What is radiography and what results does the examination give? What is an x-ray What is an x-ray examination

To diagnose various diseases of the lungs, bones and other organs and tissues of the human body, radiography (or X-ray) has been used in medicine for 120 years - this is a simple and error-free technique that has saved a huge number of lives due to the accuracy of the diagnosis and the safety of the procedure.

X-rays, discovered by the German physicist Wilhelm Roentgen, pass almost unhindered through soft tissue. The bone structures of the body do not allow them to pass through, as a result of which shadows of varying intensity are formed on X-ray photographs, accurately reflecting the condition of the bones and internal organs.

Radiography is one of the most researched and tested diagnostic techniques in clinical practice, the effect of which on the human body has been well studied for more than a century of use in medicine. In Russia (in St. Petersburg and Kyiv), thanks to this technique, already in 1896, a year after the discovery of X-rays, operations using X-ray images on photographic plates were successfully carried out.

Despite the fact that modern X-ray equipment is constantly being improved and represents high-precision medical devices that allow detailed diagnostics, the principle of obtaining an image has remained unchanged. Tissues of the human body, which have different densities, transmit invisible X-rays with varying degrees of intensity: soft, healthy structures practically do not retain them, but bones absorb them. The final images look like a collection of shadow images. The X-ray image is a negative, on which bone structures are indicated in white, soft ones in gray, and air spaces in black. The presence of pathological changes in internal organs, for example, in the lungs, is displayed as a lighter area on the pulmonary pleura or in segments of the lung itself. The description of the x-ray taken is the basis on which doctors can judge the condition of certain objects of study.

If in the 20th century the equipment allowed mainly only the examination of the chest and limbs, then modern fluoroscopy is used for high-precision diagnosis of various organs using a wide range of X-ray equipment.

Types and projections of radiography

Various types of radiography are used in medicine to conduct preventive studies and in-depth diagnostics. X-ray techniques are classified:

according to form:
- panoramic, allowing you to completely cover different areas of the body;
- targeted, which is usually carried out during in-depth diagnosis of a certain area of an organ using a special attachment on an X-ray machine;
- layer-by-layer, during which parallel sections of the studied area are performed.
by type of equipment used:
- traditional film;
- digital, which provides the ability to record the resulting image onto removable media;
- three-dimensional. This includes computed tomography, multislice and other types of tomography;
- fluorographic, allowing for safe preventive examination of the lungs;
special:
- mammography, for examining the breast in women;
- hysterosalpingography, used to examine the uterus and fallopian tubes;
- densitometric, for the diagnosis of osteoporosis and others.

The listing of various techniques shows how in demand and indispensable radiology can be in diagnostics. Modern doctors can use various forms of research to identify pathologies in most organs and vital systems of the human body.

Why are x-rays done?

X-rays in modern medicine are used for preventive examinations and targeted diagnostics. You cannot do without such an examination if:

bone fractures;
damage to internal organs as a result of external trauma;
diagnosis of breast cancer and a number of other oncological diseases;
examination of the lungs and other organs of the chest;
dental treatment and prosthetics;
deep study of brain structures;
scanning areas of vessels with suspected aneurysm, and so on.

The method of conducting an x-ray examination is chosen by the doctor depending on the patient’s indications and contraindications. Compared to some modern techniques for obtaining volumetric images, traditional x-rays are the safest. But it is not indicated for certain categories of patients.

Contraindications

Despite the safety of diagnosis, patients experience the effects of ionizing radiation, which negatively affects the bone marrow, red blood cells, epithelium, reproductive organs and the retina. Absolute contraindications for x-rays are:

pregnancy;
child's age under 14 years;
serious condition of the patient;
active form of tuberculosis;
pneumothorax or bleeding;
thyroid disease.

For children and pregnant women, such an examination is prescribed only in extreme cases, when the threat to life is greater than the potential harm from the procedure. Whenever possible, we try to resort to alternative methods. So, if a doctor needs to diagnose a tumor in a pregnant woman, then ultrasound is used instead of X-rays.

What do you need for an x-ray as preparation?

No special preparation is needed to examine the condition of the spine, stomach or jaw bones. The patient must remove clothing and metal objects before undergoing such an examination. The absence of foreign objects on the body ensures the accuracy of the x-ray image.

Preparation is required only when using a contrast agent, which is injected for X-rays of certain organs in order to improve the visualization of the results. An injection of a contrast agent is done some time before the procedure or directly during the procedure.

How to do an x-ray

All X-rays are taken in specially equipped rooms where there are protective screens to prevent radiation from reaching non-transparent organs of the body. The research doesn't take much time. Depending on the method used to perform the procedure, radiography is performed in different positions. The patient can stand, lie down or sit.

Is it possible to go at home?

Proper conditions for shooting with an X-ray machine of one modification or another are created in specially equipped rooms where there is protection from ionizing rays. Such equipment is large in size and is used only in stationary conditions, which allows for maximum safety of the procedure.

To conduct preventive examinations of a large number of people in areas remote from large clinics, mobile fluorography rooms can be used, which completely replicate the environment of inpatient medical premises.

How many times can an x-ray be taken?

Transillumination of tissues and organs is carried out as many times as allowed by one or another diagnostic technique. Fluorography and x-rays are considered the safest. The doctor may refer the patient several times for such an examination, depending on the previously obtained results and the goals set. Three-dimensional photographs are taken according to indications.

