How many times a year can fluorography be done: doctors’ recommendations. X-ray radiation and health How long is fluorography valid?

Diagnostics, which allows you to obtain images of organs chest cavity by using x-rays, discovered at the beginning of the last century.

Due to the fact that X-ray radiation is used during fluorography, many consider it dangerous and refuse this important activity.

But it’s not worth it, since FLG can detect many serious lung diseases, including tuberculosis.

Why do you need fluorography and is it harmful?

Currently, fluorography is used to diagnose acute and chronic lung diseases(including tuberculosis, pneumonia, tumors, emphysema and silicosis), hearts and large vessels(pericarditis, rheumatic carditis, congenital and acquired heart defects and others), as well as bones, forming the chest.

Photo 1. X-ray photo of the lungs. They are grayish in color, the ribs are clearly visible, as well as the organs located in this area.

The method has found application in other areas - for recognizing ailments sinuses, pituitary gland And skull bones. Using fluorography, you can monitor the course of diseases and the effectiveness of treatment.

Due to its accessibility, fluorography is widespread and is also a powerful tool for the prevention of organ diseases chest cavity. Those working at enterprises undergo mandatory preventive examinations, including fluorographic examination, once a year, unemployed adults and pensioners - once every two years.

This procedure is also necessary for those who get a job or study after graduating from school, are going to go to a resort or travel abroad, as well as for expectant fathers whose wives are registered as pregnant women.

Despite the fact that during the fluorography procedure, a person is exposed to ionizing radiation, the harm from it is minimal. This is due to the fact that the process lasts hundredths of a second, and the radiation dose itself corresponds 2-8 days tanning in the sun.

Radiation dose during fluorography of the lungs, its consequences

The fluorography method is based on open Wilhelm Roentgen special radiation lying in the range between ultraviolet And gamma radiation, special kind electromagnetic waves. The discovery made by chance by a German physicist exceeded all expectations.

However, the little-studied phenomenon also had pitfalls. While the benefits of the new discovery are difficult to overestimate to this day, people did not immediately learn about the dangers of radiation. Many researchers and patients died from the consequences of radiation sickness, which developed due to excessive consumption large doses and absence protective measures, which were developed much later based on accumulated sad experience.

In X-ray diagnostics, units of measurement are usually used to determine the radiation dose x-ray And sievert. In this case, 1 roentgen = 1000 milliroentgen (mR), 1 sievert = 1000 millisievert (mSv).

Sieverts are used to determine radiation doses sieverts received by a person during his life accumulate.

How dangerous is it, is it possible to undergo FLG 2 times in a row?

We receive radiation (in small doses) from many external sources: sunlight, water, food, soil, air, housing and other materials and buildings, Vehicle, household appliances. In general, over the course of a year, approximately 2-3 mSv.

Reference. The maximum permissible dose of radiation for a person during a lifetime should not exceed 700 mSv.

Science is moving forward, and not so long ago, along with centuries-old film fluorography, a more modern and safer one appeared digital fluorography.

Effective equivalent dose (EDD) exposure received by a person during a conventional film fluorographic examination averages from 0.5 to 0.8 mSv, depending on the type of fluorograph. Older devices also have higher radiation exposure. With modern digital fluorography, the same dose will be only 0.03 - 0.06 mSv.

Important! Exposure to large doses over a short period of time is less dangerous than long-term use of small doses. It is due to the short exposure time that fluorographic examination, like large x-rays, is considered relatively harmless for patients.

Digital fluorography allows not only to reduce the radiation dose by an order of magnitude, but also, being copied onto electronic media, makes it possible to increase image to improve diagnostic quality. At the same time, a significant drawback of its film fluorography - small image size and low quality - loses its sharpness.

Photo 2. A woman undergoes fluorography using a digital machine. It gives more accurate results compared to its film predecessor, and also has a lower radiation dose.

Without any harm to health, if necessary, you can carry out repeatedly(when performing various diagnostic procedures, to assess the dynamics of the pathological process).

Are there any contraindications?

However, like any other procedure, it has contraindications, mainly relative, which include:

Age up to 15 years. In this case, to prevent tuberculosis, a diagnostic Mantoux test is usually performed instead of fluorography. Although the reaction is not specific (that is, it can be positive in other situations), it does not involve radiation exposure at all and is completely harmless.
Pregnancy And feeding chest. The fact is that in the first and second trimesters the formation of organs and systems of the fetus occurs, and X-rays can have a detrimental effect on their formation. The reason for performing fluorography in pregnant women must exceed the risk for the development of the unborn child. Fluorography does not affect the quality of milk and the health of nursing mothers, and breastfeeding is carried out using some preventive measures - lead aprons, expressing milk before and after the procedure.

Photo 3. Pregnant woman with an ultrasound image of her stomach. During pregnancy, it is not recommended to undergo fluorography.

Heavy a patient’s condition in which it is impossible to capture the correct image for purely technical reasons - for example, in bedridden patients or with severe shortness of breath, an attack of suffocation.
Fear closed spaces and other mental health conditions.

What do people who undergo fluorography benefit from?

Some people, having read or heard a lot of incorrectly presented information, prefer don't visit clinics and do not undergo fluorography. This happens due to an incorrect comparison of the risks and benefits of preventive procedures.

Attention! Without undergoing a fluorographic examination on time, you risk missing such dangerous diseases as cancer and tuberculosis, which are on initial stages their development do not cause any discomfort, and treatment in the early stages is most effective.

