1
|
Alnaimat S, Nasr LA, Biederman RWW. Novel use of dynamic MR hydrography to rule out esophageal perforation post atrial fibrillation ablation in a patient with anaphylaxis to gadolinium. Magn Reson Imaging 2024; 109:96-99. [PMID: 38467266 DOI: 10.1016/j.mri.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/04/2024] [Accepted: 03/07/2024] [Indexed: 03/13/2024]
Abstract
Esophageal thermal injury is one of the most devastating complications of atrial radiofrequency ablation, and its diagnosis can be challenging. In this report, we highlight the novel use of free water as a contrast material to better visualize the esophageal lumen in a patient with anaphylaxis to Iodinated contrast media and Gadolinium who recently underwent atrial fibrillation ablation. This becomes particularly handy in patients with contrast allergy, and further emphasizes the role of multimodality imaging.
Collapse
Affiliation(s)
- Saed Alnaimat
- Allegheny General Hospital, Center of Cardiac MRI, 320 E North Ave, Pittsburgh, PA 15212, United States of America.
| | - Layla A Nasr
- Allegheny General Hospital, Department of Radiology, 320 E North Ave, Pittsburgh, PA 15212, United States of America
| | - Robert W W Biederman
- West Virginia University School of Medicine, 64 Medical Center Dr, Morgantown, WV 26506, United States of America; Carnegie Mellon University, Bioengineering Department, 5000 Forbes Ave, Pittsburgh, PA 15213, United States of America; Medical University of South Carolina and Roper/SF Hospital, 268 Calhoun St, Charleston, SC 29425, United States of America
| |
Collapse
|
2
|
Halder S, Johnson EM, Yamasaki J, Kahrilas PJ, Markl M, Pandolfino JE, Patankar NA. MRI-MECH: mechanics-informed MRI to estimate esophageal health. Front Physiol 2023; 14:1195067. [PMID: 37362445 PMCID: PMC10289887 DOI: 10.3389/fphys.2023.1195067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 05/23/2023] [Indexed: 06/28/2023] Open
Abstract
Dynamic magnetic resonance imaging (MRI) is a popular medical imaging technique that generates image sequences of the flow of a contrast material inside tissues and organs. However, its application to imaging bolus movement through the esophagus has only been demonstrated in few feasibility studies and is relatively unexplored. In this work, we present a computational framework called mechanics-informed MRI (MRI-MECH) that enhances that capability, thereby increasing the applicability of dynamic MRI for diagnosing esophageal disorders. Pineapple juice was used as the swallowed contrast material for the dynamic MRI, and the MRI image sequence was used as input to the MRI-MECH. The MRI-MECH modeled the esophagus as a flexible one-dimensional tube, and the elastic tube walls followed a linear tube law. Flow through the esophagus was governed by one-dimensional mass and momentum conservation equations. These equations were solved using a physics-informed neural network. The physics-informed neural network minimized the difference between the measurements from the MRI and model predictions and ensured that the physics of the fluid flow problem was always followed. MRI-MECH calculated the fluid velocity and pressure during esophageal transit and estimated the mechanical health of the esophagus by calculating wall stiffness and active relaxation. Additionally, MRI-MECH predicted missing information about the lower esophageal sphincter during the emptying process, demonstrating its applicability to scenarios with missing data or poor image resolution. In addition to potentially improving clinical decisions based on quantitative estimates of the mechanical health of the esophagus, MRI-MECH can also be adapted for application to other medical imaging modalities to enhance their functionality.
