磁共振成像在新生儿高胆红素血症中的应用价值研究  

The Value of Magnetic Resonance Imaging in Hyperbilirubinemia of the Neonatus

作　　者：葛艳明[1] 李耀武[1] 董鹏[1] 王滨[1] 管玥[1] 王锡臻[1] 徐芹艳 祝令称[1] 王文娟 张叶[1] 张桂华 

机构地区：[1]潍坊医学院附属医院影像中心,潍坊医学院医学影像学系,261031

出　　处：《临床放射学杂志》2013年第11期1630-1633,共4页Journal of Clinical Radiology

基　　金：山东省自然科学基金(ZR2010HM078);潍坊市科技发展计划(政策引导类)项目(编号:201104091;20111142)

摘　　要：目的探讨高胆红素血症新生儿脑的磁共振影像学特征,为临床早期判断高胆红素血症是否合并脑损伤提供更客观的标准。方法搜集潍坊医学院附属医院新生儿科诊断为高胆红素血症并于相关治疗前行MR检查的足月住院患儿80例,经随后电话随访证实该组患儿均未合并胆红素脑病、均成长为正常儿;另选择经临床和随访证实为正常健康儿并行MR检查的新生儿30名,测量苍白球、壳核、海马、黑质、背侧丘脑及底丘脑的T1WI信号强度、T2WI信号强度及表观扩散系数(ADC)值的差异。结果肉眼观高胆红素血症新生儿与正常健康新生儿的双侧苍白球、黑质的T1WI信号强度均比邻近脑实质高;高胆红素血症新生儿底丘脑T2WI信号强度高于正常健康新生儿,差异有统计学意义(t=-2.89,P=0.005);双侧苍白球T1WI信号强度为909.65±329.33、黑质T1WI信号强度为1009.67±378.04的高胆红素血症新生儿均未发生胆红素脑病。结论 MRI常规技术结合扩散加权成像能为临床评估高胆红素血症新生儿的预后情况、判断高胆红素血症是否合并脑损伤提供更多、更客观的影像学依据。Objective To investigate the MRI characteristics of brain of neonatal hyperbilirubinemia, to provide more objective criteria for the clinical to judge whether the early hyperbilirubinemia combined with brain damage or not. Meth ods 80 neonatus with hyperbilirubinemia received MR examination before related treatment from the affiliated hospital of Weifang medical university, which had not developed into bilirubin encephalopathy and growing up to be normal confirmed by the subsequent telephone follow up group. Another option of 30 cases of healthy neonatus confirmed by clinical and growing up to be normal confirmed by the telephone follow up, who received MR examination. The difference of T1WI sig nal intensity, T2WI signal intensity and ADC value in the globus pallidus, putamen, hippocampus, thalamus, substantia nigra and subthalamus were measured. Results T^WI signal intensity of the bilateral globus pallidus and substantia nigra was higher than the adjacent brain parenchyma both in neonatus with hyperbilirubinemia and healthy neonatus with naked eye. T2 WI signal intensity of subthalamus of neonatal hyperbilirubinemia was higher than that of healthy neonatus, and the difference was statistically significant（t = 2. 89, P = 0.005 ）. The neonatus with hyperbilirubinemia whose T1WI signal intensity was 909.65 ± 329.33 in bilateral pallidal and 1009.67 ±378.04 in substantia nigra had not developed into bili rubin encephalopathy. Conclusion Routine MRI technique combining with diffusion weighted imaging （DWI）could pro vide more objective criteria for the clinical evaluation of prognosis of the neonatus with hyperbilirubinemia, and judge whether the hyperbilirubinemia combined with brain damage earlier or not.

关 键 词：新生儿高胆红素血症 磁共振 扩散加权成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R722.1[医药卫生—诊断学]