What is radiography and what results does the examination give? X-ray of the stomach and small intestine The principle of obtaining an X-ray

in medicine - study of morphological and functional features human organs and systems, incl. for the purpose of diagnosing diseases, based on obtaining and analyzing x-ray images of relevant areas of the body.

1. Small medical encyclopedia. - M.: Medical encyclopedia. 1991-96 2. First health care. - M.: Great Russian Encyclopedia. 1994 3. encyclopedic Dictionary medical terms. - M.: Soviet Encyclopedia. - 1982-1984.

See what “X-ray examination” is in other dictionaries:

X-ray examination- 25. X-ray examination is the use of x-rays to examine a patient for the purpose of diagnosis and/or prevention of diseases, consisting of one or more x-ray procedures. Source … Dictionary-reference book of terms of normative and technical documentation

X-ray examination

Examination of an x-ray. Radiology is a branch of radiology that studies the effects on the human body of x-ray radiation arising from this disease and pathological conditions, their treatment and prevention, as well as methods... ... Wikipedia

X-ray examination of the chest organs- rus X-ray examination(c) chest organs eng chest radiography fra radiographie (f) thoracique deu Thoraxröntgen (n), Thoraxröntgenaufnahme (f) spa radiografía (f) torácica … Occupational safety and health. Translation into English, French, German, Spanish

Study of the morphological and functional characteristics of human organs and systems, including for the purpose of diagnosing diseases, based on obtaining and analyzing x-ray images of the relevant areas of the body... Large medical dictionary

See Tomography... Large medical dictionary

I Polypositional study (Greek poly many + Lat. positio installation, position) is a method of x-ray examination in which, by changing the position of the patient’s body, optimal projections of the organ being studied are obtained. When changing position... ... Medical encyclopedia

X-ray examination- rus X-ray examination(c), radiographic examination (c); X-ray examination (с) eng X ray examination, radiological examination fra examen (m) radiologique deu Röntgenuntersuchung (f) spa examen (m) con rayos X,… … Occupational safety and health. Translation into English, French, German, Spanish

Radiography

In 1918, the first X-ray clinic was created in Russia. Radiography is used to diagnose everything more diseases. Lung radiography is actively developing. In 1921, the first X-ray dental office was opened in Petrograd. Research is being actively carried out and X-ray machines are being improved. The Soviet government is allocating funds to launch the production of X-ray equipment in Russia. Radiology and equipment production are reaching a global level.

Currently, radiography remains the main method for diagnosing lesions. osteoarticular system. Plays an important role in lung examination, especially as a screening method. Contrast radiography methods make it possible to assess the state of the internal relief of hollow organs, the prevalence of fistulous tracts, etc.

Application

In medicine

Radiography is used for diagnosis: X-ray examination (hereinafter referred to as X-ray) of organs allows us to clarify the shape of these organs, their position, tone, peristalsis, and the state of the relief of the mucous membrane.

• RI of the stomach and duodenum(duodenography) is important for recognizing gastritis, ulcerative lesions and tumors.
• RI of the gallbladder (cholecystography) and biliary tract (cholegraphy) is carried out to assess the contours, size, lumen of the intra- and extrahepatic bile ducts, the presence or absence of stones, and clarify the concentration and contractile functions of the gallbladder.
• RI of the colon (irrigoscopy) is used to identify tumors, polyps, diverticula and intestinal obstruction.
• chest radiography - infectious, tumor and other diseases,
• spine - degenerative-dystrophic (osteochondrosis, spondylosis, curvature), infectious and inflammatory ( different kinds spondylitis), tumor diseases.
• various parts of the peripheral skeleton - for various traumatic (fractures, dislocations), infectious and tumor changes.
• abdominal cavity - organ perforation, kidney function (excretory urography) and other changes.
• Metrosalpingography is a contrast X-ray examination of the uterine cavity and the patency of the fallopian tubes.
• teeth - orthopantomography

Under restoration

Acquiring an image

X-ray recording technique

Obtaining an image is based on the attenuation of X-ray radiation as it passes through various tissues and its subsequent recording on X-ray sensitive film. As a result of passing through formations of different densities and compositions, the radiation beam is scattered and decelerated, and therefore an image is formed on the film varying degrees intensity. As a result, the film produces an averaged, summation image of all tissues (shadow). It follows from this that in order to obtain an adequate x-ray, it is necessary to study radiologically heterogeneous formations.

In modern digital devices, the output radiation can be recorded on a special film cassette or on an electronic matrix. Devices with an electronic sensitive matrix are much more expensive than analog devices. In this case, films are printed only when necessary, and the diagnostic image is displayed on the monitor and, in some systems, stored in the database along with other patient data.

