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Joined: 2011-05-15
Purpose: Chewing and swallowing problems are fairly common.
Many diseases are associated with chewing and swallowing problems. The purpose
of this study was to assess real-time TrueFisp MR imaging for the evaluation of
a) morphologic changes (tongue volume), and b) evaluation of functional
disorders (chewing and swallowing) in patients with acromegaly. Data were
compared with results obtained in healthy volunteers.
Methods and Materials: In fifty healthy volunteers (25 m, 25 f, mean age: 43.6
y) tongue volumes were measured by the use of a 2 D TrueFisp sequence.
Additionally, a 3D FLASH sequence was used to evaluate the oro-pharyngeal
space, and a real-time examination with TrueFISP to display the process of
chewing and swallowing after ingestion of an oral contrast bolus. All ten patients
(4m, 6f, mean age 58y) with proven acromegaly underwent the described MR
protocol twice: prior to and three months after therapy with sandostatine
analogues and transsphenoidal resection of the hypophysis.
Results: The obtained imaging data including the real-time TrueFISP sequence
for visualizing chewing and swallowing were of diagnostic quality in all
volunteers and patients. MR measurements of tongue volumes in volunteers shwoed
an average volume of 140 ml in men and 90 ml in women. The oropharyngeal space
and the chewing and swallowing process did not show any abnormalities.
The average tongue volumes in the acromegalic patients were substantially
increased with an average volume of 180 ml (male), and 145 ml (female),
respectively. Two out of the ten acromegalic patients showed chewing and
swallowing disorders: One female patient (53 y) showed involuntary swallowing
while chewing (leaking). In a 63 year-old male patient the tongue involuntarily
dropped backwards while swallowing. The follow-up examination three months
after therapy showed a significant decrease in mean tongue volumes: 154 ml for
male patients, and 125 ml for female patients. Conclusion: In addition to
providing morphologic information, real-time True-FISP imaging allows reliable
visualization of chewing and swallowing. It may yield new insights into
functional oropharyngeal disorders in acromegalic patients. The outlined
MR-protocol appears suited to measure tongue volumes reliably, and could be
used as a non-invasive imaging modality for follow-up studies in patients with
acromegaly after drug or surgical therapy.
Questions about this event email: waleed.ajaj@uni-essen.de