, Volume 21, Issue 3, pp 156–162 | Cite as

Cine Magnetic Resonance Imaging with Single-Shot Fast Spin Echo for Evaluation of Dysphagia and Aspiration

  • Dana M. HartlEmail author
  • Frédéric Kolb
  • Evelyne Bretagne
  • Patrick Marandas
  • Robert Sigal


The aim of this study was to determine the feasibility of and interest in evaluation of swallowing using dynamic magnetic resonance imaging (cine-MRI) in patients with dysphagia and aspiration caused by an abnormal pharyngeal phase of swallow. A cohort of six patients previously treated for head and neck cancer with persistent dysphagia and/or aspiration were evaluated an average of 47 months after treatment. The morphology and mobility of the oral, oropharyngeal, and laryngeal structures were analyzed using cine-MRI using single-shot fast spin echo technology. The qualitative observations were compared with a clinical fiberoptic swallowing evaluation. Swallowing physiology was analyzable for dry (saliva) swallow in all patients. MRI was well-tolerated by all six patients and no clinical aspiration occurred during the MRI. In five of six cases, further information on the cause of dysphagia was obtained using cine-MRI compared with the clinical evaluation alone. In the remaining case, cine-MRI confirmed the clinical evaluation. Cine-MRI using the dry swallow technique is feasible and without risk in patients with clinical aspiration. Cine-MRI is complementary to clinical evaluation of swallowing in patients with an abnormal pharyngeal phase of swallowing resulting from treatment of cancer.


Dynamic MRI Cine-MRI Swallowing Dysphagia Aspiration Head and neck cancer Deglutition Deglutition disorders. 


  1. 1.
    Demolin D, Delvaux V, Metens T, Soquet A: Determination of velum opening for French nasal vowels by magnetic resonance imaging. J Voice 17:454–467, 2003CrossRefPubMedGoogle Scholar
  2. 2.
    Gilbert RJ, Napadow V: Three-dimensional muscular architecture of the human tongue determined in vivo with diffusion tensor magnetic resonance imaging. Dysphagia 20:1–7, 2005CrossRefPubMedGoogle Scholar
  3. 3.
    Ikeda K, Ogura M, Oshima T, Susuki H, Higano S, Takahashi S, Kurosawa H, Hida W, Matsuoka H, Takasaka T: Quantitative assessment of the pharyngeal airway by dynamic magnetic resonance imaging in obstructive sleep apnea syndrome. Ann Otol Rhinol Laryngol 110:183–189, 2001PubMedGoogle Scholar
  4. 4.
    Shott SR, Donnelly LF: Cine magnetic resonance imaging: Evaluation of persistent airway obstruction after tonsil and adenoidectomy in children with Down syndrome. Laryngoscope 114:1724–1729, 2004CrossRefPubMedGoogle Scholar
  5. 5.
    Anagnostara A, Stoeckli S, Weber OM, Kollias SS: Evaluation of the anatomical and functional properties of deglutition with various kinetic high-speed MRI sequences. J Magn Reson Imaging 14:194–199, 2001CrossRefPubMedGoogle Scholar
  6. 6.
    Barkhausen J, Goyen M, von Winterfeld F, Lauenstein T, Arweiler-Harbeck D, Debatin JF: Visualisation of swallowing using real-time TrueFISP MR fluoroscopy. Eur Radiol 12:129–133, 2002CrossRefPubMedGoogle Scholar
  7. 7.
    Hartl DM, Albiter M, Kolb F, Luboinski B, Sigal R: Morphologic parameters of normal swallowing events using single shot fast spin echo dynamic MRI. Dysphagia 18:255–262, 2003CrossRefPubMedGoogle Scholar
  8. 8.
    Pearson BW: Subtotal laryngectomy. Laryngoscope 91:1904–1912, 1981PubMedCrossRefGoogle Scholar
  9. 9.
    Leipzig B: Neoglottic reconstruction following total laryngectomy. A reappraisal. Ann Otol Rhinol Laryngol 89:534–537, 1980Google Scholar
  10. 10.
    Sobin LH, Wittekind C (eds.): UICC International Union Against Cancer. TNM classification of malignant tumors, 6th ed. New York: Wiley-Liss, 2002, pp 19–42Google Scholar
  11. 11.
    Bastian RW: Videoendoscopic evaluation of patients with dysphagia: an adjunct to the modified barium swallow. Otolaryngol Head Neck Surg 104:339–350, 1991PubMedGoogle Scholar
  12. 12.
    Colodny N: Interjudge and intrajudge reliabilities in fiberoptic endoscopic evaluation of swallowing (FEES®) using the Penetration-Aspiration scale: a replication study. Dysphagia 17:308–315, 2002CrossRefPubMedGoogle Scholar
  13. 13.
    Niitsu M, Kumada M, Campeau NG, Niimi S, Riederer SJ, Itai Y: Tongue displacement: visualisation with rapid tagged magnetization-prepared MR imaging. Radiology 191:578–580, 1994PubMedGoogle Scholar
  14. 14.
    Gilbert RJ, Daftary S, Campbell TA, Weisskoff RM: Patterns of lingual tissue deformation associated with bolus containment and propulsion during deglutition as determined by echo-planar MRI. J Magn Reson Imaging 8:554–560, 1998PubMedCrossRefGoogle Scholar
  15. 15.
    Brennick MJ, Pickup S, Dougherty L, Kater JR, Kuna ST: Pharyngeal airway wall mechanics using tagged magnetic resonance imaging during medial hypoglossal nerve stimulation in rats. J Physiol 561:597–610, 2004CrossRefPubMedGoogle Scholar
  16. 16.
    Faust RA, Remley KB, Fimell FL: Real-time cine magnetic resonance imaging for evaluation of the pediatric airway. Laryngoscope 111:2187–2190, 2001CrossRefPubMedGoogle Scholar
  17. 17.
    Suto Y, Kamba M, Kato T: Technical note: dynamic analysis of pharynx during swallowing using turbo-FLASH magnetic resonance imaging combined with an oral positive contrast agent: a preliminary study. Br J Radiol 68:1099–1102, 1995PubMedCrossRefGoogle Scholar
  18. 18.
    Foucart JM, Carpentier P, Pajoni D, Rabischong P, Pharaboz C: Kinetic magnetic resonance imaging analysis of swallowing: a new approach to pharyngeal function. Surg Radiol Anat 20:53–55, 1998PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Dana M. Hartl
    • 1
    • 2
    Email author
  • Frédéric Kolb
    • 1
  • Evelyne Bretagne
    • 1
  • Patrick Marandas
    • 1
  • Robert Sigal
    • 1
  1. 1.Otolaryngology and Head and Neck SurgeryInstitut Gustave RoussyVillejuif CedexFrance
  2. 2.Otolaryngology and Head and Neck SurgeryInstitut Gustave RoussyVillejuif CedexFrance

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