摘要
目的探究基于头颅磁共振T;WI信号强度比较,苍白球与壳核T;WI信号比值(G/P值)、苍白球与脑脊液信号强度比值(GP/CSF值)预测早期新生儿急性胆红素脑病(ABE)的价值。方法选取本院2018年1月至2020年6月新生儿高胆红素血症(NHB)患儿118例作为研究对象,其中20例发生ABE,作为研究组,98例未发生ABE,作为对照组。比较两组、不同疾病分度[根据血清总胆红素(TBIL)水平判定NHB疾病分度:轻度TBIL 205.2~<256.5μmol/L;中度:TBIL 256.5~<342μmol/L;重度:TBIL 342~<427μmol/L;极重度:TBIL 427~<510μmol/L;危险性:TBIL≥510μmol/L]患儿G/P值、GP/CSF值,分析G/P值、GP/CSF值与疾病分度的相关性,并分析各指标与ABE的关联性及对ABE的预测价值。结果研究组左侧G/P值、右侧G/P值、GP/CSF值均高于对照组(P<0.05);随着NHB患儿疾病分度增加,左侧G/P值、右侧G/P值、GP/CSF值均呈逐渐升高趋势,不同疾病分度患儿G/P值、GP/CSF值对比差异有统计学意义(P<0.05);左、右侧G/P值、GP/CSF值与疾病分度(TBIL水平)间存在正相关关系(P<0.05);左、右侧G/P值、GP/CSF值升高均为NHB患儿发生ABE的独立危险因素(P<0.05);左、右侧G/P值、GP/CSF值预测NHB患儿发生ABE的曲线下面积(AUC)均>0.7,具有一定预测效能,各指标联合预测的AUC最大,为0.925,最佳预测敏感度、特异度分别为90.00%、82.65%。结论基于头颅磁共振T;WI的信号比值,G/P值、GP/CSF值能为NHB疾病分度提供客观的影像学证据,且在预测早期ABE方面具有较高价值。
Objective To explore the value of signal intensity ratio of globus pallidus to putamen(g/P value) and signal intensity ratio of globus pallidus to cerebrospinal fluid(GP/CSF value) in predicting early neonatal acute bilirubin encephalopathy(ABE). Methods 118 cases of neonatal hyperbilirubinemia(nhB) in our hospital from January 2018 to June 2020 were selected as the research objects, and divided into two groups according to the occurrence of Abe, 20 cases with Abe as the research group, 98 cases without Abe as the control group.According to the serum TBIL level, nhB disease grade: mild: TBIL 205.2~<2256.5μmol/L;Moderate: TBIL 256.5~<342μmol/L;Severe: TBIL 342~<427μmol/L;Very severe: TBIL 427~<510μmol/L;Risk: TBIL≥510μ,The correlation between g/P value, GP/CSF value and disease grade was analyzed, and the correlation between each index and Abe and its predictive value were analyzed. Results The left g/P value, right g/P value and GP/CSF value of the study group were higher than those of the control group(P< 0.05). The left g/P value, the right g/P value and the GP/CSF value increased gradually with the increase of nhB disease grading.There were significant differences in g/P value and GP/CSF value among children with different disease grading(P< 0.05). There was a positive correlation between left and right g/P,GP/CSF and TBIL(P< 0.05). The left and right g/P value and GP/CSF value were independent risk factors for Abe in nhB children(P< 0.05);The area under the curve(AUC) of left and right g/P values and GP/CSF values in predicting Abe in children with nhB were all > 0.7,which had a certain predictive effect.The AUC of the combined prediction of each index was the largest, which was 0.925.The best predictive sensitivity and specificity were 90.00% and 82.65% respectively. Conclusion The signal ratio, g/P value and GP/CSF value of T;WI can provide objective imaging evidence for nhB disease grading, and could provide high value in predicting early Abe.
作者
张钊
马永倩
张捷宇
赵树军
刘朝艳
康志雷
ZHANG Zhao;MA Yongqian;ZHANG Jieyu(Department of MRI,Hengshui People's Hospital,Hengshui,Hebei Province 053000,P.R.China)
出处
《临床放射学杂志》
北大核心
2022年第2期325-329,共5页
Journal of Clinical Radiology
基金
河北省医学科学研究课题项目(编号:20191779)。
