Measuring tongue volumes and visualizing the chewing and swallowing process using real-time TrueFISP imaging?initial clinical experience in healthy volunteers and patients with acromegaly

Abstract

This study assessed both two-dimensional (2D) TrueFISP imaging for quantifying tongue volume and real-time TrueFISP imaging for evaluating chewing and swallowing in healthy volunteers and patients with acromegaly. In 50 healthy volunteers, tongue volumes were measured using a 2D TrueFISP sequence. Chewing and swallowing were visualized using a real-time TrueFISP sequence. Ten patients with acromegaly were examined twice with the same magnetic resonance imaging protocol: once prior to therapy and a second time 6 months after therapy. Prior to therapy, healthy volunteers had an average tongue volume of 140 ml for men and 90 ml for women, and patients with acromegaly had an average tongue volume of 180 ml for men and 145 ml for women. However, 6 months after therapy the mean tongue volumes in patients with acromegaly had decreased to 154 ml in the men and to 125 ml in the women. The chewing and swallowing process was normal in all volunteers. Prior to therapy, just two patients showed a chewing and swallowing pathology, which disappeared after therapy. Patients with acromegaly had larger tongue volumes than healthy volunteers, and TrueFISP imaging proved feasible for visualizing chewing and swallowing in real time and is capable of detecting possible pathologies. Furthermore, TrueFISP imaging can be used to monitor therapeutic approaches in patients with acromegaly.

Functional MRI in the evaluation of oesophageal motility: feasibility, MRI patterns of normality, and preliminary experience in subjects with motility disorders

“…We therefore tested different combinations of foods (water, semolina and yoghurt) mixed with gadolinium-diethylene triamine pentaacetic acid (Gd-DTPA) 0.5 M (1:100) [8,9]. The waterbased contrast medium, despite having excellent signal intensity, proved to be functionally unreliable due to its low viscosity.…”

“…Gastrointestinal imaging is, on the other hand, a relatively unexplored field: the study of gastrointestinal function requires levels of spatial and temporal resolution that have long remained a prerogative of videofluoroscopic techniques. Current experience with fMRI of the gastrointestinal tract is limited to some preliminary [5][6][7] and clinical studies [8,9] on deglutition and other more recent reports on the evaluation of gastric motility [10]; only Manabe et al [11] have investigated the use of fMRI for the evaluation of oesophageal motility, introducing an optimised protocol based on T1-weighted fast-field-echo (FFE) sequences. The aim of our study was to use fMRI with T1-weighted turbo fast low-angle shot (FLASH) sequences in the evaluation of oesophageal motility to define MRI morphofunctional patterns of normality in healthy subjects and to gain preliminary experience in the study of patients with oesophageal motility disorders.…”

“…Di contro, il campo gastroenterologico permane sostanzialmente inesplorato; lo studio della funzionalità gastrointestinale richiede, infatti, livelli di risoluzione spazio-temporale che sono rimasti a lungo esclusiva prerogativa delle tecniche videofluoroscopiche. L'attuale esperienza nel campo della RM funzionale del tratto gastrointestinale è limitata ad alcuni studi preliminari [5][6][7] e clinici [8,9] sulla funzionalità della deglutizione e ad altri più recenti articoli sulla valutazione della motilità gastrica [10]; solo Manabe et al [11], nel 2004, hanno proposto uno studio sull'impiego della RM funzionale nella valutazione della motilità esofagea, introducendo l'ottimizzazione di un protocollo basato su sequenze Fast Field Echo T1-pesate. Lo scopo del nostro studio è stato quello di utilizzare la RM funzionale con sequenze Turbo FLASH T1-pesate nella valutazione della motilità esofagea definendo dei pattern morfofunzionali RM di normalità in soggetti sani e di acquisire un'esperienza nello studio di pazienti affetti da patologie della motilità esofagea.…”

Initial experience with magnetic resonance fluoroscopy in the evaluation of oesophageal motility disorders. Comparison with manometry and barium fluoroscopy

“…The first MR fluoroscopy studies were performed by Riederer et al [8] and Farzaneh et al [9] in the late 1980s; shortly following were the forerunning approaches in the field of clinical practice, from the monitoring of biopsies [10] to the guidance of intravascular procedures [11] and the real-time depiction of swallowing [12]. Today, MR fluoroscopy represents an actual topic of research in various clinical fields, but its employment and evolution in the functional imaging of the upper gastrointestinal tract still remains limited to few preliminary works [13][14][15] mainly based on the evaluation of the oro-pharyngeal swallowing phase. Only Manabe et al [16] evaluated oesophageal motility and morphology in healthy subjects, but current literature actually lacks clinical studies on subjects affected by oesophageal motility disorders.…”

Obstructive Sleep Apnea Syndrome Is Less Frequent in Patients With Well-Controlled Acromegaly Treated With Somatostatin Analogues, Pegvisomant or in Combination

“…Soft tissue swelling of the uvula, enlargement of the tongue and prognathism due to the mandibular growth are clinical manifestations of the period of active disease and characterize the OSA which is most prevalent in acromegaly [2][3][4][5]. Central apnea is infrequent and is associated with high endogenous somatostatin tonus [6,7].…”