Jose E Barrera1. 1. Division of Sleep Surgery, Department of Otolaryngology, Wilford Hall Medical Center, Lackland Air Force Base, Texas 78236, USA. jose.barrera@us.af.mil
Abstract
OBJECTIVES/HYPOTHESIS: To determine the dynamic characteristics of airway obstruction in subjects with obstructive sleep apnea (OSA) syndrome. STUDY DESIGN: A prospective cohort study of 20 OSA patients and 19 control subjects who underwent real-time magnetic resonance imaging (MRI) evaluation between 2006 and 2008. METHODS: The dynamics of the upper airway were visualized using real-time MRI (RTHawk system, Stanford, CA) during natural sleep. Respiratory and desaturation events were correlated to polysomnogram results, and anatomic site of obstruction was determined from the real-time MRI sequences. The relation between visually observed airway obstructions and autonomic system changes was quantified and reliability calculated (Cronbach α, Aabel 2009; Gigawiz, Ltd., Tulsa, OK). An automated analysis tool was developed to determine which respiratory event is associated with the longest duration and location of obstruction in the posterior airway space (Matlab 2009; Mathworks, Inc., Natick, MA). RESULTS: Airway obstructions visualized on Sleep MRI during natural sleep included retropalatal, retroglossal, and combined obstruction. Respiratory events (mean rate of 31.9 per hour per subject) and desaturations (mean rate of 19.4 per hour per subject) temporally coincided with airway obstructive events. Intrarater reliability coefficients ranged from a low of 0.95 to a high of 1.0 for each rater. Inter-rater reliability coefficients ranged from a low of 0.85 to a high of 1.0. CONCLUSIONS: Sleep MRI is a novel and reliable approach to simultaneously evaluate airway obstructions and respiratory events in real time during natural sleep. Sleep MRI can define the dynamic characteristics of airway obstruction in both surgically naive and postsurgical OSA patients.
OBJECTIVES/HYPOTHESIS: To determine the dynamic characteristics of airway obstruction in subjects with obstructive sleep apnea (OSA) syndrome. STUDY DESIGN: A prospective cohort study of 20 OSA patients and 19 control subjects who underwent real-time magnetic resonance imaging (MRI) evaluation between 2006 and 2008. METHODS: The dynamics of the upper airway were visualized using real-time MRI (RTHawk system, Stanford, CA) during natural sleep. Respiratory and desaturation events were correlated to polysomnogram results, and anatomic site of obstruction was determined from the real-time MRI sequences. The relation between visually observed airway obstructions and autonomic system changes was quantified and reliability calculated (Cronbach α, Aabel 2009; Gigawiz, Ltd., Tulsa, OK). An automated analysis tool was developed to determine which respiratory event is associated with the longest duration and location of obstruction in the posterior airway space (Matlab 2009; Mathworks, Inc., Natick, MA). RESULTS: Airway obstructions visualized on Sleep MRI during natural sleep included retropalatal, retroglossal, and combined obstruction. Respiratory events (mean rate of 31.9 per hour per subject) and desaturations (mean rate of 19.4 per hour per subject) temporally coincided with airway obstructive events. Intrarater reliability coefficients ranged from a low of 0.95 to a high of 1.0 for each rater. Inter-rater reliability coefficients ranged from a low of 0.85 to a high of 1.0. CONCLUSIONS: Sleep MRI is a novel and reliable approach to simultaneously evaluate airway obstructions and respiratory events in real time during natural sleep. Sleep MRI can define the dynamic characteristics of airway obstruction in both surgically naive and postsurgical OSA patients.
Authors: Dhananjay Radhakrishnan Subramaniam; Goutham Mylavarapu; Keith McConnell; Robert J Fleck; Sally R Shott; Raouf S Amin; Ephraim J Gutmark Journal: Ann Biomed Eng Date: 2015-07-28 Impact factor: 3.934
Authors: Roberta M Kato; Yoon-Chul Kim; Biswas Joshi; Shirleen Loloyan; Choo Phei Wee; Ziyue Wu; Winston H Tran; Thomas G Keens; Michael C K Khoo; Krishna S Nayak; Sally L Davidson Ward Journal: Ann Am Thorac Soc Date: 2018-12
Authors: Yoon-Chul Kim; R Marc Lebel; Ziyue Wu; Sally L Davidson Ward; Michael C K Khoo; Krishna S Nayak Journal: Magn Reson Med Date: 2013-06-20 Impact factor: 4.668