Weiyi Chen1, Emily Gillett2,3, Michael C K Khoo4, Sally L Davidson Ward2,3, Krishna S Nayak1. 1. Ming Hsieh Department of Electrical Engineering, University of Southern California, Los Angeles, California, USA. 2. Children's Hospital Los Angeles, Los Angeles, California, USA. 3. Keck School of Medicine, University of Southern California, Los Angeles, California, USA. 4. Department of Biomedical Engineering, University of Southern California, Los Angeles, California, USA.
Abstract
PURPOSE: To determine if a real-time magnetic resonance imaging (RT-MRI) method during continuous positive airway pressure (CPAP) can be used to measure neuromuscular reflex and/or passive collapsibility of the upper airway in individual obstructive sleep apnea (OSA) subjects. MATERIALS AND METHODS: We conducted experiments on four adolescents with OSA and three healthy controls, during natural sleep and during wakefulness. Data were acquired on a clinical 3T scanner using simultaneous multislice (SMS) RT-MRI during CPAP. CPAP pressure level was alternated between therapeutic and subtherapeutic levels. Segmented airway area changes in response to rapid CPAP pressure drop and restoration were used to estimate 1) upper airway loop gain (UALG), and 2) anatomical risk factors, including fluctuation of airway area (FAA). RESULTS: FAA significantly differed between OSA patients (2-4× larger) and healthy controls (Student's t-test, P < 0.05). UALG and FAA measurements indicate that neuromuscular reflex and passive collapsibility varied among the OSA patients, suggesting the presence of different OSA phenotypes. Measurements had high intrasubject reproducibility (intraclass correlation coefficient r > 0.7). CONCLUSION: SMS RT-MRI during CPAP can reproducibly identify physiological traits and anatomical risk factors that are valuable in the assessment of OSA. This technique can potentially locate the most collapsible airway sites. Both UALG and FAA possess large variation among OSA patients. LEVEL OF EVIDENCE: 1 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2017;46:1400-1408.
PURPOSE: To determine if a real-time magnetic resonance imaging (RT-MRI) method during continuous positive airway pressure (CPAP) can be used to measure neuromuscular reflex and/or passive collapsibility of the upper airway in individual obstructive sleep apnea (OSA) subjects. MATERIALS AND METHODS: We conducted experiments on four adolescents with OSA and three healthy controls, during natural sleep and during wakefulness. Data were acquired on a clinical 3T scanner using simultaneous multislice (SMS) RT-MRI during CPAP. CPAP pressure level was alternated between therapeutic and subtherapeutic levels. Segmented airway area changes in response to rapid CPAP pressure drop and restoration were used to estimate 1) upper airway loop gain (UALG), and 2) anatomical risk factors, including fluctuation of airway area (FAA). RESULTS: FAA significantly differed between OSA patients (2-4× larger) and healthy controls (Student's t-test, P < 0.05). UALG and FAA measurements indicate that neuromuscular reflex and passive collapsibility varied among the OSA patients, suggesting the presence of different OSA phenotypes. Measurements had high intrasubject reproducibility (intraclass correlation coefficient r > 0.7). CONCLUSION: SMS RT-MRI during CPAP can reproducibly identify physiological traits and anatomical risk factors that are valuable in the assessment of OSA. This technique can potentially locate the most collapsible airway sites. Both UALG and FAA possess large variation among OSA patients. LEVEL OF EVIDENCE: 1 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2017;46:1400-1408.
Authors: Bradley A Edwards; Andrew Wellman; Scott A Sands; Robert L Owens; Danny J Eckert; David P White; Atul Malhotra Journal: Sleep Date: 2014-07-01 Impact factor: 5.849
Authors: Clete A Kushida; Michael R Littner; Timothy Morgenthaler; Cathy A Alessi; Dennis Bailey; Jack Coleman; Leah Friedman; Max Hirshkowitz; Sheldon Kapen; Milton Kramer; Teofilo Lee-Chiong; Daniel L Loube; Judith Owens; Jeffrey P Pancer; Merrill Wise Journal: Sleep Date: 2005-04 Impact factor: 5.849
Authors: T Douglas Bradley; Alexander G Logan; R John Kimoff; Frédéric Sériès; Debra Morrison; Kathleen Ferguson; Israel Belenkie; Michael Pfeifer; John Fleetham; Patrick Hanly; Mark Smilovitch; George Tomlinson; John S Floras Journal: N Engl J Med Date: 2005-11-10 Impact factor: 91.245
Authors: S Javaheri; T J Parker; J D Liming; W S Corbett; H Nishiyama; L Wexler; G A Roselle Journal: Circulation Date: 1998-06-02 Impact factor: 29.690
Authors: Richard J Schwab; Michael Pasirstein; Robert Pierson; Adonna Mackley; Robert Hachadoorian; Raanan Arens; Greg Maislin; Allan I Pack Journal: Am J Respir Crit Care Med Date: 2003-05-13 Impact factor: 21.405
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
Authors: Anna C Bitners; Sanghun Sin; Sabhyata Agrawal; Seonjoo Lee; Jayaram K Udupa; Yubing Tong; David M Wootton; Kok Ren Choy; Mark E Wagshul; Raanan Arens Journal: Sleep Date: 2020-10-13 Impact factor: 5.849
Authors: Elahe Kazemeini; Eli Van de Perck; Marijke Dieltjens; Marc Willemen; Johan Verbraecken; Sara Op de Beeck; Olivier M Vanderveken Journal: Front Neurol Date: 2022-02-22 Impact factor: 4.003