Fricke Bradley L, Donnelly Lane F, Shott Sally R, Kalra Maninder, Poe Stacy A, Chini Barbara A, Amin Raouf S
Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA.
Pediatr Radiol. 2006 Jun;36(6):518-23. doi: 10.1007/s00247-006-0149-7. Epub 2006 Apr 5.
Cine MRI has become a useful tool in the evaluation of patients with persistent obstructive sleep apnea (OSA) despite previous surgical intervention and in patients with underlying conditions that render them susceptible to multilevel airway obstruction. Findings on cine MRI studies have also increased our understanding of the mechanisms and anatomic causes of OSA in children.
To compare lingual tonsil size between children with OSA and a group of normal controls. In addition, a subanalysis was made of the group of children with OSA comparing lingual tonsils between children with and without underlying Down syndrome.
Children with persistent OSA despite previous palatine tonsillectomy and adenoidectomy and controls without OSA underwent MR imaging with sagittal fast spin echo inversion-recovery images, and lingual tonsils were categorized as nonperceptible at imaging or present and measurable. When present, lingual tonsils were measured in the maximum anterior-posterior diameter. If lingual tonsils were greater than 10 mm in diameter and abutting both the posterior border of the tongue and the posterior pharyngeal wall, they were considered markedly enlarged.
There were statistically significant differences between the OSA and control groups for the presence vs. nonvisualization of lingual tonsils (OSA 33% vs. control 0%, P=0.0001) and mean diameter of the lingual tonsils (OSA 9.50 mm vs. control 0.0 mm, P=0.00001). Within the OSA group, there were statistically significant differences between children with and without Down syndrome for the three lingual tonsil width categories (P=0.0070) and occurrence of markedly enlarged lingual tonsils (with Down syndrome 35% vs. without Down syndrome 3%, P=0.0035).
Enlargement of the lingual tonsils is relatively common in children with persistent obstructive sleep apnea after palatine tonsillectomy and adenoidectomy. This is particularly true in patients with Down syndrome.
尽管先前已进行手术干预，但电影磁共振成像（cine MRI）已成为评估持续性阻塞性睡眠呼吸暂停（OSA）患者以及评估易患多平面气道阻塞的潜在疾病患者的有用工具。电影MRI研究结果也增进了我们对儿童OSA机制和解剖学病因的理解。
比较OSA儿童与正常对照组儿童的舌扁桃体大小。此外，对OSA儿童组进行亚分析，比较患有和未患有唐氏综合征的儿童的舌扁桃体情况。
尽管先前已行腭扁桃体切除术和腺样体切除术但仍患有持续性OSA的儿童以及无OSA的对照组儿童接受了磁共振成像检查，采用矢状面快速自旋回波反转恢复序列成像，舌扁桃体在成像时被分类为不可见或存在且可测量。若舌扁桃体存在，则测量其最大前后径。如果舌扁桃体直径大于10 mm且紧邻舌根后缘和咽后壁，则认为其明显增大。
OSA组与对照组在舌扁桃体的存在与否（OSA组为33%，对照组为0%，P = 0.0001）以及舌扁桃体平均直径（OSA组为9.50 mm，对照组为0.0 mm，P = 0.00001）方面存在统计学显著差异。在OSA组内，患有和未患有唐氏综合征的儿童在三个舌扁桃体宽度类别方面（P = 0.0070）以及明显增大的舌扁桃体发生率方面（患有唐氏综合征的儿童为35%，未患有唐氏综合征的儿童为3%，P = 0.0035）存在统计学显著差异。
在腭扁桃体切除术和腺样体切除术后患有持续性阻塞性睡眠呼吸暂停的儿童中，舌扁桃体增大相对常见。在唐氏综合征患者中尤其如此。
