Department of Pediatrics, 442339All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Department of Radio-Diagnosis & Imaging, 442339All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
J Child Neurol. 2021 May;36(6):440-446. doi: 10.1177/0883073820978006. Epub 2020 Dec 11.
Developmental delay (DD) is an important long-term neuromorbidity owing to various insults to the developing brain and neuroimaging plays a key role in evaluating these children. Magnetic resonance spectroscopy (MRS) is the only noninvasive method to determine the levels of various metabolites in the brain which aids in delineating the underlying abnormalities. A total of 48 children aged between 6 months to 6 years with developmental delay were included and evaluated with neuroimaging in our study. Sensitivity of MRS in children with DD and DD plus (DD along with seizures, abnormal motor findings, behavior, brainstem evoked response audiometry, visual assessment, and microcephaly) was 81.2% and 89.6% respectively. 86.6% of children with microcephaly had abnormal MRS. MRS detected abnormalities in two-thirds of children with normal magnetic resonance imaging (MRI). Children with behavioral abnormalities had significantly lower -acetyl aspartate (NAA)-creatine and NAA-choline ratios on MRS. Thus, MRS is additive to MRI in delineating the underlying pathophysiology in children with DD.
发育迟缓（DD）是一种重要的长期神经发育障碍，源于对发育中大脑的各种损伤，神经影像学在评估这些儿童方面发挥着关键作用。磁共振波谱（MRS）是唯一能确定大脑中各种代谢物水平的非侵入性方法，有助于描绘潜在的异常。本研究共纳入 48 例年龄在 6 个月至 6 岁之间的发育迟缓儿童，并进行神经影像学评估。MRS 在 DD 患儿和 DD 伴发症（DD 伴有癫痫发作、运动异常、行为异常、脑干听觉诱发电位、视觉评估和小头畸形）患儿中的敏感性分别为 81.2%和 89.6%。86.6%的小头畸形患儿 MRS 异常。MRS 检测到三分之二磁共振成像（MRI）正常的患儿存在异常。行为异常的患儿 MRS 上 -乙酰天冬氨酸（NAA）-肌酸和 NAA-胆碱比值显著降低。因此，MRS 对 MRI 是一种补充，有助于描绘 DD 患儿潜在的病理生理学变化。
