Km - Kanto-Meatal line connecting the lateral spike of the eyelids and the outer hearing aid; CRL - Central X-ray ray),
but - nobility (front front-round occupitor) Caldwell projection,
b. - Outlabming styling,
in - front semi-phase (chin) projection Waters,
g. -Basal (axial, subemertex) projection,
d. - Kosya Front Projection by Rhese

Radiodiagnostics of foreign bodies Eyes are often carried out using special prostheses with labels or contact glasses, in the case of severe eye damage and the impossibility of using traditional methods, you should use the labeling method on the water volume - a small paper sheet with a glued grain is superimposed on the Lamb or Cork contrast substance (Bismuth, Barium, etc.).

X-ray diagnostics of foreign bodies Eyes folded from two stages:

• the first is to establish the very fact of the presence of a foreign body in the eye or orbit, that is, the definition of it. Radiograph of the skull in the front direct projection allows you to make a general idea of \u200b\u200bthe state of the bones of the arch, cranial seams, pyramids temporal bone. The interpretation of the condition of the eyelid is difficult due to the layering on its top departments image of the bones of the base of the skull. However, the entrance to the eyeboard and its bottom is visible quite clearly.
• the second stage, if the foreign body is detected, the establishment of its exact location in the eye, i.e. its localization.

Patient laying

Basic (standard) styling For this study are

• caldwell's hand-born (front frontoccipital). Lying on stomachthe patient concerns the tape of the tip of the nose and forehead. The angle between the direction of X-raythe beam and the cantomeual line, constituting 15-23 °, leads the shadow of the temporal bonebook of an image of the orbit.
• outlapiculture laying. Lying on the stomach patient concerns the cassette tightjail with a nose and chin.
• front semiaxial (chin) Projection Waters. Patriotent concerns the cassette only chin, the tip of the nose is located in 0.5-1.5 cm above the checkoutthat. The angle between the cantometeal line and the central X-ray ray is37-45 °.
• basal (axial, subemertex) projection. Under the shoulders lying on the backpatient put a roller with such a calculation so that the head is thrown back to CAStakes Taken, and the infraerbital line (im) was parallel to the cassette and perpendiecoolna Central X-ray beam.
• kosy front projection by rhese. The head of the patient laying on the stomachso in order for the cassette to be pressed the Visbrovye, the cheekbone and the tip of the nose. Centerthe ray is carried out on the opposite of the parmer hill, alternate images of botheyeballs are performed strictly symmetrically.

In addition to the specified basic (standard) styling, three additional (special) are used:

• laying "on the nose"
• laying on "frontal bumps",
• kosy front (rear) projection by rhese

Caldwell Loading (Front Frontoccipient) (1918) allows you to study the contours of the entrance to the eyelet, the pits of the lacrimal bag (1),medial (2) and lateral (3) orbit walls, lattice labyrinth (7), frontal sickness (eight). Evaluation of the subprajor region (4) forit is difficult due to the imposition of shadows bottom wall Overall, frontthe third of which is located below the edge, the average - at its level,rear - above. Such important anatomyeducation, like upper and lower ornew Dice (6 - Big Wing wedge-shaped bone) This picture is blocked by the pyramids of the temporal bones (9).

Snapshot outlapiculture laying With a tight pressed nose, is an overview image of an eye in a straight projection that allows you to compare the form and dimensions of Margo orbitalis. In addition, this laying is the main in the study of the frontal, maxillary sinuses and the lattice labyrinth. Finally, the bones of the facial skeleton are clearly visible during the oscillating laying.

Front semicase (chin) projection by Waters and Waldron (1915) is indispensable when assessing the state of the front departments of the medial wall, roof and the bottom of the eye, zhilogo bones, Small wing of a wedge-shaped bone, the podgigalny hole, as well as the maxillary sinuses and the lattice labyrinth.

Due to the design of the shadow of the pyramid of the temporal bone down, the laying provides a distinct visualization of medial (1), lower (2) and the upper (3) walls of the eye, the sublipping edge (4) and the same channel (5), the front-boron seam (6), the zickie arc (7), the small wing of a wedge-shaped bone (8), as well as the frontal (9), the maxillary sinuses (10) and the lattice maze (11). 12 - Unnamed line (Linea Innominata); 13 - lattice plate of lattice bone; 14 - Cock Comb

Thanks to a distinct image of the upper eye wall, as well as the front and middle third of the lower ordinary wall, the projection is useful for visualizing the vertical of the roof fragments and the bottom, including the diagnosis of their "explosive" and depressed fractures.

When interpreting the snapshot, it should be remembered that due to the features of the laying, the image of the eye of the eye is 10 mm below the contour of the sublizzhent edge. Thus, a full-fledged analysis of the state of the lower wall of the orders involves the use of chin and nobble stacks.

Basal (axial, dark, subemertex) Projection on Schuller (1905) and Bowen (1914) allows you to visualize the lateral wall of the socket and the maxillary sinus on all its length, the nasopharynx, the wingid process of wedge-shaped bone, the wonder-sideline fossa, a wedge-shaped sinus and a lattice labyrinth. At the same time, the medial half of the eyelid is blocked by the image of the dental of the upper jaw. Due to the need to re-install the neck, the laying is not applicable in suspected damage cervical department spine.

Laying on the nose (front sagittal projection) Designed to evaluate the condition of wings of a wedge-shaped bone and the upper orphanages. Since the analysis of the images obtained when laying on the nose of images of the upper pelvices is much hampered significantly due to the variability of its structure, then when evaluating snapshots should first of all pay attention to the symmetry of their shape and size. Light interboronal asymmetry is an option of the norm, which cannot be said about pronounced (2 mm or more) differences.