No one takes into account that we cause much greater harm to our health by leading an inactive lifestyle, neglecting the basic rules of hygiene and healthy sleep, eating harmful products, unreasonably and uncontrollably taking various medications, indulging in one’s addictions - smoking, excessive consumption of alcohol or other substances.

Don't neglect yours health and the health of people close to you.

Useful video

Watch the video in which Honored Doctor of the Russian Federation L. Z. Ginzburg talks about the dangers of fluorography.

Fluorography - universal remedy for diagnosing diseases lungs and heart. It is regularly prescribed to citizens who have reached 18 years.

The main federal regulatory document is often mistakenly considered Law No. 77 of 2001 “On preventing the spread of tuberculosis in the Russian Federation.” In fact, in the text of this document there is no mention of fluorography as a method of preventing and diagnosing tuberculosis.

What does the law require for fluorography?

In Russia since 2012 valid Law No. 1011n “On approval of the Procedure for conducting preventive medical examinations”. It is designed for maximum early detection hidden forms of diseases and prescribes a medical examination for persons over 18 years old periodically 1 time every 2 years.

When to get checked

The regulatory act classifies fluorography of the lungs as mandatory event during medical examination. Diagnostics need not be made if there is documentary evidence that the patient has undergone fluorography during last year .

The same restriction applies if there are current X-ray data or chest computed tomography readings.

The standards may be revised in case of individual need or if an epidemiological situation arises. The research is carried out within the framework of mandatory health insurance and is free for the patient.

Currently, the order of the Ministry of Health No. 124 n “On approval of the procedure and timing of preventive measures” is under development. medical examinations citizens for the purpose of detecting tuberculosis”, regulatory and fluorographic control. The law may come into force in 2018 and will replace the legal act No. 77 of 2001

How often should fluorography be done: table

Order of the Ministry of Health on mandatory fluorography

In accordance with by order of the Ministry of Health of the Russian Federation No. 302 n of 2011, medical employees at all levels are required to undergo fluorography upon entry to work, and then periodically 1 time per year.

The same requirement applies to service personnel of medical institutions.

Photo 1. Sample of a certificate issued upon successful completion of fluorography.

Fluorographic examination is mandatory for employees of children's organizations and public catering establishments, as well as companies with a profile social services.

Is it possible by law to refuse to conduct

Fluorography cannot be performed forcibly. The exception is unfavorable epidemiological situation or incapacity(inability to make informed independent decisions) of the patient.

For the majority of the adult population, the question of how often fluorography can be done arises because the examination involves a certain dose of radiation. The Law “On the Fundamentals of Protecting the Health of Citizens in the Russian Federation” requires all working citizens to undergo FLG for preventive purposes, but not everyone wants to be irradiated while in full health.

At the same time, people with chronic lung pathologies are forced to control the disease, but are afraid that they undergo fluorography too often. Therefore, it is necessary to know some aspects of this procedure, its necessity, and its effect on the body.

Fluorography as an x-ray examination

During the passage of FLG, X-rays in an amount of 0.05 millisievert are passed through the human body. This is a tiny dose within the permissible radiation exposure limit, which can help save your health. Using fluorographic examination chest medical specialists diagnose:

heavy infection lungs (tuberculosis);
inflammation of the lung tissue (pneumonia);
lungs' cancer;
inflammation of the pleural layers of the lungs (pleurisy);
pathologies of the cardiovascular system.

Based on the images taken, the doctor prescribes treatment. Timely initiation of therapy sometimes saves a person’s life, and if tuberculosis is diagnosed, it allows one to protect other people from infection by isolating the patient.

The advantages of the procedure include its low cost, and in many cases district clinics they do it for free. In addition, data is stored on digital media for a long time, requiring little time investment. The study lasts three minutes, and the decoding of the indicators takes no more than 24 hours. Sometimes it is very important to know how long it will take for the result to be ready. The advantages also include the absence painful sensations, high accuracy of indicators, no need for preliminary preparation of the patient.

Photo of fluorography of a healthy person - drawing of lungs within normal limits

Frequency of examination

According to the law of the Russian Federation, the working population needs to undergo fluorography once a year. Based on the results of the examination, a certificate is issued, which is required for employment, upon admission to study, before hospital treatment, and for conscripts. The results of lung fluorography are valid for 12 months. So if not special indications for examination, there is no need to undergo the procedure frequently.

For a healthy person, once a year is enough. To avoid untimely receipt of a portion of x-rays, it is important to know exactly the expiration date of the FLG. Another question about how often fluorography can be done arises if a person goes to the doctor with complaints about bad feeling or had contact with a patient with tuberculosis. In this case, pictures are taken more often, which helps to identify the disease.

There is a separate category of citizens who are required to undergo a fluorogram in a more intensive temporary mode. This is a justified preventive measure, since the likelihood of infection or acquisition pulmonary diseases this group of people has a higher level.

These include:

medical staff of maternity hospitals. Newborn children and pregnant women need enhanced protection;
doctors working with tuberculosis-infected patients. The risk of infection in this category is higher;
workers of mining enterprises. There is a large percentage of lung cancer in this industry;
workers in hazardous industries (asbestos, rubber) and steelworkers, who are also more often susceptible to lung cancer.

For these people, different rules apply regarding how many times a year fluorography can be done.

When is research not allowed?