When ordering radiography, it is important not to exceed the maximum permitted total radiation dose per year, equal to 150 mSv. For information: radiation exposure when performing a chest x-ray in one projection is 0.15-0.4 mSv.

Where can an x-ray be taken and its average cost?

An x-ray can be taken in almost any medical institution: in public clinics, hospitals, private centers. The cost of such an examination depends on the area being examined and the number of images taken. As part of compulsory health insurance or under allocated quotas in public hospitals, organ x-rays can be done free of charge upon referral from a doctor. In private medical institutions, such a service will need to be paid for. The price starts from 1,500 rubles and may vary in different private medical centers.

What does an x-ray show?

What does the x-ray show? The picture taken or the monitor screen shows the condition of a certain organ. The variety of dark and light shades on the resulting negative allows doctors to judge the presence or absence of certain pathological changes in a certain part of the organ being examined.

Decoding the results

Only a qualified doctor who has long-term clinical practice and understands the characteristics of various pathological changes in various organs of the body can read X-rays. Based on what he saw in the image, the doctor makes a description of the resulting x-ray in the patient’s chart. In the absence of atypical light spots or darkening on soft tissues, cracks and fractures in bones, the physician records the healthy state of a particular organ. Only an experienced doctor who is well aware of the human x-ray anatomy and the symptoms of the disease of the organ whose image is being taken can accurately decipher an X-ray image.

What do inflammatory foci in the image indicate?

When soft tissues, joints or bones are examined in the presence of pathological changes, symptoms characteristic of a particular disease appear in them. The area affected by inflammation absorbs x-rays differently than healthy tissue. As a rule, such a zone contains pronounced foci of darkening. An experienced doctor immediately determines the type of disease from the resulting image.

What do diseases look like on an x-ray?

When the image is transferred to film, areas with pathological changes stand out against the background of healthy tissue. When damaged bones are scanned, places of deformation and displacement are clearly visible, which allows the traumatologist to make an accurate prognosis and prescribe the correct treatment. If shadows are detected on the lungs, this may indicate pneumonia, tuberculosis or cancer. A qualified specialist must differentiate the identified deviations. But areas of clearing in this organ often indicate pleurisy. Specific symptoms are characteristic of each type of pathology. To make a correct diagnosis, it is necessary to have a perfect command of the x-ray anatomy of the human body.

The advantages of the technique, and what are the negative effects of x-rays on the body

X-rays obtained as a result of X-ray scanning provide an accurate understanding of the condition of the organ being examined and allow doctors to make an accurate diagnosis. The minimum duration of such an examination and modern equipment significantly reduce the possibility of receiving a dose of ionizing radiation dangerous to human health. A couple of minutes is enough for detailed visualization of the organ. During this time, in the absence of contraindications for the patient, it is impossible to cause irreparable harm to the body.

How to minimize the effects of radiation

All forms of disease diagnosis using X-rays are carried out only for medical reasons. Fluorography is considered the safest, which is recommended to be performed annually for the purpose of early detection and prevention of tuberculosis and lung cancer. All other procedures are prescribed taking into account the intensity of X-ray radiation, and information about the dose received is entered into the patient’s chart. The specialist always takes this indicator into account when selecting diagnostic techniques, which allows not to exceed the norm.

Is it possible to do x-rays for children?

In accordance with international and domestic standards, any research based on the effects of ionizing radiation is permitted to be carried out by persons over 14 years of age. As an exception, a doctor may prescribe an x-ray to a child only if he suspects he has dangerous lung diseases with the consent of the parents. Such an examination is necessary in acute situations that require quick and accurate diagnosis. Before this, the specialist always weighs the risks of the procedure and the threat to the child’s life if it is not carried out.

Is it possible to have an x-ray during pregnancy?

Such an examination is usually not prescribed during pregnancy, especially in the first trimester. If it is so necessary that the lack of timely diagnosis threatens the health and life of the expectant mother, then during it a lead apron is used to protect internal organs from X-rays. Compared to other similar methods, x-rays are the safest, but in most cases doctors prefer not to use them during pregnancy, protecting the fetus from harmful ionizing effects.

Alternative to X-ray

The 120-year practice of using x-rays and similar techniques (fluorography, computer, multispiral, positron emission tomography and others) has shown that today there is no more accurate way to diagnose a number of pathologies. Using X-ray examination, you can quickly identify lung diseases, bone injuries, identify diverticula in older patients, perform high-quality retrograde urethrography, timely detect oncology at the initial stage of development, and much more.

An alternative to such diagnostics in the form of ultrasound can be prescribed only to pregnant women or patients with contraindications to X-rays.

X-ray examination is the use of X-ray radiation in medicine to study the structure and function of various organs and systems and recognize diseases. X-ray examination is based on the unequal absorption of X-ray radiation by different organs and tissues, depending on their volume and chemical composition. The more a given organ absorbs x-ray radiation, the more intense the shadow it casts on the screen or film. For X-ray examination of many organs, artificial contrast techniques are used. A substance is introduced into the cavity of an organ, into its parenchyma or into the spaces surrounding it, which absorbs X-ray radiation to a greater or lesser extent than the organ being studied (see Shadow contrast).

The principle of X-ray examination can be presented in the form of a simple diagram:
source of X-ray radiation → object of study → radiation receiver → doctor.

