Sagittal Measurement of Tongue Movement During Respiration: Comparison Between Ultrasonography and Magnetic Resonance Imaging

Abstract

The tongue makes up the anterior pharyngeal wall and is critical for airway patency. Magnetic resonance imaging (MRI) is commonly used to study pharyngeal muscle function in pharyngeal disorders such as obstructive sleep apnoea. Tagged MRI and ultrasound studies have separately revealed »1 mm of anterior tongue movement during inspiration in healthy patients, but these modalities have not been directly compared. In the study described here, agreement between ultrasound and MRI in measuring regional tongue displacement in 21 healthy patients and 21 patients with obstructive sleep apnoea was evaluated. We found good consistency and agreement between the two techniques, with an intra-class correlation coefficient of 0.79 (95% confidence interval: 0.75À0.82) for anteroposterior tongue motion during inspiration. Ultrasound measurements of posterior tongue displacement were 0.24 § 0.64 mm greater than MRI measurements (95% limits of agreement: 1.03 to À1.49). This may reflect the higher spatial and temporal resolution of the ultrasound technique. This study confirms that ultrasound is a suitable method for quantifying inspiratory tongue movement.

Dynamic tongue area measurements in ultrasound images for adults with obstructive sleep apnea

“…The tongue moves anteriorly during inspiration to open the airway and moves posteriorly during expiration to return to the original UA caliber while keeping the airway open. Previous studies comparing the tagged MRI and an automated US tracking algorithm (Kwan et al, 2014, 2015) confirmed the respiratory‐related tongue motions (Kwan, Juge, Gandevia, & Bilston, 2019). To minimize the effect of respiratory phases on tongue movement, we began acquiring the US image sequences while the participants were in an end‐expiration phase (a pause) of quiet breathing.…”

“…Upper panel: tongue area differences between non-OSA and OSA groups during normal breathing (a), Mueller maneuver (b), and the differences between normal breathing and Mueller maneuver (c). Lower panel: maximum tongue thickness between non-OSA and OSA groups during normal breathing (d), Mueller maneuver (e), and the differences between normal breathing and Mueller maneuver (f) (Kwan et al, 2014(Kwan et al, , 2015 confirmed the respiratory-related tongue motions (Kwan, Juge, Gandevia, & Bilston, 2019). To minimize the effect of respiratory phases on tongue movement, we began acquiring the US image sequences while the participants were in an end-expiration phase (a pause) of quiet breathing.…”

Ultrasound assessment of upper airway dilator muscle contraction during transcutaneous electrical stimulation in patients with obstructive sleep apnoea

“…Ultrasound measurements of the posterior tongue displacement were 0.24±0.64 mm greater than MRI measurements (95% limits of agreement: 1.03 to -1.49). The study concluded that ultrasound was a suitable method for measuring tongue movements (45).…”

Regional respiratory movement of the tongue is coordinated during wakefulness and is larger in severe obstructive sleep apnoea

“…; Kwan et al . ). Previous studies of the human upper airway indicated that the posterior region of the tongue moves anteriorly during inspiration resulting in airway dilatation (Cheng et al .…”

“…It allows dynamic tissue movements to be quantified, therefore enabling the influence of respiratory mechanics and drive on the genioglossus to be determined (Axel & Dougherty, 1989). Using tagged MRI, dilatory tongue movements have been reported during respiration in healthy adults and OSA patients (Cheng et al 2008;Brown et al 2013;Cheng et al 2014;Cai et al 2016;Kwan et al 2019). Previous studies of the human upper airway indicated that the posterior region of the tongue moves anteriorly during inspiration resulting in airway dilatation (Cheng et al 2008;Kwan et al 2014Kwan et al , 2018.…”