title: The use of magnetic resonance imaging in the evaluation of upper airway structures in paediatric obstructive sleep apnoea syndrome: a systematic review and meta-analysis.
abstract: OBJECTIVE
  A systematic review was conducted to assess the effectiveness of MRI in evaluating upper airway structures in children affected by obstructive sleep apnoea syndrome (OSAS).
  
  
  METHODS
  A literature search was performed in the Cochrane Central Register of Controlled Trials, Web of Science, Scopus and PubMed databases from their inception to 31/03/2016, including available randomized controlled trials and controlled clinical trials published in English assessing the use of MRI integrated with traditional polysomnography (PSG) among children up to 15 years of age affected by OSAS. The primary outcome to be evaluated was the efficacy of MRI in analyzing the upper airway total volume among healthy children compared with children affected by OSAS. Secondary outcomes were to compare the efficacy of MRI in analyzing the upper airway cross-sectional area in the areas adjacent to the adenoids and tonsils, adenoid and tonsil volume, and soft-tissue and maxillofacial bone parameters in the same sample. Results were expressed using a random-effects model and mean differences (MD) with 95% confidence intervals (CI).
  
  
  RESULTS
  The search yielded 1005 titles in total; the selection process narrowed to 3 titles, which were all assessed as indicating an unclear level of risk of bias. The meta-analysis found evidence of MRI effectiveness in evaluating differences in the upper airway total volume between paediatric patients affected by OSAS and paediatric patients not affected by OSAS (MD -0.56 cm(3); 95% CI: -1.05 to -0.07).
  
  
  CONCLUSIONS
  Although MRI could be considered effective in evaluating upper airway structures in children affected by OSAS, based on the present evidence, PSG is still the golden standard and further studies are required to verify MRI reliability.
authors.affiliation: 1 Dentistry Unit of Head and Neck Clinical Area, School of Dentistry, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Romeo
authors.initials: R
authors.lastname: Patini
authors.affiliation: 2 Department of Surgery, Microsurgery and Medical Sciences, School of Dentistry, University of Sassari, Sassari, Italy.
authors.forename: Mariantonietta
authors.initials: M
authors.lastname: Arrica
authors.affiliation: 3 Molecular Clinical Biology Unit of Laboratory Medicine Clinical Area, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Di Stasio
authors.affiliation: 1 Dentistry Unit of Head and Neck Clinical Area, School of Dentistry, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Gallenzi
authors.affiliation: 1 Dentistry Unit of Head and Neck Clinical Area, School of Dentistry, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Cordaro
mesh_terms: D000293:Adolescent; D019412:Anatomy, Cross-Sectional / Q000379:methods; D015982:Bias; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods*; D010614:Pharynx / Q000000981:diagnostic imaging; D017286:Polysomnography / Q000379:methods; D012137:Respiratory System / Q000000981:diagnostic imaging*; D020181:Sleep Apnea, Obstructive / Q000000981:diagnostic imaging*
keywords: MRI; child; diagnosis; sleep apnoea