急、慢性胆红素脑病MRI特征及鉴别诊断

MRI Diagnosis and Differential Diagnosis of Bilirubin Encephalopathy

目的探讨急、慢性胆红素脑病的MRI特征及鉴别诊断。方法回顾性分析23例急性胆红素脑病(ABE)及6例慢性胆红素脑病(CBE)患儿的头颅MRI图像,并随访预后。结果23例ABE中,21例双侧苍白球在T1WI呈对称性高信号,T2WI呈等信号,T2液体衰减反转恢复(FLAIR)、扩散加权成像(DWI)未见异常信号;其余2例未见异常信号。对其中16例患儿进行了随访,均未发现后遗症表现。6例CBE,双侧苍白球在T2WI呈对称性稍高信号或高信号,T1WI呈等信号或稍低信号,T2FLAIR呈稍高信号,DWI未见异常信号。对其中5例患儿进行了随访,4例有后遗症表现。结论ABE以T1WI对称性高信号为特征,及时治疗预后良好,而CBE以T2WI对称性高信号为特征,预后较差。

Objective To investigate the magnetic resonance imaging ( MRI) features and differential diagnosis of acuteand chronic bilirubin encephalopathy. Methods The head MRI images of 23 children with acute bilirubin encephalopa-thy and 6 cases of chronic bilirubin encephalopathy were retrospectively analyzed and the prognosis was followed up. Re-sults Of the 23 patients with acute bilirubin encephalopathy,21 patients with bilateral globus pallidus showed high sym-metry signal on T 1 WI,T 2 WI showed equal signal,no abnormal signal in T2FLAIR and DWI,and no abnormal signal in theother 2 cases. The patients were followed up for prognosis. No sequelae were found. Six cases of chronic bilirubin encepha-lopathy showed slightly higher symmetry signal or high signal on T 2 WI,equal signal or slightly lower signal on T 1 WI,slightly higher signal on T 2 FLAIR,and no DWI on DWI. Abnormal signals,5 cases of children were followed up for prog-nosis,and 4 cases had residual symptoms. Conclusion Acute bilirubin encephalopathy is characterized by high T 1 WIsymmetry signal,and the prognosis is good in timely treatment. Chronic bilirubin encephalopathy is characterized by highT 2 WI symmetry signal and poor prognosis.