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Perry JL, Snodgrass TD, Gilbert IR, Sutton BP, Baylis AL, Weidler EM, Tse RW, Ishman SL, Sitzman TJ. Establishing a Clinical Protocol for Velopharyngeal MRI and Interpreting Imaging Findings. Cleft Palate Craniofac J 2024; 61:748-758. [PMID: 36448363 PMCID: PMC10243551 DOI: 10.1177/10556656221141188] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Traditional imaging modalities used to assess velopharyngeal insufficiency (VPI) do not allow for direct visualization of underlying velopharyngeal (VP) structures and musculature which could impact surgical planning. This limitation can be overcome via structural magnetic resonance imaging (MRI), the only current imaging tool that provides direct visualization of salient VP structures. MRI has been used extensively in research; however, it has had limited clinical use. Factors that restrict clinical use of VP MRI include limited access to optimized VP MRI protocols and uncertainty regarding how to interpret VP MRI findings. The purpose of this paper is to outline a framework for establishing a novel VP MRI scan protocol and to detail the process of interpreting scans of the velopharynx at rest and during speech tasks. Additionally, this paper includes common scan parameters needed to allow for visualization of velopharynx and techniques for the elicitation of speech during scans.
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Affiliation(s)
- Jamie L Perry
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC, USA
| | - Taylor D Snodgrass
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC, USA
| | - Imani R Gilbert
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC, USA
| | - Bradley P Sutton
- Bioengineering Department, University of Illinois at Urbana Champaign, Urbana, IL, USA
| | - Adriane L Baylis
- Department of Plastic and Reconstructive Surgery, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, OH, USA
| | - Erica M Weidler
- Division of Plastic Surgery, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Raymond W Tse
- Division of Craniofacial and Plastic Surgery, Department of Surgery, Seattle Children's Hospital, University of Washington, Seattle, WA, USA
| | - Stacey L Ishman
- Division of HealthVine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Thomas J Sitzman
- Division of Plastic Surgery, Phoenix Children's Hospital, Phoenix, AZ, USA
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Mason KN. Magnetic Resonance Imaging for Assessing Velopharyngeal Function: Current Applications, Barriers, and Potential for Future Clinical Translation in the United States. Cleft Palate Craniofac J 2024; 61:235-246. [PMID: 36039513 PMCID: PMC9971336 DOI: 10.1177/10556656221123916] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The use of magnetic resonance imaging (MRI) in the assessment process for children with cleft/craniofacial conditions remains uncommon, particularly for velopharyngeal assessments. The purpose of this study was to analyze the perceived clinical utility of MRI for cleft/craniofacial providers and identify barriers that exist for clinical translation of this imaging modality to this population of patients. METHODS A 38-item survey was disseminated to craniofacial team providers. Workplace context and demographics, MRI as a research and clinical tool, access and barriers for use of MRI, and needs for successfully establishing MRI protocols at clinical sites were investigated. Descriptive statistics were used to identify differences in the clinical use of MRI across disciplines. Chi-square analyses were conducted to determine how different specialties perceived potential barriers. RESULTS Respondents reported that MRI is likely to be beneficial for clinical assessments (93.5%) and that this imaging modality is available for use (83.8%). However, only 11.8% of providers indicated the use of MRI in their clinical assessments. This discrepancy highlights a potential disconnect between perceived use and implementation of this imaging methodology on cleft and craniofacial teams. A number of barriers were identified by providers. Challenges and opportunities for clinical translation of MRI protocols were highlighted. CONCLUSION Results may guide the development for improved clinical feasibility and implementation of MRI for clinical planning in this population of patients. Reported barriers highlight additional areas for translational research and the potential for the development of clinical tools related to MRI assessment and protocol implementation.
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Affiliation(s)
- Kazlin N. Mason
- Department of Human Services, University of Virginia, Charlottesville, VA, 22903
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Tran T, Perry J, Blemker S, Mason K. Simulation of Velopharyngeal Biomechanics Identifies Differences in Sphincter Pharyngoplasty Outcomes: A Matched Case-Control Study. Cleft Palate Craniofac J 2024; 61:339-349. [PMID: 35996316 PMCID: PMC9943793 DOI: 10.1177/10556656221122634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The purpose of this study was to develop a framework for 3D subject-specific computational models capable of simulating velopharyngeal biomechanics for anatomic changes that occur following pharyngoplasty and to gain insight into biomechanical factors that may lead to different speech/surgical outcomes. Patient-specific models for two, matched participants with differing speech/surgical outcomes were developed: one with a successful pharyngoplasty outcome and one with a failed pharyngoplasty outcome. Surgical scenarios were simulated to model pharyngoplasty location, identify LVP muscle biomechanics, and identify an optimal pharyngoplasty location for each participant. These simulations illustrate the potential for optimizing pharyngoplasties based on patient-specific geometry.
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Affiliation(s)
- Thanh Tran
- Department of Biomedical Engineering, University of Virginia
| | - Jamie Perry
- Department of Communication Sciences & Disorders, Eastern Carolina University
| | - Silvia Blemker
- Department of Biomedical Engineering, University of Virginia
| | - Kazlin Mason
- Department of Human Services, University of Virginia
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Kollara L, Perry JL, Kirschner RE, Fang X, Baylis AL. Assessment of the Velopharyngeal Mechanism at Rest and During Speech in Children With 22q11.2DS: A Cross-Sectional Study. Cleft Palate Craniofac J 2023; 60:1250-1259. [PMID: 35575228 DOI: 10.1177/10556656221100674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Velopharyngeal dysfunction (VPD) associated with 22q11.2 deletion syndrome (22q11.2DS) has a complex etiology. This study had 3 aims: (1) assess differences in velopharyngeal and levator muscle configuration during rest versus sustained speech production (2) compare differences in velopharyngeal changes between children with and without 22q11.2DS (3) examine the relationship between adenoid thickness, pharyngeal depth, and velopharyngeal changes. DESIGN Cross-sectional. METHODS A total of 22 participants, 11 with 22q11.2DS and 11 controls with normal speech and velopharyngeal anatomy (ages 4-12 years), underwent nonsedated MRI at rest and during sustained /i/. Differences in velar and levator muscle contraction across the 2 different conditions were analyzed, using matched paired t-tests. Mean differences across participant groups were examined. Correlation analyses were also conducted. RESULTS When comparing differences between rest and sustained phoneme production (aim 1), significant (P < .05) differences were noted for all velar and levator muscle variables. For differences in velopharyngeal changes between children with and without 22q11.2DS (aim 2), VP ratio and effective VP ratio were noted to be significantly different. Pharyngeal depth and adenoid thickness were correlated with velar and levator muscle change measures and ratios (aim 3). CONCLUSION Results from this study provide quantitative in vivo measurements of the contracted levator muscle and velum in young children with 22q11.2DS. Results demonstrated that VP ratio and EVP ratio are significantly different between children with and without 22q11.2DS and that pharyngeal depth is a strong clinical determinant of VPD in children with 22q11.2DS.
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Affiliation(s)
- Lakshmi Kollara
- School of Communication Sciences and Disorders, College of Health Professions and Sciences, Biionix Cluster, University of Central Florida, Orlando, FL, USA
| | - Jamie L Perry
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC, USA
| | - Richard E Kirschner
- Section of Plastic and Reconstructive Surgery, Nationwide Children's Hospital, Columbus, USA
- Clinical Plastic Surgery, The Ohio State University College of Medicine, Columbus, USA
| | - Xiangming Fang
- Department of Biostatistics, East Carolina University, Greenville, NC, USA
| | - Adriane L Baylis
- Section of Plastic and Reconstructive Surgery, Nationwide Children's Hospital, Columbus, USA
- Clinical Plastic Surgery, The Ohio State University College of Medicine, Columbus, USA
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Kong L, He Q, Li Q, Schreiber R, Kaitin KI, Shao L. Rapid progress in neuroimaging technologies fuels central nervous system translational medicine. Drug Discov Today 2023; 28:103485. [PMID: 36623797 DOI: 10.1016/j.drudis.2023.103485] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 12/12/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023]
Abstract
Central nervous system (CNS) drug discovery suffers from high attrition rates; translational neuroscience approaches aiming to reduce these high rates include the use of brain imaging technologies. However, there is a need to better understand what methods are being used and for what diseases and purposes. Our analysis of the literature found that magnetic resonance imaging (MRI), positron emission tomography (PET), and single-photon emission computed tomography (SPECT) were the neuroimaging techniques used most often in clinical trials for the most prevalent CNS diseases: Alzheimer's disease (AD), Parkinson's disease (PD), depression, and schizophrenia. Moreover, the number of initiated clinical trials using MRI, PET, and SPECT increased over the period 1981-2021. Such insights indicate that the significant increase in the use of neuroimaging studies could decrease the attrition of novel drug candidates in late clinical development.
