Cough

How often to do fluorography after 50 years. X-Rays and Health

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-ray images 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 fluorography method, which has now been 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 include: 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 in drug treatment and psychiatric institutions, former prisoners up to 2 years after release, persons under investigation and convicts held in prison isolation wards and prisons.

It is mandatory to undergo it once a year fluorography patients with diseases of the respiratory system, 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 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 is a medical examination of the chest organs. It is performed using x-rays that are passed through the patient's body. The rays are reflected from tissues (organs, bones) and produce a visible black and white image on film or screen.

During this procedure, the body experiences a certain load due to x-ray radiation. Therefore, this procedure is considered harmful and is often not recommended.

Is that so?

This is partly true. The fact is that X-ray radiation is one of many to which the human body is exposed throughout life. On average, a person receives a dose of 2-3 mSv per year. It is summed up from cosmic radiation (solar and cosmic rays), radiation from natural radionuclides (soil, air, water) and radiation from artificial radionuclides (nuclear energy, nuclear explosions).

The recommended annual effective dose is 1 mSv. When conducting film fluorography (old technology), the radiation dose is 0.5-0.8 mSv, and when performing digital fluorography (new technology), it does not exceed 0.1 mSv.

Thus, fluorography using digital equipment once a year turns out to be practically harmless. But most clinics use film machines, which give a lower-quality image, and also a radiation dose that can be equal to what a person receives in a year.

How often can fluorography be done?

The current decree of the Government of the Russian Federation “On the implementation of the Federal Law “On preventing the spread of tuberculosis in the Russian Federation”” indicates groups of people who are required to undergo fluorography. You are required to do it twice a year:

military personnel undergoing military service upon conscription;
workers of maternity hospitals (departments).
those in close contact with tuberculosis patients;
persons deregistered from specialized anti-tuberculosis institutions due to recovery (up to 3 years after deregistration);
persons who have had tuberculosis and have residual changes in the lungs (up to 3 years from the date of diagnosis of the disease);
HIV-infected;
patients registered with drug treatment and psychiatric institutions;
released from pre-trial detention centers and correctional institutions (up to 2 years after release);
persons under investigation held in pre-trial detention centers and convicts held in correctional institutions.

Once a year it is necessary to undergo fluorography:

patients with chronic nonspecific diseases of the respiratory system, gastrointestinal tract, genitourinary system;
patients with diabetes mellitus;
persons without a fixed place of residence;
migrants, refugees, internally displaced persons;
employees of kindergartens and schools;
employees of medical and preventive, sanatorium, educational, health and sports institutions for children and adolescents.

Fluorography is included in the list of preventive medical examinations for population groups over 15 years of age. It is not performed on children, but if necessary, an ultrasound examination (ultrasound) or x-ray is performed. Fluorography is also not performed on pregnant and lactating women.

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 paid 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.

Species

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 method is currently falling out of use due to the obsolescence of the 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.

To obtain the final result, the film must be developed in a special way. The disadvantage of this method is 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 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, since X-ray irradiation can negatively affect the formation of the embryo;
when feeding newborn children, special safety measures must be observed 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 a person’s mental state during the procedure, because in some cases this phenomenon can even cause a panic attack.

Advantages and disadvantages of the method

Fluorography is a medical procedure like all others, 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 at an early stage of 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 of having serious illnesses, fluorography can be done before the age of 12.

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

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 explained by concerns that at an earlier age, X-ray irradiation can negatively affect the development of a 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. It is strictly prohibited to do fluorography in the early stages, since irradiation can negatively affect the division of fetal cells.

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 deals with all x-ray examinations, including tomography and conventional x-rays.

It is the responsibility of the radiologist to carry out the procedure as required by government 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. Then the documentation indicates numbers corresponding to possible diseases, pathologies, and characteristics.

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 darkening is detected, a CT scan should be performed. 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	Accumulation of excess fluid in the pleura.
6	Pronounced fibrosis in the lung tissue.
7	Limited fibrosis in lung tissue.
8	Increased level of transparency of lung tissue. A possible cause is 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 petrificates 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	Changes in the appearance of the 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 negative consequences of 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 facility. This requires an important employee - a radiologist, and a laboratory nurse is suitable.

In public clinics, fluorography can be done free of charge. If for some reason these institutions are not suitable for the patient, you can be examined in a paid clinic. The cost of a paid fluorography service in Moscow averages 1,000 rubles, but cheaper options can also be found.

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.	With radiography, the patient is exposed to less radiation than with 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!”:

Fluorography is an effective method of radiographing in which images obtained under the influence of an x-ray are photographed. Tissues of the human body with different densities transmit such radiation to varying degrees. 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.

