Widjaja E, Nilsson D, Blaser S, Raybaud C
Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada.
Acta Radiol. 2008 Jun;49(5):589-95. doi: 10.1080/02841850801950087.
The underlying cause of developmental delay (DD) often remains unclear despite extensive clinical examination and investigations. Interference in normal development of the brain may result in DD.
To identify the prevalence of abnormalities on magnetic resonance (MR) imaging in idiopathic developmental delay.
Of the 124 children referred for MR imaging with DD, 34 were excluded due to known history of progressive neurodevelopmental disorders, birth asphyxia, congenital CNS infections, metabolic disorder, chromosomal anomalies, and severe epileptic syndromes. The following structures were systematically reviewed: ventricles, corpus callosum, gray and white matter, limbic system, basal ganglia, brainstem, and cerebellum.
Ten out of 90 (11%) were referred with DD only, whilst 80/90 (89%) were referred with DD and additional clinical findings, such as seizures, neurological deficit, and abnormal head size. Of the 90 patients, 14 (16%) had normal MR and 76 (84%) had abnormal MR findings. Abnormal ventricles were seen in 43/90 (48%); abnormal corpus callosum was identified in 40/90 (44%). Other MR findings included abnormalities in the white matter (23/90, 26%), hippocampi (5/90, 6%), cerebellum (5/90, 6%), and brainstem (4/90, 4%).
Abnormalities of the ventricles and corpus callosum were identified in a large proportion of patients with idiopathic DD, indicative of changes in the white matter. Further studies using quantitative methods and diffusion tensor imaging are required to evaluate the white matter in these children.
尽管进行了广泛的临床检查和调查，但发育迟缓（DD）的潜在病因往往仍不明确。大脑正常发育受到干扰可能导致发育迟缓。
确定特发性发育迟缓患者磁共振成像（MR）异常的患病率。
在因发育迟缓接受磁共振成像检查的124名儿童中，34名因已知的进行性神经发育障碍、出生窒息、先天性中枢神经系统感染、代谢紊乱、染色体异常和严重癫痫综合征病史而被排除。对以下结构进行了系统评估：脑室、胼胝体、灰质和白质、边缘系统、基底神经节、脑干和小脑。
90名患者中，10名（11%）仅因发育迟缓就诊，而80/90名（89%）因发育迟缓和其他临床症状就诊，如癫痫发作、神经功能缺损和头围异常。90名患者中，14名（16%）磁共振成像正常，76名（84%）有磁共振成像异常表现。43/90名（48%）可见脑室异常；40/90名（44%）发现胼胝体异常。其他磁共振成像表现包括白质异常（23/90，26%）、海马异常（5/90，6%）、小脑异常（5/90，6%）和脑干异常（4/90，4%）。
在大部分特发性发育迟缓患者中发现脑室和胼胝体异常，提示白质改变。需要进一步采用定量方法和扩散张量成像研究来评估这些儿童的白质情况。