The source of radiation is an x-ray tube (see). The object of the study is a patient sent to identify pathological changes in his body. In addition, healthy people are also examined to identify hidden diseases. A fluoroscopic screen or a film cassette is used as a radiation receiver. Using a screen, fluoroscopy is performed (see), and using film, radiography is performed (see).

X-ray examination makes it possible to study the morphology and function of various systems and organs in the whole organism without disrupting its vital functions. It makes it possible to examine organs and systems at different age periods, allows us to identify even small deviations from the normal picture and thereby make a timely and accurate diagnosis of a number of diseases.

X-ray examination should always be carried out according to a specific system. First, they get acquainted with the complaints and medical history of the subject, then with the data of other clinical and laboratory studies. This is necessary because X-ray examination, despite its importance, is only a link in the chain of other clinical studies. Next, a plan for the x-ray examination is drawn up, i.e., the sequence of application of certain techniques to obtain the required data is determined. Having completed the X-ray examination, they begin to study the obtained materials (X-ray morphological and X-ray functional analysis and synthesis). The next stage is a comparison of X-ray data with the results of other clinical studies (clinical and radiological analysis and synthesis). Next, the data obtained are compared with the results of previous x-ray studies. Repeated X-ray examinations play an important role in the diagnosis of diseases, as well as in studying their dynamics, and in monitoring the effectiveness of treatment.

The result of the X-ray examination is the formulation of a conclusion, which indicates the diagnosis of the disease or, if the data obtained is insufficient, the most likely diagnostic possibilities.

If the correct technique and methodology are followed, X-ray examination is safe and cannot cause harm to the subjects. But even relatively small doses of X-ray radiation are potentially capable of causing changes in the chromosomal apparatus of germ cells, which can manifest itself in subsequent generations as changes harmful to the offspring (developmental abnormalities, decreased general resistance, etc.). Although each X-ray examination is accompanied by the absorption of a certain amount of X-ray radiation in the patient’s body, including his gonads, the likelihood of this kind of genetic damage occurring in each specific case is negligible. However, due to the very high prevalence of X-ray examinations, the safety issue in general deserves attention. Therefore, special regulations provide for a system of measures to ensure the safety of x-ray examinations.

Such measures include: 1) conducting X-ray examinations according to strict clinical indications and taking special care when examining children and pregnant women; 2) the use of advanced X-ray equipment, which makes it possible to reduce the radiation dose to the patient to a minimum (in particular, the use of electro-optical amplifiers and television devices); 3) the use of various means of protecting patients and personnel from the effects of X-ray radiation (increased filtration of radiation, the use of optimal technical shooting conditions, additional protective screens and diaphragms, protective clothing and protectors of the gonads, etc.); 4) reducing the duration of an x-ray examination and the time spent by personnel in the area of exposure to x-ray radiation; 5) systematic dosimetric monitoring of radiation exposure of patients and X-ray room personnel. It is recommended to enter dosimetry data in a special column of the form, which provides a written conclusion on the X-ray examination performed.

X-ray examination can only be carried out by a doctor with special training. Highly qualified radiologist ensures the effectiveness of X-ray diagnostics and maximum safety of all X-ray procedures. See also X-ray diagnostics.

X-ray examination (x-ray diagnostics) is used in medicine to study the structure and function of various organs and systems and recognize diseases.

X-ray examination is widely used not only in clinical practice, but also in anatomy, where it is used for the purposes of normal, pathological and comparative anatomy, as well as in physiology, where X-ray examination makes it possible to observe the natural course of physiological processes, such as contraction of the heart muscle, respiratory movements of the diaphragm, peristalsis of the stomach and intestines, etc. An example of the use of X-ray examination for preventive purposes is (see) as a method of mass examination of large human populations.

The main methods of x-ray examination are (see) and (see). Fluoroscopy is the simplest, cheapest and most easily performed method of x-ray examination. A significant advantage of fluoroscopy is the ability to conduct research in various arbitrary projections by changing the position of the body of the subject in relation to the translucent screen. Such a multi-axial (polypositional) study makes it possible to establish, during candling, the most advantageous position of the organ under study, in which certain changes are revealed with the greatest clarity and completeness. In this case, in some cases it is possible not only to observe, but also to palpate the organ under study, for example the stomach, gall bladder, intestinal loops, by so-called x-ray palpation, carried out in lead rubber or using a special device, the so-called distractor. Such targeted (and compression) under the control of a translucent screen provides valuable information about the displacement (or non-displacement) of the organ under study, its physiological or pathological mobility, pain sensitivity, etc.

Along with this, fluoroscopy is significantly inferior to radiography in terms of the so-called resolution, i.e., the detection of details, since, compared with the image on a translucent screen, it more fully and accurately reproduces the structural features and details of the organs being studied (lungs, bones, internal relief of the stomach and intestines and so on.). In addition, fluoroscopy, compared to radiography, is accompanied by higher doses of x-ray radiation, i.e., increased radiation exposure to patients and personnel, and this requires, despite the rapidly transient nature of the phenomena observed on the screen, to limit the exposure time as much as possible. Meanwhile, a well-executed radiograph, reflecting the structural and other features of the organ under study, is available for repeated study by different persons at different times and is, thus, an objective document that has not only clinical or scientific, but also expert, and sometimes forensic value .

