The results of fluorography can reveal not only the onset of tuberculosis, but also many inflammatory diseases and processes affecting the lungs, bronchi and nearby tissues.

It is advisable to undergo examination for preventive purposes once a year. If there is a history of respiratory disease or there is a threat to the respiratory system due to professional activity, they may prescribe additional examinations - this is not dangerous to health.

Types of dark spots in the lungs

What is it - darkening in the lungs on fluorography, and how can they be classified?

Depending on the lesion, darkening of the following nature can be seen in the image:

• focal;
• segmental;
• shared;
• focal;
• indicating the presence of liquid;
• indefinite shape with blurred contours.

All changes lung tissue reflected in the image and change the clinical picture.

The causes of darkening in the lungs can be:

• pulmonary tuberculosis in various stages and forms;
• oncological processes;
• collapse of the lung - the formation of an impassable area for air;
• purulent-inflammatory processes - abscesses;
• problems with the pleura - the membrane that separates respiratory system from other organs located in the chest;
• accumulation of fluid in the pleural area.

Dark spots in the image also appear when there are problems in the organs, which also fall into the focus of the X-ray machine. This happens when you increase lymph nodes, caused by inflammatory processes in any part of the body, neoplasms on the spine or ribs in the chest, problems with the esophagus - for example, with its pathological expansion.

If during fluorography a darkening is revealed in the image, this does not mean that they will immediately “lock you up” in a tuberculosis dispensary and begin to “force” feed you tuberculosis pills. As you can already see, a dark area in the image does not always indicate problems with the respiratory system.

First, a detailed X-ray examination will be prescribed, during which the chest will be photographed in several projections. It is very important that the image is then read by an experienced radiologist to avoid errors that could seriously affect the patient's health.

If there is darkening in the lungs, the diagnosis is made based on detailed X-ray data.

Reasons for blackouts

Focal opacities appear in the lungs as small nodules - up to 10 mm in diameter. Cause their appearance vascular disorders, initial stages of oncological processes and diseases respiratory organs. In order to accurately identify the cause, in addition to x-rays, it is necessary to do a computed tomography scan and undergo general tests, which, in addition to the “duty” tests - urine and blood, also include sputum.

Collecting sputum for examination is a common procedure for pulmonary diseases.

Despite the patient's complaints of cough and chest pain, a blood test may not show any changes. This clinical picture is typical for focal tuberculosis, so routine examinations will continue to accurately establish the diagnosis.

Focal shadows also appear in the image during myocardial infarction or lung cancer. Symptoms of a heart attack may resemble in many ways acute development tuberculosis.

Additional symptoms: chest pain, displaced in left side and radiating to the side and back, hemoptysis. With myocardial infarction, thrombophlebitis of the lower extremities develops.

Lung cancer is detected through blood tests.

Segmental shadows are visible on the image as segments with clear contours - in most cases they have a triangular shape. If the segment is single, this may be a consequence of: traumatic damage to the lung tissue, the presence of an endobronchial tumor of various etiologies, the presence foreign body– Children often inhale small parts of toys.

If there are several segments, then the patient may be diagnosed with:

• pneumonia varying degrees severity in acute or chronic form;
• tuberculosis;
• narrowing of the central bronchial branch due to stenosis;
• the presence of metastases in surrounding organs;
• accumulation of fluid in the pleural area.

The lobar darkening has clear contours that are clearly visible in the image. This picture indicates the presence of chronic pulmonary diseases - purulent tissue lesions, bronchiectasis or others. If bronchial obstruction is visible on the image, the presence of a malignant process can be suspected.

Focal shadows appear when following problems in the lungs and surrounding tissues:

• pneumonia;
• accumulation of fluid in the pleural tissue - effusion;
• emergence eosinophilic infiltrate– helminthic infestation;
• bronchial asthma;
• abscess.

Focal darkening in the image is caused by tumors of various etiologies and bone calluses that have grown on the ribs after fractures.

Causing increasing swelling of the organ, it accumulates when intravascular pressure increases due to ischemia or general intoxication of the body.

Pathologies expressed by darkening of an indeterminate shape can be signs of many diseases:

• inflammatory processes caused by staphylococcal infection;
• accumulation of pleural fluid;
• heart attack;
• exudative pleurisy.

Therefore, you should not diagnose yourself if, when you receive a form from the fluorography office, there will be an inscription on it indicating the presence of changes. Next, a detailed image will be taken and only then, according to the specialist’s description, a decision will be made on further diagnostic measures to determine how to treat the disease that has arisen.

