Perth Radiological Clinic, Subiaco, WA 6008, Australia; University of Western Australia, Nedlands, WA 6009, Australia; University of Melbourne, Carlton, Victoria 3000, Australia.
Medical Imaging, Fiona Stanley Hospital, Murdoch 6150, Australia.
Eur J Radiol. 2018 May;102:176-187. doi: 10.1016/j.ejrad.2018.03.010. Epub 2018 Mar 13.
Obstructive sleep apnoea (OSA) is characterised by recurrent upper airway collapse during sleep resulting in chronic and repetitive hypoxia, hypercapnia, subsequent arousal and fragmented sleep. Symptoms are insidious and diagnosis is usually delayed. Moderate to severe OSA has serious health implications with significant increase in all causes of mortality in patients with the condition as compared with unaffected individuals. The prevalence of OSA in the 30-70 year age group is estimated at 27% of males and 11% of females and it increases with age. 80% of affected individuals are obese and as obesity rates rise, so has the prevalence of OSA. An overnight polysomnogram (PSG) is required for a definitive diagnosis of OSA. Imaging has played a fundamental role in the evaluation of the anatomical factors associated with recurrent upper airway collapse and the pathogenesis of OSA. The upper airway is frequently imaged by radiologists, providing an opportunity to detect features that are strongly associated with unsuspected OSA and to raise the possibility of this diagnosis. The gold standard of treatment is continuous positive airway pressure (CPAP) which acts as a pneumatic splint for the upper airway. However, efficacy is frequently limited by poor tolerance; clinicians and patients are increasingly opting for one of a range of surgical procedures. Dedicated imaging protocols can be performed for evaluation of the upper airway to aid surgical planning.
阻塞性睡眠呼吸暂停（OSA）的特征是睡眠期间反复发生上气道塌陷，导致慢性和反复性低氧血症、高碳酸血症、随后觉醒和睡眠片段化。症状隐匿，诊断通常延迟。中重度 OSA 对健康有严重影响，与未受影响的个体相比，患有该病的患者各种原因的死亡率显著增加。30-70 岁年龄组 OSA 的患病率估计为男性的 27%和女性的 11%，并随年龄增长而增加。80%的受影响个体肥胖，随着肥胖率的上升，OSA 的患病率也随之上升。明确诊断 OSA 需要进行整夜多导睡眠图（PSG）。影像学在评估与反复上气道塌陷和 OSA 发病机制相关的解剖因素方面发挥了重要作用。放射科医生经常对气道进行成像，从而有机会发现与未被怀疑的 OSA 密切相关的特征，并提出这种诊断的可能性。治疗的金标准是持续气道正压通气（CPAP），它对上气道起到气动夹板的作用。然而，疗效常常受到耐受性差的限制；临床医生和患者越来越多地选择一系列手术之一。可以进行专门的气道成像方案，以帮助进行气道评估和手术规划。
