Table 1.
Systemic review of literature regarding patients who underwent dynamic sleep magnetic resonance imaging (MRI)
| Author year study design | Number of patients (Number of controls) | BMI-matched controls | Sedation use (Agent) | Outcomes analyzed | Brief description |
|---|---|---|---|---|---|
| Suto et al. [6] CCS | 15 (5) | No | Induced (hydroxyzine hydrochloride) | Site of obstruction | First study to use dynamic MRI using a novel ultrafast MRI technique |
| Suto et al. [33] PCS | 25 (0) | – | Does not specify | Image Quality | Technical paper regarding a case series that outlined the feasibility of obtaining good image quality with 3D reconstruction new ultrafast MRI technology |
| Ciscar et al. [13] CCS | 17 (8) | No | Natural | Cross-sectional imaging | This study concluded that OSA patients have a more collapsible velopharynx, this being the main mechanism of obstruction when compared to non-OSA control patients |
| Ikeda et al. [29] CCS | 6 (3) | Yes | Natural | AHI, BMI, Site of obstruction, Cross-sectional imaging | This study measured CSA and anterior–posterior width and noted a significant change in airway size from awake to sleep in the OSA patients that was not present in the control group |
| Shintani et al. [23] PCS | 41 (0) | – | Induced (midazolam) | AHI, RDI, LSAT, BMI, Site of obstruction, Cross-sectional imaging | OSA patients only were studied with awake and asleep dynamic MRI in order to correlate findings with PSG data. Authors concluded that severity of disease correlated with narrowing of the airway |
| Zhang et al. [8] PCS | 18 (0) | – | 11 natural, 4 Induced (chloral hydrate), 3 simulated snoring | Cross-sectional imaging | This study compares dynamic MRI with single slice MRI. It finds no difference in 4 sagittal measurements of the upper airway. Duration and pattern of obstruction cannot be visualized with static MRI alone |
| Barrera et al. [43] PCS | 17 (0) | – | Natural | AHI, RDI, LSAT, Site of obstruction, Cross-sectional imaging | This study's objective was to test safety and protocol for sleep MRI with PAT PSG. Able to correlate visual obstruction on dynamic MRI and physiological readings on PAT PSG |
| Chuang et al. [25] PCS | 10 (0) | – | Induced (zolpidem) | AHI, BMI, Site of obstruction | This study used dynamic MRI during awake and drug induced sleep and concluded that three different dynamic obstruction patterns occurred during drug-induced sleep |
| Moriwaki et al. [28] CCS | 31 (0) | – | Induced (hydroxyzine hydrochloride) | AHI, RDI, LSAT, BMI, Site of obstruction, Cross-sectional imaging | This study concluded that patients with multiple obstruction sites had significantly higher AHI than patients with single site obstruction. 61.3 ± 6.9 vs 31.2 ± 5.5 |
| Barrera et al. [44] CDTE | 20 (15) | No | Natural | BMI, Site of obstruction, Cross-sectional imaging | Two sleep surgeons determine if obstruction exists or not on sleep MRI images and intra-rater and inter-rater reliability coefficients were measured |
| Moon et al. [24] CCS | 35 (0) | – | Induced (midazolam) | BMI, RDI, LSAT, Site of obstruction, Cross-sectional imaging | Dynamic Sleep MRI used to determine collapsibility of the airway measured in the dimensions |
| Barrera et al. [30] PCS | 20 (19) | No | Natural | BMI, LSAT, Site of obstruction | Description and review of a protocol that could be used for dynamic sleep MRI |
| Wang et al. [22] CCS | 21 (20) | No | Natural | Tongue motion, AHI, BMI | This study compares OSA vs non-OSA tongue volume and dynamic movement of the tongue during awake and asleep states. It concluded that tongue size significantly differs between OSA patients and normal controls during sleep |
| Liu et al. [19] CCS | 15 severe (15 mild) | Yes | Natural | AHI, BMI, Upper airway length | This study concluded that severe OSA patient when compared to mild OSA patient have longer upper airway length and have pronounced lateral pharyngeal wall collapse |
| Kavcic et al. [26] PCS | 15 (0) | – | Natural | AHI, BMI, Site of obstruction | First study to use EEG synchronously with dynamic sleep MRI. Three interactions between the tongue and the palate to cause obstruction was observed |
| Faria et al. [34] CSS | 20 (0) | – | Induced (propofol) | AHI, BMI, Cross-sectional imaging | This study observed dynamic anatomical changes before and after maxillomandibular advancement |
| Huon et al. [20] CCS | 15 severe (15 mild) | Yes | Natural | AHI, BMI, Site of obstruction | This study uses a previously published cohort (Liu et al. 2015) and determines patterns of collapse |
| Bansal et al. [21] PCS | 30 (0) | – | Natural | Site of obstruction | This study included a short video of midline sagittal views of the dynamic MRI |
| Darquenne et al. [48] PCS | 9 (9) | Yes | Natural | AHI, BMI, Site of obstruction, Cross-sectional imaging | This study measured maximum and minimum CSA at eight different levels during sleep and awake states. A larger decrease of airway CSA in awake tidal breathing was observed in OSA patients when compared to controls. They note that the site of collapse during sleep in OSA patients was correlated with the site of maximal change in CSA seen in awake tidal breathing |
Table includes basic information about each study as well as a discussion of the relevance, key findings, and pertinent details from each article
BMI body mass index; CCS case control series; PCS prospective control series; CSA cross-sectional area; AHI apnea–hypopnea index; RDI respiratory disturbance index; LSAT lowest oxygen saturation; CDTE cross-sectional diagnostic test evaluation; MMA maxillary mandibular advancement