Radiography, performed repeatedly, is an objective method of dynamic monitoring of the course of various physiological and pathological processes in the organ under study. A series of radiographs of a certain part of the same child, taken at different times, allows us to trace in detail the process of development of ossification in this child. A series of radiographs taken over a long period of a number of chronic diseases (stomach and duodenum, and other chronic bone diseases) makes it possible to observe all the subtleties of the evolution of the pathological process. The described feature of serial radiography makes it possible to use this method of X-ray examination also as a method of monitoring the effectiveness of treatment measures.

X-ray (radioscopy). A method of visually studying an image on a luminous screen. Involves examining the patient in the dark. The radiologist first adapts to the darkness, and the patient is positioned behind the screen.

The image on the screen allows, first of all, to obtain information about the function of the organ being studied - its mobility, relationship with neighboring organs, etc. The morphological features of the object under study are not documented during X-ray examination; the conclusion based only on X-ray examination is largely subjective and depends on the qualifications of the radiologist.

The radiation exposure during candling is quite high, so it is performed only according to strict clinical indications. Conducting a preventive examination using the X-ray method is prohibited. Fluoroscopy is used to study the organs of the chest, gastrointestinal tract, sometimes as a preliminary, “targeting” method for special studies of the heart, blood vessels, gall bladder, etc.

Fluoroscopy is used to study the organs of the chest, gastrointestinal tract, sometimes as a preliminary, “targeting” method for special studies of the heart, blood vessels, gall bladder, etc.

In recent decades, X-ray image intensifiers (Fig. 3.) - URI or image intensifier - have become increasingly widespread. These are special devices that, using electron-optical conversion and amplification, make it possible to obtain a bright image of the object being studied on the screen of a television monitor with low radiation exposure to the patient. Using URI, it is possible to perform fluoroscopy without dark adaptation, in a darkened room and, most importantly, the patient’s radiation dose is sharply reduced.

Radiography. A method based on exposure of a photographic emulsion containing silver halide particles to X-rays (Fig. 4). Because the rays are absorbed differently by tissue, depending on the so-called "density" of the object, different areas of the film are exposed to different amounts of radiation energy. Hence the different photographic blackening of different points of the film, which is the basis for obtaining the image.

If neighboring areas of the photographed object absorb rays differently, they speak of “x-ray contrast”.

After irradiation, the film must be developed, i.e. restore Ag+ ions formed as a result of exposure to radiation energy to Ag atoms. When developed, the film darkens and an image appears. Since only a small portion of the silver halide molecules are ionized during imaging, the remaining molecules must be removed from the emulsion. To do this, after development, the film is placed in a fixing solution of sodium hyposulfite. Silver halide, under the influence of hyposulfite, transforms into a highly soluble salt that is absorbed by the fixing solution. Development takes place in an alkaline environment, fixation in an acidic environment. After thorough washing, the image is dried and labeled.

Radiography is a method that allows you to document the state of the object being photographed at a given moment. However, its disadvantages are its high cost (the emulsion contains an extremely scarce precious metal), as well as difficulties that arise when studying the function of the organ under study. The patient's radiation exposure during imaging is somewhat less than during X-ray scanning.

In some cases, the X-ray contrast of adjacent tissues allows them to be imaged in photographs under normal conditions. If neighboring tissues absorb the rays approximately equally, it is necessary to resort to artificial contrast. To do this, a contrast agent is introduced into the cavity, lumen of the organ or around it, which absorbs rays either significantly less (gaseous contrast agents: air, oxygen, etc.) or significantly more than the object being studied. The latter include barium sulfate, used to study the gastrointestinal tract, and iodide preparations. In practice, oil solutions of iodine (iodolipol, mayodil, etc.) and water-soluble organic iodine compounds are used. Water-soluble contrast agents are synthesized based on the purposes of the study to contrast the lumen of blood vessels (cardiotrast, urografin, verografin, omnipaque, etc.), bile ducts and gallbladder (bilitrast, yopognost, bilignost, etc.), urinary system (urografin, omnipaque, etc. ). Since free iodine ions can be formed when contrast agents dissolve, patients suffering from hypersensitivity to iodine (“iodism”) cannot be examined. Therefore, in recent years, non-ionic contrast agents have been used more often, which do not cause complications even when administered in large quantities (Omnipaque, Ultravist).

To improve image quality during radiography, screening gratings are used that transmit only parallel rays.

About terminology. The term “x-ray of such and such an area” is usually used. So, for example, “X-ray of the chest”, or “X-ray of the pelvic area”, “X-ray of the right knee joint”, etc. Some authors recommend constructing the name of the study from the Latin name of the object with the addition of the words “-graphy”, “-gram”. So, for example, “craniogram”, “arthrogram”, “colonogram”, etc. In cases where gaseous contrast agents are used, e.g. Gas is injected into the lumen of the organ or around it, and the word “pneumo-” (“pneumoencephalography”, “pneumoarthrography”, etc.) is added to the name of the study.

Fluorography. A method based on photographic recording of an image from a luminous screen in a special camera. It is used for mass preventive studies of the population, as well as for diagnostic purposes. The size of the fluorogram is 7´7 cm, 10´10 cm, allowing you to obtain sufficient information about the condition of the chest and other organs. The radiation exposure during fluorography is slightly greater than with radiography, but less than with transillumination.

