The difference between a smoker’s lung and a normal person’s lung on X-ray

This is an automatically translated article.

The article is professionally consulted by MSc, BS. Dang Manh Cuong – Radiologist – Radiology Department – Vinmec Central Park International General Hospital. The doctor has over 18 years of experience in the field of ultrasound – diagnostic imaging.

Smoking is a bad habit that is hard to quit not only in men but also in women. Cigarette smoke has a significant impact on health, especially the lungs. Can cause lung diseases such as chronic obstructive pulmonary disease, pneumonia, especially lung cancer.

1. Harm of cigarette smoke

Tobacco smoke contains many harmful substances that can damage the respiratory system.
These toxic substances are chemicals that, when inhaled directly into the lungs, will lead to an overproduction of mucus in the lungs along with a lower ability to excrete mucus out of the body than the average person. Therefore, the bronchial mucosa of smokers for many years has changed in structure, proliferating mucous glands, thickening the lining of the airways, increasing sputum secretion, causing narrowing of the airways. In addition, the lungs are not able to clear excess mucus effectively, which will be favorable conditions for respiratory infections. Manifested by cough, bronchitis and infections such as pneumonia, obstructive pulmonary disease, lung cancer,… The lungs of a long-time smoker can turn black, while in a healthy person ruddy. At the same time, the part that can’t pump as full of air as a non-smoker because the smoke makes the lungs hard, reduces elasticity, and affects lung function. In addition, the harmful effects of tobacco also cause:
90% of cases diagnosed with lung cancer are tobacco users. Tobacco is also the cause of 75% of cases of chronic obstructive pulmonary disease. increase the risk of dying from the disease 66 times compared to non-smokers. Secondhand smoke increases the risk of bronchitis, pneumonia, tuberculosis, and asthma in adults. In children, secondhand smoke increases the risk of respiratory symptoms such as coughing, wheezing, shortness of breath, slows lung growth, and causes premature decline in lung function. Tobacco not only affects direct smokers, but passive smokers are just as vulnerable as direct users.

Khói thuốc lá có chứa rất nhiều chất độc hại có thể làm tổn thương hệ hô hấp

2. The difference between a smoker’s lung and a normal person’s lung on X-ray

Normally, the lungs of normal healthy people will be ruddy, with no abnormal signs.
For smokers, images of the lungs on characteristic x-ray films. However, each person is not the same, because smoking time is different smoking dose, so the impact of tobacco on the lungs is different. But basically the symptoms are the same, just different in degree.
The chest x-ray image of a smoker shows:
The outside of the lung is covered with a black membrane. The longer a smoker has smoked, the more obvious this black film becomes. Lungs may increase in size than normal, many black dots are inflammatory sites… Alveolar dilatation can be seen on X-ray, showing barrel-shaped lungs, dilated intercostal spaces, and regions. Brightening corresponds to areas of alveolar dilatation. Chest X-ray can suspect chronic obstructive pulmonary disease to help detect the causes of exacerbations: Pneumonia, pneumothorax, signs of pulmonary embolism… In Vietnam, lung cancer is The disease ranks first among the 10 most common cancers in both men and women. The leading cause of lung cancer is the habit of smoking. In order to reverse lung cancer and other dangerous cancers caused by tobacco in the community, Vinmec International General Hospital offers a Lung Cancer Screening Package to help detect lung cancer early, reduce mortality. death from lung cancer.

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The hospital is home to a team of experienced experts, combined with the world’s leading modern equipment system, autologous immune-boosting therapy, biopsies, and diagnostic techniques. Imaging diagnostics such as computed tomography (CT-Scanner), magnetic resonance imaging (MRI),… help diagnose and treat diseases more accurately.

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The “dirty chest”—correlations between chest radiography, multislice CT and tobacco burden

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90,000 CT or X-ray of the lungs: which is better?

For pneumonia, tuberculosis, and even as part of preventive screening, patients are prescribed a CT scan or x-ray of the lungs.

