Botteron K N, Vannier M W, Geller B, Todd R D, Lee B C
Washington University School of Medicine, St. Louis, MO 63110, USA.
J Am Acad Child Adolesc Psychiatry. 1995 Jun;34(6):742-9. doi: 10.1097/00004583-199506000-00014.
To examine magnetic resonance imaging (MRI) characteristics in children and adolescents with mania according to DSM-III-R criteria.
A convenience sample of consecutively referred 8- to 16-year-old manic (n = 10) and normal (n = 5) subjects were assessed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present Episode Version, the Children's Global Assessment Scale, and the Family History-Research Diagnostic Criteria. MRI scans were obtained from unsedated subjects using a 1.5 T MR scanner to acquire T1-weighted coronal and sagittal images and T2-weighted axial images. Images were assessed by blind clinical interpretation, ratings of T2-weighted deep white matter hyperintensities and petalia, and computer-assisted volumetric analysis of ventricular and cerebral volumes.
Eight of 10 manic subjects and all 5 controls completed the scans. Scans of 4 manic subjects and 1 control subject showed ventricular or white matter abnormalities by clinical interpretation. Significant findings were positive correlations between increasing age and both right and left ventricular volumes. Two of the 8 manic subjects and no controls had confluent subcortical hyperintensities.
MRI brain scanning was feasible in 8- to 16-year-olds. Preliminary findings from clinical interpretations and structured ratings suggest structural differences between young manic and normal subjects. Investigations of larger samples are needed to better characterize the differences.
根据《精神疾病诊断与统计手册》第三版修订版(DSM-III-R)标准,研究儿童及青少年躁狂症患者的磁共振成像(MRI)特征。
选取8至16岁连续转诊的躁狂症患者(n = 10)和正常受试者(n = 5)作为便利样本,使用儿童情感障碍和精神分裂症量表 - 当前发作版、儿童总体评估量表以及家族史 - 研究诊断标准进行评估。未使用镇静剂的受试者通过1.5T MR扫描仪进行MRI扫描,以获取T1加权冠状位和矢状位图像以及T2加权轴位图像。图像由盲法临床解读、T2加权深部白质高信号和脑叶的评分以及脑室和脑体积的计算机辅助容积分析进行评估。
10名躁狂症受试者中的8名和所有5名对照完成了扫描。4名躁狂症受试者和1名对照受试者的扫描通过临床解读显示脑室或白质异常。显著发现是年龄增长与左右脑室体积均呈正相关。8名躁狂症受试者中有2名出现融合性皮质下高信号,而对照组无此情况。
MRI脑部扫描在8至16岁儿童中是可行的。临床解读和结构化评分的初步结果表明,年轻躁狂症患者和正常受试者之间存在结构差异。需要对更大样本进行研究以更好地描述这些差异。