Introduction to photography

Directory 1 Pinyin 2 English Reference 3 Name 4 Overview 5 Photographing Indications 6 Photographing Contraindications 7 Preparation 8 Methods 8. 1 1. Take photos in various conventional positions. Nine points for attention in unconventional posture photography. 9. 1. 1. Requirements of standard chest radiograph 9.2-2. Conditions that a standard chest radiograph should meet 1 pinyin shè piàn

2 English reference photos

3 photos

Overview photos can be used in any part, showing the fine structure of human tissues and showing the lesions that are not easy to find in perspective. In addition, the obtained image data can be permanently saved for comparison during review. Because the lungs contain a lot of air, which forms a natural contrast, the chest radiograph has a large amount of information and high definition, especially the chest radiograph with high kV (that is, the chest radiograph voltage ≥ 125kV). Therefore, chest X-ray is one of the most commonly used methods to diagnose tuberculosis.

5 indicates that the photo is suitable for:

1. Positive sputum tuberculosis.

2. Chest X-ray found lung lesions or suspected lesions.

3. Diagnosed as pulmonary tuberculosis or other pathological changes, and observed the absorption of pathological changes after treatment.

4. Tuberculosis focus has completed the whole course of anti-tuberculosis treatment, and the focus is cured and ready to stop taking drugs.

5. Suspected symptoms of tuberculosis.

6 contraindications 1. Patients with radiation diseases.

2. Pregnant women.

7 prepare 1. Operators should be prepared for dark adaptation before taking pictures, which generally takes 15 ~ 20min.

2. Do a good job in X-ray protection. Medical staff should wear lead aprons and gloves, and patients should wear lead caps.

Candidates must take off their coats, leaving only vests or underwear, paying attention to rolling up their braids and removing foreign objects such as necklaces and plasters.

Method 8. 1. 1. Posterior and anterior positions of various conventional postures (1): the display range is lung tissue, ribs, clavicle, heart, diaphragm and chest wall soft tissue. Because the posterior intercostal space is widened, the enlargement of the heart shadow is small, which can display the lung field image to the greatest extent, and at the same time, the shoulder blades on both sides are easy to move outside the lung to avoid covering the lung field.

① photographic distance: standing position 180cm. Lying position, farthest distance, with shading tube.

② Projection position: The patient stands upright in front of the BuckyWall Stand, facing the X-ray box, so that the median sagittal line of the body is opposite to the center line of the X-ray box, and the upper edge of the X-ray box exceeds the shoulder by 3 cm (65 65,438+0 inches). The patient stands with his feet apart, elbows bent, hands and wrists placed on both hips, and shoulders rotated inward as far as possible, so that the two shoulder blades are completely outside the lung field.

③ midline: aim at the 5th thoracic vertebra (equivalent to the level of the lower angle of acromion), and ask the patient to take a deep breath and hold his breath during exposure.

④ photographic conditions: the photographic conditions of ordinary chest plain film are generally determined according to the formula of KV value, that is, "limb thickness (cm)×2+ cardinal number = KV value". Chest thickness refers to the distance from the middle of the sternum to the spinous process of the thoracic spine when the chest is photographed in the anteroposterior position. In principle, for every increase in limb thickness of 1cm, the kilovolt value will increase by 2kV. If high-voltage photography is carried out, its voltage selection must be greater than or equal to 125kV. The milliamperes used can be determined according to the type of intensifying screen and the photosensitive speed of the film.

(2) Anterior and posterior position, upright position or supine position: the projection position is the same as the anterior and posterior position, and the anterior and posterior supine position is suitable for those who are weak and unable to stand. However, this method is usually not used, so the heart image is enlarged and distorted by this method.

(3) Lateral position: Lesions that cannot be seen in the anteroposterior position and the posteroanterior position can be found. It can be determined whether the lesion is located in the lung or outside the lung, especially whether the foreign body is in the chest or behind the chest, and which lobe the lesion belongs to. Lesions of interlobar pleura can be distinguished from other lesions.

① photographic distance: 150 ~ 200 cm, or 100 ~ 150 cm if there is a line filter.

② Projection position: The patient lies on his side, with the affected side leaning on the film and his jaw slightly raised. Hold your hands high, cross your head, so that the scapula does not overlap with the lungs as much as possible, the armpit midline faces the midline of the box, and the upper edge of the box exceeds the shoulder and is about flush with the mandible.

③ midline: aim at the lateral chest wall of the fifth thoracic vertebra plane, and the midpoint is perpendicular to the film box. When exposed, ask the patient to take a deep breath and hold his breath.

④ Photography conditions: It can be calculated by the formula of back and front chest photography.

(4) Right anterior oblique position: display lateral chest image. Although the images of both lung fields overlap each other, the images of the lung near the chest radiograph are clear. Lateral chest image is easy to show the anatomical position of each lung segment and the lung field behind the heart shadow.

① photographic distance: standing posture 150 ~ 180 cm, and line filter users 100cm.

② Projection posture: The patient stands upright in front of the BuckyWall Stand, facing the box, with the sagittal plane of his body or spine facing the center line of the box, and his feet standing apart. His right front chest is close to the box, his right elbow is bent, his back is placed on his hip, his left hand holds his head, and his left chest leaves the box, so that his torso and the box form an angle of 45 ~ 60. The angle is mainly determined according to the clinical needs, and the upper edge of the film box exceeds the shoulder and is about flush with the mandible.

