Comparison between the radionuclide salivagram and videofluoroscopic swallowing study methods for evaluating patients with aspiration pneumonia.

Abstract

OBJECTIVE:

A videofluoroscopic swallowing study (VFSS) is generally used to assess dysphagia and aspiration, although false-negative results may be obtained. Saliva aspiration may cause false-negative VFSS findings in elderly people. A radionuclide salivagram can be useful in detecting saliva aspiration. We therefore compared these two methods for the evaluation of patients with aspiration pneumonia.

METHODS:

We prospectively enrolled 50 patients with aspiration pneumonia into this study. All patients underwent VFSS, and were evaluated on the Penetration-Aspiration Scale. A salivagram was performed on the day after VFSS and each patient received 1 mL Tc-99 m DTPA sublingually. Both dynamic and delayed images were obtained.

RESULTS:

Aspiration was observed in 34% of patients by salivagram and in 42% by VFSS. The frequency of tests that were positive for aspiration pneumonia using a combination of the two methods was 52%. Five patients with positive aspiration findings on salivagram were negative on VFSS. The association between VFSS and salivagram findings was significant but the total agreement was 72%. The frequency of aspiration pneumonia was significantly associated with an abnormal salivagram finding.

CONCLUSIONS:

A salivagram may be a useful method for the evaluation of aspiration in elderly people, and a combination of the VFSS and salivagram methods could enable a more effective investigation of aspiration pneumonia.

• Authors: Dae-Hyun Jang, Kyoung Hyo Choi, Dae Ha Kim, Chae-Man Lim, Jae Seung Kim
• Journal: Annals of nuclear medicine (Ann Nucl Med) Vol. 27 Issue 3 Pg. 247-52 (Apr 2013) ISSN: 1864-6433 [Electronic] Japan
• PMID: 23283641 (Publication Type: Clinical Trial, Comparative Study, Journal Article)

Topics

• Aged
• Cineradiography (methods)
• Deglutition
• Female
• Humans
• Male
• Pneumonia, Aspiration (diagnosis, diagnostic imaging, physiopathology)
• Radionuclide Imaging (methods)
• Saliva (diagnostic imaging, metabolism)