集成磁共振技术在儿童孤独症谱系障碍伴或不伴精神发育迟缓中的应用研究

The application research of synthetic MRI in autism spectrum disorder in children with or without mental retardation

目的:本文旨在通过集成磁共振(SyntheticMRI,SyMRI)技术分析孤独症谱系障碍(ASD)伴精神发育迟缓(MR)儿童(ASD伴MR组)、ASD儿童(ASD组)、正常儿童(对照组)3组儿童脑区T_(1)、T_(2)弛豫值的差异,并评估SyMRI中T_(1)、T_(2)弛豫值的诊断效能。方法:共纳入20例ASD伴MR儿童(ASD伴MR组)、20例ASD儿童(ASD组)、20例正常儿童(对照组)。所有儿童在3.0TMRI上行常规MRI和SyMRI MAGiC序列扫描来获取T_(1)、T_(2)弛豫值,测量所有儿童10个白质及灰质感兴趣区域的T_(1)、T_(2)弛豫值。分析有差异脑区T_(1)、T_(2)弛豫值与儿童行为发育能力之间的相关性。并使用受试者工作特征(ROC)曲线分析T_(1)、T_(2)弛豫值在区分ASD伴或不伴MR中的诊断效能。结果:ASD伴MR组、ASD组、对照组之间左侧丘脑的T_(1)弛豫值均存在差异,差异均有统计学意义(P<0.05)。在Gesell量表中,ASD伴MR组左侧丘脑T_(1)弛豫值与适应性行为评分间呈正相关(r=0.536,P<0.05)。左侧丘脑的T_(1)弛豫值在区分ASD伴或不伴MR中具有较好的效能(AUC>0.7)。结论:T_(1)弛豫值可以较好的评估ASD伴或不伴MR儿童大脑微观结构的异常,有助于更好的了解ASD伴或不伴MR的病理机制以及提供一定的诊断价值。

Objective:This study aimed to analyze the differences between T_(1)and T_(2)relaxation time in brain region a-mong three groups,children with autism spectrum disorder(ASD)with mental retardation(MR)(ASD with MR group),children with ASD(ASD group),and typically developing children(control group),using synthetic magnetic resonance imaging(SyMRI)se-quence on 3.OT MRI.The study also evaluated the diagnostic performance of T_(1)and T_(2)relaxation time in SyMRI.Methods:This study enrolled 60 subjects,including 20 children in ASD with MR group,20 children in ASD group,and 20 children in control group.All children underwent conventional and SyMRI sequences with a 3.OT MRI machine.T_(1)and T_(2)relaxation time in ten regions of interest in both white matter and gray matter were obtained using the MAGiC sequence.The study analyzed the correlations between T_(1)and T_(2)relaxation time in specific brain regions and the behavioral and developmental abilities of children.Receiver operating characteristic(ROC)curve analysis was used to evaluate the diagnostic performance of T_(1)and T_(2)re-laxation time in distinguishing between ASD with or without MR.Results:There were statistically significant differences in the T_(1)relaxation time of the left thalamus among the ASD with MR group,ASD group,and control group(P<0.05).In the Gesell developmental scale,the T_(1)relaxation time of the left thalamus in the ASD with MR group was positively correlated with adaptive behavior scores(r=0.536,P<0.05).The T_(1)relaxation time of the left thalamus showed good diagnostic performance in distinguishing between ASD with or without MR(AUC>0.7).Conclusion:T_(1)relaxation time can effectively assess the abnormali-ties in the microstructural brain regions of children with ASD,whether accompanied with MR or not.It contributes to a better understanding of the pathological mechanisms underlying ASD with or without MR and provides diagnostic value in this context.