Tomography. In a conventional X-ray study, the planar image of objects on film or on a luminous screen is cumulative due to the shadows of many points located closer and further from the film. So, for example, the image of the organs of the chest cavity in a direct projection is the sum of shadows relating to the anterior chest, anterior and posterior lungs, and posterior chest. The lateral projection image is a summary image of both lungs, the mediastinum, the lateral sections of the right and left ribs, etc.

In a number of cases, such a summation of shadows does not allow a detailed assessment of a section of the object under study located at a certain depth, since its image is covered by shadows above and below (or in front and behind) located objects.

The way out of this is a layer-by-layer research technique - tomography.

The essence of tomography is to use the effect of smearing all layers of the studied part of the body, except for one, which is being studied.

In a tomograph, the X-ray tube and film cassette move in opposite directions during an image, so that the beam constantly passes only through a given layer, “smearing” the layers above and below. In this way, the entire thickness of the object can be examined sequentially.

The greater the angle of mutual rotation of the tube and the film, the thinner the layer, which gives a clear image. In modern tomographs this layer is about 0.5 cm.

In some cases, on the contrary, an image of a thicker layer is required. Then, by reducing the angle of rotation of the film and tube, so-called zonograms are obtained - tomograms of a thick layer.

Tomography is a very commonly used research method that provides valuable diagnostic information. Modern X-ray machines in all countries are produced with tomographic attachments, which allows them to be universally used both for X-ray and imaging, as well as for tomography.

CT scan. The development and implementation of computed tomography in the practice of clinical medicine is a major achievement of science and technology. A number of foreign scientists (E. Marcotred and others) believe that since the discovery of X-rays in medicine there has been no more significant development than the creation of a computed tomograph.

CT allows you to study the position, shape and structure of various organs, as well as their relationship with neighboring organs and tissues. During the study, the image of the object is presented as a semblance of a cross section of the body at given levels.

CT is based on creating images of organs and tissues using a computer. Depending on the type of radiation used in the study, tomographs are divided into X-ray (axial), magnetic resonance, and emission (radionuclide). Currently, X-ray (CT) and magnetic resonance (MRI) imaging are becoming increasingly common.

Oldendorf (1961) was the first to perform a mathematical reconstruction of a transverse image of the skull using 131 iodine as a radiation source, and Cormack (1963) developed a mathematical method for reconstructing a brain image with an X-ray image source. In 1972, Hounsfield in the English company EMU built the first X-ray CT scanner for examining the skull, and already in 1974, a CT scanner for tomography of the whole body was built, and since that time, the increasingly widespread use of computer technology has led to the fact that CT scanners, and in recent times years and magnetic resonance therapy (MRI) has become a common method of studying patients in large clinics.

Modern computer tamographs (CT) consist of the following parts:

1. Scanning table with a conveyor for moving the patient in a horizontal position according to a computer signal.

2. Ring-shaped stand (“Gantry”) with a radiation source, detector systems for collecting, amplifying the signal and transmitting information to a computer.

3. Installation control panel.

4. Computer for processing and storing information with a disk drive.

5. Television monitor, camera, tape recorder.

CT has a number of advantages over conventional x-ray examination, namely:

1. High sensitivity, which makes it possible to distinguish the image of neighboring tissues not within 10–20% of the difference in the degree of absorption of x-rays, which is necessary for conventional x-ray examination, but within 0.5–1%.

2. Makes it possible to study the tissue layer under study without layering of “smeared” shadows above and underlying tissues, which is inevitable with conventional tomography.

3. Provides accurate quantitative information about the extent of the pathological focus and its relationship with neighboring tissues.

4. Allows you to obtain an image of the transverse layer of an object, which is impossible with conventional x-ray examination.

All this can be used not only to determine the pathological focus, but also for certain measures under CT control, for example, for diagnostic puncture, intravascular interventions, etc.

CT diagnostics is based on the ratio of density or adsorption indicators of adjacent tissues. Each tissue, depending on its density (based on the atomic mass of its constituent elements), absorbs and adsorbs X-rays differently. For each fabric, a corresponding adsorption coefficient (CA) on a scale has been developed. The KA of water is taken as 0, the KA of bones, which have the highest density, is taken as +1000, and of air - as –1000.

To enhance the contrast of the studied object with neighboring tissues, the “enhancement” technique is used, for which contrast agents are introduced.

The radiation dose during X-ray CT is comparable to that during conventional X-ray examination, and its information content is many times higher. Thus, on modern tomographs, even with the maximum number of slices (up to 90), it is within the load limits during a conventional tomographic examination.

X-ray studies are based on the registration by an X-ray machine of radiation, which, passing through the organs of the human body, transmits the image to the screen. After this, experienced specialists, based on the resulting image, draw conclusions about the health status of the patient’s organs being examined.

The most important thing to understand is that any indications and contraindications for radiography are determined privately only by the attending physician.

An X-ray examination may be prescribed if diseases are suspected in:

chest organs;
skeletal system and joints;
genitourinary system;
cardiovascular system;
cerebral cortex.

And also for:

checking treatment results in patients of all groups;
confirmation of the diagnosis made by the doctor.

Contraindications for X-rays

When conducting a comprehensive study using X-ray analysis, a person receives a small dose of radioactive radiation. This cannot significantly affect a healthy body. But in some special cases, radiography is really not recommended.

