Detection of pharyngeal perforation: comparison of aqueous and barium-containing contrast agents.
OBJECTIVE
We sought to assess the value of aqueous and barium-containing contrast agents in the detection of pharyngeal perforation.


METHODS
Visual and objective in vitro comparisons of an iodinated aqueous contrast agent, a 50% weight/volume barium suspension, and a 100% weight/volume barium suspension were performed. Moreover, to exclude pharyngeal perforation after surgery, we prospectively examined 109 patients by pharyngography, using the aqueous contrast agent and the 100% weight/volume barium suspension. All patients with a pharyngeal perforation were followed up clinically to exclude complications due to barium application.


RESULTS
As opposed to the 100% weight/volume barium suspension, in vitro comparison between the aqueous contrast agent and the 50% weight/volume barium suspension yielded no substantial differences. Seventeen perforations could be detected with the aqueous contrast agent. Although 10 of 17 perforations could be slightly better visualized with the 100% weight/volume barium suspension, two perforations were missed with this agent. Five perforations were equally well detected with both.


CONCLUSIONS
Because of a higher radiopacity, 100% weight/volume barium suspensions may more sharply delineate perforations. However, in contrast to aqueous contrast media, narrow pharyngeal perforations can be missed. Thus, the use of a 100% weight/volume barium suspension does not improve the detection of pharyngeal perforation.
Keberle
M
M
Department of Radiology, University of Würzburg, Josef-Schneider-Str. 2, D-97080 Würzburg, Germany.
Wittenberg
G
G
Trusen
A
A
Hoppe
F
F
Hahn
D
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001466:Barium Sulfate; D003287:Contrast Media / Q000145:classification; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D006801:Humans; D007483:Iothalamic Acid / Q000031:analogs & derivatives*; D008297:Male; D008875:Middle Aged; D019047:Phantoms, Imaging; D010611:Pharyngectomy / Q000009:adverse effects; D010614:Pharynx / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D011856:Radiographic Image Enhancement / Q000379:methods*; D012449:Safety; D014867:Water
D003287:Contrast Media; D014867:Water; D007483:Iothalamic Acid; D001466:Barium Sulfate; C002587:ioxitalamic acid