Digital images can be constructed as composite pixels or spatial frequencies. Filtering algorithms operate at pixel or spatial frequencies, but they are much faster at them. One of the interests of image filtering is changing its spatial frequency.

Image smoothing is useful for noisy images or in regions where radiation doses are too low, eliminating high frequencies to allow only low frequencies to pass through. Pixel smoothing uses either the average or median intensity of the pixels in a kernel of a given size around the pixel for smoothing.

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 of various organs are diagnosed: 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.

Mean-average smoothing tends to smooth out differences in intensity between pixels and blur the outlines of small, well-defined, high-contrast structures. Average neighborhood smoothing aims to reduce gray level fluctuations and keep edges clean. Structures smaller than the size of the nucleus are erased. This type of smoothing can be used when previous neighborhood smoothing is ineffective, to attenuate large gray tone fluctuations due to noise.

There are two main methods for edge enhancement: frequency filtering and spatial filtering. Frequency filtering can suppress low frequencies to allow high frequencies to pass through. Fuzzy mask subtraction. Spatial frequency processing allows for tailoring the frequency response characteristics of radiographic structures. Phospholuminescent plates mainly use nonlinear fuzzy mask technique.

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

Employees of companies and organizations with professional activities that are related to 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 for military service, a 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:

The fuzzy mask method is expressed by the equation. The fuzzy mask method is performed in two stages. In the first stage, a clean image in which edges are enhanced is obtained by subtracting a mask, which is a fuzzy image obtained from the original image, from the original image. The spatial frequencies of the edge image depend on the degree of blur of the mask. The blur of the mask depends on the size of the kernel blurred by averaging the pixels of that kernel. Low frequencies are boosted by a large mask and high frequencies by a small mask.

The gain can be numerical and independent or dependent on the signal level in the original image kernel. Low gain is used for low x-ray and high x-ray areas. high attenuation. This nonlinear processing reduces noise in low-attenuation areas and enhances contrast in high-attenuation areas. Overall, low-frequency structures are attenuated, and detection of low-contrast and angular structures is improved. The Small Core tends to sharpen the edges of linear structures.

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:

The Large Nucleus tends to emphasize the intensity of various structures down to the size of the nucleus. Explicitly masking blur can create a dark halo artifact in steep transition zones between low- and high-intensity areas of the image.

Comparing several masks of different sizes gives an advantage to large size masks over small masks. Large mask filtering is most suitable for better simultaneous vision of linear, nodal and micronodular images of the chest. Moderate gain is most appropriate, and designers express this type of treatment differently using a fuzzy mask in terms of kernel size, frequency, and sigma value.

People aged 15 to 40 years who are admitted to inpatient 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.

Variations in the use of the fuzzy mask have been described: Abe, using a histogram of a digitized image of the chest, divided the chest into three regions: the lungs, the retrocardial region and the spine and diaphragm. An adapted blur mask is then automatically applied to each of these areas, improving their analysis. This technology has effects and results similar to dynamic scale compression.

Dynamic scale compression. Dynamic scale compression extracts numerical information from the white and black areas of an image. In Diagram 3, the ladder function simulates large anatomical structures such as the heart, lungs, and mediastinum, whose coordinates are shown on the x-axis.

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.

When smoothing is performed, small changes in the signal are suppressed. As a result, the signal of low-density zones is amplified and the dynamic scale is narrowed, leaving small signal variations as well as differences in contrast. Applying function 3a to function 3a, we obtain compression of high-density regions, which leads to a decrease in the densities of high-density regions.

In addition to irradiation, selenium is an insulator that has the property of photoconductivity. When irradiated, it has electrical conductivity proportional to the intensity of irradiation. This property is used to convert radiation directly into an electrical signal. Three sequential steps allow the image to be formed: first, the selenium cylinder is loaded, then it is irradiated, and finally it is read to extract information. The first step is to prepare the cylinder. This discharge carries a high positive electrical potential at the same time that the opposite polarity is applied to the aluminum substrate: the result is a strong electric field in the selenium that charges it.

If you carry out X-ray examinations 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.

The second step is the actual exposure through irradiation. X photons are absorbed in the selenium layer, which releases electrons. These free electrons, under the influence of an electric field, pass to the surface of the selenium layer, where they neutralize part of the deposited positive charge. This reduces the local surface charge by a greater or lesser intensity proportional to the irradiation intensity. Thus, the latent image is created as a set of charges on the selenium surface.

In the third stage, the rotation of the cylinder is accelerated and the electrical charges are scanned and converted into a digital signal. The scanning is performed without physical contact, but with 36 electrometers at a distance of about 100 microns from the surface. The resulting signal is amplified, digitized and transmitted to the processor. The selenium layer can then be recharged for the next collection. Image processing is carried out in accordance with the same principles as photo-shooting screens.

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

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.