Collapse
Affiliation(s)
- Sourav Halder
- Theoretical and Applied Mechanics Program, McCormick School of Engineering, Northwestern University, Evanston, IL, United States
| | - Ethan M Johnson
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Jun Yamasaki
- Department of Mechanical Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL, United States
| | - Peter J Kahrilas
- Department of Medicine, Feinberg School of Medicine, Division of Gastroenterology and Hepatology, Northwestern University, Chicago, IL, United States
| | - Michael Markl
- Department of Mechanical Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL, United States
| | - John E Pandolfino
- Department of Medicine, Feinberg School of Medicine, Division of Gastroenterology and Hepatology, Northwestern University, Chicago, IL, United States
| | - Neelesh A Patankar
- Theoretical and Applied Mechanics Program, McCormick School of Engineering, Northwestern University, Evanston, IL, United States
- Department of Mechanical Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL, United States
| |
Collapse
|
3
|
Biggemann L, Uhlig J, Gliem N, Al-Bourini O, Wedi E, Ellenrieder V, Ghadimi M, Uecker M, Frahm J, Lotz J, Hosseini ASA, Streit U. Assessment of esophagogastric junction morphology by dynamic real-time MRI: comparison of imaging features to high-resolution manometry. Jpn J Radiol 2021; 40:376-384. [PMID: 34874494 PMCID: PMC8977262 DOI: 10.1007/s11604-021-01210-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 10/11/2021] [Indexed: 11/30/2022]
Abstract
Purpose To assess the esophagogastric junction (EGJ) on real-time MRI and compare imaging parameters to EGJ morphology on high-resolution manometry (HRM). Methods A total of 105 of 117 eligible patients who underwent real-time MRI and high-resolution manometry for GERD-like symptoms between 2015 and 2018 at a single center were retrospectively evaluated (male n = 57; female n = 48; mean age 52.5 ± 15.4 years). Real-time MRI was performed at a median investigation time of 15 min (1 frame/40 ms). On HRM, EGJ morphology was assessed according to the Chicago classification of esophageal motility disorders. Real-time MRI was performed at 3 T using highly undersampled radial fast low-angle shot acquisitions with NLINV image reconstruction. A 10 mL pineapple juice bolus served as oral contrast agent at supine position. Real-time MRI films of the EGJ were acquired during swallowing events and during Valsalva maneuver. Anatomic and functional MRI parameters were compared to EGJ morphology on HRM. Results On HRM, n = 42 patients presented with EGJ type I (40.0%), n = 33 with EGJ type II (31.4%), and n = 30 with EGJ type III (28.6%). On real-time MRI, hiatal hernia was more common in patients with EGJ type III (66.7%) than in patients with EGJ type I (26.2%) and EGJ type II (30.3%; p < 0.001). Sliding hiatal hernia was more frequent in patients with EGJ type II (33.3%) than in patients with EGJ type III (16.7%) and EGJ type I (7.1%; p = 0.017). The mean esophagus–fundus angle of patients was 85 ± 31° at rest and increased to 101 ± 36° during Valsalva maneuver. Conclusion Real-time MRI is a non-invasive imaging method for assessment of the esophagogastric junction. Real-time MRI can visualize dynamic changes of the EGJ during swallowing events. Supplementary Information The online version contains supplementary material available at 10.1007/s11604-021-01210-9.
Collapse
Affiliation(s)
- Lorenz Biggemann
- Department of Diagnostic and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany.
| | - Johannes Uhlig
- Department of Diagnostic and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany
| | - Nina Gliem
- Department of Gastroenterology and Gastrointestinal Oncology, University Medical Center Göttingen, Göttingen, Germany
| | - Omar Al-Bourini
- Department of Diagnostic and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany
| | - Edris Wedi
- Department of Gastroenterology and Gastrointestinal Oncology, University Medical Center Göttingen, Göttingen, Germany
| | - Volker Ellenrieder
- Department of Gastroenterology and Gastrointestinal Oncology, University Medical Center Göttingen, Göttingen, Germany
| | - Michael Ghadimi
- Department of General, Visceral, and Paediatric Surgery, University Medical Center, Göttingen, Germany
| | - Martin Uecker
- Department of Diagnostic and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany
| | - Jens Frahm
- Biomedical NMR, Max-Planck-Institute for Biophysical Chemistry, Göttingen, Germany
| | - Joachim Lotz
- Department of Diagnostic and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany
| | - Ali Seif Amir Hosseini
- Department of Diagnostic and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany
| | - Ulrike Streit
- Department of Diagnostic and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany
| |
Collapse
|
4
|
Abstract
Esophageal cancer is the sixth most common cause of cancer related mortality worldwide. Advances in treatment have translated into steadily improving survival rates. Accurate preoperative staging of esophageal cancer is imperative in order to provide an accurate prognosis and direct patients to the most appropriate treatment. Current preoperative staging relies on imaging, most commonly endoscopic ultrasound (EUS), computed tomography (CT) and positron emission tomography (PET). A combination of these modalities should be used in preoperative staging, as each has advantages over another. Magnetic resonance imaging (MRI) has always shown promise in its ability to accurately stage esophageal cancer, though it has not been consistently adopted as a common tool for this purpose. Recent research has demonstrated that MRI can become an integral part of esophageal cancer clinical staging. Advances in MR technology that utilize radial sampling allow for shorter, free breathing techniques without degradation of image quality, resulting in improved capability for T and N staging of esophageal cancer. MRI enhanced with superparamagnetic iron oxide (SPIO) and ultrasmall SPIO (USPIO) nanoparticles has been shown to be useful for the detection of metastatic disease in lymph nodes. This article will review the current evidence in the role that imaging plays in staging esophageal cancer.
