Detection of Aspiration: Scintigraphic Techniques

Abstract

Dynamic scintigraphy of a milk/technetium-99m sulphur colloid mixture or other radionuclidelabeled meal is a simple technique for demonstrating gastroesophageal reflux and/or aspiration. Since gastroesophageal reflux occurs intermittently and often is not associated with aspiration, the ability to monitor patients for long periods of time is a distinct advantage of the radionuclide technique. The technique is noninvasive, and no maneuvers are employed in an attempt to reduce reflux and/or aspiration. Therefore, the radionuclide method should be viewed as being physiologic. In pediatric populations, radionuclide studies performed in patients undergoing evaluation for pulmonary aspiration occurring both during swallowing (antegrade) or at the time of gastroesophageal reflux (retrograde) are well documented. Results, however, vary greatly from one institution to another, and the clinical utility of the examination in some pediatric populations has been questioned. Although favorable, only more preliminary results on both antegrade and retrograde aspiration in adult populations have been reported.