Zeegers Mijke, Van Der Grond Jeroen, Durston Sarah, Nievelstein Rutger Jan, Witkamp Theo, Van Daalen Emma, Buitelaar Jan, Engeland Herman Van
Rudolf Magnus Institute of Neuroscience, Department of Child and Adolescent Psychiatry, University Medical Center Utrecht, The Netherlands.
Brain Dev. 2006 Sep;28(8):495-9. doi: 10.1016/j.braindev.2006.02.006. Epub 2006 Apr 17.
The aim of this study was to evaluate the prevalence of brain abnormalities in a group of young children with developmental disorders, specifically including children that came to the attention of a child psychiatrist before the age of 3 years.
Forty-five children participated in an MR study (mean age 43 months, SD=12, four females). The study design was approved by the local Medical Ethical Review Board. All parents gave written informed consent. Scans were independently assessed by two board-certified radiologists for malformations of gray and white matter.
Cohen's kappa for the consensus between the two raters was 0.79. In 22 children (49%) abnormalities were reported. Four patients (8.5%) had an arachnoid cyst. One female was diagnosed with a Chiari I malformation. Three children show enlarged Virchow-Robin spaces, an increased occurrence when compared to the normal population.
A high rate of intracranial abnormalities was found in this study. Radiological findings do not contribute to the diagnosis of developmental disorders. However, young children with developmental disorders may not be able to express discomfort associated with brain abnormalities, such as a Chiari I malformation. Given the high prevalence of abnormalities in this sample neuroimaging may be a useful tool in clinically assessing children with developmental disorders.
本研究旨在评估一组发育障碍幼儿中脑异常的患病率，具体包括3岁前引起儿童精神科医生注意的儿童。
45名儿童参与了一项磁共振成像（MR）研究（平均年龄43个月，标准差=12，4名女性）。该研究设计获得了当地医学伦理审查委员会的批准。所有家长均签署了书面知情同意书。扫描结果由两名具有委员会认证资格的放射科医生独立评估灰质和白质的畸形情况。
两位评估者之间的一致性Cohen's kappa为0.79。报告有22名儿童（49%）存在异常。4名患者（8.5%）有蛛网膜囊肿。一名女性被诊断为Chiari I畸形。3名儿童显示Virchow-Robin间隙增宽，与正常人群相比发生率增加。
本研究发现颅内异常的发生率较高。影像学检查结果对发育障碍的诊断没有帮助。然而，发育障碍的幼儿可能无法表达与脑异常相关的不适，如Chiari I畸形。鉴于该样本中异常的高患病率，神经影像学检查可能是临床评估发育障碍儿童的有用工具。
