Skip to main content
SpringerLink
Log in

Role of dynamic sleep MRI in obstructive sleep apnea syndrome

  • Original Article
  • Published:
Oral Radiology Aims and scope Submit manuscript

Abstract

Purpose

To identify obstruction sites of the upper airway during sleep in patients with obstructive sleep apnea syndrome (OSAS) under dynamic conditions and improve knowledge to guide surgical treatment and advancements.

Materials and methods

The study included 15 patients (5 females and 10 males) who were diagnosed as having OSAS. Overall mean age was 40.2 years (± 7.01 years). All the patients underwent drug-induced sleep endoscopy (DISE) and dynamic sleep MRI. The presence, location, and direction of airway collapse were assessed. Dynamic MRI findings were correlated to DISE. Data of the site and direction of airway collapse were correlated with those of endoscopic findings and interobserver agreement was done.

Results

The dynamic images in sagittal section showed collapse of the upper airway at retropalatal level in 14 patients (93.33%) and at retroglossal level in seven patients (46.7%) and of these 14 patients; seven had combined retropalatal and retroglossal collapse. These findings were highly correlated with DISE findings with an excellent interobserver agreement for retropalatal and retroglossal levels (Kappa = 1 and 0.867, P value = 0.000), respectively. Objective measurements of the direction of collapse in axial dynamic sleep MRI images showed significant statistical correlation with endoscopic findings regarding retropalatal anteroposterior and circumferential collapse (Kappa = 0.58 and 0.52, P value = 0.02 and 0.03, respectively).

Conclusion

Dynamic sleep MRI can reliably characterize the actual site of dynamic airway obstruction and has the potential of improving predictions of successful surgical outcomes in OSAS patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Moon IJ, Han DH, Kim JW, et al. Sleep magnetic resonance imaging as a new diagnostic method in obstructive sleep apnea syndrome. Laryngoscope. 2010;120(12):2546–54.

    Article  Google Scholar 

  2. Santosham R, Anand S, et al. Role of dynamic MR imaging in obstructive sleep apnoea. Indian J Otolaryngol Head Neck Surg. 2008;60(1):25–9.

    Article  Google Scholar 

  3. Chasens ER. Obstructive sleep apnea, daytime sleepiness, and type 2 diabetes. Diabetes Educ. 2007;33(3):475–82.

    Article  Google Scholar 

  4. Hung J, Whitford EG, Parsons RW, et al. Association of sleep apnoea with myocardial infarction in men. Lancet. 1990;336(8710):261–4.

    Article  Google Scholar 

  5. Das AM, Khayat R. Hypertension in obstructive sleep apnea: risk and therapy. Expert Rev Cardiovasc Ther. 2009;7(6):619–26.

    Article  Google Scholar 

  6. Li KK. Surgical therapy for adult obstructive sleep apnea. Sleep Med Rev. 2005;9(3):201–9.

    Article  Google Scholar 

  7. Naya M, Vicente E, Llorente E, et al. Predictive value of the Muller maneuver in obstructive sleep apnea syndrome. Acta Otorrinolaringol Esp. 2000;51(1):40–5.

    PubMed  Google Scholar 

  8. Barrera JE, Holbrook AB, Santos J, et al. Sleep MRI: novel technique to identify airway obstruction in obstructive sleep apnea. Otolaryngol Head Neck Surg. 2009;140(3):423–5.

    Article  Google Scholar 

  9. Chen NH, Li KK, Li SY, et al. Airway assessment by volumetric computed tomography in snorers and subjects with obstructive sleep apnea in a Far-East Asian population (Chinese). Laryngoscope. 2002;112(4):721–6.

    Article  Google Scholar 

  10. Barrera JE. Sleep magnetic resonance imaging: dynamic characteristics of the airway during sleep in obstructive sleep apnea syndrome. Laryngoscope. 2011;121(6):1327–35.

    Article  Google Scholar 

  11. Donnelly LF, Surdulescu V, Chini BA, et al. Upper airway motion depicted at cine MR imaging performed during sleep: comparison between young patients with and those without obstructive sleep apnea. Radiology. 2003;227(1):239–45.

    Article  Google Scholar 

  12. Shott SR, Donnelly LF. Cine magnetic resonance imaging: evaluation of persistent airway obstruction after tonsil and adenoidectomy in children with Down syndrome. Laryngoscope. 2004;114(10):1724–9.

    Article  Google Scholar 

  13. Chen YJ, Shih TT, Chang YC, et al. Acoustic-integrated dynamic MR imaging for a patient with obstructive sleep apnea. Magn Reson Imaging. 2015;33(10):1350–2.