Basic styling used for diagnostics orbitalfractures
	Visualized structure	Pathological changes
Chin	Front two thirds of the bottom walls of the Elets, Skulian Arc	Fractures of the upper and lower walls vertical displacement of fragments
	Topper-eyed sinus	Sinusitis, hemosine
Nobble	Frontal sinus, lattice labyrinth	Gemosinus, Mukocele, fracture of the sinuses walls
	Unnamed line	Fracture of the medial and lateral walls of the orbit
	Sphenoid bone	Fracture of the lateral wall
	Back third of the bottom wall	"Explosive" fracture
	Top Wall of the Elets.	Fracture of the upper wall
	Turkish saddle	Diseases pituitary
Basal (submeretakes)	Wedge-shaped sinus and lattice labyrinth
	Lateral wall of orbit	Fracture of the lateral wall of the orbit
	Skulian arc	The fracture of the zylo arch
Kosya Front on Rhese	Summary canal	Fracture of the walls of the canal

Laying on "frontal bumps" (At which the bint of 3-4 cm with a thickness of 3-4 cm is put under the tip of the nose, and the central beam is directed by the outer hearing aisters) allows you to visualize the lower ordrawal gaps.

To display visual channels, serial radiography is performed by the right and left eye In oblique front (rear) projections by rhese (1911). Normally, the vertical size of the visual opening on the resulting image is 6 mm, horizontal - 5 mm, and the interborbital asymmetry of the size of the visual holes in 96% of patients does not exceed 1 mm. Both an increase in the vertical diameter to 6.5 mm and more and explicit (over 1 mm) asymmetry of the visual holes indicates pathology.

In addition to the visual hole in the picture, the roots of the small wing of a wedge-shaped bone and the upper departments of the lattice labyrinth are visible. Sometimes a pneumatized front inclined process can be accepted for the visual opening. In order to avoid erroneous radiogram interpretation, it should be remembered that the visual hole is located at the lateral edge of the wedge-shaped elevation (Jugum Sphenoidale).

With the introduction of the CT-daily practice, the RHESE laying is rarely used. The interpretation of radiographs of the fractures of the eyes is significantly different from such in the fractures of any other localization. Certain difficulties create a complex image of a facial skeleton on a radiograph, about election distortions and the effect of layering of various bone formations.

To reduce the irradiation fields and obtain more contrasting radiographs, on which there are quite clearly clearly images of even small foreign bodies, radiography is produced with a narrow diaphragm (10-15 mm), directing the central beam on the studied.

In cases of injuries of both eyes (after the explosion or firearm) It is necessary to produce pretty pictures of each eye separately separately. In the study of each patient, ordinary, bone, radiographs must be complemented by overview of the front of the front segment of the eye, since the small and weakly contrast fragments located in the forefront of the eye can often be visible only in these pictures.

An inequal study should be made even in cases where the shadow of the foreign body is determined on conventional images, since other, less X-ray fragments can be in the eye.

Standard radiographic study of the society and pairbital structures includes a nose-born (front front-round-off-flow) laying on Caldwell, a messenger laying, anterior semi-perception (chin) styling by Waters, side and dark (submertex) styling.

In the history of cases for the localization of the foreign bodies, the method of commercing-Baltina is used, in which the prosthetic indicator is placed on the eye with lead points on the meridians 3-9 and 6-12.

In cases where the foreign body is poorly visible or not at all visible in a snapshot in a direct projection, but rely on radiographs in axial and lateral projections should be localized according to the method of abalihin - brewing.

Additional limb indication methods

• In cases where extensive penetrating eyes Or the coarse scars do not allow the prosthesis on the eyeball, the Limb can be labeled with bismuth cleaners (nitrate bismuth basic with vaseline oil in equal parts) or points A. M. Waterozov, applying them to the above-mentioned meridians. This procedure produces an oculist directly before shooting when the patient already lies on the table. Previously, it is delayed with the highlands of plaster of OL with special clips-blufurostats. In most cases, on the meridian of 12 hours, the point is still not possible, since the upper leb, as a rule, remains covered by the corresponding age. But in three points, it is possible to accurately make calculations. The calculation principle remains the same as when labeling is a prosthesis indicator.
• If X-ray is produced after surgical processing when the conjunct is superimposed seam And they interfere with the imposition of a prosthesis on the eyeball, you can use the prosthesis with a cut segment. Cut part of the prosthesis falls on protruding seams.
• When losing the shell Markov's eyes eyeball You can implement using the Bowman's probe. During the execution of the front (face up) and side pictures, the doctor concerns the tip of the corneal center probe.
  When calculating the front image, the meter circuit is superimposed so that the anatomical axis of the circuit with the tip of the probe is combined, and the horizontal meridian scheme would be parallel the anatomical horizontal. On the radiograph in the lateral projection, the tip of the probe corresponds to the front pole of the eye. The side scheme is imposed in such a way that the front pole of the circuit is combined with the tip of the probe, the bullet line of the circuit, denoting the plane of the limb, would be parallel to the corresponding edge of the film. Further, calculations are made in the same way as during the labeling of the limb prosthesis.
  In this way, all three main coordinates are defined, characterizing the location of the fragment in the eye.

Combination of action and axial localization pictures

In practice, there are cases when the foreign body due to a weak contrast is not determined on the side picture, but the shade is visible in direct and axial pictures. In such cases, it is possible to localize fragments by combining snapshots in direct and axial projections made with a baltin prosthesis to the eye.

According to a direct picture, the meridian of the fragmentation is determined and its distinguished from the anatomical psi, according to the axial-distortion from the limb plane.

Methods of cordless radiography of the front eye

The essence of a custody study of the eye is to obtain an X-ray image of its front segment without imposing bone shadows on it, as a result of which it is possible to obtain shades of very small and low-contrast fragments. Therefore, each patient with suspicion of the presence of foreign bodies In addition to bone images of the orbit, it is mandatory to produce inflative radiographs of the front segment of the eye

according to Baltina and Modification of Pole

The technique is the following

• The patient's head is placed on the removal table so that the sagittal plane of the skull is at an angle of 45 ° in relation to the table.
• Film with a size of 6x6 cm, embedded in the compliant envelope from a light-tight paper, applied to the outer wall of the orbit and fixed with a vanity-gauze roller.
• The tube is centered on the transfer.
• The focal length is 60 cm.
• The patient is asked at the time of shooting to reveal the eyes as widely as possible.

If there is no shadow of the fragment on a hintless radiograph of this technique, and clinical data indicate the possibility of having a foreign body in the eye, it is necessary to conduct a study

according to FOGTA method

• To perform snapshots, double films are 5.5x2.5 cm in size, rounded from one end (they are cut on a metal pattern). Such films are wrapped first in black, then into the battle paper to protect them from the effects of light and tears. Double films should be in order to distinguish random artifacts from shadows of fragments - the latter will be visible on both films in identical places.
• Overview of cordless snapshots are made in 2 mutually perpendicular projections: side and axial.
• The distance from the focus of the tube to the film when performing both pictures is 50 cm.

To perform a snapshot in the lateral projection of the patient, they put on the side of a healthy (!) Eyes, pre-installed in the conjunctival bag of its 0.5% solution of alkaine. The film is introduced by a rounded end to the conjunctival cavity and fuses as possible into the depths of the soccer between its inner wall and the eyeball, while the film is slightly bent, simulating the cryvism of the eyeball.

The X-ray bundle is centered on the front cha; the eyes, directing it perpendicular to the film. At the time of shooting (this refers to the pictures in both projections) the position of the eye should be such that the visual axis is parallel to the longitudinal edges of the film, and the Limb plane is perpendicular to the latter.

After performing the snapshot, it is necessary to measure the upper corner of the end of the film, which was not introduced into the conjunctival bag, so that it is later firmly to know that it is this corner that corresponds to the top of the eyeball. Make this mark is the easiest way through the inflection of the film.

Axial picture They are performed in the position of the patient sitting, with a slightly trapped head back, or in the lying position on the back, with the chin given to Georgia. In any case, the position of the head should be such that the abnormal arcs did not cover the front segment of the eye. The film by the rounded end, slightly simulateing it on the curvature of the eye, is introduced into the lower conjunctival arch and, as far as possible, fuse the ridge of the orbit between its lower wall and the eyeball. After performing a picture, remove the film from the conjunctival cavity and the corner of it in the nose half, to further distinguish the nasal half of the picture from the temporal one.

After the identification of the shadow of the foreign body, there is a broken image of a fragment.

Localization snapshots are performed in lateral and axial projections in the same way as sightsets according to the Foget method, but with the mandatory labeling of the limb. One of the labeling methods is to be applied to the Lamb on the meridian of 6 hours of a small drop (with a diameter of 1-1.5 mm) bismoratus casher with a muscular hook or glass stick. After performing localization snapshots, it is always thoroughly removed from the bismuth cassea of \u200b\u200bthe bismuth tap, and then remove the film from the conjunctival bag, marking the appropriate corners of it.

When performing both survey and localization shots by punleless technique The doctor only introduces the film to the conjunctival bag, and holds it throughout the entire time study itself with the help of any clamp, between the branches of which you can hold the non-chosen end of the film. If a this study It is conducted by a child, the film holds his face accompanying his face.

On a properly performed side of a pureeble localization picture, a soft-blurred profile fabric of both eyelids is visible and between them rounded the shadow of the cornea. To the contour of the cornea in its lower part, the contour of the bismuth point is adjacent, if it enters the contour of the cornea, this means that at the time of shooting or the position of the eye was wrong, or the bumular point was not strictly strictly on the 6-hour meridian, but shifted to the side 5 or or 7 hours. In this case, it is necessary to remake.

On an axial picture, a soft-bang shadow of the front segment of the eye and upper century They have outlines of symmetric semicircles. The bismuth point should be inside the shade of the median line between the longitudinal edges of the film.

Localization calculations

The method of calculating the localization of foreign bodies according to powerless images was proposed by E. S. Weinstein. The principle of calculations applied by A. A. Abalichin and V. P. Pivovarov based on them.

Calculations But the side and axial images are produced using the same meter schema, which is a special outline of the meridional cross section of the eyeball on the background of a grid of square divisions equal to 1 mm. The diagram highlighted the axial and limbal lines.

According to the radiograph in the lateral projection, determine the state of the fragment from the limb plane and at the same time distance from the horizontal axial plane (uptail or book). For this, the meter scheme is applied to the picture so that the counting point of the cornea contour and the limb line in the diagram would coincide with the shadow of the bismuth point in the picture, and the image of the horny shell in the diagram would fit into the contour of the cornea in the picture.

After that, according to the divisions applied to the scheme, the amount of mm separating the fragment from the limb plane and from the horizontal axial plane is counted.

According to the axial image, the distance of the fragment from the vertical axial plane (to the nose or to the temple) is determined. To impose a meter diagram to an axial image, it is rotated so that it corresponds to the cut of the eyeball along the horizontal axial plane.

Then the circuit is applied to the snapshot so that the longitudinal edges of the circuit and the snapshot would be parallel to each other, and the intersection point of the sagittal axis and the limb line on the scheme would coincide with the bismuth point in the picture. After that, they determine at what distance from the sagittal (vertical axial) plane of the eye is a fragment.

According to the two values \u200b\u200bobtained - the distance of the fragment from the vertical and horizontal axial planes - determine its distortion from the anatomical axis and the meridian of the occurrence, using the same or schemes A. A. Abalichina, or the table and the meridional scheme E. S. Weinstein.

Research of the Upper Century and Outdoor Spikes

For differentiation of foreign bodies located in the eyeball, from fragments that are engaged in eye from the upper eyelid and outdoor spikes, it is necessary to make insulated inequal pictures of the upper eyelid and the outer spike.

To do this, the double film, wrapped in dark and hollow paper or placed in a cassette for casual snapshots get into the upper conjunctival arch or insert between the outer spike of the eyelids and the eyeball. The X-ray ray is sent perpendicular to the film.

The technical conditions of the shooting should be different from those when performing a picture of the front segment of the eye along with the centuries: voltage and exposure should be reduced, and the soft tissues of the eyelids and spikes, as well as weakly contrast fragments in them will be "punched" throughout.

Diagnosis of fragments in the border zone of the eye

The difficulty of diagnosing foreign bodies located in the so-called borderline eye zone is that the size of the eyeball different people Various and wide limits - from 21.3 to 31 mm. Thus, the width of the so-called border zone can be about 10 mm. Such oscillations of the sizes of the eye, if they do not consider them, can become a source of errors when localizing fragments. From this it follows what great importance have information about the individual sizes of the injured eyeball
There is a complex technique - the X-ray-ultrasonic location of foreign bodies. It consists in the fact that in addition to x-rayolization of foreign bodies, an ultrasonic biometry (UZB) of the injured eye is produced, i.e., measurement of the distance from the front pole to the rear shells. Since the thickness of the rear shells according to different author varies from 0.5-0.8 to 1.7 mm, then to obtain the entire length of the front-hand axis of the eye to the Uzb data, we recommend adding 1.0-1.5 mm.

