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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What to do if the chest hurts after smoking, how to remove this pain?

Smoking is a habit that doctors constantly talk about the dangers of. Sometimes the resulting diseases do not manifest themselves immediately, but only many years after a person has started smoking, sometimes problems arise almost instantly, often right in the process of smoking or immediately after it. So, many smokers have a question: can smoking hurt in the chest and what could it be connected with? With such symptoms, a doctor is often treated, and it can appear for a variety of reasons. Chest pain may be related to pre-existing health problems that have been exacerbated by a bad habit, or may appear after you start smoking.

Chest pain after smoking: causes

To identify the exact cause, you need to see a doctor. Only the medical history collected by the doctor and the examinations passed will make it possible to make a diagnosis and begin the treatment process. If your chest hurts after smoking, then this is a very alarming sign that should not be ignored. What causes pain syndrome? These can be pulmonary (eg, bronchitis) or extrapulmonary (eg, heart or gastrointestinal disease) factors.

Thoracic sciatica

With thoracic sciatica, pain comes in attacks, the pain is acute and quite strong. The main source of pain is the spine, but it radiates to the sides or anterior chest.

Intercostal neuralgia

The cause of this pathology is herpes, and the disease is accompanied by various symptoms. If after smoking your chest not only hurts, but also a burning sensation appears, and the pain only intensifies from any touch, it is likely that this is intercostal neuralgia.

Inflammatory processes in the bronchi and lungs

Inflammation in the bronchi and lungs are signs of diseases such as bronchitis or bronchial asthma, tuberculosis, pneumonia, etc. Such pain is usually acute and appears periodically (that is, attacks) on the right or left. In addition, inflammation may be indicated by the presence of a severe cough and shortness of breath.

Breast cancer

Chest pain after smoking, accompanied by coughing and shortness of breath, is likely to be an oncological symptom that indicates the appearance of tumors in the chest (in men and women). As a rule, in the initial stages of the disease, a person does not experience any discomfort, so he does not think about going to the doctor. Lung cancer can be diagnosed during a chest x-ray or during treatment for pneumonia.

Diseases of the spine

As a rule, smokers have pain both in the chest and in the back (during or after) due to the curvature of the spine and the violation of its normal position. In this case, pain occurs in different areas (neck, lower back, etc.) when a person takes a particular position.

Gastrointestinal diseases

If you have such a bad habit as smoking, chest pain may indicate (including after giving up cigarettes) gastritis or stomach ulcers. With gastritis, aching discomfort often appears after eating, and with an ulcer, the pain is acute and is accompanied by severe spasms.

Heart disease

Pain syndrome can appear both with previously diagnosed cardiac ischemia and angina pectoris, and serve as an initial sign of these pathologies. If chest pain is associated with the heart, then it can be constant and intensify with excitement and the slightest physical exertion, or it can occur periodically. With angina pectoris, there may be a feeling of pressure and burning in the chest, as well as shortness of breath and arrhythmia.

Chest pain after quitting smoking

When a person quits smoking, certain changes begin to occur in his body, through which the former smoker must go through. As a rule, getting used to a new way of life is accompanied by a number of unpleasant, and sometimes very uncomfortable sensations. All this is connected with the process of detoxification. After quitting smoking, the chest hurts because the lungs and bronchi begin to be cleared of accumulated tar and nicotine, as well as due to exacerbated gastrointestinal diseases or due to heart failure, which appeared due to oxygen starvation.

How to relieve pain?

Much depends on the cause of the pain, which can only be established by a doctor. Accordingly, if painful discomfort occurs, you should immediately contact a neurologist , because the problem can be serious (for example, a stomach ulcer or breast cancer). What to do before consulting a specialist? Eliminate the source of pain – stop smoking. If you have already quit, but the pain remains, you need, again, to see a doctor to find out why this is happening, whether the discomfort is associated with detoxification of the body or with any disease. It is not recommended to take painkillers as they will provide temporary relief, and without a doctor’s prescription, they can cause even more harm and prevent an accurate diagnosis.

Diagnosis

If you do not know which doctor to contact, then first you can visit the therapist , who will give the first recommendations and referrals to other specialists. Patients with such problems are often recommended to undergo a complete examination of all body systems, that is, to make a diagnosis of the cardiovascular system, as well as the gastrointestinal tract and respiratory organs. Which complex of tests and examinations the doctor will prescribe depends on the causes and symptoms.