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Chest X-Ray and Children

What are X-rays?

Cardiologists use a variety of different tests to diagnose a child’s heart condition—one of which being chest X-rays. X-rays are made by using low levels of external radiation to produce images of the body, the organs and other internal structures for diagnostic purposes. X-rays pass through body structures onto special plates (similar to camera film) and a “negative” type picture is made. The more solid a structure is, the whiter it appears on the film. For this reason, bones appear white on an X-ray image, but less dense tissue such as air, muscle, skin, and fat appears darker.

Why is a chest X-ray performed?

Chest X-rays may be used to assess heart status (either directly or indirectly) by looking at the heart itself, as well as the lungs. Changes in the normal structure of the heart, lungs and/or lung vessels may show disease or other conditions. A chest X-ray can be used to look for:

  • Heart enlargement. This can happen with congenital heart defects or cardiomyopathy.
  • Pericardial effusion. A buildup of fluid in-between the heart and the membrane that surrounds it, often due to inflammation. Pericardial effusions are more often examined with echocardiography, a different imaging test.
  • Pleural effusion. A collection of blood or fluid around the lung.
  • “Fluid in the lungs,” known as pulmonary edema. This can occur with congenital heart disease or congestive heart failure.
  • Pneumonia and other lung diseases.

Chest X-rays may also be ordered:

  • As part of a physical examination
  • Before hospitalization and/or surgery
  • To look at symptoms of conditions related to the heart or lungs
  • To check the position of implanted pacemaker wires and other internal devices like central venous catheters
  • To check status of lungs and chest cavity after surgery.

More definitive tests, such as a computed tomography (CT) scan, magnetic resonance imaging (MRI), echocardiography or cardiac catheterization may be performed to make a final diagnosis of cardiac conditions.

How is a chest X-ray performed?

A chest X-ray may be performed in the hospital or in one of our outpatient facilities.

A large X-ray camera that is suspended from the ceiling or mounted on the floor is used to obtain the images. The camera can be moved in many directions in order to get different views. Portable X-ray equipment can be used to take images of patients who cannot leave certain areas of the hospital, such as the operating room, the emergency department or the intensive care units.

A chest X-ray may be performed in a standing, sitting or lying position, depending on the condition of the child and the reason for the X-ray. For a standing or sitting film, the child will stand or sit in front of an X-ray plate. If the X-ray is taken in the lying position, the plate is placed beneath the child while lying on his or her back or side.

The technologist will position the child properly in front of the plate, and then steps away to the controls of the machine. If the child is old enough to cooperate, he or she will be asked to take in a deep breath and hold it for a few seconds while the X-ray exposure is made. Otherwise, the technologist will try to take the picture at the appropriate time by watching the child breathe.

In some situations, the doctor may want an image taken from a side angle. This procedure is the same as the one just described, except that your child will stand, sit or lie at a right or left angle to the X-ray plate and his or her arms will be raised out of the way.

Parents are usually encouraged to stay in the room with their children to provide support and comfort. You will be asked to wear a lead apron to protect you from unneeded exposure to radiation to you during the X-ray.

Depending on the results of the chest X-ray, additional tests or procedures may be scheduled to gather further diagnostic information.

Learn more about what to expect at the CHOC Children’s Radiology Department.

Long Live Childhood

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