磁共振成像对新生儿急性胆红素脑病的诊断价值

The early MRI of acute high bilirubin encephalopathy in neonates and its clinical significance

目的通过与新生儿缺氧缺血性脑病(HIE)及正常新生儿比较,探讨头颅磁共振T1加权成像(T1WI)表现特征对新生儿急性胆红素脑病(ABE)的诊断价值,并分析双侧苍白球T1信号强度与血清总胆红素浓度的相关性。方法采用西门子Avanto 1.5 T超导型磁共振扫描仪对30例ABE新生儿进行头颅磁共振检查,以同期30例HIE新生儿及30例正常新生儿头颅MRI作对照,分析其T1WI特点。对双侧苍白球T1WI信号强度与血清总胆红素浓度进行相关分析。结果 30例ABE患儿中,28例双侧苍白球及底丘脑在T1WI呈对称性高信号,其余2例未见明显异常。30例HIE患儿中,5例患儿T1WI出现苍白球高信号,HIE患儿苍白球高信号的出现率低于ABE(P<0.01),HIE患儿壳核高信号的出现率高于ABE(P<0.05)。双侧苍白球T1信号强度与血清总胆红素无显著线性相关性(P>0.05)。结论 MRI T1WI双侧苍白球对称性高信号是ABE相对特征性表现,有助于鉴别新生儿ABE和HIE。而T1信号强度与血清总胆红素浓度无显著线性相关性。

Objective To compared with the normal neonatal hypoxic ischemic encephalopathy （HIE）, and explore MRI T1 - weighted images （Tj Wl） features of neonates with acute high bilirubin encephalopathy （ABE） diagnosis and analysis of bilateral pallidal T1 signal intensity and total serum bilirubin concentration （Total Serum Bilirubin） correlation. Methods The Siemens Avanto ABE of 1.5T superconducting magnetic resonance scanners in 30 cases of neonatal brain MRI, compared with 30 cases of HIE and 30 patients with normal brain MRI for comparison. The Wl features were ana-lyzed. Of bilateral pallidal Tj Wl signal intensity and correlation analysis of serum total bilirubin concentration. Results In 30 patients with ABE, 28 cases of bilateral pallidal ll Wl symmetry high signal T2 Wl normal higher signal, the other 2 cases no significant anomalies, in 30 patients with HIE, 5 infants with HIET^I pallidus high signal, infants with HIE pallidus high signal rates of less than ABE （P〈0.01）, End of bilirubin encephalopathy in acute Thalamic high signal rates than infants with HIE （P 〈0.05）, Bilateral pallidal T1 signal strength no significant linear correlation between serum total bilirubin and （ P 〉 0.05） . Conclusions MRI TjWI symmetry of bilateral pallidal high signal is characterized by ABE, contribute to the identification of bilirubin en-cephalopathy in neonates with acute and HIE.