RENTGENOKIMOGRAFIYA

From Big Medical Encyclopedia

RENTGENOKIMOGRAFIYA [rentgeno-(on a name B. X-ray) + a kimografiya] — a method of registration of the movements of body by its X-ray analysis. For this purpose make a X-ray analysis on one film in different phases of the movement of body that is reached by use of the lead plate with one or several cracks placed between a source of radiation and a film. During shooting the plate or the cartridge with a x-ray film shall move relatively each other.

By means of R. investigate hl. obr. respiratory movements of a diaphragm and edges, heartbeat and main vessels of a chest cavity.

At R. contours of moving body get a gear form on the roentgenogram (rentgenokimogramma), and the size and a form of teeth reflect the nature of movements. An indispensable condition of R. is sufficient contrast of the studied body in relation to the next fabrics (e.g., hearts against the background of pulmonary fabric).

The river can be combined with fluorography (see), tomography (see) and other methods X-ray inspection (see).

Fig. 1. Schematic diagram of a rentgenokimografiya: and — a one-slot-hole rentgenokimografiya; — multislot-hole rentgenokimografiya; 1 — a source of x-ray emission; 2 — a bunch of x-ray emission; 3 — a body of the patient; 4 — a one-slot-hole lead plate; 5 — a multislot-hole lead plate (a kimografichesky lattice); 6 — the cartridge with a x-ray film; the arrow specified the direction of the movement of a lead plate (at a horizontal arrangement of cracks).

Distinguish one - and multislot-hole R. (fig. 1). At one-slot-hole R. between a x-ray film and the patient establish a lead plate with one narrow crack, and the cartridge with a film during shooting is set in motion across or verticals. At multislot-hole R. use a plate with a large number of narrow cracks. During the research (shooting) it is set in motion or a plate (continuous R.), or the cartridge with a x-ray film (step R.).

One-slot-hole R.'s method was for the first time offered in 1911 by the Warsaw doctor Sabat (V. to Sabat), and in a year Gett and Rosenthal (Th. Gott, S. Rosenthal) applied it in clinic. In 1928 P. Stumpf offered a method and the device the USSR the design of a multislot-hole rentgenokimograf was for the first time developed for multislot-hole R. V in 1933 by G. Ginzburg. The big contribution to R.'s development to the USSR was made by M. A. Ivanitskaya, K. B. Tikhonov, V. V. Zodiyev, etc.

Though one-slot-hole R., at a cut studying only of separate points of a moving contour is possible, did not find broad application, it possesses in comparison with multislot-hole R. very essential advantage: thanks to lengthening of a way of the movement of a film for the same time of shooting kimografichesky teeth are stretched and in them it is possible to allocate much more details. Therefore one-slot-hole R. can be applied to keeping data current, received at multislot-hole

by R. Protivopokazany to R. critical condition of the patient is. R. is inexpedient and if there is a possibility of carrying out elektrokimografiya (see), it is fuller of the characterizing function of heart, large vessels and lungs.

The river is carried out with the help X-ray apparatus (see), supplied with the special mechanical device — a rentgenokimograf. In the elementary one-slot-hole rentgenokimograf the lead plate with a horizontal crack 1 mm wide is fixed between a body of the patient and a x-ray film moving down to 12 mm for 2,4 sec. In a multislot-hole rentgenokimograf a set of lead plates (a kimografichesky lattice) forms system of cracks 0,5 mm wide with distance between them 12 or 36 mm. The Kimografichesky lattice is also located between a body of the patient and a film. The device allows to move by means of the electromechanical drive either a kimografichesky lattice of rather motionless film, or a film with a format 30 X 40 cm of rather motionless lattice on 36 mm during from 2 to 6 sec. The direction of the movement is established by turn of a kimografichesky lattice concerning a support on a corner to ±90 °C fixing through everyone 15 °.

The simplified option of a multislot-hole rentgenokimograf is the kimokasseta representing the radiographic cartridge for a film a format 24 X 30 cm combined in one case with a kimografichesky lattice. Kimografiche-Skye the lattice with cracks 0,5 mm wide and distance between them 12 mm moves to 11,5 mm for 2 or 3 sec. Kimokasseta is supplied with an electrostop watch, the operating console, the electric block.