FLG is not used for diagnosis in women during pregnancy. Why is this so important? Because X-rays can cause the development of pathologies in the unborn baby. This procedure is not recommended during lactation. In case of emergency, at least 6 hours should pass between the moment of irradiation and feeding. Milk should be expressed during this period. The procedure should not be performed on patients in serious condition. If it is not possible to postpone the process, it is better to use an MRI.

Children under 14 years of age are not exposed to radiation, since they receive a higher dose of radiation due to a more intense metabolism, only under absolute indications

Other cases:

fluorogram was done more than 2 times a year. It is recommended to replace the X-ray dose with magnetic resonance imaging.
there are chronic diseases of the respiratory system. IN acute period for bronchial asthma and respiratory failure, it is necessary to wait for a period of remission, since it is difficult for a person to hold his breath, which will significantly complicate the examination.

Annual X-ray control is not only the prevention of diseases in yourself. In cases where a person has undergone the procedure and the diagnosis of a lung infection is confirmed, there is a chance to protect loved ones if they have not yet undergone FLG.

The question of how often fluorography can be done is one of the most overgrown with stereotypes and speculation. According to some people, this procedure, in addition to its diagnostic properties, can also pose a threat to the patient’s health. Among such prejudices, the most common opinion is that fluorography should not be performed more often than once a year.

What is fluorography

The main physical element in fluorography is x-ray radiation, which is one of many types of radiation and is called ionizing. This procedure is necessary to examine organs located in the chest area. During this diagnostic procedure, the human body passes small dose of radiation, which leads to partial absorption of incoming radiation by the body.

The result of these actions is to obtain tissue images internal organs, which can be seen on the fluorescent screen. Thus, when carrying out a fluorography procedure, the average radiation dose is 3 R (roentgen), or 0.03 Sv (sievert), and nowadays, with the help of the latest equipment, these indicators can be reduced to 2.3 R. At the same time, for For the human body, a dose of 5 R per year is considered harmless.

Indications and contraindications

Twice a year The fluorography procedure is recommended for people who have chronic diseases of the respiratory system, working in maternity hospitals, tuberculosis clinics, sanatoriums, as well as for the sick. The rest have enough examinations once a year.

This diagnostic method should absolutely not be used. to children who are under 15 years of age (with age, the effect of radiation on the body becomes less and less, because the older a person is, the lower the activity of processes at the intercellular level is observed; accordingly, the low influence of X-rays is observed), mothers, nursing, pregnant women, and also for people who have specific diseases.

In general, if you adhere to all established standards when undergoing a fluorographic examination, then this procedure is completely harmless to the human body. It is worth noting that a person is exposed to radioactive radiation throughout his life due to the natural radioactive background of the earth, and such elements of existence as the sun. However, the level of such radiation is extremely low.

Fluorography is effective way radiographs, in which images obtained under the influence of an x-ray are photographed. Tissues of the human body with different densities in varying degrees transmit such radiation. Thanks to this, darker and lighter areas are visible in the image, which depend on the structure of the tissues themselves. But how often can fluorography be done? To answer this question you need to thoroughly understand this topic.

In what cases is a fluorogram performed?

The standard fluorography procedure is an examination of the body in the chest area. Based on the results of the studies, diseases are diagnosed various organs: lungs, heart muscle, mammary glands. A fluorogram can show the following problems:

Tumor;
inflammatory processes (with significant spread);
cavities filled with liquids/gases;
sclerosis;
fibrosis;
foreign parts.

Regularity

Every person needs to understand how many times a year fluorography can be done. Even if you have no symptoms or other infections, having a chest exam every year is recommended. This procedure is also part of a comprehensive therapeutic examination, which allows us to identify the risk of developing various pathologies in the early stages.

The following categories of people need to be examined every year:

Employees of companies and organizations with professional activity, which is associated with the decreed contingent.
All citizens over 40 years of age. This need arises due to the fact that this category has a high risk of infection with tuberculosis or pulmonary malignant tumors.
People with a chronic nonspecific disease related to the respiratory organs, gastrointestinal tract and genital organs (diabetes, stomach/intestinal ulcers).
Citizens who have mental disorders, dust lung diseases, hyperergic reactions to the administration of tuberculin.
Persons who abuse alcohol, tobacco and drugs.
Citizens who have been prescribed corticosteroid, radiation or cytostatic therapy.
People belonging to social groups with a high probability of infection with tuberculosis inflammation.
Citizens who live in social premises for helping the homeless/refugees/implanted people.
Persons previously involved in the production of quartz/asbestos dust, the production of carcinogens (nickel, chromium, etc.).
People with residual changes in the lungs or pleura of non-tuberculous origin.
Citizens who have close and prolonged contact with pregnant women and newborn children, as well as persons surrounded by children and adolescents being tested.
For teenagers in case of conscription military service– the fluorogram is cut out and attached to the documents submitted to the military registration and enlistment office.
Persons who live in social hostels.
Citizens undergoing training from educational institutions (secondary and highest categories).

Often the answer to the question “how often should fluorography be done” is “twice a year”. This need arises among the following groups of people:

Military personnel serving on the basis of conscription based on age.
Maternity hospital employees who spend a lot of time with expectant mothers and babies.
Persons with close relatives or work colleagues who are sick.
Citizens who have previously suffered tuberculous inflammation with residual changes in the lungs. This need lasts for the first 3 years after diagnosis of the disease.
People who have recovered from tuberculosis and were deregistered from the tuberculosis dispensary.
Persons who have been released from prison must have their health checked for 2 years.
Citizens under investigation in pre-trial detention centers and convicts held in correctional colonies.
HIV-infected people.
Patients who are registered with narcologists or psychiatrists.

