The Usefulness of Scintigraphy for the Detection ofGastroesophageal Reflux and Pulmonary Aspiration.
- Author:
Sung Kil KANG
1
;
In Young HYUN
;
Dae Hyun LIM
;
Jeong Hee KIM
;
Byong Kwan SON
Author Information
1. Department of Pediatrics, College of Medicine, Inha University, Incheon, Korea. dhyunlim@inha.ac.kr
- Publication Type:Original Article
- Keywords:
Gastroesophageal reflux;
Radionuclide scintigraphy;
Aspiration;
Pulmonary disease
- MeSH:
Colloids;
Eating;
Gastroesophageal Reflux;
Humans;
Lung;
Lung Diseases;
Pneumonia, Aspiration;
Thorax;
Tin
- From:Korean Journal of Pediatric Gastroenterology and Nutrition
2008;11(1):12-20
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Chronic pulmonary disease may be caused by aspiration of gastric contents secondary to gastroesophageal reflux. At present, there is no gold standard for documenting pulmonary aspiration. The purpose of this study was to investigate the usefulness of radionuclide scintigraphy in the detection of gastroesophageal reflux and pulmonary aspiration. METHODS: Thirty-five patients with suspected aspiration pneumonia, and five normal control subjects, were included in the study. All subjects underwent gastroesophageal reflux scintigraphy after the ingestion of a (99m)Tc-tin colloid mixture. Dynamic images to detect gastroesophageal reflux were obtained for 1 hour. Additional static images of the chest, to detect lung aspiration, were obtained at 6 and 24 hours after oral ingestion of the tin colloid. In addition to visual analysis, pulmonary aspiration was quantitated by counting the number of pixels labeled with radioactive isotope in the region of interest (ROI) of both lung fields. Aspiration index (AI) was obtained by subtracting the pixel counts of the background from the pixel counts of the ROI. RESULTS: Among 35 patients with suspected aspiration pneumonia, 23 proved to have gastroesophageal reflux by scintigraphy. One patient showed definite pulmonary accumulation of activity by visual analysis of the 6-hour image. Thirty of 35 (85.7%) patients showed higher AI beyond the upper limit of AI in the healthy controls. When we compared the reflux group with the non-reflux group, there was a significantly higher AI at 6 hours in the reflux group (p<0.05). CONCLUSION: The results suggest that radionuclide scintigraphy is useful in detecting small pulmonary aspiration in patients with suspected aspiration pneumonia secondary to reflux.
