What is an X-ray chest?
X-ray thorax is a standardized examination of the chest using X-rays. This examination is used to diagnose various diseases of the lungs, heart or vessels. Although computed tomography (CT) is increasingly gaining acceptance as an imaging method today, the X-ray thorax is still frequently used. One reason for this is the comparatively low radiation exposure (between 0.1 and 1 millisievert) – by comparison, a computed tomography of the chest (CT thorax) is 8 millisieverts.
When do you perform a chest X-ray?
Various medical conditions may require a chest x-ray. Chief among these are:
Basically, an X-ray thorax should be taken from the front (anterior-posterior) and the side (lateral) so that the various structures can be well assessed.
Every physician should have a basic knowledge of diagnosing a disease by means of X-ray thorax (diagnosis). However, radiologists (X-ray specialists) are specialized in this field.
X-ray thorax: normal findings and findings typical of disease
On a normal chest X-ray, the two lungs, the heart, the bony thorax (including ribs and collarbone) and the diaphragm can be assessed. The physician in charge must pay particular attention to the following abnormalities:
Heart enlargement
A healthy heart should not be larger than half the diameter of the chest on chest x-ray (cardiothoracic ratio). Various heart diseases, such as cardiac insufficiency (heart failure), can lead to an enlargement of the heart, which can then be seen on the X-ray thorax.
In the course of various diseases and injuries in the thoracic region (such as inflammation, cardiac insufficiency, cancer or bone fractures), fluid can accumulate in the so-called pleural space – the gap-shaped space between the lung and the pleura. Such a pleural effusion can be seen on an X-ray. Due to gravity, the fluid collects at the lowest point of the chest, near the diaphragm.
The pleural effusion must be distinguished from pulmonary edema. This is an accumulation of fluid within the lung tissue, often caused by heart disease. Pulmonary edema can also be diagnosed by chest X-ray.
Pneumothorax
Infiltrate
A pulmonary infiltrate occurs when fluid and cells from blood and lymph vessels leak into the lung tissue. The reason is usually pneumonia. On the X-ray, the pulmonary infiltrate can be seen as a light-colored (compacted) structure.
What are the advantages and disadvantages of an X-ray chest?
The advantages of X-ray chest are:
- fast and available almost everywhere
- lower radiation exposure than with computer tomography
- high informative value for various diseases
The disadvantages of X-ray thorax are:
- radiation exposure
- only one-dimensional images, on which some structures are “superimposed” (with computed tomography, on the other hand, a spatial representation is possible)
Conclusion: Nowadays, it is impossible to imagine medicine without the X-ray thorax. With low radiation exposure, the examination quickly provides information about a wide variety of diseases and injuries in the chest area.
