• film fluorography: 0.15-0.25 mSv, (old fluorographs: 0.6-0.8 mSv);
• X-ray of the chest organs: 0.15-0.4 mSv;
• dental (dental) digital radiography: 0.015-0.03 mSv., conventional: 0.1-0.3 mSv.

In all of these cases we are talking about one picture. Studies in additional projections increase the dose in proportion to the frequency of their conduct.

The fluoroscopic method (involves not photographing an area of ​​the body, but a visual examination by a radiologist on a monitor screen) produces significantly less radiation per unit of time, but the total dose may be higher due to the duration of the procedure. Thus, for 15 minutes of chest X-ray, the total dose of radiation received can be from 2 to 3.5 mSv.

Diagnostics gastrointestinal tract– from 2 to 6 mSv.

Computed tomography applies doses ranging from 1-2 mSv to 6-11 mSv, depending on the organs being examined. The more modern the X-ray machine is, the lower the doses it gives.

We especially note radionuclide diagnostic methods. One radiotracer-based procedure produces a total dose of 2 to 5 mSv.

Comparison effective doses radiation received during the most commonly used diagnostic tests in medicine, and doses received daily by humans from environment, presented in the table.

Important:Magnetic resonance imaging does not use x-rays. In this type of study, an electromagnetic pulse is sent to the diagnosed area, exciting the hydrogen atoms of the tissues, then the response that causes them is measured in the generated magnetic field with a high intensity level.Some people mistakenly classify this method as X-ray.

Fluorography after x-ray is not prescribed due to the irrationality of the approach. During fluorographic examination, a lower resolution is formed, so small shadows (less than 4 mm) are not visualized.

Every person must make sure that he has no diseases. For these purposes, a screening examination is carried out annually. Fluorography allows you to detect tuberculosis, pneumonia, and malignant neoplasms in the early stages.

Fluorography after x-ray: what is it and why is it prescribed

Fluorography after chest x-ray is not prescribed. A photograph of the chest organs after the description will be counted as a fluorographic examination. If a person has x-rays of other organs ( skeletal system, abdominal cavity), during which the person received a low radiation dose (up to 1 mSv), fluorography should be done (provided there is no study this year).

If the patient has recently undergone an X-ray examination with a high radiation dose, it is recommended to wait several months to allow the body to repair the damaged cells. Similar situation occurs during radiography of the spine and contrast examinations.

Digital fluorogram of a smoker's lungs

Technical features of fluorography and radiography

Fluorographic examination using modern digital installations is characterized by low radiation exposure to humans due to technical features equipment structure. The picture is obtained by moving a thin beam in a horizontal plane. Linear scanning in rows makes it possible to reduce the volume of irradiated tissue, therefore, with such equipment, when taking an image of the lungs, a dose of 0.015 mSv is created.

Compared to classical radiography performed on film, a lower resolution is obtained. Digital equipment brought additional restrictions. The 1078x1024 resolution of the visiograph does not allow all graphic points to be reflected qualitatively, so it is almost impossible to identify shadows less than 4 mm in the image. Digital fluorogram with a resolution of more than 2000 pixels is approximately equal to film sensitivity.

Old installations are equipped with X-ray fluorescence screens. The image then conveys a non-small film size. When studying such images, it is difficult to visualize fine shadows. The devices remained only in peripheral outpatient facilities due to the low budgetary capabilities of the organization. Over time, the installations will be replaced with modern equipment.

Basic principles of radiography

Radiography is a common method that is gradually being replaced by computer and magnetic resonance imaging.

When an x-ray is formed, a beam of rays from a tube passes through the human body and is projected on film. The method is reminiscent of making photographs, as a developer and fixer are used. The X-ray is taken in a dark room.

Image formation is possible due to the fact that different tissues transmit X-rays differently - absorb and reflect. The airy tissues on the negative are black, and the dense bones are white.

Technical principles of computed tomography and magnetic resonance imaging

The basis for obtaining images when performing computed tomography is the passage of images through the body from several angles at once. Information from sensors located along the radius of the diagnostic table is processed by software. During the procedure, the radiation exposure to the patient is significantly higher than with conventional radiography.

In magnetic resonance imaging, images are obtained from the emission of radio waves by hydrogen atoms when exposed to strong magnetic field. Magnetic resonance imaging is not accompanied by radiation exposure. According to clinical research no during research side effects on the body, subject to careful compliance with the conditions of the examination.

Before performing an MRI, be sure to remove metal objects that may move under the influence of a strong magnet. The procedure is contraindicated for people who wear pacemakers or implants.

Each study is prescribed to solve specific diagnostic problems. If the doctor believes that it is possible to do an x-ray after fluorography, then suspicious shadows have been detected that require additional verification. Radiography is characterized by more high sensitivity. During the study, it is possible to verify formations more than 3 mm in diameter.

Many patients do not understand the difference between the definitions of “fluorography” and “x-ray”, so ordering one examination immediately after performing the second raises a lot of unclear questions.

