ObjectiveTo explore the application of three-dimensional pseudocontinuous arterial spin labeling (3D-PCASL) perfusion imaging in the brains of children with autism and to understand the characteristics of cerebral blood perfusion in children with autism.MethodsA total of 320 children with autism (160 men and 160 women) aged between 2 and 18 years and 320 age- and sex-matched healthy children participated in the study. All children were scanned by 3.0 T magnetic resonance axial T1 fluid-attenuated inversion recovery (FLAIR), T2 FLAIR, 3D-T1, and 3D-PCASL sequences. After postprocessing, cerebral blood flow (CBF) values in each brain region of children with autism and healthy children at the same age were compared and analyzed. Furthermore, CBF characteristics in each brain region of autistic children at various ages were determined.ResultsThe CBF values of the frontal lobe, hippocampus, temporal lobe, and caudate nucleus of children with autism are lower than those of healthy children (P < 0.05). Additionally, as the ages of children with autism increase, the number of brain regions with decreased CBF values gradually increases. A receiver operating characteristic (ROC) analysis results show that the CBF values of the frontal lobe, hippocampus, temporal lobe, and caudate nucleus can distinguish children with autism [area under the ROC curve (AUC) > 0.05, P < 0.05].ConclusionThe 3D-PCASL shows lower brain CBF values in children with autism.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier: ChiCTR2000034356.
ObjectiveTo explore the application of quantitative magnetic resonance imaging in the diagnosis of autism in children.MethodsSixty autistic children aged 2–3 years and 60 age- and sex-matched healthy children participated in the study. All the children were scanned using head MRI conventional sequences, 3D-T1, diffusion kurtosis imaging (DKI), enhanced T2*- weighted magnetic resonance angiography (ESWAN) and 3D-pseudo continuous Arterial Spin-Labeled (3D-pcASL) sequences. The quantitative susceptibility mapping (QSM), cerebral blood flow (CBF), and brain microstructure of each brain area were compared between the groups, and correlations were analyzed.ResultsThe iron content and cerebral blood flow in the frontal lobe, temporal lobe, hippocampus, caudate nucleus, substantia nigra, and red nucleus of the study group were lower than those in the corresponding brain areas of the control group (P < 0.05). The mean kurtosis (MK), radial kurtosis (RK), and axial kurtosis (AK) values of the frontal lobe, temporal lobe, putamen, hippocampus, caudate nucleus, substantia nigra, and red nucleus in the study group were lower than those of the corresponding brain areas in the control group (P < 0.05). The mean diffusivity (MD) and fractional anisotropy of kurtosis (FAK) values of the frontal lobe, temporal lobe and hippocampus in the control group were lower than those in the corresponding brain areas in the study group (P < 0.05). The values of CBF, QSM, and DKI in frontal lobe, temporal lobe and hippocampus could distinguish ASD children (AUC > 0.5, P < 0.05), among which multimodal technology (QSM, CBF, DKI) had the highest AUC (0.917) and DKI had the lowest AUC (0.642).ConclusionQuantitative magnetic resonance imaging (including QSM, 3D-pcASL, and DKI) can detect abnormalities in the iron content, cerebral blood flow and brain microstructure in young autistic children, multimodal technology (QSM, CBF, DKI) could be considered as the first choice of imaging diagnostic technology.Clinical Trial Registration[http://www.chictr.org.cn/searchprojen.aspx], identifier [ChiCTR2000029699].
Background Currently, there are many studies on the application of the 3D pseudocontinuous arterial spin-labeled (3D-pcASL) perfusion MRI technique for adult brain examinations, but few studies exist on the application of the technique for child brain examinations. Purpose To explore the application of a 3D-pcASL perfusion MRI scan combined with postlabeling delay (PLD) for assessing neonatal hypoxic-ischemic encephalopathy (HIE). Materials and methods Two-hundred neonates diagnosed with neonatal HIE were equally divided into five groups (40/group): 0- to <24-hour-old HIE group, 1- to <3-day-old HIE group, 3- to <7-day-old HIE group, 7- to <15-day-old HIE group and 15- to 28-day-old HIE group; 200 healthy neonates were equivalently divided. All 10 groups received a conventional and a 3D-pcASL perfusion MRI scan. For groups <3 days old, PLD values for the 3D-pcASL cerebral perfusion MRI scan were preset at 1025 ms; in all other groups, PLD values were preset at 1525 ms. CBF values for the 3D-pcASL cerebral perfusion MRI were compared between the HIE and corresponding control groups to determine the distinguishing characteristics of CBF values in HIE neonates. Results On the 3D-pcASL cerebral perfusion MRI scan, in the 1- to <3-day-old groups, HIE neonate CBF values were higher than those of controls in all brain regions (excluding the frontal lobe); in the 0- to <24-hour-old and 3- to <7-day-old groups, HIE neonate CBF values were lower than those of corresponding controls in all brain regions; in the 7- to <15-day-old and 15- to 28-day-old groups, there were no significant differences in the CBF values between groups in any brain regions. Conclusions The 3D-pcASL perfusion MRI scan combined with a PLD can assist in the early diagnosis of neonatal HIE, as this method more comprehensively reflects the HIE pathological process.
Objective To explore the application value of postlabeling delay (PLD) in 3D pseudocontinuous arterial spin–labeled (3D-pcASL) perfusion imaging in normal children and to find the optimal PLD values for children at each age group. Methods Five groups of children, with 50 patients in each group, who underwent routine magnetic resonance imaging scans with normal results were included. The patients were stratified according to the following ages: younger than 1 month, more than 1 month to 6 months, more than 6 months to 12 months, more than 1 year to 3 years, more than 3 years to 6 years, and more than 6 years to 18 years. All patients received 3D-pcASL perfusion magnetic resonance scanning. The PLD values were set to 1025, 1525, or 2025 milliseconds. In subjective evaluations, the signal-to-noise ratio (SNR) and cerebral blood flow (CBF) of 3D-pcASL perfusion images under different PLD values were compared and analyzed. Results For patients in the <1-month group and >1-month to 6-month group, the images were mainly grade A when the PLD value was 1025 milliseconds, which equaled 43 and 46 cases, respectively. The brain CBF values and SNR values were higher than those of the images with PLD values of 1525 and 2025 milliseconds. For patients in the >6-month to 12-month group, >1-year to 3-year group, >3-year to 6-year group, and >6-year to 18-year group, the images were mainly grade A when the PLD value was 1525 milliseconds, which equaled 43, 45, 43, and 46 cases, respectively. The brain CBF values and SNR values were higher than those of the images with PLD values of 1025 and 2025 milliseconds. Conclusions The optimal PLD values for 3D-pcASL perfusion imaging are different in children of different ages. The optimal PLD value for infants who are 6 months younger is 1025 milliseconds. The optimal PLD value for children older than 6 months to 18 years is 1525 milliseconds.
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