From Big Medical Encyclopedia

POLYPOSITION RESEARCH (grech, poly is a lot of + armor. to positio installation, situation) — a method of X-ray inspection, at Krom, changing position of a body of the patient, receive optimum projections of the studied body for detection in it pathological changes.

The method is based that at change of position of a body of the patient there is a shift of bodies, movement of gas and liquid in cavities. It promotes identification patol, process, to definition of degree of its prevalence and nature of relationship with the next bodies. Item and. it is widely used in radiodiagnosis, in particular in urgent radiodiagnosis, diseases and small damages and a pleura, digestive organs, uric and other bodies. Choice of the most effective receptions of P. and. is defined by localization and character patol, process.

Fig. 1. The scheme of an arrangement of the patient in relation to the plane of the fluoroscopic screen and the direction of a bunch of x-ray emission at an ortoskopiya (a), a trokhoskopiya (b) and a lateroskopiya (in).

Main receptions of P. and. conditionally divide on static and dynamic. Carry to static: an ortoskopiya — roentgenoscopy in an orthoposition, i.e. at vertical position of the patient and the horizontal direction of a bunch of x-ray emission; a trokhoskopiya — roentgenoscopy in a trokhopozition, i.e. at horizontal position of the patient on a support of the device (trokhoskopa) and the vertical direction of a bunch of x-ray emission; lateroskopiya) — roentgenoscopy in lateroposition, i.e. at horizontal position of the patient on a special table — the lateroskop located between the screen and a support and the horizontal direction of a bunch of x-ray emission (fig. 1). The X-ray analysis made in the provision of lateroposition received the name of a laterografiya. At static receptions of P. and. it is possible to change position of the patient concerning his longitudinal axis.

At dynamic receptions change is provided during the research of provision of a longitudinal axis of a body of the patient in space in relation to a bunch of x-ray emission; this postural change of a body can be combined with its simultaneous rotation around a longitudinal axis. Such research call multiaxial.

Item and. it can be carried out on usual and special X-ray apparatus. In the first case special prefixes are necessary for carrying out a lateroskopiya. At a dynamic multiaxial research for change of position of the patient use a special table which is established between a X-ray tube and the screen.

There are special x-ray supports providing performance of all receptions of P. and.

Fig. 2. Roentgenograms of a thorax at abscess of the right lung: and — on the roentgenogram made in an orthoposition in an upper share of the right lung the big cavity containing gas (it is specified by an arrow) and the liquid forming horizontal level is visible; — on the roentgenogram made in lateroposition in an abscess cavity the regional pulmonary sequester is visible (it is specified by an arrow).
Fig. 3. Roentgenograms of a thorax at left-side vypotny pleurisy: and — on the roentgenogram made in an orthoposition, the pleural exudate in the left pleural cavity makes an impression of high standing of the left dome of a diaphragm; — on a laterogramma (in position of the patient on the left side) the pristenochny shadow (it is specified by shooters) a free pleural exudate is visible.

In radiodiagnosis of pulmonary diseases by means of P. and. reveal cavities (fig. 2, a), sequesters (fig. 2, b), saccular bronchiectasias; it facilitates recognition and differential diagnosis of parasitic and not parasitic cysts of a lung. E.g., at an echinococcosis of lungs by means of P. and. find characteristic (in the form of a semilunum) accumulation of air between the chitinous and fibrous capsule of an echinococcal cyst. Item and. apply to differential diagnosis of vypotny pleurisy and pleural unions. At an ortoskopiya these patol, can give processes similar rentgenol, a picture in the form of partial blackout of the pulmonary field merging with a diaphragm (fig. 3, a). At a lateroskopiya of the patient in edgewise position (on the party of defeat) the exudate decides on vypotny pleurisy in the form of a longitudinal strip of blackout at an inner surface of edges (fig. 3, b). This strip disappears at a research of the patient on other side. At pleural unions the sizes and position of the site of blackout of the pulmonary field do not change at a postural change of a body of the patient.

Fig. 4. Laterogramma of the stomach contrasted by a baric suspension (and the scheme to it) at an exophytic tumor of a stomach (in position of the patient on the right side): against the background of a gas bubble of a stomach the exophytic tumor covered with a baric suspension is visible (it is specified by an arrow).

Lateroskopiya in position of the patient on spin, on a stomach, on one side is applied also in diagnosis of diseases of a stomach. Against the background of the gas moving in a stomach at change of position of a body of the patient the folds of a mucous membrane of a stomach contrasted by a suspension of barium, ulcer are well visible niches (see), shadow of an exophytic tumor (fig. 4). By means of P. and. carry out differential diagnosis of a cicatricial and tumoral stenosis of a peloric part of a stomach, find small amounts of free gas in an abdominal cavity at perforation of hollow bodies (a perforated ulcer, a traumatic rupture of a stomach or intestines, etc.), reveal arches, characteristic of intestinal impassability, with horizontal fluid levels and gas bubbles over them (Kloyber's bowls), diagnose diseases of a large intestine. Orto-, trokho-and a lateroskopiya at a double contrast study of a large intestine a suspension of barium and gas considerably increase resolving power irrigoskopiya (see).

See also X-ray inspection .

Bibliography: Questions of a technique of X-ray inspection, under the editorship of Yu. N. Sokolov, page 21, M., 1961; Lindenbraten L. D-the Artificial pneumoperitoneum in radiodiagnosis, M., 1963; Marchenko V. A., etc. Possibilities of a laterografiya in radiodiagnosis of diseases of upper uric ways, Vestn, rentgenol, and radio-gramophones., No. 4 of page 78, 1971; Rabkin I. X. and D and N and e of l I am G. A N. Polyposition X-ray television and X-ray cinema research of a gullet, Surgery, No. 4, page 103, 1968; Rosen-Shtraukh L. S. and Vinner M. Radiodiagnosis of pleurisy, M., 198; P about with t and with l and in and N and O. A. Use of lateroposition at X-ray inspection of a large intestine, Vestn, rentgenol. and radio-gramophones., No. 1, page 31, 1968; With au stakes V. G., Tumanov N. A. and Schwarzman A. 3. Shtativno-mekhanichesky devices for radiodiagnosis, M., 1979; Haspekov G. E. A poly-position method in radiodiagnosis, M., 1975, bibliogr.

G.E. Haspekov.