What is the difference between these examination methods? When is the best time to do a CT scan of the lungs, and when is it better to do an x-ray? Let’s take a closer look in this article.

How is a CT scan different from a lung x-ray?

Computed tomography is a modern method of radiation diagnostics of various diseases, which is based on radiography. . The method was developed and proposed by scientists, Nobel Prize winners G. Hounsfield and A. Cormak in 1972 year. Classical radiography was invented in 1896, most often it was used in dentistry and for examining the lungs, since at the turn of the 19th-20th centuries. mortality from pneumonia, tuberculosis and asthma was extremely high.

The key difference between digital x-rays and computed tomography of the lungs is the x-ray trajectory and imaging technique. In conventional x-rays, X-rays pass perpendicular to the area of ​​interest only once, so the x-ray is a two-dimensional, single-layer image. X-ray of the lungs is the most affordable study, which is often prescribed in the first place, if the patient has signs of pneumonia, tuberculosis, obstructive pulmonary disease, tumors. The problem of this type of diagnosis lies in the fact that, for example, with pneumonia on an x-ray, only lung damage of III and IV degrees can be reliably determined, and shadows from large organs can obscure other tissues.

CT scans are more clear and informative. During computed tomography, the x-ray tube, together with sensitive sensors, makes several revolutions along a spiral path, scanning the area under study. The CT machine makes many scans up to 1 mm thick, on the basis of which a high-resolution three-dimensional model of the lungs, vessels, organs and bones of the chest is recreated. Thus, after computer processing of images, tissues and organs can be examined in three projections, the effect of overlaying shadows from organs in the case of computed tomography is absent.

The high definition of the image in computed tomography is associated with the diagnostic technique and the physical properties of the radiation. X-ray has a 20% attenuation coefficient, while tomography has a coefficient of 0.5%, and therefore a higher resolution.

Both X-rays and CT scans can be done with contrast. X-ray or CT of the lungs with contrast will help visualize vessels and tumors. However, the primary differentiation of neoplasms into benign and oncogenic is possible only within the framework of CT, which is also associated with image quality.

Since a chest x-ray is essentially 1 image, and many CT scans are taken, the radiation on lung CT is higher due to multiple exposures. On average, a patient receives 0.1 mSv of radiation during one X-ray procedure of the lungs, and 2.5 mSv during a CT scan of the lungs. However, this dose of ionizing radiation is safe for the patient. It is permissible to do CT scans of 5 zones per year. Referring to one or another radiographic method of examination, doctors are always guided by the criterion of expediency and patient safety.

In the specialized CT center “Ami”, the procedure is performed on a new generation device Siemens Somatom go. Now with reduced radiation exposure.

Which is better: CT or X-ray of the lungs?

CT scan of the lungs and radiography are prescribed for pneumonia, tuberculosis, bronchial asthma. Both studies show the condition of the lungs, bronchi, trachea, and mediastinum. Both CT and X-ray reveal tumors, foreign objects in the lung cavity and airways. Like computed tomography, x-rays show fluid accumulation in the alveoli or fibrosis (lung damage due to pneumonia), the presence of emphysema (chronic smoker’s bronchitis), pulmonary edema and sarcoidosis (granulomas and nodular neoplasms of the lungs).

However, most doctors are inclined to believe that if it is possible to do a CT scan of the lungs instead of an X-ray, then it is better to examine the chest organs in this way. Firstly, the doctor will definitely not miss the disease or tumor in the initial stage. Secondly, after a CT scan of the lungs, there is no need for an additional clarifying examination (except for laboratory diagnostics, since infectious, viral and bacterial pathogens are determined by analyzing biological material). Thirdly, small calcifications, destructions and tumors are visible only on CT scans.

According to the World Health Organization, lung cancer continues to pose a threat to the life and health of millions of people. Therefore, patients older than 40 years, especially those at risk, are recommended annual preventive screening. Fluorography and X-rays are considered the traditional method of prevention, but low-dose computed tomography of the lungs is best suited for this purpose.