There is a kind of a multislot-hole rentgenokimograf — so-called protected, or remote, a rentgenokimograf, in Krom the kimografichesky lattice is located between a body of the patient and a source of x-ray emission that reduces an exposure dose of the patient approximately by 15 — 20 times.

Fig. 2. Rentgenokimogramma is normal of a diaphragm and edges: contours of a diaphragm and edges have the gear form, amplitude of teeth reflects the respiratory movements (teeth on a contour of heart have no diagnostic value).

Rentgenokimografiya of a diaphragm and edges carry out by means of a kimografichesky lattice, distance between cracks cover 36 mm. The movements of a lattice horizontal, and its cracks are located vertically. Time of the movement of a lattice — 6 sec. that allows to register at usual breath on a film of 1,5 — 2 complete respiratory cycles (fig. 2). At R. apply functional trials to studying of a tone and motive ability of a diaphragm: Müller (attempt of a breath at the closed glottis) and snuff (a bystry and deep breath through a nose). Determine inspiratory and expiratory coefficient by the relation of amplitude of the descending (right) part of a tooth to amplitude of its ascending (left) part. Reduction of this coefficient specifies on patol. lengthening of an exhalation that is a precursory symptom of emphysema of lungs. Determine also the frequency, depth and a rhythm of respiratory movements, their synchronism on both sides. On amplitude of movements of a diaphragm and edges calculate indicators of ventilating ability of lungs. Lowering of a diaphragm on 1 cm corresponds to increase in air volume in the right lung on 110 ml, (in left — on 90 ml). Raising of the tail of the V edge on 1 cm corresponds to increase in air volume in the right lung on 800 ml (in left — on 700 ml).

Rentgenokimografiya of heart and main vessels of a chest cavity. Before development and deployment in practice of an elektrokimografiya R. was the main method rentgenol. registration of the movement of heart, aorta and pulmonary trunk. It is applied to assessment of sokratitelny ability of a myocardium, identification of sites of a heart attack, cicatricial fields and aneurysmal protrusions in a wall of heart, to diagnosis of arrhythmias, definition of a wave of regurgitation at heart diseases, etc. Apply a lattice to R.'s performance, in a cut the distance between horizontally located cracks makes 12 mm. Shooting is made at a depth of a breath. The endurance is chosen so that in one strip of a rentgenokimogramma 3 teeth were received.

Fig. 3. Typiform of rentgenokimo-graphic teeth of heart and main vessels: and — a ventricular tooth; — a tooth of the main vessel; in — a ventricular tooth at bradycardia; — a ventricular tooth at tachycardia; d — options of atrial teeth.

Rentgenokimografichesky teeth of ventricles, auricles and the main vessels have various form (fig. 3). Ventricular teeth normal sharp-pointed with a direct lower (systolic) and flat upper (diastolic) contour; teeth of an aorta and a pulmonary trunk sharp-pointed and in a form are a mirror image of ventricular teeth. Atrial teeth have the split top. The form of teeth is connected also with the frequency of reductions: for bradycardia the tooth with the symmetric parties and the rounded-off top, is typical for tachycardia — acute, lanceolated.

Fig. 4. Rentgenokimogramma of heart and the main vessels is normal: amplitude of teeth reflects their pulsation in contours of heart and the main vessels.
Fig. 5. Rentgenokimogramma of heart at an exudative pericardis: lack of teeth on contours of heart testifies to lack of their pulsation owing to fluid accumulation in a cavity of a pericardium.

Determine the extent of a contour of each department of heart or the main vessel, frequency of reductions, their rhythm, amplitude, duration of a systole and a diastole, a ratio of frequency, a rhythm and depth of a pulsation of different departments of heart and the main vessels (fig. 4, 5) by a rentgenokimogramma.



Bibliography: Zodiyev V. V. and N. P Reasons. Multislot-hole rentgenokimo-grafiya of heart and big vessels and its clinical value, M., 1953; Lindenbraten L. D. and Naumov L. B. Methods of X-ray inspection of bodies and systems of the person, Tashkent, 1976; M and to t and z I. P. and d river Rentgenokimografichesky devices, M., 1980; Sobolev V. I. Bases of rents-genokimografii of lung respiration, L., 1948; Tikhonov K. B. Equipment of X-ray inspection. L., 1978.


X. A. Hidirbeyli; E. G. Chikirdin (tekhn.).

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