Zhang Lin, Ma Rui, Yuan Yanran, Lian Dandan, Qi Xianlong, Zheng Ning, Li Kailong
Department of Radiology.
Department of Children Rehabilitation, Jining No.1 People's Hospital.
Medicine (Baltimore). 2019 Apr;98(14):e15058. doi: 10.1097/MD.0000000000015058.
Impaired language function is frequently observed as an initial sign in people with autism spectrum disorder (ASD). However, clinically, the early stages of ASD are difficult to distinguish from those of developmental language disorder (DLD).
To evaluate the ability of diffusion tensor imaging (DTI) parameters for language-related white matter tracts (arcuate fasciculus) to differentiate ASD from DLD among toddlers.
We included 16 ASD toddlers with language delay and 18 DLD toddlers in this study. Magnetic resonance imaging sequences included T2-weighted imaging (T2WI), T1 3-dimensional magnetization-prepared rapid acquisition gradient-echo (3D MP-RAGE), and DTI. Tractography was performed using Neuro 3D in the Siemens Syngo Workstation, and fractional anisotropy (FA), average fiber length (AFL), tract volume (TV), and number of voxels (NV) were automatically calculated. Data were then analyzed using IBM SPSS Statistics 22.
The ASD group exhibited significantly lower FA values, as well as significantly higher TV and NV values compared with the DLD group. With age as the covariate, analysis of covariance revealed different significances in TV and NV. Analysis of variance for AFL revealed no significant differences between the 2 groups.
DTI parameters of arcuate fasciculus were useful for differentiating ASD with language delay from DLD among toddlers. DTI has the potential to provide an objective and effective method for aiding early diagnosis, early intervention and improving long-term outcomes of ASD.
语言功能受损常被视为自闭症谱系障碍(ASD)患者的初始症状。然而,在临床上,ASD的早期阶段很难与发育性语言障碍(DLD)相区分。
评估扩散张量成像(DTI)参数对语言相关白质束(弓状束)在幼儿中区分ASD与DLD的能力。
本研究纳入了16名有语言延迟的ASD幼儿和18名DLD幼儿。磁共振成像序列包括T2加权成像(T2WI)、T1三维磁化准备快速采集梯度回波(3D MP-RAGE)和DTI。在西门子Syngo工作站上使用Neuro 3D进行纤维束成像,并自动计算分数各向异性(FA)、平均纤维长度(AFL)、纤维束体积(TV)和体素数量(NV)。然后使用IBM SPSS Statistics 22对数据进行分析。
与DLD组相比,ASD组的FA值显著更低,TV和NV值显著更高。以年龄作为协变量,协方差分析显示TV和NV存在不同的显著性。AFL的方差分析显示两组之间无显著差异。
弓状束的DTI参数有助于在幼儿中区分有语言延迟的ASD与DLD。DTI有可能为ASD的早期诊断、早期干预及改善长期预后提供一种客观有效的方法。