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1 From the Departments of Radiology (J.G.) and Speech Pathology (G.D.G.), Boston Veterans Administration Medical Center, West Roxbury, Mass; and the Department of Radiology, Baystate Medical Center, Tufts University School of Medicine, Springfield, Mass (G.G.H.). Presented in part as an education exhibit at the 2004 RSNA Annual Meeting. Received May 14, 2005; revision requested June 27; revision received and accepted November 1. All authors have no financial relationships to disclose. Address correspondence to J.G., 288 Park Dr, Springfield, MA 01106 (e-mail: gandjhartnell{at}comcast.net).
Many patients with neurologic impairment due to stroke, multiple sclerosis, trauma, bulbar palsy, and other disorders have difficulty swallowing. Videofluoroscopy can provide important information on patterns of impairment of the swallowing mechanism, allowing important changes in patient treatment. The detailed videofluoroscopic evaluation required to provide this information is now seldom taught and is practiced by relatively few radiologists. The aim of this article is to (a) describe the indications for videofluoroscopic swallowing studies in the evaluation of patients with neurologic conditions affecting swallowing, (b) describe the techniques for evaluating the swallow mechanism with videofluoroscopy in a standardized manner, and (c) use cine videofluoroscopy to illustrate the range of abnormalities that can be demonstrated for some of these conditions and discuss the effect of patient treatment.
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