In addition to the scheduled preventive examination, an extraordinary fluorogram is indicated for the following groups of people:

People aged 15 to 40 years who are admitted to hospital treatment or are visiting medical institutions for the first time for the current year.
Citizens over 15 years of age who are entering study/work.
Persons who care for their children in children's hospitals.
Citizens coming from other countries/regions to enter a university or to work.
People who are diagnosed with HIV infection for the first time.

How often should fluorography be done for adults who do not belong to high-risk groups and the decreed population? In this case, the regularity of fluorograms is 1.5-2 years. If you have had long-term close contact with people infected with tuberculosis infection, then this kind of x-ray should be carried out every six months.

Fluorogram safety

Many people, when asked the question “how many times can you do fluorography,” answer “when you want to check your health.” But such a procedure can cause quite serious harm to the human body.

If radiographic examinations are carried out every 12 months, the dosage of radioactive exposure will be relatively low, and such procedures will in no way affect your body. Therefore, fluorograms are often indicated only when absolutely necessary.

Now you know how often you can do fluorography of the lungs, so you can correctly calculate whether the annual amount of x-ray exposure has been exceeded.

Hearing the word " radiation“We are presented with a certain image of an insidious, invisible and deadly enemy, capable of causing enormous harm to our health. It cannot be touched, cannot be seen, cannot be recognized by smell...

Impact radiation on a person is usually called exposure. Each of us has heard that this radiation can cause metabolic disorders, cell mutations, leukemia, infertility, radiation sickness and cancer. The effects of radiation are stronger on young dividing cells, so radiation affects children much more strongly than adults.

Serious effects on human health irradiation can only have an effect if the radiation dose exceeds 0.05 m3v per hour. If you are in an area of radiation charge or exposure, for example, undergoing an X-ray examination or fluorography, the level of exposure may exceed this permissible limit. In addition, radiation accumulates in the body and to maintain health, its amount over a lifetime should not exceed the limit of 100 - 700 m3v. Therefore, fluorography is considered a procedure harmful to the body and is often not recommended.

Fluorography called a medical examination of the chest organs. It is carried out using x-rays that pass through the human body. Fluorography is often called “lung x-ray”, as it is done in order to promptly identify foci of tuberculosis, tumors, neoplasms and other pathologies in the lungs. However, not all chest diseases can be detected using fluorography. For example, pneumonia will be noticeable only when it takes on a fairly advanced form.

Fluorography was invented as a cheaper and more mobile analogue of x-rays. To perform it, much less film is required, which reduces the cost of the research procedure by 10 times. X-rays are developed using special devices or baths, and until recently, fluorography images were developed directly in rolls. Due to the fact that roll film is less sensitive to X-rays, the radiation exposure during fluorography using the old method had to be done 2 times more than during X-rays.

For comparison when carrying out film fluorography the patient receives radiation up to 0.8 m3v, and when passing an x-ray only 0.10-0.26 m3v. In addition, after processing the roll film, about 15% of the images were rejected, so scientists developed a new method of fluorography, which is now implemented in almost all medical institutions.

Modern fluorography technique is digital. It does not require the use of film; the digital image is immediately transferred to a computer and stored there. Digital fluorography allows you to obtain the most accurate images and provides a lower radiation dose - it does not exceed 0.1 mSv.

Considering that the recommended The annual effective dose of radiation is considered to be 1 m3v, fluorography on digital equipment can be considered practically harmless. However, you cannot undergo any fluorography more than once a year without a doctor’s prescription. As mentioned above, radiation tends to accumulate in the body and lead to cell mutation.

Quantity procedures fluorography can be increased only according to doctor's indications. Fluorography is contraindicated for children under 15 years of age; they should not be on the list of preventive medical examinations. Also, fluorography is not performed on women during pregnancy and breastfeeding.

Today in Russia Tuberculosis is the second most common disease after HIV. The earlier tuberculosis is detected, the more successful the treatment. Therefore, the Government of the Russian Federation was forced to issue a Resolution obliging certain categories of people to undergo fluorography twice a year in order to prevent the spread of tuberculosis.

To them relate: military personnel, maternity hospital workers who were in close contact with a patient with tuberculosis, who had tuberculosis up to 3 years after deregistration, HIV-infected people, patients with drug addiction and psychiatric institutions, former prisoners up to 2 years after release, persons under investigation and convicts held in isolation wards and prisons.

It is mandatory to undergo it once a year fluorography patients with respiratory diseases, genitourinary system And intestinal tract, diabetics, migrants, displaced persons, persons without registration, employees of kindergartens and schools, sanatoriums, resorts and dispensaries.

Of course, any research radiation related, are undesirable, but if the doctor prescribes you to undergo fluorography a second time for successful treatment, it is better to follow his recommendations. May you receive more radiation than you will develop the disease and take medications for the rest of your life.

Today, when the situation in our country with morbidity tuberculosis And lung cancer disappointing, it is most likely appropriate to talk about the “uselessness” of fluorography rather than about its danger to health. After all, there are facts that the percentage of detection of tuberculosis and cancer in the early stages using fluorography is very low.

