阻塞性睡眠呼吸暂停综合征患者上呼吸道MRI形态学研究

Morphological Research on Upper Airway MRI Scan of Obstructive Sleep Apnea Patients

目的:探讨磁共振成像(Magnetic Resonance Imaging,MRI)结合梯度Muller实验方案定位诊断阻塞性睡眠呼吸暂停综合征(Obstructive Sleep Apnea Syndrome,OSAS)的价值。方法:收集OSAS患者共20例,健康成年人18名,采用MRI结合梯度Muller实验对上呼吸道进行快速自旋回波(FSE)扫描,测量软腭后区、舌后区、会厌区气道的左右径、截面积等参数,比较两组间的上呼吸道形态学差异。结果:①患者组软腭后区、舌后区、会厌区气道前后径与左右径比值均大于对照组(P<0.05),该3个区域的咽后壁厚度大于对照组(P<0.05);②患者组软腭后区咽侧脂肪垫截面积大于对照组(P<0.05);③正中矢状位测量患者软腭截面积、厚度和长度均大于对照组(P<0.01);④患者组会厌区气道截面积与对照组无统计学差异(P>0.05)。结论:OSAS患者上呼吸道较健康对照组狭窄,应用MRI结合梯度Muller实验可判定OSAS阻塞部位及来源,指导临床治疗。

Objective: To investigate the value of MRI and Muller maneuver in diagnosis of Obstructive Sleep Apnea Syndrome( OSAS). Methods: 20 adult patients with OSAS and 18 normal adults were collected,given MRI scan of upper airway combined with Muller maneuver,and then the differences of morphology were compared between two groups by measuring the diameter and section area of retro palatal( RP),retro glossal( RG) and epiglottis( EPG) Results: ①The ratio of the Anterior Posterior / Lateral ratio( AP / L) in RP,RG and EPG regions was bigger in patient group than that of normal group( P < 0. 05), and the thickness was bigger than that of the control( P < 0. 05); ② The section area of fat in RP of the patient group' was greater than that of normal group( P < 0. 05); ③The section area,thickness and length of RP in patients group were larger than that of normal group when measured in sagittal view( P < 0. 01); ④ No significant difference was found between two groups in section area of EPG( P > 0. 05). Conclusion: The study demonstrated that the upper airway was narrower in OSAS than that of normal adults. MRI with muller maneuver can be used to estimate the site of obstruction,and give some evidence to the treatment.