Alexei Volkov
Plastic foreign bodies can be challenging to detect and localize, and the visibility of plastic on CT scans varies depending on its composition and location in the body. While some plastics may be occult on CT scans, others can be visualized using different imaging modalities such as conventional radiography, ultrasound, and magnetic resonance imaging. The detection of plastic foreign bodies is crucial, especially in cases of dentoalveolar trauma and pharyngeal obstructions, as they can cause bowel perforations or gastrointestinal hemorrhage if left untreated.
| Characteristics | Values |
|---|---|
| Visibility on CT scans | Variable, depending on composition and location |
| Visibility on conventional radiography | Variable, depending on composition and location |
| Visibility on ultrasound | All types of plastic are well visualised |
| Visibility on magnetic resonance imaging | Not well visualised |
| Visibility on cone-beam computed tomography (CBCT) | Not detected in sinus area; visibility depends on location and size |
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What You'll Learn
Plastic foreign bodies in the pharynx
Foreign bodies in the pharynx are a common occurrence in children, who often put small objects in their mouths while playing. Adults can also experience this, especially in working conditions where safety measures are not adhered to. Foreign bodies in the pharynx can be of animal, plant, or inorganic origin. Inorganic bodies include plastic, metal, glass, stone, wood, graphite, and teeth.
The visibility of plastic on CT scans varies depending on the composition of the plastic. Plastic foreign bodies as small as 0.5 mm in size were not detected on NewTom images in one study. However, another study found that all types of plastic were well-visualized on ultrasound. Therefore, the imaging technique used to detect a foreign body depends on the physics of imaging and the characteristics of the foreign body, such as its material, size, and location.
If a plastic foreign body is detected in the pharynx, it is important to seek medical help immediately and not attempt to remove the object yourself. In most cases, the object can be removed without difficulty by an ENT doctor. After removal, the walls of the larynx are irrigated with an antiseptic to prevent infection. If the object is deep, surgical intervention may be required under local anaesthesia.
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Plastic visibility in CT scans
The visibility of plastic in CT scans varies depending on its composition and location in the body. Some studies have found that plastic foreign bodies can be detected using CT scans, while others have found that certain plastics may be occult on CT scans and are better visualised using ultrasound or cone-beam computed tomography (CBCT).
In one study, plastic foreign bodies with dimensions of 1x1x1 mm and 2x2x2 mm were implanted in a sheep's head in various locations, including the tongue muscle, nasal cavity, and at the interface of the mandibular cortex and soft tissue. The visibility of the plastic particles was assessed by four skilled maxillofacial radiologists who reviewed CBCT and spiral CT scans. The results suggested that the plastic particles were visible on the CT scans, although the effect of the location of the foreign bodies on their visibility was not analysed in detail.
Another study compared the detection of plastic foreign bodies in the maxillofacial region using conventional CT scans and CBCT. The plastic foreign bodies, with dimensions of approximately 2 mm, 1 mm, and 0.5 mm, were placed in a sheep head between the corpus of the mandible and muscle, in the tongue, and in an air space. The results showed that plastic was not detected on NewTom images, regardless of size. However, the study also noted that the imaging technique used for foreign body detection depends on the physics of imaging and the characteristics of the foreign body, such as its material, size, and location.
A separate study investigated the visibility of plastic foreign bodies in the pharynx using CT scans. The results suggested that pharyngeal foreign bodies may sometimes be invisible on CT scans, and it is important to use endoscopy when necessary for a more comprehensive evaluation.
Ultrasound imaging has also been found to be effective in detecting plastic foreign bodies. In a study using a cadaveric calf thigh specimen, ultrasound images revealed hyperechoic plastic objects with marked clean distal acoustic shadowing. Irregularly shaped plastic appeared as a hyperechoic irregular structure with dirty distal shadowing.
Overall, while CT scans can detect plastic foreign bodies in some cases, the visibility of plastic on CT scans is variable and depends on various factors such as the composition of the plastic, its location in the body, and the specific imaging technique used. In some cases, other imaging modalities such as ultrasound or CBCT may be more effective in visualising plastic foreign bodies.
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Plastic bread clips
If you suspect that you have ingested a plastic bread clip, it is important to obtain a CT scan of the neck and a lung window image. However, do not rely solely on a CT scan, as endoscopy may also be necessary to detect foreign bodies in the pharynx due to the difficulty in distinguishing the lumen of the pharynx from the surrounding tissues.
In conclusion, while plastic bread clips are made of plastic, which can sometimes be visualised on CT scans, the effectiveness of detection depends on various factors, and other medical procedures may be necessary to detect and locate the foreign body.
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Ultrasound for plastic detection
Plastic does not always show up on CT scans. The visibility of plastic on CT scans varies depending on its composition. However, plastic catheters, tubes, and prostheses inserted into the body for medical reasons can be detected through ultrasound.
Ultrasound is a useful imaging technique for detecting foreign bodies in human tissue. It has been used to detect shrapnel and soft-tissue foreign bodies. Ultrasound can also be used to detect foreign bodies ingested by children.
Ultrasound is a good method for detecting plastic in the body. The different plastic catheters and tubes appear as parallel echogenic lines if scanned longitudinally or as echogenic dots if scanned transversely. The flexibility and mobility of modern ultrasound scanners allow for the examination of sick patients with minimal disturbance.
Ultrasound is also useful in screening for superficial foreign bodies in human tissue. However, it may not be suitable for all situations, and its clinical utility in the ED setting remains to be tested.
In addition to ultrasound, other imaging techniques used for foreign body detection include plain radiography, xeroradiography, computed tomography (CT) scans, magnetic resonance imaging (MRI), and ultrasonography.
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Plastic in the maxillofacial area
A study comparing conventional CT scans and cone-beam computed tomography (CBCT) scans found that plastic foreign bodies measuring 0.5 mm, 1 mm, and 2 mm were not detected on NewTom CBCT images. This suggests that the size and type of plastic object can impact its visibility on CT scans. Additionally, the location of the plastic object within the maxillofacial area may also affect its detectability. For example, plastic objects in the sinus area may be more difficult to visualise due to their low density.
While CT scans are valuable tools for evaluating bony structures and soft tissue masses in the maxillofacial region, they may have limitations in detecting certain materials, such as plastic. In such cases, other imaging techniques, such as ultrasound or magnetic resonance imaging (MRI), may be more effective in visualising plastic foreign bodies. Ultrasound, in particular, has been found to provide better visualisation of plastic objects compared to CT scans.
It is important to note that advancements in CT technology have led to the development of "cone beam" CT scans, which expose patients to significantly lower radiation doses than conventional CT scans. These newer CT scanners use three-dimensional scanning techniques, providing more detailed information for accurate diagnoses and treatment plans.
In summary, while CT scans are commonly used to detect foreign bodies in the maxillofacial area, plastics may pose a challenge due to their low density and composition. The size, location, and type of plastic object can impact its visibility on CT scans. Therefore, it is crucial to consider the limitations of CT scans and utilise other imaging techniques when necessary to ensure accurate detection and diagnosis.
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Frequently asked questions
It depends on the type of plastic and the location of the scan. Some plastics may be occult on CT scans, while others can be detected with the help of ultrasound.
Plastic bread clips, for example, are challenging to detect as they are invisible on both plain radiography and CT scans.
Ultrasound examination is often used to detect plastic foreign bodies as they appear as hyperechoic curvilinear shapes with clean distal shadowing.
Yes, other imaging techniques used to detect foreign bodies include plain radiography, xeroradiography, magnetic resonance imaging (MRI), and ultrasonography.