In the case of the borderline location of the foreign body, having data on it from the plane of the limb and anatomical axis, as well as the value of the eyeball, to solve the issue of intra- or extraocular arrangement of the fragment, can be used, compiled by V. A. Rogozhina. It contains information about the length of the radii of the front sections of the eye, removed from the limb plane to any possible distance in the spherical eyes of different diameters - from 20.0 to 28 mm. In other words, it placed numbers denoted by the maximum possible distance of intraocular fragments from the anatomical axis with their different remoteness from the limb plane in the eyes of different sizes.

The numbers in the first vertical row of the table mean a possible remoteness of fragments from the limb plane within the eye. The numbers in the first horizontal row indicate the diameters (sizes) of the eyes. In places, the intersection of vertical and horizontal series are placed numbers meaning the maximum possible distance from the anatomical axis of an intraocular fragment removed from the limb plane to some particular distance in the eye of a certain size. If, as a result of X-ray radiolization, it is established that the separation of the shard from the anatomical axis exceeds the corresponding column of the table, which means the fragment is located outside the eye, if not exceeds (equal to or less specified in the table) - it means a fragment of intraocular.

For example, according to UZB, the diameter of the injured eye is 25 mm. According to X-ray, the fragment was removed from the limb plane by 10.0 mm, from an anatomical axis by 12.0 mm. In the first vertical row of the table we find the number 10.0, the corresponding remoteness of the fragment from the limb plane, in the first horizontal row we find the number 25 corresponding to the size of the eye. At the intersection of the horizontal and vertical rows we find the number 12.49 - the maximum possible for an intraocular fragment is the distance from anatomical axis when the limit plane is 10.0 mm in the face of this size. In our example, the distance of the fragment from the anatomical axis is 12 0 mm. Consequently, a fragment of intraocular, is in shells. If in our example, the separation of the fragment from the anatomical axis was equal, admissible, 13.5 mm, then the fragment would already be considered an extragalus.

Thus, the use in the complex of radiography, the Uzb and the proposed table significantly increases the effectiveness of the diagnosis of foreign bodies located in the border zone of the eye, but the finally this problem does not solve. The question of the intra-or extragallase arrangement of the fragment in terms of cases remains unresolved, and then it is recommended to be recommended for a x-ray-thrust study under the operating conditions according to the technique developed by I. Ya. Szitov

This technique besides X-rayLocalization of foreign bodies and Uzb includes the production of the posteriorless radiography of almost the entire eyeball. A cassette is used for a x-ray popular study for a cassette for casual radiography of the front eye, in which the working part made of aluminum is elongated to 7 cm.

In the absence of a special cassette, the film can be wrapped in a light-tight paper and placed in a sterile rubber attack.

Pre-coordinates of the occurrence of foreign bodies are determined by the Baltic Commerg or any other x-ray methodology. Then, after the preparation of the operating field and anesthesia, in the meridian of the occurrence of the foreign body, the limb is cut and deeply extended to the conjunctival. The success of the diagnosis depends largely on how carefully the sclera from the gentle tissues adjacent to it is released.

Next ligate and, if necessary, cut the corresponding straight muscles. Produce a thorough inspection of the sclera. In the meridian of the foreign bodies, at an appropriate distance from the Limba plane, diamond green marked the place for the subsequent diascoleral cut, the episklerally sewn a small metallic label, which serves as a guide during the operation.

The film is close to the scler under the control of the eye, the film is introduced, while the soft fabric is not fristed between it and the eyeball. The X-ray ray is directed perpendicular to the plane of the film through the entire eyeball. If on the way of passing the rays between the anode of the X-ray tube and the film is a fragment, delaying rays, then its tone image will remain on the film. In these cases, with confidence, we can talk about the location of the fragment in the eye, since the foreign body, located outside the eyeball, will not give shadows on the film.

X-ray vision is the topic that today attracts great attention to itself. She is interested not only by healers and psychics, but also quite ordinary people. At the moment, much attention is paid to the issue of self-development and influence of thoughts on their own life. X-ray or infrared vision implies the development of superposses, the ability to see situations under a different angle of view. An alternative look at everyday events helps to cope with numerous difficulties, overcome fears and doubts.

In most cases, X-ray vision learning is independently. Just at some point, a person feels the need to move the line of normal in the usual understanding, feels the strong necessity of self-development. Sometimes X-ray vision comes to man in childhood. In this case, the child is simply forced to grow with these outstanding abilities and does not always know where they can be applied correctly. In addition, possessors of extrasensory skills often face misunderstanding from those surrounding.

Healer Dar

X-ray vision is an indicator high Development Personality. The gift of healing is not every person. The first thing that distinguishes psychics from others is the ability to contemplate invisible. It is enough for him for a few seconds to focus on a person to determine not only the disease itself, but also his reason. Genuine healer sees in perfect condition internal organs Patient, his mental state. For psychics, people usually turn to psychics when they want to better figure out the origins of their ailments or radically change their lives.

Chunky

It implies a movement towards a whole person, the desire of a person to gain freedom of action, to become completed open. Chopping is a separate direction in transpersonal psychology. It is aimed at the development of the personality, to begin to feel the happy and the choppermine direction implies the mastering in one degree or another X-ray vision. Why do you need it? Only alternative thinking can fully cover the changes occurring on a subtle energy level. The mentality requires a careful and competent relationship.

Most of the healers at the moment are trying to master the chipging and begin to actively practice it, confirming the idea that a person should develop comprehensively: not only physically mentally, but also spiritually.

Is it possible to develop supervision?

Often people who do not have any attitude towards extrasensory activities are interested in this issue. How to develop alternative vision? Does it be necessary to attend some courses or can you use your own reserves? What should pay special attention to studying this issue?

The development of x-ray vision is possible only when there are many efforts and efforts for this. However, starting to study supervision, it is important to work constantly on a fine plan. These things are very interrelated, and if a person degrades, and does not develop, he will not be able to expand its capabilities. The more personality works on its own shortcomings, seeks to reach an understanding of the deep essence of things, the more internal force he can accumulate inside himself.

