发育迟缓儿童胼胝体的MRI特征

The measurement of the corpus callosum with MRI in children with developmental delay

目的 探讨磁共振测量胼胝体径线对儿童发育迟缓的评估价值。方法 收集120例1-5岁发育迟缓儿童与120例年龄匹配的正常发育儿童的头颅MRI资料,按照生长规律分为6个年龄组,在T1WI正中矢状面测量胼胝体膝部、体部、压部厚度及胼胝体长度,比较各年龄组发育迟缓儿童与正常儿童胼胝体参数的差异,并通过受试者工作特征（ROC）曲线分析各参数的诊断临界值。结果 第1-4年龄组（1-3岁）发育迟缓儿童胼胝体膝部及体部较正常发育儿童变薄（P〈0.05）,胼胝体长度及胼胝体压部厚度在两组之间无明显差异;第5、6年龄组（3-5岁）胼胝体各项参数在病例组与对照组间无明显差异。通过ROC曲线分析第1-4年龄组胼胝体膝部厚度临界值分别为8.1mm、7.5mm、8.9mm、9.2mm,敏感度分别为85.0%、60.0%、75.0%、60.0%,特异度分别为55.0%、95.0%、75.0%、85.0%;胼胝体体部厚度临界值为4.3mm、4.3mm、4.5mm、4.7mm,敏感度分别为65.0%、75.0%、75.0%、50%,特异度分别为80.0%、65.0%、95.0%、90.0%。结论 胼胝体膝部及体部的厚度可反映1-3岁发育迟缓儿童脑白质体积变化,胼胝体径线测量有助于该年龄段儿童的发育评估。

Objective To investigate the diagnostic value of the measurement of the corpus callosum with MRI in children with developmental delay （DD）. Methods We evaluated the performance of MRI and conducted a statistical analysis. MRI images of 120 children between the ages of 1 and 5 years with DD compared with 120 age-matched normal children were retrospectively analyzed, who were averagely divided into 6 groups according to the growth rhythm. Midsagittal T1-weighted images were used to measure the thickness （genu, mid-body, and splenium） and length of the corpus callosum. The threshold values of all parameters were determined by the ROC curve analysis. Results The thickness of the genu and mid-body of the corpus callosum of children with DD were significantly thinner than that of normal children in group 1 - 4 （ P 〈 0.05 ） , whereas, all the other parameters showed no statistical difference. In ROC curve analysis of the group 1 - 4, when the critical value of the thickness of the genu was 8.1 mm, 7.5 mm, 8.9 mm and 9.2 mm, the sensitiviey was 85.0% , 60.0% , 75.0% and 60.0%, and the specificity was 55.0% , 95.0% , 75.0% and 85.0% , respectively; when the critical value of the thickness of the mid-body was 4.3 mm, 4.3 mm, 4. 5 mm and 4.7 ram, the sensitivity was 65.0%, 75.0%, 75.0% and 50%, and the specificity was 80.0%, 65.0%, 95.0% and 90.0% , respectively. Conclusion The thickness of the genu and mid-body of the corpus callosum positively correlate with volume of the cerebral white matter in children between the ages of 1 and 3 years with DD. The measurement of the corpus callosum with MRI might help in assessing the development of children in this age.