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Affiliation(s)
- Linghui Kong
- School of Pharmacy, Fudan University, 826 Zhangheng Road, Zhangjiang Hi-tech Park, Pudong, Shanghai 201203, China
| | - Qian He
- School of Pharmacy, Fudan University, 826 Zhangheng Road, Zhangjiang Hi-tech Park, Pudong, Shanghai 201203, China
| | - Qiu Li
- Shanghai Center for iDrug Discovery & Development, 826 Zhangheng Road, Zhangjiang Hi-tech Park, Pudong, Shanghai 201203, China
| | - Rudy Schreiber
- Faculty of Psychology and Neuroscience, Section Neuropsychology & Psychopharmacology, Universiteitssingel 40, Maastricht University, PO Box 616, 6229 ER Maastricht, the Netherlands
| | - Kenneth I Kaitin
- Tufts Center for the Study of Drug Development (CSDD), Tufts University School of Medicine, Boston, MA, USA
| | - Liming Shao
- School of Pharmacy, Fudan University, 826 Zhangheng Road, Zhangjiang Hi-tech Park, Pudong, Shanghai 201203, China; Shanghai Center for iDrug Discovery & Development, 826 Zhangheng Road, Zhangjiang Hi-tech Park, Pudong, Shanghai 201203, China; State Key Laboratory of Medical Neurobiology, Fudan University, No. 138 Yixueyuan Road, Shanghai 200032, China.
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Nayak KS, Lim Y, Campbell-Washburn AE, Steeden J. Real-Time Magnetic Resonance Imaging. J Magn Reson Imaging 2022; 55:81-99. [PMID: 33295674 PMCID: PMC8435094 DOI: 10.1002/jmri.27411] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 10/06/2020] [Accepted: 10/09/2020] [Indexed: 01/03/2023] Open
Abstract
Real-time magnetic resonance imaging (RT-MRI) allows for imaging dynamic processes as they occur, without relying on any repetition or synchronization. This is made possible by modern MRI technology such as fast-switching gradients and parallel imaging. It is compatible with many (but not all) MRI sequences, including spoiled gradient echo, balanced steady-state free precession, and single-shot rapid acquisition with relaxation enhancement. RT-MRI has earned an important role in both diagnostic imaging and image guidance of invasive procedures. Its unique diagnostic value is prominent in areas of the body that undergo substantial and often irregular motion, such as the heart, gastrointestinal system, upper airway vocal tract, and joints. Its value in interventional procedure guidance is prominent for procedures that require multiple forms of soft-tissue contrast, as well as flow information. In this review, we discuss the history of RT-MRI, fundamental tradeoffs, enabling technology, established applications, and current trends. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY STAGE: 1.
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Affiliation(s)
- Krishna S. Nayak
- Ming Hsieh Department of Electrical and Computer Engineering, University of Southern California, Los Angeles, California, USA,Address reprint requests to: K.S.N., 3740 McClintock Ave, EEB 400C, Los Angeles, CA 90089-2564, USA.
| | - Yongwan Lim
- Ming Hsieh Department of Electrical and Computer Engineering, University of Southern California, Los Angeles, California, USA
| | - Adrienne E. Campbell-Washburn
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Jennifer Steeden
- Institute of Cardiovascular Science, Centre for Cardiovascular Imaging, University College London, London, UK
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Maryn Y, Zarowski A, Loomans N. Exploration of the Influences of Temporary Velum Paralysis on Auditory-Perceptual, Acoustic, and Tomographical Markers. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:4149-4177. [PMID: 34699253 DOI: 10.1044/2021_jslhr-20-00587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose To better understand hypernasality (HN), we explored the relations between velopharyngeal orifice, auditory perception of HN, and acoustic-spectral measures in an in vivo within-subject design: (a) with a normally functioning velum as the control condition and (b) with a temporarily paralyzed velum as the experimental condition. Method The velum of eight volunteers was injected with ropivacaine hydrochloride (Naropin) in the area of the levator veli palatini and tensor veli palatini muscles to induce temporary velopharyngeal inadequacy (VPI) and HN. Sustained [a] and [i] and oronasal text readings were recorded, and 3D cone-beam computed tomography images of the vocal tract were built before and during velar anesthesia. Differences between conditions and correlations in normal-to-numb differences between velopharyngeal cross-sectional area (VParea), mean ratings of HN severity, and nine acoustic-spectral measures were determined. Results Three subjects already had some incomplete velopharyngeal closure in the control condition. Temporary motor nerve blockage of the velum (increased VParea) was accomplished in seven subjects, leading to increased HN and changes in three acoustic-spectral measures. Furthermore, significant correlations only emerged between VParea, HN, and ModelKataoka. Conclusions In most of the participants, it was possible to temporarily increase the velopharyngeal orifice to investigate HN while controlling other speech variables and cephalic morphology. Although this study was exploratory and its are findings preliminary, it provided additional evidence for the possible clinical value of ModelKataoka, A 3-P 0, and B F1 for the objective measurement of VPI or HN.
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Affiliation(s)
- Youri Maryn
- Department of Otorhinolaryngology & Head and Neck Surgery, European Institute for ORL-HNS, GZA Sint-Augustinus, Wilrijk, Belgium
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Belgium
- Department of Speech-Language Therapy and Audiology, University College Ghent, Belgium
- School of Logopedics, Faculty of Psychology and Educational Sciences, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
- Phonanium, Lokeren, Belgium
| | - Andrzej Zarowski
- Department of Otorhinolaryngology & Head and Neck Surgery, European Institute for ORL-HNS, GZA Sint-Augustinus, Wilrijk, Belgium
| | - Natalie Loomans
- Department of Maxillo-Cranio-Facial Surgery, Craniofacial and Cleft Lip & Palate Team GZA Sint-Augustinus, Wilrijk, Belgium
- Face Ahead, Private Maxillo-Cranio-Facial Surgery Clinic, Antwerp, Belgium
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Xing F, Jin R, Gilbert IR, Perry JL, Sutton BP, Liu X, El Fakhri G, Shosted RK, Woo J. 4D magnetic resonance imaging atlas construction using temporally aligned audio waveforms in speech. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2021; 150:3500. [PMID: 34852570 PMCID: PMC8580575 DOI: 10.1121/10.0007064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/16/2021] [Accepted: 10/15/2021] [Indexed: 06/13/2023]
Abstract
Magnetic resonance (MR) imaging is becoming an established tool in capturing articulatory and physiological motion of the structures and muscles throughout the vocal tract and enabling visual and quantitative assessment of real-time speech activities. Although motion capture speed has been regularly improved by the continual developments in high-speed MR technology, quantitative analysis of multi-subject group data remains challenging due to variations in speaking rate and imaging time among different subjects. In this paper, a workflow of post-processing methods that matches different MR image datasets within a study group is proposed. Each subject's recorded audio waveform during speech is used to extract temporal domain information and generate temporal alignment mappings from their matching pattern. The corresponding image data are resampled by deformable registration and interpolation of the deformation fields, achieving inter-subject temporal alignment between image sequences. A four-dimensional dynamic MR speech atlas is constructed using aligned volumes from four human subjects. Similarity tests between subject and target domains using the squared error, cross correlation, and mutual information measures all show an overall score increase after spatiotemporal alignment. The amount of image variability in atlas construction is reduced, indicating a quality increase in the multi-subject data for groupwise quantitative analysis.
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Affiliation(s)
- Fangxu Xing
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts 02114, USA
| | - Riwei Jin
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Champaign, Illinois 61801, USA
| | - Imani R Gilbert
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, North Carolina 27858, USA
| | - Jamie L Perry
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, North Carolina 27858, USA
| | - Bradley P Sutton
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Champaign, Illinois 61801, USA
| | - Xiaofeng Liu
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts 02114, USA
| | - Georges El Fakhri
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts 02114, USA
| | - Ryan K Shosted
- Department of Linguistics, University of Illinois at Urbana-Champaign, Champaign, Illinois 61801, USA
| | - Jonghye Woo
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts 02114, USA
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Comparison of Real-Time Speech Magnetic Resonance Imagings With Perceptual Speech Analysis in Evaluation Velopharyngeal Sphincter Function. J Craniofac Surg 2021; 33:491-495. [PMID: 34260449 DOI: 10.1097/scs.0000000000007940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Identifying substantial data and their normative values related to velopharyngeal structures in cleft palate patients may have clinical significance, in order to selection of surgical intervention and prediction of postsurgical outcomes. Previous studies are lack of referring certain anatomic locations or distances that may have affect on speech intelligibility, especially in dynamic state. The aim of this study is to investigate effectiveness of magnetic resonance imagings on the velopharyngeal sphincter function and the correlation with speech intelligibility after functional cleft palate repair. Seventeen patients with repaired cleft palate by single surgeon were enrolled in this study.Quantitative velopharyngeal measures from the oblique coronal plane and midsagittal plane in static and dynamic positions were collected. Patients' speech intelligibility was evaluated by using Pittsburgh Weighted Speech Scale and nasalance score was also measured. Correlation analysis methods were used for evaluating relation between MRI gathered measurements and speech intelligibility scores for determiningconsequential data.Our study shows that the velar knee-posterior pharyngeal wall distance measurement while explosive sound production is the most related data with speech intelligibility. Although future works with more sample number is needed, according to current study the authors think magnetic resonance imagings is a very helpful method in providing reliable information.
