基于定量磁化率成像研究低龄孤独症儿童脑铁含量异常及其与症状的关联  

A quantitative magnetization rate imaging-based study of differences in brain iron content and its association with symptoms in younger autistic children

作　　者：鲁钰 程美英[1,2,3] 李思柯 刘世鹏 冯刘娟 张晓雪 王长浩 冯占起 赵鑫 LU Yu;CHENG Meiying;LI Sike;LIU Shipeng;FENG Liujuan;ZHANG Xiaoxue;WANG Changhao;FENG Zhanqi;ZHAO Xin(Department of Medical Imaging,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Henan International Joint Laboratory of Neuromedical Imaging,Zhengzhou 450052,China;Henan Provincial Key Laboratory of Pediatric Neuroimaging Medicine,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院影像科,郑州450052 [2]河南省神经医学影像国际联合实验室,郑州450052 [3]河南省小儿神经影像医学重点实验室,郑州450052

出　　处：《磁共振成像》2025年第3期10-17,共8页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金项目(编号:82472046);河南省科技攻关项目(编号:232102311091)。

摘　　要：目的利用定量磁化率成像(quantitative susceptibility mapping,QSM)技术研究1~6岁孤独症谱系障碍(autism spectrum disorder,ASD)儿童与正常儿童脑铁差异及其与临床症状的关联,为ASD病理生理及早期诊断提供新的影像学标志物。材料与方法纳入30例ASD儿童作为试验组、30例正常儿童作为对照组,收集临床资料和量表后对所有儿童进行QSM序列扫描并处理得到定量图,手动勾画感兴趣区以获取磁化率值。比较两组磁化率值差异,并分析其与Gesell发育量表评分的相关性,绘制受试者工作特征(receiver operating characteristic,ROC)曲线评估诊断效能,并按儿童孤独症评定量表(Childhood Autism Rating Scale,CARS)将ASD组分为轻中度组与重度组,进一步比较轻中度组、重度组与正常对照组三组之间磁化率值的差异。结果与健康儿童相比,ASD儿童的双侧额叶白质、左侧颞叶白质、双侧红核、双侧黑质和双侧齿状核的磁化率值明显降低(P<0.05)。相关性分析显示ASD儿童左侧额叶白质的磁化率值与语言得分正相关,右侧红核的磁化率值与精细动作得分正相关(P<0.05)。ROC曲线分析表明,右侧齿状核的AUC值最高,为0.752(95%置信区间:0.627~0.878),敏感度为76.7%,特异度为73.3%。ASD依据严重程度的组间比较结果显示,右侧额叶白质、左侧颞叶白质、右侧齿状核和左侧红核的磁化率值在正常对照组和轻中度组之间有显著差异。右侧齿状核的磁化率值在正常对照组和重度组之间有显著差异。结论ASD儿童多个脑区的铁含量低于正常儿童,且与其临床症状及ASD严重程度相关,具有临床意义。Objective:To use quantitative susceptibility imaging(QSM)technology to study the brain iron difference between children with autism spectrum disorder(ASD),so as to provide new imaging markers for the pathophysiology and early diagnosis of ASD.Materials and Methods:Thirty children with ASD were included as the experimental group and 30 normal children as the control group.After collecting clinical data and scales,all the children were scanned and processed with QSM sequence to obtain quantitative maps,and the area of interest was outlined manually to obtain the magnetization rate values.The differences in magnetization rate values between the two groups were compared,and their correlation with the Gesell Developmental Scale scores was analyzed.The diagnostic efficacy was assessed by plotting the Receiver operating characteristic(ROC)curve,and the ASD group was divided into mild-moderate and severe groups according to the Childhood Autism Rating Scale(CARS),and the magnetization rates between mild-moderate and severe groups and the control group were further compared.The differences in magnetization rate values between the mild-moderate,severe,and normal control groups were further compared.Results:Compared with healthy children,the magnetic susceptibility values in the frontal white matter,left temporal white matter,red nucleus,substantia nigra,and dentate nucleus of children with ASD were significantly lower(P<0.05).Correlation analysis revealed a positive correlation between the magnetic susceptibility value of the left frontal white matter and language scores,as well as between the magnetic susceptibility value of the right red nucleus and fine motor scores in children with ASD(P<0.05).ROC curve analysis showed that the AUC value of the right dentate nucleus was the highest at 0.752(95%confidence interval:0.627 to 0.878),with a sensitivity of 76.7%,a specificity of 73.3%.The intergroup comparison based on ASD severity indicated significant differences in the magnetic susceptibility values of the right frontal w

关 键 词：孤独症谱系障碍 学龄前儿童 定量磁化率成像 磁共振成像 GESELL发育量表 儿童孤独症评定量表 

分 类 号：R445.2[医药卫生—影像医学与核医学] R748[医药卫生—诊断学]