Fluorography as an x-ray examination

During the passage of FLG, X-rays in an amount of 0.05 millisievert are passed through the human body. This is a tiny dose within the permissible radiation exposure limit, which can help save your health. Using a fluorographic examination of the chest, medical specialists diagnose:

severe infectious lung disease (tuberculosis);
inflammation of the lung tissue (pneumonia);
lungs' cancer;
inflammation of the pleural layers of the lungs (pleurisy);
pathologies of the cardiovascular system.

The advantages of the procedure include its low cost, and many district clinics do it for free. In addition, data is stored on digital media for a long time, requiring little time investment. The study lasts three minutes, and the decoding of the indicators takes no more than 24 hours. Sometimes it is very important to know how long it will take for the result to be ready. The advantages also include the absence of pain, high accuracy of indicators, and no need for preliminary preparation of the patient.

Photo of fluorography of a healthy person - drawing of lungs within normal limits

Frequency of examination

According to the law of the Russian Federation, the working population needs to undergo fluorography once a year. Based on the results of the examination, a certificate is issued, which is required for employment, upon admission to study, before hospital treatment, and for conscripts. The results of lung fluorography are valid for 12 months. Therefore, if there are no special indications for the examination, there is no need to undergo the procedure frequently.

For a healthy person, once a year is enough. To avoid untimely receipt of a portion of x-rays, it is important to know exactly the expiration date of the FLG. Another question about how often fluorography can be done arises if a person goes to the doctor with complaints of feeling unwell or has had contact with a patient with tuberculosis. In this case, pictures are taken more often, which helps to identify the disease.

There is a separate category of citizens who are required to undergo a fluorogram in a more intensive temporary mode. This is a justified preventive measure, since this group of people is more likely to become infected or acquire pulmonary diseases.

These include:

medical staff of maternity hospitals. Newborn children and pregnant women need enhanced protection;
doctors working with tuberculosis-infected patients. The risk of infection in this category is higher;
workers of mining enterprises. In this industry a large percentage oncological diseases lungs;
workers in hazardous industries (asbestos, rubber) and steelworkers, who are also more often susceptible to lung cancer.

For these people, different rules apply regarding how many times a year fluorography can be done.

When is research not allowed?

Children under 14 years of age are not exposed to radiation, since they receive a higher dose of radiation due to a more intense metabolism, only under absolute indications

Other cases:

fluorogram was done more than 2 times a year. It is recommended to replace the X-ray dose with magnetic resonance imaging.
available chronic diseases respiratory system. In the acute period bronchial asthma and respiratory failure, it is necessary to wait for a period of remission, since it is difficult for a person to hold his breath, which will significantly complicate the examination.

The older population does not have questions regarding how often fluorography can be done, since for them this is known information. The explanation for this is very simple: people are aware of regular medical examinations and have repeatedly participated in them. But the younger generation does not yet have such experience and questions arise in connection with the small dose of radiation received during fluorographic examination. Let's consider this topic in more detail.

On the effect of X-ray radiation on humans

A diagnostic method called fluorography (FLG) involves the passage of X-rays through the human body, as a result of which images of the organs and bones of the skeleton are left on a photosensitive film. The effect of x-rays is based on the different throughput of bone and soft tissue. The former will be reflected in the image as light areas, and the latter as dark areas.

Film and digital FLG studies are now used. Of the two types, digital radiation is safer in terms of the degree of impact of EED (effective equivalent dose) with an indicator not exceeding 0.03-0.05 mSv, while for traditional it is 0.5 mSv, which is equivalent to half the permissible rate of exposure for year.

How many times a year fluorography can be done depends on a number of individual factors for the person. If a patient has a disease, the dynamics of treatment of which is monitored using FLG studies, then examinations will be carried out more often, preferably in digital format. For the most part, the population is recommended one procedure every two years for prevention.

Why is a fluorographic examination prescribed for the first time and again?

From the age of 18, the population is recommended to undergo a medical examination for preventive purposes, including to detect tuberculosis (according to the order of the Ministry of Health of the Russian Federation dated December 6, 2012 No. 1011 “On approval of the procedure for conducting a preventive medical examination”).

Previously, document No. 77-FZ of June 18, 2001 “On preventing the spread of tuberculosis in the Russian Federation” was mistakenly referred to as the Law on Fluorography in Russia.

This is an accessible type of diagnosis that effectively detects not only the specified disease, but also other pathological processes, such as:

Indications for annual FLG are:

medical examination of employees of medical institutions, social sphere, military personnel and conscripts and others;
cases of suspected tuberculosis and AIDS;
examination of antisocial persons and displaced persons;
checking the epidemiological environment of a pregnant woman, newborn, small children according to strict indications (focus of tuberculosis);
employment.

A repeated procedure is prescribed for the treatment of tuberculosis, bronchitis and pneumonia to assess the effectiveness of therapy.

About absolute contraindications and more

This diagnostic method is not used for examination:

children under 15 years of age (except in vital situations);
pregnant women up to 26 weeks (except for medical indications);
patients in a state with decompensated respiratory failure;
severe patients who cannot be kept in an upright position;

In addition, relative contraindications for the procedure include more late date pregnancy and breastfeeding period.

After FLG irradiation, the mother cannot feed the baby with milk; it must be expressed.

