Cine magnetic resonance imaging with single-shot fast spin echo for evaluation of dysphagia and aspiration

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