MRI在新生儿胆红素脑病中的应用价值

Value of MRI in bilirubin encephalopathy of neonates

目的探讨新生儿双侧苍白球磁共振成像(MRI)信号强度与血清胆红素水平的关系,为胆红素脑病的诊断提供客观依据。方法对30例新生儿进行颅脑磁共振检查,并依血清总胆红素(Total Serum Bilirubin)水平分为正常范围、轻度增高、中度增高、重度增高4组。采用Philips Achieva 1.5T超导型磁共振扫描仪,对双侧苍白球T1加权成像(T1WI)信号强度、T2加权成像(T2WI)信号强度、弥散加权成像(DWI)指数表观弥散系数(EADC值)、弥散张力成像(DTI)表观弥散系数(ADC值)和部分各向异性(FA值)进行配伍组设计资料方差分析。结果血清总胆红素重度增高组双侧苍白球T1WI信号强度明显增高(P<0.05),且T1WI信号强度超过1155±63即为信号增高;T2WI信号强度、EADC(DWI)值、ADC(DTI)值、FA值4组差异无统计学意义(P≥0.05)。结论MRIT1WI双侧苍白球对称性高信号与高胆红素血症的严重程度密切相关,是新生儿胆红素脑病的重要特征。

Objective To explore the relationship between MRI signal intensity in bilateral globus-pallidus and the level of serum bilirubin in neonates to provide diagnostic evidence of bilirubin encephalopathy. Methods Thirty neonates received cranial MRI examination using Philips Achieva 1.5T MRI scanner, and they were divided into four groups depending on the levels of total serum bilirubin （ TSB ）. Two-way analysis of variance was used to analyze the signal intensities of TlWI and T2WI, and the values of EADC, ADC and FA in bilateral globus-pallidus. Results The signal intensity of TlWI was obviously higher in the group with the highest TSB than in the others （P 〈 0.05 ）, and the signal intensity of T1WI was thought to be increased if it exceeded 1155 ± 63. There were no statistical differences among the four groups in the signal intensity of T2WI, and the values of EADC, ADC and FA （ P≥0.05 ） . Conclusions There is an intimate relationship between the signal intensity in bilateral globus-pallidus on TlWI and the severity of hyperbilirubinemia, which is an important characteristic of bilirubin encephalopathy in neonates.