高胆红素血症新生儿颅脑MRI特征与血清肝功能指标的相关性

The Study on the Correlation between Features of Magnetic Resonance Imaging and Serum Index About hyperbilirubinemia of the Neonates

目的探讨高胆红素血症新生儿颅脑6个部位的常规MRI信号强度、表观扩散系数(ADC)值与肝功能血清学指标的相关性。方法搜集临床诊断为高胆红素血症的60例新生儿治疗前的MRI资料。回顾性分析其苍白球、壳核、海马、黑质、背侧丘脑、底丘脑的T1WI信号强度、T2WI信号强度及ADC值,并与血清谷草转氨酶(AST)、血清总胆红素(TBIL)、血清间接胆红素(IBIL)对照。结果 60例高胆红素血症患儿苍白球、壳核、海马、黑质、背侧丘脑、底丘脑的T1WI信号强度均值分别为909.65±329.33、781.42±272.72、725.33±261.90、1009.67±378.04、867.81±875.50、905.43±391.74;T2WI信号强度均值分别为1247.68±116.79、1238.34±126.32、1271.32±105.33、1168.79±131.38、1242.41±124.21、1235.47±148.17;ADC均值(×10-3mm2/s)分别为1134.28±123.79、1119.49±205.57、1148.67±79.69、1040.46±108.41、1075.22±194.09、1257.77±1447.75。6个部位间2种信号强度的差异有统计学意义(F=2.297,P=0.045;F=3.733,P=0.003),ADC值的差异无统计学意义(F=0.725,P=0.605)。背侧丘脑T2WI信号强度(1242.41±124.21)与AST(61.99±35.40)呈负相关;底丘脑T1WI信号强度(905.43±391.74)与经皮肤测量颅脑额部、胸部的胆红素浓度(12.36±5.08、12.80±5.49)均呈正相关。结论 MRI指标与血清肝功能相关指标存在相关性,MRI检查有望为临床早期、无创的判断高胆红素血症对新生儿脑损伤的程度提供更多客观评价方法。

Objective Retrospective analysis of the correlation between the signal intensity and ADC value of the Globus pallidus,putamen,subthalamus,hippocampus,substantia nigra and dorsal thalamus in magnetic resonance images and serum index about the neonatal hyperbilirubinemia.. Methods Collection of 60 cases of neonates with hyperbilirubinemia received MR examination before any treatment,measurement the T1 WI signal intensity,T2 WI signal intensity and ADC value in the globus pallidus,putamen,subthalamus,hippocampus,substantia nigra,dorsal thalamus and comparation with serum index of liver function. Results There were differences in T1 WI,T2WI signal intensity of six different observation sites,but no significant difference between ADC values. The T1 WI signal intensity of hippocampus was lower than substantia nigra,substantia nigra was higher than putamen,and the difference was statistically significant. T2 WI signal intensity of hippocampus was higher than substantia nigra,substantia nigra was lower than globus pallidus,putamen,dorsal thalamus,subthalamus,and the difference was statistically significant. T2 WI signal intensity of dorsal thalamus was negatively related to the levels of aspartate aminotransferase（ AST）. T1 WI signal intensity of subthalamus was positively related to the transcutaneous bilirubin concentration of forehead and chest. Conclusion There was correlation between the MRI index and serum indexes of liver function. MRI could provide more objective criteria for the clinical judgment the degree of brain injury in neonates with hyperbilirubinemia,earlier and noninvasively.