Prayer

Appeal to the highest source allows you to cleanse from any negative emotions. In order to develop alternative vision, it is necessary to change thinking in the root. It should be started with an internal purification that will help come to spiritual increment. Prayer helps to cultivate such character qualities as humility, calm, self-confidence, cope with offend and despair, overcome anger and anger on others when they do not meet our expectations. The longer a person practices, the better it turns out.

It should be noted that to consolidate the best result, it is necessary to pray daily, two or three times a day. Only so the effect will be noticeable after a while. Correcting specific prayers, we strengthen our aura, we make it stronger and invulnerable before on the Natius of negative impressions.

Yoga and relaxation

These directions in self-development helps to achieve harmony with their own body, make it more flexible. One who at a high level owns relaxation techniques is engaged in yoga, much less suffers from any vital turmoil. Such a person ceases to accumulate the negative in himself, and concentrates on truly important things: the ability to manage their own emotions, the art of relaxation. At the same time, the ability to relax at the right moment in order to maintain energy.

Meditation

This is a technique to which more and more people show genuine interest. Meditation allows you to achieve internal equilibrium, gain agreement with you, start thinking largely and positively. Harmony with me is a very important achievement for the development of alternative vision. Unfortunately, human thinking is not as fast as I would like. You may need years to fully master this technique, come to a state of great integrity. Meditation undoubtedly opens up new opportunities in front of a person. Gradually will begin to release a large amount of energy, which it would be reasonable to spend on strengthening its mental state.

Many people make a common mistake. They strive immediately to start passing these knowledge to others, to prove something around. No, first it is necessary to drink yourself a healing energy, free from all the negative. Only when you achieve a genuine state of integrity, you can generously share knowledge with others. While the skills are only at the level of information, you do not own them, and therefore you will not be able to teach others.

Purity of thoughts

The development of alternative vision is very helpful to open consciousness. This means that a person must learn to be in such a state when he takes only positive in his life. Here it is advisable to mentally establish a kind of "filter", which will prevent the passage of all negative in your life. The stronger the personality concentrates on the problems, the more energy loses.

How to learn x-ray vision? It is necessary to pay attention to your own thoughts and feelings. The state of anger, anger or despair does not contribute to the purity of consciousness. To keep the "third eye" open, you need to free from any negative installations in time. If they only penetrate consciousness, they will have to work again for a while to free themselves to achieve a neutral state.

Harmony with me

To achieve a better result, you need to try to live in equilibrium with your inner creature. What does it mean? Harmony with him is able to bring a person to a state of integrity, help him develop and support himself in an excellent location of the Spirit constantly. Otherwise, you can very quickly lose everything you learned. Harmony with it allows us to maintain the power of the Spirit, do not lose it over time. In this case, negative situations that come to life will not be so injured and force themselves to feel like a loser. In fact, it is impossible to regain x-ray vision once and for all, the operation at the physical level is not provided here. Every day it is necessary to pay time to self-development at least gradually.

Visualization

This is a very powerful process that gives a large amount of energy. To the great regret, most people have not yet learned to use it. It seems to many that if they begin to dive into such an exercise every day, they will simply be noticed, lose control over their own life. In fact, everything is exactly the opposite. The more the person visualizes, the stronger it attracts the desired result to his life. It is necessary not just to try to imagine the ideal version of the development of events, but to do it with love, with a trembling attitude to his own personality. Never even in thoughts do not humiliate and do not hurt yourself. Otherwise, it will become and surrounding. To know how to develop X-ray vision, you need to learn how to clearly understand what you personally want to achieve in life. While a person is in constant doubt, it cannot reach internal equilibrium. Being happy is really easy. You need to love yourself, taking your own shortcomings and dignity. The developed "third eye" in this case will benefit, will bring many positive emotions.

Stretched hand

Before striving to find an alternative view, you need to understand why you need it. If there is a desire to help others - perfectly. It means that a person will feel in its internal forces who want to spend on self-development and self-improvement. You must always have a ready-made hand ready, ready to assist. Such attitude to life will definitely be rewarded sooner or later. The main thing that should be understood: it is necessary to strive to do goodless, without expecting to get something like that. In this case, the internal power of personality will be fixed constantly.

Thus, it is possible to develop X-ray vision in humans, provided that he himself seeks to this. Persons are such that we must improve them. Only in this case can we talk about the disclosure of some superpowers that will change their lives.

The organ of vision consists of an eyeball, its protective parts (soccer and eyelids) and eye appendages (tear and motor vehicle). The eyeball (orbit) in shape resembles a truncated tetrahedral pyramid. Her vertices have a hole for spectator nerve and the orphanage. 4 straight muscles are attached along the edges of the optic hole, the top oblique muscle and muscle lifting upper eyelid. The walls of the goals are made up by many facial bones and some bones of the brain skull. From the inside the wall is lined with an assault.

An icing image is available on skull overview radiographs in straight, side and axial projections. In a snapshot in a direct projection during the oscillateral position of the head in relation to the film, both sockets are visible separately, and the entrance to each of them is very clearly distinguished in the form of a quadrangle with rounded corners. Against the background of the enemy, a light narrow top of the orphanage is determined, and under the entrance to the eyeboard - a round hole through which the porznorny nerve comes out. On the side pictures of the skull, the image of the icing is projected on each other, but it is not difficult to distinguish the upper and lower walls adjacent to the eye of the orbit. On the axial radiograph of the eye shadow, the eyes are partially superimposed on the maxillary sinuses. The hole of the optic nerve channel (rounded or oval shape, diameter up to 0.5-0.6 cm) on sightsets unnoticed; For its study, a special picture is performed separately for each side.

The image free from the imposition of neighboring structures, the image of the icones and eyeballs is achieved on linear tomograms and especially on computer and magnetic resonance tomograms. It can be argued that the organ of view is the perfect object for AT in view of the pronounced differences in the absorption of radiation in the tissues of the eye, muscles, nerves and vessels (about 30 Hu) and retrobulbar fatty tissue (-100 HU). Computer tomograms make it possible to obtain an image of eyeballs, a glassy body and a lens in them, eye shells (in the form of a total structure), optic nerve, orphan artery and veins, eye muscles. For the best display of the optic nerve, the cut is carried out along the line connecting the lower edge of the orphanage with the upper edge of the outdoor auditory passage. As for magnetic resonance tomography, it has special advantages: not accompanied by X-ray irradiation of the eye, makes it possible to investigate the eye player in different projections and differentiate blood accumulations from other soft-tissue structures.

