Pulmonary aspiration studied by radionuclide milk scanning and barium swallow roentgenography
P. McVeagh, R. Howman-Giles and A. Kemp
We have examined the use of radionuclide milk scanning to detect aspiration
and have compared the clinical features of patients with demonstrated
aspiration with those of patients in whom aspiration was not demonstrated.
One hundred twenty children underwent radionuclide milk scanning for three
different clinical indications, namely, respiratory tract symptoms (n =
56), gastroesophageal (GO) reflux (n = 20), and near-miss sudden infant
death syndrome (SIDS) (n = 44). Ninety-eight (82%) of the 120 patients had
a GO reflux demonstrated on the radionuclide milk scan. The incidence of
aspiration was high in the respiratory (23%) and near-miss SIDS groups
(20%) but low in the GO reflux group (5%). Only four of the 19 patients
with an aspiration-positive scan had an aspiration-positive barium swallow
film. The clinical symptoms and signs of those patients with
aspiration-positive results were not significantly different from those of
patients in whom aspiration was not demonstrated. We conclude that
radionuclide milk scanning is more sensitive than barium swallow
roentgenography in detecting aspiration; however, the clinical significance
of such aspiration is undetermined. In view of the high incidence of GO
reflux demonstrated in the absence of aspiration by the use of radionuclide
milk scanning, the sole finding of GO reflux in a child with respiratory
tract symptoms should not be taken as presumptive evidence that aspiration
is contributing to those symptoms.