Photo interpretation

Conclusions from a radiologist with a suspected diagnosis may look like this:

1. The roots are compacted and expanded - possible: bronchitis, pneumonia, bronchial asthma.
2. The presence of stringy roots in the image is characteristic of exacerbations chronic bronchitis and may indicate smoking abuse.
3. Increased vascular pattern can be a symptom of: problems of the cardiovascular system, inflammation, bronchitis, cancer in initial stage.
4. The presence of fibrous tissue indicates a history of respiratory disease.
5. If the radiologist’s report says: focal shadows, this is a signal for the doctor: to prescribe additional examinations. Such symptoms indicate the presence of pneumonia in the upper or middle sections or tuberculosis.
6. If there are clear spots on the image caused by the presence of calcifications, the patient does not require treatment. The subject came into contact with patients with tuberculosis or bacterial pneumonia, but his body defeated the disease on its own. The infection was isolated by calcium salt deposits.

Pictures can also be described as follows.

There are aperture changes. Such anomalies develop for genetic reasons, due to adhesive processes in the chest, chronic diseases digestive organs– liver, esophagus, stomach, intestines.

With smooth, clear contours of medium intensity - such a conclusion from a radiologist is often found. It reflects infiltrative changes in the lung tissue or “plus shadow” syndrome.

What to do if a white spot is detected on the x-ray

When performing a chest x-ray or fluorography on a patient with tuberculosis White spot The X-ray image reflects either an inflammatory lesion of the lung tissue or destructive changes in the parenchyma with the formation of abscesses, tubercles, and cavities. Right this symptom should be called darkening, since it reflects the characteristics of the passage of x-rays through objects and their color display on the x-ray.

A white shadow in a photograph is also observed when:

• atelectasis;
• exudative pleurisy;
• occupational diseases(silicosis, talcosis, asbestosis).

X-rays with white spots of various origins: 124.3 – breast piercing, 124.4 – fraction in soft tissues chest, 124.5 – professional cementosis, 124.6a – contrast during bronchography, 124.6b – pneumonic focus, 124.7 – interlobar pleurisy (arrows indicate artifact)

This syndrome is a sign of many pathological changes in the lungs, but we will consider the most common options.

If stains are found, it is necessary additional research, allowing us to establish the cause of the pathology. For these purposes, a radiologist may prescribe an X-ray examination in additional projections or perform layer-by-layer computed tomography or magnetic resonance imaging.

What does a spot look like on an x-ray with pneumonia?

In pneumonia, the spot on the x-ray image has a length depending on the size of the lesion in the pulmonary parenchyma:

• limited – up to 3 cm in diameter;
• segmental – within a segment;
• subtotal – the entire field, with the exception of the tops;
• total.

Pneumonia - inflammatory disease, in which the alveolar tissue is affected with the accumulation of fluid in the acini. Pathogenesis forms a specific x-ray picture of the disease.

X-ray. Focal pneumonia in the lower lobe on the right

The white spot with pneumonia has fuzzy, blurred contours. Its intensity can be low or high, which depends on the characteristics of the exudate ( inflammatory fluid in the lumen of the alveoli). A path from the root approaches the site of its localization due to lymphangitis.

Atelectasis of the lung or x-ray semiotics of triangular spots on the image

Lung atelectasis is a disease accompanied by the collapse of a segment, lobe or lung tissue completely against the background of cessation of bronchial ventilation. Radiologically, such changes are called limited darkening, since they do not extend beyond the segment or subsegment and have a triangular shape.

Atelectasis of the middle lobe of the right lung - frontal and lateral radiographs

How to identify atelectasis in an image:

• the size of the spot coincides with the size of the changed segment;
• triangular darkening in the lungs can be seen in frontal and lateral projections;
• during inhalation photographs the size of the spot does not increase;
• the narrow end of the triangular shadow is directed towards the root;
• Holtzknecht-Jacobson symptoms are observed during fluoroscopy (suction of the mediastinum towards the lesion during exhalation).

The morphological substrate of the pathology is the accumulation of infiltrative fluid in the alveoli, infiltration of lung tissue, and tumor growth in the pulmonary parenchyma.

Spontaneous atelectasis occurs in 1-3% of patients due to a defect in surfactant (the substance that forms the framework of the alveoli).

Limited darkening during collapse of the lungs requires knowledge of the segmental structure of the lungs, as it reflects atelectasis of a certain segment. By establishing the topography of the shadow, the doctor can guess which bronchus is affected. The substrate of formation (infiltrate, additional tissue, exudate) is almost impossible to determine on the basis of a radiograph.

What does a white spot mean in a picture of tuberculosis?

