苍白球与壳核磁共振信号比值在足月新生儿急性胆红素脑病早期诊断中的价值

The value of MRI signal ratio of globus pallidus to putamen in early diagnosis of acute bilirubin encephalopathy in full-term neonates

目的探讨苍白球(简称G)与壳核(简称P)的T1WI、T2WI及ADC比值(T1WI、T2WI及ADC的G/P值)在足月新生儿急性胆红素脑病早期诊断中的价值。方法回顾性分析95例足月新生儿,根据血清总胆红素(TSB)及临床症状分组,测量苍白球与壳核T1WI、T2WI及ADC比值,通过采用Spearman等级相关及单因素方差分析(ANOVA-LSD)进行统计分析。结果按TSB分组:T1WI的G/P值及ADC的G/P值随胆红素水平增高而增加,相关性分析结果:T1WI的G/P值为极强相关(rs=0.824,P<0.05)、ADC的G/P值为强相关(rs=0.673,P<0.05),且各组间均存在差异;T2WI的G/P值为弱相关(rs=-0.054,P>0.05),且组间无差异。按临床症状分组:T1WI的G/P值及ADC的G/P值随临床症状加重而增加,相关性分析结果:T1WI的G/P值为强相关(rs=0.645,P<0.05)、ADC的G/P值为中度相关(rs=0.495,P<0.05),且各组间均存在差异;T2WI的G/P值为弱相关(rs=-0.117,P>0.05),且组间无差异。结论苍白球与壳核T1WI、ADC比值与临床症状及胆红素水平结合,能增加足月新生儿急性胆红素脑病的早期诊断准确客观性。

Objective To investigate the value of T1WI,T2WI and ADC ratios of globus pallidus(abbreviated as G)to putamen(abbreviated as P)(the T1WI G/P ratio,T2WI G/P ratio and ADC G/P ratio)in early diagnosis of acute bilirubin encephalopathy in the full-term neonates.Methods Retrospective analysis was performed for 95 full-term newborns who were grouped according to the total serum bilirubin(TSB)and clinical symptoms.The T1WI,T2WI and ADC ratios of G to P were measured.Statistical analysis was performed by Spearman grade correlation and single factor analysis of variance(ANOVA-LSD).Results According to TSB grouping:the T1WI G/P ratio and ADC G/P ratio increased with the increase of bilirubin level.Correlation analysis results:T1WI G/P ratio was most strongly correlated(rs=0.824,P<0.05),ADC G/P ratio was strongly correlated(rs=0.673,P<0.05),and there were differences among all groups.The T2WI G/P ratio was weakly correlated(rs=-0.054,P>0.05),and there were no differences among groups.According to clinical symptoms grouping:the T1WI G/P ratio and ADC G/P ratio increased with the aggravation of clinical symptoms.Correlation analysis results:the T1WI G/P ratio was strongly correlated(rs=0.645,P<0.05),and the ADC G/P ratio was moderately correlated(rs=0.495,P<0.05),and there were differences among all groups.The T2WI G/P ratio was weakly correlated(rs=-0.117,P>0.05),and there were no differences among groups.Conclusion The T1WI and ADC ratios of globus pallidus to putamen combined with clinical symptoms and TSB can increase the accuracy and objectivity of early diagnosis of acute bilirubin encephalopathy in the full-term neonates.