American Journal of Oral Medicine and Radiology

FEASIBILITY AND DIAGNOSTIC ACCURACY OF ULTRA-FAST DYNAMIC MRI IN THEEVALUATION OF VOCAL CORD MOTILITY IN PERSISTENT HOARSENESS

Dr. Donepudi Rajeev

Hoarseness, Vocal cord palsy, Magnetic resonance imaging (MRI), Signal-to-noise ratio (SNR), Steady-state free precession (SSFP)

Endoscopy is the commonly used to assess hoarseness, yet it is an invasive technique, which highly relies on patient cooperation. Anatomical difficulties, ill health, or blood clotting disorders can also restrict its success. This paper set out to discuss the possibility of applying ultra-fast magnetic resonance imaging (MRI) as a non-invasive substitute in the detection of the vocal cord movement disorders. It employed a custom-made coil array and a high signal-to-noise ratio (SNR) imaging sequence. A prospective, blinded examination was done on 12 patients (eight males and four females, aged 24 to 80 years, average age 60) who presented with persistent hoarseness and vocal cord paralysis was suspected. Signal detection was undertaken using two carotid phased-array coils. Each participant was scanned in two real-time steady-state free precession (SSFP) MRI sequences: one in silence and the other one producing the sound heee. Results of Laryngoscopic examination were then compared to those of MRI. The preparation, scanning and instructions took less than 10 minutes in total. MRI was able to detect all the seven unilateral vocal cord paralysis cases confirmed by endoscopy. The other five patients, whose hoarseness had been caused by other factors, had normal movement of the vocal cords both on MRI and endoscopy. The present study established that the image quality obtained was optimized because of the high SNR afforded by the particular coils and SSFP sequence which were better than other frequently utilized sequences. A larger study of the participants should be done to identify that this technique can become an alternative to endoscopy in a selected group of patients.