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目的研究孤独症儿童脑扩散张量成像的异常。方法对24例孤独症儿童(孤独症组)和10名正常儿童(正常对照组)进行脑扩散张量成像扫描,测量并比较两组的双侧胼胝体膝部、压部和双侧内囊后肢表观扩散系数(ADC 值)和各向异性分数(FA 值),分析孤独症儿童各被检测部位 ADC 值、FA 值与孤独症治疗评估量表(ATEC)得分的相关性。结果 (1)孤独症组双侧内囊后肢[左右侧分别为(6.8±0.3)×10~(-9)mm~2/s和(6.7±0.4)×10~(-9)mm~2/s]、左侧胼胝体膝部[(8.0±0.5)×10~(-9)mm~2/s]ADC 值高于对照组[分别为(6.6±0.2)×10~(-9)mm~2/s,(6.6±0.4)×10~(-9)mm~2/s,(7.4±O.5)×10~(-9)mm~2/s;P<0.05～0.01];孤独症组右侧胼胝体压部(0.73±0.14)FA 值低于正常对照组(0.84±0.07;P<0.05),孤独症组右侧胼胝体膝部(0.75±0.07)FA 值高于正常对照组(0.68±0.17;P<0.05)。(2)孤独症组右侧胼胝体压部 ADC 值与 ATEC 健康/行为评分呈正相关(r=0.490),右侧胼胝体压部 FA 值与 ATEC 说话/语言评分呈负相关(r=-0.453),右胼胝体膝部FA 值与社交评分呈正相关(r=0.427),均 P<0.05。(3)孤独症组内囊后肢、胼胝体膝部 FA 值左右侧的差异有统计学意义(P<0.05)。结论孤独症儿童胼胝体神经纤维连接存在异常。
Objective To study the abnormalities of brain diffusion tensor imaging in children with autism. Methods Brain diffusion tensor imaging scanning was performed in 24 autistic children (autism group) and 10 normal children (normal control group). The bilateral knee, the pressure and bilateral internal capsule hind limbs were measured and compared in two groups Apparent diffusion coefficient (ADC value) and anisotropy score (FA value) were calculated. The correlations between ADC value, FA value and ATEC score of autistic children were analyzed. Results (1) In the autism group, the hindlimbs of the bilateral internal capsule were (6.8 ± 0.3) × 10 ~ (-9) mm ~ 2 / s and (6.7 ± 0.4) × 10 ~ (-9) mm ~ / s], the ADC value of the knee of the left corpus callosum was (6.6 ± 0.2) × 10 ~ (-9) mm [(8.0 ± 0.5) × 10 -9 mm 2 / s] (P <0.05 ~ 0.01). The mean diameter was (2) / 2 (6.6 ± 0.4) × 10 -9 mm 2 / s and (7.4 ± 0.5) × 10 -9 mm 2 / s, respectively. The FA value of the right corpus callosum (0.73 ± 0.14) in autism group was lower than that of the normal control group (0.84 ± 0.07; P <0.05). The FA of the right corpus callosum in the autism group was significantly higher than that of the normal control group (0.75 ± 0.07) (0.68 ± 0.17; P <0.05). (2) The ADC value of right corpus callosum in autism group was positively correlated with ATEC health / behavioral score (r = 0.490). The FA value of right corpus callosum was negatively correlated with ATEC speech / speech score (r = -0.453) FA values of the right corpus callosum were positively correlated with social scores (r = 0.427), both P <0.05. (3) There was significant difference in the value of FA between hindlimb and corpus callosum in autosomal dominant group (P <0.05). Conclusions There is an abnormality in the connection of the corpus callosum nerve fibers in children with autism.