Lisy Jiri, Efremova Andrea, Hrdlicka Michal
Department of Radiology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.
Department of Child Psychiatry, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2019 Dec;163(4):374-378. doi: 10.5507/bp.2018.074. Epub 2018 Dec 11.
The aim of our study was to assess the yield of routine brain magnetic resonance imaging (MRI) performed at our hospital as part of the diagnostic procedures focused on autism.
Our retrospective study involved children who had attended a diagnostic examination focused on autism and underwent brain MRIs between 1998-2015. The International Classification of Diseases, 10 edition was used to make clinical diagnoses. In 489 children (404 boys, 85 girls; mean age 8.0±4.2 years), a diagnosis of a pervasive developmental disorder was confirmed. Forty-five children, where the autism diagnosis was ruled out (but other psychiatric diagnoses found), served as a control group (36 boys, 9 girls; mean age 7.0±2.4 years). We can assume that in such a control group, brain abnormalities might occur at a higher frequency than in truly healthy children which would have the effect of reducing the difference between the groups.
MRI pathologies were more common in the autistic (45.4 %) compared to the control group (31.8%) but the difference was significant only at the trend level (P=0.085). Hypoplasia of the corpus callosum (CC) was significantly more common in the autistic vs. the control group (13.7 vs. 0%; P=0.009). In contrast, nonmyelinated areas of white matter were significantly more common in controls (31.8 vs.17.3%; P=0.018). Differences in other parameters were not significant.
The occurrence of CC hypoplasia on routine MRI scans could represent a "red flag" for suspicion of autism.
我们研究的目的是评估在我院进行的常规脑磁共振成像（MRI）作为自闭症诊断程序一部分的检出率。
我们的回顾性研究纳入了1998年至2015年间参加自闭症诊断检查并接受脑部MRI检查的儿童。采用国际疾病分类第10版进行临床诊断。489名儿童（404名男孩，85名女孩；平均年龄8.0±4.2岁）被确诊为广泛性发育障碍。45名排除自闭症诊断（但发现其他精神疾病诊断）的儿童作为对照组（36名男孩，9名女孩；平均年龄7.0±2.4岁）。我们可以假设，在这样的对照组中，脑异常的发生率可能高于真正健康的儿童，这将减少两组之间的差异。
与对照组（31.8%）相比，自闭症组（45.4%）的MRI病变更常见，但差异仅在趋势水平上显著（P = 0.085）。胼胝体发育不全（CC）在自闭症组中明显比对照组更常见（13.7%对0%；P = 0.009）。相比之下，白质未髓鞘化区域在对照组中明显更常见（31.8%对17.3%；P = 0.018）。其他参数的差异不显著。
常规MRI扫描中出现CC发育不全可能是怀疑自闭症的一个“警示信号”。