At focal spot on a chest image means the infiltrative stage of the disease, when mycobacteria begin to infect the lung tissue. In this case, the x-ray shows a path to the root from the side of the lesion (due to lymphangitis). Such radiological symptoms are called “primary tuberculosis focus”.

Radiographs at various types tuberculosis

Multiple small disseminated shadows on both sides indicate miliary tuberculosis.

A single large shadow with a cavity inside (clearance) and a fluid level - an abscess formed against the background of destruction of the lung parenchyma - “ring shadow” syndrome.

A spot on an X-ray of the lungs in the projection of the pulmonary fields reflects a pathological process, the causes of which should be established by additional research.

Darkening in the lungs - possible causes

Preventative medical examinations must be completed annually. One of the mandatory activities of a periodic medical examination is a fluorographic examination of the lungs - this is done for early detection diseases. Alarm signal pathological darkening in the lungs will serve. The reasons for such manifestations may be different, and in order to identify them accurately, the doctor will definitely prescribe additional examination. The symptom of darkening of the lungs established during fluorography is not a diagnosis of the disease, but an indicator of the presence of a variety of diseases.

Darkening of the lungs on an x-ray

What is darkening of the lungs?

Pulmonary diseases are mainly accompanied by compactions in the tissues of the lungs; this occurs due to a decrease or absence of air permeability in certain areas of the organ, which appears on X-ray examination as darkened spots. Such a symptom may indicate pathological processes both in the lightest and beyond.

Image of the bronchi. At in good condition bronchi, their image can be obtained rarely and only on radiographs taken from lean subjects, and the shadows from them are obtained in the form of contoured, more or less narrow stripes with light interval between them. This image is obtained by projecting the rays perpendicular to the lumen of the bronchus; if the rays outlining the bronchus lie more or less parallel to its lumen, then the image is drawn in the form of a light circle with a dark ring-shaped rim.

When examining the image of the bronchi on an x-ray, we must not forget about the summation of the shadows, since two shadows covering each other from two tissues that are identical and different in density are added together and give a darker darkening in density. Arteries and veins are adjacent to the bronchi on both sides. The shadow of the vessel may disappear at the place where the projection coincides with the projection of the bronchial lumen, and intensify when it coincides with the shadow of the bronchial wall.

Last time great importance To diagnose certain diseases of the bronchi (especially bronchiectasis) and lungs, he acquired the method of bronchography, i.e., radiography after the introduction of a contrast agent indifferent to the body (lipiodol, etc.) into the trachea and bronchi. These substances are usually injected under the control of a laryngoscopic speculum into the trachea after preliminary cocaine anesthesia. The injected contrast agent is subsequently partly absorbed (iodipine, lipiodol) and partly expectorated.

Image of the lungs. The lungs on the x-ray and the screen are drawn in the form of two bright fields, covered, as it were, with a cage of intersecting ribs. The light appearance of the lungs is due to the content of air in them, which, like other gases, transmits more rays than liquid and solid bodies.

X-ray image of pneumonia: darkening in the lung (upper lobe of the right lung).

Primary pneumonia develops more often, of which focal pneumonia is more common.

3. Hypoventilation of lung tissue: reduction in the volume of a segment, lobe of the lung; strengthening of the vascular pattern, appearance of spotty shadows against its background, gradual increase their number and size, the merging of these shadows into larger areas of darkness. This radiological symptom of central lung cancer is observed with partial bronchial stenosis (Fig. 42).

Rice. 42. Central cancer of the left lung with hypoventilation of the upper lobe, throughout which there is a noticeable enhancement of the pattern and areas of inhomogeneous darkening; in the left root there are enlarged lymph nodes.

6. Calcium metabolism disorder– excess calcium is deposited in various organs, including in the lungs (for example, with collagenosis). In this case, multiple calcifications are detected throughout all fields of the lungs.
What do calcifications look like on radiographs?

Calcification in the lung – this is a small (up to 1 cm) darkening area, has an intensity bone tissue, appear on the x-ray as intense white dots. Calcifications can be single or multiple (more than 3-4).

Signs of calcifications after tuberculosis:

• the presence of calcifications in the root of the lung (in the intrathoracic lymph nodes) and/or in the lung tissue;
• single calcifications;
• there are no signs of active tuberculosis of the lungs or other organs;
• positive Mantoux and Diaskintest test;
• presence of contacts with tuberculosis patients in the past and other risk factors for tuberculosis.

