Clinical Study and Diagnostic Value of the Lung Perfusion Scan in Foreign Body Aspiration

ABSTRACT

PURPOSE: Early diagnosis of foreign body aspiration and removal of the inhaled material may save the patient from chronic illness and may prevent serious complications. At present the diagnostic problems of bronchial foreign bodies are being solved by using the lung scanning technique. Therefore, we investigated the clinical study and diagnositic value of the lung perfusion scan in foreign body aspiration. METHODS: Eighteen cases of airway obstruction due to foreign bodies were treated in the department of pediatrics, Kyung Hee University Hospital. We retrospectively, reviewed patient records to determine the clinical findings, radiologic findings, and findings of the perfusion lung scan. RESULTS: Fifteen cases (83.2%) out of 18 were less than 2 years of age, and the male to female ratio was 1.3:1. Vegetables, especially peanuts were the most common aspirated foreign bodies, and accounted for 72.2% of the cases. Of all foreign body obstructions, 61% were lodged in the main bronchi and there was no significant difference between the right and left main bronchus. In radiologic findings, obstructive emphysema (50%) was most common, followed by atelectasis (33%), mediastinal shifting (23.3%) and pneumonia (22.2%), respectively. There were more severe defects and a higher incidence of abnormalities in cases with prolonged periods after inhalation than that of shorter duration cases. CONCLUSION: Lung perfusion scanning is useful in the diagnosis of foreign body aspiration which presents a vague history of aspiration, insufficient clinical manifestation and normal chest radiologic findings. Our results show that perfusion scan can be helpful particularly in cases of long duration foreign body obstruction.