新生儿苍白球及下丘脑T1WI对称性高信号危险因素分析  

Logistic regression analysis on risk factors of neonates T1WI hyperintensity at globus pallidus and subthalamic nucleus

作　　者：贾桂静[1] 龚静山[1] 丁晖[1] 李安琪[1] 汪娟[1] 徐坚民[1] 

机构地区：[1]广东省深圳市暨南大学第二临床医学院深圳市人民医院放射科,518020

出　　处：《中华医学杂志》2015年第15期1171-1174,共4页National Medical Journal of China

摘　　要：目的 探讨新生儿苍白球（GP）及下丘脑（STN）T1WI对称性高信号的危险因素.方法 回顾性分析2008年8月-2014年6月在深圳市人民医院行头颅MRI检查,有完整临床资料的新生儿186例,确定GP及STN是否有T1WI对称性高信号,其中15例新生儿于首次MRI后1～5个月后行MRI复查.比较GP及STN有/无T1WI高信号的新生儿间胎龄、出生后年龄、性别、窒息史、高胆红素血症和经皮肤胆红素值（TCB）差异是否有统计学意义,采用Logistic回归分析比较在单因素分析中差异有统计学意义的因素与苍白球及下丘脑T1WI高信号的相关性,并采用ROC曲线确定危险因素的分界值.结果 186例新生儿中138例（74.2％）出现GP及STN出现对称性T1WI高信号.各观察指标中,TCB、胎龄和检查时年龄在GP及STN有无高信号的新生儿间差异有统计学意义[TCB：（132±62）比（91±55） μmol/L（t=3.935,P＜0.01）;胎龄：（36.1±2.6）比（34.8±3.4）周（t =2.263,P=0.027）;检查时年龄：（9±5）比（19±7）d（=8.992,P＜1.11）].15例有随访MRI的新生儿GP及STN均观察到对称性T1WI高信号,1～5个月复查头颅MRI时GP及STN的T1WI高信号消失,且体格检查均无异常.Logistic回归分析显示新生儿MR检查时年龄与GP及STN T1WI高信号呈负相关（OR=0.795,95％CI0.739 ～0.856,P＜0.01）.ROC曲线确定年龄分界值为20 d.＞20d新生儿出现苍白球及下丘脑出现对称性T1WI高信号的发生率为16.1％,≤20 d为83.2％,（χ^2 =51.084,P＜0.01）.结论 新生儿颅脑MRI出现GP及STN对称性T1WI高信号与年龄呈负相关,为一过性改变,较常见于＜20 d的新生儿,并随着新生几年龄增加而消失,不能作为核黄疸和新生儿缺血缺氧性脑病的特异性征象.Objective To determine risk factors of T1 WI high signal intensity at globus pallidus and subthalamic nucleus （GP and STN） of neonates.Methods Brain MR images of 186 neonates with intact clinical files were retrospectively reviewed to identify whether there were T1WI high signal intensity at GP and STN.Among them,15 neonates received followed-up MR imaging in 1-5 months after first MR examination.Statistic comparison of clinical features between neonates with and without T1WI high signal intensity at GP and STN were performed using univariate analyses.Then,multiple Logistic regression analysis was used to identify the risk factors of T1WI high signal intensity at GP and STN among those factors which were statistical significant at univariate analyses.ROC curve was employed to determine the cut-off value of the risk factors.Results T1WI high signal intensity at GP and STN was identified in 74.2% neonates （138/186）.At univariate analyses,the following factors were found with statistical difference between neonates with and without T1 WI hyperintensity at GP and STN：transcutaneous bilirubin （TCB）,（132 ±62） vs （91 ± 55） μmol/L （t =3.935,P 〈 1.11）;gestational age,36.0 ± 2.6 weeks vs 34.8 ± 3.4 weeks （t=2.263,P=0.027）;age,9 ±5 days vs 19 ±7 days （t =8.992,P〈0.11）.Multiple Logistic regression analysis revealed a significant negative contribution of age to T1WI hyperintensity at GP and STN （OR =0.795,95% CI 1.739-0.856,P 〈 0.01）.T1 WI hyperintensity at GP and STN was seen in the fifteen neonates with followed-up MRI at the first MR imaging.It was disappeared in the followed-up MR imaging and all the neonates developed well without any remarkable abnormalities at physical examinations.ROC curve determined the cut-off value of age was 20 days （The incidence of T1 WI high signal intensity at GP and STN was 16.0% in neonates 〉 20 days and 83.2% in those ≤ 20 days,respectively χ^2 =51.084,P 〈 0.01）.Conclusions T1 WI high signal intensity at GP and STN of neonates�

关 键 词：婴儿 新生 苍白球 下丘脑 

分 类 号：R722.1[医药卫生—儿科]