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Schenck GC, Perry JL, O'Gara MM, Linde AM, Grasseschi MF, Wood RJ, Lacey MS, Fang X. Velopharyngeal Muscle Morphology in Children With Unrepaired Submucous Cleft Palate: An Imaging Study. Cleft Palate Craniofac J 2020; 58:313-323. [PMID: 32909827 DOI: 10.1177/1055665620954749] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To identify quantitative and qualitative differences in the velopharyngeal musculature and surrounding structures between children with submucous cleft palate (SMCP) and velopharyngeal insufficiency (VPI) and noncleft controls with normal anatomy and normal speech. METHODS Magnetic resonance imaging was used to evaluate the velopharyngeal mechanism in 20 children between 4 and 9 years of age; 5 with unrepaired SMCP and VPI. Quantitative and qualitative measures of the velum and levator veli palatini in participants with symptomatic SMCP were compared to noncleft controls with normal velopharyngeal anatomy and normal speech. RESULTS Analysis of covariance revealed that children with symptomatic SMCP demonstrated increased velar genu angle (15.6°, P = .004), decreased α angle (13.2°, P = .37), and longer (5.1 mm, P = .32) and thinner (4 mm, P = .005) levator veli palatini muscles compared to noncleft controls. Qualitative comparisons revealed discontinuity of the levator muscle through the velar midline and absence of a musculus uvulae in children with symptomatic SMCP compared to noncleft controls. CONCLUSIONS The levator veli palatini muscle is longer, thinner, and discontinuous through the velar midline, and the musculus uvulae is absent in children with SMCP and VPI compared to noncleft controls. The overall velar configuration in children with SMCP and VPI is disadvantageous for achieving adequate velopharyngeal closure necessary for nonnasal speech compared to noncleft controls. These findings add to the body of literature documenting levator muscle, musculus uvulae, and velar and craniometric parameters in children with SMCP.
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Affiliation(s)
- Graham C Schenck
- Department of Rehabilitation Therapies, 20731Gillette Children's Specialty Healthcare, Saint Paul, MN, USA.,Department of Communication Sciences and Disorders, University of Wisconsin-River Falls, River Falls, WI, USA
| | - Jamie L Perry
- Department of Communication Sciences and Disorders, College of Allied Health Sciences, 3627East Carolina University, Greenville, NC, USA
| | - Mary M O'Gara
- Department of Pediatric Plastic Surgery, 24183Shriners Hospital for Children-Chicago, Chicago, IL, USA.,Department of Plastic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Amy Morgan Linde
- 174539Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA.,Department of Speech, Language, and Hearing Sciences, 174539Western Michigan University, Kalamazoo, MI, USA
| | - Mitchell F Grasseschi
- Department of Pediatric Plastic Surgery, 24183Shriners Hospital for Children-Chicago, Chicago, IL, USA.,Department of Plastic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Robert J Wood
- Department of Plastic and Craniofacial Surgery, 3605Banner Health System, Phoenix, AZ, USA
| | - Martin S Lacey
- Department of Plastic Surgery, 20731Gillette Children's Specialty Healthcare, Saint Paul, MN, USA.,Department of Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Xiangming Fang
- Department of Biostatistics, College of Allied Health Sciences, 3627East Carolina University, Greenville, NC, USA
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Arendt CT, Eichler K, Mack MG, Leithner D, Zhang S, Block KT, Berdan Y, Sader R, Wichmann JL, Gruber-Rouh T, Vogl TJ, Hoelter MC. Comparison of contrast-enhanced videofluoroscopy to unenhanced dynamic MRI in minor patients following surgical correction of velopharyngeal dysfunction. Eur Radiol 2020; 31:76-84. [PMID: 32740819 DOI: 10.1007/s00330-020-07098-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/02/2020] [Accepted: 07/21/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To compare dynamic magnetic resonance imaging (MRI) with videofluoroscopy (VFS) regarding image quality and assessment of gap size between soft palate (SP) and posterior pharyngeal wall (PPW) in children and adolescents following surgical correction of velopharyngeal dysfunction (VPD). METHODS Twenty-one patients undergoing unenhanced 3-T MRI and contrast-enhanced VFS were included in this IRB-approved prospective study. The MRI scan protocol comprised refocused gradient-echo sequences in transverse and sagittal planes during speech, with TE 1.97 ms, TR 3.95 ms, flip angle 8°, matrix size 128 × 128, and 5-mm slice thickness. Radial k-space sampling and sliding window reconstruction were used to achieve an image acquisition rate of 28 frames per second (fps). VFS with 30 fps was similarly performed in both planes. Closure of the velopharyngeal port during phonation was evaluated by two experienced radiologists. RESULTS Eleven (52.4%) patients displayed a complete closure, whereas ten (47.6%) patients showed a post-operative gap during speech. VFS and MRI equally identified the cases with persistent or recurrent VPD. Differences in SP-PPW distance between VFS (3.9 ± 1.6 mm) and MRI (4.1 ± 1.5 mm) were not statistically significant (p = 0.5). The subjective overall image quality of MRI was rated inferior (p < 0.001) compared with VFS, with almost perfect inter-rater agreement (κ = 0.90). The presence of susceptibility artifacts did not limit anatomical measurements. CONCLUSION Dynamic MRI is equally reliable as VFS to assess persistent or recurrent inadequate velum closure in patients following surgical treatment of VPD. KEY POINTS • Unenhanced 3-T dynamic MRI and contrast-enhanced videofluoroscopy are equally useful for the identification of patients with incomplete velopharyngeal closure during speech. • MRI using refocused gradient-echo acquisition with radial k-space sampling and sliding window reconstruction generates diagnostic images with 28 frames per second. • MRI can offer a radiation-free alternative to currently established videofluoroscopy for young patients.
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Affiliation(s)
- C T Arendt
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
| | - K Eichler
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - M G Mack
- Radiology Munich, Munich, Germany
| | - D Leithner
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - S Zhang
- Max Planck Institute for Biophysical Chemistry, Göttingen, Germany
| | - K T Block
- Department of Radiology, University Hospital Basel, Basel, Switzerland
- Department of Radiology, New York University Langone Health, New York, NY, USA
| | - Y Berdan
- Department of Oral, Cranio-Maxillofacial and Facial Plastic Surgery, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - R Sader
- Department of Oral, Cranio-Maxillofacial and Facial Plastic Surgery, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - J L Wichmann
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - T Gruber-Rouh
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - T J Vogl
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - M C Hoelter
- Institute for Neuroradiology, University Hospital Frankfurt, Frankfurt am Main, Germany
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12
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Pua Schleif E, Pelland CM, Ellis C, Fang X, Leierer SJ, Sutton BP, Kuehn DP, Blemker SS, Perry JL. Identifying Predictors of Levator Veli Palatini Muscle Contraction During Speech Using Dynamic Magnetic Resonance Imaging. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:1726-1735. [PMID: 32539646 PMCID: PMC7839028 DOI: 10.1044/2020_jslhr-20-00013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 03/18/2020] [Accepted: 03/23/2020] [Indexed: 06/11/2023]
Abstract
Purpose The purpose of this study was to identify predictors of levator veli palatini (LVP) muscle shortening and maximum contraction velocity in adults with normal anatomy. Method Twenty-two Caucasian English-speaking adults with normal speech and resonance were recruited. Participants included 11 men and 11 women (M = 22.8 years, SD = 4.1) with normal anatomy. Static magnetic resonance images were obtained using a three-dimensional static imaging protocol. Midsagittal and oblique coronal planes were established for visualization of the velum and LVP muscle at rest. Dynamic magnetic resonance images were obtained in the oblique coronal plane during production of "ansa." Amira 6.0.1 Visualization and Volume Modeling Software and MATLAB were used to analyze images and calculate LVP shortening and maximum contraction velocity. Results Significant predictors (p < .05) of maximum LVP shortening during velopharyngeal closure included mean extravelar length, LVP origin-to-origin distance, velar thickness, pharyngeal depth, and velopharyngeal ratio. Significant predictors (p < .05) of maximum contraction velocity during velopharyngeal closure included mean extravelar length, intravelar length, LVP origin-to-origin distance, and velar thickness. Conclusions This study identified six velopharyngeal variables that predict LVP muscle function during real-time speech. These predictors should be considered among children and individuals with repaired cleft palate in future studies.
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Bae Y, Lee SAS, Velik K, Liu Y, Beck C, Fox RA. Differences in nasalance and nasality perception between Texas South and Midland dialects. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2020; 147:568. [PMID: 32007026 DOI: 10.1121/10.0000543] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 09/18/2019] [Indexed: 06/10/2023]
Abstract
While previous research has primarily concerned the dialectal influence on speakers' production of oral-nasal balance, quantitatively represented by nasalance, information on cross-dialectal variation in nasality perception is limited. This study investigated the effects of speakers'/listeners' dialectal background on oral-nasal balance characteristics estimated by nasalance, as well as nasality perception measured by direct magnitude estimation with modulus. Represented by two geographically distinct regions, Texas South and Midland dialects were of special interest given that the two dialects lie at opposite ends of normal nasalance variation [Awan, Bressmann, Poburka, Roy, Sharp, and Watts. (2015). J. Speech Lang. Hear. Res. 58, 69-77]. Mean nasalance of various speech stimuli and direct magnitude estimation ratings on synthesized vowel stimuli with varying degrees of simulated nasalization were obtained from 62 participants (31 Texas South, 31 Midland). The results revealed that the two dialectal groups significantly differed in nasalance scores and nasality ratings, with Texas South exhibiting higher nasalance for standardized passage readings and assigning higher nasality ratings on the synthetic auditory stimuli than Midland. These findings indicate that, in addition to production variations of oral-nasal balance characteristics, perceptual variations of nasality exist at a dialectal level.
