磁共振多模态影像对儿童孤独症评估

MRI Multimodal Imaging Assessment of Autism in Children

目的探讨MRS、DTI、T2及3D T1多模态影像对儿童孤独症(Childhood Autism,CA)评估的应用价值。方法回顾分析2012年1月至2020年2月来我院就诊的213例CA患者,均用3T MR及头线圈行轴位T1、T2、Flair、DWI、3D TOF、DTI及MRS扫描。全扫为A组,T1、T2、DTI及MRS构成B组。对比分析各序列病灶检出率、两组检查成功率及评估价值一致性。结果213例CA患者在常规序列T1、T2、T2-flair、DWI、MRA及功能序列DTI MRS病灶检出率分别为16%、21%、22%、0.9%、0.4%、77.9%,病灶检出率差异分析全部序列及常规与功能组比较均有统计学意义(P=0.0001),T2与T2-flair及A、B组比较,差异无统计学意义(P=0.906);检查成功率A、B两组分别为61%、100%,差异分析有统计学意义(P=0.001);专家评估一致性较好(Kappa值≥0.75),A、B两组分别为170、182。结论MRS、DTI、T2及3D T1多模态影像检查速度快,具有形态和功能影像信息,结合临床症状有助于对CA病情评估,可为其治疗前后干预提供可循临床依据。

Objective To explore the value of MRS,DTI,T2 and 3D T1 multimodal imaging in evaluation of childhood autism(CA).Methods Totals of 213 children with autism who visited our hospital from January 2012 to August 2018 were retrospectively analyzed.All of them were scanned with 3 T MR and head coil of axial T1,T2,FLAIR,DWI,3D TOF,DTI,and MRS.Total sweep was classified as the A group,and T1,T2,DTI and MRS constituted the B group.The inspection success rate and evaluation value consistency were compared and analyzed for two groups.Results The detection rates of 213 CA patients in routine sequence T1,T2,T2-flair,DWI,MRA and functional sequence DTI MRS lesions were 16%,21%,22%,0.9%,0.4%,and 77.9%,respectively.Differential analysis of lesion detection rate,all sequences and comparison between routine and functional groups were statistically significant(P=0.0001),there was no statistically significant difference between T2 and T2-flair and A、B groups(P=0.906);the success rate of examination in the two groups were 61%and 100%,respectively,and the difference analysis was statistically significant(P=0.001);experts’assessments were consistent(Kappa’value≥0.75),A and B groups were 170 and 182 respectively.Conclusion MRS,DTI,T2 and 3D T1 multimodal imaging examinations are fast,with morphological and functional imaging information,combined with clinical symptoms,are helpful for the assessment of the condition of CA,and can provide a clinical basis for intervention before and after treatment.