What does an x-ray of a healthy child's lungs look like?

What is an X-ray?

Radiography is a method of non-invasive study of the internal structure of the body by shining it with X-rays and recording the result on a special film or electronic media. The principle of obtaining an image is based on the characteristics of the passage of rays through various tissues of the body. Bone absorbs radiation completely, so it looks white in the picture, soft tissues that partially block it are gray, and air layers are black.

Using a chest x-ray, for example, you can detect pneumonia - the inflammation in the lungs will be lighter in color, while healthy lungs should be black in the image.

X-ray of the lungs: what is it done for?

Radiography is a method of studying the internal structure of the body using radiation, in which the resulting image of an object is recorded on a physical medium - x-ray film.

Reference! X-ray is the most widely used method for examining the lungs.

The doctor prescribes a chest x-ray if there is a suspicion of:

pneumonia;
pleurisy;
pulmonary form of tuberculosis ;
neoplasms in the chest area;
diseases associated with the characteristics of professions - pneumoconiosis (dust diseases: silicosis, carboconiosis, metalloconiosis, silicosis, etc.);
sarcoidosis;
presence of a foreign body in the respiratory tract;
heart disease and other cardiac pathologies ;
chest injury.

How does an X-ray machine work?

The principle of radiography is based on the use of x-rays to display the structure of human internal organs and bone tissue. X-rays are a type of electromagnetic radiation that is generated by an x-ray tube. The rays pass through the human body and are recorded by a digital detector located behind the patient or on X-ray sensitive film. Body tissues absorb radiation differently: dense bones retain it, while soft tissues allow it to pass through. This difference allows you to obtain a contrast two-dimensional image of the part of the patient’s body being examined.

Safe radiation dose for x-rays

Radioactive radiation affects a person all the time and does not harm him in small doses. It is impossible to avoid its influence, since the entire surface of the Earth is exposed to irradiation from space, and some of the natural radionuclides are in the external environment (the earth's crust, water, air). Doses of radiation absorbed by the body are measured in millisieverts (mSv). Natural background radiation is approximately 2 mSv per year.

For the safety of X-ray examinations, the maximum permissible radiation dose per year (MAD) was established at 100 mSv per year. This is the maximum allowable amount of radiation doses received per year that will not cause harm to human health.

With an X-ray of the chest area (CH), a person receives only 0.1 mSv, and with an X-ray of the hip joints - 1.47 mSv, which is much less than the permissible level. During spondylography (the so-called image of the back), the radiation dose is 1.5 mSv. With OGK fluoroscopy (a radiation diagnostic method that allows real-time monitoring of the condition of the tissues and bone structures of the chest area), the patient receives 1.4 mSv in 1 minute of examination.

Radiation readings may vary depending on the X-ray machine used. The more modern it is, the lower the radiation dose. The safe dose of radiation exposure for preventive studies is 1-2 mSv per year. The vast majority of medical examinations that use x-rays use low-energy x-rays that irradiate the body for a fraction of a second and are therefore considered virtually harmless to humans even when repeated many times.

What do x-rays of a healthy person's lungs look like?

An image of healthy lungs has a typical appearance: on both sides of the chest there are lung fields, under them there are domes of the diaphragm. The heart shadow and sternum are in the center, the clavicle is at the top, and the linear rib shadows are above the pulmonary projection.

In the picture, a specialist assesses:

soft tissues;
system of bones and joints;
diaphragm;
mediastinal organs;
costophrenic sinuses.

Negative and positive images of these elements look different.

Healthy lungs on an X-ray will look different on an X-ray than those with pathological changes. But even the absence of atypical shadows in the picture does not mean that the person is absolutely healthy. There are some pathologies where changes may not be noticeable. These include:

small foci of inflammation (up to 1-2 mm in diameter, depending on the equipment used) do not appear on the image, since there is a resolution limit;
minor clearings;
small infiltrative darkening in the bronchi area;
formation of fluid in the sinus of the cardiac shadow with a volume of up to 250 ml;
an increase in the thickness of the walls of the bronchi by less than 1 mm;
subtle focal tissue thickenings.

Experts come to the conclusion that the tissues are without any peculiarities if no deviations from the norm are detected in them from the image.

