苍白球T1值诊断急性胆红素脑病

Globus pallidus T1 values in diagnosis of acute bilirubin encephalopathy

目的探讨苍白球T1值诊断新生儿急性胆红素脑病(ABE)的价值。方法对10例ABE(ABE组)、11例高胆红素血症足月新生儿(高胆组)和13名正常新生儿(对照组)行常规T1WI和T1mapping成像。T1mapping成像采用6个不同反转时间的IR-FSE序列,取其平均值,得到量化T1图,选取双侧苍白球为ROI,测量其T1值,以方差分析比较3组间苍白球T1值的差异。对ABE组苍白球T1值与血清间接胆红素的峰值进行Pearson相关性分析,并于生后6个月对患儿发育情况进行评估。结果常规T1WI显示,ABE组中10例双侧苍白球表现为对称性高信号;高胆组7例表现为高信号,4例为等信号;对照组13名均为等信号。ABE组、高胆组、对照组苍白球T1值分别为(652.40±16.25)ms、(676.45±17.21)ms、(684.08±10.20)ms,差异有统计学意(F=27.97,P<0.01);ABE组苍白球T1值与对照组、高胆组间差异均有统计学意义(P均<0.05),而高胆组与对照组间差异无统计学意义(P=0.08)。ABE组苍白球T1值与血清间接胆红素峰值无相关性(r=-0.28,P=0.23)。经过积极治疗,ABE组患儿生后6个月时均无明显神经心理发育障碍。结论苍白球T1值测量能够提供量化客观依据,结合临床,可为早期诊断新生儿ABE提供帮助。

Objective To assess globus pallidus （GP） T1 values in diagnosis of acute bilirubin encephalopathy （ABE）. Methods Ten neonates with ABE （ABE group）, 11 neonates with hyperbilirubinemia （hyperbilirubinemia group） and 13 normal neonates （control group） underwent routine MR and T1 mapping scanning. The average quantitative T1 map was obtained by using 6 different inversion time IR-FSE sequences. T1 values of ROIs in biliteral GP were calculated based on T1 map, and were compared among 3 groups. Then Pearson correlation analysis was performed between T1 values of GP and indirect bilirubin peak values in ABE group, and the development was assessed 6 mouths after delivery. Results MRI showed high signal of bilateral GP in 10 cases in ABE group, high signal of 7 and equal signal in 4 cases in hyperbilirubinemia group, equal signal of 13 cases in control group. T1 values of GP in ABE group, hyperbilirubinemia group and con-trol group was （652.40±16.25）ms, （676.45±17.21）ms and （684. 08±10. 20）ms, respectively （F=27.97, P〈0. 01）. Significant differences of T1 values of GP existed among 3 groups, between ABE and hyperbilirubinemia group, as well as ABE and control group （all P〈0.01）, but not between hyperbilirubinemia and control group （P=0.08）. T1 values of GP in ABE group were not correlated with indirect bilirubin peak value （r=-0. 28, P=0.23）. After active treatment, no sig-nificant neuropsychological developmental disorders were detected in ABE group 6 mouths after delivery. Conclusion Measurement of T1 values of GP could provide quantitative and objective information, which is helpful to early diagnosis of ABE combining with clinic manifestations.