Method for detection of aspiration based on B-mode video ultrasonography

Abstract

In this study, we aimed to develop a new method for detection of aspiration based on B-mode video ultrasonography and to evaluate its performance. To detect aspirated boluses by B-mode video ultrasonography in patients with dysphagia, we placed a linear array transducer above the thyroid cartilage and observed the area around the vocal folds. Forty-two ultrasonographic measurements were obtained from 17 patients with dysphagia who also underwent videofluoroscopy or videoendoscopy measurements at the same time. Aspirated boluses were observed in B-mode video ultrasonographic images as hyperechoic, long, narrow objects that passed through the vocal folds beneath the anterior wall of the trachea, with movement different from that of the surrounding structure. The sensitivity of aspiration detection was 0.64, and the specificity was 0.84. This newly developed detection method will enable patients with dysphagia to receive appropriate daily swallowing care.

Detecting pharyngeal post-swallow residue by ultrasound examination: a case series.

“…In our previous study, which aimed at detecting aspiration, we also found a higher disagreement between US examination and FEES for low-viscosity boluses [12]. The size of the boluses may affect the visualization of pharyngeal post-swallow residue.…”

“…This study used US images that were obtained in the previous study to develop a method to detect aspiration by US examination [12].…”

“…In our previous study we showed that it was possible to distinguish aspirated boluses from surrounding tissues based on the differences in the characteristics of their movements in US movies [11,12]. Distinguishing pharyngeal post-swallow residue from the surrounding tissues will be more difficult than distinguishing aspirated boluses from the surrounding tissues because there are no differences between remaining food and liquid boluses and surrounding tissues with respect to the characteristics of their movement.…”

Análise ultrassonográfica qualitativa e quantitativa da deglutição orofaríngea

“…It is noteworthy, however, that the USG of swallowing, as well as all the other imaging techniques, requires the speechlanguage therapist to have specific training with a specialized professional and to have basic knowledge of the appearance of the anatomic structures of the oropharynx, imaging procedures, and operation of the system (4) . There are studies that use the ultrasound of the tongue movement to characterize the oral phase of oropharyngeal swallowing (1,(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) . Among these studies, some prioritized a qualitative description (1,(5)(6)(7) whereas others propose quantitative measures (8)(9)(10)(11)(12)(13)(14)(15) .…”

“…Among the studies that proposed the quantitative measures with the use of ultrasound (US) (8)(9)(10)(11)(12)(13)(14)(15) , it was observed that the adoption of different parameters, such as, duration of propulsion of the food bolus (sec); displacement of the lateral pharyngeal walls (cm); speed (mm/s), amplitude (mm), and duration (s) of the tongue movement during swallowing; in addition to the displacement of the hyoid bone, both in terms of duration (ms) and distance (mm).…”