Collapse
Affiliation(s)
- Eric J Schmidlin
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ritu R Gill
- Department of Radiology, Beth Israel Deaconness Medical Center, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
5
|
Biggemann L, Uhlig J, Gliem N, Al-Bourini O, Wedi E, Ellenrieder V, Ghadimi M, Uecker M, Frahm J, Lotz J, Hosseini ASA, Streit U. Assessment of esophageal motility disorders by real-time MRI. Eur J Radiol 2020; 132:109265. [PMID: 33010683 DOI: 10.1016/j.ejrad.2020.109265] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 07/08/2020] [Accepted: 08/10/2020] [Indexed: 12/25/2022]
Abstract
PURPOSE To investigate imaging findings of esophageal motility disorders on dynamic real-time. MATERIAL AND METHODS 102 patients with GERD-like symptoms were included in this retrospective study between 2015-2018. Dynamic real-time MRI visualized the transit of a 10 mL pineapple juice bolus through the esophagus and EGJ with a temporal resolution of 40 ms. Dynamic and anatomic parameters were measured by consensus reading. Imaging findings were compared to HRM utilizing the Chicago classification of esophageal motility disorders, v3.0. RESULTS All 102 patients completed real-time MRI in a median examination time of 15 min. On HRM, 14 patients presented with disorders with EGJ outlet obstruction (EGJOO) (13.7 %), 7 patients with major disorders of peristalsis (6.9 %), and 32 patients with minor disorders of peristalsis (31.4 %). HRM was normal in 49 patients (48.0 %). Incomplete bolus clearance was significantly more frequent in patients with esophageal motility disorders on HRM than in patients with normal HRM (p = 0.0002). In patients with motility disorders with EGJOO and major disorders of peristalsis, the esophageal diameter tended to be wider (23.6 ± 8.0 vs. 21.2 ± 3.5 mm, p = 0.089) and the sphincter length longer (19.7 ± 7.3 vs. 16.7 ± 3.0 mm, p = 0.091) compared to patients with normal HRM. 3/7 patients with achalasia type II were correctly identified by real-time MRI and one further achalasia type II patient was diagnosed with a motility disorder on MRI films. The other 3/7 patients presented no specific imaging features. CONCLUSION Real-time MRI is an auxiliary diagnostic tool for the assessment of swallowing events. Imaging parameters may assist in the detection of esophageal motility disorders.
Collapse
Affiliation(s)
- Lorenz Biggemann
- Department of Diagnostic and Interventional Radiology, University Medical Center Göttingen, Germany.
| | - Johannes Uhlig
- Department of Diagnostic and Interventional Radiology, University Medical Center Göttingen, Germany
| | - Nina Gliem
- Department of Gastroenterology and Gastrointestinal Oncology, University Medical Center Göttingen, Germany
| | - Omar Al-Bourini
- Department of Diagnostic and Interventional Radiology, University Medical Center Göttingen, Germany
| | - Edris Wedi
- Department of Gastroenterology and Gastrointestinal Oncology, University Medical Center Göttingen, Germany
| | - Volker Ellenrieder
- Department of Gastroenterology and Gastrointestinal Oncology, University Medical Center Göttingen, Germany
| | - Michael Ghadimi
- Department of General, Visceral, and Paediatric Surgery, University Medical Center, Göttingen, Germany
| | - Martin Uecker
- Department of Diagnostic and Interventional Radiology, University Medical Center Göttingen, Germany
| | - Jens Frahm
- Biomedical NMR, Max-Planck-Institute for Biophysical Chemistry, Göttingen, Germany
| | - Joachim Lotz
- Department of Diagnostic and Interventional Radiology, University Medical Center Göttingen, Germany
| | - Ali Seif Amir Hosseini
- Department of Diagnostic and Interventional Radiology, University Medical Center Göttingen, Germany
| | - Ulrike Streit
- Department of Diagnostic and Interventional Radiology, University Medical Center Göttingen, Germany
| |
Collapse
|
6
|
Leandri C, Soyer P, Oudjit A, Guillaumot MA, Chaussade S, Dohan A, Barret M. Contribution of magnetic resonance imaging to the management of esophageal diseases: A systematic review. Eur J Radiol 2019; 120:108684. [PMID: 31563109 DOI: 10.1016/j.ejrad.2019.108684] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 09/11/2019] [Accepted: 09/18/2019] [Indexed: 01/15/2023]
Abstract
PURPOSE Currently available imaging modalities used to investigate the esophagus are irradiating or limited to the analysis of the esophageal lumen. Magnetic resonance imaging (MRI) is a non-invasive and non-radiating imaging technique that provides high degrees of soft tissue contrast. Newly developed fast MRI sequences allow for both morphological and functional assessment of the esophageal body and esophagogastric junction. The purpose of this systematic review was to identify the contribution of MRI to the diagnosis and management of esophageal diseases, such as gastroesophageal reflux, esophageal motility disorders, esophageal neoplasms, and portal hypertension. METHODS We performed a systematic search of the Medline (via Ovid), EMBASE (via Ovid), PubMed and Cochrane Library databases from inception to December 2018 inclusively, using the MESH major terms "magnetic resonance imaging" AND "esophagus". RESULTS The initial search retrieved 310 references, of which 56 were found to be relevant for the study. References were analysed and classified in different subheadings: MRI protocols for the esophagus, gastroesophageal reflux disease, achalasia and other esophageal motility disorders, esophageal cancer, portal hypertension and other esophageal conditions. CONCLUSION MR Esophagography might become a non-invasive, non-irradiating technique of choice following diagnostic esophagogastroduodenoscopy for the assessment of esophageal diseases.
