Pneumoconiosis

Diagnostics. Diagnosis of pneumoconiosis, especially in the initial stages of the disease difficult. In each case, you should consider the patient contact with industrial dust, work experience, type of dust, working conditions, previous diseases of the respiratory system, subjective and objective data, the status of the function of external respiration. X-ray picture of the lungs is an important diagnostic confirmation of pneumoconiosis. For some diseases (age pneumosclerosis, disseminated pulmonary tuberculosis, sarcoidosis and other) radiographically changes in the lungs are very reminiscent of pneumoconiosis. In these cases, it is particularly important to take into account the data of the anamnesis and other clinical data. Forecast P. depends on the nature of the dust, causing disease, stage of the process and its tendencies to progression, the presence or absence of complications. Timely treatment and preventive measures and correct employment of patients is of great importance for the prevention of disease progression.
X-ray analysis of pneumoconiosis takes the leading place in the complex clinical examination. X-ray signs of dust pneumosclerosis (see) adopted at the present time, as the main criterion in the diagnosis of P.
To identify P. apply krupnokadrovaya chest x-rays (see), it is desirable use weight fine-focus x-ray tubes.
X-ray may be used to diagnose only pronounced forms of pneumoconiosis (stage II-III), as the small details at the x-raying is not visible. However, using fluoroscopy, you can make the main idea of the morphology and function of the chest.
Radiography is made in cases when the group surveys requires specification of data obtained by x-ray. For these purposes produce regular direct x-rays of the chest and sighted, overexposed, inhaling, exhaling and more photos, charts, necessary to clarify the diagnosis (see x-ray).
Primary and enlarged photographs of light is used to identify small anatomical parts (vessels, bronchial tubes, bundles), not clearly visible on the LMS and plain radiographs. The increase in parts in 1,5-2 times is achieved by using weight fine-focus x-ray tubes and increasing distance object - film up to 24-30 see Tomography allows to obtain an isolated image of an object without layering on other parts, located anterior and posterior to the allocated layer. Tomograms produced with fast shutter speeds (up to 0.3 seconds), at the angle of swing of the tube, equal to 30 degrees, reveal not only large but also small parts within 2-3 mm Diagnostic value tomography (see) increased significantly during the initial zoom in 1,5-2 times.
These methods are essential in the diagnosis of pneumoconiosis. To solve special issues use additional methods of x-ray studies. Bronhografiya (see) can clarify some morphological and functional features of bronchial tree at P. the Main indication for use bronhografii is suspected of bronhoektasia. Along with these methods also use rentgenografii (see), pulmonary, rentgenonegativee (see).
On x-ray picture of lung changes in the development of pneumoconiosis to distinguish three stages. The first stage is characterized by diffuse bilateral increased pulmonary pattern; the emergence of an extension of shadows sealed walls of the bronchi medium and small-caliber; deformation of the vascular, bronchial shadows (change the shape, location and intensity of shadows); melkozerova or gramoteinskogo vascular, bronchial picture and a few rounded shadows Uzelkov the size of 1-3 mm; thickening and sometimes extension shadows of the roots of the lungs. Additional signs are changes midlevel pleura, the thin line of shadow, increasing the transparency of the lung fields, sometimes small pleurodelinae fusion.
The second stage is more intensity and distribution of the grounds listed in the first stage (Fig. 6).

Fig. 6. Silicosis stage II (the nodular form).
Rice, 7. Silicosis III stage (the nodular form).
Fig. 8. Siderations I-II stage.

The third stage is characterized mainly by the large-shades, the size of 1-5 cm or more occurring at the background of changes characteristic of the second stage, and signs of pulmonary heart (Fig. 7). X-ray picture at pneumoconiosis different origin varies. It depends above all on, is there sickness in interstitial (diffuse sclerosis form) or nodular type pnevmofibros. For example, when asbestosis observed interstitial (tyazhistye, net) changes, if silicosis, anthracosilicosis, siderosilicosis (Fig. 8) - knot.
Significant influence on the formation of x-ray pictures of lungs at different pneumoconiosis. also provides a degree of permeability of various kinds of dust for any x-rays. Dust containing impurities barium, iron, tin, zinc, setting in the lungs, creates a picture of intensive small dust foci (knots). Most types of dust, such as coal, silica and other poorly absorbs x-ray. So small nodular shadows when silicosis, entrecote and antracosilicosis caused not so much by the dust, how many fibrous connective tissue, growing under the action of established dust.