Principles of radiography

For diagnostic radiography, it is necessary to take pictures in at least two projections. This is due to the fact that an x-ray is a flat image of a three-dimensional object. And as a consequence, the localization of the detected pathological focus can be established only using 2 projections.

Image acquisition technique

The quality of the resulting x-ray image is determined by 3 main parameters. The voltage supplied to the X-ray tube, the current strength and the operating time of the tube. Depending on the anatomical formations being studied and the weight and dimensions of the patient, these parameters can vary significantly. There are averages for different organs and tissues, but it should be borne in mind that the actual values ​​will differ depending on the apparatus where the study is carried out and the patient for whom radiography is performed. An individual table of values ​​is compiled for each device. These values ​​are not absolute and are adjusted as the study progresses. The quality of the images taken largely depends on the ability of the x-ray technician to adequately adapt the table of average values ​​to a specific patient.

Recording an image

The most common way to record an X-ray image is to record it on X-ray sensitive film and then develop it. Currently, there are also systems that provide digital recording of data. Due to the high cost and complexity of manufacturing, this type of equipment is inferior in prevalence to analog.

Analog

There are the following options for obtaining images using X-ray film.

One of the previously used methods for obtaining usable density images is overexposure followed by underexposure, made during visual inspection. Currently this method considered obsolete and not widely used around the world.

Another way is adequate exposure (which is more difficult) and full development. With the first method, the X-ray load on the patient is overestimated, but with the second, it may become necessary to take repeated photographs. The advent of on-screen preview of a computerized X-ray machine with a digital matrix and automatic developing machines reduces the need and possibility of using the first method.

It should also be noted that the quality of the image is reduced by dynamic blur. That is, the blurring of the image is associated with the movement of the patient during irradiation. Secondary radiation poses a certain problem; it is formed as a result of the reflection of X-ray radiation from various objects. To filter scattered radiation, filtration gratings are used, consisting of alternating strips of X-ray transparent and X-ray opaque material. This filter filters out secondary radiation, but it also weakens the central beam, which requires a large dose of radiation to obtain an adequate image. The question of the need to use filter grids is decided depending on the size of the patient and the organ being x-rayed.

Many modern X-ray films have very low intrinsic X-ray sensitivity and are designed for use with intensifying fluorescent screens that emit blue or green visible light when irradiated with X-rays. Such screens, along with the film, are placed in a cassette, which, after the image is taken, is removed from the X-ray machine and then the film is developed. Film development can be done in several ways.

• Fully automatic when a cassette is inserted into the machine, after which the developing machine removes the film, develops it, dries it and refills a new one.
• Semi-automatically, when the film is removed and loaded manually, and the developing machine only develops and dries the film.
• Completely manually, when development takes place in tanks, the film is removed, refilled, and developed by an X-ray technician.

For X-ray image analysis, an analog X-ray image is recorded on an illuminating device with a bright screen - a negatoscope.

Digital

Resolution

Resolution reaches 0.5 mm (1 pair of lines per millimeter corresponds to 2 pixels/mm).

One of the highest film resolutions is considered to be “26 pairs of lines per mm,” which approximately corresponds to a resolution of 0.02 mm.

Preparing the patient for x-ray examination

Special preparation of patients for x-ray examination is generally not required, however, the following preparation methods are available for examination of the digestive organs:

• Previously, special diets were carried out, foods that contributed to flatulence were excluded from the diet, and a cleansing enema was performed, but now it is generally accepted that RI of the stomach and duodenum of patients with normal intestinal function does not require any preparation. However, in case of severe flatulence and persistent constipation, a cleansing enema is performed 2 hours before the test. If present in the patient's stomach large quantity liquid, mucus, food debris, gastric lavage is performed 3 hours before the test

• Before cholecystography, the possibility of flatulence is also excluded and a radiopaque iodine-containing drug is used (cholevid, iopagnost 1 g per 20 kg of live weight). The drug enters the liver and accumulates in the gallbladder. To determine the contractility of the gallbladder, the patient is given more choleretic agent- 2 raw egg yolks or 20 g of sorbitol.

• Before cholegraphy, the patient is injected intravenously with a contrast agent (bilignost, bilitrast, etc.), which contrasts the bile ducts.

• Before irrigography, it is carried out using a contrast enema (BaSO 4 at the rate of 400 g per 1600 ml of water). On the eve of the study, the patient is given 30 g castor oil, in the evening they give a cleansing enema. The patient does not eat dinner, the next day a light breakfast, two cleansing enemas, a contrast enema.

