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Published on: December 6, 2016
Obstructive sleep apnea: MR imaging volume segmentation analysis
M Bret Abbott1, Lane F Donnelly, Bernard J Dardzinski
1Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229-3090, USA.
Insights
Children with obstructive sleep apnea (OSA) exhibit increased airway wall motion, including distention and collapse, as shown by magnetic resonance imaging (MRI). This study quantifies these dynamic changes in airway volume during respiration.
Area of Science:
- Medical Imaging
- Pediatric Pulmonology
- Sleep Medicine
Background:
- Obstructive sleep apnea (OSA) is a common condition in children.
- Understanding the dynamic airway changes in pediatric OSA is crucial for diagnosis and management.
Purpose of the Study:
- To assess airway wall motion in children with OSA using transverse cine magnetic resonance (MR) imaging.
- To quantify airway volume changes and dynamics in pediatric OSA patients.
Main Methods:
- Retrospective analysis of transverse fast gradient-echo cine MR images of the hypopharynx in children with and without OSA.
- Volume segmentation with k-means clustering to quantify airway volumes over time.
- Comparison of airway wall motion metrics (standard deviation, range, coefficient of variance, normalized range) between groups.
Main Results:
- Children with OSA showed significantly larger fluctuations in airway volume during respiration compared to controls.
- Airway distention and collapse were evident in OSA patients.
- Statistically significant differences in airway dynamics, including larger average airway volume and motion, were observed in the OSA group.
Conclusions:
- Volume segmentation of transverse cine MR images effectively quantifies increased airway wall motion in pediatric OSA.
- Transverse MR imaging is a valuable tool for visualizing airway distention and collapse in children with OSA.
Purpose:
To retrospectively determine airway wall motion with volume segmentation of transverse cine magnetic resonance (MR) images in children with obstructive sleep apnea (OSA).
Materials And Methods:
Transverse fast gradient-echo cine MR images of the hypopharynx were obtained at 1.5 T in 31 children with OSA (eight girls, 23 boys; mean age, 11.3 years) and 21 children free of airway symptoms who underwent MR imaging for other clinical indications (11 girls, 10 boys; mean age, 3.5 years). Volume segmentation with a k-means clustering algorithm was applied to transverse cine MR images to quantify airway volumes at each time. Airway wall motion for each child was described with standard deviation and range. Coefficient of variance and normalized range, which are independent of airway size, were used to compare groups (Kruskal-Wallis test).
Results:
Plots of airway volume over time demonstrated large fluctuations during respiration in children with OSA and minimal fluctuations in controls; findings were consistent with airway distention and airway collapse in OSA. Average airway transverse volume was larger in the group with OSA than in the control group (OSA group, 2.52 mL; control group, 0.936 mL; P <.001). Mean standard deviation (OSA group, 0.840 mL; control group, 0.17 mL; P <.001) and mean range of airway cross section (OSA group, 3.552 mL; control group, 0.864 mL; P <.001) were larger in the group with OSA. Coefficient of variance (OSA group, 0.32; control group, 0.17; P <.001) and normalized range (OSA group, 1.42; control group, 0.96; P <.001) indicate statistically significant difference in airway dynamics in children with OSA.
Conclusion:
Volume segmentation of transverse cine MR images of the hypopharynx aids in quantification of increased airway wall motion in children with OSA. Transverse MR imaging demonstrates both airway distention and collapse in children with OSA.