Calcifications resulting from spontaneously cured tuberculosis contain dormant tuberculosis bacilli, which, with decreased immunity or lack of calcium in the body, can be activated and cause an active tuberculosis process. Such calcifications are especially dangerous for children; they are a kind of “powder keg” that can shoot at any moment (for example, adolescence). Moreover, such a relapse of tuberculosis is difficult, often in the form of a widespread and/or extrapulmonary process. Therefore, it is very important for such children to undergo a course of preventive treatment in order to reduce the risk of developing active tuberculosis in the future, as well as to monitor the condition of calcifications using an x-ray method 1-2 times a year.
What to do if calcification is detected in the lung?

• For children and teenagers – mandatory consultation with a phthisiatrician to exclude active tuberculosis and undergo preventive treatment.
• For adults you can do nothing if there are no symptoms of the disease and signs of active tuberculosis in the body, and in the case presence of HIV infection A course of isoniazid prophylaxis is recommended.
• In some cases, additional examination is necessary: computed tomography, bronchoscopy, sputum analysis, Mantoux test, blood test for antibodies to worms, and so on.

During a preventive examination of a 1-year-old child, unvaccinated with BCG, due to tuberculosis contact with an uncle, radiographs and computed tomography revealed calcifications in the right lung. The phthisiatrician prescribed preventive treatment for spontaneously cured tuberculosis, which the mother refused.

Photo : computed tomography (CT) slice of the lungs of a 1-year-old child. Diagnosis: spontaneous cure of the primary tuberculosis complex with residual changes in the form of calcifications.

After 1.5 years, at the age of 2.5 years, the boy was admitted to the children's department, the mother complained that the child stopped walking, became restless, refused to eat, lost weight, and began to have a fever. An X-ray of the hip joints revealed almost complete destruction of the left hip joint. The mother did not report a “tuberculosis history” to the orthopedic doctors; the child was operated on by surgeons for osteomyelitis; upon examination of the postoperative material, bone tuberculosis was revealed. While we were waiting for histology results, the child's condition worsened sharply; the child developed tuberculous meningoencephalitis, and subsequently tuberculosis of the lymph nodes and bronchi was detected.

Photo: CT scan of the head of a 2.5 year old child. The diagnosis is tuberculous meningoencephalitis.

X-ray of the hip joints of the same child . Diagnosis: tuberculosis of the right hip joint with its complete destruction.
This is how ordinary calcification in the lung without treatment led to the development of severe disseminated tuberculosis in the baby. The child survived and was cured, but remained disabled for life.

The root of the lung is changed and expanded, what could it be?

X-rays identify smokers by indirect signs: strengthening and deformation of the pulmonary pattern, accumulation of calcifications in the roots.

Indirect signs of disease in the image do not at all mean the presence of pathology. To establish a diagnosis, a comprehensive analysis of the results of clinical diagnostic research methods is necessary.

As a result, a chest x-ray is performed after other examinations. This approach is also used for the purpose of radiation safety of the patient, because sometimes obtaining the results of other research methods eliminates the need for an x-ray examination.

What does the radiologist find in the image?

Professional interpretation of images involves using many specialized terms. As a result, the protocol of a specialist’s conclusion is very difficult for an ordinary person to understand.

Rounded dark spot observed on an image of the lungs with an hydatid cyst. True, around the formation there is a clear white outline formed by the wall of the cyst.

Emphysema (increased airiness of the alveoli) is manifested by total clearing on both sides. With a local emphysematous bulla, the dark spot is limited to several ribs or a segment.

X-ray diagnostics of this syndrome is not difficult for radiologists who have seen many images of the chest organs during their practical activities.

How dangerous is darkening or clearing in the lungs?

As noted above, the process localization factor does not matter in differential diagnosis cancer and tuberculosis. The tumor node can be located in any lung segment. True, as with central cancer, there is a slight predominance of frequency in the upper lobes.

Despite the noted difficulties, a general x-ray examination, including images and tomography taking into account clinical data, in at least 80% of cases allows us to establish correct diagnosis peripheral lung cancer. Doubts remain in those in rare cases when tuberculosis and cancer have an atypical picture. Insurmountable difficulties arise in cases where peripheral cancer has the form of a solitary node about round shape homogeneous structure with clear contours, located against the background of unchanged surrounding lung tissue with complete absence clinical manifestations. General X-ray examination in similar cases turns out to be ineffective in differentiating peripheral cancer, tuberculoma, benign tumor or cysts. In these cases, the program of additional examination of the patient is completed by percutaneous transthoracic and endoscopic transbronchial puncture.

Peripheral cancer disintegrates quite often. In some cases, the tumor disintegrates completely, taking on the appearance of a thin-walled cystic formation. And yet, with a thorough tomographic examination, especially computed tomography, it is possible to detect the remains of tumor tissue in the form of an uneven thickening of the wall of such a cyst, and tissue detritus and sequesters can be seen in the cavity itself.

