Assessment by airway ellipticity on cine-MRI to differentiate severe obstructive sleep apnea

Tsukasa Kojima, Masateru Kawakubo, Mari K. Nishizaka, Anita Rahmawati, Shin Ichi Ando, Akiko Chishaki, Yasuhiko Nakamura, Michinobu Nagao

Research output: Contribution to journalArticle

Abstract

Introduction: The severity of obstructive sleep apnea (OSA) is assessed by the apnea–hypopnea index (AHI) determined from polysomnography (PSG). However, PSG requires a specialized facility with well-trained specialists and takes overnight. Therefore, simple tools, which could distinguish severe OSA, have been needed before performing PSG. Objectives: We propose the new index using cine-MRI as a screening test to differentiate severe OSA patients, who would need PSG and proper treatment. Methods: Thirty-six patients with suspected OSA (mean age 54.6 y, mean AHI 52.6 events/h, 33 males) underwent airway cine-MRI at the fourth cervical vertebra level during 30 s of free breathing and PSG. The minimum airway ellipticity (AE) in 30 s duration was measured, and was defined as the severity of OSA. Patients were divided into severe OSA, not-severe OSA, and normal groups, according to PSG results. The comparison of AE between any two of the three groups was performed by Wilcoxon rank-sum test. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cut-off of AE for identifying severe OSA patients. Results: The minimum AE for severe OSA was significantly lower than that for not-severe OSA and normal (severe, 0.17 ± 0.16; not severe, 0.31 ± 0.17; normal, 0.38 ± 0.19, P <.05). ROC analysis revealed that the optimal cutoff of the minimum AE 0.21 identified severe OSA patients, with an area under the curve of 0.75, 68% sensitivity, and 83% specificity. Conclusion: AE is a feasible quantitative index, and a promising screening test for detecting severe OSA patients.

Original languageEnglish
Pages (from-to)878-884
Number of pages7
JournalClinical Respiratory Journal
Volume12
Issue number3
DOIs
Publication statusPublished - Mar 1 2018

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Cine Magnetic Resonance Imaging
Obstructive Sleep Apnea
Polysomnography
Nonparametric Statistics
ROC Curve
Cervical Vertebrae
Area Under Curve

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine
  • Genetics(clinical)

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Assessment by airway ellipticity on cine-MRI to differentiate severe obstructive sleep apnea. / Kojima, Tsukasa; Kawakubo, Masateru; Nishizaka, Mari K.; Rahmawati, Anita; Ando, Shin Ichi; Chishaki, Akiko; Nakamura, Yasuhiko; Nagao, Michinobu.

In: Clinical Respiratory Journal, Vol. 12, No. 3, 01.03.2018, p. 878-884.

Research output: Contribution to journalArticle

Kojima, Tsukasa ; Kawakubo, Masateru ; Nishizaka, Mari K. ; Rahmawati, Anita ; Ando, Shin Ichi ; Chishaki, Akiko ; Nakamura, Yasuhiko ; Nagao, Michinobu. / Assessment by airway ellipticity on cine-MRI to differentiate severe obstructive sleep apnea. In: Clinical Respiratory Journal. 2018 ; Vol. 12, No. 3. pp. 878-884.
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AU - Kojima, Tsukasa

AU - Kawakubo, Masateru

AU - Nishizaka, Mari K.

AU - Rahmawati, Anita

AU - Ando, Shin Ichi

AU - Chishaki, Akiko

AU - Nakamura, Yasuhiko

AU - Nagao, Michinobu

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