Benefits of radiography

• Wide availability of the method and ease of research.
• Most tests do not require special patient preparation.
• Relatively low cost of research.
• The images can be used for consultation with another specialist or in another institution (unlike ultrasound images, where a repeat examination is necessary, since the resulting images are operator-dependent).

Disadvantages of radiography

• “Frozenness” of the image is the difficulty of assessing organ function.
• The presence of ionizing radiation that can cause harmful effects on the organism under study.
• The information content of classical radiography is significantly lower than such modern methods medical imaging, such as CT, MRI, etc. Conventional X-ray images reflect the projection layering of complex anatomical structures, that is, their summation X-ray shadow, in contrast to the layer-by-layer series of images obtained by modern tomographic methods.
• Without the use of contrast agents, radiography is practically uninformative for analyzing changes in soft tissues.

see also

Notes

Links

• Successful intraoral radiography - typical errors, their causes and solutions.

Literature

• Kishkovsky A.N., Tyutin L.A., Esinovskaya G.N. Atlas of placements for X-ray examinations. - Leningrad: Medicine, 1987. - 520 p.
• Lindenbraten L.D. Korolyuk I.P. Medical radiology (fundamentals) radiology diagnostics and radiation therapy). - 2nd revised and expanded. - Moscow: Medicine, 2000. - P. 77-79. - 672 s. - ISBN 5-225-04403-4

X-rays are related to special type electromagnetic oscillations that are created in the X-ray machine tube during a sudden stop of electrons. X-ray is a procedure that many people are familiar with, but some want to know more about it. What is an X-ray? How are x-rays done?

X-ray properties

IN medical practice The following X-ray properties have been used:

• Huge penetrating power. X-rays successfully pass through various tissues of the human body.
• X-rays cause light reflection of individual chemical elements. This property underlies fluoroscopy.
• Photochemical exposure to ionizing rays makes it possible to create informative images from a diagnostic point of view.
• X-ray radiation has an ionizing effect.

During an X-ray scan various organs, tissues and structures act as targets for x-rays. During a minor radioactive load, metabolism may be disrupted, and with prolonged exposure to radiation, acute or chronic radiation sickness may occur.

X-ray machine

X-ray machines are devices that are used not only in diagnostic and medicinal purposes in medicine, but also in various fields of industry (flaw detectors), as well as in other areas of human life.

X-ray machine design:

• emitter tubes (lamp) - one or more pieces;
• a power supply device that supplies the device with electricity and regulates radiation parameters;
• tripods that make it easier to control the device;
• X-ray to visible image converters.

X-ray machines are divided into several groups depending on how they are designed and where they are used:

• stationary – they are usually equipped in rooms in radiology departments and clinics;
• mobile – intended for use in surgery and traumatology departments, in wards intensive care and outpatient;
• portable, dental (used by dentists).

As X-rays pass through the human body, they are projected onto film. However, the angle of reflection of the waves may be different and this affects the image quality. The bones are best visible in the photographs - bright white. This is because calcium absorbs X-rays the most.

Types of diagnostics

In medical practice, X-rays have found application in the following diagnostic methods:

• Fluoroscopy is an examination method in which, in the past, the organs being examined were projected onto a screen coated with a fluorescent compound. In the process, it was possible to study the organ from different angles in dynamics. And thanks to modern digital processing, the finished video image is immediately obtained on the monitor or displayed on paper.
• Radiography is the main type of examination. The patient is given a film with a fixed image of the examined organ or part of the body.
• X-ray and fluoroscopy with contrast. This type of diagnosis is indispensable when examining hollow organs and soft tissues.
• Fluorography is an examination with small-format X-ray images, which allow it to be used en masse during preventive examinations of the lungs.
• CT scan(CT) is a diagnostic method that allows a detailed study of the human body through a combination of X-rays and digital processing. Computer reconstruction of layer-by-layer X-ray images takes place. Of all the methods of radiation diagnostics, this is the most informative.

X-rays are used not only for diagnosis, but also for therapy. Widely used in the treatment of cancer patients radiation therapy.

In case of provision emergency care The patient initially undergoes a plain radiography

The following types of X-ray examination are distinguished:

• spine and peripheral parts of the skeleton;
• chest;
• abdominal cavity;
• a detailed image of all teeth with jaws, adjacent parts of the facial skeleton;
• checking the patency of the fallopian tubes using x-rays;
• X-ray examination of the breast with a low dose of radiation;
• X-ray contrast examination of the stomach and duodenum;
• diagnosis of the gallbladder and ducts using contrast;
• examination of the colon with retrograde injection of a radiocontrast agent into it.