Mandatory preventive examination

In 2018, a new Order of the Ministry of Health is being prepared on the frequency of fluorography (No. 124n), which will regulate the timing and procedure for medical examinations, including FLG diagnostics. This document will develop recommendations for the location of the procedure and list categories of citizens and working professions for which an increased schedule of fluorographic examinations has been established.

This order will prescribe how many times fluorography can be done, taking into account the risk existing probability occurrence of consequences from the received radiation dose. But even today there are groups of people who, as a recommendation, should undergo FLG once every 6 months. This:

patients with an established diagnosis of tuberculosis, cancer and those who have suffered acute bronchopulmonary disease;
patients with chronic diseases: asthma, bronchitis, and HIV infection;
workers in hazardous industries.

How often chest fluorography can be done in the recovery period after an illness will depend on its severity and the patient’s health condition. Based on these indications, the doctor decides to prescribe FLG or another examination method.

About the possibility of refusing the examination

At every enterprise and in government agencies, by internal order in the prescribed manner, workers and employees must undergo medical examinations provided for by the legislation of the Russian Federation. Sample order for undergoing fluorography and others medical research for employees of different professions in the enterprise can be found in Internet sources.

But the legislative framework does not regulate forced fluorography, except in cases of patient incapacity due to illness and unfavorable epidemiological conditions. You can refuse an FLG study by writing a statement and having it signed by the head physician of the clinic.

You can undergo gentle x-ray diagnostics, which is equivalent to a fluorographic procedure, but with a lower irradiation dose and more long term actions.

What could be the consequences of frequent sessions?

There is an annual EED of 1 mSv, the impact of which is considered acceptable and does not interfere with the functioning of the body. It is assumed that after a year, the damage caused by X-rays goes away. Therefore, doctors prescribe FLG examinations taking into account the total x-ray dose.

That is why fluorography is done once a year in the absence of certain diseases and urgent need. It has already been mentioned that in some cases these procedures have to be applied repeatedly and more than once. At the same time, you need to know that in the digital diagnostic format, x-ray radiation dosages are ten times lower than with film fluorographic examination.

Whether it is harmful to do fluorography twice in a row will be clear from the amount of x-ray radiation. Even with the traditional method, this fits into the permissible indications, provided that there are no such sessions in the current year.

X-rays in large doses have a detrimental effect on a person, as a result of which changes in blood composition and damage are possible skin, the occurrence of neoplasms, infertility. Is not full list what will happen if you do fluorography often. However, when medical indications, when the risk of the procedure is less than the consequences of refusing it, the doctor takes pictures, carefully monitoring the patient’s condition during and after FLG.

Briefly about the examination of children and pregnant women

Fluorography is not prescribed for children. Diagnosis before age 16 bronchopulmonary diseases is performed for them exclusively with the help of radiography, and for a test for tuberculosis, the Mantoux test is done. This is due to the fact that x-rays can cause irreparable harm to a child’s growing body. .

For a woman carrying a baby, receiving X-ray radiation is also extremely harmful, especially during the period of active formation of the child’s systems and organs, that is, before the 26th week of pregnancy. This may lead to the development of fetal pathologies.

Cases of appointment for such a procedure are strictly limited. If you replace FLG alternative way examination is impossible; during the session, pregnant women wear protective aprons made of leaded rubber over the abdominal area. .

Let's summarize the current issues

For the majority of the Russian population, surveys are carried out no more than once a year, and during the subsequent annual period the result will be valid and can be provided at the place of request, including upon admission to study and work. But you need to remember the date of the last FLG session.

Fluorography is a chest examination based on X-ray technology. Everyone is recommended to undergo this procedure.

As a result of fluorography, a black and white image of a part of the body is obtained, as when undergoing radiography. The image shows various shadows, fibers in organs, the position of bones and organs, which greatly helps in diagnosing diseases.

The similarity between fluorography and x-rays is obvious, because the picture is obtained due to the passage of x-ray waves through body tissue and bones.

In this picture, you can see whether there are inflammation processes or any other diseases. The procedure is also useful for diagnosing various abnormalities, mainly related to the cardiovascular and respiratory systems.

In some cases, fluorography even helps to verify the presence of foreign objects in the body cavities (usually the chest) or neoplasms (both malignant and benign).

What diseases does it detect?

Most often when patients undergo fluorography Special attention is given to the chest.

Thanks to this, it becomes possible to determine the presence of diseases and defects:

lungs;
hearts;
bones;
arteries.

Diseases that can be identified through fluorography include:

cancerous, malignant tumors;
purulent abscesses, tissue inflammation;
formation of cavities (cysts) in organs;
bronchitis, tracheitis;
pneumonia;
vascular problems, including hypertension and atherosclerosis of large arteries, aortic sclerosis;
the presence of foreign bodies that could be swallowed by a person or enter the body in another way;
asthma;
changes in size, weight, position of the heart (cardiomegaly) or other organs (hypertrophy);
formation of foreign fibers (fibrosis);
accumulation of infiltrate, liquid, air;
tuberculosis.

Kinds

There are several types of fluorography. The difference between them lies in the procedure used, as well as what equipment is used in the process.

The following fluorography methods differ:

Traditional way.
Digital method.

The traditional way to this moment is already falling out of use due to obsolescence of technology. In this case, the rays pass through the body (from the back), then appear on a special film that is sensitive to light. Thanks to this, an image is obtained.