New horizons in the study of the morphology of the organ of vision opened ultrasound scanning. Ultrasound devices used in ophthalmology are equipped with special eye-eye sensors operating at a frequency of 5-15 MHz. They reduced the "dead zone" to a minimum - the nearest space before the piezoplastic of the sound probe, within which the echoes are not recorded. These sensors have a high resolution - up to 0.2 π MM in width and front (in the direction of the ultrasonic wave). They allow measurements different structures Eyes with an accuracy of 0.1 mm and judge the anatomical features of the structure of the biological environments of the eye on the basis of the value of the ultrasound attenuation in them.

Ultrasound examination of the eye and eye socket can be carried out by two methods: α-method (one-dimensional echography) and in-method (sonography) In the first case, echos are observed on the oscilloscope screen, corresponding to the reflection of ultrasound from the boundaries of the anatomical media. Each of these boundaries is reflected on the echoogram in the form of a peak between the individual peaks, is located in the normal place. Retrobulbar fabrics are caused by a one-dimensional echoogram signals of various amplitudes and lungs. At the sonograms, an image of an acoustic cutting of the eye is formed.

In order to determine the mobility of pathological foci or foreign bodies in the eye, sonography is produced twice: before and after the rapid change in the direction of the view, or after the change of the body position from the vertical in horizontal, or after exposure to the foreign body, the magnetic field. Such a kinetic echography allows you to determine whether the foci is fixed or a foreign body in anatomical structures of the eye.

Overview and targeted radiographs easily determine the fractures of the walls and edges of the orphanage. The fracture of the lower wall is accompanied by the darkening of the maxillary sinus due to hemorrhage into it. If the fracture of the socket penetrates into the incomplete sinus, the air bubbles in the eye can be detected (Empire Eyeless Emphysema). In all unclear cases, for example, with narrow cracks in the walls of the orphanage, CT helps.

Radiography of the orclaisonment allows you to assess the condition of both the most bone cavity, in which the eyes and lacrimal glands and blood vessels, nerves, muscles and fatty fiber are arranged. Due to the leaning of thin bones of the enemy to fractures, this diagnostic study is usually prescribed when maxillofacial injury. Special radiological methods allow you to detect foreign bodies that are not visible to an ophthalmoscope. In some cases, requiring detail, radiography as a valuable method of diagnosing diseases of the eye and eyeball combined with CT and ultrasound.

purpose

• Eliminate the diagnosis of fractures and eye diseases.
• Eliminating the identification of foreign bodies of the orcap and eyeball.

Preparation

• It should be explained to the patient that to estimate the state of the society, it will be performed by several pictures.
• The patient explains the essence of the study and report who and where to conduct a study.
• Patient should calm down, assuring that the study is usually painless, but may cause inconvenience when laying in case of injury to the face and that during the study it will be asked to turn his head in the same way, as well as bend and break the neck.
• Before studying the patient, they ask to remove all the decorations and metal objects.

Procedure and subsequent care

• The patient is placed on an X-ray table or sit in a chair and ask not to move while pictures are taken.
• Usually make a series of pictures in the following projections: lateral, frontwall, chore-vertical (for visualization of the base of the skull), stereoscopic in the violent (bilateral), on a tauna (semi-axis) and a visual channel. If the extension of the top of the orphanage is suspected of expanding the top of the orphanage.
• The patient should not leave the X-ray department until the end of the development and inspection of the pictures.

Normal picture

The eyeball is limited to the upper, lower, medial and lateral walls. The bones of the upper and lower walls are very thin (the thickness of the lower can be less than 1 mm). Parallel to each other, the medial walls are somewhat thicker, with the exception of a part formed by the lattice bone. The largest part of the soccer and the most durable places of the orbit is the lateral wall. Rear between the outer and the upper walls is the upper basic slit. In fact, this is the gap between the large and small wings of a wedge-shaped bone. At the top of the orphanage in a small wing of a wedge-shaped bone, there is a visual channel through which the visual nerve and eye artery come out.

Deviation from norm

With maxillofacial injury, fractures of the most subtle structures of the society - its lower wall and a lattice bone occur. Damage is detected when comparing the size and shape of both eye sockets. An increase in the eyeballs usually indicates a pathology that causes an increase in intra-community pressure and proputosis (exophthalm), and is observed in the neoplasms of this area. The expansion of the top of the orphanage is connected with the menin-geniosome of the society, intracranial pathology (for example, a pituitary tumor) or, more typical, vascular anomalies. The expansion of the visual channel can speak of the extraanuclear distribution of the retinoblastoma, and in children - about the glyom of the optic nerve. An increase in the eye in adults is caused only by a long existing pathology, but in childhood due to the unfinished development of the cords of the orbit, it occurs even with a rapidly developing disease. The eyeball may decrease in size after enucleation of the eye in childhood or with such a disease, as a congenital microftralmia.

The destruction of the walls of the orcap may indicate a malignant tumor or infection. For benign Novo-formation Or the cyst is observed a local clear gear of the wall of the orbit. X-ray changes caused by the increase and erosion of the society are encountered and with damage to the structures adjacent to it. The density of bone tissue can increase in the metastases of the osteoblastoma, the meningome crest of the wedge-shaped bone, the disease of the PEDGET. However, to confirm the pathology of the orphan pathology, radiography should be supplemented by other studies.

Factors affecting the result of the study

No missing.

B.H. Tit

"Radiography of the orbit" and others

Chapter 16. Radiation diagnosis of diseases and injuries of the organ of vision

Chapter 16. Radiation diagnosis of diseases and injuries of the organ of vision

The organ of view is part of the visual analyzer, located in the eyeboard and consists of an eye (eyeball) and its auxiliary bodies (muscles, ligaments, fascia, champions of the enemy, the vagina of the eyeball, the fat body of the society, eyelids, conjunctivation and a lacrimal).

Methods of radiation research

The radiological method is essential in the primary diagnosis of the pathology of the organ of vision. However, the main methods radiation diagnosis In ophthalmology, KT, MRI and Ultrasound. These methods allow us to assess the condition of not only the eyeball, but also all the auxiliary bodies of the eye.