It is undesirable or dangerous to examine a patient using X-rays if:

pregnancy in the early stages of fetal development;
severe damage to internal organs;
severe venous or arterial bleeding;
diabetes mellitus in the last stages of the disease;
serious disturbances in the functioning of the body’s excretory systems;
pulmonary tuberculosis in the active phase;
pathologies in the endocrine system.

Advantages of X-ray diagnostics

Radiography has a number of significant advantages, namely:

helps establish a diagnosis for almost all types of diseases;
is widely available and does not require special purpose;
is painless for the patient;
is easy to carry out;
non-invasive, therefore there is no risk of infection;
Compared to other examination methods, it is quite inexpensive.

Disadvantages of X-ray

Like any type of medical examination, radiography has its drawbacks, including:

negative impact of x-rays on the body’s condition;
the risk of allergies to the X-ray contrast agents used in the study;
inability to frequently apply the examination procedure;
the information content of this method is lower than, for example, MRI studies;
It is not always possible to correctly decipher the image obtained on an x-ray.

Types of radiography

Radiography is used for a comprehensive examination of all organs and tissues of the human body; it is divided into several types that have certain differences:

panoramic radiography;
targeted radiography;
radiography according to Vogt;
microfocus radiography;
contrast radiography;
intraoral radiography;
radiography of soft tissues;
fluorography;
digital radiography;
contrast - radiography;
radiography with functional tests.

You can learn how to take an x-ray from this video. Filmed by the channel: “This is Interesting.”

Panoramic radiography

Panoramic or survey radiography is successfully used in dentistry. This procedure involves photographing the maxillofacial region using a special device - an ortapontomograph, which is a type of x-ray. The result is a clear image that allows you to analyze the condition of the upper and lower jaw, as well as the adjacent soft tissues. Guided by the image taken, the dentist can perform complex operations to install dental implants.

It also helps to perform a number of other highly technical procedures:

suggest the best way to treat gum disease;
develop a method for eliminating defects in the development of the jaw apparatus and much more.

Sighting

The difference between general and targeted radiography is in a narrow focus. It allows you to image only a specific area or organ. But the detail of such an image will be many times greater than that of a conventional x-ray examination.

Another advantage of a targeted radiograph is that it shows the condition of an organ or area over time, at different time intervals. X-rays passing through tissue or an area of inflammation magnify its image. Therefore, in the picture the organs appear larger than their natural size.

The size of the organ or structure will appear larger in the image. The object of study is located closer to the X-ray tube, but at a greater distance from the film. This method is used to obtain an image at primary magnification. Spot radiographs are ideal for examining the thoracic region.

X-ray according to Vogt

Vogt radiography is a non-skeletal method of radiography of the eye. It is used when microscopic debris enters the eye that cannot be tracked using a regular x-ray. The image shows a clearly defined area of the eye (anterior compartment) so that the bony walls of the orbit do not obscure the damaged part.

For Vogt research in the laboratory, you need to prepare two films. Their size should be two by four, and the edges must be rounded. Before use, each film must be carefully wrapped in wax paper to prevent moisture from entering its surface during the procedure.

Films are needed to focus X-rays. Thus, any smallest foreign object will be highlighted and detected due to shading in two completely identical places in the picture.

To perform an X-ray procedure using the Vogt method, you need to take two pictures one after the other - lateral and axial. To avoid injury to the fundus, images should be taken with soft x-rays.

Microfocus radiography

Microfocus radiography is a complex definition. The research involves various methods of obtaining images of objects in X-ray photographs, the diameter of which focal spots are no more than one tenth of a millimeter. Microfocus radiography has a number of features and advantages that distinguish it from other research methods.

Microfocus radiography:

allows you to obtain multiple magnification of objects in photographs with increased sharpness;
based on the size of the focal spot and other features when shooting, it makes it possible to enlarge multiple times without losing the quality of the photograph;
The information content of an x-ray image is significantly higher than in traditional radiography, with lower doses of radiation exposure.

Microfocus radiography is an innovative research method used in cases where conventional radiography is not able to determine the area of damage to an organ or structure.

Contrast radiography

Contrast radiography is a combination of radiological studies. Their characteristic feature is the principle of using radiocontrast agents to increase the diagnostic accuracy of the resulting image.

The contrast method is used to examine the cavities inside organs, to assess their structural features, functionality and localization. Special contrast solutions are injected into the area under study so that due to the difference

One of these methods is irrigoscopy. During it, radiologists examine the structure of the walls of organs while ridding them of contrast agents.

Contrast radiography is often used in studies:

genitourinary system;
with fistulography;
to determine the characteristic features of blood flow.

Intraoral radiography

With the help of an examination using contact intraoral (intraoral) radiography, all types of diseases of the upper and lower jaw and periodontal tissue can be diagnosed. Intraoral x-rays help identify the development of dental pathologies in the early stages, which cannot be achieved during a routine examination.

The procedure has a number of advantages:

high efficiency;
rapidity;
painlessness;
wide availability.

The procedure for performing intraoral radiography is not particularly difficult. The patient is seated in a comfortable chair, then asked to stand still for a few seconds, squeezing the film with his jaws for the image. During the procedure, you must hold your breath for a short time. A photo is taken within three to four seconds.

Radiography of soft tissues

Examination of soft tissues using radiography is carried out to obtain operational information about:

muscle condition;
articular and periarticular capsules;
tendons;
ligaments;
connective tissues;
skin;
subcutaneous fat tissue.