To charge the cylinder, an electric shock is applied while the cylinder is slowly rotated. When the cylinder surface is fully loaded uniformly, the rotational motion stops and exposure can be made. After the cylinder is exposed, it accelerates at high speed, and the reading by capacitors can do. This is done in 9 seconds. The sensors slide slowly in a direction parallel to the cylinder axis, creating a helical sensing of the surface, the resolution is 0.2 mm and the signal is converted to 8-bit depth. the image on the cylindrical detector is corrected to make a matrix plane.

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 intended for the earliest possible detection of latent forms of diseases and requires individuals to undergo a medical examination over 18 years old periodically 1 time every 2 years.

The selenium detection curve is almost parallel to the 100% ideal line: it is removed from the ideal line because the 500 µm selenium layer is not thick enough to absorb all the X-rays. Phospholuminescent plates are a little further from this ideal curve because they have noise inherent in the thickness of the europium fluorescent layer. The performance of film screens is lower than the photostimulated plates themselves, lower than the selenium receptors. In addition, these latter two types of receptors have an almost linear response over a wide irradiation range, whereas film screen vapors have significant efficiency in a limited irradiation area.

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 the last year.

The retrodiaphragmatic and retrocardial regions, cheils, superior mediastinum, ribs and soft tissues were especially well analyzed. Other methods of scanning images are available. They have advantages and disadvantages depending on the regions studied. With the chest, the rib cage requires the highest spatial resolution.

The X-ray beam equation is not a digital radiology system, but can support phospholuminescent plates. Two systems allow the radiation intensity to be adapted to the radiographic area. Spot or linear measurement of the X-ray beam transmitted through the patient allows you to adjust the radiation intensity and even out the blackening of the film.

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 study is carried out as part of compulsory health insurance and is free for the patient.

The duration of radiation is too long for a chest x-ray. Both systems use electronics that equalize the intensity of the transmitted beam, but both affect conventional film and do not produce a digital image, however, instead of printing the film, a phospholuminescent plate can be irradiated. This improves image quality and creates a high-quality digital image.

Long developed and used in digital angiography, digital fluorography is unsuitable for chest radiography. The scintillator-photodiode array provides insufficient pixel size in chest radiography, but the potential of this technique is very high for imaging with flat panel detectors.

Currently, the order of the Ministry of Health No. 124 n “On approval of the procedure and timing of preventive medical examinations of citizens in order to detect tuberculosis”, regulating and fluorographic control, is under development. 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

According to 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.

X-ray film scanning can be done in several ways. The limits are close to , but the possibilities for image processing and remote transmission are very interesting. Microdensitometry scanning uses a high-intensity laser and a photomultiplier tube to accurately measure the optical density of each point on the film. This is a very interesting process for digitizing images that are originally analog and is suitable for film based images. The possibilities of processing a digital image and “catching up” with the initial non-digital image are very great. to evaluate diagnostic capabilities and digital image processing capabilities.

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 catering establishments, as well as companies with a social service profile.

Such a scan can be the starting point for remote transmission when the laser or scanner is connected to a computer with a modem. This system, developed by Professor Sharpak, is currently under evaluation and its resolution is currently insufficient for primary diagnosis on chest x-ray. However, its principle presupposes a promising future. The big advantage of this system is the very significant reduction in radiation exposure with less scattered radiation and greater image latitude.

For a chest x-ray, the radiation will be divided into 3-2 times. At the moment, this method can be indicated when monitoring already known thoracic pathology. Digital images can be reproduced and analyzed on screen or film. Screen analysis can make films disappear and allow them to be replaced by electronic film cameras, which must be easy to use, easy to use and have sufficient resolution. The film and high-definition screen rendering scores are equal to the film readings or even higher in Radiopedia.

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.

Diagnostics, which allows you to obtain an image of the organs of the chest cavity 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, a special type of electromagnetic wave. 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 effects of radiation sickness, which developed due to excessive consumption large doses and absence protective measures, which were developed much later on the basis of 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, vehicles, 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 in the initial stages of 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 unhealthy foods, unreasonably and uncontrollably taking various medications, indulging in our addictions - smoking, excessive alcohol consumption 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 is a universal tool for diagnosing diseases lungs and heart. It is regularly prescribed to citizens who have reached 18 years old.

What does the law require for fluorography?

When to get checked

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 study is carried out as part of compulsory health insurance and is free for the patient.

How often should fluorography be done: table

Order of the Ministry of Health on mandatory fluorography

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 catering establishments, as well as companies with a social service profile.

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 a fluorographic examination of the chest, medical specialists diagnose:

severe infectious lung disease (tuberculosis);
inflammation of the lung tissue (pneumonia);
lung 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 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. 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 the acute period of 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 images of the tissues of the internal organs, which can be seen on a 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.