Reading conventional and digital radiographs

With the introduction of innovations in the field of medicine, it became possible to perform digital radiography. A photograph taken in the usual way had to be developed to create a photo negative. The latest developments make it possible to eliminate several stages in creating an x-ray image. Instead of film, digital equipment is now more often used.

During digital radiography, sensors record the intensity of the rays and transmit data from an electronic matrix to a computer program. Next, the signals are analyzed, after which an image appears on the screen. It has become much easier to work with such X-ray images, since you can use various functions, for example, enlarge or edit the images.

An image of healthy lungs will not differ in film format from its digital counterpart. Although experienced experts say that the shadows in pictures taken on different devices will be slightly different.

When reading images, it is important to take into account the influence of the screening grid - an element of the X-ray machine. When comparing radiographs taken on the same equipment, it will be easier for the doctor to assess the dynamics of changes. If the study was carried out on several devices, the task of interpreting the images becomes more complicated: the anatomical structures will be displayed in different colors, the intensity of the shadows and their hardness will differ, as well as the level of the diaphragm domes.

Norm for other elements

The X-ray image is negative, like a photograph. When X-rays freely penetrate through tissue, they reach the film and are reflected on it in a dark color; if something delayed them along the way, they are reflected in a light color. The degree of retention of X-rays depends on the tissue throughput, which explains the abundance of gray shades on the X-ray. This is how the image is formed. When all elements are normal, the image should not contain:

any additional shadows;
enlightenment;
blackouts.

How often can an x-ray be taken?

X-rays can be taken as many times as the doctor prescribes. This diagnostic method is used only in cases where other types of studies are not sufficiently informative and do not allow the doctor to make an accurate diagnosis. The use of x-rays must be justified, then it will bring more benefits to the patient’s health than harm. According to regulatory documents, different categories of patients have their own maximum permissible radiation dose:

100 mSv per year for patients who need regular X-ray monitoring (oncology, precancerous conditions, diagnosis of congenital defects of the cardiovascular system, severe injuries);
20 mSv per year for patients who require diagnostic studies for somatic (non-oncological) diseases in order to clarify the diagnosis or choose treatment tactics;
1-2 mSv per year when undergoing preventive examinations.

How are x-rays done?

The need to prepare for the procedure depends on the type of examination to be performed. If an x-ray of the abdominal region or the lumbosacral spine is prescribed, then three days before the procedure it is necessary to exclude from the diet foods that contribute to increased gas formation. An X-ray of the intestines may additionally prescribe a cleansing enema or laxative. Several hours before the test you should not smoke, eat or drink.

Before the procedure, you must remove your jewelry, belt, and remove metal objects from your pockets. When taking an X-ray of the spine or chest, you must undress to the waist. X-rays of the phalanges of the hands and feet can be performed in clothing. Those parts of the body that are not being examined should be covered with a protective lead apron or cap. The doctor also puts on a special suit and goes into the next room, from where he controls the X-ray machine.

After the procedure, the patient is given an image or the examination result is recorded on digital media (flash card) in the case of digital x-rays. In the diagnostic protocol, the radiologist indicates the level of radiation exposure to which the patient was exposed.

How often can children have a chest x-ray?

The frequency of chest x-rays for children depends on the indications and the nature of the pathology of the lung tissue and bronchial tree. For example, if a tuberculosis process is suspected, an X-ray examination is carried out once every three months to assess the dynamics of the development of the pathology and the effectiveness of the therapy. In case of diagnosed pneumonia, radiography is prescribed 3-4 days after the end of the course of antibacterial therapy.

Ionizing radiation can indeed have a very negative effect on a growing organism, but undesirable reactions develop only if the maximum recommended dose of radiation exposure is exceeded. Low doses of stress cannot provoke noticeable undesirable changes, therefore, if an X-ray examination of a child is necessary, parents should not panic and question the feasibility of the study.

X-ray or CT: which is safer?

X-ray, unlike CT, is safer for health, but the value of CT as a diagnostic method is much higher. CT allows you to obtain information about the condition of bones, soft tissues and blood vessels in a three-dimensional projection. Computed tomography is a method of non-invasive examination of human internal organs that uses x-rays. However, unlike X-rays, radiation doses from CT scans are much higher due to multiple scans.