Collapse
Affiliation(s)
- Chloé Leandri
- Gastroenterology Department, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, France; Paris Descartes University, Paris, France.
| | - Philippe Soyer
- Paris Descartes University, Paris, France; Department of Radiology, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, France.
| | - Ammar Oudjit
- Department of Radiology, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, France.
| | - Marie-Anne Guillaumot
- Gastroenterology Department, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, France.
| | - Stanislas Chaussade
- Gastroenterology Department, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, France; Paris Descartes University, Paris, France.
| | - Anthony Dohan
- Paris Descartes University, Paris, France; Department of Radiology, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, France.
| | - Maximilien Barret
- Gastroenterology Department, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, France; Paris Descartes University, Paris, France.
| |
Collapse
|
7
|
Fukazawa K, Furuta K, Adachi K, Shimura S, Kamiyama K, Aimi M, Ohara S, Kajitani T, Tsurusaki M, Kitagaki H, Kinoshita Y. Continuous imaging of esophagogastric junction in patients with reflux esophagitis using 320-row area detector CT: a feasibility study. J Gastroenterol Hepatol 2013; 28:1600-7. [PMID: 23663082 DOI: 10.1111/jgh.12267] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/28/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIM The function of the lower esophageal sphincter (LES) is evaluated using an esophageal manometric study. However, information regarding the surrounding organs is difficult to obtain with use of a sensor catheter. We investigated the utility of 320-row area detector computed tomography (CT) to evaluate morphological changes of the esophagogastric junction and surrounding organs. METHODS The study subjects were 18 healthy volunteers and 29 patients with reflux esophagitis (RE). Immediately after swallowing a diluted contrast agent, continuous imaging of the esophagogastric junctional area was performed for 15 s. Using CT images, the presence or absence of esophageal hiatal hernia, His angle before and after swallowing, size of the diaphragmatic hiatus, morphologically identified-LES (MI-LES) length, intraluminal horizontal area of MI-LES during relaxation phase, MI-LES thickness, abdominal esophagus length, subcutaneous fat area, visceral fat area, and esophagogastric junction fat area were evaluated. RESULTS Analysis of CT images showed more frequent occurrence of hiatal hernia, greater His angle, and a larger diaphragmatic hiatus in patients with severe RE, while the lengths of MI-LES and abdominal esophagus were shorter in those patients. Visceral and esophagogastric junction fat areas tended to be greater in patients with RE. In all subjects, the posterior wall of the MI-LES was thicker than the anterior wall. CONCLUSION Continuous imaging with 320-row area detector CT is useful to evaluate morphological changes in the esophagogastric junction area in both normal individuals and patients with reflux esophagitis.
Collapse
Affiliation(s)
- Kousuke Fukazawa
- Second Department of Internal Medicine, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Magnetic resonance imaging for simultaneous morphological and functional evaluation of esophageal motility disorders. Surg Today 2013; 44:668-76. [PMID: 23689949 DOI: 10.1007/s00595-013-0617-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Accepted: 02/25/2013] [Indexed: 12/30/2022]
Abstract
PURPOSES The purpose of this study was to evaluate the feasibility and safety of esophageal functional magnetic resonance imaging (fMRI) for the diagnosis of achalasia. METHODS Eleven patients with suspected achalasia and three normal subjects underwent fMRI while swallowing clear liquid with original sequences; "T2-weighed single-shot fast spin-echo" and "Fast Imaging Employing Steady-state Acquisition". The fMRI-based diagnosis was compared with that based on manometry. The luminal fluctuation index (LFI) and Dd/Ds ratio were used for the objective evaluation of the esophageal peristalsis and relaxation of the lower esophageal sphincter (LES). RESULTS Functional MRI showed a dilated tortuous esophagus with no tumor, poor clearance, simultaneous waves, aperistalsis, and impaired LES relaxation in all but one case, allowing the diagnosis of achalasia with accuracy similar to that of manometry. The LFI (median 0.08, range 0.03-0.25) and Dd/Ds ratio (1.40, 1.0-2.3) of the patient group were significantly lower than those of the normal subjects [1.50, 2.32-4.05, and 2.59 (2.32-4.05)]. No severe adverse events directly related to fMRI were noted. CONCLUSIONS Using our protocol, fMRI was considered to be safe and feasible for the diagnosis of achalasia. Given the widespread use of MRI, esophageal fMRI, which does not require exposure to radiation, could be a potentially useful diagnostic tool for patients with esophageal motility disorders.
