Dynamic upper airway collapse observed from sleep MRI: BMI-matched severe and mild OSA patients.
Dynamic magnetic resonance imaging (MRI) allows real-time characterization of upper airway collapse in sleeping subjects with obstructive sleep apnea (OSA). The aim of our study was to use sleep MRI to compare differences in upper airway collapse sites between BMI-matched subjects with mild OSA and severe OSA. This is a prospective, nested case-control study using dynamic sleep MRI to compare 15 severe OSA subjects (AHI >40) and 15 mild OSA (AHI <10) subjects, who were matched for BMI. Upper airway imaging was performed on sleeping subjects in a 3.0 T MRI scanner. Sleep MRI movies were used by blinded reviewers to identify retropalatal (RP), retroglossal (RG), and lateral pharyngeal wall (LPW) airway collapse. Mean AHI in the severe OSA group was 70.3 ± 23 events/h, and in the mild group was 7.8 ± 1 events/h (p < 0.001). All mild and severe OSA subjects demonstrated retropalatal airway collapse. Eighty percent in the mild group showed single-level RP collapse (p < 0.001). All subjects in the severe group showed multi-level collapse: RP + LPW (n = 9), RP + RG + LPW (n = 6). All severe OSA subjects showed LPW collapse, as compared with three subjects in the mild group (p < 0.001). LPW collapse was positively associated with AHI in simple regression analysis (β = 51.8, p < 0.001). In conclusion, severe OSA patients present with more lateral pharyngeal wall collapse as compared to BMI-matched mild OSA patients.
Department of Otolaryngology-Head and Neck Surgery, Cathay General Hospital, Taipei, Taiwan.|School of Medicine, Fu Jen Catholic University, Taipei, Taiwan.|Department of Biomedical Sciences and Engineering, National Central University, Taoyuan, Taiwan.
Leh-Kiong
LK
Huon
Division of Sleep Surgery, Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Stanford University, Stanford, CA, USA.
Stanley Yung-Chuan
SY
Liu
Division of Medical Imaging, National Taiwan University, Taipei, Taiwan.
Tiffany Ting-Fang
TT
Shih
Department of Dental Medicine, National Taiwan University, Taipei, Taiwan.
Yunn-Jy
YJ
Chen
Department of Biomedical Sciences and Engineering, National Central University, Taoyuan, Taiwan.
Men-Tzung
MT
Lo
Department of Otolaryngology-Head and Neck Surgery, Cathay General Hospital, Taipei, Taiwan. drtony@seed.net.tw.|School of Medicine, Fu Jen Catholic University, Taipei, Taiwan. drtony@seed.net.tw.
Pa-Chun
PC
Wang
D000328:Adult; D015992:Body Mass Index; D016022:Case-Control Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000033:anatomy & histology; D015588:Observer Variation; D010614:Pharynx / Q000000981:diagnostic imaging / Q000503:physiopathology*; D017286:Polysomnography; D011446:Prospective Studies; D012890:Sleep; D020181:Sleep Apnea, Obstructive / Q000000981:diagnostic imaging / Q000503:physiopathology*; D018709:Statistics, Nonparametric
Lateral pharyngeal wall collapse; Obstructive sleep apnea; Sleep magnetic resonance imaging