A Novel Volumetric Magnetic Resonance Imaging Paradigm to Study Upper Airway Anatomy

Abstract

STUDY OBJECTIVES: We utilized novel three-dimensional volumetric analysis techniques with magnetic resonance imaging (MRI) to study the upper airway and surrounding soft-tissue structures. These MRI techniques allowed us to objectively quantify the volume of the tongue, soft palate, parapharyngeal fat pads, and lateral pharyngeal walls. DESIGN: We first validated our volumetric imaging techniques on a phantom and then demonstrated that our results were reliable and reproducible in normal subjects who did not lose weight. Finally, we studied 12 obese, nonapneic women during wakefulness before and after weight loss. We hypothesized that our novel magnetic-resonance computer-reconstruction techniques would allow us to detect small reductions in the volume of the tongue, soft palate, lateral pharyngeal walls, and parapharyngeal fat pads and increases in the volume of the upper airway with weight loss. SETTING: University medical center. PARTICIPANTS: Normal controls and 12 obese nonapneic women. INTERVENTIONS: Weight loss. MEASUREMENTS AND RESULTS: Following a mean 17.1+/-8.62 kg (17.3%) reduction in weight, upper airway volume increased (p = 0.06) in both the retropalatal and retroglossal regions. This increase in upper airway volume was mediated by significant reductions in the volume of the lateral pharyngeal wall (p = 0.0001) and parapharyngeal fat pads (p = 0.001). However, the volume of the tongue (p = 0.35) and soft palate (p = 0.39) were not reduced significantly with weight loss. CONCLUSIONS: These data indicate that volumetric MRI is a powerful tool to study anatomic changes in the upper airway and surrounding soft-tissue structures and is sensitive enough to detect changes in these structures.