title: Utility of brain MRI in children with sleep-disordered breathing.
abstract: To investigate the utility of a brain magnetic resonance imaging (MRI) in children with sleep-disordered breathing (SDB), classified as isolated obstructive sleep apnea (OSA) in the absence of adenotonsillar hypertrophy, persistent OSA following adenotonsillectomy, isolated central sleep apnea (CSA) of unclear etiology, OSA with coexisting CSA of unclear etiology, or unexplained nocturnal hypoventilation (NH).
  
  
  
  Retrospective chart review of polysomnography (PSG) and brain MRI data.
  
  
  
  Children with PSG evidence of SDB, as described above, and who subsequently had their first brain MRI, were included. PSG, MRI data, and subsequent interventions were recorded.
  
  
  
  A total of 59 of 6,087 (1%) children met inclusion criteria. Of those, 28 of 59 (47%) were nonsyndromic children and 31 of 59 (53%) were syndromic children with an underlying medical disorder. Abnormal brain MRI findings were observed in 19 of 59 (32%) children, where eight of 19 (42%) were nonsyndromic and 11 of 19 (58%) were syndromic. Abnormal brain MRI findings were most common in syndromic children with combined OSA and CSA without adenotonsillar hypertrophy. Isolated OSA was also a common PSG finding associated with an abnormal brain MRI. Of the nonsyndromic children with an abnormal brain MRI, the most common abnormal brain MRI finding was Chiari malformation (CM), observed in 88% of the group. A brainstem tumor was identified in one nonsyndromic child. Interventions following brain MRI included neurosurgery, chemotherapy, and noninvasive positive pressure ventilation (NiPPV).
  
  
  
  A brain MRI is an important diagnostic tool in syndromic and nonsyndromic children, especially in children with either isolated OSA or combined OSA and CSA without a clear etiology.
  
  
  
  4. Laryngoscope, 2016 127:513-519, 2017.
authors.affiliation: Division of Respiratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada.|University of Toronto, Toronto, Ontario, Canada.
authors.forename: Sarah
authors.initials: S
authors.lastname: Selvadurai
authors.affiliation: Division of Respiratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada.|University of Toronto, Toronto, Ontario, Canada.
authors.forename: Suhail
authors.initials: S
authors.lastname: Al-Saleh
authors.affiliation: Division of Respiratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada.|University of Toronto, Toronto, Ontario, Canada.
authors.forename: Reshma
authors.initials: R
authors.lastname: Amin
authors.affiliation: Division of Respiratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Allison
authors.initials: A
authors.lastname: Zweerink
authors.affiliation: Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada.|University of Toronto, Toronto, Ontario, Canada.
authors.forename: James
authors.initials: J
authors.lastname: Drake
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Hospital for Sick Children, Toronto, Ontario, Canada.|University of Toronto, Toronto, Ontario, Canada.
authors.forename: Evan J
authors.initials: EJ
authors.lastname: Propst
authors.affiliation: Division of Respiratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada.|University of Toronto, Toronto, Ontario, Canada.
authors.forename: Indra
authors.initials: I
authors.lastname: Narang
mesh_terms: D000234:Adenoids / Q000473:pathology; D001139:Arnold-Chiari Malformation / Q000175:diagnosis / Q000628:therapy; D001921:Brain / Q000473:pathology*; D020295:Brain Stem Neoplasms / Q000175:diagnosis / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006965:Hyperplasia; D008279:Magnetic Resonance Imaging; D008297:Male; D014066:Palatine Tonsil / Q000473:pathology; D017286:Polysomnography; D012189:Retrospective Studies; D012891:Sleep Apnea Syndromes / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D020182:Sleep Apnea, Central / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D013577:Syndrome
keywords: Pediatric; central; magnetic resonance imaging; obstructive; persistent; sleep apnea; sleep-disordered breathing