CT allows you to achieve a three-dimensional image thanks to the design of the device: the source of rays is a contour in the shape of the letter C, inside of which there is a couch for the patient. This allows you to take a series of images of organs from different angles, which are processed by a computer and create a three-dimensional image. In addition, the doctor has the opportunity to look at a cross-section of the organ, which, depending on the settings of the device, can reach a thickness of only 1 mm. It is not possible to obtain such information on an x-ray.

It is estimated that approximately 0.4 percent of cancers are caused by CT scans rather than x-rays. Some scientists expect this level to rise in parallel with the increased use of CT scans in medical procedures. Experts estimate the risk of developing cancer from undergoing one CT procedure as 1:2000.

What healthy lungs look like on an X-ray

X-rays normally show the following structures:

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Pulmonary fields . The lungs are projected on an x-ray as pulmonary fields. The organs of the mediastinum have their own anatomical features, which determines the difference between these fields: the right one is short and wide, the left one is longer and narrower, this is a normal case.

In a healthy person, these areas are transparent, as they are filled with air, which does not reflect radiation. The pulmonary fields are intersected by smooth and clear stripes - costal shadows, running obliquely.

Osteoarticular apparatus . In the spinal column, the bodies of the first three to four vertebrae are most clearly identified. At the same level their transverse processes are visible.
In the upper part of the image, the apexes of the lungs are conventionally delimited by the shadows of the clavicles, which are located almost horizontally.
The manubrium of the sternum may sometimes appear on radiographs .
Heart muscle is a dense tissue, so it reflects X-rays well. On a plain X-ray in direct projection, an intense, homogeneous cardiac shadow is localized in the central region, between the pulmonary fields, gravitating to the left side.

Important! The places of fixation of the ribs to the sternum are not shown , since this joint is represented by cartilage, which weakly reflects X-rays.

Norm for other elements

In the superolateral part of the image, non-intense additional shadows of the pectoral muscles can be detected (mainly in men) of a triangular shape on both sides.

In women, the mammary glands are visible . Also, shadows of the mammary glands can be visible in older men.

Reference! The root of the lung is a complex of certain anatomical structures that passes through the hilum of the lung and connects the lung with organs located in the mediastinum.

This complex contains the pulmonary artery and vein, bronchi, lymph nodes and vessels, nerves, tissue and pleura. The main element in this shadow formation is the vascular-bronchial component , while other structures are covered by the mediastinum.

The shadows of the roots are organized asymmetrically: the left root is higher than the right one by one edge. They are heterogeneous, their width is no more than 1.5 cm .

Reference! Pulmonary pattern is a representation of the blood vessels of the pulmonary circulation. It looks like intertwining thin strands of shadows.

Towards the peripheral part of the lung, its visibility is weakened, as the number and diameter of the vessels decreases. The pulmonary fields are delimited below by the shadow of the upward-facing dome of the diaphragm.

Under the left dome you can see 1-2 clear spots - this is gas at the bottom of the stomach.

On the inferolateral sides, between the shadow of the diaphragmatic dome and the chest wall there are sharp angles - the cardiophrenic sinuses.

What is the difference between X-ray and fluorography?

Fluorography and x-rays are based on the action of ionizing radiation, but the latter allows you to get a clearer picture with a much lower radiation dose. Fluorography is more of a preventive study, since due to the low quality of the image and the small size of the image (11 by 11 cm), it is difficult to examine small pathologies on it. To clarify the disease, in most cases an x-ray is still prescribed.

During fluorography using film equipment, the patient does not stand in front of a film cassette, as in an x-ray, but in front of a fluorescent screen. The image of the chest that appears on it is photographed on a special film. Essentially, a fluorogram is an analog photograph from a screen. This diagnostic method is limited to examining the chest, while x-rays can be performed on any part of the body.

The appearance of a digital detector of ionizing radiation in modern fluorographs has made it possible to display the image directly on the screen without loss of quality. At the same time, the radiation dose received by the patient during the study has also decreased. Now digital fluorography is a simplified analogue of an X-ray machine intended for diagnosing chest organs. The efficiency of digital fluorography is 15% higher than film fluorography due to a clearer image, but due to the high cost of equipment, this procedure is not so common.

X-rays are prescribed only when indicated or to monitor the treatment process and allow you to obtain a full-size image. It can be overview, that is, performed in two projections, or targeted, when only a certain area of the body is examined. Therefore, X-ray is preferable to fluorography due to its higher image accuracy and comparatively low radiation dose.

Preparing for an MRI of the lungs

Before a magnetic resonance imaging session, the doctor finds out whether there are any contraindications to scanning. MRI is not performed if the patient has:

metal prostheses, knitting needles, pins, etc.;
implanted electromagnetic devices (pacemaker, insulin pump, etc.);
tattoos made with metal-containing inks.

The contrast procedure is contraindicated for pregnant women and persons suffering from end-stage kidney and liver diseases.

MRI image for pulmonary tuberculosis

The duration of the diagnostic session is from 15 to 40 minutes, during which time the patient must lie motionless inside the tomograph tube. People with severe pain, claustrophobia, or increased nervousness should discuss with their doctor the need to take analgesic and sedative medications.

2-3 days before the MRI, foods that can cause an allergic reaction should be excluded from the diet. Alcohol consumption is prohibited and smoking should be limited. Before the enhancement procedure, the patient is advised to have a snack, avoiding overeating.

For breastfeeding women, preparation for a contrast MRI of the lungs includes expressing milk to feed the baby. After administration of the gadolinium solution, the baby can be put to the breast after 6-12 hours.

Before scanning, the patient removes jewelry, piercings, and metal accessories. It is recommended to change into a comfortable set (pajamas) that does not restrict movement.

What does a lung x-ray show?

X-ray of the lungs allows you to identify the presence and determine the nature of pathologies of the lungs, heart, spine and lymph nodes. The study is prescribed for a general assessment of the health of the respiratory system or to clarify the diagnosis for diseases:

pneumonia;
emphysema;
sarcoidosis;
tuberculosis;
pleurisy;
malignant neoplasms;
bronchitis.

The procedure allows you to detect dangerous pathologies at an early stage, determine their location and area of distribution. They usually appear in the image as light spots called shadows. They are classified by density, size and shape. Neoplasms or an abscess in the lungs provide a shadow, and tissue compaction indicates the development of an inflammatory process. Opacities outside the lungs may be a sign of an aortic aneurysm, tumors of the esophagus, or the spine.

The doctor may refer the patient for an x-ray of the lungs several times to assess the dynamics of treatment or in its absence. This approach is justified by the fact that the harm from an untreated disease is much greater than from the radiation received.

The radiation indicator during an X-ray of the lungs ranges from 0.03-0.3 mSv per procedure, so even when taking pictures in several projections, its total dose will not harm health. A person receives approximately the same amount of radiation in two weeks in normal life.

How does the procedure work?

No preliminary preparation is required before performing an x-ray examination. The patient can continue to lead his usual lifestyle.

Modern X-ray machines are high-tech and therefore capable of demonstrating any changes (from 1 mm in size). The result will be ready in a few minutes. All information will be immediately displayed on the screen.

The specialist who conducts the diagnosis will ask the patient to undress to the waist. It will be necessary to remove all metal objects; if they are present, the quality of the image may be spoiled. The procedure can be performed with the patient sitting, standing, or lying down. The doctor will ask you to hold your breath for a while.

The type of x-ray is determined by the purpose of the study. It can be overview or targeted. In the first case, the rays pass from two sides - directly and from the side, and in the second - the focus of the device is aimed at a certain area.

People need to undergo the described procedure to identify any diseases in the early stages.

What is the difference from fluorography

An X-ray of the lungs is also necessary for a healthy person. Thanks to this procedure, it is possible to diagnose diseases and dangerous conditions such as:

tuberculosis;
pneumothorax;
various heart pathologies and chest injuries;
the presence of objects of foreign origin;
inflammatory diseases of the pleura and accumulation of fluid in it;
tumors in the lungs, bronchi and trachea;
helminthic infestation (presence of parasites);
other diseases.

The principles of diagnostics using fluoro- and radiography methods are similar, but there are still differences:

an x-ray image has a higher resolution, therefore, when enlarged, its quality will not be distorted;
fluorographic diagnosis is more of a preventative method, since minor deviations in the image will be barely noticeable. In this case, an additional x-ray will be prescribed;
with x-rays, the patient receives a lower dose of radiation;
with fluorography, the image is obtained from a fluorescent screen, with x-rays - by exposing the film.

In many countries, fluorography is no longer used, as it is considered an outdated method. X-rays make it possible to detect pathologies at the earliest stages. Therefore, radiography is considered the best (in terms of information content) technique. Although it happens that in order to save time and consumables, fluorography is prescribed for all family members, employees of the organization and even residents of an entire locality.

Fluorography is a screening diagnostic method. In accordance with the regulations of the Ministry of Health of the Russian Federation, annual fluorography is mandatory for all adults. With its help, you can detect pronounced changes in the lungs, characteristic of tuberculosis and oncological processes.

Is it possible to do x-rays for pregnant women?

X-rays can be done for pregnant women, but only as prescribed by a doctor who will assess the duration of pregnancy, the organs that need to be examined, and take into account all possible risks.

The likelihood that x-rays taken during pregnancy will harm the baby is minimal. A diagnostic test is prescribed only when indicated, when other methods are not informative and do not make it possible to make an accurate diagnosis and begin treatment. Therefore, the benefits of x-rays are greater than the potential risk for the child. However, a large number of examinations of the abdominal organs performed shortly before pregnancy can negatively affect the development of the fetus.

X-rays of the head, limbs, or teeth do not expose the reproductive organs to radiation. The use of a protective lead apron and collar during the procedure reliably blocks scattered radiation. An exception is an abdominal x-ray, in which the abdomen and baby are exposed to direct x-rays.

The risk of harm to the fetus depends on the fetus' age and the intensity of exposure. Exposure to a high dose of radiation between the second and eighth weeks of pregnancy increases the risk of developmental disorders or birth defects, while exposure after the eighth week increases the risk that the baby will have learning and intellectual development problems.

However, the radiation dose received during an x-ray is much lower than what can cause these complications. Before taking an x-ray, you must tell your doctor that you are pregnant. Depending on the circumstances, he may delay the study or change it to reduce the amount of radiation.

At what age do children get x-rays?

X-rays are prescribed to children of any age, but only if indicated and when other research methods do not provide the necessary diagnostic information. The advantage of this procedure is that the ability to make an accurate diagnosis justifies the risk associated with radiation. When radiography is performed on children, it is necessary to minimize exposure to ionizing radiation because:

children are more sensitive to the effects of X-rays than adults, that is, the risk of cancer per unit dose of ionizing radiation is higher;
the use of equipment and radiation settings intended for adults may result in excessive exposure of children;
Children's life expectancy is expected to be longer, so the risk of cancer from radiation exposure is potentially higher than in adults.

In order to minimize possible harm to health, X-rays for children are performed using the lowest dose of radiation, which gives an image quality suitable for diagnostics. X-ray examination is performed for preventive purposes for children from 14 years of age.

Indications for chest X-ray in children

Considering the possibility of negative effects of X-rays on the child’s body, chest X-rays are not performed for preventive purposes, but are prescribed only if there are strict indications for the study:

Confirmation or exclusion of pneumonia (pneumonia).
Severe cough accompanied by a high temperature (above 38ºC) that persists for more than three days.
Leukocytosis and shift of the leukocyte formula to the left in the blood test.
Impossibility or lack of information content of other examination methods.
Suspicion of pathology of the thymus gland.
Suspicion of pulmonary tuberculosis.
Diagnosis of neoplasms.

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Contraindications for chest x-ray of a child are the child’s severe general condition, bleeding, and age under 3 months. X-rays are highly discouraged for newborn children, but this is permissible in extreme cases when the benefits of the study exceed the harm received from it.

How are x-rays done for young children?

X-rays are taken for children in the presence of parents or guardians. Their help may be needed to calm the baby or help him maintain the desired body position during the examination. The procedure is safe for both the child and those accompanying him, since the radiation dose is reduced. To protect parts of the body not involved in the study, the child is wearing a protective apron. Special preparation before diagnosis is usually not required. The only exception is an X-ray contrast study, which is performed on an empty stomach. The doctor who issued the referral will tell parents in detail about the specifics of the procedure and the need for preparation.