Preliminary Development of an MRI Atlas for Application to Cleft Care: Findings and Future Recommendations

Abstract

Objective To introduce a highly innovative imaging method to study the complex velopharyngeal (VP) system and introduce the potential future clinical applications of a VP atlas in cleft care. Design Four healthy adults participated in a 20-min dynamic magnetic resonance imaging scan that included a high-resolution T2-weighted turbo-spin-echo 3D structural scan and five custom dynamic speech imaging scans. Subjects repeated a variety of phrases when in the scanner as real-time audio was captured. Setting Multisite institution and clinical setting Participants Four adult subjects with normal anatomy were recruited for this study. Main Outcome Establishment of 4-D atlas constructed from dynamic VP MRI data. Results Three-dimensional dynamic magnetic resonance imaging was successfully used to obtain high quality dynamic speech scans in an adult population. Scans were able to be re-sliced in various imaging planes. Subject-specific MR data were then reconstructed and time-aligned to create a velopharyngeal atlas representing the averaged physiological movements across the four subjects. Conclusions The current preliminary study examined the feasibility of developing a VP atlas for potential clinical applications in cleft care. Our results indicate excellent potential for the development and use of a VP atlas for assessing VP physiology during speech.

Optimization of 3D dynamic speech MRI: Poisson‐disc undersampling and locally higher‐rank reconstruction through partial separability model with regional optimized temporal basis

“…For the child population, where 10 min may still be a challenge, separate speech samples can be acquired in separate, shorter runs of the speech sequence. For example, in another current study, we have broken up the 3D dynamic acquisition into six shorter scans with a full sampling pattern, combining all the data together for reconstruction 33 . We have seen in our target population of 4 to 9 years old children that 2.5‐min durations result in high subject compliance to the speech tasks, particularly when broken into smaller segments.…”

The Pediatric Neuroradiologist's Practical Guide to Capture and Evaluate Pre- and Postoperative Velopharyngeal Insufficiency

“…Because speech is a dynamic event, it is important that MR imaging technologies expand to also include dynamic speech at word-, phrase-, and sentence-level productions as described by Perry and colleagues. 42 These developments are already underway to support the translation of dynamic protocols into clinical scanners, 43 which will require an update to these outlined protocols. However, it is likely that sustained phonation tasks will still be of value, given the aforementioned reasons.…”