基于小脑齿状核的新生儿高胆红素血症脑损伤的DTI研究  

DTI study of neonatal hyperbilirubinemia brain injury based on cerebellar dentate nucleus

作　　者：肖斌 谭长连[1] Xiao Bin;Tan Changlian(Department of Radiology, the Second Xiangya Hospital of Central South University, Changsha 410011,China)

机构地区：[1]中南大学湘雅二医院放射科

出　　处：《中国医师杂志》2019年第7期989-992,996,共5页Journal of Chinese Physician

基　　金：国家自然科学基金项目(81471646)~~

摘　　要：目的运用磁共振弥散张量成像(DTI)技术,探讨高胆红素血症患儿小脑齿状核神经纤维束的变化。方法回顾性分析2016年12月至2018年3月期间本院运用德国西门子3. 0T Trio超导型磁共振仪对43例高胆红素血症患儿和24例正常对照新生儿(对照组)进行DTI检查的影像资料,其中高胆红素血症患儿分为总胆红素轻度增高组(34例)与中重度增高组(9例),再选择左右小脑齿状核为感兴趣区域测量相关参数,对各组所得参数进行相关的统计分析。结果与对照组比较,总胆红素轻度增高组各向异性分数(FA)降低(P=0. 022)、容积比(VR)升高(P=0. 036);与对照组比较,总胆红素中重度增高组FA降低(P=0. 002)、VR升高(P=0. 047);总胆红素中重度增高组FA值较轻度增高组降低(P=0. 035);小脑齿状核FA值与总胆红素水平存在线性负相关性(r=-0. 201,P=0. 029),VR值与总胆红素水平呈线性正相关性(r=0. 245,P=0. 045)。结论高胆红素血症患儿小脑齿状核的FA、VR存在变化,与胆红素水平有关、并呈线性相关,能早期提示患儿神经纤维束的破坏或发育不良。Objective Magnetic resonance diffusion tensor imaging (DTI) technique was used to investigate the changes of DTI parameters in nerve fiber bundles of children with hyperbilirubinemia. Methods A retrospective analysis of DTI imaging data of 43 children with hyperbilirubinemia and 24 normal controls in our hospital using the German Siemens 3.0t Trio superconducting magnetic resonance imaging instrument from December 2016 to March 2018. Children with hyperbilirubinemia were divided into two groups, total serum bilirubin mildly elevated group (34 cases) and total serum bilirubin moderate to severe elevation group (9 cases). The right and left cerebellar dentate nuclei were selected as the regions of interest. Relevant parameters were measured, and the parameters of each group were analyzed and compared. Results Compared with the normal control group, the fractional anisotropy (FA) of the total serum bilirubin mildly elevated group was decreased (P=0.022) and the volume ratio (VR) of that was increased (P=0.036). Compared with the normal control group, the FA of the total serum bilirubin moderate to severe elevation group was decreased (P=0.002) and the VR of that was increased (P=0.047). Compared with the total serum bilirubin mildly elevated group, the FA of the total serum bilirubin moderate to severe elevation group was decreased (P=0.035). In addition, in the cerebellar dentate nucleus, there was a linear negative correlation (r=-0.201, P=0.029) between the FA values and the total bilirubin level, while linear positive correlation (r=0.245, P=0.045) between the VR value and the total bilirubin level. Conclusions There are changes in FA and VR values of the cerebellar dentate nucleus in children with hyperbilirubinemia, which of them are linearly related to bilirubin levels. It can early indicate the destruction or dysplasia of nerve fiber bundles in children.

关 键 词：高胆红素血症 新生儿 弥散张量成像 小脑核 各向异性 

分 类 号：R722.1[医药卫生—儿科] R445.2[医药卫生—临床医学]