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Affiliation(s)
- Youkyung Bae
- Department of Speech and Hearing Science, The Ohio State University, 1070 Carmack Road, Columbus, Ohio 43210, USA
| | - Sue Ann S Lee
- Department of Speech-Language-Hearing Sciences, Texas Tech University Health Sciences Center, 3601 4th Street, MS 6031, Lubbock, Texas 79430, USA
| | - Karl Velik
- Department of Speech and Hearing Science, The Ohio State University, 1070 Carmack Road, Columbus, Ohio 43210, USA
| | - Yilan Liu
- Department of Speech-Language-Hearing Sciences, Texas Tech University Health Sciences Center, 3601 4th Street, MS 6031, Lubbock, Texas 79430, USA
| | - Cailynn Beck
- Department of Speech and Hearing Science, The Ohio State University, 1070 Carmack Road, Columbus, Ohio 43210, USA
| | - Robert Allen Fox
- Department of Speech and Hearing Science, The Ohio State University, 1070 Carmack Road, Columbus, Ohio 43210, USA
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Velik K, Bae Y, Fox RA. Effects of regional dialect on oral-nasal balance and nasality perception. CLINICAL LINGUISTICS & PHONETICS 2019; 33:587-600. [PMID: 30646769 DOI: 10.1080/02699206.2019.1566402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 12/21/2018] [Accepted: 12/27/2018] [Indexed: 06/09/2023]
Abstract
While cross-dialectal variations in nasalance have been investigated in previous studies, the influence of regional dialect on listeners' perceptual ratings of nasality has received limited research attention. This study explored cross-dialectal differences in the production of oral-nasal balance and the perception of nasality, with special emphasis on Inland North (IN) and Midland (M) dialects in the USA. Twenty-six adults representing the IN (n = 15) and M (n = 11) dialects participated in the study. Oral-nasal balance characteristics and nasality perception were compared between dialects using mean nasalance of various speech stimuli, measured via nasometry, and perceptual ratings of nasality of synthetic vowel stimuli, measured using direct magnitude estimation (DME). Despite similar mean nasalance scores between two regional dialects for standardized passage readings and sustained vowels, IN and M groups significantly differed in their perceptual ratings of nasality, with the DMEs of IN listeners being consistently and significantly higher, i.e. more nasal, than those of M listeners. Our findings provide evidence for perceptual variations of nasality that may exist at a dialectal level in addition to cross-linguistic variations in the perception of nasality as reported by Lee et al. (2008). Further research is needed to determine to what extent perceptual variations of nasality exist in other dialects and how these variations manifest in perceptual judgments of hypernasality and its severity ratings.
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Affiliation(s)
- Karl Velik
- a Department of Speech and Hearing Science , The Ohio State University , Columbus , OH , USA
| | - Youkyung Bae
- a Department of Speech and Hearing Science , The Ohio State University , Columbus , OH , USA
| | - Robert Allen Fox
- a Department of Speech and Hearing Science , The Ohio State University , Columbus , OH , USA
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Madill C, Nguyen DD, Yick-Ning Cham K, Novakovic D, McCabe P. The Impact of Nasalance on Cepstral Peak Prominence and Harmonics-to-Noise Ratio. Laryngoscope 2018; 129:E299-E304. [PMID: 30585334 PMCID: PMC6767134 DOI: 10.1002/lary.27685] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2018] [Indexed: 11/10/2022]
Abstract
Objectives/Hypothesis Cepstral peak prominence (CPP) has been reported as a reliable measure of dysphonia and a preferred alternative to harmonics‐to‐noise ratio (HNR). However, CPP has been observed to be sensitive to articulatory variation and vocal intensity. The aim of this study was to examine the impact of nasalance on CPP and HNR of voice signals. It was hypothesized that increased nasalance would be associated with decreased CPP. Study Design Within‐subject correlation design. Methods Thirty vocally healthy female participants were recorded reading and producing a vowel in alternation with a nasal consonant while wearing a nasometer for calculation of nasalance. Recorded vowel, nasalized, and nasal segments of speech were used to calculate CPP using Analysis of Dysphonia in Speech and Voice software, and HNR and vocal intensity using Praat software. Results Significant main effects of conditions were observed for CPP. CPP values decreased significantly when phonation changed from vowel to nasalized vowel and to nasal. There was correlation between CPP and nasalance and between CPP and intensity. HNR was slightly higher in the nasal condition than in vowel. There was a weak correlation between HNR and nasalance. No correlation was found between HNR and intensity. Conclusions CPP is sensitive to changes in vocal tract configuration caused by nasalization as well as intensity, whereas HNR is not. Therefore, CPP may reflect the periodicity in source signal or the filtering effects of vocal tract. Further research is needed to clarify the application and interpretation of CPP in clinical practice. Level of Evidence 4 Laryngoscope, 129:E299–E304, 2019
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Affiliation(s)
- Catherine Madill
- Voice Research Laboratory, The University of Sydney, Sydney, New South Wales, Australia
| | - Duong Duy Nguyen
- Voice Research Laboratory, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Daniel Novakovic
- Faculty of Health Sciences and the Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Patricia McCabe
- Voice Research Laboratory, The University of Sydney, Sydney, New South Wales, Australia
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Ramanarayanan V, Tilsen S, Proctor M, Töger J, Goldstein L, Nayak KS, Narayanan S. Analysis of speech production real-time MRI. COMPUT SPEECH LANG 2018. [DOI: 10.1016/j.csl.2018.04.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Lim Y, Lingala SG, Narayanan SS, Nayak KS. Dynamic off-resonance correction for spiral real-time MRI of speech. Magn Reson Med 2018; 81:234-246. [PMID: 30058147 DOI: 10.1002/mrm.27373] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 05/01/2018] [Accepted: 05/02/2018] [Indexed: 02/03/2023]
Abstract
PURPOSE To improve the depiction and tracking of vocal tract articulators in spiral real-time MRI (RT-MRI) of speech production by estimating and correcting for dynamic changes in off-resonance. METHODS The proposed method computes a dynamic field map from the phase of single-TE dynamic images after a coil phase compensation where complex coil sensitivity maps are estimated from the single-TE dynamic scan itself. This method is tested using simulations and in vivo data. The depiction of air-tissue boundaries is evaluated quantitatively using a sharpness metric and visual inspection. RESULTS Simulations demonstrate that the proposed method provides robust off-resonance correction for spiral readout durations up to 5 ms at 1.5T. In -vivo experiments during human speech production demonstrate that image sharpness is improved in a majority of data sets at air-tissue boundaries including the upper lip, hard palate, soft palate, and tongue boundaries, whereas the lower lip shows little improvement in the edge sharpness after correction. CONCLUSION Dynamic off-resonance correction is feasible from single-TE spiral RT-MRI data, and provides a practical performance improvement in articulator sharpness when applied to speech production imaging.
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Affiliation(s)
- Yongwan Lim
- Ming Hsieh Department of Electrical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, California
| | - Sajan Goud Lingala
- Ming Hsieh Department of Electrical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, California
| | - Shrikanth S Narayanan
- Ming Hsieh Department of Electrical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, California
| | - Krishna S Nayak
- Ming Hsieh Department of Electrical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, California
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Freitas AC, Ruthven M, Boubertakh R, Miquel ME. Real-time speech MRI: Commercial Cartesian and non-Cartesian sequences at 3T and feasibility of offline TGV reconstruction to visualise velopharyngeal motion. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.01.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Töger J, Sorensen T, Somandepalli K, Toutios A, Lingala SG, Narayanan S, Nayak K. Test-retest repeatability of human speech biomarkers from static and real-time dynamic magnetic resonance imaging. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2017; 141:3323. [PMID: 28599561 PMCID: PMC5436977 DOI: 10.1121/1.4983081] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Static anatomical and real-time dynamic magnetic resonance imaging (RT-MRI) of the upper airway is a valuable method for studying speech production in research and clinical settings. The test-retest repeatability of quantitative imaging biomarkers is an important parameter, since it limits the effect sizes and intragroup differences that can be studied. Therefore, this study aims to present a framework for determining the test-retest repeatability of quantitative speech biomarkers from static MRI and RT-MRI, and apply the framework to healthy volunteers. Subjects (n = 8, 4 females, 4 males) are imaged in two scans on the same day, including static images and dynamic RT-MRI of speech tasks. The inter-study agreement is quantified using intraclass correlation coefficient (ICC) and mean within-subject standard deviation (σe). Inter-study agreement is strong to very strong for static measures (ICC: min/median/max 0.71/0.89/0.98, σe: 0.90/2.20/6.72 mm), poor to strong for dynamic RT-MRI measures of articulator motion range (ICC: 0.26/0.75/0.90, σe: 1.6/2.5/3.6 mm), and poor to very strong for velocities (ICC: 0.21/0.56/0.93, σe: 2.2/4.4/16.7 cm/s). In conclusion, this study characterizes repeatability of static and dynamic MRI-derived speech biomarkers using state-of-the-art imaging. The introduced framework can be used to guide future development of speech biomarkers. Test-retest MRI data are provided free for research use.