X-ray method

The purpose of x-ray is the identification of pathological changes in the society, the localization of radiocontrase foreign bodies and the assessment of the condition of the lacrimal apparatus.

X-ray study in the diagnosis of diseases and injuries of the eye and eye socket includes performing overview and special pictures.

Overview radiographs of iceds

On the radiographs of the orphanage in the loop-breeding, nobble and lateral projectionswe are visualized to the entrance to the eyelet, its walls, sometimes small and large wings of a wedge-shaped bone, the upper pelvic slit (see Fig. 16.1).

Special techniques of x-ray research

Radiography of the socket in the front braid projection (snapshot of the visual channel on the cut)

The main purpose of the snapshot is to obtain an image of the visual channel. Pictures for comparison are made mandatory on both sides.

The images displays the visual channel, the entrance to the eye, lattice cells (Fig. 16.2).

Fig. 16.1.Radiographs of iceds in nobility (a), weaving (b) and side (c) projections

Radiographic examination of the eye with a prosthesis of commerga-baltina

It is performed to determine the localization of foreign bodies. The prosthesis of the Comberg-Baltina is contact lens with lead labels along the edges of the prosthesis. The snapshots are produced in the loop-breeding and lateral projections when fixing the gaze at the point, which is right in front of the eyes. Localization of foreign bodies across the pictures are carried out using the meter circuits (Fig. 16.3).

Contrast study of the tear paths (dacryocystography)The study is carried out with the introduction of RCS into tear paths to estimate the condition of the lacrimal bag and the passability of the tear duct. Upon irresistible duct, the level of occlusion and an extended atonic tear bag are clearly detected (see Fig. 16.4).

X-ray computed tomography

CT is carried out for diagnosing diseases and damage to the eye and eye socket, optic nerve, extracular muscles.

In assessing the state of various anatomical structures of the eye and the eye, it is necessary to know their density characteristics. Normally, the average values \u200b\u200bof densitometric: the lens is 110-120 Hu, the vitreous body - 10-16 Hu, the shells of the eye - 50-60 Hu, the optic nerve - 42-48 Hu, extracular muscles - 68-74 HU.

CT allows you to identify tumor lesions of all separation nerve departments. The tumors of the enemy, the diseases of the ret-robulbar fiber, the foreign bodies of the eyeball and the orphanage, including X-ray-contrast, as well as damage the walls of the socket are clearly visualized. CT allows not only to identify foreign bodies in any field of the orphanage, but also to determine their size, localization, introduction in the eyelids, the muscles of the eyeball and the optic nerve.

Fig. 16.2.Radiograph of the orphanage in the oblique plane on the cut. Norm

Fig. 16.3.Radiographs of the eyeball with a prosthesis of commerga-baltina (thin arrow) in lateral (a), axial (b) projections. Facebook Facebook (Fat Arrow)

Magnetic resonance

TOMOGRAPHY

Normal magnetic resonance anatomy of the eye and eye socket

The bone walls of the orphanage give a pronounced hypostenten signal on T1-W and on T2-W. The eyeball consists of shells and an optical system. Eye apple shells (sclera, vascular shell and retina) are visualized in the form of a clear dark strip on T1-VI on T2-W, bordering eye apple as

Fig. 16.4.Dacriaocystogram. Normal (arrows indicated lacrimal moves)

single. From elements of the optical system on MR-tomograms, anterior chamber, a lens and a glassy body are visible (see Fig. 16.5).

Fig. 16.5.MR-tomogram of the eye normally: 1 - lens; 2 - the vitreous body of the eyeball; 3 - tear gland; 4 - optic nerve; 5 - retrobulbar space; 6 - upper straight muscle; 7 - internal straight muscle; 8 - outer straight muscle;

9 - Lower straight muscle

The front chamber contains a watery moisture, as a result of which a pronounced hyperintense signal on T2-W. The lens is characterized by a pronounced hypoinencetry signal and on T1-V, and on T2-V, as it is a semi-solid evascular body. The vitreous body gives an increased MP

t2-V signal and reduced - on T1-V. The MP signal of the loose retrobulbar fiber has a high intensity on T2-W and low on T1-V.

MRI allows you to trace the visual nerve all over. It starts from the disk, has an S-shaped bending and ends in Hiazme. Especially effective for its visualization axial and sagittal plane.

Extraocular muscles on MR-tomograms for the intensity of the MR signal are significantly different from retrobulbar fiber, as a result of which are clearly visualized throughout. Four straight muscles with a homogeneous isopenten signal start from a tendon ring and headed on the sides from the eyeball to the scler.

Between the inner walls of the wristers are the lattice sinuses containing air and giving a pronounced hypocent signal with a clear differentiation of cells. Laterally from the lattice labyrinth is the topless sinuses, also give a hypocentsive signal and on T1-W and on T2-W.

One of the main advantages of MRI is the possibility of obtaining an image of intraocular structures in three mutually perpendicular planes: axial, sagittal and frontal (coronal).

Ultrasonic method

The echographic image of the eyeball in the norm has a view of a rounded echo negative education. Two echogenic lines are locked in its front departments as a lens capsule mapping. The back surface of the lens is convex. If you get into the plane scan, the optic nerve is visible as an echonegative, the vertically running strip immediately behind the eyeball. Due to the wide echothenium from the eyeball, the retrobulberry space is not differentiated.

Radionuclide method

Positron emission tomographyallows you to conduct differential diagnosis Malignant I. benign tumors The organ of vision in the level of glucose metabolism.

Used as for primary diagnosisAnd after treatment - to determine the recurrence of tumors. It is of great importance for finding remote metastases when malignant tumors Eyes and to determine the primary hearth when metastasis in the eye fabric. For example, a primary focus of 65% of metastasis in an organ of vision is breast cancer.

Radiation diagnosis of eye and eye damage

Fractures of the walls of the orchard

Radiography:flash wall fracture line with bone fragments (see Fig. 18.20).

Fig. 16.6.Computer tomogram. OS-ring fracture of the lower wall of the orbit (arrow)

CT:the defect of the bone wall of the society, the displacement of bone fragments (symptom of "steps"). Indirect signs: blood in the otolonic sinuses, retrobulbar hematoma and air in retrobulbar tissue (see Fig. 16.6).

