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Chapter 8. DIAGNOSTIC RADIOLOGY OF PULMONARY AND MEDIASTINAL DISEASES AND INJURES

8.1. METHODS OF IMAGING STUDY

Imaging study is an integral part of a complete physical examination of all patients with thoracic pathology. The data obtained in most cases, play a decisive role in the determination of the nature of the pathological process, as well as in the assessment of its dynamics and results of treatment.

8.1.1. Radiological method

In order to examine the patients with pulmonary and mediastinal injuries and diseases, different radiological methods and technics can be implemented. The physical examination usually starts with radiological examination. At the first stage of examination the native, most accessible techniques are used, such as radiology, photofluor-ography, fluoroscopy and linear tomography.

Native radiological methods

Chest X-ray, regardless of the suspected pathology, is performed at first in form of survey X-ray indirect (usually anterior) and lateral (respectively to the side of the lesion) views in order to obtain a shadow image of all anatomical structures of this area. In the standard version, the study is performed in the vertical position of the patient at the height of deep inhalation (in order to increase the natural contrast of the lungs). Additionally, according to indications, it is possible to take pictures in other projections (oblique), in the horizontal position of the patient, in lateroposition, on the exhale. In order to receive a detailed picture of the areas of interest, spot filming may be carried out.

A chest X-ray is used mostly for mass ("preventive") check-ups in order to detect pathological processes at early stages, first of all, tuberculosis and lung cancer. The main advantages of this method are its cost-effectiveness and high-capacity, which reaches 150 people per hour. A whole system of such preventive fluorography has been created in our country. Currently, fluorography began to serve as a diagnostic technique due to the possibility of obtaining a large-frame image. An important advantage of radiography and fluorography is the objective documentation of the detected changes, which allows assessing the dynamics, comparing with previous or subsequent images.

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