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Affiliation(s)
- Johannes Töger
- Ming Hsieh Department of Electrical Engineering, University of Southern California, 3740 McClintock Avenue, EEB 400, Los Angeles, California 90089-2560, USA
| | - Tanner Sorensen
- Ming Hsieh Department of Electrical Engineering, University of Southern California, 3740 McClintock Avenue, EEB 400, Los Angeles, California 90089-2560, USA
| | - Krishna Somandepalli
- Ming Hsieh Department of Electrical Engineering, University of Southern California, 3740 McClintock Avenue, EEB 400, Los Angeles, California 90089-2560, USA
| | - Asterios Toutios
- Ming Hsieh Department of Electrical Engineering, University of Southern California, 3740 McClintock Avenue, EEB 400, Los Angeles, California 90089-2560, USA
| | - Sajan Goud Lingala
- Ming Hsieh Department of Electrical Engineering, University of Southern California, 3740 McClintock Avenue, EEB 400, Los Angeles, California 90089-2560, USA
| | - Shrikanth Narayanan
- Ming Hsieh Department of Electrical Engineering, University of Southern California, 3740 McClintock Avenue, EEB 400, Los Angeles, California 90089-2560, USA
| | - Krishna Nayak
- Ming Hsieh Department of Electrical Engineering, University of Southern California, 3740 McClintock Avenue, EEB 400, Los Angeles, California 90089-2560, USA
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Lingala SG, Zhu Y, Lim Y, Toutios A, Ji Y, Lo WC, Seiberlich N, Narayanan S, Nayak KS. Feasibility of through-time spiral generalized autocalibrating partial parallel acquisition for low latency accelerated real-time MRI of speech. Magn Reson Med 2017; 78:2275-2282. [PMID: 28185301 DOI: 10.1002/mrm.26611] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 12/08/2016] [Accepted: 12/27/2016] [Indexed: 12/11/2022]
Abstract
PURPOSE To evaluate the feasibility of through-time spiral generalized autocalibrating partial parallel acquisition (GRAPPA) for low-latency accelerated real-time MRI of speech. METHODS Through-time spiral GRAPPA (spiral GRAPPA), a fast linear reconstruction method, is applied to spiral (k-t) data acquired from an eight-channel custom upper-airway coil. Fully sampled data were retrospectively down-sampled to evaluate spiral GRAPPA at undersampling factors R = 2 to 6. Pseudo-golden-angle spiral acquisitions were used for prospective studies. Three subjects were imaged while performing a range of speech tasks that involved rapid articulator movements, including fluent speech and beat-boxing. Spiral GRAPPA was compared with view sharing, and a parallel imaging and compressed sensing (PI-CS) method. RESULTS Spiral GRAPPA captured spatiotemporal dynamics of vocal tract articulators at undersampling factors ≤4. Spiral GRAPPA at 18 ms/frame and 2.4 mm2 /pixel outperformed view sharing in depicting rapidly moving articulators. Spiral GRAPPA and PI-CS provided equivalent temporal fidelity. Reconstruction latency per frame was 14 ms for view sharing and 116 ms for spiral GRAPPA, using a single processor. Spiral GRAPPA kept up with the MRI data rate of 18ms/frame with eight processors. PI-CS required 17 minutes to reconstruct 5 seconds of dynamic data. CONCLUSION Spiral GRAPPA enabled 4-fold accelerated real-time MRI of speech with a low reconstruction latency. This approach is applicable to wide range of speech RT-MRI experiments that benefit from real-time feedback while visualizing rapid articulator movement. Magn Reson Med 78:2275-2282, 2017. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Sajan Goud Lingala
- Ming Hsieh Department of Electrical Engineering, University of Southern California, Los Angeles, California, USA
| | - Yinghua Zhu
- Ming Hsieh Department of Electrical Engineering, University of Southern California, Los Angeles, California, USA
| | - Yongwan Lim
- Ming Hsieh Department of Electrical Engineering, University of Southern California, Los Angeles, California, USA
| | - Asterios Toutios
- Ming Hsieh Department of Electrical Engineering, University of Southern California, Los Angeles, California, USA
| | - Yunhua Ji
- Department of Biomedical Engineering, University of Southern California, Los Angeles, California, USA
| | - Wei-Ching Lo
- Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
| | - Nicole Seiberlich
- Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
| | - Shrikanth Narayanan
- Ming Hsieh Department of Electrical Engineering, University of Southern California, Los Angeles, California, USA
| | - Krishna S Nayak
- Ming Hsieh Department of Electrical Engineering, University of Southern California, Los Angeles, California, USA
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Burdumy M, Traser L, Burk F, Richter B, Echternach M, Korvink JG, Hennig J, Zaitsev M. One-second MRI of a three-dimensional vocal tract to measure dynamic articulator modifications. J Magn Reson Imaging 2016; 46:94-101. [PMID: 27943448 DOI: 10.1002/jmri.25561] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 11/08/2016] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To enable three-dimensional (3D) vocal tract imaging of dynamic singing or speech tasks at voxel sizes of 1.6 × 1.6 × 1.3 mm3 at 1.3 s per image. MATERIALS AND METHODS A Stack-of-Stars method was implemented and enhanced to allow for fast and efficient k-space sampling of the box-shaped vocal tract using a 3 Tesla MRI system. Images were reconstructed using an off-line image reconstruction using compressed sensing theory, leading to the abovementioned spatial and temporal resolutions. To validate spatial resolution, a phantom with holes of defined sizes was measured. The applicability of the imaging method was validated in an eight-subject study of amateur singers that were required to sustain phonation at a constant pitch, past their comfortable expiratory level. A segmentation of the vocal tract over all phonation time steps was done for one subject. Anatomical distances (larynx position and pharynx width) were calculated and compared for all subjects. RESULTS Analysis of the phantom study revealed that the imaging method could provide at least 1.6 mm isotropic resolution. Visual inspection of the segmented vocal tract during phonation showed modifications of the lips, tongue, and larynx position in all three dimensions. The mean larynx position per subject amounted to 52-85 mm, deviating up to 5% over phonation time. Parameter pharynx width was 32-181 mm2 on average per subject, deviating up to 16% over phonation time. Visual inspection of the parameter course revealed no common compensation strategy for long sustained phonation. CONCLUSION The results of both phantom and in vivo measurements show the applicability of the fast 3D imaging method for voice research and indicate that modifications in all three dimensions can be observed and quantified. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 1 J. MAGN. RESON. IMAGING 2017;46:94-101.
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Affiliation(s)
- Michael Burdumy
- University Medical Center Freiburg, Department of Radiology, Medical Physics, Freiburg, Germany.,University Medical Center Freiburg, Institute of Musicians' Medicine, Freiburg, Germany
| | - Louisa Traser
- University Medical Center Freiburg, Institute of Musicians' Medicine, Freiburg, Germany.,Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Medical Center, Freiburg, Germany
| | - Fabian Burk
- University Medical Center Freiburg, Institute of Musicians' Medicine, Freiburg, Germany
| | - Bernhard Richter
- University Medical Center Freiburg, Institute of Musicians' Medicine, Freiburg, Germany
| | - Matthias Echternach
- University Medical Center Freiburg, Institute of Musicians' Medicine, Freiburg, Germany
| | - Jan G Korvink
- Institute of Microstructure Technology, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Jürgen Hennig
- University Medical Center Freiburg, Department of Radiology, Medical Physics, Freiburg, Germany
| | - Maxim Zaitsev
- University Medical Center Freiburg, Department of Radiology, Medical Physics, Freiburg, Germany
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Relationship Between Age and Diagnosis on Volumetric and Linear Velopharyngeal Measures in the Cleft and Noncleft Populations. J Craniofac Surg 2016; 27:1340-5. [DOI: 10.1097/scs.0000000000002744] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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23
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Freitas AC, Wylezinska M, Birch MJ, Petersen SE, Miquel ME. Comparison of Cartesian and Non-Cartesian Real-Time MRI Sequences at 1.5T to Assess Velar Motion and Velopharyngeal Closure during Speech. PLoS One 2016; 11:e0153322. [PMID: 27073905 PMCID: PMC4830548 DOI: 10.1371/journal.pone.0153322] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 03/28/2016] [Indexed: 11/19/2022] Open
Abstract
Dynamic imaging of the vocal tract using real-time MRI has been an active and growing area of research, having demonstrated great potential to become routinely performed in the clinical evaluation of speech and swallowing disorders. Although many technical advances have been made in regards to acquisition and reconstruction methodologies, there is still no consensus in best practice protocols. This study aims to compare Cartesian and non-Cartesian real-time MRI sequences, regarding image quality and temporal resolution trade-off, for dynamic speech imaging. Five subjects were imaged at 1.5T, while performing normal phonation, in order to assess velar motion and velopharyngeal closure. Data was acquired using both Cartesian and non-Cartesian (spiral and radial) real-time sequences at five different spatial-temporal resolution sets, between 10 fps (1.7×1.7×10 mm3) and 25 fps (1.5×1.5×10 mm3). Only standard scanning resources provided by the MRI scanner manufacturer were used to ensure easy applicability to clinical evaluation and reproducibility. Data sets were evaluated by comparing measurements of the velar structure, dynamic contrast-to-noise ratio and image quality visual scoring. Results showed that for all proposed sequences, FLASH spiral acquisitions provided higher contrast-to-noise ratio, up to a 170.34% increase at 20 fps, than equivalent bSSFP Cartesian acquisitions for the same spatial-temporal resolution. At higher frame rates (22 and 25 fps), spiral protocols were optimal and provided higher CNR and visual scoring than equivalent radial protocols. Comparison of dynamic imaging at 10 and 22 fps for radial and spiral acquisitions revealed no significant difference in CNR performance, thus indicating that temporal resolution can be doubled without compromising spatial resolution (1.9×1.9 mm2) or CNR. In summary, this study suggests that the use of FLASH spiral protocols should be preferred over bSSFP Cartesian for the dynamic imaging of velopharyngeal closure, as it allows for an improvement in CNR and overall image quality without compromising spatial-temporal resolution.