Pancoast cancer is a type of peripheral cancer. This is cancer of the apex of the lung that spreads to the chest. This form is characterized by infiltrative growth, destruction of ribs, appearance sharp pain in the arm and Horner's triad (miosis, ptosis and enophthalmos), caused by the involvement of the cervicobrachial nerve plexus, cervicothoracic region sympathetic trunk and large vessels.

Bronchioloalveolar cancer (pulmonary adenomatosis) is observed in approximately 5% of all patients operated on for lung cancer. Many questions related to the nature of this disease are unknown. The histological picture and clinical and radiological manifestations of this disease have been well studied. It is generally accepted that bronchioloalveolar cancer arises from the epithelium of the alveoli or bronchioles. The histological picture is characterized by the formation of papillomatous structures that spread inside the lumen of the bronchial tree to more or less extensive areas of the lung without destruction of the interalveolar and interlobular septa. The tumor has a slow growth rate: the average time to double its volume is 350-500 days. In some cases, the tumor does not show growth dynamics for several years.

Clinical manifestations of bronchioloalveolar cancer on early stages there are no developments. As the process progresses, cough with sputum, shortness of breath, fever, and weakness appear. The most characteristic, although rare, sign of bronchioloalveolar cancer is the discharge large quantity foamy mucous-watery sputum.

heterogeneous triangular shadow in the upper lobe of the right lung. the interlobar pleura is involved in the process. there is an increase in the pulmonary pattern.

Name:

Sent:

Plotnitskaya E.V.
30 gr. 3rd year LF
Restricted shading syndrome.
The shadow is uniform. This is infiltration without decay.
Consequently, focal right-sided pneumonia.

Name:

Sent:

Buzhan Daria LF 30 group
A plain chest radiograph shows limited shading in the area of ​​the upper lobe of the right lung with unclear contours, but a homogeneous structure. This picture is typical for focal pneumonia.

Name:

Sent:

The diagnosis is made based on

– Complaints: cough with difficult to clear
sputum that occurs in the morning, general weakness, increased sweating at night,
inspiratory dyspnea that occurs when walking

– History – registered with the PTD since 2004
of the year

– Laboratory data – MBT sputum analysis
(++)

– X-ray data – focus
opacities in the upper lobe of the left lung

Treatment plan

1) Mode – ward

2) Diet – high protein

3) Isoniazid 0.6 IM

4) Rifampicin 0.45 IM

5) Pyrazinamide 2 tablets x 2 times a day

6) Ethambutol 1 tablet x 2 times a day

7) Glucose 5% 400 ml IV drip

8) Karsil 1 tablet x 3 times a day

9) Aevit 1 tablet x 3 times a day

10) Vitamins B1, B6 intramuscularly every other day

Forecast

Permanent disability, group II

Epicrisis

Patient Novozhilov G. O. was admitted to PTD No.
12 10/15/07 with a diagnosis of infiltrative tuberculosis of the upper lobe of the left lung,
MBT (+) Upon admission, he complained of a cough with difficult to separate sputum, general
weakness, increased sweating at night, inspiratory shortness of breath. Consists of
registration in the PTD since 2004 regarding newly diagnosed left tuberculosis
lung Upon objective examination
inspiratory shortness of breath and percussion box sound in the upper sections were detected
lungs, liver enlargement When performing radiography
of the chest organs, a focus of darkening was detected in the upper lobe of the left lung
A general blood test showed leukocytes 12 thousand/l, ESR 25 mm/h.
General urine analysis and biochemical analysis blood unchanged Sputum analysis - MBT (++) Culture
sputum for sensitivity to antibiotics - MBT are sensitive to rifampicin,
ethambutol, pyrazinamide, isoniazid. In the hospital
treatment was carried out - ward regimen, diet
high-protein, isoniazid 0.6 IM, rifampicin 0.45 IM, pyrazinamide 2 tablets x 2
times a day, ethambutol 1 tablet x 2 times a day, glucose 5% 400 ml IV drip,
Karsil 1 tablet x 3 times a day, Aevit 1 tablet x 3 times a day, vitamins B1, B6
IM every other day. During treatment in
positive dynamics are noted in the hospital - the condition has improved,
complaints decreased, examination data returned to normal. Recommendations - follow
rational daily and nutritional regimen, continue treatment

In modern realities of medicine, radiography remains an informative and uncomplicated method. It is used in the diagnosis of diseases of the lungs, heart and other organs. Fluorography in identifying pulmonary pathology is used more often. This method is considered screening and publicly available.

