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Time-Synchronized MRI-Assessment of Respiratory Apparatus Subsystems—A Feasibility Study

Published:January 13, 2023DOI:https://doi.org/10.1016/j.jvoice.2022.11.006

      Summary

      The thorax (TH), the thoracic diaphragm (TD), and the abdominal wall (AW) are three sub-systems of the respiratory apparatus whose displacement motion has been well studied with the use of magnetic resonance imaging (MRI). Another sub-system, which has however received less research attention with respect to breathing, is the pelvic floor (PF). In particular, there is no study that has investigated the displacement of all four sub-systems simultaneously. Addressing this issue, it was the purpose of this feasibility study to establish a data acquisition paradigm for time-synchronous quantitative analysis of dynamic MRI data from these four major contributors to respiration and phonation (TH, TD, AW, and PF). Three healthy females were asked to breathe in and out forcefully while being recorded in a 1.5-Tesla whole body MR-scanner. Spanning a sequence of 15.12 seconds, 40 MRI data frames were acquired. Each data frame contained two slices, simultaneously documenting the mid-sagittal (TH, TD, PF) and transversal (AW) planes. The displacement motion of the four anatomical structures of interest was documented using kymographic analysis, resulting in time-varying calibrated structure displacement data. After computing the fundamental frequency of the cyclical breathing motion, the phase offsets of the TH, PF, and AW with respect to the TD were computed. Data analysis revealed three fundamentally different displacement patterns. Total structure displacement was in the range of 0.94 cm (TH) to 4.27 cm (TD). Phase delays of up to 90 (i.e., a quarter of a breathing cycle) between different structures were found. Motion offsets in the range of -28.30 to 14.90 were computed for the PF with respect to the TD. The diversity of results in only three investigated participants suggests a variety of possible breathing strategies, warranting further research.

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      References

        • Hixon T.
        Respiratory Function in Speech and Song.
        College-Hill, Boston1987
        • Proctor D.F.
        Breathing, speech, and song.
        Springer-Verlag, Wien1980
        • Bouhuys A.
        • Proctor D.
        • Mead J.
        Kinetic aspects of singing.
        J Large, editor, Contributions of voice research to singing, pages 58–87. College-Hill Press, Houston, Texas1980
        • Zenker W.
        • Glaninger J.
        Die Stärke des Trachealzuges beim lebenden Menschen und seine bedeutung für die Kehlkopfmechanik.
        Z Biologie. 1959; 111: 154-164
        • Iwarsson J.
        • Thomasson M.
        • Sundberg J.
        Effects of lung volume on the glottal voice source.
        J Voice. 1998; 12: 424-433
        • Herbst C.T.
        A review of singing voice subsystem interactions–toward an extended physiological model of ”support”.
        J Voice. 2017; 31: 249.e13-249.e19
        • Sundberg J.
        Breathing behavior during singing.
        The NATS Journal. 1993; 49: 49-51
        • Emerich K.
        • Reed O.
        The role of the pelvic floor in respiration: A multidisciplinary literature review.
        J Voice. 2020; 34: 243-249
        • Comiter C.V.
        • Vasavada S.P.
        • Barbaric Z.L.
        • Gousse A.E.
        • Raz S.
        Grading pelvic prolapse and pelvic floor relaxation using dynamic magnetic resonance imaging.
        Urology. 1999; 54: 454-457
        • Sprenger D.
        • Lienemann A.
        • Anthuber C.
        • Reiser M.
        Funktionelle MRT des Beckenbodens: Normale Anatomie und pathologische Befunde.
        Der Radiologe 2000 40:5. 2000; 40: 451-457
        • Fielding J.R.
        MR imaging of pelvic floor relaxation.
        Radiol Clin North Am. 2003; 41: 747-756
        • Lienemann A.
        • Fischer T.
        Functional imaging of the pelvic floor.
        Eur J Radiol. 2003; 47: 117-122
        • Talasz H.
        • Kremser C.
        • Kofler M.
        • et al.
        Phase-locked parallel movement of diaphragm and pelvic floor during breathing and coughing-a dynamic MRI investigation in healthy females.
        Int Urogynecol J. 2011; 22: 61-68
        • Bitti G.T.
        • Argiolas G.M.
        • Ballicu N.
        • et al.
        Pelvic floor failure: MR imaging evaluation of anatomic and functional abnormalities.
        Radiographics. 2014; 34: 429-448
        • Farouk R.
        • Sayed E.
        • Alt C.D.
        • et al.
        Magnetic resonance imaging of pelvic floor dysfunction - joint recommendations of the ESUR and ESGAR pelvic floor working group.
        Eur Radiol. 2017; 27: 2067-2085
        • Baken R.J.
        • Orlikoff R.F.
        Clinical measurement of speech and voice.
        (2nd edition). Singular Publishing, Thompson Learning, San Diego, CA2000
        • Traser L.
        • Schwab C.
        • Burk F.
        • et al.
        The influence of gravity on respiratory kinematics during phonation measured by dynamic magnetic resonance imaging.
        Scient Rep. 2021; 11: 1-13
        • Talasz H.
        • Kremser C.
        • Kofler M.
        • et al.
        Proof of concept: differential effects of valsalva and straining maneuvers on the pelvic floor.
        Eur J Obstetr Gynecol Reprod Biol. 2012; 164: 227-233
        • Traser L.
        • Özen A.C.
        • Burk F.
        • et al.
        Respiratory dynamics in phonation and breathing–a real-time MRI study.
        Respir Physiol Neurobiol. 2017; 236: 69-77
        • Bunch M.
        • Chapman J.
        Taxonomy of singers used as subjects in scientific research.
        J Voice. 2000; 14: 363-369
        • Bieri O.
        • Scheffler K.
        Fundamentals of balanced steady state free precession MRI.
        J Magn Resonance Imaging. 2013; 38: 2-11
        • Frahm J.
        • Haase A.
        • Matthaei D.
        Rapid NMR imaging of dynamic processes using the FLASII technique.
        Magn Reson Med. 1986; 3: 321-327
        • Stumpf P.
        Kymographische Röntgendiagnostik. Zur Beurteilung des Herzens in Beispielen.
        Thieme, Stuttgart. 1951;
        • Gall V.
        Strip kymography of the glottis.
        Arch Oto-Rhino-Laryngol. 1984; 240: 287-293
        • Svec J.G.
        • Schutte H.K.
        Videokymography: high-speed line scanning of vocal fold vibration.
        J Voice. 1996; 10: 201-205
        • Boersma P.
        Accurate short-term analysis of the fundamental frequency and the harmonics-to-noise ratio of a sampled sound.
        In: Proceedings of the Institute of Phonetic Sciences. 1993; 17: 97-110
      1. Boersma P, Weenink D. Praat: doing phonetics by computer. 2020.