    Article  Google Scholar 

  14. Donnelly LF, Shott SR, LaRose CR, et al. Causes of persistent obstructive sleep apnea despite previous tonsillectomy and adenoidectomy in children with down syndrome as depicted on static and dynamic cine MRI. AJR Am J Roentgenol. 2004;183(1):175–81.

    Article  Google Scholar 

  15. Donnelly LF, Casper KA, Chen B. Correlation on cine MR imaging of size of adenoid and palatine tonsils with degree of upper airway motion in asymptomatic sedated children. AJR Am J Roentgenol. 2002;179(2):503–8.

    Article  Google Scholar 

  16. Donnelly LF, Casper KA, Chen B, et al. Defining normal upper airway motion in asymptomatic children during sleep by means of cine MR techniques. Radiology. 2002;223(1):176–80.

    Article  Google Scholar 

  17. Kendzerska T, Mollayeva T, Gershon AS, et al. Untreated obstructive sleep apnea and the risk for serious long-term adverse outcomes: a systematic review. Sleep Med Rev. 2014;18(1):49–59.

    Article  Google Scholar 

  18. Abdel Razek AA. Diagnostic role of magnetic resonance imaging in obstructive sleep apnea syndrome. J Comput Assist Tomogr. 2015;39(4):565–71.

    Article  Google Scholar 

  19. Moon SJLC, Han DH, et al. Comparison of polysomnographic findings according to obstruction sites in obstructive sleep apnea patients. Korean J Otorhinolaryngol Head Neck Surg. 2007;50:779–83.

    Google Scholar 

  20. Wang YL, McDonald JP, Liu YH, et al. Analysis of the dynamic changes in the soft palate and uvula in obstructive sleep apnea-hypopnea using ultrafast magnetic resonance imaging. Genet Mol Res. 2014;13(4):8596–608.

    Article  Google Scholar 

  21. Moriwaki H, Inoue Y, Namba K, et al. Clinical significance of upper airway obstruction pattern during apneic episodes on ultrafast dynamic magnetic resonance imaging. Auris Nasus Larynx. 2009;36(2):187–91.

    Article  Google Scholar 

  22. Rodriguez-Bruno K, Goldberg AN, McCulloch CE, et al. Test-retest reliability of drug-induced sleep endoscopy. Otolaryngol Head Neck Surg. 2009;140(5):646–51.

    Article  Google Scholar 

  23. Schwab RJ, Gupta KB, Gefter WB, et al. Upper airway and soft tissue anatomy in normal subjects and patients with sleep-disordered breathing. Significance of the lateral pharyngeal walls. Am J Respir Crit Care Med. 1995;152(5 Pt 1):1673–89.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Diagnostic Radiology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt

    Omneya Gamaleldin, Lamya Eissa & Mohamed Hossameldin Khalifa

  2. Diagnostic Radiology Department, Mansoura Faculty of Medicine, Mansoura, 13551, Egypt

    Ahmed Abdel Khalek Abdel Razek

  3. Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt

    Ahmed Bahgat, Omnia Anwar & Mahmoud Seif-Elnasr

  4. Medical Statistics and Biomedical Informatics Department, Medical Research Institute, Alexandria University, Alexandria, Egypt

    Gihan Mohamed Shehata

Authors
  1. Omneya Gamaleldin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ahmed Bahgat
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Omnia Anwar
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mahmoud Seif-Elnasr
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Lamya Eissa
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ahmed Abdel Khalek Abdel Razek
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Gihan Mohamed Shehata
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Mohamed Hossameldin Khalifa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Omneya Gamaleldin.

Ethics declarations

Conflict of interest

The authors (Omneya Gamaleldin, Ahmed Bahgat, Omnia Anwar, Mahmoud Seif-Elnasr, Lamya Eissa, Ahmed Abdel Khalek Abdel Razek, Gihan Mohamed Shehata and Mohamed Hossameldin Khalifa) have no conflicts of interest. This includes financial or personal relationships that inappropriately influence (bias) his or her actions.

Ethical approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from all patients for being included in the study. This article does not contain any studies with human or animal subjects performed by the any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gamaleldin, O., Bahgat, A., Anwar, O. et al. Role of dynamic sleep MRI in obstructive sleep apnea syndrome. Oral Radiol 37, 376–384 (2021). https://doi.org/10.1007/s11282-020-00455-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11282-020-00455-w

Keywords

Search

Navigation