ABSTRACT
Objective To investigate the value of salivagram in the diagnosis of pediatric pulmonary aspiration.Methods A total of 469 pediatric patients (age:6 weeks-16 years,average age (4.5±3.1) years;229 males,240 females) underwent salivagram.Signed informed consents were obtained.99Tcm-SC (11.1 MBq,100 μl) was dropped into the root of tongue.After the dropping,the posterior dynamic acquisition was started for 60 min,and then the anterior and posterior static images were acquired for 5 min.All patients were followed up for 3-6 months after the salivagram,and the salivagram results were analyzed.If radioactivity was shown in the main bronchus or bilateral lung fields,the pulmonary aspiration was diagnosed.Results Salivagram demonstrated positive results in 20.7％ (97/469) of the patients.However,3 patients with pulmonary aspiration showed negative results.There was no false positive result on salivagram.Conclusion Salivagram shows good results in the diagnosis of pediatric pulmonary aspiration.
ABSTRACT
BACKGROUND AND PURPOSE: PET scanning with fluorodeoxyglucose (FDG-PET) is a non-invasive method that measures regional glucose metabolic rate. Phenylalanine (Phe) and its metabolites appear to impair several aspects of brain energy metabolism. 1) To evaluate brain glucose metabolism with FDG-PET imaging in phenylketonuria (PKU) patients before and 4 months after sapropterin therapy; 2) to evaluate neurodevelopmental changes, blood Phe levels and dietary Phe tolerance before and after sapropterin therapy; 3) to generate pilot data to assess the feasibility of evaluating brain glucose metabolism with FDG-PET imaging and to explore potential trends resulting from the administration of sapropterin therapy. METHODS: We enrolled 5 subjects, ranged in age from 22 years to 51 years, with PKU. Subjects underwent FDG-PET brain imaging, blood tests for Phe and tyrosine levels, and neurocognitive evaluations before and 4 months after sapropterin therapy (20 mg/kg/day). All subjects' Phe and tyrosine levels were monitored once a week during the study. Subjects kept 3 day diet records that allow calculation of Phe intake. RESULTS: None of the subjects responded to sapropterin therapy based on 30% decrease in blood Phe level. The data show that glucose metabolism appeared depressed in the cerebellum and left parietal cortex while it was increased in the frontal and anterior cingulate cortices in all five subjects. In response to sapropterin therapy, relative glucose metabolism showed significant increases in left Broca's and right superior lateral temporal cortices. Interestingly, there was corresponding enhanced performance in a phonemic fluency test performed during pre- and postneurocognitive evaluation. CONCLUSIONS: Further studies with a larger sample size are needed to confirm the above changes in both sapropterin non-responsive and responsive PKU patients.