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Radiographic evaluation of aspirated metallic foil foreign bodies
Richard D Orgill1, Thomas R Pasic, Walter W Peppler
1Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin, Madison, Wisconsin 53792-7375, USA.
The Annals of Otology, Rhinology, and Laryngology
|July 27, 2005
Summary
Conventional and dual-energy radiography cannot reliably detect aspirated metallic candy wrappers, even in multi-layer forms. This limitation poses a diagnostic challenge for suspected foreign body aspiration.
Area of Science:
- Radiology
- Pediatric Imaging
- Foreign Body Aspiration
Background:
- Aspirated foreign bodies are common in children, with metallic objects sometimes requiring radiographic diagnosis.
- Metallic candy wrappers are a potential, yet often radiographically occult, aspirated foreign body.
- A case revealed a multi-layer metallic wrapper missed on serial chest radiographs.
Purpose of the Study:
- To evaluate the efficacy of conventional and dual-energy radiography in detecting aspirated metallic foil wrappers.
- To determine if these radiographic techniques can reliably exclude the presence of metallic wrappers.
Main Methods:
- Radiographic assessment of single-layer and multi-layer metallic candy wrappers.
- Utilized conventional and dual-energy radiographic techniques.
- Tested in three distinct tissue models simulating human anatomy.
Main Results:
- Single-layer metallic wrappers were undetectable by both radiographic methods.
- Multi-layer wrappers were not detected below 8 layers in pulmonary tissue models and 16 layers in mediastinal models.
- Detection limits were similar for both conventional and dual-energy radiography.
Conclusions:
- Conventional and dual-energy chest radiography are not reliable for excluding aspirated metallic foil wrappers.
- The radiopacity of metallic wrappers is dependent on their layer count and surrounding tissue density.
- Clinical suspicion of metallic wrapper aspiration warrants consideration of alternative diagnostic or management strategies.