阻塞性睡眠呼吸暂停综合征患者上气道的MRI研究

观察清醒状态下阻塞性睡眠呼吸暂停综合征（ＯＳＡＳ）患者与正常对照组上气道及周围软组织的变化，并在睡眠状态下应用ＭＲＩ动态扫描对阻塞部位进行定位，探讨ＯＳＡＳ的发生机制及ＭＲＩ的应用价值。方法应用ＭＲＩ对２３例经多导睡眠监测（ｐｌｙｓｏｍｎｏｇｒａｐｈｙ，ＰＳＧ）确诊的ＯＳＡＳ患者及３０例无打鼾的健康成人进行上气道检查，于轴面图像测软腭后区（ｒｅｔｒｏｐａｌａｔａｌｒｅｇｉｏｎ，ＲＰｋｋｈｎｆｔｊ

MRIevaluation of the upper airway in patients with obstructive sleep apnea syndrome

Objects To investigate the mechanisms of obstructive sleep apnea syndrome (OSAS) through observing the upper airway caliber and the corresponding pharyngeal wall of OSAS patients with MRI and to investigate the site of obstruction during sleep by using MRI dynamic scan. Methods Twenty three cases of OSAS patients proved by polysomnography (PSG) were examined with MRI. The cross sectional area of retropalatal region (RP), retroglossal region (RG), epiglottal region (EPG) and the lateral parapharyngeal fat pad (LPFP) of RP region was calculated. The thickness of bilateral and posterior pharyngeal wall and other indices were also measured. 30 nonsnoring age matched normal subjects were selected as the control group. 15 patients underwent turbo field echo (TFE) T 1 weighted imaging during sleep. The images of RP, RG, and EPG were analyzed. Results In OSAS group, the cross sectional area of RP and RG regions was smaller than that of the control group. The A P/lateral ratio in RP, RG, EPG region, the cross sectional area of LPFP and the thickness of the posterior pharyngeal wall of RP, RG and EPG region were statistically larger than that of the control group. Midsagittal MR images show the length, thickness and cross sectional area of the palate in patients group were larger than that of control group. During sleep, the RP region was obstructed in 3 of the 15 cases and the RG region was obstructed in 2 cases. In the other ten patients, both RP and RG region were obstructed. The main anatomic causes could also be presumed by analyzing the MR images. Conclusion The study suggested that the pathogenesis of OSAS be related with the upper airway caliber and its A P/lateral ratio, the thickness of posterior and lateral wall, the LPFP in RP region, and the size and length of the palate. Dynamic MRI during sleep could localize the upper airway obstruction in OSAS patients and be helpful to select the management project.