Magnetic resonance imaging of brain anomalies in fetal alcohol syndrome.
Magnetic resonance imaging of brain anomalies in fetal alcohol syndrome.
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DOI：
10.1542/peds.99.2.232
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发表时间：
1997-02
期刊：
影响因子：
8
通讯作者：
V. Swayze;V. P. Johnson;J. Hanson;J. Piven;Yutaka Sato;J. Giedd;D. Mosnik;N. Andreasen
中科院分区：
文献类型：
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作者：
V. Swayze;V. P. Johnson;J. Hanson;J. Piven;Yutaka Sato;J. Giedd;D. Mosnik;N. Andreasen
目的对患有胎儿酒精综合征（FAS）的胎儿、婴儿和幼儿进行尸检研究，发现其存在多种严重的中枢神经系统（CNS）异常。我们进行了这项磁共振研究，以（1）评估在医学稳定的典型FAS患者的临床样本中发生的CNS异常谱;（2）检查CNS和面部异常之间的关系。方法：对10例符合FAS标准的患者（4例儿童，3例青少年和3例成人）进行磁共振成像。我们系统地评估了每一次脑异常扫描，并将脑组织总体积与健康儿童、青少年和成人对照组进行了比较。结果6例患者存在不同类型的中线异常，包括部分至完全胼胝体发育不全（3例）、胼胝体发育不全（1例）、透明隔腔（3例）和海绵体发育不全（2例）。这些中线异常与大量的面部异常有关。其他脑异常包括小脑畸形、脑室扩大和下橄榄隆起发育不全。结论典型FAS患者脑中线畸形发生率高。这一发现与中线中枢神经系统是一个特别容易受到酒精致畸作用影响的发育领域的概念一致。此外，面部畸形特征更严重的患者更可能有中线脑异常。此外，我们观察到小脑畸形的发病率很高，严重程度范围很广。
OBJECTIVE Postmortem studies of fetuses, infants, and young children with fetal alcohol syndrome (FAS) have demonstrated a variety of severe central nervous system (CNS) anomalies. We undertook this magnetic resonance study (1) to assess the spectrum of CNS anomalies that occur in a clinical sample of typical patients with FAS who are medically stable; and (2) to examine the relationship between CNS and facial anomalies. METHODOLOGY Magnetic resonance imaging was performed on a series of 10 patients (4 children, 3 adolescents, and 3 adults) who met criteria for FAS. We systematically evaluated each scan for brain anomalies and compared total brain tissue volume with that of healthy child, adolescent, and adult control subjects. RESULTS Six patients had some type of midline anomaly, ranging from partial to complete callosal agenesis (three patients) to hypoplastic corpus callosum (one patient), cavum septi pellucidi (three patients), and cavum vergae (two patients). These midline anomalies were associated with a greater number of facial anomalies. Other brain anomalies identified included micrencephaly, ventriculomegaly, and hypoplasia of the inferior olivary eminences. CONCLUSION Patients with classic FAS have a high incidence of midline brain anomalies. This finding is consistent with the concept that the midline CNS is a developmental field that is particularly susceptible to the teratogenic effects of alcohol. Furthermore, patients with more severe facial dysmorphologic characteristics are more likely to have midline brain anomalies. In addition, we observed a high incidence of micrencephaly with a wide range of severity.