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Affiliation(s)
- Andreia C. Freitas
- NIHR Cardiovascular Biomedical Research Unit at Barts, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom
- Clinical Physics, Barts Health NHS Trust, London, United Kingdom
| | - Marzena Wylezinska
- NIHR Cardiovascular Biomedical Research Unit at Barts, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom
| | - Malcolm J. Birch
- Clinical Physics, Barts Health NHS Trust, London, United Kingdom
| | - Steffen E. Petersen
- NIHR Cardiovascular Biomedical Research Unit at Barts, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom
| | - Marc E. Miquel
- NIHR Cardiovascular Biomedical Research Unit at Barts, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom
- Clinical Physics, Barts Health NHS Trust, London, United Kingdom
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Perry JL, Kuehn DP, Sutton BP, Fang X. Velopharyngeal Structural and Functional Assessment of Speech in Young Children Using Dynamic Magnetic Resonance Imaging. Cleft Palate Craniofac J 2016; 54:408-422. [PMID: 27031268 DOI: 10.1597/15-120] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The purpose of this study was to demonstrate a novel method for examining the velopharyngeal mechanism using static and dynamic magnetic resonance imaging (MRI) at the sentence-level production in young children with normal anatomy. This study examined whether velopharyngeal events occurring in the midsagittal plane are correlated to muscle events occurring along the plane of velopharyngeal closure. Adenoid involvement in velopharyngeal function was also explored. METHODS A high-resolution, T2-weighted turbo-spin-echo three-dimensional anatomical scan was used to acquire static velopharyngeal data and a fast-gradient echo fast low angle shot multishot spiral technique (15.8 frames per second) was used to acquire dynamic data on 11 children between 4 and 9 years old. RESULTS Changes in velar knee height from rest to the bilabial /p/ production was strongly correlated with changes in the velar configuration (r = 0.680, P = .021) and levator muscle contraction (r = 0.703, P = .016). Velar configuration was highly correlated to levator muscle changes (r = 0.685, P = .020). Mean alpha angle during bilabial /p/ production was 176°, which demonstrated that subjects achieve velopharyngeal closure at or just below the palatal plane. Subjects with a larger adenoid pad used significantly less (r = -0.660, P = .027) levator muscle contraction compared with individuals with smaller adenoids. CONCLUSIONS This study demonstrates a potentially useful technique in dynamic MRI that does not rely on cyclic repetitions or sustained phonation. This study lends support to the clinical potential of dynamic MRI methods for cleft palate management.
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Lingala SG, Zhu Y, Kim YC, Toutios A, Narayanan S, Nayak KS. A fast and flexible MRI system for the study of dynamic vocal tract shaping. Magn Reson Med 2016; 77:112-125. [PMID: 26778178 DOI: 10.1002/mrm.26090] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 11/06/2015] [Accepted: 11/24/2015] [Indexed: 11/07/2022]
Abstract
PURPOSE The aim of this work was to develop and evaluate an MRI-based system for study of dynamic vocal tract shaping during speech production, which provides high spatial and temporal resolution. METHODS The proposed system utilizes (a) custom eight-channel upper airway coils that have high sensitivity to upper airway regions of interest, (b) two-dimensional golden angle spiral gradient echo acquisition, (c) on-the-fly view-sharing reconstruction, and (d) off-line temporal finite difference constrained reconstruction. The system also provides simultaneous noise-cancelled and temporally aligned audio. The system is evaluated in 3 healthy volunteers, and 1 tongue cancer patient, with a broad range of speech tasks. RESULTS We report spatiotemporal resolutions of 2.4 × 2.4 mm2 every 12 ms for single-slice imaging, and 2.4 × 2.4 mm2 every 36 ms for three-slice imaging, which reflects roughly 7-fold acceleration over Nyquist sampling. This system demonstrates improved temporal fidelity in capturing rapid vocal tract shaping for tasks, such as producing consonant clusters in speech, and beat-boxing sounds. Novel acoustic-articulatory analysis was also demonstrated. CONCLUSION A synergistic combination of custom coils, spiral acquisitions, and constrained reconstruction enables visualization of rapid speech with high spatiotemporal resolution in multiple planes. Magn Reson Med 77:112-125, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Sajan Goud Lingala
- Electrical Engineering, University of Southern California, Los Angeles, CA
| | - Yinghua Zhu
- Electrical Engineering, University of Southern California, Los Angeles, CA
| | | | - Asterios Toutios
- Electrical Engineering, University of Southern California, Los Angeles, CA
| | | | - Krishna S Nayak
- Electrical Engineering, University of Southern California, Los Angeles, CA
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Lingala SG, Sutton BP, Miquel ME, Nayak KS. Recommendations for real-time speech MRI. J Magn Reson Imaging 2016; 43:28-44. [PMID: 26174802 PMCID: PMC5079859 DOI: 10.1002/jmri.24997] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 06/23/2015] [Indexed: 11/11/2022] Open
Abstract
Real-time magnetic resonance imaging (RT-MRI) is being increasingly used for speech and vocal production research studies. Several imaging protocols have emerged based on advances in RT-MRI acquisition, reconstruction, and audio-processing methods. This review summarizes the state-of-the-art, discusses technical considerations, and provides specific guidance for new groups entering this field. We provide recommendations for performing RT-MRI of the upper airway. This is a consensus statement stemming from the ISMRM-endorsed Speech MRI summit held in Los Angeles, February 2014. A major unmet need identified at the summit was the need for consensus on protocols that can be easily adapted by researchers equipped with conventional MRI systems. To this end, we provide a discussion of tradeoffs in RT-MRI in terms of acquisition requirements, a priori assumptions, artifacts, computational load, and performance for different speech tasks. We provide four recommended protocols and identify appropriate acquisition and reconstruction tools. We list pointers to open-source software that facilitate implementation. We conclude by discussing current open challenges in the methodological aspects of RT-MRI of speech.
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Affiliation(s)
| | - Brad P. Sutton
- University of Illinois at Urbana-Champaign, Urbana-Champaign, Illinois, USA
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Özen AC, Traser L, Echternach M, Dadakova T, Burdumy M, Richter B, Bock M. Ensuring safety and functionality of electroglottography measurements during dynamic pulmonary MRI. Magn Reson Med 2015; 76:1629-1635. [PMID: 26599237 DOI: 10.1002/mrm.26037] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 10/14/2015] [Accepted: 10/15/2015] [Indexed: 11/06/2022]
Abstract
PURPOSE To combine vocal tract measurements with dynamic MRI of the lungs to provide fundamental insights into the lung physiology during singing. METHODS To analyze vocal fold oscillatory patterns during dynamic lung MRI, an electroglottography (EGG) system was modified to allow for simultaneous EGG measurements during MR image acquisitions. A low-pass filter was introduced to suppress residual radiofrequency (RF) coupling into the EGG signal. RF heating was tested in a gel phantom to ensure MR safety, and functionality of the EGG device was assessed in a volunteer experiment at singing frequencies from A5 to A3. In the recorded EGG signals, remaining RF interferences were removed by independent component analysis post processing, and standard EGG parameters such as fundamental frequency, contact quotient and jitter were calculated. In a second volunteer experiment, EGG recordings were compared with lung diameter measurements from 2D time-resolved trueFISP acquisitions. RESULTS RF heating measurements resulted in less than 1.2°C temperature increase in the gel phantom. EGG parameters measured during MR imaging are within the range of ideal values. In the lung measurement, both the lung diameter and the EGG recordings could be successfully performed with only minimal interference. CONCLUSION EGG recording is pos sible during dynamic lung MRI, and glottal activity can be studied safely at 1.5T. Magn Reson Med 76:1629-1635, 2016. © 2015 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Ali Caglar Özen
- Department of Radiology-Medical Physics, University Medical Center Freiburg, Germany.
| | - Louisa Traser
- Institute of Musicians Medicine, University Medical Center Freiburg, Germany.,Department of Otolaryngology, University Medical Center Freiburg, Germany
| | - Matthias Echternach
- Institute of Musicians Medicine, University Medical Center Freiburg, Germany
| | - Tetiana Dadakova
- Department of Radiology-Medical Physics, University Medical Center Freiburg, Germany
| | - Michael Burdumy
- Department of Radiology-Medical Physics, University Medical Center Freiburg, Germany
| | - Bernhard Richter
- Institute of Musicians Medicine, University Medical Center Freiburg, Germany
| | - Michael Bock
- Department of Radiology-Medical Physics, University Medical Center Freiburg, Germany
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Evaluating velopharyngeal closure with real-time MRI. Pediatr Radiol 2015; 45:941-2. [PMID: 25399057 DOI: 10.1007/s00247-014-3230-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 11/02/2014] [Indexed: 10/24/2022]
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Fu M, Zhao B, Carignan C, Shosted RK, Perry JL, Kuehn DP, Liang ZP, Sutton BP. High-resolution dynamic speech imaging with joint low-rank and sparsity constraints. Magn Reson Med 2015; 73:1820-32. [PMID: 24912452 PMCID: PMC4261062 DOI: 10.1002/mrm.25302] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 04/11/2014] [Accepted: 05/05/2014] [Indexed: 11/11/2022]
Abstract
PURPOSE To enable dynamic speech imaging with high spatiotemporal resolution and full-vocal-tract spatial coverage, leveraging recent advances in sparse sampling. METHODS An imaging method is developed to enable high-speed dynamic speech imaging exploiting low-rank and sparsity of the dynamic images of articulatory motion during speech. The proposed method includes: (a) a novel data acquisition strategy that collects spiral navigators with high temporal frame rate and (b) an image reconstruction method that derives temporal subspaces from navigators and reconstructs high-resolution images from sparsely sampled data with joint low-rank and sparsity constraints. RESULTS The proposed method has been systematically evaluated and validated through several dynamic speech experiments. A nominal imaging speed of 102 frames per second (fps) was achieved for a single-slice imaging protocol with a spatial resolution of 2.2 × 2.2 × 6.5 mm(3) . An eight-slice imaging protocol covering the entire vocal tract achieved a nominal imaging speed of 12.8 fps with the identical spatial resolution. The effectiveness of the proposed method and its practical utility was also demonstrated in a phonetic investigation. CONCLUSION High spatiotemporal resolution with full-vocal-tract spatial coverage can be achieved for dynamic speech imaging experiments with low-rank and sparsity constraints.
