European Archives of Oto-Rhino-Laryngology

, Volume 273, Issue 11, pp 4021–4026 | Cite as

Dynamic upper airway collapse observed from sleep MRI: BMI-matched severe and mild OSA patients

  • Leh-Kiong Huon
  • Stanley Yung-Chuan Liu
  • Tiffany Ting-Fang Shih
  • Yunn-Jy Chen
  • Men-Tzung Lo
  • Pa-Chun WangEmail author


Dynamic magnetic resonance imaging (MRI) allows real-time characterization of upper airway collapse in sleeping subjects with obstructive sleep apnea (OSA). The aim of our study was to use sleep MRI to compare differences in upper airway collapse sites between BMI-matched subjects with mild OSA and severe OSA. This is a prospective, nested case–control study using dynamic sleep MRI to compare 15 severe OSA subjects (AHI >40) and 15 mild OSA (AHI <10) subjects, who were matched for BMI. Upper airway imaging was performed on sleeping subjects in a 3.0 T MRI scanner. Sleep MRI movies were used by blinded reviewers to identify retropalatal (RP), retroglossal (RG), and lateral pharyngeal wall (LPW) airway collapse. Mean AHI in the severe OSA group was 70.3 ± 23 events/h, and in the mild group was 7.8 ± 1 events/h (p < 0.001). All mild and severe OSA subjects demonstrated retropalatal airway collapse. Eighty percent in the mild group showed single-level RP collapse (p < 0.001). All subjects in the severe group showed multi-level collapse: RP + LPW (n = 9), RP + RG + LPW (n = 6). All severe OSA subjects showed LPW collapse, as compared with three subjects in the mild group (p < 0.001). LPW collapse was positively associated with AHI in simple regression analysis (β = 51.8, p < 0.001). In conclusion, severe OSA patients present with more lateral pharyngeal wall collapse as compared to BMI-matched mild OSA patients.


Sleep magnetic resonance imaging Lateral pharyngeal wall collapse Obstructive sleep apnea 



This study was sponsored by the National Taiwan University Hospital, Cathay General Hospital Joint Research Fund (No. 102-CGN08) and the National Central University, Cathay General Hospital Joint Research Fund (Nos. 101CGH-NCUA4, 103CGH-NCU-A1 and 104CGH-NCU-A1).

Compliance with ethical standards

Conflict of interest


Supplementary material

Supplementary material 1 (MP4 13166 kb)

Supplementary material 2 (MP4 9635 kb)

Supplementary material 3 (MP4 10679 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Leh-Kiong Huon
    • 1
    • 2
    • 3
  • Stanley Yung-Chuan Liu
    • 4
  • Tiffany Ting-Fang Shih
    • 5
  • Yunn-Jy Chen
    • 6
  • Men-Tzung Lo
    • 3
  • Pa-Chun Wang
    • 1
    • 2
    Email author
  1. 1.Department of Otolaryngology-Head and Neck SurgeryCathay General HospitalTaipeiTaiwan
  2. 2.School of MedicineFu Jen Catholic UniversityTaipeiTaiwan
  3. 3.Department of Biomedical Sciences and EngineeringNational Central UniversityTaoyuanTaiwan
  4. 4.Division of Sleep Surgery, Department of Otolaryngology-Head and Neck Surgery, School of MedicineStanford UniversityStanfordUSA
  5. 5.Division of Medical ImagingNational Taiwan UniversityTaipeiTaiwan
  6. 6.Department of Dental MedicineNational Taiwan UniversityTaipeiTaiwan

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