Pleurisy
Pleurisy is a disease of pleura, which arises up more frequently as the second process is complication of pneumonia, tuberculosis, other diseasees of lungs, heart, blood and others like that. Distinguish a dry and exudative pleurisy.
Development of dry (fibrinous) pleurisy is a conditioned productive inflammation of pleura. Patients mark a cough, increase of body temperature, pain in breasts, which increases during cough. Roentgenological limited a dry pleurisy is not shown up. Widespread dry pleurisy is accompanied by increasing of interlobar and costal pleura (to 1 sm), by the decline of transparency lungs, unclearness of contours of costal-diaphragm recesses. Sometimes in a pleura cavity by ultrasonic examination it is succeeded to find out the two-bit of liquid.
Presence of liquid in a pleura cavity is better to find out in lateropositsion of the patient on to t sides. Sciagraphy finds out in a pleura cavity a liquid by volume of more than 0,5l ultrasound - more than 20 ml.
Fig.15.6 Exudative pleurisy on a sciagram and ultrasound
1 a liver; 2 a diaphragm; 3 exudate; 4 a visceral pleura
Ran across exudative pleurisy characterise more expressed clinical signs. On sciagrams in the anterior view of accumulation of exudate in a pleura cavity at vertical position of patient notedly a darkening of lateral costal-diaphragmal recess, or three-cornered shade in the lateral department of the inferior pulmonaris field. If a high bound of the shade is at the level of body of the 5th rib, amount of liquid is approximately 1l, at the level of the 4th rib-1,5l, 3th rib –2l. The greater amount of exudate anymore displaces the organs of mediastinum to the healthy side.
Pleura accretions can divide a pleura cavity into the separate isolated departments, forming encapsulation exudative pleurisies.
Shades of such pleurisies are not displaced at the change of the body position, their contours are clear and protuberant, they resolve slowly. The place of location is costal, costal-diaphragmal, costal-vertebral, apex, diaphragmal, mediastinal, interlobar encapsulation pleurisies.
Pneumoconiosis
Pneumoconiosis is a professional lungs disease, which arises up as a result of dust respiratory. Getting in lungs during great while, the dust of any nature (metallic, organic, inorganic) causes development of proliferative reaction of interstitial pulmonary tissue as a result appears and makes progress.
Roentgenological examination is the basic in diagnostics of pneumoconiosis. There is strengthening and deformation of lung pattern, expansion and loss roots of lung structura, emphysema, bulge of interlobar pleura, thrusting out of pulmonary barrel and hypertrophy of right ventricle.
Depending on reactivity of organism, nature of dust, character of the development of pathological process (diffuse and focal) distinguishes interstitial, nodal and nodular forms of disease. Interstitial form of pneumoconiosis is characterized by reticulate pattern from the compression of connecting tissue round pulmonary vessels and bronches. At a node form on sciagrams observed calculation of focal shade by a size to 1sm from excrescence of connecting tissue around pulmomary vessels and bronches. Progress of disease is the results of formation of the lungs infiltrations, which characterizes the nodular form of disease.
Theme №16 Radio diagnostics of the tuberculosis
The tuberculosis radio diagnostics. Algorithms of the radioexamination at this pathology (fluorography|, sciagraphy, fluoroscopy|, linear tomography|, computer tomography|, magnetically-resonance imaging |, scintigraphy|, SPECТ|, PAT, radio nuclear| scanning, radiometry, sonography)