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Detection of pulmonary aspiration in infants and children with respiratory disease: concise communication
Insights
This study found that Technetium-99m sulfur colloid (Tc-99m) can detect pulmonary aspiration in children. Oral Tc-99m scintigraphy is a noninvasive method for diagnosing aspiration in pediatric patients.
Area of Science:
- Pediatric Gastroenterology
- Nuclear Medicine
- Diagnostic Imaging
Background:
- Pulmonary aspiration of gastric contents is a concern in pediatric respiratory disease.
- Accurate diagnosis is crucial for appropriate management.
Purpose of the Study:
- To evaluate the efficacy of oral Technetium-99m sulfur colloid (Tc-99m) scintigraphy for detecting pulmonary aspiration in children.
- To establish a noninvasive diagnostic method under physiologic conditions.
Main Methods:
- Twenty children with respiratory disease ingested 500 muCi of Tc-99m sulfur colloid orally.
- Thoracic scintigrams were obtained at 5 minutes, 4 hours, and overnight using a high-sensitivity computer oscilloscope.
- Comparison with barium swallow studies was performed in some cases.
Main Results:
- Five children (25%) demonstrated definite pulmonary accumulation of Tc-99m activity.
- Four of these children also underwent barium swallow, with three showing evidence of aspiration or significant gastroesophageal reflux.
- The method proved effective in identifying aspiration under physiologic conditions.
Conclusions:
- Oral Tc-99m sulfur colloid scintigraphy is a valuable noninvasive tool for diagnosing pulmonary aspiration in infants and children.
- This technique allows for assessment under natural feeding and sleeping conditions.
- It offers a safe and effective alternative to other diagnostic modalities.
Abstract:
Twenty children with respiratory disease ingested 500 muCi of Tc-99m sulfur colloid orally, and scintigrams of the thorax were obtained to determine whether pulmonary aspiration of gastric contents could be detected. The children ranged in age from 1 mo to 14 yr; 13 were 8 mo of age or younger. Children were studied at 5 min and 4 hr after ingestion of Tc-99m sulfur colloid using a high sensitivity computer oscilloscope to record 100K-count images. Additional images were obtained after the children had slept overnight. Five children (25%) showed definite pulmonary accumulation of activity; four of these also had a barium swallow and three showed either pulmonary aspiration of barium or moderately severe gastroesophageal reflux. Oral ingestion of Tc-99m sulfur colloid provides a noninvasive means for diagnosing pulmonary aspiration under physiologic conditions in infants and children.