For getting final result The film needs to be developed in a special way. Minus this method- its duration: you have to spend more time precisely because of the need to develop the film. In addition, the result may not always be satisfactory, because this is influenced by the quality of the film used, various reagents and many other phenomena.

By the way, fluorography produces a reduced image, so in some cases you may need a magnifying glass to look at the image.

The digital method is now becoming especially popular. When carrying out the procedure using this method, a thinner X-ray beam is used, therefore the level of radiation to the body is significantly reduced. IN in some cases The radiation dose can be reduced by up to 4-5 times. The results are processed by a special program and can be viewed directly on the computer.

This means that you do not need to spend additional money on photosensitive film or its treatment with chemicals. In addition, there is a lower chance that the shot will fail. There are special programs used by doctors that allow you to compare the results of several studies or conduct additional ones without re-irradiation.

Indications

Fluorography is a procedure that citizens of the following categories must undergo:

All people undergo fluorography for preventive purposes, regardless of whether they are observed by specific doctors or not.
Patients of various medical institutions during research and examinations.
All people who live with pregnant women or infants.
Young men who are examined before being sent to the army, as well as a determination by the military registration and enlistment office about their suitability for service.
People with HIV or AIDS.

All people who suspect diseases such as:

Contraindications

People who meet one of several criteria should not undergo fluorography, such as:

age under 15-16 years, since radiation is contraindicated for people in this age range;
pregnancy because x-ray irradiation may negatively affect the formation of the embryo;
When feeding newborn babies, it is necessary to observe special measures safety during the procedure;
difficult human condition: this item includes all people who cannot stand in a standing position, for example, disabled people or bedridden patients;
the presence of severe shortness of breath or other problems that may interfere with the procedure itself;
claustrophobia, which can have a detrimental effect on mental state person during the procedure, because in some cases this phenomenon It can even cause a panic attack.

Advantages and disadvantages of the method

Fluorography is the same medical procedure, like everyone else, so it has its own special advantages and disadvantages. You can see them in the table below.

Advantages	Flaws
Low cost of the procedure. In some cases, fluorography is performed completely free of charge if you have a policy.	Patients will in any case receive a dose of x-ray radiation, which currently cannot be reduced as much as possible. This is why fluorography cannot be done often.
High speed of the procedure, especially if the digital fluorography method is used.	When using the traditional fluorography method, which includes processing of a film image, the wait for receiving results increases. Also, the picture may turn out to be defective and of poor quality.
Fluorography can be done not only in a stationary position. There are mobile and compact devices that can allow the procedure to be carried out in emergency conditions.
Fluorography helps diagnose various diseases on early stage their development. This allows you to start treatment earlier.
With the help of fluorography, it is possible to diagnose diseases that are not expressed in any way at the first stage of their development. Such silent diseases include oncology and tuberculosis.

At what age can you pass?

According to SanPiN standards, all types of X-ray examinations, which include fluorography, are prohibited for children under 14 years of age.

If a child is suspected serious illnesses, fluorography can be done before 12 years of age

Exceptions are special cases when there is an unfavorable situation - then local authorities may allow fluorography to be carried out in younger age, from 12 years old.

A similar situation occurs with children who already have a diagnosis. However, even in this case, the child will most likely be prescribed a regular x-ray rather than fluorography due to lower radiation doses.

Thus, fluorography is recommended for children from 15 years of age. This is due to concerns that X-ray exposure at an earlier age may have a negative impact on the development of child's body or even provoke the development of tumors of various types.

In addition, children will receive a higher dose of radiation than prescribed in SanPiN due to the closer location of their organs. If you reduce it, the image will be too small to diagnose anything from it.

During pregnancy and breastfeeding

Fluorography is contraindicated for pregnant women. The procedure can be carried out only in special cases, and observation by a doctor and the use of such precautions as a special protective apron are required.

Experts believe that fluorography can only be done in exceptional moments after the 20th week, because by this time all the child’s organ systems have already been formed. Do fluorography on early stages is strictly prohibited, since irradiation can negatively affect fetal cell division.

When feeding infants, you should be careful when performing fluorography and do not do this procedure too often. There are studies according to which irradiation during fluorography does not affect the quality of milk at all.

However, many women express milk before and after the examination in order to avoid the harmful effects of radiation on it and, as a result, on the child.

Which doctor is doing the test?

Fluorography is a research method that uses x-ray radiation. That is why the examination must be carried out by a radiologist. This doctor takes care of everything X-ray examinations, including tomography and conventional radiography.

The responsibilities of the radiologist include performing the procedure as required by the state standards, with all precautions and in compliance with the correct dose of radiation.

The radiologist must only express his hypotheses about the diagnosis that can be made by the patient. However, this doctor does not have the right to prescribe treatment. The final diagnosis and prescription of medications should be made by the doctor who gave the referral for fluorography.

Preparation

Preparation for the procedure is carried out immediately before it is carried out. There are no requirements for the patient to stop exercising before the study or to stop taking medications or certain foods. All this does not in any way affect the health of the chest, which is studied by fluorography.

An inaccurate photo will only work if the person is wearing unnecessary objects. They can create additional shadows in the image, which can make diagnosing diseases difficult. So, before fluorography, women should remove their bra, collect or secure their long hair in some way so that it does not get caught in the “frame.”

It is also necessary to remove absolutely all jewelry that may be, for example, on the neck. In addition, doctors usually advise patients to hold their breath for a short period of time directly while taking an image. This is explained by the fact that when breathing, the outlines of the lungs may shift slightly, which can result in a low-quality, unreliable image.