Patients and doctors often encounter this radiographic manifestation, like darkening of the lungs on fluorography. What kind of clinical situation is this, what can it be associated with? The article also covers such issues as strengthening the pattern of the lungs, sclerosis of the aorta and its arch.

Darkening of the lungs on fluorography

First you need to understand that an x-ray is a negative image. The most convenient way to view and analyze it is with the help of a negatoscope - a special screen. Denser structures are light (white). The lower the density, the darker the image will be.

The lungs are a paired organ containing air and interstitial fluid, as well as blood vessels containing blood. In the picture these are dark fields. If there is a lighter area viewed in the image using a negatoscope, they speak of a focus or a dark spot, no matter how paradoxical this may sound.

What could it be?

Among all the emerging clinical and radiological situations, the fact when a fluorography study showed darkening is of particular importance. Exist various options this phenomenon.

Extensive darkening in the lungs on fluorography. What it might be can only be judged after further examination. Such a change in the projection of the pulmonary fields can cause not only lung disease, but also damage to other organs of the chest: mediastinum, diaphragm, esophagus, lymphatic collectors.

Next possible pathology- a rounded hearth or focus of darkening. It can take the form of a circle, an oval structure, or an ellipse. It is important to understand in detail what darkening in the lungs means on fluorography oval shape. And again the doctor is faced with the question of the localization of the pathological formation or process.

Causes

There are many potential etiological factors for the described radiographic changes. It can be clarified after additional research.

When extensive darkening in the lungs is detected on fluorography, the causes should be sought using multi-projection x-ray techniques. If the mediastinal structures are displaced towards the shading focus, collapse of the lung, its absence (after pneumonectomy), as well as cirrhotic deformation of the lung tissue are suspected. The last situation differs from the first two in that the darkening itself is heterogeneous (non-uniform) in nature.

Sometimes the mediastinum and its structures are shifted to the opposite side. If a darkening is detected on fluorography, it is likely that this may be a tumor formation large sizes or total hydrothorax, accumulation of air in the pleural cavities.

The following conditions and diseases can be the causative factors for the occurrence of rounded darkening:

In doubtful cases diagnostic examination complemented by tomographic techniques.

What does increased pulmonary pattern on x-ray mean?

The lungs have a heterogeneous structure. After all, this is a whole complex of structures:

• alveoli;
• bronchial tree;
• veins;
• arteries;
• The lymph nodes;
• nerve trunks and endings.

Possible depletion and strengthening of the pulmonary pattern on x-ray. What does it look like externally, and what diseases need to be excluded?

Increased pulmonary pattern on fluorography is more common. This term means that a unit of pulmonary field area contains a larger than normal number of it. constituent elements. At the same time, their size and diameter increase.

First of all, doctors think about inflammatory changes in the lungs. Moreover, it turns out in most cases that this residual effects in the pulmonary structure after suffering inflammation. This happens after pneumonia and tuberculosis.

When the inflammatory mechanism for the appearance of an enhanced lung pattern is excluded, it is necessary to search for cardiac causes. Functional diagnostician thinks in this case about mitral defects. These are various options for disrupting the normal functioning of the valve that ensures normal blood flow from the left atrium to the left ventricle. If fluorography reveals an increase in the pulmonary pattern from an early age, the probability of a correct hypothesis is quite high. Such a change in the pulmonary picture can cause both insufficiency and stenosis (narrowing) of the mitral valve.

A less possible reason is increased pressure in the system pulmonary artery. Pulmonary hypertension can only be determined by a cardiologist, and echocardioscopy is required to confirm it.

What else can you see in the picture?

On x-ray or fluorography, in addition to darkening, clearing of the pulmonary field is revealed. At the same time, it looks darker than normal lung tissue. Deformation of the roots of the lung is also possible.

X-rays are important not only for excluding pulmonary pathology. They allow you to detect pathological changes heart and large vessels.

Enlarged heart (expanded to the left)

Left ventricular hypertrophy occurs in almost every patient with arterial hypertension. Increased numbers blood pressure, in turn, are determined in half of the population. Therefore, an enlarged heart is often detected on fluorography images.

The entire organ as a whole, as well as any individual cavity, can become enlarged. The configuration of the heart shadow will depend on this. It is this that will push the specialist to the right thought and allow him to build the correct clinical hypothesis.

An enlarged heart on fluorography is usually manifested by a change in the size of the left ventricle.

Changes in the posterior cardiophrenic angle (between the heart and the diaphragm) are detected. IN normal conditions this angle is acute. With hypertrophy of the left ventricle it becomes dull. Identification of the phenomenon indicates that the heart is enlarged to the left. Fluorography does not give comprehensive information, therefore, it is necessary to conduct an ultrasound examination to determine in more detail the sizes and volumes of the heart chambers.

