摘要
目的探讨新生儿重度高胆红素血症的MRI特征,为临床提供客观的影像学依据。材料与方法收集宝鸡市中心医院2015年1月至2017年7月住院期间临床诊断为重度高胆红素血症且胎龄≥35 w的新生儿55例,根据临床有无并发胆红素脑病分为高胆组35例,脑病组20例。另外,收集同期行MR检查的生理性黄疸新生儿30例作为对照组,定性和定量分析各组苍白球(globus pallidus,GP)、丘脑底核(subthalamic nucleus,STN)、背侧丘脑(thalamus,T)信号强度,探讨GP/T、STN/T比值与血清胆红素水平的关系。结果各组GP/T、STN/T比值在T1WI像差异均有统计学意义(F=15.854,P=0.000;F=14.057,P=0.000),T2WI像差异无统计学意义(F=2.042,P=0.137;F=0.110,P=0.896)。分析脑病组GP/T比值、STN/T比值的受试者工作特征(receiver operating characteristic,ROC)曲线下面积,分别为0.824、0.814,最佳临界点分别为1.56、1.63。10例胆红素脑病患儿MRI随访发现4例出现T2WI苍白球高信号,并出现脑瘫症状。结论新生儿重度高胆红素血症时,当磁共振T1WI像GP/T、SNT/T超过1.56、1.63时,需高度警惕胆红素脑病的发生;当相同部位在慢性期转变为T2WI对称性高信号时,多提示预后不良。
Objective:To investigate the MRI features of neonatal severe hyperbilirubinemia and provide objective imaging evidence for clinic.Materials and Methods:80 cases of hyperbilirubinemia from January 2015 to July 2017 in Baoji Municipal Central Hospital,those were divided into two groups,including 35 cases of high bilirubin group,20 cases of bilirubin encephalopathy group and correlated with cranial MRI examination.Another option of 30 cases of physiologic jaundice neonatus,who received MR examination.The difference of T1WI signal intensity in the globus pallidus(GP),subthalamic nuclei(STN),thalamus(T)were observed and measured.To analyse the relationship between serum total bilirubin level and signal intensit.Results:The ratio between the globus pallidus and the thalamus(GP/T)and the ratio between subthalamic nuclei and the thalamus(STN/T)were significantly different in T1WI(F=15.854,P=0.000;F=14.057,P=0.000),while T2WI was not statistically significant(F=2.042,P=0.137;F=0.110,P=0.896).Analyze the receiver operating characteristic(ROC)curve of GP/T ratio and STN/T ratio in bilirubin encephalopathy group,area under curve was 0.824,0.814,the best threshold was 1.56,1.63,respectively.MRI follow-up of 10 children with bilirubin encephalopathy showed 4 cases with high signal of T2WI in the globus pallidus.Conclusions:When the magnetic resonance T1WI GP/T,SNT/T exceeds 1.56,1.63 in neonatal severe hyperbilirubinemia,the occurrence of bilirubin encephalopathy should be highly vigilant;While the same region changes to T2WI high signal at chronic stage,the prognosis is poor.
作者
孟小丽
张雷
王晓虎
赵珂珂
舒俊
任转琴
MENG Xiao-li;ZHANG Lei;WANG Xiao-hu;ZHAO Ke-ke;SHU Jun;REN Zhuan-qin(Department of Radiology,Baoji Municipal Central Hospital,Baoji 721008,China;College of Medical Science Technology,Shaanxi University of Chinese Medicine,Xianyang 712046,China;Department of Radiology,Xijing Hospital Affiliated to the Air force Medical University,Xi’an 710032,China)
出处
《磁共振成像》
CAS
CSCD
2018年第10期768-772,共5页
Chinese Journal of Magnetic Resonance Imaging
关键词
高胆红素血症
新生儿
脑疾病
苍白球
信号强度
磁共振成像
Hyperbilirubinemia,neonatal
Brain diseases
Globus pallidus
Signal intensity
Magnetic resonance imaging
