急性胆红素脑病磁共振成像特征及其与预后关系的研究  

Acute bilirubin encephalopathy:MRI features and their correlation with prognosis

作　　者：汤行录[1] 梁志强[2] 陈伟[3] 严志汉[3] 梁莉丹[1] 张姿英[2] 陈翔[1] 王小同[1] 

机构地区：[1]温州医学院附属第二医院暨育英儿童医院脑科、康复中心,浙江温州325027 [2]温州医学院附属第二医院暨育英儿童医院新生儿科,浙江温州325027 [3]温州医学院附属第二医院暨育英儿童医院放射科,浙江温州325027

出　　处：《中国实用儿科杂志》2009年第6期455-458,共4页Chinese Journal of Practical Pediatrics

基　　金：2007年浙江省计划生育委员会项目;温州市科技局科研基金资助项目(Y2006B007)

摘　　要：目的探讨急性胆红素脑病的磁共振成像(MRI)特征及其与预后的关系。方法回顾性分析2006年5月至2008年4月温州医学院附属第二医院暨育英儿童医院新生儿科11例急性胆红素脑病患儿的头颅MRI图像,以同期6例正常新生儿头颅MRI作对照。结果11例急性胆红素脑病中,8例双侧苍白球在T1WI呈对称性高信号,在T2WI呈正常的稍高信号,其余3例未见明显异常。对5例急性胆红素脑病患儿进行了随访研究,初次MRI异常的3例诊断为手足徐动型脑性瘫痪,其双侧苍白球T1WI上的高信号消失,T2WI上正常的稍高信号转为对称性高信号;初次MRI正常和异常各1例,临床随访神经发育均正常。结论双侧苍白球在T1WI呈对称性高信号是急性胆红素脑病相对特征性表现,由于病例数较少,MRI图像特征与临床预后的关系尚须进一步研究。Objective To study the MRI features in acute bilirubin encephalopathy and to determine their correlation with prognosis . Methods The MR imagings in 11 cases of acute bilirubin encephalopathy were retrospectively studied, which were compared with 6 healthy neonates. Results Eight out of 11 cases of acute bilirubin encephalopathy demostrated symmetric, high-intensity signal in the the globus pallidus on T1-weighted imaging; no lesions were detected on T2WI. Three cases of acute hilirubin enccphalopathy with abnormal initial MRI findings had final diagnosis as athetoid cerebral palsy and demonstrated a signal switch from hypersignal in the globus pallidus on T1WI to hypersignal on T2WI. One case with abnormal initial MRI and 1 case with normal initial MRI of acute bilirubin encephalopathy displayed normal followed-up neurological development. Conclusion The bilateral, symmetric, high-intensity signal in the globus pallidus on T1WI is probably characteristic MRI findings of acute bilirubin encephalopathy; however, it does not correlate with long-term prognosis.

关 键 词：胆红素脑病 磁共振成像 脑性瘫痪 

分 类 号：R72[医药卫生—儿科]