Verbruggen Krijn T, Maurits Natasha M, Meiners Linda C, Brouwer Oebele F, van Spronsen Francjan J, Sijens Paul E
Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, The Netherlands.
J Magn Reson Imaging. 2009 Oct;30(4):716-21. doi: 10.1002/jmri.21909.
To assess whether proton MR spectroscopy of the brain in children with developmental delay reveals a consistent pattern of abnormalities.
Eighty-eight patients (median age, 4.6 years; interquartile range, 3.1-8.1 years) with unexplained developmental delay, were compared with 48 normally developing age-matched controls. Patients and controls were assigned to five age-groups. Multivoxel MR spectroscopy was performed on a volume of interest superior to the lateral ventricles. The relative levels of choline, creatine, N-acetyl aspartate, and glutamate/glutamine in 24 voxels containing white matter and 12 voxels containing gray matter were quantified in an operator-independent manner and expressed in proportion to the total metabolite peak area in the volume of interest.
White matter choline in DD showed less decrease with age. Mean choline levels, compared with mean control levels, increased from 99 to 111% with increasing age. This was statistically significant in the highest age groups (P = 0.015 [7 < yr <or= 12.8] and P = 0.039 [12.8 < yr]). Other metabolites did not show clear alterations.
Proton MR spectroscopy in a group of patients with unexplained DD shows small differences in the metabolite pattern, compared with normally developing controls, that is, higher choline in the white matter. The pathophysiological origin and significance may relate to myelination and maturation of the white matter.
评估发育迟缓儿童脑部的质子磁共振波谱是否显示出一致的异常模式。
将88例不明原因发育迟缓患者（中位年龄4.6岁；四分位间距3.1 - 8.1岁）与48例年龄匹配的正常发育对照进行比较。患者和对照被分为五个年龄组。在侧脑室上方的感兴趣区域进行多体素质子磁共振波谱检查。以独立于操作者的方式对24个含白质的体素和12个含灰质的体素中的胆碱、肌酸、N - 乙酰天门冬氨酸以及谷氨酸/谷氨酰胺的相对水平进行定量，并表示为感兴趣区域中总代谢物峰面积的比例。
发育迟缓患者白质中的胆碱随年龄下降较少。与对照平均水平相比，胆碱平均水平随年龄增长从99%升至111%。在最高年龄组中具有统计学意义（P = 0.015 [7岁 < 年龄 ≤ 12.8岁] 和P = 0.039 [年龄 > 12.8岁]）。其他代谢物未显示明显变化。
与正常发育的对照相比，一组不明原因发育迟缓患者的质子磁共振波谱在代谢物模式上显示出微小差异，即白质中胆碱水平较高。其病理生理起源和意义可能与白质的髓鞘形成和成熟有关。