Using a detailed image, a radiologist can examine the structure, density and size of connective tissues. During the examination, X-ray rays penetrate soft tissue, and the machine displays the scanned image on the screen.

During an examination using this method, the doctor asks the person to tilt his head in different directions, up and down. In this case, the bones are fixed in a certain position, which is subsequently displayed on the pictures. This is called radiography with functional tests.

For the majority of modern children and adolescents suffering from problems associated with dysfunction of the musculoskeletal system, this type of X-ray examination is especially important.

In order to identify hidden pathologies in a timely manner, children should undergo x-rays with functional tests of the cervical spine. This examination is suitable for all children, regardless of age. In infants, examination can reveal injuries and abnormalities received immediately after birth. Pediatric radiography can promptly report problems with skeletal development (scoliosis, lordosis, kyphosis).

Photo gallery

Intraoral Contrast Microfocus Radiography of soft tissues Panoramic X-ray according to Vogt

Preparing for X-rays

To properly prepare for the x-ray procedure, you must:

Get a referral for an x-ray from your doctor.
To ensure a clear and unblurred picture, you need to hold your breath for a few seconds before starting the x-ray.
Be sure to remove all metal objects before starting the examination.
If we are talking about examining the gastrointestinal tract, you need to minimize the amount of food and drink you consume several hours before the start of the examination.
In some special cases, the patient requires a cleansing enema before X-ray examinations.

Research technique

To comply with the rules for x-ray examination, you must:

The medical worker must leave the room before the procedure begins. If his presence is required, he must wear a lead apron for radiation safety reasons.
The patient needs to take the correct position at the X-ray machine in accordance with the instructions received from the radiologist. Often he needs to stand, but sometimes the patient is asked to sit or lie on a special couch.
The person is prohibited from moving during the examination until the procedure is completed.
Based on the purpose of a particular study, the radiologist may need to take images in several projections. Most often these are direct and lateral projections, respectively.
Before the patient leaves the office, the healthcare worker should check the quality of the image and, if necessary, repeat the procedure.

The number of images during X-ray control is determined by the doctor personally.

How are radiographic results interpreted?

When interpreting an x-ray, the doctor pays attention to factors such as:

form;
displacement;
intensity;
size;
contours, etc.

Since the image is taken in the mode of X-rays passing through the patient's body, the dimensions on the X-ray photo do not correspond to the anatomical parameters of the patient. The specialist studies the shadow picture of the organs. Draws attention to the roots of the lungs and the pulmonary pattern. Based on the image, a radiologist writes a description that is sent to the attending physician.

Plan:

1) X-ray studies. The essence of radiological research methods. X-ray examination methods: fluoroscopy, radiography, fluorography, X-ray tomography, computed tomography. Diagnostic value of X-ray studies. The role of the nurse in preparing for x-ray examinations. Rules for preparing the patient for fluoroscopy and radiography of the stomach and duodenum, bronchography, cholecystography and cholangiography, irrigoscopy and graphy, plain radiography of the kidneys and excretory urography.

X-ray examination of the renal pelvis (pyelography) is carried out using urografin administered intravenously. X-ray examination of the bronchi (bronchography) is carried out after spraying a contrast agent - iodolipol - into the bronchi. X-ray examination of blood vessels (angiography) is carried out using a cardiotrast administered intravenously. In some cases, contrasting of an organ is performed using air, which is introduced into the surrounding tissue or cavity. For example, during an X-ray examination of the kidneys, when there is a suspicion of a kidney tumor, air is injected into the perinephric tissue (pneumorrhea) ; To detect tumor growth of the stomach walls, air is introduced into the abdominal cavity, i.e., the study is carried out under conditions of artificial pneumoperitoneum.

Tomography - layer-by-layer radiography. In tomography, due to the movement of the X-ray tube on film during shooting at a certain speed, a sharp image is obtained only of those structures that are located at a certain, predetermined depth. The shadows of organs located at a shallower or greater depth are blurred and do not overlap the main image. Tomography facilitates the identification of tumors, inflammatory infiltrates and other pathological formations. The tomogram indicates in centimeters at what depth, counting from the back, the picture was taken: 2, 4, 6, 7, 8 cm.

One of the most advanced techniques that provides reliable information is CT scan, which, thanks to the use of a computer, allows one to differentiate tissues and changes in them that differ very slightly in the degree of absorption of X-ray radiation.

On the eve of any instrumental study, it is necessary to inform the patient in an accessible form about the essence of the upcoming study, the need for it, and obtain consent to conduct this study in writing.

Preparing the patient for X-ray examination of the stomach and duodenum. This is a research method based on X-ray examination of hollow organs using a contrast agent (barium sulfate), which allows one to determine the shape, size, position, mobility of the stomach and duodenum, localization of ulcers, tumors, assess the relief of the mucous membrane and the functional state of the stomach ( its towing capacity).

Before the study you must:

1. Instruct the patient according to the following plan:

a) 2-3 days before the test, it is necessary to exclude gas-forming foods (vegetables, fruits, brown bread, milk) from the diet;

b) on the eve of the study at 6 pm - light dinner;

c) warn that the study is carried out on an empty stomach, so on the eve of the study the patient should not eat or drink, take medications or smoke.

2. In case of persistent constipation, as prescribed by the doctor, in the evening, on the eve of the study, a cleansing enema is given.

