Using Atlas-driven Imaging for Determining Variations in Velopharyngeal Function Among Children with Cleft Palate and Hypernasal Speech

项目总结 唇腭裂是美国最常见的出生缺陷，每577人中就有一人受到影响 出生。尽管外科手术取得了进步，但据估计，25%-38%的腭裂修复儿童将 由于腭咽闭合不充分，继续有上鼻音，需要额外的 手术。虽然鼻内窥镜经常被用来确定手术类型，但它只提供 对言论运动的有限看法。当前诊断中可用信息不足 用于可视化儿童肌肉位置及其量化功能排列的技术。 磁共振成像(MRI)提供了良好的软组织结构可视化，例如 肌肉，但传统上太慢，无法捕捉到语音动力学，在这种情况下，完全收缩可能 发生在100毫秒内。 目前的方案开发了一种动态核磁共振成像方法，可以在 3D+时间，具有高空间和高时间分辨率，可实现166帧/秒(FPS) 整个音量。具体地说，将开发适用于以下方面的动态语音成像技术 在5-8岁儿童中的应用，这是继发性腭裂再次修复的关键年龄范围 外科治疗。这项技术整合了描述平均运动的时空地图集 在一群健康的儿童中寻找特定的语音样本。成像技术利用 该图集能够：提高重建图像的质量，自动标记边缘以进行定量 分析，并重点分析了一个受试者与健康图谱相比的运动差异。 为了考察人口平均图谱对性别、种族和方言的依赖性，时空 将在三个不同的地理地点制作地图集，其中包括40名5-8岁的健康儿童 在每个地点，男女人数相等，两个种族人数相等。此外，我们还将招聘 45例5~8岁腭裂修复术后的腭裂患者 由于过度鼻音而导致的鼻音不足。我们将应用我们的成像技术来检查颞叶 腭咽部肌肉功能的特点，决定与运动相关的差异 过度鼻音。

PROJECT SUMMARY Cleft lip and palate is the most prevalent birth defect in the United States affecting one out of every 577 births. Despite advances in surgery, it is estimated that 25-38% of children with a repaired cleft palate will continue to have hypernasal speech due to insufficient velopharyngeal closure, requiring additional surgeries. Although nasal endoscopy is frequently used to determine the type of surgery, it provides only limited views of the movements of speech. Insufficient information is available from current diagnostic technologies to visualize the location of muscles and their quantitative functional arrangement in the child. Magnetic resonance imaging (MRI) provides excellent visualization of soft tissue structures, such as muscles, but has traditionally been too slow to capture speech dynamics where complete contractions may occur in 100 ms. The current proposal develops a dynamic MRI imaging method that can image the full vocal tract in 3D+time with high spatial and high temporal resolution, achieving 166 frames per second (FPS) for the entire volume. Specifically, a dynamic speech imaging technique will be developed that is suitable for application in children aged 5-8 years old, a critical age range for re-repair of cleft palate in secondary surgical management. The technique integrates a spatiotemporal atlas that describes the mean motions across a population of healthy children for particular speech samples. The imaging technique leverages the atlas to: improve the quality of the reconstructed images, automatically label edges for quantitative analysis, and focuses the analysis on variances in motion from one subject compared to the healthy atlas. In order to examine the dependency of the population mean atlas on sex, race, and dialect, spatiotemporal atlases will be developed at three different geographical sites, with 40 healthy children ages 5-8 years old at each site, with equal numbers of both sexes and equal numbers of two races. Additionally, we will recruit 45 cleft palate patients ages 5-8 years old following cleft palate repair with and without velopharyngeal insufficiency with resulting hypernasality. We will apply our imaging technique to examine temporal characteristics of velopharyngeal muscle function, determining movement differences related to hypernasality.