Four Case Studies Radiological X Ray Analysis

Running Head: RADIOLOGICAL X-RAY ANALYSIS

RADIOLOGICAL X-RAY ANALYSIS 9

Radiological x-ray analysis

Introduction

Radiology has formed the medicine’s major scope, forming the gold standard diagnostic needed to perform surgical interventions.

This diagnostic technique uses the technology of imaging the body systems and is used to make prompt treatments. Examinations used under radiology include computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography, other related diagnostic criteria. This project focuses on the X-ray as a diagnostic tool in surgical investigations.

Posterior to anterior

(Bhandary et al., 2020).

The mediastinum

Left lung

Right lung

The posterior to anterior projection, commonly known as the PA, is an anatomical position used to take x-ray pictures in patients. The x-ray beam passes through the patients’ bodies. The beam of light passing through the patient’s body significantly determines the clarity and the contrast of the image.

The patient normally assumes an erect position and upright posture, the markedly raised and shoulders anteriorly rotated to subject the two scapular bones to deflect laterally from the lungs.

PA radiograph is taken when the patient stands in a position with his/her anterior chest wall facing towards and closer to the film; the patients is then asked to perform a deep inhalation and hold breath, the beam of x-ray is then passed from the posterior towards the anterior region to distinctively expose the internal anatomical structures under the view on the film. This position brings the heart closer to the film than the anterior-posterior view (Chouhan et al., 2020).

The anatomical structures visualized using this position include the lungs, trachea, the diaphragm, the mediastinal area, pleura, soft tissues, and other structures related to the thoracic cavity.

The PA radiograph is commonly ordered to investigate the pathologies of the thoracic cavity, which includes; metastatic diseases, chest trauma, enlargement of the superior vena cava, which occurs in congestive heart failure, an aortic aneurysm in the branches, lymphadenopathies, hepatic enlargements, pneumothorax, hemothorax, emphysema, chronic obstructive pulmonary disease (COPD), inflammation within the trachea, stenosis of the trachea, thoracic masses and splenomegaly.

The beam of x-ray is usually passed within a distance of six feet from the patient; the patient is asked to sit in an upright position.

The x-ray beam’s distance from the patient determines how clearer and sharper the radiograph image will appear.

Left lateral chest x-ray

(Deftereos et al., 2020). The vertebral column

The peritoneal space

The left lateral chest x-ray is not commonly performed nowadays as a diagnostic modality as it has been substituted for the computed tomography scan (CT). However, some pathological investigations have put the practice into use.

The lateral view is usually essential in viewing the structures behind the heart within the retrosternal airspace. Anatomically, space is located between the sternum and the heart. It is taken when the patient is on the left side of the film.

This view brings the lesions located just behind the heart’s left side into visibility and the general view of the structures on the thorax’s left side. The anatomical structures under the left lateral view include the aortic arch, scapula, left ventricle of the heart, left atrium, descending aorta, sternal body, inferior vena cava, and the retroperitoneal space.

Radiographic view on the x-ray of the left lateral compartment of the thorax is essential in differentiating between free-flowing pleural effusion and localized fluid confined within the pleural scarring area the pleural thickness. This x-ray also acts as a guide to performing thoracocentesis (Hashir et al., 2020).

Upper gastrointestinal tract series x-ray

(Hoda et al., 2017).

Esophagus

Esophageal lesion

The upper gastrointestinal tract’s radiology employs modern techniques involving fluoroscopy and barium-based contrast to assess the upper gastrointestinal tract’s motility and function.

The patient is normally not required to eat anything before the procedure, including medications or other chewable substances. The patient is also advised to reveal any illnesses or pregnancy to the radiographer.

In diabetic patients on insulin therapy, the procedure should be scheduled early in the morning to prevent hypoglycemia.

This procedure works through imaging of the barium contrast as it passes through the gastrointestinal tract using x-rays or fluoroscope and the captured image viewed on a screen.

The patient must consume liquid barium, usually light in color with a porridge-like consistency; as it passes through the upper gastrointestinal tract, the fluoroscope captures the movement sequence’s image and projects it to the screen. At times, the patient’s abdomen may be compressed to aid in the spread of the barium.

The structures visualized include; the esophagus, body of the stomach, pylorus, and duodenum.

Pathologies investigated using this diagnostic modality include tracheoesophageal fistula, esophageal strictures, esophageal atresia, stenosis of the esophagus, lower esophageal sphincter abnormalities, inflammatory diseases, hernias, motility disorders, tumors, pyloric and duodenal structural abnormalities, and upper gastrointestinal bleeding (Ng et al., 2020).

The patient is usually placed in a supine position and continuously rolled 360 degrees 2-3 times to coat the stomach lining with barium; the images are acquired. The patient is reverted to the right-lateral position.

Left lateral decubitus abdomen

(Rubin et al., 2018).

Necrotizing enterocolitis

The left lateral decubitus position involves the patients lying on their left side with their legs either flexed or balanced and their hands raised to expose the area of interest. The rotations of the pelvic region together with the shoulder regions are grossly minimized.

Imaging is done by passing the beam of x-ray laterally from the right side with a focus on the area of interest and images captured on the detector.

Anatomical structures visualized under this technique include; the lumbar vertebral column and the pelvic bone (Saragih et al., 2020).

Investigated pathologies include pneumoperitoneum, osteoporosis of the vertebral bones, pott’s disease, fractures of the vertebral and pelvic bones, and displacement of vertebral discs.

The orientation and the exposure adjustments make the image clearer and sharper.

Lower gastrointestinal tract series

(Togo et al., 2019).

colon

Irritable bowel syndrome

During this procedure, the patient is placed lying on their right side with their abdomen touching the vertical surface (right decubitus). The beam of rays is projected horizontally to enter the body midline and at the iliac crest level.

The medial aspect of the descending colon and the lateral ascending colons are both filled with air.

The imaged is obtained by positioning the patient on the examination table; a tube is then inserted through the rectum to deliver barium sulfate and water into the colon. Air may also be pushed into the colon to provide another contrast (Yan et al., 2020).

While the imaging is being done, the patient is asked to hold their breath to hold the contrast in place while the procedure is being carried out.

The anatomical structures and artifacts visualized using this diagnostic tool are the colon and the rectum.

A barium enema is indicted in the investigations of suspected lower gastrointestinal pathologies, which may include; diverticulosis, Hirschsprung disease, sigmoid colon, Crohn’s disease, ulcerative colitis, chronic diarrhea, constipation, suspected Gastrointestinal tract bleeding, blood in the stool, benign tumors, metastatic tumors, suspected narrowing along the colon and congenital anomalies.

However, this process is contraindicated in patients with colonic perforation and acute abdomen.

This process’s accuracy is improved using a higher emission x-ray beam and the distance between the patient and the film.

References

Bhandary, A., Prabhu, G. A., Rajinikanth, V., Thanaraj, K. P., Satapathy, S. C., Robbins, D. E., ... & Raja, N. S. M. (2020). Deep-learning framework to detect lung abnormality–A study with chest X-Ray and lung CT scan images. Pattern Recognition Letters, 129, 271-278.