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Published on: February 21, 2018
Development of adenoids: a study by measurement with MR images
1Department of Radiology, Kaohsiung Medical College, Kaohsiung, Taiwan, Republic of China.
Insights
Magnetic resonance imaging reveals adenoid development in children. Adenoids grow rapidly in infancy, plateau by age 2, and regress after 15, impacting nasopharyngeal airway compromise.
Area of Science:
- Pediatric imaging
- Otolaryngology
- Human anatomy and development
Background:
- Adenoids play a role in nasopharyngeal airway compromise.
- Understanding normal adenoid development is crucial for pediatric health assessments.
Purpose of the Study:
- To assess the normal development of adenoids in children using MR imaging.
- To evaluate the relationship between adenoid size and nasopharyngeal airway compromise.
Main Methods:
- Retrospective analysis of midsagittal T1-weighted spin-echo MR images from 290 children.
- Measurement of maximal adenoid thickness (A) and nasopharyngeal depth (N).
- Calculation of the adenoid-nasopharynx (A/N) ratio to assess airway compromise.
Main Results:
- Adenoids were identifiable by MR imaging from 4 months of age, with all visualized after 5 months.
- Rapid adenoid growth occurred during infancy, plateauing between ages 2-14 years (mean thickness 10.7-12.2 mm).
- Adenoids regressed significantly after 15 years of age. The A/N ratio plateaued between 2-7 years, indicating decreasing significance of adenoids in airway compromise with age.
Conclusions:
- MR imaging is effective for studying normal adenoid development and size in children.
- Adenoid size and its contribution to airway compromise change significantly throughout childhood and adolescence.
- The A/N ratio provides a quantifiable measure for assessing adenoid-related nasopharyngeal airway compromise.
Abstract:
Magnetic resonance (MR) imaging, which is able to demonstrate the actual size of adenoids by differentiating them from other soft-tissue structures, can be effectively used to study the normal development of adenoids. To assess the normal development of adenoids and to understand their role in the nasopharyngeal airway compromise, the adenoids of 290 children who had MR examination for other reasons were measured by midsagittal T1-weighted spin-echo MR image. The maximal thickness of adenoids (A), anteroposterior depth of the nasopharynx (N) and the adenoid-nasopharynx (A/N) ratios were obtained using this method. The results showed that of the infants under the age of 3 months only 2 out of 11 adenoids (18%) could be identified. By 4 months of age, adenoids could be identified in 6 of 8 infants (75%). After 5 months of age, all adenoids were well demonstrated by MR imaging. The adenoids developed rapidly during infancy and reached a plateau between 2- and 14 years of age with a mean thickness ranging from 10.7 to 12.2 mm. Finally, the adenoids regressed rapidly after 15 years old. The A/N ratios, which could be used to assess the airway compromise, had a plateau between 2- and 7 years of age. After that, with the steady growth of the nasopharynx, the possible role of adenoid in airway compromise will become increasingly less significant in later childhood.