Aortic seal

The shadow of the heart consists of two contours - right and left. Each of them reflects the structure of the heart cavities and efferent vessels. Top part the right contour and the larger half of the left is formed by the aorta and its branches.

Compaction of the aorta on fluorography indicates the presence of atherosclerosis.

We are talking about a metabolic disease, which is expressed in the accumulation of excess fat in the wall of blood vessels. It can cause strokes and heart attacks when the atherosclerotic plaque is destabilized. Consolidation of the aortic arch during fluorography is a reason to prescribe biochemical research blood to determine the concentration of cholesterol and its fractions. It can be supplemented with ultrasound techniques - ECHO-CG and ultrasound Dopplerography.

Sclerosis of the aortic arch

This is another commonly encountered radiological phenomenon. Sclerosis of the aortic arch during fluorography is considered a manifestation of systemic atherosclerosis.

If cholesterol plaques discovered during fluorography of the lungs, there is a high probability of damage to vessels of other locations. First of all, atherosclerotic changes in the coronary and renal arteries should be excluded.

Sclerosis of the aortic arch can be confirmed using ultrasound. For this purpose, echocardioscopy is used.

Useful video

Why you need to do fluorography can be found out in the following video:

Conclusion

1. Darkening in the lungs on fluorography, like other radiological signs, is a reason to expand the diagnostic search.
2. Only the correct interpretation of the image allows the doctor and the patient to make a preliminary diagnosis.
3. Detection of darkening in the lung on fluorography, strengthening of the pulmonary pattern serves as a reason for further additional examination: X-ray examination or computed x-ray tomography.

Darkening in the lungs on a fluorography image - what is it? This is a question asked by many patients whose fluorography results are ambiguous.

Darkening can mean anything, so if the radiologist issued such a conclusion, there is no need to panic - most likely, you will be prescribed an additional examination.

Darkening in the picture can be either a sign of an incipient disease or a common defect in the film.

Darkening in the lungs may be a consequence of:

• inflammation;
• bronchitis;
• tuberculosis;
• tumors, including cancer;
• injuries;
• ingress of foreign bodies;
• abscesses;
• accumulation of fluid;
• smoking.

IN medical practice this is the most common reasons the appearance of darkening. Among them there are diseases that are life-threatening to the patient and his environment.

Therefore, if a darkening is detected on fluorography, then this is always a reason to begin a more detailed examination using other diagnostic methods.

Darkening in the lungs, detected on fluorography, indicates disorders both in the lungs themselves and in adjacent areas.

The spot may be an enlarged lymph node, a formation on a rib, vertebrae, or an enlargement of the esophagus.

Shape and location of darkening

A single spot on the image indicates a tumor. Multiple spots indicate inflammation, tuberculosis, fluid accumulation and the presence of tumors in other organs.

If the darkening is at the apex of the lung, then tuberculosis can be suspected. A spot with blurred boundaries indicates pneumonia, especially if the person being examined is weak or has a high fever.

But in some cases, pneumonia occurs without fever. A certain geometric shape of the spot can tell the doctor that the patient has pulmonary infarction, hemorrhage.

Lungs of a smoker on fluorography

People who smoke are at risk for pulmonary diseases. Over the course of a year of smoking, approximately a glass of toxic resins deposits on the tissue of this organ.

Smokers, more than others, need an annual fluorographic examination.

Changes in the lung tissue of a smoker occur quickly, but, as a rule, they are not displayed on fluorography.

Fluorography helps to identify not the fact of smoking, but neoplasms that have arisen as a result of this bad habit.

How smoking affects the lungs is clearly shown by another examination - x-ray.

X-ray shows how different the organs are healthy person and a smoker.

The lungs of a non-smoker in the picture will be of a light, uniform color, since they are filled with air, the pattern can be clearly distinguished blood vessels. The lungs of a smoker are covered with dark spots.

What might darkening look like in a photo?

Darkening in the lungs can be of different sizes and shapes, located anywhere in the lung. The following classification of blackouts is accepted.

Focal darkening of the lungs on fluorography - they look like nodular spots less than a centimeter in diameter on the picture. They appear as a result tumor processes, vascular disorders.

This type of darkening may well turn out to be serious illness, But fluorographic image does not give the doctor the opportunity to make an accurate diagnosis.

Focal darkening accompanied by high temperature, general weakness, cough, can talk about focal tuberculosis- specialized studies are prescribed to identify it.

To clarify the diagnosis, the patient is sent for a more informative examination: computed tomography.

It will be necessary to pass laboratory research: donate sputum, blood, urine.

