From the Departments of Physical Medicine & Rehabilitation (Y-HH, S-CC, M-SL, M-CW), Nuclear Medicine (P-FK), and Urology (S-LC), Chung Shan Medical University Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan (Y-HH, P-FK, S-LC); and Department of Neurology, Cheng Ching Hospital, Taichung, Taiwan (T-HC).
Am J Phys Med Rehabil. 2013 Dec;92(12):1075-83. doi: 10.1097/PHM.0b013e31829e77e3.
The aim of this study was to evaluate the correlation between scintigraphy and videofluoroscopy (VFS) in swallowing evaluation and the ability of scintigraphy to predict penetration/aspiration in VFS.
This is a case-control study enrolling 50 patients with dysphagia who received scintigraphy and VFS and 18 age-matched control subjects who received scintigraphy alone. Three parameters were compared between scintigraphy and VFS: premature pharyngeal entry, pharyngeal transit time, and postswallow pharyngeal stasis, with cutoff values defining dysfunction of 3% or greater, 1.2 secs or longer, and 9% or greater, respectively.
The correlation coefficients were fair to good between scintigraphy and VFS (r = 0.678, 0.837, and 0.721 for premature pharyngeal entry, pharyngeal transit time, and postswallow pharyngeal stasis, respectively, P < 0.05). The scintigraphy parameters also had good predictive value for the VFS findings, with sensitivity, specificity, positive predictive values, and negative predictive values between 70% and 95%. Scintigraphy had good sensitivity in detecting 91% of aspirations and 81% of penetrations and/or aspirations in VFS if one of the three parameters was abnormal; however, the specificities were low (46% and 52% for scintigraphy and VFS, respectively).
The measurements of premature pharyngeal entry, pharyngeal transit time, and postswallow pharyngeal stasis by scintigraphy were correlated with those of VFS. Scintigraphy also had good sensitivity in detecting penetration and/or aspiration in VFS.
本研究旨在评估吞咽评估中闪烁扫描与视频透视（VFS）之间的相关性，以及闪烁扫描预测 VFS 中渗透/吸入的能力。
这是一项病例对照研究，纳入了 50 例接受闪烁扫描和 VFS 的吞咽困难患者和 18 例仅接受闪烁扫描的年龄匹配对照者。在闪烁扫描和 VFS 之间比较了三个参数：过早的咽入口、咽通过时间和吞咽后咽停滞，分别定义为 3%或更大、1.2 秒或更长以及 9%或更大的功能障碍的截止值。
闪烁扫描和 VFS 之间的相关系数为中等至良好（过早的咽入口、咽通过时间和吞咽后咽停滞的相关系数分别为 0.678、0.837 和 0.721，P<0.05）。闪烁扫描参数对 VFS 结果也具有良好的预测价值，灵敏度、特异性、阳性预测值和阴性预测值在 70%至 95%之间。如果三个参数中的一个异常，闪烁扫描在检测 91%的吸入和 81%的 VFS 渗透/吸入方面具有良好的灵敏度；然而，特异性较低（闪烁扫描和 VFS 的特异性分别为 46%和 52%）。
闪烁扫描测量的过早的咽入口、咽通过时间和吞咽后咽停滞与 VFS 的测量值相关。闪烁扫描在检测 VFS 中的渗透/吸入方面也具有良好的灵敏度。
