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）：这项研究的总体目标是1）表征使用磁共振成像（MRI）（MRI）和2）在清醒和睡眠期间的上呼吸道动力学表征，以确定在唤醒过程中收集的数据是否可以预测OSA的发生。 OSA的特征是在睡眠期间反复出现部分或完整的气道关闭，并且具有重要的临床意义，从睡眠中断，与白天的嗜睡和生活质量差的白天后遗症到不良心血管或代谢结果。尽管基于气道压力和阻力的测量的多个术语和研究提供了有关上气道生理学的大量信息，但他们无法评估上呼吸道的三维解剖结构及其在呼吸过程中的构象变化。对这种结构的形态和机械行为的了解对于更完整地了解上气道阻塞的发生至关重要。这些信息可以通过成像技术获得，这是本研究的重点。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力学：1）OSA患者； 2）打s志志愿者； 3）健康的年龄和重量匹配的对照，以进行比较。受试者将接受MR成像，以评估潮汐呼吸期间潮气和自然睡眠期间气道尺寸的变化，并同时测量鼻口流分区，睡眠状态和阶段。将从MR图像中重建上呼吸道形态计量学的动态患者特异性模型，从中可以计算出各种解剖标记。将评估组之间和阶段之间的这些标记差异（觉醒与入睡）。提出的关于潮汐呼吸过程中上呼吸道构象变化的构象变化的研究将提供一种鉴定导致气流阻塞的几何异常的新方法。该提案是解决当前未满足的治疗指南需求的第一步，考虑到上呼吸道的动态性质。这些研究的完成还将为将来的建模研究奠定基础，这些研究将结合患者特异性的上呼吸道动力学与详细的流动模拟，以更好地了解上呼吸道的生物力学特性和流动驱动机制，以优化治疗治疗。这项研究中开发的方法将直接适用于所有具有上气道功能障碍的患者人群。