When it is impossible or possible to take an x-ray after fluorography

There are certain indications and contraindications for performing both procedures. Chest X-ray is prescribed to identify the following nosological forms:

1. Pleurisy;
2. Pneumonia;
3. Tuberculosis;
4. Malignant neoplasms;
5. Bronchitis (chronic).

Doctors prescribe a referral for imaging if the patient has the following symptoms:

Lung wheezing;
Chest pain;
Severe shortness of breath;
Prolonged cough.

Photo X-ray of the lungs

According to the law, every citizen of the country must undergo a preventive examination once every 2 years. There are additional categories that must undergo fluorography once every 6 months:

1. Convicts;
2. HIV-infected;
3. Military personnel;
4. Maternity hospital workers.

The study is contraindicated for children under 15 years of age and pregnant women due to the high risk to life. Radiation affects fast-acting cells. Under the influence of ionizing radiation, a mutation of the genetic apparatus occurs. This modification causes cancer. To prevent these complications, it is necessary to prescribe x-rays only when the harm from an unclear diagnosis is greater than the consequences from ionizing radiation.

Is it possible to do an x-ray after fluorography?

X-rays and fluorography have a negative impact on the human body. Radiation is harmful to the cells of the body, as it causes irreversible changes in blood cells and provokes cancer.

When X-raying the lungs, depending on the type of equipment, a person receives a dose of 0.3-3 mSv. A person receives a similar amount when flying about 2000 kilometers by plane. When performing fluorography, the radiation is 2-5 times greater, which depends on the quality of the equipment. Historical literature indicates such characteristics, but with the advent of modern digital installations the situation has changed. With X-ray of the chest organs in direct projection, the radiation dose is 0.18 mSv, and with digital fluorography - only 0.015 mSv. Thus, if you take pictures with modern fluorographs, you can reduce the level of radiation by 100 times.

According to the requirements of radiation safety standards, when performing research, the annual radiation dose for a person should not exceed 150 mSv. Only after this threshold is exceeded does the likelihood of malignant neoplasms increase.

Moderate amounts of x-rays are safe for the body. According to the standards of the Russian Ministry of Health, when performed, the prophylactic dose for humans should not exceed 1.4 mSv. Significant harm to radiography for the body occurs during radiation therapy of tumors. If the cancer is not operable, it can be destroyed by radiation. No other methods of eliminating neoplasms have been identified, so it comes to destroying healthy cells along with atypical ones in order to allow a person to live longer.

After fluorography, they sent me for an x-ray - why?

After fluorography, the person is sent for an X-ray of the lungs for a more detailed study of the state of the pulmonary fields. The resolution of these methods was described a little higher in the article. According to research X-ray shadows with a diameter of more than 3 mm are detected, fluorography - 4-5 mm. If a fluorogram reveals a small lesion, in order to find out its characteristics and nosological affiliation, an x-ray examination is necessary. The procedure involves not only direct radiography, but also lateral, targeted radiographs. With the help of full-fledged X-ray diagnostics, the radiologist gives the attending physician the maximum information that is necessary for correct setting diagnosis, adequate treatment.

How often can radiography and fluorography be done?

X-rays of the lungs can be taken as many times as needed by the attending physician for diagnostic purposes. During preventive studies, the patient's radiation dose should not exceed 1 mSv per year. When prescribing, the specialist takes into account possible complications, evaluates the harm of x-rays for the patient and the benefits of the information received.

In Russia, fluorography must be done at least once every 2 years. More often, the test is prescribed for people who are at risk of contracting tuberculosis. For the general population, there is no point in doing fluorographic examination more often. If necessary, x-rays should be taken.

What does fluorography show?

Fluorography – preventive screening examination for diagnosis different types pathology bronchopulmonary system. It is used to verify the following nosological forms:

Tuberculosis;
Cancer;
Pneumonia (pneumonia);
Fungal diseases;
Foreign bodies.

If the tumor is about 1 mm, it cannot be detected by radiography or fluorography, since the formation is beyond the resolution of the method. Computed tomography helps to verify such nodes.

During a preventive examination, the qualifications of a radiologist are of great importance. The analysis of many darkenings, clearings with clear, fuzzy contours, additional destructive foci, paths to the root depends on it. Many small darkened areas, pathology of the cardiovascular system - all these changes are detected in the image, but only a trained, qualified specialist can determine them.

For tuberculosis initial stages pathological shadows may not be visible in the lungs. The only manifestation of the disease is a bumpy outline of the roots. Enlarged lymph nodes become the main source of accumulation of mycobacteria. With radiography important feature qualitative research is not only the qualifications of the specialist, but also the characteristics of the equipment. Modern installations are equipped with exposure meters that allow optimal selection of radiation characteristics depending on the weight and volume of the patient.

In conclusion, I would like to note frequently asked question patients - “why are they sent for fluorography if it is less informative than x-rays and the radiation doses are higher?” When using non-digital fluorographs, this statement is true. The answer lies in the cost-effectiveness of mass screening for the state. Savings in research when compared with x-rays are 2-3 times. Only if suspicious shadows are detected, a person is sent for an x-ray. Maybe it would be easier to do an x-ray right away? This question is best addressed to specialists from the Ministry of Health.

Digital fluorogram of a patient with fibrous tuberculosis