Khaisang Chousangsuntorn1, Thongchai Bhongmakapat2, Navarat Apirakkittikul3, Witaya Sungkarat4, Nucharin Supakul5, Jiraporn Laothamatas6. 1. Biomedical Engineer, Department of Radiological Technology, Faculty of Medical Technology, Mahidol University, Phutthamonthon, Nakhon Pathom, Thailand. 2. Assistant Professor, Department of Otolaryngology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. 3. Otolaryngologist, Department of Otolaryngology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. 4. Biomedical Engineer, Department of Radiology, Faculty of Medicine Ramathibodi Hospital, and Advanced Diagnostic Imaging Center (AIMC), Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. 5. Assistant Professor, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, IN. 6. Professor, Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, and Advanced Diagnostic Imaging Center (AIMC), Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. Electronic address: laothamatas@gmail.com.
Abstract
PURPOSE: We hypothesized that computed tomography (CT) combined with portable polysomnography (PSG) might better visualize anatomic data related to obstructive sleep apnea (OSA). The present study evaluated the CT findings during OSA and assessed their associations with the PSG data and patient characteristics. PATIENTS AND METHODS: We designed a prospective cross-sectional study of patients with OSA. The patients underwent scanning during the awake state and apneic episodes. Associations of the predictor variables (ie, PSG data, respiratory disturbance index [RDI]), patient characteristics (body mass index [BMI], neck circumference [NC], and waist circumference [WC]), and outcome variables (ie, CT findings during apneic episodes) were assessed using logistic regression analysis. The CT findings during apneic episodes were categorized regarding the level of obstruction, single level (retropalatal [RP] or retroglossal [RG]) or multilevel (mixed RP and RG), degree of obstruction (partial or complete), and pattern of collapse (complete concentric collapse [CCC] or other patterns). RESULTS: A total of 58 adult patients with OSA were scanned. The mean ± standard deviation for the RDI, BMI, NC, and WC were 41.6 ± 28.55, 27.80 ± 5.43 kg/m2, 38.3 ± 4.3 cm, and 93.8 ± 13.6 cm, respectively. No variables distinguished between the presence of single- and multilevel airway obstruction in the present study. A high RDI (≥30) was associated with the presence of complete obstruction and CCC (odds ratio 6.33, 95% confidence interval 1.55 to 25.90; and odds ratio 3.77, 95% confidence interval 1.02 to 13.91, respectively) compared with those with a lesser RDI. CONCLUSIONS: An increased RDI appears to be an important variable for predicting the presence of complete obstruction and CCC during OSA. Scanning during apneic episodes, using low-dose volumetric CT combined with portable PSG provided better anatomic and pathologic findings of OSA than did scans performed during the awake state.
PURPOSE: We hypothesized that computed tomography (CT) combined with portable polysomnography (PSG) might better visualize anatomic data related to obstructive sleep apnea (OSA). The present study evaluated the CT findings during OSA and assessed their associations with the PSG data and patient characteristics. PATIENTS AND METHODS: We designed a prospective cross-sectional study of patients with OSA. The patients underwent scanning during the awake state and apneic episodes. Associations of the predictor variables (ie, PSG data, respiratory disturbance index [RDI]), patient characteristics (body mass index [BMI], neck circumference [NC], and waist circumference [WC]), and outcome variables (ie, CT findings during apneic episodes) were assessed using logistic regression analysis. The CT findings during apneic episodes were categorized regarding the level of obstruction, single level (retropalatal [RP] or retroglossal [RG]) or multilevel (mixed RP and RG), degree of obstruction (partial or complete), and pattern of collapse (complete concentric collapse [CCC] or other patterns). RESULTS: A total of 58 adult patients with OSA were scanned. The mean ± standard deviation for the RDI, BMI, NC, and WC were 41.6 ± 28.55, 27.80 ± 5.43 kg/m2, 38.3 ± 4.3 cm, and 93.8 ± 13.6 cm, respectively. No variables distinguished between the presence of single- and multilevel airway obstruction in the present study. A high RDI (≥30) was associated with the presence of complete obstruction and CCC (odds ratio 6.33, 95% confidence interval 1.55 to 25.90; and odds ratio 3.77, 95% confidence interval 1.02 to 13.91, respectively) compared with those with a lesser RDI. CONCLUSIONS: An increased RDI appears to be an important variable for predicting the presence of complete obstruction and CCC during OSA. Scanning during apneic episodes, using low-dose volumetric CT combined with portable PSG provided better anatomic and pathologic findings of OSA than did scans performed during the awake state.
Authors: W M Faizal; N N N Ghazali; C Y Khor; Irfan Anjum Badruddin; M Z Zainon; Aznijar Ahmad Yazid; Norliza Binti Ibrahim; Roziana Mohd Razi Journal: Comput Methods Programs Biomed Date: 2020-06-26 Impact factor: 5.428