MRI:fractures are determined in unclearly. It is possible to identify indirect signs of fractures: the accumulation of fluid in the incomplete sinuses and air - in the structures of the damaged eye. In case of damage, the water, as a rule, completely fills the galonial sinus,

and the intensity of the MR signal depends on the terms of hemorrhage. With OS-ringed fractures of the lower wall of the orphanage with displacement of content in topper dasukha Appears pitpoftrals.

Air accumulation in damaged structures of the eye with MRI is distinctly detected in the form of foci of a pronounced hypo intensive signal on T1-W and on T2-Vi on the background of the usual image of the fabric of the soccer.

Foreign bodies

Radiography on the Comberg-Baltina method:to determine their in-or extragallase arrangement, X-ray-functional studies are carried out with the design of images when viewed up and down (see Fig. 16.3).

CT:the method of choice for the detection of radiocontrase foreign bodies (Fig. 16.7).

Fig. 16.7.Computer tomograms. Foreign body of the right eyeball (arrow)

MRI:the visualization of X-ray-contrast foreign bodies is possible (see Fig. 16.8).

Ultrasound:the foreign bodies look like echoposive inclusions, giving an acoustic shadow (Fig. 16.9).

Fig. 16.8.MR-tomogram. Plastic Foreign Body of the Left Eye Apple (arrow)

Fig. 16.9.Echogram of the eyeball. Foreign body of the eyeball (artificial lens)

Intraocular hemorrhage

Ultrasound:fresh hemorrhages are displayed in echographs in the form of small hyperheogenic inclusions. Sometimes it is possible to identify their free movement inside the eye when the eye shifts of the eyeballs, in the later dates of hemophthalma, dense intraocularities are formed and the molars are formed (see Fig. 16.10).

Fig. 16.10.Echograms of the eyeball: a) Fresh hemorrhage in the oral cavity, b) the formation of connective tissue, fibrosis of the vitreous body

CT:hematoma give zones of increased density (+40 ... + 75 Hu) (Fig. 16.11).

Fig. 16.11.Computer tomograms. Hemorrhage in the oral cavity

(arrows

MRI:according to informative, CT is inferior, especially in acute stage Hemorrhage (Fig. 16.12).

Fig. 16.12.MR-tomograms. Heporium in the cavity of the vitreous body (subacted

stage) (arrows)

The recognition of hemophthalma at MRI is based on the detection of foci and sections of changing the intensity of the MR signal against the background of a homogeneous signal from the vitreous body. Visualization of hemorrhage depends on the limit of their occurrence.

Traumatic retinal detachment

Ultrasound:the retinal detachment may be incomplete (partial) and complete (total). Partially detached retina has a look of a clear echogen strip, located at the rear pole of the eye and parallel to his shells.

Subtotal retinal detachment can be in the form of a flat line or a funnel form; Total, as a rule, funnel-shaped or T-shaped. It is located not at the rear pole of the eye, and closer to its equator (the detachment can reach 18 mm or more), across the eyeball (Fig. 16.13).

The funnel-shaped retinal detachment has a typical form in the form of latin letters V With the place of attachment at the disk of the optic nerve (see Fig. 16.13).

Fig. 16.13.Echograms of the eyeball: a) Subtotal retinal detachment; b) total (funk-shaped) retinal detachment

Raewy semiotics eye and eye diseases

Tumor vascular shell Eyes (Melanoblastoma)

Ultrasound:hypoheogenic formation of irregular shape with fuzzy contours against the background of a pronounced retinal detachment (see Fig. 16.14).

MRI:the melanoblastoma gives a pronounced hypoinenceful MR signal on T2-W, which is associated with a reduction in relaxation times characteristic of melanin. The tumor is, as a rule, on one of the walls of the eyeball with a printed in the vitreous body. On T1-type, the melanoblastoma is manifested by a hyper-triented signal against the background of a hypo intensive signal from the eyeball.

PET-CT:the formation of the wall of the eyeball of inhomogeneous soft-tissue density with increased level Glucose metabolism.

Elets tumors

Tumors of optic nerves

CT, MRI:determined thickening of the affected nerve various shapes and magnitude. It is more common to occur spindle-shaped, cylindrical or rounded expansion of the optic nerve. With one-sided defeat of the visual nerve, the Exophthalm on the side of the lesion is clearly defined. Glioma optic nerve can occupy almost the entire cavity of the orphanage (Fig. 16.15). Clearer data on the structure and

Fig. 16.14.Echogram of the eyeball. Melanoblastoma

the prevalence of the tumor is given by T2-W, on which the tumor is manifested by a hyper-cridium mp signal.

Fig. 16.15.Computer tomogram. Nevnoma of optic nerve

CT and MRI Contrast:after intravenous amplification, there is a moderate accumulation of kV tumor nodes.

Vascular Eyeball Tumors (Hemangioma, Lymphangioma)

CT, MRI:tumors are characterized by distinct vascularization, as a result of which they intensively accumulate the contrast agent.

Tumor tear gland

CT, MRI:the tumor is localized in the upper ventilation department of the orphanage and gives a hyperintensive MR signal on T2-W and iso-retented - on T1-W. Malignant forms of tear gland tumors are involved in the pathological process adjacent bones. At the same time, destructive changes in bones, which are visualized to CTs are noted.

Dacryocystitis

Radiography, CT, MRI:in the upper ventilator, an enlarged tear bag with liquid content, thickened and uneven walls is visualized (Fig. 16.16).

Fig. 16.16.Dacryocystitis: a) dacriaocystogram; b, c) computer tomograms

Endocrine ophthalmopathy

CT, MRI: distinguish 3 options for endocrine ophthalmopathy:

With preferably lesion of extracular muscles;

With preferably damage to the retrobulbar fiber;

On mixed type (lesion of extracular muscles and retro-bulbar fiber).

Pathognomonic CT and MRI signs of endocrine ophthalmopathy are thickening and sealing extracular muscles. Internal and outer straight lines are affected, lower straight muscles. The main signs of the endocrine ophthalmopathy include the change in retrobulbar fiber in the form of edema, vascular full-wheel, increasing the volume of the orbit.