③ centerline: aim at the 4th thoracic vertebra, perpendicular to the film box, and ask the patient to take a deep breath and hold his breath after exposure.

④ Photography conditions: It can be calculated by the formula of back and front chest photography.

(5) Left anterior oblique position: it is basically the same as the right anterior oblique position except that the left anterior chest is close to the cassette.

8.2 2. Anomalous projection (1): A small amount of pleural effusion can be examined to determine the size of the cavity and whether there is liquid in the cavity. A few patients with pneumothorax or hydropneumothorax can use this position to observe the compression of lung.

① photographic distance: 60 ~ 100 cm.

② Projection posture: The patient lies on the examination table, with the affected side close to the table top, the film box lying on the side, parallel to the body, close to the chest, and the film box is held and fixed by the upper arm. Stretch your arms forward at the edge of the table, or raise them above your head. A cotton pad can be placed between the chest and the table to raise the chest, so that the whole chest can be inserted.

③ midline: the tube is in a horizontal position, aiming at the fifth thoracic vertebra and perpendicular to the film box. During the exposure, ask the patient to take a deep breath and hold his breath.

④ Photography conditions: basically the same as chest posterior and anterior photography.

⑤ Precautions: If a small amount of pleural effusion is examined, the affected side should be close to the table; However, when examining pneumothorax or hydropneumothorax, in order to observe the compression of the lung, the healthy side should be close to the table and exposed after exhalation. Due to the gravity of mediastinum, the density and width of lung field in this position are often inconsistent, which should be paid attention to.

(2) Protrusion of the chest: it is mainly used to check the lesions at the apex of the lung. Because the collarbone image moves up, the lung apex can be better displayed, so that the cavities or lesions covered by ribs or collarbone in the front and back positions can be clearly displayed.

① photographic distance: 100 ~ 150 cm.

② Projection posture: The patient stands upright with his back to the photo frame, his feet are separated from the center line of the photo box by the sagittal plane of his body or spine, his elbows are bent, his hands are placed on his hips, his body is slightly away from the photo frame, his upper chest is tilted back, his back is close to the photo box, his abdomen protrudes forward, and his shoulders are rotated inward as far as possible, so that the scapula image does not overlap with the lung shadow, and the upper edge of the photo box should exceed his shoulders by 8cm(2.5 inches).

③ Midline: The tube inclines to the head side 12, aiming at the midpoint of the connecting line between sternal angle and xiphoid process, and shooting at the center of cassette. During the exposure, ask the patient to take a deep breath and hold his breath.

④ Photographing conditions: Compared with the back chest radiograph and the front chest radiograph, the voltage is increased by 4 ~ 6 kV and the milliampere second (MAS) is increased by 30% ~ 50%.

(3) Lateral position of lung apex: The changes of lung apex can be observed from the lateral position.

① photographic distance: 100 ~ 150 cm.

② Projection posture: The patient stands sideways in front of the photo frame, with the affected side leaning against the film, with the sagittal plane of his body parallel to the film box, his feet standing apart, his head raised on the arm of the affected side, his armpit close to the film box, and his healthy upper limb hanging to the side. A sandbag can be lifted to make his shoulders droop, and the upper edge of the film box exceeds his shoulders.

③ midline: incline 20 to the foot, aim at the healthy shoulder and shoot at the center of the cassette. When exposed, ask the patient to take a deep breath and hold his breath.

④ Photographic conditions: lateral photography with the same chest.

(4) Unilateral chest overexposure method: it is suitable for cases where one side of the chest is normal or has mild diseases, while the other side of the lung has high-density diseases, such as pulmonary sclerosis, pleural thickening, or atelectasis.

① Projection position: The projection position and method are the same as the common projection before and after. Cut black paper into half the size of the film, put it between the film with normal light transmission and the enhancement screen, generally in front, and then shoot under the projection condition of high-density side, so that the fluorescence generated by the enhancement screen on the normal side is partially absorbed by the black paper, and the high-density side is fully irradiated, so that the image density on both sides of the chest tends to be consistent, which is beneficial to diagnosis.

② midline: the same as the conventional posterior and anterior position.

③ Photographic conditions: calculated according to the density of lesions.

9 Precautions 9. 1. 1. The standard chest radiograph requires (1) that the collarbone should be flat and the image of the lung apex should be clearly displayed.

(2) Bilateral sternoclavicular joints are symmetrical.

(3) The scapula is completely outside the lung field.

(4) Thoracic vertebra 1 ~ 4 should be displayed, and the vertebral body below the fifth thoracic vertebra should not be displayed (but high-pressure photography usually shows the vertebral body below the fourth thoracic vertebra).

(5) The ribs and lung tissue at the left rear of the heart are faintly displayed.

(6) The neck without soft tissue should be black.

(7) The lung texture should be clearly displayed.

(8) The costal diaphragm angle should be visible in the film.

9.2 2. The standard chest radiograph should meet the requirements (1). Appropriate blackening degree: represents the density of tissues and organs.

(2) Sharp contrast: distinguish images of different tissues and lesions.

(3) Good clarity: clearly display the outline and fine structure of various tissues.