Chu Cheng-An, Chen Yunn-Jy, Chang Ke-Vin, Wu Wei-Ting, Özçakar Levent
Department of Dentistry, School of Dentistry, National Taiwan University Hospital, Taipei, Taiwan.
Department of Physical Medicine and Rehabilitation and Community and Geriatric Research Center, National Taiwan University Hospital, Bei-Hu Branch and National Taiwan University College of Medicine, Taipei, Taiwan.
Front Physiol. 2021 Mar 25;12:654667. doi: 10.3389/fphys.2021.654667. eCollection 2021.
Few studies have explored the feasibility of shear-wave ultrasound elastography (SWUE) for evaluating the upper airways of patients with obstructive sleep apnea (OSA). This study aimed to establish a reliable SWUE protocol for evaluating tongue muscle elasticity and its feasibility and utility in differentiating patients with OSA. Inter-rater and intra-rater reliability of SWUE measurements were tested using the intraclass correlation coefficients. Submental ultrasound was used to measure tongue thickness and stiffness. Association between the ultrasound measurements and presence of OSA was analyzed using multivariate logistic regression. One-way analysis of variance was used to examine if the values of the ultrasound parameters varied among patients with different severities of OSA. Overall, 37 healthy subjects and 32 patients with OSA were recruited. The intraclass correlation coefficients of intra- and inter-rater reliability for SWUE for tongue stiffness ranged from 0.84 to 0.90. After adjusting for age, sex, neck circumference, and body mass index, the risk for OSA was positively associated with tongue thickness [odds ratio 1.16 (95% confidence interval 1.01-1.32)] and negatively associated with coronal imaging of tongue muscle stiffness [odds ratio 0.72 (95% confidence interval 0.54-0.95)]. There were no significant differences in tongue stiffness among OSA patients with varying disease severity. SWUE provided a reliable evaluation of tongue muscle stiffness, which appeared to be softer in patients with OSA. Future longitudinal studies are necessary to investigate the relationship between tongue softening and OSA, as well as response to treatment.
很少有研究探讨剪切波超声弹性成像（SWUE）用于评估阻塞性睡眠呼吸暂停（OSA）患者上气道的可行性。本研究旨在建立一种可靠的SWUE方案，用于评估舌肌弹性及其在鉴别OSA患者中的可行性和实用性。使用组内相关系数测试SWUE测量的评分者间和评分者内可靠性。使用颏下超声测量舌厚度和硬度。使用多因素逻辑回归分析超声测量值与OSA存在之间的关联。使用单因素方差分析检查超声参数值在不同严重程度的OSA患者中是否存在差异。总共招募了37名健康受试者和32名OSA患者。SWUE评估舌硬度的评分者内和评分者间可靠性的组内相关系数范围为0.84至0.90。在调整年龄、性别、颈围和体重指数后，OSA风险与舌厚度呈正相关[比值比1.16（95%置信区间1.01-1.32）]，与舌肌硬度的冠状位成像呈负相关[比值比0.72（95%置信区间0.54-0.95）]。不同疾病严重程度的OSA患者之间舌硬度无显著差异。SWUE对舌肌硬度提供了可靠的评估，OSA患者的舌肌似乎更软。未来有必要进行纵向研究，以调查舌软化与OSA之间的关系以及对治疗的反应。
