Pharynx and oesophagus evaluation during the swallow using helical computerized tomography.

Area of Science:

• Medical Imaging
• Gastroenterology
• Anatomy

Background:

• Videofluorography and endoscopy are standard dynamic imaging techniques for pharyngeal swallowing.
• These methods lack transverse plane (TP) visualization capabilities.
• Pharyngeal swallowing mechanics require detailed 3D assessment.

Purpose of the Study:

• To evaluate helical computerized tomography (HCT) for dynamic imaging (DI) of pharyngeal swallowing.
• To assess HCT's ability to provide transverse plane (TP) information.
• To determine HCT's utility in visualizing the pharyngoesophageal segment (PES).

Main Methods:

• Utilized single-slice cine mode HCT with 100 ms scan times.
• Subjects underwent HCT during dry swallow and swallowing of barium sulphate jelly and solutions (3-20 ml).
• Test-retest reliability was assessed in 9 subjects over intervals exceeding one week.

Main Results:

• HCT visualized pharyngeal constriction, vocal fold closure, and piriform sinus narrowing during swallowing.
• Laryngeal elevation and pharyngoesophageal segment (PES) opening were observed.
• A 20 ml bolus maximized anteroposterior/transverse diameters and PES opening area; test-retest reliability (0.86-0.98) was high.

Conclusions:

• Helical computerized tomography (HCT) effectively visualizes the transverse plane of the pharyngoesophageal segment (PES).
• HCT complements existing dynamic imaging (DI) methods like videofluorography and endoscopy.
• HCT offers valuable 3D insights into pharyngeal swallowing dynamics.