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Real‐time multislice MRI during continuous positive airway pressure reveals upper airway response to pressure change
Author(s) -
Chen Weiyi,
Gillett Emily,
Khoo Michael C.K.,
Davidson Ward Sally L.,
Nayak Krishna S.
Publication year - 2017
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.25675
Subject(s) - medicine , airway , continuous positive airway pressure , obstructive sleep apnea , magnetic resonance imaging , intraclass correlation , reproducibility , anesthesia , apnea , wakefulness , radiology , electroencephalography , clinical psychology , statistics , mathematics , psychometrics , psychiatry
Purpose To determine if a real‐time magnetic resonance imaging (RT‐MRI) method during continuous positive airway pressure (CPAP) can be used to measure neuromuscular reflex and/or passive collapsibility of the upper airway in individual obstructive sleep apnea (OSA) subjects. Materials and Methods We conducted experiments on four adolescents with OSA and three healthy controls, during natural sleep and during wakefulness. Data were acquired on a clinical 3T scanner using simultaneous multislice (SMS) RT‐MRI during CPAP. CPAP pressure level was alternated between therapeutic and subtherapeutic levels. Segmented airway area changes in response to rapid CPAP pressure drop and restoration were used to estimate 1) upper airway loop gain (UALG), and 2) anatomical risk factors, including fluctuation of airway area (FAA). Results FAA significantly differed between OSA patients (2–4× larger) and healthy controls (Student's t ‐test, P < 0.05). UALG and FAA measurements indicate that neuromuscular reflex and passive collapsibility varied among the OSA patients, suggesting the presence of different OSA phenotypes. Measurements had high intrasubject reproducibility (intraclass correlation coefficient r > 0.7). Conclusion SMS RT‐MRI during CPAP can reproducibly identify physiological traits and anatomical risk factors that are valuable in the assessment of OSA. This technique can potentially locate the most collapsible airway sites. Both UALG and FAA possess large variation among OSA patients. Level of Evidence: 1 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2017;46:1400–1408.