Focal darkening also appears with this rare disease, like a pulmonary infarction, in which hemoptysis is possible.

In addition, pulmonary infarction is accompanied by inflammation of the veins of the legs, heart pain, and pain in the side.

Round dark spots of the lungs are round-shaped single spots, the diameter of which is more than a centimeter. These spots on the image can indicate either an inflammatory process or the presence of tumors (both benign and malignant).

It is for this reason that if there are round-shaped shadows in the image, the doctor will definitely prescribe additional procedures.

Segmental darkening of the lungs on fluorography - in this case, the spots on the image have a triangular shape, there may be several of them.

The causes of segmental opacification of the lung or lungs are endobronchial tumor, the presence of a foreign body, trauma.

If there are several darkened segments, then this is a sign of pneumonia, tuberculosis, central cancer, narrowing of the central bronchus, metastasis.

Shapeless darkening of the lungs on fluorography - they look like spots without clear boundaries and do not have the correct geometric shape.

They most often talk about staphylococcal or common pneumonia. Staphylococcal pneumonia has a primary and secondary form.
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Primary appears as a result of inflammatory processes in tissues, secondary - when a purulent focus is introduced into the body (this can happen with osteomyelitis, adnexitis).

Staphylococcal pneumonia has recently become more common than usual.

Also, darkening in an indefinite form can indicate exudative pleurisy. In all these cases the patient will have elevated temperature, cough, weakness.

Darkening of the lung lobe on fluorography is when the affected lobe is clearly visible on the image and has clear contours.

Darkening of the lung lobe is a sign of any “chronicity” in the lungs: cirrhosis, purulent lesions, bronchiectasis.

Darkening with liquid on fluorography indicates pulmonary edema, which occurs during ischemia, poisoning with certain toxins, and vascular diseases.

If, after visiting the fluorography office, they gave you a stamp and sent you home in peace, this means that no pathology was found, since otherwise the office employee is obliged to notify the patient or his local doctor about the need for an in-depth examination.

Interpretation of fluorogram and other methods

After visiting the fluorography room, the patient receives a picture and its transcript.

Comments on a photo may contain the following information:

• enlarged roots - indicates bronchitis, pneumonia;
• stringy roots - pathological changes due to smoking, bronchitis;
• in-depth drawing of blood vessels - indicates poor circulation in the lungs, problems with the heart and cardiovascular system, bronchitis and pneumonia, the initial stage of oncology;
• fibrous tissue - trace of earlier past diseases, operations, injuries;
• focal shadows are actual shadows. If the shadows are accompanied by an increase in the vascular pattern, then this indicates pneumonia;
• calcifications - indicate that there was contact with a tuberculosis patient, but healthy body enclosed the stick in a calcium “shell” and no further spread of the infection occurred;
• changes in the diaphragm - consequences of obesity, pleurisy, diseases of the gastrointestinal tract;
• sinus - in healthy lungs, pleural folds form air cavities; in patients, these cavities are filled with fluid or are in a stuck together state.

Spots on the image may indicate several dozen diseases, so it is necessary to continue the examination.

For further examination, the doctor sends the patient to a pulmonologist and oncologist, where he will have to undergo specific procedures.

Diaskintest is a method for diagnosing tuberculosis. Unlike the Mantoux test, which very often shows an erroneous result, Diaskintest does not react to BCG and makes it possible to diagnose tuberculosis much more accurately.

Sputum tests - laboratory examination of sputum. Detects tuberculosis bacteria, malignant cells, various impurities characteristic of certain pathological conditions.

Computed tomography of the lungs is optional, but informative method diagnosis of diseases of the lung tissue, pleura and mediastinum.

Diagnostic or tracheobronchoscopy - performed using flexible endoscopes that are inserted through the nose.

Before the procedure, a chest x-ray is taken to rule out airway obstruction.

The examination allows you not only to see the lungs, but also to collect material (this is absolutely painless).

The material is subsequently subjected to histological, cytological, and bacterial examination.

A blood test for tumor markers is an auxiliary method for diagnosing cancer; it allows one to identify specific proteins in the blood produced by malignant tumor cells.

Blood is taken from a vein on an empty stomach. The number of tumor markers increases not only in cancer, but also in a number of infectious and inflammatory diseases.

When interpreting fluorography, there are errors, but the method itself cannot be called ineffective. Using fluorography, dangerous diseases such as tuberculosis and lung cancer are diagnosed.

This is a quick and inexpensive method that can be used for medical examination of the population.

Often only thanks to him it is possible to identify new cases of tuberculosis infection and begin to treat the patient in a timely manner.