What is chest fluoroscopy?
Chest fluoroscopy is a type of X-ray procedure used to assess the motion and function of the lungs and other structures of the respiratory tract.
Fluoroscopy is a study of moving body structures, similar to an X-ray "movie." A continuous X-ray beam is passed through the body part being examined. The beam is transmitted to a TV-like monitor so that the body part and its motion can be seen in detail. Fluoroscopy, as an imaging tool, enables physicians to look at many body systems, including the skeletal, digestive, urinary, respiratory, and reproductive systems.
Chest fluoroscopy may be performed when the motion of the lungs, diaphragm (dome-shaped muscle that separates the abdominal cavity from the chest cavity), or other structures in the chest need to be evaluated. However, chest fluoroscopy involves a higher exposure to radiation than a standard chest X-ray, so its use is carefully considered.
Other related procedures that may be used to diagnose problems of the lungs and respiratory tract include bronchoscopy, computed tomography (CT scan) of the chest, chest X-ray, chest ultrasound, lung biopsy, lung scan, mediastinoscopy, oximetry, peak flow measurement, positron emission tomography (PET) scan, pleural biopsy, pulmonary angiography, pulmonary function tests, and thoracentesis. Please see these procedures for additional information.
Anatomy of the respiratory system
The respiratory system is made up of the organs involved in the interchanges of gases, and consists of the:
The upper respiratory tract includes the:
Ethmoidal air cells
The lower respiratory tract includes the lungs, bronchi, and alveoli.
What are the functions of the lungs?
The lungs take in oxygen, which cells need to live and carry out their normal functions. The lungs also get rid of carbon dioxide, a waste product of the body's cells.
The lungs are a pair of cone-shaped organs made up of spongy, pinkish-gray tissue. They take up most of the space in the chest, or the thorax (the part of the body between the base of the neck and diaphragm).
The lungs are enveloped in a membrane called the pleura.
The lungs are separated from each other by the mediastinum, an area that contains the following:
The right lung has three sections, called lobes. The left lung has two lobes. When you breathe, the air enters the body through the nose or the mouth. It then travels down the throat through the larynx (voice box) and trachea (windpipe) and goes into the lungs through tubes called main-stem bronchi.
One main-stem bronchus leads to the right lung and one to the left lung. In the lungs, the main-stem bronchi divide into smaller bronchi and then into even smaller tubes called bronchioles. Bronchioles end in tiny air sacs called alveoli.
Reasons for the procedure
Chest fluoroscopy may be performed when a problem with the motion of the lungs, diaphragm, or other chest structures is suspected. Such problems may include, but are not limited to, the following:
Diminished movement or paralysis of the diaphragm due to pulmonary disease or injury
Loss of lung elasticity
Obstruction of the bronchioles
Pleural effusion. Accumulation of fluid in the pleural space between the lungs and the chest wall
Mass in the chest cavity
In addition, chest fluoroscopy may be used in conjunction with other diagnostic or therapeutic procedures, such as guiding the insertion of needles or catheters (long narrow tubes) within the chest.
There may be other reasons for your doctor to recommend a chest fluoroscopy.
Risks of the procedure
You may want to ask your doctor about the amount of radiation used during the procedure and the risks related to your particular situation. It is a good idea to keep a record of your past history of radiation exposure, such as previous scans and other types of X-rays, so that you can inform your doctor. Risks associated with radiation exposure may be related to the cumulative number of X-ray examinations and/or treatments over a long period of time.
If you are pregnant or suspect that you may be pregnant, you should notify your doctor. Radiation exposure during pregnancy may lead to birth defects.
There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.
Before the procedure
Your doctor will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure.
Generally, no prior preparation, such as fasting or sedation, is required.
Notify the radiologic technologist if you are pregnant or suspect you may be pregnant. If it is necessary for you to have chest fluoroscopy, special precautions will be made to minimize the radiation exposure to the fetus.
Notify the radiologic technologist if you have any body piercing on your chest.
Based on your medical condition, your doctor may request other specific preparation.
During the procedure
Chest fluoroscopy may be performed on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your doctor's practices.
Generally, chest fluoroscopy follows this process:
You will be asked to remove any clothing, jewelry, or other objects that may interfere with the exposure of the chest.
If you are asked to remove clothing, you will be given a gown to wear.
You will stand between the X-ray machine and the fluoroscopic screen. If you are unable to stand, you will be positioned on an X-ray table. You may be asked to assume different positions, cough, or hold your breath at intervals while the fluoroscopy is being performed.
A special X-ray scanner will be used to produce the fluoroscopic images of the chest. The fluoroscopy images may be displayed on a monitor so that the doctor can observe the motion of the chest structures during the procedure.
After all required views have been taken, the procedure is complete.
After the procedure
Generally, there is no special type of care after chest fluoroscopy. However, your doctor may give you additional or alternate instructions after the procedure, depending on your particular situation.