Zeng G H, Li Y, Teng Y H, Zhu J
Department of Otorhinolaryngology Head and Neck Surgery, Hangzhou First People's Hospital, Hangzhou, 310006, China.
Department of Otorhinolaryngology Head and Neck Surgery, Baoan District Fuyong People's Hospital in Shenzhen.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Aug 5;31(15):1174-1177. doi: 10.13201/j.issn.1001-1781.2017.15.008.
To evaluate application value of the dynamic adenoidal/hypertrophy (A/N) ratio in children with OSAHS by analyzing the correlation between the A/N ratio at the different respiratory phases and the index of polysomnography.Fifty-one childrens, with simple hypertrophic adenoids, were diagnosed as OSAHS. Magnetic resonance imaging (MRI) with respiratory gating technology were used to scan the upper airway of children during sleep at the early, middle and end phases of respiratory cycle, and measure adenoidal hypertrophy ratio in different respiratory phases. The correlation analysis was performed between the A/N ratio in different respiratory phases and the index of polysomnography (AHI and LaSO2). Finally, via ROC curve and Kappa analysis, the critical value and diagnosis accordance rate of A/N ratio in illness severity evaluation of children with OSAHS were confirmed.At the 6 respiratory phases, the A/N ratios showed significantly positive correlations with AHI (All < 0.01). There was a highest coefficient between the end-expiratory A/N ratio and AHI (= 0.559 4). In addition, the optimal cut-off point of A/N ratio between slight-moderate and severe OSAHS was 0.834. The diagnosis accuracies of the end-expiratory A/N ratio in severe and slight moderate OSAHS were 81% and 84%, respectively.MRI with respiratory gating technology obtaining dynamic A/N ratio might be an important method of imaging diagnosis of children OSAHS, and the end expiratory A/N ratio is expected to become a classification index of slight moderate and severe children OSAHS.
通过分析不同呼吸阶段的腺样体/鼻咽部（A/N）比值与多导睡眠图指标之间的相关性，评估动态A/N比值在儿童阻塞性睡眠呼吸暂停低通气综合征（OSAHS）中的应用价值。51例单纯腺样体肥大儿童被诊断为OSAHS。采用呼吸门控技术的磁共振成像（MRI）在呼吸周期的早期、中期和末期对睡眠中的儿童上气道进行扫描，并测量不同呼吸阶段的腺样体肥大比值。对不同呼吸阶段的A/N比值与多导睡眠图指标（呼吸暂停低通气指数（AHI）和最低血氧饱和度（LaSO2））进行相关性分析。最后，通过ROC曲线和Kappa分析，确定A/N比值在儿童OSAHS病情严重程度评估中的临界值和诊断符合率。在6个呼吸阶段，A/N比值与AHI均呈显著正相关（均P<0.01）。呼气末A/N比值与AHI的相关性系数最高（r=0.559 4）。此外，轻度-中度与重度OSAHS之间A/N比值的最佳截断点为0.834。呼气末A/N比值对重度和轻度-中度OSAHS的诊断准确率分别为81%和84%。采用呼吸门控技术的MRI获取动态A/N比值可能是儿童OSAHS影像学诊断的重要方法，呼气末A/N比值有望成为儿童轻度-中度和重度OSAHS的分类指标。
