Scintigraphic monitoring of mucociliary tracheo-bronchial clearance of technetium-99m macroaggregated albumin aerosol

A simple method for in vivo monitoring mucociliary tracheo-bronchial clearance is described. Eighteen healthy subjects and 13 patients with various chronic lung diseases were studied by this method. The principle of using an aerosol administration system similar to the system used for routine ventilation lung studies is stressed. Proximal large airway deposition of the radioaerosol was obtained by using relatively large particles (average diameter 2 μM) of [^99mTc]MAA aerosol. Monitoring was performed by visual inspection of the tracheo-bronchial cinescintigraphic ascendence of the accumulated radioactive boli and by assessing their rate of clearance via automated computer analysis of the time-activity curves, following the movement of each bolus. The normal mean ± s.d. clearance rate thus obtained was 4.7 ± 1.3 mm/min. This rate appears to be more precise as compared with the range of results obtained by other radioisotopic methods. Significantly faster rates, mean 8.2 ± 1.4 mm/min (p < 0.001) were obtained in bronchiectatic patients while slower rates (2.8 mm/min) were seen in a patient with ciliary dyskinesia.