Advantages of lung X-ray

• Low cost of examination.
• Irradiation approx. 0.1 mSv.
• Many medical institutions are equipped with X-ray machines.

Cons of lung X-ray

• Low information content.
• Low specificity.
• 2D images, suspicious areas may be obscured by organ shadows.
• Does not show pneumonia, tumors and other lung pathologies in the early stages. Also, CT is more informative for examining the lymph nodes.
• It is impossible to give a primary assessment of neoplasms, to differentiate them into benign and oncogenic.
• There is a possibility of getting an incomplete picture.

Advantages of lung CT

• Three-dimensional (spatial) image of the lungs, comprehensive information content.
• Shows diseases and pathologies of the lungs in the early stages.
• Early detection of lung cancer.
• The physician can initially differentiate neoplasms.
• It is prescribed for atypical course of diseases, as a clarifying method of examination after X-ray.

Lung CT cons

• Higher price.
• Higher dose of ionizing radiation.
• Relatively low prevalence of medical centers equipped with tomographs.

What is more informative: CT of the lungs or X-ray?

Computed tomography is the most modern and informative X-ray examination method. On scans in three projections, soft tissues, internal organs, bones and blood vessels are visualized. 2D x-rays give a more general picture of the lung condition, but sometimes it is enough for the subsequent successful treatment of the patient.

Is it dangerous to do a CT scan of the lungs after an x-ray?

Ionizing (X-ray) radiation is not useful for humans, but in excess causes radiation syndrome and can become a “trigger” for the development of cancer in patients predisposed to them. According to the current “Radiation Safety Standards”, up to 30-50 mV of radiation is permissible per year, but one should not forget about the natural radiation background. CT of the lungs (about 2.5 mSv) after X-ray (about 0.1 mSv) is safe, and such a precise diagnosis can save the patient’s life.

However, in order to avoid additional radiation exposure, it is most advisable to immediately perform a CT scan of the lungs, without resorting to x-rays.

What is better to do with pneumonia: CT or X-ray?

Only a doctor can prescribe a CT or X-ray of the lungs for pneumonia after examining the symptoms, laboratory tests, and the individual clinical picture of the patient. The presence of fluid or pus in the alveoli, as well as fibrosis, is visualized on both radiographs and CT scans. However, conventional x-rays may not be sufficient for grade I-II pneumonia, while on CT it is seen more clearly as ground glass. For SARS and coronavirus, it is recommended to do a CT scan of the lungs.

Is it possible to do a CT scan of the lungs instead of an x-ray?

Yes, lung CT can replace x-rays. However, the doctor who prescribes this or that study always takes into account the individual characteristics of the patient, for example, how many X-ray studies have already been carried out during the year, whether there are any contraindications to CT. Also, ionizing radiation is harmful to pregnant women and the fetus, so in this case, pneumonia is preferable to MRI of the lungs.

Text prepared by

Maksim Anatolievich Kotov, Chief Physician of the Ami CT Center, Candidate of Medical Sciences, Associate Professor. Experience 21 years

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3. Eva-Christina Schliewert, Kara M Lascola, Robert T O’Brien, Stuart C Clark-Price, Pamela A Wilkins, Jonathan H Foreman, Mark A Mitchell, Susan K Hartman, Kevin H Kline. Comparison of radiographic and computed tomographic images of the lungs in healthy neonatal foals, 2015.
4. Sokolov V.A., V.M. Kartashov, A.I. Piven’, S.Iu. Krasnoborova, L.V. Blinova, A.V. Savel’ev. X-ray longitudinal and computed tomography in the diagnosis of peripheral tumor-like formations of the lungs, 1997.
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7. Ministry of Health of the Russian Federation. Temporary guidelines. Prevention, diagnosis and treatment of novel coronavirus infection COVID-19, version 8, 2020.
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Chest x-ray in Moscow from 1500 rubles.