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Affiliation(s)
- Maojing Fu
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois
- Beckman Institute of Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Bo Zhao
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois
- Beckman Institute of Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | | | - Ryan K. Shosted
- Department of Linguistics, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Jamie L. Perry
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, North Carolina
| | - David P. Kuehn
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Zhi-Pei Liang
- Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois
- Beckman Institute of Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Bradley P. Sutton
- Beckman Institute of Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, Illinois
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Wylezinska M, Pinkstone M, Hay N, Scott AD, Birch MJ, Miquel ME. Impact of orthodontic appliances on the quality of craniofacial anatomical magnetic resonance imaging and real-time speech imaging. Eur J Orthod 2015; 37:610-7. [PMID: 25667040 DOI: 10.1093/ejo/cju103] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
AIMS The aim of this work was to investigate the effects of commonly used orthodontic appliances on the magnetic resonance (MR) image quality of the craniofacial region, with special interest in the soft palate and velopharyngeal wall using real-time speech imaging sequences and anatomical imaging of the temporomandibular joints (TMJ) and pituitaries. METHODS Common orthodontic appliances were studied on 1.5 T scanner using standard spin and gradient echo sequences (based on the American Society for Testing and Materials standard test method) and sequences previously applied for high-resolution anatomical and dynamic real-time imaging during speech. Images were evaluated for the presence and size of artefacts. RESULTS Metallic orthodontic appliances had different effects on image quality. The most extensive individual effects were associated with the presence of stainless steel archwire, particularly if combined with stainless steel brackets and stainless steel molar bands. With those appliances, diagnostic quality of magnetic resonance imaging speech and palate images will be most likely severely degraded, or speech imaging and imaging of pituitaries and TMJ will be not possible. All non-metallic, non-metallic with Ni/Cr reinforcement or Ni/Ti alloys appliances were of little concern. LIMITATIONS The results in the study are only valid at 1.5 T and for the sequences and devices used and cannot necessarily be extrapolated to all sequences and devices. Furthermore, both geometry and size of some appliances are subject dependent, and consequently, the effects on the image quality can vary between subjects. Therefore, the results presented in this article should be treated as a guide when assessing the risks of image quality degradation rather than an absolute evaluation of possible artefacts. CONCLUSIONS Appliances manufactured from stainless steel cause extensive artefacts, which may render image non-diagnostic. The presence and type of orthodontic appliances should be always included in the patient's screening, so the risks of artefacts can be assessed prior to imaging. Although the risks to patients with fixed orthodontic appliances at 1.5 T MR scanners are low, their secure attachment should be confirmed prior to the examination.
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Affiliation(s)
- Marzena Wylezinska
- *Clinical Physics, Barts Health NHS Trust, London, **Barts and the London NIHR CVBRU, London Chest Hospital
| | - Marie Pinkstone
- ***Cleft Lip and Palate Team, Great Ormond Street Hospital for Children, London
| | - Norman Hay
- ****Dental and Maxillofacial Department, Great Ormond Street Hospital for Children, London
| | - Andrew D Scott
- *Clinical Physics, Barts Health NHS Trust, London, *****NIHR Cardiovascular Biomedical Research Unit, The Royal Brompton Hospital, London, UK
| | | | - Marc E Miquel
- *Clinical Physics, Barts Health NHS Trust, London, **Barts and the London NIHR CVBRU, London Chest Hospital,
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Burdumy M, Traser L, Richter B, Echternach M, Korvink JG, Hennig J, Zaitsev M. Acceleration of MRI of the vocal tract provides additional insight into articulator modifications. J Magn Reson Imaging 2015; 42:925-35. [PMID: 25647755 DOI: 10.1002/jmri.24857] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 01/09/2015] [Indexed: 11/05/2022] Open
Abstract
PURPOSE To accelerate dynamic imaging of the vocal tract during articulation. MATERIALS AND METHODS Five subjects were imaged by magnetic resonance imaging (MRI) while repeating the word "Partikel" at 90 beats per minute, using both a radio-frequency-spoiled radial gradient echo sequence with golden angle projection rotation and a previously applied real-time Cartesian sequence. The acquired data were reconstructed using a CG-SENSE method and Cartesian reconstruction. The images from both methods were compared by measuring distances between anatomical landmarks that are important for resonance behavior of the vocal tract. Only commonly available hardware and software were used. RESULTS With the presented radial method a spatial resolution of 1.8 mm at 25 frames per second could be achieved. Overall, the morphometric measurements of the vocal tract showed less deviation for the radial sequence both across repetitions and for all subjects. Fast modifications, such as complete lip closing, could be analyzed with greater fidelity using the high temporal resolution of the radial sequence. CONCLUSION The results indicate that higher temporal resolution is a necessity to catch fast morphometric changes in the vocal tract.
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Affiliation(s)
- Michael Burdumy
- University Medical Center Freiburg, Department of Radiology, Medical Physics, Freiburg, Germany.,Institute of Musicians' Medicine, University Medical Center, Freiburg, Germany
| | - Louisa Traser
- Institute of Musicians' Medicine, University Medical Center, Freiburg, Germany.,Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Medical Center, Freiburg, Germany
| | - Bernhard Richter
- Institute of Musicians' Medicine, University Medical Center, Freiburg, Germany
| | - Matthias Echternach
- Institute of Musicians' Medicine, University Medical Center, Freiburg, Germany
| | - Jan G Korvink
- IMTEK, University Freiburg, Lab of Simulation, Freiburg, Germany
| | - Jürgen Hennig
- University Medical Center Freiburg, Department of Radiology, Medical Physics, Freiburg, Germany
| | - Maxim Zaitsev
- University Medical Center Freiburg, Department of Radiology, Medical Physics, Freiburg, Germany
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Bettens K, Wuyts FL, Van Lierde KM. Instrumental assessment of velopharyngeal function and resonance: a review. JOURNAL OF COMMUNICATION DISORDERS 2014; 52:170-183. [PMID: 24909583 DOI: 10.1016/j.jcomdis.2014.05.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 04/14/2014] [Accepted: 05/16/2014] [Indexed: 06/03/2023]
Abstract
UNLABELLED The purpose of this literature review is to describe and discuss instrumental assessment techniques of the velopharyngeal function in order to diagnose velopharyngeal disorders and resonance characteristics. Both direct and indirect assessment techniques are addressed, in which successively nasopharyngoscopy, videofluoroscopy, magnetic resonance imaging (MRI), cephalometric radiographic analysis, computed tomography (CT), ultrasound, acoustic and aerodynamic measurements are considered. Despite the multiple instrumental assessments available to detect and define velopharyngeal dysfunction, the ideal technique is not yet accessible. Therefore, a combination of different quantitative parameters can possibly form a solution for a more reliable determination of resonance disorders. These multi-dimensional approaches will be described and discussed. The combination of quantitative measurement techniques and perceptual evaluation of nasality will probably remain necessary to provide sufficient information to make appropriate decisions concerning the diagnosis and treatment of resonance disorders. LEARNING OUTCOMES The reader will be able to describe and discuss currently available instrumental techniques to assess the velopharyngeal mechanism and its functioning in order to diagnose velopharyngeal disorders. Additionally, he will be able to explain the possible advantages of the combination of several types of complementary measurement techniques.
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Affiliation(s)
- Kim Bettens
- Department of Speech, Language and Hearing Sciences, Ghent University, Ghent, Belgium.
| | - Floris L Wuyts
- Department of Speech, Language and Hearing Sciences, Ghent University, Ghent, Belgium; Biomedical Physics, University of Antwerp, Antwerp, Belgium
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Bae Y, Perry JL, Kuehn DP. Videofluoroscopic investigation of body position on articulatory positioning. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2014; 57:1135-1147. [PMID: 24167231 DOI: 10.1044/2013_jslhr-s-12-0235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE To quantitatively examine the effects of body position on the positioning of the epiglottis, tongue, and velum at rest and during speech. METHOD Videofluoroscopic data were obtained from 12 healthy adults in the supine and upright positions at rest and during speech while the participants produced 12 VCV sequences. The effects of body position, target sounds, and adjacent sounds on structural positioning and vowel formant structure were investigated. RESULTS Velar retropositioning in the supine position was the most consistent pattern observed at rest. During speech, all structures, with varying degrees of adjustment, appeared to work against the gravitational pull, resulting in no significant narrowing in the oro- and nasopharyngeal regions while in the supine position. Minimal differences in the formant data between the body positions were also observed. Overall, structural positioning was significantly dependent on the target and adjacent sounds regardless of body position. CONCLUSIONS The present study demonstrated that structural positioning in response to gravity varied across individuals based on the type of activities being performed. With varying degrees of positional adjustment across different structures, fairly consistent articulatory positioning in the anterior-posterior dimension was maintained in different body positions during speech.
