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患有胎儿酒精综合征(FAS)、部分胎儿酒精综合征(pFAS)和酒精相关神经发育障碍(ARND)的儿童的磁共振成像(MRI)检查结果。

Magnetic resonance imaging (MRI) findings among children with fetal alcohol syndrome (FAS), partial fetal alcohol syndrome (pFAS) and alcohol related neurodevelopmental disorders (ARND).

作者信息

Anna Dyląg Katarzyna, Sikora-Sporek Aleksanda, Bańdo Bożena, Boroń-Zyss Joanna, Drożdż Dorota, Dumnicka Paulina, Przybyszewska Katarzyna, Sporek Mateusz, Walocha Jerzy W, Wojciechowski Wadim, Urbanik Andrzej

出版信息

Przegl Lek. 2016;73(9):605-9.

Abstract

BACKGROUND

The aim of the study was to analyze the findings in MRI (magnetic resonance imaging) of the brain amongst children diagnosed with fetal alcohol syndrome (FAS), partial fetal alcohol syndrome (pFAS) or alcohol related neurodevelopmental disorders (ARND). The issue has been studied in several researches previously but the experts agree that there is still few data on the MRI results in the group of younger children.

MATERIAL AND METHODS

MRI results of 121 patients with either FAS or pFAS or ARND diagnosed with Canadian criteria were analyzed regarding the presence of abnormalities. The group consisted of 71 patients diagnosed with FAS, 33 diagnosed with pFAS and 17 diagnosed with ARND. The mean age of the patients was 8.03 years (standard deviation 4.07).

RESULTS

In the total group of FASD patients 61.98% of the patients’ MRI results were abnormal. The most common abnormality in MRI of the patients were demyelination plaques (incidence 23.1%) and corpus callosum narrowing (20.7%) as well as ventricular asymmetry (18.8%).The demyelination plaques and corpus callosum narrowing were more frequent among children ≤4 years old (41.7% vs 18.6%; p=0.016 and 50.0% vs.13.4%; p<0.001, respectively). Age ≤4 years predicted the presence of demyelination plaques and corpus callosum narrowing independently of FAS diagnosis. Among younger children, multiple central nervous system abnormalities were observed more often than in the older age group (54.2% vs. 14.4%; p<0.001). Odds ratio for multiple changes was 0.84 per one-year increase in age (95% CI 0.73-0.97), p=0.016. Furthermore, in the analysis according to the specific diagnosis, among the patients diagnosed with FAS, multiple anomalies were more common than in pFAS and ARND. Both age ≤4 years and FAS diagnosis were independent predictors for multiple anomalies in multiple logistic regression.

CONCLUSION

In structural brain MRI of younger children, multiple anomalies were found more frequently than among older children. Demyelination plaques and corpus callosum narrowing were more common in younger FASD patients than in older ones.

摘要

背景

本研究旨在分析被诊断为胎儿酒精综合征(FAS)、部分胎儿酒精综合征(pFAS)或酒精相关神经发育障碍(ARND)的儿童脑部磁共振成像(MRI)的检查结果。此前已有多项研究探讨过该问题,但专家们一致认为,关于年幼儿童组MRI结果的数据仍然较少。

材料与方法

分析了121例根据加拿大标准诊断为FAS、pFAS或ARND患者的MRI结果,以确定是否存在异常。该组包括71例被诊断为FAS的患者、33例被诊断为pFAS的患者和17例被诊断为ARND的患者。患者的平均年龄为8.03岁(标准差4.07)。

结果

在FASD患者的总群体中,61.98%患者的MRI结果异常。患者MRI中最常见的异常是脱髓鞘斑块(发生率23.1%)、胼胝体狭窄(20.7%)以及脑室不对称(18.8%)。脱髓鞘斑块和胼胝体狭窄在4岁及以下儿童中更为常见(分别为41.7%对18.6%;p = 0.016以及50.0%对13.4%;p < 0.001)。4岁及以下年龄可独立于FAS诊断预测脱髓鞘斑块和胼胝体狭窄的存在。在年幼儿童中,观察到的中枢神经系统多处异常比年龄较大组更常见(54.2%对14.4%;p < 0.001)。年龄每增加一岁,出现多处变化的优势比为0.84(95%可信区间0.73 - 0.97),p = 0.016。此外,在根据具体诊断进行的分析中,在被诊断为FAS的患者中多处异常比在pFAS和ARND患者中更常见。在多因素逻辑回归中,4岁及以下年龄和FAS诊断都是多处异常的独立预测因素。

结论

在年幼儿童的脑部结构MRI中,发现多处异常比年龄较大儿童更频繁。脱髓鞘斑块和胼胝体狭窄在年幼的FASD患者中比年长患者更常见。

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