5. In order to contrast the esophagus, stomach and duodenum, in the X-ray room the patient drinks an aqueous suspension of barium sulfate.

Performed to diagnose diseases of the gallbladder and biliary tract. It is necessary to warn the patient about the possibility of nausea and loose stools as a reaction to taking a contrast agent. It is necessary to weigh the patient and calculate the dose of contrast agent.

The patient is instructed according to the following scheme:

a) on the eve of the study, for three days the patient follows a diet without high fiber content (exclude cabbage, vegetables, wholemeal bread);

b) 14 - 17 hours before the study, the patient takes the contrast agent in fractions (0.5 grams) for an hour every 10 minutes, washed down with sweet tea;

c) at 6 pm - light dinner;

d) in the evening, 2 hours before bedtime, if the patient cannot empty the intestines naturally, give a cleansing enema;

e) in the morning on the day of the examination, the patient must come to the X-ray room on an empty stomach (do not drink, do not eat, do not smoke, do not take medications). Take 2 raw eggs with you. In the X-ray room, survey images are taken, after which the patient takes a choleretic breakfast (2 raw egg yolks or sorbitol solution (20g per glass of boiled water) for a choleretic effect). 20 minutes after taking the choleretic breakfast, a series of survey photographs are taken at certain intervals over a period of 2 hours.

Preparing the patient for cholegraphy(X-ray examination of the gallbladder of the biliary tract after intravenous administration of a contrast agent).

1. Find out allergy history (intolerance to iodine preparations). 1 - 2 days before the study, conduct a sensitivity test to the contrast agent. To do this, administer 1 ml of contrast agent, heated to t = 37-38 o C, intravenously, and monitor the patient’s condition. An easier way is to take a tablespoon of potassium iodide orally 3 times a day. If the allergy test is positive, a rash, itching, etc. appears. If there is no reaction to the injected contrast agent, continue preparing the patient for the study.

2. Before the study, instruct the patient according to the following plan:

2 - 3 days before the study - a slag-free diet.

At 6 pm - light dinner.

2 hours before bedtime - a cleansing enema, if the patient cannot empty the intestines naturally.

- The study is carried out on an empty stomach.

3. In the X-ray room, inject slowly intravenously over 10 minutes 20-30 ml of contrast agent, heated to t = 37-38 0 C.

4. The patient undergoes a series of survey photographs.

5. Ensure monitoring of the patient’s condition within 24 hours after the test in order to exclude delayed types of allergic reactions.

Preparing the patient for bronchography and bronchoscopy.

Bronchography is a study of the respiratory tract, which allows one to obtain a radiographic image of the trachea and bronchi after introducing a contrast agent into them using a bronchoscope. Bronchoscopy- an instrumental, endoscopic method for examining the trachea and bronchi, allowing for examination of the mucous membrane of the trachea, larynx, collection of contents or bronchial lavage water for bacteriological, cytological and immunological studies, as well as treatment.

1. To exclude idiosyncrasy to iodolipol, a single dose of 1 tablespoon of this drug is prescribed orally 2-3 days before the study and during these 2-3 days the patient takes a 0.1% solution of atropine 6-8 drops 3 times a day).

2. If bronchography is prescribed for a woman, warn that there is no varnish on her nails and no lipstick on her lips.

3. The night before, as prescribed by the doctor, the patient should take 10 mg of seduxen for sedative purposes (for sleep disturbances, a sleeping pill).

4. 30-40 minutes before the procedure, administer premedication as prescribed by the doctor: inject subcutaneously 1 ml of a 0.1% atropine solution and 1 ml of a 2% promedol solution (make an entry in the medical history and narcotic drug log).

Preparing the patient for X-ray examination of the large intestine (irrigoscopy, irrigography), which allows you to get an idea of the length, position, tone, shape of the colon, and identify motor function disorders.

1. Instruct the patient according to the following scheme:

a) three days before the study, a slag-free diet is prescribed; b) if the patient is bothered by bloating, then it can be recommended to take chamomile infusion, carbolene or enzyme preparations for three days;

c) on the eve of the study at 15-16 hours the patient receives 30 g of castor oil (in the absence of diarrhea);

d) at 19:00 - light dinner; e) at 20:00 and 21:00 on the eve of the study, cleansing enemas are carried out until the effect of “clean water”;

f) in the morning on the day of the study, no later than 2 hours before irrigoscopy, 2 cleansing enemas are performed with an interval of one hour;

g) on the day of the study, the patient should not drink, eat, smoke or take medications. Using an Esmarch mug in the office, the nurse administers an aqueous suspension of barium sulfate.

Preparing the patient for X-ray examination of the kidneys (general X-ray, excretory urography).

1. Provide instructions on preparing the patient for the study:

Exclude gas-forming foods (vegetables, fruits, dairy, yeast-like products, brown bread, fruit juices) from the diet for 3 days before the test.

For flatulence, take activated charcoal as prescribed by your doctor.

Avoid eating 18-20 hours before the test.

2. The night before at about 22:00 and in the morning 1.5-2 hours before the study, give cleansing enemas

3. Invite the patient to empty the bladder immediately before the study.

In the X-ray room, a radiologist performs a survey of the abdominal cavity. The nurse administers a contrast agent slowly (over 5-8 minutes), constantly monitoring the patient’s well-being. The radiologist takes a series of images.