Development patterns of adenoids in Chinese children without sleep-disordered breathing: a retrospective magnetic resonance imaging study with consecutive age groups

To the Editor:Sleep-disordered breathing(SDB)is a health problem affecting approximately 12%of children in China,[1]characterized by habitual loud snoring and increased respiratory effort.Increased upper airway resistance related to enlarged adenoids has been identified as the most common cause in children with obstructive SDB,and adenoidectomy is the standard treatment for the disorder.Similar to lymphoid tissues,adenoids show a unique natural growth pattern,which incorporates both overgrowth and involution.However,the development patterns of adenoids have not been clearly elucidated.Since the adenoids are located in the nasopharynx roof,direct evaluation of their size and proportion to the upper airway area is difficult.Thus,radiological methods have been employed widely for such purposes,including traditional plain cranial radiographs,computed tomography(CT),cone-beam CT,and magnetic resonance imaging(MRI).MRI can reveal the accurate size of adenoids by differentiating them from other soft tissue structures without any ionizing radiation;therefore,it can effectively study the adenoids’developmental pattern in normal children.Previous studies have evaluated age-associated changes in adenoid size by MRI.Arens et al[2]indicated that adenoids grow proportionally to the skeletal structures in children aged 1 to 11 years.Papaioannou et al[3]reported that head MRI examinations demonstrated increased adenoid size during the first 7–8 years of life and then decreased gradually in children without snoring signs.Variabilities of the above-reported adenoids’development pattern exist due to the limitations associated with the small sample size.Furthermore,none of the above-mentioned studies on normal children used a strict method to exclude SDB.Additionally,for adenoid hypertrophy,the adenoid/nasopharyngeal(A/N)ratio was found to be a useful,tolerable,and confident diagnostic method in pediatric patients,with emphasis on the correlation of the adenoid size and upper airway lumen to variable degrees.Therefore,the A/N ratio can be considered a useful objective tool in evaluating adenoid development in children.We aimed to investigate the growth and involution patterns of adenoids in consecutive age groups from birth to 16 years in Chinese children without SDB using MRI data,which may benefit the study of diseases associated with the development of adenoids.

Intrapulmonary lipoma: a case report and literature review

Background:Intrapulmonary lipoma is extemely rare in children.So far,all reported pulmonary lipomas were from adult patients.Methods:We present herein a case of intrapulmonary lipoma in a child and a review of the related literature.Results:A 13-month-old boy was hospitalized because of cough and fever.Chest CT showed patchy infiltration and round-shape,hypodense homogeneous lesions located in the lung.After 19 days of antibiotic treatment,his clinic symptoms disappeared,but the round lesions remained without any change.One month and one year later,he was examined by chest MRI with technique of fat suppression.The child was diagnosed as having an intrapulmonary lipoma without biopsy.Conclusions:Intrapulmonary lipoma is rare in children.Chest CT and MRI are very important for the correct diagnosis of intrapulmonary lipoma.