SPM is a powerful technique for the comparison of functional imaging data sets among groups of patients. While this technique has been widely applied in studies of adults, it has rarely been applied to studies of children, due in part to the lack of validation of the spatial normalization procedure in children of different ages. In order to determine if spatial normalization of FDG PET images using SPM96 to an adult template can be successfully applied in children, we applied PET-derived transformation parameters to coregistered MRI images. We then compared contours of spatially normalized MRI images obtained from 13 children with epilepsy (ages 2-14 years, mean 7.6 +/- 3.9 years) with those derived from 17 adult controls (mean age 27.6 +/- 4.5 years). Contours of spatially normalized MRI image volumes derived from the pediatric group were more variable than those obtained from adult controls. The average deviation from the mean adult contour was age-dependent and decreased with age (average deviation (mm) = 2.22 (mm) - 0.021 (mm/year) x years, r = 0.70, P < 0.001). Separate SPM analyses were performed for children less than 6 years (N1 = 6) and for children between 6 and 14 years of age (N2 = 7). SPM analyses performed in both pediatric groups showed significant regions of hypometabolism in locations consistent with their epileptic foci. SPM analyses in the younger group also showed significant artifacts. Therefore, the error associated with spatial normalization of pediatric brains to an adult template in children less than 6 years of age precludes the application of statistical parametric mapping in this age group. Although the error in the spatial normalization procedure for children ages 6 to 14 years is higher than in adults, it appears that this error does not result in artifacts in the SPM analysis. Furthermore, in contrast our previous studies showing large age-related changes in the absolute glucose metabolic rate at puberty, the SPM analysis showed children over 6 years of age appear to display the same pattern of glucose utilization as adults. However, small differences in the pattern of glucose utilization which might occur during late childhood and adolescence may not have been detected due to the sample size.

译文

:SPM是一项功能强大的技术,可用于比较患者组之间的功能成像数据集。尽管该技术已广泛用于成人研究,但很少用于儿童研究,部分原因是缺乏对不同年龄儿童的空间归一化程序的验证。为了确定使用SPM96到成人模板的FDG PET图像的空间归一化是否可以成功应用于儿童,我们将PET衍生的转换参数应用于共配准的MRI图像。然后,我们比较了从13例癫痫患儿(2-14岁,平均7.6 /-3.9岁)获得的空间归一化MRI图像的轮廓与从17位成人对照(平均年龄27.6 /-4.5岁)获得的轮廓进行了比较。与从成人对照组获得的图像相比,从儿科组获得的空间归一化MRI图像体积的轮廓变化更大。与成人平均轮廓的平均偏差与年龄有关,并且随着年龄的增长而降低(平均偏差(mm)= 2.22(mm)-0.021(mm /年)x年,r = 0.70,P <0.001)。对6岁以下的儿童(N1 = 6)和6至14岁的儿童(N2 = 7)进行了单独的SPM分析。在两个儿科组中进行的SPM分析显示,在与其癫痫灶一致的位置存在明显的低代谢区域。年轻组中的SPM分析也显示出明显的伪影。因此,在6岁以下的儿童中,与小儿大脑对成人模板进行空间标准化相关的错误,排除了在该年龄组中应用统计参数映射的可能性。尽管6至14岁儿童的空间归一化程序中的误差高于成人,但似乎该误差不会在SPM分析中导致伪像。此外,相比之下,我们以前的研究显示青春期绝对葡萄糖代谢率的年龄相关变化很大,SPM分析显示,超过6岁的儿童似乎表现出与成年人相同的葡萄糖利用方式。然而,由于样本量的原因,可能未检测到儿童后期和青春期可能发生的葡萄糖利用模​​式的细微差异。

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