基于纵向驰豫时间成像技术定量评估新生儿高胆红素血症脑损伤  

Quantitative Assessment of Neonatal Hyperbilirubinemia Brain Injury Based on T_(1) Mapping

作　　者：黎星 孟小丽 张雷 张坤[2] 张伟[2] 范晴[2] 王晓虎[2] 任转勤 LI Xing;MENG Xiao-li;ZHANG Lei;ZHANG Kun;ZHANG Wei;FAN Qing;WANG Xiao-hu;REN Zhuan-qin(School of Medical Technology,Shaanxi University of Traditional Chinese Medicine,Xianyang 712046,Shaanxi Province,China;Department of Imaging,Baoji Central Hospital,Baoji 721008,Shaanxi Province,China;Department of Nuclear Medicine,Xijing Hospital,Air Force Military Medical University,Xi’an 710032,Shaanxi Province,China;Department of Imaging,Baoji High-Tech Hospital,Baoji 721006,Shaanxi Province,China)

机构地区：[1]陕西省陕西中医药大学医学技术学院,陕西咸阳712046 [2]陕西省宝鸡市中心医院影像科,陕西宝鸡721008 [3]陕西省空军军医大学西京医院核医学科,陕西西安710032 [4]陕西省宝鸡高新医院影像科,陕西宝鸡721006

出　　处：《中国CT和MRI杂志》2022年第3期4-7,共4页Chinese Journal of CT and MRI

基　　金：陕西省卫健委项目(2018C001)。

摘　　要：目的探讨纵向驰豫时间技术(T_(1) mapping)在定量评估新生儿高胆红素血症脑损伤中的可行性,观察各脑区T_(1)值与胆红素值的相关性,为临床提供更加客观的量化参考依据。方法收集我院2017年9月至2018年5月住院期间临床诊断为胆红素脑病的新生儿26例(脑病组),高胆红素血症新生儿40例(高胆组)及生理性黄疸新生儿27例(对照组)。对其行常规MRI及T_(1) mapping成像序列扫描,并测量苍白球、壳核、尾状核头、背侧丘脑、内囊前肢及内囊后肢的T_(1)值。采用方差分析比较三组间各脑区T_(1)值的差异,采用直线相关分析法计算各脑区T_(1)值与胆红素值的相关系数r。结果苍白球和内囊后肢T_(1)值在三组间有统计学差异(F=5.979,P=0.005)、(F=6.943,P=0.003);苍白球(r=-0.388,P=0.011)、壳核(r=-0.414,P=0.006)及内囊后肢(r=-0.352,P=0.022)T_(1)值与胆红素水平呈负相关。结论T_(1) mapping成像可用于对新生儿高胆红素血症的脑损伤评估;其中苍白球和内囊后肢受胆红素值影响较明显;苍白球、壳核及内囊后肢T_(1)值随着胆红素值的增高而降低。Objective Investigate the feasibility of T_(1) mapping in quantitative evaluation of neonatal brain injury with hyperbilirubinemia,and to observe the correlation between T_(1) value and bilirubin value in various brain regions,in order to provide a more objective quantitative reference for clinical practice.Methods 26 neonates with bilirubin encephalopathy(encephalopathy group),40 neonates with hyperbilirubinemia(Hyperbilirubinemia group)and 27 neonates with physiologic jaundice(control group)who were clinically diagnosed as we mentioned above were collected,during hospitalization in our hospital from September 2017 to May 2018.Routine MRI and T_(1) mapping imaging sequence were performed,and T_(1) values of globus pallidus,putamen,caudate head,dorsal thalamus,anterior limb of internal capsule and posterior limb of internal capsule were measured.Variance analysis was used to compare the differences in T_(1) values among the three groups,and linear correlation analysis was used to calculate the correlation coefficient r between T_(1) values and bilirubin values in each brain region.Results The T_(1) values of globus pallidus and posterior limb of internal capsule were statistically different among the three groups(F=5.979,P=0.005)and(F=6.943,P=0.003).T_(1) values of globus pallidus(r=-0.388,P=0.011),putamen(r=-0.414,P=0.006)and posterior limb of internal capsule(r=-0.352,P=0.022)were negatively correlated with bilirubin level.Conclusion T_(1) mapping imaging can be used for brain injury assessment of neonatal hyperbilirubinemia.The influence of bilirubin value on the globus pallidus and the posterior limb of internal capsule was obvious.The T_(1) values of globus pallidus,putamen and posterior limb of internal capsule decreased with the increase of bilirubin.

关 键 词：磁共振 纵向驰豫时间技术 高胆红素血症 脑损伤 

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]