Analysis of pharynx MRI in stroke patients with and without obstructive sleep apnea
WU Qi, ZHANG Li-xia, ZHANG Qian, LU Gan, YUAN Yong, WANG Tong
Chinese Journal of Clinical Anatomy ›› 2018, Vol. 36 ›› Issue (5) : 507-513.
Analysis of pharynx MRI in stroke patients with and without obstructive sleep apnea
Objective Based on stroke patients with and without Obstructive Sleep Apnea (OSA) with pharyngeal morphological comparison, to understand the relationship of pharyngeal anatomy and OSA in stroke patients. Methods Patients within 30 days of stroke underwent nocturnal polysomnography, were divided into two groups based on whether had OSA or not. 3.0 weighted magnetic resonance imaging (MRI) performed for clinical purposes was used to measure retropalatal distance, soft palatal length, soft palatal thickness, retroglossal space, and tongue length, lateral pharyngeal wall thickness，high retropharyngeal area, low retropharyngeal area, minimum retropharyngeal area. The pharyngeal measured data of two groups were compared. Pearson correlation analysis was conducted between the retropalatal distance and other measurement indexes of pharyngeal, AHI, sub-water test score, age, course of disease, BMI and neck circumference in OSA patients with stroke. A receiver operating characteristic curve (ROC) was plotted and the area under it was calculated to assess the ability of retropalatal distance to discriminate OSA status. Results The retropalatal distance of stoke OSA patients was shorter than that of the compared group（P=0.002）.The retropalatal distance of stoke OSA patients was related with retroglossal space （R=0.502, P=0.017）. The sub-water test score of OSA patients with stroke was higher than that of non-OSA patients (P=0.049). The retropalatal distance of stoke OSA patients was related with AHI（R=-0.873, P=0.000）. The area under the ROC curve for retropalatal distance as a predictor of presence or absence of OSA was 0.888, which indicated moderate discrimination between groups. Conclusion The morphological changes of pharynx are associated with OSA in stroke patients. The retropalatal distance has certain diagnostic value for OSA in stroke patients, and the retropalatal distance is related to the severity of OSA in stroke patients. OSA patients with stroke have higher sub-water test score than non-OSA patients, and OSA in stroke patients may be related to dysphagia.
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