李铮,鲜军舫,叶京英.电影MRI评估阻塞性睡眠呼吸暂停低通气综合征患者自然睡眠时上气道阻塞部位及模式[J].中国医学影像技术,2018,34(7):990~993
电影MRI评估阻塞性睡眠呼吸暂停低通气综合征患者自然睡眠时上气道阻塞部位及模式
Cine MRI evaluation on site and pattern of upper airway obstruction in patients with obstructive sleep apnea-hypopnea syndrome during natural sleep
投稿时间:2017-08-08  修订日期:2018-05-08
DOI:10.13929/j.1003-3289.201708043
中文关键词:  睡眠呼吸暂停,阻塞性  低通气综合征  睡眠  磁共振成像
英文关键词:Sleep apnea,obstructive  Hypoventilation syndrome  Sleep  Magnetic resonance imaging
基金项目:北京市卫生系统高层次卫生技术人才学科带头人(2014-2-005)、北京市医院管理局重点医学专业发展计划(ZYLX201704)、中国博士后科学基金资助(2011M500026)、科技部国家科技计划支撑项目(2015BAI16H00)、北京市"百千万人才工程"(2014001)。
作者单位E-mail
李铮 首都医科大学附属北京同仁医院放射科, 北京 100730  
鲜军舫 首都医科大学附属北京同仁医院放射科, 北京 100730 cjr.xianjunfang@vip.163.com 
叶京英 北京清华长庚医院耳鼻喉头颈外科, 北京 102218  
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中文摘要:
      目的 比较阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者自然睡眠发生呼吸暂停时上气道阻塞部位与清醒状态时上气道最狭窄部位之间的一致性,并评估自然睡眠发生呼吸暂停时上气道阻塞模式的类型。方法 对32例重度OSAHS患者于清醒状态下获取上气道矢状位3D T2WI,于自然睡眠发生呼吸暂停时行上气道正中矢状位电影MR (CMR)扫描,比较自然睡眠发生呼吸暂停时气道阻塞部位与清醒状态时上气道最狭窄部位的一致性,并根据患者软腭和舌部等上气道相关结构动态塌陷特点对上气道阻塞模式进行分型。结果 18例(18/32,56.25%)自然睡眠发生呼吸暂停时上气道阻塞部位与清醒状态时上气道最狭窄部位不一致(χ2=3.87,P<0.05),14例一致。自然睡眠发生呼吸暂停时上气道阻塞模式Ⅰ型10例(10/32,31.25%)、Ⅱ型9例(9/32,28.12%)、Ⅲ型13例(13/32,40.63%),3种上气道阻塞模式间患者年龄、体质量指数及睡眠呼吸暂停低通气指数差异均无统计学意义(P均>0.05)。结论 自然睡眠发生呼吸暂停时,上气道正中矢状位CMR扫描可准确判断OSAHS患者上气道阻塞部位,并能评估上气道及相关结构动态变化的差异。
英文摘要:
      Objective To compare the difference between the narrowest site of the upper airway (UA) during wakefulness and the obstructed site of UA at apneic events during natural sleep and apnea, and to evaluate different dynamic collapse patterns of UA during natural sleep in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods Totally 32 patients with severe OSAHS were enrolled. Sagittal 3D T2WI of UA during wakefulness and median sagittal Cine MR (CMR) during natural sleep and apnea were obtained. The consistency of narrowest site during wakefulness and the obstructed site during natural sleep was observed. The dynamic collapse patterns of the soft palate and the tongue of OSAHS patients were evaluated.Results The narrowest site of UA during wakefulness was inconsistent with the obstructed site of UA at apneic events during natural sleep in 18 patients (18/32, 56.25%; χ2=3.87, P<0.05), while the narrowest site during wakefulness were consistent with the obstruction site during natural sleep in 14 patients. Type Ⅰobstruction pattern was observed in 10 patients (10/32, 31.25%), type Ⅱin 9 patients (9/32, 28.12%), and type Ⅲ in 13 patients (13/32, 40.63%). There was no statistically significant difference of patients' age,body mass index and apnea-hypopnea index among three obstruction patterns.Conclusion CMR imaging during natural sleep could accurately identify the site of UA obstruction and evaluate UA and related structures dynamic collapse patterns.
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