新生儿胆红素脑病MRI特征的研究

Study of MRI characteristics of newborn bilirubin encephalopathy

目的探讨新生儿胆红素脑病（NBE）MRI特征。方法回顾性分析17例NBE患儿的常规MRI和临床资料，评价苍白球及底丘脑信号高低，并根据底丘脑有无高信号分为底丘脑高信号组和无高信号组，对苍白球信号强度的增加值与血清总胆红素的峰值进行Pearson相关性分析，采用t检验比较底丘脑高信号组和无高信号组血清总胆红素峰值水平。结果17例患儿中15例有T1WI苍白球对称性高信号，1例表现为T1WI苍白球后部对称性高信号。9例患儿底丘脑T1WI呈高信号，T2WI呈等信号，主要表现为底丘脑点状或八字形对称性短T1信号。4例患儿中脑、桥脑背侧、延髓T1WI呈高信号，而桥脑腹侧信号正常。使用1．0TMR仪扫描的12例患儿苍白球信号强度增加值为249．0～423．8，血清总胆红素峰值为366．0～983．3μmol／L，两者呈正相关（r=0．676，P〈0．05）。底丘脑高信号组9例，无高信号组8例，血清总胆红素分别为（660．7±192．4）、（513．3±107．5）μmol／L，2组差异无统计学意义（t=1．914，P〉0．05）。结论NBE的MRI表现有一定特征性，有助于NBE的诊断。

Objective To explore routine magnetic resonance imaging characteristics of newborn bilirubin encephalopathy （NBE）. Methods MRI features and clinical data of 17 patients with Newborn bilirubin encephalopathy were retrospectively analyzed, globus pallidus （GP）and subthalamic signal intensity was evaluated. The increase of GP signal intensity and serum total bilirubin peak value were analyzed using pearson correlation analysis. Serum total bilirubin peak value between patients with high signal in the subthalamic nuclei on T, WI and patients without high signal in the subthalamic nuclei were compared statistically. Results The main MRI presentation in the NBE group was abnormally increased signal intensity in the GP on T1WI, which was not apparent on T2WI. One patient showed abnormal high signal intensity in the posteromedial part of GP. Nine patients had high signal in the subthalamic nuclei on T1 WI and normal signal on T2WI. Four patients showed high signal in the brainstem with sparing of dorsal pontine. The increase in value of GP signal intensity was 249. 0-23.8 in 12 patients and their serum total bilirubin peak values were 366. 0-983.3 μmol/L. A positive correlation was found between increase of GP signal intensity and serum total bilirubin peak value. The serum total bilirubin level of abnormal subthalamic group and normal subthalamic group were 660.7 ± 192.4 μmol/L and 513.3 ± 107. 5μmol/L respectively. The difference between the two groups was not statistically significant（ t = 1. 914, P 〉 0. 05 ）. Conclusion The routine MRI has some characteristics and is useful in the diagnosis of newborn bilirubin encephalopathy.