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Magnetic Resonance Imaging Research of Obstructive Sleep Apnea-hyponea Syndrome

Author: LiuXueHuan
Tutor: LiuZuo
School: Tianjin Medical University
Course: Medical Imaging and Nuclear Medicine
Keywords: Obstructive sleep apnea -hypopnea syndrome Magnetic resonance imaging Magnetic resonance spectroscopy Uvula uvulopalatopharyngoplasty
CLC: R766.43
Type: Master's thesis
Year: 2009
Downloads: 29
Quote: 0
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Abstract


Objective: To investigate the MRI features of obstructive sleepy apnea hypopnea syndrome (OSAHS), and evaluation of magnetic resonance spectroscopy (1H-MRS) on conventional MRI, and head of the airway multibody quality of sub-clinical value in the OSAHS. Materials and Methods: 20 patients diagnosed for patients with moderate to severe OSAHS (case group) and age and sex matched 20 healthy volunteers (control group), downstream on the airway conventional MRI and cranial voxels in the awake state 1H-MRS check. The upper airway is divided into three sub-zones soft palate area (RP), the tongue after District (RG) and epiglottis District (EPG) and measuring the minimum cross-sectional area of ??the sub-region. Three sub-regions at the narrowest cross-sectional area as the minimum cross-sectional area of ??the upper airway. Record each lobe brain mass metabolite ratios include: nitrogen - acetyl aspartate / creatine (NAA / Cr), choline / creatine (Cho / Cr), nitrogen - acetyl aspartate / choline (NAA / Cho), and observe whether lactate (Lac) peaks. Record patient clinical indicators include: sleep apnea and hypopnea index (AHI), the average nighttime oxygen saturation (SpO2). A comparative analysis of the indicators. The case group of 10 patients with severe OSAHS patients underwent modified uvula velopharyngeal plasty (UPPP), and after 2-6 months later. Results: Compared with the control group, the case group RP, RG minimum cross-sectional area and the upper airway in the smallest cross-sectional area decreases, the difference was statistically significant (P lt; 0.05). EPG minimum cross-sectional area decreases slightly, the difference was not statistically significance (P gt; 0.05). 11 OSAHS patients sulci widened slightly, to reduce the five cases the occipital the slopes bone marrow signal. Case group, 20 patients appear the frontal medial frontal gyrus and semi-oval center NAA / Cr, Cho / Cr increased NAA / Cho, reduce the inferior frontal gyrus, postcentral gyrus, supramarginal gyrus and superior temporal gyrus, middle temporal gyrus were only 14 cases, 15 cases, 17 cases, 14 cases, 13 cases of the above indicators of change, and the control group, the difference was statistically significant (P lt; 0.05). The two groups were not detected in the Lac peak. Statistical studies have shown that patient group AHI and the minimum cross-sectional area of ??the upper airway and SpO2 was negatively correlated (P lt; 0.05). The AHI, Sp02 and semi-oval central area of ??NAA / Cho were also negatively correlated (P lt; 0.05), with the ratio of NAA / Cr, Cho / Cr no correlation (P gt; 0.05). 10 patients after review of the RP, RG minimum cross-sectional area compared with preoperative increased significantly, and the differences were statistically significant (P lt; 0.05). EPG minimum cross-sectional area was no significant change. Multi-voxel 1H-MRS results show that the the centrum semiovale area and inferior frontal gyrus, precentral gyrus, postcentral gyrus, supramarginal gyrus and superior temporal gyrus, middle temporal gyrus of NAA / Cr and NAA / Cho, compared with preoperative elevated Cho / Cr decreased compared with the preoperative difference was statistically significant (P lt; 0.05). After review showed no Lac peak. Conclusion: retropalatal District (RP) is the most common obstruction site OSAHS patients. Due to the long-term chronic hypoxia causes severe OSAHS patients with bone marrow reconversion. Multi-voxel 1H-MRS sensitive display OSAHS brain metabolic changes in prefrontal medial frontal gyrus and semi-oval central area of ??OSAHS patients with ischemia, hypoxia sensitive areas. The modified UPPP can not only relieve the upper airway obstruction, and can be effective in improving the condition of cerebral metabolic abnormalities of patients with OSAHS. Application on airway conventional MRI combined head multi-voxel 1H-MRS technology to provide imaging evidence to assess the efficacy of surgical treatment improved UPPP has important clinical implications for effectively avoid or reduce the incidence of cerebral infarction.

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CLC: > Medicine, health > Otorhinolaryngology > To pharynx Science, pharyngeal disease > Oropharyngeal disease > Uvula disease
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