X-rays of the chest and lungs are performed in the X-ray department of the clinic. As prescribed by the doctor, x-rays can be performed in two projections. Image transcription is included in the price.
You can make an appointment and undergo an examination at a convenient time for you.

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Contents:

Cost of lung x-ray
Chest x-ray
What x-ray shows
Indications for a chest x-ray
Contraindications for x-rays
Preparing for a chest x-ray
Explanation of pictures

Cost of a lung x-ray

X-ray examinations 9 0005

Price

X-ray (plain) chest cells 1 projection

1,500.00

Chest X-ray in 2 projections

1,700.00

Chest x-ray

Chest x-ray is considered the most simple, informative and accessible diagnostic method Used in the examination of patients with signs indicating pathological changes in the lungs and adjacent structures. Radiography in two projections – these are two pictures, one lateral and one straight, is prescribed if it is necessary to clarify the diagnosis and the expected benefit of the procedure exceeds the possible harm from radiation.

What X-ray shows

Chest X-ray in 2 projections (lateral and anteroposterior) determines the exact localization of inflammation and infiltration. On direct images, the lung segments are not clearly visible. The image on the lateral images is more accurate, the interlobar boundaries with their anatomical features are well visualized on them. At the same time, the doctor receives a lot of information about the mediastinal organs – their size, pathological foci, neoplasms. The pictures also show the heart – its position and size.
Obligatory when deciphering the radiograph, secondary signs are also evaluated:

• Volume of lung tissues;
• Soft tissue condition;
• Features of lung fields;
• Airiness of large and small bronchi;
• The position of the roots of the lungs and their structure;
• Diaphragm dome status.

All changes are evaluated in aggregate. After a plain chest x-ray, the attending physician may refer you to other diagnostic procedures to clarify or exclude the diagnosis.

Indications for the appointment of a chest x-ray

Plain chest x-ray in 1 projection is the standard of investigation. It is prescribed for suspected bronchitis and acutely developing pneumonia, after injuries and to exclude tuberculosis.
X-ray in 2 projections as a diagnostic method is required if the doctor needs to know exactly the morphological changes in the lungs, the functionality of the organs, and the features of the diaphragm displacement. According to two pictures, you can find hidden foci of inflammation, dystrophic processes, tumor-like formations. The examination also shows anomalies in the structure of the broncho-pulmonary system and the heart.
Doctors prescribe X-rays if you suspect:

• Acute and chronic pneumonia;
• Bronchitis;
• Pulmonary emphysema;
• Pleurisy;
• Malignant tumors in the chest;
• Pneumothorax;
• Cysts;
• Tuberculosis.

A chest x-ray is used to check the placement and position of the cardiac catheter and pacemaker leads. Diagnosis is necessary if the patient complains of severe weakness, loss of appetite, persistent cough, rapid weight loss, pain in the projection of the lungs.

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X-ray contraindications

There are no absolute contraindications for chest x-rays. However, there are a number of relative contraindications, these include:

• Pregnancy;
• Multiple rib fractures;
• Severe bleeding from chest injuries;
• General serious condition of the patient.

However, relative contraindications are neglected if an x-ray is necessary for health reasons, that is, diagnostics are needed for diagnosis and treatment.

Chest x-ray preparation

Chest x-ray does not require specific preparation. The patient will only need to undress to the waist at the time of the procedure, remove metal objects from the body and listen to the orders of the health worker. During the diagnosis, the laboratory assistant may ask you to hold your breath. The picture in the lateral projection is taken from the prone position.

Image interpretation

The images taken are interpreted by the radiologist. After evaluating all organs, the doctor writes his opinion, but only the attending doctor can make a diagnosis for the patient. Based on the results, therapy is prescribed, or the patient is sent for further examination.
You can make an appointment for a chest x-ray at our clinic by phone. We take pictures on modern devices with a small dose of radiation. There are few queues in the diagnostic department of our center, since the flow of patients is distributed by registrars quickly and correctly.

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