阻塞性睡眠呼吸暂停低通气综合征患者上气道的MRI研究

The MRI study of upper airway on obstructive sleep apnea hyponea syndrome

目的:应用MRI比较阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者和正常健康人上气道及其周围软组织的差异,分析判断阻塞部位,为OSAHS的临床诊疗提供参考。方法:对经PSG确诊的33例OSAHS患者(OSAHS组)应用超快速MRI对其上气道进行扫描观察,对患者软腭后区、舌后区和会厌后区的截面积、咽壁厚度等进行测量。选择20例无打鼾的同年龄组健康人作为对照组。结果:不同程度OSAHS患者咽部气道面积均小于对照组,程度越重,相应的气道面积越小、咽壁厚度越大。OSAHS组软腭截面积、长度和厚度均大于对照组,OSAHS程度越重,软腭截面积、长度和厚度越大。OSAHS组软腭后区气道截面积与AHI呈负相关,舌后区气道截面积与颈围呈负相关。结论:运用MRI进行上气道扫描并辅以形态测量可有效判定OSAHS患者上气道咽腔狭窄情况,对确定治疗措施具有一定指导意义。

Objective：To investigate the character of upper airway and to offer the reference for clinical treatment through observing the upper airway caliber and its corresponding pharyngeal wall of OSAHS patients by magnetic resonance imaging （MRI）. Method： The upper airway of 33 obstructive sleep apnea hyponea syndrome （OSAHS） patients diagnosed by PSG were analyzed and compared by MRI. The cross-sectional area of the upper airway and thickness of lateral parapharyngeal wall were calculated. The cross-sectional area of the upper airway and thickness of lateral and posterior pharyngeal wall were also measured in 20 nonsnoring age-matched normal subjects selected as the control group. Result： The cross-sectional areas of upper airway of OSAHS patients were smaller than that of the control. The Thickness of posterior pharyngeal wall and lateral pharyngeal wall of the retropalatal region, retroglossal region and epiglotttal region were thicker in patients group than that of the control. The thickness and length of the palate in patients group were larger than that of the control. The cross-sectional areas of retropalatal region of OSAHS patients had negative correlation with apnea hyponea index （AHI）. There was also negative correlation between the retroglossal region cross-sectional area and the neck circumference. Conclusion： Measurement of upper airway with MRI could observe the change of pharynx cross-sectional area and had reference value in guiding the clinical diagnosis and treatment.