X-ray examination of thyroid gland

When conventional x-ray examination of the thyroid gland, usually not detected. The exceptions are large Zobov, dramatically altering the configuration necks and squeeze the larynx and trachea; chest goiter, descending in the anterior chest and visible in the background is clear lung fields in direct projection on the background of retrosternal space in the lateral projection, and calcified goiter, rather Islands lime, visible against the background of an enlarged thyroid.
In order to determine the size and weight gland, are necessary for the correct dosage of radioactive iodine used to treat goiter, the technique of artificial contrast study of the thyroid gland with gas introduced into the tissue surrounding gland (pneumocystography). The same method is used for sophisticated diagnosis of various thyroid diseases.
For direct pneumocystography patient is placed on rohoska on the back with a few head thrown back. After anesthesia skin and subcutaneous tissue pierce on the middle line above the thyroid cartilage aponeurotic plate and enter 15-20 ml of 0.25% solution novokaina, and then the needle is attached device for gas insufflation. Can be used oxygen, filtered air, and easily absorbable gases (nitrous oxide, carbon dioxide) in the amount of 150 to 250 ml After insufflation produce x-rays in direct and lateral projections, and tomography. The cuts have generally at a distance 1-2-3-4 cm from the front of the neck (for front tomograms) and on the middle line, and at a distance of 1-2-3 see to the right or left from it (for the sagittal tomograms).
Gas enveloping the thyroid gland from all sides, creates a light background, allowing to study the form of cancer, size, shape, relationships with other organs and tissues and identify parenchymatous and nodular goiter (Fig. 16), adenoma and cysts (Fig. 17), cancer and other diseases of the thyroid gland. The method gives an opportunity to clarify the topography of cancer, its relationship with the larynx, trachea, spine.
The method of indirect pneumocystography based on the introduction of gas into the mediastinum (see Pneumomediastinum).
Pneumocystography allows you to define the volume and weight of the thyroid gland by measuring parallel sections planimeters, create a model of the thyroid gland by the superposition of tomograms and some other techniques.

Fig. 16. Nodular goiter, affecting mostly the left lobe of the gland. Direct tomogram. Visible seam gas enveloping goiter.
Fig. 17. Cyst thyroid gland. Literarum lateral projection. The patient lies on his back; see the level of fluid in the cavity cysts, above the liquid is determined by gas.