阻塞性睡眠呼吸暂停患儿的脑MRI分析

Brain MRI Analysis of Children with Obstructive Sleep Apnea

目的 探讨阻塞性睡眠呼吸暂停患儿的脑MRI价值。方法对2020年1月至2024年4月期间连续接受MRI和DISE检查的患者进行图表回顾。报告了描述性统计,并计算了Cohen kappa系数,以评估腺样体、舌扁桃体和舌根部梗阻的MRI和DISE之间的一致性。结果MRI上最常见的梗阻部位是下咽(56.3%)、舌根(44.8%)、舌扁桃体(38.0%)和巨舌症(37.6%)。对腺样体肥大的符合率为中等(k=0.53),对舌扁桃体肥大(k=0.15)和舌根梗阻(k=0.09)的符合率较低。DISE发现多节段梗阻的例数多于MRI(94.9%vs48.2%)。结论DISE能更好地检查鼻腔和声门上的阻塞,对部分和完全塌陷敏感,而MRI为淋巴组织肥大提供了更好的软组织分辨率,并提供了原发和继发性呼吸道阻塞的全景。

Objective To investigate the value of brain MRI in children with obstructive sleep apnea.Methods A chart review of patients who underwent consecutive MRI and DISE examinations between January 2020to April 2024 was performed.Descriptive statistics were reported and Cohen kappa coefficients were calculated to assess consistency between film MRI and DISE for obstruction of adenoids,lingual tonsils,and base of the tongue.Results The most common sites of obstruction on MRI were hypopharynx(56.3%),base of tongue(44.8%),lingual tonsil(38.0%) and macroglossia(37.6%).The coincidence rate fo r adenoid hypertrophy was moderate(k=0.53) and low for lingual tonsil hypertrophy(k=0.15) and root obstruction(k=0.09).DISE found more cases of multisegmental obstruction than MRI(94.9%vs48.2%).Conclusion DISE provides better detection of nasal and supratroglottic obstruction and is sensitive to partial and com plete collapse,while MRI provides better soft tissue resolution for lymphoid hypertrophy and provides a panora mic view of primary and secondary respirato ry obstruction.