Collapse
|
9
|
Functional magnetic resonance in the evaluation of oesophageal motility disorders. Gastroenterol Res Pract 2011; 2011:367639. [PMID: 21904543 PMCID: PMC3166566 DOI: 10.1155/2011/367639] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Revised: 06/24/2011] [Accepted: 06/25/2011] [Indexed: 11/23/2022] Open
Abstract
Functional magnetic resonance imaging (fMRI) has been recently proposed for the evaluation of the esophagus.
Our aim is to assess the role of fMRI as a technique to assess morphological and functional parameters of the esophagus in patients with esophageal motor disorders and in healthy controls. Subsequently, we assessed the diagnostic efficiency of fMRI in comparison to videofluoroscopic and manometric findings in the investigation of patients with esophageal motor disorders. Considering that fMRI was shown to offer valuable information on bolus transit and on the caliber of the esophagus, variations of these two parameters in the different types of esophageal motor alterations have been assessed. fMRI, compared to manometry and videofluoroscopy, showed that a deranged or absent peristalsis is significantly associated with slower transit time and with increased esophageal diameter. Although further studies are needed, fMRI represents a promising noninvasive technique for the integrated functional and morphological evaluation of esophageal motility disorders.
Collapse
|
10
|
Abstract
BACKGROUND Magnetic resonance imaging (MRI) is a useful technique for evaluating gastrointestinal (GI) motor functions because it provides multi-planar imaging capability, high imaging speed, good spatial resolution and excellent soft tissue contrast. Moreover, multiple parameters of GI function can be assessed non-invasively during a single study. PURPOSE This critical review of the literature discusses the strengths and limitations of MRI for evaluating GI motor functions.
Collapse
Affiliation(s)
- L Marciani
- Nottingham Digestive Diseases Centre and NIHR Biomedical Research Unit, Nottingham University Hospitals, University of Nottingham, Nottingham, UK.
| |
Collapse
|
11
|
Panebianco V, Ruoppolo G, Pelle G, Schettino I, Roma R, Bernardo S, De Vincentiis C, Longo L, Passariello R. Morpho-functional patterns of physiologic oropharyngeal swallowing evaluated with dynamic fast MRI. Eur Arch Otorhinolaryngol 2010; 267:1461-6. [PMID: 20376470 DOI: 10.1007/s00405-010-1232-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2009] [Accepted: 03/04/2010] [Indexed: 11/25/2022]
Abstract
With the advent of dynamic fast MRI sequences the act of deglutition can be dynamically visualized in cine-mode. Twenty-three healthy volunteers were enrolled in this study to define the morpho-functional patterns of oral and pharyngeal deglutition using new dynamic MRI techniques. All subjects were previously submitted to video endoscopic assessment, to exclude swallowing abnormalities. As contrast material a combination of yogurt mixed with gadolinium-diethylene diamine pentaacetic acid was used. The protocol was divided into three parts: (a) preliminary assessment of the oral cavity, pharynx and laryngeal structures; (b) morphologic assessment of tongue, soft palate, pharynx, epiglottis and larynx-hyoid bone; (c) dynamic assessment of swallowing without administrating any contrast media and, in subsequent phase, by injecting 5 ml of yogurt-based contrast medium in the patient's mouth. The time resolution was 3-4 images/s. The MR protocol revealed to be effective in the evaluation of normal motility patterns of the structures involved in swallowing. Moreover, the evaluation of the bolus progression, slowdown or stagnation, was possible. On the contrary problems were encountered in calculating precisely the bolus progression time, because of the insufficient temporal resolution. However, more energy should be invested to optimize the spatial and temporal resolution of turbo-FLASH sequences, to obtain a better dynamic representation of a complex function such as deglutition.
Collapse
Affiliation(s)
- V Panebianco
- Department of Radiological Sciences, La Sapienza University, Rome, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
12
|
|