Abdominal x-rays are divided into plain x-rays and procedures performed with contrast. Fluoroscopy has been widely used to determine pathologies in the lung. X-ray examination of the spine, joints and other parts of the skeleton is a very popular diagnostic method.

Neurologists, traumatologists and orthopedists cannot give their patients an accurate diagnosis without using this type of examination. X-ray shows spinal hernia, scoliosis, various microtraumas, disorders of the osseous-ligamentous apparatus (pathologies of a healthy foot), fractures (of the wrist joint) and much more.

Preparation

Most of Diagnostic procedures involving the use of X-rays do not require special training, but there are exceptions. If an examination of the stomach, intestines or lumbosacral spine is planned, then 2-3 days before the x-ray you need to follow a special diet that reduces flatulence and fermentation processes.

When examining the gastrointestinal tract, it is necessary to do cleansing enemas in the classical way using an Esmarch mug on the eve of diagnosis and directly on the day of the examination or to cleanse the intestines using pharmaceutical laxatives (oral medications or microenemas).

When examining the abdominal organs, you should not eat, drink, or smoke at least 3 hours before the procedure. Before going for a mammogram, you should visit a gynecologist. An X-ray examination of the breast should be performed at the beginning of the menstrual cycle after the end of menstruation. If a woman who is planning a breast examination has implants, then she must inform the radiologist about this.

Carrying out

Upon entering the X-ray room, he must remove items of clothing or jewelry that contain metal, and also leave them outside the room. mobile phone. Typically, the patient is asked to undress to the waist if being examined rib cage or peritoneum. If it is necessary to perform an x-ray of the extremities, the patient can remain in clothes. All parts of the body that are not subject to diagnosis must be covered with a protective lead apron.

Pictures can be taken in various positions. But most often the patient stands or lies down. If a series of images from different angles is needed, the radiologist gives commands to the patient to change body position. If an x-ray of the stomach is performed, the patient will need to take the Trendelenburg position.

This is a special pose in which the pelvic organs are slightly above the head. As a result of the manipulations, negatives are obtained, which show light areas of denser structures and dark areas indicating the presence of soft tissues. Deciphering and analysis of each area of ​​the body is performed according to certain rules.

Children often have x-rays taken to check for hip dysplasia.

Frequency

The maximum permissible effective dose of radiation is 15 mSv per year. As a rule, only people who need regular X-ray monitoring (after severe injuries). If during the year the patient only undergoes fluorography, mammography and x-rays at the dentist, then he can be completely calm, since his radiation exposure will not exceed 1.5 mSv.

Acute radiation sickness can only occur if a person receives a single dose of 1000 mSv. But if this is not a liquidator at a nuclear power plant, then in order to receive such a radiation dose, the patient must undergo 25 thousand fluorographs and a thousand x-rays spine. And this is nonsense.

The same radiation doses that a person receives during standard examinations, even if they are increased in quantity, are not capable of having a noticeable negative effect on the body. Therefore, x-rays can be taken as often as required. medical indications. However, this principle does not apply to pregnant women.

X-rays are contraindicated for them at any stage, especially in the first trimester, when the formation of all organs and systems in the fetus occurs. If circumstances force a woman to have an X-ray while carrying a child (serious injuries during an accident), then they try to use maximum protective measures for the abdomen and pelvic organs. During breastfeeding, women are allowed to have both x-rays and fluorography.

Moreover, according to many experts, she does not even need to express milk. Fluorography is not performed on young children. This procedure is permissible from the age of 15. As for X-ray diagnostics in pediatrics, they resort to it, but take into account that children have increased radiosensitivity to ionizing radiation(on average 2–3 times higher than adults), which creates a high risk for them of both somatic and genetic effects of radiation.

Contraindications

Fluoroscopy and radiography of organs and structures of the human body have not only many indications, but also a number of contraindications:

• tuberculosis in active form;
• endocrine pathologies thyroid gland;
• general serious condition of the patient;
• carrying a child at any stage;
• for radiography using contrast – lactation period;
• serious disturbances in the functioning of the heart and kidneys;
• internal bleeding;
• individual intolerance to contrast agents.

Nowadays, X-rays can be taken in many medical centers. If radiographic or fluoroscopic examination is done on digital complexes, then the patient can count on a lower radiation dose. But even digital x-ray can be considered safe only if the permissible frequency of the procedure is not exceeded.