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Scott AD, Wylezinska M, Birch MJ, Miquel ME. Speech MRI: morphology and function. Phys Med 2014; 30:604-18. [PMID: 24880679 DOI: 10.1016/j.ejmp.2014.05.001] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 04/24/2014] [Accepted: 05/01/2014] [Indexed: 11/27/2022] Open
Abstract
Magnetic Resonance Imaging (MRI) plays an increasing role in the study of speech. This article reviews the MRI literature of anatomical imaging, imaging for acoustic modelling and dynamic imaging. It describes existing imaging techniques attempting to meet the challenges of imaging the upper airway during speech and examines the remaining hurdles and future research directions.
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Affiliation(s)
- Andrew D Scott
- Clinical Physics, Barts Health NHS Trust, London EC1A 7BE, United Kingdom; NIHR Cardiovascular Biomedical Research Unit, The Royal Brompton Hospital, Sydney Street, London SW3 6NP, United Kingdom
| | - Marzena Wylezinska
- Clinical Physics, Barts Health NHS Trust, London EC1A 7BE, United Kingdom; Barts and The London NIHR CVBRU, London Chest Hospital, London E2 9JX, United Kingdom
| | - Malcolm J Birch
- Clinical Physics, Barts Health NHS Trust, London EC1A 7BE, United Kingdom
| | - Marc E Miquel
- Clinical Physics, Barts Health NHS Trust, London EC1A 7BE, United Kingdom; Barts and The London NIHR CVBRU, London Chest Hospital, London E2 9JX, United Kingdom.
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35
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Displacement of oropharyngeal structures during suction-swallowing cycles. Eur Arch Otorhinolaryngol 2014; 271:1987-97. [DOI: 10.1007/s00405-014-2919-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 01/23/2014] [Indexed: 10/25/2022]
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Perry JL, Sutton BP, Kuehn DP, Gamage JK. Using MRI for assessing velopharyngeal structures and function. Cleft Palate Craniofac J 2013; 51:476-85. [PMID: 23566261 DOI: 10.1597/12-083] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Direct visualization of the velopharynx and, in particular, the levator muscle is particularly important in the assessment of velopharyngeal function and normal speech production. The purpose of this study is to demonstrate the development of a static and dynamic magnetic resonance imaging protocol for evaluation of velopharyngeal structures and function. METHODS A high-resolution, T2-weighted turbo-spin-echo three-dimensional anatomical scan (sampling perfection with application optimized contrasts using different flip angle evolution) was used to acquire a large field of view covering the velopharyngeal anatomy. Dynamic speech assessment was obtained using a fast-gradient echo, fast low-angle shot, multi-shot spiral technique to acquire 15.8 frames per second (FPS) of the sagittal and oblique coronal image planes. RESULTS Using a three-dimensional data set, as opposed to two-dimensional data, the full contour of the levator muscle can be appreciated. Dynamic images were obtained at 15.8 FPS in the sagittal and oblique coronal planes, enabling visualization of the movements of the velum, posterior pharyngeal wall, lateral pharyngeal walls, and levator muscle during speech. CONCLUSIONS A three-dimensional magnetic resonance imaging sequence, such as that used in the present study, may provide better analyses and more precise measurements. A dynamic fast low-angle shot sequence allows for visualization of the levator muscle and the velum during speech at a high image rate. This protocol could have a significant impact in improving the process of visualizing pathology and promoting clinical treatment plans for individuals born with cleft lip and palate.
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Scott AD, Boubertakh R, Birch MJ, Miquel ME. Adaptive averaging applied to dynamic imaging of the soft palate. Magn Reson Med 2012; 70:865-74. [PMID: 23023822 DOI: 10.1002/mrm.24503] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Revised: 08/13/2012] [Accepted: 08/24/2012] [Indexed: 11/07/2022]
Abstract
Achieving sufficient temporal and spatial resolution with adequate signal-to-noise ratio (SNR) in dynamic soft palate imaging is challenging. Triggered acquisitions require repeated reproducible speech samples, and while real-time imaging is more reliable, it may lack SNR. Adaptive averaging was implemented to improve SNR in nongated imaging during repetition of a speech task. Similar images were identified using localized cross-correlation before averaging. Adaptive averaging was applied to the soft palate region of images from six volunteers and one patient acquired with various sequences. In volunteers, soft palate SNR increased by 53 ± 17% with four averages. The additional SNR was used to enable reduced slice thickness in two example subjects. Adaptive averaging was also compared to pseudotriggered images in one example and, in another, it was applied to an unrepeated speech task. In a patient with a repaired cleft palate, the technique was used to demonstrate residual velopharyngeal insufficiency. This initial work demonstrates that increased temporal or spatial resolution may be traded for reduced SNR, which can be recovered using adaptive averaging. This will be a valuable tool in assessing velopharyngeal function, particularly in pediatric patients where cooperation may make gated studies difficult or when their head sizes require increased spatial resolution while maintaining temporal resolution.
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Affiliation(s)
- Andrew D Scott
- Department of Clinical Physics, Barts Health NHS Trust, London, UK
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Scott AD, Boubertakh R, Birch MJ, Miquel ME. Towards clinical assessment of velopharyngeal closure using MRI: evaluation of real-time MRI sequences at 1.5 and 3 T. Br J Radiol 2012; 85:e1083-92. [PMID: 22806623 DOI: 10.1259/bjr/32938996] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The objective of this study was to demonstrate soft palate MRI at 1.5 and 3 T with high temporal resolution on clinical scanners. METHODS Six volunteers were imaged while speaking, using both four real-time steady-state free-precession (SSFP) sequences at 3 T and four balanced SSFP (bSSFP) at 1.5 T. Temporal resolution was 9-20 frames s(-1) (fps), spatial resolution 1.6 × 1.6 × 10.0-2.7 × 2.7 × 10.0 mm(3). Simultaneous audio was recorded. Signal-to-noise ratio (SNR), palate thickness and image quality score (1-4, non-diagnostic-excellent) were evaluated. RESULTS SNR was higher at 3 T than 1.5 T in the relaxed palate (nasal breathing position) and reduced in the elevated palate at 3 T, but not 1.5 T. Image quality was not significantly different between field strengths or sequences (p=NS). At 3 T, 40% acquisitions scored 2 and 56% scored 3. Most 1.5 T acquisitions scored 1 (19%) or 4 (46%). Image quality was more dependent on subject or field than sequence. SNR in static images was highest with 1.9 × 1.9 × 10.0 mm(3) resolution (10 fps) and measured palate thickness was similar (p=NS) to that at the highest resolution (1.6 × 1.6 × 10.0 mm(3)). SNR in intensity-time plots through the soft palate was highest with 2.7 × 2.7 × 10.0 mm(3) resolution (20 fps). CONCLUSIONS At 3 T, SSFP images are of a reliable quality, but 1.5 T bSSFP images are often better. For geometric measurements, temporal should be traded for spatial resolution (1.9 × 1.9 × 10.0 mm(3), 10 fps). For assessment of motion, temporal should be prioritised over spatial resolution (2.7 × 2.7 × 10.0 mm(3), 20 fps). Advances in knowledge Diagnostic quality real-time soft palate MRI is possible using clinical scanners and optimised protocols have been developed. 3 T SSFP imaging is reliable, but 1.5 T bSSFP often produces better images.
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Affiliation(s)
- A D Scott
- Clinical Physics, Barts Health NHS Trust, London, UK.
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Bae Y, Kuehn DP, Sutton BP, Conway CA, Perry JL. Three-dimensional magnetic resonance imaging of velopharyngeal structures. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2011; 54:1538-1545. [PMID: 22052285 DOI: 10.1044/1092-4388(2011/10-0021)] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
PURPOSE To report the feasibility of using a 3-dimensional (3D) magnetic resonance imaging (MRI) protocol for examining velopharyngeal structures. Using collected 3D MRI data, the authors investigated the effect of sex on the midsagittal velopharyngeal structures and the levator veli palatini (levator) muscle configurations. METHOD Ten Caucasian healthy adults (5 women and 5 men) participated. A whole-head 3D MRI scan was obtained while participants were at rest in the supine position. Basic anatomic parameters of the velopharynx including midsagittal velopharyngeal structures and levator muscle configurations were compared between sexes. RESULTS Detailed information on the 3D MRI protocol and data analysis method was introduced in the study. On the basis of the data, only the length of the levator muscle showed a statistically significant sex difference: Male participants had significantly longer levator muscles than those of female participants. CONCLUSIONS The present study successfully demonstrated the use of 3D MRI in quantifying major velopharyngeal structures and provided additional data on the anatomic variations that exist in healthy adult individuals.
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