采用优化的基于体素的形态测量学方法研究不同类型智力障碍患儿脑灰质容积的变化  

The alteration of gray matter volume in children with mental retardation： the differences between the patients presented with operation deficit predominantly and those presented with language deficit mainly

作　　者：袁新宇[1] 肖江喜[2] 蒋学祥[2] 金春华 张远超[4] 白振华[1] 仪晓立[1] 

机构地区：[1]首都儿科研究所放射科,100020 [2]北京大学第一医院影像科 [3]儿童生长发育科 [4]中国电子科技大学生命科学与技术学院

出　　处：《中华放射学杂志》2012年第12期1083-1087,共5页Chinese Journal of Radiology

摘　　要：目的利用优化的基于体素的脑形态学分析法（VBM），分别比较以操作缺陷为主和以语言缺陷为主的智力障碍患儿与正常儿童脑灰质容积的差异，探究患儿脑区灰质发育与操作和语言缺陷之间的联系。方法选取9例以操作缺陷为主（操作缺陷组）和11例以语言缺陷为主（语言缺陷组）的智力障碍患儿，以及分别与之性别、年龄及优势利手相匹配的正常对照组儿童11、14名，行三维快速扰相梯度回波（FSPGR）序列高分辨率脑MR扫描，然后采用VBM方法进行图像分析。采用独立样本t检验比较操作缺陷组和语言缺陷组与相应正常对照组问灰质总容积差异以及不同区域脑灰质容量差异。结果操作缺陷组患儿脑灰质容积总量平均值[（1．030±0．078）×10^6mm^3]明显大于正常对照组[（0．984±0．058）×10^6mm^3]，差异有统计学意义（t=-2．6，P〈0．05）；患儿脑局部区域灰质容积较正常对照组高的脑区包括：后扣带回、右侧额上回、左侧楔叶、左侧额中回和左侧尾状核体部。语言缺陷组患儿脑灰质容积总量[（1．002±0．068）×10。mm。]明显大于正常对照组[（0．957±0．057）×10^6mm^3]，差异有统计学意义（t=-3．0，P〈0．05）；患儿脑局部区域灰质容积较正常对照组高的脑区包括：双侧丘脑、左侧颞下回、左侧额下回和左侧小脑。结论VBM能够显示常规MRI表现正常的智力障碍患儿中的脑灰质发育异常。不同临床表型的智力障碍患儿脑灰质容积改变区域分布存在差异。Objective To detect the differences of grey matter volume between the patients with mental retardation （MR） presented clinically as operation deficit （OD） or as language deficit （LD） and the children with typical normal development using optimal VBM. The developmental connections between brain gray matter and language or operation skills were examined. Methods Magnetic resonance imaging was obtained from 9 children with mental retardation presented as OD predominantly and 11 children with mental retardation presented as LD mainly, as well as the age-matched control group （ 11 and 14 normal children, respectively ） on a 1.5 T scanner. Voxel-based morphometry analysis with an optimization of spatial segmentation and normalization procedures was applied to compare the volume of grey matter between the two groups （OD VS. control; LD VS. control ）. Statistically, the total and local gray matter volumes were compared between the two groups with t test. Results The total gray matter volume of OD group was [（1.030±0.078） × 106 mm^3]. Compared to that of controls [（0.984 ±0.058） × 10^6 mm^3], it was increased significantly （ t = - 2. 6, P 〈 0. 05 ）. And the gray matter volume in the posterior cingulated gyms, left superior prefrontal gyms, left cuneus, left middle prefrontal gyrus and the body of left caudate nucleus showed significantly increased. Meanwhile, the total gray matter volume of the MR children presented as LD [ （ 1. 002± 0. 068 ） × 10^6 mm^3 ] showed significantly increased （ t = - 3.0, P 〈 0. 05 ） compared with that of control group [ （0. 957 ±0. 057） ×10^6 mm^3]. The gray matter volume in bilateral thalami, the left inferiortemporal gyrus, the left inferior frontal gyrus, and the left cerebellum of the LD group was more than that of normal children. Conclusion As revealed by VBM, there are differences in alterations of gray matter volume between MR children presented with OD and with LD relative to control.

关 键 词：儿童 精神发育迟滞 磁共振成像 脑 

分 类 号：R445.2[医药卫生—影像医学与核医学]