        • Blackman R.B.
        • Tukey J.W.
        The measurement of power spectra from the point of view of communications engineering – part i.
        Bell Syst Tech J. 1958; 37: 185-282
      2. Jones E, Oliphant T, Peterson P, and Others. Scipy: Open Source Scientific Tools for Python. 2001.

        • Oliphant T.E.
        Python for scientific computing.
        Comput Sci Eng. 2007; 9: 10-20
        • Slavin G.S.
        • Bluemke D.A.
        Spatial and temporal resolution in cardiovascular MR imaging: review and recommendations.
        Radiology. 2005; 234: 330-338
        • Zhao Z.
        • Lim Y.
        • Byrd D.
        • et al.
        Improved 3D real-time MRI of speech production.
        Magn Reson Med. 2021; 85: 3182-3195
        • Story B.
        • Titze I.R.
        • Hoffman E.A.
        Vocal tract area functions for an adult female speaker based on volumetric imaging.
        J Acoust Soc Am. 1998; 104: 471-487
        • Guite K.M.
        • Hinshaw J.L.
        • Ranallo F.N.
        • et al.
        Ionizing radiation in abdominal CT: Unindicated multiphase scans are an important source of medically unnecessary exposure.
        J Am Coll Radiol. 2011; 8: 756-761
        • Chambers C.E.
        Health risks of ionizing radiation: Dr Roentgen today.
        Circulation. 2017; 136: 2417-2419
        • Puckett Y.
        • Nappe T.M.
        Ionizing radiation.
        Encyclopedia Genetics Genomics Proteom Informatics. 2018;
      3. 1625–1625
        • Meyer D.
        • Rusho R.Z.
        • Alam W.
        • et al.
        High-resolution three-dimensional hybrid MRI + low dose CT vocal tract modeling: a cadaveric pilot study.
        J Voice. 2022; in presshttps://doi.org/10.1016/j.jvoice.2022.09.013
        • Breyer T.
        • Echternach M.
        • Arndt S.
        • et al.
        Dynamic magnetic resonance imaging of swallowing and laryngeal motion using parallel imaging at 3 T.
        Magn Reson Imaging. 2009; 27: 48-54
        • Lingala S.G.
        • Zhu Y.
        • Kim Y.-C.
        • et al.
        A fast and flexible MRI system for the study of dynamic vocal tract shaping.
        Magn Reson Med. 2016; 77: 112-125
        • Fischer J.
        • Özen A.C.
        • Ilbey S.
        • et al.
        Sub-millisecond 2D MRI of the vocal fold oscillation using single-point imaging with rapid encoding.
        MAGMA. 2022; 35: 301-310
        • Roark R.M.
        Frequency and voice: perspectives in the time domain.
        J Voice. 2006; 20: 325-354
        • Herbst C.T.
        • Dunn J.C.
        Fundamental frequency estimation of low-quality electroglottographic signals.
        J Voice. 2018;