MR Imaging of Upper Airway Dynamics in Obstructive Sleep Apnea

阻塞性睡眠呼吸暂停上气道动力学的 MR 成像

基本信息

批准号：
8771245
负责人：
CHANTAL DARQUENNE
金额：
$ 23.25万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN DIEGO
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-09-01 至 2016-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8771245
关键词：
Accounting Address Age Airway Resistance Anatomy Area Behavior Biomechanics Breathing Cardiovascular system Clinical Data Dependence Disease Functional disorder Future Gender Geometry Guidelines Image Imaging Device Imaging technology Ionizing radiation Knowledge Lead Location Magnetic Resonance Imaging Measurement Metabolic Methods Metric Modeling Monitor Morphology Nature Neurologic Nose Obstruction Obstructive Sleep Apnea Operative Surgical Procedures Oral Outcome Pathology Patients Physiology Play Polysomnography Property Public Health Quality of life Recurrence Reflex action Research Resistance Resolution Role Shapes Sleep Snoring Staging Structure Study models Sturnus vulgaris Testing Therapeutic Thick Time Unnecessary Procedures Wakefulness Weight Width X-Ray Computed Tomography airway obstruction awake base clinical decision-making expiration imaging modality insight mechanical behavior morphometry patient population pharynx muscle pressure prevent public health relevance respiratory simulation soft tissue theories treatment planning volunteer

项目摘要

DESCRIPTION (provided by applicant): The overall objectives of this research are 1) to characterize upper airway dynamics during wakefulness and sleep in patients with obstructive sleep apnea (OSA) using magnetic resonance imaging (MRI) and 2) to determine if data collected during wakefulness can predict the occurrence of OSA. OSA is characterized by recurrent partial or complete airway closure during sleep, and has important clinical implications ranging from disruption of sleep with daytime sequelae of excessive sleepiness and poor quality of life to adverse cardiovascular or metabolic outcomes. While polysomnography and studies based on measurements of airway pressures and resistance have provided a wealth of information on upper airway physiology, they are unable to assess the three-dimensional anatomy of the upper airway and its conformational changes during breathing. Knowledge of the morphology and mechanical behavior of this structure is essential for a more complete understanding of the occurrence of upper airway obstruction. Such information can be obtained with imaging technology and is the focus of this study. We propose to use state-of-the-art MRI tools to quantify upper airway dynamics in three groups of subjects: 1) OSA patients; 2) snoring volunteers; and 3) healthy age and weight-matched controls for comparison purposes. Subjects will undergo MR imaging to assess upper airway morphometry and changes in airway size during tidal breathing both during wakefulness and natural sleep with simultaneous measurement of nasal-oral flow partition and sleep state and stages. Dynamic patient-specific models of upper airway morphometry will be reconstructed from the MR images from which various anatomical markers will be calculated. Differences in these markers between groups and between stages (awake vs. asleep) will be evaluated. The proposed studies of characterizing the conformational change of the upper airway during tidal breathing will provide a new means of identifying geometrical abnormalities that lead to airflow obstruction. This proposal is a first step in addressing a currently unmet clinical need for treatment guidelines tha take into account the dynamic nature of the upper airway. Completion of these studies will also lay the groundwork for future modeling studies that will combine patient-specific upper airway dynamics with detailed flow simulations to provide better insight in biomechanical properties of the upper airway and flow-driven mechanisms on which to optimize therapeutic treatment. The methods developed in this research will be directly applicable to all patient populations with upper airway dysfunction.

描述（由申请人提供）：本研究的总体目标是 1) 使用磁共振成像 (MRI) 来表征阻塞性睡眠呼吸暂停 (OSA) 患者清醒和睡眠期间的上呼吸道动态，2) 确定是否在睡眠期间收集数据清醒状态可以预测OSA的发生。 OSA 的特点是睡眠期间反复出现部分或完全气道关闭，具有重要的临床意义，包括白天过度嗜睡和生活质量差的后遗症导致的睡眠中断，以及不良的心血管或代谢结果。虽然多导睡眠图和基于气道压力和阻力测量的研究提供了有关上气道生理学的丰富信息，但它们无法评估上气道的三维解剖结构及其在呼吸过程中的构象变化。了解该结构的形态和机械行为对于更全面地了解上呼吸道阻塞的发生至关重要。这些信息可以通过成像技术获得，是本研究的重点。我们建议使用最先进的 MRI 工具来量化三组受试者的上呼吸道动态：1) OSA 患者； 2）打鼾志愿者； 3) 用于比较目的的健康年龄和体重匹配对照。受试者将接受 MR 成像，以评估上呼吸道形态测量以及清醒和自然睡眠期间潮式呼吸期间气道尺寸的变化，同时测量鼻-口流量分配以及睡眠状态和阶段。将从 MR 图像中重建上呼吸道形态测量的动态患者特异性模型，并从中计算各种解剖标记。将评估这些标记在各组之间和不同阶段（清醒与睡眠）之间的差异。拟议的研究潮式呼吸期间上呼吸道构象变化的特征将提供一种识别导致气流阻塞的几何异常的新方法。该提案是解决目前未满足的治疗指南临床需求的第一步，该治疗指南考虑了上呼吸道的动态性质。这些研究的完成还将为未来的建模研究奠定基础，这些建模研究将结合患者特定的上气道动力学与详细的流量模拟，以更好地了解上气道的生物力学特性和流量驱动机制，从而优化治疗。本研究开发的方法将直接适用于所有上呼吸道功能障碍的患者群体。