Dynamic imaging of speech and swallowing with MRI

Sutton, Bradley P.; Conway, Charles A.; Bae, Youkyung; Brinegar, Cornelius; Liang, Zhi‐Pei; Kuehn, David P.

doi:10.1109/iembs.2009.5332869

Cited by 23 publications

(34 citation statements)

References 12 publications

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“…The present study demonstrates the importance of an additional image plane for static and dynamic assessments, that is, the oblique coronal image plane. Bae et al (2011) and Sutton et al (2009) demonstrated a similar high temporal, serial acquisition during speech production; however, data were obtained only in the midsagittal image plane. Although the imaging rate was high (21 fps), both studies used a head-only MRI system that is typically designed for brain imaging.…”

Section: Discussionmentioning

confidence: 97%

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Using MRI for Assessing Velopharyngeal Structures and Function

Perry

Sutton

Kuehn

et al. 2014

The Cleft Palate Craniofacial Journal

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Objective Direct visualization of the velopharynx and, in particular, the levator muscle is particularly important in the assessment of velopharyngeal function and normal speech production. The purpose of this study is to demonstrate the development of a static and dynamic magnetic resonance imaging protocol for evaluation of velopharyngeal structures and function. Methods A high-resolution, T2-weighted turbo-spin-echo three-dimensional anatomical scan (sampling perfection with application optimized contrasts using different flip angle evolution) was used to acquire a large field of view covering the velopharyngeal anatomy. Dynamic speech assessment was obtained using a fast-gradient echo, fast low-angle shot, multi-shot spiral technique to acquire 15.8 frames per second (fps) of the sagittal and oblique coronal image planes. Results Using a three-dimensional data set, as opposed to two-dimensional data, the full contour of the levator muscle can be appreciated. Dynamic images were obtained at 15.8 fps in the sagittal and oblique coronal planes, enabling visualization of the movements of the velum, posterior pharyngeal wall, lateral pharyngeal walls, and levator muscle during speech. Conclusions A three-dimensional magnetic resonance imaging sequence, such as that used in the present study, may provide better analyses and more precise measurements. A dynamic fast low-angle shot sequence allows for visualization of the levator muscle and the velum during speech at a high image rate. This protocol could have a significant impact in improving the process of visualizing pathology and promoting clinical treatment plans for individuals born with cleft lip and palate.

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Section: Discussionmentioning

confidence: 97%

“…Alternatively, the images in the native frame rate (15.8 fps) could be interpolated to the desired output rate, but this would result in significant blurring of information across time. The sliding-window reconstruction process minimizes redundant information in adjacent time points and minimizes temporal blurring (Sutton et al, 2009). …”

Section: Methodsmentioning

confidence: 99%

Using MRI for Assessing Velopharyngeal Structures and Function

Perry

Sutton

Kuehn

et al. 2014

The Cleft Palate Craniofacial Journal

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“…We created a 3D finite element model of the VP mechanism based on static MRI scans of a 20-year-old Japanese male subject with healthy VP anatomy and compared velum deformations with dynamic MRI scans 19–21 . The model components included the velum, the PPW, the LVP, and the MU (Fig.…”

Section: Methodsmentioning

confidence: 99%

Contributions of the Musculus Uvulae to Velopharyngeal Closure Quantified With a 3-Dimensional Multimuscle Computational Model

Inouye

Lin

Perry³

et al. 2016

Annals of Plastic Surgery

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The convexity of the dorsal surface of the velum is critical for normal velopharyngeal (VP) function and is largely attributed to the levator veli palatini (LVP) and musculus uvulae (MU). Studies have correlated a concave or flat nasal velar surface to symptoms of VP dysfunction including hypernasality and nasal air emission. In the context of surgical repair of cleft palates, the MU has been given relatively little attention in the literature compared with the larger LVP. A greater understanding of the mechanics of the MU will provide insight into understanding the influence of a dysmorphic MU, as seen in cleft palate, as it relates to VP function. The purpose of this study was to quantify the contributions of the MU to VP closure in a computational model. We created a novel 3D finite element model of the VP mechanism from MRI data collected from an individual with healthy non-cleft VP anatomy. The model components included the velum, posterior pharyngeal wall (PPW), LVP, and MU. Simulations were based on the muscle and soft tissue mechanical properties from the literature. We found that, similar to previous hypotheses, the MU acts as i) a space-occupying structure and ii) a velar extensor. As a space-occupying structure, the MU helps to nearly triple the midline VP contact length. As a velar extensor, the MU acting alone without the LVP decreases the VP distance 62%. Furthermore, activation of the MU decreases the LVP activation required for closure almost three-fold, from 20% (without MU) to 8% (with MU). Our study suggests that any possible salvaging and anatomical reconstruction of viable MU tissue in a cleft patient may improve VP closure due to its mechanical function. In the absence or dysfunction of MU tissue, implantation of autologous or engineered tissues at the velar midline, as a possible substitute for the MU, may produce a geometric convexity more favorable to VP closure. In the future, more complex models will provide further insight into optimal surgical reconstruction of the VP musculature in normal and cleft palate populations.

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“…Upright MRI scanners have been proposed by some [26]; however, these are not as readily available as traditional scanners requiring a prone or supine position. Utilization of highspeed imaging sequences have enabled near real-time visualization of the process of swallowing [27][28][29]. It is important to have an understanding of the effects of gravity on the process of swallowing so that findings from such data sets (e.g., supine MRI data and upright swallowing studies) can be used interchangeably.…”

Section: Limitations Of the Study And Future Researchmentioning

confidence: 99%

Effect of Posture on Deglutitive Biomechanics in Healthy Individuals

2011

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The purpose of this study was to assess displacement of oropharyngeal structures, particularly the hyoid bone and velum, and variations in timing of the pharyngeal stage of swallowing in the upright versus the supine position. Twelve Caucasian adult subjects between 19 and 27 years of age participated. Subjects were recorded swallowing 7 cc of liquid barium in the upright and supine positions. The hyoid bone had a significantly greater amount of anterior displacement while in the supine position compared to that of the upright position (p< 0.01). While in the upright position, the velum comes to a fully elevated position at nearly the same time as the initiation of the pharyngeal swallow (within an average of 27 ms of each other), whereas in the supine position the velum continues to elevate on average 115 ms after the initiation of the pharyngeal swallow. Results indicated a significant difference (p < 0.05) in the amount of velar movement from rest to the fully elevated position between the upright and supine positions for female subjects. The results from the study demonstrate variations in hyoid displacement, velar movement, and bolus movement through the pharynx with respect to the two body positions and the subjects' gender.

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Dynamic imaging of speech and swallowing with MRI

Cited by 23 publications

References 12 publications

Using MRI for Assessing Velopharyngeal Structures and Function

Using MRI for Assessing Velopharyngeal Structures and Function

Contributions of the Musculus Uvulae to Velopharyngeal Closure Quantified With a 3-Dimensional Multimuscle Computational Model

Effect of Posture on Deglutitive Biomechanics in Healthy Individuals

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