Editing Choking (section)

=== Imaging and visualization methods ===
[[File:Diagram_showing_a_bronchoscopy_CRUK_053.svg|thumb|Use of bronchoscopy to visualize the respiratory tract.]]

; Bronchoscopy
: According to the American Heart Association, [[bronchoscopy]] is a reliable method used to visualize the cause of choking when not resolved via oxygen and supportive care.<ref name=":92" /> Bronchoscopy also is a crucial tool in foreign body removal after supportive care has been provided and the person who is choking is stable.<ref name=":3">{{Citation |last1=Mahmoud |first1=Naser |title=Bronchoscopy |date=2023 |url=http://www.ncbi.nlm.nih.gov/books/NBK448152/ |work=StatPearls |access-date=2023-11-17 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=28846283 |last2=Vashisht |first2=Rishik |last3=Sanghavi |first3=Devang K. |last4=Kalanjeri |first4=Satish}}</ref> However, bronchoscopy is an invasive form of imaging and intervention in comparison to the below diagnostic tools, and requires sedation to perform.<ref name=":3" />
; X-ray
: An [[X-ray]] uses high-frequency electromagnetic radiation to visualize the human body. In the case of choking, a chest X-ray is obtained to visualize the lungs and upper airway. However, many objects do not show up on X-ray ([[Radiodensity|radiolucent]]).<ref>{{Cite journal |last1=Mu |first1=Liancai |last2=Sun |first2=Deqiang |last3=He |first3=Ping |date=October 1990 |title=Radiological diagnosis of aspirated foreign bodies in children: Review of 343 cases |url=http://dx.doi.org/10.1017/s0022215100113891 |journal=The Journal of Laryngology & Otology |volume=104 |issue=10 |pages=778–782 |doi=10.1017/s0022215100113891 |issn=0022-2151 |pmid=2246577 |s2cid=36021333}}</ref> About 10% objects are radio-opaque and can be visualized using X-ray. X-rays are more accessible than other imaging modalities but expose a person to radiation. In cases where X-ray is inconclusive, [[fluoroscopy]] may be able to demonstrate radiolucent or smaller foreign bodies.<ref>{{Cite journal |last1=Tan |first1=Henry K.K. |last2=Brown |first2=Karla |last3=McGill |first3=Trevor |last4=Kenna |first4=Margaret A. |last5=Lund |first5=Dennis P. |last6=Healy |first6=Gerald B. |date=December 2000 |title=Airway foreign bodies (FB): a 10-year review |url=http://dx.doi.org/10.1016/s0165-5876(00)00391-8 |journal=International Journal of Pediatric Otorhinolaryngology |volume=56 |issue=2 |pages=91–99 |doi=10.1016/s0165-5876(00)00391-8 |issn=0165-5876 |pmid=11115682}}</ref> Chest fluoroscopy is a real-time X-ray image (sometimes referred to as an X-ray movie) to view breathing and coughing.<ref>{{Cite web |date=2019-08-14 |title=Chest Fluoroscopy |url=https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/chest-fluoroscopy |access-date=2022-09-16 |website=www.hopkinsmedicine.org |language=en}}</ref>
; Computerized tomography (CT)
: A [[CT scan]] uses a tube with multiple X-ray machines to build a 3D image from 2D X-ray images of multiple cross-sections. Radiolucent objects can be better captured on CT than X-ray.<ref>{{Cite journal |last1=Gibbons |first1=Alexander T. |last2=Casar Berazaluce |first2=Alejandra M. |last3=Hanke |first3=Rachel E. |last4=McNinch |first4=Neil L. |last5=Person |first5=Allison |last6=Mehlman |first6=Tracey |last7=Rubin |first7=Michael |last8=Ponsky |first8=Todd A. |date=January 2020 |title=Avoiding unnecessary bronchoscopy in children with suspected foreign body aspiration using computed tomography |url=http://dx.doi.org/10.1016/j.jpedsurg.2019.09.045 |journal=Journal of Pediatric Surgery |volume=55 |issue=1 |pages=176–181 |doi=10.1016/j.jpedsurg.2019.09.045 |issn=0022-3468 |pmid=31706607 |s2cid=207966218}}</ref> Additionally, modern imaging analysis software allows for airway reconstruction following a chest CT, creating a model of the airway network in the lungs that can better visualize the exast location of a foreign body.<ref>{{cite journal | pmc=9939907 | date=2023 | last1=Wang | first1=M. L. | last2=Png | first2=L. H. | last3=Ma | first3=J. | last4=Lin | first4=K. | last5=Sun | first5=M. H. | last6=Chen | first6=Y. J. | last7=Tang | first7=X. C. | last8=Bi | first8=X. Y. | last9=Gao | first9=Y. Q. | last10=Zhang | first10=T. S. | title=The Role of CT Scan in Pediatric Airway Foreign Bodies | journal=International Journal of General Medicine | volume=16 | pages=547–555 | doi=10.2147/IJGM.S398727 | doi-access=free | pmid=36814890 }}</ref> Since a CT is multiple X-rays, the exposure to radiation is significantly greater.
; Magnetic resonance imaging (MRI)
: An [[Magnetic resonance imaging|MRI]] scan uses radio-frequency pulse under a magnetic field to create a high-resolution image of the body. MRIs can detect foreign bodies with higher accuracy than X-ray or CT.<ref>{{Cite journal |last1=Laya |first1=Bernard F. |last2=Restrepo |first2=Ricardo |last3=Lee |first3=Edward Y. |date=July 2017 |title=Practical Imaging Evaluation of Foreign Bodies in Children: An Update |url=https://pubmed.ncbi.nlm.nih.gov/28601182 |journal=Radiologic Clinics of North America |volume=55 |issue=4 |pages=845–867 |doi=10.1016/j.rcl.2017.02.012 |issn=1557-8275 |pmid=28601182}}</ref> MRI does not expose the person to radiation. Drawbacks of MRI include claustrophobia and high cost.<ref>{{Cite journal |last1=Nguyen |first1=Xuan V. |last2=Tahir |first2=Sana |last3=Bresnahan |first3=Brian W. |last4=Andre |first4=Jalal B. |last5=Lang |first5=Elvira V. |last6=Mossa-Basha |first6=Mahmud |last7=Mayr |first7=Nina A. |last8=Bourekas |first8=Eric C. |date=June 2020 |title=Prevalence and Financial Impact of Claustrophobia, Anxiety, Patient Motion, and Other Patient Events in Magnetic Resonance Imaging |url=https://journals.lww.com/10.1097/RMR.0000000000000243 |journal=Topics in Magnetic Resonance Imaging |language=en |volume=29 |issue=3 |pages=125–130 |doi=10.1097/RMR.0000000000000243 |issn=0899-3459 |pmid=32568974 |s2cid=219987072}}</ref> For children, sedation may be required to undergo MRI imaging, which is an increased risk when the airway is already potentially compromised.