阻塞性睡眠呼吸暂停综合征患者上气道大小的磁共振研究

The magnetic resonance imaging of the upper airway in obstructive sleep apnea syndrome

目的：以软组织显影好的磁共振技术（ｍａｇｎｅｔｉｃ ｒｅｓｏｎａｎｃｅｉｍａｇｉｎｇ，ＭＲＩ） 探讨阻塞性睡眠呼吸暂停综合征（ｏｂｓｔｒｕｃｔｉｖｅｓｌｅｅｐ ａｐｎｅａ ｓｙｎｄｒｏｍｅ， ＯＳＡＳ） 患者上气道与无鼾正常人的差异。方法：２３ 名ＯＳＡＳ患者均经整夜多导睡眠监测确诊。每２ 或１ 名ＯＳＡＳ患者选取１ 名年龄、性别配比的无鼾对照者。对２３ 名ＯＳＡＳ患者与１２ 名配对对照的上气道进行ＭＲＩ扫描及测量，比较鼻咽、腭咽、舌咽和喉咽的大小。结果：ＯＳＡＳ患者的上气道各段，在矢向径、横向径、矢向／ 横向径比、截面积和体积几乎各项指标上均普遍小于无鼾对照，其鼻咽尤其值得重视。结论：ＯＳＡＳ存在形态学病因机制。ＭＲＩ在ＯＳＡＳ研究中是有重要价值的诊断工具，但不能替代整夜睡眠监测。

Objective: We used magnetic resonance imaging(MRI) which could provide super imaging of soft tissue to investigate the difference between the obstructive sleep apnea syndrome(OSAS) and the non snorers. Methods: 23 OSAS patients were diagnosed by whole night polysomnography. Every one or two patients had one age sex matched control subject with no snoring at night. Both 23 OSAS patients and 12 controls took MRI scans of upper airway. Compared those images within nasopharynx, palatopharynx, glossopharynx and hypopharynx. Results: OSAS patients showed smaller airway than controls in almost every aspect, such as sagittal size, horizontal size, the ratio of sagittal size to horizontal size, cross sectional area and volume of the upper airway. The difference in the nasopharynx was an interesting discovery. Conclusion: A structurally abnormal airway might serve as an anatomic substrate for the development of sleep apnea. MRI was a valuable diagnostic tool in the research of OSAS, though it could not be replaced of whole night polysomnography.