MRI成像在新生儿核黄疸诊断中的应用价值

Application value of MRI in the diagnosis of kernicterus in newborn infants

目的探讨MRI常规序列在新生儿核黄疸的诊断价值。方法回顾性分析我院2014年5月至2016年8月经临床确诊的35例病理性核黄疸新生儿头颅MRI图像。年龄3~25 d,平均14 d。观察患儿双侧苍白球在T1WI、T2WI、T2FLAIR、DWI及ACD图上的信号变化规律。结果 35例病理性核黄疸新生儿中,26例T1WI上双侧苍白球区表现为对称性高信号;5例T1WI表现为双侧苍白球后部对称性高信号,T2WI、T2FLAIR、DWI及ADC图上未见异常改变;另外4例各序列均未见异常信号;5例病理性核黄疸患儿在随后2~3个月随访、复查中出现脑后遗症改变,均表现为双侧苍白球区T2WI对称性高信号,ADC图上呈稍高信号,T1WI、T2FLAIR及DWI上未见异常信号。结论 MRI常规扫描序列T1WI、T2WI及ADC图分别对新生儿病理性核黄疸急性期及后遗症期的诊断及预后判定具有重要价值。

Objective To investigate the diagnostic value of routine magnetic resonance imaging （MRI） se- quence in newborn infants with kemicterus. Methods The head MRI images of 35 cases of newborn infants with ker- nicterus diagnozed clinically in our hospital from May 2014 to August 2016 were retrospectively analyzed. The age ranged from 3 days to 25 days, with median age of 14 days. Signal variation law of the bilateral globus pallidus in chil- dren on TIWI, T2WI, T2FLAIR, DWI and ACD images were observed. Results Among the 35 neonates, 26 demon- strated bilateral, symmetric hyperintence in the globus pallidus on T1WI. Five neonates had symmetric hyperintense in the rear of bilateral globus pallidus on T1WI, and no lesions were detected on T2WI, T2FLAIR, DWI and ACD. Five in- fants received the second MRI at ages of 2 to 3 months, and all cases showed symmetric hyperintense in the golbus palli- dus on T2WI and slight hyperintense on ADC. Conclusion T1WI, T2WI and ADC images have important value in the diagnosis and prognosis of the newborn infants with acute stage of pathological kemicterus and sequela stage.