Radiological Society of North America 2003 Scientific Assembly and Annual Meeting

w.ajaj's picture
Research Title: 
Measuring Tongue Volumes and Visualizing the Chewing und Swallowing Process Using Real-Time TrueFISP Imaging in Patients with Acromegaly: Initial Clinical Experience
Waleed Ajaj
Wed, 2004-12-01
Research Abstract: 

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: