PDF(1429 KB)
Application of apparent diffusion coefficient in children aged 2-12 years with intellectual disability/global developmental delay who have normal conventional brain MRI findings
LI Lin, ZHAO Jian-She, GAO Zai-Fen, MA Chang-You, DONG Chun-Hua, ZHANG Hong-Wei
Chinese Journal of Contemporary Pediatrics ›› 2019, Vol. 21 ›› Issue (6) : 541-546.
PDF(1429 KB)
PDF(1429 KB)
Application of apparent diffusion coefficient in children aged 2-12 years with intellectual disability/global developmental delay who have normal conventional brain MRI findings
Objective To study the value of fast spin-echo diffusion weighted imaging (TSE-DWI) apparent diffusion coefficient (ADC) in children aged 2-12 years with intellectual disability (ID)/global developmental delay (GDD) who have normal conventional brain MRI findings. Methods A total of 578 children with normal conventional brain MRI findings who met the diagnostic criteria for ID/GDD and 375 normal children were enrolled. Their imaging and clinical data were collected. All children underwent scanning with brain TSE-DWI sequence and routine sequence. ADC values of each brain region were compared between normal children with different ages, as well as between children with different degrees of ID/GDD in each age group. The influence of Adaptive Behavior Assessment System-Ⅱ (ABAS-Ⅱ) score on ADC values of each brain region was analyzed. Results For the normal children, the ADC values of the frontal and temporal white matter, the corpus callosum, the inner capsule, the centrum semiovale, the cerebellar dentate nucleus, the optic radiation, the thalamus, the lenticular nucleus, and the caudate nucleus gradually decreased with age (P < 0.05). ADC values of the deep white matter, the shallow white matter, the deep gray matter nuclei, and the shallow gray matter increased with the increase in the degree of ID/GDD in the ID/GDD children aged 4-6 years (P < 0.05). In the children with ID/GDD, the ADC values of the deep white matter, the shallow white matter, and the deep gray matter nuclei decreased with age (P < 0.05). The ADC values of the children with ID/GDD decreased with the increase in ABAS-Ⅱ score (P < 0.05). Conclusions ADC can reflect the subtle structural changes of brain regions in children with ID/GDD who have normal conventional brain MRI findings. It may be associated with social adaptation. It can provide an objective basis for the quantitative diagnosis of ID/GDD in children.
Intellectual disability / Global developmental delay / Magnetic resonance imaging / Apparent diffusion coeffcient / Child
[1] 美国精神医学学会. 精神障碍诊断与统计手册(第五版)[M]. 张道龙, 刘春宇, 童慧琦, 等, 译. 北京:北京大学出版社, 2015:31-46.
[2] Mathew T, Avati A, D'Souza D, et al. Expanding spectrum of RARS2 gene disorders:myoclonic epilepsy, mental retardation, spasticity, and extrapyramidal features[J]. Epilepsia Open, 2018, 3(2):270-275.
[3] Maenner MJ, Blumberg SJ, Kogan MD, et al. Prevalence of cerebral palsy and intellectual disability among children identified in two U.S. National Surveys, 2011-2013[J]. Ann Epidemiol, 2016, 26(3):222-226.
[4] Silove N, Collins F, Ellaway C. Update on the investigation of children with delayed development[J]. J Paediatr Child Health, 2013, 49(7):519-525.
[5] Arican P, Olgac Dundar N, Ozyilmaz B, et al. Chromosomal microarray analysis in children with unexplained developmental delay/intellectual disability[J]. J Pediatr Genet, 2019, 8(1):1-9.
[6] Forbes K. MRI brain white matter change:spectrum of change - how we can grade?[J]. J R Coll Physicians Edinb, 2017, 47(3):271-275.
[7] Cox AD, Virues-Ortega J, Julio F, et al. Establishing motion control in children with autism and intellectual disability:applications for anatomical and functional MRI[J]. J Appl Behav Anal, 2017, 50(1):8-26.
[8] Wijdicks EFM. Metabolic encephalopathy:behind the name[J]. Neurocrit Care, 2018, 29(3):385-387.
[9] Jeong JW, Sundaram S, Behen ME, et al. Differentiation of speech delay and global developmental delay in children using DTI tractography-based connectome[J]. AJNR Am J Neuroradiol, 2016, 37(6):1170-1177.
[10] Erbetta A, Bulgheroni S, Contarino VE, et al. Low-functioning autism and nonsyndromic intellectual disability:magnetic resonance imaging (MRI) findings[J]. J Child Neurol, 2015, 30(12):1658-1663.
[11] Abdel Razek AAK. Arterial spin labelling and diffusion-weighted magnetic resonance imaging in differentiation of recurrent head and neck cancer from post-radiation changes[J]. J Laryngol Otol, 2018, 132(10):923-928.
[12] Moeschler JB, Shevell M; Committee on Genetics. Comprehensive evaluation of the child with intellectual disability or global developmental delays[J]. Pediatrics, 2014, 134(3):e903-e918.
[13] Jiang H, Li X, Jin C, et al. Early diagnosis of spastic cerebral palsy in infants with periventricular white matter injury using diffusion tensor imaging[J]. AJNR Am J Neuroradiol, 2019, 40(1):162-168.
[14] Murias K, Moir A, Myers KA, et al. Systematic review of MRI findings in children with developmental delay or cognitive impairment[J]. Brain Dev, 2017, 39(8):644-655.
[15] 蒋婷婷. 语言发育迟缓儿童社会适应能力与心智发育水平的关系研究[J]. 临床医药文献电子杂志, 2017, 4(18):3434-3435.
[16] Dubois J, Dehaene-Lambertz G, Kulikova S, et al. The early development of brain white matter:a review of imaging studies in fetuses, newborns and infants[J]. Neuroscience, 2014, 276:48-71.
[17] Hacohen Y, Ciccarelli O, Hemingway C. Abnormal white matter development in children with multiple sclerosis and monophasic acquired demyelination[J]. Brain, 2017, 140(5):1172-1174.
[18] 刘骁, 毛健, 李娟, 等. 早产儿微小型脑白质损伤的MRI-DTI评价[J]. 中国当代儿科杂志, 2015, 17(6):554-559.
[19] Lipton ML, Kim N, Park YK, et al. Robust detection of traumatic axonal injury in individual mild traumatic brain injury patients:intersubject variation, change over time and bidirectional changes in anisotropy[J]. Brain Imaging Behav, 2012, 6(2):329-342.
[20] Yang C, Li L, Hu X, et al. Psychoradiologic abnormalities of white matter in patients with bipolar disorder:diffusion tensor imaging studies using tract-based spatial statistics[J]. J Psychiatry Neurosci, 2019, 44(1):32-44.
[21] Faria AV, Zhang J, Oishi K, et al. Atlas-based analysis of neurodevelopment from infancy to adulthood using diffusion tensor imaging and applications for automated abnormality detection[J]. Neuroimage, 2010, 52(2):415-428.
