Application of B+M-Mode Ultrasound in Evaluating Dysphagia in Elderly Stroke Patients

The purpose of this study was to evaluate and compare the swallow-related muscles and bones movement patterns during swallowing quantitatively by B+M-mode ultrasound, and to investigate its application value in dysphagia.

Sixty elderly stroke patients with dysphagia (patient group) and sixty healthy elderly individuals (control group) were enrolled in this study. M-mode ultrasound was utilized to measure the radial displacement and duration of tongue and geniohyoid muscle movements. B-mode ultrasound was employed to assess hyoid bone displacement and the distance of hyoid-larynx approximation. Ultrasound parameters were compared between the two groups. Logistic regression was used to identify the optimal parameters with independent predictive value. The predictive efficacy of each parameter for dysphagia was evaluated using ROC curve analysis.

Both intraindividual and interindividual variations were observed in the B+M-mode imaging traces during the three swallows. Significant differences were found in the average radial displacement and duration of tongue and geniohyoid muscle movements, hyoid bone displacement, and hyoid-larynx approximation distance between the two groups (all p < 0.001). The radial displacement of the tongue and geniohyoid muscle, hyoid bone displacement, and hyoid-larynx approximation distance were lower in the patient group compared to the control group, while the duration of tongue and geniohyoid muscle movements was higher in the patient group. Logistic regression selected the radial displacement of the tongue, the duration of geniohyoid muscle movement, and the hyoid-larynx approximation distance as significant predictors. The combined model demonstrated excellent predictive performance with an AUC of 0.994 and good model fit (p < 0.001).

The B+M-mode ultrasound offers a rapid and safe technique for the preliminary evaluation of swallowing movements. It can serve as a quantitative and noninvasive method for the clinical screening of dysphagia.