额叶纤维束扩散张量成像对语言发育迟缓儿童的定量分析

Quantitative Analysis of Diffusion Tensor Imaging in Frontal Lobe Fiber for Children’s Language Delay

目的:探讨DTI对语言发育迟缓儿童诊断价值及与语言发育能力、社交能力、社会生活能力的相关性。方法:收集30例语言发育迟缓患儿,行常规头颅MRI及DTI扫描,手动测量相应脑功能区的DTI值。对各功能区DTI值采用Mann-Whitney秩和检验且两两比较,同时比较左右两侧的FA/VR的差异,并绘制ROC曲线。对差异有统计学意义的脑功能区与患儿临床评估指标进行Spearman相关性分析。结果:双侧额叶功能区白质FA/VR值低于枕叶白质。左右两侧额下回FA及VR值差异有统计学意义,左侧额下回白质明显低于右侧;而左右两侧额上回、额中回FA及VR值差异无统计学意义。左侧额下回FA、VR两者ROC曲线下面积分别为0.722、0.738,FA值判断左侧额下回异常敏感性较高为86.7%。左侧额下回FA值与语言能力、社会适应能力、社交能力存在相关性,与语言能力之间的相关系数最高(r=0.57)。结论:左侧额下回FA、VR值对语言发育迟缓患儿的诊断有一定价值,前者与语言发育能力存在相关性,可为临床诊断及治疗提供影像学参考依据。

Objective:To evaluate the diagnostic values of DTI in children with language delay and its correlation with language developing quotient, social quotient and social ability.Methods:Thirty children with language delay were collected who experienced conventional MRI and DTI. The DTI values of corresponding brain functional domain were measured manually. Mann Whitney rank sum test was used for statistical analyzing. The DTI values of each functional domain were compared and also FA/VR value s of functional domain between left and right sides were compared. The ROC curve was drawn. If FA/VR values of functional domain had statistical difference, correlating between the measured values of functional domain and clinical score were analyzed with Spearman.Results:FA/VR values of white matter in bilateral frontal functional lobe areas was lower than that in occipital white matter. There was significant difference in FA and VR between the left and right inferior frontal gyrus, the white matter of the left inferior frontal gyrus was marked lower than that of the right, while there was no significant difference in FA and VR between the left and right superior frontal gyrus and the middle frontal gyrus.The area under ROC curve of FA and VR in left inferior frontal gyrus were 0.722 and 0.738 respectively. The FA value’s sensitivity judging the abnormality of left inferior frontal gyrus was 86.7%. FA value of left inferior frontal gyrus was correlated with language ability, adaptability and social behavior. the highest correlation coefficient was language ability(r=0.57,p<0.05).Conclusion:FA and VR values of the left inferior frontal gyrus have diagnostic value in children with language delay. FA values are correlated with language developing ability and can provide imaging reference for clinical diagnosis and treatment.