定量磁共振成像在儿童自闭症诊断中的应用。
Application of Quantitative Magnetic Resonance Imaging in the Diagnosis of Autism in Children.
作者信息
Tang Shilong, Nie Lisha, Liu Xianfan, Chen Zhuo, Zhou Yu, Pan Zhengxia, He Ling
机构信息
Department of Radiology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.
GE Healthcare, MR Research China, Beijing, China.
出版信息
Front Med (Lausanne). 2022 May 12;9:818404. doi: 10.3389/fmed.2022.818404. eCollection 2022.
OBJECTIVE
To explore the application of quantitative magnetic resonance imaging in the diagnosis of autism in children.
METHODS
Sixty autistic children aged 2-3 years and 60 age- and sex-matched healthy children participated in the study. All the children were scanned using head MRI conventional sequences, 3D-T1, diffusion kurtosis imaging (DKI), enhanced T2*- weighted magnetic resonance angiography (ESWAN) and 3D-pseudo continuous Arterial Spin-Labeled (3D-pcASL) sequences. The quantitative susceptibility mapping (QSM), cerebral blood flow (CBF), and brain microstructure of each brain area were compared between the groups, and correlations were analyzed.
RESULTS
The iron content and cerebral blood flow in the frontal lobe, temporal lobe, hippocampus, caudate nucleus, substantia nigra, and red nucleus of the study group were lower than those in the corresponding brain areas of the control group ( < 0.05). The mean kurtosis (MK), radial kurtosis (RK), and axial kurtosis (AK) values of the frontal lobe, temporal lobe, putamen, hippocampus, caudate nucleus, substantia nigra, and red nucleus in the study group were lower than those of the corresponding brain areas in the control group ( < 0.05). The mean diffusivity (MD) and fractional anisotropy of kurtosis (FAK) values of the frontal lobe, temporal lobe and hippocampus in the control group were lower than those in the corresponding brain areas in the study group ( < 0.05). The values of CBF, QSM, and DKI in frontal lobe, temporal lobe and hippocampus could distinguish ASD children (AUC > 0.5, < 0.05), among which multimodal technology (QSM, CBF, DKI) had the highest AUC (0.917) and DKI had the lowest AUC (0.642).
CONCLUSION
Quantitative magnetic resonance imaging (including QSM, 3D-pcASL, and DKI) can detect abnormalities in the iron content, cerebral blood flow and brain microstructure in young autistic children, multimodal technology (QSM, CBF, DKI) could be considered as the first choice of imaging diagnostic technology.
CLINICAL TRIAL REGISTRATION
[http://www.chictr.org.cn/searchprojen.aspx], identifier [ChiCTR2000029699].
目的
探讨定量磁共振成像在儿童自闭症诊断中的应用。
方法
60名2 - 3岁的自闭症儿童和60名年龄及性别匹配的健康儿童参与了本研究。所有儿童均采用头部MRI常规序列、三维T1加权成像、扩散峰度成像（DKI）、增强T2*加权磁共振血管造影（ESWAN）和三维伪连续动脉自旋标记（3D - pcASL）序列进行扫描。比较两组各脑区的定量磁化率图（QSM）、脑血流量（CBF）和脑微观结构，并分析相关性。
结果
研究组额叶、颞叶、海马、尾状核、黑质和红核的铁含量及脑血流量低于对照组相应脑区（P < 0.05）。研究组额叶、颞叶、壳核、海马、尾状核、黑质和红核的平均峰度（MK）、径向峰度（RK）和轴向峰度（AK）值低于对照组相应脑区（P < 0.05）。对照组额叶、颞叶和海马的平均扩散率（MD）和峰度分数各向异性（FAK）值低于研究组相应脑区（P < 0.05）。额叶、颞叶和海马的CBF、QSM和DKI值可区分自闭症谱系障碍（ASD）儿童（AUC > 0.5，P < 0.05），其中多模态技术（QSM、CBF、DKI）的AUC最高（0.917），DKI的AUC最低（0.642）。
结论
定量磁共振成像（包括QSM、3D - pcASL和DKI）可检测年幼自闭症儿童铁含量、脑血流量和脑微观结构的异常，多模态技术（QSM、CBF、DKI）可被视为成像诊断技术的首选。
临床试验注册
[http://www.chictr.org.cn/searchprojen.aspx]，标识符[ChiCTR2000029699]
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