Research methodology

First, the patient must remove all clothing above the waist, as well as any foreign objects that may create an unwanted shadow on the future image. Then you should press your chest as tightly as possible against the screen of a special device called a fluorograph, so that your chin can be placed on its top.

The picture is taken while the patient takes a deep breath and then holds his breath.

What happens next depends on the type of fluorography used in a particular medical institution. So, with the traditional method of conducting the procedure, you will have to wait some time until the image is developed using special chemicals.

Only after this can the photograph be taken back if it is suitable. Waiting time is reduced when using the digital method, when the fluorographic image is transported to a specialized program, where it can subsequently be processed by a doctor.

Fluorography results

The results of fluorography are examined visually. The doctor should examine the images for shadows, thickening of organs, or changes in organ size or position. The documentation then provides the numbers corresponding to possible disease, pathologies, features.

They, along with the transcript, are presented in the table below:

Number (code) assigned to the pathology	Name of pathology, explanations
1	Shadow in the form of a ring. Typically, such darkening occurs as a result of cysts, abscesses, and cavities.
2	Darkening of the lung tissue.
3	Focal shadow. If such a darkening is detected, you should go through computed tomography. Small shadows should not cause concern, just observation is required. If focal darkening grows in size, then cancer may be suspected.
4	Expansion of the mediastinal shadow. It may indicate various, including minor, heart problems.
5	Cluster excess liquid in the pleura.
6	Pronounced fibrosis in the lung tissue.
7	Limited fibrosis in lung tissue.
8	Increased level of transparency of lung tissue. Possible reason- emphysema.
9	Pronounced, pathological pleural changes.
10	Limited pleural modifications.
11	Focal deposition of petrificates (calcium salts) in the lung tissues.
12	A large number of large deposits of petrification in the roots of the lungs.
13	A large number of small deposits of petrification in the lung tissues.
14	A large number of small deposits of petrification in the roots of the lungs.
15	Single large deposits of petrification in the lung tissues.
16	Single large deposits of petrification in the roots of the lungs.
17	Isolated small deposits of petrificates in the lung tissues.
18	Single small deposits of petrification in the roots of the lungs.
19	Modifications of the diaphragm. This is not affected in any way by pleural diseases. A possible cause is a hernia.
20	Lung surgery was performed.
21	Change appearance chest skeleton. Possible cause: rib fracture, scoliosis, osteochondrosis.
22	Foreign object.
23	Heart or vascular disease.
24	Other pathologies.
25	Normal state. In this case, there are no pronounced darkening or highlighting in the picture, the picture is clean.
26	Marriage. It may be caused by a poor-quality photograph, film, or an error in the fluorography technique.

How often can fluorography be done?

It is recommended to do fluorography once every 1-2 years, and there is good reason for this. This is motivated by the fact that if the procedure is performed more frequently, the body will receive a higher dose of radiation, which can negatively affect human health.

However, fluorography can still be performed more often, but only under the strict supervision of a doctor and if there are certain indications.

People who are forced to undergo testing more often than others include:

medical staff working in maternity hospitals;
medical staff working with tuberculosis patients, for example, in a tuberculosis clinic;
employees of hazardous enterprises who have a statistically higher risk of lung cancer. This includes people working in the mining, asbestos or rubber industries.

How long is fluorography valid?

The results of fluorography, documented in a certificate issued by a doctor, are valid for 12 months. After this period, repeated fluorography is considered safe for the body.

For some Russian citizens, fluorography results are valid for only six months. These include the same people who need to undergo the procedure more often than others.

Also six months results are valid for:

military personnel;
HIV patients;
patients of dispensaries (psychiatric, tuberculosis, drug treatment).

Possible negative consequences

Normally, if the schedule of fluorographic examinations and the procedure are followed, no negative consequences are observed. If the X-ray dose recommended by official documents is exceeded, they may the following consequences will occur:

To reduce the likelihood of occurrence negative consequences fluorography, you can use a special protective apron during the procedure. You should also carefully monitor the time intervals between each study: they should not be less than a year.

Where are diagnostics done?

Fluorography is a procedure that can be performed in almost any medical institution. This requires an important employee - a radiologist, and a laboratory nurse is suitable.

IN state clinics Fluorography can be done free of charge. If these institutions for some reason are not suitable for the patient, you can be examined in paid clinic. Price paid service fluorography in Moscow averages 1000 rubles, but you can find cheaper options.

X-ray and fluorography: what is the difference

Many people do not know exactly how X-ray and fluorography differ, because these procedures are very similar. All the main similarities and differences can be found in the table below.

Similarities	Differences
In both cases, X-rays are used.	X-rays expose the patient to less radiation than fluorography.
When performing radiography and fluorography in the traditional way, a special film is used.	Radiography costs more than the average price of fluorography.
	Fluorography is used as a preventative measure and can also be useful in diagnosing diseases. Radiography is more often used to clarify the accuracy of the diagnosis or long-term comparison of the development of pathology.

Fluorography and radiography have different purposes. However, for prevention, it is better to undergo fluorography, because this procedure can even be done for free.

Fluorography is an important study that everyone needs to undergo in a timely manner. If you do not do this, you may miss the moment when you should start treating the disease.

Article format: Mila Friedan

Video about fluorography

X-ray and fluorography in the TV show “Live Healthy!”: