Radiography or fluoroscopy of the heart is a specialized non-invasive( without tissue dissection) method of radiation diagnosis, invented more than 100 years ago, aimed at detecting myocardial pathologies and disorders of cardiovascular activity.
What is a radiograph of the heart
The concept of the
method Radiography or fluoroscopy of the heart is a specialized non-invasive( without tissue dissection) method of radiation diagnosis, invented more than 100 years ago, aimed at detecting myocardial pathologies and disorders of cardiovascular activity. Ionizing radiation, depending on the tissue density of the organ, is able to either penetrate through them, or linger.
This X-ray property allows you to take a picture or image on the screen. The specialist examines and analyzes the contrast black-gray-white drawing - an X-ray, where the configuration of the organ, the dimensions of individual sections or viewing the image on the screen are clearly visible.
- Radiograph is a photograph taken during radiography.
- Fluoroscopy - output images to the computer screen without taking pictures.
The method is used separately for the diagnosis of the heart muscle or for joint examination of the heart and other organs of the chest cavity.
On X-ray images with high reliability are determined:
- pericarditis exudative - infectious inflammatory lesion of the pericardium - pericardial membrane( to detect exudate - fluid accumulating between the pericardial sheets);
- myocardial hypertrophy( abnormal increase in heart size), which occurs with ischemic disease and persistent hypertension;
- aneurysm of the wall after a heart attack( in the form of protrusion);
- cardiomyopathy dilatation( defeat of the heart muscles with stretching of its chambers);
- pronounced defects in the anatomy of the myocardium( as a rule - valve defects);
- change in pulmonary pattern - turbidity, expansion of the roots of the lungs, which also indicates the development of cardiac pathology;
- calcification of the coronary artery( deposition of calcium on the walls of the vessel), compaction, atherosclerotic and thrombotic plaques.
Disadvantages and advantages of
Cons:
- The method does not have high information content;
- It is impossible to assess the condition of moving organs( because of cardiac contractions, the image is blurred);
- Low, but the existing probability of obtaining a radiation load with frequent X-ray passage;
- Continuous film processing.
Pros:
- Maximum availability for patients in terms of the cost of the procedure and the number of medical radiology rooms. Today, radiographic facilities are available in all polyclinics and hospitals.
- Excellent film resolution, in which detailed detailed shots are obtained. This allows to reveal the degree of development of pathology, the reaction of neighboring organs, surrounding tissues.
- X-ray is a document that can be easily compared with previous and next images and assess the dynamics of the disease;
- The use of the method with regular preventive examinations makes it possible to detect early changes in the contours and sizes of the myocardium.
Random detection of abnormalities in the annual heart examination with X-ray often becomes the basis for subsequent diagnosis of possible pathology and timely prescribed therapy.
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To whom it is prescribed
Radiographic examination of the myocardium is used in therapy, cardiology and heart surgery.
Patients sent to the examination:
- with signs of angina pectoris - pressing pain behind the sternum, burning sensation, irregular heartbeat;
- with persistent symptoms of cardiac insufficiency:
- dyspnea, increased fatigue with physical stress, weakness at rest;
- frequent heart rhythm disorder - tachycardia, arrhythmias;
- swelling of the feet;
- enlargement of the liver;
- marked paleness of mucous membranes, skin;
- with signs of an increase in the volume of the heart, found during tapping or during ultrasound;
- with noises detected while listening to the heart area.
The video below shows the radiography of the mitral heart shape:
Why undergo this procedure
X-ray diffraction is performed:
- for detecting and possibly preventing developing pathological conditions in the myocardium and coronary vessels;
- detection of acquired organ defects, defects in structure;
- for preliminary diagnosis in case of heart and vascular problems.
- For the prevention of x-rays are done once a year( or in 2 years, for example, for workers in the food industry), and at such low radiation loads, x-rays do not have a negative effect. Usually this is a fluorography - X-ray study with photographing the image on a fluorescent screen - conducted for the early detection of lung diseases and not giving accurate data in the study of the heart. In case of fluorography, a single dose of radiation is not more than 0.015 mSv, and exceeding the radiation load is possible only with the implementation of thousands of procedures per year, that is, three times a day daily.
- Patients suffering from serious illnesses have to undergo a radiographic examination more often if pathology threatens health and life more than X-rays. As a rule, this does not apply to radiographs of the heart. Usually it is enough to perform a single procedure and further examination of the myocardium using more advanced diagnostic methods.
Types of such diagnostics
There are two types of examination:
- Heart radiography standard
- Radiography of the heart using a contrast mixture filling the esophagus so that the contours of the heart are better viewed. The patient is allowed to drink a spoon( up to 5-7 ml) of a suspension with barium, in which the border of the left atrium and esophagus is more clearly marked in the picture.
Indications for
Radiography is used in many diseases of the heart and vessels feeding it. Indications for the procedure:
- planned treatment of patients suffering from coronary artery disease( impaired blood flow in the areas of the myocardium);
- initial signs of angina pectoris or worsening of the condition;
- unstable, asymptomatic angina;
- suspected heart disease;
- monitoring the state of the small circle of the circulatory system in dynamics;
- very often - to detect calcifications of aortic valves, mitral valve, pericardium, myocardial area after a heart attack, in thrombi within the heart chambers and differentiation of such foci in the heart from calcifications of the lungs and mediastinal zone;
- latent heart disease, the search for the localization of fat in the epicardium with exudative pericarditis.
Aortic heart shape occurs quite often and the radiologic method helps to identify it, as described below:
Contraindications for carrying out
The procedure is prohibited:
- Women who are carrying a child( especially in the first three months) are contraindicated because the effect on the embryo of ionizing radiation at the stage of planting is considered to be extremely negative. It is allowed to hold in special cases when the small pelvis and abdomen are fully closed by a special protective apron made of lead that does not transmit radiation. After radiography, a pregnant woman should undergo ultrasound examination of the fetus.
- Patients in serious condition regardless of the type of disease.
- For children under 14 years.
Children
Children's state when x-ray examination is permitted:
- serious tooth pathologies and threat of jaw tissue suppuration;
- urination disorder for various reasons;
- frequent and severe attacks of bronchial asthma.
Strongly not recommended:
- to carry a radiograph to a child if the Mantoux test is negative;
- do x-ray of the hip joints - in childhood it is considered one of the most dangerous types of diagnosis.
Lactation
Breastfeeding of the infant is permitted when the infant is breastfeeding. Radiation does not affect the composition of breast milk and does not harm the infant.
Safety of
method X-rays are radioactive, and high dose irradiation negatively affects a person, lingering in tissues, destroying DNA and provoking malfunctions in the functioning of organs. The degree of danger of X-rays is directly related to the dose.
During the radiography of the heart region, the patient receives very little radiation. ED - the so-called effective dose - an indicator of the risk of development of consequences after radiation exposure of individual organs or the whole body, taking into account their sensitivity.
If cardiac radiography is performed, the ED will be performed in one procedure:
- For , the X-ray diffraction pattern of the film , when the picture is retained on the film, is 0.3 mSv-milliSivert( 30% of the permissible annual ED, 1 mSv).
- With , the digital X-ray diffraction pattern , when the X-ray image on the plate is scanned, and then the image is transferred to the program - 0.03 mSv( only 3%).
Before the X-ray the patient should know the dose of radiation and check its indicator in the protocol, which is signed by the doctor-radiologist. It is better to keep the information if you have to do the procedure several times a year. It is always possible to calculate the total dose received, which should not exceed the total annual allowable 1 mSv allowed by physicians.
For comparison of data:
- In Russia, the indices of the natural background radiation range from 5 to 25 microR / hour.
- If they are recalculated into international radiation units - Sievert( Sv) - this will be 0.05 - 0.25 μSv / h.
- A total radiation dose received from natural radiation will be 0.4 - 2.2 mSv per year.
The preparation of the patient for radiograph of the heart will be further considered.
Patient preparation
In the case of cardiac radiography preparation is almost not required. In comparison with fluoroscopy of other organs, the procedure of heart examination is often carried out in an emergency mode.
- Before the examination, the patient removes clothing to the waist and all metal objects and jewelry( including piercings).
- Women pin their long hair. Otherwise, when objects are placed on the research area, the quality and informative nature of the image will suffer.
How the procedure passes
The procedure for radiography takes a few minutes. If you want to take off your clothes, the doctor issues a protective apron( cloak) that closes the organs that are not subject to inspection.
During the procedure, the patient stands with his arms raised, bent at the elbows. The shooting is done instantly. The procedure is not accompanied by unpleasant sensations, the only thing that can be a bit annoying is the lime taste of the barium solution in contrast radiography.
- The sharpness of the image is determined by the voltage, the current in the X-ray machine for radiography and the duration of the work. These parameters are set separately for each examinee, which depends on the type of X-ray, weight and "size" of the patient.
- Although there are averages for different tissues and organs, the doctor makes adjustments for each examination. The result and quality of the images depend on this.
- In addition, the immobility of the patient is required for x-rays, so that there is no distortion.
- As the heart contracts, it's difficult to get a blurry high-quality image. To reduce distortion to a minimum, a short exposure is used or fluoroscopy is performed - a study of the work of the heart in motion on the screen.
- Survey of the heart is carried out at a distance of 1.5 - 2 meters. As a rule - in two projections. But with the specification of the presumptive diagnosis, a chest radiograph is performed - in three to four projections - anterior, lateral left, oblique left and right, but at an angle of 45 degrees.
- Skew snaps give the opportunity to see the walls of the myocardium, arcs, aorta, which are not visible during lateral shooting. For example, the right oblique projection allows full exploration of all parts of the heart.
Decoding of the results of
After radiography and film development, the radiologist makes a report. It indicates the size of the heart, evaluate the shape of the heart - outline. The outline of the heart is normal, as well as mitral and aortic, which indicates a possible heart disease.
- The shape of the heart in the form of a triangle means a high probability of pericarditis.
- Based on the findings of aortic wall seals due to the deposition of calcium salts, a conclusion is drawn about prolonged arterial hypertension.
Heart enlargement occurs more often due to hypertrophy of the walls, enlargement of the left ventricle. Observation of such abnormalities assumes the following:
- congestive heart failure;
- hypertension;
- disease of the heart vessels, vices;
- inflammatory diseases of the myocardium;
- viral pathology;
- systemic atherosclerosis;
- ischemic disease, amyloidosis.
The interpretation of the results of radiography is carried out by a specialist, and the conclusion is made by the doctor who sent the patient to the examination( cardiologist, therapist or surgeon).About the price of heart radiography with contrasting of the esophagus and its other methods will be described below.
The video below describes the decoding of the chest radiograph:
Cost of the procedure
Prices in private clinics for radiographs of the heart are quite acceptable. In Russia ranges from 700 to 2000 rubles. The doctor will tell you where to take radiography.
During the procedure, it is possible to register images on film( film radiography) or scan to digital media( digital).Fixing X-ray data in digital format is much more expensive, so today high-sensitivity X-ray films are used everywhere.