Chauvel Marin, Tessier Christophe, Venkatasamy Aïna, Estebe Sandrine, Jégoux Franck
Department of Otorhinolaryngology-Head and Neck Surgery, Rennes University Hospital, 2 Rue Henri Le Guilloux, Rennes CEDEX 9, 35033, France.
IHU-Strasbourg, Institute of Image-Guided Surgery, Strasbourg, 67200, France.
Dysphagia. 2025 Aug;40(4):700-710. doi: 10.1007/s00455-024-10797-w. Epub 2024 Dec 27.
Videofluoroscopy, recognized as the gold standard for dysphagia exploration, has inherent limitations, including poor soft tissue discrimination, radiation exposure, and aspiration risk. In response to these challenges, cine-MRI of swallowing has evolved over the past three decades, yielding diverse methodologies and results across various studies.This systematic review, conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, meticulously outlines cine-MRI protocols, applications, advantages, and limitations. Our qualitative analysis encompasses 36 studies involving 715 subjects from 2001 to 2023. Cine-MRI, a promising alternative, provides safe application for dysphagic patients, offering insights into the intricacies of deglutition mechanisms and eliminating the necessity for oral contrast material. Notably, this approach is adaptable to both 1.5 and 3T MRI scanners with specific image acceleration protocols.Despite these merits, a crucial gap remains, as no non-inferiority prospective study has yet been conducted to compare cine-MRI with the gold standard. Additionally, the lack of uniform swallowing assessment criteria and the uncertain impact of the supine position underscore the need for further investigation. In conclusion, while cine-MRI of deglutition emerges as a compelling tool for dysphagia exploration, its precise indications and role in the diagnostic approach to swallowing disorders necessitate comprehensive evaluation in future studies.
视频荧光吞咽造影检查被公认为吞咽困难检查的金标准,但它存在一些固有局限性,包括软组织分辨能力差、辐射暴露以及误吸风险。为应对这些挑战,吞咽电影磁共振成像(cine-MRI)在过去三十年中不断发展,不同研究产生了多样的方法和结果。本系统评价按照系统评价与Meta分析的首选报告项目(PRISMA)指南进行,详细概述了cine-MRI的方案、应用、优势和局限性。我们的定性分析涵盖了2001年至2023年的36项研究,涉及715名受试者。Cine-MRI是一种有前景的替代方法,可为吞咽困难患者提供安全应用,深入了解吞咽机制的复杂性,并且无需使用口服造影剂。值得注意的是,这种方法可通过特定的图像加速方案适用于1.5T和3T磁共振成像扫描仪。尽管有这些优点,但仍存在一个关键差距,因为尚未进行非劣效性前瞻性研究来将cine-MRI与金标准进行比较。此外,缺乏统一的吞咽评估标准以及仰卧位的影响不确定,这突出表明需要进一步研究。总之,虽然吞咽cine-MRI成为吞咽困难检查的一种有吸引力的工具,但其在吞咽障碍诊断方法中的精确适应症和作用需要在未来研究中进行全面评估。